bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implications for the geometry of plate boundaries in NE Asia based on the geodetic analysis of the 2020Mw 6.4 Koryak event
Authors: Svigkas Nikos , Atzori Simone , Kozhurin Andrey , Tolomei Cristiano , Antonioli Andrea , Pezzo Giuseppe 
Published: March 2023

SUMMARYOn the 9th of January 2020, an Mw 6.4 strike-slip earthquake took place north of the Asian margin of the Bering Sea. The earthquake occurred within the known reverse-right-lateral active fault zone, called Khatyrka–Vyvenka, which transverses the Koryak Highland from SE to NW and is thought to be a surface manifestation of the Asian portion of either the Bering plate boundary or the northern edge of the Alaskan stream. No other strong earthquake has ever been recorded in this remote uninhabited area and the few existing seismic stations provide poor quality earthquake locations. We adopt SAR interferometry (InSAR) technique to define an improved location of the Koryak 2020 earthquake and constrain the seismic source. The analysis of the 2020 event revealed a previously unknown active fault of left-lateral kinematics that is possibly hidden and strikes NW transversely to the Khatyrka–Vyvenka fault zone. Although several mechanisms could account for left-lateral kinematics of this fault, we propose that the structure is part of a more extended NW fault structure, that formed in pre-neotectonic times and has played a role of a pre-existing rheological discontinuity. This revived NW structure together with a similar structure located easterly, so far aseismic, make the plate/stream boundary segmented, step-like in plan view. The step-like boundary geometry may be the result of internal transform deformation of a rigid plate, but it is better explained by deflections of the Alaskan stream edge at local crustal asperities, which are pre-Cenozoic terrains.
When Time Is Short
Authors: Schaulis Monique 
Published: March 2023

Abstract
Patients will present to the emergency department (ED) while actively dying, with minutes, hours, or days to live. ED clinicians can compassionately, effectively, and efficiently manage these patients. It is useful to try and understand the underlying reasons leading to end-of-life ED visits. Often, patients and families do not understand the expected disease trajectory and/or have not been referred in a timely manner to palliative or hospice care. There may also be a misunderstanding about what those services are and what they can provide. Families may also experience caregiver distress and overload as care needs increase. Patients may have inadequate symptom management, an abrupt change in condition (often active dying), or have concerns about dying at home. A communication map that emphasizes providing clear information and responding to emotion helps providers have effective and meaningful conversations near the end of life. ED evaluation and management should balance the benefits and burdens of interventions in the context of the patient’s illness trajectory and the goals of care. Actively dying patients in distress need urgent symptom management, most often for pain, dyspnea, and delirium. Families and caregivers need social and emotional support. Palliative and hospice care can improve both quality and quantity of life in these patients.
“I Don’t Like It Hot”
Authors: Bell Gretchen E. , DeSandre Paul L. 
Published: March 2023

Abstract
Chronic pain, or pain that lasts longer than 3 months, is prevalent in the palliative care population. The overall approach involves adherence to a comprehensive plan of care, optimally driven by a single primary provider. For the emergency clinician, the initial assessment focuses on the functional impact of the pain complaint and identifying any new component of the complaint that might indicate an immediate threat to life or limb. Improvement is a long-term goal, best coordinated with the primary provider whenever possible. Opioids may play a role in managing chronic pain if associated with overall functional improvement. Adjuvant therapies, both nonpharmacological and pharmacological, also play an important role in the comprehensive plan of care.
“Take It Off . . . Now”
Authors: Shreves Ashley 
Published: March 2023

Abstract
Emergency physicians commonly intubate patients and initiate mechanical ventilation in the emergency department (ED). While these interventions can be life-saving, for some patients, particularly those with poor prognoses, they are tools that simply prolong the dying process. Many patients do not want their life artificially extended when death is certain and/or their quality of life would be severely diminished. As more clinical data becomes available during the ED encounter and time allows for careful communication with loved ones, it may become clear that removal of mechanical ventilation is actually the appropriate next step. Withdrawing ventilator support should be within the scope of emergency medicine practice. With the use of ventilator simulation and medications, when necessary, patients can be comfortably transitioned off mechanical ventilation. Opioids and benzodiazepines are effective at palliating the dyspnea and anxiety and/or agitation that can accompany this transition. Prognosis after ventilator withdrawal varies across patient populations, but most patients live for hours, not days. For those with a lengthier prognosis, hospice referral is appropriate.
Judgment Awaits
Authors: Kuntz Joanne 
Published: March 2023

Abstract
The death of a child in the ED is one of the most challenging problems facing emergency health care providers. When compared to deaths in the adult population, pediatric deaths, particularly those that occur unexpectedly or without immediate explanation further compound these challenges. Best practice models include systems in place to care for both the patient and surviving family members as well as the staff involved in the child’s care. This is best achieved by an interdisciplinary approach that includes many different members of the emergency care team and other hospital support staff. In circumstances when there is concern for accidental or intentional injury add even more complexity. Pre-existing collaboration with local law enforcement and investigating authorities helps to ensure a coordinated effort that preserves needed physical evidence as well as the rights of the bereaved family affected by the tragedy. The death of a child is a critical incident. It is crucial for Emergency Medicine personnel to be familiar with best practices to comprehensive to both satisfy the all of the necessary medical and legal responsibilities as well as attending to the care of the acutely bereaved and affected ED staff.
Introduction
Authors: Ho Anita 
Published: March 2023

Abstract
This chapter introduces the key concepts and technologies driving health-related artificial intelligence (AI), as well as the ethical quandaries that accompany those technologies. Section 1 provides a brief primer on the origins of AI and why there is increasing excitement surrounding its development and deployment in health care and health monitoring. Section 2 explains how the promises of AI in health care are tempered by growing ethical concerns as implementation of these technologies expands. Section 3 introduces the concept of relational autonomy, which will ground the ethical analysis of various emerging AI health monitoring practices. The author concludes with a brief outline of the subsequent chapters.
Artificial Autonomy or Relational Intelligence
Authors: Ho Anita 
Published: March 2023

Abstract
This chapter explains how a liberal account of autonomy is too individualistic and narrow to adequately capture the impact of the rapid proliferation of artificial intelligence (AI) health monitoring technologies on people’s ability to determine how they would like health monitoring and data collection/sharing to take place. It follows Catriona Mackenzie’s tripartite conceptualization of autonomy (self-governance, self-determination, and self-authorization) and argues for a constitutively relational approach that problematizes the rapid development and adoption of AI health monitoring technologies. This conceptualization centers relationships and power asymmetries in bioethical analysis, and underscores how relationships can enhance or deprive people’s ability to exercise autonomy.
From One-Way Mirror to Two-Way Street
Authors: Ho Anita 
Published: March 2023

Abstract
This final chapter argues that the concept of relational autonomy can promote a systems approach to ensure that development and utilization of predictive health monitoring will enhance rather than erode users’ practical identities. Section 1 explains how a relational feedback loop can help strengthen therapeutic relationships and ensure that evolving health monitoring technologies will be used as collaborative tools to enhance patients’ care priorities rather than surveillance mechanisms to regulate distrust of patients’ testimonies. Section 2 argues that multilevel dialogic engagement at the individual, technological, professional/institutional, and societal levels may help promote a responsible and responsive feedback loop to guide the development and implementation of AI health monitoring, holding technologists and decision-makers responsible for ensuring valid technologies and providing transparent information. This in turn may improve the social determinants of health and digital literacy, thereby enhancing patients’ capacity to make goal-concordant health monitoring decisions that can advance their autonomy.
Mixed Venous Oxygen Saturation
Authors: Christopherson Heather , Crimi Ettore 
Published: March 2023

Abstract
Mixed venous oxygen saturation (SvO2) is the percentage of oxygenated hemoglobin in the blood returning to the right side of the heart. SvO2 reflects the balance between oxygen delivery and oxygen consumed by tissues. Normally, SvO2 is 65%–75%. SvO2 can be measured with intermittent blood samples from the pulmonary artery or continuously with the use of oximetric catheters. Determinants of SvO2 are cardiac output, hemoglobin concentration, arterial oxygen saturation, and oxygen consumption. A decrease in oxygen delivery (e.g., cardiogenic shock, anemia, hypoxemia) or increase in oxygen demand (e.g., hyperthermia, shivering, malignant hyperthermia) causes a drop in SvO2. An increase in oxygen delivery (e.g., increased cardiac output, hyperoxia) and decrease in oxygen demand (e.g., hypothermia, anesthesia) cause high SvO2 values. SvO2 in combination with other clinical information can help to identify global tissue hypoxia during the perioperative period and in critically ill patients.
Nebulizers, Humidifiers, Drug Delivery Systems
Authors: Hussain Nasir , Abd-Elsayed Alaa 
Published: March 2023

Abstract
Understanding the basic anesthetic drug delivery devices is paramount for the safe delivery of anesthetics to patients. There are several different methods used to deliver anesthetics and medications to patients, which include the variable bypass vaporizer, measured flow vaporizer, nebulizers, and humidifiers. Each of these devices has nuances and specifics that the anesthesiologist should be aware of.
Increased Intracranial Pressure and Herniation
Authors: Nasim Syed Sohaib , Minear Steven 
Published: March 2023

Abstract
Brain herniation results from increased intracranial pressure, which can be due to different etiologies. Brain herniation is a life-threatening event that occurs when the intracranial pressure increases and leads to brain protrusion through the openings in the cranium. The symptoms can vary from headache and weakness to loss of consciousness, elevated blood pressure, pupillary dilation, cardiac and respiratory arrest, loss of brainstem reflexes, and respiratory arrest. The symptoms depend on the specific part of the brain that herniates, compressing local structures and causing particular symptoms. The neurological signs and symptoms can help identify the location of increased pressure and herniation.
Common Complications of Local Anesthetics
Authors: Hanna Rewais B. , Abd-Elsayed Alaa 
Published: March 2023

Abstract
Local anesthetics, such as lidocaine, bupivacaine, and mepivacaine, are effective in treating localized pain and have been used in a multitude of ways. These medications come in different forms, including topical, infiltrative, injectable, field block, or peripheral nerve block. These drugs are often lauded for their fast onset, high efficacy, and low complication rate. They do this by interrupting neural conduction by inhibiting the influx of sodium ions through channels or ionophores within neuronal membrane, specifically neural fibers with more rapid firing rates. However, the complications of local anesthetics are often overlooked. Complications of local anesthetics include local and systemic neurotoxicity, allergic reactions, and adverse drug-drug interactions causing cardiovascular stimulation.
Diagnosis and Management of Local Anesthetic Systemic Toxicity (LAST)
Authors: Schroeder Kristopher M. , Pfaff Andrew 
Published: March 2023

Abstract
The provision of regional anesthesia may offer significant benefits to patients with painful conditions or presenting for surgery associated with significant perioperative pain. Improvements in imaging technology, the introduction of novel approaches/techniques, improvements in education, and a broad recognition of the harmful effects of opioid therapy has resulted in an increase in the number of regional anesthesia procedures performed and variety of practitioners performing regional anesthesia procedures. The provision of local anesthetics by surgeons and other nonanesthesia providers, increased use of intravenous lidocaine infusions, and risk of tourniquet failure during intravenous regional anesthesia techniques requires that all anesthesiologists possess a thorough understanding of the presenting symptoms, diagnosis, and management of local anesthetic systemic toxicity (LAST).
Anesthetic Implications of Addiction
Authors: Harris Brian , Ferguson Kris 
Published: March 2023

Abstract
Addiction is characterized by psychological dependence, compulsive drug use, and other aberrant behavior. A high proportion of patients will have been or will be addicted to drugs. Complicating the anesthetic plan are the acute and chronic impact of drug use on the patient. Acute intoxication can potentiate anesthetics, leading to overdose. Chronic drug abuse can cause end-organ damage and tolerance to anesthetics and require modification of the anesthetic plan. Further complicating the anesthetic plan are the drugs used in medication assistance treatment programs for patients with addiction. The anesthesiologist should also try to limit the use of medications that may trigger an addiction relapse in a patient who is in recovery.
Arousal Agents
Authors: Nemergut Greta 
Published: March 2023

Abstract
Reversal agents, or arousal agents, are sometimes needed to wake a patient who is having delayed emergence from anesthesia. The anesthetic agents are removed in a way that permits the patient to wake safely. The agent used will depend on the cause of the delayed emergence. There are reversal agents available for opioids, benzodiazepines, anticholinergic drugs, and neuromuscular blocker agents (NMBAs). A complete and accurate medical history needs to be taken pre-operatively to help assess causes and risks for prolonged effects of anesthetics. During the procedure, considerations of drug synergy and potential consequences of concomitant drug use needs to be considered. The chapter reviews these agents and how they are used.
Airway Management in Cervical Spine Disease
Authors: Sharma Balram , Romanov Evgeny 
Published: March 2023

Abstract
Cervical spine injury is particularly common in trauma patients. This can frequently cause airway obstruction or inadequate ventilation, resulting in hypoxia and rapid deterioration of the patient’s status. Observational studies showed that airway obstruction is a major cause of preventable death in trauma patients. Thus, airway evaluation and management are the critical first steps in any trauma patient. Chronic cervical spine disorders can also cause difficult airway. Flexible scope intubation and videoendoscopic intubation are preferred methods for securing an airway in patients with unstable cervical spine. Spinal cord injury commonly co-occurs in patients with an unstable cervical spine. It may lead to a variety of changes in systemic physiology, which must be recognized and treated accordingly. The approach to induction, maintenance, and emergence from anesthesia in patients with cervical spine disease is significantly different from the basic approach, and details are discussed in this chapter.
Spinal Fluid Drainage
Authors: Agarwal Deepak , Arora Lovkesh L. 
Published: March 2023

Abstract
The cerebrospinal fluid (CSF) is contained in the brain ventricles and the cranial and spinal subarachnoid spaces. The mean CSF volume is 150 mL, with 25 mL in the ventricles and 125 mL in subarachnoid spaces. CSF is renewed about four times every 24 hours. The CSF space is a dynamic pressure system. CSF pressure determines intracranial pressure, with physiological values ranging between 3 and 4 mm Hg before the age of 1 year and between 10 and 15 mm Hg in adults. Either alone or in combination with other interventions, CSF drainage remains one of the most frequently used spinal cord protection techniques. Despite no definitive proof of efficacy for reducing spinal cord injury, there are compelling data supporting its use. However, the potential benefit of CSF drainage must be balanced against the risks associated with its use, including nerve injury during insertion, compressive neuraxial hematoma formation, intracranial hemorrhage due to excessive drainage, and infection. The optimal benefit-to-risk ratio can be achieved by understanding the rationale for its use and following practical management guidelines.
Awake Craniotomy
Authors: Shin John S. , Bui Timothy T. 
Published: March 2023

Abstract
Awake craniotomy allows for patient participation in functional testing of eloquent cortical tissue in real-time intraoperatively. This allows for more extensive resections of tumor or ictal foci, providing the potential for better outcomes. The only absolute nonsurgical contraindication to awake craniotomy is patient refusal. Preoperative evaluation must include assessment of the patient’s anxiety, claustrophobia, risk of aspiration, and thorough evaluation of the airway (including risk of obstruction and likelihood of difficult mask ventilation or intubation). The two most common techniques for awake craniotomy are asleep-awake-asleep and monitored anesthesia care. Both approaches allow for sedation and analgesia during the craniotomy, alertness during intraoperative testing, and sedation during closure. Awake craniotomy limits exposure to general anesthesia. This allows for reduced postoperative nausea and vomiting as well as potentially lower costs by reducing hospital length of stay. Overall, awake craniotomy by either approach is well tolerated by the patient and should be considered the standard of care for resection of brain tumors in eloquent areas.
Lung Mechanics
Authors: Davidson Evan , Crimi Ettore 
Published: March 2023

Abstract
Knowledge of respiratory mechanics is fundamental for correct use of mechanical ventilation and full understanding of the impact of lung disease during anesthetic administration. The role of the respiratory system is to deliver oxygen to cells so that respiration can occur. To accomplish this task, the respiratory system during spontaneous breathing generates negative pressure differentials able to overcome airway and tissue resistance, allowing inspiration. In contrast, mechanical ventilation uses positive pressure differentials between the mouth and the alveoli to inflate the lungs and allow for inspiration. The work of breathing, which is responsible for the energy consumption required for respiration, should be kept to a minimum. Increases in work of breathing can lead to fatigue and respiratory failure.
Ventilation-Perfusion
Authors: Bang Jarrod , Sharma Archit 
Published: March 2023

Abstract
Gas exchange occurs in the respiratory zone of the lung, where alveoli are present. For effective gas exchange to occur, alveoli must be ventilated and perfused. Ventilation (V) refers to the flow of air into and out of the alveoli, while perfusion (Q) refers to the flow of blood to alveolar capillaries. A major cause of hypoxemia in anesthesia is ventilation-perfusion (V/Q) mismatch. With more advanced surgery and an aging population, monitoring of V/Q is of increasing importance. This chapter evaluates the different ways that the ventilation and perfusion are altered and how they can cause the patient various effects.
Thoracic and Pulmonary Surgery
Authors: Dabaliz Al-Awwab Mohammad , Stachur Christina 
Published: March 2023

Abstract
Operations involving the trachea, lungs, and chest wall pose unique anesthetic considerations that can provide difficult yet engaging challenges to the anesthesia provider. Special considerations throughout the perioperative period are particularly necessary for pulmonary surgeries. The primary indication for these operations is early stage cancer; other indications include infections, hemorrhage, and air leak. This chapter describes the indications and anesthetics management for patients undergoing thoracic and pulmonary surgery. It outlines what criteria to use for predicting postoperative complications, including the assessment of FEV1, DLCO, and VO2 max. Intraoperative and postoperative management is discussed, as well as techniques for minimizing common complications in these settings.
BiPAP, Airway Pressure Release Ventilation, and Prone Ventilation
Authors: Marrero-Figueroa Neisaliz , Crimi Ettore 
Published: March 2023

Abstract
Biphasic positive airway pressure (BiPAP), airway pressure release ventilation (APRV), and prone ventilation are used as rescue therapies for refractory hypoxemia in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). BiPAP and its variant, APRV, allow the patient to breathe spontaneously at two levels of continuous positive airway pressure (CPAP). BiPAP uses conventional I:E ratios, while APRV is an inverse ratio ventilation. The significant advantages of these two modes of ventilation are the preservation of spontaneous breathing, improved ventilation-perfusion matching, use of lower peak pressure, and better oxygenation. Ventilation in the prone position determines a rapid and sustained improvement in oxygenation in patients with ALI/ARDS. Mechanisms that can explain its beneficial effects include a reduced pleural pressure gradient with more uniform lung inflation and improved lung recruitment, an increase in functional residual capacity, redistribution of regional lung perfusion, variations in diaphragm movement, and better clearance of secretions.
Coronary Artery Bypass Procedures
Authors: Ahmed Andaleeb A. 
Published: March 2023

Abstract
Coronary artery bypass grafting (CABG) is indicated for chronic stable angina with high-risk coronary disease; unstable angina; post–myocardial infarction angina; and ischemia on noninvasive testing. CABG remains the mainstay for many patients with multivessel disease. The anatomical complexity of CAD, predicted surgical mortality, and anticipated completion of revascularization are some of the crucial factors in deciding revascularization strategy. Standard CABG is performed through a median sternotomy incision and involves the institution of cardiopulmonary bypass (CPB). Vascular conduits like the saphenous vein, internal thoracic artery, and radial artery are grafted between the ascending aorta and coronary artery distal to its obstruction. In addition to on-pump CABG, off-pump CABG (OPCAB), minimally invasive direct CABG (MIDCAB) robotic, and hybrid revascularization strategies are increasingly being used.