ED90 of spinal 2-chloroprocaine 1% in ambulatory knee arthroscopy up to 45 min: a randomized biased-coin- up-and-down sequential allocation trial

BackgroundA short acting spinal anesthetic facilitates smooth flow since quick recovery of motor function will facilitate unassisted ambulation. The aim of this study was to estimate the effective dose (ED90) of intrathecal 2-chloroprocaine 1% in outpatient knee arthroscopy.MethodsTwo cohorts were included in two different hospitals. In cohort I, a randomized biased-coin up-and-down design with 40 patients was used to find the ED90. Four dose-levels of plain 2-chloroprocaine 1% were used: 25, 30, 35 and 40 mg. The identified primary outcome, the ED90, was validated in 50 patients in cohort II with an open label design. Secondary outcomes included time to complete recovery from motor and sensory block with spinal injection as time zero, peak sensory block level, urine retention and time until hospital discharge.ResultsForty patients were included in the final analysis in cohort I. The ED90 was estimated at 27.8 mg, successful spinal anesthesia was obtained in 38 patients (95%). Fifty patients were included in the final analysis in cohort II, 49 patients had successful anesthesia with a fixed round dose of 28 mg. In this Cohort, peak sensory block was T10/T11 (range: (L4–T4)). The median time to full recovery of the motor block was 60 min (45–60) and 90 min (75–105) for the sensory block. The mean time to hospital discharge was 2.9 hours (0.7).ConclusionThe ED90 of 2-chloroprocaine 1% in knee arthroscopy was estimated to be 27.8 mg. In an external population, the ED90 resulted in successful anesthesia in 98% of the patients (95% CI 89% to 100%).Trial registration numberNetherlands Trial Registry (NL6769).

Variability of artistic and aesthetic features of social dance Brazilian Zuk and its bedding

The purpose of the article is to identify the genre, stylistic and rhythmic specifics of the social dance Brazilian Sound, as well as to theorize the artistic and aesthetic features of the new dance backgrounds developed on its basis. Methodology. A typological method was applied, thanks to which the main characteristics of the social dance Brazilian Zuk were determined; figurative-stylistic and formal-stylistic method, which helped to identify a system of typical forms and lexical features inherent in the dance and developed on its basis substrates; the method of comparative analysis, which revealed the common and distinctive features of the traditional social dance Brazilian Sound and innovative backgrounds created on its basis; method of theoretical generalization, which helped to summarize the results of the study. Scientific novelty. The process of origin and development of one of the most popular social dances of the XXI century is studied. Brazilian Zuk; the compositional features of the Brazilian Sound were identified and analyzed; For the first time in domestic art history the genre-stylistic and rhythmic features of the main sub-styles (Rio-zouk style, Porto-Seguro style, M-zouk, Neo-zouk) and sub-styles (Modern zouk, Soulzouk R&B zouk) of the Brazilian Zuk are considered and the specificity of their art is revealed. aesthetic variability. Conclusions. The study found that the Brazilian Sound is an independent style of modern dance art, which is characterized by a number of features: the atmosphere of performance (platforms for social dances, dance conferences, seminars, etc.); creating a composition of the Brazilian Sound is usually a collective process - the authorship of style and background belongs to talented dancers, who are endowed with the gift of improvisation and specific temperament; special individual type of dance movement: the basic sequence of steps is connected with metrorhythmic features of musical accompaniment; a specific combination of plasticity, flexibility, and rotations creates individual dance backgrounds: acrobatic Acro Zouk, smooth Flow Zuk, contrast Zuk Revolution, improvisational M-zuk, inflammatory Lambazuk, philosophical-hypnotic Neo-zuk, and others. Prospects for innovative research in the field of genre-style interaction of the Brazilian Sound and modern dance trends are the unique basis of dance, which is positioned as the initial impetus for further lexical and rhythmic-intonational choreographic experiments and depends on the peculiarities of musical material. Keywords: Brazilian Zuk, social dance, artistic and aesthetic features, M-zuk, Neo-zuk, Lambazuk.

A Perspective on Patient Centricity in Health Ecosystem: A Call for an Enabling Culture

Today, patients are more empowered and informative than ever because of which the aim of the health ecosystem is to centre on the patient centred goals. The term patient centricity is no longer a health care buzzword; however, a lot needs to be done to implement this concept in the real world. Therefore, the objective of the current research is to bring in the importance of cultural change in the health ecosystem for the smooth flow of patient centricity. The current research is exploratory in nature that tried to explore the concept of patient centricity in the health ecosystem through literature and interviews. The research utilized secondary sources such as Journal articles, reports, and such others to draw how OCTAPACE culture is important in health ecosystem for promoting patient centricity. The eight strong pillars of OCTAPACE are Openness, Confrontation, Trust, Autonomy, Proactivity, Authenticity, Collaboration, and Experimentation and its relationship with patient centricity is proposed. The researchers can reasonably deduce that patient centricity requires a changed mindset and vision shared by all the stakeholders. For this, support from regulators, pharmaceutical companies, health care professionals etc. are required. The current research is among a few researches that highlights the importance of OCTAPACE culture in health ecosystem. This construct to meet patient centric goals is worthy of additional study. From the practical standpoint, training can be provided to all the employees of the entire health ecosystem to incorporate the OCTAPACE culture and to meet the demands of the patients and caregivers.

Teknik Marmet terhadap Kelancaran Asi pada Ibu Post Partum

Breast milk is a liquid produced by mothers as the best food intake for the nutritional needs of babies. Several problems related to breastfeeding in post partum mothers are lactation management which is less effective on the first day of birth, caused by lack of knowledge and stress. One of the methods used to overcome breast milk insufficiency is the marmet technique. Marmet technique is a combination of massage that is effective, manual, safe and free of cost. The marmet technique is an optimal effort to stimulate the hormones oxytocin and prolactin in the smooth flow of breast milk. The purpose of this study was to determine the effect of the marmet technique on the smoothness of breastfeeding in post partum mothers in the Tanjungpinang City Health Center Work Area. This is a study with a quasi-experimental design (Quasi Experiment) with a Pre and Post Test without Control design. The research population was post partum mothers as many as 201 people and the number of samples was 30 respondents. Samples were taken using purposive sampling. Hypothesis test using non parametric by doing Wilcoxon test. The results showed that there was an effect of the marmet technique on the smoothness of breastfeeding in post partum mothers with a value of 0.000. Research recommendations for effective marmet techniques are carried out to launch breast milk in postpartum mothers and the marmet technique can stimulate an increase in the hormones prolaksin and oxytocin so that it has a relaxing effect on postpartum mothers

Classification of the Morse – Smale flows on surfaces with a finite moduli of stability number in sense of topological conjugacy

Purpose. The purpose of this study is to consider the class of Morse – Smale flows on surfaces, to characterize its subclass consisting of flows with a finite number of moduli of stability, and to obtain a topological classification of such flows up to topological conjugacy, that is, to find an invariant that shows that there exists a homeomorphism that transfers the trajectories of one flow to the trajectories of another while preserving the direction of movement and the time of movement along the trajectories; for the obtained invariant, to construct a polynomial algorithm for recognizing its isomorphism and to construct the realisation of the invariant by a standard flow on the surface. Methods. Methods for finding moduli of topological conjugacy go back to the classical works of J. Palis, W. di Melo and use smooth flow lianerization in a neighborhood of equilibrium states and limit cycles. For the classification of flows, the traditional methods of dividing the phase surface into regions with the same behavior of trajectories are used, which are a modification of the methods of A. A. Andronov, E. A. Leontovich, and A. G. Mayer. Results. It is shown that a Morse – Smale flow on a surface has a finite number of moduli if and only if it does not have a trajectory going from one limit cycle to another. For a subclass of Morse – Smale flows with a finite number of moduli, a classification is done up to topological conjugacy by means of an equipped graph. Conclusion. The criterion for the finiteness of the number of moduli of Morse – Smale flows on surfaces is obtained. A topological invariant is constructed that describes the topological conjugacy class of a Morse – Smale flow on a surface with a finite number of modules, that is, without trajectories going from one limit cycle to another.

Spatiotemporal Graph Indicators for Air Traffic Complexity Analysis

There has been extensive research in formalising air traffic complexity, but existing works focus mainly on a metric to tie down the peak air traffic controllers workload rather than a dynamic approach to complexity that could guide both strategical, pre-tactical and tactical actions for a smooth flow of aircraft. In this paper, aircraft interdependencies are formalized using graph theory and four complexity indicators are described, which combine spatiotemporal topological information with the severity of the interdependencies. These indicators can be used to predict the dynamic evolution of complexity, by not giving one single score, but measuring complexity in a time window. Results show that these indicators can capture complex spatiotemporal areas in a sector and give a detailed and nuanced view of sector complexity.

“Hybrid” scientific conference: lessons learned from the digital annual meeting of the CARS international conference during the Covid-19 pandemic

Objectives Due to the coronavirus disease 2019 (Covid-19) pandemic, all scientific conferences in the year 2020 had to be adapted in their form of presence to accommodate for safety regulations, postponed, or canceled entirely. As organizers of the annual Computer Assisted Radiology & Surgery International Conference & Exhibition (CARS)-Conference 2020, we decided to hold a “hybrid” conference, i.e., a virtual conference with partial presence to mitigate the drawbacks of a purely virtual conference. It is the purpose of this paper to describe the results and experience gained by our first hybrid conference. Methods Besides technical necessities like an online conferencing tool, we introduced additional personal namely the technical chairs and communication officers ensuring a smooth flow of presentations. To measure the success of the hybrid conference, we assessed various parameters during the conference (e.g., counting of adverse events, delays, and no-shows) and sent a questionnaire to participants for evaluation after the conference. Results We offered four types of presentation formats, whereas the majority of speakers presented their pre-produced videos including live discussions. Significant delays in sessions occurred during the morning sessions, which could be reduced during lunch breaks. The analysis of the influence of the distribution of the audience’s location/time zone toward the attendance rate showed a high relevance for the American zone and only little influence for the Asian-Pacific region. Based on the questionnaire, 60% of responders considered the hybrid approach as superior and 12% as inferior to purely virtual conferences. Conclusions Most scientific associations in 2020 had to struggle with a dramatic change: Regular, traditional meetings with personal communication and exchange, networking, and creation of new visions became obsolete almost instantly. As an alternative, virtual conferences became increasingly popular, and are offering additional advantages (e.g., reduction of cost for travel, lodging, and time on transit). To overcome the drawbacks of purely virtual conferences, we introduced a hybrid concept for the CARS-Congress. While certainly, those with the privilege to take part personally on-site did benefit most from the hybrid format. Facing upcoming waves of the Covid-19 Pandemic, with ongoing changes to the regulations on meetings and transit, hybrid conferences are a viable option for scientific conferences for the future.

Numerical analysis of heat transfer enhancement in pulsating flow pipes

In this paper, a rectangular flow runner is used as the research object to study the influence of adding a spoiler on the wall of the flow runner on its heat transfer characteristics and flow characteristics. Using the finite element method to analyse the influence of different spoiler’s structures and parameters of the spoilers on the heat transfer characteristics and flow characteristics of the flow runner, the study found that: by the comparison of the smooth flow runner and the rectangular spoiler flow runner, the comprehensive heat exchange effect of the spoiler runner is the best when the arc is arranged in the flow runner, and the accumulation effect of impurities in the runner is the slowest.

Complete characteristic curve processing method based on improved backpropagation neural network and Logarithmic curve projection

The calculation of transient process is the basis of the design and construction of pumped storage power plant, which directly affects operation stability of pumped storage units. However, for satisfying the design of uniform and smooth flow in both directions, the complete characteristic curves of pumped turbine show a significant S feature, which brings difficulties to the interpolation calculation in the transient process as there are crossover and overlap phenomenon in pump and turbine working conditions. In this paper, a transformation method for complete characteristic curves based on logarithmic curve projection and improved backpropagation neural network is presented to solve the above problem. Furthermore, the feasibility and accuracy of the method are verified through the comparison of load rejection condition with on-site measurement, the results show that the proposed method overcomes the multi-value problem that exists in the original curve, in especial makes the small opening region well expressed. The simulation based on the transformed curve reaches a high similarity of transient process with the field test, both in the trend and extreme values, which provides great convenience for the calculation of transient process.

Continuity, Discontinuity, and Scenes

Continuity is the smooth flow of movies, whereas discontinuity is an interruption. Continuity generally rules within scenes, and discontinuity is fostered between them. Movie scenes are psychological events, and they have beginnings, middles, and ends. These manifest themselves in shot durations that go from longer to shorter to longer again, creating an arc. Shot scales show a similar arc—long shots, moving to medium shots and medium close-ups, and then often backing away. Scenes typically take place in a single location, with a fixed set of characters, over a small but continuous time period. Narrational shifts to a new scene occur when any one of these three dimensions is changed. This chapter discusses examples covering all seven possible shifts. It also discusses, with examples, Walter Murch’s Rule of Six, an ordered ranking of editing principles. This leads to a discussion of the less-than-overwhelming importance the 180-degree rule.