Search

Background: Providing adequate paralysis and appropriate sedation is challenging in patients with obesity during rapid sequence intubation (RSI). Pharmacokinetic parameters play an important role in dosing of rocuronium due to low lipophilicity. Rocuronium may be dosed based on ideal body weight (IBW). Current guidelines do not offer recommendations for dosing in the setting of obesity. Dosing depends on clinician preference based on total body weight (TBW) or IBW.Objectives: In this study we performed non-inferiority analysis to compare the intubation conditions, duration of paralysis, and incidence of new-onset tachycardia or hypertension after intubation in obese patients requiring RSI in the emergency department (ED).Methods: This was a single-center, prospective, observational study. Eligible for enrollment were adultpatients with a TBW ≥30% IBW or body mass index ≥30 kilograms per meters squared who presented to the ED requiring RSI with the use of rocuronium. Rocuronium was dosed according to intubating physicians’ preference. Physicians completed a survey assessing intubation conditions. Height and weight used for the calculation of the dose, the dose of rocuronium, time of administration, and time of muscle function recovery were recorded. Endpoints assessed included grading of view during laryngoscopy, first-past success, and duration of paralysis.Results: In total, 96 patients were included, 54 in TBW and 42 in IBW. The TBW cohort received a mean of 1 milligram per kilogram (mg/kg) compared to 0.71 mg/kg in the IBW group. Excellent intubation conditions were observed in 68.5% in the TBW group and 73.8% in the IBW group. The non-inferiority analysis for relative risk of excellent intubation was 1.12 (P = 0.12, [90% CI 0.80–1.50]).Conclusion: Non-inferiority analysis suggests that IBW dosing provides similar optimal intubation conditions when compared to TBW dosing, but the noninferiority comparison did not reach statistical significance. This study was unable to show statistical non-inferiority for IBW dosing.

Copyright of Ido Movement for Culture. Journal of Martial Arts Anthropology is the property of Idokan Poland Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

During the operation of a reversible pump-turbine, a hump area can easily appear under the pump condition, which will greatly affect the performance of a storage unit, with pressure pulsation being the key factor for the stable operation of a pump-turbine. Therefore, in order to explore the pressure pulsation characteristics of each flow component in the hump area, this paper first compared the full characteristics of the model test under different working conditions, and then it analyzed the pressure pulsation characteristics. By analyzing the pressure pulsation characteristics in the unit's flow component under different flow rates in the hump area, the pulsation rule of a pump-turbine running in the hump area was revealed. It was found that the peak-to-peak value of the draft tube in the hump area was the smallest under the optimal flow condition, and the peak-to-peak value increased along the flow direction, with the rotor and stator interaction (RSI) effects being continuously enhanced. When away from the runner basin, the influence of RSI gradually weakened after leaving the runner. No low frequency was found in the optimal traffic. The peak-to-peak value of the low flow condition increased compared with the optimal flow condition, and the distribution was not uniform. The main frequency of the whole basin was relatively complex, indicating that the flow of water was unstable in the condition of partial load, resulting in the hump area during the unit operation. The research results can provide a theoretical reference for improving the stability of pump-turbines. [ABSTRACT FROM AUTHOR]

Background: Currently, an advanced imaging method may be necessary for magnetic resonance imaging (MRI) to diagnosis and quantify liver fibrosis (LF). Purpose: To evaluate the feasibility of the multicompartmental restriction spectrum imaging (RSI) model to characterize LF in a mouse model. Methods: Thirty mice with carbon tetrachloride (CCl4)‐induced LF and eight control mice were investigated using multi‐b‐value (ranging from 0 to 2000 s/mm2) diffusion‐weighted imaging (DWI) on a 3T scanner. DWI data were processed using RSI model (2–5 compartments) with the Bayesian Information Criterion (BIC) determining the optimal model. Conventional ADC value and signal fraction of each compartment in the optimal RSI model were compared across groups. Receiver operating characteristics (ROC) curve analysis was performed to determine the diagnosis performances of different parameters, while Spearman correlation analysis was employed to investigate the correlation between different tissue compartments and the stage of LF. Results: According to BIC results, a 4‐compartment RSI model (RSI4) with optimal ADCs of 0.471 × 10−3, 1.653 × 10−3, 9.487 × 10−3, and > 30 × 10−3, was the optimal model to characterize LF. Significant differences in signal contribution fraction of the C1 and C3 compartments were observed between LF and control groups (P = 0.018 and 0.003, respectively). ROC analysis showed that RSI4‐C3 was the most effective single diffusion parameter for characterizing LF (AUC = 0.876, P = 0.003). Furthermore, the combination of ADC values and RSI4‐C3 value increased the diagnosis performance significantly (AUC = 0.894, P = 0.002). Conclusion: The 4‐compartment RSI model has the potential to distinguish LF from the control group based on diffusion parameters. RSI4‐C3 showed the highest diagnostic performance among all the parameters. The combination of ADC and RSI4‐C3 values further improved the discrimination performance. [ABSTRACT FROM AUTHOR]

The Relative Strength Index (RSI) is a widely used technical indicator in stock trading because of its simple application. However, its application combined with fundamental analysis in Kuala Lumpur Stock Exchange (KLSE) is yet to be explored extensively. Hence, this study aimed to investigate the effectiveness of RSI as a predictive tool in the KLSE market. First, 39 stocks that met the set of criteria guided by fundamental soundness were identified. Trading signals are then initiated based on the RSI indicators, which are superimposed on the charts of the identified stocks. The return on investment (ROI) was then estimated and benchmarked against KLCI performance over a period of five years starting from 21st July 21, 2018. It was found that the average ROI was 3.46% against KLCI's - 24.37% over the same period of 5 years, measured between 21st July 21, 2018, 21st July 21, 2023. The average ROI improves as the number of trade iterations increases to five. The peak average ROI is approximately 22%. Technology is the top performer, recording an ROI of more than 40%. In conclusion, the combination of RSI and fundamental analysis yielded a mixed set of results. Although it outperforms KLCI, the annualised ROI is only slightly above 4%. Nevertheless, the results of this study provide valuable insights into the application of the RSI as a trading signal generator in the KLSE market. [ABSTRACT FROM AUTHOR]

La utilización de técnicas de elongación muscular se ha puesto en práctica durante mucho tiempo antes de iniciar actividades físicas para incrementar la activación, aumentar la amplitud articular o como parte de técnicas de calentamiento. En los últimos años, ha habido discrepancia a la hora de utilizar elongaciones estáticas (STA), dinámicas o intermitentes (DYN), o no hacerlas (CON) antes de iniciar la sesión de Educación Física. El objetivo de este estudio fue averiguar qué tipo de trabajo de flexibilidad obtendría mejores resultados en el salto con contramovimiento (CMJ) con las variables: índice de fuerza relativa (RSI), altura del salto (HGT) y tiempo de contacto (CT) con una plataforma de contacto. Formaron parte de esta investigación 86 participantes de 16.74 ± 0.19 años, 65.17 ± 30.03 kg y 1.71 ± 0.09 m. Todos los participantes se sometieron de forma aleatorizada a los 3 protocolos, 2 de elongación (STA y DYN) durante 30 segundos y 1 de control sin ninguna elongación (CON). Los resultados mostraron incrementos significativos en el RSI y HGT (p < .001) en la condición de DYN vs. CON y STA. Por otra parte, el CT mostró aumentos significativos en STA con respecto a CON (p < .01) y DYN. A partir de los resultados obtenidos, se podría afirmar que un programa agudo de estiramientos dinámicos podría producir mejoras sobre el salto con contramovimiento (CMJ) en comparación con la ausencia de estiramiento o un mantenimiento de elongación muscular de 30 s.

Copyright of Computer Measurement & Control is the property of Magazine Agency of Computer Measurement & Control and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Reactive Strength Index (RSI) is used to determine the load and intensity of plyometric training in sports that require explosive strength. Although upper extremity plyometrics are used in athletic' training programmes, there are no studies investigating upper extremity RSI. The aim of this study was to determine the upper and lower extremity reactive strength index generated during different plyometric push-up and jump techniques in boxers, and to examine the relationship between upper and lower extremity RSI. Twenty male boxers aged 18-35 years (age: 20.9±4.83; height: 1.76±.072; BMI: 22.42±2.39) with at least 4 years of boxing experience participated in the study. The RSI values were assessed during depth push-ups (10 cm, 15 cm, 20 cm) and depth jumps (30 cm, 45 cm, 60 cm), pliyometric push-ups and countermovement jumps using a force platform (TekScan, Matscan, model 3150, Boston, USA). The RSI values were calculated from the jump heights and ground contact times obtained from the force platform. No statistically significant correlation was found between the lower and upper extremity RSI for any of the plyometric exercises (p>0.05). When comparing countermovement jump and depth jumps, a statistically significant difference was found between the countermovement jump RSI and all depth jump RSIs (p<0.05). However, when comparing push-up RSIs, there was no statistically significant difference between any of the push ups (p>0.05). Boxers transfer the power generated by the ground reaction force through the trunk to the upper extremities in order to punch quickly and effectively. The lack of a correlation between upper and lower extremity RSI values in this study may be attributed to the significant contribution of the trunk strength in generating power with the upper extremities. In addition, it is believed that the varying RSI values obtained during different plyometric push-up and jump techniques may provide insight into determining the load and intensity of plyometric training. [ABSTRACT FROM AUTHOR]

Prehospital rapid sequence intubation (RSD, like inpatient RSI, is not without risk of adverse effects to the patient. The most notable of these adverse effects is postintubation hemodynamic instability. Air medical providers choose induction agents for critically ill patients who require emergent airway management, some of whom may already be hemodynamically unstable prior to RSI. Ketamine is often selected as the induction agent of choice for patients who are either unstable before RSI or have a high index of suspicion of becoming unstable in the postintubation period. Although widely considered to have a good safety profile for induction, ketamine administration has been correlated with episodes of postintubation hypotension. In this retrospective literature review, the effect of using half-dose ketamine for induction in patients who show pre-RSI instability (systolic blood pressure <90 mm Hg or body mass index >30) on postintubation hemodynamics is examined. [ABSTRACT FROM AUTHOR]

The use of muscle stretching techniques has long been practised prior to physical activities to increase activation, increase joint amplitude or as part of warm-up techniques. In recent years, there has been discrepancy in the use of static stretching (STA), dynamic or intermittent stretching (DYN), or no stretching (CON) before starting the Physical Education session. The aim of this study was to find out which type of flexibility work would obtain better results in the countermovement jump (CMJ) with the variables: relative strength index (RSI), jump height (HGT) and contact time (CT) with a contact platform. 86 participants aged 16.74 ± 0.19 years, 65.17 ± 30.03 kg and 1.71 ± 0.09 m took part in this research. All participants were randomised to the 3 protocols, 2 stretching protocols (STA and DYN) for 30 seconds and 1 control without any stretching (CON). The results showed significant increases in the RSI and HGT (p < .001) in the DYN condition vs. CON and STA. On the other hand, CT showed significant increases in STA with respect to CON (p < .01) and DYN. From the results obtained, it could be affirmed that an acute programme of dynamic stretching could produce improvements on countermovement jumping (CMJ) compared to no stretching or a 30 s maintenance of muscle elongation. [ABSTRACT FROM AUTHOR]

The study evaluated Spatio-temporal pattern of heat stress (HS) vulnerability in India's Agartala urban region using Composite Z-score method. The experiment combined NDVI (Normalized difference vegetation Index), NDMI (Normalized difference moisture Index), MNDWI (Modified normalized difference water Index), MBUI (Modified Built up index), and LST (Land surface temperature) with gridded population density (1 × 1 km) to estimate HS vulnerability in the Agartala urban region. RSI (Relative Strain Index) was also used to calculate the vulnerability of near-surface HS over different months and seasons of the year. Landsat-8 and Sentinel data from 2022 were collected from earthexplorer.usgs.gov and , respectively. The population density gridded landscan has been accessed via landScan.ornl.gov. Similarly, climatic data for RSI estimation is obtained from power.larc.nasa.gov. HS vulnerability was observed in the central region of Agartala, with maximum areal coverage in the October and minimum in the April month. In the October and April month, 15.41 percent and 7.4 percent of urban populations, respectively, are considered vulnerable to very high HS. RSI estimates the maximum number of days under OHR (Overheating Risk) for 50% of the population in April and May with 7 and 2 days, respectively, with no HSR (Heat stroke risk) months. But an hourly estimate reveals maximum HSR in May followed by April with 111 and 109 h of HSR to all population. The positive correlation between LST and RSI and negative correlation between NDVI and RSI evidencing potential role of LST and NDVI on near surface HS level of Agartala city. [ABSTRACT FROM AUTHOR]

Reactive Strength Index (RSI) is a neuromuscular assessment used to measure stretch–shortening cycle (SSC) function of the lower limb. Increased RSI scores have been frequently associated with running performance, such as faster sprint times, greater running economy and reduced change of direction times. These locomotor activities are involved in various sports and therefore, RSI is an important indicator of athletic capacity in sport. Whilst RSI has been commonly used in studies to assess SSC performance, no review has been conducted examining the difference in RSI between athletic populations. Thus, the aim of this systematic review was to summarise the literature and determine whether there was any significant difference in RSI between different populations and summarise the underlying factors contributing to these results. The systematic review protocol yielded 865 articles for screening by which 19 were included for final analysis following inclusion/exclusion criteria. Moderate to large differences were predominately found between different athlete populations, and the strength of these relationships varied depending on the populations being compared. The findings indicated that relative strength is an influencing factor that differentiated RSI performance between populations. This should be an area, which practitioners aim to develop if wanting to improve reactive strength. [ABSTRACT FROM AUTHOR]

Current paper looks at the vicissitudes of thought on violence and non-violence in India, from Vedic period to the present. The early Vedic people lived a nomadic life and practiced customary animal sacrifice. Gradually, however, they started using euphemisms in connection with ritualistic violence and switched subsequently to non-violent rituals. Possibly, because there was a lot of opposition to ritualistic violence, mainly from the Buddhist and the Jaina thinkers, even the later Hinduism ultimately accepted the principle of ahiṃsā (non-violence). Although at present most followers of Vedic rituals do not practice violence when performing Vedic rituals, some others still partly accept it and act accordingly. Also, there is some ritualistic violence outside the Vedic ritual, but there is definitely a change in outlook.

During the operation of a reversible pump-turbine, a hump area can easily appear under the pump condition, which will greatly affect the performance of a storage unit, with pressure pulsation being the key factor for the stable operation of a pump-turbine. Therefore, in order to explore the pressure pulsation characteristics of each flow component in the hump area, this paper first compared the full characteristics of the model test under different working conditions, and then it analyzed the pressure pulsation characteristics. By analyzing the pressure pulsation characteristics in the unit’s flow component under different flow rates in the hump area, the pulsation rule of a pump-turbine running in the hump area was revealed. It was found that the peak-to-peak value of the draft tube in the hump area was the smallest under the optimal flow condition, and the peak-to-peak value increased along the flow direction, with the rotor and stator interaction (RSI) effects being continuously enhanced. When away from the runner basin, the influence of RSI gradually weakened after leaving the runner. No low frequency was found in the optimal traffic. The peak-to-peak value of the low flow condition increased compared with the optimal flow condition, and the distribution was not uniform. The main frequency of the whole basin was relatively complex, indicating that the flow of water was unstable in the condition of partial load, resulting in the hump area during the unit operation. The research results can provide a theoretical reference for improving the stability of pump-turbines.

Current paper looks at the vicissitudes of thought on violence and non-violence in India, from Vedic period to the present. The early Vedic people lived a nomadic life and practiced customary animal sacrifice. Gradually, however, they started using euphemisms in connection with ritualistic violence and switched subsequently to non-violent rituals. Possibly, because there was a lot of opposition to ritualistic violence, mainly from the Buddhist and the Jaina thinkers, even the later Hinduism ultimately accepted the principle of ahi'sā (non-violence). Although at present most followers of Vedic rituals do not practice violence when performing Vedic rituals, some others still partly accept it and act accordingly. Also, there is some ritualistic violence outside the Vedic ritual, but there is definitely a change in outlook. [ABSTRACT FROM AUTHOR]

Copyright of Corporate Governance & Research & Development Studies is the property of FrancoAngeli srl and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Anesthesia for patients with life-threatening injuries is an essential part of post-accident care. Unfortunately, there is variability in trauma anesthesia care and numerous nonstandardized methods of working with patients remain. Uncertainty exists as to when and how best to intubate trauma patients, the use of vasopressors, and the appropriate management of severe traumatic brain injury. Some physicians recommend prehospital rapid sequence intubation, whereas others use bag-mask ventilation at lower pressures with no cricoid pressure and early transport to a trauma center. Overall, the absence of uniformity in trauma anesthesia care underlines the need for continued study and dialogue to define best practices and optimize patient outcomes. [ABSTRACT FROM AUTHOR]

PurposeRestriction spectrum imaging (RSI) decomposes the diffusion-weighted MRI signal into separate components of known apparent diffusion coefficients (ADCs). The number of diffusion components and optimal ADCs for RSI are organ-specific and determined empirically. The purpose of this work was to determine the RSI model for breast tissues.MethodsThe diffusion-weighted MRI signal was described using a linear combination of multiple exponential components. A set of ADC values was estimated to fit voxels in cancer and control ROIs. Later, the signal contributions of each diffusion component were estimated using these fixed ADC values. Relative-fitting residuals and Bayesian information criterion were assessed. Contrast-to-noise ratio between cancer and fibroglandular tissue in RSI-derived signal contribution maps was compared to DCE imaging.ResultsA total of 74 women with breast cancer were scanned at 3.0 Tesla MRI. The fitting residuals of conventional ADC and Bayesian information criterion suggest that a 3-component model improves the characterization of the diffusion signal over a biexponential model. Estimated ADCs of triexponential model were D1,3 = 0, D2,3 = 1.5 × 10-3 , and D3,3 = 10.8 × 10-3 mm2 /s. The RSI-derived signal contributions of the slower diffusion components were larger in tumors than in fibroglandular tissues. Further, the contrast-to-noise and specificity at 80% sensitivity of DCE and a subset of RSI-derived maps were equivalent.ConclusionBreast diffusion-weighted MRI signal was best described using a triexponential model. Tumor conspicuity in breast RSI model is comparable to that of DCE without the use of exogenous contrast. These data may be used as differential features between healthy and malignant breast tissues.

Utilizing super-concentrate for direct hydrogen reduction in pelletizing which decrease energy consumption and improve smelting quality are critical steps towards achieving the dual carbon goal. The reduction swelling behavior and its corresponding mechanism of ultra-high-grade pellets were studied from multi-dimensions combing visualization detection, micromorphological analysis, and first-principles molecular dynamics simulation in present work. The results showed that for the reduction no matter in CO or H2 atmosphere, the ultra-high grade pellets expand abnormally. Whereas the increase of SiO2 content and the selection of H2 atmosphere can effectively inhibited the reduction swelling behavior of pellets, while Al2O3 content had only a slight effect. The cause of catastrophic expansion was related to the various formation of new-born iron that it exhibited angular during CO reduction while became flatter with SiO2 addition or by H2 reduction. The simulation results were validated the accuracy since the structure and energy changes during iron oxide reduction were corresponding to the experimental observations. C and Fe mainly formed chemical bonds while H and Fe primary produced physical adsorption during FexO reduction. Combing the comprehensive effect of adsorption energy, electrostatic force, and energy change, it was tended to create iron whiskers by CO reduction contrary to H2 reduction. It was conductive to generate iron whisker after Si doped in FexO. However, the decrease of pellets RSI with SiO2 addition in H2 reduction was caused by the increase of pellet porosity, which provided space for the growth of iron whisker. With the increase of Si doping amount in CO reduction, iron whiskers gradually changed from thin to chunky, resulting in more uniform growth of iron whiskers and uniform stress, which brought about a decrease in pellet reduction expansion rate contrarily.

Background/Aims: The Reflux Symptom Index (RSI) is a questionnaire that evaluates the severity of extra-esophageal symptoms and is one of the most widely used measures to evaluate LPR. This study assessed the validity and reliability of the RSI questionnaire in Bahasa Indonesia and investigated the association between each extra-esophageal symptom reported in the questionnaire and the severity of erosive esophagitis as determined by endoscopic findings. Methods: 85 adult patients with GERD symptoms had an upper endoscopy examination and were asked to complete the translated RSI. The validity and reliability of the questionnaire were assessed. Results: The construct validity of the RSI translated into Bahasa Indonesia was verified with the r value of each question being higher than the crucial table value (r>0.213, p

Abstract The iRAP Star Rating Methodology and Road Safety Inspection (RSI) have similar objectives to improve road safey condition but with different approaches. This research is utilizing iRAP Star Rating to filter road segments that require more detailed analysis using RSI on the Kopo – Soreang road section, which is road segments with a Star Rating value less than 3. The results of the assessment using iRAP Star Rating show that there are still road segments with a Star Rating value below 3 for all road users, with a value of fatality estimated at 58 annually. Using SR4RSA Methodology, a series of countermeasures from the iRAP Star Rating Methodology are adjusted to Road Safety Inspection Methodology resulting in 28 countermeasures that can be applied to Kopo – Soreang road section therefore, resulting in road segments with a minimum Star Rating of 3 for all road users and a reduction in fatality estimation value of 49,91%. After countermeasures have been implemented, the Star Rating value for vehicle occupants with a rating of 5 stars is higher compared to other road users Star Rating which indicates that the implemented countermeasures are more focused on vehicle occupant’s safety. Keywords: iRAP Star Rating, RSI, SR4RSA Abstrak Metode iRAP Star Rating dan Inspeksi Keselamatan Jalan (IKJ) memiliki tujuan yang sama untuk meningkatkan keselamatan jalan tetapi dengan pendekatan yang berbeda. Penelitian ini memanfaatkan iRAP Star Rating untuk menyaring segmen jalan yang memerlukan analisis lebih detail menggunakan IKJ pada ruas jalan Kopo – Soreang, yaitu segmen jalan dengan Star Rating kurang dari 3. Hasil penilaian iRAP Star Rating menunjukkan bahwa masih terdapat segmen jalan dengan nilai Star Rating dibawah 3 untuk seluruh pengguna jalan, dengan estimasi fatalitas sebanyak 58 kejadian dalam satu tahun. Dengan metode SR4RSA, rekomendasi penanganan keselamatan dari metode iRAP Star Rating disesuaikan dengan metode IKJ sehingga didapatkan 28 rekomendasi penanganan yang dapat diterapkan pada ruas jalan Kopo – Soreang, sehingga menghasilkan segmen-segmen dengan Star Rating minimal 3 untuk seluruh pengguna jalan dengan estimasi pengurangan fatalitas sebanyak 49,91%. Setelah penanganan, jumlah segmen yang memiliki Star Rating 5 untuk pengguna kendaraan penumpang lebih banyak dibanding Star Rating untuk pengguna jalan lainnya. Hal ini mengindikasikan rekomendasi penanganan yang diterapkan lebih berorientasi pada keselamatan pengguna kendaraan penumpang. Kata Kunci: IKJ, iRAP Star Rating, SR4RSA

Objectives: To compare the screening value of the Reflux Symptom Score (RSS) and the Reflux Symptom Index (RSI) for laryngopharyngeal reflux (LPR). Methods: All included patients attending the Department of Otolaryngology at the Sixth Medical Center of the PLA General Hospital from February 2022 to August 2022, completed the RSS and the RSI and underwent 24‐hour hypopharyngeal‐esophageal multichannel intraluminal impedance‐pH (24 h HEMII‐pH) monitoring. The results of 24 h HEMII‐pH were used as a diagnostic criterion for LPR, consistency between two questionnaires (RSS, RSI) and 24 h HEMII‐pH was compared by the weighted Cohen's kappa statistic and the screening value of RSS and RSI for LPR was compared by receiver operating characteristics analysis. Results: A total of 77 patients, 58 males, and 19 females, were included. The Kappa values of between RSS, RSI, and 24 h HEMII‐pH were 0.663 (p < 0.001) and 0.213 (p < 0.05), respectively. The sensitivity of RSS and RSI were 92.8% and 48.2%, respectively, the specificity was 71.4% and 80.9%. The negative predictive value and positive predictive value of RSI were 36.9%, 87.1%, and that of RSS were 78.9%, 89.6%. The area under curve of the RSS (0.783; 95% CI = 0.53, 0.75) is significantly higher than RSI (0.633; 95% CI = 0.72, 0.90). Conclusion: The RSS has a higher consistency and better screening value for LPR compared to RSI. In addition, the RSS includes more reflux symptoms, which may reduce the number of missed diagnoses in patients with LPR to some extent. Level of Evidence: 3 Laryngoscope, 133:2104–2109, 2023 [ABSTRACT FROM AUTHOR]

Copyright of Journal of Techniques is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Along with the increasing demand for access to data and information, the shares of telecommunication issuers are projected to become one of the resilience sectors. This study analyzes the sell signals and buy signals of the telecommunications shares listed on the IDX for the period 2019 to September 2021. The population is 18 issuers and the sample is 12 issuers selected using purposive sampling technique. This study uses a descriptive quantitative approach, in the form of analyzing, describing and summarizing phenomena from the data obtained through historical data observations. The aim is to describe in full and in depth the phenomenon under study. The results showed that 4 issuers gave a buy signal and 5 issuers showed that they had not yet shown a definite signal (recommended to hold), while 3 issuers seemed overbought and showed a sell signal. These results indicate that telecommunication stocks tend to be in demand and have good prospects. However, the RSI indicator is most reliable when adjusted for the long-term trend of stock price movements. This makes investors need to be careful to review further whether the signal shown is just a false signal or is a buy-sell signal.

From the perspective of portfolio management, hedging is a proactive risk management measure that aims to protect the portfolio from unwanted drawdown risk and avoid loss on investment by incorporating assets into a portfolio which moves in the opposite direction as the market. However, trying to limit the risk could result in limiting potential profits. Commodities are one of the best hedges against inflation as their price typically accelerates during such times providing benefit to the investor. We use the innovative approach of hedging commodities using a combination of CAPM and RSI Strategy to identify which of 9 observed hard commodities (Aluminium, Zinc, Nickel, Lead, Tin, Copper, Gold, Brent Oil and Natural Gas) should have been incorporated into investment portfolio during the period 2008-2023. The SML strategy is reviewed in the empirical analysis for its suitability as a hedging instrument compared to the RSI, which is regularly used to hedge metals and commodities. Our MS Excel and IBM SPSS software analysis showed that RSI was a better hedging strategy than SML in 21 out of 36 cases but without statistical significance. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to analyze the characteristics of laryngopharyngeal reflux (LPR) by using narrow band imaging (NBI) endoscopy. Study Design: A prospective study. Setting: A large‐volume practice with tertiary care providers. Methods: A total of 67 patients with suspected LPR who underwent 24‐hour multichannel intraluminal impedance–pH monitoring were included from June 2020 to March 2022. Manifestations of NBI endoscopy included submucosal clustered brownish microvessels (CBMs), spotted brownish microvessels, and no special microvessels; the latter 2 formed the non‐CBM group. The manifestations of all patients and their changes were observed after 8 weeks of proton pump inhibitor and symptomatic treatment for patients with LPR, and symptomatic treatment for patients without LPR. Results: According to the results of 24‐hour multichannel intraluminal impedance–pH monitoring, the incidence of submucosal CBMs was significantly higher in patients with LPR (30 cases) than in those without LPR (37 cases, P <.001), particularly in the posterior cricoid area (P <.001). Besides Reflux Finding Score, the incidence of signs such as subglottic edema and vocal fold edema was significantly higher in the CBM group than the non‐CBM group (P <.05). Finally, 22 patients with LPR (91.7%) and only 2 patients without LPR (28.6%) underwent a transformation from CBMs to spotted brownish microvessels after continuous medication for 8 weeks in the CBM group (χ2 = 15.916, P <.001), while no significant change was observed in patients with or without LPR in the non‐CBM group (P >.05). Conclusion: Submucosal CBMs in the posterior cricoid area under NBI endoscopy may be a characteristic of LPR. Level of Evidence: 4. [ABSTRACT FROM AUTHOR]

Endotracheal intubation (ETI) is a high-risk procedure commonly performed in emergency medicine, critical care, and the prehospital setting. Traditional rapid sequence intubation (RSI), the simultaneous administration of an induction agent and muscle relaxant, is more likely to harm patients who do not allow appropriate preparation and preoxygenation, have concerning airway anatomy, or severe hypoxia, acidemia, or hypotension. Ketamine, a dissociative anesthetic, can be used to facilitate two alternatives to RSI to augment airway safety in these scenarios: delayed sequence intubation – the use of ketamine to allow airway preparation and preoxygenation in the agitated patient; and ketamine-only breathing intubation, in which ketamine is used without a paralytic to facilitate ETI as the patient continues to breathe spontaneously. Ketamine may also provide hemodynamic benefits during standard RSI and is a valuable agent for post-intubation analgesia and sedation. When RSI is not an optimal airway management strategy, ketamine’s unique pharmacology can be harnessed to facilitate alternative approaches that may increase patient safety.

Abstract Background Pre hospital emergency anaesthesia (PHEA) is a complex procedure with significant risks. First-pass intubation success (FPS) is recommended as a quality indicator in pre hospital advanced airway management. Previous data demonstrating significantly lower FPS by non-physicians does not distinguish between non-physicians operating in isolation or within physician teams. In several UK HEMS, the role of the intubating provider is interchangeable between the physician and critical care paramedic—termed the Inter-Changeable Operator Model (ICOM). The objectives of this study were to compare first-pass intubation success rate between physicians and critical care paramedics (CCP) in a large regional, multi-organisational dataset of trauma PHEA patients, and to report the application of the ICOM. Methods A retrospective observational study of consecutive trauma patients ≥ 16 years old who underwent PHEA at two different ICOM Helicopter Emergency Medical Services in the East of England, 2015–2020. Data are presented as number (percentage) and median [inter-quartile range]. Fisher’s exact test was used to compare proportions, reported as odds ratio (OR (95% confidence interval, 95% CI)), p value. The study design complied with the STROBE (Strengthening The Reporting of Observational studies in Epidemiology) reporting guidelines. Results In the study period, 13,654 patients were attended. 674 (4.9%) trauma patients ≥ 16 years old who underwent PHEA were included in the final analysis: the median age was 44 [28–63] years old, and 502 (74.5%) were male. There was no significant difference in the FPS rate between physicians and CCPs—90.2% and 87.4% respectively, OR 1.3 (95% CI 0.7–2.5), p = 0.38. The cumulative first, second, third, and fourth-pass intubation success rates were 89.6%, 98.7%, 99.7%, and 100%. Patients who had a physician-operated initial intubation attempt weighed more and had a higher heart rate, compared to those who had a CCP-operated initial attempt. Conclusion In an ICOM setting, we demonstrated 100% intubation success in adult trauma patients undergoing PHEA. There was no significant difference in first-pass intubation success between physicians and CCPs.

Textile dyeing industries are regarded as one of the most polluting by virtue of the chemicals used and wastewater released. A great deal of chemicals, fasteners, dispersing agents is employed in the stages of dyeing and finishing. The aim of the study was to evaluate scaling and corrosion tendency of polyester textile dyeing effluent using Langelier saturation index (LSI), Ryznar stability index (RSI), and aggressiveness index (AI). The estimation of water stability indices helps in assessing the scaling and corrosive nature of wastewater which in turn facilitates evaluating the condition of the pipelines and valves. Wastewater released from textile dyeing units contains high levels of color (892 ± 20Pt-Co), chemical oxygen demand (2461 ± 48.45 mg/L), electrical conductivity (2906 ± 5.77 μS/cm), and sulfate (6620 ± 7.22 mg/L). The LSI ranged from 2.12 to 3.45, RSI varied from 2.84 to 5.62, and AI varied from 13.67 to 14.99. It was found from the results that the polyester textile dyeing effluent was scaling and non-aggressive. Also, the pipes containing this effluent have to undergo regular maintenance so that they are not blocked by scales which can render financial losses to the industry. [ABSTRACT FROM AUTHOR]

In 2020 and 2021, the cryptocurrency market attracted millions of new traders and investors. Lack of regulation, high liquidity, and modern exchanges significantly lowered the entry threshold for new market participants. In 2021, over 5 million Americans were regularly involved in cryptocurrency trading. At that time, the interest in market indicators and trading strategies remained low, leading to the conclusion that most investors did not use decision-support indicators. The correct and backtested use of technical analysis signals can give the trader a significant advantage over most market participants. This work introduces an algorithmic approach to examining the effectiveness of the signals generated by one of the most popular market indicators, the Relative Strength Index (RSI). A model corresponding to an actual cryptocurrency exchange was used to backtest the strategies. The results show that the RSI as a momentum indicator in the cryptocurrency market involves high risk. Using alternative RSI applications can allow traders to gain an advantage in the cryptocurrency market. Comparing the results with the traditional buy and hold strategy shows the credible potential of the indicated method and the usage of signals generated by the technical analysis indicators. [ABSTRACT FROM AUTHOR]

Volume increment is one of the main concerns in forestry practice. The aim of our study was to examine the impact of factors influencing the periodic annual increment of oak. To meet our objective, we used measurement data from the national forest inventory in Poland from 2005 to 2019 for oak-dominated stands. Our study used data of 1464 sample plots with dominant oak species (Quercus sessilis Ehrh. ex Schur and Quercus robur L.) measured within the national forest inventory in Poland. We developed models explaining the dependence of the periodic annual volume increment on stand characteristics using the generalized additive model. The generalized additive model allows us to analyze each variable's effect on the dependent variable, with all other variables fixed. We documented the effect of age, height, basal area, and relative spacing index (RSI) on the periodic annual volume increment (PAIv) of oaks in Poland. The PAIv of oaks decreased gradually as the tree aged. The dependence of the PAIv on stand density was shown through its relationship with the basal area and RSI. The developed model explained about 64.6% of the periodic annual volume increment variance. [ABSTRACT FROM AUTHOR]

Objective: To explore the diagnostic efficacy of pepsin concentration in saliva for laryngopharyngeal reflux (LPR) disease. Methods: In this study, we recruited 40 participants with abnormal sensation of throat into the study who visited our hospital from March 2020 to December 2020. The 24 h multichannel intraluminal impedance and pH monitoring (24 h MII-pH), reflux symptom index (RSI) and reflux finding score (RFS), pepsin concentration in saliva were collected. The Cohen's kappa test and receiver-operating characteristic (ROC) curves were performed to determine and compare the sensitivity and specificity of five diagnostic methods: RSI; RFS, pepsin concentration, RSI + RFS, RSI + RFS + pepsin concentration. Results: The area under the curve (AUC) of RSI, RFS, pepsin concentration, RSI + RFS, RSI + RFS + pepsin concentration were 0.767, 0.733, 0.870, 0.750,0.867, respectively. That is, the pepsin concentration has maximum AUC (the cutoff point is 219.47 (ng/mL); the sensitivity and 1-specificity is 0.300, 0.933, respectively.). The positive predictive value was 90.3% (28/31), and the negative predictive value was 77.8% (7/9). The Cohen's kappa coefficients of the five diagnostic subgroups were: RSI 0.486 (95% CI 0.207–0.764, P = 0.001); RFS 0.333 (95% CI 0.021–0.644, P = 0.032); RSI + RFS: 0.517 (95% CI 0.205–0.829, P = 0.001); pepsin concentration: 0.699 (95% CI 0.379–0.931, P = 0.001); RSI + RFS + pepsin concentration: 0.500 (95% CI 0.181–0.819, P < 0.001). Conclusion: The pepsin concentration has the maximum AUC area and highest consistency with the 24 h MII-pH. Therefore, it has certain value in the screening and diagnosis of diseases related to LPR disease. [ABSTRACT FROM AUTHOR]

Background: There is conflict in the literature addressing the role of paramedics in the outcomes and potential complications of rapid sequence induction (RSI) in pre-hospital settings. Objective: This review aims to describe the common indications, complications, anesthetic agents, and success rate of RSI, as performed by paramedics at a pre-hospital setting. Method: This scoping review utilized the PRISMA® flow diagram to guide the literature searching process across multiple resources. MEDLINE, Google Scholar, and PubMed search engines were accessed and searched for related articles using different combinations of keywords. The quality of the selected articles was assessed via the critical appraisal skills program. Results: Twenty-seven articles were included in this review. The main indication of RSI was the loss of consciousness due to different physical disorders. Potential complications include hypoxia, hypotension, and hypo-/hypercapnia. Anesthetic agents ketamine and succinylcholine were extensively used. Success rates of RSI, if performed by paramedics, ranged from 45% to 92%. Conclusion: Endotracheal intubation (ETI) with RSI has various indications and sedative agents that, if used appropriately, increase the victim's survival rates. Also, ETI with RSI is associated with several complications and challenges that affect the success rate, especially for the first intubation attempt. [ABSTRACT FROM AUTHOR]

Laryngopharyngeal Reflux Disease (LPRD) is form of extra-oesophageal reflux due to the backflow of gastric contents into the upper aero digestive tract leading to throat symptoms. World over, the prevalence rate of LPRD, ranges from 5 to 30%. The aim of this study was to find the prevalence rate of LPRD in Indian population. This was an observational study whereby the RSI questionnaire was circulated amongst the population and records collected. All subjects who had RSI score more than 13 were considered to be suffering from LPRD. 2300 responses were collected from almost all strata of population. Out of 2300 people who responded 253 had RSI score > 13, and were considered as suffering from LPRD. Thus the prevalence rate of LPRD in population was 11%. The prevalence rate of LPRD in females was 11.2% and in males was 10.6%. The difference in prevalence among both the genders was not significant.The most common symptom of LPR reported by subjects was heartburn followed by clearing of throat and excess throat mucous. The prevalence of LPRD in Indian population as assessed by RSI score > 13 was 11%. The prevalence is same in males and females. [ABSTRACT FROM AUTHOR]

LPRD is a common condition in patients attending ENT OPDs. Although esophageal manometry and 24 h pH monitoring is considered the gold standard for diagnosis, it is an expensive and time consuming investigation. Newer clinical scales have been developed for diagnosing LPR such as RSI, RFS, Carlsson-Dent, ReQuest, GerdQ, etc. The objective of the study is to compare RSI with RFS and to establish its effectiveness in diagnosing LPRD among OPD patients. It's a descriptive cross-sectional study. ENT outpatients with features of LPRD were asked to fill RSI proforma (score ≥ 13 abnormal), after which they were subjected to indirect laryngoscopy to obtain the RFS (score ≥ 7 diagnostic of LPRD). RSI was compared with RFS. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of RSI were noted. Of 165 patients, 53.9% were females. Mean RSI scores in males and females were 11.9 and 11.5 and mean RFS scores were 6.4 and 5.7 respectively. RSI had 79.1% sensitivity and 83.7% specificity in diagnosing LPRD with PPV 76.8%, NPV 85.4% and accuracy 81.8% (Chi square value 64.5, p ≤ 0.01). There was substantial agreement between RSI and RFS (Cohen's kappa: 0.625, p ≤ 0.0001). RSI is a simple tool to diagnose LPRD which doesn't mandate invasive procedures such as endoscopy or esophageal manometry. Hence it can be used effectively to diagnose LPRD in ENT outpatients and start the treatment at the earliest. [ABSTRACT FROM AUTHOR]

A multidisciplinary geomechanical method to evaluate and quantify rockfall hazards in rock slopes equipped for sport climbing is presented. This method exploits close-range survey data obtained from terrestrial laser scanner (TLS) and unmanned aerial vehicle-based digital photogrammetry (UAV-DP) and integrates them with traditional scanline survey data collected in the field. Based on the acquired information, a kinematic analysis is performed to predict the location of structurally controlled rock failure mechanisms. An index denoted as route stability index (RSI) is then proposed to quantify the associated hazard along sport climbing routes in the study area. In addition, hazard is also assessed at the overall slope scale. The method was successfully applied at an abandoned climbing site historically affected by rockfalls, 5 km north of Florence (Italy). RSI can be adopted as part of the planning and monitoring strategies for the management of risk related to outdoor climbing activities, which are becoming an important part of Italian and European geo-tourism. [ABSTRACT FROM AUTHOR]

Ángela María Muñoz,1,2 Manuela Estrada,1 Jaime A Quintero,1– 3 Mauricio Umaña1 1Emergency Department, Fundación Valle del Lili, Cali, 760032, Colombia; 2Universidad ICESI, Emergency Medicine Residency, Cali, Colombia; 3Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, 760032, ColombiaCorrespondence: Jaime A Quintero; Mauricio Umaña Email jaime.quintero.ra@fvl.org.co; mauricio.umaña@fvl.org.coBackground: The rapid intubation sequence is advanced airway management that effectively ensures an adequate supply of oxygen in critically ill patients. The medical personnel in the emergency department performed this procedure.Objective: To describe the main characteristics of the rapid intubation sequence in an emergency department of a high complexity hospital.Methods: This is a descriptive, cross-sectional, retrospective study. We included all older patients with a rapid intubation sequence requirement in the emergency department from 2014 to 2017. We used central tendency measures for numerical variables and proportions for categorical variables.Results: A total of 401 patients were eligible for this analysis. The main indication for intubation was the Glasgow Coma Scale = < 8 in 170 patients (42.4%), followed by hypoxemia in 142 patients (35.4%). In 36 patients, at least one complication occurred. RSI was performed in 54.4% by emergency physician. RSI was successful on the first attempt in 90.5%. Only 36 patients (9%) presented complications.Conclusion: In this study, we found that the rapid intubation sequence was not related to a high proportion of complications. Perhaps, this is attributed to the degree of medical training and the use of emergency department protocols in our hospital.Keywords: intubation, sequence, rapid intubation, emergencies, RSI

Managing the health and wellbeing of full-time professional athletes is a multifaceted task. In elite high-performance environments, medical staff and strength training coaches attempt to identify improved methods to monitor player health. Monitoring player health could indicate potential injury risk and assist in adjustments to training and workload management. Measuring fatigue is a notable component of monitoring player readiness before and after training sessions, and after competitive fixtures. In the present study, a novel method of gathering non-invasive player data was investigated by utilizing the Omegawave (OW) to monitor direct current (DC) potential brainwave activity. This method allowed for non-invasive data gathering to assess recovery, player readiness and indicators of workload that may affect optimal performance. DC potential is based on recording low electrical frequencies (>0.5 Hz) that is derived from (1) Stabilization point of DC potential (mV), (2) Stabilization time (1.0–7.0) and (3) Curve shape (1.0–7.0). These measures evaluate the athlete's internal stress, readiness to perform, and neurological function through DC potential brain wave activity and heart rate variability (HRV) assessments. The primary aim of this case series was to compare the efficacy of objective DC potential brainwave activity measurements (neurological function) with neuromuscular fatigue data using reactive strength index modified (RSImod) and profile of mood states (POMS) questionnaires to assess a player's state of readiness to train. The participants in this study were eleven male senior professional rugby union players with a mean stature (±SD) of 185.2 ± 8.6 cm, mass of 101.1 ± 12.9 kg, and age of 27.1 ± 2.1 years. All players were tested 3 days per week over a 6-week mid-season period. Results from this case study suggest that DC potentials could be used as an objective measure to indicate player readiness and managing individual player workload. The final analyses identified a weak negative correlation (r = −0.17) between the RSImod data and the DC potential data was observed. DC potential brainwave activity data could be used in conjunction with subjective measures such as POMS, RSImod and reported injury status to adjust player daily activity.

Background: Pre hospital emergency anaesthesia (PHEA) is a complex procedure with significant risks. First-pass intubation success (FPS) is recommended as a quality indicator in pre hospital advanced airway management. Previous data demonstrating significantly lower FPS by non-physicians does not distinguish between non-physicians operating in isolation or within physician teams. In several UK HEMS, the role of the intubating provider is interchangeable between the physician and critical care paramedic—termed the Inter-Changeable Operator Model (ICOM). The objectives of this study were to compare first-pass intubation success rate between physicians and critical care paramedics (CCP) in a large regional, multi-organisational dataset of trauma PHEA patients, and to report the application of the ICOM. Methods: A retrospective observational study of consecutive trauma patients ≥ 16 years old who underwent PHEA at two different ICOM Helicopter Emergency Medical Services in the East of England, 2015–2020. Data are presented as number (percentage) and median [inter-quartile range]. Fisher's exact test was used to compare proportions, reported as odds ratio (OR (95% confidence interval, 95% CI)), p value. The study design complied with the STROBE (Strengthening The Reporting of Observational studies in Epidemiology) reporting guidelines. Results: In the study period, 13,654 patients were attended. 674 (4.9%) trauma patients ≥ 16 years old who underwent PHEA were included in the final analysis: the median age was 44 [28–63] years old, and 502 (74.5%) were male. There was no significant difference in the FPS rate between physicians and CCPs—90.2% and 87.4% respectively, OR 1.3 (95% CI 0.7–2.5), p = 0.38. The cumulative first, second, third, and fourth-pass intubation success rates were 89.6%, 98.7%, 99.7%, and 100%. Patients who had a physician-operated initial intubation attempt weighed more and had a higher heart rate, compared to those who had a CCP-operated initial attempt. Conclusion: In an ICOM setting, we demonstrated 100% intubation success in adult trauma patients undergoing PHEA. There was no significant difference in first-pass intubation success between physicians and CCPs. [ABSTRACT FROM AUTHOR]