bluuebunny/crossref_metadata_2025 huggingface dataset:
Injuries in the landscape: The Suseni quarry – A case study from Transylvania, Romania
Authors: Lihăt Ildikó , Ványolos Endre , Henning Anna Imola , Hegedüs Noémi Melitta , Szekely-Varga Zsolt , Kentelky Endre
Published: November 2023

Mining and quarrying operations exert a substantial influence on both the environment and nearby communities. Plenty of them can be found in mountainous areas of Transylvania. These activities, which involve the excavation of expansive open pits and the disruption of soil and vegetation, can lead to adverse consequences such as soil erosion, deforestation, habitat degradation, and water contamination. Mining and quarrying operations carry notable consequences for both the environment and the nearby communities. The interventions of contemporary humans have changed the landscape on an unprecedented scale. The signs of human involvement are apparent in numerous locations in the Giurgeului Depression; the Suseni quarry site is an example of a place that necessitates a comprehensive rehabilitation plan.
Effect of Machining on Mechanical Properties of Borosilicate Glasses
Authors: Václavek Lukáš , Tomáštík Jan , Čtvrtlík Radim
Published: November 2023

Although optical properties are essential for materials for optical purposes, their mechanical properties must also be considered as they directly govern their practical applicability as well as their machining. The machining of optical glasses is mainly carried out by mechanical removal of the material using free or bonded abrasives. The relationship between the local mechanical properties of three types of borosilicate glasses used to produce optical elements (mirrors) and the type of surface machining was investigated. The samples were machined using two approaches, namely 7-axis CNC surface machining and conventional manual machining. Advanced analysis of nano/micro-mechanical properties was performed on glass samples using quasi-static nanoindentation and microindentation and dynamic impact test complemented by the analysis of the acoustic emission signals generated during the mechanical tests.

The results show a difference in mechanical properties between industrial and optical borosilicate glasses. The type of machining has a strong influence on studied mechanical properties and surface quality. Glasses manufactured by CNC have more pronounced acoustic emission signal and crack more than glasses manufactured by hand. The different behavior of hand- and CNC-machined surfaces can be linked to different subsurface damage caused by different contact conditions between the workpiece and the instrument/abrasive. As a result, a different density of surface and especially (near)-subsurface flaws are present in the glass. Simax is slightly softer than BG33 glass, which together with the less pronounced AE may indicate a lower amount of subsurface cracks/damage.
Revolutionizing the Building Envelope: A Comprehensive Scientific Review of Innovative Technologies for Reduced Emissions
Authors: Narbuts Jānis , Vanaga Ruta
Published: November 2023

This paper reviews innovative building envelope technologies that can improve total building energy efficiency and reduce greenhouse gas emissions. The building envelope has a significant impact on energy and thermal performance, making various technologies like phase change materials, aerogel, and active and adaptive systems essential for enhancing the building envelope’s energy efficiency. Phase change materials reduce energy consumption by lowering peak heating and cooling loads, improving thermal comfort. Paraffin wax is considered the most dependable phase change material for building envelopes, as it can decrease energy consumption for heating and cooling. Study shows that active PCM thermal energy storage system can reduce room temperature by 6.8 °C in summer. Aerogel, in comparison, is recognized for its exceptional insulation capabilities and low density that minimize heat transfer and boost thermal insulation in buildings. Silica aerogel’s outstanding feature is its capacity to offer thermal performance that surpasses traditional insulation materials by 2–4 times, thereby delivering substantial energy savings of up to 35 %. Active and adaptive systems, such as smart windows and kinetic facades, enable real-time control of building envelope performance, improving energy efficiency and indoor comfort. Smart windows can lead to annual energy savings up to 35.9 kWh/m2 compared to traditional windows, and kinetic facades can reduce cooling loads for buildings up to 21 %. The review assesses various adaptive facade solutions for their suitability in diverse climate zones, versatility in application and energy efficiency. Despite the existence of some limitations and challenges, such as high costs and insufficient understanding of their long-term performance, the continuous development and deployment of these technologies can still yield a significant contribution to improving building energy efficiency and mitigating greenhouse gas emissions.
Recent management of extrapyramidal syndrome in antipsychotic use
Authors: Farahmadilah Reisha , Amris Fazil
Published: November 2023

Antipsychotic drugs are crucial for treating mental illnesses but can cause various side effects due to their non-selectivity and high affinity. A study has shown that the prevalence of extrapyramidal side effects among patients with schizophrenia spectrum disorder on antipsychotic medication was 42.6%, with specific side effects including tardive dyskinesia, parkinsonism, and akathisia. These symptoms can significantly impact individuals' quality of life, so effective management is crucial to minimize their impact. Recent advances in the management of EPS include the use of atypical/second-generation antipsychotics and anticholinergic medications. These have been shown to be effective in managing EPS and have a better safety profile than first-generation antipsychotics. Other important strategies for managing EPS include using lower doses of antipsychotics, combination therapy, anticholinergic drugs, and non-pharmacological interventions such as physical therapy, lifestyle modifications, andaddressing potential non-adherence to treatment.
Analysis of cardiovascular risk factors as predictors for coronary artery disease stenosis severity
Authors: Abduh Saugi , Rizaldy Rheza
Published: November 2023

The risk factors for coronary artery disease (CAD) include age, hypertension, diabetes mellitus (DM), total cholesterol levels, smoking status, and obesity, with central obesity being of particular concern. However, there is a lack of research on the connection between CAD risk factors and the severity of stenosis in the Indonesian population, specifically in Central Java, as assessed by the Gensini score. The purpose of this study was to analyze hypertension, diabetes mellitus, total cholesterol levels, smoking status, body mass index (BMI), and waist circumference (LP) as predictors of the severity of CAD stenosis assessed using the Gensini score. A cross-sectional study was conducted on CAD patients at RSI Sultan Agung for the period of 2018-2021. The risk factors for CAD studied were age, gender, blood glucose (GDS), blood pressure, total cholesterol, smoking status, BMI, and LP. The degree of stenosis was grouped using gensini score into severe stenosis if the vessel narrowing was 40% and mild-moderate if  ≤40%. The data were analyzed using logistic regression test. Gender, smoking status, BMI, and LP had a significant relationship to the severity of stenosis as assessed using the Gensini score. The results of multivariate analysis showed that gender, smoking status, BMI, and LP could increase the risk of CAD with the severity of severe stenosis as much as 2,774; 1,959; 2,269; and 1,883 times respectively. Gender, smoking status, BMI, and LP can be used as predictors of the severity of coronary artery disease stenosis as assessed using the Gensini score.
The effect of progressive muscle relaxation (PMR) therapy on the anxiety levels of type 2 diabetes mellitus patients at Universitas Sebelas Maret Hospital
Authors: Sari Mulia , Indriati Maria Rini , Septiawan Debree
Published: November 2023

Introduction: Diabetes mellitus (DM) is one of the most common chronic metabolic diseases. Diabetic patients suffer from anxiety almost twice as much as the general population. Progressive Muscle Relaxation (PMR) is a systematic technique that can be used to achieve a state of deep relaxation.Objective: To determine the effect of PMR therapy on the anxiety levels of type 2 diabetes mellitus patients at Universitas Sebelas Maret Hospital.Methods: A quasi-experimental group design study was conducted at the Internal Medicine Outpatient Clinic at Universitas Sebelas Maret Hospital in April 2022–May 2022. This study used a purposive sampling technique with a total sample of 19 subjects in the intervention group and 19 subjects in the control group. The instrument used to assess anxiety is the Hamilton Anxiety Rating Scale (HARS). The intervention uses PMR videos, which were carried out at least twice per week for a month.Results: The parametric test showed a significant effect of PMR therapy on the anxiety levels of type 2 diabetes mellitus patients (Z = -3.675; p value (Asymp. sig. 2-tailed) = 0.001).Conclusion: There was an effect of PMR on anxiety, and the intervention group experienced more reduction in anxiety levels than the control group in type 2 diabetes mellitus patients at Universitas Sebelas Maret Hospital.
The application of ergonomics to improve work productivity
Authors: Salawati Liza , Abbas Ibnu
Published: November 2023

Ergonomics in the workplace is an aspect that must be considered, because it has potential hazards such as work position, inappropriate body posture when doing work, design of work tools, workplaces that are not in accordance with labor anthropometry, and lifting loads that exceed work capacity. By implementing ergonomics in the workplace, a safe and comfortable work system, work environment, and work equipment will be created for all workers. So that workers can avoid injury or accidents while working, but it can also avoid occupational diseases. Therefore, work facilities must be designed ergonomically so that it has an impact on increasing work productivity.
The relationship between pesticide exposure and neuropathy in farmers in Wuluhan district
Authors: Graciella Cindy , Narwanto Muhammad Ihwan , Jauhani Muhammad Afiful
Published: November 2023

Farmers rely heavily on pesticides to protect crops from pests. Pesticides exposure will inhibit the acetylcholinesterase enzyme and will cause cholinergic symptoms which manifest as neuropathy. The research was conducted in March-April 2023 in Wuluhan District, Jember Regency. Pesticide exposure was evaluated through interviews using a pesticide exposure questionnaire, while neuropathy was evaluated through interviews and physical examination using the Diabetic Neuropathy Symptom Score-Indonesian version (DNS-Ina) and Diabetic Neuropathy Examination-Indonesian version (DNE-Ina) questionnaires. Univariate data analysis and bivariate analysis using the Chi-Square test. The results of this study showed that most of the study subjects had worked 10 years, the frequency of using pesticides ≤2 times per week, the duration of using pesticides ≤3 hours per day, the use of PPE is lacking. Bivariate analysis showed that neuropathy occurred in the farmer group, and there was a significant relationship between length of service and neuropathy, as well as the completeness of PPE use and neuropathy. However, there was no relationship between the frequency of pesticide use and neuropathy and the duration of pesticide use and neuropathy. The conclusion of this study is that the variable length of service and the completeness of the use of PPE have a relationship with the symptoms of neuropathy in farmers. While the variables of frequency and duration of use of pesticides are not related to neuropathy in farmers.
AN IMPORTANT ELEMENTS IN PROMOTING READING COMPREHENSION
Authors: Artayasa I Kadek , Ni Komang Dwi Eka Yuliati
Published: November 2023

Reading is a strong foundation that must be instilled in the early grades and is the key to successful learning in subsequent classes. The essence of reading is to understand what is being read. This study aims to analyze important elements in improving the teaching of reading for comprehension. This research is qualitative research with a descriptive approach. The stages passed in this research begin with planning, research, implementation, data analysis, and then writing reports. The subjects in the study were two supervisors, two literacy coaches, two principals and six early-grade teachers. The results of interviews and observations explain that there are nine important elements in improving the teaching of reading for understanding. Some of those things are getting into the habit of making connections between the book and the outside world.
EXAMINING EDUCATORS' STRATEGIES IN TEACHING ENGLISH FOR SPECIFIC PURPOSES: A CASE ANALYSIS
Authors: Devinka Nandya Putri Kirani  , Savitri Wiwiet Eva
Published: November 2023

The effectiveness of English language teaching in the classroom can be influenced by a multitude of factors, and among these, the teaching style employed by the teacher is a critical determinant that can significantly impact the success of the learning activities. This study aims to investigate the types of teaching strategies employed by English teachers in teaching English in vocational high schools, specifically under the implementation of the Merdeka Curriculum launched by the Indonesian Ministry of Education. A qualitative research approach has been adopted, and data collection will be done through two main techniques: classroom observation and interviews. The results showed that both teachers implemented lecturing and small group discussions as their primary teaching strategies. The study also revealed the need for English lessons to be more specific to a topic that is closely related to students' majors, as highlighted by previous research. Moreover, the study revealed that different learning topics necessitate different teaching strategies, and using multiple strategies can enhance learning outcomes.
USING COOPERATIVE LEARNING MODEL WITH PEER TUTORS TO IMPROVE UNDERGRADUATE STUDENTS' READING ACHIEVEMENT
Authors: Superjaya I Gede
Published: November 2023

This research is aimed to improve students' reading achievement by implementing cooperativelearning with peer tutors in the learning process. The subjects of this research were the students of XI MIPA 1of SMA Negeri 1 Pupuan studying reading in the English subject in academic year 2022/2023. The data of thisresearch were collected using a reading test. The result of this reasearch was analyzed by using descriptiveanlysis. The study found that students achieved improvement in reading achievement after being taught usingcooperative learning with peer tutor method. The improvement was signified by the increase of the students'mean scores from the preliminary study to the end of the second cycle. Students' initial mean score was 69with 30,77% of completion in preliminary study. Students' mean score increased to 74 with the total numberof mastery learning of 61,54% after the first cycle. In the second cycle it had increased into 76,81 with 88,64%of mastery learning. The data analysis implies that the implementation of cooperative learning model with peertutor has been able to increase the reading achievement of the students in XI MIPA 1 of SMA Negeri 1 Pupuan.
Comparative Evaluation of Three Rotary Retreatment Systems for Apical Extrusion of Root Canals Obturated with Different Techniques
Authors: S. Kamil Saif , A. Al-Sabawi Nawal
Published: November 2023

The aim of this study was to evaluate the quantitative amount of apically extruded debris after endodontic retreatment using three retreatment rotary systems D-RaCe, R-Endo, and EdgefileXR in the teeth obturated by two techniques (single cone and continuous wave compaction). Sixty human mandibular premolars with single straight root canals were prepared by 2Shape endodontic rotary system with file size (25/0.04). After that, samples were divided into two groups according to the technique of obturation used (n=30/group): A: single cone and B: continuous wave compaction. Then, further random subdivision for each group into three sub groups according to the system used for retreatment (n=10/group) as follow: A1,B1:D-RaCe, A2,B2:R-Endo, and A3,B3: EdgefileXR. Preweighed Eppendorf tubes were used to collect the apical extruded material during endodontic retreatment. Then, Eppendorf tubes were stored in an incubator at 68C for 5 days. The weight of extruded debris was calculated by subtracting the weight of the empty tube from the weight of the tube containing the extruded debris. Data were analyzed statistically using one way ANOVA analysis of variance and post hoc Duncan test. EdgeFileXR and R-Endo were significantly not different, but significantly different from D-race in two obturation technique. Also, result showed that the same system exhibited no difference in both obturation techniques. All retreatment techniques resulted in apical extrusion debris. Also, it was concluded that the techniques of obturation had no significant effect in the amount of apical extruded debris by different retreatment systems used in this study.
Distribution of Misdiagnostic Maxillofacial Nonmalignant Lesions and Conditions in Salah Alden Government
Authors: Ali Tuma Noori
Published: November 2023

Diagnosis is the corner stone & entry to the treatment of lesions or conditions. Because misdiagnosis leads to incorrect treatment. It is very important to understand the distribution between the most common misdiagnosis nonmalignant lesions& conditions in the maxillofacial region as apart of whole misdiagnosis. Decrease patient complaining. Evaluate the most common misdiagnosis lesions& conditions in maxillofacial region. Decrease load to hospitals& clinics& decrease infections. The data collected by standardized formula for all patients& different patient clinical, radiological examination & methods used to confirm the diagnosis. Total no. are 30 patients, misdiagnosis lesions& conditions 13% (Sinusitis or dental pain), 20% (submandibular Lymphadenitis. or Sialadenitis), 20% (Otalgia). 10%(Psychopath),10%(Trigeminal neuralgia) ,7%(migraine) ,7%( maxillary sinusitis),13%(submandibular saialidinitis). the true diagnosis was 13%,( Oroantral fistula),20%(oro-Cutaneous fistula),20%(Tmj pain),10%(Tmj dislocation),10%(dental pain),7%(dental pain),7%(Maxillary sinus cyst),13%(submandibular Salivary gland stone). The more unorganized medical &or surgical branches interference within region may lead to these misdiagnosis results. Poor educated patients, doctor’s decision with inadequate examination& investigation participate in increase patients complaining.
ANALISIS KESALAHAN SISWA SMPN 2 TELUKJAMBE TIMUR DALAM MENJAWAB SOAL TIMSS BERDASARKAN PROSEDUR NEWMAN
Authors: Imanudin Defa , Sutirna Sutirna
Published: November 2023

Penelitian ini bertujuan untuk menjelaskan apa saja yang jenis kesalahan yang dilakukan siswa dalam menyelesaikan soal TIMSS dengan menggunakan metode analisis kesalahan Newman. Subjek dalam penelitian adalah siswa kelas VIII-J SMPN 2 Telukjambe Timur. Jenis penelitian dilakukan dengan menggunakan penelitian deskriptif dengan pendekatan kualitatif. Pengumpulan data yang dilakukan dengan metode observasi, tes, dan wawancara. Analisis data yang digunakan menurut Miles dan Huberman yaitu dengan mereduksi data, lalu menyajikan data dan menarik kesimpulan. Hasil dari penelitian ini berdasarkan analisis kesalahan Newman menunjukan bahwa terdapat 18% kesalahan dalam jenis membaca soal, 13% kesalahan memahami soal, 15% kesalahan transformasi, 16% keterampilan proses dan 26% kesalahan dalam menuliskan/menyimpulkan jawaban. Faktor terjadinya kesalahan yang dilakukan oleh siswa adalah siswa kurang telitinya dalam menjawab soal, siswa tidak mencermati pertanyaan soal sehingga siswa tidak dapat menangkap maksud dari soal, kurangnya penguasaan konsep  oleh siswa, siswa juga terkadang ceroboh dan terburu-buru dalam menjawab soal sehingga mereka tidak melakukan pengecekan kembali terhadap jawabannya. Sebaiknya guru dapat mengajarkan siswa untuk lebih teliti dalam menjawab soal-soal sehingga tidak terjadi lagi kesalahan yang diakibatkan dari kecerobohan dan kurang teliti.
TIME SERIES MOVING AVERAGE BERBASIS WEB DENGAN SHINY R
Authors: Sauddin Adnan , Irwan Irwan , Astuti Astuti
Published: November 2023

Penelitian ini membahas mengenai pembuatan shiny R untuk analisis time series moving average berbasis web.  Adapun tujuan penelitian ini yaitu untuk mengetahui bagaimana cara membuat shiny R berbasis web untuk Moving Average. Hasil penelitian ini menghasilkan sebuah aplikasi shiny R yang berbasis web yang dapat digunakan untuk mengolah data time series. Nama aplikasi ini yaitu LSDA.  Aplikasi ini dapat dibuat dengan cara membuat script ui dan  server, kemudian mendeploy dan mengunggah aplikasi ke web. dari  semua tahap ini akan menghasilkan sebuah link. Link ini dapat dibagikan kepada orang lain melalui social media. Aplikasi ini dapat diakses  secara gratis serta dapat digunakan oleh semua kalangan tanpa harus mengunduh aplikasi R dan menguasai bahasa pemrograman
ANALISIS LITERASI MATEMATIS SISWA DALAM MENYELESAIKAN SOAL PISA KONTEN CHANGE AND RELATIONSHIP
Authors: Nurinayah Indira Novelia , Nur Iyan Rosita Dewi
Published: November 2023

Tujuan penelitian ini untuk mengetahui literasi matematis siswa dalam menyelesaikan soal PISA konten change and relationship. Penelitian ini merupakan penelitian kualitatif metode deskriptif. Pengambilan sampel yang digunakan pada penelitian ini adalah purposive sampling berjumlah 3 siswa. Penelitian ini menggunakan instrumen tes tulis PISA dan wawancara mengenai literasi matematis. Hasil penelitian ini diperoleh bahwa secara keseluruhan ketercapaian literasi matematis siswa memiliki presentase 29,62%. Berdasarkan kategori literasi matematis maka disimpulkan bahwa 1) siswa dengan kategori tinggi mampu menuntaskan 2 indikator kemampuan literasi matematis; 2) siswa dengan kategori sedang mampu menuntaskan 2 indikator kemampuan literasi matematis, tetapi siswa masih kesulitan dalam menafsirkan permasalahan soal; dan 3) siswa dengan kategori rendah hanya mampu menuntaskan 1 indikator kemampuan literasi matematis.
EFEKTIVITAS MODEL PROBLEM BASED LEARNING BERBANTUAN SLICE FRACTION TERHADAP KEMAMPUAN PEMECAHAN MASALAH MATEMATIKA PADA SOAL HOTS
Authors: Lestari IIn , Ardani Anwar
Published: November 2023

Kemampuan pemecahan masalah merupakan salah satu tujuan pembelajaran matematika yang harus dicapai siswa. Namun, permasalahan muncul terkait rendahnya kemampuan siswa dalam pemecahan masalah matematika. Salah satu solusi yang bisa diterapkan adalah dengan menggunakan model PBL berbantuan Slice Fraction. Tujuan dari penelitian ini adalah untuk mengetahui apakah kemampuan pemecahan masalah matematika siswa yang pembelajarannya menggunakan model PBL berbantuan Slice Fraction lebih baik daripada kemampuan pemecahan masalah matematika siswa yang pembelajarannya dengan model pembelajaran konvensional. Metode penelitian yang digunakan adalah pendekatan kuantitatif dengan jenis eksperimen. Populasi dalam penelitian ini adalah siswa kelas IV SDN Kaliwadas. Teknik sampling yang digunakan adalah probability sampling yaitu cluster sampling. Data dikumpulkan melalui tes dan observasi, yang kemudian dianalisis menggunakan uji independent sample t test. Hasil penelitian menunjukkan kemampuan pemecahan masalah matematika siswa yang pembelajarannya menggunakan model PBL berbantuan Slice Fraction lebih baik daripada kemampuan pemecahan masalah matematika siswa yang pembelajarannya dengan model pembelajaran konvensional.
PENGARUH METODE CERAMAH PLUS TANYA JAWAB DAN TUGAS (CPTT) TERHADAP KEMAMPUAN PEMAHAMAN KONSEP MATEMATIS DITINJAU DARI SELF-CONFIDENCE
Authors: Purwaningsih Dian , Ardani Anwar , Widodo An Nur Ami , Amalia Sofri Rizka
Published: November 2023

Penelitian ini bertujuan untuk mengetahui pengaruh metode Ceramah Plus Tanya jawab dan Tugas (CPTT) terhadap kemampuan pemahaman konsep matematis ditinjau dari self-confidence. Penelitian ini menggunakan metode quasi experimental design. Subyek Penelitian ini adalah mahasiswa jurusan Pendidikan Matematika Universitas Peradaban semester II Tahun Akademik 2022/2023 yang berjumlah 15 mahasiswa. Tempat penelitian dilakukan di Universitas Peradaban. Instrumen penelitian yang digunakan yaitu lembar observasi, lembar tes dan lembar angket. Berdasarkan hasil penelitian dijelaskan bahwa salahsatu faktor yang mempengaruhinya adalah faktor keaktifan dalam pembelajaran menggunakan metode Ceramah Plus Tanya jawab dan Tugas (CPTT). Hasil yang dapat dilihat pada tabel hasil interpretasi self-confidence mahasiswa memperoleh hasil yang paling banyak berada dalam kategori sedang.
Representasi sosiopat dalam web series korea it’s okay to not be okay
Authors: Prasetya Novi , Wibowo Tangguh
Published: November 2023

Web series It's Okay to Not Be Okay illustrates how people with mental health illnesses are still an issue that gets less attention in society. Ko Moon-young's character represents how a sociopath behaves and behaves in his environment with all his shortcomings in self-control. The purpose of this study is to show the representation of a sociopath in the web series It's Okay to Not Be Okay. This study uses a qualitative approach with a descriptive type of research to explain how a sociopath is described through the character of Ko Moon-young. This research uses representation theory with semiotic analysis technique from Charles Sanders Peirce with sign, object, and interpretant. From the results of research which shows that a sociopath thinks that is irrational, selfish, has no empathy, has no shame.
USO DE PROTETORES BUCAIS EM PACIENTES INTUBADOS NA UNIDADE DE TERAPIA INTENSIVA: UMA REVISÃO DE LITERATURA
Authors: Lucas Vasconcelos de Oliveira , Bruna Vieira Vilarinho , Jessyca da Silva de Araújo , Kaio Jordao Hipolito Gomes , Welington Hipolito de Oliveira Júnior , Jussara Ferreira Carvalho
Published: November 2023

Intubation is a medical technique that consists of placing a tube inside the trachea, orally or nasally, with the aim of maintaining definitive control of the airway. However, there may be complications such as laceration of the lips and gums, vocal fold avulsion, fracture and tooth avulsion. This literature review therefore aims to report the damage that is caused to dental structures, the factors that increase the risk of trauma in the intubation process and the methods that are used to prevent them. A literature review was performed through a search for articles in the Medline/PubMed database including 10 articles. Based on the analysis of the articles included, it can concluded that the use of mouthguards, whether they are 3M tape, wooden spatulas, or mouthguards molded by dentists, can significantly reduce the forces that act on the teeth, minimizing the risks of dental trauma. Thermoplastics have their effectiveness discussed in different studies, but the most recent one discusses that they are effective, in addition to being easy to handle and cost-effective, but it is not the most recommended method of protection.
Aplicação das Escalas de Morse e Braden por estudante de enfermagem na vivência prática: contribuições à formação acadêmica
Authors: Cargnin Maiara Stefanello , Donaduzzi Joanita Cechin , Cogo Silvana Bastos , Munhoz Oclaris Lopes
Published: November 2023

Objetivo: Relatar a experiência de uma acadêmica de enfermagem no uso das Escalas de Morse e de Braden durante vivência extracurricular em uma Unidade de Clínica Cirúrgica. Relato de experiência: Trata-se de um estudo descritivo, do tipo relato de experiência oriundo da participação em uma vivência extracurricular ocorrida no período de fevereiro a março de 2023 em um hospital universitário do sul do Brasil que abrange pacientes internados em condições pré e pós-operatória. Nesse período, foram realizados procedimentos de enfermagem e atividades privativas do enfermeiro como aplicação das escalas de Morse e de Braden, respaldadas pela Lei do exercício profissional n° 7.498/86 e Resolução do Conselho Federal de Enfermagem n° 358/2009, que dispõe sobre a Sistematização da Assistência de Enfermagem e Processo de Enfermagem. Considerações finais: A aplicação desses instrumentos de avaliação, no momento da admissão do paciente permitem identificar características individuais e também avaliar o risco de quedas e do desenvolvimento de LPP. Ainda, tal experiência extracurricular, durante a formação acadêmica, permite o desenvolvimento de habilidades e competências como o olhar ampliado para proporcionar um cuidado integral, priorizando pela manutenção das metas do Programa Nacional de Segurança do Paciente.
Erythematous Plaque on Right Ear with Extension to Face and Neck in an Older Adult Male
Authors: Trifoi Mara , Shamloul Norhan , Anderson Bryan , Svoboda Ryan
Published: November 2023

Leishmaniasis poses a diagnostic challenge due to its resemblance to many dermatologic conditions. As the incidence of Leishmaniasis has increased in the United States due to a rise in world travel it is imperative for healthcare providers, especially dermatologists, to recognize and properly diagnose Leishmaniasis. In this case report, we present a unique case of New World Leishmaniasis, highlighting key histopathological findings important in diagnosis.
Cellular Deconvolution Reveals Unique Findings in Several Cell Type Fractions Within the Basal Cell Carcinoma Tumor Microenvironment
Authors: Diaz Michael , Tran Jasmine , Natarelli Nicole , Sureshkumar Akash , Forouzandeh Mahtab
Published: November 2023

Introduction: Despite therapeutic advancements, locally advanced and metastatic basal cell carcinomas continue to carry poor prognoses and high recurrence rates. Current treatment options remain suboptimal due to limited efficacy and associated adverse events. The objectives of this study are to 1) characterize the basal cell carcinoma immune cell microenvironment and 2) identify novel therapeutic targets.

Methods: Transcriptome data representing 25 basal cell carcinoma and 25 control tissue samples were obtained from the Gene Expression Omnibus. Cell type fraction estimates were derived by least-squares deconvolution. Population differences were determined by Mann-Whitney U test.

Results: Most significantly, two deconvolution algorithms similarly observed greater B cell infiltration in tumor samples compared to normal tissue (P<0.0001).

Conclusion: Importantly, the results of this study provide new insight into the basal cell carcinoma tumor microenvironment and nominate testable immune cell populations for future therapeutic discovery. Study limitations include sample size and applicable background prediction levels of bulk deconvolution tools.
A Comparative Outcomes Analysis: The Evolution and Growth of a Teledermatology Program to Accommodate High Patient Volumes
Authors: Doan Leandra , Kreidel, MD Marit , Benabio, MD, MBA Jeffrey , Hernandez, BS Gabriel , Engler, BS Walt , Tolbert, MD, JD, EdD, MPH Linda
Published: November 2023

Background:  Most teledermatology studies include reviews of programs on a limited scale, whereas there are fewer reports on how to expand a program to accommodate high patient volumes.

Objective: To share our insights into the growth and maintenance of a teledermatology program that sees over 100,000 cases a year. 

Methods: Retrospective review of a teledermatology program between 2015 and 2022. Outcomes were compared between the initial phase from 2015-2017 and the maturation phase from 2018-2022.

Results: In 2015, the teledermatology program was piloted in 3 hospital centers and expanded to 10 more centers by 2017. There was a total of 12,385 cases in 2015, which increased to 139,110 cases in 2022. Despite the dramatic increase in number of cases, our program adapted well: the initial phase of program development resulted in 69.2% of concerns being treated remotely, compared to 70.9% of submissions in the later years, p <0.001.

Limitations: Overall generalizability as this study was performed in a large integrated health system.

Discussion: We maintain that the following can help scale a teledermatology program: 1. Communication with all interested parties; 2. Streamlined implementation of technological devices; 3. Training for dermatologists and primary providers; 4. Image guidelines to maintain photo quality.
Assessment of Wound Care Products at Major Retailers in Accordance with the American Academy of Dermatology’s Recommendations
Authors: Shimon Stephanie , Hombal Aishwarya , Romanelli Paolo
Published: November 2023

Background: Proper wound care is important for improving healing outcomes and minimizing long-term effects of scar formation. Selection of appropriate care may be challenging for individuals due to overabundance of product selection, and conflicting evidence on common wound care products, which may pose a risk for delayed wound healing.  

Objective: We aimed to assess whether wound care products sold by major retailers, specifically Walmart, Walgreens, and Target, align with the recommendations on patient support information websites provided by the American Academy of Dermatology.

Methods: A unique search inquiry was established for each major retailer, and analysis of their first aid wound care sections was performed.

Results: 393 Walgreens, 334 Walmart, and 285 Target products were included. 0% of wound cleansing products available were recommended by the academy. Petroleum-based products were represented in 61% in Walgreens, 76.2% in Walmart, and 78.4% in Target products assessed. In total, 61.6% of products in Walgreens, 57% in Walmart, and 52.7% in Target were consistent with AAD recommendations for providing appropriate wound coverage.

Conclusion: Many products sold in retailers are not recommended in managing acute minor wounds; appropriate counseling from the AAD may provide insight to optimizing wound care and scar minimization.
AAD Officer Panel at the 2023 Practical Symposium, Beaver Creek, Colorado
Authors: Cockerell Clay
Published: November 2023

N/A
Deucravacitinib, an Oral, Selective, Allosteric Tyrosine Kinase 2 Inhibitor, in Moderate to Severe Plaque Psoriasis: Absolute PASI Outcomes Over 52 Weeks in the Phase 3 POETYK PSO-1 Trial
Authors: Lebwohl Mark , Gooderham Melinda , Warren Richard B. , Thaçi Diamant , Foley Peter , Gottlieb Alice B. , Hippeli Lauren , Kisa Renata M. , Banerjee Subhashis , Griffiths Christopher EM
Published: November 2023

Introduction: Tyrosine kinase 2 (TYK2) is an intracellular enzyme that mediates signaling of cytokines (eg, interleukin-23, Type I interferons) involved in psoriasis pathogenesis. Deucravacitinib, an oral, selective, allosteric TYK2 inhibitor, is approved in the US, EU, and other countries for the treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy. In POETYK PSO-1 (NCT03624127) and POETYK PSO-2 (NCT03611751), deucravacitinib was significantly more effective vs placebo and apremilast based on multiple endpoints. This study compared efficacy of deucravacitinib vs apremilast over 24 weeks in mean Psoriasis Area and Severity Index (PASI) improvements and evaluated absolute PASI thresholds with continuous deucravacitinib treatment from Day 1 through 52 weeks in PSO-1.

Methods: PSO-1 randomized patients 1:2:1 to oral placebo, deucravacitinib 6 mg once daily, or apremilast 30 mg twice daily; patients randomized to placebo and apremilast switched to deucravacitinib at Week 16 and Week 24, respectively. Mean change from baseline in PASI and proportions of patients achieving absolute PASI thresholds of ≤1, ≤2, ≤3, ≤4, and ≤5 were evaluated at Week 24 (deucravacitinib vs apremilast) and Week 52 (deucravacitinib only).

Results: Mean baseline PASI was similar in both groups (deucravacitinib, 21.8; apremilast, 21.4). Significantly greater mean percent reductions from baseline in PASI were observed with deucravacitinib vs apremilast at Week 24 (−77.1% vs −50.2%; P < 0.0001); mean reduction in the deucravacitinib group was maintained through Week 52 (−78.4%). Higher proportions of patients receiving deucravacitinib vs apremilast, respectively, achieved absolute PASI thresholds of ≤1 (31.3% vs 12.5%), ≤2 (41.3% vs 21.4%), ≤3 (54.8% vs 28.0%), ≤4 (63.3% vs 33.3%), and ≤5 (68.7% vs 35.7%) at Week 24 (nominal P < 0.0001 for all); response rates were maintained through Week 52 with deucravacitinib (31.3%, 45.5%, 54.5%, 61.4%, and 66.0%, respectively).

Conclusions: Deucravacitinib treatment was associated with clinically meaningful PASI outcomes that were superior to apremilast over 24 weeks and maintained through 52 weeks in patients with moderate to severe plaque psoriasis.
Safety, Tolerability and Efficacy of Tirbanibulin Ointment 1% Treatment on 100 cm2 of the Face and Scalp in Patients with Actinic Keratosis: A Phase 3 Study
Authors: Bhatia Neal , Blauvelt Andrew , Lain Edward , Jarell Abel , DuBois Janet , Tamarit Maria Luisa , Falqués Meritxell , Kiyasova Vera , Padullés Laura , Otero Raquel
Published: November 2023

Introduction: Tirbanibulin ointment 1% has demonstrated efficacy, tolerability, and safety for AK and is approved in the US and Europe for treating AK on the face or scalp over an area up to 25 cm2 [1]. The objective of this study was to evaluate safety and tolerability of tirbanibulin applied to a larger area, a field of 100 cm2, on the face or balding scalp in adult patients with AK.

Methods: A phase 3, multicenter, open-label, single-arm study (NCT05279131) was conducted among adult patients having a treatment field on the face or balding scalp that measured 100 cm2 and contained 4-12 AKs. Patients received tirbanibulin for 5 consecutive days and were evaluated for safety, tolerability, and AK persistence until Day 57. Safety was assessed by evaluating treatment emergent adverse events (TEAEs). Tolerability endpoints included scores, 0 (absent) to 3 (severe), of 6 local signs captured at each timepoint. Exploratory efficacy was measured as percentage change from baseline (CFB) in AK lesion count.

Results: A total of 105 patients (20 sites in the US) were included in the safety analysis set (males: 69%; ≥65 years: 65%; Fitzpatrick skin type II: 63%; AK on the face: 68%). Most common local tolerability signs after 100 cm2 tirbanibulin administration were erythema (96% of patients) and flaking/scaling (85%), which were mild-to-moderate in severity, peaked at Day 5 to 8, and resolved or returned to baseline by Day 29. Severe erythema was reported only in 6% of patients and severe flaking/scaling in 9% of patients. Overall, the tolerability profile of treating a 100 cm2 area was consistent with that seen with a 25 cm2 area [1]. Most frequent TEAEs were application site pruritus (11%) and application site pain (9%), consistent with previous Phase 3 study results. No serious TEAEs related to drug were reported. Maximum local tolerability composite score was 4 out of 18, consistent with prior pivotal trials. Patients entered the study with a mean of 7.7 AKs and completed the study with a mean of 1.8 AKs, indicating outstanding efficacy. Mean percentage CFB in lesion count at Day 57 was 78%, consistent with the Phase 3 study with a 25 cm2 treatment area [1].

Conclusions: Safety, local tolerability, and efficacy in patients with AK treated with tirbanibulin over a 100 cm2 area were consistent with those previously reported in patients with AK treated in pivotal trials with tirbanibulin over a smaller area.

[1] Blauvelt A et al. N Engl J Med. 2021;384(6):512–20.
Spesolimab for Hidradenitis Suppurativa: A Proof-of-Concept Study
Authors: Alavi Afsaneh , Prens Errol , Kimball Alexa , Krueger James , Mukhopadhyay Sutirtha , Wang Hui , Ivanhoff Nathalie , Hernandez Ana Cristina , Zouboulis Christos
Published: November 2023

Introduction: Hidradenitis suppurativa (HS) is a chronic, inflammatory disorder characterized by painful inflammatory nodules (N), abscesses (A) and draining tunnels (dT), primarily affecting intertriginous areas. Interleukin-36 (IL-36) signaling has been notably expressed within HS inflammatory lesions. To address the need for targeted therapies, this Phase IIa proof-of-clinical-concept (PoCC) study (NCT04762277) explored the effect of spesolimab, an anti-IL-36 receptor monoclonal antibody, in patients with moderate-to-severe HS.

Methods: Eligible patients (N=52) were randomized (2:1) to receive spesolimab or placebo (1200 mg intravenous dosing once weekly for three weeks [loading dose], followed by 1200 mg subcutaneous dosing every 2 weeks for 12 weeks). No formal statistical tests were performed, as this was an exploratory study. Of patients who completed the study, 45 were enrolled in an ongoing open-label extension (OLE) study (NCT04876391) with spesolimab. For each study, endpoints included change from baseline at Weeks 12 and 24 in total A, N and dT (ANdT) counts, and adverse events (AEs).

Results: Mean changes from baseline at Week 12 in dT, A and total ANdT counts were -1.30, -0.53 and -4.87 in the spesolimab arm, and 1.07, 3.07 and -0.86 in the placebo arm, respectively. Mean changes in N count were numerically similar between the spesolimab (-3.00) and placebo (-5.00) arms. Of patients with ≥1 dT at baseline, a numerically greater proportion had a decrease in dT count at Week 12 in the spesolimab (16/24, 66.7%) versus the placebo (5/13, 38.5%) arm. Least squares mean changes from baseline in total AN count at Week 12 were -38.8% and -34.7% in the spesolimab and placebo arms, respectively, which may have been affected by higher baseline AN and N counts in the spesolimab versus placebo arm. In the OLE, patients originally randomized to spesolimab (n=30) achieved sustained reductions in dT count and in International Hidradenitis Suppurativa Severity Score (IHS4) at Week 24. The safety profile of spesolimab was similar to that reported in other trials; among the 52 patients enrolled in the PoCC study, 77.8% (spesolimab) and 87.5% (placebo) of patients reported ≥1 AE. No patients receiving spesolimab reported serious AEs, and no new safety concerns were identified by Week 24. No deaths were reported.

 Conclusion: Our findings show that spesolimab was well tolerated and decreased all HS lesions. These results support the development of spesolimab in HS.

This study was supported and funded by Boehringer Ingelheim.
Comparison of Study Designs for Primary Phase III Trials for Omalizumab Versus Dupilumab for Patients With Chronic Spontaneous Urticaria
Authors: Alexis Andrew , Anders Kyle , Seetasith Arpamas , Holden Michael
Published: November 2023

Introduction

Omalizumab is currently the only biologic approved and recommended as second-line treatment for patients with chronic spontaneous urticaria (CSU). However, clinical trial programs are underway for other biologic treatments such as dupilumab. Given head-to-head trials will not be conducted, consideration of study design may be important.

Methods

Comparison of participants, interventions, outcomes, and results for phase III primary efficacy clinical trials for omalizumab versus dupilumab for patients with CSU. The omalizumab trials were ASTERIA I/II (NCT01287117 and NCT01292473) and the dupilumab trial was LIBERTY-CSU CUPID (NCT04180488) that consisted of Study A, B, and C.

Results

Participants in ASTERIA I/II were 12 to 75 years with a diagnosis of CSU refractory to H1 antihistamines. Participants in LIBERTY-CSU CUPID were 6 to 80 years (Study A and C) or 12 to 80 years (Study B) with a diagnosis of CSU refractory to H1 antihistamines, and Urticaria Activity Score (UAS)7≥16 and Itch Severity Score (ISS)7≥8 during the 7 days before randomization; Study A and C included participants who were omalizumab naïve and Study B included intolerant or incomplete responders to omalizumab. For ASTERIA I and II, the interventions were placebo or omalizumab (75mg, 150mg, 300mg) every 4 weeks for 24 and 12 weeks, respectively. For LIBERY-CSU CUPID, the interventions were placebo or dupilumab (200mg or 300mg, weight based) every 2 weeks for 24 weeks. The primary efficacy outcome for ASTERIA I/II was change from baseline in ISS7 at Week 12. The primary efficacy outcome for LIBERTY-CSU CUPID was change from baseline in ISS7 at Week 24. For the ASTERIA I primary outcome, the change from baseline in ISS7 at Week 12 was -3.6 for placebo and -6.5, -6.7, and ‑9.4 for omalizumab 75mg, 150mg, and 300mg, respectively. For the ASTERIA II primary outcome, the change from baseline in ISS7 at Week 12 was -5.1 for placebo and ‑5.9, ‑8.1, and ‑9.8 for omalizumab 75mg, 150mg, and 300mg, respectively. For the LIBERTY-CSU CUPID Study A primary outcome, the change from baseline in ISS7 at Week 24 was ‑6.0 for placebo and -10.2 for dupilumab. The LIBERTY-CSU CUPID Study B was stopped due to futility based on a pre-specified interim analysis.

Conclusion

Comparing study designs for primary clinical trials for omalizumab and dupilumab for patients with CSU will aid in the comparative analysis and clinical evaluation of final trial results.
The impact of social interactions on organisational performance in sports: A case study of Ambon City's sports organisations
Authors: Fenanlampir Albertus , Budiatin Yasmu , Hasbullah Bahmid
Published: November 2023

Studying the impact of social interactions on sports organisations’ performance in Ambon City remains a relatively unexplored area. This research aims to address this gap by investigating the influence of social interactions among administrators, coaches, and athletes on sports organisations' performance. Additionally, it explores the disparity in performance levels between individual and team sports. The study focused on sport administrators in Ambon City affiliated with the Indonesian National Sports Committee (KONI). Fifteen participants were selected through purposive sampling, comprising administrators, coaches, and athletes from various sports branches, including athletics, taekwondo, boxing, water skiing, and football. Findings suggest that sports organisation management in Ambon City has not yet achieved optimal levels of effectiveness and facilitation, affecting the dynamics of group sports in particular. Team sports display a higher dependency on teamwork and board roles, notably the coach’s role. Despite suboptimal management, athletes retain the freedom to determine their paths to success or achievement. However, an imbalance exists between expectations and obligations in social relationships, except for the coach-athlete relationship. In summary, this study sheds light on the role of social interactions in sports organisations’ performance and highlights the differences between individual and team sports in Ambon City. These insights may serve as a foundation for more effective management strategies to enhance sports organisations’ performance in the future.
Karl Marx y el campo pedagógico. Ensayos a partir del estudio colectivo de sus textos tempranos, (1839-1848).
Authors: Cabaluz Fabián , Zurita Felipe
Published: November 2023

El libro que tiene en sus manos, es resultado de un proceso de construcción colectiva, abiertamente posicionado dentro del amplio campo marxista. Su contenido remite a un conjunto de once ensayos creados a partir de la enriquecedora experiencia de lo que fue el Círculo de Estudios “Escritos tempranos de Karl Marx (1839-1848). Lectura colectiva desde el campo educativo y pedagógico”, desarrollado en Santiago de Chile durante el año 2020, el cual fue organizado por el Centro de Estudios de Marxismos y Educación (CEMED), que es el nombre que precedió a nuestro actual Grupo de Estudios en “Educación Popular y Pedagogías Emancipatorias” (GEPEM). Nos interesa recalcar nuestra invitación a educadoras/es de Nuestra América a leer a Marx con los pies en el barrio, la población, las villas, las favelas, los sindicatos, las organizaciones, los partidos políticos y los movimientos, de la mano de nuestro trabajo comunitario, territorial, político, pedagógico, militante y sindical.