bluuebunny/crossref_metadata_2025 huggingface dataset:
irrupción ficcionada en novelas sociales de la naciente clase media en Colombia
Authors: Bacca-Contreras Rafael Eduardo
Published: August 2024

En este escrito se aborda la irrupción ficcionada del empleado y empleada en novelas sociales de los años treinta y cuarenta del siglo XX en Colombia, particularmente analizando a un sujeto reproducido como precarizado, en un ambiente trágico y, en algunos casos, hasta considerado en una clase social “falseada”. En primer lugar, se analizan obras literarias que dialogan con la novela social, resaltando el vacío llenado por Osorio Lizarazo y Morales Pino en tanto la incorporación del sujeto clase media en esta vertiente literaria. Luego, se profundiza en las revelaciones que presentan las obras analizadas, exponiendo a un sujeto de clase media precarizado, experimentando una vida paradójica o contraria a los vientos modernizantes que el gobernante proyecto político liberal pregonaba. Así, además de la testificación sobre el injusto lugar social que se le daba a esta clase, estas obras literarias terminaron -grosso modo- sembrando más dudas que certezas sobre la existencia o autenticidad de esta clase social. Para estos objetivos, junto a la indagación de algunas obras de literatura al respecto estarán presentes informes, notas periodísticas y otras declaraciones de gremios de clase media de la época, los cuales permiten sustentar ciertos rasgos y vivencias del sujeto ficcionado en cuestión.
Redes que unen: Estudio sobre las redes de apoyo comunitarias en contextos de vulnerabilidad ambiental y antrópico por avenida torrencial como expresión de resiliencia comunitaria
Authors: Cañaveral-Guisao Daniela , Londoño-Torres Gloria Esperanza  , Posada-Pérez Natalia 
Published: August 2024

El presente artículo tiene como objetivo contrastar las redes de apoyo comunitarias en contextos vulnerables reconociéndolas como expresiones de resiliencia comunitaria en el marco del proyecto “Vulnerabilidad, resiliencia y riesgo de comunidades y cuencas abastecedoras afectadas por fenómenos de deslizamientos y avalanchas” donde se elige dos territorios, ex post y ex ante respectivamente, con factores de riesgo de avenida torrencial. Como resultado, se evidencian dos tipos de redes de apoyo, primero, redes combinadas donde diferentes actores se unen para trabajar en torno a las necesidades de la población y la segunda, redes circunstanciales, que surgen en un momento particular y desaparecen en el momento en que la situación es resuelta. Esta investigación es de carácter cualitativo, busca la comprensión, reconstrucción e interpretación de momentos, hechos, situaciones y acciones desde las voces de los sujetos que vivencian determinados fenómenos, elaborando con ellos un “todo- con-sentido”, de acuerdo con sus historias, trayectorias y subjetividades. Se implementaron técnicas de revisión documental, informes de base comunitaria y entrevistas semiestructuradas, así como la aplicación de instrumentos de identificación y caracterización de actores y redes.
La escritura académica y su aporte al aprendizaje ¿Qué piensan los profesores universitarios? Análisis de la literatura
Authors: Arenas-Hernández Karina Alejandra ,  Rojas-Rojas Sandra Patricia
Published: August 2024

El objetivo de este artículo es presentar los resultados de una revisión bibliográfica exploratoria acerca de las concepciones de profesores universitarios sobre la escritura académica en 35 artículos de investigación hallados en las bases de datos Scopus, Web of Science, Ebsco y Scielo. Se usó el análisis de contenido para identificar la definición de concepciones sobre escritura y las tendencias teóricas de estas, las metodologías que se han usado para indagarlas, las disciplinas que se han interesado por esta temática en términos de investigación y las tendencias de dichas concepciones. Los resultados muestran que las concepciones se sitúan en una función comunicativa instrumental explicadas desde representaciones sociales o teorías implícitas, además existe poco reconocimiento de la mediación en el aprendizaje de las disciplinas científicas. Las áreas de mayor investigación e interés en la temática son las ciencias sociales, humanidades y ciencias naturales; las técnicas cualitativas como las entrevistas en profundidad y el análisis de contenido son predominantes como decisiones metodológicas en estos estudios. Estos resultados son insumos importantes para la elaboración de programas de intervención e innovación pedagógica para profesores de educación superior de cualquier área del conocimiento.
Modelo de Teletrabajo en la educación universitaria: Estrategias para fortalecer su implementación en la Universidad Católica de Cuenca, Ecuador
Authors: Ramírez-Velásquez Joanna , Quinde-Quizhpi Luis Ernesto  , Alarcón-Vélez Ricardo Agustín , Vega-Abad Cesar Remigio
Published: August 2024

El teletrabajo se ha constituido como modelo de prestación de servicios que requiere necesariamente el uso de herramientas tecnológicas. Esta forma de desarrollar las actividades se ha expandido en el sector educativo. Desde la época de la pandemia por covid-19 se implementó con un mayor auge en el campo universitario enfrentando grandes retos y dificultades. El objetivo fue analizar las fortalezas, oportunidades, debilidades y amenazas del teletrabajo implementado en el contexto de la educación universitaria, durante los años 2020-2021 en la Universidad Católica de Cuenca, Campus La Troncal, Ecuador. En la metodología se aplicó el enfoque cualitativo de tipo descriptivo, el análisis FODA, la técnica de revisión bibliográfica, así como la interpretación y descripción a través de los grupos focales. De los resultados se desprende que, los docentes requieren capacidades y competencias específicas para desarrollar las actividades en teletrabajo. La implementación del teletrabajo en la educación universitaria presenta oportunidades significativas, pero también desafíos, que deben ser abordados con estrategias efectivas y un marco jurídico sólido para garantizar su aplicación exitosa, prevenir la vulneración derechos fundamentales y la aparición de enfermedades ocupacionales que se vinculan con esta forma de organización laboral.
biodiversidad que incorpore los diversos sistemas de conocimiento
Authors: Parra-Romero Adela
Published: August 2024

La conferencia de las partes- COP tendrá lugar en su versión 16 en la ciudad de Cali en el segundo semestre del 2024. Un evento que reúne a 196 países miembro del Convenio sobre la Diversidad Biológica.
Como lo expresa el texto resultado de la COP15,  “La diversidad biológica es fundamental para el bienestar humano y un planeta sano, y para la prosperidad económica de todas las personas, entre otras cosas, para vivir bien, en equilibrio y en armonía con la Madre Tierra; dependemos de ella para obtener alimentos, medicamentos, energía, aire y agua limpios, protección frente a los desastres naturales, así como para el ocio y la inspiración cultural, y sostiene todos los sistemas de vida en la Tierra.” (Convenio de Montreal, 2022).
Cali representa la diversidad del Pacífico colombiano, donde más del 30% de sus habitantes se reconocen como afros o indígenas. Asimismo, según el Ministerio del Medio Ambiente: “La región del Pacífico, cuenta con más de 200 áreas protegidas, 11 Parques Nacionales Naturales que conforman 51.388 kilómetros cuadrados de biodiversidad, y hábitat de 1297 especies de fauna, así como de 14.000 especies de plantas.” (Ministerio del Medio Ambiente, 2024)
THEORETICAL INVESTIGATION OF NITROGEN AND BORON DOPING EFFECTS ON THE ELECTRONIC AND OPTICAL PROPERTIES OF CERIA
Authors: Hoang Hao Nguyen , Thi Binh Giang Truong , Hoang Minh Chau Cao , Thi Kim Giang Nguyen , Thi Thu Ha Nguyen
Published: August 2024

This study investigates the impact of nitrogen (N) and boron (B) doping on the electronic structure and optical properties of ceria (CeO2) using a combination of density functional theory plus U (DFT+U) and the GFN-xTB method. The calculations of electronic parameters and population analysis indicated that doping with N and B reduces the surface Lewis acidity of ceria, decreases the bandgap, and narrows the edges of the valence band and conduction band. These findings offer valuable insights into comprehending the photocatalytic performance of CeO2-based materials.
Development of LVEP-Based IPAS Monopoly Media to Improve Nationalist Character on Grade IV Elementary School Students
Authors: Vita Rima Widya Nugraha , Apriani An-Nisa , Sari Indah Perdana , Aryani Yusinta Dwi
Published: August 2024

The problem studied in this research is the lack of use of learning media that incorporates the Living Values Education Program (LVEP) and nationalist character by teachers, and there are still moral deviations from students, which illustrates the lack of strengthening of nationalist character. The aims of this research are 1) to produce LVEP-based IPAS monopoly media on the material "My Indonesia is Rich in Culture" to increase the character of nationalism, 2) to find out the teacher's response, 3) students' responses to the LVEP-based IPAS monopoly media on the material "My Indonesia is Rich in Culture ” to increase the character of nationalism. This type of research is Research and Development (R&D). This research uses a 4D development model. Data collection techniques in this research are observation, interviews, and questionnaires. The questionnaire in this research is in the form of a questionnaire given to one lecturer for validation by material experts who provide assessments regarding material in monopoly media. Then, one lecturer for validation was a media expert who provided an assessment regarding the media developed by the researcher. Then, the assessment was given to the class IV teacher at SDN Sambikerep to get an assessment in terms of media material and appearance. A questionnaire was given to students to find out responses regarding monopoly media. The techniques used are qualitative and quantitative. The results showed that 1) This development uses a 4D model. The validation results obtained an average score from material experts of 4.5, while the average score obtained from media experts was 4.3, with very good criteria. 2) The average score obtained from class IV teacher responses was 4.7, with criteria very good 3) Furthermore, the student's responses were positive and obtained a score percentage of 93.16%.
Hospital Pharmaceutical Inventory Control in In-Vitro Fertilization Services Using Minimum-Maximum Stock Level
Authors: Paramesthi Prasasya , Jati Sutopo Patria , Suryoputro Antono
Published: August 2024

Type C "X" Specialized Hospital in Semarang experienced in vitro fertilization (IVF) and embryology laboratory consumable medical supplies (CMS) stockouts in early 2023, delaying medical care. Minimum-maximum stock level (MMSL) is an alternative pharmaceutical inventory procurement method. Compared to the conventional method, this study examined how well the MMSL method controls IVF medications and embryology laboratory CMS at Hospital “X” Department of Pharmacy. This study is a quantitative, secondary data-based, quasi-experimental, non-equivalent study without a control group. The study sampled all IVF medications and embryology laboratory CMS data from October to December 2023 at Hospital “X” with consistent supply. MMSL was implemented prospectively in January – March 2024. Twelve (12) IVF medications and fifty-six (56) embryology laboratory CMS were studied. Efficiency analysis included inventory value, inventory turnover ratio (ITOR), and stockout value; effectiveness analysis included stockout incidences. Statistics were tested using Wilcoxon signed-rank and McNemar tests. MMSL implementation led to increased inventory value of IVF medications (from IDR21,514,537.00 to IDR49,635,116.00, p=0.040, p<0.05), decreased inventory value of embryology laboratory CMS (from IDR117,421,582.00 to IDR105,318,804.00, p=0.005, p<0.05), and increased ITOR of embryology laboratory CMS (from 0.82 to 0.84 times, p=0.040, p<0.05). MMSL significantly improved IVF medications and embryology laboratory CMS inventory management efficiency.
Transcendując dychotomie. Narrator w powieści Drach Szczepana Twardocha
Authors: Nowara-Matusik Nina
Published: August 2024

Autorka artykułu bada profile i funkcje narratora w powieści Drach (2014) górnośląskiego pisarza Szczepana Twardocha. Punkt wyjścia stanowi założenie, że powieściowy narrator to konstrukt hybrydyczny, jednoczący w sobie różnorakie – mitologiczne oraz archetypowe – obrazy. Wykraczając poza konwencjonalne dychotomie, tworzy Twardoch oryginalną górnośląską powieść, w której porusza kwestię (auto)destrukcyjnej (górnośląskiej) tożsamości.
The Influence of Augmented Reality Mobile App on Electronics Engineering Students' Self-Competence
Authors: Hidayat Hendra , M. Tanucan Jem Cloyd , Harmanto Dani , Dewi Fitrika Kumala , Dewi Ika Parma , Anori Sartika , Agustiarmi Winda
Published: August 2024

Augmented reality (AR) is currently becoming educational trend by offering visualization of learning and making abstract concepts more concrete. Therefore, this research aimed to investigate the effect of AR technology based on mobile application on self-competence of electronics engineering students. It also considered the role of self-regulated learning, intrinsic learning motivation, and perceived usefulness as moderating factors. A cross-sectional survey with quantitative method was conducted on 848 electronics engineering education students at Universitas Negeri Padang, Indonesia. The data were obtained through questionnaires, and Structural Equation Model (SEM) analysis was conducted using SmartPLS 3. Furthermore, a fuzzy C-means clustering analysis was carried out using JASP software. The results showed that perceived usefulness had a significant positive effect on students' self-competence and moderated the significant positive relationship between self-regulated learning and self-competence. These empirical results showed that an improved level of self-regulated learning and beneficial application of technology could increase self-competence.
Roughness Ecosystem-based Approach to Estimate the Exposure Area of Tsunami on a Coastal City: A Case Study in Bengkulu City, Indonesia
Authors: Lestari Della Ayu , Yonvitner  , Damar Ario , Kurniawan Fery , Nurjaya I Wayan
Published: August 2024

Bengkulu City, as the main activity center in Bengkulu Province, is experiencing significant population growth. However, geographically, the city is vulnerable to tsunami disasters. High population growth outside the line with coastal area management also increases the risk of tsunami disasters in Bengkulu City due to green land conversion into built-up land. This condition is exacerbated by coastal abrasion that threatens the coastline, brings residential settlements closer to the shoreline, and conflicts over spatial utilization of the coastal green belt. Therefore, implementing tsunami mitigation measures, mainly through coastal ecosystem-based strategies, is crucial. This study compares the spatial modeling of tsunami inundation in Bengkulu City with three roughness scenarios of coastal vegetation: coastal forest and mangrove. These scenarios include a scenario without coastal vegetation, a scenario based on existing conditions, and a scenario with optimized coastal vegetation. Spatial modeling was conducted using cost distance analysis modeling to calculate the effectiveness of coastal vegetation in reducing tsunamis. The results showed that coastal forests and mangroves in existing conditions could effectively reduce tsunamis by 3.84% compared to land cover without coastal forests and mangroves. The coastal vegetation optimization scenario has effectively reduced the exposure area by 5.00% compared to that without vegetation. The coastal vegetation optimization scenario also has an effectiveness of 1.20% compared to the existing condition. The findings underscore the critical role of coastal vegetation as a natural barrier against tsunamis and emphasize the potential advantages of optimizing land cover to improve coastal protection.
Lactiplantibacillus plantarum IS-10506 Supplementation Improves Clinical Outcome and Immunology Markers in Psoriasis Vulgaris Patients: A Randomized Controlled Trial
Authors: Umborowati Menul Ayu , Hasna Iffa Halimah , Endaryanto Anang , Surono Ingrid Suryanti , Prakoeswa Cita Rosita Sigit
Published: August 2024

BACKGROUND: Probiotics may modify the gut microbiome and have been proven to improve psoriasis vulgaris. Lactiplantibacillus plantarum IS-10506 is a probiotic strain of Indonesian origin. It offers a safe and effective probiotic for psoriasis patients in Indonesia. This study was conducted to evaluate the effect of L. plantarum IS-10506 on clinical and immunology markers in psoriasis vulgaris.METHODS: This randomized, placebo-controlled, and double-blind trial compared L. plantarum IS-10506 (2×1010 CFU/day) and placebo in 49 patients mild-moderate psoriasis vulgaris, which were divided into intervention (n=24) and control groups (n=25). The interventions were given twice daily for 12 weeks. Both groups received topical corticosteroid and emollient as standard treatment. Psoriasis area and severity index (PASI), dermatology life quality index (DLQI), interleukin (IL)-10, IL-17, and forkhead box protein (Foxp3) were then assessed.RESULTS: Mean PASI score for the the subjects in probiotic group was significantly reduced compared to placebo at week-6 (p=0.024), and was sustained until week-12 (p=0.049). At week-12, DLQI scores in the probiotic group were lower than placebo (7.57±5.77 vs. 7.79±5.48). IL-17 level was significantly decreased (p=0.013), while the IL-10 and Foxp3 were significantly increased (p≤0.001 and p=0.048, respectively) in probiotic group. Six months after the completion of study, subjects in probiotic group had a lower probability of flares (52.2%) compared to placebo (79.2%). Two subjects receiving probiotics and one receiving placebo noticed changes in defecation frequency, while another subject in the placebo group complained of mild nausea.CONCLUSION: L. plantarum IS-10506 might effectively improve clinical outcomes and immune biomarkers in psoriasis vulgaris patients, potentially acting as an adjuvant therapy.KEYWORDS: psoriasis, probiotic, clinical severity, immune marker, human and health
Sarcopenic Obesity: The Underlying Molecular Pathophysiology and Prospect Therapies
Authors: Meiliana Anna , Dewi Nurrani Mustika , Defi Irma Ruslina , Rosdianto Aziiz Mardanarian , Qiantori Adziqa Ammara , Wijaya Andi
Published: August 2024

BACKGROUND: Age contributes to body composition alteration, rises a common disorder in elderly known as sarcopenic obesity (SO), which is characterized by the combination of obesity (excess fat mass) and sarcopenia (reduced skeletal muscle mass) clinical form and function.CONTENT: The primary cause of SO is insulin resistance. Glucose transporter 4 (GLUT4) dysfunction results in impaired fatty acids oxidation. Decreased muscle mass results in lower mitochondria number and volume. Both will increase oxidative stress. Together with altered myokines in SO, oxidative stress was promoted and lead to higher M1 macrophages and failure in autophagy. The pro-inflammatory condition and dysbiosis links SO to a variety of cardiometabolic conditions, including non-alcoholic fatty liver disease, type 2 diabetes, and cardiovascular disease. The mortality, comorbidities, cardiometabolic diseases, and disability or impairment of SO is higher compare to obesity or sarcopenia alone. Some treatments have been developed for SO including adequate dietary intake, vitamin D and antioxidant supplementation, and exercises.SUMMARY: SO is more prevalent among the elderly and has a significant negative impact on their quality of life. Therefore, maintaining muscle mass and strength as well as preventing obesity should be the key goals of initiatives to support healthy aging.KEYWORDS: aging, body composition, obesity, sarcopenia, skeletal muscle, metabolic syndrome
Exosomal miRNAs as Potential Biomarkers for Preeclampsia: miR-1283 Has the Highest Expression, while miR-152-3p Has the Lowest Expression
Authors: Sumawan Herman , Giantari Ifrinda , Mubarika Sofia , Hadiati Diah Rumekti , Pradjatmo Heru
Published: August 2024

BACKGROUND: Preeclampsia management is necessary, as it is one of the leading causes of death during pregnancy. Exosomal microRNAs (miRNAs) can serve as biomarkers for early detection, diagnosis, and prognosis of preeclampsia. NanoStrings is an effective method for identifying exosomal miRNA due to their high sensitivity and ability to work with small amounts of miRNA; however, the analysis using this method for determining preeclampsia biomarker is still limited. Therefore, this study was conducted to utilize the NanoStrings method in identifying preeclampsia biomarkers related to its underlying pathophysiology.METHODS: This study involved 12 pregnant women at 20–40 weeks of gestation, including 6 preeclampsia women and 6 normotension women. The miRNAs from plasma exosomes were processed using NanoStrings method with NanoString nCounter SPRINT Profiler. Enrichment analysis of The Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathways were performed to examine the pathophysiological pathways of preeclampsia, using the DIANA–miRPath v3.0.RESULTS: Forty-eight miRNAs were downregulated and 7 were upregulated (miR-1283, miR-613, miR-520a-3p, miR-3185, miR-556-3p, miR-1973, and miR-598-3p) in women with preeclampsia. The highest expression was observed in miR-1283 (log fold-change: 3.69) and the most lowest expression was in miR-152-3p (log fold-change: 1.41). Enrichment analysis showed that the most upregulated miRNAs pathways was estrogen signaling pathway, and the most downregulated was Hippo signaling pathways.CONCLUSION: miR-1283 has the highest expression, while and miR-152-3p has the lowest expression in preeclampsia women. These miRNAs are shown to be linked to specific pathways, shedding light on the pathophysiology of preeclampsia, and may serve as promising biomarkers.KEYWORDS: exosomes, biomarker, miRNAs, pathophysiology, preeclampsia, pregnancy
The Influence of the STEAM Learning Model on Mathematics Learning Outcomes in Percent Material
Authors: Khairah Annisa , Sapri Sapri , Siregar Lailatun Nur Kamalia
Published: August 2024

The aim of this research is to determine the effect of the STEAM (Science, Technology, Engineering, Art and Mathematics) learning model on mathematics learning outcomes in percent material in class IV SDIT Al-Fauzi, Medan City. This research uses quantitative field research methods and uses a pre-test and post-test control group design. 22 students from class IV-A were used as the control class and 22 students from class IV-B were used as the experimental class. Multiple choice test instruments are used to determine students' level of knowledge. The t-test is used to analyze research hypothesis data. The one-way anova test is used to analysis homogeneity data. By using one-way analysis of variance with a significance level of 0.05, the sig value is 0.000, which means 0.000 is less than 0.05. This situation shows that the STEAM learning model has a significant impact. In the experimental class, students obtained an average learning result of 81.45 with a difference in pre-test and post-test scores of 52.04. Meanwhile in the control class, students obtained an average learning outcome of 67.90. Therefore, the application of the STEAM model has a significant impact on the learning outcomes of students at SDIT Al-Fauzi Medan City in mathematics learning.
PREPARING STUDENTS OF SMKN 7 KOTA SERANG FOR 21ST CENTURY WORK ENVIRONMENT THROUGH PJBL
Authors: Sanam Sanam , Ramdani Sulaeman Deni , Susanto Triyo
Published: August 2024

The 21st-century work environment presents new challenges for education. Therefore, preparing students to face the 21st-century work environment requires innovative and relevant educational approaches. This study aims to analyze the preparation of SMKN 7 Serang City students in facing the 21st-century work environment through a project-based learning (PjBL) approach. This research uses a descriptive quantitative approach, data in the form of questionnaires are analyzed to identify teamwork, project management, communication skills, interpersonal skills, and problem-solving. The results showed that PjBL has made a positive contribution to improving students' 21st-century skills. Students involved in PjBL have a deeper understanding of the application of theoretical concepts in the context of the work environment. The conclusion is that PjBL is an effective learning method in preparing students of SMKN 7 Serang City for the 21st-century work environment. The results of this study confirm the importance of innovative approaches in vocational education to ensure students have skills and knowledge relevant to future developments.
THE USE OF QUIZ METHOD TO INCREASE STUDENTS' LEARNING OUTCOMES OF DISCUSSION TEXT
Authors: Zakiah Mutiara , Jaya Hariswan Putera , Agustina Sri
Published: August 2024

This study was Collaborative Classroom Action Research. This study was conducted at SMA Negeri 1 Palembang from February to April 2023 during the 2022/2023 academic year. There were 36 students of X.3 at SMA Negeri 1 Palembang as the subject in this study. The data collection in this study used observation, pre-test, and post-test. The data analysis technique used in this study was to compare students’ learning outcomes before and after the action in Cycle I and Cycle II. The objective of this study was to know the use of quiz method to increase students' learning outcomes of discussion Text. The result of this study showed that quiz method helps students' increase their learning outcomes.
Towards A Human Centred Leadership For 4IR: Exploring Female Leadership Within 21st Century
Authors: Swanepoel Eben H , Pelser Anna-Marie
Published: August 2024

The changes brought on by the fourth industrial revolution call on leaders to adopt 21st-century skillsets to navigate the changing workforce landscape. While equality in the workforce has seen strides towards equal participation of men and women in the workforce, women are still documented to be underrepresented in managerial positions. This article consists of a systematic review of literature aimed at analyzing leadership styles within the modern workforce, with a specific focus on female equality and leadership. The research question from which this paper emanates is: How does the Fourth Industrial Era shape a context for female leadership ascension? Framed through Harro’s cycle of socialization and Trait theory, this paper seeks to analyze current literature to examine the barriers women face in the workplace in their subsequent influence on industry 4.0 practice.
Prevention of Opioid Induced Hyperalgesia Following Remifentanil Infusion: A Case Report
Authors: Gray Lauren
Published: August 2024

Remifentanil, a potent µ-opioid agonist, is useful in anesthesia because of its rapid onset and short duration of action. However, the same traits that make remifentanil useful can also lead to increased pain sensation when it is discontinued. Nociceptive sensitization following opioids is termed opioid-induced hyperalgesia (OIH). Proposed preventative treatments for remifentanil-induced OIH run the spectrum of cost and feasibility. This case report will discuss the use of and rationale for readily available techniques aimed at preventing OIH. These techniques include intravenous ketamine, inhaled nitrous oxide, oral pregabalin, and gradual cessation of remifentanil infusion.
Job Satisfaction Among Certified Registered Nurse Anesthetist: A Multigenerational Analysis
Authors: Mileto, CRNA, DNP Lisa , Penprase RN, PhD, CNOR Barbara
Published: August 2024

Popular press coverage has noted that generational diversity exists in the workplace, suggesting strategies for generational harmony and improving job satisfaction.  However, little empirical evidence has linked job satisfaction to generational profiles.  The current nurse anesthesia workforce includes three predominant generations:  Baby Boomers, Generation X, and Generation Y.  A quantitative descriptive design was used to compare job satisfaction between generational cohorts of CRNAs in Michigan.  Four hundred and seven respondents completed an online survey (The Nursing Work Index – Revised) as a measure of job satisfaction.  Results indicated that overall, nurse anesthetists have a relatively high job satisfaction across generations.  CRNA job satisfaction scores were impacted by their sense of autonomy, their ability to work with clinically competent peers, working for employers who provide opportunity for advancement and education, and having leadership representation at high administrative levels.  ANOVA revealed no significant differences in job satisfaction scores between the three generations.  Information from this study has implications for surgical teams, patients, hospital administrators, nurse anesthesia leaders and individual CRNAs.  Understanding factors that influence CRNA job satisfaction can enhance the work environment and prove to be beneficial to all generations of CRNAs.
Anesthesia Management of Venous Gas Embolism with Hepatectomy
Authors: Kunisawa Yoshiya
Published: August 2024

Abstract
 
Background: This is a case review of the intraoperative management of a 46 year old male patient with a history of stage IV sigmoid colon adenocarcinoma with metastasis to the liver that presented for a robotic assisted sigmoidectomy and partial hepatectomy and had an intraoperative venous gas embolism that resulted in acute hemodynamic instability.
 
Description of the case: A robotic assisted sigmoidectomy and partial hepatectomy was performed on a 46 year old male patient with a history of stage IV sigmoid colon adenocarcinoma with metastasis to the liver.  The patient was otherwise healthy with no other significant medical history, and the perioperative lab results were within normal ranges with the exception of elevated liver function test results.  The patient received preoperative medications for multimodal pain management as part of the enhanced recovery after surgery (ERAS) protocol and had an uneventful induction with intravenous anesthetic induction and endotracheal intubation.  During the intraoperative course, the patient exhibited an acute hypotensive episode followed by acute desaturation. A venous gas embolism was suspected, and immediate interventions were implemented which helped the patient stabilize.  The patient remained hemodynamically stable throughout the remainder of the case.  After surgery, the patient was admitted to the intensive care unit for postoperative monitoring for any neurological or cardiovascular effects related to the intraoperative venous gas embolism.  The postoperative period was uneventful, and the patient was successfully discharged home several days later without any adverse sequelae.
 
Discussion and conclusions: Venous gas embolism can be a life-threatening intraoperative event that requires fast recognition of the symptoms and appropriate interventions in response to the patient changes.  Evidence suggests that venous gas embolisms are very common with certain procedures but often subclinical.  Preventative measures, early recognition, and prompt treatment of venous gas embolisms are important interventions to minimize the risk for any significant hemodynamic instability and any resulting neurological or cardiovascular sequelae.
Verification of Ventilation before Neuromuscular Blocker Administration during Anesthetic Induction and Endotracheal Tube Insertion in the Non-Rapid Sequence Induction Setting
Authors: Murdock Skyler
Published: August 2024

Anatomically, the upper airway consists of the cartilaginous and bony structures of the nose and mouth, followed by the soft tissue of the oropharynx and laryngopharynx, and ending in the rigid trachea.1 The soft tissue of the pharynx is prone to collapse in the unconscious, or anesthetized, patient and may be further compromised by obesity, a large tongue, airway edema, large neck circumference, external compression, and many other factors.1,4 In response to this collapse, anesthesia professionals who plan to place an endotracheal tube have historically been instructed to refrain from administering muscle relaxation until adequate mask ventilation in the anesthetized patient was confirmed in order to both avoid a critical hypoxemic event, and to ensure an attempt at an escape wake up.  However, there is little published evidence to support this practice, and the administration of muscle relaxation before ensuring adequate BVM ventilation remains controversial.1-8
Perioperative Management of a Patient Receiving Suboxone
Authors: Hipps Hugh Hayden
Published: August 2024

The use of Suboxone in the treatment of opioid addition and/or chronic pain is gaining popularity, and these patients are presenting for surgery more frequently than ever before. The perioperative case management of these patients is complex, especially when they present for elective outpatient surgical procedures.1,3,4,5 This case study evaluated the techniques utilized for analgesia during the preoperative, intraoperative, and postoperative period for a patient undergoing a total laparoscopic hysterectomy. Analysis of this case and a review of complementary research articles, revealed that perioperative continuation of suboxone therapy paired with administration of a multimodal analgesia technique, resulted in higher patient satisfaction ratings, a decreased length of hospital stay, and a reduced incidence of chronic pain develop.1,2,3,4,5 These findings are limited to outpatient surgical procedures when postoperative pain is expected to be mild/moderate thus, it is imperative that the anesthesia plan be tailored to the individual patient and surgical procedure after analysis of the risks vs benefits profile.
The Evolution of the Adductor Canal Block: The Emerging Technique for Motor-Sparing Analgesia to the Knee
Authors: Kline, CRNA, MSN Jonathan P
Published: August 2024

This article summarizes current relevant data regarding the adductor canal block. It provides readers with background information of this emerging technique, including history, review of literature, relevant anatomy,and the technique itself.
The Anesthetic Management of a Patient with Hereditary Coproporphyria
Authors: Fisher Audrey
Published: August 2024

Introduction: The anesthetic management of a patient with hereditary coproporphyria (HCP) is complicated because many anesthetic drugs have the potential to induce an acute attack of porphyria. Acute attacks of HCP exhibit a wide variety of metabolic defects that may result in life-threatening reactions, such as severe autonomic dysfunction and blood pressure (BP) lability. The anesthesia provider must be knowledgeable of concomitant triggers as well as appropriate treatment of porphyric crises. Since anesthetic-linked porphyric crises are understudied, a lack of agreement on triggering anesthetic agents dominates the literature, although there is unanimity among commonly administered drugs such as barbiturates, etomidate, and ketamine.
Case presentation: The case involved a 63-year-old male with a diagnosis of right intracranial glioblastoma undergoing a right parietal temporal craniotomy for a tumor resection under general endotracheal anesthesia (GETA). The unique concerning issue was management of the patient’s anesthetic despite his underlying history of HCP and its known anesthetic risks.
Discussion: HCP is an inborn error of metabolism that causes accumulation of porphyrins and porphyrin precursors, which can potentially lead to neurotoxicity and acute crisis with introduction of a triggering agent. Many anesthetic drugs have been labeled porphyrinogenic, therefore safe anesthetic management of patients with HCP demands understanding of the disease process. Although most of the current clinical reports are anecdotal and/or outdated, there is consensus that unsafe agents include: barbiturates, ketamine, and etomidate; and safe agents include: propofol, nitrous oxide, volatile agents (excluding sevoflurane), all neuromuscular blocking agents, all reversal agents, commonly used narcotics, antiemetics (excluding metoclopramide), and sedatives. Further investigation of anesthetic management of the patient with HCP is indicated, given that most current clinical reports are anecdotal and/or outdated. The anesthesia provider should refer to the American Porphyria Foundation website for the most up-to-date information on porphyria and up-to-date drug database for healthcare professionals caring for porphyria patients.
Open-Globe Eye Injuries and Choice of Muscle Relaxant: A Review of the Evidence
Authors: Benoit, BSN, RRNA Joelle , Welliver, DNP, CRNA, ARNP Mark
Published: August 2024

A goal of treatment of open-globe eye injuries is preventing rises in intraocular pressure and the resulting loss of vitreous humor fluid from the eye globe. Surgical repair of these injuries often requires general anesthesia and tracheal intubation. Normal intraocular pressure is 10-22 mm Hg, with variations between daytime and nighttime values. Factors such as eye muscle structure, fluid volume in the eye, overall hemodynamic status, blood acidity, and mechanical pressure collectively contribute to fluid pressure within the eye. One factor that has been shown to be strongly correlated with increased intraocular pressure is elevated venous pressure with physiological conditions during tracheal intubation (eg, straining, coughing, bucking). To determine intubation best practices, we reviewed the literature on succinylcholine, a depolarizing neuromuscular blocking agent, and nondepolarizing neuromuscular blocking agents. Research and case reports have not shown an association between the loss of ocular contents and succinylcholine administration. However, succinylcholine has been associated with increased intraocular pressure after administration and intubation. Nondepolarizing neuromuscular blocking agents, particularly rocuronium, administered before or instead of succinylcholine, have been found to attenuate the rise in intraocular pressure after induction and intubation.
Noise Pollution in the Operating Room
Authors: Davis-Sandfoss Tyler A.C. , Smith-Steinert Rachel
Published: August 2024

Introduction:
Noise pollution in the operating room (OR) poses a threat to both patients and providers. Sound levels often exceed recommended standards set forth by the National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA). The purpose of this project was to examine current evidence and implement education for student registered nurse anesthetists (SRNAs) regarding noise pollution in the OR. The education module emphasized the effect of increased noise levels on the delivery of an anesthetic, with a focus on resultant sequelae.
Methods:
A literature review produced 117 articles, of which thirty-five were included for analysis. Systematic reviews, randomized and non-randomized control trials, cohort studies, case studies, qualitative studies and expert opinion were all considered. A research based education module was delivered to SRNAs. A pre-test and post-test methodology was utilized to assess the efficacy of the education module for SRNAs.
Analysis of Results:
Results generated from the education module illustrate a knowledge deficient of student registered nurse anesthetists pertaining to noise reduction, cognitive demand, and attention allocation. Post-test scores (M=90%) for SRNAs who completed the education module were significantly greater than pre-test scores (M=60%).  t(39)= 10.1, p = 1.88 x 10-12.
Recommendations for Practice:
Noise pollution is a complex, multifactorial problem. The physical, psychological and emotional effects of noise pollution are the inability to critically think, impaired team communication, chronic hearing loss, increased incidence of cardiovascular disease, and medical error. Emphasis placed on sustaining and integrating noise reduction education into curriculum schemas of nurse anesthesia programs is prudent. Educational content delivered to all anesthesia providers and the interdisciplinary care team in the operating room would be a comprehensive plan. Although several national initiatives are in place to reduce noise, it is imperative that knowledge is shared and interventions implemented to protect both provider and patient. Furthermore, there should be a collaboration amongst a variety of surgical specialties to continue research pertaining to the production of noise in the operating room.
Keywords: Anesthesia, Noise, Noise pollution, Operating room, Occupational safety
Methodologic procedure of beer competitions eliminating the problematic practices and based on the probabilistic approach
Authors: Vrzal Tomáš , Olšovská Jana
Published: August 2024

In beer competitions, there are some common problematic practices which ruin the final results, i.e. inappropriate distribution of samples into individual groups, inappropriate scoring of samples, comparison of results obtained from different sub-groups selecting better samples, inappropriate method of handling tied scores, and inappropriate numerical evaluation. To avoid these, the presented study aims to propose a methodologic procedure which eliminates these problematic practices and is based on the probabilistic approach. Further, it wishes to test and evaluate it by the Monte Carlo simulation. The procedure is based on a sensory evaluation of beer samples by assessors through ranking tests. Beer samples and assessors are randomly divided into groups in the lowest round of the competition. Data evaluation, which determines advancing samples or winners, is based on the application of the probability theory, namely the Bayesian theorem, so that the best-evaluated samples could be identified. This procedure achieves a higher probabilitiy of accurately recognised best-evaluated samples in comparison to the procedures involving the aforementioned problematic practices.
Etika Interaksi Sosial dalam Pola Meminta Izin Memasuki Rumah Perspektif Hadis
Authors: Agusta Putra Yandri
Published: August 2024

The moral decline that has occurred in the current era of globalization has caused concern in the community. The absence of etiquette when entering other people's homes, the absence of asking permission to enter the house, the absence of prior notification is often found in this day and age. This is contrary to the teachings of Shari'ah, which principle is that Adab is above knowledge. It is better for someone to be civilized but have little knowledge than someone who has a lot of knowledge but is not civilized. Basically, there cannot be any Shari'a demands unless there must be something bad behind it all that must be abandoned. Islam does not only demand knowledge, but must instill Adab first. Surely this is a problem of the people that must be addressed immediately. The purpose of this study is to provide a detailed description of the Prophet's explanation of what procedures / ethics must be considered in entering someone else's house in order to avoid disputes or protect the disgrace of the homeowner. This research collects data through a qualitative approach in the form of a literature review which includes articles, journals, theses, and books. The result of this research is to provide an understanding and emphasis on the importance of the ethics of asking permission in terms of visiting other people's homes. The conclusion of this study also implies that parents should instill good manners from an early age to children, especially the manners of visiting other people's homes.
Pemikiran Hadis Kaum Modernis Indonesia
Authors: Anshori Muhammad
Published: August 2024

This paper analyzes Soekarno’s thoughts on hadith. Hadith studies that have developed so far are still Arab-oriented, rarely in the context of Indonesia. Using the descriptive-analytical method, this paper tries to explain Soekarno's hadith thoughts that are scattered in several of his books. Soekarno is known as a modernist thinker who is critical in reading religious discourses, including hadith. Among the themes of hadith studies raised by Soekarno in this paper are the importance of hadith studies, ḍa’īf hadith, and the methods of understanding hadith
MANEJO DO PSICÓLOGO CLÍNICO NO ATENDIMENTO AO PACIENTE COM COMPORTAMENTO SUICIDA
Authors: Marissa Beletti  , Fernanda de Máximo Braz  , Carraro Patrícia Rossi , Lucimar Magri Bernardes  , Paulino Semíramis de Matos
Published: August 2024

O presente estudo teve por objetivo, apoiado em uma revisão de literatura, compreender o manejo do psicólogo clínico no atendimento ao paciente com comportamento suicida.  Realizou-se um levantamento bibliográfico, por meio dos sistemas informatizados de busca: SciELO, PePSIC, LILACS e no buscador Google Acadêmico, no período de 2013 a 2020, cujos descritores foram: psicólogo, prática clínica, comportamento suicida e manejo. Foram utilizados oito artigos, uma dissertação e dois livros. Os resultados revelaram que o manejo do psicólogo clínico ao paciente com comportamento suicida, para ser efetivo e assertivo, depende, entre muitos fatores, principalmente da capacitação profissional específica, visto que a informação sobre o assunto não é insuficiente na graduação e orientação na prática clínica. Além disso, saber identificar o grau e os fatores de risco e poder contar com os familiares e amigos são aspectos fundamentais no tratamento desses pacientes. O psicólogo deve investir na psicoterapia pessoal e supervisão clínica para realizar um manejo adequado, pautado nos princípios do Código de Ética do Psicólogo, sem negligenciar o autocuidado, uma vez que há uma sobrecarga emocional ao cuidar do paciente com comportamento suicida. Conclui-se que, quando se trata do manejo do psicólogo clínico a esse paciente, é necessário contar com uma rede de apoio e com outros profissionais. É preciso um olhar acolhedor e respeitoso com a dor do paciente que transita entre o viver e o morrer.
Editorial
Authors: Dos Santos Rosa Daniele
Published: August 2024

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Toward precision and efficiency: a bibliometric study on robotic-assisted unicompartmental knee arthroplasty research and development
Authors: Yang Yao , Chen Yuan , Wang Yingjie , Zhou Yanling , Zheng Zhiwen , Zhu Wanbo , Zhu Junchen , Zhang Xianzuo
Published: August 2024

Aim: With the increasing prevalence of knee diseases affecting human health and quality of life, it is essential to explore more advanced surgical assistive technologies to improve the precision, safety, and success rate of unilateral knee replacement surgery. This study aims to conduct a comprehensive bibliometric analysis of robotic-assisted unicompartmental knee arthroplasty (r-UKA) to understand its current status, trends, and future directions.

Methods: Retrieve articles about r-UKA in the Web of Science Core Collection (WOSCC) database. Data from 128 selected articles, including author information, publication details, citations, and evidence level, were analyzed. Statistical analyses and data visualizations explored publication and citation trends, research interests, core author groups, and cooperative networks.

Results: Interest in r-UKA research has grown, particularly after 2013, which is evident from increased publications and citations. The United States is the largest contributor, followed by the United Kingdom, both of which have prominent medical research institutions and universities actively involved in r-UKA research. Frequent keywords such as “alignment”, “accuracy”, “revision”, and “survivorship” highlight the focus on surgical precision, implant longevity, and patient outcomes.

Conclusion: Robotic-assisted unicompartmental knee arthroplasty has gained significant attention, promising improved surgical precision and patient outcomes. Collaboration between researchers and medical institutions globally has driven progress in this field. However, long-term outcomes and clinical efficacy compared to traditional techniques require further investigation. As robotic technology evolves, its application in knee replacement surgery holds potential for better therapeutic effects and advancements toward more accurate, safe, and efficient procedures, benefiting patients and advancing unicompartmental knee arthroplasty (UKA).