bluuebunny/crossref_metadata_2025 huggingface dataset:
Thoracal Paravertebral vs. Serratus Anterior Plane Block in Combination with COMBIPECS for Modified Radical Mastectomy
Authors: Utomo Wandito Gayuh , Fitriani Calcarina , Sudadi Sudadi , Ali Farhan
Published: November 2024

Background: Breast cancer is one of the most common malignancies in women worldwide. Surgical options for breast cancer include modified radical mastectomy (MRM), in which the entire breast is removed but the pectoralis major muscle is spared. Routine anesthesia modalities for MRM include general anesthesia (GA), epidural blockade combined GA, and nerve blockade combined GA . Thoracic paravertebral block (TPVB) is still recognized as the gold standard analgesic procedure for breast surgery. However, TPVB is more difficult to perform with possible complications such as hypotension, pneumothorax, and unintentional spread of anesthetic agent to epidural space. Serratus anterior plane block (SAPB) is a promising new procedure that is relatively easier to perform and safer. Previous studies have reported its benefit in reducing the need of postoperative opioids and postoperative pain.

Case illustration: We describe the case of 2 females with left breast cancer undergoing unilateral MRM, both with ASA class II. First patient was given TPVB, PEC 1, and PEC 2 (COMBIPECS). Second patient was given nerve block and guided ultrasonography using SAPB, PEC1, and PEC 2 (COMBIPECS). Each patient was sedated with a dexmedetomidine loading dose of 1mcg/kg/10 minutes, titration 0.2-0.4mcg/kg/hour. Both types of blocks provide adequate anesthesia. Ketorolac 30mg/8 hour was given post-operative. Both patients showed normal vital signs, and the same post-operative NRS of 0. No block related complication was found in both cases.

Conclusions: TVPB and SAP combined with COMBIPECS have similar results in terms of post-operative pain score and minimal complication.
Thromboprophylaxis in Intensive Care Unit Patients
Authors: Rikardi Fachrizal , Fitriani R.W Calcarina
Published: November 2024

Background: Intensive Care Unit (ICU) patients are at twice the risk of experiencing thrombosis compared to patients in regular wards. This risk is associated with prolonged immobility, sedation, and neuromuscular blockade to facilitate ventilation. The incidence ranges from 8-40%. This undoubtedly leads to poorer patient outcomes, including increased patient mortality. ICU patients require prophylaxis to prevent thrombotic events. The use of thromboprophylaxis has been shown to reduce mortality rates in these patients.
Content: Intensive Care Unit (ICU) patients are at risk of developing thrombosis, which is closely related to Virchow's triad, which consists of venous stasis, endothelial dysfunction, and hypercoagulability. Considering the high morbidity associated with thrombotic events and the low side effects of carefully administered anticoagulants, pharmacological prophylaxis should be provided to all critically ill patients without contraindications to anticoagulants. Regular monitoring is necessary when administering pharmacological prophylaxis. Compared with UFH and mechanical compression, LMWH is the preferred thromboprophylaxis for ICU patients. Generally, patients weighing 50-100 kg can be given LMWH, such as enoxaparin, at a subcutaneous dose of 40 mg per day. The discontinuation of thromboprophylaxis should consider the patient's clinical condition and drug side effects.
Summary: Thromboprophylaxis is highly necessary for Intensive Care Unit (ICU) patients. The preferred thromboprophylaxis for ICU patients is LMWH. In certain circumstances, UFH or mechanical thromboprophylaxis may be considered.
Designing an E-Module on the Solar System to Develop Critical Thinking Skills
Authors: Vebrianto Rian , Lilandariati Fadhillah , Yuliastrin Adisti , Hardila Dilva , Sukor Nur Suhaidah
Published: November 2024

This study aimed to develop learners' critical thinking abilities through concentrated application in related learning activities. A quasi-experimental design of the Pretest-Posttest Non-Equivalent Control Group type was employed. The study was done between January and February 2023 with a sample of 60 junior high school students in grade VII, divided evenly into an experimental group and a control group, each with 30 participants, focused on the solar system. The experimental group utilized problem based learning (PBL) e-modules, while the control group followed conventional teaching methods. The instrument used in this study included a critical thinking variable with four components in the form of a multiple-choice exam with a reliability value of 0.183, allowing it to evaluate students' critical thinking skills. The data were collected during the pretest and after treatments by administering the posttest. After the SPSS analysis, the data was shown descriptively and inferentially. The results revealed a notable difference in critical thinking capabilities between students involved in PBL-based e-modules and those taught using conventional approaches (P < 0.01). Therefore, the study shows that including PBL-based e-modules into the curriculum could improve students' critical thinking ability quite successfully.
Examining the relationship between environmental ethics literacy and environmental awareness characteristics
Authors: Hudha Atok Miftachul , Aini Firda , Miharja Fuad Jaya
Published: November 2024

Behavior that damages the environment can be changed through knowledge, because knowledge can influence a person's attitude in protecting theenvironment. This research aims to analyze the relationship between environmental ethics literacy and environmental awareness in prospective biology teacher students. The research was conducted on Biology Education students at "X" University, Malang City. The research sample was taken randomly from the population and the sample in this study was 74 prospective biology teacher students in semester V of the 2020/2021 academic year, and semester VII of the 2019/2020 academic year. Sample selection was based on all students who had taken and passed ethics andecology courses. The instruments used to collect data were test questions and attitude observation sheets with Likert scales and Guttman scales. Data were analyzed using the Pearson Product Moment correlation test with data processing using the SPSS 24 for Windows program. Theresearch results show that (1) the environmental ethics literacy of prospective biology teacher students is in the medium category; (2) environmental awareness of prospective biology education teacher students in the good category; (3) there is a relationship betweenenvironmental ethical literacy and environmental awareness character, because the results of correlation analysis with the Pearson ProductMoment correlation show a significance value of 0.000 < 0.05. The results of this research show that environmental ethics literacy has a positiverelationship with environmental awareness, so to foster environmental awareness it is necessary to continuously increase environmental ethics literacy.
PENINGKATAN KEMANDIRIAN MELALUI KEGIATAN PEMBELAJARANPRACTICAL LIFE
Authors: RANTINA MAHYUMI
Published: November 2024

Abstract: The purpose of this research was to determine the process of implementation of the learning activities of practical life. The research was conductedon agroup ofkindergartenwith anumber of14in March andApril 2015.The method used in this research is an action research which refers to the model of a Classroom Action Research Kemmis and Mc. Taggart consist of four phase: planning, action, observation and reflection. This research consist of two cycles, each cycle consist of 8 times in actions.Data analysis usingquantitative and qualitative data.Quantitativedata analysis wasdone usingdescriptive statisticsto dataattainment of self-relianceof childreninpre-cycle, the first cycleandsecond cycle. While thequalitative analysiscarried out onthe data offield notesandinterview transcripts. The results showedan increase inthe child's self-relianceafterlearning activities ofpracticallife. Dataattainment of self-relianceof childreninpre-recorded cycle of47.99%.The data isincreased to69.31% at the end ofthe firstcycle, and furtherincreased to85.01% at the end ofthe second cycle.
Keywords: Early Chilhood, self-reliance, learning activities of practical life
PENINGKATAN KREATIVITAS GERAK MELALUI KEGIATAN TARI PENDIKAN BERBASIS CERITA (TARITA)
Authors: JUNIASIH INDAH
Published: November 2024

Abstract: This research purposes is to obtain empirical data about educational dance activity based on story (TARITA), in an effort to improve early childhoodâ€™s creative movement. The method that used in this research is a action research. In this study.These research through four stages activities, which are planning, action, observation and refelection. Action in this research was conducted in two cycles with a total of 12 times meetings. Sources of data in this study were students who join RA Robbani dancing extracurricular activities. The collection of data is done through the rubric, observation, interviews, and documentation study. The results showed that TARITA activities can improve children's creative movementthat on a pre-cycle was 30.72%. Then increased to 54.4% at the end of the first cycle and continued to increase to 77.4% at the end of the second cycle. It shows that it has been achieving the research minimal target of 71%. The research concludes that TARITA become one of the good alternative methods for improving early childhood creative movement.
Keyword: Educational Dance, Story Teling, dan Creative Movement
PENINGKATAN KEMAMPUAN BERPIKIR KRITIS MELALUI METODE EKSPERIMEN BERBASIS LINGKUNGAN
Authors: ANGGREANI CHRESTY
Published: November 2024

Abstract: The aim of this research is to improving critical thinking abilty in group B PAUD Mentari, Kab Bengkulu Selatan. The research used ation research method according to Kemmis and Taggart were conducted over 14 meetings. Teh subject of this research is gruop B PAUD Mentari which is consist about 10 childrenâ€™s where consist of 5 male and 5 female. The steps of the action research method of Kemmis and Taggart models that include: (1) planning, (2) action, (3) observation, and (4) reflection. The data collected by observation, documentation with data analysis by quantitative and qualitative. Qualitative data analysis is used mode analysis by Miles and Huberman.Before conducting the research, pre-action research conducted to determine the percentage of the initial result of the critical thinking of children. The result of research  says that the average grade in the pre-action amounted to 40,27% After the action in the first cycle increased the average grade o 56,03% and became the second cycle increased to 88,48%. The result of this research shows that critical thinking abilty can be improved through experiment method, proven by the result of the observation which did it and had reach success indicator about 71%.
Keywords: Critical Thinking, Experiment Method, Action Research
Peningkatan Literasi dan Numerasi Siswa SDN Karang Manik Melalui Program Kampus Mengajar
Authors: Delfi Iftina , Hidayat Syafri , Triviana Fina , Camellia Camellia
Published: November 2024

Indonesia's PISA results, which are always below the average score and are ranked in the bottom 10, are a strong indicator showing the low literacy and numeracy skills of students, which should be very important for students in strengthening their problem solving abilities, especially in accordance with everyday life. . The state, through the Ministry of Education and Culture, is always creative and innovative to overcome this problem, one of which is by launching the Kampus Mengajar Program which is part of the Merdeka Belajar kampus Merdeka (MBKM) policy. Through this program, students with creative ideas and burning enthusiasm are at the forefront of achieving the above goals. This program is implemented through 3 stages consisting of pre-assignment, assignment and post-assignment. This publication is a publication from students and lecturers of the 5th class of the Kampus Mengajar program with SDN Karang Manik as the placement school. Through the programs that we have designed, the literacy and numeracy skills of SDN Karang Manik students have increased, which can be seen from the comparison of the AKM class pretest and posttest scores conducted at the beginning and at the end of the assignment period which has increased. Even though we only carried out this activity for 1 semester, the work programs that we have designed continue to be carried out by the teachers at the school with the same aim as the aim of holding this Kampus Mengajar program. For us, the Kampus Mengajar program can be used to improve teaching abilities and solve problems that exist in target schools.
Infografis sebagai Media Informasi Mengenai Situs Sejarah di Desa Cisaat, Kecamatan Ciater, Kabupaten Subang, Provinsi Jawa Barat
Authors: Hadi Santosa Firdaus , Umasih Umasih , Hasan Rinie Octaviany , Kadar Raka El-Chuza Adnan , Christiono Marchel
Published: November 2024

The purpose of this community service activity is to increase understanding and ability to make infographic media as information media about historical sites in Cisaat Village, Subang, West Java. This is because the use of infographic media is needed in delivering information about historical sites as a form of utilizing information technology and updating information dissemination. The partner in this activity is the Tourism Awareness Group of Cisaat Village, Ciater District, Subang Regency. Participants in this activity are the community, especially members of the tourism awareness group and youth who will become developers and preservers of historical sites. The method that will be used to be able to increase understanding and ability to make infographic media is to use seminars or workshops to members of the tourism awareness group and youth of the Cisaat village community. Through this activity, the output of community service activities is expected to be able to obtain (1) Intellectual Property Rights (IPR), (2) Publication of activity videos on YouTube, (3) Partner Certificate regarding an increase in partner empowerment according to the problem. (4) Online mass media publication.
Identifikasi Kebutuhan Peserta Didik di Sekolah-Sekolah Kabupaten Flores Timur Desa Pledo
Authors: Rohi Enasely Mega Wenyi , Margaretha Dhiu
Published: November 2024

Student service camp activities are a form of community service in disseminating Student Needs Questionnaires (AKDP) in schools and taking a role in providing information services for students at school. Implementing AKDP in schools aims to know every dominant problem in several schools spread across Pledo Village, Witihama District, and East Flores Regency. The results of the spread of AKPD in several schools can provide benefits. The benefit of this activity is that schools know what problems are experienced by students related to four areas of service, namely, the fields of personal, social, learning and career services and can help BK teachers develop programs related to the problems of each school.
Pendampingan Analisis Potensi Wisata Alam di Desa Medalsari, Kecamatan Pangkalan, Kabupaten Karawang Jawa Barat
Authors: Sahara Lala Siti , Nova Nova Dian Aprianty , Musyafa Muhammad Akmal , Arrizkia Nissa
Published: November 2024

Medalsari Village is located in Base District, Karawang Regency which has the potential tobecome a tourist destination, one of which is natural tourism with a waterfall called GreenCanyon. The main problem faced is the lack of optimal management of natural tourism andthe lack of awareness of local park tourism activists about the innate potential possessed byMedalsari Village. The purpose of this service is to identify and analyse the natural tourismpotential of Medalsari Village and how the direction of its development, using the method ofobserving natural tourism sites, conducting interviews and FGDs with local tourism activists toobtain data used as SWOT analysis material on natural tourism potential so that local tourismactivists, Medalsari Village government understand the concept of natural tourism potentialand its development. The results of the assistance illustrate that Medalsari Village has naturaltourism potential, there are waterfalls and rivers, but it has yet to be maximised in developingthese potentials. Using SWOT analysis, we know the potential, opportunities and challengesthat must be done in developing natural tourism in Medalsari Village.
Program Ruang Ilmu Untuk Meningkatkan Motivasi Belajar Baca Tulis Qur'an Anak di Desa Margaluyu, Kiarapedes Kabupaten Purwakarta
Authors: Budianingrum Wangi
Published: November 2024

Pengabdian masyarakat ini dilatarbelakangi oleh motivasi belajar BTQ masih rendah di Desa Margaluyu serta masih ada anak yang belum bisa membaca dan menulis al-qur’an. Adapun Tujuan dari Kegiatan KPM yang dilaksanakan adalah program ruang ilmu untuk meningkatkan motivasi belajar BTQ pada anak di Desa Margaluyu. Maka dari itu pengabdi membuat satu program yaitu ruang ilmu untuk meningkatkan motivasi belajar anak di Desa Margaluyu dusun 2 yang berjumlah 10 anak. Setelah program ini dilaksanakan, pengetahuan anak-anak menjadi meningkat dan lebih memahami tentang metode atau tatacara memahami, menghafal dan mendalami AL-Qur’an. Ucap Syukur karena program ini bisa berjalan dengan lancar dan mendapat dukungan dari pihak desa dan para warga dusun 2, terutama para orang tua.
Implementasi Media KarierOnWheels untuk meningkatkan pemahaman karir pada siswa SMK Negeri 3 Makassar
Authors: Suwardani Ni Kadek
Published: November 2024

Salah satu program dari Merdeka Belajar Kampus Merdeka (MBKM) adalah Asistensi Mengajar yang bertujuan untuk memberikan kesempatan bagi mahasiswa yang memiliki minat dalam bidang pendidikan untuk turut serta mengajarkan dan memperdalam ilmunya dengan cara menjadi guru di satuan pendidikan. Kegiatan pengabdian ini bertujuan untuk memahami mengenai ragam jenis pekerjaan dan profesi, permainan ini juga membantu siswa agar dapat mengenal klasifikasi kepribadian karirnya serta dapat memilih pekerjaan yang tepat, sesuai bakat dan minatnya. Pelaksanaan pengabdian ini dilakukan melalui beberapa tahapan yaitu; (1) Focus Group Discussion, (2) bimbingan klasikal, (2) penggunaan media KarierOnWheels, (4) BMB3. Dalam kegiatan ini, digunakan pendekatan deskriptif kualitatif. Berdasarkan hasil tersebut diperoleh informasi bahwa kegiatan ini sangat relevan dengan kebutuhan peserta serta berjalan dengan baik dan memberikan manfaat positif kepada siswa
Анализ динамики эпидемического процесса COVID-19 в мире за неделю с 26.10.2024 г. по 01.11.2024 г.
Authors: Зимирова Анастасия , Поспелов Михаил , Иванова Александра , Карнаухов Игорь , Щербакова Светлана , Кутырев Владимир , Дмитриева Людмила , Чумачкова Елена
Published: November 2024

В обзоре представлен анализ эпидемиологической ситуации в странах мира по COVID-19 за неделю с 26.10.2024 г. по 01.11.2024 г.
Study Assesses Effects of Carbon Dioxide on Drilling-Fluid Performance in CCS Wells
Authors: Carpenter Chris
Published: November 2024

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This article, written by JPT Technology Editor Chris Carpenter, contains highlights of paper SPE 217711, “CCS Well-Control Impact of CO2 on Drilling-Fluid Performance,” by Jan O. Skogestad, SPE, Blandine Feneuil, SPE, and Elie N’Gouamba, SPE, SINTEF, et al. The paper has not been peer reviewed.

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Drilling carbon-dioxide (CO2) storage wells is a task expected to involve handling an influx of CO2 into the drilling fluid. In the study described in the complete paper, experimental characterization of density, rheology, phase envelope, hydrate formation, and drilling-fluid stability are performed on drilling fluids mixed with CO2 for relevant pressures and temperatures. Based on these experiments and verified thermodynamic model descriptions, local models for properties of drilling-fluid/CO2 mixtures were developed and integrated into an existing drilling software suite.

Requirements for Enhanced Well-Control Software

Well-control-evaluation software based on sophisticated and verified models of the drilling-fluid/gas interaction in the wellbore plays an important role in planning drilling operations. The software also can be used to evaluate the strategy for circulating out a kick and regaining control of the well. When drilling infill wells into CO2 storage sites, this software must be able to process kicks originating from both CO2 and natural gas influx.

To achieve this ability, knowledge gaps related to the interaction of CO2 and drilling fluid must be closed. Hydraulic-flow models need to be enhanced with local models that capture the unique properties of CO2 and how it affects drilling-fluid performance.

Starting from carefully devised experimental campaigns, the authors developed local models for drilling-fluid/CO2 interaction that were integrated into an existing hydraulic flow model. A well-control-evaluation product for use during planning and execution of infill drilling operations into CO2 storage reservoirs may then be built using the upgraded models.

Experimental methods, equipment, and setup are detailed in the complete paper.

Experimental Results

Bubblepoints.

Bubblepoint experiments in the base oil have been performed with CO2 weight content from 4 to 50% of the total weight of the mixture and at room temperature and 50 and 100°C. All measurements have been repeated at least once.

At room temperature, CO2 can be dissolved in oil at mass fractions of up to approximately 50%. The bubblepoint increases when the temperature increases (i.e., the solubility decreases).

As with base oil, the solubility of oil-based drilling fluid (OBDF) decreases with temperature. The bubblepoint at room temperature with 25% of CO2 by weight of the mixture is approximately 60 bar, roughly the bubblepoint of pure CO2. Therefore, the maximal solubility of CO2 in OBDF is probably below 25%. To compare the measured solubility in base oil and in OBDF, the CO2 content relative to the base oil has been calculated using the OBDF composition provided by the manufacturer.
Technology Focus: Flow Assurance (November 2024)
Authors: Wilson Adam
Published: November 2024

This year’s Flow Assurance Technology Focus provides a trio of papers, selected by ChampionX’s Celestina Kissi, concerning the use of advanced techniques in detection, mitigation, and risk calculation. SPE technical conferences and meetings remain a critical conduit for the transfer of forward-thinking research and insight to both project developers and field practitioners who make certain that production is optimized and that goals are met.

Paper SPE 216216 investigates asphaltene risks inherent in the gas-injection enhanced oil recovery (EOR) process. The authors’ research identifies what they term “stealth” asphaltenes, referring to asphaltenes detectable only by laser-light-scattering techniques and not by traditional microscopy. These asphaltenes are still flowable and can still pose risks to flow assurance.

In the second selection, SPE 218101, the authors delve into the risks posed by hydrate formation in water-alternating-gas EOR operations, particularly during changeover operations, an area in need of further research in the literature. Additionally, the authors explore the effect of natural gas composition on these phenomena.

Finally, paper SPE 218700 describes an operator’s development and deployment of a suite of cloud-based digital-twin tools designed to provide online, real-time calculation of scale risk and barrier health on a well-by-well basis. The complete paper includes four diverse case studies in which the described toolkit proved its value.

As the technology used in the field sharpens, it will simultaneously overcome long-standing obstacles and discover entirely new ones, such as the challenge posed in the first presented paper. SPE technical conferences will continue to ensure that the flow of innovation reaches the page and the field with equal effect.
Unlocking Pan-Cancer Detection with Phenyl-β-D-Glucuronide Like Exogenous Agent and Induced Breath Analysis for Non-Invasive Early Discovery
Authors: Jin Han , Xue Cuili , Yan Yufei , Wang Shuanghu , Ni Huiyan , Lu Zebei , Wu Yuejun , Haick Hossam , Cui Daxiang
Published: November 2024

The urgent need for a non-invasive, universally applicable cancer detection method has never been more critical. In response to the pressing demand, we presents the discovery of phenyl-β-D-glucuronide, a natural compound, for tumor detection. Metabolized into phenol by β-glucuronidase, an enzyme prevalent in the tumor microenvironment, this compound led to elevated phenol levels in exhaled breath. Moreover, phenyl-β-D-glucuronide's exceptional bio-compatibility and minimal residual presence post-24 hours offer unparalleled advantages over conventional synthetic agents. Building upon this innovation, we created a cutting-edge cancer screening method known as phenyl-β-D-glucuronide induced breath analysis. Specifically, a handheld breath-analyzer is proposed to capture breath signals indicative of cancer presence. Preliminary animal tests, utilizing both subcutaneous and orthotopic tumors model, validated the effectiveness of our method in assessing various cancer risk, including gastric, lung, colon and liver cancers, with specificity/sensitivity/accuracy rates surpassing 94.3%; and minimal interference from other diseases. These impressive findings mark a significant step toward cancer detection, improving diagnosis and treatment outcomes universally.
Stress hyperglycaemia ratio is an independent predictor of in-hospital heart failure among patients with anterior ST-segment elevation myocardial infarction
Authors: Sabah Zia ul , Alqahtani Saif Aboud M , Iqbal Javed , Aziz Shahid , Durrani Humayoun Khan , Patel Ayyub Ali , Rangraze Imran , Mirdad Rasha , Alfayea Muad Ali , Shahrani Sara
Published: November 2024

Background
Stress hyperglycaemia ratio (SHR) has been reported to be independently and significantly associated with various adverse cardiovascular events as well as mortality. Moreover, in-hospital heart failure following acute myocardial infarction has been demonstrated to account for majority of all heart failure (HF) cases with anterior myocardial infarction showing higher rates of HF. However, the association between SHR and in-hospital HF following an anterior ST-elevation myocardial infarction (STEMI) has not been reported earlier. Therefore, the present study aimed at identifying the relationship between SHR and in-hospital HF post STEMI.
Methods
In this retrospective study electronic health records of 512 patients who presented with anterior STEMI from 01 January 2022 to 31 January 2024 were analysed. Based on the development of in-hospital HF, the enrolled patients were stratified into two groups: Group I, comprising of 290 patients who developed in-hospital HF and Group II comprising of 222 patients who did not develop in-hospital HF. ROC and Multivariable logistic regression analyses were performed to assess the relationship between SHR and in-hospital HF.
Results
The results revealed that SHR is a significant independent predictor of in-hospital HF (OR: 3.53; 95%CI: 2.02–6.15; p < 0.001). Apart from SHR, the results also identified age, nosocomial pneumonia, ventricular fibrillation, LVEF, and NT-pro-BNP levels as other independent predictors. ROC analysis showed that SHR independently had a moderate discriminative power with AUC: 0.683, 95% CI 0.605–0.762; p = 0.04, which was almost comparable to the combined predictive value of other independent risk factors (AUC: 0.726, 95% CI 0.677–0.784). Noticeably, combining SHR and other identified independent predictors demonstrated a significant predictive power (AUC: 0.813, 95% CI 0.757–0.881; p = 0.01).
Conclusion
SHR is an independent predictor for in-hospital HF in anterior wall STEMI patients.
Development of System for on-site dosimetry audit of High Dose Rate Brachytherapy
Authors: Gwon Hyeok Jun , Lee Wonho , Choi Sang-Hyoun , Cho Gyu-Seok , Lee Soon Sung , Hwang Sun-Boong , Kim Kum Bae
Published: November 2024

Background: Various international institutions established key quality assurance guidelines for radiation therapy, focusing on treatment accuracy and equipment reliability. Despite international standards, the lack of an independent audit system in South Korea has led to quality management challenges in high-dose-rate brachytherapy, prompting this study to develop a precise source activity measurement system and regulatory MATLAB code.
Methods: Variations in Remote After-Loading System (RALS) models across institutions are considered, with Standard Imaging source holders and a CDX2000B electrometer used for accurate source strength measurements, focusing on maximum point accuracy. Mechanical accuracy checks involve assessing dwell position accuracy, reproducibility, and offset using self-developed phantoms with in-house MATLAB code, supported by EBT3 film for precise measurement and verification of radiation source positions and offsets.
Results: Measured data present the discrepancy between measured and calculated values, with uncertainty observed below 0.14%. Additionally, The developed in-house MATLAB code for film data analysis, utilizes grayscale window analysis for accurate identification of irradiated points, demonstrating minimal position and step size errors, affirming the precision of the method.
Conclusion: In this study, we developed an audit system integrating a source strength measurement system and mechanical accuracy check phantoms, utilizing a well-type chamber – electrometer setup and in-house MATLAB code. We achieved audit suitability with appropriate uncertainty, compatible across various Remote After-Loading Systems (RALS). Uncertainty assessments resulted in proposed expanded uncertainties (k = 2) of 2.72% and 2.71% for models 70010 and 72280. Based on these results, we plan to implement this audit system nationwide to comply with domestic regulations.
Opisthorchis felineus first autochthonous case in Austria
Authors: Kulmer Lisa-Maria , Unterköfler Maria Sophia , Vali Yasamin , Schwendenwein Ilse , Luckschander-Zeller Nicole
Published: November 2024

Opisthorchis felineus is a feline pathogen with zoonotic potential that can cause opisthorchiasis and cholangiocarcinoma in humans. In Europe, endemic areas particularly include Eastern Europe and parts of Asia, such as Russia, Ukraine, and Kazakhstan. However, the parasite has also been sporadically detected in Germany and northern Poland. A seven-year-old female neutered European shorthair cat without any travel history presented in May 2023 with weight loss, anorexia and vomiting. The cat presented increased liver enzyme activity, hyperbilirubinemia and hyperammonemia, which was consistent with the suspected diagnosis of cholangitis with subsequent hepatoencephalopathy. Opisthorchis felineus was detected via routine cytological examination of bile smears, and PCR confirmed O. felineus. This is the first report of autochthonous O. felineus infection in Austria.
Investigating Hippocampal Proteome Dynamics in Aging Rats with Minimal Hepatic Encephalopathy via High-Resolution Mass Spectrometry
Authors: Singh Vishal Vikram , Prasad Shambhu Kumar , Acharjee Arup , Srivast Sanjeeva , Acharjee Papia
Published: November 2024

The aging population faces a gradual decline in physical and mental capacities, with an increased risk of liver cirrhosis and chronic liver diseases leading to hepatic encephalopathy (HE). The intertwining of physiological manifestations of aging with the pathophysiology of HE significantly impairs cognitive ability, reduces quality of life, and increases mortality. Hence, effective therapeutic intervention is imperative. The present study investigated the impact of minimal HE (MHE) on cognitive impairment in an aging rat population by analyzing hippocampal proteome dynamics. For this purpose, an old MHE rat model was induced via thioacetamide. The label-free LC‒MS/MS method was employed to explore hippocampal proteomic changes and associated dysregulated biological pathways. A total of 1533 proteins were identified, and among these, 30 proteins were significantly differentially expressed (18 upregulated, and 12 downregulated). Three upregulated proteins, namely, fetuin-A, p23, and intersectin-1 were selected and validated for their increased expression via western blotting and immunofluorescence analysis, which confirmed the mass spectrometry results. These proteins have not been reported previously in MHE cases. We also identified the possible dysregulated biological pathways associated with the differentially expressed proteins via Metascape, a network analysis tool. We found that the differentially expressed proteins may be involved in the generation of precursor metabolites and energy, the neurotransmitter release cycle, positive regulation of dendritic spine development, chaperone-mediated protein folding and protein stabilization. This study highlights the potential mechanisms underlying neurological dysfunction in the aging population with MHE and identifies novel therapeutic targets for improved disease management.
Atlantic ocean circulation slowdown intensifies tropical cyclones in the North Atlantic
Authors: Levin Emma , Studholme Joshua , Fedorov Alexey , Liu Wei , Emanuel Kerry , Burls Natalie
Published: November 2024

The slowdown of the Atlantic Meridional Overturning Circulation (AMOC) is ubiquitous in climate projections, representing a major risk of global warming with far-reaching climatic impacts. Here, we investigate how the future AMOC slowdown can affect the activity tropical cyclones (TCs). To that end, we compare two sets of global warming simulations: one that exhibits AMOC weakening and another in which AMOC intensity is fixed. Using these experiments, we compute Genesis Potential Indices (GPI), to assess large-scale ocean-atmosphere conditions for TC formation, and conduct downscaling TC simulations for the two scenarios. Our analysis shows strongly enhanced tropical cyclogenesis in the North Atlantic, especially along the U.S. eastern seaboard and in the Gulf of Mexico, in a warm climate with a weakened AMOC. The AMOC slowdown causes roughly 60% of the estimated seasonal increase of 12 storms in the Atlantic with warming. Higher TC potential intensity (PI) in the North Atlantic due to greater air-sea thermodynamic disequilibrium and, to a lesser extent, reduced vertical windshear explain these findings, which highlight the important role of AMOC slowdown in 21st -century TCs.
From Pandemic to Progress: Maternal Health Resilience in the post COVID-19 era in Tamil Nadu, India
Authors: Paramasivan Kandaswamy , Prakash Ashwin
Published: November 2024

Background and Objectives The COVID-19 pandemic considerably impacted emergency medical services (EMS), particularly in the context of maternal care. In response, the government made significant investments in both EMS and maternal health during the pandemic. This study aims to evaluate maternal and childbirth outcomes, specifically during the resilient period, by analyzing the long-term effects of the pandemic on healthcare delivery. Data and Methods The research analyzed key metrics related to emergency medical services for pregnancy, including call volume, response and transfer times, hospital handoff times, and ambulance travel distances. Maternal outcomes assessed included mortality rates, institutional childbirth, home deliveries, miscarriages, vaginal complications, and C-section rates. Data was sourced from the Tamil Nadu State Control Room registry, covering historical data from Jan 2017 including the pandemic phases in 2020–2022 and the subsequent resilient period in 2023-24. This study employs time-series analysis to compare the distribution of daily key metrics of EMS during eight pandemic phases with the average daily frequency during the pre-pandemic period. An effect size measure is then used to quantify the improvement in maternal healthcare outcomes and EMS metrics. Results Throughout the various stages of the pandemic, there was a notable increase in call volume related to women. Despite this, there were significant improvements in response times, transfer times, and hospital handoff times. In comparison to the corresponding period before the pandemic, maternal and childbirth outcomes saw marked enhancements during the post pandemic phase in 2023 and resilient phase in 2024. Specifically, the maternal mortality rate dropped by 19%, with 37 deaths per 100,000 live births, significantly lower than the national average of 97 deaths per 100,000 live births. Additionally, the rates of infant mortality, neonatal mortality, miscarriages, complicated vaginal births, and home deliveries decreased by 19.35%, 17.03%, 28.02%, 19.23%, and 36.05%, respectively. Conclusions: Government investments during the pandemic, along with the sustained focus on maternal health programs, appear to have provided substantial support to pregnant women and newborns. The reproductive health of women in Tamil Nadu does not seem to have been adversely impacted by the pandemic.
The impact of SARS-CoV-2 infection at different stages of pregnancy on placental inflammatory responses
Authors: Yin Mengyue , Peng Lingling , Zhang Chunling , Zhang Xueyan , Han Mei , Wang Yongmei , Hao Yafei , Guo Zhaolun , Li Hua , Zhang Lan
Published: November 2024

Background
The specific impact and pathology of SARS-CoV-2 infection on maternal and fetal health have not been comprehensively investigated. Therefore, we investigated the inflammatory response of fetal tissues in pregnant women infected with SARS-CoV-2 at different stages of pregnancy.
Methods
We collected placenta samples from 52 patients at Tai’an Central Hospital, who underwent delivery between November 2022 and September 2024. We analyzed general patient data and maternal-fetal outcomes and conducted histological observations using HE staining. Furthermore, we used ELISA to quantitatively analyze the concentration of IL-6 in umbilical cord blood and amniotic fluid. Additionally, Western blot analysis was conducted to evaluate the expression levels of TNF-α and IL-1β in the placental tissues.
Results
Among participants, 33 pregnant women were diagnosed with SARS-CoV-2 infection. Patients infected SARS-CoV-2 during mid-pregnancy developed thrombosis, stromal protein deposition, and villous interstitial inflammation compared to the control group (P < 0.05). However, No significant placental pathology differences were found between late-term stages with the control group (P > 0.05). Western blot analysis revealed elevated TNF-α and IL-1β levels in infected placental tissues, with no significant difference between mid-term and late-term pregnancies. IL-6 levels in amniotic fluid showed no significant difference, and IL-6 expression was not detected in umbilical cord blood.
Conclusion
SARS-CoV-2 infection during pregnancy appears to have limited impact on overall maternal and fetal outcomes. However, the infection may lead to inflammatory changes in placental tissues, particularly during the mid-trimester. These findings suggest the importance of careful monitoring and management of SARS-CoV-2 infection in pregnant women. Nonetheless, larger studies are necessary to confirm these observations and explore the long-term effects on both maternal and fetal health.
GDF-15 as a Proxy for Epigenetic Aging: Associations with Biological Age Markers, and Physical Function
Authors: Torrens-Mas Margalida , Navas-Enamorado Cayetano , Galmes-Panades Aina , Masmiquel Luis , Sanchez-Polo Andrés , Capo Xavier , Gonzalez-Freire Marta
Published: November 2024

Growth differentiation factor 15 (GDF-15) has emerged as a significant biomarker of aging, linked to various physiological and pathological processes. This study investigates circulating GDF-15 levels in a cohort of healthy individuals from the Balearic Islands, exploring its associations with biological age markers, including multiple DNA methylation (DNAm) clocks, physical performance, and other age-related biomarkers. Seventy-two participants were assessed for general health, body composition, and physical function, with GDF-15 levels quantified using ELISA. Our results indicate that GDF-15 levels significantly increase with age, particularly in individuals over 60. Strong positive correlations were observed between GDF-15 levels and DNAm GrimAge, DNAm PhenoAge, Hannum, and Zhang clocks, suggesting that GDF-15 could serve as a proxy for epigenetic aging. Additionally, GDF-15 levels were linked to markers of impaired glycemic control, systemic inflammation, and physical decline, including decreased lung function and grip strength, especially in men. These findings highlight the use of GDF-15 as a biomarker for aging and age-related functional decline. Given that GDF-15 is easier to measure than DNA methylation, it has the potential to be more readily implemented in clinical settings for broader health assessment and management.
Albumin-muscle density score predicts overall survival in patients with hepatocellular cancer undergoing treatment with transarterial chemoembolization
Authors: Surov Alexey , Wienke Andreas , Borggrefe Jan , Auer Timo Alexander , Gebauer Bernhard , Mähringer-Kunz Aline , Nensa Felix , Haubold Johannes , Schaarschmidt Benedikt Michael , Hosch René , Kleesiek Jens , Diallo Thierno D , Roehlen Natascha , Bettinger Dominik , Eisenblätter Michel , Steinle Verena , Mayer Philipp , Zopfs David , Santos Daniel Pinto dos , Müller Lukas , Kloeckner Roman
Published: November 2024

Purpose
The purpose of the present study was to analyze associations between different skeletal muscle quality parameters and survival in patients with hepatocellular carcinoma (HCC) undergoing treatment with transarterial chemoembolization (TACE).
Methods
We retrospectively enrolled 784 treatment-naïve patients with HCC undergoing TACE at six tertiary care centers between 2010 and 2020. Intramuscular adipose tissue (IMAT) and skeletal muscle density (SMD) were estimated. Myosteatosis was defined as SMD < 28.0 HU for men and < 23.8 HU for women. Furthermore, albumin-SMD score (ADS) was calculated as follows: serum albumin (g/dL) × SMD (HU). To assess the impact of muscle quality on survival, Cox regression model was used. Kaplan-Meier curves were used for survival analysis. Parameters of skeletal muscle quality were compared in univariate and multivariate regression analyses, adjusted for established risk factors.
Results
In the overall sample, survivors had higher SMD and ADS in comparison to non-survivors. Patients with low ADS had a lower OS than patients with high ADS (8.4 vs 14.3 months, p < 0.001). In alcohol-induced HCC, none of the analyzed parameters of muscle quality influenced survival. In viral induced HCC, patients with low ADS had lower OS than patients with high ADS (8.8 vs 15.7 months, p < 0.001). In patients with non-alcoholic steatohepatitis (NASH), none of the analyzed parameters of muscle quality influenced survival.
Conclusions
Low ADS is an independent predictor of worse OS in patients with viral-induced HCC undergoing treatment with TACE. In alcohol-induced and NASH-induced HCCs, parameters of muscle quality do not influence OS.
NTRK-Rearranged Spindle Cell Tumor with SPECC1L-NTRK3 Fusion in the Thoracic Spine: A Case Report
Authors: Zhou Mi , Xu Huaiyuan , Niu Jianxiong , Yang Qibing , Wang Anqi , WU Hao , Hu Jinxin , Wang Xiangqin , Yang Meng , Tang Qinglian , Wang Jin
Published: November 2024

Neurotrophic Tyrosine Receptor Kinase (NTRK)-rearranged spindle cell tumors are a category of soft tissue tumors characterized by rearrangements of the NTRK gene that exhibit unique molecular genetics, morphological, and immunophenotypic features. The core feature of NTRK-rearranged tumors is rearrangement of the NTRK gene family (NTRK1, NTRK2, and NTRK3), often involving fusion with other genes, leading to abnormal tropomyosin receptor kinase (TRK) protein expression and activation. Herein, we report the first case of an NTRK spindle cell tumor with SPECC1L-NTRK3 fusion. This case highlights the significance of next-generation sequencing (NGS) for tumor diagnosis and targeted drug selection. After one month ofentrectinib therapy, the patient had considerable tumor shrinkage and symptom relief. For bone-derived NTRK-rearranged spindle cell sarcomas, entrectinib has demonstrated favorable therapeutic effects and can be considered priority treatment option.
A Novel Nomogram for Individually Predicting 30-Day Pneumonia Mortality Risk in ILD Patients with Long-Term Use of Glucocorticoid
Authors: Chen Luying , Zhang Kaixiang , Zhou Yajie , Wang Saibin
Published: November 2024

Objective: Long-term glucocorticoid use in patients with interstitial lung disease (ILD) is associated with a significantly increased risk of death within 30-day following pneumonia, indicating poor prognosis. This study aims to identify the risk of mortality after pneumonia onset to optimize treatment strategies and enhance patient management.
Methods: This study retrospectively analyzed ILD pneumonia patient data from DRYAD. Patients were randomly split into training and validation sets. LASSO regression selected predictive factors, and a nomogram model was built. ROC curves and AUCs assessed the model's 30-day mortality prediction. Bootstrap resampling (500 times) on the validation set confirmed the model's robustness with a 95% CI for AUC. The model's calibration and discrimination were evaluated in both sets.
Results: A total of 324 patients with ILD who developed pneumonia were included in this study, among which 82 patients died within 30-day. LASSO regression identified respiratory failure, vasoactive drug use, ventilator use, and lymphocytopenia as predictors for constructing a nomogram model. The model showed good calibration in both training and validation datasets, with AUCs of 0.897 (95% CI: 0.8642-0.9292) and 0.903 (95% CI: 0.8680-0.9321), respectively. Decision curve analysis suggested clinical benefits when the threshold probability was <77%.
Conclusion: The nomogram developed in this study effectively predicts the 30-day mortality risk in patients with ILD following pneumonia, demonstrating strong discrimination and calibration. This provides a valuable tool for optimizing treatment strategies and improving patient outcomes.
Chitinase-3-like protein 1 depletion in glioma cells restricts myeloid cell infiltration and normalizes neovasculature in human glioma xenografts
Authors: Cyranowski Salwador , Ghosh Mitrajit , Wojtas Bartosz , Zawadzka Małgorzata , Malik Anna R. , Baluszek Szymon , Swatler Julian , Wojnicki Kamil , Gielniewski Bartłomiej , Kaza Beata , Klejman Agata , Łukasik Hanna , Kaminska Bozena
Published: November 2024

Chitinase-3-like protein 1 (CHI3L1) is a secreted, non-enzymatic glycoprotein that interacts with cell-surface and extracellular-matrix proteins, proteoglycans, and polysaccharides. Many studies reported the overexpression of CHI3L1 in various cancers, but its exact role in tumorigenesis/cancer progression remains elusive. We performed a comprehensive analysis of CHI3L1 expression in public repositories including single-cell RNAseq datasets to determine the cellular source of CHI3L1 expression in gliomas. The highest CHI3L1 expression was detected in glioblastoma (GBM), a high-grade diffusive brain tumor with dismal survival prognosis. CHI3L1 knockout (KO) in human U87-MG glioma cells grossly affected transcriptional profile and in vitro invasiveness of these cells and strongly reduced the growth of intracranial U87-MG tumors in athymic mice. CHI3L1 KO in glioma cells resulted in normalization of tumor vasculature. Co-culture of CHI3L1 KO glioma cells with astrocytes upregulated Aquaporin 4 in p38 MAPK-dependent manner. Diminished infiltration of glioma-associated myeloid cells in CHI3L1 KO tumors was associated with reduction in SPP1 expression in CHI3L1KO cells. Altogether, we demonstrate that CHI3L1 depletion affects several mechanisms crucial for GBM progression, therefore its targeting represents a novel strategy to treat GBM patients.