bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between nephrotic syndrome and tuberculosis in ICU patients: A cross-sectional study of the MIMIC-IV database
Authors: Du Shenghua , Su Ning , Li Xinya , Li Junhong , Jiang Yingyi , Zeng Limeng , Yu Zhaoxian , Hu Jinxing
Published: April 2024

Background
This study investigated hospital mortality rates among patients with nephrotic syndrome (NS) and tuberculosis (TB) using data from the Medical Information Mart for Intensive Care IV version 2.2 (MIMIC-IV v2.2) database. The aim was to assess the impact of TB infection on in-hospital mortality risk in NS patients.
Methods
A total of 2167 NS patients were enrolled, among whom 1079 were co-infected with TB. Potential confounding factors included demographics, vital signs, laboratory values, acute physiology score, clinical treatments, and comorbidities. Univariate logistic regression was conduted to identify in-hospital mortality risk factors and multivariable multifactorial logistic regression was performed to explore the TB’s impact on in-hospital mortality. A restricted cubic spline regression analysis was carried out to investigate the linear relationship between hemoglobin, albumin, and in-hospital mortality. Stratified analyses were conducted for age, gender, sepsis, and acute kidney injury(AKI) stage to determine their effect on mortality of NS co-infected with TB.
Results
The prevalence of NS co-infected with TB was 49.8%, with a 14.6% in-hospital mortality rate, representing a 44% increased risk (P=0.005). The adjusted multivariable analysis revealed a mortality risk exceeding 20%. Among patients with sepsis, the incidence was 48.3% in those without TB and 46.7% in those co-infected with TB, with a 63% incidence of AKI within 7 days. Sepsis was associated with a 2.54-fold increase in mortality risk, and AKI stage 3 had an odds ratio (OR) of 9.03. Subgroup analyses suggested that both sepsis and AKI were independent risk factors for mortality. Hemoglobin and albumin exhibitedL-shaped linear relationships with in-hospital mortality, acting as protective factors below the inflection point. Only 1.8% received steroid treatments (NS 2.6%, NS and TB 0.9%), and 10.1% underwent continuous renal replacement therapy.
Conclusions
Our study results revealed significantly increased in-hospital mortality risk among NS patients with concurrent TB infection, alongside numerous complications. Sepsis and AKI independently increase mortality risk in NS patients co-infected with TB. These findings inform disease severity assessment and prognosis determination in adult NS patients with TB co-infection.
PmAm, a broad-spectrum powdery mildew resistance source located on Amblyopyrum muticum chromosome 6T is transferred to common wheat
Authors: Xu Wenjing , Ma Pengtao , He Huagang , Yang Zujun , Han Ran , Xu Xiaoyi , Liu Aifeng , Cao Xinyou , Li Haosheng , Liu Jianjun , Komatsuda Takao , Liu Cheng
Published: April 2024

Powdery mildew (caused by Blumeria graminis f. sp. tritici) limits grain production and reduces grain quality in wheat. Amblyopyrum muticum (2n=2x=14, TT genomes), a wild relative of wheat, carries agronomically valuable traits, including resistance to powdery mildew, that have not been transferred to wheat. Here, a powdery mildew resistant Chinese Spring-Amblyopyrum muticum amphiploid was backcrossed to a powdery mildew susceptible wheat cultivar and homozygous resistant derivatives with broad-spectrum resistance were selected. Fluorescence in situ hybridization analysis identified chromosome substitution and compensating Robertsonian translocation lines involving chromosome 6T from Amblyopyrum muticum.
Effect of Vaned and Vaneless Diffuser on the Performance of Turbo Blowers
Authors: DEMIRCIOGLU Pinar , BOGREKCI Ismail , SERT Berkay , ABBAKAR Mujtaba , Gogebakan Ahmet
Published: April 2024

The choice of diffuser type in centrifugal compressors and turbo blowers impacts efficiency. Vaned diffusers perform best at high flow rates but lose efficiency at lower flows due to their fixed design. Vaneless diffusers, without fixed blades, adapt better to varying flow rates and excel at part-load conditions. Therefore, vaned diffusers are ideal for applications with constant high flow rates, while vaneless diffusers offer efficiency advantages in variable flow rate applications. HAUS Centrifugal technology's XMP 122 Turbo blower will be employed in performance tests with both vaned and vaneless diffusers. The blower features an automatic variable geometry diffuser (VGD) system that optimizes flow efficiency. During testing, the blower operated within a speed range of 19,000 to 33,000 rpm. Analysis of the obtained data revealed a noticeable enhancement in volume flow rate.
Obstacle avoidance strategy and path planning of medical AGV based on the bionic characteristics of antelope migration
Authors: Hu Jing , Niu Junchao , Gao Xiang , Zhang Xinming
Published: April 2024

Aiming at the problem that Automated guided vehicle (AGV) faces dynamic and static obstacles in the process of transporting patients in medical environment and needs to avoid in real time, inspired by the behavior of antelopes during migration, this paper proposes a bionic obstacle avoidance strategy based on adaptive behavior of antelopes. The traditional artificial potential field and dynamic window algorithm are improved by using the bionic characteristics of antelope migration.By adding new potential field force points and improving the window size, the success rate and prediction range of AGV navigation are improved.Simulation experiments were carried out through the numerical simulation platform, and the verification results showed that:The bionic obstacle avoidance strategy proposed in this paper can avoid dynamic and static obstacles at the same time. In the example, the success rate of path planning is increased by 34%, the running time is reduced by 33%, and the average path length is reduced by 1%. The proposed method can realize the integration of “dynamic and static” avoidance in the process of transporting patients, and effectively save the time of transporting patients by AGV.It provides a theoretical basis for realizing obstacle avoidance and rapid loading of AGV in medical environment.
Evaluation of secondary metabolites, nutraceutical potential and amino acid profile of fresh dates (Phoenix dactylifera) wine
Authors: Choudhary Aditya , Kumar Aditya , Kandpal Rohan , Gupta Arun Kumar , Jha Avinash Kumar , Naik Bindu , Kumar Vijay , Rustagi Sarvesh , Chutia Hemanta , Khan Javed Masood
Published: April 2024

The present study comprehensively investigated the fermentation process of fresh dates juice to wine, analyzing various aspects including physicochemical properties, nutraceutical potential, amino acid composition, color properties, sensory evaluation, and microbial load. Over the fermentation period, TSS increased from an initial 3.2 to 5 oBrix, pH decreased from 7 to 3.9, and titratable acidity rose from 0.15% to 0.22%. The nutraceutical potential of the wine displayed dynamic transformations, with total phenolic content (TPC) decreasing from 23 to 9 mg GAE/mL, while total flavonoid content (TFC) increased significantly. Amino acid analysis revealed distinct concentrations, with wine exhibiting higher levels of essential amino acids due to fermentation. Color analysis showed a gradual darkening, a shift towards reddish hues, and a progression towards a more yellowish color during fermentation. Sensory evaluation favored wine over juice, scoring higher in appearance, flavor, texture, taste, mouthfeel, and overall acceptability. Microbial load increased from an initial 5–6 log CFU ml-1 to 8–9 log CFU ml-1 after 4 days, indicating the occurrence of alcoholic fermentation. Kinetics study was also performed for different quality parameters. This is the first study provides a comprehensive understanding of the multifaceted changes occurring during the fermentation process, offering valuable insights for winemakers and researchers.
Differential Learned Helplessness Phenotypes in Male and Female Rats: Exploring the Therapeutic Impact of Cannabidiol Treatment
Authors: Akirav Irit , Bright Uri
Published: April 2024

Evidence suggests a bidirectional relationship between depressive symptoms and neuroinflammation. We studied the effects of chronic treatment with cannabidiol (CBD) in male and female rats exposed to an unpredictable chronic mild stress (UCMS) model of depression. We analyzed gene expression related to neuroinflammation, cannabinoids, and estrogen receptors, as well as specific microRNAs (miRs) in the ventromedial prefrontal cortex (vmPFC), CA1, and ventral subiculum (VS). We found sex- and brain region-dependent effects of UCMS and CBD. UCMS exerted sex-specific effects on immobility, increasing it in males while decreasing it in females; CBD reversed this effect in both sexes. Regarding neuroinflammation, CBD restored Tumor Necrosis Factor α (TNF-α) gene upregulation in the CA1 and VS in males. In both sexes, UCMS led to nuclear factor kappa B subunit 1 (NF-κB1) gene upregulation in the VS, unaffected by CBD. In males, UCMS-induced CB1 gene downregulation in the VS was restored by CBD. UCMS resulted in CB1 gene downregulation in the vmPFC in both sexes, with no CBD effect. In males, CBD restored UCMS-induced downregulation of VS ERα and ERβ genes. Finally, UCMS downregulated miR-146a-5p in the VS in females and upregulated it in the CA1 in males without CBD restoring effects. Our findings highlight sex-specific differences in learned helplessness and CBD’s modulation of neuroinflammatory, cannabinoid, and estrogen gene expression following exposure to chronic stress. Specifically, in males, hippocampal neuroinflammatory and estrogenic mechanisms play pivotal roles in mediating CBD's antidepressant effects.
Exploring the Lived Experience of faculty implementing case-based learning: A Phenomenological Study
Authors: Delany Caroline , Illing Jan , McIlroy Marie , Daly Ronan , Bruen Catherine , Alamuddin Naji , Condron Clare , Crehan Martina , Doherty Sally , Meagher Frances , Offiah Gozie , O’Neill Sarah , Stuart Ellen , Torrens Christopher , Morgan Maria P.
Published: April 2024

Background
Case-based learning (CBL) is a useful pedagogical approach, for which learner experience has been well researched. The experience of faculty is less known. CBL was integrated into the first year of a new pre-licensure medical curriculum, so the faculty experience of transition from large group teaching to structured CBL was investigated.
Methodology:
Interpretative phenomenological analysis (IPA) was undertaken to explore the facilitator lived experience through reflective inquiry. Ten CBL facilitators were purposively selected from a diverse pool of faculty using maximum variation; faculty were involved in patient care, research, and education, and were a mix of ages, ethnicities and genders. Semi-structured interviews were conducted and analysed according to the IPA structure.
Results
Overall experiences were positive. Facilitators repeatedly expressed the enjoyment felt from closer student interaction. They reported that CBL afforded an authentic and active teaching approach. Other themes included: initial uncertainty regarding their role, anxiety around standardisation of the student experience and concerns regarding the level of content expertise required. However, confidence generally improved with experience facilitating.
Conclusion
These new insights expose a deeper understanding of perceptions of the role and will better inform faculty development initiatives and support going forward, as well as the iterative design of the CBL process itself.
Thiourea treatment broadens the lattice structure to enhance the electrochemical stability of lithium-rich manganese-based materials
Authors: Zhao Zhifeng , Feng Wangjun , Su Wenxiao , Niu Yueping , Hu Wenting , Zheng Xiaoping
Published: April 2024

The lithium-rich manganese-based material Li1.2Mn0.54Ni0.13Co0.13O2 is currently the most promising anode material due to its high capacity and low cost. However, the material still suffers from severe capacity degradation and low multiplicity performance. After thiourea treatment, the electrochemical performance of the material is improved. Through elemental and morphological characterization, the treated crystals show more dispersed particles and a small amount of Sulphur doped on the surface. Various electrochemical tests were performed on the cells and the 3wt% thiourea treated cells showed improved discharge specific capacity and cycling performance compared to the non-thiourea treated cells. Moreover, the polarity of the battery was reduced and the impedance decreased. The specific capacity of the first cycle was 274.2mAh/g at 0.1C. The specific capacity was 236mAh/g at 0.5C and the capacity retention rate was 72.46% after 100 cycles.
HGCN_MDA: Hierarchical Heterogeneous GraphConvolutional Neural Network for PredictingmiRNA-Disease Associations
Authors: Li Ying , Yang Xiao , Sun Ruihan , Zhang Jielin , Zhang Lu
Published: April 2024

miRNAs are non-coding, single-stranded RNA molecules approximately 22 nucleotides in length. They play pivotal roles in numerous biological regulatory processes and have close associations with a variety of diseases, including cancer, cardiovascular diseases, and neurodegenerative disorders. miRNAs have become new candidate molecular targets for disease diagnosis and treatment. Therefore, the swift and effective identification of associations between miRNAs and diseases holds significant clinical significance. Presently, the available methods for predicting miRNA-disease associations remain quite limited. Moreover, there is a scarcity of approaches that specifically address the varying importance of different nodes in miRNA and disease interactions, and then model these variations. Consequently, there is an urgent and challenging need to develop computational models for forecasting potential miRNA-disease associations. In this paper, we propose a hierarchical heterogeneous graph convolutional network named HGCN_MDA for the prediction of miRNA-disease associations. Our approach encompasses several key steps: First, we gather data on the associations between miRNAs and diseases, miRNAs and miRNAs, and diseases and diseases. Subsequently, we compute the importance scores of nodes in the graph, which serve as indicators for stratifying the hierarchical network. We then construct a multi-layer network to extract features based on their respective importance. Our approach combines global and local features, which are integrated by the attention mechanism. Finally, a fully connected layer is used to build a prediction model. Comprehensive experimental comparisons demonstrate that our proposed HGCN_MDA has better ability to predict positive samples and comprehensive performance.
SGLT2 Inhibitors in COVID-19: Umbrella Review, Meta-analysis, and Bayesian Sensitivity Assessment
Authors: Suresh Vinay , Shamim Muhammad Aaqib , Ghosh Victor , Dave Tirth , Jayan Malavika , Verma Amogh , Sanker Vivek , Roy Priyanka , Bardhan Mainak
Published: April 2024

Background: Several studies have reported a reduced risk of COVID-19-related mortality in patients taking antidiabetic medications. This is an umbrella review, meta-analysis, and Bayesian sensitivity assessment of SGLT2 inhibitors in COVID-19 patients with type 2 diabetes mellitus (T2DM).
Methods: A search was conducted in the MEDLINE (PubMed), EMBASE, Cochrane, and ClinicalTrials.gov databases on 5/12/2023. We performed an umbrella review of systematic reviews and meta-analyses on SGLT2i effects in T2DM patients with COVID-19 and critically appraised them using AMSTAR 2.0. Trials investigating SGLT2i use in COVID-19 patients post-hospitalisation and observational studies on prior SGLT2i use among COVID-19 patients were included in the meta-analysis, adhering to the PRISMA guidelines.
Results: SGLT2 inhibitors exhibited significantly lower odds of mortality (OR 0.67, 95% CI 0.53-0.84) and hospitalisation (OR 0.84, 0.75-0.94) in COVID-19 patients with T2DM. Bayesian sensitivity analyses corroborated most of the findings, with differences observed in hospitalisation and mortality outcomes. SGLT-2 inhibitors showed an OR of 1.20 (95% CI 0.64-2.27) for diabetic ketoacidosis. Publication bias was observed for hospitalisation but not for mortality. The GRADE assessment indicated a low to very low quality of evidence because of observational studies.
Conclusions: Prophylactic use of SGLT2 inhibitors reduces mortality and hospitalization among COVID-19 patients, particularly in diabetic patients. The utility of SGLTi after hospitalization is uncertain and warrants further investigation. Limited efficacy has been observed under critical conditions. Individualized assessment is crucial before integration into COVID-19 management.
Rider Re-Route Suggestions Using Demand Forecasting Based on Passenger's Routes and User Behaviour Analysis
Authors: Dharun.V.S  , S Bairavel , Suriyalakshmi.V.C  , Sricharan.A  , M Kanipriya
Published: April 2024

This project explores the optimization of ride-sharing in urban transportation through data analysis and internet networking. It aims to revolutionize commuting habits by connecting riders and passengers via an intelligent platform, suggesting alternative routes based on demand. By addressing the issue of lone commuters, the project aims to enhance urban mobility efficiency, reduce trip costs, and promote sustainability. Divided into components for rider and passenger registration, demand forecasts, matchmaking, and route optimization, the project showcases significant results. The suggested deviations offer comparable travel times, substantial cost savings, and increased customer satisfaction. This initiative aligns with environmental goals by reducing single-occupancy car use. Additionally, the project delves into analyzing user behavior within the ride-sharing platform, utilizing data analytics and vehicle telemetry. Leveraging K-Means clustering, it classifies behavior patterns to anticipate future actions and enhance user experiences while contributing to vehicle health management and safety. The proposed solution integrates feature engineering, behavior classification, and automation modules supported by robust database design and implemented using React JS, Python, and Node.js. The algorithm employs preprocessing, optimal K determination, and K-Means clustering for behavior analysis, leading to actionable insights and targeted interventions. Through simulation tools and real-time implementation, the project demonstrates its potential to optimize user engagement, enhance safety, and boost service efficiency, marking a data-driven shift in urban transportation paradigms.
Estimation of the Generalized Exponential Distribution Parameters Based on Picard’s Method
Authors: Maswadah Mohamed Sadek
Published: April 2024

In statistical inference, Bayes’ method is the most commonly applicable in reliability analysis, despite its subjectivity to prior information other than data. Therefore, the main objective of this work is to introduce an efficient numerical method, Picard’s method, as a tool for estimation in statistical inference and compatible with Bayes’ method. The proposed method has been applied to the generalized exponential distribution parameters and compared to Bayes’ method based on different priors via Monte Carlo simulation. The simulation results indicated that Picard’s method provides better estimates and outperforms Bayes’ method based on the generalized progressive hybrid censoring scheme. Finally, two real datasets have been analyzed for illustrations and comparison of the proposed methods.
Scenario Planning of Digital Transformation in Indonesia’s Fast-Moving Consumer Goods Sales Organization: Uncertainties and Possibilities
Authors: Kusuma Adhitya Rendra , Syarief Rizal , Ekananta Arry , Sukmawati Anggraini
Published: April 2024

Since uncertainty in the business domain has increased the urgency for scenario development as a strategic tool, the research examined a relationships between a leadership model, organizational citizenship behavior, and sales management control variables using scenario planning. The questionnaire’s scaling using a Likert scale was done toward results from discussions and in-depth interviews with several experts in Fast-Moving Consumer Goods (FMCG) organizations, FMCG organizational leaders (Chief Executive Officers/CEOs), leadership experts, organizational behavior consultants, and organizational performance practitioners. The research finds that external and internal forces determine the success of digital transformation. External forces consist of digital technology availability, consumer expectations,business competition maps, and digital talents. Internal forces are budget allocation, competency trap versus growth mindset, organizational structure, and organizational culture. The scenario matrix plot forms four scenarios of the digital transformation in the sales organization of Indonesia’s FMCG companies (realistic, pessimistic, optimistic, and superoptimistic), where realistic (iteration improvement scenario) is largely predicted to occur for companies carrying out digital transformation. Such scenario requires sales organizations to have a growth mindset to deal with the uncertainty of customer/consumer expectations properly. The strategy appearing as an FMCG digital transformation compass is expected to advise FMCG companies in Indonesia when executing and overseeing the digital transformation within theircompanies.
Blockchain-Capabilities, Supply Chain Resilience, and Company Performance:
Authors: Sudrajat Darjat , Kreie Andre , Kuncoro Engkos Achmad , Hakim Adam Zulyiko
Published: April 2024

Alignment and agility are essential supply chain capabilities required to maintain and enhance performance, particularly in the current era of disruption. The research aimed to examine the impact of blockchain capabilities on supply chain resilience and company performance using quantitative and cross-sectional survey methods. Logistics service providers (LSP) were selected as the units of analysis, and individuals such as logisticians in Indonesia and Switzerland served as units of observation. Data were collected through an electronic questionnaire (Google Forms) using a quota sampling technique and analyzed using Smart-PLS software. The sample size included 60 respondents, comprising 45 and 15 from Indonesia and Switzerland based on the 10-times rule. The results show that supply chain resilience partially and fully mediated the impact of blockchain capabilities (supply chain alignment and agility) on LSPPerformance. LSP could also enhance performance and resilience by implementing blockchain technology to enhance supply chain alignment and agility. In theoretical terms, the results have implications contributing to dynamic capability theory. In practical applications, the research serves as valuable insights for government authorities and IT consultants when formulating effective plans and strategies to analyze the adoption of blockchain technology among LSP. Additionally, directors and owners of these companies are persuaded that blockchain has the potential to create and enhance supply chain capabilities, as well as increasing competitive advantage.
Integrating Planned Behavior and Technology Acceptance Models: A Study of GoFood after COVID-19
Authors: Margaret Felicia , Sidharta Helena
Published: April 2024

One of the most apparent changes due to COVID-19 pandemic was the increase in the utilization of online food delivery services. An in-depth analysis was needed to find the fundamental aspects behind this change that make online food delivery services an integral part of people’s lifestyles even after the pandemic. The research aimed to explore the determinants of customers’ intention to use GoFood (IU) by integrating the Technology Acceptance Model (TAM) and the Theory of Planned Behavior (TPB) to construct the research model. The research novelty was reflected through convenience motivation, which was crucial in enhancing the intention to use GoFood. This was achieved by exploring the interaction between the TAM and TPB. The underlying factors behind customers’ intention to use GoFood were defined by price-saving orientation (PSO) and timesaving orientation (TSO) with a mediating variable called convenience motivation (CM). Afterward, 252 valid questionnaires from respondents who live in Surabaya and Sidoarjo were collected using thesnowball sampling method and analyzed using the SEM-PLS method. The result reveals that PSO is the most significant factor behind the intention to use (IU). Meanwhile, TSO only indirectly affects IU, which means it will only be impactful when mediated by CM. Moreover, CM itself has a significant impact on IU.
Impact of E–Supply Chain Management on Customer Satisfaction Through Service Quality in Agricultural E-Commerce
Authors: Eni Yuli , Chandra Anggraini Kumala
Published: April 2024

The research aimed to assess the impact of applying e-supply chain management (E-SCM) on service quality (SQ) and customer satisfaction (CS) in agricultural e-commerce. It was motivated by challenges in Indonesia that led to foodwaste due to lengthy supply chain, particularly evident in the horticulture category, such as vegetables. The inefficiencies along the chain resulted in substantial annual losses, ranging from IDR 213 to 551 trillion, equivalent to 4% - 5% of Indonesian GDP. Using associative investigation with three variables and 446 samples selected through simple random sampling, the research aimed to evaluate and enhance E-SCM performance in supply chain. The effective applicationof E-SCM offered benefits, including time and cost efficiency, work flexibility, and other conveniences. Not only this did benefit the company but also enhanced service quality and customer satisfaction. SEM-PLS was used with a reflective method, and data processing was facilitated by SMART-PLS 4 software. The results show a significant influence ofE-SCM application on service quality and customer satisfaction. Furthermore, service quality has a significant and direct impact on customer satisfaction. E-SCM influences customer satisfaction through both direct and indirect pathways, which are mediated by service quality variables.
Quem dança seus males espanta? Dança como prática promotora de saúde no SUS
Authors: Mariano Vinícius Gonçalves , Graup Susane
Published: April 2024

Objetivos: analisar as percepções de mulheres sobre os efeitos da prática da dança na sua saúde e identificar as barreiras e facilitadores da participação em um projeto de uma ESF de um município da fronteira Oeste do Rio Grande do Sul, Brasil. Métodos: trata-se de um estudo de caráter qualitativo e delineou-se quanto aos seus objetivos como um estudo descritivo. A amostra foi composta por mulheres acima de 18 anos, integrantes de um projeto de dança de uma ESF, cujo os dados foram coletados por meio de uma entrevista semiestruturada. Resultados:  a amostra foi composta por 11 mulheres, cuja a média de idade foi de 45 anos, sendo que 9 apresentaram alguma condição de saúde, com destaque para hipertensão (n=3) e diabetes (n=2). Em relação a percepção dos benefícios da prática da dança, todas as participantes relataram que percebem benefícios para a saúde, sendo que 54,4% percebem uma maior felicidade e melhora no ânimo e no humor. Ainda, 45,5% relatam maior disposição e também diminuição do estresse e da ansiedade. Em relação a influência da dança na saúde física e mental, 35,4% relatou possuir “maior disposição”, sendo quando questionada sobre os efeitos da dança sobre os sintomas da doença, 33,3% relataram melhoria na pressão arterial e nas atividades diárias. Considerações finais: os resultados nos mostram que além da saúde física, a saúde mental também é um importante benefício da prática da dança como atividade física e que a gratuidade do projeto e a proximidade do local facilitam a participação.
Clinical Accuracy, Relevance, Clarity, and Emotional Sensitivity of Large Language Models to Surgical Patient Questions: Cross-Sectional Study
Authors: Dagli Mert Marcel , Oettl Felix Conrad , Gujral Jaskeerat , Malhotra Kashish , Ghenbot Yohannes , Yoon Jang W , Ozturk Ali K , Welch William C
Published: April 2024

This cross-sectional study evaluates the clinical accuracy, relevance, clarity, and emotional sensitivity of responses to inquiries from patients undergoing surgery provided by large language models (LLMs), highlighting their potential as adjunct tools in patient communication and education. Our findings demonstrated high performance of LLMs across accuracy, relevance, clarity, and emotional sensitivity, with Anthropic’s Claude 2 outperforming OpenAI’s ChatGPT and Google’s Bard, suggesting LLMs’ potential to serve as complementary tools for enhanced information delivery and patient-surgeon interaction.
Faktor Risiko Perioperatif Terhadap Kejadian Delirium Saat Pulih Sadar Setelah Anestesi Umum Pada Pasien Dewasa Yang Menjalani Operasi Elektif Di RSUP Dr Sardjito
Authors: Dewi Wahyu Jati Paramita , Widodo Untung , Apsari Ratih Kumala Fajar
Published: April 2024

Background. Emergence delirium in anesthesia is a common problem after anesthesia especially in recovery room,but the incidence and risk were unclear. Emergence delirium makes serious complication and impact in morbidity and mortality were no treated properly. So this study built. Objective. To determine the perioperative risk factors of emergence delirium after general anesthesia of elective surgery at Dr Sardjito Hospital. Method. Ninety-nine patients who have surgery under general anesthesia were prospectively observed and variables were potentials perioperative risk factors for delirium at recovery room were dated. The data were statistically analyzed by bivariate and multivariate analysis based on the incidence of delirium after recovery. Results. Total sample of the study were 99 patients who had delirium 55 (55.6%). The results of multivariate analysis showed risk factor of emergence delirium were age 18-25 years old (p=0,045, OR 5,54, 95%CI 1,02-15,189), smoker (p=0,06, OR 6,83, 95%CI 1,769-21,069), alkoholism (p=0,018, OR 10,34, 95%CI 2,09-78,98), ophthalmology (p=0,005, OR 5,43, 95%CI 1,86-32,266), alprazolam premedication (p=0,045, OR 4.035, 95%CI = 1.029-15.819), general anesthesia/ET (p=0,024, OR 5,23, 95%CI 1,697-21,792), duration of surgical procedure > 2 jam (p=0,025, OR 10.320, 95% CI 1.331-79.987), duration 1-2 jam (p=0.023, OR 6.554, 95% CI 1.291-33.266), opioid analgetic (p=0,019, OR 4,15, 95%CI 1,028-17,819) epidural cath (p=0,021, OR 5,83, 95%CI 1,981-20,069), artery line/CVC (p=0,043, OR 9,79, 95% CI 1,08-89,32), DC (p=0.010, OR 0.074. 95%CI 0.010-0.529), blood transfusion and vasopressors (p=0.004, OR 10,38, 95% CI = 2.11-51,08), pain scale/NRS >7 (p=0.049, OR 10.598, 95%CI 0.933-120.386), and NRS 3-7 (p=0.039, OR 5.465, 95%CI 1.091-27.372), PONV dan shivering (p=0.006, OR 3,77, 95% CI = 1.47-9,67). Conclusions. Age 18-25 years old, smoking and alcoholism, ophthalmology surgery, alprazolam premedication, general anesthesia/ET, duration surgery > 1 hour, opioid and epidural catheter analgesia, artery line/CVC, DC, blood transfusion and vasopressor, post operative pain with NRS >3, PONV/shivering have increased risk for emergence delirium.
Pemberian Analgetik Epidural Lumbal Kontinu sebagai Tatalaksana Nyeri Kanker dengan Metastasis
Authors: Mahmud  , Kumala Ratih , Alamsyah Erry
Published: April 2024

Pain is the most common symptom of cancer patients. Pain in cancer patients is mainly caused by cancerprogressivity and tissue necrosis. Management of chronic pain needs considerable high socioeconomic costs. As an alternative for chronic pain management, a continuous infusion of local anesthetics via epidural catheter is recommended to alleviate chronic pain which caused by cancer pain in certain concentration that can relieve pain. We report 3 cases of patients with cancer pain related to metastatic process. All three patients had previously prescribed with oral opioids and fentanyl patches, which were inadequate in eliminating pain. In all these three patients, lumbal epidural catheter was placed and continuous local anesthetic drugs were administered in 1-2 ml/hour rate. The local anesthetics solution contains levobupivacaine 0.1%, morphine 0.08 mg/ml and klonidin 1.2 mg/ml.
Manajemen Anestesi pada Pasien Sectio Caesarea dengan Preeklamsia Berat dan Edema Pulmo
Authors: Rahardjo Sri , Suryono Bambang , Rudita Muhammad
Published: April 2024

Perawatan multi modal yang memastikan oksigenasi optimal dan hemodinamik stabil denganjumlah cairan minimal tampaknya bisa dibenarkan. Dengan tidak adanya pemahaman lengkap tentang patogenesis edema pulmo, untuk mengurangi komplikasi ibu dan janin, manajemen terutama didasarkan pada pengobatan gejala dan tanda-tanda efek sekunder preeklamsia. Manajemen pasien ini idealnya harus multidisiplin dan ahli anestesi harusterlibat dalam perawatan pasien sejak tahap awal. Asesmen awal yang cermat oleh ahlianestesi direkomendasikan untuk semua pasien dengan preeklamsia, terutama dalam kasus yang berat. Kecuali ada kontraindikasi yang diketahui sebelumnya, seperti koagulopati, anestesi regional direkomendasikan untuk pasien preeklamsia. Mengingat risiko anestesi umum pada pasien dengan preeklamsia, anestesi spinal harus dipertimbangkan dalam kasus-kasus urgensi tanpa mengesampingkan anestesi epidural. ketika diperlukan anestesi umum, sangat penting untuk mengantisipasi dan mengobati tekanan darah yang tidak stabil. Jugapenting untuk dipersiapkan untuk manajemen jalan nafas ibu yang sulit, mengingat peningkatan risiko edema faringolaringeal.
Serial Kasus Tatalaksana Sulit Jalan Napas pada Tumor Tiroid
Authors: Bayu Timor Krisna , Widodo Untung , Sudadi  , Wisudarti Calcarina Fitriani Retno , Farid Anisa Fadhila
Published: April 2024

This case report studies three patients with difficult airways managed according to the American Society of Anesthesiologists (ASA) algorithm. The first case is a 46-year-old woman with bilateral SNNT who underwent a subtotal thyroidectomy without prior hyperthyroid therapy. The patient, with an ASA physical status II, was intubated using a videolaryngoscope. Postoperatively, the patient was cared for in the ward. The second case is a 58-year-old woman with a retrosternal goiter and comorbid hyperthyroidism and hypertension, who underwent a total thyroidectomy. The patient, with an ASA physical status II, was intubated while conscious. Postoperatively, the patient was admitted to the ICU. The third case is a 60-year-old woman with bilateral SNNT planned for thyroidectomy and permanent tracheostomy. The patient, with an ASA physical status III and comorbid hyperthyroidism, had failed intubation attempts with a videolaryngoscope and fiber optics. The patient could not be intubated, and the family was educated about the condition. This study demonstrates the importance of individualized management in patients with difficult airways, following ASA guidelines for optimal results.
Profil Keamanan Ventilator Venindo Kode R-03 dengan Penilaian Oxygen Index (OI), Rasio PaO2/FiO2 dan Oxygen Saturation Index (OSI) Pada Pasien Paska Operasi di ICU RSUP Dr. Sardjito Yogyakarta
Authors: Yuniarti Aisyah Ratna
Published: April 2024

Latar Belakang: Gagal napas adalah suatu kondisi akibat tidak adekuatnya sistem respirasi dalam pertukaran gas yang ditandai dengan kegagalan transport O2 ke dalam darah (gagal napas tipe hipoksemik) atau pengeluaran karbondioksida (CO2) dari dalam darah (gagal napas tipe hiperkapnia). Ventilator adalah alat yang digunakan untuk membantu dan menggantikan system respirasi pada pasien kritis yang mengalami kondisi gagal nafas. Ventilasi mekanik dapat menginduksi cedera paru. Pengunaan Oxygen Index (OI), rasio PaO2/FiO2, Oxygen Saturation Index (OSI) dapat menggambarjan aspek keparahan cedera paru.

Tujuan: Untuk mengetahui nilai OI, Rasio PaO2/FiO2, dan OSI sebagai penanda untuk menilai keamanan Ventilator Venindo R-03 pada pasien paska operasi yang dirawat di ICU RSUP Dr. Sardjito.

Metode: Penelitian ini menggunakan rancangan penelitian quasi eksperimental. Jumlah sampel yang diambil merupakan pasien paska operasi yang dirawat di ICU. Didapatkan jumlah sampel 38 pasien yang selanjutnya dapat dilakukan pengolahan data.

Hasil : Penelitian ini menunjukkan bahwa penggunaan ventilator Venindo kode R-03 dan ventilator Hamilton kode T1 tidak mempengaruhi status oksigenasi individu dari kondisi dasar sebelum pemasangan ventilator dibuktikan dengan rata-rata nilai OI dengan kedua jenis ventilator tidak berbeda bermakna dibandingkan kondisi dasar sebelum pemasangan ventilator (OI pre vs OI post 1 p = 0.527, OI pre vs OI post 2 p = 0.566, PF pre vs PF post 1 p = 0.199, PF pre vs PF post 2 p = 0.274, OSI pre vs OSI post 1 p = 0.600, OSI pre vs OSI post 2 p = 0.402). Rata-rata rasio PaO2/FiO2 setelah pemasangan ventilator Venindo kode R-03 apabila dibandingkan dengan setelah pemasangan ventilator Hamilton memiliki perbedaan yang bermakna secara statistik (PF post 1 vs PF post 2 p = 0.039) namun secara klinis tidak didapatkan perbedaan.

Kesimpulan : Pada penelitian ini didapatkan tidak ada perbedaan bermakna nilai OI, rasio PaO2/FiO2 dan OSI sebelum dan etelah penggunaan ventilator Venindo R-03 dan Ventilator HamiltonT-1 . Sedangkan, rata-rata rasio PaO2/FiO2 setelah pemasangan ventilator Venindo kode R-03 apabila dibandingkan dengan setelah pemasangan ventilator Hamilton memiliki perbedaan yang bermakna secara statistik namun secara klinis tidak didapatkan perbedaan bermakna.. Penelitian ini juga membuktikan korelasi kuat antara OI dan rasio PaO2/FiO2 sehingga OI dapat memiliki potensi untuk menjadi parameter dalam menilai kerusakan paru

Kata Kunci: Ventilator, Oksigen Indeks, Rasio PaO2/FiO2, oksigen saturasi indeks
Third Harmonic Less Inverter
Authors: Rahul Jinendra , Baldwa Piyush , Rathi Piyush Kumar , Tiwari Pulkit , Sharma Rohit
Published: April 2024

Proposed work focuses on the implementation of a third harmonic elimination technique in an inverter system using the SG3525 PWM controller and optocoupler. The aim is to reduce the harmonic distortion in the output voltage waveform, leading to improved efficiency and reduced stress on connected loads. The SG3525 PWM controller is utilized to generate pulse-width modulated signals, while the optocoupler ensures galvanic isolation between the control circuitry and the power stage. Through proper modulation techniques and control algorithms, the third harmonic component is actively suppressed, resulting in a cleaner output waveform. The project presents the design methodology, simulation results, and experimental validation of the proposed system, demonstrating its effectiveness in harmonic mitigation and enhancing the overall performance of the inverter system.
To design a controller for the solar power Inverter to nullifying the temperature effect
Authors: Modi Bharat , Kumar Dinesh , Jain Shubhi , Sharma Mohit Kumar , Sharif MD. Yusuf , Rahul Jinendra
Published: April 2024

The output waveform of sine triangle pulse width modulation at different modulation index is a crisp waveform. This waveform can be completed by adding another waveform. It is called a clamp waveform. This concept is called C to C concept or clipper clamper concept. The single-phase controller circuit is shown below. According to this circuit, anti-parallel diodes with constant DC supply connect to the grid supply. The extension of this circuit i.e. the 3-φ clamper circuit has been shown in The output of controller circuit is added up with NPC inverter.
THE ROLE OF EMPLOYER BRAND ATTRACTIVENESS IN THE HOTEL LABOUR MARKET
Authors: Ognjanović Jasmina
Published: April 2024

The employer brand is seen as part of the intangible assets of a hotel that provides economic, functional, and psychological benefits to current and potential employees. This paper aims to identify and examine the influence of EBA on potential employees in the hotel industry. The study analyses the relationship between the dimensions of employer brand attractiveness and the decisions of potential employees - intent to join hotels and future behaviour. The sample includes 203 final year bachelor’s students and master’s students in the Hotel management course. The results reveal a positive effect of the dimensions of employer brand attractiveness (compensation and benefits, management value, and development and training) on intent to join. Also, the results reveal the effect of the dimensions (work/life balance, compensation and benefits, and development and training) on the future behaviour of potential employees.
АКУСТИЧКЕ КАРАКТЕРИСТИКЕ ГЛАСА И ГОВОРА ОДРАСЛИХ ОСОБА СА АТАКСИЧНОМ ДИЗАРТРИЈОМ
Authors: Arsenić Ivana , Jovanović Simić Nadica , Šešum Mia , Drljan Bojana
Published: April 2024

The aim of this study was to determine the acoustic characteristics of voice and speech in adults with ataxic dysarthria, and to examine the extent to which they differ from those of typical speakers. The sample consisted of 30 patients with ataxic dysarthria, ages 21 through 82 (M = 56.07). Using the computer programme for multidimensional voice analysis (MDVP), the individual values of 10 acoustic voice parameters were determined for each sex. Additionally, the programme provided the frequency values of the first two formants for all five vowels of the Serbian language, based on the participants’ reading of the Balanced Text. The results of the analysis showed statistically significant differences in the values of the acoustic parameters between the participants with ataxic dysarthria and the reference values valid for typical speakers, which were generated by the MDVP. These differences were observed in parameters indicating voice frequency variability (F0, Fhi, Flo, STD, Jitt, vF0), voice intensity variability (Shim and vAm), and the presence of voice interruptions (DVB) and voiceless periods (DUV). Furthermore, a statistically significant difference was found between participants with ataxic dysarthria and typical speakers in the second formant (F2) of the vowels /E/ (p <0.01), /I/ (p <0.01), and /U/ (p <0.05). The significant deviations from the norms applicable to typical speakers indicate the substantial changes present in the voice and speech of individuals with ataxic dysarthria.
Distribution and Etiology of Gummosis Syndrome Associated with Apricot Fruit Trees of Gilgit-Baltistan, Pakistan
Authors: Ahmad Riaz , Ali Alamdar , Abbas Aqleem
Published: April 2024

Gummosis syndrome is a serious disease of apricot trees in Gilgit Baltistan (GB), Pakistan. The symptoms of gummosis syndrome on branches, twigs, and the trunk of apricot trees include oozing of a gummy or resinous material, lesions or cankers, bark discoloration, and the disintegration of bark integrity. The disease can weaken branches and twigs, making them more susceptible to breakage. In severe cases, affected branches can die back. In this study, we investigated the fungal species associated with gummosis syndrome in apricots across four districts in GB: Nagar, Hunza, Gilgit, and Ghizer. We recovered a total of 40 isolates from different locations of above four districts, and the most frequently isolated fungal species was Botryodiplodia theobromae. Fusarium solani was also isolated from several locations, and Neoscytalidium spp. were isolated from a few locations in Nagar and Hunza. The spatial distribution of gummosis syndrome in apricots in GB is not uniform. The disease is more prevalent in the northern and western parts of GB, and in areas with higher elevations and cooler temperatures. The Nagar district is the most affected by gummosis syndrome, followed by Ghizer District. Our findings suggest that Botryodiplodia theobromae is the major fungal pathogen associated with gummosis syndrome in apricots in GB. Fusarium solani and Neoscytalidium spp. may also play a role in the disease. The spatial distribution of gummosis syndrome in GB suggests that environmental factors, such as elevation and temperature, may contribute to the disease. Further research is needed to develop effective control measures for gummosis syndrome in apricots in GB. This research should focus on identifying resistant apricot varieties, developing new and more effective fungicides, and developing integrated pest management (IPM) programs.
Harnessing Essential Oils for in-vitro Control of Trichoderma sp. in Mushroom Cultivation
Authors: Khan Gohar , Ali Syed Zulfiqar , Waris Muhammad
Published: April 2024

Mushrooms are highly nutritious dietary items that are rich in vitamins, minerals, antioxidants, and high-quality protein. Oyster and button mushrooms are highly significant species, cultivated in diverse farms and locations. Various fungal contaminants, including Trichoderma sp. hindered the mycelium growth of button mushroom, hence reduces its yield. In this study, bio-management of Trichoderma horzianum which is a major causative agent of mushroom mold was investigated by using different essential oils viz., cinnamon, coconut, neem and rose oil with increasing concentration of 4%, 8%, 12% and 16% against Trichoderma sp. All of the essential oils showed significant impact, but rose oil with concentration of 16% demonstrated the highest efficacy in controlling Trichoderma sp against mushroom mold. Thus, it is suggested that increasing concentration of rose oil would be more effective under in-vitro conditions in controlling Trichoderma horzianum
Genome-Wide in Silico Analysis of the Heat Shock Protein (HSP) Family in Vigna Species: Insights into Molecular Mechanisms of Stress Response
Authors: Shahzadi Misha , Habib Zakia , Ijaz Siddra
Published: April 2024

Heat shock proteins, HSPs, are essential for plants to develop defense systems against various abiotic challenges. Vigna species are widely grown cash crops in the world. However, some unfavorable environmental conditions hinder the growth and production of these crops. It is therefore essential to investigate the factors influencing their growth, development, and tolerance to abiotic stress to develop stress-tolerant varieties. Consequently, a comprehensive genome-wide identification study was conducted to identify the Heat Shock Factor (HSF) genes in three Vigna species genomes employing computational tools. In the current study, 43 non-redundant HSP proteins were identified in three Vigna species including 17 in Vigna angularis, 22 in Vigna radiata, and 4 non-redundant in V. ungucuilata. Moreover, subcellular locations were predicted, and all HSPs were found in the nucleus. The theoretical isoelectric point predicted that most of the HSP proteins were acidic. The aliphatic index of the HSP proteins demonstrated that all proteins are highly thermostable. Moreover, the instability index revealed two proteins VangHSP_9 and VradHSP_9, considered stable while the rest of the HSP proteins were unstable. The phylogenetic analysis categorized HSP genes into two major clusters and gene structure analysis displayed that all HSP genes were intronless. This study gives novel insight into the functional characterization of HSPs in Vigna species for plant breeding programs.