bluuebunny/crossref_metadata_2025 huggingface dataset:
A rare case of extra adrenal retroperitoneal paraganglioma: case report
Authors: Ramnani Sakshi , Chawla Subhash , Utaal Maneshwar Singh , Singh Mrigendra , Adlakha Dakshita , Thakor Mrugen
Published: March 2024

Extra adrenal retroperitoneal paragangliomas are neuro endocrine neoplasms with extremely rare incidence and a wide plethora of clinical presentations. They originate from the neural crest cells interspersed throughout the body. They can present with vague symptoms of pain abdomen, hypertension, palpitations and in severe cases with renal failure, and shock owing to catecholamine excess. On the other end of the spectrum they can be totally asymptomatic and detected incidentally. The multitude of clinical presentations and lack of specific diagnostic tests hence pose a great difficulty in the pre-operative diagnosis of the disease. We are presenting a case of a 20-year-old female with vague symptoms to highlight the management and clinical diagnosis of extra adrenal retroperitoneal paraganglioma.
Assessment of knowledge and attitude of dental undergraduates students towards CBCT- From students perspective, a cross sectional questionnaire study
Authors: Kiresur Surayya , Shetti Arvind , Patil Namrata , Naik Zameera , Thirupathi Jayapriya , Keluskar Vaishali
Published: March 2024

Cone-beam computed tomography (CBCT) is a three-dimensional dento maxillofacial imaging modality, Where the volumetric data is recorded by rotating the beam and detector around the desired region of interest. The main advantages of CBCT are, its compact size, lower radiation dose, and faster scanning time. Given the increasing availability of CBCT in dental practice and the importance of dental students accessing new technologies, this study assesses knowledge and attitude regarding CBCT among UGs and interns.

This was a cross-sectional questionnaire study conducted among the dental undergraduate and interns. Student demographics and data about their knowledge and attitude towards CBCT were collected. The responses obtained were statistically analysed using descriptive statistics and the chi-square test.

There were 78% of female participants among fourth year undergraduates and 64 % female participants among interns. (50.8%) of fourth year undergraduate and (71.4%) interns accepted that CBCT is precise than OPG in detecting orofacial pathologies. (45.5%) of fourth year undergraduates and (54.4%) of interns specified that they would use CBCT in the future. (37.1%) of fourth year undergraduates and (62.9%) of interns acquired knowledge about CBCT through a seminar, while (48%) of fourth year undergraduates and (52%) of interns learned from faculty lecture classes.

This study emphasised on students' knowledge of CBCT application in dentistry and their perception of CBCT's potential value in future general dentistry practice. Results of the study revealed that dental students had an average knowledge and positive attitude towards CBCT. It is recommended to engage students in educational programmes concerning theoretical knowledge and practical aspects of CBCT. This could promote better knowledge and attitude among dental undergraduates.
The political guidelines of the cadets in 1906 in the estimates of V. A. Maklakov
Authors: Saraeva Elena L.
Published: March 2024

The article is dedicated to the representation of one of the leaders of the constitutional democratic party V. A. Maklakov about the main ideas of the Russian liberals in 1906, the period of work I the State Duma, the importance of interaction between government and society with the aim of strengthening the state and protection of the right to initiative. The interpretation by Maklakov circumstances of the growing popularity of the cadets in 1906 revealed its socio-political values: the state, establishing the legitimacy that ensure the integrity of the country; a person of interest in the rule of law, freedom, and prosperity; the constitutional rights of citizens and reasons for criticism of the cadets of the monarchy.
Violência contra as mulheres no estado de Pernambuco – Brasil: perfil das agredidas e características das ocorrências notificadas entre 2015 e 2019
Authors: Santana da Silva Santos Mychelson , De Lima Martelli Petrônio José , Cardoso Lyra da Fonseca Jorge Luiz
Published: March 2024

Objetivo: Descrever as características epidemiológicas das notificações das mulheres que sofreram violências, residentes em Pernambuco, no período 2014 a 2019. Métodos: Estudo epidemiológico, transversal, com dados das notificações do Sistema de Informação de Agravos de Notificação. Resultado: Identificamos 31.439 casos. Predominaram mulheres na faixa etária dos 10 a 29 anos (16.730), raça/cor parda (20.384). As solteiras foram as que mais sofreram violências (14.405). A zona urbana (26.005) foi a mais frequente. Quanto ao local de ocorrência, predominou a residência (19.013). No que diz respeito à natureza das violências, os maiores registros foram física (19.049), psicológica (9.609) e sexual (4.983). A força corporal/espancamento alcançou (13.662). Os parceiros íntimos foram os autores mais prováveis (9.964), frequentemente do sexo masculino (17.879). Conclusão: Por meio da notificação completa e adequada é possível conhecer o perfil da violência, identificar os fatores de risco e realizar um planejamento estratégico, tendo em vista a prevenção e assistência de qualidade às mulheres que sofrem violência.
 
Palavras-chave: Violência Contra a Mulher; Notificação; Sistemas de Informações em Saúde; Epidemiologia.
Difficulties in studying the scientific concepts from the view point of 10th grade students at Irbid governorate
Authors: Yahya Shaimaa
Published: March 2024

This study sought to identify the difficulties of studying the scientific concepts among the tenth-grade students in Irbid governorate. In order to achieve the objectives of the study, a questionnaire was used to measure the students’ view point about difficulties they faced in learning scientific concepts. The questionnaire contained three areas: content, teachers and students. The sampling method involved selecting tenth-grade students from the first Irbid Directorate of Education at the end of the 2018-2019 academic year. A total of 415 students were included in the study; the gender distribution was nearly equal, and they were grouped according to their GPA. The results of the study showed that these three domains were a source of determining the difficulty levels. The students’ domain came first, followed by teachers, and content ranked last. The results also showed that there were statistically significant differences in the sources of difficulty due to gender differences in males, and due to the average difference in the benefit of students whose grades were less than 84%. In light of the results, the study framed a set of recommendations, including the need to emphasize the activation of technology in teaching, and holding lectures showing the importance of science and scientists.
The role of multiple directorships in minimizing idiosyncratic risk due to the presence of large shareholders: Evidence from Indonesian companies
Authors: My Ani Siska , Utama Cynthia Afriani , Lubis Arief Wibisono
Published: March 2024

This study aims to evaluate the role of multiple directorships in the relationship between large shareholders and idiosyncratic risk in Indonesian companies for 2017-2021. The study model included dynamic panel data for estimation and a two-step GMM system to address endogeneity issues. Multiple directorships and long-term shareholders have low-frequency data whereas idiosyncratic risk is associated with high-frequency data. The robustness test employed the Fama-Frenchhee factor model while the single factor model was used to evaluate idiosyncratic risk.  Indonesia adheres to a two-tier system that separates the roles and functions of the board of directors and the board of commissioners. Furthermore, the concentrated ownership structure of Indonesian companies can cause agency problems between large and small shareholders. The study results show that large shareholders can strengthen the relationships of busy directors to reduce idiosyncratic risk. As a result, this research recommends increasing the role of multiple directorships in monitoring and predicting business conditions internally and externally to minimize interference from large shareholders which can cause expropriation due to agency problems.
Translation, cross-cultural adaptation and validation of the MBI-SS questionnaire for Chinese art students
Authors: Meng Zhang , Fah Lay Yoon
Published: March 2024

The 16-item Maslach Burnout Inventory-Student Survey (MBI-SS) was translated into simplified Chinese (MBI-SS-C) and tested for reliability and validity among Chinese art college students. A sample of 437 students from a Beijing art college was analyzed. The MBI-SS-C with 16 items shows relatively poor psychological measurement characteristics for items 2 and 7. The remaining 14 items showed good validity and reliability after being removed. Confirmatory factor analysis confirmed the structural validity of the 14-item MBI-SS-C. The Cronbach alpha for the MBI-SS-C was 0.854, with the three subscales having Cronbach alpha of 0.898, 0.890 and 0.902. The 14-item MBI-SS-C has a moderate correlation with general self-efficacy (GSE) and high concurrent validity. The 14-item MBI-SS-C is a reliable tool for evaluating burnout in Chinese art college students and is simple and effective.
Financial Constraints on Firm Growth: The Role of Firm Age in the ASEAN–6
Authors: Ling Ng Yee , Theng Lau Wei , Ni Soh Wei , Ab Razak Nazrul Hisyam
Published: March 2024

The paper assesses the moderating role of firm age in the relationship between financial constraints, as measured by the KZ index, and the WW index on three alternative measures of firm growth (Asset growth, ROA, and ROE) in the ASEAN–6 region. This study employs a sample of ASEAN–6 listed firms over the period 2009–2019 using Fixed Effects and the System GMM model. Firm age is found to interact positively with financial constraints in their effects on firm growth. The negative impact of financial constraints on firm growth is less severe with older age firms.
The Role of Digital Services Trade Restrictiveness in Exports: Before and During COVID–19
Authors: Nikensari Sri Indah , Oktavilla Shanty , Istikomah Navik , Puspitasari Nindya Farah Dwi
Published: March 2024

Digital technology has penetrated various fields, including international trade. This study aims to analyze how barriers/openness to trade in digital services affected exports before the COVID–19 pandemic (2015–2016) and during the pandemic (2019–2020). Based on the Gravity model, exports seem to be influenced by digital services trade restrictiveness, including infrastructure and connectivity restrictions (X1), electronic transaction restrictions (X2), and other restrictions (X3). The panel data regression equation was used to analyze data from various countries (European 17 countries, Asian 8 countries, and Latin American 3 countries) sourced from OECD Statistical Data. The selection of sample countries was based on data availability and homogeneity. The results showed that the effect of digital services trade restrictiveness on exports was low before the pandemic and increased during the pandemic era. Prior to the pandemic, restrictions on electronic transactions had a weak and negative impact on exports; meanwhile, during the pandemic, all restrictions impacted exports, except for other restrictions. In the pandemic era, restrictions on infrastructure & connectivity had a negative impact, but restrictions on electronic transactions had a positive impact on exports due to a decline in global exports and several countries reducing restrictions on electronic transactions.
The Interactions between Labour Market Policies and Income Inequalities in Groups of European Union Countries
Authors: Szulc‑Obłoza Agnieszka , Szczepaniak Małgorzata
Published: March 2024

Social cohesion and a sustainable labour market remain the aims of sustainable development policy. However, income inequalities and labour market policies are more often separately analysed. To fill the identified research gap, our article presents the results of an analysis of interactions between active and passive labour market policies and income inequalities in the European Union. The 27 countries were divided into two clusters based on their active and passive labour market policy (LMP) expenditures in 2019. These clusters sustain the basis for analysing the interactions between LMP and income inequalities in its different measures. The results reveal that labour market interventions interact with income inequalities, decreasing disposable income inequalities (equalising the disposable income after transfers and taxes) and therefore contributing to social cohesion. This paper concerns social cohesion as the manifestation of intragenerational justice.
DISKRETNA SKLONOST LORENCOVE FILOZOFIJE KA PRAGMATIZMU
Authors: JEVTIĆ NEVENA
Published: March 2024

Predmet razmatranja u ovom radu jeste bliskost Lorencovog filozofskog pogleda na svet i pragmatizma. Polazeći od razmatranja pragmatičke korisnosti filozofskih ideja i teorija, onako kako ju je razumeo Viljem Džejms, jedan od istaknutih predstavnika pragmatizma, Lorencov se svetonazor „delimičnog racionalizma“ rasvetljava s obzirom na subjektivističku tezu koju deli s Džejmsovim pragmatizmom. Uvodeći, zatim, Lukačev kritički orijentisan pojam modernog iracionalizma, u koji ubraja pragmatizam, dovodi se Lorencov filozofski pogled na svet u dublju misaonu vezu s temeljnim filozofskim i ideološkim pretpostavkama Džejmsovog učenja.
MOMČILO SELESKOVIĆ I RASPRAVA O JEZIKU
Authors: VLAŠKI STANKO
Published: March 2024

Pitanje o kreiranju jedinstvene jezičke politike u Kraljevini Jugoslaviji uključivalo je i lematsko, često implicitno, a ponekad i izričitije prihvatanje stava o potrebi da se jezik razvija na prirodan način. Rad je podstaknut tim pitanjem i u njemu se pažnja usmerava na koncepciju Momčila Seleskovića kao jednog od naših međuratnih mislilaca kod kojih se raspravi o poreklu i načinu razvijanja jezika ne samo tematski pristupa, nego joj se priznaje najviši filozofski dignitet. Sagledavajući Seleskovićevu filozofiju jezika u svetlu načina na koji je jezik poiman kod mislilaca poput Herdera, Vilhelma fon Humbolta, ali i Aristotela i Ničea, autor nastoji da pokaže da teza o veštačkom karakteru jezika koju Selesković izrekom zastupa kod njega nema smisao prostog priklanjanja jednoj od sukobljenih strana u vekovnom filozofskom sporenju između pristalica jezičkog naturalizma i jezičkog konvencionalizma. Ona kod Seleskovića ima značenje poziva da se spozna humanistička, slobodarska bit jezika i da se koncepcije u kojima se na različite načine tvrdi njegova transcendentnost podriju u svom osnovu. Učenje o jeziku kao skupu simbola, kao i kritika jezika koja se usredsređuje na njegovu neinventivnost, kod Seleskovića su imali zadatak da to bliže pokažu. Seleskovićeva razmatranja puteva formiranja jezičkih paradigmi evropskih naroda neposrednije su pak dovedena u vezu s tadašnjim perspektivama jugoslovenske jezičke politike.
GENEALOGIJA I DEKONSTRUKCIJA
Authors: ROMČEVIĆ BRANKO
Published: March 2024

U ovom tekstu bavimo se najpre Fukoovom i Deridinom polemikom povodom Dekartove prve Meditacije. Fuko je, u Istoriji ludila, ustvrdio da Dekart isključuje ludilo iz procesa meditiranja i da je taj potez paradigmatičan za klasicističku epohu. Derida, međutim, smatra da Dekart to čini samo prividno, kako bi udovoljio prirodnom stavu, i da s pojavom Zloduha počinje kvalifikovana sumnja, s kojom dolazi do afirmacije ludila kao uslova za rađanje meditativnog subjekta. Derida veruje da Fuko nije napravio previd, nego da je nerazumevanjem da Dekartovo isključenje s početka Meditacija nije definitivno, izvršio ograđivanje cogita analogno onom kakvim klasicizam od sebe odvaja ludilo. Zbog toga je, smatra, s tim stranicama o Dekartu na kocku dospela celokupna Istorija ludila. Fuko, pak, misli da Derida ne shvata da je ludilo Zloduha simulirano, ne izvorno, te da je neodgovorno očekivati kako se na osnovu tri stranice može diskreditovati ostalih preko šest stotina. Ono što je dodatno zanimljivo (to je tema drugog dela teksta) jeste način na koji se preko ta dva različita pristupa Meditacijama ispoljavaju sličnosti i razlike između fukoovske arheologije/genealogije i deridijanske dekonstrukcije. Ključ se nalazi u pojmu margine, na koju Fuko računa kad tematizuje nesvesno znanja (viđeno da se emancipuje kroz genealoške intervencije), i koja je kod Deride određena kao polazište za dekonstruktivni preokret. Ali, na kraju će se pokazati da njih dvojica marginu drukčije koncipiraju i da se preko toga mogu sagledati razlike između njihovih poduhvata.
КОНТРАДИКЦИЈЕ СРПСКОГ ПРОСВЕТИТЕЉСТВА: АУТОНОМИЈА И ЈЕДНОУМЉЕ
Authors: АТАНАСКОВИЋ ЛАЗАР
Published: March 2024

Овај рад анализира појмове учености, једноумља и народа као карактеристичне за епоху српског просветитељства крајем осамнаестог и почетком деветнаестог века. Специфичност ових појмова оцртана је њиховом компарацијом са појмовима аутономије, неслоге и космополитизма као карактеристичним за западноевропско, у првом реду немачко просветитељство. У раду је спроведена компаративна анализа наведених појмова у њиховом друштвеном и политичком контексту. Овакво читање резултира оцртавањем концептуалног оквира одређујућег за потоње расправе у оквирима српског просветитељства, а које су се у значајној мери тицале супротстављености између ауторитета и аутономије, неслоге и јединства, космополитизма и народа.
Phytochemical Composition, Biological Activity and Molecular Docking Studies of the Endemic Marrubium trachyticum Boiss.
Authors: Derelli Tüfekçi Ebru , Gürgiç Alişan , Ekinci Emel , Tüfekçi Ali Rıza
Published: March 2024

In this study, Marrubium trachyticum Boiss., which is an endemic species for Türkiye, belonging to the genus Marrubium selected from the family Lamiaceae, was examined. The phytochemical composition of hexane and methanol:chloroform (MeOH/CHCl3) (1:1) extracts of M. trachyticum were analyzed quantitatively by GC-MS and LC-MS/MS. Antioxidant activities of the plant extracts and inhibitory activities for various enzymes were determined. In addition, molecular docking studies were performed to understand how the phytochemicals may have an effect on tyrosinase, α-amylase and α-glucosidase enzyme activities. Since there are no studies on the phytochemical composition and bioactivities of M. trachyticum, the data obtained from this study will be recorded for the first time. The chemical composition of the extract of M. trachyticum was determined by GC/MS and the major compound was the dotriacontane with a percentage of 20.23% followed by nonacosane (19.94%). Phenolic compound analysis of MeOH/CHCl3 extract of M. trachyticum plant was carried out quantitatively by LC-MS/MS and rutin (1200 mg kg-1 extract), kaempferol-3-O-glucoside (100.2 mg kg-1extract), hesperidin (75.97 mg kg-1 extract) were found to be the most abundant main compounds in this plant. While no inhibitory effect of M. trachyticum hexane extract was observed on all three enzymes, methanol-chloroform extract showed inhibitory effect on -glycosidase and tyrosinase enzymes. The in vitro and in silico results are evaluated, it is seen that compounds such as rutin, hesperidin and isoquercitrin are more abundant in the extract and have the highest potential to inhibit both enzymes. The present study's results indicate that M. trachyticum is an excellent source of flavonoid components and other bioactive substances that may be responsible for the observed antioxidant and specific enzyme inhibitory effects.
The Pivotal Decade Revisited, or the Contemporary Novel of the Seventies
Authors: Smith-Brecheisen Davis
Published: March 2024

This paper takes up the recent turn in the contemporary novel to the aesthetic and economic debates of the 1970s as ways of thematizing their own aesthetic and political ambitions. Turning to art’s legibility within a matrix of global economic relations, I argue for the political importance of two recent novels — Percival Everett’s So Much Blue and Rachel Kushner’s The Flamethrowers — that not only dramatize a particular moment of economic violence in the 1970s (the expansion of US hegemony via financial instruments), but formalize the era’s aesthetic upheaval (the turn from modernism to postmodernism). In doing so, they offera vision of the politics of literature not dependent on our experience of capitalism but which looks instead to the formation of a political and economic regime that has come to govern the world system under capitalism in the twenty-first century.
The Rules of the Game in Carlos Reygadas’s “Serenghetti”
Authors: Di Stefano Eugenio
Published: March 2024

At first glance, Mexican filmmaker Carlos Reygadas’ Serenghetti (2009) appears to be a documentary, capturing nothing more than an amateur women’s soccer match filmed in Santo Domingo Ocotitlán (Morelos, Mexico). Commentary on the film has focused on social issues such as urban development, anthropocentrism, and sport as spectacle. This essay, however, argues that Serenghetti is much more interested in examining the aesthetic dimension of cinema, or what Reygadas calls the film’s “fiction.” In some respects, Serenghetti recalls Douglas Gordon and Philippe Parreno’s Zidane: A 21st Century Portrait (2006), as both movies record complete soccer matches. But where Gordon and Parreno’s film engages, as Michael Fried contends, with the issue of absorption in contemporary art, this essay suggests that Reygadas’s film is concerned with contesting an anti-representational account of cinema, particularly the question of time, which has been central to how slow cinema scholarship has understood his work. Indeed, since his Cannes award-winning film Japón (2001), Reygadas’ films have been labeled as slow cinema—films that are understood less as a representation of time than as what Thiago de Luca calls “duration itself.” This essay proposes that through the concept of the soccer game, Serenghetti not only asserts itself as fiction but also, in doing so, provides a reading of cinematic time that challenges many political and aesthetic fantasies endorsed by contemporary cultural criticism.
The Boundaries of an Organism: Purposefulness and Autonomy
Authors: Partyka Adam
Published: March 2024

In this article I want to argue that the organic metaphor— most commonly associated with the Romantic notion of an artwork being analogous to a living being—served throughout the last two centuries as a means of conceptualising autonomy, remaining in a dialectical relation to the latter concept: the structure of the metaphor posited within different critical traditions influenced the theorists’, critics’ and artists’ ideas of what it meant for an artwork to be autonomous, while itself being shaped and modelled by their expectations and beliefs regarding the ontology of the artwork and the possibility of the latter’s autonomy. Over this time the metaphor has undergone substantial modifications, supporting both art’s claim for autonomy, and an attempted denial of the latter. In order to illustrate these shifts, I will discuss three theoretical and critical moments in the history of the organic metaphor: Romantic organicism, centred on the concept of the principle of life, New Critical formalist organicism, which turns out to shadow forth what Michael Fried called literalism, and postmodern organicism, as exhibited by the environmental humanities and ecocritical discourses. The brief outline of the recent history of the organic metaphor is intended to offer an aid to understanding the origins of contemporary organicism, and to show that its reluctance towards the idea of aesthetic autonomy stems from the characteristically postmodern notion of organic form. Finally, I propose to show how the concept of organic form can be fruitfully reinterpreted in light of Kant’s considerations on teleological judgement and Anscombe’s views on intention.
EFEKTIVITAS MODEL PEMBELAJARAN MAKE A MATCH TERHADAP HASIL BELAJAR IPA KELAS IV DI MADRASAH IBTIDAIYAH ASH SHOBIRIN SAMARINDA
Authors: Nisa Hairun Nisa , Agil Muhammad , Kadir Marniati , Subhan Muhammad
Published: March 2024

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Pengaruh Air Rebusan Sirih Merah (Piper Crocatum) dalam Menghambat Pertumbuhan Jamur Candida Albicans
Authors: Lastri Sulastri , Makkadafi Suparno Putera , Azahra Sresta
Published: March 2024

Candida albicans merupakan flora normal dan biasa ditemukan di dalam tubuh manusia seperti saluran pencernaan, saluran pernapasan bagian atas, dan mukosa genital yang dapat menyebabkan penyakit kandidiasis. Hasil uji resistensi Candida albicans terhadap flukonazol dengan jumlah yang tinggi yaitu 46% resisten terhadap flukonazol. Pengobatan juga tidak hanya dapat dilakukan secara medis tetapi juga dapat diobati dengan cara tradisional. Salah satu tumbuhan tradisional yang dikenal luas oleh masyarakat adalah sirih merah. Kandungan senyawa pada daun sirih merah adalah minyak atsiri. Senyawa ini mempunyai khasiat antiseptik dalam menghambat pertumbuhan jamur. Tujuan penelitian ini untuk mengetahui sifat antifungi pada air rebusan daun sirih merah pada konsentrasi 10%, 20%, 30%, 40%, dan 50% terhadap pertumbuhan jamur Candida albicans. Desain penelitian ini adalah true eksperiment post test only control group design. Metode yang digunakan adalah dilusi padat dan kontrol positif menggunakan ketokenazol. Penelitian ini dilakukan 4 kali pengulangan, setelah itu diinkubasi selama 5 hari dalam suhu 37°C dan dihitung jumlah jamur menggunakan colony counter. Hasil uji Oneway ANOVA diperoleh nilai (p-value) 0.000 nilai ini sesuai dengan signifikasi (p) < 0,05 sehingga H1 diterima yaitu air rebusan daun sirih merah memiliki efektivitas dalam menghambat pertumbuhan jamur Candida albicans. Kesimpulan penelitian ini yaitu kualitas antifungi pada air rebusan daun sirih merah (Piper crocatum) dalam menghambat pertumbuhan jamur Candida albicans dengan efektivitas tertinggi yaitu pada konsentrasi 40% dan 50% yang dikategorika sebagai antijamur kuat.
Analisis Respon Siswa Terhadap Pengoptimalan Alat Peraga Pada Mata Pelajaran IPA Kelas V di SDN Koripan Bungkal Ponorogo
Authors: Sekar Yoga Palupi  , Wirawan Fadly
Published: March 2024

Guru di SDN Koripan menggunakan alat peraga dalam setiap pembelajarannya terumata pada mata pelajaran IPA. Guru menggunakan alat peraga sebagai alat bantu untuk menjelaskan kepada siswa serta dapat membantu siswa memahami dan menyerap materi lebih cepat. Keunikan yang ada pada guru di SDN Koripan ialah guru tersebut membuat alat peraga sendiri ketika mengajar di depan kelas kemudian guru tersebut juga meminta siswa membuat alat peraga yang sama dengan yang dibuat oleh guru. Jadi, keunikan ini terjadi ketika ada kekurangan yang ada pada prasarana sekolah tersebut. Alat peraga yang dibuat pun lebih bervariasi dan mudah dipahami oleh siswa serta terbuat dari bahan-bahan yang mudah ditemukan di sekitar. Tentunya, bahan-bahan yang digunakan akan mudah ditemukan juga oleh siswa ketika siswa diminta untuk membuat alat peraga. alat peraga yang dibuat sendiri secara tidak langsung bisa menimbulkan rasa ingin tau siswa akan materi tentang alat peraga tersebut. Siswa secara tidak langsung juga dituntut lebih kreatif dalam mewujudkan sebuah inovasi baru terkait penggunaan alat peraga pada materi tertentu. respon siswa sangat antusias ketika guru menjelaskan materi menggunakan alat peraga. Dari hasil observasi, ditemukan fakta ketika siswa diajarkan materi menggunakan alat peraga, siswa tersebut merasa pembelajaran yang dilakukan menggunakan alat peraga lebih menyenangkan dan materi dapat terserap dengan mudah sehingga hasil belajar yang diperoleh juga memuaskan. Siswa merasa lebih percaya diri dan berani mengungkapkan pendapatnya ketika guru menjelaskan materi menggunakan alat peraga daripada hanya dijelaskan menggunakan teori saja. Penelitian ini bertujuan untuk mengetahui, mengidentifikasi, dam mendeskripsikan (1) pelaksanaan penggunaan alat peraga di dalam kelas (2) respon siswa ketika dijelaskan menggunakan alat peraga (3) keterkaitan respon siswa dengan alat peraga. Teknik analisis data yang digunakan digunakan pada penelitian ini adalah teknik wawancara, dokumentasi, dan observasi. Kemudian, subjek penelitian ini adalah guru kelas 4, 5, dan 6 serta 4 siswa kelas V sebagai informan.  Berdasarkan hasil analisis data dapat diperoleh kesimpulan (1) pelaksanaan penggunaan alat peraga di dalam kelas cukup effektif terbukti ketika guru menjelaskan menggunakan alat peraga di dalam kelas siswa bisa lebih memahami dan menyerap materi lebih cepat (2) respon siswa yang antusias adalah bukti dari penggunaan alat peraga hasil belajar siswa jauh lebih meningkat dan siswa terbukti bisa berpikir kritis serta percaya diri dalam menngemukakan pendaptnya (3) Keterkaitan respon siswa dengan alat peraga adalah keberhasilan siswa dan guru dalam memahami suatu materi jika menggunakan alat peraga. Kemudian, hasil belajar siswa yang baik adalah salah satu keterkaitan antara respon siswa dengan alat peraga. Karena, ketika siswa mengungkapkan respon positif terhadap materi otomatis siswa memahami materi yang diajarkan oleh guru.
Tackling the Operational Challenges of Sour Produced Water Treatment and Disposal
Authors: Alzaabi Alya Jasem , Ray Tapas Nitaipada , Inamdar Sameer
Published: March 2024

Treating produced water in Upstream Oil and Gas industry is challenging due to high H2S and salt content, presence of temperature-sensitive salts and acidic components. Conventional H2S stripping technologies like reboiled stripping used in downstream facilities need extensive review before applying them in Upstream due to propensity for scaling at high temperature. This paper discusses the several challenges faced in the newly installed Produced Water Treatment (PWT) Unit, to treat sour produced water to the specification of disposal into aquifers and how they were overcome to maintain Business continuity.

Problems faced include severe corrosion in carbon steel piping and components of treated water circuit, hydrocyclones under-performance, frequent filter choking (present downstream of hydrocyclones), and salt/scale deposition in the high temperature reboiler section. This caused frequent shutdown of the system, reducing the unit's availability and impacting oil production target. To identify the root causes and recommend mitigation measures, design data was collected, and deviations were established with respect to design basis. Sampling and analysis for water characterization including pH, suspended solids, oil and oxygen content, bacteria, deposits, and metallurgical failures were carried out. Studies including process, corrosion were conducted by the Original Equipment Manufacturer (OEM).

The severely corroded carbon steel sections were found to be due the Low pH (<4.5), against the design value of pH 6.5, caused by the Oxygen scavenger injected upstream and the presence of Volatile Fatty Acids (VFAs). To maintain the pH, Alkali dosing downstream the stripper is considered as a low-cost solution. The hydrocyclone under performance was due to high oil content (> 5000 mg/l) in feed, compared to design (2500 mg/l), low feed rate (below turn-down) and feed flow variation. These were overcome by adjusting interface levels in upstream separators, changing demulsifier and dosage rate, reducing flow variation through control loops tuning and providing recycle line. As for the frequent filter choking, the main reason is the higher oil content due to hydrocylone underperformance, biofilm formation and wrong cartridge selection (20-micron instead of 70-100 micron acceptable to downstream stripper/disposal well). Improvement in hydrocyclone performance and change in cartridge mesh size resolved the problem to manageable level.

Salt/scale deposits were mainly due to high salinity of water and high temperature as a result of reboiled stripping. Mode of operation was changed to cold stripping with fuel gas taking the advantage of low pH in the system. To maintain the low pH in the system, acid was added whenever required along with caustic injection in treated water to avoid costly CRA material, which was found to be a cost-effective solution.
Preliminary Outcomes of Patients with Lumbar Disc Herniation Undergoing Unilateral Biportal Endoscopic Spine Surgery: A Single-Center Retrospective Study in Vietnam
Authors: Duong Tran Vu Hoang , Tuan Pham Anh , Linh Pham Quoc , Bao Le Tan , Vu Huynh Van , Lam Chu Van , Linh Le Tan , Hung Vo Anh , Duy Phan
Published: March 2024

Objective: Unilateral biportal endoscopic (UBE) treatment for lumbar disc herniation (LDH) is an advanced surgical procedure that has recently gained popularity. Numerous reports from developed countries have demonstrated the effectiveness of this minimally invasive technique. We evaluated the initial outcomes of UBE at a healthcare facility with limited resources.Methods: Clinical and radiographic data of 82 patients with LDH treated between July 2022 and June 2023 using UBE discectomy techniques, including the ipsilateral interlaminar approach, contralateral sublaminar approach, and paraspinal approach, were reviewed. Outcomes were analyzed in terms of the modified MacNab criteria, Japanese Orthopaedic Association (JOA) score, and visual analogue scale (VAS), with a mean follow-up of 3.1 months.Results: At the final follow-up, the mean VAS for low back pain improved from 4.5±1.0 to 1.2±0.4 and the VAS for leg pain improved from 7.8±0.9 to 1.6±0.5. The mean JOA score improved from 13.5±2.4 to 24.2±2.1. The modified MacNab criteria were excellent in 56 patients (68.3%), good in 22 (26.9%), and fair in 4 (4.8%). In total, 106 levels of LDH were treated. L4–5 disc herniation was performed in 55 patients (51.9%), L5–S1 in 36 (34.0%), L3–4 in 8 (7.5%), L2–3 in 6 (5.7%), and L1–2 in 1 (0.9%). The ipsilateral interlaminar approach was performed in 93 patients (87.7%), the contralateral sublaminar approach in 7 (6.6%), and the paraspinal approach in 6 (5.7%). Operative time significantly improved after performing 20 cases. In the early stage (1–20 cases), the operation time per level was 102.0±28.2 min, while in the next stage (21–82 cases) it was 78.1±20.4 minutes. No serious complications, including cauda equine syndrome or root palsy, were observed. Three patients had dural tears (2.8%), and 1 had epidural hematoma (0.9%).Conclusion: UBE discectomy may be performed safely and effectively for the treatment of LDH in limited-resource settings.
Evaluation of Interventions in Online Grocery Shopping for Sustainability and Health: An Adaptive Design Randomized Controlled Trial
Authors: Bentil Helena , Oyebode Oyinlola , Rens Thijs van
Published: March 2024

Effective interventions are needed to promote more sustainable and healthier food choices for both human and planetary health. This study will evaluate two interventions in two independent adaptive design randomised controlled trials (one 2-arm and one 3-arm trial) within the same study population (a factorial design is not powered). The interventions are (i) eco-labelling, which will provide participants with information on the environmental impact of their food purchases using a score ranging from A (most sustainable) to G (least sustainable); and (ii) price discounts on alternative products with a better sustainability profile (and equal or better nutritional profile) in place of specific products in their basket. To implement these interventions, we will use a browser extension on online shopping websites for one or multiple large UK supermarkets, accessed using the Google Chrome browser on a desktop or laptop computer. We will assess the effect of these interventions on the average eco-score of the basket (primary outcome) as well as its nutritional content (secondary outcome). Health outcomes of the intervention will be modelled using nutrition scores.
Incidence and Predictors of Post-operative Hypoxemia in Pediatric Patients Undergoing General Anesthesia: a Single-arm Prospective Multi-center Cohort Study 2023
Authors: Mengistu Semon , Mulugeta Haile Mariam , Destaw Belete , Molla Simeneh
Published: March 2024

Background: Pediatrics use more oxygen than adults do, which has an impact on how quickly the body desaturates after an apnea. Depending on age and other physiological parameters, the clinically relevant hypoxemia in pediatric patients can drop to 40% in as little as 1.5 minutes, which makes the transfer to the Post-Anesthesia Care Unit (PACU) a risky phase. Postoperative hypoxemia (POH) happens critically postoperatively and various factors predict POH. The objective of the study is to determine the incidence and predictors of POH in pediatric patients undergoing general anesthesia (GA) at Hawassa University Comprehensive Specialized Hospital (HUCSH), Saint Peter Specialized Hospital, and Tikur Anbessa Specialized Hospital (TASH)
Methodology: In 292 pediatric patients, a single-arm prospective multi-center cohort study using systematic random sampling was carried out. Data entry and analysis were performed using Statistical Package for Social Sciences (SPSS) version 25.00 software. For logistic regression, a Hosmer-Lemeshow goodness of fit test was used (variables with a p > 0.05 were considered fit). Binomial logistic regression and multivariable analysis were performed. Independent variables were examined for multicollinearity, and those exhibiting a variance inflation factor (VIF) > 10 were removed. Additionally, the association between the variables was determined using Pearson chi-square, and p < 0.05 indicated statistically significant variables.
Results: The incidence of POH was 47.9%. Pediatric age (≤ 2 years), opioids, and above-abdominal surgeries are associated with POH (p = < 0.001) and AOR = 3.263 (1.686–6.314), 5.545 (2.983–10.307), and 3.642 (1.969–6.736), respectively. Additionally, the presence of at least one comorbidity, use of muscle relaxants, prolonged anesthesia, and surgery duration are associated with POH (p = 0.001, 0.003, 0.02, and 0.037) and AOR = 4.259 (1.788–10.145), 29.72 (3.262–270.778), 2.153 (1.131–4.1), and 2.560 (1.058–6.196), respectively. However, anesthesia type is insignificantly associated with POH (p = 0.096).
Conclusion:The incidence of POH in pediatric patients undergoing GA is high, and the presence of at least one comorbidity, pediatric age (≤ 2 years), use of opioids and muscle relaxants, above-abdominal surgeries, prolonged anesthesia, and surgery durations are significantly associated with POH. We recommend taking precautions, following them and having oxygen therapy for these high-risk pediatric patients.
Complexity in palliative care inpatients: prevalence and relationship with provision of care, a retrospective study
Authors: Schutzbach Kevin , Corminboeuf Yann , Wild Beate , Schellberg Dieter , Stiefel Friedrich
Published: March 2024

Context:
Palliative car aims to provide comprehensive care, since end of life can be marked by somatic, psycho-social and spiritual distress, requiring interdisciplinary care. However, interdiscoplinary care is costly, and palliative care services, as all other medical services, get under pressure to be as cost-effective as possible.
Objectives
To describe the case complexity of palliative care inpatients, to evaluate possible correlations between complexity and provision of care and to identifycomplexity subgroups.
Methods
Patients (N = 222) hospitalized in a specialized palliative care unit (Switzerland) were assessed regarding their biopsychosocial case complexity by means of the INTERMED. Based on a chart review, INTERMED scores were determined at admission and the end of hospitalization/death. Descriptive statistics and Pearson correlation coefficients were estimated for the association between biopsychosocial case complexity and amount and type of care provided. A principal component analysis (PCA) was conducted to explain variance and to identify patient subgroups.
Results
Almost all patients (98.7 %) qualified as complex as indicated by the INTERMED. Provision of care correlated positively (r=0.23, p=0.0008) with the INTERMED scores upon admission. The change of INTERMED score during stay correlated negatively with provided care (r=-0.27, p=0.0001). PCA performed with two factors explained 49% of the total variance and identified two subgroups which differed regarding the psychosocial item scores of the INTERMED.
Conclusion
Specialized palliative care inpatients show the highest complexity score of all populations assessed up to now with the INTERMED. Correlations between biopsychosocial complexity and care provided, and between care and decrease of complexity scores, can be considered as an indicator for care efficiency. Patient subgroups with specific needs (psychosocial burden) suggest that palliative care teams need specialized staff.
Trial registration
The study was accepted August 24, 2023 by the ethics committee of the Canton of Vaud (CER-VD 2023-01200).
Analysis of early death in critically ill patients with acute promyelocytic leukaemia in HICU
Authors: Li Haitao , Zhang Yingmei , Fan Shengjin , Li Dandan , Zhang Qian , Fu Jinyue , Lu Dongxue , Ji Jiajuan , Li Yinghua
Published: March 2024

This study was conducted to identify the characteristics and risk factors for early death of the critically ill acute promyelocytic leukaemia (APL) patients in Hemato-oncologyical ICU (HICU). A total of 44 APL patients from 2017 to 2023 were recruited. The mortality of APL patients in HICU was high (27/44, 61.36%). In comparison to patients who survived, nonsurvivors had longer PT (P = 0.02), lower FIB (P = 0.004), and higher WBC (P = 0.004) at hosipital admission. Severe bleeding was the most frequent complication (34 cases, 77.27%), which occurred either pre-induction or on day 5 (IQR, 3-7.5 days) of induction therapy. The leading cause of death was fatal hemorrhage (18 cases, 40.90%), which occurred either pre-induction or on day 4 (IQR, 3–7 days) of induction therapy. In conclusion, the primary cause of mortality for APL patients in the HICU was fatal bleeding, whereas patients who experienced severe bleeding were more likely to die from secondary infection.
Risk factors and global prevalence of Neovascular age-related macular degeneration: protocol for a systematic review and meta-analysis
Authors: Ling Juan , Zhang Huazhi , Glujovsky Demián , Xie Zhuo-Lin , Wang Yan , Esoimeme Gloria , Luo Xiang-Xia
Published: March 2024

Background: Neovascular age-related macular degeneration (nAMD) is the most prevalent cause of blindness among individuals over 50 years old in developed countries. nAMD can result in vision loss due to the degeneration of the retinal pigment epithelium or the formation of abnormal blood vessels called choroidal neovascular membranes (CNVM) beneath the macula. These CNVM can leak fluid and blood, leading to the formation of a scar that can cause severe vision impairment.
Methods: A comprehensive search was conducted on various databases including PubMed, Cochrane Library, Web of Science, Embase, OVID MEDLINE, China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Biomedicine Literature Database (CBM-SinoMed), and VIP to gather research literatures on the risk factors and global prevalence of nAMD. The search strategy Headings (MeSH) terms and free-text terms, and Stata12.0 software was utilized for meta-analysis of the collected data.
Results: This study is ongoing and the results will be submitted to a peer-reviewed journal for publication.
Ethics and dissemination: Ethical approval is not applicable, since this is an overview based on published articles.
Protocol registration number: CRD42023470864
Investigation into the early modification of left ventricular mass following mitral valve replacement and the development of a nomogram prediction model
Authors: Wu Song-zhe , Xia Lin , Wei Tao , Niu Tian-yu , Zhu Yan
Published: March 2024

Background
Mitral valve disease caused by rheumatic heart disease and mitral valve disease caused by degenerative valvular disease are common types of mitral valve disease. Mitral valve replacement surgery (MVR) is an effective treatment for mitral regurgitation. This study observed the changes of left ventricular mass (LVM) and other indicators through mitral valve lesions caused by different types of lesions, and further observed the changes of LVM and other indicators after MVR. The effects of preoperative LVM and other indicators on postoperative ejection fraction reduction in patients with MVR were described, and the model was established as a risk factor.
Method
A retrospective study was conducted on the baseline data and perioperative echocardiographic data obtained during hospitalization of 80 patients with rheumatic or degenerative mitral valve disease from September 2022 to March 2023. The patients were divided into two groups, group A and Group B, according to the relevant perioperative indicators obtained by LVM, left ventricular mass index (LVMI) and relative ventricular wall thickness (RWT). Group A (rheumatic heart disease, n = 50) and group B (degenerative valvular disease, n = 30). The changes of left ventricle in two groups were observed. Then, the risk factors affecting the reduction of ejection fraction (EF) 3 months after surgery were screened by univariate and multivariate Logistic regression analysis, and the corresponding risk prediction model was established by using RStudio, and the model was evaluated and verified.
Results
The preoperative LVM, LVMI, left ventricular volume and left ventricular size in group A were lower than those in group B, and the differences were statistically significant (P < 0.05); The LVM, LVMI, left ventricular volume and left ventricular size of the whole patients at 1 week and 1 month after surgery were all regression compared with those before surgery, and the differences were statistically significant (P < 0.05); There were no significant changes in LVM, left ventricular volume and left ventricular size 3 months after surgery compared with 1 month after surgery (P > 0.05).Logistic regression analysis showed that left atrial diameter and left ventricular end-diastolic diameter, LVM and serum creatinine were independent risk factors for postoperative EF decline (P < 0.05).
A novel approach: exploring the potential of retinal thickness and microvascular alterations for diagnosing cirrhosis
Authors: Li YIbin , Zou Jie , Jin Xiaobing , Yang Siqi , Li Ming , SHAO YI
Published: March 2024

Background: The objective of this study was to investigate the correlation between fundus alterations and cirrhosis through the use of optical coherence tomography angiography (OCTA).
Methods: This study involved 17 patients with cirrhosis (34 eyes) and 17 healthy controls (HCs; 34 eyes). The OCTA fundus data were segmented into various layers and regions and categorized according to the subzones of the Early Treatment Diabetic Retinopathy Study for comparison.
Results: Patients with cirrhosis had a lower full retinal thickness (RT) in the IS, OS, and ON regions than did healthy controls (HCs) (P < 0.001), and the RT was also lower in the IN and central regions (p<0.05). Additionally, the inner layer RT was lower in the IS, OS, IT, and OT regions in patients with cirrhosis (P < 0.05), and the outer layer RT was lower in the IS, IN, and ON regions in patients with cirrhosis than in HCs (P < 0.05). The ROC curve of the inner RT of the IS region showed a greater sensitivity to the pathological changes associated with the disease, with an AUC of 0.9324 (95% CI: 0.8665-0.9983). Furthermore, compared with HCs, patients with cirrhosis exhibited significantly lower superficial vessel density (SVD) in the IS, OS, IT, and OT regions (P < 0.001) and lower SVD density in the ON and central regions (P < 0.05). The AUC for the IT region was 0.9429 (95% CI: 0.8928–0.9930), indicating good diagnostic sensitivity.
Conclusion: The RT and SVD of specific subregions in the macular retina of patients with cirrhosis were lower than those in the macular retina of HCs. OCTA measurement could be a valuable aid for imaging in cirrhosis patients.