bluuebunny/crossref_metadata_2025 huggingface dataset:
Dislocated and Dissociated Dual-Mobility Components Are Easily Missed and More Than Half Fail Closed Reduction
Authors: Mallett Katherine E. , Taunton Michael J. , Abdel Matthew P. , Sierra Rafael J.
Published: July 2023

Background:

Dual-mobility (DM) implants reduce the risk of dislocation in patients who have undergone total hip arthroplasty (THA); however, DM implants are at risk for large-head dislocation and intraprosthetic dissociation (IPD), where the inner femoral head dissociates from the outer polyethylene head. This study aimed to report the incidence of DM dislocation and IPD, evaluate the rate of recognition of IPD before and after reduction, investigate the outcomes of these complications, and provide treatment recommendations for their management.

Methods:

Between 2010 and 2021, 695 primary and 758 revision THAs were performed with DM constructs at a single institution. There were 44 large-head dislocations (3.0%) and 10 IPDs (0.7%). Four additional IPDs occurred during attempted closed reduction, increasing the IPD incidence to 0.96%. We reviewed prior instability history, dislocation management, success of reduction, recognition of IPD, and subsequent rates of revision and complications. The mean follow-up was 2.5 years.

Results:

Nine of 10 IPDs were missed at presentation and thus not treated as such. Sixty-three percent of attempted closed reductions in the emergency department failed and led to 4 IPDs and 1 periprosthetic fracture. Reduction success was associated with the following factors: use of general anesthesia with paralysis (p = 0.02), having the reduction performed by an orthopaedist (p = 0.03), and undergoing only 1 reduction attempt (p = 0.015). Two-thirds of dislocations required revision. The rate of redislocation was 33%, and 5 hips required subsequent revision at a mean of 1.8 years after the initial dislocation.

Conclusions:

We present an evaluation of DM-implant dislocation and dissociation along with management recommendations based on these data. Given the low success and high complication rates of attempted closed reduction and the need for eventual revision, we recommend that all patients with dislocated DM implants be brought to the operating room for closed reduction as well as potential revision if the reduction fails.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Tinjauan Yuridis Kedudukan Peraturan Pemerintah Pengganti Undang-Undang (Perppu) Dalam Menakar Negara Berada Dalam Ikhwal Kegentingan Memaksa Oleh Presiden
Authors: MOZA Moza Dela Funika , Aryo Aryo Akbar , Asri Asri Muhammad Saleh
Published: July 2023

Government Regulation in Lieu of Law (Perppu) is a legal product in the field of legislation issued by the President without waiting for prior approval by the House of Representatives. Perppu can be issued by the president to address conditions of urgency/State in an emergency that requires fast regulation to address the state's emergency problems. However, in the phenomenon that occurs, every Perppu issued by the president always raises pros and cons in the community. Instead of dealing with state emergencies, it tends to protect certain powers over the birth of a Perppu. Especially during the administration of President Jokowi, which also caused a commotion in the government when the President issued several Perppu. This of course needs to be reviewed from a juridical aspect whether the indicators of a State emergency interpreted by a President have certainty and legal justice for the community. This study aims to answer juridically related to the position of the Perppu in measuring the state is in the crisis of coercion by the president.
Implementation Of The Principles Of Transparency To Ensure Legal Protection For Sharia Bank Customers In Indonesia
Authors: Pelengkahu Muhammad Rahjay
Published: July 2023

This study's objective is to investigate the implementation of the principle of transparency in Sharia banking operations to guarantee legal protection for Islamic bank customers. This study utilised descriptive analysis as its research approach. Secondary data, including laws and regulations, papers, books, research reports, and other sources or information pertinent to this subject, are employed. Then, the method of data collection is library research or library research. The study's findings indicate that transparency is one of the most crucial parts of implementing excellent corporate governance. Article 34, paragraph (1) of the Law of the Republic of Indonesia Number 21 of 2008 concerning Islamic Banking regulates the principle of transparency. This paper's case studies and discussion demonstrate that transparency and Good Corporate Governance can provide the best protection for customers. Hence the principle of transparency must be adopted. as a sort of legal protection for sharia bank consumers in sharia banking activities.
Efektifitas Tindakan Pemerintah Indonesia dalam Menyikapi Persoalan Perubahan Iklim Ditinjau dari Perspektif Hukum Administrasi Negara
Authors: Lianti Lita , Dwi Utami Putri
Published: July 2023

Perubahan iklim akhir-akhir ini menjadi topik yang hangat dibicarakan dalam forum-forum internasional. Sebagai wujud kontribusi dalam mengatasi perubahan iklim dan pengupayaan pemenuhan hak atas warga negaranya, pemerintah Indonesia mengeluarkan berbagai kebijakan berkaitan dengan upaya menciptakan lingkungan hidup yang baik. Selanjutnya, Indonesia juga meratifikasi berbagai peraturan internasional yang berkaitan dengan perubahan iklim. Tujuan dari penelitian ini adalah untuk mengungkapkan sudah sejauh mana komitmen tindakan pemerintah dalam penanggulangan perubahan iklim yang melanda dunia. Penelitian dilakukan dengan metode hukum normatif yang menganalisis peraturan dan norma hukum yang terkait dengan menggunakan studi kepustakaan. Data sekunder yang digunakan dalam artikel ini diperoleh dari melakukan studi kepustakaan untuk selanjutnya disajikan dengan pendekatan deskriptif. Dari penelitian yang dilakukan, kemudian didapati bahwa seringkali tindakan yang diambil pemerintah Indonesia dalam menyikapi perubahan iklim terasa kurang efektif dan efisien. Oleh karenanya negara diharapkan dapat melakukan tindakan yang lebih progresif dalam menyikapi perubahan iklim sebagai bentuk pemenuhan dari hak warga negaranya untuk mendapatkan lingkungan yang layak.
Pengaruh Kemajuan Pembangunan Negara Dalam Defisit APBN Pada Tahun 2022
Authors: Azizah Shafiyah Nur , Maulana Livia Putri
Published: July 2023

Kemajuan suatu negara tidak luput dari dari pengeluaran dan pendapatan suatu negara. APBN atau Anggaran Pendapatan dan Belanja Negara merupakan penyelenggara anggaran negara. Namun pada tahun ini terjadi defisit atau pengurangan anggaran APBN salah satunya disebabkan oleh ketidakseimbangan antar pesatnya perkembangan negara indonesia dan pendapat nasional. Dengan makalah ini, kami akan membahas bagaimana dampak dari kemajuan untuk negara yang masih belum mencapai stabilitas dalam ranah anggaran. Dimana kemajuan adalah suatu hal yang tidak dapat dihindari dan merupakan bagian dari cara agar suatu negara bisa mempercepat pertumbuhan ekonomi negara. Tujuan dari penelitian ini untuk mengkaji anggaran negara yang masih banyak ketimpangan dalam pemerataan APBN yang hanya terpacu pada pemerintah pusat dengan pengeluaran yang lebih besar dalam pembangunan serta mengkaji anggaran APBN sehingga tidak lagi terjadi penggelapan dana yang mengatas namakan publik. Metode penelitian yang kami peroleh menggunakan teknik kualitatif dengan mengumpulkan data -data yang ada di dalam internet, dan hasil dari konferensi pers APBN. Dengan adanya kenaikan pengeluaran maka melakukan pembatasan atas anggaran yang dikeluarkan oleh pemerintah dengan melakukan pembatasan atas permintaan dan jasa yang diberikan.
Perlindungan Hukum Kepada Konsumen Terkait Peredaran Kosmetik Ilegal
Authors: Gabriella Theresia , Bakhtiar Handar
Published: July 2023

Penyebaran dan penjualan kosmetik ilegal menjadi masalah besar di berbagai negara. Kosmetik ilegal merupakan produk kecantikan yang gagal memenuhi persyaratan keselamatan otoritas kesehatan dan kualitas industri. Dalam konteks ini, pentingnya perlindungan hukum terhadap konsumen yang dapat menjaga kepentingan dan kesejahteraan konsumen tidak dapat dianggap sepele. Tujuan dari penelitian ini adalah untuk melihat peran dan mekanisme perlindungan hukum dalam menangani peredaran kosmetika ilegal, serta dampaknya terhadap konsumen. Kajian ini mengumpulkan data dan informasi dari berbagai sumber, antara lain studi literatur dan peraturan perundang-undangan yang berlaku, dengan menggunakan metodologi deskriptif analitis. Hasil penelitian ini membantu peningkatan kesadaran akan pentingnya hukum dalam melindungi konsumen dalam perdagangan kosmetika ilegal. Hal ini penting untuk memastikan akses ke barang kosmetik yang aman, berkualitas tinggi, dan memenuhi standar yang diakui.
Study Of Types And Dosages Of Management On The Growth And Years Of Red Spinach (Amaranthus tricolor)
Authors: Khomariyah Nurul , Nurmalasari Intan Rohma
Published: July 2023

Red spinach is a vegetable whose demand is very high, so further research is needed to increase theproduction quality of this commodity. The use of organic fertilizers such as manure can help increase the yield and growth of red spinach (Amaranthus sp) cultivation. This study aims to determine the effect of the use and a good dose for growth and obtain good results on red spinach (Amaranthus sp). This study used a randomized block design consisting of 2 factors and was repeated 3 times. The first factor was the type of manure, namely chicken manure and quail manure. The second factor is the dose of manure, namely the dose of 10 tons/ha, the dose of 20 tons/ha, and the dose of 30 tons/ha. From the results of the study, it was found that there was no significant interaction with all the red spinach measurement variables.
Implementation of the Customer Relationship Management Scorecard and AHP Methods in the Manufacturing Industry
Authors: Mauludhin Ahmad Yudha , Jakaria Ribangun Bamban
Published: July 2023

PT X is a company in the manufacturing sector of the paint industry Competition in the paint industry fighting for market share. To form relationships with customers used customer relationship management method. This study aims to determine the results of implementing the CRM Scorecard. Researchers collect search data from literature or interviews with experts in the field of customers. From the search results, the data yields perspectives and Key Performance Indicators for each perspective, namely customer knowledge, interaction,value and satisfaction. From the perspective and indicators of the CRM Scorecard, it will be determined by weighting using the Analytical Hierarchy Process method. Significant results for company evaluation were obtained from CRM assessments using the AHP method, namely value (0.3737) and Satisfaction (0.34) obtaining the highest ratings indicating that the company is in line with the objectives of these two perspectives, namely creating corporate value and create customer loyalty to the company.
Analisis Kesulitan Belajar Ditinjau Dari Efikasi Diri Pada Mahasiswa Pendidikan Matematika Saat Mengikuti Pembelajaran Daring
Authors: Putri Radianing Anggita , Apriyani Dwi Cahyani Nur
Published: July 2023

Abstrak- Penelitian ini dilatar belakangi oleh adanya kesulitan belajar daring yangdialami oleh mahasiswa pendidikan matematika. Tujuan dari penelitian ini adalahuntuk mengetahui : 1) Apa saja kesulitan belajar mahasiswa pendidikanmatematika pada pembelajaran daring ditinjau dari efikasi diri tinggi, 2) apa sajakesulitan belajar mahasiswa pendidikan matematika pada pembelajaran daringditinjau dari efikasi diri sedang, 3) apa saja kesulitan belajar mahasiswapendidikan matematika pada pembelajaran daring ditinjau dari efikasi diri rendah.Jenis penelitian ini adalah penelitian kualitatif dengan teknik pengumpulan datamenggunakan angket secara online dan wawancara secara online sertadokumentasi. Sampel penelitian adalah semua mahasiswa prodi pendidikanmatematika semester II, IV dan VI sebanyak 40 mahasiswa. Dikarenakan adanyapandemi covid-19, sehingga penelitian yang dilakukan menjadi terbatas.Instrumen yang digunakan dalam penelitian ini adalah angket kesulitan belajardaring, angket efikasi diri, dan wawancara. Teknik analisis data menggunakanmodel Miles and Huberman. Hasil penelitian ini menunjukkan bahwa mahasiswapendidikan matematika STKIP PGRI Pacitan dengan efikasi diri tinggimengalami kesulitan belajar pada aspek kesulitan teknis. Kemudian mahasiswadengan efikasi diri rendah mengalami kesulitan belajar juga pada aspek kesulitanadaptasi mahasiswa dan aspek ketidaksiapan pengajar atau dosen. Sedangkanmahasiswa dengan efikasi diri sedang mengalami kesulitan mahasiswa kesulitanteknis, kesulitan adaptasi mahasiswa dan ketidaksiapan pengajar atau dosen.
Interlanguage as An Oral Communication Strategy Used by The First Graders of The English Education Study Program of STKIP PGRI Pacitan
Authors: Rahayu Dwi
Published: July 2023

This study describes the communication strategies in English used by first-level students of the English Education Study Program at STKIP PGRI Pacitan which can be seen in their interlanguage production. The research data is in the form of interlanguge which they produce when performing oral communication. Data collection techniques are elicitation and documentation. Data were analyzed qualitatively. The results of the study show that there are three main types of communication strategies used by learners, namely: over-generalization, first language transfer, and simplification. This strategy is intended by students to maintain that communication using English as the target language can continue with the limitations of their language skills. The implication of this research is that mistakes are an inevitable process in the process of learning a foreign language, so it needs to be addressed positively. Appropriate training needs to be provided to learners so that they better understand the differences between the target language and their mother tongue so as to help them develop their interlanguage system.
A Utilização do Material Concreto para o Ensino de Matemática: um Relato de Experiência no Ensino Fundamental
Authors: Dal Medico Baerle Lucilene , Kuiawinski Cláudia Fátima , De Paula Dias Kescy , Rodrigues Paulina
Published: July 2023

Este relato de experiência resultou de um projeto de extensão desenvolvido no IFC - Instituto Federal Catarinense que teve por finalidade analisar a importância e efeitos da utilização do material concreto no ensino da Matemática, com abordagens qualitativa e quantitativa, baseando-se na modalidade pesquisa-ação com aplicação de questionários aos envolvidos. A escolha da turma deve-se ao fato de ser justamente a fase de transição do estágio operatório concreto para o formal, descrito por Piaget (1980) apud Kamii (2012). A utilização do material concreto pode ser realizada de forma lúdica, já que é característica inerente, até certa idade, aprender de forma descontraída, representando também um momento de investigação na apreensão do conhecimento matemático. As atividades lúdicas ou com o uso de material concreto objetivam desmistificar a dificuldade de aprender/ensinar matemática, apresentando um viés prático e não apenas na perspectiva da memorização. Na mesma proposta, o planejamento previa atividades de geometria com diversos materiais e a construção de alguns sólidos geométricos, como o cubo e o tetraedro com palitos de picolé e massinha de modelar. Na proposição do trabalho, a reflexão permeou pela utilização de material concreto em turmas de 5º ano, através da aplicação de atividades aos alunos. O aporte bibliográfico se consubstanciou em Kamii, Lorenzato, entre outros. A proposição inicial do planejamento, tencionava para a aplicação de um questionário, na perspectiva da avaliação diagnóstica dos conhecimentos dos alunos e, ao término, com a intencionalidade de analisar os objetivos propostos, respondendo às indagações na elaboração do projeto.
Discalculia e problemas familiares que interferem no processo de aprendizagem da matemática
Authors: Silva Érika Andressa , Augusta Ferreira de Lima Valéria
Published: July 2023

Para alguns alunos, a aprendizagem da matemática pode ser algo desagradável e repleto de conflitos. Tais acontecimentos estão ligados às dificuldades que alguns indivíduos possuem em relação à assimilação desse conteúdo que pode ser ocasionado por diversos fatores, dentre os quais estão os problemas familiares e a discalculia. O objetivo do trabalho é destacar o papel da escola, professores e família frente aos problemas ocasionados pela discalculia. Esse distúrbio afeta a assimilação das habilidades matemáticas, mas pode ser contornado com ajuda de profissionais especializados e auxílio dos professores na utilização de ferramentas didáticas diversificadas inseridas em diferentes formas de intervenção. Além disso, a parceria professor e família necessita estar presente nesse processo, uma vez que os problemas familiares interferem na vida escolar do aluno e por isso, o trabalho de aproximação entre escola e família é de extrema importância para a educação. Nesse estudo, percebeu-se a falta de uma proposta padrão para intervenção nas salas de aulas com alunos discalcúlicos. Mas não se pode desistir de nenhum aluno. Educadores devem realizar o que está ao seu alcance para que o aluno discalcúlico consiga acompanhar, da melhor forma possível, os conteúdos ensinados. Por isso, são necessários professores que “não param no tempo”, mas que estejam dispostos a “arregaçar as mangas”, a aprender novas práticas pedagógicas e que tenham preocupação em se aproximar e orientar os pais a procurar ajuda de profissionais qualificados para os filhos com discalculia. Ademais, os pais não devem “deixar tudo por conta da escola” e devem exercer seu papel na educação de seus filhos.
Uma análise do ensino de funções a partir de uma revisão integrativa de literatura sobre o estilo de aprendizagem de Kolb e metodologias de ensino
Authors: Alves Maria Antônia Keila , Menezes Daniel Brandão
Published: July 2023

O presente artigo traz o objetivo de apresentar os resultados sobre uma análise de como os Estilos de Aprendizagem (EA’s), Metodologias de Ensino (ME’s) e tecnologias, podem influenciar no ensino e aprendizagem de funções matemáticas. Para isso, fez-se uma revisão integrativa da literatura envolvendo artigos e recortes de dissertações com as temáticas Estilo de Aprendizagem de Kolb (E.A.K) e Metodologias de Ensino (ME’s), sendo tais materiais retirados dos periódicos da CAPES, Google Scholar e Scielo, durante a pesquisa foi possível examinar as fases envolvidas no E.A.K. Assim, foi possível firmar um elo entre os Estilos de Aprendizagem (EA’s) e as Metodologias de Ensino (ME’s), pois, por meio das ME’s compreende-se que as formas de aprender e ensinar podem ser diferentes, isso vai auxiliar o docente na identificação do EA que corresponde a seus discentes de forma a modificar sua metodologia. Entre os resultados, é inegável que tratando de ensino de funções, as ferramentas tradicionais de ensino, já não apresentam eficácia e por esse motivo torna-se importante a inclusão de softwares como o Geogebra, e o trabalho do professor com os EA’s e as ME’s, para auxiliar na visualização de seu comportamento e dos outros tópicos a serem trabalhados.
Geodiversidade do IFC- Araquari: identificação dos afloramentos do embasamento cristalino
Authors: Da Silva Casas Caio , Teodoro da Silva Luiza , Da Rocha Andrade Luiz Antônio
Published: July 2023

Em termos gerais, considerando a geodiversidade local, o município de Araquari-SC está sobre duas grandes províncias geológicas: a planície sedimentar e o embasamento cristalino. A planície sedimentar compreende depósitos de origem marinha, flúvio-marinha, eólico e lagunar. Por outro lado, o embasamento cristalino compreende rochas de origem magmáticas e metamórficas. A ocorrência na superfície dessas rochas associados a planície costeira se dá em forma de afloramentos pontuais. Nesse sentido, a pesquisa da geodiversidade visou identificar a ocorrência dessas rochas tendo como recorte os limites do terreno do Campus. Ademais, esta proposta integra os esforços para a valorização do patrimônio natural do Campus Araquari enquanto recursos didáticos e no desenvolvimento de uma cultura acadêmica comprometida com a sustentabilidade. A pesquisa se deu por meio de estudo bibliográfico, documental, análise de imagens de satélite e pela observação de campo. Da triangulação dos dados obtidos, verificou-se predomínio sobre a área de estudo depósitos sedimentares com formação no período Quartenários, originados principalmente durante a fase de regressão do nível do mar. Além disso, foram identificados dois afloramentos do embasamento cristalino, todavia sua ocorrência no Campus é rara se comparada com o predomínio dos depósitos sedimentares. São rochas do complexo granulítico Catarinense. A hipótese é de que esses afloramentos, no passado geológico, foram ilhas durante as transgressões marinhas. Junto com os depósitos sedimentares, esses afloramentos representam a geodiversidade do IFC- Araquari que deve ser preservada considerando seu potencial científico e, acima de tudo, pelo seu valor ambiental.
Detetive Matemático e Jogo do Dado: propostas metodológicas para ensinar Matemática brincando
Authors: Reisdoefer Deise Nivia
Published: July 2023

Este manuscrito apresenta um relato de experiência que descreve a criação, o uso, a divulgação e o compartilhamento de duas propostas metodológicas envolvendo jogos para o ensino da Matemática: “Detetive Matemático” e “Jogo do Dado”. Ambas foram criadas pela autora deste relato em 1999 e, desde então, passaram por alterações e adaptações importantes durante sua atuação docente na área da Matemática em diversos âmbitos: nos Ensinos Fundamental e Médio; em cursos com a temática dos jogos; e, ainda, na formação inicial e continuada de professores. Ao longo dos anos, foram dezenas de adaptações, incrementos e desenvolvimento de atividades exitosas na Educação Básica, a partir do material criado. As experiências aqui descritas evidenciam as potencialidades no trabalho com jogos e a importância de compartilhar e adaptar materiais conforme as necessidades e características das turmas, dos professores e dos conteúdos abordados.
A Systematic Literature Review on Blockchain for Real Estate Transactions: Benefits, Challenges, Enablers, and Inhibitors
Authors: Cunha Florbela Galvão , Silva Miguel Mira da
Published: July 2023

This paper provides a systematic literature review of using blockchain applications for real estate transactions. For this purpose, we analyse the main benefits, challenges that need to be tackled, enablers and inhibitors to the adoption of technology. Due to its perceived features, Blockchain can increase transparency and security, offering trust to the market, reducing the number of intermediaries and, consequently, decreasing transaction costs and time spent. Nevertheless, several challenges need to be overcome for the market to feel secure in adopting the Blockchain technology, especially the ones related to legal enforcement. This paper broadly discusses the benefits and challenges, enablers, and inhibitors raised in peer-reviewed articles published so far. We found that there is a fair possibility of reducing intermediaries and thus decreasing fraud, time spent and costs. Still, this possibility needs to be carefully analysed, and further research must be done to understand which intermediaries can be removed without compromising transactions’ security.
Vitrectomy combined with preoperative intravitreal ranibizumab improves surgical outcomes in patients with proliferative diabetic retinopathy: a systematic review.
Authors: Zhu Anmin , Wu Jiangni , Tang Kai , Cui Yueling , Song Zhaoxi , Tan Wei
Published: July 2023

Background. To summarize the current evidence on the effects of vitrectomy combined with preoperative intravitreal ranibizumab (IVR) on proliferative diabetic retinopathy (PDR) and compare surgical outcomes with preoperative no IVR and preoperative intravitreal conbercept (IVC). Methods. The PubMed, Embase, and Cochrane Library databases published until June 2023 were comprehensively searched for studies that compared vitrectomy combined with preoperative IVR and preoperative no IVR or preoperative IVC in patients with PDR. The intraoperative and postoperative outcomes were extracted from the final eligible studies. The mean difference (MD) and odds ratio (OR) were calculated for continuous and dichotomous variables, respectively, with 95% confidence intervals (CIs). Results. A total of 12 studies with 1190 cases (eyes) were included. In the comparison between the IVR group and the no IVR group, the mean surgery time and the rates of endodiathermy, silicone oil tamponade, intraoperative bleeding, and iatrogenic retinal breaks were lower in the IVR group (MD = -22.24,P < 0.00001; OR = 0.24,P < 0.00001; OR = 0.35,P < 0.00001; OR = 0.17,P < 0.0001; OR = 0.23,P < 0.00001). The mean change in best-corrected visual acuity (BCVA) was more significant in the IVR group at one month (MD = − 0.41,P = 0.005) and three months (MD = − 0.16,P = 0.004) postoperatively. Lower incidences of early (≤ 4 weeks) postoperative vitreous hemorrhage (VH) and postoperative neovascular glaucoma (NVG) were associated with the IVR group (OR = 0.36,P < 0.00001; OR = 0.17,P = 0.0001). There was no significant difference between the IVR and IVC groups in mean BCVA improvement or intraoperative and postoperative outcomes. Conclusions. Compared with preoperative no IVR, preoperative IVR not only reduces surgery time, intraoperative electrocoagulation, silicone oil tamponade, intraoperative bleeding, and iatrogenic retinal breaks but also significantly improves early postoperative BCVA and reduces early postoperative VH and postoperative NVG. In addition, preoperative IVR has similar surgical outcomes to preoperative IVC.
The Cost and Outcome of Treatment of Patients Admitted with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Shiraz, Southern Iran
Authors: Emadi Mehrnoosh , Taheri Mohammad Hossein , Keshavarz Khosro , Masoompour Seyed Masoom
Published: July 2023

Background
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) decreases lung function and quality of life, and is the main driver of the costs of chronic obstructive pulmonary disease (COPD), the treatment of which in hospital is highly expensive. The present study aimed at determining the costs and outcomes of treatment of the patients hospitalized with AECOPD in Shahid Faqihi Hospital in Shiraz in 2021.
Methods
The present cost-outcome analysis was conducted as a descriptive-analytical, retrospective study. The research tool was a researcher-made form prepared and used to extract the patients' demographic and clinical information as well as the outcome and direct and avoidable medical costs, after consultations with some experts. In order to analyze the collected data, descriptive and inferential statistics indicators (t-tests with two independent groups and analysis of variance) were used and the data were analyzed using Excel and SPSS23 statistical software.
Results
Most of the studied patients were male (70.7%), and 81.3% of the patients had comorbidities. Besides, 76% of the patients had experienced disease exacerbation at most twice a year and 69.3% had been hospitalized < 7 times in the last year. The total average direct and avoidable medical costs were $2620 and $754, respectively. The financial burdens of avoidable antibiotics, stay, ICU, and lung CT scan in 2021 were $1,501, $3,244, $869, and $1,856, respectively. Of all the patients, 80.6% were discharged with full recovery, 7.3% were transferred to ICU, and 10.7% died. The number of hospitalization days, the use of other drugs, and AECOPD with brain disease had a significant effect on the patients’ total medical costs (p < 0.01).
Conclusion
Prevention of AECOPD, especially moderate or severe ones, is potentially cost-effective. Given that exacerbations can impose a large financial burden on patients and insurers, they will certainly lead to resource loss and prevent the resources from being allocated to effective interventions. Therefore, the use of effective clinical guidelines seems necessary to prescribe avoidable services to patients with AECOPD.
Population Structure and Genetic Differentiation Analyses Reveal High Level of Diversity and Allelic Richness in Crop Wild Relatives of AA-Genome Species of Rice (Oryza sativa L.) in India
Authors: Mahendran Aswin , Yadav Mahesh C. , Tiwari Shailesh , Bairwa Rakesh Kumar , Krishnan S. Gopala , Rana Mukesh Kumar , Singh Rakesh , Mondal Tapan Kumar
Published: July 2023

With a view to explore genetic diversity in crop wild relatives of AA-genome species of rice (Oryza sativaL.) in India, we analyzed 96 accessions of 10Oryzaspecies for 17 quantitative traits with 45 microsatellite markers. The morpho-quantitative traits revealed high extent of phenotypic variation within and between species. Shannon-Weiner's diversity index (H′) also confirmed the presence of high level of genetic variation for both within species, inO. nivara(H′=1.09) andO. rufipogon(H′=1.12), and between species (H′=1.31). Principal component (PC) analysis explained 79.22% variance with five PCs. Among the traits related to phenology, morphology and yield, days to heading showed strong positive association with days to 50% flowering (r = 0.99). However, filled grains per panicle revealed positive association with spikelet fertility (0.71) but negative with awn length (-0.58) and panicle bearing tillers (-0.39). Cluster analysis grouped all the accessions into three major clusters. Microsatellite analysis revealed 676 alleles with mean of 15.02 alleles per locus and 0.83 mean polymorphism information content. UPGMA dendrogram separated wild rice accessions at 0.10 similarity value and delineated 96 accessions into four major clusters. Structure analysis revealed four subpopulations; first and second subpopulations comprised only ofO. nivaraaccessions, while third subpopulation included bothO. nivaraandO. rufipogonaccessions. Molecular variance among the populations was 11.0%, whereas it was 70.0% among genotypes and 19.0% within genotypes. The high level of molecular and morphological variability detected in the germplasm of crop wild relatives could be utilized for genetic improvement of cultivated rice.
Factors influencing the effectiveness of public health emergency preparedness: a cross-sectional study from China
Authors: Zhuge Ruiqian , Liu Jingjing , Chang Na , Wang Xing , Qi Xinye , Kang Zheng , Wu Qunhong
Published: July 2023

To identify the factors that impair the effectiveness of public health emergency drills in China by assessing staff perspectives for improvements, we conducted a cross-sectional survey in Heilongjiang, a province in northeastern China by stratified cluster sampling. The staff perceived the inadequacy of equipment and facilities for scenario training (practice drills) to be the most important factors that impair response capacity. Conversely, integrated knowledge and skill-oriented emergency skills were enhanced during scenario training, as well as if such training were repeated periodically. We found that funding constraints, lack of departmental coordination, and insufficient leadership attention adversely affect the response capacity and effectiveness. A greater focus on emergency training and participation in simulated drills improves the preparedness of public health personnel to face crises. We consider the equipping of CDC staff with practical skills to face complex emergencies a priority, which will require a strategic decision to increase funding for equipment, leadership training support, and effective emergency coordination.
Multiple genetic control of anti-COVID-19 vaccine response by HLA locus
Authors: Colombo Francesca , Esposito Martina , Minnai Francesca , Copetti Massimiliano , Miscio Giuseppe , Perna Rita , Piepoli Ada , De Vincentis Gabriella , Benvenuto Mario , D'Addetta Paola , Croci Susanna , Baldassarri Margherita , Bruttini Mirella , Fallerini Chiara , Brugnoni Raffaella , Baggi Fulvio , Corsini Elena , Ciusani Emilio , Andreetta Francesca , Dragani Tommaso , Fratelli Maddalena , Carella Massimo , Mantegazza Renato , Renieri Alessandra
Published: July 2023

Since the beginning of the anti-COVID-19 vaccination campaign, it has become evident that vaccinated subjects exhibit considerable inter-individual variability in the response to the vaccine that could be partly explained by host genetic factors. A recent study reported that the immune response elicited by the Oxford-AstraZeneca vaccine in individuals from the United Kingdom was influenced by a specific allele of the human leukocyte antigen geneHLA-DQB1. We performed a genome-wide association study to investigate the genetic determinants of the antibody response to the Pfizer-BioNTech vaccine in an Italian cohort of 1,351 subjects. We confirmed the involvement of the HLA locus and observed significant associations with variants inHLA-Agene. In particular, the HLA-A*03:01 was the most significantly associated with serum levels of anti-SARS-CoV-2 antibodies. These results support the hypothesis that HLA genes modulate the response to anti-COVID-19 vaccines and highlight the need for genetic studies in diverse populations.
A Dynamic Fuzzy Rule-Based Inference System: Fuzzy Inference with Semantic Reasoning
Authors: Shoaip Nora , El-Sappagh Shaker , Abuhmed Tamer , Elmogy Mohammed
Published: July 2023

The challenge of making flexible, standard, and early medical diagnoses is significant. It has some limitations that it hasn't fully overcome. First, the diagnosis rules established by medical experts or learned from a trained dataset prove static and too general. It leads to decisions that lack adaptive flexibility when finding new circumstances. Secondly, medical terminological interoperability is highly critical. It increases realism and medical progress. Avoid isolated systems and the difficulty of data exchange, analysis, and interpretation. Third, criteria for diagnosis are often heterogeneous and changeable. It includes symptoms, patient history, demographic, treatment, genetics, biochemical, and imaging. Symptoms represent a high-impact indicator for early detection. It is important that we deal with these symptoms differently. It has a great relationship with semantics, varies widely, and has linguistic information. Symptoms cannot be ignored or fixed with variables with specific values. Negatively affects early diagnosis decision-making. Under the circumstances, the diagnosis is made solo on imaging and various medical tests. In this case, although the accuracy of the diagnosis is very high, can these decisions be considered an early diagnosis or prove the condition is deteriorating? Our contribution in this paper is to present a real medical diagnostic system based on semantics, fuzzy, and dynamic decision rules. We attempt to integrate ontology semantics reasoning and fuzzy inference. It promotes fuzzy reasoning and handles knowledge representation problems. In complications and symptoms, ontological semantic reasoning improves the process of evaluating rules in terms of interpretability, dynamism, and intelligence. A real-world case study, ADNI, is presented involving the field of Alzheimer's disease (AD). The proposed system has indicated the possibility of the system to diagnose AD with an accuracy of 97.2%, 95.4%, 94.8%, 93.1%, and 96.3% for AD, LMCI, EMCI, SMC, and CN, respectively.
Effect of chronic F- exposure on ionotropic glutamate AMPA and NMDA receptors in rat hippocampus
Authors: Nadei Olga V. , Agalakova Natalia Ivanovna
Published: July 2023

Our previous study has shown that long-term consumption of excessive fluoride (F−) impaired spatial learning and formation of long-term memory of Wistar rats. The present study examined alterations in expression of a few subunits composing glutamate AMPA and NMDA receptors in hippocampal cells in response to F− poisoning at transcriptional and translational levels, as well as their subcellular distribution and phosphorylation state. The rats were given water with background 0.4 (control), 5, 20 and 50 ppm F− (as NaF) for 12 months. The expression of Gria1, Gria2 and Gria3 genes remained stable in the hippocampal tissues of F−-exposed animals. However, long-term F− intake resulted in translocation of GluA2 subunits of AMPA receptors from membranes to cytosol and opposite trafficking of GluA3 subunits, whereas subcellular distribution of GluA1 subunits was unaltered. These changes were accompanied by increased phosphorylation of GluA1 and GluA2 subunits in cytosol and/or membranes. The expression of Grin1 gene and GluN1 subunits of NMDARs were comparable in hippocampal cells of rats from all groups. In contrast, F− poisoning was accompanied by a rise in both Grin2a and Grin2b mRNA content and enhanced levels of total and phosphorylated forms of GluN2A and GluN2B subunits in/or cytosol and membranes. Such changes indicate the predominance of Ca2+-permeable AMPARs and altered ratio between different types of NMDARs subunits at membranes of hippocampal cells of F−-exposed rats, which may underly the disturbances in cognitive capacities of animals.
Short-term wind speed probability interval prediction based on secondary decomposition and multi-objective optimization combination model
Authors: Qiu Wenzhi , Zhang Wenyu , Wang Gang , Guo Zhenhai , Zhao Jing , Ma Keke
Published: July 2023

Reliable interval prediction can quantify the potential risk of wind speed, which is important for the planning and application of wind energy. In this paper, a new probabilistic prediction model, called QRCfC, is proposed for the first time by combining quantile regression and closed-form continuous-time neural network. A new combined model combining QRCfC, secondary decomposition, multi-objective optimization and dynamic weight combination strategy is proposed, which makes full use of the advantages of each single model to obtain reliable probabilistic interval prediction of wind speed. Firstly, a secondary decomposition method based on variational modal decomposition and singular spectrum analysis is constructed to decompose the original wind speed series into different subseries. Then, four base models are used to predict these subseries separately. After that, the predicted values of the four base models are input into QRCfC for training, where the hyperparameters of QRCfC are dynamically adjusted by a multi-objective ant lion optimization algorithm. Finally, to verify the effectiveness of the proposed models, experiments are conducted using data sets from three wind farms in Gansu, China. The simulation results indicate that the proposed model is significantly superior to other conventional models in the 1-step to 3-step interval prediction for the three sites.
Characterization of novel 3D-printed honeycomb bolus for radiotherapy
Authors: Zhang Te , Wang Zhongfei , Wang Xuemin , Sun Xiaohuan , Wang Wei , Chen Liting , Duan Jie , Lv Bo , Yao Xiaowei , Zhao Lina
Published: July 2023

Purpose
To characterize a novel 3D-printed honeycomb bolus design by evaluating the impact on dose distribution and testing its feasibility in skin surface dose modulation using volumetric-modulated arc therapy (VMAT) treatment plans.
Methods
Multiple honeycomb boluses were 3D-printed with different infill percentages of 10%, 30%, 50%, 70%, and 90%, respectively. CT scan was then performed for each bolus placed on an I’mRT phantom. The CT DICOM file was imported into the treatment planning system (TPS) Eclipse for dose calculation using a 6 MV photon beam. In parallel, a virtual bolus structure was defined in Eclipse as the analog. The CT number of the virtual bolus was manually adjusted until its depth dose curve matches the one calculated from the actual CT structures. Gafchromic EBT3 film was then used to validate the calculation. Finally, we tested the feasibility of applying the virtual bolus in making VMAT plans.
Result
Using the depth dose matching method, the equivalent CT number values were determined to be -475, -438, -274, -118, and − 4 for the infill percentage of 10–90%, respectively. The dose difference between the TPS calculation with a virtual bolus and film measurement was lower than 3% when the infill percentage was greater than 30%. When the infill percentage was greater than 50%, the dose-volume quantities indicated that the VMAT plans are clinically acceptable.
Conclusion
It is clinically feasible to use the novel 3D-printed honeycomb bolus and virtual bolus method in treatment planning for skin surface dose modulation.
Muscle Fatigue Analysis and Stress Detection from Surface EMG and ECG Using Deep Learning for Upper-Limb Trauma Rehabilitation
Authors: Kassaw Ewunate , Worassa Emnet , Fetene Kinde , Aboye Genet
Published: July 2023

Background The repetitive nature of physical rehabilitation exercises may result in an excess of muscular fatigue, which can adversely impact an individual's motor function, leading to discomfort or even physical injury. Moreover, individuals who have undergone traumatic experiences tend to encounter difficulties with concentration, which can significantly impede their physical capabilities. Regrettably, existing therapy approaches do not appear to consider the potential mental exhaustion of their patients. Developing Bidirectional Long Short-Term Memory (Bi-LSTM) model for the assessment of Muscle fatigue stage and mental stress condition during physical rehabilitation of trauma injured patient was the aim of this study.Methods 188 EMG signal data and 223 ECG signal data were collected from Jimma University physiotherapy clinic and prepared for signal processing. Since 4th order Butterworth filter perform better than other, it was chosen to denoise the data. The data then split in to a ratio of 60:20:20 train, validate and test data. Finally, the developed Bi-LSTM model was deployed.Result The Bi-LSTM model achieved an accuracy of 95% for multiclass muscle fatigue classification and 97% accuracy was achieved during the binary classification of mental stress. The GUI provides a setting appropriate for routine model usage.Conclusion The obtained result indicates that monitoring the muscle condition and mental status of trauma injured patient can be performed in clinical setup for an effective physical rehabilitation.
Indole-3-methanol Reduces Apoptosis and Improves Neurological function after Cerebral Ischemia-reperfusion Injury by Modulating Microglia Inflammation
Authors: Peng Long , Zhu Xingjia , Wang Chenxing , Jiang Qiaoji , Yu Shian , Song Gaochao , Liu Qianqian , Gong Peipei
Published: July 2023

Indole-3-carbinol(I3C) is a tumor chemopreventive substance that can be extracted from cruciferous vegetables.Indole-3-methanol(I3C) has been shown to have antioxidant and anti-inflammatory effects. In this study, we investigated the cerebral protective effects of I3C in an in vivo rats model of middle cerebral artery occlusion(MCAO). 8–10 Week-Old male SD rat received I3C (150 mg/kg, once daily) for 3 days and underwent 3 h of middle cerebral artery occlusion (MCAO) followed by reperfusion. The results showed that I3C pretreatment (150 mg/kg, once daily) prevented CIRI-induced cerebral infarct size in rats. I3C pretreatment also decreased the mRNA expression levels of several apoptotic proteins, including Bax, caspase-3 and caspase-9, by increasing the mRNA expression levels of the anti-apoptotic protein Bcl-2. inhibited apoptosis in the brain cells of MCAO rats. In addition, we found that I3C pretreatment reduced neuronal loss, promoted neurological recovery after ischemia-reperfusion injury and increased seven-day survival in MCAO rats. I3C pretreatment also significantly reduced the expression of inducible nitric oxide synthase (INOS), interleukin-1β (IL-1β) and interleukin-6 (IL-6) mRNA in ischemic brain tissue; Increased expression of interleukin-4 (IL-4) and interleukin-10 (IL-10) mRNA. At the same time, I3C pretreatment significantly decreased the expression of the M1 microglial marker IBA1 after cerebral ischemia-reperfusion injury and increased the expression of these results in the M2 microglial marker CD206. I3C pretreatment also significantly decreased apoptosis and death of HAPI microglial cells after hypoxia induction, decreased interleukin-1β (IL-1β) and interleukin-6 (IL-6) mRNA The expression of interleukin-4 (IL-4) and interleukin-10 (IL-10) mRNAs was increased. These results suggest that I3C protects the brain from CIRI by regulating the anti-inflammatory and anti-apoptotic effects of microglia.
Growth of Organized Flow Coherent Motions within a Single-Stream Shear Layer: 4D-PTV Measurements
Authors: Gautam Ankit K , Livescu Daniel , Mejia-Alvarez Ricardo
Published: July 2023

This study investigates the evolution of a Single-Stream Shear Layer (SSSL) originating from a wall boundary layer past a backward-facing step. Utilizing a time-resolved 3D-Particle Tracking Velocimetry (4D-PTV) technique, we track the trajectories of fluorescent particles to gain insight into the flow characteristics of the SSSL. A compact water-tunnel facility (Reτ = 1240) is fabricated to obtain an SSSL with a perpendicular slow entrainment stream past the separation edge. Spanwise-dominant coherent motion accompanied by finer flow scales is observed. The SSSL layer grows due to flow entrainment through "nibbling" actions of small-scale vortices, "engulfing" by large-scale vortices, and vortex-pairing events. Furthermore, the non-zero-speed stream edge grows considerably faster than the zero-speed stream edge, showing a strong asymmetry in mixing composition across a mixing layer. The SSSL reaches self-similarity around ≈ 60 θ0, where θ0 is the initial momentum thickness, a streamwise extent considerably shorter than suggested by previous studies. A turbulent kinetic energy (TKE) budget analysis reveals a negative production region immediately downstream of the separation edge attributed to a large positive streamwise gradient of streamwise velocity. In the self-similar region, the phase-averaged flow mapping demonstrates a larger concentration of turbulence production rate at the outer edges of spanwise vortices and the intersection of braids and vortices. Furthermore, a spatial separation exists in the regions of high production and dissipation rates within the vortex core region favoring dissipation. The braids exhibit a larger concentration of positive turbulence diffusion rates, indicating their function as a conduit for exchanging turbulence between neighboring coherent motions.