bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral versus intravenous antibiotic treatment of moderate-to-severe community-acquired pneumonia: a propensity score matched study
Authors: Kaal Anna G. , Roos Rick , de Jong Pieter , Pepping Rianne M. C. , van den Berg Johanna M. W. , van Aken Maarten O. , Steyerberg Ewout W. , Numans Mattijs E. , van Nieuwkoop Cees
Published: April 2024

Community-acquired Pneumonia (CAP) guidelines generally recommend to admit patients with moderate-to-severe CAP and start treatment with intravenous antibiotics. This study aims to explore the clinical outcomes of oral antibiotics in patients with moderate-to-severe CAP. We performed a nested cohort study of an observational study including all adult patients presenting to the emergency department of the Haga Teaching Hospital, the Netherlands, between April 2019 and May 2020, who had a blood culture drawn. We conducted propensity score matching with logistic and linear regression analysis to compare patients with moderate-to-severe CAP (Pneumonia Severity Index class III–V) treated with oral antibiotics to patients treated with intravenous antibiotics. Outcomes were 30-day mortality, intensive care unit admission, readmission, length of stay (LOS) and length of antibiotic treatment. Of the original 314 patients, 71 orally treated patients were matched with 102 intravenously treated patients. The mean age was 73 years and 58% were male. We found no significant differences in outcomes between the oral and intravenous group, except for an increased LOS of + 2.6 days (95% confidence interval 1.2–4.0, p value < 0.001) in those treated intravenously. We conclude that oral antibiotics might be a safe and effective treatment for moderate-to-severe CAP for selected patients based on the clinical judgement of the attending physician.
Design, optimization, and comparative analysis of wide-band polarization conversion along with dual coding sequences for RCS reduction
Authors: Ahmad Ashfaq , Choi Dong-You
Published: April 2024

In this paper, a wideband polarization conversion metasurface is designed. Additionally, coding and chessboard metasurfaces are specifically tailored for radar cross-section reduction (RCS). Initially, a compact unit cell demonstrating exceptional polarization conversion performance is introduced, achieving a polarization conversion ratio (PCR) exceeding 90$$\%$$
%
across frequencies ranging from 7.9 to 22.7 GHz. The PCR remains effective even when oblique incidence angles of up to 30$$^\circ$$

∘

are utilized across this frequency band. Roger RT5880, with a thickness of 0.254 mm, serves as the substrate. An airgap is introduced between the substrate and the ground plane to enhance the polarization conversion bandwidth. This unit cell serves as the fundamental building block for subsequent metasurface configurations. To assess the scalability and effectiveness, a 36 $$\times$$
×
36 unit array is assembled, confirming efficient polarization conversion capabilities extending to larger structures. Moreover, a 1-bit coding unit “0” and “1” are formed by the Pancharatnam-Berry phase based on the same-sized meta-atom with 90$$^\circ$$

∘

orientations. The robustness and practicality of the design are demonstrated by creating 12 $$\times$$
×
12 lattices and evaluating their RCS reduction potential under two distinct scenarios: a chessboard pattern and a coding-based scheme. Notably, its results indicate substantial RCS reduction across a broad frequency spectrum (7.9 to 22.7 GHz) for both configurations. This study demonstrates the wide-ranging applicability of metasurface design, making it a valuable contribution to the fields of microwave engineering, polarization control, and radar stealth technology. Owing to its simplicity, bandwidth, and versatility, this approach offers innovative solutions for diverse real-world applications.
Evaluating the effectiveness of sulfidated nano zerovalent iron and sludge co-application for reducing metal mobility in contaminated soil
Authors: Ojo Omolola , Vaňková Zuzana , Beesley Luke , Wickramasinghe Niluka , Komárek Michael
Published: April 2024

Sewage sludge has long been applied to soils as a fertilizer yet may be enriched with leachable metal(loid)s and other pollutants. Sulfidated nanoscale zerovalent iron (S-nZVI) has proven effective at metal sorption; however, risks associated with the use of engineered nanoparticles cannot be neglected. This study investigated the effects of the co-application of composted sewage sludge with S-nZVI for the stabilization of Cd, Pb, Fe, Zn. Five treatments (control, Fe grit, composted sludge, S-nZVI, composted sludge and S-nZVI), two leaching fluids; synthetic precipitation leaching procedure (SPLP) and toxicity characteristic leaching procedure (TCLP) fluid were used, samples were incubated at different time intervals of 1 week, 1, 3, and 6 months. Fe grit proved most efficient in reducing the concentration of extractable metals in the batch experiment; the mixture of composted sludge and S-nZVI was the most effective in reducing the leachability of metals in the column systems, while S-nZVI was the most efficient for reducing about 80% of Zn concentration in soil solution. Thus, the combination of two amendments, S-nZVI incorporated with composted sewage sludge and Fe grit proved most effective at reducing metal leaching and possibly lowering the associated risks. Future work should investigate the longer-term efficiency of this combination.
Direct detection of dithiocarbamate fungicides by SALDI/MS using porous TiC ceramic powder as a substrate
Authors: Moriwaki Hiroshi , Osaka Issey , Hashimoto Kotaro , Yamada Osamu
Published: April 2024

Direct detection of dithiocarbamate fungicides (DTCs) has been achieved by SALDI/MS using porous titanium carbide (TiC) ceramic powder as a substrate.
New insights into the photocyclization reaction of a popular diarylethene switch: a nonadiabatic molecular dynamics study
Authors: Martyka Mikołaj , Jankowska Joanna
Published: April 2024

Schematic representation of the photocyclization mechanism of PT.
The structural, optical and photovoltaic properties of Zn-doped MAPbI2Br perovskite solar cells
Authors: Khan M. I. , Hussain Saddam , Almutairi Badriah S. , Dahshan A. , Mujtaba Ali , Ahmad Syed Muhammad
Published: April 2024

Doping Zn in MAPbI2Br reduces band gap, increases refractive index, and lowers extinction coefficient, enhancing solar cell performance.
Structural optimization of icaritin for advanced cancer: novel carbamates via oral administration
Authors: Li Fengxiao , Wang Weiping , Fan Jiaqi , Zhai Yixiu , Zhang Jiaming , Zhang Tianhong , Jiang Qikun
Published: April 2024

Carbamates of icaritin (3N-Me and 3N-Et) are synthesized first to overcome the challenge of the phase II metabolism of ICT. 3N-Me has potential as a novel advanced cancer treatment agent via oral administration in the future.
Possibility of highly efficient 2D–3D perovskite/CIGS tandem solar cells with over 30% efficiency
Authors: Kim Eun-Bi , Akhtar M. Shaheer , Liu Cong , Wang Yousheng , Ameen Sadia
Published: April 2024

Tandem photovoltaics consisting of a wide-bandgap top cell and a narrow-bandgap bottom cell have shown great potential to exceed current single-junction photovoltaics.
A highly biocompatible CE-crosslinked collagen implant with exceptional anti-calcification and collagen regeneration capabilities for aging skin rejuvenation
Authors: Wang Qi , Yan Huiyu , Yao Linyan , Li Wenhua , Xiao Jianxi
Published: April 2024

Skin aging, a complex and inevitable biological process, results in wrinkles, dermal laxity, and skin cancer, profoundly influencing appearance and overall health.
Macrophage membrane-camouflaged nanoclusters of ultrasmall iron oxide nanoparticles for precision glioma theranostics
Authors: Zhang Bin , Yang Rui , Yu Hongwei , Peng Yamin , Huang Haoyu , Hameed Meera Moydeen Abdul , Wang Han , Zhang Guixiang , EL-Newehy Mohamed , Shen Mingwu , Shi Xiangyang , Peng Shaojun
Published: April 2024

Macrophage membrane-camouflaged nanoclusters of ultrasmall iron oxide nanoparticles can be developed to cross the blood–brain barrier for magnetic resonance imaging and chemo/chemodynamic therapy.
Photocatalytic aerobic α-oxygenation of amides to imides using a highly durable decatungstate tetraphenylphosphonium salt
Authors: Gu Chen , Yatabe Takafumi , Yamaguchi Kazuya , Suzuki Kosuke
Published: April 2024

We report a highly durable and efficient decatungstate tetraphenylphosphonium salt as a hydrogen atom transfer photocatalyst, enabling the photocatalytic α-oxygenation of various amides to their corresponding imides using O2 as an oxidant.
Co-doped modified LiLuF4:Eu microcrystalline scintillator-based flexible film for high resolution X-ray imaging
Authors: Huang Xixi , Yang Jinhai , Lu Hao , Xu Xieming , Wang Shuaihua , Wu Shaofan
Published: April 2024

Herein, Gd3+ co-doping has been found to improve the scintillation properties of LiLuF4:Eu microcrystals (MCs). And the film based on LiLuF4:Eu,Gd MCs exhibits outstanding imaging performance with a high spatial resolution of 14.8 LP mm−1.
The impact of a dopant atom on the distribution of hot electrons and holes in Au-doped Ag nano-clusters
Authors: Mokkath Junais Habeeb
Published: April 2024

The generation of hot carriers (HCs) through the excitation of localized surface plasmon resonance (LSPR) in metal nanostructures is a fascinating phenomenon that fuels both fundamental and applied research.
Enhanced intramolecular charge transfer and near-infrared fluorescence in 4-dimethylamino-chalcone analogues through extended conjugation: synthesis, photophysical properties, and theoretical modelling
Authors: Al-Saadi Balqees S. , Ibrahim A. Ramadan , Husband John , Ismail Ahmed H. , Baqi Younis , Abou-Zied Osama K.
Published: April 2024

Expanding the conjugation center between the donor and acceptor in chalcone molecules enhances induced intramolecular charge transfer, accompanied by ultrafast twisting, causing the fluorescence to shift from green to near-infrared in polar solvents.
Synergistic effect of Ag@CN with BiVO4 in a unique Z-type heterojunction for enhancing photoelectrochemical water splitting performance
Authors: Chu Shuai , Zhai Wei , Ding Lei , Wang Lin , Li Jie , Jiao Zhengbo
Published: April 2024

The all-solid Z-type heterostructure photoanode achieved a photocurrent density of 5.30 mA cm−2 and a charge separation efficiency rising up to 85% at 1.23 V vs. RHE. These can be majorly attributed to the acceleration of the hydrolysis kinetics.
Unravelling the complex speciation of halozincate ionic liquids using X-ray spectroscopies and calculations
Authors: Seymour J. M. , Gousseva E. , Towers Tompkins F. K. , Parker L. G. , Alblewi N. O. , Clarke C. J. , Hayama S. , Palgrave R. G. , Bennett R. A. , Matthews R. P. , Lovelock K. R. J.
Published: April 2024

Using a combination of liquid-phase X-ray spectroscopy experiments and small-scale calculations we have gained new insights into the speciation of halozincate anions in ionic liquids.
A waste-minimized approach for the synthesis of iodinated organic borazines
Authors: Marchionni Dario , Gernini Daniele , Nazari Khodadadi Alireza , Cela Ejdi , Huang Fan , Vaccaro Luigi
Published: April 2024

We herein report a waste-minimized process for the synthesis of iodinated hexa-aryl borazines in different iodination patterns and amounts.
Photoredox catalytic aminomethylation of sulfonylthiazoles
Authors: Meng Li , Dong Jun , Tang Yan , Yang Hekun , Sun Long , Chen Jingchao , Fan Baomin
Published: April 2024

A photoredox catalytic aliphatic C(sp3)–H thiazolation of tertiary amines was developed, affording the biologically valuable alkylated thiazoles via the aminomethylation of sulfonylthiazoles.
Exploring the thermal decomposition and detonation mechanisms of 2,4-dinitroanisole by TG-FTIR-MS and molecular simulations
Authors: Yang Nian , Wu Tianlong , Bao Xiaofang , Ma Teng , Huang Yinsheng , Liu Dabin , Gong Xuedong , Wang Yan A. , Xu Sen , Zhou Baojing
Published: April 2024

Investigating the thermal decomposition and detonation mechanisms of DNAN by combining TG-FTIR-MS with DFT and ReaxFF MD.
Comprehensive assessment of carbon-, biomaterial- and inorganic-based adsorbents for the removal of the most hazardous heavy metal ions from wastewater
Authors: Sheraz Nashra , Shah Afzal , Haleem Abdul , Iftikhar Faiza Jan
Published: April 2024

This article is about recoverable adsorbents for the removal of metal-based water contaminants. It presents the role of the homogeneity and heterogeneity of adsorbents, kinetics of adsorption, and the mechanism of the sorption process.
Enhanced hydrogen uptake of dihydrogen complex via porous materials support
Authors: Uchida Kaiji , Tanaka Shunya , Adachi Shuta , Iguchi Hiroaki , Sakamoto Ryota , Takaishi Shinya
Published: April 2024

This study shows using [Mo(PCy3)2(CO)3] complex supporting on the porous materials boosts H2 adsorption up to 9.3 times by enhancing gas access to metal sites.
Design, synthesis and cytotoxic activity of molecular hybrids based on quinolin-8-yloxy and cinnamide hybrids and their apoptosis inducing property
Authors: Binjawhar Dalal Nasser , Al-Salmi Fawziah A. , Abu Ali Ola A. , Alghamdi Maha Ali , Fayad Eman , Saleem Rasha Mohammed , Zaki Islam , Farouk N. A.
Published: April 2024

A sequence of novel quinoline-8-yloxy and cinnamide hybrids has been synthesized and evaluated for in vitro cytotoxicity against HepG2 liver cancer cells.
Highly stable photovoltaic effects in A2+–Zr4+ (A = Ca, Sr, Ba) co-doped BiFeO3 films with self-polarization
Authors: Shi Lei , Zhao Wenyue , Wang Zhao , Hua Wenjing , Yang Xiaoxia , Fei Weidong , Zhao Yu
Published: April 2024

The photovoltaic responses and temperature stabilities of A2+–Zr4+ (A = Ca, Sr, Ba) composite doped BiFeO3 films with self-polarization were enhanced in the R to MA phase transition.
Immobilisation of benzo[c][1,2,5]thiadiazole (BTZ) within polymers of intrinsic microporosity (PIMs) for use in flow photochemistry
Authors: Taylor Dominic , Tobin John M. , Amicosante Leonardo , Prentice Andrew W. , Paterson Martin J. , Dalgarno Scott J. , McKeown Neil B. , Vilela Filipe
Published: April 2024

Benzo[c][1,2,5]thiadiazole PIM-EA-TB copolymers are solution processable and microporous photosensitisers that can be deposited onto glass beads for use in a fixed bed continuous flow photoreactor.
Room-temperature phosphorescence in coal-based humic acid-derived carbon dots
Authors: He Ziguo , Yuen Mukfung , Zhang Cheng , Zhang Jian , Wang Zhicai , Yue Caibo , Ye Mingfu , Zhang Kui
Published: April 2024

Coal-based humic acid derived carbon dots are first prepared as room temperature phosphorescent materials using an innovative, simple and large-scale method, developing a new direction to modulate the emission mechanism of coal-derived carbon dots.
Image super‐resolution via dynamic network
Authors: Tian Chunwei , Zhang Xuanyu , Zhang Qi , Yang Mingming , Ju Zhaojie
Published: April 2024

Convolutional neural networks depend on deep network architectures to extract accurate information for image super‐resolution. However, obtained information of these convolutional neural networks cannot completely express predicted high‐quality images for complex scenes. A dynamic network for image super‐resolution (DSRNet) is presented, which contains a residual enhancement block, wide enhancement block, feature refinement block and construction block. The residual enhancement block is composed of a residual enhanced architecture to facilitate hierarchical features for image super‐resolution. To enhance robustness of obtained super‐resolution model for complex scenes, a wide enhancement block achieves a dynamic architecture to learn more robust information to enhance applicability of an obtained super‐resolution model for varying scenes. To prevent interference of components in a wide enhancement block, a refinement block utilises a stacked architecture to accurately learn obtained features. Also, a residual learning operation is embedded in the refinement block to prevent long‐term dependency problem. Finally, a construction block is responsible for reconstructing high‐quality images. Designed heterogeneous architecture can not only facilitate richer structural information, but also be lightweight, which is suitable for mobile digital devices. Experimental results show that our method is more competitive in terms of performance, recovering time of image super‐resolution and complexity. The code of DSRNet can be obtained at https://github.com/hellloxiaotian/DSRNet.
Booster Circuit for Harvesting Renewable Energy Based on Bioelectric Microbial Fuel Cells Whose Power Can Be Adjusted
Authors: Misto  , Siswanto  , Mulyono Tri , Sutisna  , Dwi Alawiyah Dela
Published: April 2024

Microbial fuel cells (MFCs) represent a promising technology that converts organic waste into electrical energy through bacterial activity. The process involves capturing a low voltage of approximately 0.4 V generated by the MFC using a small capacitor, which is then stored and transferred to a larger capacitor to increase the capacity. In order for this energy to be used for general AC-powered devices, an inverter is essential to convert the DC output to AC. This system, consisting of a series of capacitors and inverters, along with voltage dampers and rectifiers, forms a circuit that can potentially function as an efficient low-power generator. The effectiveness of this arrangement remains to be tested, which will determine its viability as a renewable energy storage solution.
Liverworts (Marchantiophyta) of Ireng-ireng forest Bromo Tengger Semeru National Park, east Java Indonesia
Authors: Kartika Putri Intan , Haerida Ida , Setyati Dwi , Nadhifah Ainun , Bahrul Ulum Fuad
Published: April 2024

The liverwort diversity of Java Island totaled 480 species and was mainly dominated by specimens from West Java. However, exploration of this plant group was still insufficient in East Java. Ireng-ireng forest, a tropical mountain forest located in the Bromo Tengger Semeru National Park (BTS National Park) east Java Indonesia, is an area with a high potency of liverworts diversity. The aim of this research was to explore the liverwort diversity originating from the Ireng-ireng forest in BTS National Park. The study investigated liverworts across the elevation gradient of tropical mountain forests in the Ireng-ireng forest. A total of 24 liverwort species were identified, belonging to 18 genera and 11 families. The family with the highest number of species in the study area was Lejeuneaceae.
Dependence of the reproduction coefficient on donor cells in in vitro improvement of potato cultivars
Authors: Elmurodov Abdugani , Abdullayeva Yulduz , Obloberdieva Navruza , Kuldashov Bobomurod
Published: April 2024

In the experiment, along with growing potato varieties from the meristem cells of the tuber growth, we germinate the botanical seeds of the varieties, grow them from the growth, grow the primary donor cells, obtain healthy callus tissue, grow morphogenetically identical cells, the yield of healthy plant sprouts from the callus tissue is 20% compared to the usual experimental options. 25-30% of callus tissue sprouts, which did not meet the requirements and changed in morphogenesis, remained underdeveloped when callus tissue was grown by taking cells from a normal tumor. It was found that the morphogenesis of the callus sprouts, which were germinated from the seed, obtained from the growths and formed, the weight of the remaining sprouts was 9-10%, and the reproduction coefficient of the sprouts was more than 20%.
Inorganic additives in meat production and processing
Authors: Dissanayake Kasun , Rifky Mohamed , Hunupolagama Dulangana , Harris Jaladeen Mohamed , Zokirov Kurbonalijon , Azizova Kholida , Ermat Sanaev , Samadiy Murodjon
Published: April 2024

The present research focuses on the different ways that inorganic chemicals can affect processed meat quality and its impact on the Finial food quality. The processed meat products (ham, bacon, frankfurters, sausages, salami, and so on) are treated with food additives to increase its shelf life and/or taste (curing, smoking, salting, or the application of chemical preservatives and additives). One area of focus is the preservation and extension of shelf life and other area is to identify the effects and benefits. By incorporating natural additives, such as essential oils and plant extracts, through nano systems, antioxidant effects and improved properties have been observed when applied directly to meat or during manufacturing processes. Additionally, the general trend is a decrease in the level of sodium chloride of processed meat products. Many studies have looked into the use of NaCl substitutes to limit the pro-oxidant effects and control microbial development, including Potassium Chloride (KCl), K-lactate, Calcium Chloride (CaCl2) and Magnesium Chloride (MgCl2) microspheres and it should be governed to minimise and control the use of inorganic substances to reduce impact to the consumers.
Development of the information system for vegetation cover condition tracking with the help of data provided by VEGA-Science service
Authors: Gladkikh D.A. , Linnik M.A. , Manzhula I.S. , Vikhtenko E.M.
Published: April 2024

The article describes the development of an information system that is supposed to be used to aggregate information obtained from the VEGA-Science, with use it to track the state of agricultural fields. The developed information system uses information technologies to design client-server applications using databases for the .NET platform using programming languages, such as C#, Python.
Mitigating greenhouse gases emissions in processing fossil carbon containing industrial waste
Authors: Tikhonova Irina , Grosheva Svetlana , Shlapak Sofya , Averochkin Eugene , Vartanyan Maria
Published: April 2024

The article assesses the Best Available Techniques for the methods of reduction of greenhouse gases (GHG) emissions in the waste treatment sector, that includes oil, plastic and rubber materials. The certain GHG emissions sources were shown and an attention is paid to the economic feasibility of specified methods in different places. It was shown, that for GHG mitigation policy, waste-management should be complied with the product life-cycle optimization, while recycling is considered as initially the best available method. The article is based on methods of scaling and statistical generalization. The data was obtained from official resources, including Reference Documents on the Best Available Techniques, National Inventory of GHG and from scientific publications. It was intended with full agreement, that resource efficiency enhancement relevantly should be in top priority of environmental and economic regulation.
Study and evaluation of the level of pollution of Gallaorol springs
Authors: Tashpulatova S.A. , Choriyeva Sh.Q. , Zokirov X.X. , Abramatov M.B. , Maxammadiyev A.Sh.
Published: April 2024

The amount of organic substances in the water of 70 springs in Jizzakh region (Gallaorol) of Uzbekistan, total iron (Fe+), CNS, K, Na, Mn, Pb, Cu, Cr, Zn, Ni, Co, As, Al were investigated as pollutant factors of spring water. As a result of the analysis, it was found that in some (12 spring water resources) of the 70 springs, the content of harmful organic substances is higher than the standard requirements. The results of the analysis of all other factors of the spring water proved that the waters are not at the level of pollution.
Investigation of the possibility of biological modification and regeneration of plant-based sorption materials
Authors: Zemtsova E.A. , Gornostaeva E.A.
Published: April 2024

The paper considers the possibility of using biomass of hogweed Sosnowski as a sorbent of petroleum products in aqueous medium. The expediency of using plant sorbent in complex with cyanobacteria to increase sorption activity towards petroleum products is proved. The prospectivity of the use of cyanobacteria as a biological regenerator of the used plant sorbent is shown.
The influence of burning of steppe vegetation on the number of locusts (Insecta: Orthoptera, Acrididae) in the feather grass steppe of Dauria
Authors: Korsun Oleg
Published: April 2024

An important factor influencing the structure of steppe communities in the south of Transbaikalia (Dauria) are spring fires. The frequency of fires is influenced by both the climatic features of the territory and the large amount of dry grass remaining until spring. In this regard, it is of great interest how fires can affect the communities of such an important group of herbivorous insects as locusts (Orthoptera, Acrididae). The results of surveys in the feather grass steppe on the territory of the Daursky Nature Reserve, carried out in the second half of summer, showed differences in the number, age and species structure of locust communities occupying unburned areas and areas subjected to burning in the spring. In the unburnt area, the number of locusts was significantly higher, but the proportion of larvae was lower. These differences can be associated both with the quality of shelters for locusts in the form of dry grass, and with the peculiarities of the temperature regime that arise in the event of burning.
Fuzzy rule-based classification of complex biogas energy projects
Authors: Lomazov Alexander V. , Lonazov Vadim A. , Klyosov Dmitriy N. , Miroshnichenko Irina V. , Zuev Nikolay P.
Published: April 2024

The work is devoted to the problems analyzing the effectiveness of projects in the field of biogas energy. The purpose of the work is to build an intellectual toolkit for classifying innovative bioenergy projects. To form a variety of classification characteristics, it is proposed to use the Ishikawa cause-and-effect diagram, which makes it possible to systematize the factors influencing the features of the project. The specifics of biogas technologies, associated with the possibility of generating not only electrical but thermal energy, as well as waste disposal and the production of organic fertilizers, are taken into account by introducing an additional group of factors reflecting the need for these types of products. Expert technologies for assessing factors led to the use of the methodology of fuzzy analysis. The constructed classification procedure is based on a system of fuzzy production rules that reflect the cause-and-effect relationships of the subject area.The developed tools make it possible to reduce the labor intensity of comparative analysis of the effectiveness of the implementation of innovative bioenergy projects by identifying the class of compared projects.
The Effect of Climbing Stairs Activity Toward Aerobic Fitness and Measurement of Its Energy Expenditure
Authors: Aysiat Debora Anne Yang , Palit Herry Christian
Published: April 2024

Aerobic fitness is one of the factors that affect occupational health. The way to improve aerobic fitness is through exercise that trains the cardiovascular organs. Busyness is often the cause of someone being too lazy to exercise. Researchers from Cambridge University say being sedentary is far more dangerous than being overweight. WHO says about two million people worldwide die from diseases caused by a lazy lifestyle and lack of exercise. One of the simple sports activities that can be done together with daily activities is going up and down stairs. This activity does not require special equipment and does not take much time. This study aimed to determine the effect of climbing stairs on aerobic fitness and the energy expenditure rate when climbing stairs. The treatment of climbing stairs was given to 28 respondents. Respondents were divided into two groups: the group that did the treatment five times a week for one month and the group that did the treatment six times a week for one month. The respondent’s initial aerobic fitness level was compared to aerobic fitness level after treatment. Fitness level measurement was carried out using sub-maximum exercise, namely the Harvard Step Test method. The comparison results show that all respondents experienced an increase in aerobic fitness level, and two respondents had a change in the aerobic fitness category from poor to below average. The treatment portion given did not differ between 5 times a week and six times a week. The Metabolic Work Rate (MWR) equation measured respondents’ energy expenditure. The average MWR of respondents is 5.7 kilocalories per minute or is included in the rather heavy physiological load category, the same as walking at a speed of 3 kilometers per hour, cycling at a speed of 16 kilometers per hour, and jogging at a speed of 7.2 kilometers per hour.
Analysis of Mental Workload and Fatigue Level in Online Learning during the Pandemic among Industrial Engineering Students (A Case Study at Buana Perjuangan University of Karawang)
Authors: Auliani Sevty , Rahdiana Nana , Suhara Ade , Karlina  , Nafia Isya , Didin Fatin Saffanah , Soekarsono Setyo Utomo
Published: April 2024

Adjustments in online learning systems during the COVID-19 pandemic have led to an increase in mental workload and fatigue levels among students. This study aims to determine the influence of independent factors and the relationship between mental workload and fatigue levels among Industrial Engineering students during online learning. The research methods used were NASA-TLX and SOFI. The results show a significant influence of marital status on the level of mental workload with a p-value of 0.016, while there is no significant influence of student status and gender with p-values of 0.435 and 0.210. However, there is a significant influence of student status and gender on fatigue level with p-values of 0.008 and 0.000, while marital status has a significant influence with a p-value of 0.326. The correlation test results show that in the NASA-TLX method, 6 pairs of elements have a significant relationship with a p-value of 0.000, while the remaining 8 pairs of elements do not have a significant relationship with p > 0.05. Furthermore, the SOFI method shows all elements have a significant relationship with a p-value of 0.000. The findings of this study can serve as evaluation for institutions to create effective and successful online learning.
Checklist Audit and Improvement Recommendations at TPS LB3 PT Sinar Sosro Ungaran
Authors: Aileen Elvira R. Vania , Mahachandra Manik
Published: April 2024

PT Sinar Sosro Ungaran is a subsidiary of PT Sinar Sosro which produces ready-to-drink tea in bottles. Product manufacturing process produces LB3 (Limbah Bahan Berbahaya dan Beracun). LB3 is stored and packaged in TPS, but the conditions do not comply with health and environmental sector regulations. The research method was carried out using an audit checklist, the hierarchical control to minimize the level of risk that occurs. In addition, this study also used a risk assessment questionnaire on existing conditions and repair simulations. The aim is to analyze the comparison between the two questionnaires as a form of validation of proposed improvements. Risk assessment only uses the severity parameter to see the severity of the risks that occur. Based on the results of the analysis, it was obtained that 29.09% of the TPS LB3 conditions needed to be repaired so that they comply with the LB3 Management regulations (PLB3). The results show that there are 14 TPS LB3 conditions that need to be repaired. Based on the analysis conducted, it is known that the risk level is significantly reduced by 2.70%, so that recommendations for improvement are considered valid to be implemented.
Rheumatologie und Infektiologie
Authors: Hasseli-Fräbel Rebecca
Published: April 2024

In dieser Ausgabe der 'Aktuellen Rheumatologie' werden verschiedene
Infektionen im Kontext von entzündlich-rheumatischen Erkrankungen näher
erläutert.
Humangenetische Aspekte in Orthopädie und
Unfallchirurgie
Authors: Henn Wolfram
Published: April 2024

Humangenetisch relevante orthopädische Fragestellungen sind insgesamt keineswegs
selten, stellen aber die Summe einer Vielzahl meist seltener Anomalien dar. Sie
können sich in den verschiedensten Lebensphasen manifestieren, so etwa als
angeborene syndromale Fehlbildungen, als Aufbaustörungen von
Bindegewebsproteinen, aber auch als familiäre Tumordispositionen. Für die Praxis
ist es wichtig, die genetische Dimension eines klinischen Falles überhaupt zu
erkennen und in Zusammenarbeit mit genetischer Beratung und Diagnostik eine
individuelle Behandlung und Begleitung sicherzustellen.
Editorial
Authors: Zeeb Hajo
Published: April 2024

Liebe Leserinnen und Leser,für viele gesundheitsbezogene Maßnahmen und Programme
haben wissenschaftliche Studien klare Hinweise ergeben, dass sie als effektiv gelten
können, also grundsätzlich wirksam sind. Oft fehlen aber genaue und an die
Versorgungsrealität angepasste Studien, die sich damit befassen, auf welche Weise
derartige Erkenntnisse angemessen und erfolgreich in der Versorgung oder auch in
gesundheitspolitischen Konzepten umgesetzt werden sollen: Das ist das Feld der
Implementationswissenschaft. Sie wird beschrieben als Forschung zu Methoden und
Ansätzen, wie geprüfte Behandlungen, Praktiken oder Maßnahmen systematisch in die
Versorgungsroutine aufgenommen werden können. Implementationsforschung stellte
Fragen wie: Was funktioniert für wen, unter welchen Umständen, und wie genau? Im
Mittelpunkt stehen Interventionen und die für deren Umsetzung entscheidenden
Prozesse und Rahmenbedingungen.
Bewegungsbezogene Versorgungsbereiche im
Gesundheitswesen
Authors: Baldus Angelika , Peters Stefan , Scheer Janik
Published: April 2024

Der folgende Beitrag stellt eine Überarbeitung des Artikels Bewegungsbezogene
Versorgungsbereiche im Gesundheitswesen (B&G 6/22; 38: 263–264) dar. Die
tabellarische Darstellung wurde um Abrechnungsfähigkeiten erweitert. Der Beitrag
soll Sport-/Bewegungstherapeut*innen helfen, deren Qualifikationen (Lizenzen und
Zertifikate) abrechnungsfähigen Versorgungsbereichen zuzuordnen. Andererseits
erhalten Leistungserbringer (Einrichtungen) eine Übersicht über mögliche
Vergütungsformen und die dafür notwendigen Anbieterqualifikationen. Zudem bietet die
Tab. 1 eine trägerübergreifende Übersicht
bestehender Vorgaben für die Sport-/Bewegungstherapie DVGS.
Mitochondriopathie
Authors: Feldhaus Simon
Published: April 2024

Die Mitochondrienmedizin zeigt als eine junge und sehr beachtenswerte Medizinrichtung Wege auf, um die Zukunft des therapeutischen Handelns in vielfacher Hinsicht zu bereichern und zu verbessern. Mitochondriale Funktionsstörungen sollten als erhebliches Problem für die Entstehung und den Verlauf einer Reihe chronischer gesundheitlicher Störungen angesehen werden: postinfektiöse oder idiopathische Fatigue-Syndrome (chronisches Fatigue-Syndrom, Fibromyalgie-Syndrom, Multiple Chemical Sensitivity, Tumorfatigue etc.). Durch moderne integrative Diagnostik und daraus abgeleiteter Therapie ergeben sich neue Behandlungsoptionen für bisher schwer behandelbare Krankheiten und somit bessere Aussichten für betroffene Patienten. Dieser wissenschaftliche Artikel bietet eine umfassende Analyse der Mitochondriopathie, einschließlich ihrer Ursachen, Pathophysiologie und der diagnostischen Ansätze.
Association Between Triglyceride Glucose Index with Cognitive
Impairment and Dementia in Adult Population: A Meta-Analysis
Authors: Han Yuqing , Meng Xu , Wang Dahui
Published: April 2024

The current understanding of the correlation between insulin resistance (IR) and
cognitive dysfunction is limited. Therefore, the objective of this systematic
review and meta-analysis was to assess the association between the triglyceride
glucose (TyG) index, a recently suggested indicator of IR, and cognitive
impairment and dementia in the adult population. Observational studies pertinent
to our research were identified through comprehensive searches of the PubMed,
Embase, and Web of Science databases. To account for potential heterogeneity,
the random-effects models were employed to aggregate the findings. This
meta-analysis included ten observational studies involving 5602409 participants.
Compared to those with the low TyG index, subjects with the high TyG index were
significantly associated with the risk of cognitive impairment [risk ratio (RR):
1.39, 95% confidence interval (CI): 1.22 to 1.59, p<0.001; I2=45%) and
dementia (RR: 1.30, 95% CI: 1.06 to 1.60, p=0.01; I2=50%). The association was
consistent for Alzheimer’s disease (RR: 1.35, 95% CI: 1.04 to 1.76, p=0.03;
I2=54%) and vascular dementia (RR: 1.18, 95% CI: 1.13 to 1.24, p<0.001;
I2=0%). Subgroup analyses showed that the association between TyG index with
cognitive impairment and dementia were stronger in cross-sectional studies than
that in cohort studies (p for subgroup difference=0.02), but not significantly
modified by age, sex, or diabetic status of the participants. In conclusion, a
high TyG index may be associated with higher risk of cognitive impartment and
dementia in adult population.
New-Onset Atrial Fibrillation Is a Red Flag to Microvascular Free Tissue Transfer Failure in Head and Neck Cancer Patients
Authors: Tsai Chia-Hsuan , Chen Yu-Jen , Lin Yu-Chih , Liu Yao-Chang , Kao Huang-Kai , Mao Shih-Hsuan
Published: April 2024

Background Postoperative new-onset atrial fibrillation (AF) has been shown to be associated with increased surgical morbidity and mortality following cancer ablation surgery. However, evidence of new-onset AF's impact on surgical outcomes in head and neck cancer patients undergoing tumor ablation and microvascular free tissue transfer remains scarce. This study aims to evaluate the association between AF and surgical outcomes in these patients.

Methods We enrolled head and neck cancer patients who underwent tumor ablation reconstructed with microvascular free tissue transfer from the National Health Insurance Research Database (NHIRD). Patients were grouped into the following: (1) without AF, (2) new-onset AF, and (3) preexisting AF. The groups were matched by propensity score based on age, gender, cancer stage, and comorbidities. The primary outcome was postoperative complications, whereas all-cause mortality was the secondary outcome.

Results In total, 26,817 patients were included in this study. After matching, we identified 2,176 (79.24%) patients without AF, 285 (10.37%) with preexisting AF, and 285 (10.37%) with new-onset AF. Our results demonstrated that the free flap failure rate was twofold escalated in patients with new-onset AF (9.8%) compared to those without AF (5.4%) or preexisting AF (5.3%; p = 0.01). However, we did not identify significant differences among other postoperative complications across groups. Additionally, we found that the risk of all-cause mortality was significantly elevated in patients with preexisting AF (p < 0.001) compared to those without AF or new-onset AF.

Conclusion Our study demonstrated that new-onset AF is associated with an increased risk of flap failure and could serve as a predictor. On the other hand, all-cause mortality in patients with preexisting AF was significantly elevated. Close postoperative monitoring in patients with new-onset and preexisting AF is crucial to identify any potential adverse effects.
Implementation and Clinical Impact of a Guideline for Standardized, Evidence-Based Induction of Labor
Authors: Triebwasser Jourdan E. , Louis LeAnn , Bailey Joanne M. , Mitchell-Solomon Leah , Malone Anita M. , Hamm Rebecca F. , Moniz Michelle H. , Stout Molly J.
Published: April 2024

Objective This study aimed to assess the impact of implementation of an induction of labor (IOL) guideline on IOL length and utilization of evidence-based practices.

Study Design We conducted a quality improvement project to increase utilization of three evidence-based IOL practices: combined agent ripening, vaginal misoprostol, and early amniotomy. Singletons with intact membranes and cervical dilation ≤2 cm admitted for IOL were included. Primary outcome was IOL length. Secondary outcomes included cesarean delivery and practice utilization. We compared preimplementation (PRE; November 1, 2021 through January 31, 2022) to postimplementation (POST; March 1, 2022 through April 30, 2022) with sensitivity analyses by self-reported race and ethnicity. Cox proportional hazards models and logistic regression were used to test the association between period and outcomes.

Results Among 495 birthing people (PRE, n = 293; POST, n = 202), IOL length was shorter POST (22.0 vs. 18.3 h, p = 0.003), with faster time to delivery (adjusted hazard ratio [aHR] = 1.38, 95% CI: 1.15–1.66), more birthing people delivered within 24 hours (57 vs. 68.8%, adjusted odds ratio [aOR] = 1.90 [95% CI: 1.25–2.89]), and no difference in cesarean. Utilization of combined agent ripening (31.1 vs. 42.6%, p = 0.009), vaginal misoprostol (34.5 vs. 68.3%, p < 0.001), and early amniotomy (19.1 vs. 31.7%, p = 0.001) increased POST.

Conclusion Implementation of an evidence-based IOL guideline is associated with shorter induction time. Additional implementation efforts to increase adoption of practices are needed to optimize outcomes after IOL.

Key Points
Identifying ChatGPT-Written Patient Education Materials Using Text Analysis and Readability
Authors: Monje Silas , Ulene Sophie , Gimovsky Alexis C.
Published: April 2024

Objective Artificial intelligence (AI)-based text generators such as Chat Generative Pre-Trained Transformer (ChatGPT) have come into the forefront of modern medicine. Given the similarity between AI-generated and human-composed text, tools need to be developed to quickly differentiate the two. Previous work has shown that simple grammatical analysis can reliably differentiate AI-generated text from human-written text.

Study Design In this study, ChatGPT was used to generate 25 articles related to obstetric topics similar to those made by the American College of Obstetrics and Gynecology (ACOG). All articles were geared towards patient education. These AI-generated articles were then analyzed for their readability and grammar using validated scoring systems and compared to real articles from ACOG.

Results Characteristics of the 25 AI-generated articles included fewer overall characters than original articles (mean 3,066 vs. 7,426; p < 0.0001), a greater average word length (mean 5.3 vs. 4.8; p < 0.0001), and a lower Flesch–Kincaid score (mean 46 vs. 59; p < 0.0001). With this knowledge, a new scoring system was develop to score articles based on their Flesch–Kincaid readability score, number of total characters, and average word length. This novel scoring system was tested on 17 new AI-generated articles related to obstetrics and 7 articles from ACOG, and was able to differentiate between AI-generated articles and human-written articles with a sensitivity of 94.1% and specificity of 100% (Area Under the Curve [AUC] 0.99).

Conclusion As ChatGPT is more widely integrated into medicine, it will be important for health care stakeholders to have tools to separate originally written documents from those generated by AI. While more robust analyses may be required to determine the authenticity of articles written by complex AI technology in the future, simple grammatical analysis can accurately characterize current AI-generated texts with a high degree of sensitivity and specificity.

Key Points
A Prospective Study of Lactate Levels in Uncomplicated Spontaneous and Induced Labor
Authors: Kleinmann Whitney , Zofkie Amanda , McIntire Donald , Adhikari Emily H.
Published: April 2024

Objective Maternal pushing can yield lactate levels that are above the normal range for nonpregnant individuals. Many hospitals require lactate levels as part of sepsis bundles, and this can confuse the clinicians when measured during labor. The objective of this study was to observe lactate levels in uncomplicated labor.

Study Design This was a prospective study of patients presenting to Labor and Delivery in early labor. Patients met inclusion criteria if they presented at 37 weeks' gestation or greater and were either 3 to 4 cm dilated, in early labor with rupture of membranes less than 12 hours, or were being induced for oligohydramnios or postdates gestation. A baseline maternal lactate level was collected at enrollment. Further levels were collected at complete cervical dilation and every 30 minutes during the second stage of labor up to 3 hours or until delivery.

Results From January 7, 2021, through December 30, 2021, a total of 148 screened patients met the inclusion criteria and 38 were enrolled. Eight (21%) patients withdrew after baseline lactate level was drawn. Twenty-three (61%) patients had a level drawn at complete dilation. Of the 12 (32%) patients with a lactate level drawn at complete and after 30 minutes of pushing, the mean change in lactate level was 2.0 ± 1.8 mmol/L or 0.07 ± 0.06 mmol/L/min (p < 0.01). This change is more pronounced in the second stage of labor for patients with chorioamnionitis (2.6 mmol/L), although this difference is not statistically significant (p = 0.41).

Conclusion Lactate levels increase significantly once a patient reaches complete cervical dilation within 30 minutes of pushing. This increase is more pronounced, although significantly, in patients with chorioamnionitis. As sepsis is one of the leading causes of maternal morbidity and mortality, this pilot study is relevant for providers to see the natural course of lactate levels in labor.

Key Points
Cost-effectiveness of Neonatal Hearing Screening Programs: Systematic Review
Authors: Vernier Luíza Silva , Fernandes Carolina Pereira , Skorin Pedro Pablo , Ávila Audrei Thayse Viegel de , Levandowski Daniela Centenaro
Published: April 2024

Introduction Universal newborn hearing screening (UNHS) has been widely and strongly advocated as an early detection strategy for hearing loss in children. This intervention aims to prevent delays in speech and language development, which, in turn, has long-term beneficial effects on the social and emotional development and quality of life of individuals. However, the implementation of UNHS programs is circumstantial in different settings, for different reasons.

Objectives The present systematic review aimed to identify whether the implementation of UNHS programs are cost-effective, as well as their variations by localities.

Data Synthesis A search was conducted in seven databases: PubMed (Medline), Scopus, Web of Science, Embase, CINAHL, Lilacs, and Cochrane Library. Studies that included a cost analysis of UNHS programs were eligible for inclusion. Studies on evaluations of preschool or school-based programs only were excluded, among others. A total of 1,291 records were found. Of these, 23 articles were analyzed in full. All articles identified the cost-effectiveness of the UNHS programs implemented. Regarding the UNHS protocols, a wide variation was observed in all aspects: tests used, period established between tests and retests, professionals responsible for screening, environment, and criteria for defining hearing loss, limiting the generalization of this information. All studies presented values related to the expenses with the program, but none of them showed statistical elements for the described analyzes or any theoretical basis for such.

Conclusion It is necessary to estimate local specific issues, as well as the accuracy of the chosen tests and the NHS protocols used, so that more accurate analyzes on cost-effectiveness are possible.