bluuebunny/crossref_metadata_2025 huggingface dataset:
Unveiling Influence of Psychological and Social Factors on Purchase Intentions Behavior of Environmentally Friendly Fashion in the Digital Era
Authors: Masnita Yolanda , Wulandari Maryana , Haliza Delanea Azlia
Published: September 2024

barang-barang dalam industri fashion yang ramah lingkungan.Studi ini bertujuan untuk menguji pengaruh sosial, kepedulian lingkungan, iklan, dan altruisme terhadap minat pembelian produk pakaian ramah lingkungan. Lalu bertujuan untuk mengetahui bagaimana pengaruh dari niat beli produk pakaian ramah lingkungan terhadap kesediaan untuk membayar dan pemasaran dari mulut ke mulut secara elektronik. Penelitian ini menggunakan pendekatan pemodelan persamaan struktural (SEM),  lalu data akan  dikumpulkan melalui sampel konsumen yang sudah memiliki pengalaman berbelanja terhadap pakaian ramah lingkungan. Penelitian ini akan menunjukkan pengaruhnya secara positif dari faktorfaktor tersebut. Penelitian ini dapat berkontribusi dalam pemahaman pengambilan keputusan dari konsumen dalam memiliki produk pakaian ramah lingkungan.
Peran Kepemimpinan Kepala Sekolah dalam Meningkatkan Mutu Sekolah di Sekolah Dasar
Authors: Sulistiyarini Endang , Hartinah Sitti , Purwanto Burhan Eko
Published: September 2024

Salah satu cara mewujudkan tenaga pendidikan yang profesional adalah dengan dukungan dari pihak yang mempunyai peran penting dalam hal ini adalah Kepala Sekolah. Tujuan penelitian adalah (1) Untuk mengetahui peran kepemimpinan Kepala Sekolah di SDN Bumijawa 01, (2) Untuk mengetahui seberapa besar peran LEMOS (leader, Edukator, Motivator, Supervisi) kepala sekolah terhadap peningkatan Mutu Sekolah SDN Bumijawa 01 dan (3) Untuk mengetahui faktor pendukung dan tantangan dalam meningkatkan Mutu Sekolah. Pendekatan dalam penelitian ini menggunakan pendekatan kualitatif. Pendekatan kualitatif tersebut dilakukan untuk memperoleh gambaran secara mendalam tentang implementasi leadership yang meliputi perencanaan, pelaksanaan dan kendala serta solusi menyelesaikannya di SDN Bumijawa 01 sehingga pada akhirnya dapat meningkatkan mutu sekolah, baik mutu dalam bidang akademik maupun bidang nonakademik. Penelitian kualitatif ini berakar pada latar alamiah sebagai keutuhan, dan mengandalkan manusia sebagai alat penelitian.Jenis penelitian menggunakan jenis fenomenologi. Desain dalam penelitian ini bertujuan untuk mendeskripsikan sejauhmana peran Kepemimpinan kepala sekolah dalam meningkatkan Mutu sekolahannya. Teknik penelitian meliputi, prapenelitian, menyusun instrumen dan melaksanakan pengumpulan data, menganalisis data dan mengecek keabsahan data. Teknik pengumpulan datanya Wawancara, Observasi dan Dokumentasi. Peran kepala sekolah memiliki kontribusi besar dalam menentukan keberhasilan sekolah dalam meningkatkan mutu pendidikan. Mutu pendidikan sendiri tidak lepas dari kerjasama semua pihak, oleh sebab itu kemampuan kepala sekolah dalam memotivasi dan melakukan inovasi di semua bidang pendidikan baik dalam kegiatan intra maupun ekstra sekolah menjadi bagian yang di prioritaskan, Kepala sekolah harus bertanggung jawab atas penyelenggaraan kegiatan pendidikan, administrasi pendidikan, pembinaan tenaga kependidikan lainnya, dan pendayagunaan serta pemiliharaan sarana dan prasarana. Mutu sekolah adalah kemampuan lembaga pendidikan dalam mendayagunakan sumber-sumber pendidikan untuk meningkatkan kemampuan belajar secara optimal. Dalam konteks pendidikan, pengertian kualitas atau mutu mengacu pada proses pendidikan dan hasil pendidikan. Kualitas sekolah merupakan kemampuan sekolah dalam mengembangkan ide dinamis yang meliputi input, process, output dan outcame. Beban kerja Kepala Sekolah untuk melaksanakan tugas pokok manajerial, pengembangan kewirausahaan, dan supervisi kepada Guru dan tenaga kependidikan. Kepala sekolah berperan sebagai EMASLIM (Educator/pendidik, Manajer /pengelola
Pengembangan Bahan Ajar Berdasarkan Pendekatan RME Ditinjau dari Gaya Belajar Peserta Didik Kelas VI SD
Authors: Warsini Warsini , Munadi Munadi , Paridjo Paridjo
Published: September 2024

Penelitian ini bertujuan menghasilkan media pembelajaran berupa bahan ajar materi operasi bilangan bulat berdasarkan pendekatan RME ditinjau dari gaya belajar peserta didik sekolah dasar kelas enam SDN di Gugus Bahari Kecamatan Warureja, Kabupaten Tegal. Penelitian ini menggunakan metode penelitian dan pengembangan  Research and Development. Metode penelitian Research and Development yang digunakan adalah model yang dikembangkan oleh Borg & Gall. Uji coba pertama adalah uji coba awal untuk mengetahui kelayakan produk sebelum uji coba lapangan utama, dan diperoleh hasil bahan ajar memenuhi kriteria kelayakan dengan kategori “Sangat Baik” yang didapat dari hasil angket respon guru memperoleh skor 324 dan masuk ke dalam kategori “Sangat Setuju” dan observasi respon peserta didik memperoleh skor 4689 dan masuk kategori “Sangat Setuju”.  Selanjutnya adalah uji coba lapangan operasional, hal ini dibuktikan dengan hasil uji t- test independen dengan hasil lebih kecil dari 0,05 yaitu nilai sig 0,001 yang menunjukkan adanya perbedaan yang signifikan terhadap tersimulusnya hasil belajar peserta didik.
Kritik Sosial dalam Kumpulan Cerpen Mereka Mengeja Larangan Mengemis: Cerpen Pilihan Kompas
Authors: Nuraini Rani , Muhtarom Imam , Herlina Dewi
Published: September 2024

Penelitian bertujuan untuk mendeskripsikan hasil analisis mengenai Kritik sosial dalam kumpulan Cerpen Mereka Mengeja Larangan Mengemis: Cerpen Pilihan Kompas 2019. Penelitian menggunakan pendekatan sosiologi sastra dengan fokus pada teori kritik sosial. Metode yang digunakan adalah metode kualitatif deskriptif analitis. Subjek penelitian ini adalah dua belas cerita pendek dalam kumpulan cerpen Mereka Mengeja Larangan Mengemis: Cerpen Pilihan Kompas 2019, sedangkan objek penelitianya yaitu kritik sosial cerpen mereka mengeja larangan mengemis: Cerpen Pilihan Kompas 2019. Teknik pengumpulan data yang digunakan dalam penelitian ini teknik dokumen. Hasil analisis terhadap kritik sosial dalam dua belas cerita pendek dalam buku kumpulan cerpen Mereka Mengeja Larangan Mengemis: Cerpen Pilihan Kompas 2019 berdasarkan teori Soekanto tahun 2018 yang meliputi atas kemiskinan, kejahatan, disorganisasi keluarga, masalah generasi muda dalam masyarakat modern, peperangan, pelanggaran terhadap norma-norma masyarakat, masalah kependudukan, masalah lingkungan hidup, dan masalah birokrasi.
Analisis Pengaruh Kualitas Layanan terhadap Loyalitas Pelanggan Pada Rumah Sakit Mutiara Bunda Tulang Bawang
Authors: Ribowo Riko , Ardansyah Ardansyah
Published: September 2024

Rumah sakit merupakan lembaga pelayanan kesehatan paripurna yang menyediakan layanan gawat darurat, rawat jalan dan rawat inap yang penyelenggaraanya dilakukan oleh dokter, perawat dan tenaga ahli. Penelitian ini bertujuan untuk mengetahui apakah kualitas layanan berpengaruh terhadap loyalitas pelanggan. Penelitian dilakukan di poliklinik Rumah sakit mutiara bunda pada bulan desember tahun 2023. Metode penelitian analitik deskriptif dengan desain cross sectional terhadap 100 sample. Teknik pengambilan sample consecutive sampling. Variable bebas (Independent) adalah kualitas layanan yang terdiri dari variabel keandalan(reliability), ketanggapan (responsiveness), jaminan (assurance), empati (empathy), bukti fisik (tangibles), dan variabel terikat (dependents) adalah loyalitas pelanggan. Penelitian ini menggunakan instrumen kuesioner. Metode analisis menggunakan uji t, uji F, dan uji koefisien determinasi (R2). Hasil uji t terhadap lima variabel kualitas layanan yaitu keandalan, ketanggapan, jaminan, empati dan bukti fisik menunjukan nilai t hitung > t tabel dan nilai signifikasi <0,05 sehingga dapat disimpulkan kelima variabel kualitas layanan secara parsial berpengaruh terhadap loyalitas pelanggan. Hasil uji F menunjukan tingkat signifikasi = 0,000 sehingga dapat disimpulkan lima variabel kualitas pelayanan secara bersama-sama berpengaruh terhadap loyalitas pelanggan. Hasil uji koefisien determinasi diperoleh nilai R2 = 0,905 berarti kualitas pelayanan berpengaruh sebesar 90,5% terhadap loyalitas pelanggan. Kesimpulan penelitian ini kualitas layanan berpengaruh terhadap loyalitas pelanggan.
Bitcoin: a Ponzi scheme or an emerging inflation-fighting asset?
Authors: Liu Fangying , Su Chi Wei , Qin Meng , Umar Muhammad
Published: September 2024

Under the dual impact of the COVID-19 pandemic and the Russian-Ukrainian conflict, the excessive stimulation of monetary policy continuously pushes up global inflation (INF). Therefore, this article explores whether Bitcoin can serve as a safe haven for INF. We apply the rolling-window Granger causality test to solve the issue of parameter instability in vector autoregression (VAR) systems and investigate the time-varying interaction between INF and Bitcoin price (BP). The negative influence of INF on BP means a high inflation shock causes BP to decline, indicating that Bitcoin cannot be a safe asset against INF. This is because investors have decreased their willingness to hold Bitcoin under the high INF expectations and cause BP to fall. This finding is not supported by the Intertemporal Capital Asset Pricing Model, emphasising that INF positively impacts BP. Conversely, BP has positive and negative impacts on INF. The positive effect highlights the effectiveness of Bitcoin in predicting INF fluctuations, but economic factors could undermine this effectiveness. In the context of economic stagnation and market turmoil, investors can adjust their portfolio investments based on Bitcoin. The government should utilise the trend of BP to regulate the dynamics of INF to reduce uncertainty in the financial system.
The Galactic Bulge Exploration. III. Calcium Triplet Metallicities for RR Lyrae Stars
Authors: Kunder Andrea , Prudil Zdenek , Skaggs Claire , Reggiani Henrique , Nataf David M. , Hughes Joanne , Covey Kevin R. , Devine Kathryn
Published: September 2024

RR Lyrae stars (RRLs) are excellent tracers of stellar populations for old, metal-poor components in the the Milky Way and the Local Group. Their luminosities have a metallicity dependence, but determining spectroscopic [Fe/H] metallicities for RRLs, especially at distances outside the solar neighborhood, is challenging. Using 40 RRLs with metallicities derived from both Fe(ii) and Fe(i) abundances, we verify the calibration between the [Fe/H] of RRLs from the calcium triplet. Our calibration is applied to all RRLs with Gaia Radial Velocity Spectrometer (RVS) spectra in Gaia DR3 and to 80 stars in the inner Galaxy from the BRAVA-RR survey. The coadded Gaia RVS RRL spectra provide RRL metallicities with an uncertainty of 0.25 dex, which is a factor of two improvement over the Gaia photometric RRL metallicities. Within our Galactic bulge RRL sample, we find a dominant fraction with low energies without a prominent rotating component. Due to the large fraction of such stars, we interpret these stars as belonging to the in situ metal-poor Galactic bulge component, although we cannot rule out that a fraction of these belong to an ancient accretion event such as Kraken/Heracles.
Primordial Lithium from Globular Cluster Turnoff Stars: M13 and M71
Authors: Boesgaard Ann Merchant , Deliyannis Constantine P.
Published: September 2024

During Big Bang nucleosynthesis (BBN) in the first 15 minutes of the Universe, some 7Li was created along with isotopes of H and He. The determination of that primordial value of Li can help constrain the conditions at that time. The oldest stars with known ages can be found in globular clusters which have well-determined ages through stellar evolution models. High-resolution spectra of Li have been obtained with the Keck I Telescope and HIRES in several unevolved stars in the clusters M13 and M71 with V magnitudes of 17.6–17.9. Abundances of Li have been determined with spectrum synthesis techniques and show a range of a factor of 4. We attribute that spread to differences in initial angular momentum resulting in different amounts of spin-down, related mixing, and destruction of Li. Our results are compared with similar results for main-sequence and turnoff stars in other globular clusters. The range in age of these clusters is 11.2–14.2 Gyr for an age span of 3 Gyr. These clusters range in [Fe/H] from −0.75 to −2.24 corresponding to a factor of 30 in metallicity. The maximum in the Li abundance for these unevolved stars in all eight clusters is the same corresponding to Li/H = 3.16 × 10−10, while the predicted Li abundance, based on the deuterium abundance and the BBN predictions, is 5.24 × 10−10.
The Size–Mass Relation at Rest-frame 1.5 μm from JWST/NIRCam in the COSMOS-WEB and PRIMER-COSMOS Fields
Authors: Martorano Marco , van der Wel Arjen , Baes Maarten , Bell Eric F. , Brammer Gabriel , Franx Marijn , Nersesian Angelos
Published: September 2024

We present the galaxy stellar mass–size relation in the rest-frame near-IR (1.5 μm) and its evolution with redshift up to z = 2.5. Sérsic profiles are measured for ∼26,000 galaxies with stellar masses M
⋆ > 109
M
⊙ from JWST/NIRCam F277W and F444W imaging provided by the COSMOS-WEB and PRIMER surveys using coordinates, redshifts, colors, and stellar mass estimates from the COSMOS2020 catalog. The new rest-frame near-IR effective radii are generally smaller than previously measured rest-frame optical sizes, on average by 0.14 dex, with no significant dependence on redshift. For quiescent galaxies, this size offset does not depend on stellar mass, but for star-forming galaxies, the offset increases from −0.1 dex at M
⋆ = 109.5
M
⊙ to −0.25 dex at M
⋆ > 1011
M
⊙. That is, we find that the near-IR stellar mass–size relation for star-forming galaxies is flatter in the rest-frame near-IR than in the rest-frame optical at all redshifts 0.5 < z < 2.5. The general pace of size evolution is the same in the near-IR as previously demonstrated in the optical, with slower evolution (R
e ∝ (1 + z)−0.7) for L* star-forming galaxies and faster evolution (R
e ∝ (1 + z)−1.3) for L* quiescent galaxies. Massive (M
⋆ > 1011
M
⊙) star-forming galaxies evolve in size almost as fast as quiescent galaxies. Low-mass (M
⋆ < 1010
M
⊙) quiescent galaxies evolve as slow as star-forming galaxies. Our main conclusion is that the size evolution narrative as it has emerged over the past two decades does not radically change when accessing the rest-frame near-IR with JWST, a better proxy of the underlying stellar mass distribution.
Elemental Abundances in And XIX from Coadded Spectra
Authors: Cullinane L. R. , Gilbert Karoline M. , Escala Ivanna , Wojno J. Leigh , Kirby Evan N. , Kvasova Kateryna A. , Tollerud Erik , Collins Michelle L. M. , Rich R. Michael
Published: September 2024

With a luminosity similar to that of Milky Way dwarf spheroidal systems like Sextans, but a spatial extent similar to that of ultra-diffuse galaxies, Andromeda (And) XIX is an unusual satellite of M31. To investigate the origin of this galaxy, we measure chemical abundances for And XIX derived from medium-resolution (R ∼ 6000) spectra from the Deep Extragalactic Imaging Multi-Object Spectrograph on the Keck II telescope. We coadd 79 red giant branch stars, grouped by photometric metallicity, in order to obtain a sufficiently high signal-to-noise ratio to measure 20 [Fe/H] and [α/Fe] abundances via spectral synthesis. The latter are the first such measurements for And XIX. The mean metallicity we derive for And XIX places it ∼2σ higher than the present-day stellar mass–metallicity relation for Local Group dwarf galaxies, potentially indicating it has experienced tidal stripping. A loss of gas and associated quenching during such a process, which prevents the extended star formation necessary to produce shallow [α/Fe]–[Fe/H] gradients in massive systems, is also consistent with the steeply decreasing [α/Fe]–[Fe/H] trend we observe. In combination with the diffuse structure and disturbed kinematic properties of And XIX, this suggests tidal interactions, rather than galaxy mergers, are strong contenders for its formation.
GRB 231129C: Another Thermal Emission Dominated Gamma-Ray Burst
Authors: Chen Jia-Ming , Zhu Ke-Rui , Peng Zhao-Yang , Zhang Li
Published: September 2024

This study presents detailed time-integrated and time-resolved spectral analysis of the Fermi Gamma-ray Burst Monitor observations of the bright GRB 231129C. The results reveal its distinct spectral characteristics, featuring a hard low-energy spectral index (α) and soft high-energy spectral index (β), similar to GRB 090902B, suggesting a possible dominance of thermal emission. Further analysis indicates that 92% of the spectral indices exceed the synchrotron “line of death,” with the hardest index at α ∼ +0.44. Simultaneously, 53% of the spectra can be well fitted by the nondissipative photosphere model, supporting a potential origin from a nondissipative photosphere. Additionally, we observe strong correlations between the spectral index α and peak energy E
p with flux. For the α−F relationship, we employ F = F
0
e
(3.00±0.10)α
to describe it, whereas the E
p−F relationship requires a smoothly bending power-law function. Based on the framework proposed by Hascoët et al. and Gao & Zhang, the jet characteristics of this burst were studied, revealing that both methods support the suitability of a pure fireball model for this GRB at small initial jet radii.
Ingolfiellids (Crustacea, Peracarida, Ingolfiellidea) from the Intra-Americas Sea with the description of a new deep-sea species of Ingolfiella from the southern Gulf of Mexico
Authors: Ortiz Manuel , Winfield Ignacio , Cházaro-Olvera Sergio
Published: September 2024

The order Ingolfiellida (Crustacea, Peracarida) represents a small group of peracarid crustaceans, usually less than 3 mm long and comprising 53 species in several ecosystems worldwide. Previously, eight ingolfiellid species had been documented from the Intra-Americans Sea: one from the Gulf of Mexico and eastern Florida and seven from the Caribbean Sea, including the Bahamas. A new deep-sea species of Ingolfiella is described based on material collected from bathyal soft bottoms (2650 m depth) offshore Veracruz State, southern Gulf of Mexico. The new species can be differentiated as follows: accessory flagellum 2-articulate; antenna 2 flagellum 4-articulate; pereopods 5-6 with long curved seta on dactylus; rami of uropod 1 subequal in length; uropod 3 ramus longer than peduncle, unarticulated; pleopods 1-3 as long as pleonal segments; maxilla 1 inner plate with one tiny seta distally; mandible without palp; molar poorly developed; pleopods reduced; telson as a fleshy ovoidal lobe with two slender dorsal setae. A table and a map featuring the nine ingolfiellids recorded in the Gulf of Mexico, the Caribbean Sea, and eastern Florida are also provided. The new species increases the number of Ingolfiella species to 35 worldwide, representing the second record of ingolfiellids from the Gulf of Mexico.
Separating invariants for certain representations of the elementary Abelian $ p $-groups of rank two
Authors: Jia Panpan , Nan Jizhu , Ma Yongsheng
Published: September 2024

For a finite group acting linearly on a vector space, a separating set is a subset of the invariant ring that separates the orbits. In this paper, we determined explicit separating sets in the corresponding rings of invariants for four families of finite dimensional representations of the elementary abelian $ p $-groups $ (\mathbb{Z}/p)^2 $ of rank two over an algebraically closed field of characteristic $ p $, where $ p $ is an odd prime. Our construction was recursive. The separating sets consisted only of transfers and norms, and the size of every separating set depended only on the dimension of the representation.
As ações do Programa Monumenta no patrimônio histórico da cidade de Pelotas/RS
Authors: Neto Dary Pretto , Serres Juliane Conceição Primon
Published: September 2024

Resumo: A inclusão da cidade de Pelotas, na lista de prioridades de conservação elencadas pelo programa Monumenta, deu-se pela importância do patrimônio histórico e cultural pelotense no cenário nacional. O objetivo deste estudo foi descrever as ações do Monumenta no patrimônio histórico da Cidade de Pelotas/RS, assim como as parcerias entre órgão públicos e privados em ações de preservação. O programa federal de preservação ao patrimônio histórico Monumenta, além da preservação do patrimônio e do desenvolvimento econômico e social, visava a recuperação sustentável do patrimônio investido e atuou na preservação e restauração de imóveis públicos e privados, na elaboração de projetos e ações, voltadas à preservação do patrimônio histórico e cultural, e em diversas ações extraprograma.
Diaphragm muscle parameters as a predictive tool for weaning critically ill patients from mechanical ventilation: a systematic review and meta-analysis study
Authors: Pour Yashar Iran , Zandifar Afrooz
Published: September 2024

Diaphragmatic ultrasound, valued for its portability and safety, assesses both structural and functional aspects of the diaphragm. While some studies support its predictive value, others conflict. This meta-analysis aims to clarify diaphragmatic ultrasound's role in predicting successful liberation from mechanical ventilation in intensive care settings. A systematic search was performed on Web of Science, Scopus, and PubMed up to March, 2024. The search strategy included a combination of relevant medical subject heading (MeSH) terms and relevant keywords. We defined our eligibility criteria based on the PICO framework. Two authors performed the data extraction using a standardized sheet. The pooled mean difference was calculated using random effects model and Hedges’ g along with SD estimation. R and RStudio were used for the statistical analysis and creating forest and funnel plots. The pooled mean difference was 7.25 (95% CI: 4.20, 10.21) for DE among the two groups. We found a statistically significant difference among the two groups indicating that those with successful weaning from intubation had higher means of DE compared to those with failed weaning attempt (p-value<0.01). The mean difference of DTF was also higher among those with successful weaning from intubation compared to those with failed weaning attempt with the pooled mean difference of 14.52 (95% CI: 10.51, 18.54, p-value<0.01). The mean difference of RSBI was lower among those with successful weaning from intubation compared to those with failed weaning attempt with the pooled mean difference of -28.86 (95% CI: -41.82, -15.91, p-value<0.01). Our results suggest that evaluating diaphragmatic excursion and thickening fraction can reliably anticipate successful liberation from mechanical ventilation. However, significant heterogeneity was present among the included studies. High-quality research, particularly randomized clinical trials, is required to further elucidate the role of diaphragmatic ultrasound in predicting weaning from mechanical ventilation.
2: Evaluation of role of exogenous melatonin in prevention of delirium in postoperative patients admitted in intensive care unit : a randomised placebo-controlled study
Authors: Gupta Kriti , Singh Vipin Kumar , Singh G.P.
Published: September 2024

Background and Aims:

Delirium is extremely prevalent in hospitalised patients; 37–46% of the general surgical population and in up to 87 % of patients in the intensive care unit (ICU).Melatonin – a potential agent in the management of delirium since its low plasma concentrations and altered secretion patterns have been found in the critically ill (6-sulphatoxymelatonin (MT6) in subjects’ urine). To establish the reduction in incidence of delirium [as determined by the confusion assessment method (CAM-ICU) scale], in post operative patients admitted in ICU after administration of exogenous oral melatonin ,and determining the association of acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores with occurrence of delirium.

Methods:

140 post operative patients admitted in the ICU , comparable on the basis of age, gender, APACHE II and SOFA scores were randomly divided into two groups ; CASES and CONTROLS with 70 patients each. In this double blind , randomized placebo control study ,CASES(group A) were administered Tablet Melatonin 5mg at 8pm everyday through Ryle’s Tube and CONTROLS(group B) were given 1gm lactose powder indistinguishable from study .Both drugs were given everyday till ICU discharge/transfer.At discharge/transfer, the patients were assessed and categorised as “Delirious” and “Not delirious” using the CAM-ICU scale.

Results:

Incidence of delirium patients was lower in Group A(16.6%) as compared to group B ( 31.4%).Patients with delirium as compared to non-delirium had higher values of APACHE-II (20.57±6.26 vs. 18.42±7.14) and SOFA score (4.49±1.63 vs. 1.75±1.37).The incidence of delirium increased with age since mean age was greater in those with delirium (41.57±9.99 vs. 35.87±11.81). The incidence of delirium did not vary significantly with gender.Between Group Comparison of Outcome¸²=3.665; p=0.160

Conclusion:

The reduced incidence of delirium in the cases (group A) indicated that Melatonin can be a potential drug for the prevention of delirium in the critically ill. APACHE II and SOFA scores can be used as individual predictors of delirium, owing to significantly higher values of these scores in delirious patients when compared to those without delirium.

JOURNAL/ijana/04.03/01762628-202203001-00106/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff
3: Comparison of the blockbustertm and air-q®supraglottic airway devices as a conduit to blind endotracheal intubation in paediatric patients: a randomised controlled trial.
Authors: ArunimaPattnayak
Published: September 2024

Background and Aims:

There is scarcity of literature recommending the use of supraglottic airway devices (SADs) as conduits for blind endotracheal intubation. This study was conducted to compare the efficacy of two laryngeal mask airways (BlockbusterTMSAD and air-Q® SAD) in acting as a conduit for blind endotracheal intubation in paediatric patients undergoing non-emergency surgeries under general anaesthesia.

Methods:

In this randomised controlled trial, 80 paediatric patients with American Society of Anesthesiologists (ASA) physical status I and II, aged between 6 months and 10 years and weighing between 5 to 30 kg, were randomly allocated to two groups in which the airway was secured either with BlockbusterTMSAD or air-Q® SAD followed by blind endotracheal intubation. The primary outcome was the percentage of successful blind endotracheal intubation in a single attempt. The secondary outcomes were oropharyngeal leak pressure (OLP), insertion time, manipulations, perioperative complications.

Results:

Success rate of intubation with BlockbusterTMSAD was significantly higher (p value = 0.03) as compared to with air-Q® SAD ( 77.5% vs 55%). OLP was also significantly higher (p value = 0.001) with BlockbusterTM SAD (25.74 ± 7.05) cm H2O as compared to air-Q® SAD (15.2 ± 5.58) cm H2O. Complications were comparable in the groups.

Conclusion:

We found that both BlockbusterTM and air-Q® SAD have good success rate; however, Blockbuster success rate was significantly higher. Hence we conclude that BlockbusterTM is a better SAD for use as a conduit to blind endotracheal intubation in paediatric patients. It can reliably be used as a ventilatory device as well because of better OLP.

JOURNAL/ijana/04.03/01762628-202203001-00107/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff
7: Comparison of real-time cervical oesophageal ultrasonography and gastric antral ultrasonography to detect gastric insufflation during face-mask ventilation under general anaesthesia-Aprospective observational study.
Authors: EmayahTenzing  , A Vasudevan
Published: September 2024

Background and Aims:

Face mask ventilation (FMV) is live saving. It is paramount to maintain oxygenation and ventilation. But FMV is avoided in rapid sequence induction( RSI), for fear of gastric insufflation. Gastric insufflation predisposes the patient to pulmonary aspiration. But the current methods available to detect gastric insufflation are not reliable markers. These include epigastric auscultation for insufflated gases, insertion of nasogastric tube to aspirate and measure the gases, and gastric antral cross-sectional area (CSA) measurement. Each of the above have their own limitations. So, reliable markers denoting gastric insufflation can prevent pulmonary aspiration and can enable “safe” FMV. Real-time transcutaneous ultrasonography(USG) of cervical oesophagus during FMV was done to look for comet-tail artefacts (acoustic shadows created by entrainment of gases into digestive tract)The aim of this study was to compare real-time upper cervical USG with gastric antral USG to detect gastric insufflation during FMV under general anaesthesia.

Methods:

Results:

Ninety patients were recruited. One case of accidental intubation was withdrawn. Remaining 89 patients were analysed. There was an increased incidence of comet-tail artefacts in the oesophagus when compared to gastric antrum. This difference was statistically significant as analysed by Mcnemar test. The lowest peak airway pressure at which comet-tail artefacts appeared in oesophagus was 21.47 (SD-2.86) cm H20.

Conclusion:

Cervical oesophageal USG is better than gastric antral USG in identifying insufflation of gas into digestive tract. Limiting the airway pressures to < 20 cm H2O would be safer in providing safe FMV without cricoid pressure. Real-time USG monitoring of oesophagus in the neck for comet-tail artefacts is useful in early identification of early gastrooesophageal insufflation.

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8: Ultrasonographic assessment of diaphragmatic parameters for predicting weaning outcome in patients on mechanical ventilation in the intensive care unit setting.
Authors: Gupta Sakshi
Published: September 2024

Background and Aims:

The aim of this study was to ultrasonographically assess diaphragmatic parameters for predicting weaning outcome in patients on mechanical ventilation in the intensive care unit ( ICU ) setting. The primary objective was to assess the diagnostic accuracy of diaphragmatic excursion(DE) and diaphragmatic thickness fraction(DTF) by ultrasonography to predict weaning outcome in patients on mechanical ventilation. The secondary objectives were:

To correlate diaphragmatic dysfunction with re-intubation within 48 hours of extubation

To assess which of the two - DE) or DTF is a better predictor of weaning.

To compare diaphragmatic rapid shallow breathing index (RSBI) with clinical RSBI.

Methods:

This cohort study was conducted on 50 adult patients of either sex, admitted in the ICU and scheduled to undergo extubation. The patient’s readiness to wean was assessed by clinical judgment. When the patient was ready to be weaned, he/she was put on pressure support ventilation (PSV). The pressure support was gradually reduced to 6cm H2O. If the patient remained stable and extubation was planned, T-piece trial was given. Baseline parameters (Heart rate, non invasive blood pressure, respiratory rate, tidal volume, RSBI, SpO2, signs of respiratory distress- nasal flaring, sweating, agitation, use of accessory muscles,arterial blood gas analysis, Maximum Inspiratory Pressure (MIP), Maximum Expiratory Pressure(MEP) were recorded.

Results:

DE and DTF were assessed ultrasonographically and diaphragmatic RSBI was later calculated. DE andDTF were found to have similar sensitivity (94.12% and 97.06%), specificity (75%), positive predictive values(88.89 and 88.19% respectively) and negative predictive values (85.71% and 92.31% respectively). Overall DTF was comparable to DE in terms of diagnostic accuracy (88% and 90% respectively). (p value=1)

Conclusion:

DE and DTF are rapid and non invasive ultrasonographic indices with a high diagnostic accuracy for predicting weaning outcome. They provide objective and accurate results and are comparable to each other for predicting weaning outcome. Diaphragmatic RSBI is a good predictor of weaning outcome and is comparable to clinical RSBI.

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10: Efficacy of premixed versus sequential administration of fentanyl and bupivacaine in subarachnoid block for lower limb tibial surgeries: A randomised double blind clinical Study
Authors: Bevisetti Sagar
Published: September 2024

Background and Aims:

Opioids are most commonly used as adjuvants in subarachnoid block. The drug and its mode of administration affects the various block characteristics. Intrathecal administration of bupivacaine and fentanyl as premixed is compared to sequential administration in two separate syringes.

Methods:

Total eighty patients were randomly allocated into two groups of 40 each: Group M (Mixed) received premixed 0.5% heavy bupivacaine 2.5 ml (12.5 mg) and 0.5 ml (25µg ) of fentanyl in a single 5.0 ml syringe, Group S (Sequential) received 0.5 ml (25 microgram) of fentanyl in a 2.0 ml syringe followed by 0.5% heavy bupivacaine 2.5 ml (12.5 mg) in a 5.0 ml syringe. Double blinding was ensured in all the cases performed. The onset and duration of sensory and motor blockade and haemodynamic parameters were observed. Data analysis was done using MedCalc software.

Results:

The mean time for onset of sensory and motor block was less in group S (P<0.0001). The duration of sensory and motor block was prolonged in group S (P<0.0001). Patients in group M experienced more hypotension as compared to group S (P<0.05). Need for rescue analgesia was less in Group S in 24 hours (P<0.05).

Conclusion:

Administering fentanyl first followed by hyperbaric bupivacaine leads to an early onset and prolonged duration of sensory and motor block and better haemodynamic stability and less need of rescue analgesia in 24 hours.
11: Comparison of intraperitoneal dexamethasone, dexmedetomidine and dexamethasone-dexmedetomidine combination on postoperative nausea, vomiting and analgesics requirement after gynaecological laparoscopy: A randomised clinical trial.
Authors: Srivastava PoojaShree Vinit Kumar
Published: September 2024

Background and Aims:

Female patients undergoing laparoscopic gynaecological surgery are more prone to postoperative nausea and vomiting (PONV). We hypothesised that an intraperitoneal administration of dexamethasone, dexmedetomidine and combination would reduce the incidence of PONV and analgesics requirement after laparoscopic hysterectomies.

Methods:

One hundred ninety-two female patients undergoing laparoscopic hysterectomies were randomly assigned to four groups. Anaesthesia technique was identical in all the groups. Patients in group D1 received dexamethasone 8 mg, group D2 received dexmedetomidine 1 µg/kg, group D3 received dexamethasone 8 mg + dexmedetomidine 1 µg/kg combination and group D4 received 20 ml normal saline intraperitoneally at the end of the procedure, before withdrawal of trocar. The primary outcome was the incidence of PONV experienced by the patients within the 24 h postoperative period. The secondary outcome was the analgesic consumption during the first 24 h after surgery, and the need for rescue antiemetic drugs.

Results:

The incidence of PONV within first 24 h postoperatively was significantly decreased in D1, D2 and D3 group compared to group D4 (p=0.001), however, there was no significant difference among patients in the D1, D2 and D3 groups. The consumption of paracetamol and rescue antiemetic were significantly higher in the group D4 compared to other intervention groups.

Conclusion:

Intraperitoneal administration of dexamethasone, dexmedetomidine and combination of dexamethasone-dexmedetomidine in laparoscopic hysterectomies significantly reduces the incidence of PONV and also reduces the postoperative analgesics requirement as compared to control group.

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12: Comparison of the effects of propofol and sevoflurane on postoperative cognitive functions and memory in patients undergoing general anaesthesia
Authors: Shrivastav Priyal , Mehrotra Shikha , TriptiVatsalya
Published: September 2024

Background and Aims:

Aim of the study was to compare the effects of propofol and sevoflurane on cognitive functions and memory in terms of psychometric test pre and post general anaesthesia.

Methods:

60 patients of age group 18– 40 years and of American Society of Anesthesiologists ( ASA) grade I and II scheduled for general anaesthesia were included in this study. According to anaesthetic considerations and patients’ needs, they were given either propofol infusion or sevoflurane for maintenance of general anaesthesia. Intraoperatively, depth of anaesthesia was monitored by clinical assessment. Assessment of cognitive functions and memory of patients was done preoperatively by following: MMSE score, CVLT, DST, RBMT and Recalling the names of surgeon and anaesthetist. After extubation, patients were observed for recovery by Aldrette recovery score up to 1 hour and assessed for pain by visual analogue scale up to 2 hours postoperatively. Cognitive function and memory was assessed postoperatively upto 2 hours.

Results:

The recovery characteristics were better with sevoflurane than propofol up to 60 minutes.

Sevoflurane had less impact on cognitive function as compared to propofol up to 30 minutes postoperatively.

Effect on verbal and numerical memory was less with sevoflurane as compared to propofol up to 30 minutes.

Effect on semantic memory was less with sevoflurane as compared to propofol up to 5 minutes except recall memory.

RIVERMEAD BEHAVIOURAL MEMORY TEST.

MINI MENTAL STATE EXAMINATION:

Conclusion:

Sevoflurane is more favourable than propofol for a faster recovery and emergence from anaesthesia, where rapid recovery of cognitive function and memory are desired.

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Surprise evidence of a bronchial rent in a case of pulmonary Koch’s posted for lung decortication using the one-lung ventilation protocol
Authors: Aishwarya Pingley
Published: September 2024

Tracheobronchial injury is a potentially life-threatening clinical scenario. In the case of surprise evidence of bronchial wall tear while doing lung surgery, tracheal tube extubation and post-operative management pose a challenge to the anaesthesiologist. We present a case of a 16-year-old girl, a known case of pulmonary Koch’s taking anti-Koch’s treatment, admitted with hydropneumothorax, who was posted for left lung decortication. She presented with complaints of left-sided chest pain and cough since 3 months and a weight loss of 13 kg in 3 months. An inter-costal drain was inserted on the left side.

Her high-resolution computed tomography thorax showed multiple cavitatory lesions with ground glass opacities in right lung parenchyma,

Hydropneumothorax from the upper lobe to lower lobe of the left lung; consolidation, calcification in the left lower lobe; mediastinal shift toward the right.

In the Operation theatre, the patient was pre-oxygenated, induced with Inj Propofol + Inj Fentanyl + Inj Suxamethonium according to the patient’s weight, and intubated with a 28 Fr’ left-sided double lumen tube (DLT). Left-sided decortication was performed uneventfully. On conclusion of surgery, while checking for leaks, it was noted that the exhaled tidal volume was unacceptably low and a rent on the left main bronchus of around 2 x 2 cm with scarred borders was detected, which was repaired with tissue patch suturing by the surgeons. After closure, the DLT was removed and re-intubation was performed with endotracheal tube no. 6. The patient was shifted to the intensive care unit, electively ventilated, and gradually weaned off in 2 days. Then, the patient was discharged in a week.

To conclude, meticulous planning, vigilant monitoring of vital parameters, and close communication between the surgeons and the anaesthesiologists are essential to timely manage a life-threatening complication.
Comparison of two external manoeuvres with the conventional technique on glottic visualisation using a C-MAC® videolaryngoscope in children for elective surgery
Authors: A Yazhini
Published: September 2024

Background and Aims:

Glottic visualization is a pre-requisite for successful intubation. We compared the effect of backward upward rightward pressure (BURP) and jaw thrust manoeuvres with the conventional technique on glottic visualisation using a C-MAC® videolaryngoscope in children of 3 to 10 years.

Methods:

Ninety children of either gender of 3 to 10 years with normal airways and of the American Society of Anesthesiologists grade I or II for elective surgery under general anaesthesia with endotracheal intubation using a C-MAC® videolaryngoscope were enroled. Glottic views with the conventional technique (C), BURP (B), and jaw thrust (J) manoeuvres in three groups were assessed by modified Cormack Lehane grade (MCL) grade, percentage of glottic view (POGO) score, and a new two-dimensional metric – approximate glottic opening area in pixels squared. Approximate glottic opening area calculations were performed using tool pencil in horos medical imaging software.

Results:

Jaw thrust had statistically significant superiority over the conventional technique and BURP on glottic visualisation (a p value of C vs J < 0.0001 and B vs J < 0.05 for all the three parameters). BURP was comparable to the conventional technique in MCL grade and POGO score (a p value of C vs B > 0.05) but was superior to the conventional technique in glottic area (a p value of C vs B = 0.013).

Conclusion:

Jaw thrust enhanced glottic visualisation by maximising all the glottic view parameters as compared to the BURP manoeuvre and the conventional technique and should be considered the primary manoeuvre to aid intubation in children.

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Retrospective study of association of haematological parameters with disease severity in COVID patients admitted in Burdwan Medical College and Hospital
Authors: Roy Sougata
Published: September 2024

Background and Aims:

Since December 2019, an increasing number of pneumonia cases of unknown reasons emerged in Wuhan, China. Deep-sequencing analysis from nasopharyngeal swabs, sputum, lower respiratory tract samples, and blood indicated a novel coronavirus, known as 2019-nCoV. Our aim was to determine the association of haematological parameters such as haemoglobin (Hb%), total leukocyte count (TLC), platelet count (Plt) with severity of coronavirus disease 19 (COVID 19) infection among patients admitted in the COVID intensive care unit (ICU) and COVID ward, and our objectives were to estimate haemoglobin (Hb), TLC, differential leukocyte count (DLC), and platelet count of patients admitted in the COVID ward and ICU; to derive neutrophil lymphocyte ratio (NLR) from the DLC of the patients admitted in the COVID ward and ICU; and to determine the correlation between Hb, platelet count, TLC, and NLR with severity of disease among COVID patients.

Methods:

After receiving approval from institutional ethics committee, data were collected according to our study parameter (age, weight, height, Hb%, TLC, platelet, NLR) from the medical record section for ICU-admitted (Group A) and ward-admitted (Group B) patients and compared. Here, SPSS version 22 was used for analysis, and a p value <0.05 was considered significant.

Results:

A decreasing trend in Hb%, TLC, and platelet count was seen in both the groups but more in group A than group B, which is statistically significant; NLR got an increasing trend in these two groups, and the increase in group A is more and statistically significant compared to group B.

Conclusion:

Our study tries to explore the feasibility of such parameters in this regard and found that a combination of NLR, Hb%, TLC, and platelet count can be considered together as an effective prognostic indicator in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

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Abstract No. : ABS0107 : Ultrasound guided lower thoracic erector spinae plane block for postoperative analgesia following gynaecologic oncology surgery - A randomised controlled trial
Authors: Solanki Rekha
Published: September 2024

Background and Aims:

Erector spinae plane (ESP) block is a relatively novel block which provides local and visceral analgesia for abdominal surgery. The present study is aimed to assess the efficacy of ESP block for postoperative analgesia following major open gynaecologic oncology surgery.

Methods:

Sixty female patients posted for elective open gynaecologic oncology surgeries were enroled in this prospective, double blind study and randomised to B and C group. Group B patients received general anaesthesia plus ultrasound guided bilateral ESP block at T9 level at the end of surgery while group C patients received general anaesthesia only. Primary outcome was postoperative visual analogue scale (VAS) scores. Secondary outcomes were time to first rescue analgesic, 24 hours tramadol consumption, and side effects. Chi square and student t tests were used and P < 0.05 was considered significant.

Results:

Postoperative pain scores were lower in B group compared to C group at rest and on movement . Time to first rescue analgesic was prolonged in B group (8.10 ± 1.48 hours) as compared to C group (0.7 ± 0.38 hours) [P < 0.0001]. Total 24 hours tramadol consumption was less in B group (68 ± 48.55 mg) than C group (210 ± 52.65 mg)(table 1) [P < 0.0001].

Conclusion:

Ultrasound guided ESP block with general anaesthesia provides superior postoperative analgesia compared to general anaesthesia alone following major gynaecologic oncology surgeries without any side effects. It can be used as an alternative to epidural analgesia.

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Abstract No. : ABS0260: Comparison of phantom cadaver based simulations with blue phantom model for teaching ultrasound guided regional anaesthesia: a randomised controlled trial
Authors: Dang Deepanshu
Published: September 2024

Background and Aims:

Various methods of simulation have different advantages and disadvantages.This study was aimed to compare the block performance of novice post-graduate students of anaesthesiology after teaching them ultrasound guided regional anaesthesia on blue phantom model or cadaver-based phantom model.

Methods:

This study was conducted in the Department of Anaesthesiology and Critical Care and Department of Anatomy at a tertiary medical college hospital.

Video lecture on ultrasound knobology and transducer movement was given to all study participants. In group BP, participants trained on blue phantom model. In group CP, participants trained on fresh human cadaver model. After training, participants were shown video of supraclavicular brachial plexus block,and finally performance was assessed on patients.

Results:

The median block performance time was 525.0 seconds in group BP with an interquartile(IQR) of (494-552.5) and 440.0 seconds in group CP with an IQR of (419.5-487.5)(table 1).

This difference was statistically significant (p<0.001). The median image quality score was 3.0 in group BP with an IQR of 2-3, and it was also 3.0 in group CP with an IQR of 3-4, and it was statistically significant (p = 0.00398) (table 2).

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Conclusion:

Time taken to perform brachial plexus block was less in the cadaver phantom group compared to the blue phantom group. The image quality scores and number of attempts required to perform brachial plexus block were statistically significant between groups. Novices trained on cadavers had better transducer target orientation and were able to identify ultrasonographic artifacts better than those trained on the blue phantom.