bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness Of Warm Ginger Milk Consumption In Reduce Emesis Gravidarum In 1st Trimester Pregnant Women In Pmb Karawang City Year 2023
Authors: Rismayanti Tetin , Ratnaningsih Romih
Published: March 2024

Background: In early pregnancy, many mothers experience complaints of nausea, vomiting, especially in the morning, which is known as morning sickness or in medical language known as emesis gravidarum. Symptoms of emesis gravidarum in pregnant women can be treated both with conventional and non-conventional treatments or often referred to as complementary therapy, namely with herbal plants that are easily available such as lemongrass, lemon, peppermint leaves and the most popular is ginger. Research Objectives: To determine the effectiveness of consuming warm ginger milk juice in reducing emesis gravidarum in first trimester pregnant women at PMB Karawang City in 2023 Research Methods: The type of research used in this study is quasi-experimental and post test only design one group. The population in this study were 54 mothers. The sample in this study were 35 mothers who were in PMB Karawang City. Bivariate analysis using the Wilcoxon test. Results: The average frequency of emesis gravidarum in 1st trimester pregnant women before being given warm ginger juice was 9.97, a standard deviation of 1.636, a minimum of 7 and a maximum of 13. The average frequency of emesis gravidarum in 1st trimester pregnant women after being given consumption warm ginger milk juice is 5.54, a standard deviation of 1.039, a minimum of 4 and a maximum of 7. Conclusion: It can be concluded that consumption of warm ginger milk juice is effective in reducing emesis gravidarum in first trimester pregnant women at PMB Karawang City in 2023.
Analysis Of Factors Influencing Patient Safety Incidents at Royal Prima Medan General Hospital in 2021
Authors: Rahmadana Rizka , Ginting Rafael , Lestari Nasution Sri , Girsang Ermi
Published: March 2024

Incident safety patients must be minimized to avoid undesirable danger during maintenance in the hospital. Perception of health workers reporting patient safety incidents at the Royal Prima Medan General Hospital still needs to be higher. Low perception of health workers in writing incident Patient safety is related to individual and organizational factors. The study aims to identify the influence factor on patients' personal and corporate incident safety in the inpatient room of royal prima hospital medan. The type of research used is a method survey with a cross-sectional approach. The population in the study of health workers at the Royal Prima General Hospital in Medan was 259 people, and the sample was 119.  Collection data with primary, secondary, and tertiary data was analyzed with multiple logistic regression statistical tests with a level of trust of 95%. Results study show bring individual factors (knowledge with p-value = 0.021 and experience with p-value=0.021) effect-on-patient safety incident reporting and organizational factors (organizational environment with p-value = 0.038 and power with p-value=0.014) effect on reporting incident safety patient, individual characteristics (motivation with p-value = 0.557) have no impact on writing incident safety patient And factor organization (organizational culture with p-value =0.535) has no effect to reporting incident patient safety and most influence reporting incident patient safety in Royal Prima General Hospital Medan is a knowledge variable (OR=155.6). They are recommended for a hospital for-develop system information integration related to writing incident patient safety and officer health to increase the perception of officer health through improvement, knowledge, and experience of officer health.
Differences In The Effectiveness Of Green Belt Leaf Boiled Water And Soursop Leaves On Which White In Adolescent Girls At SMAN 4 Serang City, Banten, 2023
Authors: Anitasari Matanari Uli , Rismayanti Tetin
Published: March 2024

In Indonesia, the problem most often experienced by young women is vaginal discharge. In medical circles, vaginal discharge is known as leukorrhea or fluor albus, which is a discharge from the vagina. Vaginal discharge is a candida fungal infection in female genitalia and is caused by organisms such as yeast, namely candida albicans. Under normal circumstances, the vagina produces fluid that is clear, odorless, colorless, not excessive in quantity and not accompanied by itching. Vaginal discharge is the most common complaint found in women. Vaginal discharge can occur in normal circumstances (physiological), but can also be a symptom of a disorder that must be treated (pathological). The research used was a Quasy Experiment type of research to determine the difference in the effectiveness of giving boiled water from green betel leaves and soursop leaves on vaginal discharge in young women at SMA Negeri 4 Serang Banten with a Two Group Pretest - Posttest research design. Respondents were divided into 2 groups, namely the betel leaf group and the soursop leaf group, each group numbering 45 people. With univariate and bivariate analysis. With the results of the Wilcoxon test, which obtained a significance value of 0.001 (p<0.05), it can be concluded "there is a significant difference in the effect of boiled green betel leaf water on vaginal discharge" and the results of the Wilcoxon test obtained a significance value of 0.000 (p<0.05 ), it can be concluded "there is a significant difference in the effect of boiled soursop water on vaginal discharge".
The Effect of Giving Butterfly Pea Flower Extract (Clitoria ternatea) on Reducing Cholesterol Levels and Histopathological Features of White Rat Testes (Rattus norvegicus) Wistar Male Obesity Model
Authors: Jaya Risnaldo , Budi Andre , Sihombing Bungaran
Published: March 2024

Obesity is a global, non-communicable condition that causes male infertility. Obesity impacts spermatogenesis and male fertility. Butterfly pea blossoms (Clitoria ternatea) contain antioxidants that fight free radicals and prevent obesity. This research looked at how butterfly pea flower extract (Clitoria ternatea) affected cholesterol levels, testicular function, and the histopathology of the testicles of obese male Wistar rats (Rattus norvegicus). This research is quantitative and uses a lab or actual experiment. The 24 test mice were randomly divided into four groups. The research data was analyzed using SPSS 25.0 for Windows. The normality test significance is 0.577. One-way ANOVA test results demonstrate 0.000 or greater than 0.05 significance. LSD post-hoc test values. The control and treatment groups 1–3 differed significantly (p = 0.000). No change was seen between treatment groups 2 and 3 (p = 0.088). The research found butterfly pea flower extract therapy (Clitoria ternatea) at 400mg and 600 mg/kgBW lowers cholesterol. Flavonoids, saponins, tannins, and triterpenoids reduce cholesterol and improve testicular function in obese white rats.
The Effect of Swimming Aerobic Physical Exercise On White Rats (Rattus Novergicus) Of the Wistar Strain That Are Obese
Authors: Altamira Vita , Angie Evelyn , Kunardi Sidharta
Published: March 2024

Women are more likely to be obese and at risk of hypertension and coronary heart disease than men. Genetic factors influence it. Physical exercise can reduce obesity, especially on endothelial factors such as ET-1 and NO. This research explores the effect of swimming physical training on the expression of endothelin-1 and receptor-A in obese mouse models. This type of research is a true experiment carried out on 12 adult female Wistar rats (Rattus norvegicus) as research samples. The research procedures were carried out by caring for test animals, raising rats until they were obese, not giving treatment (control), physical training in the form of swimming exercises, and finally, examination of ET-1, ET-A, blood sugar levels, and total cholesterol levels. The data obtained was analyzed using SPSS. The research results of the normality test for the treatment group were more significant than 0.05 in the ET-1 examination of 0.315 and ET-A of 0.261. ET-1 levels were 92.5 pg/ml and ET-A levels were 62.5 pg/ml. Their blood sugar level was 167 mg/dL. The research concluded that in mouse tests, physical training was better for increasing ET-1 levels and reducing ET-A levels. Swimming and aerobics are better at lowering blood sugar levels.
Application Of Complementary Therapy With Fenugreek Seed Tea (Klabet) To Increase Breast Milk Production In Langkapura District, Bandar Lampung City, 2023
Authors: Silfia Sari Mega , Indayani Ninik
Published: March 2024

Background: Exclusive breastfeeding coverage in Indonesia in 2019-2020 decreased from 67.74% to 56.9%. This is caused by several problems, both maternal and baby problems. Babies who are not exclusively breastfed are very susceptible to diseases such as respiratory tract infections (ARI), diarrhea, severe intestinal problems in premature babies, decreased Intelligence Quotient (IQ) (Wijayanti, 2015). Therefore the author is interested in conducting research on "Therapeutic Application Complementary with Fenugreek Seed Tea (Klabet) to Increase Breast Milk Production in Langkapura Village, Bandar Lampung City in 2023.” Research Objective: To determine the effectiveness of applying complementary therapy of Fenugreek seed tea (Klabet) to increase breast milk production in breastfeeding mothers. Research Method: This study used an independent t test research design with a population of 30 breastfeeding mothers and the sample for this study used the total population. Data techniques use computer program statistical calculations. Research Results: In the experimental group 93.3% of respondents were aged 21-35 years, 66.7% had a high school education, 80.0% were unemployed and 53.3% were multiparous, while in the control group 100.0% were aged 21-35 years old, 60% had a high school education, 66.7% did not work and 53.3% were primiparous. In the experimental group the pre test average was 4.47 and the post test average was 9.53. Meanwhile, in the control group, the pre-test average was 4.07 with the post-test average being 6.93. Conclusions and Recommendations: Based on the results of research using an independent t test, it was found that Ho was rejected, which means there was an effect of fenugreek seed tea on breast milk production in breastfeeding mothers in Langkapura Village, Bandar Lampung City in 2023.
The Influence Of Booklet On The Success Of Toilet Training In Children Aged 2-3 Years At Ra Bintang Zhafira Tulang Bawang Regency
Authors: Wulandari M Ranti , Nur Assyaidah Sonda
Published: March 2024

Background: According to the Child Development Institute Toilet training, it is reported that 10 -20% of children aged 5 years, 5% of children aged 10 years, almost 2% of children aged 12-14 years, and 1% of children aged 18 years still wet the bed. Toilet training is an effort to train children to be able to control defecation (BAB) and urination (BAK) in their place (toilet). Education is one way to increase mothers' or parents' intellectual knowledge about toilet training. Education or health education can be provided using various methods and media, including: lectures, discussions, giving leaflets, booklets or direct practice related to the mother's needs. A booklet is a small book that contains writing, pictures or both. Research objective: to determine the effect of booklets on the success of toilet training in children aged 2-3 years at RA Bintang Zhafira, Tulang Bawang Regency. Research method: This research uses quantitative with a Quasy Experiment design with a one group pretest and posttest design. The population in this study was 32 mothers who had children aged 2-3 years and the sample taken was 32 respondents. The research was carried out at RA Bintang Zhafira, Tulang Bawang Regency in December 2023-January 2024. Data analysis was carried out univariate and bivariate (t test). Research results: it is known that the average success of toilet training before intervention was given to children aged 2-3 years was 8.0 and after intervention was given to children aged 2-3 years was 12.1. There is an influence of the booklet on the success of toilet training in children aged 2-3 years at RA Bintang Zhafira, Tulang Bawang Regency with p-value = 0.000 or p ≤ α (0.05). Conclusions and Suggestions: There is an influence of the booklet on the success of toilet training in children aged 2-3 years at RA Bintang Zhafira, Tulang Bawang Regency and suggestions for RA Bintang can provide health education to mothers who have toddler age children regarding the implementation of toilet training.
Quimioterapia más inmunoterapia como tratamiento neoadyuvante en el cáncer de pulmón de células no pequeñas CPCNP: caso clínico de un superviviente con enfermedad limítrofe para resecabilidad al diagnóstico
Authors: Ospina Serrano Aylen Vanessa , Calvo de Juan Virginia , Provencio Pulla Mariano
Published: March 2024

El cáncer de pulmón de células no pequeñas (CPCNP) representa la principal causa de mortalidad asociada al cáncer a nivel mundial. La base de tratamiento curativo es la resección quirúrgica completa, sin embargo, aproximadamente el 70 % de los pacientes debutan con enfermedad avanzada o localmente avanzada irresecable. Históricamente, el manejo estándar en la etapa temprana ha sido la administración de 3 a 4 ciclos de un doblete de quimioterapia basado en platino pre o post quirúrgicamente. Con este tratamiento se ha demostrado un beneficio de aproximadamente un 5 % en la supervivencia a cinco años. Recientemente, dados los resultados positivos en el contexto metastásico, se ha estudiado la utilidad del esquema de inmunoterapia con inhibidores del punto de chequeo inmunológico más quimioterapia (IQt), como tratamiento neoadyuvante del CPCNP potencialmente resecable. Esto ha llevado a obtener evidencia científica que apoya que este tratamiento aumenta significativamente las tasas de respuesta y la supervivencia, lo cual ha permitido la aprobación de esta indicación por las agencias regulatorias de medicamentos y la inclusión en guías de manejo.  Caso clínico: se describe un caso clínico de largo seguimiento, como ejemplo ilustrativo del abordaje de un paciente con CPCNP con un tumor con criterios limítrofes de resecabilidad, que presentó muy buena respuesta al tratamiento con el nuevo esquema de IQt neoadyuvante; además, resalta la importancia del abordaje y valoración de los pacientes con CPCNP localmente avanzado en el marco de un equipo multidisciplinar oncológico. Conclusión: esta aproximación terapéutica presenta un perfil de seguridad predecible y manejable que no genera retrasos en el tratamiento quirúrgico y muestra un impacto positivo en la supervivencia global.
Ethical Dilemmas Behind The Unsmoothed Framework Of The National Public Oversight Bodies
Authors: TACHE Marta , NEAGU Ștefania-Florentina , IGNAT Ioana
Published: March 2024

The aim of Public Oversight Bodies (POBs) is to improve firms’ audit quality through inspections of audit engagements. Nonetheless, the effectiveness of specific actions of POBs is yet to be documented in the literature. By using a hand-collected data on the framework of POB inspection framework from all the European countries, we are able to provide novel evidence that a smoothed framework of POB inspection can influence the appearance of ethical dilemmas in auditing. Specifically, after analyzing the general frame of the European POBs, we find that the setting of national POBs differs in time and the unsmoothed frame of POB inspections varies from country to country even if there are some recommendations developed by the European Directive 2014/56/EU and the Regulation 537/2014. Overall, this research documents that the uniform disclosure of annual reports is relevant for auditors and the effect of national POB inspections augments the audit quality.
COMPETÊNCIAS E ATUAÇÃO DO ENFERMEIRO PERFUSIONISTA EM CIRURGIAS DE REVASCULARIZAÇÃO MIOCÁRDICA: REVISÃO INTEGRATIVA
Authors: Gomes Kátia Cristina , Pascoal Matheus Mendes , Tashiro Sabrina Ronconi Benedet
Published: March 2024

A atuação para o exercício profissional do enfermeiro perfusionista é definida através da Sociedade Brasileira de Circulação Extracorpórea, possuindo notável papel nos processos assistenciais e gerenciais. O objetivo foi evidenciar as competências e atuação do enfermeiro, a fim de elucidar qual a formação do enfermeiro perfusionista e a sistematização de assistência de enfermagem na circulação extracorpórea de cirurgias de revascularização miocárdica. Trata-se de uma revisão integrativa realizado através do levantamento bibliográfico e das experiências vivenciadas pelos autores da revisão bibliográfica através da incorporação da aplicabilidade de resultados de estudos significativos na prática, buscando avaliar a Sistematização de Assistência de Enfermagem para o direcionamento das ações do enfermeiro perfusionista em cirurgias de revascularização miocárdica. Foi realizada uma busca criteriosa e sistemática por publicações nas bases de dados Medical Literature and Retrieval System onLine (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Base de Dados de Enfermagem (BDENF), acessados pela Biblioteca Virtual em Saúde (BVS). Considerando as principais intervenções em saúde e estratégias aplicadas pelo enfermeiro perfusionista, mostrou-se eficaz no gerenciamento de diversos fatores que podem ocasionar sérias lesões em clientes submetidos a cirurgias de RVM, utilizando a ECMO. Evidencia-se a importância da assistência e sistematização de enfermagem em cirurgias de revascularização do miocárdio que devem ser aplicadas por um profissional altamente qualificado, proporcionando qualidade na assistência prestada. Enfatizando a importância do profissional enfermeiro perfusionista nas cirurgias, tendo em vista suas habilidades com a equipe multidisciplinar, e o conhecimento, com base nos conceitos técnicos e científicos, além do conhecimento teórico e prático.
O CONTROLE JURISDICIONAL SOBRE O ATO ADMINISTRATIVO DISCRICIONÁRIO: ANÁLISE DE CASO
Authors: Cunha Alan Vargas da , Ferreira Marcelo Benetele
Published: March 2024

Por meio da presente pesquisa, buscou-se através de um levantamento teórico conceitual, tratar sobre o controle jurisdicional sobre o ato administrativo discricionário a partir da análise do Agravo em Recurso Especial nº 1.806.617/DF. Atêm-se que o objetivo central consubstancia a analisar o referido precedente jurisprudencial do Superior Tribunal de Justiça quanto aos pressupostos autorizadores da intervenção jurisdicional. Mediante a metodologia de pesquisa bibliográfica foi possível realizar um estudo prévio acerca do controle jurisdicional sobre o ato discricionário e assim, investigar profundamente o estudo do caso. Noutra via, a adoção do método indutivo foi crucial para realizar um melhor aprofundamento do instituto. Reunidas as condições necessárias para desenvolver o estudo, problematizou-se a delimitar a análise do controle jurisdicional sobre o ato administrativo sob o viés do Agravo em Recurso Especial nº 1.806.617/DF. De outro modo, constatou-se que o mérito administrativo pode sofrer interferência externa mediante o controle jurisdicional, mas restringe-se aos aspectos de legalidade não adentrando nuclearmente nos elementos afigurativos como a subjetividade da conveniência e oportunidade. Percebeu-se que o princípio da proporcionalidade e razoabilidade exerce capital importância na fundamentação jurídica do interventivo controle.
FUNCTIONAL OUTCOME OF PROXIMAL SEGMENTAL FIBULAR RESECTION IN MEDIAL COMPARTMENT KNEE OSTEOARTHRITIS
Authors:   Belarusian State Medical University, О. Shahine , M. A. Gerasimenko ,   Belarusian State Medical University, V. E. Chyrak ,   Belarusian State Medical University, V. N. Gurko ,   Belarusian State Medical University
Published: March 2024

Osteoarthritis (OA) of the knee joint is the commonest form of OA. It occurs commonly in the medial compartment because of a preponderance of varus knees. High tibial osteotomy, total knee replacement and unicompartmental knee replacement are technically demanding procedures, while proximal segmental fibular resection (PSFR) significantly relieves pain and improves joint function in knee osteoarthritis (OA). This study was conducted at the department of traumatology and orthopedics at the Belarusian state medical university. The objective of this study was to assess functional outcomes after PSFR and its correlation with bone mineral density. 23 patients with unicompartmental OA with varus deformity were included in the study. Inclusion criteria included patients with moderate-to-severe symptomatic medial unicom- partmental OA of the knee, who had an indication for a surgical procedure, and who were able to give informed consent for the surgery. Exclusion criteria included patients with posttraumatic knee OA or inflammatory joint disease and patients with a history of previous operations or fractures the primary outcome was measured by calculating the ratio of knee joint space. The secondary outcome measure was pain measured by the visual analog scale (VAS).
DIFFERENTIATED APPROACH TO PROVIDING HELP FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS (BASED ON THE EXAMPLE OF MINSK)
Authors:   Belarusian State Medical University, I. A. Khrushch , A. F. Krot ,   Belarusian State Medical University, S. N. Shubina ,   Belarusian State Medical University
Published: March 2024

Autism spectrum disorders (ASD) are neurological and developmental disorders characterized by difficulties with social communication and repetitive interests and/or behaviors that begin before age of 3 years. The exact etiology of ASD remains unknown today. According to literature reviews, several factors may predispose to the development of these entities, which, according to scientific publications, can be both genetic and environmental factors. A problematic area remains the timely provision of highly qualified assistance in the management and treatment of such patients [1]. It is important that the child with ASD and his family have the support of a multidisciplinary team to help overcome current situations and problems. The aim of the work: to emphasize the advantages of a multidisciplinary approach in accompanying children with autism spectrum disorders. The authors describe some epidemiological data on autism spectrum disorders using the example of Minsk.
USING OF HYALURONIC ACID PREPARATIONS TO STIMULATE REGENERATION WITH TROPHIC DISORDERS AS A RESULT OF CHRONIC VASCULAR DISEASES OF THE LOWER EXTREMITIES
Authors:   Belarusian State Medical University, N. A. Rogovoy , S. A. Alekseev ,   Belarusian State Medical University, D. V. Kress , S. S. Kalinin , U. A. Shitikova , A. V. Ludchik , D. S. Alekseev ,   Belarusian State Medical University
Published: March 2024

Trophic ulcers as a result of chronic vascular diseases of the lower extremities are an urgent and complex task of surgical treatment. Local treatment of the ulcer is an important role after revascularization. Hyaluronic acid (HA) preparations are among the most promising in this regard. HA provides increased tissue resistance to ischemia, suppression of the inflammatory response, stimulation and acceleration of tissue regeneration. HA ensures the formation of a temporary matrix in a fresh wound, facilitates the diffusion of nutrients and cleans the wound from products of cellular metabolism. Secondly, it takes an active part in the proliferation and migration of keratinocytes, which make up the bulk of the epidermis. Due to the insignificant use of HA in local therapy of trophic disorders of chronic vascular diseases of the lower extremities, it is interesting to further study the effect as part of complex and pathogenetically oriented treatment in patients of this group.
LIPOMA OF THE TEMPORAL REGION
Authors:   Belarusian State Medical University, B. M. Bazarov , T. V. Kahanovich
Published: March 2024

Lipoma is a benign neoplasm, often encountered in the practice of maxillofacial surgeon. The clinical manifestations of lipomas are varied. The formation is encapsulated, does not cause pain, leads to bulging of the affected area, and easily moves with pressure. It can grow to enormous sizes, causing stretching and sagging of the skin. The treatment of this pathology is surgical. The complexity of surgical intervention depends on the location of the formation and its size. To diagnose lipomas, in addition to clinical methods (examination, palpation), instrumental research methods are used. This article analyzes the frequency of lipomas in the maxillofacial area, clinical manifestations, and differential diagnosis of this disease. A clinical case of lipoma of the temporal region is described.
ALTERNATIVE CORRECTION OF CLIMACTERIC SYMPTOMS IN WOMEN AT NATURAL OR SURGICAL MENOPAUSE
Authors:   Grodno State Medical University, T. S. Milosh
Published: March 2024

One of the effective mechanisms for reducing the development of pathologies at menopause is the search for significant alternative means of reducing the severity of menopausal manifestations. In order to identify the correction of the severity of climacteric symptoms a study of 154 patients was conducted, the patients were divided into three groups: 53 women at natural menopause, 50 women at surgical menopause, the same patients (n=53 and n=50) 6 months after taking flaxseed oil and 51 control patients. Thus, it was found out that operated women develop more often extragenital pathology and more frequently consult medical specialists than those at natural menopause and healthy participants. Comorbidity in the main groups is more than two nosologies with a predominance of arterial hypertension. According to the Green scale menopausal severesymptoms in female patients with oophorectomy and moderate biological menopause symptoms of vasomotor and emotional-mental statusare leading. After daily use of flaxseed oil in operated women and those at natural meno-pause the severity of menopausal symptoms decreased equaling moderate and mild severity, respectively, along with the frequency of patients’visits to specialists to a greater extent in patients at natural menopause. The effectiveness of taking flaxseed oil by women at surgical or natural menopause for menopausal disorders of varying severity makes it possible to use it as an alternative for correction during the period of estrogen deficiency.
CHANGES IN THE BLOOD PLASMA LIPID PROFILE, HOLTER MONITORING PARAMETERS AND ECHOCARDIOGRAPHY IN PATIENTS WITH CORONARY HEART DISEASE AND HYPOTHYROSIS
Authors:   Belarusian State Medical University, A. V. Polyanskaya , O. A. Patorskaya ,   Belarusian State Medical University, E. Povalyaev ,   Belarusian State Medical University, L. Fael ,   Belarusian State Medical University
Published: March 2024

The article presents the results of a study of changes in the lipid spectrum of the blood plasma and certain indicators of Holter monitoring and echocardiography data in patients with coronary heart disease (CHD) and hypothyroidism who were in a cardiology hospital. The incidence of hypothyroidism in cardiac patients was 2.8 %. In patients with ischemic heart disease and hypothyroidism, no reliable correlation has been established between the presence of hypothyroidism and dyslipidemia, but a high incidence of hypercholesterolemia and increased levels of low-density lipoprotein cholesterol was found in patients with ischemic heart disease in combination with hypothyroidism, as in the control group. Extrasystole was determined in all patients with coronary artery disease, regardless of the presence of hypothyroidism. Only 2.7 % of patients with coronary artery disease and hypothyroidism had a decrease in myocardial contractile function according to the assessment of left ventricular ejection fraction (EF). The detection rate of left ventricular hypertrophy (LVH) in patients with coronary artery disease and hypothyroidism was 83.7 %. There was a significantly significant moderate correlation in the group of patients with coronary artery disease, regardless of the presence of hypothyroidism, between the number of premature atrial complexes (PAC) and the number of premature ventricular complexes (PVC). There was no effect of TSH level on EF values and the presence of LVH in patients with coronary artery disease in combination with hypothyroidism and in the absence of the latter.
An optimal transformation method applied to diagnosing the ocean carbon sink
Authors: Mackay Neill , Zika Jan , Sohail Taimoor , Williams Richard , Andrews Oliver , Watson Andrew
Published: March 2024

Abstract. The ocean carbon sink plays a critical role in climate, absorbing anthropogenic carbon from the atmosphere and mitigating climate change. The sink shows significant variability on decadal timescales, but estimates from models and observations disagree with one another, raising uncertainty over the magnitude of the sink, its variability, and its driving mechanisms. There is a need to reconcile observationally-based estimates of air-sea CO2 fluxes with those of the changing ocean carbon inventory in order to improve our understanding of the sink, and doing so requires knowledge of how carbon is transported within the interior by the ocean circulation. Here we employ a recently developed Optimal Transformation Method (OTM) that uses water mass theory to relate interior changes in tracer distributions to transports and mixing and boundary forcings, and extend its application to include carbon using synthetic data. We validate the method using model outputs from a biogeochemical state estimate, and test its ability to recover boundary carbon fluxes and interior transports consistent with changes in heat, salt and carbon. Our results show that OTM effectively reconciles boundary carbon fluxes with interior carbon distributions when given a range of prior fluxes. OTM shows considerable skill in its reconstructions, reducing root-mean-squared errors from biased priors between model ‘truth’ and reconstructed boundary carbon fluxes by up to 71 %, with bias of the reconstructions consistently ≤ 0.06 mol-Cm−2 yr−1 globally. Inter-basin transports of carbon also compare well with the model truth, with residuals < 0.25 Pg C yr−1 for reconstructions produced using a range of priors. OTM has significant potential for application to reconciling observational estimates of air-sea CO2 fluxes with the interior accumulation of anthropogenic carbon.
Deep learning based automatic grounding line delineation in DInSAR interferograms
Authors: Ramanath Tarekere Sindhu , Krieger Lukas , Floricioiu Dana , Heidler Konrad
Published: March 2024

Abstract. The regular and robust mapping of grounding lines is essential for various applications related to the mass balance of marine ice sheets and glaciers, especially in Antarctica and Greenland. With Differential Interferometric Synthetic Aperture Radar (DInSAR) interferograms, it is possible to accurately capture the tide-induced bending of the ice shelf at a continent-wide scale and a temporal resolution of a few days. While current processing chains typically automatically generate differential interferograms, grounding lines are still primarily identified and delineated on the interferograms by a human operator. This method is time-consuming and inefficient, considering the volume of data from current and future SAR missions. We developed a pipeline that utilizes the Holistically-Nested Edge Detection (HED) neural network to delineate DInSAR interferograms automatically. We trained HED in a supervised manner using 421 manually annotated grounding lines for outlet glaciers and ice shelves on the Antarctic Ice Sheet. We also assessed the contribution of non-interferometric features like elevation, ice velocity and differential tide levels towards the delineation task. Our best-performing network generated grounding lines with a median distance of 186 m from the manual delineations. Additionally, we applied the network to generate grounding lines for undelineated interferograms, demonstrating the network's generalization capabilities and potential to generate high-resolution temporal and spatial mappings.
Impacts of soil storage on microbial parameters
Authors: Fromin Nathalie
Published: March 2024

Abstract. This review aims to determine the impact of soil storage on microbial parameters (abundance/biomass, activity and various diversity metrics). We analysed the literature dealing with the impact of storage practices (cold, freeze, dry, freeze-dry and ambient storage) on soil microbial parameters. A total of 73 articles were included in the analysis, representing 261 basic data (impact of a given storage practice on a microbial parameter). Globally, 74 % of these data showed significant impact of storage on the measured microbial parameters, as compared to those measured on fresh, non-stored soil samples. The storage practices showed various effects on the soil microbial parameters, with sometimes opposite effects across different soil types. For instance, various soil enzyme activities did not respond the same way to storage practices, even in a given soil type. There are currently too few studies to draw recommendations, but some studies suggest that the pedoclimatic context could be useful for choosing the best storage option, with soils that regularly undergo drought or freezing being less impacted by dry and freeze storage, respectively. I conclude that storage practices for soil samples, when unavoidable, should be carefully selected according to conditions that prevail in the native soil environment, to microbial parameters that are analysed (even though there is no consensus for a best practice), and with different storage practices for different microbial parameters if necessary.
North American Pleistocene Glacial Erosion and Thin Pliocene Regolith Thickness Inferred from Data-Constrained Fully Coupled Ice-Climate-Sediment modelling
Authors: Drew Matthew , Tarasov Lev
Published: March 2024

Abstract. Beyond the impact of glacial isostatic adjustment, landscape evolution is typically neglected at large scale when considering the basal boundary condition for ice sheet and climate modelling over past glacial cycles. Erosion and changing sediment loads impact bed elevation, land/sea mask, and basal drag. To date, how the above affects past ice sheet evolution is unclear. Constraining the role that Pliocene regolith may have played in Pleistocene glacial cycle variability requires bounds on the amount of regolith preceding those glacial cycles. However, quantitative bounds on regolith thickness at the spatial scale of the glaciated regions of North America are currently absent in the literature. To address the above, we present an updated sediment production and transport model with dynamically calculated soft sediment mask, isostatic adjustment to dynamical sediment load and bedrock erosion, and a new subglacial hydrology model coupled to the Glacial Systems Model. The coupled model is capable of multi-million year integrations driven only by greenhouse gas concentration and insolation. The model passes a set of verification tests and conserves mass. We assess parametric sensitivity of sediment transport rates. We compare the final sediment solutions in an ensemble of whole-Pleistocene simulations for a range of initial (Pliocene) regolith thicknesses against multiple estimates for present day drift thickness distribution, Quaternary sediment volume in the Atlantic Ocean, and erosion depth estimates. Consistency of modelling and data constraints requires a Pliocene regolith thickness of less than 50 m.
A MAGICC Arctic Sea Ice Emulator
Authors: Chilcott Sian , Meinshausen Malte , Notz Dirk
Published: March 2024

CMIP6 models present our best understanding of the Earth system, yet they currently fail to simulate a plausible evolution of sea ice area to changes in the global-mean temperature. We aim to assess whether correcting the temperature and Arctic Amplification biases between CMIP6 models and observations can simulate a sensitivity of sea ice loss to global warming that is within the plausible range. To do this, we develop an emulator that is calibrated to physically-based CMIP6 models and then constrained to observations. Such a tool efficiently translates the global-mean temperature of a specific year into a physically-based and observationally constrained probabilistic ensemble of SIA in each month. This setup allows our emulator to capture the core physical processes of CMIP6 projections, while capturing the observed sensitivity of sea ice loss to global warming through the observational constraint of Arctic Amplification. While there are many application possibilities of our emulator, we use our model here to probabilistically diagnose the timing of an ice-free Arctic Ocean. We find that under a high (SSP5-8.5), medium (SSP2-4.5) and low (SSP1-2.6) emission scenario, an ice-free September Ocean is ‘likely’ at 1.73 of global warming above the pre-industrial level, however we note that the probability in the lower emission scenario reduces to ‘unlikely’ in the late 21st century as the global temperature partially recovers. Our projections suggest that the probability of an ice-free summer ocean rises rapidly from ‘unlikely’ at 1.5 of global warming to ‘likely’ at 2 of global warming, stressing the importance of preventing global temperatures rising above 1.5, as the probability of losing sea ice coverage in September rises sharply thereafter. For March, we also find that the observational constraints increase the probability of an ice-free ocean under SSP5-8.5, becoming ‘likely’ in early 2200, while the probability remains very low under SSP2-4.5 and SSP1-2.6 as less than 5% of models reach ice-free conditions. Our projections suggest an ice-free summer ocean could occur at 0.5 cooler levels than the CMIP6 multi-model ensemble mean implies. Likewise, our approach suggests the probability of an ice-free Arctic Ocean year-round is increased when constraining the Arctic Amplification to observations.
The effect of land surface characteristics on runoff generation and nitrate fluxes from a Kenyan tea plantation
Authors: Neill Aaron , Jacobs Suzanne , Breuer Lutz , Reaney Sim
Published: March 2024

The conversion of tropical montane forests to commercial plantation agriculture affects both the generation of runoff and nutrient water quality, degrading ecosystem service delivery and impacting downstream freshwater environments. Previous empirical studies have inferred that changes to nitrate dynamics at the catchment scale likely reflect the interplay of local topography and climate, crop characteristics (e.g., type and density), fertiliser usage and soil management practices. However, the relative importance of such factors is not well understood. Through the 20th century, the Mau Forest Complex in Kenya experienced dynamic and rapid land use change, including the conversion of pristine forest to commercial tea and tree plantations. Utilising a unique long-term (2015-2021), high-resolution (10-minute) discharge and nitrate dataset collected for such a plantation (33.3 km2), we developed a simple, semi-distributed conceptual model to disentangle the drivers of runoff generation and nitrate fluxes. Insights from weekly stable water isotope data helped to further constrain simulated flow paths. The model represented the main land surfaces of the plantation (tea, eucalyptus, compacted tracks, and impervious and built surfaces) as a set of conceptual stores. Rainfall inputs were weighted by the proportional area of each surface and, where relevant, fertiliser inputs were estimated based on application rates reported in the literature. Lateral water and nitrate fluxes from each conceptual store to the river were delayed and transformed as a function of the mean distance to the river and slope gradient. The available long-term data combined with the structure of the model allowed the relative contribution of each land surface to runoff and nitrate fluxes to be successfully simulated under a range of local hydroclimatic conditions. These insights provide a valuable knowledge base for optimising fertiliser use and implementing mitigation measures to sustain water quality and ecosystem service delivery under conditions of expanding plantation agriculture. 
Seismicity clusters in the Eastern Alps: New insights from the large-N Swath-D seismic network
Authors: Hofman Rens , Petersen Gesa , Kummerow Jörn , Cesca Simone ,   The AlpArray Swath-D Working Group
Published: March 2024

The installation of the temporary, large-N Swath-D seismic network in the years 2017-2019 (Heit et al., 2021) provided the basis for the recent compilation of a high-resolution, consistently processed seismicity catalogue for the eastern and southern Alps (Hofman et al., 2023). The catalogue contains more than 6,000 earthquakes with magnitudes down to −1.7 ML. In the present study, we analyse in more detail several of the newly detected microseismic clusters in the study area, which includes the most active parts of the Alps as well as particularly quiet regions with very little previously reported seismicity. We combine inter-event waveform similarity clustering, catalogue statistics and rupture mechanisms to characterise the clustered seismicity swarms and mainshock-aftershock sequences. We apply a relative location technique based on differential Ts-Tp arrival times to better resolve the seismogenenic structures. For subgroups of microseismic events with magnitudes Mw 1.2-3.0, we obtain moment tensor solutions using the flexible probabilistic inversion framework Grond, which allows to combine different fitting targets and frequency bands, while providing meaningful estimates of uncertainties (Heimann et al., 2018, Petersen et al., 2021). This adds to resolve subtle, but systematic variations of the inner-cluster seismicity.Thanks to the outstanding network density, we can report a variability of seismic sequences and microseismic event mechanisms across the study area and interpret them with in terms of long-term tectonic and intermediate triggering processes.
Simulated Atlantic Meridional Overturning Circulation in a warmer climate and the linkage with the North Atlantic convection using EC-Earth-HR
Authors: Navarro Labastida René Gabriel , Karami Mehdi Pasha , Koenigk Torben , de Boer Agatha , Sicard Marie
Published: March 2024

This study aims to analyze the effect of increasing atmospheric CO2 concentrations on the Atlantic Meridional Overturning Circulation (AMOC) and its dependence on convection in the  Labrador (LAB) and Greenland (GIN) Seas. We have used EC-Earth3-HR, the high-resolution version of the global coupled climate model EC-Earth3 in this study. EC-Earth3-HR has a resolution of about 0.25 degrees in the ocean and 40 km in the atmosphere. In contrast to the HighResMIP-protocol, EC-Earth3-HR has undergone a tuning process and a multi-centennial spin-up has been performed. The set of experiments analyzed here consists of a pre-industrial control simulation (piControl), a one percent per year increase in CO2 experiment (1pctCO2) branching from year 250 of our piControl simulation, and two experiments with fixed CO2 concentrations (400.9 ppm and 551.5 ppm) branch off from two points corresponding to global temperature anomalies of around 1°C and 2°C in the 1pctCO2 experiment. Here we have defined deep convection as the mean mixed volume in March, with deep convection equal to zero when the mixed-layer is shallower than a critical depth. Our preliminary results suggest that as the climate warms, the North Atlantic waters become warmer and fresher, promoting the weakening of the North Atlantic deep convection and a subsequent reduction in AMOC strength (up to 20% reduction). The simulated overturning circulation weakening seems to be dominated by changes in LAB deep convection with GIN convection contributing less. Circulation changes in the pre-industrial and the different CO2 concentration experiments are dominated by a strong decadal variability. Compared to the standard resolution EC-Earth3-version, the use of a high resolution leads to deeper ocean mixing in LAB and GIN. More analysis has to be done on the way to clarify to what extent increased resolution affects our results in comparison with previous studies.
Is stereo satellite imagery a reliable method to infer geomorphic dynamics in fluvial systems at high spatial resolution and precision?
Authors: Llena Manel , Deschamps-Berger César , Demarchi Luca , Brardinoni Francesco
Published: March 2024

Remote sensing techniques (e.g., SfM photogrammetry, LiDAR) have been proved as a consistent method to reconstruct fluvial landscapes and processes at high temporal and spatial resolutions. Despite the advantages, these methods still presenting some limitations as, for example spatial covering, which usually is limited to 100 km) in one single satellite caption. Several studies have proved the accuracy and precision of this method in various geomorphological contexts, despite this, today there are very few works that study the reliability of these methods in fluvial environments with different degrees of complexity. The main objective of this study is to evaluate the use of stereo satellite imagery as a reliable method to reconstruct the topography of fluvial systems at high spatial resolution, precision, and accuracy. Additionally, we assess the reliability of this method to infer on geomorphic processes through the comparison of multi temporal high-resolution topography. To pursue these objectives two sets of stereo satellite imagery (i.e., DEIMOS and Pleiades) were compared with reference topographic datasets composed of SfM-photogrammetric (i.e., UAV platform) and GNSS-RTK surveys collected at the same time. These datasets were confronted in three different fluvial reaches located in the Marecchia River (Nortern Appennines). Study reaches presented contrasted characteristics in terms of fluvial pattern, active width, confinement, and channel-slope, which cover a wide range of fluvial types of mid-mountain rivers. Residuals between datasets were compared with different morphometric variables (e.g., slope, roughness) and channel characteristics (e.g., water depth).
Effects of different slurry application techniques on Nitrogen Use Efficiency (NUE) in an extensive grassland
Authors: Floßmann Sebastian , Lei Kaiyu , van Grinsven Sigrid , Kögel-Knabner Ingrid , Völkel Jörg , Dannenmann Michael
Published: March 2024

Nitrogen (N) fertilization is essential to increase grassland productivity, but losses of excess N to the environment are causing environmental and health issues such as nitrate contamination and eutrophication of water bodies, greenhouse gas emissions, and impaired soil and air quality.  Especially organic fertilization with cattle slurry is known for high environmental N losses. In that respect, different refined cattle slurry management strategies targeted to increase nitrogen use efficiency (NUE) are legally prescribed. However, a holistic assessment of the nitrogen-related agronomic and environmental impacts is still missing. This study aims to test different slurry application techniques for their effects on NUE, hydrological and gaseous N losses, productivity and fodder quality, soil organic nitrogen formation and total N balances. In a small-scale experiment 15N enriched slurry was applied on 1 m² grassland plots using the following application methods: (1) traditional slurry broadcast spreading under dry weather; (2) application like (1) followed by a heavy rainfall event to increase slurry infiltration into the soil; (3) broadcast spreading of slurry diluted with water; (4) injection of slurry into the soil via shallow slits; and (5) injection of slurry into the soil via deep slits. Variants (4) and (5) represent modern trailing shoe injections requiring extensive machinery. Fates of fertilizer N such as plant uptake, stabilization in soil through microbial immobilization as well as NO3 leaching were investigated by 15N tracing approaches in order to create full fertilizer N balances. Sampling and harvest began 3 months after fertilization with 15N-labeled slurry and first results indicate that both injection treatments lead towards a markedly higher slurry-N retention in the soil compared to broadcast spreading, which was not achieved by slurry dilution and traditional application plus strong irrigation. Based on further isotopic analyses, full fertilizer N balances for the different cattle slurry application techniques will be provided. 