bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hubungan Sikap Keselamatan dengan Implementasi Sasaran Keselamatan Pasien oleh Perawat di Rumah Sakit
Authors: Galleryzki Annisa Rahmi , Hariyati RR Tutik Sri , Afriani Tuti , Rahman La Ode 
Published: May 2021

Keselamatan pasien menjadi tujuan sangat penting dalam pemberian pelayanan kesehatan yang berkualitas. Penelitian bertujuan untuk mengetahui hubungan antara sikap keselamatan dengan implementasi keselamatan pasien di rumah sakit dengan menggunakan standar nasional akreditasi rumah sakit (SNARS). Penelitian merupakan penelitian kuantitatif dengan metodean deskriptif dan cross-sectional. Metode sampling dengan purposive sampling, didapatkan sampel sebanyak 345 orang. Terdapat hubungan signifikan antara sikap keselamatan dengan implementasi keselamatan perawat (r= 0,441, P<0,01). Faktor jenis kelamin, usia, pengalaman kerja, dan jenjang karier secara signifikan berpengaruh pada implementasi keselamatan (P<0,05). Rumah sakit dan manajer perawat memiliki peranan penting dalam meningkatkan keselamatan pasien untuk menghindari terjadinya insiden keselamatan dengan melakukan pemanfaatan sumber daya secara optimal
Pengembangan Literasi Digital Keperawatan Dimasa Pandemi Covid-19: Case Study
Authors: Zaharany Tsania Ayu , Hariyati Rr Tutik Sri , Anisah Siti 
Published: May 2021

Perkembangan teknologi dan informasi saat ini turut andil dalam mengubah pola pikir dan sikap seorang pegawai. Rumah sakit harus mengembangkan SDM dalam menggunakan teknologi digital untuk peningkatan pelayanan kepada masyarakat agar dapat menjadi organisasi yang responsif, inovatif, produktif, efektif, efisien dan berkualita. Studi ini bertujuan untuk mengembangkan program literasi digital di Unit Rawat Jalan dan Unit Rawat Inap Rumah Sakit Jakarta. Studi ini menggunakan studi kasus dengan analisa situasi SWOT. Pengambilan data dilakukan dengan menggunakan teknik purposive sampling dengan metode kuesioner, wawancara dan telaah dokumen. Jumlah partisipan terdiri dari 5 perawat manajer dan 15 perawat pelaksana. Proses studi ini merupakan sebuah proyek inovasi yang sudah memiliki izin dari Rumah Sakit Jakarta. Belum optimalnya peran dan fungsi manajemen keperawatan dalam peningkatan literasi digital meliputi belum ada petunjuk penggunaan digital, SDM beresiko mengalami resistance to change, inovasi dikembangakan dengan panduan dan SPO pelaksanaan literasi digital. Evaluasi didapatkan perubahan signifikan perilaku digital sebanyak 80 % memberikan feedback positif. Pengembangan peningkatan Literasi digital mencakup berbagai faktor diantaranya komponen management centered digital literacy and person centered digital literacy. Rekomendasi dari studi ini dengan penerapan inovasi panduan pengembangan literasi digital dan SOP pengembangan literasi digital terhadap pemberian informasi dan edukasi
The Pembuatan Briket Sebagai Upaya Pemanfaatan Limbah Kulit Durian di Desa Sinduagung Kecamatan Selomerto Kabupaten Wonosobo
Authors: Mahmudati Rina 
Published: May 2021

Desa Sinduagung sebagai sentra penghasil dan penjual durian di Kab. Wonosobo mampu menyediakan durian lokal dan jenis durian dari berbagai daerah di Jawa Tengah, Sumatera dan Jawa Barat. Banyaknya penjualan durian berakibat pada menumpuknya limbah kulit durian yang belum termanfaatkan. Limbah kulit durian yang menumpuk mengakibatkan lingkungan kotor dan bau yang tidak sedap,sehingga apabila diabaikan dapat menyebabkan pencemaran lingkungan, munculnya penyakit dan menurunkan nilai estetika/keindahan kota serta masalah-masalah lainnya. Tujuan dilaksanakannya kegiatan ini untuk membantu masyarakat menjadi kreatif dan mandiri dalam memanfaatkan limbah disekitar lingkungan menjadi sumber energi alternatif dalam bentuk briket. Selain itu, untuk menjaga lingkungan agar selalu bersih dan indah sehingga semakin menarik minat para konsumen, khususnya para pengguna jalan yang melewati daerah ini. Metode kegiatan yang akan dilakukan berupa penyuluhan dan pelatihan mengenai pembuatan briket dari limbah kulit durian. Keluaran dari program pengabdian kepada masyarakat ini adalah meningkatkannya pengetahuan dari anggota masyarakat terhadap pemanfaatan limbah kulit durian sebagai sumber energi alternatif dalam bentuk briket. Selain itu, lingkungan Desa Sinduagung lebih bersih, bebas limbah kulit durian, dan meningkat pendapatan ekonomi keluarga dengan menciptakan wirausaha baru yaitu dengan pembuatan briket dari limbah kulit durian
Screening and Ranking Methodology Applied to Biochars Aimed at Acidic and Calcareous Sandy Soil Improvement
Authors: Farkas Éva , Feigl Viktória , Vaszita Emese , Uzinger Nikolett , Rékási Márk , Gruiz Katalin , Molnár Mónika 
Published: May 2021

The application of biochar (the by-product of biomass pyrolysis), as a soil amendment has been accepted as a sustainable solution to improve soil quality. The current study aims to establish a decision support tool for characterizing, ranking, and selecting biochars of different origins for soil improvement, thereby contributing to the development of a systematic approach, which lacks in the existing literature.The development of a Multi-Criteria Decision Support Approach applying a banded and weighted rating and scoring system allowed the selection and ranking of various biochars suitable for improving sandy soils before application. First, 14 selected, different biochar products (produced from industrial by-products, herbaceous, wood-based and manure-based feedstocks) were characterized with several physicochemical, biological and ecotoxicological methods taking into account both the technological and the environmental efficiency aspects of biochar utilization. Then, a system for the assessment and ranking of biochars for acidic, and calcareous neutral sandy soil improvement was developed, which could be flexibly adapted to different soil problems as well. Based on their performance in the tests, scores from (−5) to (+5) were assigned to each biochar. As a result, the grain husks and paper fiber sludge biochar was ranked as the most suitable for both acidic and neutral calcareous sandy soil improvement, with 55 and 43 scores, respectively (from the maximum 100). The applicability of this innovative multicriteria scoring-ranking system, as a tool for potential biochar users, was verified in microcosms and field-scale experiments, demonstrating the positive influence of this biochar on the acidic sandy soil.
NIR-II Upconversion Photoluminescence of Er3+ Doped LiYF4 and NaY(Gd)F4 Core-Shell Nanoparticles
Authors: Feng Qilong , Zheng Wenjing , Pu Jie , Chen Qiaoli , Shao Wei 
Published: May 2021

The availability of colloidal nano-materials with high efficiency, stability, and non-toxicity in the near infrared-II range is beneficial for biological diagnosis and therapy. Rare earth doped nanoparticles are ideal luminescent agents for bio-applications in the near infrared-II range due to the abundant energy level distribution. Among them, both excitation and emission range of Er3+ ions can be tuned into second biological window range. Herein, we report the synthesis of ∼15 nm LiYF4, NaYF4, and NaGdF4 nanoparticles doped with Er3+ ions and their core-shell structures. The luminescent properties are compared, showing that Er3+ ions with single-doped LiYF4 and NaYF4 nanoparticles generate stronger luminescence than Er3+ ions with doped NaGdF4, despite the difference in relative intensity at different regions. By epitaxial growth an inert homogeneous protective layer, the surface luminescence of the core-shell structure is further enhanced by about 5.1 times, 6.5 times, and 167.7 times for LiYF4, NaYF4, and NaGdF4, respectively. The excellent luminescence in both visible and NIR range of these core-shell nanoparticles makes them potential candidate for bio-applications.
Plasma Amino Acids and Residual Hypertriglyceridemia in Diabetic Patients Under Statins: Two Independent Cross-Sectional Hospital-Based Cohorts
Authors: Wang Shuang , Cao Yun-Feng , Sun Xiao-Yu , Hong Mo , Fang Zhong-Ze , Luo Hui-Huan , Sun Huan , Yang Ping 
Published: May 2021

Objective: The objective of the study was to investigate the relationship of amino acid metabolism with hypertriglyceridemia in diabetic patients under statins free of prior cardiovascular diseases.Methods: Two independent cross-sectional hospital based cohorts, i.e., Liaoning Medical University First Affiliated Hospital (LMUFAH, n = 146) and the Second Affiliated Hospital of Dalian Medical University (SAHDMU, n = 294) were included in the current analysis. Hypertriglyceridemia was defined as triglyceride ≥1.7 mmol/L, and well-controlled LDL-C was defined as &lt;2.6 mmol/L. The adjusted ORs (95% CI) of circulating metabolic measures for hypertriglyceridemia were assessed using logistic regression. Pooled results of metabolites with the same direction of association in both cohorts were combined using inverse variance-weighted fixed-effect meta-analysis. Difference of identified metabolites in patients with and without hypertriglyceridemia were also obtained in the context of LDL-C.Results: Patients, 86 and 106, were with hypertriglyceridemia in LMUFAH and SAHDMU, respectively. We observed that elevated alanine, asparagine, leucine, and valine were consistently associated with increased hypertriglyceridemia in both cohorts. In fixed-effect pooled analysis, the OR (95% CI) per SD increase was 1.71 (1.32–2.20) for alanine, 1.62 (1.20–2.19) for asparagine, 1.64 (1.22–2.20) for leucine, and 1.62 (1.22–2.13) for valine (all P values ranged from 0.0018 to &lt;0.0001); adjusting for C-peptide attenuated effect sizes of Ala, Leu, and Val for hypertriglyceridemia. The difference were robust in groups with well- or bad-controlled LDL-C.Conclusion: Among 23 amino acids, alanine, asparagine, leucine, and valine were positively associated with increased residual risk of hypertriglyceridemia in diabetic patients with statin treatment.
Provenance and Climatic Implications of the Middle-Pleistocene Loess Deposit, Southern China
Authors: Fan Qingbin , Liao Jie , Li Yan , Ye Wei , Wang Tao , Feng Xiao 
Published: May 2021

The middle-Pleistocene Xiashu loess deposit in the lower reaches of the Yangtze River (LRYR), southern China, may yield evidence with significant climatic and environmental significance. However, its provenance remains controversial. In this study, grain size analysis, and quartz grain surface microtextural and morphological observations, enabled comparison of the provenance of loess in the LRYR with those on the Loess Plateau in northern China. The results show that the grain size characteristics of the Xiashu loess do not follow the coarse-fine NW-SE trend in northern China, and the surface microtextures of the quartz grains in the Xiashu loess are distinctly different from those on the Loess Plateau in northern China, indicating that the loess deposits in the two regions have different provenances. The Gobi Desert in inland northwestern China are not considered as the primary provenance of the Xiashu loess. Instead, the adjacent floodplains in the LRYR, the alluvial plains of the Huai River and the Yellow River to the north during glacial periods are suggested as the dominant source materials for the Xiashu loess. Under the background of middle-Pleistocene climate transition (MPT), regional aridity and a strengthened east Asian winter monsoon (driven by global cooling and the rapid uplift of the Tibetan Plateau) were considered as the primary drivers for the development of the Xiashu loess. The sustained eolian loess accumulation represent a regional response of the northern subtropical area of southern China to the MPT global cooling event at around 0.9 Ma.
Familial Acromegaly and Bilateral Asynchronous Pheochromocytomas in a Female Patient With a MAX Mutation: A Case Report
Authors: Mamedova Elizaveta , Vasilyev Evgeny , Petrov Vasily , Buryakina Svetlana , Tiulpakov Anatoly , Belaya Zhanna 
Published: May 2021

BackgroundThere are very few cases of co-occurring pituitary adenoma (PA) and pheochromocytomas (PCC)/paragangliomas caused by MAX mutations. No cases of familial PA in patients with MAX mutations have been described to date.Case PresentationWe describe a 38-year-old female patient, presenting with clinical and biochemical features of acromegaly and PCC of the left adrenal gland. Whole-exome sequencing was performed [NextSeq550 (Illumina, San Diego, CA, USA)] identifying a nonsense mutation in the MAX gene (NM_002382) [c.223C&gt;T (p.R75X)]. The patient had a medical history of PCC of the right adrenal gland diagnosed aged 21 years and prolactinoma diagnosed aged 25 years. Cabergoline treatment was effective in achieving remission of prolactinoma at age 33 years. The patient’s father who died at age 56 years of a heart attack had a medical history of PA and prominent acromegalic features, which supports the familial presentation of the disease.ConclusionThis clinical case gives an insight into the clinical presentation of familial PA and PCC probably associated with a MAX mutation.
Acceleration of Load Changes by Controlling the Operating Parameters in CFB Co-Combustion
Authors: Peters Jens , Langner Eric , Ströhle Jochen , Epple Bernd 
Published: May 2021

The integration of intermittent renewable energy sources into the electricity market requires flexible and efficient technologies that compensate for the fluctuating electricity demand. A circulating fluidized bed (CFB) boiler is a suitable solution due to its fuel flexibility, but the thermal inertia of the fluidized bed can have negative effects on the load following capabilities. This study investigates the influence of the operating parameters of the fire side on the speed of load changes on the waterside. Co-combustion of lignite, straw, and refuse derived fuel (RDF) was carried out. In a 1 MWth pilot CFB combustor fifteen load changes were performed with a varying step input of the primary air, the secondary air, and the fuel mass flow. The step input of the primary air had a large influence on the load ramps, as it strongly affects the solids concentration in the upper furnace. The step size of the fuel mass flow had a positive effect on the load change rate. Based on the results, concepts were developed to accelerate load ramping by controlling the hydrodynamic conditions and the temperature on the fireside.
Risk Stratification Score to Predict Readmission of Patients With Acute Decompensated Cirrhosis Within 90 Days
Authors: Xu Xiaomei , Tan Juntao , Wang Haolin , Zhao Wenlong , Qin Bo 
Published: May 2021

Background and Aims: Patients with acute decompensated (AD) cirrhosis are frequently readmitted to the hospital. An accurate predictive model for identifying high-risk patients may facilitate the development of effective interventions to reduce readmission rates.Methods: This cohort study of patients with AD cirrhosis was conducted at six tertiary hospitals in China between September 2012 and December 2016 (with 705 patients in the derivation cohort) and between January 2017 and April 2020 (with 251 patients in the temporal validation cohort). Least absolute shrinkage and selection operator Cox regression was used to identify the prognostic factors and construct a nomogram. The discriminative ability, calibration, and clinical net benefit were evaluated based on the C-index, area under the curve, calibration curve, and decision curve analysis. Kaplan–Meier curves were constructed for stratified risk groups, and log-rank tests were used to determine significant differences between the curves.Results: Among 956 patients, readmission rates were 24.58, 42.99, and 51.78%, at 30, 60, and 90 days, respectively. Bacterial infection was the main reason for index hospitalization and readmission. Independent factors in the nomogram included gastrointestinal bleeding [hazard rate (HR): 2.787; 95% confidence interval (CI): 2.221–3.499], serum sodium (HR: 0.955; 95% CI: 0.933–0.978), total bilirubin (HR: 1.004; 95% CI: 1.003–1.005), and international normalized ratio (HR: 1.398; 95% CI: 1.126–1.734). For the convenience of clinicians, we provided a web-based calculator tool (https://cqykdx1111.shinyapps.io/dynnomapp/). The nomogram exhibited good discrimination ability, both in the derivation and validation cohorts. The predicted and observed readmission probabilities were calibrated with reliable agreement. The nomogram demonstrated superior net benefits over other score models. The high-risk group (nomogram score &gt;56.8) was significantly likely to have higher rates of readmission than the low-risk group (nomogram score ≤ 56.8; p &lt; 0.0001).Conclusions: The nomogram is useful for assessing the probability of short-term readmission in patients with AD cirrhosis and to guide clinicians to develop individualized treatments based on risk stratification.
Core Values of Family Physicians and General Practitioners in the African Context
Authors: Lawson Henry J. O. , Nortey David N. N. 
Published: May 2021

Introduction: Family Medicine is a growing specialty in the medical world. While it is expected that the specialty should have its own unique and established core values and tasks, the breath of the practice in several countries of the world has made this a daunting task. Core values and Tasks have far reaching effects on professions. They guide development of curricula, methods of instruction, standards of performance and even the culture of the profession. We aimed to explore the core value system of Family Physicians and General Practitioners practicing in Africa.Methods: Using the Delphi technique, a purposive selection of African Family Medicine practitioners in academia, public service, private practice and clinical training across Central, East, North, South and West Africa was conducted. Participants were asked to select five core values from an alphabetically collated global list of 29 core values in an online survey. The five most selected core values were collated and sent out in the second round to the participants to rank in order of importance.Results: Practitioners from nine African countries in three out of the five United Nations subregions of Africa completed the study. The first round of the study saw participation of a team of nineteen experts who selected the following five core values—Comprehensive care, Continuity of Care, Collaborative Care, Patient centered care, and Life-long learning.Discussion/Conclusion: The core values selected were not very different from global literature. These core values should guide the development of curricula, standardization of training methods and creation of benchmarks for standards of practice for the specialty in Africa.
Association Between Postoperative Long-Term Heart Rate Variability and Postoperative Delirium in Elderly Patients Undergoing Orthopedic Surgery: A Prospective Cohort Study
Authors: Sun Jiaduo , Zhang Qingguo , Lin Baojia , He Mengjiao , Pang Yimin , Liang Qibo , Huang Zhibin , Xu Ping , Que Dongdong , Xu Shiyuan 
Published: May 2021

BackgroundPostoperative delirium (POD) is a common complication after orthopedic surgery in elderly patients. The elderly may experience drastic changes in autonomic nervous system (ANS) activity and circadian rhythm disorders after surgery. Therefore, we intend to explore the relationship between postoperative long-term heart rate (HR) variability (HRV), as a measure of ANS activity and circadian rhythm, and occurrence of POD in elderly patients.MethodsThe study population of this cohort was elderly patients over 60 years of age who scheduled for orthopedic surgery under spinal anesthesia. Patients were screened for inclusion and exclusion criteria before surgery. Then, participants were invited to wear a Holter monitor on the first postoperative day to collect 24-h electrocardiographic (ECG) data. Parameters in the time domain [the standard deviation of the normal-to-normal (NN) intervals (SDNN), mean of the standard deviations of all the NN intervals for each 5-min segment of a 24-h HRV recording (SDNNI), and the root mean square of successive differences of the NN intervals (RMSSD)] and frequency domain [heart rate (HR), high frequency (HF), low frequency (LF), very low frequency (VLF), ultra low frequency (ULF), and total power (TP)] were calculated. Assessment of delirium was performed daily up to the seventh postoperative day using the Chinese version of the 3-Min Diagnostic Interview for CAM-defined Delirium (3D-CAM). The relationship between HRV and POD, as well as the association between HRV and duration of POD, was assessed.ResultsOf the 294 cases that finally completed the follow-up, 60 cases developed POD. Among the HRV parameters, SDNNI, VLF, and ULF were related to the occurrence of POD. After adjustment for potential confounders, the correlation between HRV indices and POD disappeared. Through stratified analysis, two significant negative correlations emerged: ULF in young-old participants and SDNNI, VLF, and ULF in male patients.ConclusionThe lower HRV parameters may be related to the occurrence of POD, and this correlation is more significant in young-old and male patients. ANS disorders and rhythm abnormalities reflected by HRV changes may represent a possible mechanism that promotes POD.
Use of a Smartphone Application to Speed Up Interhospital Transfer of Acute Ischemic Stroke Patients for Thrombectomy
Authors: Tsai Sheng-Ta , Wang Wei-Chun , Lin Yu-Ting , Huang Wei-Shih , Huang Hung-Yu , Wang Chun-Ju , Lin En-Zu , Kung Wei-Ling , Guo Yuh-Cherng , Lin Kang-Hsu , Lu Ming-Kuei , Yen Pao-Sheng , Chen Wei-Laing , Tseng Ying-Lin , Kuo Chin-Chi , Cho Der-Yang , Chen Chun-Chung , Tsai Chon-Haw 
Published: May 2021

Background: In most countries, large cerebral artery occlusion is identified as the leading cause of disability. In 2015, five large-scale clinical trials confirmed the benefit of intra-arterial thrombectomy. However, thrombectomy is a highly technical and facility-dependent procedure. Primary stroke centers need to transfer patients to comprehensive stroke centers to perform thrombectomy. The time-lapse during interhospital transfer would decrease the chance of the patient's proper recovery. Communication barriers also contribute to this delay.Aims: We used a smartphone application to overcome communication barriers between hospitals. We aimed to shorten the door-to-puncture time of interhospital transfer patients.Methods: We began using a smartphone application, “LINE,” to facilitate interhospital communication on May 01, 2018. We carried out retrospective data analyses for all the transfer patients (n = 351), with the primary outcome being the door-to-puncture time in our comprehensive stroke center (China Medical University Hospital). We compared the three periods: May 01 to Dec 31, 2017 (before the use of the smartphone application); May 01 to Dec 31, 2018 (the 1st year of using the smartphone application); and May 01 to Dec 31, 2019 (the 2nd year of using the smartphone application). We also compared the transfer data with non-transfer thrombectomies in the same period.Results: We compared 2017, 2018, and 2019 data. The total number of transfer patients increased over the years: 63, 113, 175, respectively. The mean door-to-puncture time decreased significantly, going from 109, through 102, to 92 min. Meanwhile, the mean door-to-puncture time in non-transfer patients were 140.3, 122.1, and 129.3 min. The main reason of time saving was the change of the way of communication, from point-to-point interhospital communication to hub-to-spoke interhospital communication.Conclusions: We used this smartphone application to enhance interhospital communication, changed from the point-to-point to hub-to-spoke method. It made us overcome the communication barrier and build up interhospital connection, thus shortening the door-to-puncture time. Our experience demonstrated the importance of close communication and teamwork in hyperacute stroke care, especially in interhospital transfer for thrombectomy.