bluuebunny/crossref_metadata_2025_split huggingface dataset:
PENERAPAN PICTURE AND PICTURE TERHADAP PEMAHAMAN MATERI PERSAMAAN KEDUDUKAN WARGA NEGARA INDONESIA DAN BUDAYA PADA MATA PELAJARAN PKn SISWA KELAS X AP 3 SMK SWAKARYA BINJAI
Authors: Feronika Ema Sri , Manurung Ismail 
Published: March 2021

Adapun tujuan penelitian ini adalah untuk meningkatkan hasil belajar siswa pada mata pelajaran PKn dengan menerapkan Metode Pembelajaran Picture and Picture di kelas X AP 3 SMK SWAKARYA BINJAI. Subjek penelitian ini adalah seluruh siswa kelas X AP 3 SMK SWAKARYA BINJAI yang berjumlah 34 orang. Adapun metode penelitian ini adalah penelitian tindakan kelas. Instrumen penelitian ini terdiri d ari lembar observasi, dan lembaran tes. Data tes dianalisis dengan menggunakan nilai rata-rata dan persentase ketuntasan belajar, sedangkan data observasi dianalisis dengan rata-rata skor, skor tertinggi, skor terendah, selisih skor dan kisaran untuk tiap kriteria. Adapun temuan penelitian ini adalah aktivitas guru pada siklus I diperoleh rata-rata skor 30,5 dengan kriteria baik dan pada siklus II rata-rata skor aktivitas guru meningkat menjadi 33 dengan kriteria baik. Untuk aktivitas siswa pada siklus I diperoleh rata-rata skor 23 dengan kriteria cukup dan pada siklus II ratar-ata skor aktivitas siswa meningkat menjadi 30,5 kemudian untuk hasil data tes siklus I mendapat nilai rata-rata 6,46 dengan ketntuasan klasikal 50% dan untuk siklus II diperoleh nilai rata-rata 8,06 dengan ketuntasan belajar klasik 184,61%. Berdasarkan hasil penelitian tersbeut dapat disimpulan bahwa melalui metode pembelajaran Picture and Picture dapat meningkatkan hasil belajar siswa serta dapat meningkatkan aktivitas guru dan siswa dalam proses pembelajaran PKn khususnya di kelas X AP 3 SMK SWAKARYA BINJAI. Berdasrkan hasil penerapan dengan model pembelajaran picture and picture dapat dijadikan bahan acuan untuk mengadakan peneltian selanjutnya dari sudut permasalahan yang berbeda. Selain itu dapat diimplementasikan sebagai bahan kajian pendekatan pembelajaran bagi guru untuk diterapkan di kelas X AP 3 SMK SWAKARYA BINJAI sebagai alternative model pembelajaran.
25 au Angular Resolution Observations of HH 211 with ALMA: Jet Properties and Shock Structures in SiO, CO, and SO
Authors: Jhan Kai-Syun , Lee Chin-Fei 
Published: March 2021

Abstract
HH 211 is a highly collimated jet with a chain of knots and a wiggle structure on both sides of a young Class 0 protostar. We used two epochs of Atacama Large Millimeter/submillimeter Array (ALMA) data to study its inner jet in the CO(J = 3–2), SiO(J = 8–7), and SO(N

J
= 89–78) lines at ∼25 au resolution. With these ALMA and previous 2008 Submillimeter Array data, the proper motion of 8 knots within ∼250 au of the central source is found to be ∼0068 per year (∼102 km s−1), consistent with previous measurements in the outer jet. At about four times higher resolution, the reflection-symmetric wiggle can be still fitted by a previously proposed orbiting jet source model. Previously detected continuous structures in the inner jet are now resolved, containing at least 5 subknots. These subknots are interpreted in terms of a variation in the ejection velocity of the jet with a period of ∼4.5 yr, shorter than that of the outer knots. In addition, backward and forward shocks are resolved in a fully formed knot, BK3, and signatures of internal working surface and sideways ejection are identified in position–velocity diagrams. In this knot, low-density SO and CO layers are surrounded by a high-density SiO layer.
Platelet Augmentation Potential of Polyherbal Formulation in Cyclophosphamide-Induced&nbsp;Thrombocytopenia in Wistar Rats
Authors: Sailor Girish , Hirani Komal , Parmar Ghanshyam , Maheshwari Rajesh , Singh Rupa , Kumar Seth Avinash 
Published: March 2021

Introduction: Thrombocytopenia is a condition characterized by abnormally low levels of thrombocytes, also known as platelets, in the blood. Several medicinal plants possess curative and protective effect against thrombocytopenia associated with diseases or drugs.
Aim: In the present study, we have investigated the platelet augmentation activity of polyherbal formulation (VITA PLAT Capsule) in cyclophosphamide-induced thrombocytopenic rat model.&nbsp;
Materials and methods: Twenty-four albino Wistar rats were divided into four groups. Thrombocytopenia was induced in the rats by administering cyclophosphamide (25 mg/kg, i.p.) for three days to all the groups except normal controls. The test groups were given orally a polyherbal formulation suspended in normal saline for 14 days. Blood was withdrawn from the retro-orbital plexus of the rats on days 1, 7, and 14 of study to determine platelet counts in all groups. Clotting time and bleeding time were determined on the last day of study. Data were collected and analyzed using GraphPad Prism 8.&nbsp;
Results: The results showed that the polyherbal formulation treatment could significantly ameliorate platelet count in thrombocyto-penic rats in the initial as well as in the later phase. The total WBC count was also improved during later phase in test groups. However, there is no significant difference between clotting time and bleeding time in all groups.&nbsp;
Conclusions: Our study suggests a potential role of this formulation in the augmentation of platelet counts in various thrombocyto-penic disorders including a role in ameliorating the haemorrhagic complications of dengue fever.
Microwave and Conventional Study of Coumarin-Oxadiazole Adducts and their Anti-Microbial Evaluation
Authors: Kapadiya Khushal , Dholaria Piyush 
Published: March 2021

Introduction: Nowadays, researchers are progressively concentrated to generate economical, affordable and also greener synthesis approach for the synthesis of various heterocycles. On look at the beauty of coumarin molecules and oxazoles, it seems to be lead &nbsp;molecules in the anti-microbial area.&nbsp;
Aim: With the target to identify efficient molecules, we studied 2-oxo-2H-chromen-4-yl-2-((5-substituted aryl-1,3,4-oxadiazol-2-yl) thio)acetate derivatives using two synthetic protocol/methods, i.e. conventional synthesis and microwave-based synthesis.
Materials and methods: Two simultaneous methods, i.e. conventional and microwave synthesis have been used for the synthe-sis of 2-oxo-2H-chromen-4-yl-2-((5-substituted aryl-1,3,4-oxadiazol-2-yl)thio)acetate (6a-l) derivatives. The desired molecules were synthesized by conventional and microwave synthesis and a comparative study was carried out to identify an easy route for industrial applications. The confirmations of the compounds were carried out by spectroscopic techniques such as IR, 1H NMR, 13C NMR, mass spectra and elemental analysis.&nbsp;
Results: All synthesized compounds were evaluated for their in-vitro antibacterial activity against gram-positive bacteria (Staphylococcus aureus, Staphylococcus pyogenes), gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa), and antifungal activity (Candida albicans, Aspergillus niger).&nbsp;
Conclusions: All conventional synthesis of final coumarin derivatives were completed within 4-6 h. While that of microwave-based reaction took comparatively more reaction time. Surprisingly, the compounds 6f and 6g could not be synthesized by microwave radiation even after 32 minutes of irradiation. As to the medicinal application part, microbial evaluation of synthesized analogues showed that the compounds 6b, 6e, 6d, and 6j were found more potent in comparison to the reference drug.&nbsp;
Tunnelled hemodialysis catheter-related bloodstream infection with Ochrobactrum anthropi: a report of the first two cases from Bulgaria and a brief overview
Authors: Borisov Biser K. , Hitkova Hristina Y. , Linkova Stela P. 
Published: March 2021

The use of central venous catheters for hemodialysis continues to grow worldwide, despite the efforts of many specialists. Patients with end-stage renal disease have impaired immunity, which is why infections are the most common complication seen in them. It worsens their quality of life and is a major cause of high morbidity and mortality, especially in hemodialysis patients.
We report two cases of catheter-related bloodstream infection in hemodialysis patients caused by Ochrobactrum anthropi, which are the first reported cases in Bulgaria and present a brief literature review of the known facts.
Efficacy and safety of Aviron Rapid&reg; in 18-60-year-old patients with clinical diagnosis of acute respiratory viral infection: a multicenter, randomized, double-blind, placebo-controlled clinical trial
Authors: Popov Georgi , Gospodinova-Bliznakova Margarita , Kalvatchev Zlatko , Tchorbanov Andrey 
Published: March 2021

Aim: Prevention and treatment of upper respiratory tract infections are given the highest priority because of the tremendous health and economic impact of these diseases. Development of novel effective and safe options for treatment can contribute considerably to decrease the burden of disease.
Materials and methods: We designed a multicenter, randomized, double-blind, placebo-controlled study in ambulatory-treated adult patients with a clinical diagnosis of acute upper respiratory tract viral infection. The patients (18-60 years old) were randomized into two groups and followed-up for 5 days. Group 1 received the standard symptomatic therapy + Aviron Rapid&reg;, and Group 2 received the standard symptomatic therapy + placebo. The primary endpoint of the study was defined as the duration of disease measured by the percentages of disease-free patients for every 12-hour period of the study.&nbsp;
Results: Treating clinically relevant patients with the natural product Aviron Rapid&reg; for 5 days decreases the duration of disease, the intake of antipyretics and the severity of symptoms. Significant difference between the tested groups for most of studied parameters was found as soon as 12 or 24 hours after initiation of administration in favour of active arm and was the most prominent on days 3 and 4. Significant decrease in the total score of symptoms severity was achieved on day 4 and extended to the end of study. There were no dif-ferences in the adverse events between the groups and the tested product demonstrated excellent safety profile.&nbsp;
Conclusions: This study is a clinical confirmation of well documented antiviral activity of the product targeting multiple points in viral replication and covering broad spectrum viral pathogens.
Composite Measures for Routine Clinical Practice in Psoriatic Arthritis:
Testing of Shortened Versions in a UK Multicenter Study
Authors: Tillett William , FitzGerald Oliver , Coates Laura C. , Packham Jon , Jadon Deepak R. , Massarotti Marco , Brook Mel , Lane Suzanne , Creamer Paul , Antony Anna , Korendowych Eleanor , Rambojun Adwaye , McHugh Neil J. , Helliwell Philip S. 
Published: March 2021

Objective
To test shortened versions of the psoriatic arthritis (PsA)
composite measures for use in routine clinical practice.

Methods
Clinical and patient-reported outcome measures (PROMs) were
assessed in patients with PsA at 3 consecutive follow-up visits in a UK
multicenter observational study. Shortened versions of the Composite
Psoriatic Arthritis Disease Activity Index (CPDAI) and Group for
Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)
Composite Exercise (GRACE) measures were developed using PROMs and
tested against the Disease Activity Score in 28 joints (DAS28),
composite Disease Activity in Psoriatic Arthritis, and Routine
Assessment of Patient Index Data (RAPID3). Discrimination between
disease states and responsiveness were tested with the
t-score, standardized response mean
(SRM), and effect size (ES). Data were presented to members at the
GRAPPA 2020 annual meeting and members voted on the recommended
composite routine practice.

Results
The SRM for the GRACE, 3 visual analog scale (VAS), and 4VAS were
0.67, 0.77, and 0.63, respectively, and for CPDAI and shortened CPDAI
(sCPDAI) were 0.54 and 0.55, respectively. Shortened versions of the
GRACE increased the t-score from 7.8 to 8.7
(3VAS) and 9.0 (4VAS), but reduced the
t-score in the CPDAI/sCPDAI from 6.8 and 6.1.
The 3VAS and 4VAS had superior performance characteristics to the
sCPDAI, DAS28, Disease Activity in Psoriatic Arthritis, and RAPID3 in
all tests. Of the members, 60% agreed that the VAS scales contained
enough information to assess disease and response to treatment, 53%
recommended the 4VAS for use in routine care, and 26% the 3VAS, while
leaving 21% undecided.

Conclusion
Shortening the GRACE to VAS scores alone enhances the ability to
detect status and responsiveness and has the best performance
characteristics of the tested composite measures. GRAPPA members
recommend further testing of the 3VAS and 4VAS in observational and
trial datasets.
Daytime-to-Nighttime Sleep Ratios and Cognitive Impairment in Older Intensive Care Unit Survivors
Authors: Elías Maya N. , Munro Cindy L. , Liang Zhan 
Published: March 2021

Background
Sleep duration and proportion of daytime versus nighttime sleep may affect cognitive function in older patients in the transition out of the intensive care unit.

Objective
To explore the relationship between the daytime-to-nighttime sleep ratio and cognitive impairment in older intensive care unit survivors.

Methods
The study enrolled 30 older adults within 24 to 48 hours after intensive care unit discharge. All participants were functionally independent before admission and underwent mechanical ventilation in the intensive care unit. Actigraphy was used to estimate daytime (6 AM to 9:59 PM) and nighttime (10 PM to 5:59 AM) total sleep duration. Daytime-to-nighttime sleep ratios were calculated by dividing the proportion of daytime sleep by the proportion of nighttime sleep. The National Institutes of Health Toolbox Cognition Battery Dimensional Change Card Sort Test (DCCST) was used to assess cognition. Associations between sleep and cognition were explored using multivariate regression after adjusting for covariates.

Results
The mean (SD) daytime sleep duration was 7.55 (4.30) hours (range, 0.16-14.21 hours), and the mean (SD) nighttime sleep duration was 4.99 (1.95) hours (range, 0.36-7.21 hours). The mean (SD) daytime-to-nighttime sleep ratio was 0.71 (0.30) (range, 0.03-1.10). Greater daytime sleep duration (β = −0.351, P = .008) and higher daytime-to-nighttime sleep ratios (β = −0.373, P = .008) were negatively associated with DCCST scores.

Conclusions
The daytime-to-nighttime sleep ratio was abnormally high in the study population, revealing an altered sleep/wake cycle. Higher daytime-to-nighttime sleep ratios were associated with worse cognition, suggesting that proportionally greater daytime sleep may predict cognitive impairment.
Manual vs Automatic Prone Positioning and Patient Outcomes in Acute Respiratory Distress Syndrome
Authors: Morata Lauren , Sole Mary Lou , Guido-Sanz Frank , Ogilvie Carrie , Rich Rebecca 
Published: March 2021

BackgroundProne positioning is a standard treatment for moderate to severe acute respiratory distress syndrome (ARDS), but the outcomes associated with manual versus automatic prone positioning have not been evaluated.ObjectiveTo retrospectively evaluate outcomes associated with manual versus automatic prone positioning as part of a pronation quality improvement project implemented by a multidisciplinary team.MethodsA retrospective, descriptive-comparative approach was used to analyze data from 24 months of a prone positioning protocol for ARDS. The study involved 37 patients, with 16 undergoing manual and 21 undergoing automatic prone positioning. Descriptive and nonparametric statistical analyses were used to evaluate outcomes associated with manual versus automatic prone positioning.ResultsOutcomes were similar between the 2 groups regarding time to initiation of prone positioning, discharge disposition, and length of stay. Manually pronated patients were less likely to experience interruptions in therapy (P = .005) and complications (P = .002). Pressure injuries were the most common type of complication, with the most frequent locations in automatically pronated patients being the head (P = .045), thorax (P = .003), and lower extremities (P = .047). Manual prone positioning resulted in a cost avoidance of $78 617 per patient.ConclusionManual prone positioning has outcomes similar to those of automatic prone positioning with less risk of interruptions in therapy, fewer complications, and lower expense. Further research is needed to determine whether manual prone positioning is superior to automatic prone positioning in patients with ARDS.
Key Elements of the Critical Care Work Environment Associated With Burnout and Compassion Satisfaction
Authors: Kelly Lesly A. , Johnson Karen L. , Bay R. Curtis , Todd Michael 
Published: March 2021

Background
As the role of a health care system’s influence on nurse burnout becomes better understood, an under-standing of the impact of a nurses’ work environment on burnout and well-being is also imperative.

Objective
To identify the key elements of a healthy work environment associated with burnout, secondary trauma, and compassion satisfaction, as well as the effect of burnout and the work environment on nurse turnover.

Methods
A total of 779 nurses in 24 critical care units at 13 hospitals completed a survey measuring burnout and quality of the work environment. Actual unit-level data for nurse turnover during a 5-month period were queried and compared with the survey results.

Results
Among nurses in the sample, 61% experience moderate burnout. In models controlling for key nurse characteristics including age, level of education, and professional recognition, 3 key elements of the work environment emerged as significant predictors of burnout: staffing, meaningful recognition, and effective decision-making. The latter 2 elements also predicted more compassion satisfaction among critical care nurses. In line with previous research, these findings affirm that younger age is associated with more burnout and less compassion satisfaction.

Conclusions
Efforts are recommended on these 3 elements of the work environment (staffing, meaningful recognition, effective decision-making) as part of a holistic, systems-based approach to addressing burnout and well-being. Such efforts, in addition to supporting personal resilience-building activities, should be undertaken especially with younger members of the workforce in order to begin to address the crisis of burnout in health care.
Rapid Mortality Review in the Intensive Care Unit: An In-Person, Multidisciplinary Improvement Initiative
Authors: Schwab Kristin E. , Simon Wendy , Yamamoto Myrtle , Dermenchyan Anna , Xu Xueqing , Kao Yuhan , Zider Alexander , Shaikh Faisal , Garber Bryan , Lee Elinor , Anklesaria Zafia , Nelson G. Sofia , Ramsey Allison , Neville Thanh H. 
Published: March 2021

Background
Significant resources have been allocated to decreasing the number of preventable deaths in hospitals, but identifying preventable factors and then leveraging them to effect system-wide change remains challenging.

Objective
To determine the ability of a novel in-person, multidisciplinary “rapid mortality review” process to identify deaths that are preventable and action items that lead to improvements in care.

Methods
Rapid mortality review sessions were conducted weekly for patients who died in the medical intensive care unit. Patient data and clinician opinions regarding preventable deaths were discussed and recorded. Bivariate analyses were done to detect associations between case variables and the formation of an action item.

Results
From 2013 to 2018, 542 patient deaths were reviewed; of those, 36 deaths (7%) were deemed potentially preventable. Facilitators identified issues in 294 cases (54%). A total of 253 action items were identified for 175 cases (32%); 60% of those action items were subsequently completed and led to tangible systemic change in 29 instances (11%). Action items were more likely to be identified for patients who had not been receiving comfort care (P &lt; .001), for patients who had received cardiopulmonary resuscitation (P &lt; .001), when the treatment team (P &lt; .001) or the rapid mortality review facilitator (P &lt; .001) had care-related concerns, and when the patient’s death had been preventable (P &lt; .001).

Conclusions
Even in settings with low reported rates of preventable deaths, an in-person multidisciplinary mortality review can successfully identify areas where care can be improved, leading to systemic change.
The effects of Benjakul extract and its isolated compounds on cell cycle arrest and apoptosis in human non-small cell lung cancer cell line NCI-H226
Authors: Itharat Arunporn , Rattarom Ruchilak , Hansakul Pintusorn , Sakpakdeejaroen Intouch , Ooraikul Buncha , Davies Neal M. 
Published: March 2021

Background and purpose:
Benjakul, a traditional Thai formulation for cancer treatment, is composed of five plants. This study aimed to assess the cytotoxicity of Benjakul, its five plants, and its isolated compounds against non-small cell lung cancer (NSCLC) by the sulforhodamine B (SRB) assay.

Experimental approach:
Analyses of cell cycle and membrane asymmetry changes were performed with different fluorescent dyes and analyzed by flow cytometry in NCI-H226 cells. Activation of caspase-3 was measured using a caspase-3 colorimetric assay kit. The pan-caspase inhibitor Z-VAD-FMK was used in analyses of cell cycle and caspase-3 activity.

Findings/Results:
Benjakul exhibited cytotoxicity against NSCLC with IC50 between 5.56-5.64 μg/mL. Among its five ingredients, Benjakul displayed the highest selectivity with selectivity index values ranging from 2.93 to 6.88, with the exception of Plumbago indica, indicating its protective effects. Plumbagin and 6- shogaol displayed the highest cytotoxicity and underwent molecular studies in NCI-H226 cells. Flow cytometry analysis revealed that Benjakul and 6-shogaol dose-dependently induced G2/M phase arrest, and plumbagin dose-dependently induced S-G2/M phase arrest with the highest percentage in early incubation time (12-24 h). At the highest doses, Benjakul extract, 6-shogaol, and plumbagin time-dependently increased the population of sub-G1 apoptotic cells with the highest percentage in longer incubation time (60-72 h). Similarly, membrane asymmetry changes showed time-dependent increases in the percentage of early and late apoptotic cells. Moreover, the apoptosis-inducing effect of Benjakul, 6-shogaol, and plumbagin at the highest dose, via the caspase cascade was confirmed by time-dependent induction of caspase-3 activity, followed by its complete reduction and abolished sub-G1 peaks upon addition of Z-VAD-FMK.

Conclusion and implication:
Our findings demonstrated for the first time the effects of Benjakul and its compounds on S-G2/M or G2/M phase arrest and caspase-dependent apoptosis in lung cancer cells.