bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efektivitas Pembelajaran Tematik di Kelas IV MIN Bengkulu Dengan Pendekatan Clil
Authors: Muktadir Abdul Muktadir 
Published: June 2021

Penelitian ini bertujuan untuk meningkatkan kemampuan guru dalam merancang, melaksanakan dan meningkatkan hasil pembelajaran Tematik dengan pendekatan CLIL di Kelas IV MIN Kota Bengkulu. Penelitian ini adalah Penelitian Tindakan Kelas menggunakan 2 siklus, setiap siklus terdiri dari perencanaan, observasi, tindakan dan refleksi. Data penelitian adalah pembelajaran dan hasil pembelajaran Tematik. Data diambil melalui metode wawancara, dokumentasi, dan observasi, instrumen yang digunakan adalah lembaran observasi dan tes. Data dianalisis dengan rumus persentase. Hasil penelitian menyimpulkan: 1) guru belum terampil merumuskan indikator dari kompetensi dasar, 2) guru belum terampil merumuskan tujuan pembelajaran, 3) guru belum terampil mengajukan pertanyaan-pertanyaan yang menggali kemampuan siswa yang menggiring ke materi pembelajaran, 4) penerapan pendekatan CLIL dapat mengaktifkan siswa dalam pembelajaran, dan 5) pendekatan CLIL dapat mendekatkan siswa dengan lingkungan serta mengasah kemampuan komunikasi siswa.
Avaliação da suplementação com caseína sobre o periodonto e osso mandibular de ratos alimentados com dieta padrão e dieta de cafeteria
Authors: Rizzi Marília , Pasqualotto Karoline Rodrigues , Delfrate Gabrielle , Mroczek Tayline , Soistak Amanda Priscilla , David Larissa Portela , Claudino Marcela , Scomparin Dionísia Xavier 
Published: June 2021

Objetivo: Avaliar o efeito da suplementação com caseína sobre o periodonto e osso mandibular de ratos alimentados com dieta padrão e dieta de cafeteria. Metodologia: 24 ratos Wistar foram divididos em quatro grupos experimentais: dieta normal (DN), dieta normal com caseína (DNC), dieta de cafeteria (DC) e dieta de cafeteria com caseína (DCC). Os grupos DNC e DCC receberam 2 mL de caseína micelar do 60º ao 90º dia. Aos 90 dias, os animais foram ortoeutanasiados e os materiais foram coletados para análise. Resultados: Os animais dos grupos DC e DCC apresentaram maior índice de adiposidade comparados a DN e DNC (p<0001). O grupo DCC teve dosagem de colesterol HDL significativamente menor que DN (p<0,0092). Na análise radiográfica da hemimandíbula dos animais, não foi observada diferença em relação à densidade de pixels, entretanto, houve diferença no tamanho da porção anterior mandibular entre DCC e DNC (p<0,0196) e DCC e DN (p<0,0039). Histologicamente, observou-se redução de vasos sanguíneos, tanto em osso alveolar (p=0,0033), osso da furca (p<0,0001) e ligamento periodontal (p=0,0001) em DCC. Além disso, no osso alveolar houve diminuição de osteócitos no grupo DCC em relação à DNC (p=0,0198). Conclusões: O aumento da adiposidade contribuiu para diminuição de vasos sanguíneos e osteócitos no tecido ósseo de ratos, apesar de não influenciar na inflamação. Esse efeito foi independente de caseína. Portanto, a suplementação com caseína em ratos submetidos a dieta de cafeteria não foi efetiva para diminuir o acúmulo de tecido adiposo, bem como não interferiu positivamente no metabolismo ósseo da hemimandíbula.
Perspective of pharmaceutical practice in adrenal insufficiency: An integrative review
Authors: Caetano Juliana Denicoli Silvestre , Castilho Selma Rodrigues de , Santos Vania dos 
Published: June 2021

An integrating review of the literature about the perspectives of the pharmaceutical practices in Adrenal Insufficiency (AI) was carried out. Researches were done on the LILACS database, Medline (Pubmed), and Scientific Electronic Library OnLine-SCIELO. Articles published between January 2007 and February 2021, written in Portuguese, English, and Spanish, were included. A total of 43 articles were selected to compose the review. A great deal of the studies considers patient education fundamental for the treatment and AI control. Among the education measures found in these studies, which can subside the service routines are: guidelines on the precipitating factors, signs and disease symptoms, dose adjustment, drug interaction, and condition identification cards. Relevant interventions of clinic management reported hospital discharge plans, management of AI acute and chronic phases, home care management, and routine outpatient follow-up. For an effective self-care support system, patient-centered assistance must be the core of the health care standards model. The review establishes that the AI patient follow-up must be performed regularly by a multidisciplinary team. It also allowed the identification of health measures that a pharmacist integrated with the healthcare team should perform.
A enfermagem no manejo da dor em recém-nascidos internados em unidade de terapia intensiva neonatal
Authors: Santos Kareem Fernanda Mendonça , Andrade Ana Fátima Souza Melo de , Torres Ruth Cristini , Teles Weber de Santana , Debbo Alejandra , Silva Max Cruz da , Vinícius Cunha Azevedo Marcel , Barros Ângela Maria Melo Sá , Silva Maria Hozana Santos , Morais André Luiz de Jesus , Santos Junior Paulo Celso Curvelo 
Published: June 2021

Introdução: O manejo adequado da dor no neonato é indispensável para uma assistência de qualidade. Os enfermeiros e técnicos de enfermagem devem possuir entendimento satisfatório para avaliar e proporcionar o correto alívio da dor, através de medidas não farmacológicas de acordo com as necessidades de cada bebê. Objetivo Geral: Descrever estratégias das equipes de enfermagem para a identificação, avaliação e intervenções da dor em recém-nascidos internados em Unidades de Terapia Intensiva. Metodologia: Trata-se de uma pesquisa de revisão integrativa de literatura publicada no mês dezembro 2020, onde os dados foram analisados no Programa Microsoft Excel 2010 e dispostos em frequências simples e percentuais. Resultados: A amostra final desta revisão integrativa, após a leitura sistemática e aplicação dos critérios de inclusão resultou num total de 19 artigos, espera- se que os resultados desta pesquisa possam subsidiar a enfermagem no manejo da dor em recém-nascidos internados em unidade de terapia intensiva neonatal. Discussão: O manejo da dor em recém-nascidos, de forma científica e padronizada, deve ser uma constante na prática clínica dos trabalhadores da saúde em cuidados intensivos, para que a assistência oferecida seja de excelência, segura e humanizada. Considerações Finais: Ao término deste trabalho pôde-se concluir que o enfermeiro que atua em Unidade de Terapia Intensiva Neonatal deve ter conhecimento suficiente sobre a fisiologia, os fatores psicológicos e culturais que podem influenciar a dor dos recém-nascidos nestas unidades e principalmente as técnicas de avaliação e a terapia oferecida.
Interpreting in Sexual and Reproductive Health Consults With Burma Born Refugees Post Settlement: Insights From an Australian Qualitative Study
Authors: Tuteja Amita , Riggs Elisha , Sanci Lena , Mascarenhas Lester , VanVliet Di , Sangster Katrina , McGuinness Kimberley , Temple-Smith Meredith 
Published: June 2021

Interpreters work with health care professionals to overcome language challenges during sexual and reproductive (SRH) health discussions with people from refugee backgrounds. Disclosures of traumatic refugee journeys and sexual assault combined with refugees’ unfamiliarity with Western health concepts and service provision can increase the interpreting challenges. Published literature provides general guidance on working with interpreters in primary care but few studies focus on interpretation in refugee SRH consults. To address this, we explored the challenges faced by providers of refugee services (PRS) during interpreter mediated SRH consultations with Burma born refugees post settlement in Australia. We used qualitative methodology and interviewed 29 PRS involved with migrants from Burma including general practitioners, nurses, interpreters, bilingual social workers, and administrative staff. The interviews were audio-recorded, transcribed, and subjected to thematic analysis following independent coding by the members of the research team. Key themes were formulated after a consensus discussion. The theme of “interpretation related issues” was identified with six sub-themes including 1) privacy and confidentiality 2) influence of interpreter’s identity 3) gender matching of the interpreter 4) family member vs. professional interpreters 5) telephone vs. face-to-face interpreting 6) setting up the consultation room. When faced with these interpretation related challenges in providing SRH services to people from refugee backgrounds, health care providers combine best practice advice, experience-based knowledge and “mundane creativity” to adapt to the needs of the specific patients. The complexity of interpreted SRH consultations in refugee settings needs to be appreciated in making good judgments when choosing the best way to optimize communication. This paper identifies the critical elements which could be incorporated when making such a judgement. Future research should include the experiences of refugee patients to provide a more comprehensive perspective.
Association of Total Bilirubin With All-Cause and Cardiovascular Mortality in the General Population
Authors: Chen Ziwei , He Jing , Chen Chu , Lu Qi 
Published: June 2021

Objective: The study aims to investigate the association of total bilirubin with all-cause and cause-specific mortality in the general population.Methods: A total of 37,234 adults from the United States National Health and Nutrition Examination Survey 1999–2014 were enrolled. Baseline levels of total bilirubin associated with risk of mortality were evaluated on a continuous scale (restricted cubic splines) and by quartile categories with Cox regression models.Results: Higher levels of total bilirubin was positively associated with an increased risk of all-cause mortality [hazard ratio (HR) 1.59, 95% confidence interval (CI) 1.46–1.72; p &lt; 0.001]. Compared with individuals with the lowest quartile of bilirubin, the multivariable adjusted hazard ratio for all-cause mortality was 1.25 (1.14–1.37) for individuals in the highest quartile. Restricted cubic splines indicated that the association was non-linear in cardiovascular mortality and cancer mortality while linear in all-cause mortality.Conclusions: Total bilirubin was associated with all-cause and cause-specific mortality in the general population.
Long-Term Effect of a Vaccine Targeting Endothelin-1 Receptor Type A in Pulmonary Arterial Hypertension
Authors: Dai Yong , Qiu Zhihua , Ma Wenrui , Li Chang , Chen Xiao , Song Xiaoxiao , Bai Zeyang , Shi Dingyang , Zheng Jiayu , Pan Guangwei , Liao Yuhua , Liao Mengyang , Zhou Zihua 
Published: June 2021

Background: Previously, we invented a therapeutic vaccine targeting the endothelin-A receptor (termed ETRQβ-002). ETRQβ-002 successfully prevented the remodeling of pulmonary arterioles (PAs) and right ventricle (RV) without significant immune-mediated damage in experimental pulmonary arterial hypertension (PAH) mice models.Objective: Here, we aim to further evaluate the long-term effects of ETRQβ-002.Methods: PAH mice model was induced by a combination of subcutaneous injection with Sugen5416 and chronic hypoxic conditions (10% O2). PAH mice were immunized with ETRQβ-002 at different time points, and the experiment lasted for 21 weeks. Hemodynamic, histological, and biochemical analyses were conducted to evaluate the long-term effects of ETRQβ-002.Results: We demonstrated that the titer of the specific antibody against ETR-002 could be maintained chronically after periodic booster immunization in PAH mice. Long-term reduction of right ventricular systolic pressure and amelioration of PA remodeling by ETRQβ-002 were confirmed. Moreover, we found that ETRQβ-002 also exerted antiproliferation, anti-inflammation, and antifibrosis effects in PA remodeling. Besides, ETRQβ-002 durably limited pathological RV hypertrophy and fibrosis. Finally, no immune-mediated damage was observed in hepatic or renal function or by pathology in liver and kidney during the long-term administration of ETRQβ-002.Conclusion: Our findings indicate that ETRQβ-002 provides long-term therapeutic effects in Sugen/hypoxia-induced PAH animals and offers a promising clinical prospect for PAH treatment.
Myocardial Work Assessment for the Prediction of Prognosis in Advanced Heart Failure
Authors: Hedwig Felix , Nemchyna Olena , Stein Julia , Knosalla Christoph , Merke Nicolas , Knebel Fabian , Hagendorff Andreas , Schoenrath Felix , Falk Volkmar , Knierim Jan 
Published: June 2021

Objectives: The aim of this study was to investigate whether echocardiographic assessment of myocardial work is a predictor of outcome in advanced heart failure.Background: Global work index (GWI) and global constructive work (GCW) are calculated by means of speckle tracking, blood pressure measurement, and a normalized reference curve. Their prognostic value in advanced heart failure is unknown.Methods: Cardiopulmonary exercise testing and echocardiography with assessment of GWI and GCW was performed in patients with advanced heart failure caused by ischemic heart disease or dilated cardiomyopathy (n = 105). They were then followed up repeatedly. The combined endpoint was all-cause death, implantation of a left ventricular assist device, or heart transplantation.Results: The median patient age was 54 years (interquartile range [IQR]: 48–59.9). The mean left ventricular ejection fraction was 27.8 ± 8.2%, the median NT-proBNP was 1,210 pg/ml (IQR: 435–3,696). The mean GWI was 603 ± 329 mmHg% and the mean GCW was 742 ± 363 mmHg%. The correlation between peak oxygen uptake and GWI as well as GCW was strongest in patients with ischemic cardiomyopathy (r = 0.56, p = 0.001 and r = 0.53, p = 0.001, respectively). The median follow-up was 16 months (IQR: 12–18.5). Thirty one patients met the combined endpoint: Four patients died, eight underwent transplantation, and 19 underwent implantation of a left ventricular assist device. In the multivariate Cox regression analysis, only NYHA class, NT-proBNP and GWI (hazard ratio [HR] for every 50 mmHg%: 0.85; 95% CI: 0.77–0.94; p = 0.002) as well as GCW (HR for every 50 mmHg%: 0.86; 95% CI: 0.79–0.94; p = 0.001) were identified as independent predictors of the endpoint. The cut-off value for predicting the outcome was 455 mmHg% for GWI (AUC: 0.80; p &lt; 0.0001; sensitivity 77.4%; specificity 71.6%) and 530 mmHg% for GCW (AUC: 0.80; p &lt; 0.0001; sensitivity 74.2%; specificity 78.4%).Conclusions: GWI and GCW are powerful predictors of outcome in patients with advanced heart failure.
Travel Time Tomography to Delineate 3-D Regional Seismic Velocity Structure in the Banyumas Basin, Central Java, Indonesia, Using Dense Borehole Seismographic Stations
Authors: Hidayat Hidayat , Nugraha Andri Dian , Priyono Awali , Marjiyono Marjiyono , Setiawan Januar H. , Sahara David P. , Winardhi Sonny , Zulfakriza Zulfakriza , Rosalia Shindy , Lelono Eko B. , Permana Asep K. , Setiawan Ahmad 
Published: June 2021

The Banyumas Basin is a tertiary sedimentary basin located in southern Central Java, Indonesia. Due to the presence of volcanic deposits, 2-D seismic reflection methods cannot provide a good estimation of the sediment thickness and the subsurface geology structure in this area. In this study, the passive seismic tomography (PST) method was applied to image the 3-D subsurface Vp, Vs, and Vp/Vs ratio. We used 70 seismograph borehole stations with a recording duration of 177 days. A total of 354 events with 9, 370 P and 9, 368 S phases were used as input for tomographic inversion. The checkshot data of a 4, 400-meter deep exploration well (Jati-1) located within the seismic network were used to constrain the shallow crustal layer of the initial 1-D velocity model. The model resolution of the tomographic inversions was assessed using the checkerboard resolution test (CRT), the diagonal resolution element (DRE), and the derivative weight sum (DWS). Using the obtained Vp, Vs, and Vp/Vs ratio, we were able to sharpen details of the geological structures within the basin from previous geological studies, and a fault could be well-imaged at a depth of 4 km. We interpreted this as the main dextral strike-slip fault that controls the pull apart process of the Banyumas Basin. The thickness of the sediment layers, as well as its layering, were also could be well determined. We found prominent features of the velocity contrast that aligned very well with the boundary between the Halang and Rambatan formations as observed in the Jati-1 well data. Furthermore, an anticline structure, which is a potential structural trap for the petroleum system in the Banyumas Basin, was also well imaged. This was made possible due to the dense borehole seismographic stations which were deployed in the study area.
Botryoidal and Spherulitic Aragonite in Carbonates Associated with Microbial Mats: Precipitation or Diagenetic Replacement Product?
Authors: Ge Yuzhu , Della Porta Giovanna , Pederson Chelsea L. , Lokier Stephen W. , Hoffmann René , Immenhauser Adrian 
Published: June 2021

Similar carbonate fabrics may result from different pathways of precipitation and diagenetic replacement. Distinguishing the underlying mechanisms leading to a given carbonate fabric is relevant, both in terms of an environmental and diagenetic interpretation. Prominent among carbonate fabrics are aragonite botryoids and spherulites, typically interpreted as direct seawater precipitates and used as proxies for fluid properties and depositional environments. This study investigated μm to mm-scale Holocene botryoidal and spherulitic aragonite from marine and non-marine carbonate settings associated with microbial mats, and reports two distinct formation mechanisms: 1) early diagenetic replacement, and 2) primary precipitation via nanocrystal aggregation. In the intertidal microbial mats of Khawr Qantur (Abu Dhabi), botryoidal and spherulitic aragonite are replacement products of heavily micritized bioclasts. To form the botryoidal and spherulitic aragonite, skeletal rods and needles, resulting from disintegration of micritized bioclasts, recrystallize into nanocrystals during early marine diagenesis. These nanocrystals then grow into fibrous crystals, forming botryoidal and spherulitic aragonite. In the lacustrine microbial bioherms of the hypersaline Great Salt Lake (United States) and in the hydrothermal travertines of Bagni San Filippo (Italy), botryoidal and spherulitic aragonite evolve from nanocrystals via precipitation. The nanocrystals are closely associated with extracellular polymeric substances in microbial biofilms and aggregate to form fibrous crystals of botryoidal and spherulitic aragonite. The studied fabrics form a portion of the bulk sediment and show differences in terms of their formation processes and petrological features compared to the often larger (few mm to over 1 m) botryoidal and spherulitic aragonite described from open-marine reefal cavities. Features shown here may represent modern analogues for ancient examples of carbonate depositional environments associated with microbialites. The implication of this research is that botryoidal and spherulitic aragonite associated with microbial mats are relevant in paleoenvironmental interpretations, but must be combined with a detailed evaluation of their formation process. Care must be taken as the term “botryoidal and spherulitic aragonite” may in fact include, from the viewpoint of their nucleation and formation mechanism, similar fabrics originated from different pathways. At present, it seems unclear to which degree the μm to mm-scale botryoids and spherulites described here are comparable to their cm-to dm-size counterparts precipitated as cements in the open pore space of reefal environments. However, it is clear that the investigation of ancient botryoidal and spherulitic aragonite must consider the possibility of an early diagenetic replacement origin of these precipitates.
Prognostic Significance of Altered ATRX/DAXX Gene in Pancreatic Neuroendocrine Tumors: A Meta-Analysis
Authors: Wang Fei , Xu Xiaowu , Ye Zeng , Qin Yi , Yu Xianjun , Ji Shunrong 
Published: June 2021

BackgroundPancreatic neuroendocrine tumors (PanNETs) are a heterogeneous group of neoplasms with increasing incidence and unpredictable behavior. Whole-exome sequencing recently has shown very frequent somatic mutations in the alpha-thalassemia/mental retardation X-linked (ATRX) and death domain-associated protein (DAXX) genes in PanNETs. And the prognostic significance of altered ATRX/DAXX genes in PanNETs patients have been revealed in several reports. However, many of these include small sample size and hold controversial opinions. To increase statistical power, we performed a systematic review and meta-analysis to determine a pooled conclusion. We examined the impact of altered ATRX/DAXX genes mainly on overall survival (OS), disease-free survival (DFS) and relapse-free survival (RFS) in PanNETs.MethodsEligible studies were identified and quality was assessed using multiple search strategies (last search May 2021). Data were collected from studies about prognostic significance of altered ATRX/DAXX in PanNETs. Studies were pooled, and combined hazard ratios (HRs) with 95% confidence intervals (CIs) were used to estimate strength of the associations.ResultsFourteen studies involving 2313 patients treated for PanNETs were included. After evaluating for publication bias, disease-free survival and relapse-free survival was significantly shortened in patients with altered ATRX/DAXX gene, with combined HR 5.05 (95% confidence interval (CI): 1.58-16.20, P = 0.01) and 3.21 (95% confidence interval (CI): 1.44-7.16, P &lt; 0.01) respectively. However, the combined data showed there were no difference between patients with altered ATRX/DAXX gene or not in overall survival, with a combined HR 0.71 (95% confidence interval (CI): 0.44-1.15, P = 0.23). We also performed a subgroup analysis with metastatic patients in overall survival, showing a combined HR 0.22 (95% confidence interval (CI): 0.11-0.48, P = 0.96). The small number of studies and paucity of multivariate analyses are the limitations of our study.ConclusionsThis is the first rigorous pooled analysis assessing ATRX/DAXX mutation as prognostic biomarkers in PanNETs. Patients with altered ATRX/DAXX gene would have poor DFS according to the combined data. And altered ATRX/DAXX genes in metastatic patients showed a trend towards improved overall survival, although the difference did not reach statistical significance.