bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Arcor Nitrocarburizing Process on the Case Chemistry and Morphology of AISI 1018 Low-Carbon Steel
Authors: Sharma Jagdeep , Sidhu Balwinder Singh , Gupta Rajesh 
Published: August 2018

Abstract
Industrial modern machinery components, such as gears, bolts, and shafts, are always subjected to continuous frictional wear. The wear resistance and cost of material are the two most important factors while selecting a material for such components. The conventional materials are costly, and there is always a quest for inexpensive materials. The designers mostly choose the low-cost, low-carbon steels. AISI 1018 is one such low-cost, low-carbon grade, which has been used extensively in high-volume screw machine parts applications and is commonly employed in spindles, pins, rods, sprocket assemblies, axles, bolts, connecting rods, motor shafts, hydraulic shafts, pump shafts, and machinery parts. However, the wider applications are restrained by their relatively poor wear and surface properties. This necessitates the need for research on these low-carbon, low-cost materials to address the problem. For decades, surface treatments have been performed to enhance the tribological properties of these components. Salt bath nitrocarburizing is one of the oldest methods and an economical method to improve the tribological properties, as well as the mechanical properties of materials. Unfortunately, in the present literatures, there is not much attention paid on treating AISI 1018 low-carbon steel. A nontoxic salt bath surface modification process nitrocarburizing (Arcor) in ferritic state is investigated on AISI 1018 low-carbon steel. It has been observed that with the increase in nitrocarburizing time and nitrocarburizing temperature, a significant enhancement in mechanical properties, like the hardness of the work material, has been found. Field Emission Scanning Electron Microscope (FESEM) investigations identified compound and diffusion regions on the surface of steel along with line scan elemental intensities.
The Role of Cholinergic Midbrain Neurons in Startle and Prepulse Inhibition
Authors: Azzopardi Erin , Louttit Andrea G. , DeOliveira Cleusa , Laviolette Steven R. , Schmid Susanne 
Published: August 2018

One of the two major cholinergic centers of the mammalian brain is located in the midbrain, i.e., the pedunculopontine tegmentum (PPTg) and the adjacent laterodorsal tegmentum. These cholinergic neurons have been shown to be important for e.g., arousal, reward associations, and sleep. They also have been suggested to mediate sensorimotor gating, measured as prepulse inhibition of startle (PPI). PPI disruptions are a hallmark of schizophrenia and are observed in various other psychiatric disorders, where they are associated with, and often predictive of, other cognitive symptoms. PPI has been proposed to be mediated by a short midbrain circuitry including inhibitory cholinergic projections from PPTg to the startle pathway. Although the data indicating the involvement of the PPTg is very robust, some more recent evidence challenges that there is a cholinergic contribution to PPI. We here use transient optogenetic activation of specifically the cholinergic PPTg neurons in male and female rats to address their role in startle modulation in general, and in PPI specifically. Although we could confirm the crucial role of PPTg cholinergic neurons in associative reward learning, validating our experimental approach, we found that activation of cholinergic PPTg neurons did not inhibit startle responses. In contrast, activation of cholinergic PPTg neurons enhanced startle, which is in accordance with their general role in arousal and indicate a potential involvement in sensitization of startle. We conclude that noncholinergic PPTg neurons mediate PPI in contrast to the longstanding hypothetical view that PPI is mediated by cholinergic PPTg neurons.SIGNIFICANCE STATEMENTActivation of cholinergic neurons in the midbrain has been assumed to mediate prepulse inhibition of startle (PPI), a common measure of sensorimotor gating that is disrupted in schizophrenia and other psychiatric disorders. We here revisit this long-standing hypothesis using optogenetic activation of these specific neurons combined with startle testing in rats. In contrast to the hypothetical role of these neurons in startle modulation, we show that their activation leads to an increase of baseline startle and to prepulse facilitation. This supports recent data by others that have started to cast some doubt on the cholinergic hypothesis of PPI, and calls for a revision of the theoretical construct of PPI mechanisms.
Hyperthyroidism or hypothyroidism and gastrointestinal cancer risk: a Danish nationwide cohort study
Authors: Kirkegård Jakob , Farkas Dora Körmendiné , Jørgensen Jens Otto Lunde , Cronin-Fenton Deirdre P 
Published: August 2018

Objective
The association between thyroid dysfunction and gastrointestinal cancer is unclear.

Design
We conducted a nationwide population-based cohort study to examine this potential association.

Methods
We used Danish medical registries to assemble a nationwide population-based cohort of patients diagnosed with hyperthyroid or hypothyroid disease from 1978 to 2013. We computed standardized incidence ratios (SIRs) with corresponding 95% CIs as measures of the relative risk of each cancer, comparing patients with thyroid dysfunction with that expected in the general population.

Results
We included 163,972 patients, of which 92,783 had hyperthyroidism and 71,189 had hypothyroidism. In general, we found an increased risk of all gastrointestinal cancers within the first year after thyroid disease diagnosis. After more than 5 years of follow-up, patients with hyperthyroidism had a slightly increased risk of pancreatic and gallbladder and biliary tract cancer. Patients with hypothyroidism had a slightly increased risk of stomach, anal, liver, gallbladder and biliary tract, and pancreatic cancer after more than 5 years of follow-up, but the observed numbers of cancers were in general similar to the expected.

Conclusions
The increased risks of all gastrointestinal cancers in the first year following hyper- or hypothyroidism diagnosis are likely due to detection bias. After more than 5 years of follow-up, there does not seem to be a consistent causal association between thyroid disease and gastrointestinal cancer.
A systematic review of pocket-sized imaging devices: small and mighty?
Authors: Galusko Victor , Bodger Owen , Ionescu Adrian 
Published: August 2018

AbstractIntroduction: Hand-held imaging devices are widely used in clinical practice and are a useful tool. There is no published review examining the diagnostic parameters achieved with these devices in clinical practice.Methods: We searched three online medical literature databases (PubMed, EMBASE and MEDLINE) for all literature published up until January 2018. We selected studies that (1) were conducted in the adult population; (2) used a truly hand-held device; (3) featured sensitivities and/or specificities on the use of the hand-held scanner. We extracted and summarised the diagnostic metrics from the literature.Results: Twenty-seven articles were excluded from the initial 56 relevant articles, as the device featured was not truly hand-held. Ultimately a total of 25 studies were analysed. Sixteen studies were carried out by experienced users, seven by users with little previous experience and two studies by nurses. High diagnostic parameters were achieved by all three groups when scanning cardiac pathology and intra-abdominal structures. Training of non-expert users varied, taking a mean of 21.6 h. These hand-held devices can change diagnoses at the bedside and be used as gate-keepers to formal echocardiography. Individual studies show them to be cost-effective.Conclusion: Hand-held echocardiography is a useful tool in the hands of experts and novices alike. Studies conducted are highly heterogeneous making it difficult to pool data for the diagnostic metrics. Further studies with rigorous methodology are needed to evaluate the true diagnostic potential in the hands of non-experts and in the community as well as to validate training protocols.
A Novel Model for Enhanced Prediction and Understanding of Unplanned 30-Day Pediatric Readmission
Authors: Ehwerhemuepha Louis , Finn Stacey , Rothman Michael , Rakovski Cyril , Feaster William 
Published: August 2018

OBJECTIVES:To develop a model to assist clinicians in reducing 30-day unplanned pediatric readmissions and to enhance understanding of risk factors leading to such readmissions.METHODS:Data consisting of 38 143 inpatient clinical encounters at a tertiary pediatric hospital were retrieved, and 50% were used for training on a multivariate logistic regression model. The pediatric Rothman Index (pRI) was 1 of the novel candidate predictors considered. Multivariate model selection was conducted by minimization of Akaike Information Criteria. The area under the receiver operator characteristic curve (AUC) and values for sensitivity, specificity, positive predictive value, relative risk, and accuracy were computed on the remaining 50% of the data.RESULTS:The multivariate logistic regression model of readmission consists of 7 disease diagnosis groups, 4 measures of hospital resource use, 3 measures of disease severity and/or medical complexities, and 2 variables derived from the pRI. Four of the predictors are novel, including history of previous 30-day readmissions within last 6 months (P &lt; .001), planned admissions (P &lt; .001), the discharge pRI score (P &lt; .001), and indicator of whether the maximum pRI occurred during the last 24 hours of hospitalization (P = .005). An AUC of 0.79 (0.77–0.80) was obtained on the independent test data set.CONCLUSIONS:Our model provides significant performance improvements in the prediction of unplanned 30-day pediatric readmissions with AUC higher than the LACE readmission model and other general unplanned 30-day pediatric readmission models. The model is expected to provide an opportunity to capture 39% of readmissions (at a selected operating point) and may therefore assist clinicians in reducing avoidable readmissions.
Newborn Falls in a Large Tertiary Academic Center Over 13 Years
Authors: Loyal Jaspreet , Pettker Christian M. , Raab Cheryl A. , O’Mara Elizabeth , Lipkind Heather S. 
Published: August 2018

OBJECTIVES:
We sought to report the frequency of, circumstances surrounding, and outcomes of newborn falls in our hospital. We evaluated the impact of specific interventions on the frequency of newborn falls and the time between falls.

METHODS:
We performed a retrospective study of newborn falls reported on our postpartum unit over a 13-year period. Demographic information and circumstances of falls were collected via an electronic event reporting system and medical record review.

RESULTS:
There were 63 633 births and 29 newborn falls, yielding an average of 4.6 falls per 10 000 live births (median: 2 per year; range 0–5 per year). Newborns who sustained a fall were exclusively breastfeeding (75.9%), 24 to 48 hours of age at the time of the fall (58.6%), and had first-time parents (62.1%). At the time of the fall, most newborns were with the mother compared with being with the father or both parents (65.5% vs 34.5%); in the mother’s bed compared with being elsewhere, such as on a couch or chair, with a parent, or in the parent’s arms (62.1% vs 37.9%); and feeding at the time of the fall versus not (79.3% vs 20.7%). All newborns were monitored after the fall, with no adverse outcomes. Despite interventions, we continued to see cases of newborn falls, although the overall trend revealed decreasing falls per 10 000 patient-days and longer time between falls over the study period.

CONCLUSIONS:
Newborn falls in our hospital are infrequent but continue to occur despite preventive efforts, highlighting the importance of continuous awareness and education.
Variation in Diagnostic Test Use and Associated Outcomes in Staphylococcal Scalded Skin Syndrome at Children’s Hospitals
Authors: Neubauer Hannah C. , Hall Matt , Wallace Sowdhamini S. , Cruz Andrea T. , Queen Mary Ann , Foradori Dana M. , Aronson Paul L. , Markham Jessica L. , Nead Jennifer A. , Hester Gabrielle Z. , McCulloh Russell J. , Lopez Michelle A. 
Published: August 2018

OBJECTIVES:The incidence of staphylococcal scalded skin syndrome (SSSS) is rising, but current practice variation in diagnostic test use is not well described. Our aim was to describe the variation in diagnostic test use in children hospitalized with SSSS and to determine associations with patient outcomes.METHODS:We performed a retrospective (2011–2016) cohort study of children aged 0 to 18 years from 35 children’s hospitals in the Pediatric Health Information System database. Tests included blood culture, complete blood count, erythrocyte sedimentation rate, C-reactive protein level, serum chemistries, and group A streptococcal testing. K-means clustering was used to stratify hospitals into groups of high (cluster 1) and low (cluster 2) test use. Associations between clusters and patient outcomes (length of stay, cost, readmissions, and emergency department revisits) were assessed with generalized linear mixed-effects modeling.RESULTS:We included 1259 hospitalized children with SSSS; 84% were ≤4 years old. Substantial interhospital variation was seen in diagnostic testing. Blood culture was the most commonly obtained test (range 62%–100%), with the most variation seen in inflammatory markers (14%–100%). Between hospital clusters 1 and 2, respectively, there was no significant difference in adjusted length of stay (2.6 vs 2.5 days; P = .235), cost ($4752 vs $4453; P = .591), same-cause 7-day readmission rate (0.8% vs 0.4%; P = .349), or emergency department revisit rates (0.1% vs 0.6%; P = .148).CONCLUSIONS:For children hospitalized with SSSS, lower use of diagnostic tests was not associated with changes in outcomes. Hospitals with high diagnostic test use may be able to reduce testing without adversely affecting patient outcomes.
Linking Pediatrics Patients and Nurses With the Pharmacy and Electronic Health Record System Through the Inpatient Television: A Novel Interactive Pain-Management Tool
Authors: Aldekhyyel Raniah N. , Melton Genevieve B. , Lindgren Bruce , Wang Yan , Pitt Michael B. 
Published: August 2018

OBJECTIVES:
Implement a novel pain-management interface that is used to bring real-time, patient-reported pain assessments to the inpatient television and evaluate the impact of implementation on the pain-management clinical workflow, patient engagement, and nursing pain reassessments.

METHODS:
We developed a pain-management tool interfacing 4 stand-alone technologies: a television-based, interactive patient care system; electronic health record system; nursing call system; and pharmacy inventory–management system. The workflow is triggered when pain medications are dispensed by sending an automatic pain assessment rating question via the patient’s television at a predefined time. To measure the effects of implementation, we calculated patient and/or parent use rates and pain reassessment timely documentation rates. Data were extracted from the electronic health record for a period of 22 months and covered pre- and postimplementation.

RESULTS:
A total of 56 931 patient records were identified during the study period, representing 2447 unique patients. In total, 608 parents and/or patients reported their pain through the tool. Use rates were 6.5% for responding to the pain rating prompt and 13.3% for the follow-up prompt, in which additional nonpharmacologic strategies to eliminate pain were offered. A modest increase was found in the mean timely documentation rates on the basis of nursing documentation standards (26.1% vs 32.8%, a percentage increase of 25.7%; P &lt; .001) along with decreased median time to pain reassessment documentation (29 minutes versus 25 minutes, a percentage decrease of 13.8%; P &lt; .001).

CONCLUSIONS:
With this novel tool, we offer a potentially scalable approach in supporting the pain-management clinical workflow, integration of technologies, and promoting of patient and/or parent engagement in the inpatient setting.
PENDEKATAN SUFISTIK DALAM MENAFSIRKAN AL-QURAN
Authors: M. Yunus Badruzzaman 
Published: August 2018

Karya-karya tafsir Alqur’ân bercorak sufistik seperti halnya tasawuf sebagai disiplin ilmu, mendapat label plus-minus dari para pengkaji. Imam al-Thusiy mengomentari penafsiran sufi sebagai “Penafsiran seperti itu keliru (خطاء ) dan dusta (بهتان) kepada Allâh”. Imam al-Suyuthiy menyatakan bahwa pendapat para sufi dalam memaknai Alqur’ân tidak dianggap sebagai tafsir. Ibn Shalah dalam Fatâwa-nya, Ia mengutip apa yang dikatakan oleh Imam Abi Hasan al-Wahidi; siapa yang menganggap bahwa kitab al-Sulami itu kitab tafsir maka ia telah menjadi kafir. Demikian juga penolakan dari Imam al-Zarkasyiy, Imam al-Nasafi dan Imam al-Rafi’iy. Sementara itu, banyak ulama yang memandang bahwa tafsir sufistik memiliki faidah untuk mengurai sisi esoterik Alquran dengan asumsi bahwa Alqur’ân memiliki makna dzahir dan makna bathin. Jika demikian, maka tafsir sufistik memiliki kontribusi jelas pada pemaknaan dari aspek bathinnya dengan perangkat takwil atau isyarat-isyarat tertentu, sementara untuk makna dzâhir-nya sudah digarap oleh perangkat tafsir. Imam al-Ghazali menegaskan bahwa tidak ada larangan seseorang menafsirkan Alqur’ân dengan penafsiran sufistik jika bermaksud untuk menampilkan kekayaan makna Alqur’ân hingga batas-batas pemaknaan dengan simbol atau isyarat-isyarat tertentu. Perdebatan tentang status tafsir sufistik antara kebolehan membaca, memahami dan mengamalkannya seperti yang representasikan oleh Imam al-Ghazali versus beberapa ulama yang menolak karya-karya tafsir sufistik, me-niscayakan untuk mendefinisikan tafsir sufistik dan me-meta-kan (mapping) tafsir sufistik dengan membuat kategori-kategori baik paradigma, karya-karya, kelebihan-kelebihan dan kekurangan-kekurangannya.Teori tafsir sufistik merujuk pada karakteristik metodologi tafsir Alqur’ân yang terbagi kedalam tiga bagian bersar; referensi tafsir (mashadir); referensi tafsir informatif (matsur), nalar (ma’qul) dan intuitif/esoterik (isyariy), metode tafsir (manhaj); ijmaliy, tahliliy, muqaran dan mawdluiy dan yang terakhir adalah teori tentang pendekatan/corak tafsir.Penelitian ini menemukan bahwa secara paradigmatik, posisi tafsir sufi mengambil ruang esoterik dengan memakai perangkat takwil. Tafsir sufistik terbagi kepada dua kategori; isyariy; tafsir yang diperoleh dari isyarat-isyarat ghaib dan nadzariy; penafsiran dengan teori-teori tasawuf dan filsafat (theosophy, tasawuf-falsafi). Pendekatan tafsir sufi berupaya memaknai Alquran dengan menggunakan tasawuf sebagai ilmu bantu. Tafsir dengan corak sufistik memiliki kelebihan terutama pada penyingkapan makna esoterik, bathin Alquran, sementara kelemahannya adalah tidak ada tolok ukur validitas dan hanya dikonsumsi oleh komunitas terbatas.
EPISTEMOLOGI DOA KH ASEP MUKARRAM (Studi Kasus di Lembaga Terapi KH Asep Mukarram Kecamatan Sukanagara, Cianjur Selatan Kabupaten Cianjur)
Authors: Solehudin Solehudin 
Published: August 2018

Terapi adalah upaya penyembuhan atau normalisasi atas “penyakit” yang diderita oleh pasien. Terdapat banyak ragam cara penyembuhan yang dilakukan terapis terhadap penyakit pasien. Jenis penyakit dan tingkat keakutannya juga bervariasi. Penyakit-penyakit kategori medis dengan level ke-akut-an dan penyakit-penyakit yang ditengarai non-medis membuka cukup ruang munculnya lembaga-lembaga terapi alternatif di berbagai wilayah khususnya di Indonesia. Untuk wilayah Jawabarat, terdapat banyak lembaga-lembaga terapi baik yang memiliki legal-formal terdaftar di departemen kehakiman maupun yang tidak mengantongi surat izin. Lembaga terapi pada scope satuan-satuan wilayah yang lebih kecil misalnya terdapat di Kampung Ciawitali Sukanagara, Cianjur Selatan Kabupaten Cianjur. Lembaga terapi ini merupakan bagian dari Lembaga pesantren Salafi Ciawitali yang dipimpin KH. Asep Mukarram.Tujuan pnelitian ini fokus pada basis terapinya yakni do’a. Ada beberapa ilustrasi yang dinarasikan penulis di depan nanti tentang epistemologi do’a yang ada di lembaga terapi tersebut dengan penjelasan-penjelasan langsung atau tidak langsung yang bersumber dari terapis (KH. Asep Mukarram). Karenanya, penelitian ini hanya berkisar pada prosesi perolehan do’a (ijazah, mahar), riyadlah, puasa (shaum), wirid dan lain-lain. Metode penelitian yang digunakan adalah deskriptif-analitik dengan jenis data kualitatif. Adapun teknik pengumpulan data yang digunakan adalah field research dengan teknik wawancara mendalam (deep interview) dengan puposive sampling. Penelitian ini berbasis pada kerangka epistemologi atau teori pengetahuan (nadzariyyat al-ma’rifah). kata do’a (الدعاء). Jika merujuk kepada Alquran, banyak kata-kata do’a dengan berbagai derivasinya baik dalam bentuk kata kerja maupun kata benda, sebanyak 90 kali disebut; 48 dalam bentuk kata benda [isim] dan 44 dalam bentuk kata kerja [fi’il]. Kata ini memiliki variasi makna; ibadah, meminta, memanggil, memuji dan seterusnya. doa secara definitif dimaknai dengan; permintaan kepada Allah untuk didatangkan kemanfaatan dan dicegah berbagai keburukan.Hasil penelitian ini dapat disebutkan secara singkat sebagai berikut; epistemologi do’a di lembaga terapi KH Asep Mukarram meliputi prosesi pembersihan fisik dengan di”rebus”, melakukan riyadlah (latihan penyucian jiwa), shaum, Idan wirid. Perolehan ilmu para santri atau pasien melalui proses ijazah dan mahar. Do’a-do’a yang di-ijazahkan bersumber dari Alquran, literatur kitab-kitab hikmah, dan “racikan” KH Asep Mukarram sendiri. Relasi do’a dengan terapi dapat terlihat dari prosesi terapi dengan media wafaq, transfer energi do’a pada pemindahan penyakit ke tubuh hewan, dan pengisian benda dengan energi doa. Ide utama dari berdoa menurut KH Asep Mukarram adalah keyakinan bahwa do’a kita akan di-qabul (diterima).
SEMI QUANTITATIVE RISK PROFILE OF AFLATOXIN B1 FROM AN ASPERGILLUS FLAVUS IN A DRIED SALTED FISH IN JAVA ISLAND RESELLERS
Authors: Hidayah Izhamil 
Published: August 2018

This study aims to determine the probability of Aflatoxin B1 exposure from Aspergillus flavus in dried salted fish. The exposure of that may cause a health problems to consumers. The collecting of salted fish was conducted in several areas in Java Island, which were Tangerang, Bandung, Cirebon, Pelabuhan Ratu, Tegal, Cilacap, Banyuwangi and Tuban. Isolation and identification of Aspergillus flavus was conducted by using pour plate method on Aspergillus Flavus Parasiticus Agar (AFPA) media. Meanwhile, Measurement of Aflatoxin B1 (AFB1) content had been done by enzyme linked immunosorbent assay (ELISA). On the other hand, the occurence probability of Aflatoxin B1 risk from Aspergillus flavus was calculated by statistical probabilistic approach in @risk version 7.0 software with Monte Carlo simulation. The results of this study showed that in the consumption of salted fish for about 3.7 g/capita/day, it is probable that there are risk of 7.74 cfu/g A. flavus exposure and 0.7291 ppb aflatoxin B1 exposure in 1 g of salted fish that were taken from sampling locations. This value is still catagorized as low risk level