bluuebunny/crossref_metadata_2025_split huggingface dataset:
One Size Does Not Fit All: A Perspective on the American Society of Anesthesiologists Physical Status Classification for Pediatric Patients
Authors: Ferrari Lynne R. , Leahy Izabela , Staffa Steven J. , Johnson Connor , Crofton Charis , Methot Craig , Berry Jay G. 
Published: June 2019

BACKGROUND:
The American Society of Anesthesiologists physical status (ASA-PS) classification system is used worldwide to classify patients based on comorbid conditions before general anesthesia. Despite its popularity, the ASA-PS classification system has been shown to have poor interrater reliability due to its subjective definitions, especially when applied to the pediatric population. We hypothesized that the clarification of ASA-PS definitions to better reflect pediatric conditions would improve the accuracy of ASA-PS applied to this population.

METHODS:
A stratified, randomized sample of 120 pediatric surgical cases was collected from a tertiary-care pediatric hospital. A team of senior anesthesiologists reclassified ASA-PS within this patient sample using the suggested pediatric-specific ASA-PS definitions. Interrater reliability was measured using intraclass correlation (ICC) and Fleiss κ statistic. In addition, a qualitative study component using small focus groups of senior anesthesiologists identified areas of ambiguity within the ASA-PS system.

RESULTS:
Among the 90 reclassifications within each ASA-PS group, 42.2% (n = 38) of ASA-PS I were upgraded to ASA-PS II, and 36.7% (n = 33) of ASA-PS II were upgraded to ASA-PS III. In addition, 28.9% (n = 26) of ASA-PS III were upgraded to ASA-PS IV, and 24.4% (n = 22) of ASA-PS IV were downgraded to III. ICC across the reclassified ASA-PS categories was 0.77 (95% confidence interval [CI], 0.71–0.83; P < .001) demonstrating strong overall agreement. Fleiss κ statistic was lowest in ASA-PS II and III patients (κ = 0.41 and κ = 0.30, respectively) indicating lower agreement beyond chance within these subgroups. Focus groups revealed common themes such as active sequelae of disease, active versus well-controlled presence of comorbidities, and the possible inclusion of functional limitations as important considerations.

CONCLUSIONS:
The ASA-PS classification system has several benefits including ease-of-use, simplicity, and flexibility. However, revising the ASA-PS system to provide better guidance for pediatric patients could be valuable. While this study demonstrates good interrater reliability with the included ASA-PS pediatric definitions, further work is needed to clarify accurate assignment of ASA-PS within the midrange of the scale (ASA-PS II and III) and explore its implementation in other institutions.
Active receptor tyrosine kinases, but not Brachyury, are sufficient to trigger chordoma in zebrafish
Authors: D'Agati Gianluca , Cabello Elena María , Frontzek Karl , Rushing Elisabeth J. , Klemm Robin , Robinson Mark D. , White Richard M. , Mosimann Christian , Burger Alexa 
Published: June 2019

ABSTRACT
The aberrant activation of developmental processes triggers diverse cancer types. Chordoma is a rare, aggressive tumor arising from transformed notochord remnants. Several potentially oncogenic factors have been found to be deregulated in chordoma, yet causation remains uncertain. In particular, sustained expression of TBXT – encoding the notochord regulator protein brachyury – is hypothesized as a key driver of chordoma, yet experimental evidence is absent. Here, we employ a zebrafish chordoma model to identify the notochord-transforming potential of implicated genes in vivo. We find that Brachyury, including a form with augmented transcriptional activity, is insufficient to initiate notochord hyperplasia. In contrast, the chordoma-implicated receptor tyrosine kinases (RTKs) EGFR and Kdr/VEGFR2 are sufficient to transform notochord cells. Aberrant activation of RTK/Ras signaling attenuates processes required for notochord differentiation, including the unfolded protein response and endoplasmic reticulum stress pathways. Our results provide the first in vivo evidence against a tumor-initiating potential of Brachyury in the notochord, and imply activated RTK signaling as a possible initiating event in chordoma. Furthermore, our work points at modulating endoplasmic reticulum and protein stress pathways as possible therapeutic avenues against chordoma.
Modern contraceptive use among female adolescents in rural Nigeria: Does exposure to family planning messages matter? A cross-sectional study
Authors: Chima Victor , Alawode Oluwatobi Abel 
Published: June 2019

Background: The world currently has the highest number of adolescents in all of history. Africa is home to quite a number of them, with most of these adolescents in Africa live in rural areas where they are more disadvantaged and their reproductive decisions could have telling impacts on their lives, family planning (contraception) has been identified as important to avoid such impacts. Factors associated with the use of modern contraceptives among female adolescents have been extensively researched but the importance of mass media family planning messages on modern contraceptives use among female adolescents in rural Nigeria is under-researched, hence this study. Method: This paper uses the 2013 Nigeria Demographic and Health Survey (NDHS) data with a weighted sample size (n=4473) to examine the association between exposure to family planning messages and use of modern contraceptives among female adolescents in rural Nigeria. Results: Findings indicated that exposure to family planning messages on radio and television were significantly associated with modern contraceptive use, however, educational attainment and region of residence were other factors that influenced modern contraceptive use.. Conclusion: The study concludes that family planning messages through mass media especially radio and television are associated with modern contraceptives use among rural adolescents. The continued use of mass media would enhance opportunities to achieve more results, however, other interventions addressing education with objectives of closing the rural-urban socio-economic gap should be encouraged also, as these factors play critical roles in improving uptake of family planning among rural adolescents. Further, messages on modern contraceptive use should be sensitive to regional divides in terms of content and delivery.
Enhanced recovery after anterior resection: earlier leak diagnosis and low mortality in a case series
Authors: D’Souza N , Robinson PD , Branagan G , Chave H 
Published: June 2019

Introduction Early detection and treatment of anastomotic leak may mitigate its consequences. Within an enhanced recovery setting, the subtle signs of a leak can be more apparent. There are multiple treatment options for anastomotic leak following anterior resection. This study aimed to determine when leaks are diagnosed in enhanced recovery, and whether the choice of intervention affects outcomes. Materials and methods We conducted a retrospective study of a prospectively maintained database of complications of anterior resections for rectal cancer in a district general hospital in the UK. Data were extracted on day of leak diagnosis, length of stay, intensive care admission, mortality and ileostomy reversal rate. Statistical analysis was performed using Student’s t, Mann–Whitney U and chi square tests. Results A total of 323 patients underwent anterior resection for colorectal cancer between 1 January 2007 and 1 October 2015. The leak rate was 10.8% (35/323). Patients were diagnosed in hospital with leaks on median day 4 compared with day 11 for patients diagnosed with leaks after readmission from home (P < 0.001). Defunctioned patients diagnosed with a leak had a longer median length of stay (24 vs 18.0 days, P = 0.31) but were more frequently managed non-operatively (100% vs 19.0%, P < 0.001) and had a lower admission rate to intensive care (9.5% vs 42.9%, P = 0.02) than patients who were not defunctioned at time of resection. Overall mortality from anastomotic leak was 2.9% (1/35). Ileostomies were reversed in 73.5% of patients (25/34). Discussion Enhanced recovery enables early diagnosis of leaks following anterior resection. Defunctioning of patients with anastomotic leak lowers mortality.
‘SANGU AKHIRAT’ SEBAGAI GERAKAN FILANTROPI: TRANSFORMASI BANTUAN PEMBANGUNAN MASJID AL-AMIN MENJADI DANA SOSIAL UMAT
Authors: Efendi Aweng , Abu Suhud Moh. 
Published: June 2019

The program ‘Sangu Akhirat’ is popularity by people of Sumber Gamol Village, Sleman. If we are variously from behind, ‘Sangu Akhirat’ program is a model of Muslim philanthropy movement who increasingly develops in the society of this country for old. For the early, this programs has been the purpose of cost salvage building mosque in 2007, but the next step when mosque building after finished is still existed until right now. Meanwhile, the programs have been changing of function become social cost since 2012. Hence, this article aims to explain the transforming develop from cost building mosque become social cost security for empowerment. For the step early, this paper is developing research of thesis for the graduate program, then this article cultivated to become a narrative field study with a qualitative approach. Data of this research has been treated through the interview process, observation, and documentation. Moreover, the data was cultivated by reduction data, display data, and conclusion. Based on field discovery, this article is twice part of the implementation program both interpretation and organizing steps and the application program. After implementation of ‘Sangu Akhirat’ program, I am discovering of impact in the growing of mutual assistance spirit, increasingly of sympathy, and developing for spirit helping people in the village.[Program ‘Sangu Akhirat’ dipopulerkan oleh masyarakat Dusun Sumber Gamol, Sleman. Jika ditelisik, ‘Sangu Akhirat’ masuk dalam gerakan filantropi Islam yang sudah tumbuh berkembang di tengah masyarakat negeri ini. Pada tahap awal, program ini bertujuan untuk menutupi biaya pembangunan masjid di tahun 2007, namun tahap selanjutnya ketika pembangunan masjid selesai, program ini masih memiliki eksistensi. Di mana eksistensi program ini berubah fungsi menjadi dana sosial umat sejak 2012. Dengan demikian, artikel ini menjelaskan tentang transformasi program bantuan pembangunan masjid Al-Amin Aminah Binti Saif menjadi dana sosial umat. Secara eksploratif, artikel ini menjelaskan lebih dalam tentang implementasi program ‘Sangu Akhirat’. Pada awalnya, kajian ini adalah penelitian lapangan (field research) dengan jenis kualitatif. Seiring dengan kebutuhan publikasi, maka hasil draft penelitian ini diolah menjadi sebuah artikel dengan analisis deskriptif. Data penelitian ini diolah dari proses wawancara, obsevasi, dan dokumentasi. Adapun data yang diperoleh melalui proses penyederhanaan dengan cara reduksi data, menyajikan data, dan penarikan kesimpulan. Berdasarkan temuan lapangan, artikel ini di bagi menjadi dua implementasi program, yakni tahapan interpretasi, tahapan pengorganisasian, dan tahapan aplikasi. Setelah melalui tahap implementasi, penulis menemukan beberapa dampak dari program ini, antara lain: tumbuhnya semangat gotong royong, meningkatnya rasa simpatik sesama masyarakat, dan berkembangnya rasa saling tolong menolong di masyarakat.]
PERBANDINGAN INDEKS KEANDALAN SISTEM DISTRIBUSI PADA PENYULANG SRL03 DALAM KEADAAN PERFECT SWITCHING DAN IMPERFECT SWITCHING
Authors: Afriana Elza , Hermawan Hermawan , Handoko Susatyo 
Published: June 2019

Dewasa ini tenaga listrik telah menjadi kebutuhan pokok bagi masyarakat, sehingga kontinuitas penyediaan tenaga listrik menjadi tuntutan yang semakin besar dari konsumen. Berdasarkan data catatan teknik di PT PLN (Persero) Rayon Semarang Selatan pada tahun 2016, penyulang SRL03 merupakan penyulang yang paling sering mengalami pemadaman yaitu sebanyak 18 kali/tahun. Penyulang SRL03 mengalami pemadaman selama 16,934 jam/tahun. Berdasarkan permasalahan diatas maka perlu adanya studi tentang perhitungan tingkat keandalan sistem tenaga listrik pada penyulang SRL03. Pada penelitian ini dievalusi nilai indeks keandalan menggunakan metode Reliability Index Assesment (RIA) pada penyulang SRL03 dalam keadaan perfect switching dan imperfect switching. Indeks keandalan yang didapat berdasarkan perhitungan menggunakan metode RIA saat kondisi jaringan diasumsikan perfect switching, nilai SAIFI sebesar 1,1564 gangguan/tahun, nilai SAIDI sebesar 6,7839 jam/tahun, dan CAIDI sebesar 5,8664 jam/gangguan, sedangkan indeks keandalan saat kondisi jaringan diasumsikan imperfect switching, nilai SAIFI sebesar 1,1684 gangguan/tahun, dan nilai SAIDI sebesar 6,7839 jam/tahun, dan CAIDI sebesar 5,8061 jam/gangguan.
PERANCANGAN BOOST CONVERTER SEBAGAI SUPLAI INVERTER MENGGUNAKAN DSPIC30F4011 DENGAN METODE KONTROL PROPORTIONAL INTEGRAL
Authors: Irkham Irkham , Setiawan Iwan , Nugroho Agung 
Published: June 2019

Energi fosil adalah energi yang paling banyak digunakan, namun ketersediaan bahan bakar fosil semakin menipis. Energi terbarukan dapat digunakan sebagai salah satu alternatif pemenuhan energi. Panel surya adalah salah satu energi terbarukan yang bekerja dengan mengubah energi matahari menjadi energi listrik. Pemanfaatan panel surya sebagai pembangkit dapat dihubungkan lagsung dengan grid melalui sebuah inverter. Permasalahan ketika panel surya dihubungkan ke grid adalah tegangan panel surya lebih rendah dibanding nilai tegangan grid. Digunakan boost converter untuk menaikkan tegangan DC. Tegangan keluaran panel surya tergantung pada iradiasi dan beban yang disuplai panel surya. Untuk menjamin tegangan keluaran panel surya konstan, diperlukan umpan balik tegangan pada konverter DC-DC. Pada Penelitian ini dirancang boost converter mengunakan umpan balik tegangan dengan sistem kontrol proportional integral. Tahapan perancangan diawali menghitung komponen boost converter, verifikasi menggunakan software PSIM dan implementasi perangkat keras. Boost converter telah berhasil dibuat, dari pengujian menggunakan umpan balik tegangan variasi tegangan masukan dengan nilai keluaran dijaga konstan pada nilai 50 volt pada parameter kontrol Kp=0.5 dan Ki=0.0, tegangan keluaran pada keadaan steady state memiliki nilai error rata-rata sebesar 30% dari set point, pada parameter kontrol Kp=0.0 dan Ki=0.1 tegangan keluaran pada keadaan steady state memiliki nilai error rata-rata sebesar 0% dari set point, pada parameter kontrol Kp=0.5 dan Ki=0.1 tegangan keluaran pada keadaan steady state memiliki nilai error rata-rata sebesar 0% dari set point.
PERANCANGAN KENDALI SUHU PADA PURWARUPA PENGERING PAKAN IKAN MENGGUNAKAN METODE KONTROL PI BERBASIS MIKROKONTROLER
Authors: Jaelani Achmad , Triwiyatno Aris , Sudjadi Sudjadi 
Published: June 2019

Metode kontrol yang digunakan pada alat pengeringan pakan ikan di Lab FPIK (Fakultas Perikanan dan ilmu Kelautan) Universitas Diponegoro ini masih menggunakan metode kontrol On-off yang kurang efektif serta pengendalian suhu masih menghasilkan keluaran yang tidak stabil dan susah untuk mencapai referensi suhu yang diinginkan terlebih jika mendapat gangguan. Oleh karena itu, dibutuhkan metode kontrol yang baik untuk menangani permasalahan kurang efektifnya metode kontrol pada alat pengering pakan ikan di Lab FPIK UNDIP. Pada penelitian ini dirancang kendali suhu pada purwarupa pengering pakan ikan menggunakan sensor DHT22 dan sensor SEN0193, mikrokontroler Atmega328P sebagai otak pengendalian utama, modul bluetooth HC-05 sebagai media komunikasi antara mikrokontroler dengan interface. Metode kontrol yang digunakan untuk mengendalikan suhu pada purwarupa pengering pakan ikan adalah PI (Proporsional Integral). Parameter kontrol PI diperoleh melalui metode tuning Ziegler Nichols 1 dengan nilai Kp = 18,4 dan Ti = 133,2. Hasil pengujian metode kontrol PI terhadap tiga variasi referensi suhu 55°C, 57°C, dan 53°C serta pemberian gangguan pada referensi suhu 55°C, yaitu mampu menghasilkan respons sistem yang stabil meskipun masih berosilasi.
ANALISIS DAN PERBANDINGAN JENIS KAWAT KANTHAL A-1 DAN NICHROME 80 SEBAGAI ELEMEN PEMANAS PADA OVEN LISTRIK HEMAT ENERGI
Authors: Vingtsabta Victorius Veinard , Syakur Abdul , Warsito Agung 
Published: June 2019

Pada era ini kita membutuhkan peralatan elektronik yang hemat dan efisien, contohnya oven. Dalam oven terdapat elemen pemanas. Elemen pemanas yang digunakan harus menghasilkan panas yang optimum dan hemat energi. Elemen pemanas yang digunakan dalam penelitian ini yaitu FeCrAl alloy and NiCrSi alloy. FeCrAl alloy atau kawat Kanthal A-1 tersusun atas 20% kromium, 5,8% aluminium dan besi, sedangkan NiCrSi atau Nichrome 80 tersusun atas 80% nikel, 19,5% kromium dan 1,45% silicon. Digunakannya kedua bahan tersebut karena kedua bahan tersebut memiliki nilai resitansi yang rendah dan dapat menghasilkan panas yang tinggi. Dalam penelitian ini menggunakan Kawat Nichrome 80 dan Kanthal A-1 berdiameter kawat 0,8 mm dan 1 mm dengan variasi lilitan 8 mm, 10 mm dan 12 mm. Kedua kawat tersebut diaplikasikan dalam pemanas oven berukuran 40 cmx 40 cm x 50 cm. Didapatkan kawat Nichrome berdiameter kawat 1 mm dengan diameter lilitan 8 mm menghasilkan suhu maksimal 76,17 dengan waktu 60 menit. Daya terendah dikonsumsi yaitu 170 W oleh kawat Nichrome 80 (diameter kawat 0,8 mm dengan diameter lilitan 10 mm). Sedangkan energi terendah yang dikonsumsi yaitu 10,45 Wh oleh Kawat Nichrome 1 mm dengan diameter lilitan 8 mm. Dapat simpulkan bahwa diameter kawat dan jenis kawat memengaruhi nilai resistansi. Nilai resistansi memengaruhi arus, daya dan energi yang digunakan.
PdIn Catalysts in a Continuous Fixed Bed Reactor for the Nitrate Removal from Groundwater
Authors: Marchesini F. A. , Mendow G. , Picard N. P. , Zoppas F. M. , Aghemo V. S. , Gutierrez L. B. , Querini C. A. , Miró E. E. 
Published: June 2019

Abstract
The ground water (GW) is a real sample of water which contains nitrates (81 mg/L), carbonates and sulphates. This sample was treated by catalytic reduction in a bubble column fixed-bed reactor. The reaction conditions were room temperature and atmospheric pressure, and hydrogen was used as reducing agent. A comparison between the catalytic activity of Pd,In/SiO2 and Pd,In/Al2O3 catalysts was performed, giving the latter the best results regarding the nitrate conversion and the former the selectivity to nitrogen. Synthetic water containing nitrates (SW) and the groundwater (GW) with high salinity (81 mg/L nitrates) and humic acid content were treated in these conditions using HCl and CO2 as acidifiers. When the SW was acidified with CO2 at an H2 flow (2.17 mL/min), more than 50 % of conversion was obtained with an ammonia and nitrite concentrations of 0.44 and 0.92 ppm respectively. These results reached the level established by the WHO and the USEPA. However, both Pd,In/SiO2 and Pd,In/Al2O3 catalysts showed evidence of some deactivation process. This deactivation was higher in the GW sample, possibly due to the presence of Ca+2 and Mg+2 cations that precipitate on the active sites, and/or the presence of humic acids. The characterization studies indicated that, after the reaction, the composition of the metal phases was modified, specifically on their surface. As the catalyst activity is related to surface ratio Pd/In, a relative increase in the concentration of Pd decreases the activity and causes changes in the selectivity to N2. Some sintering of the metal particles was also observed to contribute to catalyst deactivation. Nevertheless, promising results were obtained since a high water volume could be treated with a relatively low amount of low metal loading catalysts.
Optimal Unit Commitment with Concentrated Solar Power and Thermal Energy Storage in Afghanistan Electrical System
Authors: Matin Ibrahimi Abdul , Howlader Harun Or Rashid , Sayed Shah Danish Mir , Shigenobu Ryuto , Masih Sediqi Mohammad , Senjyu Tomonobu 
Published: June 2019

Abstract
Power sector, as one of the least progressed division, is limiting the socioeconomic development in Afghanistan. Although the country has a vast solar energy potential with a bright prospect for growth, however inadequate endorsement and attention have prevented its proper use. Meanwhile, Kabul the capital city and one of the fastest growing cities in the world, is suffering severe challenges to supply its energy needs. Presently, Kabul electrical system is subjected to insecure and insufficient supply due to the lack of integrated networks and deployment of Renewable Energy (RE) sources. This research investigates an appropriate approach by introducing two Linear Fresnel Reflector (LFR) plants with a total capacity of 120 MW to overcome the present challenges in Kabul city. The proposed LFR units are incorporated with an energy storage system of full capacity production for five hours to cover the power shortage at night. The design aspect of LFR is specified by using of System Adviser Model (SAM). Levelized Cost of Electricity (LCOE) and the total annual output of the proposed LFR units are estimated as 0.2508$/kWh and 294,657.28 kWh respectively. To minimize the total operating costs of the integrated model and mitigate CO2 emissions, an optimal Unit Commitment is (UC) fulfilled as well. UC is accomplished by using MATLAB INTLINPROG optimization toolbox.
Evaluation of the relationship between short-term glycemic control and netrin-1, a urinary proximal tubular injury marker in children with type 1 diabetes
Authors: Uçaktürk Seyit Ahmet , Mengen Eda , Elmaoğulları Selin , Yücel Çiğdem , A. Yılmaz Aslıhan , Çifci Atilla 
Published: June 2019

Abstract

Background
Diabetic nephropathy (DN) is a significant cause of morbidity and mortality in young adults with type 1 diabetes (T1D). Microalbuminuria (MA) is generally considered as the earliest manifestation of DN. However, it has been shown that MA may be temporary and not reflect permanent renal failure. For this reason, sensitive markers are needed for the detection of kidney damage in the early period. Urinary tubular injury markers increase in the early period of diabetes. These tubular markers are rather indicators of acute renal damage. The objective of this study was to measure the urinary netrin-1 level, a marker of tubular injury in children with normoalbuminuric (NA) T1D, and to determine its relationship with short-term fluctuations in blood glucose using fructosamine levels.

Methods
Netrin-1 levels in spot urine samples from 82 children with T1D (median age 13.6 years) without MA or hypertension and from 59 healthy controls (median age 11.3 years) with a similar distribution of age and body mass index (BMI) were compared. The relationship of the netrin-1 levels with diabetes parameters such as fructosamine, hemoglobin A1c (HbA1c) or duration of diabetes was investigated.

Results
Urinary netrin-1 level was found to be higher in patients with T1D than in healthy controls (590 [interquartile range (IQR) = 811] pg/mg-creatinine [pg/mg-cr] and 396 [IQR = 742] pg/mg-cr, respectively) (p = 0.03). Urinary netrin-1 was found to correlate with HbA1c (p = 0.007, r = 0.320) and fructosamine (p = 0.04, r = 0.310) but not with average HbA1c in the last year (p = 0.14, r = −0.19), duration of diabetes (p = 0.83, r = 0.02) or other diabetes indices.

Conclusions
These results support the idea that tubular damage occurs early in the course of diabetes. However, the fact that netrin-1 is related to fructosamine and HbA1c but not to the duration of diabetes or average HbA1c in the last year may suggest that the tubular damage markers are affected by short-term fluctuations in blood glucose.