bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aplikasi klinis Continous Interscalene Block
Authors: Basuki Djujuk R 
Published: May 2019

Blok pleksus brakialis dimulai oleh Ansbro pada tahun 1946. Pada tahun 1999, Boezaart mempublikasi tehnik baru yaitu continuous interscalene block. Sebagian besar metode ini memiliki kendala pada penempatan kateter yang tidak akurat atau dislokasi kateter. Continous Interscalene Block (CISB) adalah blok plexus brachial proximal di leher yang dapat dilakukan melalui pendekatan anterior atau posterior. Pendekatan anterior disebut juga True Continous Interscalene Block dan pendekatan posterior dikenal sebagai continous Cervikal Paravertebral Block. CISB diindikasikan untuk setelah pembedahan mayor bahu, clavicula lateral, acromiocalvicular join dan proksimal humerus serta juga dapat digunakan untuk terapi nyeri kronik ekstremitas atas. Komplikasi Continous Interscalene Block (CISB) mirip dengan single ISB injeksi, meskipun insiden paralisis diafragma akibat blok nervus frenicus telah dilaporkan secara signikan berkurang.Dalam praktik rutin, interscalene blok dapat menggunakan bolus awal 10-15 ml obat anastesi lokal seperti rovipacaine 0,2-0,75 %. Konsentrasi yang digunakan tergantung pada faktor pasien, tujuan blok (analgesia atau anestesia), dan ada tidanya kateter. Jika terdapat kateter, dosis bolus awal bisa dikurangi dan anastesi lokal tambahan bisa disuntikkan melalui kateter. Infus kontinyu rovipacaine 0,2 % 4-10 ml/ jam dapat digunakan untuk analgesia pasca operasi. Penggunaan infus kontinyu bupivacaine 0,125 % dengan kecepatan 0,125 ml/kg per jam juga dapat mengatasi nyeri secara efisien. Dibandingkan dengan teknik kontinyu, teknik PCRA (Patient control regional analgesia) dengan infus basal rendah 5 ml/jam bupivacaine ditambah dengan bolus kecil PCA 2,5 ml/30 menit dapat memberikan kontrol nyeri yang efisien, tetapi konsumsi lokal anastesi berkurang 37 % dan efek sampingnya rendah.
Preoksigenasi pada Anestesi Umum
Authors: Malawat Faizal Rahmat , Cahyadi Bondan Irtani 
Published: May 2019

Latar Belakang: Pemantauan saturasi hemoglobin selama tatalaksana jalan napas penting untuk keselamatan pasien. Desaturasi di bawah 70% menghantarkan pasien pada risiko mengalami disritmia, dekompensasi hemodinamik, kerusakan otak akibat hipoksia dan kematian. Tantangan untuk dokter emergensi adalah dapat melakukan intubasi endotrakeal secara cepat tanpa hipoksia atau aspirasi. Preoksigenasi dengan 100% oksigen sebelum induksi anestesi, merupakan manuver yang diterima secara luas yang dapat meningkatkan penyimpanan oksigen tubuh, sehingga menunda onset desaturasi selama periode apnea setelah induksi anestesi dan muscle relaksan.Tujuan: Tujuan preoksigenasi adalah mengganti nitrogen di FRC dengan oksigen; yang disebut proses denitrogenasi. Hal ini memiliki dampak pada penyimpanan oksigen tubuh dan meningkatkan toleransi terhadap apneu secara substansial. Preoksigenasi efektif menghasilkan batas aman untuk intubasi darurat dan memperpanjang durasi dari apnea tanpa desaturasi.Metode: Preoksigenasi di dalam kamar operasi biasanya menggunakan sirkuit yang terpasang pada mesin anestesi, yang akan memberikan FiO2 yang tinggi. Kemudian, keberhasilan dari preoksigenasi dapat terus dinilai dengan memperkirakan derajat denitrogenasi menggunakan penganalisa gas untuk menentukan konsentrasi fraksi oksigen yang dihembuskan (FeO2). Untuk operasi pasien dengan risiko aspirasi yang tinggi, anestesi mengembangkan induksi dengan sekuens cepat dengan cara pemberian sedatif dan paralitik tanpa ventilasi secara simultan sembari menunggu paralitik berefek, sehingga dapat mengurangi risiko aspirasi. Posisi supine tidak ideal untuk mencapai preoksigenasi optimal, karena menjadi lebih sulit untuk mengambil napas penuh dan lebih banyak bagian paru posterior yang menjadi prone sampai kolaps. Sebaliknya posisi trendelenburg akan meningkatkan preoksigenasi dan mungkin berguna pada pasien yang diimobilisasi karena kemungkinan spinal injury.Simpulan: Dalam keadaan apneu, faktor yang memiliki efek terbesar pada waktu tercapainya hipoksia kritis adalah FRC, konsentrasi oksigen alveoli, dan kecepatan metabolisme. Konsentrasi hemoglobin dan derajat shunting sirkulasi kurang penting dibandingkan faktor-faktor diatas. Ahli anestesi dapat menghindari hipoksia dengan preoksigenasi. Sampai kontrol definitif jalan napas dapat dicapai, ahli anestesi dapat memberikan oksigen 100% sehingga memungkinkan masuknya oksigen ke paru dan membantu mencegah terjadinya hipoksia.
Analisis Anesthesia Ready Time Dalam Pelayanan Anestesi untuk Pembedahan Darurat di Kamar Operasi IGD RSUD Dr. Soetomo Surabaya Tahun 2018
Authors: Prabowo Yudha Adi , Basoeki April Poerwanto , Sylvaranto Teguh , Edwar Pesta Maurid 
Published: May 2019

Latar Belakang: Pelayanan anestesi untuk operasi darurat bertujuan memberikan kedalaman anestesi secara cepat dan adekuat untuk dilakukan pembedahan. Survei pendahuluan di kamar operasi elektif RSUD Dr. Soetomo pada Oktober hinggaDesember 2017 menunjukkan bahwa pada lebih dari 30% pasien, waktu sejak masuk kamar operasi hingga manipulasi pembedahanmencapai lebih dari 60 menit, sedangkan waktu benchmark internasional adalah kurang dari 45 menit. Tujuan: Untuk menganalisis Anesthesia Ready Time (ART) dalam pelayanan anestesi di kamar operasi darurat IGD RSUD Dr. Soetomo, Surabaya.Metode: 254 subyek dengan Pasien Status (PS) ASA 1-4 yang menjalani operasi darurat di RSUD Dr. Soetomo selama April 2018 yang terlibat dalam penelitian ini. Waktu dicatat sejak pemasangan monitor, waktu induksi anestesi, waktu pemasangan prosedur invasif, dan deklarasi pasien siap dilakukan manipulasi bedah. Kesulitan dan kendala yang terjadi dari pemasangan monitor hingga deklarasi siap operasi juga dicatat.Hasil: ART di kamar operasi darurat IGD RSUD Dr. Soetomo 24,00 menit untuk PS ASA 1;22,08 menit untuk PS ASA 2;29,03 menit untuk PS ASA 3;25,00 menit untuk PS ASA 4;23,34 menit untuk Sub Arachnoid Block (SAB); 36,67 menit untuk epidural; 21,71 menit untuk pemasangan ABP ; dan 21,25 menit untuk pemasangan Central Venous Catheter (CVC). Faktor yang mempengaruhi lamanya ART adalah menunggu kedatangan operator (42,5%), pemasangan prosedur invasif anestesi (7,3%), dan menunggu kedatangan PPDS anestesi yang lebih senior untuk mendampingi proses induksi anestesi (5,2%).Kesimpulan: ART di kamar operasi darurat IGD RSUD Dr. Soetomo sudah mendekati benchmark internasional.
Manajemen Anestesi Prosedur Fontan
Authors: Ridconi Akhmad , Nugroho Budi 
Published: May 2019

PendahuluanSingle ventricle merupakan kelainan jantung kongenital kompleks, dan seseorang yang hidup dengan kelainan ini akan disertai dengan sejumlah keterbatasan. Tanpa terapi bedah, univentrikel akan menjadi malapetaka. Prosedur Fontan merupakan teknik pembedahan terpilih yang dapat diterapkan pada pasien dengan single ventricle. Hasil prosedur Fontan dipengaruhi oleh beberapa faktor termasuk faktor, prosedur, pengelolaan, dan tekanan vena sisi kanan berangsur-angsur akan meningkat. Seiring dengan berjalannya waktu gagal jantung kanan akan mengalami penurunan fungsi sistem, meliputi peningkatan resistensi pembuluh darah pulmoner (PVR), peningkatan tekanan vena sistemik (SVR), low-cardiac output kronis, disfungsi ventrikel kanan, dan kegagalan prosedur perbaikan single ventricle. Presentasi KasusWanita 19 tahun dengan Double Outlet Right Ventricle, Ventricular Septal Defect, Pulmonal Stenosis, Patent Ductus Arteriosus, Bilateral Superior Vena Cava yang akan menjalani prosedur Fontan. KesimpulanProsedur Fontan akan meningkatkan usia harapan hidup pasien. Keberhasilan jangka panjang ditentukan oleh banyaknya komplikasi. Dalam kondisi tidak adanya ketaatan.
Obesity-induced immune dysfunction and immunosuppression: TEM observation of visceral and subcutaneous lymph node microarchitecture and immune cell interactions
Authors: Solt Claudia M. , Hill Jessica L. , Vanderpool Kim , Foster Michelle T. 
Published: May 2019

Abstract

Background
Inflammation, induced by excessive adiposity, links obesity to disease risk yet little attention has been devoted to the lymphoid tissues embedded within adipose tissue depots. Lymph nodes are the primary site for the development of protective immunity, hence any disease process that affects these tissues will also directly impact immunity. Here we examined how obesity alters secondary lymphatic tissue structure and encapsulated immune cells.

Materials and methods
Four-month-old C57BL/6 male mice were fed standard rodent chow or a Western high fat diet (HFD) for 6 months. Center regions of visceral and subcutaneous lymph nodes (SQLNS) were observed via transmission electron microscopy (TEM).

Results
Compared with chow, HFD-induced obesity deleteriously modified the structural microarchitecture and immune cell morphology of visceral and SQLNs. In HFD mice, fibroblastic reticular cells (FRCs) were dysregulated while laying among excessive amounts of disorganized collagen (C). In addition HFD lymph nodes contained a disproportionate amount of cellular debris from damaged or dead cells, increased sinus spacing and decreased immune cell interactions. Specifically, dendritic cells (DCs) that are necessary for adaptive immune response where embedded among extracellular debris with decreased pseudopodia. Similarly, the extraneous fibrous extracellular matrix (ECM) in HFD mice limited contact between lymphocytes (LCs) causing their microvilli extensions to decrease.

Discussion
Overall, excessive C production within lymph nodes, driven by diet-induced obesity, creates a physical barrier that impedes proper lymph flow and cellular communication. Obesity-induced disorganization of the immune cell guidance network interrupts immune cell adhesion and consequently inhibits travel within cortex regions needed for cell interactions, survival and proliferation.
Accelerated wound healing process in rat by probiotic Lactobacillus reuteri derived ointment
Authors: Khodaii Zohreh , Afrasiabi Saman , Hashemi Seied Ali , Ardeshirylajimi Abdolreza , Natanzi Mahboobeh Mehrabani 
Published: May 2019

Abstract

Background
Antioxidant agents have positive effects on wound healing process and on the other hand probiotics also have great antioxidation or oxidation-resistance properties.

Methods
In this study, we investigated the effects of Lactobacillus reuteri derived ointment as a probiotic bacterium on the wound healing process using a full-thickness rat skin model. The wound diameter and contraction percent measurement, histopathological examination, and myeloperoxidase (MPO) enzyme activity evaluation were carried out during the period of study.

Results
Amount of deposit collagen was significantly increased; epithelization speed and epidermis production were also observed in the ointment-treated group, while the inflammation rate was also significantly lower than the control group. In addition, a significant reduction in the activity of enzyme MPO was also detected in the ointment-treated group.

Conclusions
According to the results, probiotic ointment effectively accelerates the wound healing process and it can be used as a promising drug for wound dressing application.
Persistent hyperinsulinaemic hypoglycaemia in children with Rubinstein–Taybi syndrome
Authors: Welters Alena , El-Khairi Ranna , Dastamani Antonia , Bachmann Nadine , Bergmann Carsten , Gilbert Clare , Clement Emma , Hurst Jane A , Quercia Nada , Wasserman Jonathan D , Meissner Thomas , Shah Pratik , Kummer Sebastian 
Published: May 2019

Objective
Genetic aetiology remains unknown in up to 50% of patients with persistent hyperinsulinaemic hypoglycaemia (HH). Several syndromes are associated with HH. We report Rubinstein–Taybi syndrome (RSTS) as one of the possible causes of persistent HH. Early diagnosis and treatment of HH is crucial to prevent hypoglycaemic brain injury.

Design
Four RSTS patients with HH were retrospectively analysed.

Methods
Genetic investigations included next-generation sequencing-based gene panels and exome sequencing. Clinical characteristics, metabolic profile during hypoglycaemia and treatment were reviewed.

Results
Disease-related EP300 or CREBBP variants were found in all patients, no pathogenic variants were found in a panel of genes associated with non-syndromic HH. Two patients had classic manifestations of RSTS, three had choanal atresia or stenosis. Diagnosis of HH varied from 1 day to 18 months of age. One patient was unresponsive to treatment with diazoxide, octreotide and nifedipine, but responded to sirolimus. All required gastrostomy feeding.

Conclusions
Given the rarity of RSTS (1:125 000) and HH (1:50 000), our observations indicate an association between these two conditions. We therefore recommend that clinicians should be vigilant in screening for HH in symptomatic infants with RSTS. In children with an apparent syndromic form of HH, RSTS should be considered in the differential diagnosis.
Understanding Social Entrepreneurial Intention Through Social Cognitive Career Theory: a Partial Least Squares Structural Equation Modelling Approach
Authors: Aure Patrick Adriel P. , Dui Rayan P. , Jimenez Shieradel V. , Daradar Denver D. , Gutierrez Alvin Neil A. , Blasa Angelique C. , Sy-Changco Joseph 
Published: May 2019

This research attempted to find empirical evidence that examines the drivers of social entrepreneurial intentions (SEI) through the lens of social cognitive career theory (SCCT). Since the SCCT model of SEI is still in the early stages and needs to be further developed, experts recommend the use of partial least squares structural equation modelling (PLS-SEM) to analyze data collected from 294 business students from a Philippine university. To account for observed heterogeneity, differences among senior high school and college business students were explored via multigroup analysis (PLS-MGA). Across all respondents, perceived support and internal outcome expectations have the strongest total effects on SEI, while self-efficacy and agreeableness have marginally significant direct effects and significant indirect effects on SEI. This study contributed to the field of social entrepreneurship by looking at alternate and developing explanations to the formation of SEI apart from conceptual models based on the theory of planned behavior.
Upgrading Crude Biodiesel dari Minyak Goreng Bekas menggunakan Katalis H-Zeolit
Authors: Aziz Isalmi , Tafdila Muhammad Akbar , Nurbayti Siti , Adhani Lisa , Permata Wahyu 
Published: May 2019

Crude biodiesel hasil transesterifikasi minyak goreng bekas dapat ditingkatkan kualitasnya melalui proses catalytic cracking menggunakan zeolit alam. Penelitian ini bertujuan untuk menentukan kondisi optimum proses catalytic cracking dan sifat fisika dan kimia biofuel yang dihasilkan. Reaksi dijalankan dalam reaktor dengan memvariasikan waktu (1, 2 dan 3 jam), konsentrasi katalis (3, 5 dan 7 %), ukuran partikel katalis (180, 250 dan 630μm) dan suhu reaksi (325, 350 dan 375°C). Kondisi optimum proses catalytic cracking crude biodiesel didapatkan pada : waktu 3 jam, konsentrasi katalis 7%, ukuran partikel katalis 180 μm dan suhu reaksi 375°C. Biofuel yang dihasilkan mengandung 6,26% fraksi bensin(C5-C11); 17,6% kerosin (C12-C15), 47,73% biodiesel (C16-C20) dan asam lemak 28,4%. Analisis sifat fisik menunjukan densitas 0,9631g/mL, titik tuang 12°C, titik nyala 49°C dan angka oktan 72,6. Kata kunci: catalytic cracking, crude biodiesel, angka oktan, biofuel. Crude biodiesel from transesterification of used cooking oil can be improved in quality through catalytic cracking using natural zeolite. This study aims to determine the optimum conditions for catalytic cracking and the physical and chemical properties of biofuels produced. The reaction was carried out in the reactor by varying the time (1, 2 and 3 hours), catalyst concentration (3, 5 and 7%), catalyst particle size (180, 250 and 630 μm) and reaction temperature (325, 350 and 375°C) . The optimum conditions for the catalytic cracking crude biodiesel process were obtained at: 3 hours, 7% catalyst concentration, catalyst particle size 180 μm and reaction temperature 375 ° C. The resulting biofuel contains 6.26% gasoline fraction (C5-C11); 17.6% kerosene (C12-C15), 47.73% biodiesel (C16-C20) and fatty acids 28.4%. Physical properties analysis showed density of 0.9631g/mL, pour point 12°C, flash point 49°C and octane number 72.6. Keywords: Catalytic cracking, crude biodiesel, octane number, biofuel.
Outpatient Prescription Opioid Use in Pediatric Medicaid Enrollees With Special Health Care Needs
Authors: Feinstein James A. , Rodean Jonathan , Hall Matt , Doupnik Stephanie K. , Gay James C. , Markham Jessica L. , Bettenhausen Jessica L. , Simmons Julia , Garrity Brigid , Berry Jay G. 
Published: May 2019

BACKGROUND AND OBJECTIVES:Although potentially dangerous, little is known about outpatient opioid exposure (OE) in children and youth with special health care needs (CYSHCN). We assessed the prevalence and types of OE and the diagnoses and health care encounters proximal to OE in CYSHCN.METHODS:This is a retrospective cohort study of 2 597 987 CYSHCN aged 0-to-18 years from 11 states, continuously enrolled in Medicaid in 2016, with ≥1 chronic condition. OE included any filled prescription (single or multiple) for opioids. Health care encounters were assessed within 7 days before and 7 and 30 days after OE.RESULTS:Among CYSHCN, 7.4% had OE. CYSHCN with OE versus without OE were older (ages 10–18 years: 69.4% vs 47.7%), had more chronic conditions (≥3 conditions: 49.1% vs 30.6%), and had more polypharmacy (≥5 other medication classes: 54.7% vs 31.2%), P &lt; .001 for all. Most (76.7%) OEs were single fills with a median duration of 4 days (interquartile range: 3–6). The most common OEs were acetaminophen-hydrocodone (47.5%), acetaminophen-codeine (21.5%), and oxycodone (9.5%). Emergency department visits preceded 28.8% of OEs, followed by outpatient surgery (28.8%) and outpatient specialty care (19.1%). Most OEs were preceded by a diagnosis of infection (25.9%) or injury (22.3%). Only 35.1% and 62.2% of OEs were associated with follow-up visits within 7 and 30 days, respectively.CONCLUSIONS:OE in CYSHCN is common, especially with multiple chronic conditions and polypharmacy. In subsequent studies, researchers should examine the appropriateness of opioid prescribing, particularly in emergency departments, as well as assess for drug interactions with chronic medications and reasons for insufficient follow-up.
Aktif Co-Ti (II) -B alaşım katalizörlerinin hidrojen üretiminde NaBH4 hidroliz reaksiyonu ve çevresel etkiler için kinetik özelliklerin analizi
Authors: ÖZDEMİR Oğuz Kaan 
Published: May 2019

Aktif
olmayan soy metallerin ilavesi, katalizörün katalitik performansını etkiler. Bu
çalışmada, sodyum borohidrit (NaBH4) 'in katalitik hidroliziyle
hidrojen üretimi için TiCl2 metal tuzundan yeni ve verimli bir üçlü
Kobalt-Titanyum (II) -Borid (Co-Ti(II)-B) katalizörleri hazırlanmıştır.
Co-Ti(II)-B katalizörü yardımıyla, hidrojen üretim oranı, farklı titanyum
konsantrasyonu, çözelti sıcaklığı, NaBH4 konsantrasyonu ve NaOH (baz
dengeleyici) konsantrasyonunun bir fonksiyonu olarak ölçülmüştür. Katalizörün
aktivitesi, termodinamik bakış açılarından analiz edilmiş ve Co-B katalizörü
ile karşılaştırılmıştır. Yüksek katalitik verimliliğe ek olarak, katalizör
ciddi koşullarda yüksek kararlılık ve aktivasyon kaybına karşı yüksek tolerans
gibi önemli özellikleri içermelidir. En yüksek hidrojen üretim oranı, %5 ağ.
Ti/(Ti + Co) molar oranı ile elde edilmiş ve bu katalizör için, optimum yakıt
konsantrasyonu, ağırlıkça %7,5 NaOH ile %7,5 NaBH4 olarak
tanımlanmıştır.
Panoramik görüntülerde gökyüzü sınır çizgisini kullanarak hareketli robotlar için yer kestirimi
Authors: KOKU Ahmet Buğra 
Published: May 2019

Robotik alanındaki ilerlemeler
20. yüzyılın sonuna doğru robotları fabrika ortamlarından çıkarmıştır. Zaman
içinde robotların günlük hayatımızdaki yerinin daha da artması beklenmektedir.
Diğer taraftan, robotların fabrikalardaki güvenlikli alanlar dışında çalışmaya
başlamalarına rağmen, birçok robotun hala önceden sınırları belirlenmiş
alanlarda çalışması yapacakları işlerin doğası itibarı ile beklenmektedir.
Dolayısıyla, bir robotun işlevselliğinin artması bakımından çalışacağı bölgeyi
iyi tanıması gerekecektir. Bu çalışmada panoramik görüntülerden elde edilen
gökyüzü sınır çizgisinin robot konumlandırması için kullanılabilirliği
değerlendirilmiştir. Robotun konumlandırılması için önce ilgili bölgeden
çekilen panoramik görüntüler kullanılarak bir tür harita üretilmiş, daha sonra
aynı bölgeden farklı zaman ve hava şartlarında çekilen görüntülerin bu harita
üzerinde konumlandırması gerçekleştirilmiştir. Önerilen yöntem görüntünün küçük
bir kısmına odaklandığı için, görüntünün tümünü işleyen yöntemlere göre bu yöntem
farklı kapasitedeki (özellikle düşük hesaplama kabiliyetli) platformlarda daha
kolay uygulanabilir niteliktedir.
A Comparative Evaluation of Internal Adaptation and Marginal Fitness of Two Zirconium Design Fabricated by CAD/CAM
Authors: Marqus Loura , Martani Nabeel 
Published: May 2019

Objective: Full anatomic zirconia crowns had been launched to overcome the problems associated with veneering porcelain. The aim of this study was to evaluate the internal and marginal adaptation of CAD/CAM milled zirconia core to full anatomic zirconia crown.
Methods: The mandibular right first molar of a dentaform model was prepared for the full ceramic crown with deep shoulder finish line. The model was scanned using intra-oral scanner to produce ten full anatomic zirconia crowns and ten zirconia cores. The internal and marginal adaptations (that represents the cement analog) were evaluated using the replica technique with the aid of a stereomicroscope.
Results: All There was no statistically significant difference between the internal and marginal adaptation of core and full anatomic zirconia crown, while a significant difference exists between them at the occlusal point that was greater in full anatomic crown. Both groups revealed the mean gap width of 146.7 +- 18 which is significant when compared to the standard value.
Conclusions: Both zirconia core and crown revealed comparable results of marginal and internal adaptation after sintering without any effect of bulk thickness. The obtained results were greater than the acceptable range.