bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moderate Tricuspid Regurgitation Found on a Fetal Echocardiogram
Authors: Fraser Megan 
Published: September 2024

This case study is a presentation of moderate tricuspid regurgitation found on a fetal echocardiogram performed at 14 weeks gestational age (following the suggestion of a cardiac abnormality at 11 weeks gestational age). The fetus showed moderate tricuspid regurgitation on a 14-week transvaginal fetal echocardiogram which was having a noticeable effect on the right sided heart structures. These findings were again assessed at 22 weeks gestational age and a noted improvement was documented. The gradual resolution of mild tricuspid regurgitation has been well documented however this case showed moderate levels of regurgitation combined with enlarged right sided heart structures and pericardial effusion. This is a unique case that characterizes the progression of tricuspid regurgitation from echocardiograms in the first and second trimester, utilizing both transvaginal and transabdominal approaches and demonstrates how it can have adverse effects on the heart at an early age and little to no effect later in pregnancy.
Le stéréotype de la « bonne grand-mère » comme facteur de clémence des tribunaux : analyse des biais de genre à l’épreuve de la détermination de la peine chez les femmes aînées
Authors: Pinel Valérine 
Published: September 2024

À partir d’un cadre théorique féministe, cette recherche exploratoire se penche sur la manière dont les critères appliqués par les tribunaux au moment de la détermination de la peine, pour les femmes aînées accusées, révèlent des stéréotypes genrés. L’analyse de cinquante-neuf décisions de première instance concernant des femmes âgées de plus de cinquante ans condamnées au Québec dans les dix dernières années a révélé l’application de modèles stéréotypés genrés dans plus de la moitié d’entre elles, ce qui crée une dichotomie dans le traitement de ces femmes par les tribunaux. Ainsi, à partir du stéréotype d’une nature non violente, maternelle et sacrificielle de la femme, la « bonne grand-mère » serait traitée avec plus de clémence que la « femme déviante » qui, par la commission d’une infraction, viendrait troubler les schémas genrés dans le cadre d’une société patriarcale, et donc dévier du rôle qui est attendu d’elle, en plus d’enfreindre la loi.
Pengembangan Modul IPA Terpadu Berbasis Problem-Based Learning Terintegrasi Isu Kemaritiman
Authors: Sarkity Dios , Fernando Adam 
Published: September 2024

Indonesia merupakan salah satu negara maritim terbesar di dunia yang terbilang lambat dalam mengintegrasikan pengetahuan kemaritiman di dalam pembelajaran. Integrasi pengetahuan kemaritiman ke dalam pembelajaran penting dilakukan untuk menanamkan pengetahuan kelautan kepada peserta didik dan menjadikan peserta didik lebih peka terhadap isu-isu kemaritiman. Integrasi pengetahuan kemaritiman salah satunya dapat dilakukan melalui Mata Pelajaran IPA yang bidang kajiannya erat dengan lingkungan. Dengan memiliki pengetahuan tentang kelautan, peserta didik diharapkan dapat memberikan solusi untuk mengatasi permasalahan-permasalahan kemaritiman. Tujuan penelitian ini adalah untuk mengembangkan Modul IPA berbasis Problem based learning terintegrasi isu-isu kemaritiman yang valid, praktis, dan efektif. Penelitian pengembangkan ini dilakukan dengan tahapan model pengembangan ADDIE. Pada artikel ini, penyajian hasil penelitian dibatasi sampai pada tahapan development. Modul yang telah dikembangkan diuji validitasnya dengan melibatkan beberapa validator. Data hasil uji validitas dianalisis dengan menggunakan Skala Likert. Hasil uji validitas modul menunjukkan bahwa modul berada pada kategori sangat valid untuk aspek materi dan aspek kegrafisan. Hasil ini menunjukkan bahwa modul layak diimplementasikan untuk diuji kepraktisan dan keefektifannya.
Relationships of B12 and Homocysteine with Outcomes in the SURE-PD, SURE-PD3, and STEADY-PDIII Trials
Authors: Christine Chadwick W. , Auinger Peggy , Forti Esther A.R. , Tat Lyvin , Cannizzaro Noemi , Mustafa Arshi , Iyer Jay M. , Oakes David , Green Ralph 
Published: September 2024

Background: DATATOP was a study of early Parkinson’s disease (PD) conducted in the 1980 s, before mandatory folic acid fortification in the United States. Our analysis of its baseline serum samples revealed a geometric mean vitamin B12 of 369 pg/mL and homocysteine (tHcy) of 9.5μmol/l. We also found that low B12 predicted greater worsening of ambulatory capacity (AC) and elevated tHcy (>15μmol/L) predicted greater declines in cognitive function. Objective: We sought to measure B12 and tHcy in contemporary trial participants with early PD who had not started dopaminergic treatment and to determine whether these analytes were associated with clinical progression. Methods: We measured B12 and tHcy from baseline and end-of-study blood samples from three recent clinical trials. Results: Baseline geometric mean B12 levels for these studies ranged from 484– 618 pg/ml and for tHcy ranged from 7.4– 10μmol/L. Use of B12-containing supplements ranged from 41– 61%, and those taking supplements had higher B12 and lower tHcy. Those who began levodopa, but were not taking B12-supplements, had greater end-of-study tHcy. There was no association of baseline tHcy > 15μmol/L with annualized change in Montreal Cognitive Assessment and no association of baseline B12 tertiles with change in AC. Conclusions: In these longitudinal trials, B12 levels were higher than for DATATOP, due in large part to increased B12-supplement intake, while tHcy levels were similar. Initiation of levodopa was associated with increases of tHcy in those not taking a B12-containing supplement. These smaller studies did not replicate prior findings of low B12 and elevated tHcy with features of progression, possibly due to higher baseline B12.
Enhancing liver tumor segmentation with UNet-ResNet: Leveraging ResNet’s power
Authors: Sheela K. Selva , Justus Vivek , Asaad Renas Rajab , Kumar R. Lakshmana 
Published: September 2024

BACKGROUND: Liver cancer poses a significant health challenge due to its high incidence rates and complexities in detection and treatment. Accurate segmentation of liver tumors using medical imaging plays a crucial role in early diagnosis and treatment planning. OBJECTIVE: This study proposes a novel approach combining U-Net and ResNet architectures with the Adam optimizer and sigmoid activation function. The method leverages ResNet’s deep residual learning to address training issues in deep neural networks. At the same time, U-Net’s structure facilitates capturing local and global contextual information essential for precise tumor characterization. The model aims to enhance segmentation accuracy by effectively capturing intricate tumor features and contextual details by integrating these architectures. The Adam optimizer expedites model convergence by dynamically adjusting the learning rate based on gradient statistics during training. METHODS: To validate the effectiveness of the proposed approach, segmentation experiments are conducted on a diverse dataset comprising 130 CT scans of liver cancers. Furthermore, a state-of-the-art fusion strategy is introduced, combining the robust feature learning capabilities of the UNet-ResNet classifier with Snake-based Level Set Segmentation. RESULTS: Experimental results demonstrate impressive performance metrics, including an accuracy of 0.98 and a minimal loss of 0.10, underscoring the efficacy of the proposed methodology in liver cancer segmentation. CONCLUSION: This fusion approach effectively delineates complex and diffuse tumor shapes, significantly reducing errors.
Fondaparinux sodium combined with conventional therapy improves subchorionic hematoma with protein S deficiency
Authors: Tan Yan , Yan Zhenjiao , Chen Minhong , Wang Yinglan 
Published: September 2024

BACKGROUND: Fondaparinux sodium can prevent and treat acute illnesses and venous thromboembolism in patients undergoing surgery. At present, no studies have reported on treating subchorionic hematoma combined with protein S deficiency using fondaparinux sodium. OBJECTIVE: To investigate the clinical efficacy of fondaparinux sodium in the treatment of patients with subchorionic hematoma combined with protein S deficiency. METHODS: This single-center, open-ended, and prospective study enrolled 78 patients with subchorionic hematoma and protein S deficiency. They were randomly assigned to the treatment and control groups. The control group received conventional treatment, and the observation group received subepithelial injections of fondaparinux sodium (2.5 mg/day) based on conventional treatment. After 30 days of continuous treatment, the hematoma was evaluated by ultrasonography. RESULTS: After treatment with fondaparinux sodium, a significant improvement in subchorionic hematoma was observed in the observation group compared with that in the control group ([Formula: see text] 0.05). A substantial improvement in prothrombin time and activated partial thromboplastin time was observed in the observation group after fondaparinux sodium treatment ([Formula: see text] 0.05). Furthermore, after fondaparinux sodium treatment, the duration of hematoma maintenance and incidence of adverse pregnancy outcomes were significantly reduced in the observation group compared with that in the control group ([Formula: see text] 0.05). CONCLUSION: With a favorable safety profile, fondaparinux sodium is effective in treating subchorionic hematoma combined with protein S deficiency. The results provide new ideas and methods for treating this disease, which is worthy of further promotion and application in clinical practice.
Characterization of Silver Nanoparticles Synthesized With Fungi Isolated From Cocoa and Orange Plantation Soils
Authors: Ogunsakin OA , Ekundayo EA , Ekundayo FO , Olalemi OA 
Published: September 2024

Green synthesis of nanoparticles with various metals is being interested among researchers globally attention for due to their safety, environmental friendliness and non-toxicity in contrast to chemical synthesis. Here, fungi were isolated from rhizosphere of cocoa and orange obtained from Federal University of Technology, Akure using standard mycological techniques with the aim of synthesizing silver nanoparticles. The silver nanoparticles synthesized by these fungal isolates were characterized using Ultraviolet-Visible (UV-Vis) and Fourier Transmission Infra- Red (FTIR) spectroscopy. Seven fungi isolated from the soil samples viz. Nigrospora sphaerica, Penicillium discolor, P. digitatum, Neurospora crassa, Alternarium infectoria, Trichophyton verrucosum and Mucor mucedo. The colour transformation from yellow to brown indicated the formation of silver nanoparticles. All the isolates showed an intense peak in the wavelength range of 410-440 nm. The FTIR analysis of silver nanoparticles synthesized by N. sphaerica, P. discolor, P. digitatum, N. crassa, A. infectoria, T. verrucosum and M. mucedo revealed the existence of a band at different stretches of bonds at different peaks of 3314.36 cm-1, 3310.47 cm-1, 2412.22 cm-1, 3912.33 cm-1 3614.52 cm-1, 3852.11 cm-1 and 2112.11 cm-1, respectively. The silver nanoparticles synthesized could have the potential application in agricultural, pharmaceutical and food industries as well as petrochemical industries for the clean - up of crude oil contaminated soils.
J. Bio-Sci. 32(2): 31-44, 2024
Perencanaan Kapasitas Produksi Industri Pakan Ternak dengan Metode Theory of Constraints
Authors: Ikhwana Andri , Taptajani Dedi Sa’dudin , Nurul Hikmah Ikmal Wahyudi 
Published: September 2024

Untuk mengubah input produksi menjadi output produksi, sistem produksi terdiri dari kumpulan subsistem yang saling berhubungan. Input produksi ini termasuk bahan baku, mesin, tenaga kerja, modal, dan informasi, sedangkan output produksi adalah produk dari hasil sampingnya, seperti limbah, informasi, dan lain-lain. Kapasitas untuk memproduksi pakan ternak yang tidak memenuhi permintaan konsumen adalah tujuan penelitian ini. Pendekatan kuantitatif digunakan dalam penelitian ini, yang melibatkan observasi atau pengamaran secara langsung. Selain itu, metode identifikasi masalah menggunakan Theory Of Constraints untuk mengidentifikasi bagian stasiun kerja yang mengalami hambatan atau hambatan. mengoptimalkan kapasitas produksi untuk mencapai tujuan produksi atau memenuhi permintaan pelanggan. Hasil penelitian menunjukkan bahwa masalah disebabkan oleh factor mesin gilling yang memiliki kapasitas lebih kecil dan hanya ada 1 mesin gilling sehingga terjadinya bottleneck. Berdasarkan permasalahan tersebut, mengetahui besar kekurangan permintaan pasar yaitu 51.53% yang berarti masih ada 49.47% permintaan pasar yang tidak dapat terpenuhi. Kemudian, beban kerja SK penimbangan sebesar 82,8%, beban kerja SK penyortiran sebesar 85%, beban kerja SK pengeringan 89.4%, beban kerja SK mesin gilling sebesar 117,9%, beban kerja SK pengemasan sebesar 91.2%. Penentuan bottleneck dapat dilihat pada persentase beban kerja yang paling tinggi yaitu pada SK mesin gilling sebesar 117,9%. Maka terdapat untuk mengatasi bottleneck tersebut dilakukan perhitungan routing sheet untuk mengetahui jumlah mesin yang perlu ditambahkan pada stasiun kerja mesin gilling. Sehingga permintaan konsumen dapat terpenuhi dengan adanya penambahan mesin gilling sebanyak 2 buah mesin, serta biaya penambahan mesin pada stasiun kerja mesin gilling sebesar Rp 12.802.918.
Efeitos hemodinâmicos da administração de sulfato de magnésio na indução anestésica durante a laringoscopia e intubação orotraqueal: Um ensaio clínico randomizado
Authors: Silva Michelly Gomes da , Rocha Neto Aguinaldo Freire , Sena Jessica Suelen , Ribeiro Saula Maria de Lira , Barros Lucas Soares Brandão , Sousa Maria Clara Oliveira Campos , Epitácio Bruno de Castro Fernandes 
Published: September 2024

A resposta hemodinâmica aos estímulos da laringoscopia e intubação orotraqueal, especialmente hipertensão e taquicardia, é um fenômeno comum, o controle desse reflexo indesejado é parte fundamental do manejo anestésico. Nessa perspectiva, o presente estudo teve como objetivo analisar os efeitos hemodinâmicos da administração de sulfato de magnésio na indução anestésica durante a laringoscopia e intubação orotraqueal. Trata-se de um ensaio clínico randomizado, controlado, simples-cego, prospectivo e unicêntrico, realizado em um Hospital Universitário de uma capital da região Nordeste, foram avaliados 40 pacientes, que seriam submetidos à intubação orotraqueal após a indução para anestesia geral, que foram divididos em dois grupos, Grupo 1: sulfato de magnésio a 10%, e Grupo 2: solução salina 0,9% simples. Foram incluídos pacientes entre 18 e 59 anos, escalados para cirurgias eletivas sob anestesia geral com intubação orotraqueal, classificados como ASA I ou II. Dentre os participantes da pesquisa houve prevalência de indivíduos com 46-59 anos (32,5%), do sexo feminino (67,5%), classificados no grau ASA I (60%) e provenientes de Teresina (62,5%). Com relação aos parâmetros fisiológicos avaliados, verificou-se que os indivíduos do Grupo 1, apresentaram menores médias quando comparados a amostra total e Grupo 2. Os resultados deste estudo apontam que a administração de sulfato de magnésio a 10%, durante a realização do procedimento de laringoscopia e intubação orotraqueal pode ser uma alternativa adequada. A administração de sulfato de magnésio pode ser um método eficaz e seguro, sem alterações hemodinâmicas aparentes.
Internações por Condições Sensíveis à Atenção Primária (ICSAP), entre 2008 e 2023, no estado de São Paulo
Authors: Rubim Larissa Daniele , Bastos Tassia Fraga , Gomes Marcos Costa Naves , Almeida Gabrielle Oliveira 
Published: September 2024

As Internações por Condições Sensíveis à Atenção Primária (ICSAP) têm sido utilizadas como indicador indireto da qualidade do primeiro nível de cuidados à saúde e faz parte de uma estratégia para aprimorar o planejamento e gestão dos serviços de saúde por autoridades. O contexto de pandemia da COVID-19 levou a uma situação inédita em vários municípios do estado de São Paulo: a diminuição do horário de funcionamento e o fechamento das Unidades Básicas de Saúde (UBSs), gerando dificuldades de acesso da população à Atenção Primária. Vários estudos apontam diversos fatores que podem interferir nas ICSAP, dentre eles o horário de atendimento e as barreiras de acesso, que vão desde as geográficas à oferta de profissionais e serviços. Considerando-se que o acesso às UBSs ficou prejudicado durante a pandemia, é possível que haja um impacto nas ICSAP ocorridas no estado. Nesse sentido, o objetivo é descrever a evolução das ICSAP no estado de São Paulo, entre os anos de 2008 e 2023. Trata-se de um estudo ecológico, quantitativo e descritivo, com dados de origem secundária, obtidos do Sistema de Informações Hospitalares do SUS (SIH/SUS), disponíveis na base de dados governamental DATASUS. Os resultados finais demonstram que houve uma queda das ICSAP ao longo dos anos, acentuada no período da pandemia, e posterior aumento das ICSAP nos anos de 2022 e 2023. Com os resultados, pretende-se contribuir para o conhecimento do perfil dessas internações, ainda não estudado, e subsidiar a organização de ações a fim de minimizá-las.
STRATEGI KOMUNIKASI POLITIK PARTAI PERSATUAN PEMBANGUNAN (PPP) DI KABUPATEN GORONTALO
Authors: Istyan Harun Nur , Napir Suaib , Nuna Muten , Hunawa Robby , A. Sahi Nirmala 
Published: September 2024

Partai Persatuan Pembangunan (PPP) in the 2019 Election in Gorontalo Regency showed extraordinary achievements, where PPP's vote acquisition increased by 250% from PPP's vote acquisition in the 2014 election. With this increase in votes, PPP's vote acquisition in the Gorontalo Regency DPRD experienced a significant increase from 4 the seats in the 2014 election results became 7 seats in the 2019 election results, which led PPP to become the chairman of the Gorontalo Regency DPRD Chairperson. Of course, this achievement is the success of the PPP strategy, both in beating its legislative candidates and in the communication that is built in the midst of society. This qualitative descriptive research by prioritizing primary data and secondary data focuses on seeing how PPP's political communication strategy won in Gorontalo District. The results of the study show that the United Development Party's winning strategy for Gorontalo Regency in the 2019 legislative election uses a winning strategy that utilizes marketing politics for campaign strategies both to gain political support in general elections and to maintain an image during the election break. The obstacles faced by PPP candidates in the implementation of the 2019 legislative elections in Gorontalo Regency include money politics, black campaigns, political apathy, and overlapping claims between fellow candidates on the same choice basis.
Case Report: Acute myocarditis in a patient with Duchenne muscular dystrophy
Authors: Zhang Xinyuan , Guo Yingkun , Xu Huayan 
Published: September 2024

BackgroundCardiovascular complications are the leading cause of death among individuals with Duchenne muscular dystrophy (DMD). However, due to the difficulty in evaluating individuals with inactive DMD, acute myocardial injury may be overlooked.Case presentationAn 11-year-old boy with DMD presented to the emergency department with a 5-day history of persistent nasal congestion, runny nose, and cough. He was regularly taking prednisolone acetate, angiotensin-converting enzyme (ACE) inhibitors, and β-blockers for suspected DMD-associated cardiomyopathy. Upon presentation, a substantially elevated cardiac troponin I (cTnI) level of 19.8 μg/L and abnormal electrocardiogram (ECG) results were detected. Further cardiac magnetic resonance imaging (CMR) showed myocardial inflammation with localized T2 hyperintensity from the basal to middle lateral and inferior walls, as well as late gadolinium enhancement (LGE) from the basal to apical inferior lateral walls, supporting a diagnosis of acute myocarditis. Subsequently, the patient showed clinical improvement in response to combination treatment with intravenous immunoglobulin, oral prednisolone acetate, potassium chloride sustained-release tablets, anti-heart failure medication, and broad-spectrum antibiotics.ConclusionsWe report a rare case of acute myocarditis in a patient with DMD, potentially due to upper respiratory tract infection. This case highlights the importance of early myocarditis recognition and treatment in patients with DMD.
Effectiveness of β-blockers in improving 28-day mortality in septic shock: insights from subgroup analysis and retrospective observational study
Authors: Zhang Ling , Yu Yue , Wu Tong , Pan Tingting , Qu Hongping , Wu Jingyi , Tan Ruoming 
Published: September 2024

BackgroundIn recent years, septic shock remains a common fatal disease in the intensive care unit (ICU). After sufficient fluid resuscitation, some patients still experience tachycardia, which may lead to adverse effects on cardiac function. However, the use of β-blockers in the treatment of septic shock remains controversial. Thus, the purpose of this study is to evaluate the efficacy of β-blockers in the treatment of patients with septic shock and explore the most appropriate patient subgroups for this treatment.MethodsThis retrospective observational study enrolled septic shock patients from the Medical Information Mart for Intensive Care (MIMIC)-IV and used propensity score matching (PSM) to balance some baseline differences between patients with and without β-blockers treatment. The primary outcome was the 28-day mortality. Length of stay (LOS) in the ICU and hospital, and the degree of support for organs such as circulatory, respiratory and renal systems were also assessed. Subgroup analysis and multivariate logistic regression were performed to determine the relationship between β-blockers therapy and 28-day mortality in different patient groups.ResultsA total of 4,860 septic shock patients were enrolled in this study and 619 pairs were finally matched after PSM. Our analysis revealed that β-blocker therapy was associated with a significant improvement in 28-day mortality (21.5% vs. 27.1%; P = 0.020) and led to a prolonged LOS in both the ICU and hospital. Subgroup analysis indicated that there was an interaction between cardiovascular diseases and β-blocker therapy in patients with septic shock. Patients with pre-existing heart disease or atrial arrhythmias were more likely to derive benefits from β-blocker treatment.ConclusionWe found β-blockers therapy was effective to improve 28-day mortality in patients with septic shock. Patients in the subgroup with cardiovascular diseases were more likely to benefit from β-blockers in mortality.