bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case study: exploring the impact of 3D printed models on cognitive integration during clinical skills training
Authors: Lisk Kristina , Cheung Jeffrey JH 
Published: August 2024

Background: Cognitive integration occurs when trainees make conceptual connections between relevant knowledges and is known to improve learning. While several experimental studies have demonstrated how text and audio-visual instruction can be designed to enhance cognitive integration, clinical skills training in real-world contexts may require alternative educational strategies. Introducing three-dimensional (3D) printed models during clinical skills instruction may offer unique learning opportunities to support cognitive integration.
Methods: Using case study methodology, we explore how learners and an instructor used 3D printed bones to augment their learning interactions during a clinical skills laboratory on shoulder on palpation, and to describe the instructional strategies with 3D printed bones that may support learning. Students (n = 21) worked in small groups and were given access to a 3D printed clavicle, scapula, and humerus. Data were collected through observation, a student focus group, and a semi-structured interview with the instructor. Thematic analysis to review and code the data and to generate themes.
Results: We developed four themes that describe how 3D printed models were used in the classroom and how they may support cognitive integration: classroom interactivity, visualization of anatomy, integrating knowledge, and educational potential.
Conclusions: The findings demonstrate several ways 3D printed models can augment how learners, instructors, and educational materials interact with one another and how readily learners make connections between different sources and types of knowledge. This research extends previous work by demonstrating how social learning processes and interactions with physical models can offer unique affordances that may support cognitive integration.
PKM Penggunaan Regulasi Emosi Untuk Menurunkan Kecemasan Ibu Hamil Dalam Menghadapi Persalinan Di Desa Pulau Rambai Wilayah Kerja Puskesmas Kampa
Authors: Alini  , Novrika Bri , Hotna Siagian Siti 
Published: August 2024

Kehamilan merupakan sesuatu yang akan terjadi pada wanita yang produktif, tetapi ketidaktahuan mereka akan perilaku-perilaku, informasi-informasi yang berkaitan dengan organ reproduksi akan menimbulkan kekhawatiran tersendiri pada saat kehamilan. Ibu yang pertama kali hamil akan lebih sering kekhawatiran dan rasa cemas terhadap cerita yang diperolehnya pada saat hamil. Pada trimester ketiga, rasa khawatir menjelang persalinan ibu akan muncul karena pada trimester ini jika ibu memiliki rasa khawatir yang terlalu tinggi dapat menyebabkan resiko yang akan dialami oleh ibu seperti kelahiran bayi premature. Pertanyaan dan bayangan menghadapi proses persalinan, apalagi seringkali ibu mendengar cerita dan pengalaman orang sekitar mengenai proses persalinan yang melelahkan dan menyakitkan. Kegiatan pengabdian kepada masyarakat yang berbentuk latihan regulasi emosi untuk menurunkan kecemasan ibu hamil dalam menghadapi persalinan di Desa Pulau Rambai berhasil memberikan dampak berupa meningkatnya pengetahuan, kesadaran dan pemahaman SDM mitra dalam hal ini ibu hamil di Desa Pulau Rambai tentang kecemasan yang dialami dalam menghadapi proses persalinan dan mampu menggunakan tehnik regulasi emosi untuk menurunkan kecemasan ibu hamil dalam menghadapi persalinan.
JWST Imaging of the Closest Globular Clusters. II. Discovery of Brown Dwarfs in NGC 6397 and Measurement of Age from the Brown Dwarf Cooling Sequence, Using SANDee—A New Grid of Model Isochrones across the Hydrogen-burning Limit
Authors: Gerasimov Roman , Bedin Luigi R. , Burgasser Adam J. , Apai Daniel , Nardiello Domenico , Alvarado Efrain , Anderson Jay 
Published: August 2024

Abstract
Globular clusters contain vast repositories of metal-poor stars that represent some of the oldest stellar generations in the Universe. The archaeological footprint of early Galactic evolution may be retained in the measurable properties of globular clusters, such as their ages, mass functions, and chemical abundances. Until recently, all photometric studies of globular clusters were restricted to stellar members. Now, the sensitivity of JWST can extend this analysis to the substellar regime. If detected in sufficient numbers, brown dwarf members can provide tight constraints on the properties of their parent population. We present SANDee—a new grid of stellar models that accurately represent the color–magnitude diagrams of globular clusters across the hydrogen-burning limit at a wide range of metallicities. Using JWST NIRCam photometry and the new models, we identify three brown dwarfs in the globular cluster NGC 6397 with T
eff = 1300–1800 K, confirmed by both proper motion and model fitting. We use the observed luminosities of discovered brown dwarfs to obtain the first age estimate of a globular cluster from its substellar cooling sequence: 13.4 ± 3.3 Gyr. We also derive the local mass function of the cluster across the hydrogen-burning limit and find it to be top heavy, suggesting extensive dynamical evolution. We expect that the constraints on both age and mass function of NGC 6397 derived in this work can be greatly improved by a second epoch of NIRCam imaging in the same field.
Photometry of Saturated Stars with Neural Networks
Authors: Winecki Dominik , Kochanek Christopher S. 
Published: August 2024

Abstract
We use a multilevel perceptron (MLP) neural network to obtain photometry of saturated stars in the All-Sky Automated Survey for Supernovae (ASAS-SN). The MLP can obtain fairly unbiased photometry for stars from g ≃ 4 to 14 mag, particularly compared to the dispersion (15%–85% 1σ range around the median) of 0.12 mag for saturated (g < 11.5 mag) stars. More importantly, the light curve of a nonvariable saturated star has a median dispersion of only 0.037 mag. The MLP light curves are, in many cases, spectacularly better than those provided by the standard ASAS-SN pipelines. While the network was trained on g-band data from only one of ASAS-SN’s 20 cameras, initial experiments suggest that it can be used for any camera and the older ASAS-SN V-band data as well. The dominant problems seem to be associated with correctable issues in the ASAS-SN data reduction pipeline for saturated stars more than the MLP itself. The method is publicly available as a light-curve option on ASAS-SN Sky Patrol v1.0.
Observations of Locally Excited Waves in the Low Solar Atmosphere Using the Daniel K. Inouye Solar Telescope
Authors: Bahauddin Shah Mohammad , Fischer Catherine E. , Rast Mark P. , Milic Ivan , Woeger Friedrich , Rempel Matthias , Keys Peter H. , Rimmele Thomas R. 
Published: August 2024

Abstract
We present an interpretation of the recent Daniel K. Inouye Solar Telescope (DKIST) observations of propagating wave fronts in the lower solar atmosphere. Using MPS/University of Chicago MHD radiative magnetohydrodynamic simulations spanning the solar photosphere, the overshoot region, and the lower chromosphere, we identify three acoustic-wave source mechanisms, each occur at a different atmospheric height. We synthesize the DKIST Visible Broadband Imager G-band, blue-continuum, and Ca ii
K signatures of these waves at high spatial and temporal resolution, and conclude that the wave fronts observed by DKIST likely originate from acoustic sources at the top of the solar photosphere overshoot region and in the chromosphere proper. The overall importance of these local sources to the atmospheric energy and momentum budget of the solar atmosphere is unknown, but one of the excitation mechanisms identified (upward propagating shock interaction with down-welling chromospheric plasma resulting in acoustic radiation) may be an important shock dissipation mechanism. Additionally, the observed wave fronts may prove useful for ultralocal helioseismological inversions and promise to play an important diagnostic role at multiple atmospheric heights.
Revisiting the Fundamental Metallicity Relation with Observation and Simulation
Authors: Ma Chengyu , Wang Kai , Wang Enci , Peng Yingjie , Jiang Haochen , Yu Haoran , Jia Cheng , Chen Zeyu , Li Haixin , Kong Xu 
Published: August 2024

Abstract
The gas-phase metallicity of galaxies is regulated by multiple astrophysical processes, which makes it a crucial diagnostic of galaxy formation and evolution. Beyond the fundamental mass–metallicity relation, a debate about the secondary galaxy property to predict the metallicity of galaxies arises. Motivated by this, we systematically examine the relationship between gas-phase metallicity and other galaxy properties, i.e., the star formation rate (SFR) and galaxy size, in addition to stellar mass in both observation and simulation. We utilize the data from the Mapping Nearby Galaxies at Apache Point Observatory survey and the TNG50 simulations. We find that the combination of

M

*

/

R

e

β

with β ∼ 0.6–1 is in much stronger correlation to the metallicity than stellar mass alone, regardless of whether the SFR is included or not, in both observation and simulation. This indicates that galaxy size plays a more important role in determining gas-phase metallicity of galaxies than SFR. In addition, The Next Generation simulation predicts that the SFR, although being a subdominant role, becomes increasingly important in the high-z universe. Finally, we speculate that the SFR modulates metallicity on the temporal dimension, synchronized with time-varying gas inflows, and galaxy size regulates metallicity on the spatial dimension by affecting the gravitational potential and the mass-loading factor.
Le binôme de notions « Cohérence - Cohésion » en tant que prérequis à l’intégration normative des PME
Authors: Bueno Luis 
Published: August 2024

Quelles sont les difficultés rencontrées par les PME lorsqu’elles sont contraintes d’intégrer des normes règlementaires ou volontaires dans le cadre de leur stratégie de développement ? Le présent article décrit l’accompagnement du processus d’intégration normative d’une petite entreprise par le biais d’une recherche-intervention longitudinale de 6 années menée avec la méthodologie d’intervention du management socio-économique. C’est dans ce contexte que nous évaluons les contributions d’un renforcement préalable de l’infrastructure de l’organisation à la démarche d’intégration normative. La mobilisation des notions de cohérence (stratégique puis opérationnelle) et de cohésion permet le renforcement de ce que nous avons identifié comme le « socle managérial » de l’organisation.
Smartphone-based 12-lead electrocardiogram monitoring in an elderly patient with multimorbidity: A case report of comprehensive cardiac assessment using the Spandan device
Authors: Singh Yogendra , Pandey C. B. , Chandola Nitin , Agarwal Deeksha 
Published: August 2024

ABSTRACT
The advent of mobile health (mHealth) technologies, particularly smartphone-based 12-lead electrocardiogram (ECG) devices, has revolutionized cardiac care. This case report highlights the utility of the Spandan ECG device in managing an 84-year-old female patient with a complex medical history of hypertension (HTN), left ventricular hypertrophy, hypothyroidism, osteoarthritis, dyslipidemia, and obstructive sleep apnea. The patient, diagnosed with systemic HTN in 1992 and hypothyroidism in 2002, experienced a decline in mobility due to knee pain and was later diagnosed with bilateral osteoarthritis. Over the years, she developed additional comorbidities including hyperuricemia and dyslipidemia. On several occasions, fluctuating blood pressure and cardiac symptoms led to multiple hospital visits. Comprehensive diagnostic evaluations revealed significant cardiac conditions including right bundle branch block, sinus bradycardia, atrial fibrillation, and diastolic dysfunction. The use of the Spandan 12-lead ECG device facilitated the early detection of these abnormalities, enabling timely interventions. This case underscores the value of smartphone-based ECG devices in providing continuous cardiac monitoring and early diagnosis, particularly for elderly patients with multiple comorbidities. The Spandan device’s portability and ease of use allowed for effective point-of-care diagnostics, leading to proactive management and improved patient outcomes. The ability to perform ECGs at home and during medical consultations ensured that the critical changes in the patient’s cardiac status were promptly identified and addressed. The integration of the Spandan smartphone-based 12-lead ECG device into the patient’s care regimen proved instrumental in managing her complex cardiac conditions. This case highlights the potential of mHealth ECG technologies to enhance point-of-care diagnostics and promote patient-centered care, particularly for elderly individuals with multiple comorbidities. The widespread adoption of such technologies could significantly improve cardiovascular health outcomes and quality of life for patients with similar profiles.
Predominance of Cephalic Presentation at Birth: An Oxygen Delivery-Based Concept
Authors: Wong Hsui Yang , Chan Yoo Kuen 
Published: August 2024

Background:
Fetuses closer to term present predominantly as cephalic, and by the time of delivery 96-97% of them are born headfirst. To date, no coherent hypothesis has been put forth to explain the phenomenon.

Observation:
As pregnancy advances, there is a progressive increase in cephalic presentation; by 25 weeks, 60% are cephalic, at 35 weeks 90% cephalic and at term only less than 3-4% remain breech.

Hypothesis:
Oxygen delivery to the fetus comes from the environment through the parturient and it must traverse a very long passage to get to the fetal tissues making oxygen delivery a very precarious process. The fetus develops several compensatory mechanisms to enhance the delivery of oxygen—higher hemoglobin level, hemoglobin with greater affinity for oxygen, the double Bohr phenomenon to improve the diffusion of oxygen from the parturient and lastly redesign of the fetal circulation to increase flow to the brain whilst in the state of near chronic hypoxia whilst in utero. The better flow of blood to the head and therefore more oxygen to the brain makes this organ the densest causing it to progressively present cephalic as pregnancy advances.

Implications:
The hypothesis aligns well with not only the observed progressive cephalic phenomenon but also the long-term subtle cognitive deficits and neurological sequelae observed in several studies of those born breech.

Conclusion:
Cephalic presentation at birth is driven by better blood flow to the brain as another compensatory mechanism to cope with hypoxia.
A Comparative Study of Intrathecal 0.5% Hyperbaric Bupivacaine and Intrathecal 0.75% Hyperbaric Ropivacaine in Elective Lower Segment Cesarean Section
Authors: Shirpurkar Rajat M. , Kokate Minal V. , Deshpande Nandini A. , Tambakhe Mayuri G. , Borkar Vijaya P. 
Published: August 2024

Aim:
To evaluate and compare the efficacy and safety of intrathecal 0.5% hyperbaric bupivacaine and intrathecal 0.75% hyperbaric ropivacaine in patients posted for elective lower segment cesarean section (LSCS) under spinal anesthesia.

Objective:
The objective of this study was to compare intrathecal 0.5% hyperbaric bupivacaine and intrathecal 0.75% hyperbaric ropivacaine in patients posted for elective LSCS under spinal anesthesia with respect to the onset and duration of sensory block, onset and duration of motor block, hemodynamic parameters, and adverse effects.

Material and Methods:
Patients with ASA physical status II of age ranging from 18 to 35 years were included in the study. Patients were randomized into two groups using a sealed envelope technique. A) Group B (n = 30); 10 mg 0.5% (2 mL) bupivacaine + Inj. buprenorphine (60 µg). B) Group R (n = 30); 15 mg 0.75% (2 mL) ropivacaine + Inj. buprenorphine (60 µg). Hemodynamic parameters, onset and duration of sensory, and motor blockade, level achieved, and side effects were compared between the two groups. Qualitative data were analyzed by Chi-square test and quantitative data were analyzed by independent sample t-test.

Results:
None of the patients in either group dropped out of the study. At the beginning of the study, patients’ demographic characteristics, hemodynamic parameters, time of onset of sensory and motor blockade, postoperative pain relief, and side effect profile were comparable between the two groups. However, 0.75% hyperbaric ropivacaine can serve as an efficacious alternative to the conventional 0.5% hyperbaric bupivacaine for patients undergoing elective cesarean section, as it produces a similar quality of block with faster attainment of desired sensory levels and early recovery from the motor blockade, thereby allowing early ambulation.

Conclusion:
Considering its comparable duration of sensory blockade, stable hemodynamics, and postoperative analgesia, along with a shorter duration of motor blockade, the use of 0.75% hyperbaric ropivacaine can be considered a safe and effective alternative to bupivacaine in elective LSCS.
Efficacy of Intravenous Low-Dose Ketamine for Prevention of Post-Spinal Anesthesia Shivering in Cesarean Section: A Double-Blind, Randomized Controlled Study
Authors: Meena Khemraj , Meena Yogesh K. , Verma Reena , Jain Shweta , Azad Aman , Meena Yamini 
Published: August 2024

Background:
Post-spinal anesthesia shivering in cesarean section is a common complication owing to sympatholysis, resulting in vasodilation and heat redistribution from the core to peripheral parts of the body. The physiological consequences of shivering include an increase in cardiac and systemic energy expenditure, oxygen consumption, and carbon dioxide production. Ketamine, a N-methyl D-aspartate (NMDA) receptor antagonist, has been reported to have anti-shivering effects. The aim of this study is to determine the effectiveness of prophylactic low-dose intravenous (IV) ketamine (0.25 mg/kg) in preventing shivering after spinal anesthesia as compared to placebo in elective cesarean sections.

Methods:
A randomized, double-blind study was conducted on 80 patients aged 18 to 40 years and American Society of Anesthesiologists grade II undergoing elective cesarean section under spinal anesthesia. Groups K and group S received IV ketamine 0.25 mg/kg diluted to 5 ml in normal saline and 5 ml normal saline IV, respectively, 10 minutes after spinal anesthesia. The incidence and duration of shivering, tympanic membrane temperature, sedation score, hemodynamic parameters, and side effects were recorded.

Results:
The incidence of shivering in group K was 12.5% compared to 32.5% in group S (P = 0.030). The mean duration of shivering was only 0.75 ± 2.02 min in group K as compared to 2.38 ± 3.57 min in group S (P = 0.014). Mean arterial pressure and heart rate were stable in group K without any significant sedative effect.

Conclusion:
The use of prophylactic low-dose ketamine (0.25 mg/kg) significantly reduces the incidence and duration of spinal anesthesia-induced shivering compared to placebo.
Comparison of Carbetocin and Oxytocin Efficacy in Preventing Postpartum Hemorrhage after C-Section
Authors: Rao Yarramsetti V. , Sravanthi Thumpati Sai , Kummarapurugu Srividya , Prasanna Battula Lakshmi , Kuppili Satwik 
Published: August 2024

Introduction:
Postpartum hemorrhage (PPH) is defined as a blood loss of more than 0.5 liters within 24 hours of birth, and a blood loss of more than 1 liter is considered a significant PPH. In low- and middle-income countries, PPH is a major factor causing maternal morbidity and mortality, whereas in high-income countries, the mortality is comparatively lower, but still PPH poses a major risk for postpregnancy complications. Uterine atony is the most frequent cause of the PPH, and it accounts for up to 80% of PPH cases.

Aim:
The aim of this study is to examine the prophylactic effects of oxytocin and carbetocin in preventing atonic PPH in individuals receiving recurrent elective CS under spinal anesthesia.

Materials and Methods:
A computerized, randomized, cross-sectional prospective comparative study was conducted on 100 pregnant women at Konaseema Institute of Medical Sciences and Research Foundation for the time period of an year, from October 2020 to October 2021.

Inclusion Criteria:
This study includes patients with singleton pregnancy, gestational age >38 weeks, spinal anesthesia and repeated C.S with cephalic, breech, or any malpresentations.

Exclusion Criteria:
Patients with placenta previa and placental abruption, uterine myomata, congenital uterine anomalies, gestational age before 38 weeks, women having emergency cesarean section for fetal or maternal distress, and patients with hepatic or pre-existing bleeding disorder were excluded from the study. The patients included based on the above criteria were split into two equal groups. Group I received carbetocin as a single dose of 100 microgram slow intravenous, and Group II received oxytocin as 5 IU intravenous drip followed by 20 IU of oxytocin infusion on 500 ml saline or lactated ringer with a rate of 150 ml per hour.

Results:
When compared to the oxytocin group, the blood loss was considerably reduced in the carbetocin group. The levels of Hb and hematocrit [HCT] were evaluated pre- and postoperative in both the groups. The levels of preoperative Hb and HCT showed nonsignificant difference between the two groups, while the levels of postoperative Hb and HCT were significantly higher in carbetocin group than oxytocin group concluding that carbetocin showed the better results in controlling the blood loss and maintaining the levels of Hb and HCT volume and the carbetocin group showed less need for administration of uterotonic agents (20%) in comparison with (32%) in oxytocin group but with no statistically significant difference. Only 8 (16%) patients showed PPH in carbetocin treatment, whereas 14 (28%) showed PPH in patients on oxytocin treatment.