bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-pancreatic hyperlipasemia: A puzzling clinical entity
Authors: Feher Krisztina Eszter , Tornai David , Vitalis Zsuzsanna , Davida Laszlo , Sipeki Nora , Papp Maria 
Published: May 2024

BACKGROUND
Increased lipase level is a serological hallmark of the diagnosis of acute pancreatitis (AP) but can be detected in various other diseases associated with lipase leakage due to inflammation of organs surrounding the pancreas or reduced renal clearance and/or hepatic metabolism. This non-pancreatic hyperlipasemia (NPHL) is puzzling for attending physicians during the diagnostic procedure for AP. It would be clinically beneficial to identify the clinical and laboratory variables that hinder the accuracy of lipase diagnosis with the aim of improve it. A more precise description of the NPHL condition could potentially provide prognostic factors for adverse outcomes which is currently lacking.
AIM
To perform a detailed clinical and laboratory characterization of NPHL in a large prospective patient cohort with an assessment of parameters determining disease outcomes.
METHODS
A Hungarian patient cohort with serum lipase levels at least three times higher than the upper limit of normal (ULN) was prospectively evaluated over 31 months. Patients were identified using daily electronic laboratory reports developed to support an ongoing observational, multicenter, prospective cohort study called the EASY trial (ISRCTN10525246) to establish a simple, easy, and accurate clinical scoring system for early prognostication of AP. Diagnosis of NPHL was established based on ≥ 3 × ULN serum lipase level in the absence of abdominal pain or abdominal imaging results characteristic of pancreatitis.
RESULTS
A total of 808 patients [male, n = 420 (52%); median age (IQR): 65 (51-75) years] were diagnosed with ≥ 3 × ULN serum lipase levels. A total of 392 patients had AP, whereas 401 had NPHL with more than 20 different etiologies. Sepsis and acute kidney injury (AKI) were the most prevalent etiologies of NPHL (27.7% and 33.2%, respectively). The best discriminative cut-off value for lipase was ≥ 666 U/L (sensitivity, 71.4%; specificity, 88.8%). The presence of AKI or sepsis negatively affected the diagnostic performance of lipase. NPHL was associated with a higher in-hospital mortality than AP (22.4% vs 5.1%, P < 0.001). In multivariate binary logistic regression, not lipase but increased amylase level (> 244 U/L) and neutrophil-to-lymphocyte ratio (NLR) (> 10.37, OR: 3.71, 95%CI: 2.006-6.863, P < 0.001), decreased albumin level, age, and presence of sepsis were independent risk factors for in-hospital mortality in NPHL.
CONCLUSION
NPHL is a common cause of lipase elevation and is associated with high mortality rates. Increased NLR value was associated with the highest mortality risk. The presence of sepsis/AKI significantly deteriorates the serological differentiation of AP from NPHL.
PENGEMBANGAN BAHAN AJAR BERBASIS CERITA BERGAMBAR MELALUI PENDEKATAN ASSURE PADA PEMBELAJARAN MENULIS DI SEKOLAH DASAR
Authors: Sulistyorini Tri , Widayati Mukti , Nurnaningsih  
Published: May 2024

Peneltian ini bertujuan (1) mendeskripsikan pengembangan bahan ajar berbasis cerita bergambar dengan pendekatan assure pada pembelajaran Bahasa Indonesia, (2) Mendeskripsikan Kelayakan, Kepraktisan dan Keefektifan bahan ajar berbasis cerita bergambar dengan pendekatan assure pada pembelajaran Bahasa Indonesia. Metode penelitian yang digunakan adalah Research and Development (R&D) dengan prosedur pendekatan ASSURE yang melibatkan lima tahapan. Data dikumpulkan melalui angket dan observasi, kemudian divalidasi oleh ahli materi dan ahli media. Produk pengembangan tersebut divalidasi kelayakannya oleh ahli dengan persentase ketercapaian 87,05% (sangat layak). Validasi kepraktisan dilakukan melalui uji coba kelompok dan uji coba lapangan dengan persentase skor tanggapan guru dan siswa yang sangat praktis. Data keefektifan bahan ajar diambil dari uji kompetensi, yang menunjukkan hasil yang baik pada kedua uji coba. Hasil ini mengindikasikan bahwa bahan ajar tersebut efektif untuk digunakan dalam pembelajaran Bahasa Indonesia.
NILAI-NILAI KEBHINEKAAN MELALUI PROGRAM PERTUKARAN MAHASISWA MERDEKA DI PERGURUAN TINGGI
Authors: Rahmat Acep , Suharyati Henny , Nazib Fiqra Muhamad 
Published: May 2024

Setiap orang memiliki latar belakang, pengalaman, dan cara pandang yang berbeda. Untuk mengatasi masalah tersebut, diperlukan pendekatan yang inklusif, dialog yang terbuka, dan promosi nilai-nilai kebhinekaan, seperti toleransi, saling menghormati, dan kesepakatan bersama. batasan masalah pada penelitian ini sebagai berikut: (1) Bagaimana Implementasi nilai-nilai Kebhinekaan melalui program pertukaran mahasiswa Merdeka bagi mahasiswa di universitas Garut; (2) Bagaimana nilai-nilai Kebhinekaan melalui program pertukaran mahasiswa Merdeka bagi mahasiswa di universitas Garut; (3) Bagaimana dampak nilai-nilai Kebhinekaan melalui program pertukaran mahasiswa Merdeka bagi mahasiswa di universitas Garut Penelitian ini bertujuan untuk menanamkan nilai-nilai kebhinekaan melalui program Pertukaran Mahasiswa Merdeka (PMM). Pendekatan yang digunakan dalam penelitian ini adalah dengan menggunakan pendekatan deskriptif kualitatif. Subjek dalam penelitian ini meliputi mahasiswa yang mengikuti program Pertukaran Mahasiswa Merdeka di Perguruan Tinggi. Teknik pengumpulan data yang digunakan dalam penelitian ini yaitu wawancara, observasi, dan analisis dokumen. Hasil dari penelitian ini adalah (1) Implementasi nilai-nilai Kebhinekaan program pertukaran mahasiswa Merdeka (PMM) dilakukan melalui modul nusantara; (2) nilai-nilai Kebhinekaan melalui program pertukaran mahasiswa Merdeka bagi mahasiswa; (3) dampak nilai-nilai Kebhinekaan melalui program pertukaran mahasiswa Merdeka bagi mahasiswa mendapatkan respon positif karena mengembangkan pemahaman, keterampilan, dan sikap kebhinekaan.
PENERAPAN MODEL PEMBELAJARAN PADA KURIKULUM MERDEKA: STUDI KASUS DI SMA NEGERI 1 PARE
Authors: Muchtar Azmy Ali , Hidayat Taufik , Utsman Soraya , Ikhsan Muhammad , Umam Muhammad Ihdal , Putri Renesya Febbiyana 
Published: May 2024

Berdasarkan fakta di lapangan, implementasi awal kurikulum Merdeka di SMAN 1 Pare tidak secara langsung berjalan dengan baik. Penelitian ini dilatarbelakangi pada tantangan dan kendala-kendala di sekolah terkait implementasi kurikulum Merdeka yang telah ditetapkan oleh pemerintah. Tujuan penelitian ini yaitu untuk mengetahui strategi pembelajaran pada Kurikulum Merdeka yang diterapkan oleh pendidik di SMAN 1 PARE dan untuk mengetahui hambatan pada proses implementasi strategi pembelajaran pada kurikulum Merdeka yang diterapkan oleh pendidik di SMAN 1 PARE. Penelitian ini menggunakan Metode Penelitian Kualitatif Deskriptif jenis studi kasus. Pengumpulan data dilakukan dengan metode observasi, wawancara dan dokumentasi. Subjek penelitiannya ialah pendidik dan objek penelitiannya ialah strategi pembelajaran Kurilukum Merdeka yang diterapkan oleh pendidik di SMAN 1 Pare, mulai dari konsep perencanaan, pelaksanaan sampai evaluasi staregi pembelajarannya. Analisis datanya menggunakan teori miles dan huberman, diawali dengan pengumpulan data, reduksi data, penyajian data dan pengambilan kesimpulan. Hasil dari penelitian ini yaitu Kurikulum merdeka di SMAN 1 Pare mulai diterapkan tahun 2021 dan telah berjalan cukup baik seiring berjalannya waktu dengan menggunakan beberapa metode dan strategi dalam peroses pembelajaran. Strategi dan metode yang digunakan adalah metode diferensiasi dan sosial emosional. Metode diferensiasi yang diterapkan ini adalah diferensiasi konten untuk melihat minat belajar peserta didik dari audio, kinestik atau audio visual. pendidik juga menerapkan ice breaking di awal pembelajaran untuk meningkatkan semangat belajar dan hasil belajar peserta didik. Dalam pelaksanaan implemantasi pembelajaran yang di lakukan adalah tindakan - tindakan dukungan seperti: Memotivasi peserta didik, mengkondisikan peserta didik agar lebih aktif dalam pembelajaran dan memberikan pembelajaran yang menyenangkan.
The angiographic study of right ventricular outflow tract and pulmonary artery anatomy in tetralogy of Fallot
Authors: Buchade Anusha , Sastry Usha MK , Jayranganath M. , Parshwanath Bharath Adaligere 
Published: May 2024

Objective:
The objective of the study is to determine various anatomic variations in the pulmonary vasculature and associated cardiac defects in patients with tetralogy of Fallot (TOF).

Methods:
This was a cross-sectional descriptive study conducted at Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore from January 2009 to December 2017. A total of 100 patients irrespective of age and gender, who were subjected to cardiac catheterization were enrolled in the study which included all age groups. Measurement of pulmonary valve annulus, main pulmonary artery, right pulmonary artery (RPA), left pulmonary artery (LPA), and descending aorta was taken and corresponding z scores were calculated. McGoon ratio and Nakata index were also calculated.

Results:
The age group in our study varied from 9 months to 49 years of age. Male-to-female gender ratio was 3:2. All patients had subvalvar (infundibular) stenosis and 82% of patients had stenosis at the valvar level. Seven patients had discrete stenosis, another seven patients had disconnection of RPA or LPA and six patients had supravalvar stenosis in the form of diffuse hypoplasia of one of the pulmonary arteries (PA). Significant communicating major aortopulmonary collaterals arteries (MAPCAs) were seen in 5% of patients and 16% of the patients had a persistent patent ductus arteriosus (PDA). Persistent left superior vena cava was present in 9 patients and 13% of the patients had coronary anomalies.

Conclusion:
Subvalvular stenosis, confluence of PA, discrete, disconnected, and diffuse stenosis of LPA and RPA were the most common PA abnormalities found in patients with TOF. Significant-associated cardiac lesions including communicating MAPCA, PDA, and coronary anomaly were more commonly observed in these patients.
Safety and effectiveness of angiotensin receptor-neprilysin inhibitors in Indian patients with heart failure with preserved ejection fraction – “ARNI-PRESERVED” study
Authors: JARIWALA PANKAJ , PUNJANI ARSHAD , BOORUGU HARIKISHAN , MADHAWAR DILIP BABU , JADHAV KARTIK 
Published: May 2024

Background:
The goal of this study is to look at the safety and efficacy of angiotensin receptor-neprilysin inhibitors (ARNI) (valsartan/sacubitril), a combination of angiotensin II receptor blocker and neprilysin inhibitor ARNI, in patients with heart failure with preserved ejection fraction (HFpEF).

Materials and Methods:
Between June and December 2020, retrospective research was conducted on a study participant of primarily angiographically confirmed computer-aided design patients who underwent complete revascularization. A total of 154 HFpEF patients (87 females and 67 males) were treated with ARNI, which was subsequently titrated up to a maximum tolerable dose and monitored in an outpatient clinic. Fifty-six patients were given ARNI while in the hospital for decompensated heart failure before being discharged.

Results:
Patients were categorized as the New York Heart Association (NYHA) class III (71.4%) and NYHA class II (28.6%). Diabetes mellitus was identified in 52% of patients, while hypertension was found in 78%. Symptomatic clinical improvement was observed, with a substantial decrease in NYHA class down to NYHA class II (P = 0.018). A considerable decrease in NYHA class resulted in symptomatic clinical improvement as well as the rales and peripheral edema had resolved (P < 0.001). The NT-pro-BNP levels were considerably lowered (P < 0.001). The echocardiographic parameters for diastolic function (E/A, E/E' ratios) improved. In individuals with HFpEF, ARNI resulted in significant clinical benefits.

Conclusion:
In individuals with HFpEF, sacubitril/valsartan, ARNI resulted in significant clinical benefits. A randomized research is also required to see if it results in beneficial outcomes for a wider sample.
An approach of Ayurveda clinical diagnosis in managing acute Pakshavadha (~hemiplegia): A case report
Authors: Mukhedkar Arundhati Rajesh , Thakar Anup B. , Gandhi Rahul S. 
Published: May 2024

Abstract
The case presented is to exemplify the use of Ayurveda diagnostic techniques in treating diseases. Among the diagnostic tools, Upashaya-Anupashaya (~understanding of aggravating and relieving factors) is useful during unclear pathology and symptomatology. Upashaya is the betterment, and Anupashaya is the aggravation of disease by medication, diet, and lifestyle. The case presented here is of a 60-year-old male with sudden weakness of the left upper and lower extremities, with no other symptoms and significant previous medical history. The provisional diagnosis was Pakshavadha (~hemiplegia) and treated through Brimhana (~nourishing therapy), which led to the aggravation of the disease condition. Anupashaya by Brimhana treatment confirmed the diagnosis to Kaphavrita
Vata (~occlusion of Vata by Kapha
dosha) and was treated with Rukshana (~dryness inducing therapies), Pachana (~enhancing digestion) with significant relief in symptoms within four days, with no recurrence. The significance of Upashaya-Anupashaya in the confirmation of disease and treatment is highlighted in this case.
Two Cases of Symptomatic Posterior Migration of Interbody Cage Following Lumbar Fusion
Authors: Krishnan Prasad 
Published: May 2024

Abstract
Instrumented surgery for degenerative lumbar spine disease is a commonly performed operation. Interbody cages filled with bone grafts have been used both as a stand-alone procedure and also as an adjunct to posterior pedicle screw fixation to aid in lumbar fusion. While hardware-related complications such as screw breakage and implant pullout have been well documented in the literature, symptomatic cage migration resulting in fresh symptoms is not that frequently described. Two cases of posterior cage migration into the spinal canal that necessitated reoperation are described, highlighting the risk factors for the same and measures that can be taken to prevent this complication.
Stand growth, Biomass and Carbon sequestration potentials of Parkia biglobosa (jacq.) Bench plantation in South-Western Nigeria
Authors: Akintunde-Alo D. A. , Onilude Q. A. , Ige P. O. , Adeoti O. O. 
Published: May 2024

This study assessed tree growth variables, above (AGB), below ground biomass (BGB) and total carbon content (TC) sequestered by Parkia biglobosa (Jacq.) Bench. Plantation in Wasangare, Oyo State using non-destructive ground base survey. Tree growth data (Diameter at breast height, Dbh and Tree height, Th) were collected using lacer ace hypsometer and diameter girth tape from 20 temporary sampling plots of size 25 m X 25 m established through systematic transect lines. Diameter size classes (DSC) for the plantation was examined, carbon stock for each DSC was also determine while basal area (m2 ha-1), volume (m3 ha-1), Biomass (Mg ha-1) and Carbon (Mg ha-1) were also estimated. Results showed mean Dbh of 18.7 + 0.25 cm with 8.14 + 0.10 m, 0.033 + 0.00 m2 ha-1 and 0.320 + 0.01 m3 ha-1 for tree height, basal area and volume respectively. AGB and BGB were 10.877 + 0.39 Mgha-1 and 2.175 + 0.08 Mgha-1 respectively while TC was 6.527 + 0.24 Mgha-1. The percentage carbon stock proportion for each DSC revealed class size 25-29-9 cm (19.02%) as the highest while the least proportion was observed in less than 5 cm class with 0.04% of carbon. The DSC showed majority of the tree Dbh in lower Dbh classes with fewer trees in higher classes forming almost a normal bell shape. The study provides information that can help the management in planning silvicultural activities and selective removal from the stand (harvesting schedule). Tree Dbh, height, basal area, volume and biomass are the determinant characteristics for forest carbon assessment. In conclusion, the plantation actively sequesters carbon showing potentials for indigenous trees in climate change mitigation.
Numerical method for predicting first crack load on hollow-cored beams subjected to point load at Midspan
Authors: Orie O.U. , Ogbonna U.K. 
Published: May 2024

Predicting the initial crack load in concrete is important to detect early warning of a problem. In this study, a model for predicting the first crack load on a hollow-cored rectangular beam point loaded at mid-span was developed by combining a numerical method and an experimental approach. The modulus of rupture was introduced into the governing moment-curvature relationship. Experimentally, flexural testing with point loads at mid-span was performed on fifteen (15) beams made up of three (3) beam types at 1 kN intervals for a span of 750mm using the Universal Testing machine. The beams were simply supported by roller points. The dimensions of the beams were kept constant and later varied while investigating the following hollow diameters: 0, 30, 60, 75, and 105mm. Numerically, the beams were designed as a beam element point loaded at mid-span with a span of 700mm centers, and the support conditions were defined as pinned support. Governing equations relating failure load with the modulus of rupture, stiffness matrix, shape functions, and moment of inertia were developed. The equation for predicting the first crack load, incorporating the modulus of rupture, was derived. The moment of inertia was calculated by discretizing the hollow-cored beam section using an isoparametric geometric transformation. The experimental results were used to validate the numerical model. 90.55% agreement between experimental and numerical results was observed. The overall average percentage difference between the two methods recorded is 9.45%. This shows that at about 91% confidence level, both approaches are the same and can be applied with confidence in the prediction of the first crack load on hollow- cored reinforced concrete beams.
Peran Strategis Guru Penggerak Sebagai Penguatan Implementasi Kebijakan Merdeka Belajar
Authors: Sujana I Gede , Sri Suharti  , Joni Wilson Sitopu  , Heppy Sapulete  , Yohanis Hukubun  
Published: May 2024

Penelitian ini berujuan untuk mengetahui penguatan implementasi merdeka belajar melalui peran strategis guru penggerak. Metode yang diaplikasikan dalam penulisan artikel penelitian ini adalah kualitatif. Adapun jenis penelitian ini adalah penelitian pustaka. Data yang dikumpulkan kemudian dilakukan analisis secara mendalam dengan menggunakan pisau analisis konten. Selanjutnya hasil penelitian disajikan secara deskriptif kualitatif sesuai dengan pokok permasalahan dan tujuan dilaksanakannya penelitian ini. Hasil penelitian ini membuktikan, peran strategis dari guru penggerak, yaitu (1) Guru penggerak juga berperan mengubah pola transformasi pendidikan, yang sebelumnya dari pola terpusat pada guru menuju ke arah desentralisasi dengan memposisikan guru penggerak menjadi agen dan pemimpin proses transformasi; (2) sebagai penggerak disekolah yang berdasarkan pada pengalaman mengajar di sekolah. Guru penggerak bertugas menggerakan semua komponen pendidikan agar terlibat dan berpartisipasi secara aktif dalam rangka meningkatkan kualitas pendidikan; (2) Guru penggerak mampu mengarahkan, membentuk dan mengembangkan secara utuh dan menyeluruh kepribadian siswa; (4) Guru penggerak merupakan pemimpin dalam pembelajaran diera merdeka belajar dengan kemampuan menggerakkan lingkungan pendidikan untuk mewujudkan nyatakan pendidikan unggul yang berpusat pada siswa.
Pengaruh Kualitas Pelayanan Baggage Handling System (BHS) terhadap Kepuasan Penumpang Garuda Airlines di Bandar Udara Internasional Soekarno-Hatta Cengkareng
Authors: Aziz Satya Lailan Nur , Syaputra Andi 
Published: May 2024

Salah satu upaya dalam memenuhi kepuasan penumpang adalah pelayanan dalam penanganan bagasi. Penanganan bagasi memiliki peran penting dalam suatu bisnis penerbangan, karena departemen ini bertanggung jawab atas bagasi semua penumpang. Proses penanganan bagasi dibuat secara sistematis dengan sebutan Baggage Handling System (BHS). BHS merupakan sistem keamanan bagasi yang menggunakan teknologi otomatisasi. Penelitian ini bertujuan untuk mengetahui apakah kualitas pelayanan BHS berpengaruh dan seberapa besar pengaruh kualitas pelayanan BHS berpengaruh terhadap kepuasan penumpang Garuda Airlines di Bandar Udara Internasional Soekarno-Hatta Cengkareng. Penelitian ini menggunakan metode pendekatan kuantitatif deskriptif dan jenis data yang digunakan yaitu data primer dan data sekunder. Teknik pengumpulan data yang digunakan dalam penelitian ini yaitu dengan penyebaran kuesioner, sampel dalam penelitian ini adalah penumpang yang pernah menggunakan maskapai garuda Indonesia di terminal 3 Bandar Udara Internasional Soekarno-Hattta Cengkareng. Penelitian ini menyimpulkan hasil bahwa kualitas pelayanan Baggage Handling System memiliki pengaruh yang positif dan signifikan sebesar 68,2% terhadap kepuasan penumpang, sedangkan 31,8% dipengaruhi oleh variabel lain yang tidak diteliti. Hal ini dibuktikan dari hasil Thitung > Ttabel yaitu sebesar 1,940.
Interactions between trade wind clouds and local forcings over the Great Barrier Reef: a case study using convection-permitting simulations
Authors: Zhao Wenhui , Huang Yi , Siems Steven , Manton Michael , Harrison Daniel 
Published: May 2024

Abstract. Trade wind clouds are ubiquitous across the subtropical oceans, including the Great Barrier Reef (GBR), playing an important role in modulating the regional energy budget. These shallow clouds, however, are by their nature sensitive to perturbations in both their thermodynamic environment and microphysical background. In this study, we employ the Weather Research and Forecasting (WRF) model with a convection-permitting configuration at 1 km resolution to examine the sensitivity of the trade wind clouds to different local forcings over the GBR. A range of local forcings including coastal topography, sea surface temperature (SST), and local aerosol loading is examined. This study shows a strong response of cloud fraction and accumulated precipitation to orographic forcing both over the mountains and upwind over the GBR. Orographic lifting, low-level convergence, and lower troposphere stability are found to be crucial in explaining the cloud and precipitation features over the coastal mountains downwind of the GBR. However, clouds over the upwind ocean are more strongly constrained by the trade wind inversion, whose properties are, in part, regulated by the coastal topography. On the scales considered in this study, the warm-cloud fraction and the ensuant precipitation over the GBR show only a small response to the local SST forcing, with this response being tied to the surface flux and lower troposphere stability. Cloud microphysical properties, including cloud droplet number concentration, liquid water path, and precipitation, are sensitive to the changes in atmospheric aerosol population over the GBR. While cloud fraction shows little responses, a slight deepening of the simulated clouds is evident over the upwind region in correspondence to the increased aerosol number concentration. A downwind effect of aerosol loading on simulated cloud and precipitation properties is further noted.
Educación Geográfica Panamericana para el Desarrollo Sostenible
Authors: Álvarez Barahona Sandra , Araya Palacios Fabian 
Published: May 2024

El propósito del trabajo es analizar el compromiso del Instituto Panamericano de Geografía e Historia (IPGH) con la educación geográfica y específicamente con los objetivos para el desarrollo sostenible (ODS). A través de la comisión de Geografía y del comité de educación geográfica este organismo se encuentra desarrollando diversas iniciativas para la concreción de los ODS en el contexto Panamericano. Metodológicamente, se realizó un análisis documental de los escritos emanados del IPGH y específicamente de la red de educación geográfica. Entre los principales resultados, se aprecia que los documentos y trabajos analizados propenden al desarrollo de los ODS a través del pensamiento geográfico, el uso de nuevas tecnologías y el cambio climático.