bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the effect of dexmedetomidine versus magnesium sulphate as an adjuvant to bupivacaine in ultrasound guided erector spinae block; a prospective randomized trial
Authors: Refaat Sameh Ahmed , Abdelmageed Walid Mohammed , Alwedeny Hadil Magdy , Soliman Ehab Hussein , Fouly Mohammed Abdelmoneim 
Published: February 2024

Background & Objectives: Since the introduction of erector spinae plane block (ESPB) in 2016 it has been used with success in various thoracic, abdominal, and spine surgeries. Spine surgeries result in significant postoperative pain. Postoperative opioids provide adequate pain control in most of the cases, but some patients continue to suffer from uncontrolled pain. Patients receiving multiple doses of opioids suffer from various side effects including postoperative nausea and vomiting, constipation, and delayed ambulation. We aimed to compare effect of dexmedetomidine and magnesium sulfate given as adjuvants with bupivacaine 0.25% for ESPB.
Methodology: It was a prospective randomized single-blinded study including 52 patients divided into 2 groups; one receiving ESPB with a combination of bupivacaine 0.25% plus magnesium sulfate and the other receiving the same block with a combination of bupivacaine 0.25% plus dexmedetomidine.
Results: The group receiving bupivacaine and dexmedetomidine had a prolonged postoperative analgesia duration as well as a decreased total opioid consumption (P < 0.05) compared to group receiving bupivacaine 0.25% plus magnesium sulfate, but had a significant decrease in intraoperative pulse rate and blood pressure compared to the group receiving bupivacaine 0.25% plus magnesium sulfate (P < 0.05).
Conclusion: Although dexmedetomidine results in prolonged postoperative analgesia duration compared to magnesium sulfate when combined with bupivacaine 0.25% in ESPB, its negative effects on hemodynamics should be considered.
Trial registration: This trial was registered on clinicaltrials.gov registry (NCT05694897) on 23/1/2023.
Abbreviations: ASA: American Society of Anesthesiologist; ESPB: Erector Spinae Block; ERAS: Enhanced recovery After Surgery; SPSS: Statistical Package for Social Sciences; VAS: Visual Analog Score
Key words: Erector Spinae Plane Block; Dexmedetomidine; Bupivacaine; Visual Analog Scale
Citation: Refaat SA, Abdelmageed WM, Alwedeny HM, Soliman EH, Fouly MA. A randomized comparative trial of ultrasound guided erector spinae block with bupivacaine-magnesium sulphate vs. bupivacaine-dexmedetomidine for lumbar spine surgeries. Anaesth. pain intensive care 2023;27(5):425−430; DOI: 10.35975/apic.v27i5.2292
Received: July 15, 2023; Reviewed: August 16, 2023; Accepted: August 16, 2023
Good correlation between necessary remifentanil concentrations in individual patients determined from sedative-analgesic interactions using pharmacokinetic simulations and the remifentanil concentrations used at anesthesiologists’ discretion
Authors: Matsuki Yuka , Nagata Osamu , Shigemi Kenji 
Published: February 2024

Background: Analgesic and sedative agents interact with each other, and their relationship is explained in a curve convex below. In the automated control anesthesia system based on this relationship that we developed, the dose of analgesic is adjusted with the necessary remifentanil concentration, determined with propofol-remifentanil interactions, as an estimated maximal individual concentration (esMIC). With the system, a study in patients under anesthesia management by an anesthesiologist was conducted to compare the effect-site concentration (ESC) of remifentanil administered at the anesthesiologist’s discretion and the esMIC calculated with drug-drug interactions for their relationship and to assess whether the analgesic dose administered based on esMIC is appropriate.
Methodology: In the present study involving 20 patients, anesthesiologists changed the propofol (P) infusion rate and remifentanil (R) infusion rate to maintain BIS value of 45. The estimated target-effect-site concentration of propofol for maintaining BIS 45 and the ESC of remifentanil (ESC_R) based on the model by Minto et al. were calculated. Moreover, with these data sets, the isodynamic curve of ESC of propofol (ESC_P) for maintaining BIS 45 (Y) and ESC_R (X) was determined to be an equilateral hyperbola (Y = c/(X-a) + b). With the ESC_R at which even raising ESC_R would result in small decreases in ESC_P considered the esMIC, the ESC_R at the point at which the slope of this curve is apos;1 (neutral point) and at the point of the curve where the y-component deviation of the asymptote (y = b) is 20% (esMIC20) calculated every 6 sec. The ESC_R at the time point of an adequate analgesic state as deemed by the anesthesiologist after anesthesia had been started for 15 min was compared with the esMIC20 determined by objective calculations.

Results: The ESC_R and esMIC were 11.9 ± 2.4 and 11.6 ± 2.0 ng/ml, respectively. Moreover, the median ESC_R and esMIC in the patients showed a very good correlation (correlation coefficient R² = 0.88, p < 0.01).
Conclusion: The necessary analgesic concentrations estimated with drug-drug interactions did not contradict those determined at anesthesiologists’ discretion and are considered to assure a reasonable analgesic state.
Key words: Analgesia; Sedation; Remifentanil; Effect-Site Concentrations
Citation: Matsuki Y, Nagata O, Shigemi K. Good correlation between necessary remifentanil concentrations in individual patients determined from sedative-analgesic interactions using pharmacokinetic simulations and the remifentanil concentrations used at anesthesiologists’ discretion. Anaesth. pain intensive care 2023;27(5):491−494; DOI: 10.35975/apic.v27i5.2300
Received: April 04, 2023; Reviewed: May 13, 2023; Accepted: June 16, 2023
The effect of a combination of functional electrical stimulation and cycle ergometer (FES-cycling) on physiological changes and functional ability in patients with ICU-acquired weakness
Authors: Nazir Arnengsih 
Published: February 2024

Intensive care unit-acquired weakness (ICU-AW) is the most common complication found in the intensive care unit (ICU) patients, especially those on prolonged use of mechanical ventilation (MV). It is known to cause poor long-term outcomes, and early rehabilitation (ER) intervention has been proved to be useful in improving muscle strength, physical function, and quality of life of ICU survivors. Several obstacles, such as patients’ medical condition and limited availability of equipment or trained personnel, interfere with ER. Passive ER including functional electrical stimulation (FES) and cycling were found to be effective. The combination of FES with a cycle ergometer (FES cycling) can be implemented, but research on using this modality in the ICU is still limited. This review aimed at providing information on the use of FES cycling in ICU patients to explain its effect on physiological changes and functional abilities. The physiological effects of FES cycling are obtained through local metabolic changes in muscles due to FES and increased cardiovascular responses due to muscle contraction during cycling. Its effects on muscle strength, cross-section area, days free of MV, mobilization, cognitive ability, delirium, and quality of life were positive, and only rarely adverse events occurred during the intervention. To conclude, the use of FES cycling in the prevention and treatment of ICU-AW can be considered since this modality causes positive physiological effects and has proven safe.
Abbreviations: EM – Early Mobilization; ER- early rehabilitation; FES - functional electrical stimulation; ICU-AW - Intensive Care Unit-Acquired Weakness; MV - mechanical ventilation; NMBA - neuromuscular blocking agents; PICS - post-intensive care syndrome; NMES - neuromuscular electrical stimulation;
Key words: Electrical Stimulation; Intensive Care Unit; Muscle Contraction; Muscle Strength; Quality of Life
Citation: Nazir A. The effect of a combination of functional electrical stimulation and cycle ergometer (FES-cycling) on physiological changes and functional ability in patients with ICU-acquired weakness. Anaesth. pain intensive care 2023;27(5):599−606; DOI: 10.35975/apic.v27i5.2315
Received: July 03, 2023; Reviewed & Accepted: August 18, 2023
Remimazolam tosilate infusion has a lower incidence of hypotension than propofol infusion during painless colonoscopy
Authors: Li Sitong , Zhang Yi , Wang Hongbai , Ye Gang , Yao Nana , Zhu Xianlin 
Published: February 2024

Background: Remimazolam tosilate is an ultra-short-acting sedative drug with the advantages of rapid onset and recovery, mild respiratory, and circulatory inhibition. This study primarily investigated the effect of remimazolam on incidence of intraoperative hypotension compared to the widely used propofol in patients undergoing outpatient painless colonoscopy.
Methodology: This was a double-blinded, randomized, controlled trial. We randomly divided the eligible patients with outpatient appointment for painless colonoscopy in our hospital into the remimazolam group and the propofol group. The modified observer’s assessment of alert/sedative was used to evaluate the depth of the patient's sedation. The Narcotrend score was monitored throughout the whole process. In the propofol group, propofol 0.5-1.5 mg/kg was infused intravenously as a loading dose, followed by 3-5 mg/kg/h to maintain a satisfied sedation depth during operation. While, with regarding to the patients in remimazolam group, remimazolam 0.05-0.15 mg/kg was induced intravenously as a loading dose, and continuously pumped at a rate of 0.3-0.5 mg/kg/h. SPSS 23.0 software was used to analyze the data.
Results: From December 2020 to March 2021, we enrolled 116 eligible patients. The incidence of hypotension during sedation (13.8%) in the remimazolam group was significantly lower than that in propofol (37.9%), and the success rate of remimazolam (98.3%) was slightly lower than propofol (100.0%), but the awakening time was significantly shorter (P < 0.001); The incidence of respiratory inhibition, nausea, vomiting and other adverse events during colonoscopy, remimazolam was significantly lower than that of propofol (P < 0.05).
Conclusion: Remimazolam tosilate still has higher circulatory stability than propofol in painless colonoscopy under continuous administration with a loading dose.
Trial registration: The trial was registered at the Chinese Clinical Trial Registry (ChiCTR2000040557), data of registration: December 2020.
Abbreviations: BMI- Body Mass Index; MOAA/S- Modified Observer’s Assessment of Alert Scale; MAP- Mean Arterial Pressure; Rem- Remimazolam; Pro- Propofol

Key words: Remimazolam tosilate; Propofol; Painless Colonoscopy; Hypotension
Citation: Li S, Zhang Y, Wang H, Ye G, Yao N, Zhu X. Continuous remimazolam tosilate infusion has a lower incidence of hypotension than propofol infusion for sedation in painless colonoscopy. Anaesth. pain intensive care 2022;27(6):697−705; DOI: 10.35975/apic.v27i6.2341
Received: Aug 27, 2023; Revised: October 16, 2023; Accepted: October 16, 2023
Hypotension as a first presentation of myasthenia gravis in an elderly patient scheduled for cervical disc surgery: a case report
Authors: Seyam Sameh Hamdy , Ali Mohamed Abdelhamid , Razein Hassan , Elkousy Islam , Schandran Shyam Babu 
Published: February 2024

Myasthenia gravis presents with progressive skeletal muscle weakness. The disease can affect any group of muscles, along with the proximal limb and neck musculature. Elderly patients, especially those over 60 y of age, frequently face extensive delays in diagnosis, or are misdiagnosed, as the symptoms may be erroneously attributed to different other causes frequently seen in this age group, such as degenerative joint disease, disk herniation, osteoporotic vertebral fractures, or metastases. We present a case of a 61-year-old male patient with significant medical records of hypertension, who presented with neck pain for a few months, posted for cervical disc surgery at C6-7 with cage fixation. Two attempts for general anesthesia induction were complicated by severe hypotension. He was evaluated with low-frequency repetitive stimulation, Acetyl-choline receptor antibody, and P/Q calcium channel antibodies. The low-frequency Repetitive Nerve Stimulation (RNS) showed a severe reduced response that was corrected after rest, which was consistent with the diagnosis of myasthenia gravis.
Key words: Myasthenia; Pain, Neck; Hypotension; Weakness
Citation: Seyam SH, Ali MA, Razein H, Elkousy I, Schandran SB. Hypotension as a first presentation of myasthenia gravis in an elderly patient scheduled for cervical disc surgery: a case report. Anaesth. pain intensive care 2023;27(6):763−767; DOI: 10.35975/apic.v27i6.2351
Received: July 08, 2023; Revised: September 16, 2023; Accepted: October 09, 2023
FORMULATION AND CHARACTERIZATION OF ANTI-INFLAMMATORY TRANSDERMAL PATCH PREPARATIONS FROM THE EXTRACT OF PATAH TULANG (Euphorbia tirucalli)
Authors: Sutiswa Shandra Isasi , Saripah Syipa Siti , Martihandini Nooryza 
Published: February 2024

Transdermal patches are pharmaceutical preparations that aim to provide a drug delivery system across the surface of the skin and tissue, which is then delivered to the blood. is a plant that contains secondary metabolites with anti-inflammatory activity, such as alkaloids, flavonoids, polyphenols, tannins, steroids, and saponins. This study aimed to determine the characteristics of anti-inflammatory transdermal patch preparations prepared from Euphorbia tirucalli extract. The research method was laboratory experimental by preparing patches using varying concentrations of Euphorbia tirucalli extract, namely F1 (5%), F2 (10%), and F3 (15%). Next, an evaluation of patch preparation was carried out, including organoleptic tests, weight uniformity tests, thickness tests, fold durability tests, pH tests, and moisture tests. From the research results, it can be concluded that Euphorbia tirucalli extract at concentrations of 5%, 10%, and 15% can be made into patch preparations. The best characteristics of the patch preparation were F2 with an extract concentration of 10%, which had a smooth, flexible texture, folding durability >300 folds, pH 4.5, and moisture value of 7.30%.
Keywords: Anti-inflammatory, Euphorbia tirucalli, Transdermal patch
Meningkatkan Kemampuan Motorik Halus Anak Kelompok B Usia 5-6 dengan Metode Kolase melalui Media Bahan Alam TK Pertiwi Pangkalpinang
Authors: Zaleha Zaleha 
Published: February 2024

Penelitian ini dilakukan untuk meningkatkan kemampuan motorik halus anak kelompok B di TK Pertiwi Pangkalpinang terhadap kegiatan kolase dengan menggunakan media bahan alam telah dilaksanakan pada tanggal 18 April 2022 s.d 29 April 2022. Waktu penelitian ini dilaksanakan dalam 2 siklus yaitu siklus I dilaksanakan pada tanggal 18-22 April 2022 dengan tema binatang hasil yang diperoleh adalah anak dalam kategori Belum Muncul sebanyak 6,25%, kategori Mulai Muncul 6,25%, kategori Berkembang Sesuai Harapan 25%, kategori Berkembang Baik Sekali 62,5%, Siklus II dilaksanakan pada tanggal 25 April 2022 s.d 29 April 2022 dengan tema tanaman hasil yang diperoleh yaitu anak dalam kategori Belum Muncul dan Mulai Muncul tidak ada, kategori Berkembang Sesuai Harapan sebesar 12,5%, kategori Berkembang Baik Sekali sebesar 87,5%. Penelitian ini di laksanakan di kelompok B usia 5-6 tahun, dengan jumlah 16 orang anak yang terdiri dari 9 orang anak laki-laki, dan 7 anak perempuan. Dengan demikian, maka dapat disimpulkan bahwa media pembelajaran dengan menggunakan media bahan alam dapat meningkatkan kemampuan motorik halus anak kelompok B di TK Pertiwi Pangkalpinang.
MOTIVASI DAN KINERJA GURU PAUD DI TKK SATAP RUTOSORO
Authors: Mau Gili Angela Marici 
Published: February 2024

Tujuan penelitian ini adalah untuk mengetahui informasi mengenai, jabatan profesional dan peran dari seorang guru Paud di TKK Satap Rutosoro. Penelitian ini adalah penelitian lapangan (Filed research) yang bersifat kualitatif, dengan tujuan yang akan dicapai peneliti adalah suatu gambaran secara faktual dengan pengumpulan data yang digunakan yaitu observasi, wawancara, dan dokumentasi yang diperoleh langsung di lapangan. Adapun hasil peneliti yang diperoleh dalam pengembangan sikap profesionalisme guru melalui kinerja guru Paud pada satuan pendidikan di TKK Satap Rutosoro yaitu dilakukan dengan berbagai program yaitu upaya membangun kerja sama dengan orang tua, masyarakat dan lingkungan terkait dalam rangka pengelolaan Paud (TK) yang profesional, akuntabel, dan berdaya saing nasional dan juga guru-guru disiplin dalam membuat Rencana Pelaksanaan Pembelajaran Harian (RPPH). Akhir dari penelitian ini bahwa kepala sekolah dan guru adalah pemeran yang berada di garda terdepan dalam menentukan keberhasilan peserta didik dalam sebuah lembaga pendidik. Motivasi guru dalam melaksanakan tugas menjadi jembatan untuk mengukur kinerja guru untuk menciptakan motivasi dan kinerja guru yang diharapkan maka dibutuhkan kepala sekolah yang memiliki kemampuan sebagai pemimpin dan guru yang profesional.
Kata kunci: motivasi guru, kinerja guru, kepemimpinan kepala sekolah, profesionalisme.
PENGEMBANGAN MEDIA KARTU HURUF UNTUK MENINGKATKAN ASPEK MEMBACA PERMULAAN ANAK USIA 5-6 TAHUN
Authors: Tunga Maria Fausta , Ita Efrida Ita , Nafsia Andi 
Published: February 2024

Abstrak
Penelitian ini bertujuan untuk: 1) Mendesain atau merancang media kartu huruf yang digunakan untuk meningkatkan keterampilan membaca permulaan pada anak usia 5-6 tahun di TKK Negeri St. Fransiska Tarawaja. 2) Mengetahui tingkat kelayakan media kartu huruf untuk meningkatkan aspek membaca permulaan pada anak usia 5-6 Tahun di TKK Negeri St. Fransiska Tarawaja. Jenis penelitian pengembangan, model ADDIE. Hasil penelitian menunjukkan bahwa media kartu huruf yang digunakan dalam meningkatkan aspek membaca permulaan kelompok B di TKK Negeri St. Fransiska Tarawaja dikategorikan layak berdasarkan aspek yang sudah divalidasi dan diuji coba. Berdasarkan hasil uji coba ahli materi memperoleh persentase 90 % dengan kriteria “ Sangat Valid”, penilaian dari ahli media memperoleh 94,28 % dengan kategori “ Sangat Valid”, penilaian dari ahli desain memperoleh 80 % dengan kriteria “ Valid”, penilaian pada uji coba perorangan memperoleh persentase 85,71 % dengan kriteria “ Valid”, dan penilaian pada uji coba kelompok kecil memperoleh persentase 83,3 % dengan kriteria “ Valid”. Dari hasil tesebut menunjukkan bahwa media kartu huruf layak untuk digunakan sebagai media pembelajaran untuk meningkatkan aspek membaca permulaan anak usia 5-6 tahun di TKK St. Fransiska Tarawaja.
PENGEMBANGAN MEDIA POHON ANGKA MELATIH KEMAMPUAN BERHITUNG PERMULAAN ANAK USIA 5-6 TAHUN
Authors: Wea Maria Marselina , Ita Efrida , Meo Maku Karmelia Roswinda 
Published: February 2024

Penelitian ini bertujuan untuk: 1) Menghasilkan media pohon angka untuk melatih berhitung permulaan anak. 2) Mengetahui kualitas hasil uji coba produk media pohon angka dalam melatih berhitung permulaan pada anak usia dini kelompok B. Penelitian ini dilakukan di TKK Negeri wue, Desa wue, Kecamatan wolomeze Kabupaten Ngada Nusa Tenggara Timur. Adapun subyek dalam penelitian ini adalah 1 ahli materi pembelajaran, 1 ahli media pembelajaran, 1 ahli desain pembelajaran dan 5 orang anak usia dini kelompok B TKK Negeri wue.
Hasil penelitian ini menunjukan bahwa: 1. Dihasilkannya media pohon angka dengan kelayakan berdasarkan hasil uji ahli materi pembelajaran diperoleh hasil dengan presentase 93,3% dengan kualifikasi “Sangat Valid”, penilaian dari ahli media pembelajaran memperoleh presentase 76% dengan kualifikasi “Valid”, penilaian dari ahli desain pembelajaran memperoleh presentase 77,6% dengan kualifikasi “Valid”, penilaian pada uji coba perorangan memperoleh presentase 100% dengan kualifikasi.
PENGEMBANGAN MEDIA TABUNG ANGKA UNTUK KEMAMPUAN MENGENAL ANGKA PERMULAAN PADA ANAK USIA 4-5 TAHUN
Authors: Owa Yasinta Owa , Oka Gde Putu Arya Oka , Fono Yasinta Maria Fono 
Published: February 2024

Abstrak (Indonesia)
Penelitian ini bertujuan untuk mendesain media tabung angka aspek kognitif berpikir simbolik pada anak usia 4-5 tahun di TKK Rosamistika Piga 1 dan mengetahui tingkat kelayakan media tabung angka. Jenis penelitian ini adalah penelitian pengembangan Research and Development (R&D). Sedangkan model pengembangan menggunakan model ADDIE. Instrumen yang digunakan untuk mengumpulkan data dalam penelitian pengembangan ini yaitu angket, wawancara, dan observasi. Uji kevalitan media dari seluruh rangkaian uji coba dengan rincian hasil uji coba dijabarkan masing-masing sebagai berikut: 1) uji coba oleh ahli materi memperoleh total skor sebesar 78,67% dengan kategori “Valid”, 2) uji coba oleh ahli media pembelajaran memperoleh total skor sebesar 90,67% dengan kategori “Sangat Valid”, 3) uji coba oleh ahli desain pembelajaran memperoleh total skor sebesar 85,33% dengan kategori “Valid”, 4) uji coba perorangan memperoleh total skor sebesar 80% dengan kategori “Valid”, dan 5) uji coba kelompok kecil memperoleh total skor sebesar 87,55% dengan kategori “Sangat Valid”. Dengan demikian dapat dikatakan bahwa media tabung angka sudah layak digunakan sebagai media pembelajaran bagi anak usia dini untuk aspek kognitif berpikir simbolik.
PENGEMBANGAN MEDIA PUZZLE DENGAN TEMA ALAM SEMESTA UNTUK MENINGKATKAN KEMAMPUAN KOGNITIF ANAK USIA DINI
Authors: Endang Lusia Soviana , Ngura Elisabeth Tantiana , Maku Karmelia Rosfinda Meo 
Published: February 2024

Penelitian pengembangan ini bertujuan untuk menghasilkan media puzzle berdasarkan perkembangan kognitif anak usia dini di kelompok B TKK Negeri Ture Inka Mengeruda. Dalam penelitian dan pengembangan ini media yang digunakan yaitu media puzzle dengan tema alam semesta yang kemudian akan dijadikan sebagai media pembelajaran. Media puzzle ini dikembangkan dengan menggunakan model ADDIE. Terdapat lima tahap dalam model ADDIE yaitu: 1) tahap analisis (analize), 2) tahap desain (design), 3) tahap pengembangan (development), 4) tahap implementasi (implementation), 5) tahap evaluasi (evalution).Sesuai hasil dan uji coba dari para ahli dan anak sebagai pengguna media dalam penelitian dan pengembangan yaitu antara lain. 1) berdasarkan penilaian yang dilakukan oleh ahli materi/isi pada media puzzle yaitu berada pada kategori “sangat valid” (97%), 2) berdasarkan hasil uji coba yang dilakukan oleh ahli media pada media puzzle yaitu berada pada kategori “sangat valid” (91%), 3) berdasarkan penilaian yang dilakukan oleh desain pada media puzzle yaitu termasuk dalam kategori “sangat valid” (86%), 4) berdasarkan penilaian perorangan pada media puzzle yaitu termasuk dalam kategori “sangat valid” (86%), 5) berdasarkan penilaian pada kelompok kecil terhadap media puzzle yaitu berada pada kategori “valid” (83%).
The Application of Machine Learning to Quasar and Seyfert Classification
Authors: Abraham Vivek , Deville Joel , Kinariwala Garv 
Published: February 2024

Abstract
Machine learning can be utilized to classify spectra flagged as Active Galactic Nuclei (AGNs) belonging to Seyferts or Quasars, expediting data collection and aiding in analyzing the AGN types. While many properties of Seyferts and Quasars can be used as feature points in training a machine learning model, one relatively available property with high information density is the spectra of the AGN types. This paper aims to describe the training and results of a K-Nearest Neighbors and a Dense Neural Network machine learning model built to classify AGNs as Seyfert type 1s, Seyfert type 2s, or Quasars.
La dimension raciale du droit de la nationalité ?
Authors: Calvo Stéphanie 
Published: February 2024

Si le droit de la nationalité procède, par définition, d’une logique de tri distinguant le national de l’étranger, les normes élaborées à l’égard des binationaux, ressortissants des anciens territoires colonisés par la France, et de leur descendance dévoilent une définition racisée de la nation. Pour celles et ceux amenés à défendre leur nationalité, la remise en cause systématique des actes d’état civil étrangers participe pleinement de cette logique d’éviction, semble-t-il, érigée en principe. Droit discriminatoire, impensé racial ?