bluuebunny/crossref_metadata_2025_split huggingface dataset:
A novel exploration of how localized magnetic field affects vortex generation of trihybrid nanofluids
Authors: Ahmad Shabbir , Ali Kashif , Khalid Fareeha , McKeon John Joseph , Alballa Tmader , Khalifa Hamiden Abd El-Wahed , Cai Jianchao 
Published: November 2023

Abstract
Nanofluidics have better thermal properties than regular fluids, which makes them useful for heat transfer applications. This research investigated the complex dynamics of confined magnetic forces that influence the rotation of nanostructures and vortex formation in a tri-hybrid nanofluid (Ag, Al2O3, TiO2) flow regime. The study shows that the magnetic field can change the flow and heat transfer of nanofluidic, depending on its direction and strength. The study also provides insights into the complex physics of nanofluid flow and heat transfer, which can help design devices that use nanofluids more efficiently for cooling electronics, harvesting solar energy, and generating power from fuel cells. We used a single-phase model to model the nanofluids while the governing partial differential equations were solved numerically. An alternating-direction implicit approach has been employed to analyze the impact of confined magnetic fields on the nanofluid flow and thermal properties. Unlike previous studies that assumed uniform magnetic fields, we introduced multiple confined magnetic fields in the form of horizontal and vertical strips. Using our custom MATLAB codes, we systematically examined various parameters, including the magnetic field strength, number of strips and their position, and nanoparticle volume fraction, to assess their effects on nanofluid flow and thermal characteristics. Our findings revealed that the confined Lorentz force induced the spinning of tri-hybrid nanoparticles, resulting in a complicated vortex structure within the flow regime. In the absence of a magnetic field, a single symmetric vortex can be seen in the flow field. However, the introduction of magnetic sources stretches this vortex until it splits into two smaller, weaker vortices in the lower cavity, rotating clockwise or counterclockwise. Furthermore, the magnetic field strength significantly reduces both skin friction and the Nusselt number, while Reynolds numbers mainly affect the Nusselt number.
Erythrocyte labile iron pool indicating concealed iron overload in non-transfusion-dependent β-thalassemia
Authors: Chutvanichkul Boonyanuch , Vattanaviboon Phantip , Mas-oodi Sumana , U-pratya Yaowalak , Wanachiwanawin Wanchai 
Published: November 2023

Abstract

Objectives
Not only do transfusion-dependent thalassemia (TDT) patients have a risk of clinical consequences arising from iron overload, non-transfusion-dependent thalassemia (NTDT) patients may encounter it also. In this study, we demonstrated the usefulness of intra-erythrocyte labile iron pool (LIP) measurement in NTDT patients with HbE/β-thalassemia in revealing a concealed iron overload and the resultant oxidative cell damage.

Methods
LIP and ferritin levels were assayed in 20 HbE/β-thalassemia patients, comprising 10 NTDT and 10 TDT patients and 10 healthy individuals. Erythrocyte oxidative stress parameters (intraerythrocyte reactive oxygen species (ROS) levels, numbers of erythrocyte vesicles, and cell apoptosis) were also determined and their correlations to LIP and ferritin levels were analyzed.

Results
LIP levels (based on different mean fluorescence intensity (MFI) values obtained by flow cytometry) were high in both the NTDT (54 [42–90]) and TDT (71 [68–77]) patients compared to the healthy individuals (43 [31–61]). The ferritin level observed in the NTDT group (2,149 [781–4,071] ng/mL) was lower than that of the TDT group (4,885 [2,343–7,826] ng/mL). The LIP level was significantly correlated with the NTDT patients’ age and all oxidative stress parameters, but the ferritin level was not. Correlation analysis predicted that NTDT patients without receiving any therapy aged 32.5 years old or over are likely at risk of iron overload status and oxidative cell damage.

Conclusions
The results indicate that LIP may be a helpful alternative parameter for defining the risk of iron overload.
Die Regulierungswut muss aufhören – wir ruinieren unser Land!
Authors: Junker Claudia 
Published: November 2023

Abstract
The ever increasing regulation is overwhelming and strangles the companies. It ties up enormous resources, foremost the upcoming EU Supply Chain Directive. Regulation is based on anecdotic examples instead of a systematic analysis. Simple proposals to ease up the burden to come along with the European supply chain regulation – e. g. excluding the supply chain parts laying within Europe – exist, but the debate does not progress. Other examples of the ever increasing regulation include the Foreign Subsidies Regulation and the Barrier-Free Reinforcement Act. Again, well intended regulation. But all adding up to an immense bureaucratic burden. That the Federal Ministry of Justice has put the reduction of bureaucracy on its to-do-list gives hope. In times of crises such as the pandemic, wars, energy crisis, climate crises and inflation, burdens on businesses should be reduced to free up resources.
Insulin autoimmune syndrome: not just one but two different diseases with therapeutic implications
Authors: Wammer Anne Cathrine Parelius , Nermoen Ingrid , Medbøe Thorsby Per , Bolstad Nils , Lima Kari , Tran Hoa , Følling Ivar 
Published: November 2023

Summary
We present a young woman with treatment resistant insulin autoimmune syndrome (IAS) with a protracted course. Her serum insulin level was 6945 pmol/l (<160), C-peptide 4042 pmol/L (<1480), anti-insulin antibodies 5305 U/mL (<0.4) were monoclonal IgG kappa. After 12 h of fasting, her blood glucose fell to 1.2 mmol/L. Post-meal blood glucose peaked at 12.2 mmol/L with reactive hypoglycaemia below 2 mmol/L. Frequent meals and continuous blood glucose monitoring were helpful, but further treatments advocated in the literature with prednisolone, rituximab, plasmapheresis, cyclophosphamide and ciclosporin were without beneficial effect.
Based on this case and a review of the literature, we propose that IAS is not one but two different diseases with different therapeutic strategies. The first disease, polyclonal IAS, predominates in Asia and is characterized by polyclonal anti-insulin antibodies, association with certain HLA genotypes and other autoimmune conditions, medications and viral infections possibly triggering the disease, a possible female predominance among young patients and a tendency towards spontaneous remission. The other disease, monoclonal IAS, predominates in Caucasians. Typical features are monoclonal anti-insulin antibodies, only weak HLA association, no drug predisposition, no sex difference, rare remission and conventional therapy often being without any clinical effect. We suggest that monoclonal IAS with IgG or IgA anti-insulin antibodies should receive therapy targeting plasma cells rather than lymphocytes.

Learning points

IAS may be considered as two separate diseases, polyclonal and monoclonal.

The presence of either polyclonal or monoclonal antibodies should determine the choice of treatment for IAS.

In polyclonal IAS, discontinuation of a triggering medication and treatment of triggering conditions should be the backbone of therapy.

Monoclonal IAS should receive treatment targeting plasma cells.
Hubungan kemampuan berpikir kritis terhadap keaktifan belajar pada mahasiswa sarjana kedokteran Universitas Udayana
Authors: Icha Milenia Yanwar  , I Gusti Ayu Sri Darmayani  , I Gde Haryo Ganesha  , I Putu Bayu Mayura  
Published: November 2023

Introduction: Problem-based learning is a method of approach in assisting students in finding problems from a real event. This can affect learning methods to increase skills of critical thinking and active learning, where critical thinking will encourage the formation of knowledge and will be interpreted personally and will be applied to conditions or problems so as to increase active learning. This study aims to determine association between critical thinking skills towards active learning in medical students at Universitas Udayana.
Methods: The respondents of this study were medical students class 2020 in Universitas Udayana. The type of this research is analytic research with a cross-sectional approach. The sampling technique used was the total sampling method and used a questionnaire of critical thinking and active learning.
Results: A total of 165 respondents met the inclusion criteria in this research. The analysis results showed that critical thinking skills increased active learning significantly (p < 0.001) with moderate and direct correlation (r = 0.574).
Conclusion: The ability to think critically can affect the level of active learning in medical education students.

Pendahuluan: Salah satu metode pendekatan untuk membantu mahasiswa dalam menemukan masalah dari suatu peristiwa yang nyata adalah pembelajaran berbasis masalah. Hal ini dapat mempengaruhi metode belajar yang menyebabkan peningkatan kemampuan berpikir dan keaktifan belajar. Berpikir kritis akan mendorong terbentuknya pengetahuan dan akan diinterpretasi personal dan akan diaplikasikan pada kondisi atau masalah sehingga meningkatkan keaktifan belajar. Penelitian ini memiliki tujuan untuk menganalisis hubungan antara kemampuan berpikir kritis dan keaktifan belajar pada mahasiswa sarjana kedokteran Universitas Udayana.
Metode: Responden penelitian ini adalah mahasiswa program studi sarjana kedokteran Universitas Udayana angkatan 2020. Penelitian ini merupakan penelitian analitik dengan pendekatan potong lintang. Teknik pengambilan sampel dilakukan dengan total sampling dan menggunakan kuesioner berpikir kritis dan keaktifan belajar.
Hasil: Sebanyak 165 responden memenuhi kriteria inklusi dalam penelitian ini. Hasil analisis menunjukkan bahwa kemampuan berpikir kritis meningkatkan keaktifan belajar secara signifikan (p < 0,001) dengan korelasi sedang dan searah (r = 0,574).
Simpulan: Kemampuan berpikir kritis dapat mempengaruhi tingkat keaktifan belajar pada mahasiswa sarjana kedokteran Universitas Udayana.
Prevalensi dan faktor risiko mask acne pada mahasiswa program studi sarjana kedokteran dan profesi dokter Universitas Udayana angkatan 2019-2021
Authors: Bella Trisha Agung Saraswati  , I Dewa Ayu Inten Dwi Primayanti  , Luh Putu Ratna Sundari  , I Putu Adiartha Griadhi  
Published: November 2023

Introduction: One of the mandatory health protocols during the COVID-19 pandemic is wearing a mask. Masks that are used for a long time can increase the risk of developing acne vulgaris in the area around the mouth and nose (mask acne). The impact caused by acne masks is very detrimental both in terms of aesthetics, comfort, and psychology. This study aims to analyze the prevalence and risk factors for mask acne in undergraduate medical students and the medical profession at Udayana University class of 2019-2021.
Methods: This study has a cross-sectional design with observational analytic methods. The sample of this research was 260 respondents who were taken by consecutive sampling. Data analysis was performed by chi-square test and logistic regression.
Results: The prevalence of mask acne in students of the Faculty of Medicine, Udayana University class of 2019-2021 is 50.8%. Risk factors for mask acne in students of the Faculty of Medicine, Udayana University class of 2019-2021 include skin type (p = 0.025), oily skin condition after using a mask (p <0.001), and having a history of acne vulgaris due to sunlight (p = 0.002).
Conclusion: About half of the 2019-2021 class of Udayana University Faculty of Medicine students experience mask acne with various risk factors.

Pendahuluan: Salah satu protokol kesehatan saat pandemi COVID-19 yang wajib dilakukan adalah menggunakn masker. Masker yang digunakan dalam waktu lama dapat meningkatkan risiko timbulnya acne vulgaris di area sekitar mulut dan hidung (mask acne). Dampak yang ditimbulkan mask acne sangat merugikan baik dari segi estetika, kenyamanan, dan psikologis. Penelitian ini memiliki tujuan untuk menganalisis prevalensi dan faktor risiko mask acne pada mahasiswa program studi sarjana kedokteran dan profesi dokter Universitas Udayana angkatan 2019-2021.
Metode: Penelitian ini memiliki desain cross-sectional dengan metode analitik observasional. Sampel dari penelitian ini sebanyak 260 responden yang diambil dengan cara consecutive sampling. Analissi data dilakukan dengan uji chi-square dan regresi logistik.
Hasil: Prevalensi mask acne pada mahasiswa Fakultas Kedokteran Universitas Udayana angkatan 2019-2021 adalah 50,8%. Faktor risiko mask acne pada mahasiswa Fakultas Kedokteran Universitas Udayana angkatan 2019-2021 antara lain jenis kulit (p = 0,025), kondisi kulit berminyak setelah menggunakan masker (p<0,001), dan memiliki riwayat acne vulgaris akibat sinar matahari (p = 0,002).
Simpulan: Sekitar setengah dari jumlah mahasiswa Fakultas Kedokteran Universitas Udayana angkatan 2019-2021 mengalami mask acne dengan berbagai faktor risiko.
A full-term infant with large patent ductus arteriosus successfully closed with oral ibuprofen: a case report
Authors: Christian Hans , Gunawijaya Eka , Limantara Veronica Lily , Limantara Ancelia , Gerdyman Joseph 
Published: November 2023

Background: Ductus arteriosus is a vascular shunt between the aorta and pulmonary artery. Within the first 24-48 hours of life, the ductus usually closes. Failure of closure is called patent ductus arteriosus (PDA). Timing for treatment is crucial. Early treatment can decrease the need for drugs or surgery, but it can cause more adverse events, such as brain hemorrhage, bowel perforation and renal dysfunction. On the other hand, late treatment can cause complications such as pulmonary hemorrhage, necrotizing enterocolitis and can render drugs to be less effective.
Case Presentation: The patient was a 2 hours old male, 39 weeks, Apgar 7/8, 3100 grams, referred to the cardiology team because of tachypnea and peripheral cyanosis. Initial echocardiographic showed large patent ductus arteriosus, coarctation aorta, patent foramen ovale and moderate tricuspid regurgitation. The patient was given 60mg of oral ibuprofen for the first day and 30mg of oral ibuprofen for the second and third days. In addition, the patient was given 2mg of furosemide, 2.5mg of spironolactone and 12.5mcg of digoxin twice daily to prevent heart failure. Echocardiographic evaluation after three days showed closure of large patent ductus arteriosus, no mild preductal coarctation aorta remains, trivial tricuspid and patent foramen ovale. No side effects were observed.
Conclusion: This case showed successful early treatment of large PDA in full-term infants with a double dose of oral ibuprofen. Adverse events were not found. As a result, Ibuprofen should be considered as an early treatment for PDA in full-term infants.
Case report: corticosteroid as an alternative therapy for Kawasaki disease
Authors: Izawati Elok , Sandhi Parwata  , Maharani Pande Tiara 
Published: November 2023

Background: Kawasaki disease is an acute febrile illness with systemic vasculitis and predominantly causes acquired heart disease. The etiology is still unknown, and there is no specific diagnostic test. The diagnosis was made using clinical criteria, laboratory and echocardiographic findings. It is characterized by fever, bilateral non-exudative conjunctivitis, erythema of lips and oral mucosa, rash, cervical lymphadenopathy, edema and erythema of the hand and foot. The initial treatment for both complete and incomplete Kawasaki disease is a single high dose of intravenous immunoglobulin (IVIG) and aspirin. The place of corticosteroids in the initial therapy is still controversial.
Case Description: A 3-year-old boy presented with a 7-day history of high fever and not relieved by antipyretic, which was followed by a maculopapular rash on his trunk and extremities, vomiting, reduced appetite, red on her lips and eyes who aspirin, IVIG and corticosteroid treated as initial therapy. He showed clinical improvement and did not have cardiovascular complications.
Conclusion: We report a case of Kawasaki disease in a 3-year-old boy. This case highlighted that adding corticosteroids to IVIG and aspirin as initial therapy might improve outcomes in Kawasaki disease and could be selected as a treatment modality to treat Kawasaki disease.
Penggunaan klonidin sebagai terapi shivering pasca anestesi spinal: sebuah tinjauan sistematis
Authors: Arthana I Nyoman Dwi Ari 
Published: November 2023

Background: Shivering can increase oxygen use, the risk of hypoxemia, and post-operative sequelae. The many properties of clonidine make this medication versatile enough to be employed not just to avoid shivering, but also to treat additional spinal anesthesia adverse effects.
Methods: Researchers combed the PubMed database for randomized clinical trials (RCTs) conducted between 2012 and 2022. Each study must be accessible and written in English. Individuals older than 18 who received spinal anesthesia operations.
Results: A total of 41 article abstracts and 12 full-length studies were evaluated, and seven papers met the inclusion criteria. The studied clinical outcome was the frequency of post-spinal anesthesia shivering. The majority of prior investigations found no significant difference in the shivering impact between the clonidine and midazolam groups. Shivering was much less common after tramadol treatment than after clonidine administration. Dexmedetomidine is known to be more effective than clonidine in controlling post-spinal blockade shivering.
Conclusion: Clonidine is beneficial in lowering the occurrence of post-spinal anesthesia shivering.

Latar Belakang: Shivering dapat meningkatkan konsumsi oksigen, meningkatkan risiko hipoksemia, dan meningkatkan komplikasi setelah operasi. Berbagai efek klonidin membuat agen ini cukup potensial untuk digunakan tidak hanya sebagai pencegahan shivering tetapi juga untuk mengatasi efek samping lain dari anestesi spinal.
Metode: Peneliti mencari database PubMed untuk uji coba terkontrol acak/randomized clinical trial (RCT) dalam periode 2012-2022. Setiap studi harus dalam bahasa Inggris dan dapat diakses untuk full review. Subjek berusia >18 tahun yang menjalani prosedur anestesi spinal.
Hasil: Total 41 abstrak artikel yang ditelaah, 12 studi full paper ditelaah dan 7 studi yang memenuhi kriteria inklusi. Keluaran klinis yang dievaluasi adalah kejadian shivering pasca anestesi spinal. Hasil sebagian besar studi sebelumnya menunjukkan bahwa tidak terdapat perbedaan bermakna efek shivering pada kelompok klonidin dan midazolam. Insiden shivering pasca pemberian tramadol secara bermakna lebih rendah dibandingkan kelompok klonidin. Pemberian dexmedetomidine diketahui lebih efisien dibandingkan klonidin untuk mengontrol post spinal blockade shivering
Kesimpulan: Klonidin efektif mengurangi kejadian shivering pasca anestesi spinal.
Hubungan stadium klinis awal dan lanjut dengan kejadian depresi pada penderita Karsinoma Nasofaring (KNF) sebelum terapi di Poliklinik THT – KL RSUP Prof. Dr. IGNG Ngoerah, Bali, Indonesia
Authors: Sudana Ketut Wahyudiana , Suanda I Ketut , Sutanegara Sari Wulan Dwi 
Published: November 2023

Background: Nasopharyngeal Carcinoma (NPC) is a tumor or malignancy that manifests in the nasopharynx, in the upper throat and back of the nose. When someone is diagnosed with cancer, many of them experience mental disorders, such as one example of depression. This study aimed to determine the relationship between early and advanced clinical stages with the incidence of depression in nasopharyngeal carcinoma patients before therapy.
Methods: An observational cross sectional comparative study design was conducted. Fifty-four research subjects were obtained with consecutive sampling techniques. The data obtained were analyzed descriptively, followed by the Chi-Square test and ended with the Logistic Regression test by SPSS version 26.0 for Windows.
Results: Based on bivariate analysis, three variables are significantly related to the level of depression in NPC patients, such as age, level of education and stage of cancer (p<0.05). Based on multivariate analysis using Logistic Regression, only one variable had a statistically significant relationship with the level of depression in NPC patients, namely the cancer stadium variable (p=0.001).
Conclusion: These findings suggest a significant relationship between the stage of cancer and the level of depression in NPC patients.

Latar Belakang: Karsinoma Nasofaring (KNF) adalah tumor atau keganasan yang bermanifestasi pada daerah nasofaring yaitu pada daerah atas tenggorokan dan belakang hidung. Ketika seseorang didiagnosa menderita kanker,banyak yang mengalami gangguan mental seperti salah satu contohnya depresi. Tujuan penelitian ini adalah untuk mengetahui hubungan stadium klinis awal dan lanjut dengan kejadian depresi pada pasien karsinoma nasofaring sebelum terapi.
Metode: observasional dengan rancangan cross sectional comparative study. Didapatkan 54 subjek penelitian dengan tehnik consecutive sampling. Data yang diperoleh dianalisis secara deskriptif, dilanjutkan dengan uji Chi-Square dan diakhiri uji Regresi Logistik menggunakan SPSS versi 26.0 untuk Windows.
Hasil: Berdasarkan analisis bivariat, terdapat tiga variabel yang berhubungan secara bermakna dengan tingkat deprersi pada pasien KNF yakni usia, tingkat pendidikan terakhir dan stadium kanker (p<0.05). Berdasarkan analisis multivariat dengan menggunakan Regresi Logistik hanya terdapat satu variabel yang secara statistik memiliki hubungan bermakna dengan tingkat depresi pada pasien KNF yaitu variabel stadium kanker (p=0.001).
Kesimpulan: Hasil penelitian ini menunjukkan bahwa terdapat hubungan yang bermakna antara stadium kanker dengan tingkat depresi pada pasien KNF.