bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Point of Care Ultrasound Training in Medical Education, Making the Case with a Case Report
Authors: Wilcox James , Lawson Bret , Gauger Andrew 
Published: November 2023

Background: Point of Care Ultrasound (PoCUS) emerged in the early 1990’s as a promising clinical and educational tool that allows for quicker diagnosis at the bedside. Our PoCUS program at Indiana University School of Medicine uniquely exposes students to training during their first weeks of medical school, with training continuing through all 4 years. Our paper demonstrates the portability and efficiency of PoCUS devices to benefit student run clinics, where vulnerable patients come to seek free medical care.
Case: We report the case of a 48-year-old man presenting to our student run clinic with shortness of breath and cough. He recently immigrated from Nigeria, had no prior interaction with United States healthcare, and faced a significant language barrier. Physical examination conducted by the medical students revealed mild bibasilar crackles and 1+ pitting edema in the lower extremities. This prompted the students to suspect heart failure, and the first-year medical student used bedside ultrasound to reveal a reduced ejection fraction of approximately 15%, which resulted in expedited and escalated medical care.
Conclusion: This case report demonstrates how incorporating PoCUS early into the undergraduate medical curriculum might improve patient care by expediting the diagnosis, while also enhancing student education. The use of bedside ultrasound rapidly updated the team to the severity and type of heart failure present. Therefore, the care team quickly escalated the appropriate treatment, and impressed the importance of follow up care to the patient.
Association of objectively measured lifting load with low-back pain, stress, and fatigue: A prospective cohort study
Authors: Bláfoss Rúni , Aagaard Per , Clausen Thomas , Andersen Lars L 
Published: November 2023

OBJECTIVES: Limited knowledge exists about the association of lifting loads on a daily basis with physical and mental symptoms among warehouse workers. This study investigated associations between objectively measured lifting load and low-back pain (LBP), mental stress, and bodily fatigue after work and the following morning.
METHODS: Warehouse workers (N=85) from the retail industry replied to daily questionnaires before and after work for 21 days about LBP intensity, mental stress, and bodily fatigue (outcome, all scales 0–10). We assessed lifting exposure using company records from the warehouse logistic systems on total lifting load (kg) per workday. Associations between variables were tested using linear mixed models with repeated measures controlling for relevant confounders.
RESULTS: Mean daily lifting load was 1667.2 kg (range: 0–9998.4 kg). Compared to lifting 0–499 kg during a workday, lifting 500–1999 kg was associated with 0.59 points [95% confidence interval (CI) 0.10–1.08] elevated LBP intensity after work, while lifting ≥5000 showed a higher LBP intensity of 1.26 points (95% CI 0.48–2.03). LBP intensity remained elevated the following morning. Lifting ≥5000 kg was associated with higher mental stress after work of 0.74 points (95% CI 0.10–1.37), while no association was observed for bodily fatigue.
CONCLUSIONS: Higher daily lifting loads were associated with higher LBP intensity after work and the following morning. These findings suggest that warehouses should consider the daily lifting loads when organizing warehouse work to prevent development of LBP, eg, using company records to provide a more equal distribution of daily lifting loads between workers.
Planeamento, execução e avaliação: as findas no Cancioneiro da Ajuda
Authors: Correia Ângela 
Published: November 2023

Estudo da marcação do espaço para as iniciais de finda na Cancioneiro da Ajuda, assim como da execução das iniciais e de algumas indicações de correção. Do estudo resulta que os espaços destinados no cancioneiro à inscrição de partituras próprias para algumas findas terão decorrido de uma deficiente interpretação da sequência de textos no antecedente.
Cancioneiros. Entre lacunas e ausências textuais. O indício de uma letra de espera
Authors: Ramos Maria Ana 
Published: November 2023

O Cancioneiro da Ajuda singulariza-se por deficiências físicas e variações com origem na qualidade das fontes. A distinção entre lacuna (consequência de desgaste, perda física ou acidente material) e ausência textual (privação de texto consecutiva a um planeamento codicológico) é formulada, na presente investigação, conjuntamente a dois tipos de conjetura no processo de restituição crítica das cantigas ajudenses: a conjetura de proximidade e a conjetura a distância. Ilustrando estas considerações, são examinados vários casos concretos: a ausência textual da cantiga A69, as alterações derivadas de distintos momentos organizativos do caderno VII e, por último, a partir da existência de uma letra de espera ainda visível na rebarba de um fólio perdido, é conjeturada a muito interessante inclusão de cantigas de Ayras Engeitado no Cancioneiro da Ajuda.
Polpa de açaí congelada: características nutricionais, físico-químicas, microscópicas e avaliação da rotulagem
Authors: Fregonesi Brisa Maria , Yokosawa Cristina Eico , Okada Isaura Akemi , Massafera Gisele , Costa Telma Maria Braga , Prado Sonia de Paula Toledo 
Published: November 2023

As polpas de açaí congeladas comercializadas no município de Ribeirão Preto/SP foram avaliadas quanto às características nutricionais, físico-químicas, microscópicas e a rotulagem do produto. Os parâmetros físicoquímicos como umidade, sólidos totais, cinzas, acidez, proteínas, lipídios, carboidratos, calorias e fibras foram analisados em 30 amostras de polpa de açaí integral, açaí tipo B e açaí tipo C. Os valores obtidos foram comparados com os da legislação e analisados pelo teste de Kruskal-Wallis (p<0,05). A pesquisa de sujidades leves foi realizada seguindo-se a metodologia da AOAC. A informação nutricional descrita no rótulo do produto foi avaliada baseando-se nas egislações em vigor. Os três tipos de polpas analisados não apresentaram diferenças estatisticamente significantes em todos os parâmetros físico-químicos. Na análise microscópica, 50% das amostras apresentaram sujidades como fragmentos de insetos, ácaros, cristais de areia e pelo humano, que indicam a existência de falhas na adoção e/ou manutenção das Boas Práticas de Fabricação. Além disso, 3,33% das amostras foram consideradas impróprias para consumo pela presença de pelo de roedor, matéria estranha prejudicial à saúde humana. Irregularidades nas informações contidas nos rótulos dos produtos indicam a necessidade de melhor adequação quanto às normas gerais de rotulagem por parte dos fabricantes.
COMPARING OUTCOMES OF PERCUTANEOUS CORONARY INTERVENTION OF NATIVE ARTERY VERSUS BYPASS GRAFT IN PATIENTS WITH PRIOR CORONARY ARTERY BYPASS GRAFTING : A SYSTEMATIC REVIEW
Authors: Tria Fadilla Annisa , Tri Sutrisno Reza , Arifin Rambe Zainal , Namora Siregar Aulia Doli , Syahroni Nasution Faisal , Sabri Muhammad 
Published: November 2023

Background: Percutaneous coronary intervention (PCI) is common in patients with prior coronary artery bypass graft surgery (CABG), however the data on the association between the PCI target-vessel and clinical outcomes are not clear. We aimed to investigate long-term clinical outcomes of patients with prior CABG who underwent PCI of either bypass graft or native artery. We performed a systematic review of observational studies comparing PCI of either bypass graft or native artery in patients with prior CABG.
Methods: By comparing itself to the standards set by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. So, the experts were able to make sure that the study was as up-to-date as it was possible to be. For this search approach, publications that came out between 2013 and 2023 were taken into account. Several different online reference sources, like Pubmed and SagePub, were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done.
Result: In the PubMed database, the results of our search brought up 23 articles, whereas the results of our search on SagePub brought up 19 articles. The results of the search conducted for the last year of 2013 yielded a total 9 articles for PubMed and 5 articles for SagePub. In the end, we compiled a total of 5 papers, 4 of which came from PubMed and 1 of which came from SagePub. We included five research that met the criteria.
Conclusion: Most PCIs performed in prior CABG patients are done in native coronary artery lesions. Compared with native coronary PCI, bypass graft PCI is independently associated with higher in-hospital mortality.
Canvas Model Business Design (BMC) in Karawang Batik Production Business at Bale Batik Taza Karawang
Authors: Sukmasari Lina , Suyaman Dede Jajang , Hartelina Hartelina 
Published: November 2023

The research objective is to implement the Design strategy to develop the Karawang Batik Business by using the design of the nine elements of the Canvas business model which includes Customer segment, value proposition, channel, customer relationship, revenue stream, key resources, key activities, key partnership, cost structure. This Canvas Model is expected to be able to overcome and provide solutions to problems and obstacles from all activities or activities at Bale Batik Taza Karawang which until now seems to have not been fully implemented so that researchers want to create, map, design, and direct what indicators should be improved to build a business that it can produce maximum production, marketing, and sales. The type of research used is descriptive with a qualitative approach method. The research location was conducted at Bale Batik Taza, KH. Ahmad Dahlan street No.20 at Karawang city. Respondents were carried out purposively by considering the factors of understanding the company's strategy, company conditions, internal conditions, business models, the company's main competitors. alternative Strength–Opportunity strategy as a strategy to use strengths to take advantage of existing opportunities. The conclusion of the research that can be found is that the mapping of the Canvas business model run by Bale Batik Taza Karawang has not been maximally implemented. Some elements that need to be improved are Key partnership, Key Resource, Key Activity, Customer Relationship, Customer segment, Channel, and Cost Structure. While the approach using SWOT analysis should be more maximal in developing its business innovations such as expanding marketing strategies, networking with vendors, and the quality of the various designs and variations of the typical Karawang batik patterns that are packaged according to consumer demand so that they will be satisfied with the results of the pattern designs made. The strategy is carried out using the S–O, S–T, W–T, and W-O to determine how many strategies can be used to build and develop the Karawang Batik Business at Bale Batik Taza Karawang so that it can increase.
Does Environmental Performance In Green Accounting Affect Profitability?
Authors: Lutfillah Novrida Qudsi , Amadea Thea Samantha 
Published: November 2023

This study aims to examine the effect of implementing Green Accounting as measured by Environmental Performance and Environmental Disclosure on Profitability. The t test was used as the method of analysis. The research sample is additional companies listed on the Indonesia Stock Exchange in 2017-2020. The results showed that environmental performance had no effect on profitability, while environmental disclosure had an effect on the profitability of mining companies. The demands on environmental performance made by the company are more directed at companies with large sizes, not to companies with high profitability. Furthermore, environmental disclosure is a means to meet the expectations and needs of stakeholders who want to learn more about the company's environmental performance through annual reports. If the ROA value is not in prime condition, it will have an impact on the company's environmental disclosure.
Aftergrass ability of grass stands for hay-pasture use in the autumn period
Authors: Panasyuk S.S. 
Published: November 2023

Aim. To identify the best types of perennial grasses in terms of fertility in their pure form and mixtures, and to develop a technology for the formation and use of sown meadow phytocenoses in the Forest Steppe during their autumn alienation in the system of an extended pasture conveyor for meat breeds of cattle. Methods. Field, laboratory, mathematical, system analysis. Results. The article on onion growing considers the problems of quality provision of meat cattle with green fodder not only in the summer, but also in the autumn period. On the basis of many years of experimental research, the article reveals the processes of formation of perennial grasses depending on the weather and climate conditions, species composition, fertilization system, and the timing of the removal of the pasture mass in the fall. The indicators of the transformation of the quality of the green mass of аftergrass depending on the terms of deepening of the autumn period are given. According to the results of field research, it was established that early-ripening and medium-ripening perennial grasses in the autumn period form a sufficient supply of grass at the root (oats) for livestock grazing, in the range of 2.3-3.1 t/ha with moderate moisture supply and application of nitrogen fertilizers with a dose of N20 under the pasture moving. Early-ripening and medium-ripening perennial grasses produce a 1.4–1.6 times higher yield than late-ripening coenoses over the years of use. This pattern was stable over the years of use. Аftergrass cereal grasses of the autumn period were of sufficient quality and met the zootechnical standards for feeding cattle of the meat sector. The supply of green fodder with organic nutrients and mineral elements for the cultivation of аftergrass on the background of N20 was characterized by the following indicators: the content of raw protein in the dry weight of the fodder was in the range of 11–15.3%, fat – 2.4–3.1%, raw fiber – 27.7–35.3%, potassium – 2.39–2.75%, calcium – 0.51–0.68%. The digestibility of cereal grass fodder was 58-72%. Conclusions. Among the perennial grasses, the following types of grasses showed better seeding in the autumn period on dry meadows with the application of nitrogen fertilizers with a dose of N20: thornless sedge, oriental sedge and ryegrass, the share of which in the yield of seeded grass mixtures depends on the intensity of precipitation after 3 years of use was at the level of 62–71%, and in some dry years even more.
Hubungan Neutrophil-Lymphocyte Ratio dengan Kejadian Acute Kidney Injury Pada Pasien Sepsis yang Dirawat di Intensive Care Unit (ICU)
Authors: Jaelani Abd Qadir , Arif Syafri Kamsul , Muchtar Faisal , Nurdin Haizah , Salam Syamsul Hilal , Tanra Andi Husni 
Published: November 2023

Latar Belakang: Gagal Ginjal Akut (Acute Kidney Injury/AKI) adalah salah satu komplikasi yang umum dijumpai pada pasien dengan penyakit kritis di unit perawatan intensif (ICU). AKI merupakan komplikasi utama dari sepsis dan syok sepsis. Neutrophil-to-Lymphocyte Ratio (NLR) adalah penanda pengganti untuk respon inflamasi sistemik yang tersedia secara luas dan murah. Studi mengenai nilai diagnostik NLR dalam mendeteksi kejadian AKI masih terbatas dan hanya sedikit diketahui nilai klinis NLR terhadap pasien AKI sepsis.
Tujuan: Mengetahui hubungan antara NLR dengan kejadian AKI pada pasien sepsis yang menjalani perawatan di ICU.
Subjek dan Metode: Metode kohort retrospektif diaplikasikan dalam penelitian ini terhadap 80 pasien sepsis yang dirawat di ICU RSUP Dr. Wahidin Sudirohusodo (RSWS) Makassar sejak Januari 2019 – Desember 2021 yang dibagi dalam 40 sampel kelompok AKI dan 40 sampel non AKI. Sampel dikumpulkan dari data rekam medik pasien selama bulan Juli – September 2022. SPSS 25.0 dipakai untuk mengenalisis data dengan pengujian statistik Mann-Whitney, Chi-Square dengan level signifikansi α=0,05 dan analisis Kurva ROC.
Hasil: Ditemukan perbedaan yang signifikan dari nilai NLR dan kadar kreatinin hari pertama dan ketiga pada kelompok AKI dan non-AKI (p<0.001). Terdapat penurunan nilai NLR yang signifikan jika dibandingkan antara hari pertama dan ketiga pada Kelompok AKI dengan nilai p= 0.001. Pada hari pertama dan ketiga terdapat korelasi antara nilai NLR dan kejadian AKI dengan hubungan linier sedang (r=0.577 dan r=0.534, berurutan). Uji ROC Curve dan Youden Index menunjukkan nilai cut off NLR untuk dapat memprediksi AKI yakni 15.15 dengan sensitivitas 70% dan spesifisitas 90%.
Simpulan: Nilai NLR yang diukur pada 24 jam saat masuk ICU dapat menjadi prediktor terjadinya AKI sepsis, sehingga dapat dimasukkan dalam pemeriksaan rutin untuk deteksi dini terjadinya AKI sepsis pada penderita sepsis yang menjalani perawatan di ICU.
Gambaran Trakeostomi terhadap Length of Stay Pasien yang Dirawat di ICU RSUP Haji Adam Malik Medan Tahun 2021
Authors: Berutu Veny Putri , Lubis Bastian 
Published: November 2023

Pendahuluan: Intensive Care Unit (ICU) adalah suatu bagian dari rumah sakit yang ditujukan untuk observasi, perawatan, dan terapi pasien yang menderita penyakit berpotensi mengancam nyawa. Kriteria pasien yang berada di ICU adalah pasien sakit kritis dengan ketidakstabilan atau kegagalan sistem organ dan memiliki length of stay (LOS) yang relatif lama serta memerlukan bantuan alat seperti ventilator. Untuk meningkatkan kualitas perawatan medis, tujuan utama dalam perawatan intensif adalah untuk mengurangi LOS. Trakeostomi adalah salah satu prosedur di unit perawatan intensif yang paling umum dilakukan. Keuntungan yang didapat yaitu dapat menurunkan LOS ICU, meningkatkan kenyamanan pasien dan manajemen jalan napas yang lebih baik.
Metode: Penelitian ini merupakan penelitian deskriptif dengan desain cross-sectional. Metode pengumpulan data dengan menggunakan data rekam medik. Metode pengambilan sampel menggunakan teknik total sampling.
Hasil: Hasil penelitian terhadap pasien ICU yang terpasang ventilator di RSUP HAM Medan didapatkan sebanyak 46 orang (70,2%) yang tidak ditrakeostomi dan 19 orang (29,2%) yang ditrakeostomi. Rata-rata LOS pasien yang ditrakeostomi yaitu 19 hari dan rata-rata LOS pasien yang tidak ditrakeostomi yaitu 11 hari.
Simpulan: Rata-rata LOS pasien ICU yang terpasang ventilator di RSUP HAM Medan lebih besar pada pasien yang ditrakeostomi.
Kata kunci: ICU; intubasi; LOS; trakeostomi; ventilator
Perbandingan Dexmedetomidine 1 mcg/kgBB Intravena Dan Fentanyl 2 mcg/kgBB Intravena Terhadap Mula Kerja, Efek Hemodinamik Dan Waktu Pulih Sadar Selama Anestesi Endoskopi Retrograde Cholangiopancreatography
Authors: Mufti Asnurhazmi Hilaluddin , Wahyudi  , Musba A.M. Takdir , Salam Syamsul Hilal , Muchtar Faisal , Datu Madonna D. 
Published: November 2023

Latar Belakang: Endoscopic Retrograde Cholangio Pancreatography (ERCP) adalah prosedur diagnostik dan terapeutik untuk evaluasi penyakit bilier dan pankreas. Dexmedetomidine mengurangi kebutuhan propofol selama anestesi. Kombinasi propofol dan fentanil memberikan efek analgesik sentral terutama dengan mengaktifkan reseptor µ-opioid, yang terutama didistribusikan di area yang berhubungan dengan nyeri, pernapasan, mual, dan muntah. Penelitian ini bertujuan untuk membandingkan pemberian dexmedetomidine intravena dan fentanyl intravena terhadap mula kerja, efek hemodinamik dan waktu pulih sadar selama anestesi ERCP.
Metode: Penelitian uji acak tersamar ganda terhadap 42 pasien yang menjalani prosedur ERCP dengan anestesi umum di Instalasi Gastroenterohepatologi RSUP Wahidin Soedirohusodo bulan Agustus-September 2022. Subjek dibagi menjadi 2 kelompok, kelompok A (Dexmedetomidine) dan kelompok B (Fentanyl).
Hasil: Pada kedua kelompok masing-masing 21 orang tiap kelompok, mula kerja dan pulih sadar didapatkan perbedaan yang bermakna pada mula kerja dengan nilai p <0,001, sedangkan pada pulih sadar dengan nilai p 0,022, sehingga dapat dikatakan ada perbedaan pada mula kerja dan pulih sadar antara kedua kelompok. Terdapat perbedaan bermakna pada kejadian penurunan tekanan arteri rerata (TAR) dengan p= 0,030, kejadian bradikardi dengan nilai p =0,014, dan pada kejadian bradipneu pada kedua kelompok dengan nilai p = 0,004, sehingga dapat dikatakan ada perbedaan efek hemodinamik antara kedua kelompok. Efek samping didapatkan perbedaan yang bermakna pada kejadian mual dengan nilai p = 0,014. Tidak didapatkan perbedaan yang bermakna pada kejadian muntah dengan nilai p = 1,000, dan nyeri kepala dengan nilai p = 0,311.
Simpulan: Kelompok dexmedetomidine-propofol lebih cepat mula kerja dibandingkan dengan kelompok fentanyl-propofol, sedangkan pada waktu pulih sadar kelompok dexmedetomidine-propofol lebih lambat. Kelompok dexmedetomidine-propofol lebih kurang mengalami penurunan TAR, lebih banyak kejadian bradikardi, dan lebih kurang kejadian bradipneu dibandingkan dengan kelompok fentanyl-propofol. Kelompok dexmedetomidine-propofol lebih kurang mengalami kejadian mual dibanding kelompok fentanyl-propofol, namun tidak terjadi perbedaan antar kelompok dalam kejadian muntah dan nyeri kepala.
Using Process-Tracing to Evaluate Competing Accounts of Proportional Representation in Belgium
Authors: Barzachka Nina 
Published: November 2023

Using Process-Tracing to Evaluate Competing Accounts of Proportional Representation in Belgium
Analyses of the historical origins of proportional representation (PR) in Belgium have helped shed light on the origins of electoral systems in Western Europe. Nevertheless, debates over what exactly led to the introduction of PR in Belgium persist. Was it electoral threat, Left existential threat or a combination of these two factors? This article applies the completeness standard for process-tracing and employs theoretical insights from the institutional change literature to evaluate these explanations. It re-examines the historical sources used by the extant scholarship of the Belgian case. It finds that both extra-institutional threat and electoral threat fluctuated over time, interacted with one another and mattered during different points of the electoral system reform process. In 1899, when pure PR was finally introduced, both of these factors played a role.
PERAN KELUARGA KRISTIANI SEBAGAI ECCLESIA DOMESTICA DALAM MENUMBUHKAN HABITUS BERDOA BAGI ANAK-ANAK DI STASI MANDAM
Authors: Adventura Mario Febiyanto Londa  , Silvester Adinuhgra  
Published: November 2023

This study aims to describe the role of Christian Families as Ecclesia Domestica in growing the habit of praying children at Stasi St. Maria Manikam Damai Mandam. This research is based on the problem of difficulty in praying experienced by children at the stasi. In this case, the family actually has a role as Ecclesia Domestica (Church-Family), which is a place for children to learn to persevere in prayer, through the habit of praying together in family. This study uses a qualitative approach with a descriptive method. The research data was obtained by using the interview method which was carried out together with 5 couples, 5 teenagers, 1 priest, and 1 nun. The data obtained were analyzed using the “Miles and Hubberman” analysis method, which was divided into three stages, namely reduction, data presentation, and drawing conclusions. Based on the results of the study, it was concluded that the role of Christian families in fostering the habit of praying for children at Stasi St. Maria Manikam Damai Mandam has not been implemented optimally. This conclusion is based on the statements of the informants who revealed that they often experience obstacles caused by the busyness of their parents at work, so they do not have time to pray together in the family or to accompany the children in praying. In addition, other factors that also influence are not yet rooted in the Christian tradition and the lack of parental education. Thus, the role to cultivate the habit of praying is carried out by advising and reminding each other.