bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Study of the Compound Sentence Structure in the Ephemeral: Breeder
Authors: Ni Kadek Ari Dwi Safitri  , Ni Putu Cahyani Putri Utami  
Published: February 2024

Compound sentence is a combination of two independent clauses which in every clause have their own subject and verb. The aim of this research is to analyze the base structure of compound sentence used in Wattpad story entitled The Ephemeral: Breeder, and the compound sentence analyzed through a tree diagram. This study uses the observation method in collecting the data from the story. In analyzing the data, the writer uses a qualitative method to describe the base sentences in compound sentences. In this study the theory used to analyze the base sentences is the theory from Moeller (2021) about sentence structure. The other theory used is a theory proposed by Brown and Miller (1991) to classify the small unit through a tree diagram. The writer found 88 data over 13 selected chapters in the Wattpad story. Coordinating conjunction and become the most conjunction found in the compound sentences.
Pengaruh Model Problem Based Learning terhadap Hasil Belajar Siswa Kelas VII pada Materi Fotosintesis di SMP Negeri 16 Palangka Raya
Authors: Wijaya Nuriman 
Published: February 2024

Ilmu pengetahuan berperan sangat penting dalam meningkatkan kehidupan manusia. Salah satu ilmu pengetahuan yang berperan penting dalam meningkatkan kehidupan manusia adalah ilmu biologi. Jika diajarkan dengan benar, sesuai metode ilmiah, ilmu biologi berpotensi untuk meningkatkan kemampuan kognitif, terutama kemampuan berpikir kritis peserta didik, meningkatkan sikap yang baik dan luhur serta dapat meningkatkan keterampilan peseta didik dalam berbagai aspek kehidupan. Namun sayang, hasil pembelajaran IPA (biologi) saat ini berbanding terbalik dengan harapan yang diinginkan. Hal itu terjadi karena kekeliruan yang terjadi pada pembelajaran biologi itu sendiri. Akhir-akhir ini pembelajaran biologi lebih banyak menekankan pada penguasaan konsep semata, tidak diimbangi dengan penekanan sikap dan keterampilan yang memadai. Dalam menyongsong abad 21 salah satu kemampuan yang dituntut dari siswa adalah kemampuan bepikir kritis. Oleh karena itu guru sebaiknya berupaya semaksimal mungkin dalam mengelola pembelajaran yang memungkinkan siswa untuk bisa berpikir kritis. Model pembelajaran berbasis masalah dipercaya bisa mengembangkan kemampuan berpikir kritis siswa. Di kelas VII SMP Negeri 16 Palangkaraya tidak pernah dilakukan pembelajaran yang menerapkan model pembelajaran Problem Based Learning (PBL).Tujuan dari penelitian ini adalah untuk mengetahui pengaruh model belajar Problem Based Learning (PBL) terhadap hasil belajar siswa pada materi fotosintesis kelas VII SMP Negergi 16 Palangka Raya.
Analisis Dan Perancangan Sistem Informasi Sharing File Berbasis Web Sebagai Pendukung Proses Kerja Pada Pada CV. Conslink Teknikindo
Authors: Pratiwi Bintang , Effendy Marwan 
Published: February 2024

Information Systems file sharing is an important aspect of organizational workflow. CV. Conslink Teknikindo, a company engaged in environmental consulting services. This study aims to design and build a web-based file sharing information system that can help CV. Conslink Teknikindo to improve the process of sharing files and managing documents within the organization.
The method used in this study is system requirements analysis, system design, and web-based application development. Analysis of system requirements involves identifying the needs and requirements needed in managing file sharing. Based on the results of the needs analysis, a system design was carried out which included database design, user interface, and system workflow. After that, web-based application development was carried out using the Agile method.
It is hoped that this designed and built file sharing information system will provide significant benefits for CV. Conslink Teknikindo in improving efficiency, accuracy and control over the management of their file sharing. In addition, this system can also be a reference for other companies that have similar needs in managing petty cash funds.
Left Ventricular Global Longitudinal Strain Following Acute ST-Elevation Myocardial Infarction – A Comparison of Primary Coronary Angioplasty and Tenecteplase-Based Pharmacological Reperfusion Strategy
Authors: Abushabana Mosaad , Korashy Mahmoud , Al-Tahmody Kamaleldin 
Published: February 2024

Objective:
In the setting of acute ST-elevation myocardial infarction (STEMI), reperfusion therapy with primary percutaneous coronary intervention (PCI) performed by an experienced team or pharmacological reperfusion with thrombolytic therapy is highly recommended. Standard echocardiographic measurement of the left ventricular ejection fraction (LVEF) is widely used to assess left ventricular global systolic function. This study was designed to compare the assessment of global left ventricular function by standard LVEF and global longitudinal strain (GLS) in the two well-known reperfusion strategies.

Materials and Methods:
We conducted a retrospective single-center observational study in 50 patients with acute STEMI who underwent primary PCI (n = 25) and Tenecteplase (TNK)-based pharmacological reperfusion therapy (n = 25). The primary outcome was left ventricle (LV) systolic function after primary PCI, as assessed by two-dimensional (2D) GLS using speckle-tracking echocardiography (STE), as well as LVEF using standard 2D echocardiogram using Simpson’s biplane method.

Results:
Overall mean age was 53.7 ± 6.9 years with 88% male gender. The mean door-to-needle time was 29.8 ± 4.2 min in the TNK-based pharmacological reperfusion therapy arm, and the mean door-to-balloon time was 72.9 ± 15.4 min in the primary PCI arm. LV systolic function was significantly better in the primary PCI arm as compared to the TNK-based pharmacological reperfusion therapy, both by 2D STE (mean GLS: −13.6 ± 1.4 vs. −10.3 ± 1.2, P ≤ 0.001) and LVEF (mean LVEF: 42.2 ± 2.9 vs. 39.9 ± 2.7, P = 0.006). There were no significant differences in mortality and inhospital complications in both groups.

Conclusion:
Global LV systolic function is significantly better after primary coronary angioplasty as compared to TNK-based pharmacological reperfusion therapy when assessed by routine LVEF and 2D GLS in the setting of acute STEMI.
Not all Postmyocardial Infarction Ventricular Septal Rupture Need Immediate Surgery
Authors: Khandaker Mohammed Azizul Hasan , Panduranga Prashanth 
Published: February 2024

A 56-year-old man presented with acute anterior ST elevation myocardial infarction. Initially he was thrombolysed at a peripheral hospital and a transthoracic echocardiography revealed multiple (2-3 mm) apical muscular ventricular septal defects suggesting ventricular septal rupture (VSR), with the largest measuring 10mm with left to right shunt and max gradient was 74 mmHg. His left ventricular ejection fraction was 45%.
A coronary angiogram revealed tight proximal (95%) and mid segments (80%) stenosis in the left anterior descending artery (LAD) but diffusely diseased distally. Another significant stenosis (80%) was present at the ostium of the right posterior descending artery (r-PDA). He was in Society for Cardiovascular Angiography and Intervention (SCAI) cardiogenic shock Stage B, hence cardiac surgeons advised conservative medical treatment in order to stabilize the infarct area with view of good surgical outcome. Although, there was a dilemma between the surgeon and the cardiologist regarding timing VSR closure, classification of shock stages helped to delay surgery. Eventually, he was taken for surgery at the 18th day of admission with a graft to r-PDA rather to LAD (due to difficult visualization) and repair of VSR with Gortex patch.
In conclusion, in all patients with post MI VSR, SCAI shock stages classification has to be applied in determining the timing of surgery.
Comparison of Long-Term Complications of Using Amplatzer Ductal Occluder and Ventricular Septal Defect Occluder for Transcatheter Ventricular Septal Defect Closure
Authors: Ghaderian Mehdi , Salemi Negin 
Published: February 2024

Background:
Ventricular Septal Defect (VSD) is the most common type of congenital heart disease and perimembranous type is the commonest form of these defects. Trans-catheter management of these defects is a challenging procedure.

Objectives:
The purpose of this study was to compare of Trans-catheter closure of perimembranous ventricular septal defect (PMVSD) using Amplatzer Ductal Occluder (ADO) and VSD occluder and their complications and follow-up.

Patients and Methods:
Between 2013 and April 2019, 69 patients underwent percutaneous closure of PMVSD using ADO (29 patients) and VSD occluder (40 patients). After obtaining the size of VSD from the ventriculogram at least 2 mm larger than the orifice diameter of VSD at the right ventricular side was chosen. The devices were positioned after verification of the proper device position by echocardiography, aortogram and left ventriculography.

Results:
The mean age of patients were 9.07 ± 7.73 years, mean weight 26.12 ±16.25 kg. The mean defect size of the right ventricular orifice and device sizes were 5.54 ± 1.83 mm 7.72 ± 1.94 mm respectively.
Small residual shunts were seen at the completion of the procedure, but they disappeared during follow-up in all but one patient. Two patients had mild AI before the procedure in ADO group that disappeared during the follow-up. The mean follow-up period was 3.3 ± 1.7 years (range 1 to 6 years). Complete atrioventricular block (CAVB) was seen in one patient (VSD occluder) during the procedure that disappeared after the retrieval of the device. Major complication or death was not observed in our study.

Conclusions:
Trans-catheter closures of PMVSD with ADO or VSD occluder had similar effects in these patients and are safe and effective treatment associated with excellent success and closure rates. Long-term follow-up in a large number of patients is warranted.
Unprotected Left Main Primary PCI via Distal Transradial Access in the Setting of STEMI-Related Cardiogenic Shock
Authors: Oliveira Marcos Danillo Peixoto , Navarro Ednelson Cunha , de Sá Glenda Alves , Caixeta Adriano 
Published: February 2024

Despite all well-known benefits of transradial access, patients presenting with cardiogenic shock are usually submitted to coronary angiography and percutaneous coronary intervention via traditional transfemoral access, mainly due to challenge puncture of radial artery in the setting of hemodynamic instability.
We report a challenging case of STEMI-related cardiogenic shock requiring primary PCI of an occluded and unprotected left main, safety, and successfully performed via right distal trans radial access in the anatomical snuffbox.
The Effect of Early Aggressive Diuresis on Hospital Length of Stay in Acute Congestive Heart Failure
Authors: Butt Muhammad , Jabri Ahmad , Messeh Hany , Ahmed Abdullah , Alameh Anas , Haddadin Faris , Mullis Andin , Elayi Claude S. 
Published: February 2024

Background:
Diuresis is the mainstay of treatment during hospitalization for patients admitted with congestive heart failure (CHF). Hospital length of stay (LOS) is considered an important patient outcome for CHF patients; previous studies comparing higher rates of diuresis (aggressive) versus relatively lower rates (nonaggressive) on patient outcomes have shown contradicting results. In fact, no specific guidelines to direct diuretic therapy exist. This investigation was designed to study the effect of early aggressive diuresis on hospital LOS.

Methods:
Data from 194 CHF patients (admitted to the hospital for 1 year) were collected and analyzed in a retrospective cohort study design. Patients were divided into two cohorts based on urine output achieved in the first 24 h of admission; the aggressive diuresis cohort (urine output ≥2400 mL) comprised of 29 subjects while the nonaggressive diuresis cohort (urine output ≤2400 mL) had 165 subjects. The primary endpoint was LOS.

Results:
Median LOS for the aggressive diuresis cohort was 4 days (95% confidence interval [CI]: 2.95–5.06) as compared to 5 days (95% CI 4.40–5.60) for the nonaggressive diuresis cohort; log-rank test showed no significant differences between the hospitalized proportions between the two cohorts over time (P = 0.67).

Conclusion:
Hospital LOS for CHF patients treated with early aggressive diuresis was not significantly different compared to patients treated with nonaggressive diuresis.
The Variability of Anginal Radiation
Authors: Hayat Nasser , Ali Mohamed , Subha Remya Pushparajan , Toufiq Hadeel , Al-Saddah Jadaan 
Published: February 2024

Aims:
The goal of this study was whether we could clinically anticipate the extent of CAD and whether we could determine the frequency of less common angina radiation in the population of stable angina group. We hypothesized that the extent of angina radiation (AR) may be related to ischemic burden.

Methods:
One hundred (100) consecutive patients referred for coronary arteriography were divided into 2 groups according to anginal radiation. The patients were divided into 2 broad categories. Those whose anginal discomfort limited to chest and back were assigned to group 1. If the anginal radiation was more widespread, then those patients were placed in group 2.

Results:
Forty-four (44) patients who had AR limited to chest and back radiation were classified to group 1. Fifty-six (56) were in more extensive radiation and were classified as group 2. In group 2, there were 15 patients whose AR extended to lower jaw, wrists or head. We labeled these 15 patients as remote radiation. Although group 1 and 2 differed clinically, no differences existed in the distribution of CAD. However, the 15 patients with remote AR had high sensitivity for multi-vessel CAD; but specificity was only 50%.

Conclusions:
Extensive radiation of anginal discomfort does not necessarily reflect diffuse disease of coronary vessels. However, if anginal discomfort reaches the lower jaw, wrists and head, it carries high sensitivity (93%) for multi vessel CAD. The radiation to remote sites constitute 15% of patients referred for coronary arteriography.
Surviving a Decade or More after Coronary Revascularization in a Middle Eastern Population
Authors: Alhaddad Imad A. , Tabbalat Ramzi , Khader Yousef , Elkarmi Zaid , Dahabreh Zaid , Hammoudeh Ayman 
Published: February 2024

Introduction:
Studies that evaluate Middle Eastern patients who have long-term survival after coronary artery revascularization are scarce. The prevalence of diabetes mellitus (DM) is high and rapidly increasing in our region.

Methods:
The study enrolled consecutive ambulatory or in-patients who had percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery at least 10 years earlier. Collected data included cardiovascular risk factors at the time of the index revascularization and evolution of risk factors since then, the occurrence of cardiovascular events, and the need for coronary revascularization after the index procedure. Events were compared between patients with DM and no DM at baseline.

Results:
The study population consisted of 891 consecutive patients with 351 patients (39.4%) had DM and 540 patients (60.6%) had no DM. The mean age at baseline was 53.9 ± 8.8 years for DM patients and 53.0 ± 9.8 years for no DM patients (P = 0.16). At baseline, the DM group had more hypertension (70.9% vs. 27.6%, P < 0.0001), more dyslipidemias (12% vs. 5.2%, P = 0.001) but less smokers compared to no DM group (44.4% vs. 58.3%, P < 0.001). DM and no DM groups had similar proportion of PCI (65.5% vs. 68.3%, P = 0.42) and CABG (34.5% vs. 31.7%, P = 0.43) at baseline. Following the index revascularization procedure, acute coronary events, heart failure, and stroke developed in similar proportions in the two groups. Repeat revascularization after the index procedure showed that the DM group had more PCI compared to no DM group (52.7% vs. 45.4%, P = 0.04) but similar proportions of CABG (7.1% vs. 9.8%, P = 0.20).

Conclusions:
In this retrospective observation of Middle Eastern patients who survived at least a decade after coronary revascularization, the DM group had more hypertension and dyslipidemias but fewer smokers compared to no DM at baseline. During follow-up, the DM group required more PCI revascularization compared with no DM group.
Psychological Distress in Patients with Coronary Artery Disease During the COVID-19 Pandemic and its Association with Coping Mechanisms
Authors: Maheshwari Prerna , Lakshmi K. P. , Menon Bindu , Thachathodiyl Rajesh , Bhaskaran Renjitha , Chandra Subhash 
Published: February 2024

Background and Objectives:
Coronary artery disease (CAD) has been associated with increased stress both etiologically and as a consequence. The current pandemic of COVID-19 infection has impacted the personal, social, and occupational spheres of people's lives and has negatively affected mental health. People with existing chronic medical illnesses may be more vulnerable to the stressful effects of the ongoing pandemic.
This study was conducted on patients with CAD during the COVID-19 pandemic to estimate the prevalence of psychological distress, the factors associated with distress, and their coping mechanisms.

Materials and Methods:
A cross-sectional study was conducted at a tertiary care teaching hospital in Kerala in the cardiology department. After informed consent was obtained from the patients with CAD, sociodemographic details were collected, Kessler Psychological Distress Scale (K-10 scale) was administered to assess psychological distress and the Brief COPE scale was administered to assess their coping mechanisms.

Results:
Among 50 patients who participated, the prevalence of psychological distress was 50%. The factors associated with distress were female gender, semiskilled occupation, incomplete COVID-19 vaccination status, exposure of family to COVID-19, experiencing financial difficulties, and experiencing difficulty acquiring medications prescribed for CAD. Religion and acceptance were the most common coping strategies applied by the patients and acceptance was found to be a better coping strategy than religion.

Conclusion:
There is a high prevalence of psychological distress among patients with CAD during the pandemic, owing to the emotional, financial, and familial instability faced during the pandemic.
Clinical Characteristics and Prognosis of Young Middle Eastern Adults with ST-Elevation Myocardial Infarction
Authors: Obeidat Omar Sami , Makhamreh Hanna , Al-Muhaisen Ra’ad Zaid , Obeidat Layan R. , Kitana Farah I. , Amarin Justin Z. , Ebada Mahmoud Ahmed , Murad Mhd Anas , Alhameedi Tuqa , Haj-Yasin Dania , Hammoudeh Ayman 
Published: February 2024

Aims:
Few studies have investigated premature ST-elevation myocardial infarction (STEMI) in the Middle East. We aimed to compare the clinical characteristics and one-year prognosis of young (<45 years) and older (≥45 years) Middle Eastern adults with STEMI.

Methods and Material:
A total of 706 patients with STEMI, who were prospectively enrolled in the First Jordanian Percutaneous Coronary Intervention Registry, were stratified into two groups (<45 or ≥45 years). Baseline clinical variables and one-year major adverse cardiovascular events (MACE) were evaluated.

Results:
Young patients (<45 years) comprised 17.4% of STEMI patients (123 of 706). Compared with older patients (≥45 years), young patients were mostly male (96% vs 82%, P<0.001), smokers (86% vs 49%, P<0.001) and less likely to have multi-vessel disease (26% vs 44%, P=0.001). Anterior STEMI was the most common diagnosis and left anterior descending artery was the most common culprit vessel in both groups. There were no significant differences between the younger and older patients in in-hospital (20% vs 19%, P=0.12) and one-year MACE (24% vs 26%, P=0.68). However, none (0%) of the young died during one-year follow-up while 21 (4%) of the older patients died (P=0.036).

Conclusions:
Young adult patients in the Middle East with STEMI are more likely to be smoking men with multiple risk factors and single vessel disease by angiography. Although, younger patients had similar one-year MACE to older patients, their mortality rate appears to be better. A larger study is warranted to investigate this vulnerable group of patients to prevent future events.
Thrombolysis in Acute Pulmonary Embolism
Authors: Showkathali Refai , Yalamanchi Radhapriya , Ramakrishnan Balasubramaniam , Oomman Abraham , Sivaprakash Aruna , Kumar Pramod 
Published: February 2024

Aim and Methods:
We aimed to study the clinical data and outcome of patients admitted in our center with acute pulmonary embolism (PE) over a 5-year period from May 2013 to April 2018. The main outcome data included were: in - hospital bleeding, in - hospital right ventricular (RV) function improvement, pulmonary arterial hypertension improvement, duration of hospital stay, and 30- and 90-day mortality.

Results:
A total of 114 (69 m, 55 f) patients with the mean age of 55 ± 15 years were included. Patients who had involvement of central pulmonary trunk called as “Central PE” group (n = 82) and others as “Peripheral PE” group (n = 32). There were more women in the peripheral PE group (53.1% vs. 34.1%, P = 0.05), while RBBB (22% vs. 3.1%, P = 0.02) and RV dysfunction (59.8% vs. 25%, P = 0.002) were noted more in the central PE group. Systemic thrombolysis was done in 53 patients (49 central, 4 peripheral), of which only 3 had hypotension and 28 patients were in the Intermediate-high risk group. The overall inhospital, 30-day, and 90-day mortalities were 3.6, 13.2, and 22.8%, respectively. Bleeding was significantly higher in the thrombolysis group compared to the nonthrombolysis group (18.9% vs. 0, P = 0.0003). However, improvement in pulmonary hypertension was noted more in thrombolysis group compared to nonthrombolytic group (49% vs. 21.2%, P = 0.01).

Conclusion:
This retrospective data from a tertiary center in South India showed that short- and mid-term mortality of patients with PE still remains high. The high nonguideline use of thrombolysis has been reflected in the increased bleeding noted in our study.
Gender Association with Incidence, Clinical Profile, and Outcome of Out-of-Hospital Cardiac Arrest
Authors: Khazaal Fadi , Arabi Abdulrahman , Patel Ashfaq , Singh Rajvir , Al Suwaidi Jassim Mohd , Al-Qahtani Awad , Arafa Salaheddin Omran , Asaad Nidal , Hajar Hajar A. 
Published: February 2024

Background:
Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide. However, there is limited information on the outcome of the OHCA in the Middle East population, and limited studies have been carried out in the Arab Gulf countries. Hence, we aim to study the incidence and rate of survival in the OHCA setting and to assess the impact of gender on the clinical outcome following OHCA.

Methods:
Retrospective analysis of a prospective registry of all eligible, consecutive, and nontraumatic adult patients who successfully resuscitated (return of spontaneous circulation) from “Cardiac Arrest” occurring outside the hospital, Hospitalized in Doha, Qatar from January 1991 to June 2010.

Results:
A total of 41,453 consecutive patients were admitted during the study, of whom 987 (2.4%) had a diagnosis of OHCA. Among them, 269 (27.3%) were women and 718 (72.7%) were men. Although the mortality rate was higher in females than in males (65.4% vs. 57.7%, P = 0.03), the logistic regression analysis did not show gender as an independent predictor of death in this clinical setting.

Conclusion:
In this sample of the state population, women who have OHCAs had a lower rate of survival, but gender was not an independent predictor of mortality following OHCA.