bluuebunny/crossref_metadata_2025_split huggingface dataset:
Access and Emergency Medical Care for Massive or Multiple Injuries
Authors: Lenjani Basri , Baftiu Nehat , Krasniqi Blerim , Makolli Shpresa , Lenjani Dardan , Mišanović Verica , Ljuhar Kenan , Dogjani Agron 
Published: January 2023

Access and emergency medical care for massive or multiple injuries is an comprehensive interdisciplinary challenge. Taking care of the growing causes of emergency care levels as well as cross-sectoral collaboration in the management of multiple incidents, reducing disease, disability, and mortality in the population with multiple disorders. In a disaster or extraordinary situation with mass casualties is a state in which the health care system is overloaded and the ability to provide emergency health care is considerably hindered. The aim of this review is to present the current state of knowledge on what we, the authors, say are the central aspects of trauma management of mass casualty incidents. Emergency planning and methodology are related to accidental states, elementary medical staff disasters, medical equipment, drilling material, concretizing assessment tools, monitoring, mass incident prevention. In terms of implementing a good action plan, effective collaboration between state agencies such as fire departament and law enforcement is necessary in identifying and directing critically ill patients to designated trauma centres. The integration of emergency systems for incident management, through providing resources like, medical equipment, drugs, autoambulances, ongoing education and training. This has the impact of increasing knowledge of medical emergency procedures that would help reduce the risk of consequences of mass incidents. When applied to MCI responses, damage-control principles reduce resource utilization and optimze surge capacity, consequently reducing the rate of mortality.
Hallux Valgus in Osteoporosis.
Authors: Ruci Julian , Gjika Eduart 
Published: January 2023

The aim of this study is to evaluate the outcomes of the surgical treatment in patients with osteoporosis with moderate or severe hallux valgus regarding the correction of Hallux Valgus Angle (HVA) and Intermetatarsal Angle (IMA) compared to non-osteoporotic patients.
Materials and Methods: The timeline of the study was from 2015 to 2020 with 20 patients with the mean age of 61.6±4.1 within the osteoporotic group and 63.5±5.0 within the non-osteoporotic group. 12 osteotomies in osteoporotic patients and eight osteotomies in non-osteoporotic patients were seen at follow-up after 2 years after surgery. Preoperative bone density of T-Score 2.5 SD or more below is named osteoporosis and IMA and was used to define patient groups; mild hallux valgus was defined with IMA of 11-16 degrees, moderate hallux valgus was defined with IMA from 16 to twenty degrees, and severe hallux valgus was defined with IMA from 20 degrees or more.
Results: No statistical differences were found in HVA, IMA and between the osteoporotic patients and non-osteoporotic patients preoperatively, postoperatively, and therefore the final follow-up in mild to moderate hallux valgus. The mean AOFAS score ameliorated from 52.6 preoperatively to 89.1. Regarding satisfaction, ~ 83 you look after patients were very satisfied or satisfied. No evidence of complications and every one of the patients resulted with complete union of the osteotomy.
Conclusion: We believed that the surgical treatment is a safe, effective procedure for the correction of elderly patients with osteoporosis. In patients with moderate and severe hallux valgus the results of osteotomy have not any specific difference between the osteoporotic and non-osteoporotic groups
Percutaneous Achilles Tenotomy in Idiopathic Clubfoot treatment
Authors: Selmani Edvin , Ruci Julian , Gjonej Arben 
Published: January 2023

Introduction; Percutaneous Achilles tenotomy is a standard procedure in most clubfoot patients treated with Ponseti method as the most widely use method of conservative clubfoot treatment. To our knowledge, there are not studies published in Albanian literature about this technique. Our goal is to present results of conservative treatment of idiopathic clubfoot where this technique was performed.
Material and Method. This is a prospective study of all idiopathic clubfoot patients treated in our Institution with Ponseti Method. We performed this technique under sedation anesthesia in operation room, not in clinic. We measured age of patient at time of presentation, gravity according to Pirani score, number of casting, need for Achilles tenotomy).
We measured the degree of angle of dorsiflexion before and after this procedure, the gravity and need for a second procedure.
Results: Out 400 clubfeet treated during 2005-2010 we included in our study 372 case that needed the percutaneous Achilles tenotomy performed. Average age at presentation was 3 weeks. Average Pirani score was 5.5. The number of weekly serial cast needed before the tenotomy was 8. Dorsiflexion angle after this procedure was improved by 45 degree (range from 30 to 90 degree). Only 2 cases needed reoperation due to non-compliance with foot abduction bar and physiotherapy
Conclusion: The percutaneous Achilles tenotomy is used in 93% of case with idiopathic clubfoot serie of patient. It is an easy technique performed with sedation anesthesia in operation room not with local anesthesia. Achilles tenotomy is an important element to avoid recurrence This supports other studies that have used this method.
Results of Selective Non-Operative Management for Penetrating Neck Trauma in 594 patients.
Authors: Laher Naadiyah , Monzon B Ignacio , Mauser Martin 
Published: January 2023

Background: The management of penetrating neck trauma (PNT) evolved from a policy of mandatory exploration to one of selective non-operative management (SNOM) based on clinical examination, and the liberal use of Computed Tomography Angiography (CTA) irrespective of the zone of injury for those patients who are stable on presentation.
Methods: A retrospective audit of patients with penetrating neck injuries managed at Chris Hani Baragwanath Academic Hospital (CHBAH) Trauma Unit, from 2010 to 2015 was conducted. Statistical analysis was performed for all collected variables. A p-value of ≤ 0.05 was considered statistically significant.
Results: The results of treatment of 594 patients were reviewed. There was a predominance of young males (93.4%) with a median age of 28 years (IQR 18-67) presenting with injuries in zone 2, left side of the neck, commonly due to stab wounds (89.3%). Immediate surgical exploration was needed in 145(24.4%), while the remaining (75.4%) were investigated with CTA. CTA showed a sensitivity and specificity of over 90% for vascular injuries and more than 80% for aerodigestive injuries. Major vascular injuries were the most common surgical finding. The overall negative exploration rate was 6%, and the mortality 2.5%.
Conclusions: Our unit’s SNOM protocol relies on liberal CTA use. Despite the obvious limitations of a retrospective study our results showed an acceptable negative and non-therapeutic exploration rate and a low incidence of complications and mortality.
Troponin I, and Lactic Acid variations, during Cardiopulmonary Bypass under Moderate Hypothermia vs Normothermia.
Authors: Zeka Merita , Kuci Saimir , Arapi Blerim , Ibrahimi Alfred , Lilaj Krenar 
Published: January 2023

Introduction: In open heart surgery such as Coronary artery Bypass Grafting, valve repair or replacement, or some congenital heart disease, patients are connected to the Cardiopulmonary bypass machine [1]. Cardiopulmonary bypass machine pumps the blood around the body while the heart is stopped and provides a bloodless field during cardiac surgery. Since an extracorporeal circuit is incorporated to the patient, there are observed abnormal physiological events during Cardiopulmonary bypass. These events include hemodilution, interstitial fluid accumulation, complement activation and depression of immune system. Cardiopulmonary bypass is associated with an acute phase reaction of protease cascades, leucocyte, and platelet activation that result in tissue injury [2, 3] and limited functional reserve. For many years was believed that Cardiopulmonary bypass under hypothermia is much safer. The main reason for “cooling body” is to protect the brain, heart and organs during cardiopulmonary bypass through reducing body metabolic rate [4]. During more recent years, according to many studies, it is shown that Cardiopulmonary bypass under Normothermia has much more advantages compared to Moderate Hypothermia.
The aim of this study was to compare and examine which method has advantages in terms of clinical outcome, morbidity and mortality.
Patients and methods. 60 patients were selected, who were scheduled for Coronary artery Bypass Grafting x 3, were enrolled in this study.
Results: According to the primary variables (Troponin I, Lactic Acid) and also secondary variables of our study, resulted that Cardiopulmonary bypass in Normothermia has superiority compare to Moderate Hypothermia in patients that underwent Coronary artery Bypass Grafting.
Conclusion: According to our data and literature [15, 16, 17], we concluded that Cardiopulmonary bypass in Coronary artery Bypass Grafting under Normothermia has advantages vs Moderate Hypothermia and Troponin I and Lactic Acid are very good biomarkers that show us if heart and organs perfusion/protection is adequate during this procedure.
Ulnar Nerve Entrapment at Elbow, a Retrospective Clinical Observational Study.
Authors: Alimehmeti Ridvan , Seferi Arsen , Dashi Florian , Muça Aurora , Petrela Elizana , Cecia Arba , Pilika Kliti , Brace Gramoz 
Published: January 2023

Importance: Ulnar neuropathy at the elbow is the second most frequent entrapment neuropathy, affecting 6% of the population. Surgical criteria are based on a general agreement but remain controversial about which procedure is associated with the best results and the fewest complications. This data can help evaluate the effectiveness of operative techniques in symptomatic cure.
Material and Methods: The study analysis included 26 out of 35 patients with 'Ulnar neuropathy at elbow' diagnosis, treated between January 2017- March 2022 at the Department of Neurosciences, University Service of Neurosurgery, University Hospital Center “Mother Theresa”, Tirana, Albania.
9 patients from the time period January-June 2018 were excluded from this study analysis due to lack of access to data. Data sources such as medical records and documentation copies of instrumental examinations were extracted from archives of Statistics Service and Hospital Registers, University Hospital Center “Mother Theresa”, Tirana, Albania. Phone follow-up was applied as well.
Results: We report 26 patients analyzed retrospectively (female: male ratio 1:2.71). 29 operated extremities were studied: 26 with Cubital Tunnel Syndrome, of which 2 presented with ipsilateral Carpal Tunnel Syndrome and 1 bilateral; 2 with contralateral Carpal Tunnel Syndrome. There were 11 patients gr. II McGowan and 15 patients gr. III McGowan.
There are no positive elbow flexion-extension test cases, indicative of the transposition technique. All patients were clinically evaluated at a distance of 1-3 years post-operatively and 19% presented objective symptoms. Long-term follow-up shows the motor and sensory improvement for gr. II McGowan patients, while gr. III McGowan patients show only sensory and grip improvement, with the persistence of muscular atrophy.
The most frequent cause of compression was determined fibrosis and hypertrophy around the Osborne ligament (13/26).
Conclusions: Clinical stage of neuropathy is the decisive factor influencing prognosis. Simple decompression in situ is sufficient in most cases. Dynamic intraoperative testing of sulcus competence, to assess (sub)luxation of the ulnar after decompression, determines the final operative technique.
Cardiac Trauma. Management Strategies short panoramic View.
Authors: Dumani Selman , Ibrahimi Alfred , Likaj Ermal , Dibra Laureta , Refatllari Ali , Pellumbi Devis , Baboci Arben 
Published: January 2023

Introduction; Trauma is the leading cause of death in United States in the younger population. National Trauma Data Bank in 2017 reported that 140 000 Americans dies and 80 000 are permanently disabled as a result of trauma each year. Cardiac trauma is identified in less than 10% of all trauma admissions but is associated with a much higher mortality than other organ system injuries. Considering the lethality of this type of injury, better guidelines should exist to direct management. We have analyzed data from pub med, surgery books, reviews and original presentations from many institutions to present actuality in management strategies of cardiac injuries.
Cardiac injuries are classified penetrating and blunt. Penetrating trauma includes stab or guns wounds. All patients with a penetrating wound anywhere near the heart should be considered to have a cardiac injury. The penetrating cardiac traumas is a surgical emergency while the blunt injuries treatment consists mainly in observation.
With early aggressive management only 1/3 of patient that arrive at hospital can be saved and this number can arise to more than 70 % if the patient survives until operating room. The results of treatment depend from infrastructural health system to the clinical presentation of the patients. Penetrating cardiac wounds mortality varies 5 % to 76 %. Blunt cardiac injuries are encountered mostly during motor vehicle accidents. The incidence of cardiac injuries in blunt trauma is 2.3-4.6 %. Overall mortality varies 11.4-24.5 %. Myocardial contusion is the most frequent type of blunt cardiac injuries.
The diagnose of the cardiac trauma include: clinical assessment, physical examinations, chest radiographs, echocardiography, cardiac enzymes, ECG, CT scan and even chest drainage. Despite many diagnostic tools we have, it is very important the right management of these tools and the time.
Conclusion: The surgery teams should be familiar with the management of the cardiac injuries and continuing education about this topic is the success key to manage better these emergencies.
MENGUKUR KESUKSESAN IMPLEMENTASI SISTEM APLIKASI KEUANGAN TINGKAT INSTANSI (SAKTI) DI KANTOR WILAYAH KEMENTERIAN AGAMA PROVINSI BALI DENGAN MODEL DELONE DAN MCLEAN
Authors: Lestara Permana Gusi Putu , Cahyaning Putri Ni Putu Eka 
Published: January 2023

Through the use of Management Information Systems, the company has utilized technology to help improve service and business quality. The Management Information System used in the organization, for example at the Regional Office of the Ministry of Religion of the Province of Bali which uses a Management Information System as a tool for achieving goals based on the application they use. The Regional Office of the Ministry of Religion of Bali Province made the decision to use the Application from the Institutional Level Financial Application System (SAKTI) in January 2022.
The results of this study suggest that, the four main constructs of Information Quality to users, System Quality to Users, System Quality to User Satisfaction, and Users to Net Benefits, were rejected based on test results which indicated that these constructs were not able to assess the successful implementation of the application. Institution Level Financial Application System (SAKTI). However, Information Quality on user satisfaction, Service Quality on users, Service Quality on User Satisfaction, Users on User Satisfaction and User Satisfaction with Net Benefits, of the 5 constructs were accepted based on test results which indicated that this construct was able to assess the success of the implementation of Application of the Institution Level Financial Application System (SAKTI) at the Regional Office of the Ministry of Religion of the Province of Bali.
SISTEM PERPAJAKAN, NORMA DAN KEADILAN PADA PENGGELAPAN PAJAK
Authors: Sari Luhdina Eka , S Yayuk , Bau Leonarda , Mukoffi Ahmad Mukoffie , Indah Sri 
Published: January 2023

Abstract
Taxe play an important role in increasing state tax revenues, several factors that influence the occurrence of tax evasion, namely the uneven taxation system, low taxpayer norms and lock of tax justice. MSMEs in Tlogomas Malang Village partially This study uses quantitative methods. Determination of the sampel is abtained as many as 34 MSME taxpayers in Tlogomas Malang Village, the data collection technique used by the researcher is a questionnaire, the data analysis method used isregression multiple using SPSS 26 program. The result of the study prove that the taxation system has a significant effect on tax evasion with a tag value of 4.191, norms system has a significant effect on tax evasion with a tag value of thg 4.070 and fairness is significant effect on tax evasion with a value of 6.027 As for what needs to be considered by taxpayers, namely paying in time.
KEANEKARAGAMAN SERANGGA HAMA DAN SERANGGA PREDATOR PADA BUNGA TANAMAN BELIMBING MANIS (Averrhoa Carambola) VARIETAS BANGKOK MERAH
Authors: Ariani Novita Endah , Windriyanti Wiwin , Wuryandari Yenny 
Published: January 2023

Tanaman belimbing manis merupakan salah satu jenis tanaman holtikultura yang memiliki tingkat kerontokan bunga 60% yang diakibatkan adanya serangan hama pada bunga sehingga terjadi penurunan produksi buah belimbing manis. Penelitian ini bertujuan untuk mengetahui keanekaragaman jenis serangga hama dan serangga predator pada bunga belimbing manis serta pengaruh faktor lingkungan (suhu dan kelembapan) terhadap serangan hama dan kunjungan serangga predator pada bunga belimbing manis. Pengamatan dilakukan dalam 3 periode waktu, mulai dari pukul 08.00-17.00 WIB selama 20 hari. Jumlah tanaman yang digunakan pada penelitian ini sebanyak 40 pohon belimbing, dalam satu hari pengamatan membutuhkan dua pohon belimbing, untuk setiap pohon dilakukan pengamatan selama 30 menit. Pengamatan dilakukan menggunakan sweep net, yellow sticky trap dan secara visual. Parameter fisika lingkungan yang dicatat terdiri dari suhu udara dan kelembapan udara. Berdasarkan hasil penelitian terdapat 4 jenis serangga hama dan 2 jenis serangga predator bunga tanaman belimbing manis. Analisis indeks Shannon-Wiener serangga hama menunjukkan kategori indeks keanekaragaman rendah, indeks dominansi rendah dan indeks kemerataan rendah. Serangga predator menunjukkan kategori indeks keanekaragaman rendah, indeks dominansi tinggi dan indeks kemerataan merata.
Experimental Study of Axially Loaded Pile Group Near a Sloping Ground
Authors: Alinejad Reza Mohammad , Bayat Meysam , Nadi Bahram , Pakbaz Mohammad Siroos 
Published: January 2023

Understanding the axial loading response of pile group located near the crest of the slope is of practical value to structural design. In this paper, a large-scale test setup (1.8 m × 0.90 m × 0.90 m) has been developed to investigate the response of pile group (2 × 2) located near the crest of the slope under axial loading. This paper presents a series of physical modelling tests performed to investigate the effects of slope angles, distance of the pile group from the slope crest, embedment length of the pile group and pile diameter on the axial loading response of pile groups. The results show that the response of pile group located near the crest of the slope approaches to the level ground condition with increasing edge distance from slope crest. In addition, the horizontal displacement of pile group towards the slope face increases with decreasing distance of pile group from the slope crest or embedded length of piles or with increasing slope angle. Furthermore, increasing pile diameter results in a low increase in the horizontal displacement for edge distances less than 3 dp (dp = pile diameter). However, the horizontal displacement is almost independent of pile diameter at edge distances greater than 3 dp. Higher embedded length results in the response of pile group approaches to the response of pile group located on the level ground at a shorter edge distance from the slope crest.
El medioambiente como un bien jurídico protegido en el Derecho Penal Internacional
Authors: Villalva-Chacha Carmen 
Published: January 2023

En el presente trabajo se ocupa del estudio de la protección del medioambiente desde el Derecho Penal Internacional a través de una investigación cualitativa, cuyo contenido se levanta de manera sistemática y en narrativa, haciendo una retrospectiva de la evolución de su protección vista desde el desarrollo de los tratados internacionales y la influencia de juristas que brindan su impulso dogmático.
De la misma manera se presenta por medio del análisis selectivo la apreciación de los hechos plasmados en los tratamientos de los crímenes internacionales visto desde de la jurisprudencia y, del desarrollo de las normas y mecanismos de enjuiciamientos en los tribunales penales internacionales, incluso el acercamiento al marco de protección medioambiental existente en el Estatuto de Roma, norma de competencia de la Corte Penal Internacional. Ofreciendo un estado situacional del límite de la potestad punitiva entre la protección y, las lesiones más graves y atentatorias del medioambiente natural.
Palabras clave: crímenes internacionales, medioambiente, Estatuto de Roma, Corte Penal Internacional, Justicia Penal Internacional.
Rene policistico autosomico dominante: dalla patogenesi alla terapia
Authors: Piscopo Giovanni 
Published: January 2023

Autosomal Dominant Polycystic Kidney (ADPKD) is the most common genetically determined kidney disease of Mendelian inheritance. It has a variable prevalence, depending on the case series, from 1:1,000 to 1:2,500, and represents the fourth cause of renal failure in the world. It is part of the so-called ciliopathies and is mainly caused by the mutation of two genes: PKD1, located on chromosome 16p and the PKD2 gene, located on chromosome 4q and coding for Polycystin-2 (PC2); although two other disease-causing genes have recently been identified: DNAJB11 and GANAB. These two proteins consist, respectively, of a calcium channel and a transmembrane receptor, and they play a decisive role in regulating cell proliferation, division and differentiation, apoptosis and autophagy. The molecular mechanisms underlying the genesis of the cysts are multiple and for this reason not yet completely understood and although several of them have been the subject of preclinical and clinical studies aimed at evaluating the efficacy of therapies that could continue to interfere in a specific way, to date, only tolvaptan and octreotide-LAR (the latter only in Italy) have been approved for the treatment of renal disease secondaryto ADPKD. Here, we therefore recapitulate the different pathogenetic pathways in ADPKD and the possible therapeutic treatments.
Evaluasi Kualitas Hasil Produksi Urea Diperusahaan Pupuk Menggunakan Metode Kansai Engineering
Authors: Alwiyansyah Abib , Zahri Amiluddin 
Published: January 2023

Pupuk urea merupakan jenis pupuk yang paling sering dicari dipasaran karena banyak digunakan dalam dunia pertanian, sehingga PT PUSRI Palembang memproduksi pupuk urea dalam jumlah besar untuk memenuhi kebutuhan pupuk nasional. Dalam penelitian ini adapun metode yang digunakan adalah metode kuantitatif dengan pendekatan Kansai Engineering. Pengumpulan data didapatkan dari data primer dan sekunder ,kemudian diolah menjadi angket yang disebarkan kepada karyawan yang terlibat dalam proses produksi. Kemudian didapatkan hasil dari pengolahan angket tersebut kemudian disimpulkan peningkatan terdapat pada peningkatan kualitas produk setelah dilakukannya penambahan injeksi cairan formal dehyde. Peningkatan terjadi dapat dilihat dari kualitas pupuk yang mana nilai nya mencapai 79% responden menyatakan bahwa peningkatan terjadi dari kondisi pupuk dan menurut lab departemen tehnik proses peningkatan Crungshing Strenght tertinggi didapat dari variabel HCHO 0,235% dari 17,88 ke 19,24 kg/Cm2. Dan peningkatan terjadi juga dalam aspek lingkungan dimana terjadi pengurangan debu urea pada area produksi, berdasarkan jawaban responden yang mencapai 75%.