bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Hydrogen versus Helium on Electromagnetic Black Hole Observables
Authors: Wong George N. , Gammie Charles F. 
Published: September 2022

Abstract
The centers of our Galaxy and the nearby Messier 87 are known to contain supermassive black holes, which support accretion flows that radiate across the electromagnetic spectrum. Although the composition of the accreting gas is unknown, it is likely a mix of ionized hydrogen and helium. We use a simple analytic model and a suite of numerical general relativistic magnetohydrodynamic accretion simulations to study how polarimetric images and spectral energy distributions of the source are influenced by the hydrogen/helium content of the accreting matter. We aim to identify general trends rather than make quantitatively precise predictions, since it is not possible to fully explore the parameter space of accretion models. If the ion-to-electron temperature ratio is fixed, then increasing the helium fraction increases the gas temperature; to match the observational flux density constraints, the number density of electrons and magnetic field strengths must therefore decrease. In our numerical simulations, emission shifts from regions of low to high plasma β—both altering the morphology of the image and decreasing the variability of the light curve—especially in strongly magnetized models with emission close to the midplane. In polarized images, we find that the model gas composition influences the degree to which linear polarization is (de)scrambled and therefore affects estimates for the resolved linear polarization fraction. We also find that the spectra of helium-composition flows peak at higher frequencies and exhibit higher luminosities. We conclude that gas composition may play an important role in predictive models for black hole accretion.
Lorentz Invariance Violation Test from Time Delays Measured with Gravitationally Lensed GRB Candidates 950830 and 200716C
Authors: Lan Lin , Piórkowska-Kurpas Aleksandra , Wen Xudong , Biesiada Marek , Liao Kai , Gao He , Li Zhengxiang 
Published: September 2022

Abstract
The spectral lag features in gamma-ray bursts (GRBs) have been widely used to investigate possible Lorentz invariance violation (LIV). However, these constraints could depend on the unknown source-intrinsic time delays in different energy bands. Biesiada & Piórkowska theoretically proposed that gravitational lensing time delays in a strongly lensed GRB can become a tool for testing LIV free from the intrinsic time lag problem. Recently GRB 950830 and GRB 200716C have been proposed to be lensed by an intermediate-mass black hole. They should still be considered as candidates of strongly lensed bursts, since no angular offset (i.e., the evidence for multiple images) was detected, but only a double peak structure in the light curve. The redshift of the burst z

s
and of the lens z

l
have not been measured in either case; hence we assumed a reasonable guess of z

l
= 1.0, z

s
= 2.0 for GRB 950830 and z

l
= 0.174, z

s
= 0.348 for GRB 200716C. Bearing all this in mind, we attempted to constrain LIV theories in a prospective way based on the two GRBs by considering time delays between two pulses in different energy channels. By directly fitting the time delay data of GRBs 950830 and 200716C we obtained the following limits on LIV energy scale: E
QG,1 ≥ 3.2 × 109 GeV and E
QG,1 ≥ 6.3 × 109 GeV, respectively. Sensitivity analysis regarding the (unknown) redshifts leads to the most conservative estimate, E
QG,1 ≥ 1.5 × 108 GeV for GRB 950830 and E
QG,1 ≥ 4.8 × 108 GeV for GRB 200716C, when they would be located at z

s
∼ 5.
Consolidation d’une paysannerie émiettée…
Authors: Hooge Roma , Landy Frédéric , Noûs Camille , Ruiz Laurent 
Published: September 2022

Alors que la superficie moyenne des exploitations en Inde ne cesse de diminuer, il y a dans notre zone d’étude (Karnataka) des exploitations d’assez grande taille et avec une forte productivité de la terre : les estates. S’agit-il de l’embryon d’une « consolidation » de l’agriculture, voire de « firmes agricoles » ? Après avoir présenté l’environnement régional et la petite paysannerie locale, l’article définit les estates, fondées en général sur une agroforesterie irriguée et appartenant à des étrangers à la région. Leurs bilans au niveau hydrique et de l’emploi sont négatifs et on peut même parler d’un accaparement (relatif) de la terre et de l’eau. Le développement de ces estates ne peut donc être considéré comme une solution durable aux problèmes structurels des campagnes indiennes.
The level of knowledge about rheumatic diseases in Saudi Arabia
Authors: Alenzi Fahidah , Al-Sheikh Haifa , Alnasser Manal , Adwani Maha Al , Aldhuwayhi Raghad , Algenaim Eatedal , Abowadaan Maha 
Published: September 2022

Introduction:
Joint inflammation, which causes pain and swelling, is common in rheumatic diseases. In Saudi Arabia, large multicenter studies on the prevalence of rheumatic diseases and the common beliefs about these diseases are lacking. Our study aimed to investigate the false beliefs about rheumatic diseases in Saudi Arabia.

Materials and Methods:
A cross-sectional questionnaire-based study was carried out in Riyadh, Saudi Arabia, from December 2019 to January 2020, to assess the understanding and misconceptions of rheumatic disorders in the study population. The statistical analysis was performed using the Fisher's exact test and the Chi-squared test, and binary logistic regression was employed for dichotomous variables.

Results:
Five hundred and eleven respondents were recruited in the study, with a mean age of 26.9 years; 76.9% of respondents were female. 89.4% of the respondents were Saudi nationals; 75.2%, 20.3%, and 4.5% of respondents had bachelor's, prebachelor's, and master's degrees, respectively. The most frequently reported rheumatic disease was rheumatoid arthritis (66%), followed by myositis (13.3%). Most of the respondents (77%) in this study were aware of rheumatic diseases.

Conclusion:
Most of the respondents were aware of rheumatic diseases. However, a more exhaustive multicentric survey with a wider population-based survey is needed to provide substantial data and help rheumatologists overcome patients' misconceptions and improve outcomes.

The following core competencies are addressed in this article:
Medical knowledge, Patient care, Systems-based practice, Practice-based learning and improvement.
Comparison of undergraduate dental students' academic performance using structured and unstructured oral examinations
Authors: Lakshminarayan Nagesh , Usha G. V. 
Published: September 2022

Introduction:
Assessment plays a central role in formal education. Unstructured oral examinations are the status quo in dental education in India but have some drawbacks, including a lack of inter-rater reliability. It is not known whether structured oral examinations provide different scores nor how they will be accepted by students or examiners.

Materials and Methods:
A sample of 20 students were randomly selected from a group of third-year BDS students who had scored 65% and above in the 2nd year university examination in Bapuji Dental College and Hospital. They were exposed to a total of 4 h of lecture and problem-solving sessions on dental ethics. Four raters (teaching faculty), having similar academic experience and designation, were selected and they were trained to conduct structured oral examinations according to a format, especially designed for the same purpose. Half the students underwent structured examination followed by unstructured examination while half the students underwent unstructured examination followed by structured examination. Paired t-test was applied to find out the statistical difference between structured and unstructured oral examination formats.

Results:
The students obtained a mean score of 13.35 ± 3.8 out of a total score of 20 in the unstructured oral examination when compared to a mean score of 14 ± 3.76 in the structured oral examination. The difference was not statistically significant (P = 0.69). The acceptance trended favorable for structure examination but was not statistically significant. The structured examination had higher inter-rater reliability than the unstructured examination.

Conclusion:
The results showed good reliability and repeatability of the structured oral examination format with an inter-rater reliability of 0.82. Structured viva voce was not found to improve the performance of students when compared to unstructured viva voce.

The following core competencies are addressed in this article:
Practice-based learning and improvement, Patient care and procedural skills, Systems-based practice, Medical knowledge, Interpersonal and communication skills, and Professionalism.
Intra-Articular Lidocaine versus Procedural Sedation for Shoulder Dislocation Reduction
Authors: Zitek Tony , Koneri Nicholas , Georges Nikkitta , Slane Matthew 
Published: September 2022

Introduction:
Two common ways of providing anesthesia for shoulder dislocation reductions in the emergency department (ED) are intra-articular lidocaine (IAL) injections and procedural sedation (PS). We sought to compare PS with propofol or etomidate to IAL for shoulder dislocation reductions in the ED.

Methods:
This was an open-label, randomized controlled trial of patients aged 18–70 years with anterior shoulder dislocations who presented to a single ED. We randomized patients to either PS or IAL for their shoulder dislocation reduction. The primary outcome measure was ED length of stay (LOS). Secondarily, we assessed patient satisfaction and the number of attempts required for successful reduction.

Results:
We identified 60 patients who met the criteria for enrollment, and were able to enroll 43. We randomized 23 patients to IAL and 20 to PS. In the IAL group, the mean ED LOS was 133 min as compared to 124 min for the PS group (difference 9 min [95% confidence interval (CI)-22–41], P = 0.54). Patients in the IAL group required an average of 1.9 reduction attempts as compared to 1.2 in the PS group (difference of 0.7 [95% CI 0.2–1.2]). The mean patient satisfaction scores were similar at 9.7 and 9.8 for the IAL and PS groups, respectively.

Conclusions:
This study lacked a sufficient sample size to detect small differences but found no statistically significant difference in mean ED LOS or patient satisfaction for patients who received IAL as compared to PS. Patients in the PS group required fewer attempts for successful reduction.
Polypharmacy and Potential Drug–Drug Interactions in Patients with Rheumatoid Arthritis
Authors: Al-Ghazaly Zakaria M. , Jassim Nizar Abdul Latif 
Published: September 2022

Background:
Rheumatoid arthritis (RA) is a systemic autoimmune disease with protean manifestations. It is characterized by symmetric polyarticular inflammation, which can lead to progressive joint damage. As a result, RA is associated with substantial functional disability, morbidity, and accelerated mortality, which pose an enormous and growing societal burden. Polypharmacy is a major public health concern, which is growing worldwide. Polypharmacy is associated with adverse outcomes including mortality, falls, adverse drug reactions, increased length of stay in hospital and readmission to hospital soon after discharge.

Objectives:
The aim of this study was to quantify polypharmacy in a group of patients with RA, its relationship with patients’ characteristics and to assess the risk of potential undesirable interactions between medications used for managing RA and those used for chronic and non-chronic diseases.

Materials and Methods:
A cross-sectional study was conducted at Baghdad Teaching Hospital, Rheumatology Unit during the period from December 2019 to December 2020. A total of 188 adult patients, previously diagnosed with RA according to the 2010 American College of Rheumatology/ European League against Rheumatism rheumatoid arthritis classification criteria, were included in the study. Data were collected using a pre-constructed data collection sheet. Questionnaires included demographic and clinical data of the patients. In this study, polypharmacy was defined as the association of five or more medications, regardless of the duration. Drug interactions were identified by use of the Medscape’s drug interaction checker® database.

Results:
Among 188 RA patients in this study, polypharmacy was found in 71.8% of the patients and there were 331 potential drug–drug interactions (1.77 ± 2.52 DDIs/patient). Most of the potential drug–drug interactions were related to the use of methotrexate, with nonsteroidal anti-inflammatory drugs being the major representative of these drug–drug interactions with methotrexate.

Conclusion:
High prevalence of polypharmacy was found in RA patients. Positive correlation between polypharmacy and patient’s age, disease activity and the presence of other comorbid conditions. Polypharmacy was associated with increased incidence of potential drug–drug interactions in RA patients. Methotrexate was involved in most drug–drug interactions.
Effectiveness and safety of combined use of tranexamic acid and Xiyu dressing in chloasma therapy, and its effect on recurrence in patients
Authors: Chen Xiaojian , Wu Lei , Wu Jian , Cai Meihong 
Published: September 2022

Purpose: To determine the effectiveness and safety of combined use of tranexamic acid (TA) and Xiyu dressing in chloasma patients.
Methods: Ninety female patients with moderate-to-severe melasma who were admitted to the Affiliated Suzhou Hospital of Nanjing Medical University (February 2020 - February 2021), were equally divided into 3 groups: A, B and C. Patients in group A were orally treated with TA, those in group B received oral TA and Xiyu dressing, while those in group C received Xiyu dressing only. Treatment effectiveness, Melasma Area and Severity Index (MASI) score, whole blood viscosity (WBV) and disease recurrence rate were assessed.
Results: General patient profile was comparable amongst the 3 groups (p > 0.05). Objective treatment effectiveness was higher in group B than in group A, and higher in group A than in group C (p < 0.05). At weeks 8, 16 and 20, the order of Melasma Area and Severity Index (MASI) scores was: C > A > B, with lower scores in group B than in group A, and lower in group A than in group C (p < 0.05). The whole blood viscosity (WBV) was highest in group B, while group C had the lowest WBV (p < 0.05). No notable differences occurred in disease recurrence rate amongst the 3 groups. Onset time of cure was shorter in group A than in group C, but was longer in group A than in group B (p < 0.05).
Conclusion: Treatment with TA and Xiyu dressing is more effective when combined than when using either of them alone; furthermore, disease recurrence rate is lowest with the combination therapy. Therefore, the combined therapy has potentials for use in the management of chloasma, but further clinical trials are required prior to application in clinical practice
Effect of combined use of L carnitine and hemodialysis on clinical efficacy and quality of life of uremic patients
Authors: Liu Huanhuan , Zhang Ren 
Published: September 2022

Purpose: To investigate the clinical efficacy of combined use of L-carnitine and hemodialysis in the treatment of uremic patients, and its effect on their quality of life.
Methods: A total of 160 uremic patients who were admitted to Lujiang County People's Hospital from November 2018 to August 2020 were selected and divided equally into dialysis group (hemodialysis), and combined group (L-carnitine + hemodialysis). Some clinical indices and parameters, including safety profile, National Institutes of Health Stroke Scale (NIHSS) score, CD4+ and CD4+/CD8+, and plasma protein levels were evaluated for both study groups.
Results: Patients treated with L-carnitine + hemodialysis in the combined group resulted in significantly higher clinical treatment effectiveness than those in the dialysis group (p < 0.05). However, safety profiles were comparable in the two groups (p > 0.05). No significant difference in NIHSS score between the two groups before treatment, but L-carnitine + hemodialysis led to a better NIHSS score than in the dialysis group after treatment (p < 0.05). However, there were better levels of CD4+ and CD4+/CD8+ in the combined group than in the dialysis group (p < 0.05). Similarly, although pre-treatment plasma protein levels in the two groups were comparable, there were significantly lower plasma protein levels in the combined group than in the dialysis group post-treatment (p < 0.05).
Conclusion: The combination of L-carnitine and hemodialysis in the treatment of uremia patients improves the clinical management of the patients, enhances their quality of life, and shows good safety profile. However, further clinical trials should be carried out prior to the application of the combined treatment in clinical practice.
Tectorigenin ameliorates myocardial cell injury caused by hypoxia/reoxygenation by inhibiting autophagy via activation of PI3K/AKT/mTOR pathway
Authors: Wu Jijun , Zhou Yingli , Guo Ming , Yang Jie , Wu Feifei , Wang Jialin 
Published: September 2022

Purpose: To investigate the protective role of tectorigenin in myocardial ischaemia/reperfusion.
Methods: Myocardial cells (H9c2) were treated with different concentrations of tectorigenin and exposed to hypoxia/reoxygenation. Cell viability and apoptosis were determined by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide) and TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling) staining, respectively. Oxidative stress and inflammation were evaluated using enzyme-linked immunosorbent assay (ELISA), while autophagy and the underlying mechanisms of action were evaluated by Western blot.
Results: Tectorigenin enhanced the proliferative activity of H9c2 under hypoxia/reoxygenation conditions, and significantly reduced the apoptotic activity (p < 0.001) through decrease in Bax and increase in Bcl-2. Tectorigenin also significantly up-regulated SOD (superoxide dismutase) and GSH (glutathione) levels (p < 0.01), and down-regulated MDA (malondialdehyde) and MPO (myeloperoxidase) in hypoxia/reoxygenation-induced H9c2. TNF-α (tumor necrosis factor-α), IL(interleukin)-1β, and IL-6 levels were also inhibited by tectorigenin by down-regulating p-p65. Hypoxia/reoxygenation-induced increase in p62 and decrease in Beclin-1 and LC3-II/LC3-I were reversed by tectorigenin. Protein expressions of p-mTOR, p-AKT, and p-PI3K in hypoxia/reoxygenation-induced H9c2 were elevated by tectorigenin.
Conclusion: Tectorigenin exerts anti-oxidant, anti-inflammatory, and anti-autophagic effects on hypoxia/reoxygenation-induced H9c2 through the activation of PI3K/AKT/mTOR pathway, thus suggesting that it is a potential agent for the management of myocardial ischaemia/reperfusion.
Patchouli alcohol suppresses inflammation and autophagy, and reduces osteoclast formation in periodontitis via regulation of ERK and NF κB signaling pathways
Authors: Fei Fei , Zhang Changqing 
Published: September 2022

Purpose: To evaluate the effect of patchouli alcohol (PA) on periodontitis and reveal its possible mechanism.
Methods: Primary human periodontal membrane cells (PDLC) were isolated and treated with lipopolysaccharide (LPS) to establish a periodontitis model. The MTT, flow cytometry and immunofluorescence assay were used to determine the effect of PA on cell viability and apoptosis in PDLC exposed to LPS. The inflammation status and osteoclast formation were measured using enzyme-linked immunosorbent assay (ELISA) and TRAP staining. Immunoblot assays were performed to analyze the effect of LPS on ERK and NF-κB pathways.
Results: Patchouli alcohol (PA) improved LPS-induced PDLC growth arrest (p < 0.001). In addition, PA relieved LPS - induced autophagy of PDLCs (p < 0.001). Further data confirmed that PA inhibited lPS-induced inflammation of PDLCs. In addition, PA reduced osteoclast formation, and suppressed inflammation and autophagy, and also reduced osteoclast formation by regulating ERK and NF-κB pathways.
Conclusion: Patchouli alcohol inhibits inflammation and autophagy, and decreases osteoclast formation in periodontitis via the regulation of ERK and NF-κB signaling pathways. Thus, this compound has potentials for development for the treatment of periodontitis; however, in vivo studies should first be undertaken.
Hemşirelikte Deneysel Araştırmalarda Süreç Değerlendirme
Authors: ÖZDEMİR KOYU Hazal , KILIÇARSLAN TÖRÜNER Ebru 
Published: September 2022

Süreç değerlendirme, bir girişimin uygulanmasını en üst düzeye çıkarmak amacıyla; uygulanan girişimin başarılı ve geliştirilmesi gereken yönlerini etkileyen mekanizmaların, süreçlerin ve uygulama stratejilerinin geliştirilmesine katkı sağlayan bir değerlendirmedir. Süreç değerlendirme, girişimin tüm yönlerini, girişimi etkileyen etki mekanizmalarını ve girişimin bağlamını inceleyerek hemşirelik alanındaki çok boyutlu müdahalelerin yeterli doğruluk, doz ve kalitede sunulmasını sağlamaktadır. Böylece, hemşirelik araştırmalarında uygulanan girişimlerin etkinliği süreç değerlendirme kullanılarak değerlendirilebilir. Son yıllarda hemşirelik alanında iyi tasarlanmış, sonuç değerlendirme çalışmaları olarak da bilinen, deneysel araştırmalar literatürde yer almasına rağmen süreç değerlendirmeye yönelik çalışmaların sınırlı olduğu görülmektedir. Bu derleme, süreç değerlendirme kavramı, süreç değerlendirmenin temel bileşenleri, aşamalarına yönelik bakış açısı kazandırmak ve hemşirelik araştırmalarında süreç değerlendirmenin önemini vurgulamak amacıyla planlanmıştır.
Pentingnya Sikap Profesional untuk Meningkatkan Kepercayaan Konseli terhadap Konselor
Authors: Kusmiati Meti , Rohmatullah Niam 
Published: September 2022

As a service worker, a counselor is required to be a professional. Where a professional is someone who is an expert in their field, easy to adapt to their environment, easy to manage their time and attitude. Becoming a professional counselor is regulated in a counseling code of ethics that must be maintained and carries counseling principles that can facilitate counseling services. The performance of a counselor is spread across various fields, because basically every field requires guidance and the counselor is an expert in terms of guidance and development. The professionalism of a counselor is not only in terms of work, there are several criteria for a counselor to be considered a professional. This professionalism can create a positive influence for counselors and counselees. The counselee will put his trust in a professional counselor.
Keywords: Professional, Counselor, Trust
Pemanfaatan Fitur Aplikasi WhatsApp dan Zoom Cloud Meeting Sebagai Media Pembelajaran Daring pada Masa Pandemi Covid-19 di MTs An-Nashihin Kademangan
Authors: Hermawati Lili , Arif Miftakhul , Marina Dewi 
Published: September 2022

describe the Utilization of WhatsApp Application Features and Zoom Cloud Meetings as Online Learning Media during the Class IX Covid-19 Pandemic at MTs An-Nashihin Kademangan, inhibiting factors and supporting factors in the use of WhatsApp application features and zoom cloud meetings as online learning media. during the covid-19 pandemic class IX at MTs An-nashihin Kademangan and solutions that were carried out to overcome obstacles that occurred in the use of the whatsapp application features and zoom cloud meetings as online learning media during the covid-19 pandemic class IX at MTs An-Nashihin Kademangan This research was conducted at MTs An-Nashihin Kademangan, South Tangerang City from February 8, 2022 to February 21, 2022. This type of research is qualitative descriptive. The results of the study show that teachers have utilized the WhatsApp application features and zoom cloud meetings to support online learning activities, by utilizing various available features such as photo, video, document, video calls, and video conferencing features. From the results of this study, it is recommended that educators further improve their competence regarding the use of ICT, so that the readiness of learning using technology-based learning can be maximized.
Keywords: WhatsApp, Zoom Cloud Meetings, Learning Media, Online Learning.