bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Versus Late DNR Orders and its Predictors in a Saudi Arabian ICU
Authors: Aletreby Waleed Tharwat , Mady Ahmed F. , Al-Odat Mohammed A. , Balshi Ahmed N. , Mady Anas A. , Al-Odat Adam M. , Elshayeb Amira M. , Mostafa Ahmed F. , Abd Elsalam Shereen A. , Odchigue Kriz L. 
Published: August 2022

Background
Practices of Do-Not-Resuscitate (DNR) orders show discrepancies worldwide, but there are only few such studies from Saudi Arabia.

Objective:
To describe the practice of DNR orders in a Saudi Arabian tertiary care ICU.

Methods:
This retrospective study included all patients who died with a DNR order at the ICU of King Saud Medical City, Riyadh, Saudi Arabia, between January 1 to December 31, 2021. The percentage of early DNR (i.e., ≤48 hours of ICU admission) and late DNR (>48 hours) orders were determined and the variables between the two groups were compared. The determinants of late DNR were also investigated.

Results:
A total of 723 cases met the inclusion criteria, representing 14.9% of all ICU discharges and 63% of all ICU deaths during the study period. The late DNR group comprised the majority of the cases (78.3%), and included significantly more patients with acute respiratory distress syndrome (ARDS), community acquired pneumonia (CAP), acute kidney injury, and COVID-19, and significantly fewer cases of readmissions and malignancies. Septic shock lowered the odds of a late DNR (OR = 0.4, 95% CI: 0.2–0.9;P= 0.02), while ARDS (OR = 3.3, 95% CI: 2–5.4;P < 0.001), ischemic stroke (OR = 2.5, 95% CI: 1.1–5.4;P= 0.02), and CAP (OR = 2, 95% CI: 1.3–3.1;P= 0.003) increased the odds of a late DNR.

Conclusion:
There was a higher frequency of late DNR orders in our study compared to those reported in several studies worldwide. Cases with potential for a favorable outcome were more likely to have a late DNR order, while those with expected poorer outcomes were more likely to have an early DNR order. The discrepancies highlight the need for clearer guidelines to achieve consistency.
Prevalence and Risk Factors of Osteoporosis in Saudi End-Stage Renal Disease Patients on Hemodialysis
Authors: Mahzari Moeber M. , Alibrahim Ahmed R. , Alghamdi Nawaf A. , Alsadhan Muatassem A. , Almoamary Saad M. , Masuadi Emad M. , Al Shahrani Awad S. 
Published: August 2022

Background:
Osteoporosis is characterized by a decrease in bone mineral density, thereby increasing the risk of pathological fractures. It is a common complication of chronic kidney disease. However, there is limited local data on the prevalence of osteoporosis in end-stage renal disease.

Objective:
The current study evaluated the epidemiology of osteoporosis in end-stage rental disease patients at a Saudi Arabian tertiary care center.

Methods:
This cross-sectional retrospective study was conducted using data obtained between 1 January 2016 and 31 December 2019 at the Dialysis Center at King Abdulaziz Medical City, Riyadh, Saudi Arabia. End-stage rental disease patients who were aged ≥50 years and underwent hemodialysis for at least 1 year were included, while those with documented metabolic bone disease and absence of bone mineral density data were excluded.

Results:
Sixty-four end-stage rental disease patients undergoing hemodialysis met the inclusion criteria. The patients underwent bone mineral density measurement at the discretion of the treating physician. The mean patients' age was 73 ± 11.5 years and 76% were women. The overall prevalence of osteoporosis was 37.5%, and it was similarly distributed among women and men (38.8% and 33.3%, respectively). Nine of the 15 male patients (60%) and 24 of the 49 female patients (49%) had fractures. Twenty-five (39%) patients used glucocorticoids. Osteoporosis was most commonly identified in the femoral neck (26.2%), followed by proximal femur (19.4%), and lumbar spine (18.8%). A high rate of osteoporosis was significantly associated with older age and being underweight.

Conclusion:
A high rate of low bone mineral density was demonstrated in end-stage renal disease patients. The femoral neck was the most common osteoporosis site in this patient population, and advanced age and underweight were possible risk factors for low bone mass.
Ruscogenin Protects Against Deoxynivalenol-Induced Hepatic Injury by Inhibiting Oxidative Stress, Inflammation, and Apoptosis Through the Nrf2 Signaling Pathway
Authors: Elsawy Hany , Rajendran Peramaiyan , Sedky Azza Mahmoud , Alfwuaires Manal 
Published: August 2022

Background
Deoxynivalenol (DON) is a trichothecene mycotoxin with demonstrated cytotoxicity in several cell lines and animals, primarily owing to inflammation and reactive oxygen species accumulation. Ruscogenin (RGN), a steroidal sapogenin of Radix Ophiopogon japonicus, has significant anti-thrombotic/anti-inflammatory effects.

Objective:
The aim of this study was to assess the protective role of RGN against DON-induced oxidative stress, which occurs through the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway and is regulated by phosphoinositide 3-kinases/protein kinase B (PI3K/AKT).

Methods:
The effects were examined using the HepG2 cell line. RGN and DON were suspended in serum-free medium. Cells were seeded onto plates, and then RGN, DON, or both were added over 24 h in triplicates for each group.

Results:
RGN conferred protection against DON-exhibited cytotoxicity against HepG2 cells. RGN pretreatment downregulated the expression of DON-induced TNF-α and COX-2 and the formation of reactive oxygen species in a dose-dependent manner. RGN upregulated the expression of Nrf2 and its antioxidant proteins as well as mRNA levels of HO-1/NQO-1/HO-1/Nrf2. Similarly, treatment with DON + RGN resulted in upregulation of the pI3K/pAKT signaling pathway in a dose-dependent manner. Finally, RGN was also found to inhibit the DON-induced apoptosis by upregulating the levels of cleaved proteins and downregulating the expression of Bcl2.

Conclusion:
The study demonstrates that RGN suppresses hepatic cell injury induced by oxidative stress through Nrf2 via activation of the pI3K/AKT signaling pathway.
Osteoarthritis of the knee joint in the obese patient: Do metabolic factors play a role?
Authors: Obiegbu Obinna Henry 
Published: August 2022

Introduction:
Osteoarthritis (OA), a disease process characterized by progressive softening of the articular cartilage, sclerosis of subchondral bone, and cyst formation often affects the knee joint. Although OA has traditionally been interpreted as wear and tear, its etiology is now thought to be multifactorial with both biomechanical and metabolic factors implicated. Of the metabolic factors, leptin a glycosylated peptide hormone produced by the adipocytes has received major attention because of its correlation to body size. The aim of this study was to determine the correlation between the clinical severity of knee OA and serum leptin in obese patients.

Materials and Methods:
This was a prospective study; recruiting 100 patients (50 obese and nonobese patients) with OA of the knee joint. The severity of knee OA was ascertained using the WOMAC scoring system, and serum leptin of all patients was determined.

Results:
The age group most commonly affected by knee OA was 51–60 years. The mean serum leptin level in nonobese patients was 4.88 ± 5.08, compared to 20.11 ± 15.04 in obese patients. There was a statistically significant correlation between the severity of knee OA (using WOMAC score) and serum leptin level; P = 0.001.

Conclusion:
This study shows a statistically significant positive correlation between serum leptin and severity of clinical symptoms in obese patients with knee OA.
Visual outcomes and higher-order aberrations in eyes implanted with hybrid extended depth of focus intraocular lens
Authors: Kenia Vaishal P. , Kenia Raj V. , Mudaliya Laxmi , Pirdankar Onkar H. 
Published: August 2022

Abstract

PURPOSE:
To study the visual outcomes and higher order aberrations in eyes implanted with Hybrid EDOF IOL, particularly in Indian eyes.

MATERIALS AND METHODS:
This is retrospective case series where subjects aged between 40-65 years and were implanted with LUCIDIS IOL by single surgeon were included. Subjects with Pre surgery corneal astigmatism > 1.50 D, corneal guttae, IOP >22mmHg, any ocular Co morbidities, Intra or post operative complication were excluded. At 1 month follow up, uncorrected visual acuities at distance (UCDVA), intermediate (UCIVA) and near (UCNVA), refraction were recorded. Internal Higher order aberrations and strehl ratio for a fixed pupil of 4mm and 6mm were calculated using NIDEK OPD Scan. Monocular defocus curve was obtained at 4 meter logMAR chart.

RESULTS:
Total of 55 eyes of 35 patients with mean±SD age of 58.50±7.49 years were evaluated. 89.09% of the eyes achieved visual acuity of 6/6. 49.09% could read N10 font at intermediate distance without any correction and 85.45% of the eyes had uncorrected near visual acuity of N6. Around 67% of the eyes did not require any refractive correction whereas around 26% of the eyes required correction upto ±0.25D. The defocus curve showed that visual acuity also ranges from 0.05 logMAR to 0.2 logMAR for Plano to -3.00D respectively. Mean±SD Strehl ratio at 4 and 6 mm pupil size was 0.06±0.04 and 0.02±0.02 respectively.

CONCLUSION:
Hybrid EDOF IOL such as LUCIDIS provides excellent vision at all distances. This could be attributed to IOL design which is spherical aberration neutral lens.
THE REALIZATION OF SEMANTIC MAPPING STRATEGY IN READING OF ENGLISH FOR FOREIGN LANGUAGE CLASS IN SMK BARDAN WASALAMAN BATANG
Authors: Huda S. Thoriqul , Sutinnarto Sutinnarto , Hamdani Haris 
Published: August 2022

The purpose of this study is to gain a better understanding of the effectiveness of Semantic Mapping strategies in teaching reading comprehension in second grade students of SMK Bardan Wasalaman Batang. The research question is whether Semantic Mapping strategies are effective in Reading of English for Foreign language Class. Forty-two eleventh grade of in SMK Bardan Wasalaman Batang was chosen as a subject and divided equally into two groups; one group is the experimental group and the other is the control group. There are several procedures carried out in data collection to answer research questions; first, a pre-test is given before the experiment is performed to ascertain whether there are no significant differences in English proficiency in the two subject groups of lesson. Subjects are required to complete a reading comprehension test consisting of forty-five multiple-choice tests within ninety minutes. Second, after the experiment, a post-test was carried out using the same test for the pre-test. Finally, the t-test was used to determine whether there were significant differences in the achievement of reading comprehension between the two groups. The data showed that there were significant differences in the achievement of reading comprehension between the experimental groups - treated with Semantic Mapping strategies and the control group taught with KWL strategy. It means that the Semantic Mapping Strategy is more effective than KWL Strategy. The data indicate that there is significant difference in reading comprehension achievement between the experimental group - treated and Semantic Mapping strategy, and the control group taught with KWL strategy. It means that Semantic Mapping Strategy is more effective than KWL Strategy.
Pengembangan Mobile Carwash Application pada Carwash Trijaya Menggunakan Waterfall
Authors: Favian Randy Elian , Mirza Ahmad Haidar 
Published: August 2022

Cucian Mobil Trijaya merupakan perusahaan yang bergerak di bidang jasa. Perusahaan ini masih menggunakan cara manual dalam proses bertransaksi dan pembuatan laporan harian, sehingga sering kali salah dalam penulisan dan laporan yang telah dibuat sering mengalami kerusakan fisik seperti kotor dan robek. Penulis bertujuan untuk membuat Aplikasi Kasir Cucian Mobil Trijaya. Aplikasi ini dibuat dengan bahasa java menggunakan platform Android Studio, dikembangkan menggunakan metode waterfall, di rancang melalui Data Flow Diagram (DFD) dan Entity Relationship Diagram (ERD). Hasil dari pembuatan Aplikasi Kasir Cucian Mobil Trijaya yaitu aplikasi ini dapat mengeluarkan output berupa struk pembayaran dan pembuatan laporan harian secara otomatis dalam bentuk pdf sehingga dapat mempermudah dalam penyimpanan. yang dapat mencatat transaksi penjualan.
Implementasi Algoritma Vignere Chiper Berbasis QRCode Untuk Absensi Pegawai PT. Delameta Bilano Cabang Ruas Tol Palembang - Inderalaya
Authors: Ichsan Muhammad , Hutrianto Hutrianto 
Published: August 2022

Pemanfaatan teknologi dalam mempermudah proses Absensi telah banyak di lakukan, hal ini yang di terapkan pada Aplikasi Absensi Pegawai PT. Delameta Bilano Cabang Ruas Tol Palembang – Inderalaya. Adapun Aplikasi ini di buat dengan menggunakan metode Extreme Programming meliputi tahapan Planning, Design, Coding, Testing dan Software Increment. Aplikasi ini di harapkan mempermudah proses pendataan Absensi pegawai baik dari proses pelaksanaan yang di lakukan oleh pada PT. Delameta Bilano Cabang Ruas Tol Palembang – Inderalaya maupun dari sisi Admin yang mengolah data – data absensi sehingga kinerja dari dapat terpantau dengan baik. Adapun pengujian yang di lakukan pada Aplikasi ini yaitu dengan menggunaan metode Black Box Testing yang dilakukan dengan cara pengujian dari sisi proses Logic yang telah di buat dan dari sisi fungsional fitur – fitur yang ada baik pada menu Admin dan menu , dari proses pengujian di dapat Aplikasi Absensi Pegawai PT. Delameta Bilano Cabang Ruas Tol Palembang – Inderalaya berjalan dengan baik dan tidak di temukan proses yang salah dari konsep yang telah di rencanakan pada metode pengembangan yang di terapkan
PRE-POST PEMBERIAN AROMATERAPI BUNGA LAVENDER TERHADAP SKALA ANSIETAS PADA PASIEN PRE-MASTEKTOMI
Authors: Tarigan Eka Ristin , Simanullang Rostime Hermayerni , Wahyu Afnijar , Ginting Laurena , Hutahaean Masta Melati 
Published: August 2022

Background: Breast cancer is group of abnormal cells in the breast that continue to grow multiply. Mastectomy is one of the options for surgical action in breast cancer. In patients who will undergo mastectomy, all breast tissue and axillary lymph nodes are suspected. Surgery will cause psychological disorders in the form of anxiety that can lead to complications during surgery. One way to reduce anxiety is through the provision of aromatherapy, especially aromatherapy lavender, which is known to be sedative. Purpose: the aims to determine the effect of aromatherapy on anxiety scale in pre mastectomy patients. Method: this study was used a quasi-experimental research design with the one group pre- and post-test without control method. Determination of sample size was using purposive sampling teqniuqe with 15 respondents. The instrument to assess anxiety is the Hamilton Anxiety Rating Scale (HARS). Data from the research results were analyzed by statistical tests, namely the Wilcoxon test. Results: this study show that there is a significant effect of pre- and post-administration of aromatherapy of lavender flowers to decrease the level of anxiety in patients with pre-mastectomy with p value (p = 0,001) <0.05. Conclussion: the granting of aromatherapy lavender can reduce of anxiety levels in patients with pre-mastectomy which means a decline in the level of anxiety after the administration of aromatherapy lavender flowers in patients with pre-mastectomy. The results of study are expected to be used as recommendations for health workers, especially the profession of a nurse to handle the patient's anxiety.
KEHAMILAN REMAJA DENGAN DEPRESI POSTPARTUM PADA IBU POSTPARTUM
Authors: Illustri Illustri 
Published: August 2022

Depresi menduduki peringkat keempat penyakit di dunia dan diperkirakan menjadi urutan kedua pada tahun 2020. Remaja merupakan kelompok penduduk yang perlu mendapatkan perhatian. Tingkat depresi pada kehamilan remaja sekitar 20% - 40 % dan depresi postpartum pada remaja adalah 19% - 50%. Depresi postpartum dapat mempengaruhi interaksi antara ibu dan bayi. Faktor risiko terjadinya depresi postpartum adalah depresi selama masa kehamilan, dimana terjadi kesulitan koping dan pengalaman emosi yang negatif setelah persalinan. Hampir semua remaja mengalami tekanan psikologis yang berasal dari ketidaksiapan psikososialnya untuk mengemban peran dan tanggung jawab sebagai calon orang tua. Tujuan dalam penelitian ini adalah mengetahui hubungan antara kehamilan remaja dengan kejadian depresi postpartum. Penelitian ini menggunakan desain cross sectional study dengan teknik inccidental sampling. Sampel dalam penelitian ini sebanyak 80 responden. Pengambilan data dengan kuesioner sosiodemografi dan Edinburg Postnatal Depression Scale (EPDS). Analisis data menggunakan uji Fisher’s Exact Test.Hasil uji statistik menunjukkan variabel yang berhubungan dengan depresi postpartum adalah kehamilan remaja (p=0,001). Kesimpulan penelitian ini terdapat hubungan kehamilan remaja dengan kejadian depresi postpartum. Kehamilan remaja meningkatkan risiko sebesar 20,9 kali terjadinya depresi postpartum.
Condensation–mass flux connection in warm convective clouds: theory and implications for cloud supersaturation
Authors: Kogan Yefim L. 
Published: August 2022

Abstract. The study focused on the relationship between Condensation Rate (CR) and the upward/Plus Mass Flux (MFP) in a system of trade wind cumulus clouds simulated by an LES model. The model was initialized with data observed during the RICO field project, and simulated in a 50.0×50.0 km horizontal domain. In our previous study (Kogan, 2021) we showed that a nearly perfect
correlation exists between CR and MFP (correlation coefficient R=0.99). As a result, condensation rate can be highly accurately expressed as a linear function of upward mass flux. This LES derived finding was explained using condensation theory and concept of quasi-steady supersaturation. The
obtained from the LES model slope of the CR–MFP linear fit was in excellent agreement with its theoretical value (error less than 5 %). The theory also showed that the equality between the LES and theoretical values of the slope follows from the equality between supersaturation and its quasi-steady value. The study results suggest that condensation rates, for a variety of cloud
conditions, can be precisely estimated using the single variable–upward
mass flux. Possible implications of the results for evaluating supersaturation and degree of non-adiabaticity in clouds are discussed.
Effects of orbital forcing, greenhouse gases and ice sheets on Saharan greening in past and future multi-millennia
Authors: Duque-Villegas Mateo , Claussen Martin , Brovkin Victor , Kleinen Thomas 
Published: August 2022

Abstract. Climate archives reveal alternating arid and humid conditions in North Africa during the last several million years.
Most likely the dry phases resembled current hyper-arid landscapes, whereas the wet phases known as African humid periods (AHPs) sustained much more surface water and greater vegetated areas that “greened” large parts of the Sahara region.
Previous analyses of sediment cores from the Mediterranean Sea showed the last five AHPs differed in strength, duration and rate of change.
To understand the causes of such differences we perform transient simulations of the past 190 000 years with the Earth system model of intermediate complexity CLIMBER-2.
We analyse the amplitude and rate of change of the modelled AHP responses to changes in orbital parameters, greenhouse gases (GHGs) and ice sheets.
In agreement with estimates from Mediterranean Sea sapropels, we find the model predicts a threshold in orbital forcing for Sahara greening and occurrence of AHPs.
Maximum rates of change in simulated vegetation extent at AHP onset and termination correlate strongly with the rate of change of the orbital forcing.
As suggested by available data for the Holocene AHP, the onset of modelled AHPs usually happens faster than termination.
A factor separation analysis confirms the dominant role of the orbital forcing in driving the amplitude of precipitation and vegetation extent for past AHPs.
Forcing due to changes in GHGs and ice sheets is only of secondary importance, with a small contribution from synergies with the orbital forcing.
Via the factor separation we detect that the threshold in orbital forcing for AHP onset varies with GHG levels.
To explore the implication of our finding from the palaeoclimate simulations for the AHPs that might occur in a greenhouse-gas-induced warmer climate, we extend the palaeoclimate simulations into the future.
For the next 100 000 years the variations in orbital forcing will be smaller than during the last 100 millennia, and the insolation threshold for the onset of late Quaternary AHPs will not be crossed.
However, with higher GHG concentrations the predicted threshold drops considerably.
Thereby, the occurrence of AHPs in upcoming millennia appears to crucially depend on future concentrations of GHGs.
The impact of terrain model source and resolution on snow avalanche modeling
Authors: Miller Aubrey , Sirguey Pascal , Morris Simon , Bartelt Perry , Cullen Nicolas , Redpath Todd , Thompson Kevin , Bühler Yves 
Published: August 2022

Abstract. Natural hazard models need accurate digital elevation models (DEMs) to simulate mass movements on real-world terrain. A variety of platforms (terrestrial, drones, aerial, satellite) and sensor technologies (photogrammetry, lidar, interferometric synthetic aperture radar) are used to generate DEMs at a range of spatial resolutions with varying accuracy. As the availability of high-resolution DEMs continues to increase and the cost to produce DEMs continues to fall, hazard modelers must often choose which DEM to use for their modeling. We use satellite photogrammetry and topographic lidar to generate high-resolution DEMs and test the sensitivity of the Rapid Mass Movement Simulation (RAMMS) software to the DEM source and spatial resolution when simulating a large and complex snow avalanche along Milford Road in Aotearoa/New Zealand. Holding the RAMMS parameters constant while adjusting the source and spatial resolution of the DEM reveals how differences in terrain representation between the satellite photogrammetry and topographic lidar DEMs (2 m spatial resolution) affect the reliability of the simulation estimates (e.g., maximum core velocity, powder pressure, runout length, final debris pattern). At the same time, coarser representations of the terrain (5 and 15 m spatial resolution) simulate avalanches that run too far and produce a powder cloud that is too large, though with lower maximum impact pressures, compared to the actual event. The complex nature of the alpine terrain in the avalanche path (steep, rough, rock faces, treeless) makes it a suitable location to specifically test the model sensitivity to digital surface models (DSMs) where both ground and above-ground features on the topography are included in the elevation model. Considering the nature of the snowpack in the path (warm, deep with a steep elevation gradient) lying on a bedrock surface and plunging over a cliff, RAMMS performed well in the challenging conditions when using the high-resolution 2 m lidar DSM, with 99 % of the simulated debris volume located in the documented debris area.