bluuebunny/crossref_metadata_2025_split huggingface dataset:
Addition of dexmedetomidine and nalbuphine as an adjuvant to ketofol for deep sedation during endoscopic retrograde cholangiopancreatography
Authors: Alka Chhabra , Sharma Karuna , Chaudhary Neelam , Dave Milan , Pandey Neha , Gupta Sunanda 
Published: March 2022

Background:
Deep sedation has evolved as a better choice against general anesthesia in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). This study was aimed to evaluate the efficacy of dexmedetomidine and nalbuphine as an adjuvant to ketofol based deep sedation in ERCP.

Methods:
One hundred patients undergoing ERCP were randomly assigned to receive either IV dexmedetomidine 1 μg/kg (Group D, n = 50) or I. V nalbuphine 0.1 μg/kg (Group N, n = 50), 10 min before ketofol induction. The primary outcome was the total dose of ketofol used for induction and maintenance of deep sedation throughout the procedure. Hemodynamics and respiratory parameters, recovery characteristics, endoscopist's, and anesthetist satisfaction scores were secondary outcomes. P < 0.05 was considered statistically significant.

Results:
The dose of ketofol at the time of induction was significantly high in Group N as compared to Group D (P < 0.05). Supplemental dose of ketofol at the time of insertion of endoscope was equivalent in both the groups (P > 0.05) but significantly more number of patients in Group D (n = 19 vs. n = 11, P < 0.05) received supplement for facial pain score >5 compared to patients in Group N, where more patients received supplement for Ramsay Sedation Score <3 (n = 20 vs. n = 11 P < 0.05). Significant decrease in heart rate (HR) and mean arterial pressure from baseline values was found in Group D as compared to Group N (P < 0.001). Group N patients achieved postanesthesia recovery score >12 earlier than Group D (P < 0.001). Anesthetist satisfaction score was more in Group N (P < 0.05).

Conclusion:
Dexmedetomidine reduces the total consumption of ketofol and provides smooth hemodynamics whereas Nalbuphine provides better analgesia and early recovery with high anesthetist satisfaction for deep sedation in ERCP.
Comparing the intraoperative and postoperative analgesic effect of transabdominal block versus caudal block in children undergoing laparoscopic appendectomy
Authors: Nagappa Saraswathi , Nanjundaswamy Nethra H. , Maralusiddappa Vinay , Nayak Vinayak 
Published: March 2022

Background:
Laparoscopic appendectomy is commonly performed in children. Regional anesthesia in children is complementary to general anesthesia, which allows conscious postoperative analgesia and reducing hospital stay. Caudal anesthesia and transverses abdominis plane (TAP) block is commonly used in children because it is easy to practice and provides effective analgesia during surgery. However, its efficacy in laparoscopic appendectomy is not tested much.

Aim
: The aim of this study is to evaluate the analgesic efficacy of caudal block and TAP block, when used as pre-emptive analgesia using ropivacaine in terms of opioid consumption, postoperative visual analog score (VAS), duration of analgesia, time for rescue analgesia, postoperative nausea, and vomiting and other side effects following elective laparoscopic appendectomy.

Methodology
: The study design was a prospective, double-blinded, comparative randomized trial on children undergoing laparoscopic appendectomy. Sixty patients between 12 and 18 years were included in the study. They were allocated into any one of two groups of 30 patients each, employing computer-generated randomization. Group I: receive ultrasound-guided caudal block using 0.2% ropivacaine 1 mL/kg. Group II: receive ultrasound-guided TAP block using 0.2% ropivacaine 1 mL/kg.

Results
: Total intraoperative consumption of opioid fentanyl in Group I is 14.83 ± 18.78 compared to 25.50 ± 17.88 in Group II, which is statistically significant P = 0.028*. VAS score was significantly lower in Group II compared to Group I, P < 0.001**.

Conclusion
: Caudal block is effective for intraoperative management, whereas TAP block is effective for postoperative management in children undergoing laparoscopic appendectomy.
Analisis Sentimen Review Film Menggunakan TF-IDF dan Support Vector Machine
Authors: Gifari Okta Ihza , Adha Muh. , Freddy Fernandito , Durrand Fernandito Freddy Setlight 
Published: March 2022

Intisari—Dengan kemajuan teknologi saat ini seluruh informasi tentang semua film sudah tersedia di Internet. Jika informasi dikelola dengan baik maka dapat memberikan manfaat berupa informasi yang berguna untuk membantu individu atau organisasi untuk mengambil keputusan. Penelitian ini bertujuan untuk menjelaskan analisis sentimen pada dokumen film. Metode yang digunakan pada penelitian ini adalah TF-IDF (Term Frequency-Inverse Document Frequency) dan SVM (Support Vector Machine) . Metode ini dipilih karena mampu melakukan pembobotan terhadap kata dan mengklasifikasikan data berdimensi tinggi. Dari uji skenario yang dilakukan, diketahui bahwa algoritma TF-IDF dan SVM dapat digunakan untuk kasus review film dengan nilai Accuracy 85%, nilai Precision 100%, nilai Recall 70%, dan nilai F1-Score sebesar 82%.
Biological treatment in resistant adult-onset Still’s disease: A single-center, retrospective cohort study
Authors: Çolak Seda , Tekgöz Emre , Mammadov Maghrur , Çınar Muhammet , Yılmaz Sedat 
Published: March 2022

Objectives: The aim of this study was to assess the demographic and clinical characteristics of patients with adult-onset Still’s disease (AOSD) under biological treatment.
Patients and methods: This retrospective cohort study included a total of 19 AOSD patients (13 males, 6 females; median age: 37 years; range, 28 to 52 years) who received biological drugs due to refractory disease between January 2008 and January 2020. The data of the patients were obtained from the patient files. The response to the treatment was evaluated based on clinical and laboratory assessments at third and sixth follow-up visits.
Results: Interleukin (IL)-1 inhibitor was prescribed for 13 (68.4%) patients and IL-6 inhibitor prescribed for six (31.6%) patients. Seventeen (89.5%) patients experienced clinical remission.
Conclusion: Biological drugs seem to be effective for AOSD patients who are resistant to conventional therapies. Due to the administration methods and the high costs of these drugs, however, tapering the treatment should be considered, after remission is achieved.
Women Entrepreneurship: Issues and Problems in Chandigarh & Panchkula
Authors: Sonika  
Published: March 2022

Background and objective: As we are living in an era of modernization and globalization, everyone wants to increase the growth and economic, social development of the country. Women entrepreneurship had been started in the USA where women had started working by themselves. This paper has revealed the issues that are being faced by the women entrepreneurs in Panchkula & Chandigarh, which are the small cities of India.Materials and Methods: Through this paper the author wants to identify the challenges and issues faced by women entrepreneurs. The self-structured questionnaire had been designed by the authors and circulated these questionnaires to the 50 women in both cities; among them, 30 had given their responses. Data and interpretation have been done in percentage form and has shown in the form of a pie chart. Student t-test had been applied to know the difference between the different problems & different lines of activity.Result and Conclusion: This paper identified various financial, social, infrastructural problems being faced by women entrepreneurs. It has been found that there is no difference between the problems faced by women entrepreneurs who have engaged in a different line of activity. The paper concluded that women could be encouraged for entrepreneurship and problems related to the concerned study could be minimized by taking various measures.
Emprendedores: una figura difusa dentro del sistema financiero nacional
Authors: García Zúñiga Víctor Gabriel 
Published: March 2022

El emprendimiento no es nuevo, ha estado presente a lo largo del tiempo y se caracteriza por su constante búsqueda de innovación y creatividad. Esta investigación se formula bajo la premisa de conocer el nivel de acceso de los emprendedores a la oferta de productos y/o servicios financieros implementados como un alivio económico en el marco de la pandemia por COVID-19. Considerando elementos destacables como las necesidades del emprendedor, las políticas públicas y requisitos definidos por las instituciones financieras, todos como determinantes para la inclusión financiera.
Realidad Empresarial No. 12, 2022: 16-25.
What caused a record high PM10 episode in northern Europe in October 2020?
Authors: Groot Zwaaftink Christine D. , Aas Wenche , Eckhardt Sabine , Evangeliou Nikolaos , Hamer Paul , Johnsrud Mona , Kylling Arve , Platt Stephen M. , Stebel Kerstin , Uggerud Hilde , Yttri Karl Espen 
Published: March 2022

Abstract. In early October 2020, northern Europe experienced an episode with poor air
quality due to high concentrations of particulate matter (PM). At several
sites in Norway, recorded weekly values exceeded historical maximum
PM10 concentrations from the past 4 to 10 years. Daily mean PM10
values at Norwegian sites were up to 97 µg m−3 and had a
median value of 59 µg m−3. We analysed this severe pollution episode caused by long-range atmospheric transport based on surface and
remote sensing observations and transport model simulations to understand
its causes. Samples from three sites in mainland Norway and the Arctic
remote station Zeppelin (Svalbard) showed strong contributions from mineral
dust to PM10 (23 %–36 % as a minimum and 31 %–45 % as a maximum) and biomass burning (8 %–16 % to 19 %–21 %). Atmospheric transport simulations indicate that Central Asia was the main source region for mineral dust
observed in this episode. The biomass burning fraction can be attributed to
forest fires in Ukraine and southern Russia, but we cannot exclude other
sources contributing, like fires elsewhere, because the model underestimates observed concentrations. The combined use of remote sensing, surface
measurements, and transport modelling proved effective in describing the
episode and distinguishing its causes.
The presence of a draining sinus is associated with failure of re-implantation during two-stage exchange arthroplasty
Authors: Gabrielli Alexandra S.​​​​​​​ , Wilson Alan E. , Wawrose Richard A. , Dombrowski Malcolm , O'Malley Michael J. , Klatt Brian A. 
Published: March 2022

Abstract. Background: Reinfection rates after two-stage
exchange arthroplasty for prosthetic joint infection (PJI) have been
reported as high as 33 % in the literature. Understanding risk factors for
treatment failure will help to preoperatively counsel patients on the
likelihood of successful treatment and possibly influence the surgeon's
treatment algorithm. This study aimed to delineate whether the presence of a
draining sinus tract is associated with risk of failure of two-stage
exchange arthroplasty. Methods: We performed a single
institution, multi-center retrospective chart review of outcomes of patients
treated for PJI with two-stage exchange arthroplasty between June 2006 and
May 2016. For patients treated prior to 2011, PJI was defined based on the
preoperative work-up and intraoperative findings as determined by the
attending surgeon. After 2011, PJI was defined using MSIS consensus
criteria. All patients had a minimum of follow-up of 2 years or treatment
failure prior to 2 years. Treatment failure was defined as reinfection or
failure to complete two-stage exchange secondary to persistent infection or
other host factors. Operative reports and clinical notes were reviewed to
assess for presence of a draining sinus tract. Results: 240
patients were treated for PJI with intended two-stage exchange arthroplasty.
The overall rate of treatment failure was 29.6 % (71/240), while the
overall rate of reinfection was 13.3 % (32/240). A total of 39 patients did not
complete second stage revision; final treatment for these patients was
amputation, fusion, or chronic antibiotic suppression. A total of 52 of 240 patients
(21.7 %) had a draining sinus tract at presentation. Patients with a sinus
tract were significantly less likely to be replanted compared to those without a
sinus tract at presentation (13.3 % vs. 26.9 %, p=0.02). However, when
accounting for all mechanisms of treatment failure, including reinfection
following replantation, there was no statistically significant difference
detected between the sinus and no-sinus groups (27.7 % vs. 36.5 %, p=0.22). Discussion: A draining sinus tract represents a chronic,
deep infectious process with ultimate compromise of overlying soft tissues.
Thus we hypothesized it would be associated with failure in a two-stage
exchange arthroplasty. These data demonstrate that patients with a draining
sinus are significantly less likely to undergo re-implantation. This
provides evidence to the paucity of data surrounding draining sinuses and
two-stage PJI treatment.
The Cambodian Mekong floodplain under future development plans and climate change
Authors: Horton Alexander J. , Triet Nguyen V. K. , Hoang Long P. , Heng Sokchhay , Hok Panha , Chung Sarit , Koponen Jorma , Kummu Matti 
Published: March 2022

Abstract. Water infrastructure development is considered necessary to drive economic
growth in the Mekong region of mainland Southeast Asia. Yet the current
understanding of hydrological and flood pattern changes associated with
infrastructural development still contains several knowledge gaps, such as
the interactions between multiple drivers, which may have serious
implications for water management, agricultural production, and ecosystem
services. This research attempts to conduct a cumulative assessment
of basin-wide hydropower dam construction and irrigation expansion, as well
as climate change, implications on discharge, and flood changes in the
Cambodian Mekong floodplain. These floodplains offer important
livelihoods for a considerable part of the 6.4 million people living on
them, as they are among the most productive ecosystems in the world –
driven by the annual flood pulse. To assess the potential future impacts, we
used an innovative combination of three models: Mekong basin-wide
distributed hydrological model IWRM-VMod, with the Mekong delta 1D flood
propagation model MIKE-11 and 2D flood duration and extent model IWRM-Sub
enabling detail floodplain modelling. We then ran scenarios to approximate
possible conditions expected by around 2050. Our results show that the
monthly and seasonal hydrological regimes (discharges, water levels, and
flood dynamics) will be subject to substantial alterations under future
development scenarios. Projected climate change impacts are expected to
decrease dry season flows and increase wet season flows, which is in
opposition to the expected alterations under development scenarios that
consider both hydropower and irrigation. The likely impact of decreasing
water discharge in the early wet season (up to −30 %) will pose a
critical challenge to rice production, whereas the likely increase in water
discharge in the mid-dry season (up to +140 %) indicates improved water
availability for coping with drought stresses and sustaining environmental
flows. At the same time, these changes would have drastic impacts on total
flood extent, which is projected to decline by around 20 %, having
potentially negative impacts on floodplain productivity and aquaculture,
whilst reducing the flood risk to more densely populated areas. Our findings
demonstrate the substantial changes that planned infrastructural development
will have on the area, potentially impacting important ecosystems and
people's livelihoods, calling for actions to mitigate these changes as well
as planning potential adaptation strategies.
Pemahaman Guru Pendidikan Agama Katolik (PAK) terhadap Ajaran Moral pada Jenjang SMA di Pontianak
Authors: Hariyanto Gustaf , Muhrotien Andreas , Andreas Acin Mayong 
Published: March 2022

antara pendidikan dengan ajaran moral, dan pendidikan dengan agama di lain pihak. Orang-orang pada beberapa dekade sebelumnya berkeyakinan bahwa inti dari seluruh pendidikan terletak pada kekuatan moral dan agama. Moralitas sangat terkait dengan perilaku manusia yang ditinjau dari sisi normatif. Misalnya, apa yang harus dilakukan ternyata berbeda dengan apa yang senyatanya dilakukan. Selain dengan diri kita sendiri, moralitas juga terkait dengan tindakan yang memengaruhi kepentingan dan kebahagiaan orang lain. Namun, klaim-klaim moral tersebut harus disikapi dan diterima secara kritis. Artinya, harus ada pengertian mendasar dan kritis mengapa seseorang harus bertindak seturut ketentuan tertentu. Dalam hal ini diperlukan pemahaman mengenai konsep moralitas. Penelitian ini bertujuan untuk mengetahui pemahaman guru agama Katolik jenjang Sekolah Menengah Atas mengenai relasi antara ajaran moral dan agama. Aspek yang ingin diketahui mencakup bagaimana pemahaman mendasar dan kritis para guru agama berupa orientasi fundamental dalam memertanggungjawabkan pandangan-pandangan moral secara rasional. Metode yang digunakan dalam penelitian ini adalah kualitatif. Selain wawancara dan angket, dalam penelitian ini juga digunakan teknik Focus Group Discussion. Hasil yang diperoleh dalam penelitian ini menunjukkan bahwa pemahaman guru mengenai ajaran moral dan agama bersifat dinamis, utuh dan holistik. Temuan penelitian memerlihatkan bahwa sebagian besar guru agama Katolik berpandangan bahwa ajaran moral sudah jelas dengan sendirinya, dan antara ajaran moral dan agama pada dasarnya sama, baik dari sisi materi maupun bentuk.
Implementasi Kebijakan Pembendaharaan Keuangan Daerah terhadap Manajemen Pengelolaan Keuangan SKPD dalam Mewujudkan Efektivitas Pengeluaran Anggaran SKPD Kabupaten Garut
Authors: Susanti  
Published: March 2022

Tujuan Penelitian ini adalah untuk menganalisa pengaruh Implementasi Kebijakaan Pembendaharaan Keuangan Daerah terhadap Manajemen Pengelolaan Keuangan SKPD dalam mewujudkan efektifitas pengeluaran anggaran SKPD Kabupaten Garut. Penelitian ini terdiri dari tiga variabel yaitu Implementasi Kebijakaan Pembendaharaan Keuangan Daerah (X), Manajemen Pengelolaan Keuangan SKPD (Y) dan efektifitas pengeluaran anggaran SKPD Kabupaten Garut (Z). Metode penelitian yang digunakan adalah survei deskriptif analisis, hasil analisis bahwa Implementasi Kebijakan Pembendaharaan Keuangan Daerah menunjukan pada kriteria cukup baik, Pengelolaan Keuangan SKPD dikategorikan baikdan Efektifitas pengeluaran anggaran SKPD Kabupaten Garut menunjukan pada kriteria baik. Hasil dari pengujian hipotesis penelitian ini dapat disimpulkan bahwa Implementasi Kebijakan Pembendaharaan Keuangan Daerah secara simultan berpengaruh secara signifikan terhadap Pengelolaan Keuangan SKPD dan Efektifitas pengeluaran anggaran SKPD Kabupaten Garut.
Subungual Exostosis of the Hand: A Case Report in a 5-Year-Old Boy and Literature Review
Authors: Womack Meagan E. , Fisher Olivia J. , Landrum Matthew R. , Rose Ryan A. 
Published: March 2022

Subungual exostosis is a relatively uncommon benign tumor that occurs at the distal end of the distal phalanx of the toes and rarely the hands. We present in this article a review of the currently published English literature and provide a case report of a 5 year old male with subungual exostosis of the thumb.
A 5 year old male presented with a slow growing mass of the distal dorsal aspect of the left thumb. Radiographs showed dorsal calcifications on the thumb. Surgical removal of the mass and histopathological analysis was performed supporting a diagnosis of subungual exostosis. Post-operatively, the patient had complete excision of the mass, normal nail morphology, no reoccurrence, and no post-surgical complications.
Subungual exostosis remains a rare entity especially in the upper extremity. Its cause is not fully understood, nor is there an agreed upon method of treatment. However, with careful dissection during surgical removal good outcomes can be obtained. To our knowledge, this is the largest literature review on subungual exostosis and our case report is an uncommon presentation in the youngest reported male patient. It is our hope that this literature review and case report lend to increased awareness of subungual exostosis and how to diagnose and treat this lesion.
Kepercayaan Publik, Kualitas Pelayanan Fiskus Dan Sanksi Perpajakan Terhadap Kepatuhan Wajib Pajak Orang Pribadi (Studi Kasus Wajib Pajak Orang Pribadi Di Daerah Bantul)
Authors: Paot Novi Bergita 
Published: March 2022

Tujuan: Untuk membuktikan pengaruh Kepercayaan Masyarakat, Kualitas Pelayanan Fiskal dan Sanksi Perpajakan terhadap Kepatuhan Wajib Pajak Orang Pribadi (Studi Kasus Wajib Pajak Orang Pribadi di Wilayah Bantul).
Metode: Sampel penelitian ini adalah Wajib Pajak Orang Pribadi yang terdaftar di KPP Pratama Bantul. Sampel dipilih dengan metode purposive sampling. Jumlah sampel sebanyak 180 responden dengan teknik pengambilan sampel dengan metode cluster random sampling.
Temuan: Temuan penelitian ini menunjukkan bahwa kepercayaan masyarakat berpengaruh positif terhadap kepatuhan wajib pajak. Kualitas pelayanan perpajakan berpengaruh positif terhadap kepatuhan wajib pajak orang pribadi dan sanksi perpajakan berpengaruh positif terhadap kepatuhan wajib pajak orang pribadi.
Kebaruan: Kebaruan dalam penelitian ini adalah kepercayaan masyarakat menjadi penentu peningkatan kepatuhan wajib pajak dalam melaksanakan kewajiban membayar dan melaporkan pajak. Penelitian ini dilakukan untuk memperkuat hasil penelitian sebelumnya dan teori-teori yang ada.
Determinantes da Gestão do Portfólio de Projetos (PPM) para a agilidade organizacional: proposta de um modelo conceitual
Authors: Moura Myrian Teixeira , Carvalho Rodrigo Baroni , Carvalho Larieira Cláudio Luís , Martens Cristina Dai Prá , Garcia Lopes Humberto Elias , Brandão Bernardes Maria Elisa 
Published: March 2022

A resposta da organização às mudanças em seu ambiente é concretizada, frequentemente, pela decomposição das estratégias em um portfólio de projetos. O gerenciamento do portfólio de projetos (Project Portfolio Management) afeta a velocidade e flexibilidade da execução dos projetos e, por extensão, da execução estratégica. A necessidade de gerar resultados em ciclos cada vez mais curtos realça a finalidade e pressiona a contribuição da gestão do portfólio para a agilidade nas dinâmicas organizacionais. No entanto, a literatura não detalha claramente como esta gestão integra as diferentes percepções e relações desencadeadas pelo trabalho estratégico e as incorpora em seus processos, amplificando ou restringindo a agilidade. Este estudo tem por objetivo efetuar uma revisão integrativa para em seguida propor um modelo conceitual que associa determinantes da estruturação e condução do portfólio de projetos para a agilidade organizacional. A modelagem considerou quatro perspectivas teóricas sobre o portfólio de projetos: otimização, estratégica, tomada de decisão e organizacional. Palavras-chave e categorias teóricas foram organizadas numa modelagem em dois níveis, integrando múltiplos determinantes cuja aplicabilidade foi corroborada por pares. O modelo evidencia os seguintes determinantes que impactam a agilidade na resposta organizacional: clareza estratégica, qualidade da decisão, intensidade do controle e complexidade integrativa. Embora o modelo ainda demande validação empírica, combinando determinantes para agilidade em diferentes perpectivas PPM, em nível da definição e da execução, o modelo proposto pode tornar mais prática e robusta a gestão dos portfólios, oferecendo referências para uma configuração orientada às prioridades de valor da organização.