bluuebunny/crossref_metadata_2025_split huggingface dataset:
Temporary standalone percutaneous fixation with pedicle screws for the treatment of subacute tuberculous osteomyelitis with kyphotic deformity in the lumbar spine
Authors: Porwal Mokshal H. , Anderson Danyon J. , Hussain Omar , Laing Brandon Robert Winston , Soliman Hesham 
Published: June 2022

Background:
Tuberculous (TB) osteomyelitis is a rare, but challenging infection, that mandates antituberculosis antibiotics, and potentially surgical intervention. Per the Gulhane Askeri Tip Akademisi (GATA) classification system, corrective reconstruction is indicated in severe cases, where the kyphotic deformity is >20° (GATA Class III). Here, we describe a case of BCG vaccine-induced lumbar TB osteomyelitis at the L1-2 level in a patient presenting with mechanical pain and a focal, nonfixed kyphotic deformity of 36.1°. Surgery consisted of percutaneous fixation with pedicle screws without debridement, fusion arthrodesis, or anterior reconstruction.

Case Description:
A 77-year-old male presented with L1-2 TB osteomyelitis secondary to intravesical BCG application. A 36.1° focal nonfixed kyphotic deformity was evident on standing X-rays that reduced in the supine position. He underwent posterior percutaneous screw fixation with rods extending from the T12 to L3 levels, with resolution of his mechanical pain. Nine months later, the CT demonstrated reconstitution of the vertebral bodies (i.e., volume increase of 6.99 cm3 (21%) and 7.49 cm3 (27%) at L1 and L2, respectively). Standing X-rays after hardware removal demonstrated 32.7° of lumbar lordosis and a reduction of focal kyphosis to 12.9°.

Conclusion:
Here, we present an exceedingly rare case of BCG vaccine-induced L1-2 spinal tuberculosis with extensive vertebral body destruction and deformity. This was effectively treated with standalone temporary pedicle fixation instead of corpectomy and reconstruction.
Surface Characterization of PEKK Modified by stron-tium–hydroxyapatite coating as implant material Via the magnetron sputtering Deposition technique
Authors: Jani Ghasak H , Fatalla Abdalbseet A 
Published: June 2022

Background: The best material for dental implants is polyetherketoneketone (PEKK). However, this substance is neither osteoinductive nor osteoconductive, preventing direct bone apposition. Modifying the PEKK with bioactive elements like strontium hydroxyapatite is one method to overcome this (Sr-HA). Due to the technique's capacity to provide better control over the coating's properties, RF magnetron sputtering has been found to be a particularly useful technique for deposition.
Materials and methods : With specific sputtering conditions, the RF magnetron technique was employed to provide a homogeneous and thin coating on Polyetherketoneketone substrates.. the coatings were characterized by Contact angle, adhesion test, X-ray diffraction (XRD), atomic force microscope and Elemental Analysis with Energy Dispersive X-Ray (EDX)
Results : indicated that strontium hydroxyapatite had successfully deposited onto the surface with significant improvement in the wettability value to provide a suitable environment for cell attachment, spreading, proliferation, and differentiation
Conclusion: Coating PEKK with RF magnetron sputtering can provide homogeneous surfaces laying the groundwork for improving PEKK's potential bioactivity, such as surface wettability. Wetting qualities are critical in implantable materials and are used to predict future osseointegration success.
Pengembangan PENGEMBANGAN MEDIA BUKU PINTAR UNTUK KEMAMPUAN SOSIAL EMOSIONAL DENGAN KEGIATAN BERCERITA DI KELOMPOK A TKM NU 295 ROUDLOTUN NAFILAH GRIYA PEGANDEN ASRI
Authors: Musayyachah Musayyachah 
Published: June 2022

Penelitian ini bertujuan untuk mengembangkan dan mengetahui tingkat kelayakan media pembelajaran berupa Buku Pintar untuk perkembangan keterampilan sosial emosional anak Kelompok A. Penelitian ini merupakan Penelitian dan Pengembangan (Research and Development) 6 tahapanm, yaitu : 1) mengobservasi potensi dan masalah, 2) pengumpulan data, 3) desain produk, 4) validasi desain, 5) revisi produk, dan 6) ujicoba produk. Penelitian ini menggunakan angket untuk mengevaluasi kualitas media pembelajaran, respon anak, orangtua, guru dan kepala sekolah.validasi media pembelajaran dilakukan oleh dosen Jurusan PIAUD Universitas Muhammadiyah Gresik, dan diujicobakan pada anak Kelompok A di TKM NU 295 Roudlotun Nafilah Griya Peganden Asri. Hasil penelitian ini adalah produk media pembelajaran Buku Pintar untuk perkembangan sosial emosional anak kelompok A. Penilaian aspek kelayakan media pembelajaran memperoleh presentase sebesar 68,18% dengan kategori “Baik” sehingga layak di ujicobakan dan untuk respon anak peneliti mendapatkan skor 58 dan kelayakan produk sebesar 80,55% dengan kesimpulan hasil produk termasuk dalam kategori “Sangat Baik” atau media “buku pintar” layak digunakan sebagai media perkembangan sosial emosional anak di sekolah.
Kata kunci : media pembelajaran, buku pintar, bercerita, sosial emosional, Metode Research and Development
Features of operation of ship electrical power systems with electrical propulsion systems
Authors: Savenko A. E. , Savenko P. S. 
Published: June 2022

THE PURPOSE. Consider the issue of the presence of distortions in the form of sinusoidal voltage and current in autonomous electrical power systems with electrical propulsion systems, built on the principle of the unified electric power system. Compare the results of the study of voltage distortion for electrical power systems with electrical propulsion systems of various structures and give recommendations for their application.METHODS. For research, unified electric power systems with DC electrical propulsion systems on the Yeysk ferry and alternating current on the asymmetric icebreaker Baltika are considered. The possibilities of programming with frequency control of modern drives of rudder propellers with AC motors are analyzed.RESULTS. Oscillograms of voltages and currents of generators were obtained using thyristor converters and inverters to control electrical propulsion systems in various modes. Significant ripples and distortions of the sinusoidal voltage and generator currents were noted when thyristor converters are used to power DC propulsion electric motors. Also, small deviations from the sinusoidal form of the ship's network voltage were recorded when inverters were used to control AC propulsion motors as part of rudder propellers.CONCLUSION. The issue of ensuring the quality of electricity produced in autonomous electrical power systems of sea vessels is of great relevance and importance. To ensure the best results, it is advisable to use azimuthing podded drive with AC electric motors, the rotation speed of which is implemented by inverter frequency converters with a DC link.
Dexmedetomidine as an adjunct to bupivacaine and xylocaine with adrenaline in ultrasound guided supraclavicular brachial plexus block in upper limb surgeries
Authors: Shrestha Alisha , Shrestha Abhisesh , Shrestha Anil , Piya Roshan , Pradhan Manisha , Amatya Shirish Prasad , Hirachan Niroj , Ghimire Binam 
Published: June 2022

Introduction: Supraclavicular brachial plexus block is widely used for perioperative anesthesia and analgesia. Dexmedetomidine is highly selective alpha-2 receptor agonist which provides analgesia, sedation and anxiolysis. Our study aims to evaluate the effect of addtion of dexmedetomidine with bupivacaine and xylocaine with adrenaline in supraclavicular block in upper limb surgeries.
Method: This was a comparative study conducted at Patan Hospital, Patan Academy of Health Sciences, Nepal among 44 patients randomly assigned in Group-I (N=22, bupivacaine and xylocaine with adrenaline 28 ml + dexmedetomidine 2 ml (1 mcg/kg), and Group-II (N=22, without dexmedetomidine) for ultrasound-guided supraclavicular block for upper limb surgeries. The study was approved by institutional review committee. Onset of sensory and motor block, duration of analgesia, demographics, hemodynamic parameters, and side effects of drug were compared. Pin-prick test and modified Bromage scale were used to evaluate sensory and motor block. Visual analogue scale was used for severity of pain. Statistical analysis was performed with SPSS v.16.
Result: The median time for onsets of sensory and motor block were significantly shorter in group I (1 m and 3 m) than group II (5 m and 10 m). The duration of analgesia was s longer in group I (720 m) than group II (360 m). Two patients had bradycardia and one hypertension in dexmedetomidine group whch were managed successfully.
Conclusion: Dexmedetomidine added to local anesthetics significantly prolongs the effect of supraclavicular block in upper limb surgeries.
CT KUB evaluation of suspected urolithiasis
Authors: Jaiswal Pooja , Shrestha Shreejana , Dwa Yogita , Maharjan Dinesh , Sherpa Ngawang Temba 
Published: June 2022

Introduction: Non-contrasted computed tomography scan for kidney, ureter, and bladder (CT KUB) for diagnosis of urolithiasis is important for accurate diagnosis, followup, and management. Unlike USG, CT KUB has more diagnostic yield in urolithiasis and other incidental findings. This study aims to evaluate the use of the CT KUB in suspected urolithiasis, presented with severe flank pain.
Method: A retrospective observational study was carried out in the Department of Radiology and Imaging, Patan Hospital, Nepal.TheCT KUB reports of patients with suspected urolithiasis from a period of 3 years from Jan 2017 to Jan 2020 were analyzed for evidence of urolithiasis and secondary signs of obstruction as ‘diagnostic’ of CT KUB. Other incidental radiological findings were further analysed and categorized into urinary and extra-urinary. Ethical approval was obtained.Association of USG and CT KUBwas analysed using Chi-square test,with p value<0.05considered statistically significant.
Result: Total of 414 CT KUB reports were analysed, 230(55.6%) males, 314 patients had USG before CT KUB. Considering CT KUB as a gold standard for diagnois of urolithiasis, the accuracy of ultrasound was found to be 85.03% and sensitivity is 94.09% and specificity of 27.9%.
Conclusion: Majority of the patients included in the study had ultrasound done before CT KUB. The sensitivity of ultrasound was significant considering CT KUB as a gold standard in diagnosis of urolithaisis.
Spectrum of Chest Computed Tomography (CT) Findings of COVID-19 Pneumonia Patients in B & C Hospital, Birtamode, Jhapa, Nepal
Authors: Shrestha Manmohan Bir , Sharma Umesh Kumar , Thapaliya Suraj , Pokhrel Abishek , Shrestha Shreya , Nepal Prajwal , Rai Ujwal 
Published: June 2022

Background: Coronavirus disease outbreak, first reported in Wuhan, China in December, 2019 is a WHO declared pandemic. Chest tomography (CT) findings can supplement in the diagnosis of COVID-19 pneumonia.
Methods: This was a retrospective descriptive study in 40 patients with reverse transcriptase polymerase chain reaction (RT-PCR) positive patients with respiratory symptoms who underwent Computed tomography (CT) chest. This retrospective study was conducted at B & C Medical College Teaching Hospital, Birtamode, Jhapa, Nepal.
Results: Total 40 patients, more than 3 lobes of lung involved in all 40 patients (100 %). Only ground-glass opacities seen in 11 patients, only consolidative opacities seen in 5 patients, both ground-glass and consolidation seen in 23 patients, and 1 patient had neither of them. Subpleural linear density was present in 16 patients (40%). Pleural effusion was present in 8 patients and crazy paving pattern in 9 patients. Total lung severity score range from 3 to 19 with a mean score of 9.8.
Conclusions: Characteristic chest Computed tomography (CT) findings were observed in Corona virus disease 2019 infection, which are helpful to the radiologists, clinical physicians and other public health officials in the early detection and diagnosis of this global health emergency.
Assessing the Level of Knowledge and Practice regarding Blood transfusion and Its Complications among Staff Nurses working at B & C Teaching Hospital and Purbanchal Cancer Hospital, Birtamode, Jhapa, Nepal
Authors: Dahal Sushmita , Khanal Smita 
Published: June 2022

Background: Blood transfusion is a liquid transplant. Nurses are having more responsibility in many aspects of the transfusion process such as taking and labeling blood samples, collection of blood from the blood bank, short term storage in ward areas, checking, administering, documenting transfusion process and monitoring of the patient, it is vital that they are through and methodical in all task related to transfusion to ensure patients safety and must be aware of the steps necessary at each stage to safe guard the patient. Nurses are responsible not only for the actual administration of the blood product and monitoring of the patient during its administration but they also need to efficiently identify and manage any potential transfusion reactions. It is important to remember that transfusion reactions can occur during the actual blood transfusion as well as for days and weeks following the administration of the blood product. Although blood transfusion reactions are rare, it is important that any nurse who administers a blood product be aware of potential reactions and knows how to manage these reactions safely and effectively.
Methods: This is a descriptive study to assess the knowledge and practice regarding blood transfusion and its complications.
Results: Forty-four percent (44%) of the nurses had obtained Proficiency Certificate Level (PCL) Nursing and Health Assistant (HA) degree qualification. Forty percent (40%) of the nurses had one year of experience. Forty percent of the nurses worked in general ward at the hospital. Almost 80% of the nurses (79%) of the nurses stated that they attended Continuing Nursing Education regarding blood transfusion. 59% of total respondents have adequate knowledge.
Conclusions: Continuous Nursing Education for the improvement of nurses’ knowledge and skills as well as routine monitoring should be carried out to ensure safe practice in blood transfusion.
Comparison of Logistic Euroscore with Euroscore II in predicting postoperative mortality in adult cardiac surgical patients
Authors: Parajuli Santosh Sharma , Rajbhandari Nivesh , Thakur Apurb 
Published: June 2022

Background: Logistic Euroscore and Euroscore II are widely used in predicting perioperative mortality after cardiac surgery; however the data regarding the superiority of one over the other in predicting outcome regarding 30 days mortality in isolated coronary artery surgeries are not consistent. This study assessed the predictive accuracy of logistic Euroscore versus Euroscore II in determining 30 days mortality after isolated CABG surgery in a single cardiac center of Nepal.
Methods: One hundred and forty-two patients scheduled for isolated coronary artery bypass surgery during the one-year period was taken for this prospective observational study. The predictive post-operative mortality was calculated using both of the scoring system. The actual mortality observed during the 30 day of postoperative period was recorded and the findings were compared with the predictive post-operative mortality according to the scoring systems by using area under the receiver operating characteristics curve (AUC).
Results: One hundred and forty-two patients were enrolled in this study and average cross clamp time was 65.92 +/- 26.39 minutes and total cardiopulmonary bypass time was 102.90 +/- 37.32 minutes. The average hours of ventilator stay was 9.56 +/- 8.45 and total days of ICU stay was 4.96 +/- 2.00. The observed 30 day mortality was 2.11% (95% CI, 1.96-2.36%) which was slightly better predicted by ESL 2.40% (95% CI, 2.04-2.76%) in comparison to ES II 1.44% (95% CI, 1.22-1.66%). The AUC value was 0.917 (0.817-1.000) for ESL and 0.946 (0.887-1.000) for ES II in predicting 30 day postoperative mortality and were comparable.
Conclusion: Both of the logistic Euroscore and Euroscore II are comparable to each other in predicting 30 day postoperative mortality after isolated CABG surgery.
Repair of Ruptured Sinus of Valsalva Aneurysm: 15 years of Single Center experience
Authors: Joshi Dikshya , Aryal Marisha , Gurung Minani , Timala Rabindra B. 
Published: June 2022

Background and Aims: Ruptured sinus of Valsalva aneurysm is an uncommon cardiac anomaly, fatal if not treated in time. This study was designed to retrospectively analyze our 15‐year experience of the surgical repair for ruptured sinus of Valsalva aneurysm and to study the optimal surgical strategy, morbidity, mortality, and long-term surgical outcome.
Methods: This study was conducted on 48 (36 Male, and 12 Female) patients of ruptured sinus of Valsalva aneurysm, operated at department of cardiac surgery, Shahid Gangalal National Heart Centre, Nepal, from January 2006 to December 2020 and followed up till March 2021. Follow‐up data were obtained from the outpatient department records and telephone calls.
Results: Mean age was 30.17±11.5 (12-63) years. Rupture of the right coronary sinus into the right atrium was the most common anatomic type (52%). Preoperative aortic regurgitation equal to or greater than grade II were seen in 9 patients (19%) and ventricular septal defects in 6 cases (13%). Two patients had preoperative renal failure. One patient had associated aortic root dilatation and underwent modified Bentall’s procedure. Ruptured sinus of Valsalva aneurysm was repaired from single chamber approach in 9 patients, and dual chamber approach in 39. There was a single mortality (2.08%), two patients required permanent pacemaker placement for complete heart block, and two had wound infection. Follow‐up data were available for 36 patients (75%). With the mean follow up of 7.07±3.93 (range, 0.83-15) years, there was no recurrence present. All survivors were in New York Heart Association functional Class I or II. There was one late death, due to non-cardiac cause.
Conclusion: Ruptured sinus of Valsalva aneurysm is rare, yet prompt diagnosis and optimal surgical management is crucial in reducing the deleterious effects. Surgical repair of ruptured sinus of Valsalva carries an acceptable low operative risk and can be performed with laudable long-term outcome, with low incidence of recurrence.
SELF-STARTING OF SYNCHRONOUS MOTORS WITH COMPENSATION INERTION OF THE EXCITATION CONTOUR
Authors: Nizimov V. , Tonkonog I. , Cherstvyakov M. 
Published: June 2022

The actual scientific problem is solved in the work, which consists in the development, theoretical and experimental researches of devices for self - starting of synchronous motors with compensation of inertia of excitation circuit. The aim of the work is to increase the reliability of the self-starting mode of synchronous motors of responsible mechanisms to maintain the continuity of complex technological processes. In the event of natural disasters and natural disasters, power outages can cause long-term disruptions of technological processes, large material losses, and in some cases fires and explosions, which can lead to human casualties and significant economic damage.
Under these conditions, the mode of restarting synchronous motors must be used to power the responsible electric drives of mechanisms, such as mine fans, water pumping stations.
To limit the dynamic loads, it is necessary to have the smallest possible value of e.r.s. stator SD in order to limit the switching current, which can be achieved by using various methods and means of extinguishing the field, increasing the time of introduction of automatic re-inclusion or automatic inclusion of the reserve. The calculated dependences of the self-starting modes of SD when extinguishing the magnetic field due to the inclusion of capacitive energy storage devices are obtained. The developed device for self-starting of SD with a capacity of 1000 kW of the drive unit of the pump unit with ENE was implemented at the pumping station of the Dnieper Metallurgical Plant. The efficiency of the developed device does not depend on the presence of voltage that supplies the excitation system in the self-starting mode. The use of ENE in the excitation circuit provides compensation for the inertia of the OZ and increase the input coin and intensive quenching of the magnetic field. The developed devices provide reliable self-starting of synchronous electric drives of mechanisms with continuous technological processes regardless of the presence of voltage in the power supply system of the exciter.
INTEGRASI METODE IPA DAN KANO MODEL DALAM MENGANALISIS KUALITAS LAYANAN TOKO ROTI DI UNIT SUNTER
Authors: Rembulan Glisina Dwinoor , Septorino Giovandri , Nurprihatin Filscha 
Published: June 2022

Perusahan XYZ yang bergerak di bidang makanan khususnya roti, ingin terus mempertahankan kualitas produk dan pelayanan yang baik untuk memenuhi kepuasan konsumen dengan memberikan perbaikan berkelanjutan. Dalam upaya perbaikan berkelanjutan, perusahaan harus mengetahui faktor yang menjadi perhatian utama bagi para konsumen dengan melakukan observasi terhadap pelayanan yang diberikan perusahaan. Penelitian ini dilakukan dengan menggunakan metode Importance Performance Analysis (IPA) dan Kano Model, kemudian kedua metode tersebut diintegrasikan untuk mengetahui urutan perbaikan setiap atribut yang harus diprioritaskan oleh perusahaan. Penelitian ini menunjukkan bahwa terdapat 4 atribut yang perlu diperbaiki berdasarkan metode IPA karena berada pada kuadran pertama, 11 atribut berada dalam kategori one-dimensional dan 6 atribut berada dalam kategori must-be berdasarkan metode Kano Model, dan 8 atribut yang perlu dilakukan perbaikan berdasarkan dengan integrasi metode IPA dan Kano Model.Kata Kunci: IPA, Kano Model, integrasi IPA dan Kano Model
ANALISIS UMKM SARI RASA DALAM MENGOPTIMALKAN PENUGASAN PRODUKSI ROTI DENGAN MENGGUNAKAN METODE HUNGARIAN
Authors: Asrobiah Tis , Wulandari Mellani Dwi 
Published: June 2022

Usaha Mikro Kecil Menengah (UMKM) merupakan suatu kegiatan usaha yang dimiliki oleh perseorangan maupun kelompok yang memenuhi kriteria usaha. Salah satunya adalah usaha dalam bidang makanan yang banyak sekali penggemarnya dikalangan masyarakat. UMKM Sari Rasa merupakan suatu UMKM yang berproduksi berbagai macam jenis roti yang berada di desa Cilamaya, Karawang, terdapat 6 jenis roti yang diproduksi oleh UMKM ini yaitu donat, pizza mini, roti isi, risoles, pudding roti, dan kue sus. Dalam hal ini, permasalahan yang dialami pada UMKM ini adalah kurang mengoptimalkan pembagian penugasan kerja produksi roti kepada pekerja. Tujuan penelitian ini yaitu untuk memudahkan pemilik UMKM dalam membagi penugasan kerja dalam memproduksi roti. Metode yang digunakan dalam penelitian ini adalah metode Hungarian. Dalam penelitian ini data yang telah diperoleh akan dihitung kembali dengan menggunakan software QM for windows untuk mengetahui apakah hasil perhitungan manual sama dengan hasil perhitungan software QM for windows. Kesimpulan yang didapat pada penelitian ini adalah nilai optimal bernilai 385 untuk keuntungan produksi yang dibuat oleh 6 orang karyawan dengan 6 jenis produk roti.Kata Kunci: UMKM, Penugasan, Metode Hungarian.