Kendall College

High cervical spinal cord injuries (SCIs) can lead to diaphragmatic paralysis, necessitating long-term mechanical ventilation. Diaphragmatic pacemakers (DPs) offer an alternative by stimulating the phrenic nerve to restore diaphragmatic function, thereby improving quality of life and reducing ventilator dependence. However, anesthetic management for DP placement presents unique challenges due to the need to preserve diaphragmatic activity and manage autonomic instability. This case reports a 35-year-old male with complete C4 SCI resulting in quadriplegia and respiratory failure requiring mechanical ventilation. After multiple interventions, including spinal fusion and tracheostomy, he underwent DP placement to reduce ventilator dependency. The patient was successfully transitioned to DP postoperatively and discharged from the hospital on room air via a tracheostomy collar. DP is a valuable intervention for high cervical SCI patients but requires anesthetic strategies that preserve diaphragmatic function and manage common complications such as pneumothorax, autonomic dysreflexia, and ventilator challenges with abdominal insufflation. Avoiding muscle relaxants, continuous diaphragmatic monitoring, and proactive hemodynamic management are essential. The literature highlights rare but serious device-related complications, emphasizing the importance of vigilant intraoperative monitoring and interdisciplinary planning. As DP becomes more accessible, particularly in community hospitals, anesthesiologists must be prepared to navigate its perioperative challenges. This case underscores the importance of tailored anesthetic approaches to support safe and effective DP implantation.

Background: Obesity represents a major global health concern, significantly affecting individuals' quality of life. Transforming self-care practices among individuals with obesity necessitates innovative strategies to overcome challenges related to weight management and lifestyle modifications. Aims: This research seeks to assess the effectiveness of audiovisual media as an intervention for enhancing self-care, improving quality of life, and reducing body mass index (BMI) among individuals with obesity. Methods: This research employs a mixed-method approach with a quasi-experimental design to quantitatively examine changes in self-care behavior and a qualitative phenomenological approach to explore participants' experiences. The study sample consisted of 100 people (intervention group: 50, control: 50) for quantitative analysis, as well as 10 people from the intervention group for in-depth interviews. The intervention group engaged with interactive audiovisual media focused on diet management, physical activity, and psychosocial support over an 8-week period, while the control group received only written educational materials. Pre- and post-intervention measurements were conducted using the Self-Care Obesity Scale questionnaire, standard BMI measurement tools, and a qualitative interview guide. Quantitative data were analyzed using paired t-tests and independent t-tests, while qualitative data were processed through thematic analysis. Results: The findings revealed that the intervention group demonstrated a significant reduction in BMI compared to the control group (p<0.001), along with a substantial increase in self-care scores (p<0.001) and notable improvements in quality of life (p<0.001). Qualitative insights highlighted that audiovisual media facilitated better comprehension of information and boosted motivation among participants, although some struggled with maintaining consistency. Additionally, the use of this media was reported to positively influence both physical and mental well-being. Conclusion: This study concludes that audiovisual media represents an innovative and effective method for enhancing self-care, reducing BMI, and improving the quality of life among individuals with obesity. This approach holds significant potential for incorporation into future health promotion initiatives. The integration of audiovisual tools into health promotion programs is recommended for broader application in community and clinical settings.

High-stakes domains are exploring the transformative potential of Large Language Models (LLMs) for complex decision-making tasks. However, LLM deployment in real-world settings presents challenges in data security, evaluation of its capabilities outside controlled environments, and accountability attribution in the event of adversarial decisions. This paper proposes a framework for responsible deployment of LLM-based decision-support systems through active human involvement. It integrates interactive collaboration between human experts and developers through multiple iterations at the pre-deployment stage to assess the uncertain samples and judge the stability of the explanation provided by post-hoc XAI techniques. Local LLM deployment within organizations and decentralized technologies, such as Blockchain and IPFS, are proposed to create immutable records of LLM activities for automated auditing to enhance security and trace back accountability. It was tested on Bert-largeuncased, Mistral, and LLaMA 2 & 3 models to assess the capability to support responsible financial decisions on business lending.

Penelitian ini membahas terkait penanaman nilai-nilai aswaja an-Nahdliyin di era modern guna melestarikan dan memfilter akan gejolak aliran lain. Sebagaimana Maraknya aliran dan ajaran Islam dengan berbagai perbedaan, acapkali menimbulkan perbandingan bahkan perdebatan untuk berlomba-lomba untuk melegitimasi bahwa aliran yang dijalani merupakan ajaran yang sesuai dan merupakan ajaran Nabi Muhammad, sahabat maupun tabi’in. permasalahan yang akan di jawab pada penelitian ini adalah bagaimana praktek dan nilai-nilai aswaja an-Nahdliyin di era modern dan bagaimana cara memfilter masyarakat modern terhadap gejolak aliran lain dengan menggunakan nilai nilai aswaja an-Nahdliyin. Penelitian ini menggunakan metode kualitatif dengan jenis penelitian studi pustaka. Pada penelitian ini tergolong kepada penelitian basic research, yaitu penelitian dalam rangka memperluas dan memperdalam pengetahuan secara teoritis. Hasil dari penelitian ini adalah; Aswaja An-Nahdliyah memiliki sumbangsih yang cukup besar dalam upaya menanamkan sikap-sikap sesuai ajaran yang telah diwariskan oleh Nabi Muhammad dan para sahabat. Salah satu aspek nilai-nilai Aswaja an-Nahdliyah dengan sikap tasamuh (toleran), mampu menjadi filter manusia di era modern dari tawaran-tawaran dan ajaran paham Islam radikal yang semakin marak bertebaran.

O artigo apresenta uma metodologia para a seleção de investimentos utilizando dados de indicadores econômico-financeiros e a cotação de ações de cinco empresas listadas na Brasil, Bolsa e Balcão (B3) do segmento de Carnes e Derivados e o índice IBOVESPA de 2021. O objetivo foi parcialmente atingido, sendo necessário uma nova etapa para o tratamento do problema com métodos multicritérios. O trabalho possui como contribuição científica a apresentação de uma metodologia para a seleção de investimentos para um portfólio, uma solução para a tomada de decisão com o objetivo minimizar o risco na compra de ações de empresas. Foram estimados os coeficientes de correlação com as empresas com empresa com o índice IBOVESPA, foi observado que mesmo que sejam do mesmo segmento, duas empresas acompanharam a movimentação do mercado, enquanto outras duas foram no sentido oposto e a última não apresentou um coeficiente de correlação expressivo. Empresas em que o ROA e ROE são maiores que os indicadores das demais empresas, o desvio-padrão também foi maior, frisando a teoria de associação de risco e retorno.

Penelitian diarahkan pada pendidikan karakter kemandirian dan tanggung jawab pada anak usia dini melaui aplikasi digital interaktif. Pendidikan anak di usia dini sangat penting sekali karena pada masa tersebut anak memasuki masa yang dinamakan dengan golden age atau masa emas anak. Saat ini proses pedidikan PAUD masih belum banyak melibatkan teknologi. Sedangkan kondisi sekarang anak-anak memiliki kesempatan luas untuk mempelajari segala jenis pengetahuan. Hal ini memicu penyampaian pendidikan karakter anak usia dini perlu dilakukan melalui pendekatan modern menggunakan keterlibatan teknologi. Pembuatan aplikasi digital interaktif merupakan salah satu upaya dan alternatif media untuk menanamkan pendidikan karakter pada anak usia dini. Penelitian ini Metode perancangan digital yang digunakan dalam penelitian ini adalah MDLC (Multimedia Development Life Circle) karena merupakan metode pengembangan multimedia yang banyak digunakan saat ini dan sesuai untuk pemecahan masalah. Penelitian ini mengasilkan sebuah aplikasi digital interaktif yang dapat diinstal pada perangkat mobile berbasisi android.

One of the highly nutritious vegetables because it contains a lot of protein, vitamin A, vitamin C and mineral salts that are needed by the body and contains anthocyanins which are useful in curing anemia. The purpose of this study was to determine the antioxidant activity and to determine the comparison between fresh and boiled red spinach leaf extract using the DPPH method. The research method used is an experimental method with a post test only control group design research by comparing the differences in the antioxidant activity content of fresh and boiled red spinach leaves. This study used red spinach which was divided into 2 groups, namely the fresh group and the boiled group. Each group of spinach was replicated 5 times using various concentrations (2500 ppm, 5000 ppm, 10000 ppm 15000 ppm, and 20000 ppm) for each replication. A linear regression analysis was performed between the concentration of fresh and boiled red spinach juice. The results showed that there was a very significant difference in antioxidant activity between fresh and boiled red spinach leaves. Fresh and boiled red spinach leaves have weak antioxidant activity due to IC50 150 g/ml. Fresh red spinach leaves have greater antioxidant activity, namely the IC50 value of 237,251 g/ml, while boiled red spinach leaves have an IC50 value of – 279,412 µg/ml.
 Keywords: Red spinach (Amaranthus tricolor L.), Antioxidant, DPPH.

Marine biogeochemist Clare Ostle tracks the stories that plankton tell from all corners of the globe. Marine biogeochemist Clare Ostle tracks the stories that plankton tell from all corners of the globe.

Entomologist Jackie Billotte reconstructs the burrows and housekeeping habits of tarantulas, which help to keep insect and rodent populations under control in southeastern Colorado. Entomologist Jackie Billotte reconstructs the burrows and housekeeping habits of tarantulas, which help to keep insect and rodent populations under control in southeastern Colorado.