Thematic evolution of smart learning environments, insights and directions from a 20-year research milestones: A bibliometric analysis.

Smart learning environments (SLEs) have been developed to create an effective learning environment gradually and sustainably by applying technology. Given the growing dependence on technology daily, SLE will inevitably be incorporated into the teaching and learning process. Without transforming technology-enhanced learning environments into SLE, they are restricted to adding sophistication and lack pedagogical benefits, leading to wasteful educational investments. SLE research has grown over time, particularly during the COVID-19 pandemic in 2020-2021, which fundamentally altered the "landscape" of technology use in education. This study aims to discover how the stages of SLE transform from time to time by applying two bibliometric analysis approaches: publication performance analysis and science mapping. The dataset was created by extracting bibliometric data from Scopus, including 427 articles, 162 publication sources (journals and proceeding), and 1080 authors from 2002 to 2022. Three kinds of SLE research subjects were identified by keyword synthesis: SLE features, technological innovation, and adaptive learning systems. Adaptive learning and personalized learning are consistently used interchangeably to demonstrate the significance of supporting the diversity of student and teacher conditions. Learning analytics, essential to employing big data technology for educational data mining, is a new theme being considered increasingly in the future to achieve adaptive and personalized learning. The 20-year SLE research milestone, broken down into five stages with various focuses on goals and served as the foundation for creating a maturity model of SLE.

Invertase-producing bacteria and the sweetness content dataset of Cilembu sweet potatoes (Ipomoea batatas (L.) Lam.) grown in various agroecosystems.

Cilembu sweet potato is one of Indonesia's leading agricultural commodities. The high carbohydrate content in sweet potatoes has the potential to change into sugar (glucose, sucrose, and fructose) during storage. The level of sweetness is one of the characteristics that determines the quality of sweet potatoes. The sweetness level of sweet potatoes is influenced by various factors, including genetics, environment, and their interactions. Apart from that, the role of invertase-producing bacteria in breaking down carbohydrates into sugars is very important. Information regarding the number of invertase-producing bacteria in Cilembu sweet potatoes and their activity during storage is still limited. This research aimed to determine the number and activity of invertase-producing bacteria in Cilembu sweet potatoes and estimate the relationship between activity and total invertase-producing bacteria during storage of Cilembu sweet potatoes. The results showed significant differences between the number and activity of invertase-producing bacteria at each storage time. There is a relationship between sugar levels and invertase-producing bacteria. Sucrose levels had a negative and significant correlation with fructose levels (-0.56) and invertase-producing bacteria (-0.58). Glucose levels were significantly and positively correlated with fructose levels (0.91) and invertase-producing bacteria (0.88). Fructose levels also significantly and positively correlated with invertase-producing bacteria (0.95). This information can be used as a reference in determining the quality of sweet potatoes directly and indirectly.

High Preoperative Systemic Immune-Inflammation Index Values Significantly Predicted Poor Outcomes After on-Pump Coronary Artery Bypass Surgery.

Purpose: On-pump coronary artery bypass grafting (CABG) is one of the most common revascularization surgical therapies for coronary artery disease (CAD). However, owing to the use of cardiopulmonary bypass ("on-pump"), the body develops systemic inflammatory response syndrome, which leads to the risk of morbidity and mortality. This study aimed to determine the perioperative outcomes of patients who underwent on-pump CABG surgery using the systemic immune-inflammation index (SII). Patients and methods: This single-center retrospective study used secondary data from patients' electronic medical records and medical records archives at the National Cardiovascular Center Harapan Kita, who underwent on-pump CABG from January 2019 to December 2022. A total of 1056 on-pump CABG procedures were performed after exclusion. Lymphocyte, segmental neutrophil, and platelet counts from the preoperative data were used to calculate the SII values. An SII cutoff value of 528.715 × 103/mm3 divided the patients into two groups. Results: The SII value of 1056 patients were calculated, among which 490 (46%) patients had a preoperative SII value of ≥528.715 × 103/mm3. Multivariate analysis showed that a high SII significantly prolonged the duration of surgery (OR 1.005, 95% CI 1.003-1.006) and cardiopulmonary bypass (CPB) time (OR 1.007, 95% CI 1.005-1.009). High SII values significantly predicted prolonged mechanical ventilation (OR 6.154, 95% CL 3.938-9.617), intensive care unit (ICU) stay (OR 6.332, 95% CL 4.232-9.474), and hospital stay (OR 3.517, 95% CL 2.711-4.562). Regarding other perioperative outcomes, a high SII significantly predicted the risk of postoperative atrial AF, cardiac arrest, acute myocardial infarction, and mortality. Conclusion: A high preoperative SII value can predict morbidity and mortality in patients undergoing on-pump CABG surgery.

Systemic Immune-Inflammation Index Predicts Prolonged Mechanical Ventilation and Intensive Care Unit Stay After off-Pump Coronary Artery Bypass Graft Surgery: A Single-Center Retrospective Study.

Purpose: Coronary artery disease (CAD) is the primary cause of mortality in developing countries. Off-pump coronary artery bypass grafting (OPCAB) offers more upside in revascularization by preventing cardiopulmonary bypass trauma and minimizing aortic manipulation. Even though cardiopulmonary bypass is not involved, OPCAB still causes a significant systemic inflammatory response. This study determines the prognostic values of the systemic immune-inflammation index (SII) towards perioperative outcomes in patients who underwent OPCAB surgery. Patients and methods: This was a single-center retrospective study at the National Cardiovascular Center Harapan Kita, Jakarta, using secondary data from electronic medical records and medical record archives of all patients who underwent OPCAB from January 2019 through December 2021. A total of 418 medical records were obtained, and 47 patients were excluded based on the exclusion criteria. The values of SII were calculated from preoperative laboratory data of segmental neutrophil count, lymphocyte count, and platelet count. Patients were divided into two groups based on the SII cutoff value of 878.056 x 103/mm3. Results: The baseline SII values of 371 patients were calculated, among which 63 (17%) patients had preoperative SII values of ≥878.057 x 103/mm3. High SII values were a significant predictor of prolonged ventilation (RR 1.141, 95% CI 1.001-1.301) and prolonged ICU stay (RR 1.218, 95% CI 1.021-1.452) after OPCAB surgery. A positive correlation was observed between SII and hospital length of stay after OPCAB surgery. From the receiver operating characteristic curve analysis, SII predicted prolonged ventilation duration, with an area under the curve of 0.658 (95% CI 0.575-0.741, p = 0.001). Conclusion: High preoperative SII values are capable of predicting prolonged mechanical ventilation and intensive care unit stay after OPCAB surgery.

Initial Thrombocyte Concentrate Transfusion in Woman with Chronic Immune Thrombocytopenia Purpura (ITP) Who Underwent Mitral Valve Replacement Surgery: A Case Report.

BACKGROUND Chronic immune thrombocytopenia purpura (ITP) is associated with a higher incidence of adverse outcomes, increased morbidity and mortality rates, and higher health care costs, especially in open-heart surgery. The information regarding managing chronic ITP in patients undergoing mitral valve replacement (MVR) surgery is scarce, and reported cases are limited. CASE REPORT A 42-year-old woman with more than 20 years of history of immune thrombocytopenia purpura (ITP) had episodes of breathing difficulties in the last 4 years. The patient was diagnosed with severe mitral stenosis (MS) and moderate mitral regurgitation (MR). Laboratory examination before surgery showed thrombocytopenia (49 000/µL). Therefore, the surgery was postponed until the platelet count exceeded 100 000/µL. The patient was given 10 units of thrombocyte concentrate 1 day before surgery and 500 mg of methylprednisolone 3 times a day orally for 5 days as preoperative management. Under a total cardiopulmonary bypass, MVR was performed using a bioprosthetic valve. Postoperative transthoracic echocardiography (TTE) showed no valvular leakage in the surrounding of the prosthetic valve and that the valve was functioning normally. Platelet monitoring was conducted, and the platelet count increased to 147 000/µL on the third day. CONCLUSIONS Our case report shows that aggressive preoperative platelet count correction and treatment may lower the risk associated with a low and unstable platelet count and reduce the risk of mortality and morbidity in patients with ITP who undergo MVR procedures.

Case Report: Purple urine bag syndrome in woman with neurogenic bladder.

Purple urine bag syndrome (PUBS) is a rare phenomenon in patients that is associated with the use of a long-term/indwelling urinary catheter. The purple color results from indigo and indirubin, accumulated from bacteria-mediated tryptophan conversion. High risk patients include: the elderly; women; immobilized patients; patients with an indwelling catheter, chronic constipation, alkaline urine or poor hygiene; and those with catheter bags and tubes made of certain types of plastic. We reported PUBS in an elderly woman with an indwelling catheter and chronic constipation which, to our knowledge, was the first case in our hospital. The patient underwent urinary catheter change and received intravenous ciprofloxacin, following which the urine returned to a yellow color and the patient was discharged. This case report describes the diagnosis, management and also strategies for the prevention of PUBS in Gatot Soebroto Army Hospital, Indonesia.