bluuebunny/crossref_metadata_2025 huggingface dataset:
Peculiarities of the Grounds and Procedures for Issuance, Modification and Revocation of Customs Rulings under the Law of Kazakhstan
Authors: Drofich O.Yu.
Published: February 2023

Having studied the experience of Kazakhstan of legal regulation of key aspects of issuance, modification and revocation of customs rulings, the author infers that the peculiarity of rules and regulations of substantial and procedural aspects related to customs rulings under the law of Kazakhstan reveals itself in the following fundamental principles as well as in these regulatory and administrative practices: 1) the possibility of making advance rulings regarding the classification and origin of goods, as well as regarding the application of methods of customs valuation with specification at the sublegal regulatory level of the range of contracts and transactions, the value within framework of which can be certified or be adjusted by the customs authorities in advance; 2) the clear legislative aspiration towards ensuring the utmost facilitation to trading activities (in particular, by eliminating excessive formalism when assessing contractual documents and by fairly taking into account the individual situation of enterprises and individuals engaging in customs procedures) with proper enforcement of security and fiscal goals by customs authorities; 3) a set of detailed rules for collection and examination of evidence by customs authorities within the framework of the administrative appeal procedure, which includes, among other things, sending requests for information and documents necessary for making a lawful and well-founded decision, as well as the possibility of arrangement of an unscheduled on-site inspection for clarification of the authenticity of documents that persons did not submit during the implementation of customs control measures against them, but submitted during the administrative appeal of the relevant decisions; 4) inadmissibility of evidence that was not submitted without a good reason by a business entity or a natural person during the conduct of customs control measures and administrative appeals; 5) taking into account the recommendations and explanations given by the World Customs Organization when interpreting the provisions of customs law.
Regulatory and legal ensuring the training of the staff of the State border service of Ukraine: problems and directions of improvement
Authors: Radchenya N.M.
Published: February 2023

In the article highlights the factors that determine the specifics of regulatory support for the training of personnel of the State Border Service of Ukraine. The system of regulatory and legal support for the training of the personnel of the State Border Service of Ukraine was considered and the defects that negatively affect the effectiveness of the training of the personnel of the State Border Service of Ukraine were singled out. Possible ways of improving the regulatory and legal support for the training of personnel of the State Border Service of Ukraine in modern conditions are considered. The emphasis is on necessity to take targeted measures to bring the current acts in the field of training of the personnel of the State Border Service of Ukraine into a single system and in compliance with the law-making technique. Methods of systematization and their effectiveness in thecontext of improving the regulatory support for the training of personnel of the State Border and Border Service of Ukraine are considered. It is justified that the most effective way to improve the regulatory and legal support for the training of the personnel of the State Border Service of Ukraine is systematization in the form of a special codification. Attention is focused on the need to adopt a codified legal act that will ensure complex regulation of relations in the field of personnel training of the State Border Service of Ukraine.It was determined that the legislative basis for the functioning of the training system for the personnel of the State Border Service of Ukraine is the Law of Ukraine “On the State Border Service of Ukraine”, however, the declarative nature of the relevant provisions of the law does not provide conditions for the development and improvement of regulatory support in the field oftraining the personnel of the State Border Service of Ukraine. It can be concluded that the ways of improving the regulatory and legal support for the training of the personnel of the State Border Service of Ukraine in modern conditions are thesystematization of normative legal acts that regulate the training of the personnel of the State Border Service of Ukraine and the introduction of amendments and additions to the Law of Ukraine “About the State Border Service of Ukraine” in the part of legal regulation of personnel training.
Information security against the threats of transnational organized crime
Authors: Shulzhenko N.V.
Published: February 2023

The article is devoted to the study of information security against the threats of transnational organized crime. Organized crime is a potential and major threat to the national security of our country. The relevance of the research topic is determined by the fact that transnational organized crime is not only a potential, but also a real threat to national security, state sovereignty, and the provision of human and citizen rights and freedoms. Transnational crime is a phenomenon that is not only not limited to the borders of one state, but also affects the global security of humanity.

Transnational organized crime is a significant problem for the development of Ukraine as a democratic, social and legal state with the irreversibility of Ukraine's European and Euro-Atlantic course. At the same time, the issue of the commission of criminal offenses by organized crime is one of the most complex and problematic both in the theory of criminal law and in judicial and investigative practice.

Attention is drawn to the fact that since the full-scale invasion of the Russian Federation, the issue of ensuring information security, as a component of national security, has acquired a new meaning, and therefore requires research and resolution.

The article focuses on issues of legislative consolidation of the concepts «information security», «national security», «transnational organized security». The main provisions of the normative legal acts establishing these concepts were analyzed, as well as threats to national security and problems of organized crime were determined.

The United Nations Convention against Transnational Organized Crime, November 15, 2000, approved by resolution 55/25 of the General Assembly regarding the consolidation of the concept of «transnational organized crime», «crime of a transnational nature» was analyzed.
Evidence in constitutional proceedings: conceptual foundations
Authors: Bielova M.V. , Byelov D.M.
Published: February 2023

It is indicated that the realities of social life, the political situation, global processes of transformation of phenomena and processes require legal precision in understanding the fundamental prescriptions specified by the Constitution, as well as ensuring the compliance of legislation with its provisions. The author emphasizes that. That evidence and the corresponding activities related to their collection, research, evaluation and use have long attracted the interest of scientists from various areas of legal science. The concepts of “evidence” and “proving” are among the central ones in science and practice, which necessitated a deeper study of these issues, the separation of a separate scientific direction - the theory of evidence, especially in constitutional proceedings.Admittedly, legal knowledge as an activity can be considered as a complex system consisting of a number of elements and having a certain structure, which allows us to talk about the technological process of reproduction of legal knowledge. Analysis of the internal structure of legal knowledge makes it possible to reveal all the features of this activity in a deeper and morecomplete way. Identifying and studying how legal knowledge is built is a necessary prerequisite for solving the problems of its scientific organization and management. In legal knowledge, the central link is the theory of evidence, the core of which- the concept of “evidence” - is interpreted quite differently, especially in the constitutional judiciary.It is noted that one of the main places belongs to the process of proving and collecting evidence in constitutional proceedings. This is due to the fact that it is on the basis of correctly collected evidence that a legal and fair judgment can be rendered, in addition, the trial itself will take place in compliance with one of the leading principles - competition and equality of the parties. At the same time, proof (regardless of the type of judicial procedure) has common features as a certain type of knowledge.It is asserted that since proof is a type of cognitive process that is carried out in the order established by law and covers the activities of subjects involved in constitutional proceedings, then proof in constitutional proceedings is a type of knowledge that is carried out in the order established by law and covers the activities of subjects of entities involved in constitutional proceedings, at the same time represents a combination of both cognitive and procedural activity. At the same time, evidencein constitutional proceedings in the most general terms is information about the circumstances and facts to be established in the case, aimed at establishing the constitutional content of the norms that are the immediate object of study, obtained with the help of judicial logic, the subject of which is judicial reasoning and forensic analytics.
Some issues of the application of public-law mediation with the participation of states in the settlement of the Cyprus conflict
Authors: Tragniuk O. , Anakina T.
Published: February 2023

The article is devoted to the analysis of public law mediation in the settlement of international conflicts. Using the example of the armed confrontation on the territory of the Republic of Cyprus that took place in 1974, the authors analyze the role of international intermediaries (mediators) in resolving the armed conflict and overcoming its consequences. The causes of the Cyprus armed conflict are studied, and the conditions under which public law mediation is expedient are analyzed. At the same time, the conditions for providing mediation services in the settlement of such conflicts are evaluated.

In the conditions of the armed aggression of the Russian Federation against Ukraine, the study of the role of mediation in international law plays a positive role, taking into account the aspiration of some UN member states to play a positive peaceful conciliatory role in the cessation of military aggression by the aggressor state.

            Along with the abovementioned, the positive features of public-law mediation are noted and the consequences of using this institute of mediation procedure in armed conflicts are described. The criteria for evaluating the effectiveness of public legal mediation are expressed. It also describes the conditions under which the guarantor states assumed international obligations regarding the settlement of the Cyprus crisis.

            The conclusions indicate attempts to settle it, which, unfortunately, did not find the support of the population of this island state. Along with this, it is noted that the subjects of public-legal mediation act as mediators not only in the solution, but also in the possible introduction of peaceful measures that will mitigate the international conflict. As an example, Turkey's participation in unblocking the work of Ukrainian seaports for the purpose of exporting food products by sea transport during the armed aggression of the Russian Federation against Ukraine in 2022 is given.
Dialogical theory of constitutional jurisdiction
Authors: Vatamaniyk A.
Published: February 2023

The metaphor of dialogue between constitutional jurisdictions and legislatures was born in Canada to describe the role of the Supreme Court after the adoption of the Charter of Rights and Freedoms in 1982. Then he was engaged in the Anglo-American academic space of comparative constitutional law. It is the relationship of the constitutional judiciary to the deliberative paradigm that raises questions, as it is difficult to see how the supervisory function of the judge and his authority to repeal or amend legislative texts can be anything other than a transfer within the limits of the separation of powers. A famous argument in the 1803 U.S. Supreme Court decision Marbury v. Madison: Justice Marshall postulated that the existence of a written Constitution, supreme since its adoption by a sovereign people, implied a judicial guarantee, even if the text did not state it, which applies to all legal acts. including the law. Constitutional justice developed mainly a century later, and then especially at the end of World War II, as did the theory that accompanied it. Those proposed in the context of continental Europe by the Austrian legal theorist Hans Kelsen, who participated in its creation in Austria in 1920. Schematically, the legal order is a hierarchically structured system of norms, each norm of which is valid when it is produced by a norm of a higher rank, up to the Constitution. The judge checks the validity of the rules within the system; A constitutional judge, whether a court specializing in this control or an ordinary judge headed by a universal Supreme Court, checks the conformity of all or part of the norms with the constitutional norm, thus performing an essential function in structuring the legal order. Outside the European Union, the dialogue metaphor has been reused in two contexts where it has played two very different roles, in the space of English-language comparative law and then in America. Then the theory of democratic deliberation was extended to the constitutional judge. In the dialogic conception, as in other variants of constitutionalism understood as cooperative, the case for constitutional revision derives from the ability of courts to help counter failures of inclusiveness and responsiveness to the political process, framed here in terms of "blind spots" and "inertia weights."
Pencahayaan Alami pada Masjid Amirul Mukminin Makassar
Authors: Ulfirah Rahmayanti , Saha Riska , Rahayu Irma
Published: February 2023

Abstrak_ Masjid merupakan pusat peradaban umat islam sebagai sarana ibadah umat muslim yang dapat menampung jumlah jamaah dalam jumlah lumayan banyak, namun seiring berjalannya waktu bangunan ini memiliki fungsi lain yang tidak hanya digunakan sebagai tempat beribadah. Masjid Amirul Mukminin sebagai sentra kegiatan islam maupun kajian ilmu yang berlangsung hampir setiap hari mulai dari waktu subuh hingga pukul 22:00. Bangunan masjid amirul mukminin berpotensi menggunakan pencahayaan alami pada siang hari karena lokasinya yang mendapatkan pencahayaan matahari setiap harinya. Penelitian ini menggunakan metode kuantitatif sebagai metode umum. Pembahasan memiliki alur deduktif yaitu menjelaskan bahasan umum terlebih dahulu lalu menjelaskan bahasan khusus. Dan menggunakan Metode observasi ,dokumentasi,wawancara,dan pengukuran alat berupa luxmeter. Penelitian difokuskan untuk mengetahui kinerja pencahayaan alamipada masjid amirul mukminin, mengetahui kualitas cahaya dibeberapa titik yang dipetakan dengan pembagian area berdasarkan tingkat cahaya pada ruangan. Dan Hasil menunjukkan  kondisi pencahayaan alami pada lantai 1, lantai 2 dan lantai 3 terjadi pada pukul  08:00- 10:00 WITA melebihi standar pecahayaan alami pada SNI. Hal ini dikarenakan pada titik tersebut tidak ada penghalang sinar matahri.                                                                                                                                          Kata Kunci : Amirul mukminin, ibadah, Makassar, Masjid, pencahayaan alami, Abstrak_ Mosque is the center of Islamic civilization as a place of worship for Muslims which can accommodate a large number of worshipers, but over time this building has other functions that are not only used as places of worship. The Amirul Mukminin Mosque as a center of Islamic activities and the study of science which takes place almost every day from dawn until 22:00. The amirul mukminin mosque building has the potential to use natural lighting during the day because of its location which gets sunlight every day. This study uses quantitative methods as a general method. Discussion has a deductive plot, namely explaining general discussion first and then explaining specific topics. And using the method of observation, documentation, interviews, and measurement tools in the form of luxmeter. The study focused on knowing the natural lighting performance of the mosque of the Believers, knowing the quality of light in some points mapped by dividing the area based on the level of light in the room. And the results show the condition of natural lighting on the 1st floor of the 2nd and 3rd floor occurs at 08: 00-10: 00 WITA This is because at that point there is no sun beam barrier.Keywords: Amir al-mu'minin, worship, Makassar, mosque, natural lighting,
Skuldbinding leikskólakennara til vinnustaðar: Starfsandi í lykilhlutverki
Authors: Isaksen Rakel Ýr , Ástvaldsdóttir Ingileif , Stefánsson Kristján Ketill
Published: February 2023

Lög um eitt leyfisbréf leik-, grunn- og framhaldsskólakennara tóku gildi þann 1. janúar 2020. Eftir gildistöku laganna flutti fjöldi leikskólakennara sig um set og hóf störf á grunnskólastigi. Markmið rannsóknarinnar var að bæta stöðu þekkingar og koma auga á vísbendingar um hvernig megi varðveita hæfni og sérþekkingu starfandi leikskólakennara. Rannsóknaraðferðin var megindleg, rýnt var í fyrirliggjandi gögn og þau greind með lýsandi tölfræði og fjölbreytuaðhvarfsgreiningu. Gagnasafnið samanstóð af svörum 1250 leikskólakennara við starfsmannakönnun Skólapúlsins fyrir leikskóla, sem svarað var vorin 2020 og 2021. Tvíþáttakenningin (e. Motivation hygiene theory) var lögð til grundvallar varðandi greiningu gagnanna. Tvær tilgátur voru prófaðar: 1. Leikskólakennarar sem upplifa sterka hvataþætti (t.d. góðan starfsanda) eru líklegir til að sýna skuldbindingu til vinnustaðar; 2. Leikskólakennarar sem upplifa slaka hollustuhætti (t.d. mikið vinnuálag) eru ólíklegir til að sýna skuldbindingu til vinnustaðar. Niðurstöður rannsóknarinnar bentu til að hvataþættirnir starfsandi, jákvæðar áskoranir í starfi og ræktun mannauðs væru í lykilhlutverki hvað varðar skuldbindingu leikskólakennara til vinnustaðarins. Niðurstöðurnar gáfu jafnframt til kynna að viðvarandi vinnuálag spilaði mikilvægt hlutverk í ótímabæru brotthvarfi leikskólakennara úr starfi. Brýnt virðist að styðja við hvatabundna þætti og draga úr neikvæðum hollustuþáttum í starfsumhverfi leikskóla.
Pediatric Sepsis by Multi-Drugs Resistance Organism: Length of Stay, Prognosis, and Hospitalization Cost Evaluation
Authors: Damayanti Anindita Novia , Sri Rejeki IGAA Putri , Marpaung Ferdy Royland
Published: February 2023

Multi-Drugs Resistance (MDR) is a condition where bacteria are resistant to at least one type of antibiotic from three classes of antibiotics. One of the organisms included in the MDR is an Extended-Spectrum Beta Lactamase (ESBL) producing bacteria. Multi-drug resistance bacteria have been widely reported globally as a cause of severe infections. Still, information on the comparison of Length of Stay (LOS), hospitalization costs, and outcome status of the patients infected with MDR bacteria and infected with non-MDR bacteria is still limited. This study aimed to compare LOS, treatment costs, and outcome status of the BPJS pediatric sepsis patients infected with MDR bacteria and non-MDR bacteria in Dr. Soetomo General Academic Hospital, Surabaya. This study was observational research using medical records of hospitalized pediatric patients with BPJS insurance at the Dr. Soetomo General Academic Hospital from January 2015-July 2018 (n=49). The variables of this study were microbiology culture results and antibiotics sensitivity tests, LOS, INA-CBGs rates provided by BPJS, actual hospitalization cost, and outcome status. Statistical analyses were performed to compare LOS, INA-CBGs, actual cost, and outcome status of patients infected by MDR bacteria (ESBL and non-ESBL) or non-MDR bacteria. The results of this study include the average LOS value of non-MDR, MDR ESBL, and MDR non-ESBL cases, which were 30.55; 46.18; 32.41. Comparison of INA-CBGs and the actual cost of the three were 0.886 and 0.990, respectively, with p>0.05, and each percentage of the mortality patients was 27.3%, 45.5%, and 40.7%. There was no significant difference in the hospitalization cost and outcome status of patients infected by MDR bacteria (ESBL and non-ESBL) and non-MDR bacteria. Each percentage of LOS was also not much different. Still, MDR patients tended to be treated longer, require higher costs, and have a worseprognosis.
Gene Expression of SOX2, OCT4, and Nanog by Small Molecule Compound VC6TFZ on Peripheral Blood Mononuclear Cell
Authors: Amalia Rizka , Pikir Budi Susetyo , Andrianto Andrianto
Published: February 2023

Peripheral blood mononuclear cells are a potential source of cells to be induced into pluripotent stem cells because the collection procedure is easy, minimally invasive, and can be stored in a frozen form. Small molecule compound VC6TFZ consisting of valproic acid (VPA), CHIR990210 (CHIR), 616452, Tranylcypromine, Farsokline, 3-deazaneplanocin (DZnep) and TTNPB has been shown to induce pluripotency in mouse fibroblasts, but this has not been proven in peripheral blood cells. This chemical reprogramming strategy has the potential to be used in producing the desired functional cell types for clinical applications. This study aims to determine whether the small molecule compound VC6TFZ can induce pluripotency of peripheral blood mononuclear cells to become induced pluripotent stem cells. Mononuclear cells were isolated from peripheral venous blood by density gradient centrifugation method. The cells are grouped into 4 groups. Group 1 was the control group, which was not exposed to the small molecule. Groups 2-4 were experimental groups exposed to different doses of the small molecule VC6TFZ. Identification of induced pluripotent stem cells was carried out by identifying colony morphology and pluripotent gene expression of Octamer-binding transcription factor-4 (OCT4), Sex-determining region Y-box 2 (SOX2), and Nanog using Real-Time Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR). Colonies with a round shape, large, cobble stone like, and clear boundaries resembling pluripotent stem cell colonies appeared on the 9th day of the induction process. OCT4 and Nanog gene expression were significantly increased in the treatment group compared to the control.
Analysis of Platelet Indices and Proteinuria in Primary Hypertensive Patients
Authors: Suryana Deny , Widaningsih Yuyun , Mangarengi Fitriani , Muhadi Darwati
Published: February 2023

Hypertension is a silent killer that causes premature death, an estimated 9.4 million people die each year due to hypertension and its complications. Primary hypertension promotes endothelial damage-causing platelet release reaction. Without treatment, it may cause renal damage, which leads to proteinuria. This study aimed to analyze the relationship of the platelet indices (PLT, PDW, PCT, MPV) in predicting proteinuria among patients with primary hypertension based on its stage. A retrospective study using medical records of patients diagnosed with primary hypertension by clinicians at Dr. Wahidin Sudirohusodo Hospital from January-December 2019. Complete Blood Count (CBC) using the flow cytometry and routine urine test with urine analyzer were performed. The statistical test used in this study were the independent T-test, Chi-Square test, and oneway ANOVA test. Receiver Operating Characteristics (ROC) were used to determine the cut-off. The sample consisted of 78 patients. Mean Platelet Volume (MPV) was significantly higher in proteinuria patients and stage two hypertension with p<0.001. There was a significant relationship between stage two hypertension and proteinuria with p=0.018. ROC analysis showed MPV Area Under the Curve (AUC) of 0.774 with p<0.001, which indicated that MPV can be used as a predictor of proteinuria with a cut-off point of 8.55. MPV increases on the platelet indices, proteinuria with stage 2 hypertension are caused by damage to glomerular endothelium, which leads to platelet activation characterized by degranulation, swelling, and increases in platelet mass and volume. There was a relationship between an increase of MPV and proteinuria in patients with stage 2 hypertension.
Validity ICT and CLIA of SARS-CoV-2 Antibody
Authors: Oei Fili , Nurulita Asvin , Muhadi Darwati , Arif Mansyur
Published: February 2023

The varying validity of antibody test requires a good diagnostic accuracy analysis in determining the right tome to perform antibody testing in patients. This study is to evaluate sensitivity and specificity of SARS-CoV2 antibody test based on the testing time. This stugy is a cross sectional retrospective diagnostic test study include 960 subject divided into 3 groups based on the testing time using 2 antibody test methods are ICT and CLIA. The sensitivity and specificity of ICT method was 45.8% and 59.7%, while the CLIA method was 81.6% and 74.4%. Based on timing of antibody test after symptom onset, the highest sensitivity was obtained at >15 days of symptom onset (84.4% and 78.7%). Low sensitivity can be caused due to the absence or low antibodies in the first week to second weeks of infection. Sample collection is done 2-4 weeks after symptom onset. The SARS CoV-2 IgM and IgG antibodies have high sensitivity and specificity at onset >15 days (84.4% and 78.7%).
Correlation between Inflammatory Markers of Platelet Index and Vitamin D with Body Mass Index
Authors: Harviendo Grace Yuni , Ariosta Ariosta , Hendrianingtyas Meita
Published: February 2023

Weight loss is more of a worldwide health problem and a risk factor for chronic disease. The decrease in serum vitamin D levels in body weight leads to more low grade inflammation. This study aims to determine the relationship between the platelet index, namely MPV, P-LCR as a marker of inflammation and vitamin D with body mass index (BMI). This study was a cross-sectional study of 78 women at the Diponegoro National Hospital with overweight (BMI> 23) in July - September 2020. Data analysis was done using Pearson and Spearman tests and significant if p <0.05. Of the 78 research samples, there was a significant relationship between BMI and MPV (r = 0.404; p = 0.000); P-LCR (r = 0.425; p = 0.000) and 25 (OH) D (r = -0.231; p = 0.04). Low vitamin D levels in obesity and low-grade inflammation increase pro-inflammatory cytokines. Increased leptin levels in obesity contribute to platelet hyperreactivity. Increased platelet activity compensates for the platelets so that the MPV and P-CLR values increase. There is a moderate significant positive relationship between MPV, P-CLR and BMI and a weak significant negative relationship between 25 (OH) D and BMI.
Procalcitonin and Troponin-I as Predictor of Mortality in Acute Myocardial Infarction Patients
Authors: Firani Novi Khila , Prisilla Jennifer
Published: February 2023

Acute Myocardial Infarction (AMI) is known as one of the leading causes of death in the world as well as in Indonesia. Procalcitonin is a marker of inflammation that has been recognized as a predictor of mortality in sepsis patients. The role of procalcitonin as a predictor of mortality in AMI patients has not been widely studied. Troponin-I has been recognized as a biomarker of AMI. It is unclear whether Troponin-I can also act as a biomarker to predict the death of AMI patients. This study aim is to determine the role of procalcitonin and troponin-I as predictors of mortality in AMI patients. A 5-month analytical observational study was performed on AMI patients who were admitted to Dr. Saiful Anwar, Malang. Patients with sepsis or infection were excluded. There were 51 study subjects, of whom median procalcitonin and troponin-I levels of patients who died were significantly different from survivors (p<0.05). Procalcitonin level with a cut-off of 2.16 ng/mL had a sensitivity of 77% and specificity of 87%. Troponin-I level with a cut-off of 3.1 ng/mL had a sensitivity of 61% and specificity of 84%. Odds ratio of procalcitonin to mortality was 17.78 (p=0.001), while troponin-I was not significant. Procalcitonin correlated with mortality (r= 0.519, p= 0.005). The conclusion of this research is procalcitonin acts as a predictor of in AMI patients.
Cut-Off Value of Procalcitonin in Sepsis and Septic Shock patients at Dr. Soetomo Hospital
Authors: Ambaringrum Shinta Lungit , Hernaningsih Yetti , Kusuma Edward , Kahar Hartono
Published: February 2023

Sepsis is a state of life-threatening organ dysfunction caused by dysregulation of the body's response to infection. Organ dysfunction is marked by an increase in SOFA score â‰¥ 2 or qSOFA score â‰¥ 2. Septic shock is a subset of sepsis with fairly severe circulatory disorders that can significantly increase mortality. Although the current gold standard diagnosis method for sepsis is bacterial culture, some researchers believe PCT can help identify sepsis severity because bacterial culture requires a relatively long time. This study aims to determine the cut-off point of procalcitonin in patients with sepsis and septic shock. The data taken were secondary data from the medical records of sepsis and septic shock patients in Dr. Soetomo General Hospital from 2017 to 2019. Determination of cut-off PCT for sepsis and septic shock using Receiver Operating Characteristic (ROC) analysis curve. Most sepsis patients were young (18 - 65 years) (69%) (p = 0.331) and male (60%) (p = 0.156). The majority of the clinical sepsis patients have focal infections of the respiratory system (55.17%). Patients with respiratory tract infections who develop sepsis have an OR of 6.182, which means it is six times more likely to develop septic shock. There was a significant difference between septic and non-septic PCT levels (p = 0.000), and there was a positive correlation between PCT and sepsis. The cut-off of procalcitonin in sepsis was 0.6 ng/mL, and the cut-off of procalcitonin in septic shock was 10 ng/mL.
Diagnostic Performance of Molecular Rapid Test in Establishing Diagnosis of MDR-TB
Authors: Wahyuningtyas Nunung Dartini , Sianipar Osman , Dahesihdewi Andaru
Published: February 2023

Tuberculosis (TB) is a global health problem and is the leading cause of morbidity and mortality in many developing countries.   Multi Drug Resistant Tuberculosis (MDR TB) becomes one burden of health problems considering the high morbidity and mortality rates. Establishment of MDR TB diagnosis is still a challenge, related to the tools and methods used, while cultural examination as  gold standard is expensive and takes a long time. This study aims to evaluate diagnostic performance  of Molecular Rapid Test or MRT (GeneXpert) in establishing diagnosis of MDR TB  using Mycobacteria Growth Indicator Tube (MGIT) culture as gold standard. Using a cross sectional design, this study involved 51 subjects, a total of 26 (51%) male and 25 (49%) female, adult patients suspected TB, treated at dr. Ario Wirawan Lung Hospital (RSPAW) Salatiga.  Mean age 48.2 + 16.35 years, (17-79 years). The MRT for TB and MDR TB detection showed 13 and 7 true positives, 32 and 43 true negatives; obtained 68.4% and 87.5% Sensitivity, 100% and 100% Specificity, 100% and 100% Positive Predictive Value (PPV),  84.2% and 97.7% Negative Predictive Value (NPV), respectively. A specific analysis to diagnose MDR TB by MRT on TB patient groups showed 7 true positives, 0 false positives, 11 true negatives and 1 false negative;   obtained  87.5% Sensitivity, 100% Specificity, 100% PPV and 91.7% NPV.  For establishing diagnosis of MDR TB, MRT provides perfect specificity.  One false negative MDR TB in MRT results is likely resistant to other than rifampicin.
Pancreatitis in Acute Lymphoblastic Leukemia
Authors: Adnyani Putu Yudi , Wande I Nyoman , Herawati Sianny
Published: February 2023

Pancreatitis is inflammation of the pancreatic parenchyma and diagnosed based on symptoms of heartburn accompanied by increased levels of pancreatic enzymes. Acute pancreatitis in acute lymphoblastic leukemia in addition to being caused by therapy can also be caused by other factors. 13-year-old female patient with a diagnosis of acute lymphoblastic leukemia complained of heartburn which was felt through to the back. Patients also experience nausea, vomiting, decreased appetite, difficulty in bowel movements, and fever. Physical examination found an increase in body temperature, anemic eyes, multiple neck gland enlargement, and enlargement of the liver. The results of complete blood tests showed leukocytosis, anemia, and thrombocytopenia. The results of examination of bone marrow aspiration show a picture of the bone marrow in accordance with acute lymphoblastic leukemia (ALL-L2). Clinical chemistry tests showed an increase in amylase, lipase, SGOT, BUN, creatinine, LDH, ferritin, calcium, and procalcitonin. The patient has never received chemotherapy for the ALL. Acute pancreatitis in ALL in addition to being caused by administration of leukemia can also be caused by sepsis conditions which are complications of the ALL. ALL patients who experience acute pancreatitis in this case show a poor prognosis.
The Diagnostic Value of Platelet Count and MPV in Suspected COVID-19 Patient at Dr. Saiful Anwar Hospital
Authors: Iskandar Agustin , Sri Listyoko Aditya , Hari Oki Hambiah
Published: February 2023

COVID-19 is a disease caused by SARS-CoV-2. Haematology alterations like lymphopenia is common, but not much study involves about thrombocyte. Incidence of thrombocytopenia in COVID-19 patient is 5-53.6%. Purpose of this study is to analyze diagnostic value of thrombocyte count and MPV in COVID-19. Cross sectional design took place at Dr. Saiful Anwar Hospital on March-June 2020. Data was taken at first admission. Confirmation test with SARS-CoV-2 gene detection with RT-PCR method. 115 patient suspected COVID-19 collected at the end of study with 69 positive and 46 negative. AUROC for thrombocyte is 0.336 (CI: 95%, 0.238 – 0.435, p= 0.01); MPV 0.488 (CI  95%, 0.378 – 0.598, p= 0.762). Thrombocyte count and MPV doesn't have good diagnostic value for COVID-19. This might be due to different conditions that patient might had at admission. Thrombocytopenia and increased MPV often caused by hyperinflammatory condition and severe infection as mentioned in other study. Thrombocyte count and MPV alone can't be used to diagnose COVID-19. Coincide use of other marker such inflammatory markers might be useful. Future study with larger sample and serial testing may needed to evaluate more about diagnostic value of thrombocyte count and MPV.
Prevalence of Extended-Spectrum Beta Lactamase-Producing Microorganisms in Dr. Mohammad Hoesin Hospital Palembang
Authors: Liana Phey , Binti Chahril Norlaila , Nita Sri , Umar Tungki Pratama
Published: February 2023

Production of Extended-Spectrum Beta-Lactamase (ESBL) by Enterobacteriaceae continues to be a problem of infectious diseases, especially in hospitals. The main causes of ESBL-producing bacteria colonization are urinary tract infections, length of hospital stay, invasive medical equipment, and antibiotics usage. This study aims to compare the incidence of ESBL based on the type of organism in Dr. Mohammad Hoesin Hospital for the 2017 and 2018 periods. The research design used was descriptive with a cross-sectional approach, which used secondary data at the Clinical Pathology Department of Dr. RSUP. Mohammad Hoesin Palembang. The findings of this study showed a decreasing pattern in the incidence of ESBL in 2017 and 2018, but with a similar pattern which was dominated by Klebsiella pneumoniae (followed by Escherichia coli and Klebsiella ozaenae), inpatients in pediatric wards, internal medicine, and intensive care units, and on sputum specimens. This study showed the presence of high levels of ESBL-producing bacteria (>60%) in Dr. Mohammad Hoesin Hospital, which was mainly caused by Klebsiella pneumoniae.
Determining Glomerular and Non-Glomerular Hematuria Dysmorphic Red Blood Cell: Study on Automatic Urine Analyzer
Authors: Setiawan Dias , Sidharta B. Rina A. , Ariningrum Dian
Published: February 2023

Hematuria is a sign of glomerular and non-glomerular kidney disease. Erythrocytes that pass through the glomerulus will change shape to become dysmorphic. Dysmorphic red blood cells (dRBC) can be screened using an automatic urine analyzer based on flowcytometry to distinguish the source of hematuria from glomerular or non-glomerular. The purpose of this study was to determine the diagnostic performance of the flowcytometry-based dRBC automatic urine analyzer in differentiating glomerular and non-glomerular hematuria. This study used a cross-sectional research design at the Clinical Pathology Installation at RSUD Dr. Moewardi in Surakarta. The subjects of the study were patients with hematuria at the Polyclinic and Internal Medicine Ward, Nephrology sub-division, Pediatric Polyclinic, nephrology sub-division, Urology Surgery Polyclinic in March – July 2021. The diagnostic test was carried out after determining the cut-off value of dRBC with ROC curve and AUC value. The results showed that the cut-off value of dRBC for glomerular and non-glomerular hematuria was 67% and had the best analytical performance with sensitivity 91.07%, specificity 85.36%, AUC 0.890 (95%CI: 0.832–0.947; p=0.000). In this study, dRBC parameters can be used for screening and diagnostics of patients with glomerular and non-glomerular hematuria. Further research needs to be done with other more specific gold standards such as examination of urine sediment with a phase contrast microscope.
Correlation of Immature Granulocytes and C-Reactive Protein with Blood Culture in Neonatal-SIRS at Gambiran Hospital
Authors: Hasna Muthia Maraya , Widyaningsih Sri , Utama M. Reza , Djalilah Gina Noor
Published: February 2023

Sepsis can occur in patients with Systemic Inflammatory Response Syndrome (SIRS) symptoms, especially in neonates due to their underdeveloped immune systems. Blood culture as the gold standard test to diagnose sepsis in SIRS patients takes a long time to perform. The other rapid test parameters are needed to support the early diagnosis of infection (sepsis) in SIRS patients, including Immature Granulocytes (IG%) and C-Reactive Protein (CRP). This study aimed to determine the correlation between IG% with blood culture and CRP with blood culture in neonatal SIRS patients at Gambiran Hospital, Kediri. The research design used retrospectively using secondary data. A total of 63 samples were obtained using simple random sampling on the medical record of neonatal SIRS patients who met the inclusion criteria, without any exclusion criteria. There were significant results with a value of p=0.000 (p < 0.05) between IG% and blood culture using the Mann-Whitney test, as well as on CRP and blood culture using the independent samples T-test. The bivariate statistical test between IG% and CRP was carried out using the Spearman test and showed significant results with p=0.000 (p < 0.05) with a correlation coefficient (rs) of 0.740, which indicated a strong positive relationship. It was concluded that there was a correlation between IG% and CRP with blood culture in neonatal SIRS patients.
Sputum Smear Conversion as Prognostic Determinant of Timely Complete Therapy on Pulmonary Tuberculosis
Authors: Bastiana Bastiana , Arimbi Muzaijadah Retno
Published: February 2023

Tuberculosis (TB) remains a major health problem worldwide. The bacteriological diagnosis of TB is confirmed by a sputum smear, which shows a positive result. Sputum culture conversion at two months of TB therapy has a higher possibility of completing therapy; however, this method is time-consuming and expensive. This study aimed to analyze the initial smear and smear conversion of sputum in the intensive phase therapy as a prognostic determinant of appropriate time-targeted therapy. This was a retrospective study on pulmonary TB patients collected from January 2016 to December 2017. The research subjects at the beginning of the intensive phase were divided into Acid-Fast Bacilli (AFB)-negative and AFB-positive (1+, 2+, 3+) sputum smears. The sputum smear examination was evaluated at the end of the intensive phase and the end of the six-month treatment. The pulmonary TB patients in this study were 430 patients, dominated by males with the main distribution age of 45-54 years. At the beginning of the intensive phase, the negative results of the AFB examination were 85.4% and the total positive results with 1+, 2+, or 3+ were 14.6%. At the end of the intensive phase, the sputum smear examination of all patients showed 100% conversion, and the sputum smear examination at the end of six months of treatment showed negative results. This study has revealed that sputum conversion at the end of the 2-month intensive phase can be used as a prognostic determinant of timely complete therapy on pulmonary tuberculosis.
The Combination of NLR and D-dimer as Predictor Instrument for the Severity of COVID-19
Authors: Murti Shofia Widya , Prihatni Delita , Sugianli Adhi Kristianto
Published: February 2023

Coronavirus Disease-19 (COVID-19) is caused by Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2). In severe cases, the immune response may cause a cytokine storm. Neutrophil Lymphocyte Ratio (NLR) and D-dimer are parameters that may be used to predict the severity of COVID-19. This study aims to determine the diagnostic validity of the combination of NLR and D-dimer on the severity of COVID-19 patients. The study population was hospitalized COVID-19 patients whose diagnosis were confirmed by real time-PCR. This was a retrospective cross-sectional study. The cut-off value was based on the Area Under Curve (AUC) of the Receiver Operator Characteristic Curve (ROC) analysis and the combination of NLR and D-Dimer validity was tested against the severe and non-severe COVID-19 groups by assessing sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), positive Likelihood Ratio (LR+) and negative Likelihood Ratio (LR-). There were 1,314 subjects. Seven hundred and forty-four were in the severe group, 570 in the non-severe group. The combination of NLR > 4.02 and D-dimer > 1.12 mg/L on the severity of COVID-19 showed a sensitivity value of 70.8%, specificity 98.3%, PPV 98.1%, NPV 72.1%, LR+ 40.38 and LR- 0.30. The combination of NLR >4.02 and D-dimer >1.12 mg/L for the severity of COVID-19 showed high specificity and PPV (98.3% and 98.1%). This was also supported by the LR+ value, which indicates that if NLR > 4.02 and D-dimer > 1.12 mg/L, it may cause severe COVID-19 by 40.38 times compared to NLR â‰¤4.02, and D-dimer â‰¤1.12 mg/L. The combination of NLR and D-Dimer can be used to predict the severity of COVID-19.
Non-HDL Cholesterol and LDL Cholesterol as Main Risk Factors for Coronary Heart Disease: Meta-Analysis
Authors: Untono Ravell Hansen , Nugraha Jusak , Rurus Suryawan I. Gde , Andrianto Andrianto
Published: February 2023

Coronary heart disease is a highly frequent illness in both developed and developing nations. Non-HDL cholesterol (n-HDL-c) and LDL cholesterol (LDL-c) stages are biomarkers that doctors frequently utilize to assess the risk of Coronary Heart Disease (CHD). This study was a systematic review and meta-analysis to assess the association between n-HDL-c and LDL-c as major risk factors for CHD. Cochrane, PubMed, and Science Direct searches were conducted using the keywords "LDL cholesterol," "non-HDL cholesterol," and "coronary heart disease." Any research that describes the analysis of LDL-c and n-HDL-c as key risk factors for CHD and all studies involving patients diagnosed with CHD are included in the literature. A total of seven papers were involved in the qualitative analysis (systematic review), while five studies were included in the quantitative analysis (meta-analysis). The English-language research includes two RCTs, four case-control studies, and one cohort study, with a total of 68,713 individuals. LDL-c parameters were obtained (MD = 8.45; 95 percent CI = 7.03-9.87 p=0.001) and n-HDLc (p=0.001) (MD = 35.57; 95 percent CI = 33.27-37.88). n-HDL-c may be a more significant parameter of CHD risk because it has a higher MD value.
COVID-19 (Symptomatic Non-Respiratory) with Type 2 Diabetes Mellitus
Authors: Kadir Nursin Abdul , Parwati Ida
Published: February 2023

COVID-19 is a respiratory infection caused by a new strain of Coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which is highly contagious, primarily through respiratory droplets and contact. Typical symptoms include fever, cough, and shortness of breath. Weakness, nausea, and vomiting are often accompanied by respiratory symptoms but are sometimes confusing when these symptoms occur without respiratory symptoms. COVID-19 can affect any age group, are more common in adults and males and increase in patients with comorbidities. One of the most common comorbidities is Diabetes Mellitus (DM). A 40-year-old male patient complained of fever and weakness for three days. Nausea and vomiting since nine days before hospital admission, accompanied by painful swallowing, heartburn, and decreased appetite. History of going out of town and eating with friends 14 days before access to the hospital. 3 3 Laboratory examination results: 6600 leukocytes/mm , 264,000/mm platelets, NLR 2.3, 209 mg/dL of blood glucose, HbA1C 8.6%, SGOT 67 IU/L, SGPT 102 IU/L, IgG SARS-CoV-2 reactive, positive TCM SARS-CoV-2 (N2 Ct 18 and E Ct 20.3), and the duration of negative conversion of RT-PCR SARS-CoV-2 results was 19 days. The SARS-CoV-2 virus not only infects pneumocytes but also gastrointestinal, pancreatic, and endothelial cells via ACE2 receptors in DM patients, causing increased cell wall permeability to foreign pathogens and viral replication in the gastrointestinal lining cells. Subsequent enterocyte invasion causes malabsorption resulting in enteric symptoms. Uncontrolled glycemia conditions can slow viral shedding, so the length of negative conversion of RT-PCR SARS-CoV-2 results is prolonged. Based on the data above, the diagnosis in this patient was COVID-19 (symptomatic non-respiratory) with type 2 DM.
Comparison between Sysmex CyFlow Counter and BD FACSCanto II + for counting CD4 Cells in Indonesia
Authors: Hayuanta Hubertus Hosti , Kosasih Agus Susanto , Nasuroh Nasuroh
Published: February 2023

CD4 count is essential in evaluating the immunological status of HIV+ patients and the need for prophylaxis therapy + against opportunistic infections. CyFlow Counter is a novel Sysmex instrument to count CD4 cells and reports the results in + + absolute and percentage values (aCD4 , %CD4 ). However, it has not been evaluated in Indonesia. This study aimed to compare the Sysmex CyFlow Counter with BD FACSCanto II. Samples were collected from leftover EDTA blood samples of + + + patients with CD4 count tested in Dharmais Cancer Hospital. The aCD4 and %CD4 from CyFlow Counter were compared against FACSCanto II using correlation, Bland-Altman, and mean difference test. Sensitivity, specificity, and misclassification rates were also analyzed with aCD4+ count threshold of 200 cells/µL. A total of 70 EDTA blood samples from Dharmais + Cancer Hospital were analyzed with BD FACSCanto II and Sysmex CyFlow Counter, with 20 subjects having CD4 count of 150-299 cells/µL, 28 having 300-449 cells/µL, and 22 having 450-550 cells/µL. CyFlow Counter had a good correlation + + with FACSCanto II in aCD4 and %CD4 (r = 0.892 [p=0.000], r=0.955 [p=0.000], respectively). There was no significant mean + + difference between CyFlow Counter and FACSCanto II (p=0.097 for aCD4 and p=0.611 for %CD4 ). Bland-Altman test + results showed a high agreement (94.29%) with a mean difference of -32.29 cells/µL for aCD4 and a high agreement + (98.57%) with a mean difference of -0.76% for %CD4 . Sensitivity, specificity, and total misclassification rates were 83.33%, + 100.00%, and 3.33%, respectively. Sysmex CyFlow Counter CD4 count results were comparable to FACSCanto II.