bluuebunny/crossref_metadata_2025 huggingface dataset:
Tekanan Pemangku Kepentingan, Good Corporate Governance dan Kualitas Sustainability Report Perusahaan di Indonesia
Authors: Sawitri Aristha Purwanthari , Ardhiani Mutiara Rachma
Published: July 2023

Kondisi lingkungan di seluruh dunia saat ini  memerlukan perhatian khusus. Perubahan lingkungan ini menjadi sorotan pemangku kepentingan (stakeholder) terhadap kegiatan operasional yang dilakukan oleh perusahaan. Salah satu cara perusahaan untuk memenuhi keinginan stakeholder terkait permasalahan lingkungan melalui pengungkapan sustainability report. Penerapan praktik keberlanjutan perusahaan yang ada di Indonesia dalam bentuk laporan keberlanjutan (sustainability report) belum banyak sehingga peneliti bertujuan untuk menganalisis kualitas sustainability report yang dilihat dari tekanan stakeholder dan corporate governance agar Transparency, Accountability, Responsibility, Independency dan Fairness (TARIF) serta Program SDGs dapat tercapai. Populasi dalam penelitian ini adalah perusahaan yang terindeks SRI-KEHATI. Metode pengumpulan data dalam penelitian ini menggunakan content analysis dari dokumen annual report yang diperoleh dari Indonesian Stock Excange (IDX) serta Sustainability Report dari website masing-masing perusahaan. Hasil Penelitian menunjukkan Tekanan Karyawan dan Kreditur berpengaruh terhadap kualitas sustainability report
WEB-BASED LPG DISTRIBUTION MANAGEMENT INFORMATION SYSTEM AT PT BOY BAGUS WINDI
Authors: Silviana Dwi , Samsudin Samsudin , Putri Raissa Amanda
Published: July 2023

PT Boy Bagus Windi is one of the LPG distributors in the Langkat Regency. Because Microsoft Excel is still used to hold distribution data, financial data, sales and purchase data, and personnel data, PT. Boy Bagus Windi faces a number of difficulties managing his data. The problem that businesses run into is that when they need to look for data, it takes a while since they have to access each folder or page in Microsoft Excel individually. Due to the current rapid growth of information technology, many businesspeople conduct their everyday activities online. In order to administer its business management information system, a company is compelled to adopt a web-based information system. Therefore, PT. Web-based Boy Bagus Windi developed a management information system. This system is intended to make it simpler for businesses to search data and handle human, financial, and products data management in one web for a more streamlined and orderly arrangement.
IMPLEMENTATION OF TWO LANGUAGE CHATBOT WEB TO FIND INFORMATION ON BATIK USING THE ARTIFICIAL NEURAL NETWORK MODEL
Authors: Tanjung Taufik Maulana , Hidayat Rahmat
Published: July 2023

Information technology plays an important role in the progress of a country in order to disseminate information massively and make it easier for the public to obtain information. Currently, the development of information technology continues to innovate, such as with the existence of artificial intelligence (AI) technology. This research will discuss AI technology, namely the BatikInd chatbot with the artificial neural network (ANN) method, which aims to make it easier for people to find information about the types of batik that, exist in all regions of Indonesia. The design of the ANN method for making chatbots uses hundreds of sentences to be processed into a database of information about the types of batik and explanations about the batik you want to find. Database processing with epochs reaching 200 produces an accuracy rate of 1.0 (100%) which means the accuracy rate is very good and the error rate reaches 0.03 (0%) which means the error rate is very low. The results of a very good level of accuracy and a very low error rate indicate that this AI can function properly and is feasible to use. It is hoped that with information technology like this, it will make it easier for people to find information about batik and can increase people's literacy and knowledge about batik in all regions of Indonesia.
PENDEKATAN INTERNET OF THINGS UNTUK PREDIKSI BIAYA PENGGUNAAN LISTRIK RUMAH PADA APLIKASI ANDROID
Authors: Aziz Faisal Faris , Hidayat Rahmat
Published: July 2023

Technology is currently growing rapidly and of course, in this era electrical energy has become a necessity for carrying out activities. Therefore, the Smart Watt Meter system can be interpreted as a tool that can monitor and predict costs for home electricity use using the Android application, so that all these devices and systems can be connected to one another. Only by connecting to a smartphone, users can monitor electricity usage and can predict home electricity costs that will be incurred every month using an Android application remotely in real time. Due to the large amount of electricity used in homes that is difficult to control, the aim of designing a Smart Watt Meter system is to reduce excess electricity usage by providing predictions of electricity user costs. This Smart Watt Meter is composed of Wemos D1R1 as the microcontroller in the main system, where when the PZEM 004T V3 sensor reads the value of electricity usage, an output will be produced in the form of a value on the application that has been made and also an OLED display. The results of this study found that voltage, current, power, frequency, power loss, energy consumption, the cost of using electricity per month can be measured. One of the suggestions from this study is to make a dashboard that can be accessed on any device, such as making a dashboard that can be opened on websites and also on smartphones.
STORAGE ROOM TEMPERATURE AND HUMIDITY MONITORING IOT- BASED MEDICINE
Authors: Fauzi Mohamad Adnan , Hidayat Rahmat , Hidayat Taufik
Published: July 2023

This research is important as it portrays a notable advancement in current internet technology known as the Internet of Things (IoT), which facilitates advanced services through the interconnection of physical and virtual objects. One crucial aspect of everyday life is air quality, especially indoors, as indoor air pollution differs from outdoor air pollution. An important indicator to determine the cleanliness of a room is its humidity level. In this context, this research holds significant relevance as it can help ensure the effectiveness and safety of stored medications under appropriate temperature and humidity conditions. Therefore, this study designed a drug storage room that requires a tool to measure the humidity value of the room in real time and the humidity conditions in the room. The solution to this problem can be overcome using Internet of Things technology. In this project, a hygrometer, or humidity meter, based on Internet of Things technology is made. Humidity is measured by the DHT-11 sensor, which is integrated on the NodeMCU ESP8266 board. Humidity measurement data can be observed via the Blynk IoT platform available on smartphones. With this tool, humidity can be observed in real time, even from a distance. The results of this study are that the tool can measure the temperature and humidity of the medicine room, and the tool can send humidity and temperature measurement data to the Blynk IoT and MIT APP Inventor servers. On the Blynk IoT website, the dashboard can display temperature, humidity, and drug safety measurement data in real time.
IMPROVING EXAMPLE-PROBLEM-BASED-LEARNING (EPBL) WITH GROW COACHING MODEL AND DESIGN SPRINT TO OPTIMIZE PRE-INCUBATION CURRICULUM: CASE STUDY OF USER INTERFACE DESIGN
Authors: Susanto Eko Heri , Rizal Ahmad Faisal , Suwina I Putu Indra Wijaya
Published: July 2023

Learning to develop user interfaces is one of the subject matter in startup business pre-incubation activities in PT. Tunas Inkubator Creative Startup. The Example-Problem Based Learning (EPBL) learning method is proven to be able to improve students' cognitive abilities (hard skills). However, hard skill competence alone is not enough to measure one's ability. This research aims to improve the hard skill competencies, as well as the soft skills of the tenants. The contribution to this research is that researchers apply the GROW coaching model method to measure tenant motivation and insert design sprints into the Example-Problem-Based Learning method. Where the function of the design sprint is to improve the attitude of cooperation between teams. The improvisation of learning methods in this study aims to measure students' speed in mastering user interface design subjects. From the trial results it is known that tenants can complete the user interface design within 2 weeks.
ANALISIS PENGUJIAN TAN DELTA PADA TRANSFORMATOR ARUS DI GITET TASIKMALAYA BAY PENGHANTAR BANDUNG SELATAN-1
Authors: Febrijanto Harris Rifqi , Hidayat Rahmat
Published: July 2023

Current transformers are essential for substation protection. It converts large currents into smaller currents that are used for measurement and triggering protection systems. Errors in the conversion of electric current can lead to measurement inaccuracies and protection system failures. Improper maintenance and use can shorten the life of the transformer and also lead to earlier system failure. One of the tests applied is the tan delta test to determine the loss coefficient of the insulating material. A decrease in insulation quality increases the tan delta value. The capacitance value is also measured in the tan delta test. An increased capacitance value indicates the paper insulation has been damaged. Generally, damaged insulation causes a short circuit between capacitor layers which is characterized by an increase in capacitance value. By using the GST-Ground method with the Megger Delta 4110 measuring instrument, the tan delta results of the R, S, and T phases in the southern send bay of Bandung-1 GITET Tasikmalaya are 0.42%, 0.47%, and 0.45%. The results of independent calculations are phase R, S, T are 0.29%, 0.28% and 0.31%. From both results, the current transformer can be said to be feasible to operate because the tan delta value is below 1% which is the operational standard of the current transformer.
IMPLEMENTATION OF MEDIUM VOLTAGE AUTOMATIC CHANGE OVER (ACO-MV) DEVICE AS POWER OUTAGE REDUCTION FOR PREMIUM CUSTOMERS AT PT PLN (PERSERO) UP3 KRAMAT JATI
Authors: Wardhana Oracle Bramantyo , Hidayat Rahmat
Published: July 2023

This qualitative research analyzes the implementation of the ACO-MV device in reducing power outages. The study aims to understand the experiences, perspectives, and impacts of the ACO-MV device on stakeholders, including premium customers, businesses, and industries. Using a qualitative approach, in-depth interviews are conducted with key stakeholders, such as PT PLN (PERSERO) UP3 Kramat Jati representatives, premium customers, and business owners. These interviews provide insights into their experiences and perspectives regarding the ACO-MV device. Observational studies and document analysis supplement the interview data, providing a comprehensive understanding of outage incidents, device operation, and maintenance procedures. Thematic analysis is employed to identify recurring themes, patterns, and insights related to the effectiveness of the ACO-MV device in reducing power outages and its impact on stakeholders. The research findings contribute to a deeper understanding of the qualitative aspects of the ACO-MV device's implementation, informing decision-making and potential improvements in its design, operation, and maintenance. The framework and dataset utilized in this study offer a robust foundation for analyzing stakeholder perspectives and experiences. This research helps advance the understanding of the ACO-MV device's impact on power outage reduction and supports informed decision-making processes.
SISTEM OTOMATISASI PEMANAS AIR MENGGUNAKAN SENSOR DHT11 BERBASIS ARDUINO UNO
Authors: Syaiji Alfin Alif , Hidayat Rahmat
Published: July 2023

Heat water is part of our needs in our daily life. With its variety of uses, a tool is needed to heat the water. In this study, a system will be designed so that the heat water can turn off automatically whenever the water is boiling. The methods used will include literacy studies from previous research journals, component selection based on literacy studies, and system design. The results obtained will be in the form of division of experimental water based on the set of temperature points on programming as a benchmark. From the experimental data, it can be concluded that the relationship between the amount of water and the temperature value for the set point in the programming will affect the water produced at the end of the experiment greatly. The more the amount of water, the higher the set point must be given.
IMPLEMENTASI KEPEMIMPINAN PEMBELAJARAN KEPALA SEKOLAH DI SMA NEGERI 1 OKSIBIL KABUPATEN PENGUNUNGAN BINTANG PROVINSI PAPUA
Authors: Saalino Mexen , Mataputun Yulius
Published: July 2023

Penelitian ini bertujuan untuk menganalisis implementasi kepemimpinan pembelajaran kepala sekolah dalam merumuskan dan mensosialisasikan visi-misi sekolah, menerapkan manajemen partisipasi, memberikan dukungan pembelajaran, pemantauan pembelajaran, dan sebagai fasilitator di SMA Negeri 1 Oksibil Kabupaten Pegunungan Bintang Provinsi Papua. Penelitian ini menggunakan pendekatan deskriptif kualitatif rancangan studi kasus. Sumber datanya kepala sekolah, wakasek kesiswaan, guru mata pelajaran, komite sekolah, pengawas dan didukung dengan pengamatan serta pengecekan dokumen. Teknik keabsahan data menggunakan uji kredibilitas data yaitu perpanjangan pengamatan, triangulasi dan diskusi teman sejawat. Teknik analisis data menggunakan analisis interaktif Miles dan Huberman, yaitu : reduksi data, display data, dan kesimpulan. Hasil penelitian ini menunjukkan bahwa : secara umum, kepala SMA Negeri 1 Oksibil telah mengimplementasikan kepemimpinan pembelajaran yang diwujudkan melalui kegiatan merumuskan dan mensosialisasika visi-misi pada warga sekolah; melibatkan pemangku kepentingan dalam pengelolaan sekolah; memberikan dukungan utama dalam pembelajaran; memantau pelaksanaan proses pembelajaran; memfasilitasi pembinaan guru dalam program PKB guru namun belum optimal dalam melengkapi jurnal mengajar dan kelas, refleksi PTK, dan pengembangan metode-media pembelajaran.
IMPLEMENTASI TEKNIK SUPERVISI INDIVIDUAL KEPALA SEKOLAH: SEBUAH STUDI LITERATUR
Authors: Sembiring Desy Anita Karolina
Published: July 2023

Kepala sekolah sebagai supervisor berperan penting dalam pelaksanaan proses pembelajaran di sekolah. Melalui kegiatan pembinaan atau yang dikenal dengan istilah supervisi, diharapkan dapat membimbing secara kontiniu pertumbuhan dan perkembangan potensi para guru baik secara individual ataupun kolektif. Penelitian ini bertujuan untuk mengetahui teknik supervisi yang dapat digunakan oleh supervisor, terkhusus pada teknik individual. Jenis penelitian ini adalah studi literatur dengan menelaah 10 artikel terkait teknik dan implementasi supervisi. Hasil penelitian ini adalah terdapat berbagai jenis teknik supervisi secara individual, yakni Kunjungan Kelas (Classroom Visitation), Observasi Kelas (Classroom Observation), Pertemuan Individual (Individual Conference), Kunjungan Antar Kelas (Intervisitation) dan Penilaian Diri Sendiri (Self Evaluation Check-List).
KOMPETENSI KEPRIBADIAN GURU DALAM MENANAMKAN NILAI AGAMA DAN MORAL PADA ANAK USIA DINI SELAMA PANDEMI COVID-19 DI TK PATTOLA PALALLO
Authors: SYARIF NURMI YULIANTI , ITING ANDI , RUSDU MUHAMMAD , SAFITRI FEBRIANI
Published: July 2023

Situasi saat ini, dimana adanya peralihan sistem pembelajaran tatap muka ke daring/online, menjadi tantangan terhadap para guru dalam upaya pencapaian tujuan pendidikan nasional. Dalam hal ini, kompetensi guru diperlukan untuk dapat mengelola pembelajaran di PAUD tanpa mengabaikan internalisasi nilai-nilai agama dan moral kepada anak didiknya.Tujuan penelitian ini guna mengkaji kompetensi kepribadian guru dalam penanaman nilai agama dan moral pada anak usia dini di masa pandemi covid-19 di TK Pattola Palallo. Penelitian ini termasuk dalam jenis penelitain deskriptif dengan pendekatan kualitatif. Data penelitian diperoleh melalui wawancara, observasi, dan dokumentasi. Hasil penelitian menunjukkan bahwa pembelajaran yang dilaksanakan di TK Pattola Palallo pada Tahun Ajaran 2020/2021 sejak pandemi Covid-19 yaitu menggunakan sistem pembelajaran daring (online). Guru memanfaatkan aplikasi What’sApp untuk berkomunikasi dan memberikan pembelajaran kepada peserta didik.
ANALISIS PERUBAHAN KEBIJAKAN PENDIDIKAN DARI KURIKULUM 2013 KE KURIKULUM MERDEKA
Authors: Puspita Yanti , Atikah Cucu
Published: July 2023

This curriculum emphasizes enjoyable and burden-free learning. Each learning process is expected to be differentiated to accommodate the diversity of students' interests and talents. In this study, the method used was literature research. The data collection technique involved searching for information related to the research focus through notes, books, scientific articles, and other relevant sources. The research instrument used by the researcher was a checklist of research materials based on the topics and focus of the study. This study’s findings are: 1) replacing the National Final Examination (USBN) with competency assessments for students. This assessment consists of written tests, portfolios, and group assignments such as essays; 2) eliminating the National Examination and replacing it with Minimum Competency Assessment and Character Survey developed by schools; 3) simplifying lesson plan; 4) more flexible zoning regulations for new student admission; 5) teaching assistance in educational units to provide work experience for students. In order to achieve the noble goals of the Merdeka Curriculum, support from all educational stakeholders, parents, and the community is needed. In addition, periodic training for teachers is necessary to improve readiness for implementing the Merdeka Curriculum.
HUBUNGAN MOTIVASI DAN PARTISIPASI BELAJAR MAHASISWA PADA MATA KULIAH SISTEM INFORMASI GEOGRAFIS DI PROGRAM STUDI GEOGRAFI FKIP UNCEN
Authors: Tumober Renny Threesje , Abrauw Rudolf Doni , Hamokwarong Ester Y.
Published: July 2023

This study aims to determine the relationship between learning motivation and student participation in semester VI Class of 2019 in the Geographic Information Systems course with the hypothesis that if rcount ≥ rtable, then Ho is rejected and Ha is accepted, and if rcount ≤ rtable, then Ho is accepted and Ha is rejected. The method used in this research is quantitative research with correlational analysis of Pearson Product Moment (PPM), with a total sample of 40 students in this study. Based on the results of the normality test, linearity test, homogeneity test and Pearson Product Moment correlation test, the research results show that there is a fairly strong relationship between learning motivation and learning participation, because the results of tcount ≥ ttable are 0.512 ≥0.312, so it can be concluded that the research hypothesis mentioned at the beginning of this study was accepted.
Pertimbangan Orang Tua Dalam Memilih Taman Kanak-Kanak
Authors: Kurniawan Diki
Published: July 2023

Parents' considerations in choosing a school for their child, especially early childhood education in the kindergarten program, are activities that must be carried out by parents before enrolling their child in school. It is intended that the education that children receive is in accordance with their needs so that it can stimulate their growth and development. Various reasons for parents in choosing a school must be adjusted to the situation and conditions they experience. On the other hand, the reasons for this consideration can be used as reference material for school principals in developing their schools. Data collection used an online survey with 39 respondents. The results of his research are that the distance between school and place of residence is the reason that dominates parents choosing a school for their children, although the other reasons are not much different in presentation. But other things that need attention for school principals are competitors of similar schools, the age of school children around the school, parents' perceptions of the importance of getting early childhood education, especially kindergarten. In addition, the regulations for granting operational permits for kindergartens by authorized agencies must pay attention to the number of similar schools in the area, this is due to avoid schools going out of business due to not having students.
PROBLEMATIKA PEMBELAJARAN DARING DI MASA PANDEMI COVID-19
Authors: Tijow Meylani Aljeinie , Sembiring Desy Anita Karolina , Risamasu Putri Ellen Gracia , Aryesam Agnes
Published: July 2023

The Covid-19 pandemic resulted in the emergence of accelerated learning that was previously carried out attractively to be courageous in order to suppress the increase in cases of the Covid-19 virus. This study describes what learning problems are faced by students and also lecturers in the Department of Education, Cenderawasih University. The research method used is descriptive quantitative with indicators including, encouraging learning strategies and clarity, quality of learning materials, student involvement and activeness in the brave class (student engagement) and achievement of course learning achievements (CPMK) as a form of evaluating brave learning during the Covid pandemic -19. The results showed that from a student's point of view, learning courage during the Covid-19 pandemic at JIP Cenderawasih University was still not effective and efficient. Some of the reasons behind this are that there are still many students who do not have gadgets as learning media and it is difficult for students to get internet access.
EFEKTIVITAS KEBIJAKAN "MERDEKA BELAJAR, KAMPUS MERDEKA" BAGI MAHASISWA DI DAERAH PERBATASAN
Authors: Dimmera Bella Ghia , Lumbantobing Winda Lidia , Purnasari Pebria Dheni , Sadewo Yosua Damas , Saputro Totok Victor Didik
Published: July 2023

The purpose of this study is to determine the effectiveness of the "Merdeka Belajar, Kampus Merdeka" (MBKM) policy for students in border areas. The problems that exist in border areas are analyzed through descriptive qualitative case studies. The main data sources for this research were obtained through surveys and interviews. Questionnaires and instructions for surveys were given to respondents, namely students. Data were collected through interviews and documentation; triangulation to ensure data validity; and data were analyzed through reduction, presentation, and conclusion drawing. The results of the study revealed that the target of the MBKM policy for 36 students is the effectiveness of the MBKM policy in border areas is considered not entirely appropriate.  The results obtained are not the right policy, not the right implementation, not the right target, and not the right environment.  With the existence of the MBKM policy, students have not received and understood the benefits, namely the MBKM policy has been socialized but students have not understood it well, not yet appropriate implementation, that the government has established the MBKM policy, but it is not in accordance with the conditions of universities in border areas. Not yet on target, that education equity has not yet reached the target. Not yet appropriate environment, that the MBKM policy has not provided information related to educational development in border areas.
Geodesics as Equations of Motion
Authors: Aaberge Terje
Published: July 2023

The empirical description of the evolution of a physical system is the account of observed changes of state of the system in time, the measure of time being that of the Systeme International. To describe the Sun-Mercury system Einstein proposed a model based on the assumption that the evolution of the system, i.e. its relative space-time trajectory describes a geodesic on space-time endowed with the Schwarzschild metric. The evolution parameter of a geodesic is, however, an affine parameter or equivalently the proper time. However, the geodesic equation can be expressed in coordinate time. It has been shown that the solution of this equation reproduces the empirical evolution. A possiblee interptetation of the proper time is presented.
Impact of Men’s Labour Migration on Non-migrating Partner’s Health in Low- and Middle-Income Countries: A Systematic Review
Authors: Manandhar Shraddha , Simkhada Padam , Brown Philip , van Teijlingen Edwin
Published: July 2023

Globally, international and internal labour migration are common phenomena. In LMICs, labour migration, particularly international migration, typically means the men migrate while their wives/partners remain at home to take care of their family. Little attention has been paid to the impact of men’s migration on non-migrating partner’s health. Therefore, we undertook a systematic review to explore the impact of men's migration on the health of women who remain behind in LMICs. We searched five databases, CINAHL, Google Scholar, PsycINFO, PubMed and Scopus, for publications from 2005 to 2022. Thirty-three peer-reviewed publications were included in the review out of which 15 explored mental health, 13 looked at sexual and reproductive health, ten at physical health, five at health-care accessibility and four studies focused on other health related issues. Findings suggest that women who remained behind or ‘left-behind’ women had increased access to healthcare due to better financial positions (via remittances). Remittances led to improved food and housing security, a critical wider determinant of health. However, some studies reported that in the longer term, the physical health of women who remain behind was negatively impacted. Almost all studies on mental health reported higher depressive symptoms among migrant wives compared to women co-habiting with their spouses. Left-behind women feared contracting sexually transmitted infections from their migrant partners. Our findings also showed that several marriage, family, finance and individual factors could affect the health of women who remain behind. National and local policies should include support groups and counselling services at the local health centre for women who remain behind. We recommend further studies on the areas presented above as well as unexplored areas such as vulnerability to violence and impact of remittance on health and nutrition.
Scrotal Kaposi's Sarcoma in HIV-negative Patient: A Case Report and Review of the Literature.
Authors: Bushati Teona , Berdica Leart , Ndoja Albina , Sukaj Erion , Ibrushi Ilirian , Kaza Leon
Published: July 2023

Background: Kaposi's sarcoma (KS) is an indolent angio-proliferative tumor proliferation with spindle cells originating from endothelial and immune cells infected with human herpes virus type 8. (HHV-8: also known as Kaposi sarcoma herpes virus [KSHV]). HHV-8 was identified as the causative agent of KS. This virus is present in 95-98% of cases with KS. Kaposi's sarcoma was first described by a Hungarian dermatologist 1872 named Moritz Kaposi.[1]

The lesions are characterized by the proliferation of spindle cells of endothelial origin, which present different degrees of abnormal vascularization, inflammatory infiltrates, and fibrosis. Kaposi's Sarcoma (KS) is a malignancy that generally affects the skin, and can be systemic with internal organ involvement. It originates from the vascular endothelium. KS's relationship with human immunodeficiency virus (HIV) infection is well known.

In this article, we will present a 73-year-old male patient with 3 purple scrotal lesions up to 0.5 cm in size.

Conclusion; Kaposi's sarcoma of the scrotum in a negative patient is a rare pathology. However, in cases of scrotal lesions that last over time, a differential diagnosis should be made and Kaposi's sarcoma should be taken into consideration. Also, a screening for other accompanying lesions, especially a detailed examination of the gastrointestinal tract is important in cases of Kaposi’s sarcoma of the scrotum.
Evaluation of ALK, EGFR and PD-L1 Mutations in Pulmonary Carcinomas through Immunohistochemistry
Authors: Bushati Teona , Berdica Leart , Memçaj Jeta , Laçi Ilirian , Ibrushi Ilirian
Published: July 2023

Introduction: Lung cancer, with about 2.2 million new cases and 1.8 million deaths, is the second most commonly diagnosed cancer and the leading cause of cancer death in 2020. Immunohistochemistry (IHC) now is used not only to diagnose and classify lung tumors into subtypes, but also to determine the eligibility of patients for different molecular-targeted therapies.

Objectives : Study of ALK, EGFR and PD-L1 mutations in Pulmonary Carcinomas through immunohistochemistry examinations to help determine the prognosis and cases that may benefit from target therapy. Detection of possible links between ALK, EGFR, PD-L1 and other variables such as age, sex, histological entity and degree of tumor differentiation.

Materials and Methodology: The study is retrospective and includes 266 patients diagnosed with lung cancer who underwent biopsy at the American Hospital in the period 2016-2020. Tissues obtained were subjected to IHC examination using antibodies against factors EGFR, ALK, PD-L1, etc.

Results: The study showed that out of 266 patients, 24% of lung cancer cases are females and 76% are males. The average age was 61.8 years. No statistically significant relationship was found between ALK, PD-L1 and EGFR with variables such as age, gender and degree of differentiation of adenocarcinomas. No significant link was found between ALK and PD-L1 and the histological entity, but a significant link was found between EGFR and histological type of pulmonary carcinomas.

Conclusions : Lung cancer is one of the most common cancers, found mainly in men, but also in women. Nowadays, IHC helps not only to diagnose lung cancer, but also to determine patients who can respond to target therapy and their prognosis. Therefore, the use of IHC to detect ALK, EGFR, PDL-1 mutations and their links to patient characteristics is becoming increasingly necessary.
MRI in Evaluation of Rectal Cancer pre- and post-Chemo-Radiation Treatment.
Authors: Darweesh Adham , Al Obaidli Amal , Kambal Alaa , Aboughalia Hassan , El Ansari Walid , Ramadan Reda , Abu Nada Mohamed , Abdelmoneim Ahmed Hassan
Published: July 2023

Rectal cancer is associated with a high risk of metastases and local recurrence; local recurrence rates after surgical treatment being up to 32%. An accurate local staging at the time of initial diagnosis is therefore very important. Magnetic Resonance Imaging (MRI) is already established as an accurate tool for the preoperative staging of rectal cancer and has resulted in marked improvements in staging accuracy.

Material and Methods: This study used MRI in comparing the morphologic features of rectal cancer before and after 8 weeks of chemo-radiation treatment (CRT) and to correlate the post treatment MRI appearances with the histological findings in resected tumors. 45 patients with histo-pathologically proven rectal adenocarcinoma received standardized 8 weeks chemo-radiation therapy and subjected to MRI before and after treatment for clinical staging. A correlation between pathological response and MRI findings was done.

Results:  The MRI diagnostic accuracy to diagnose T2 is 74.2% with relatively low specificity (64.7%). The diagnostic accuracy of MRI in evaluation of stage T3 and T4, the MRI sensitivity was 96.2% however of low specificity 26.3%. The diagnostic accuracy was 66.7%. Additionally, in evaluation of T2 stage, the sensitivity of MRI was very low 27.3% and specificity relatively high 94.7%. Diagnostic accuracy was 70%.

Post RCT, based on downstaging after CRT, the sensitivity of MRI to show no tumor was very low 0% with diagnostic accuracy 88.9%. However, to evaluate stage T2, the sensitivity was 84.6% with low specificity 66.7% and the diagnostic accuracy was 74.2%.

Conclusion: MRI had an accuracy average of 81.6% in T stage and 68.9% in N stage in re-staging rectal tumors after CRT. Over-staging results of majority of the inaccuracy. The statistical agreement between post-CRT MRI and the pathologic staging involving T and N stages was not satisfactory. In view of the above, Post CRT, restaging rectal cancer remains a challenge.
Staged Crystalized Phenol Treatment in Pilonidal Disease: A Retrospective Cross-Sectional Study
Authors: Güler İlkay , Balas Şener , Karabacak Harun
Published: July 2023

Background: In recent years, minimally invasive techniques with less tissue excision, rather than surgical treatments including wide tissue excisions, are preferred in the surgical treatment of pilonidal sinus. Crystallized phenol treatment is a widely used minimally invasive method. The aim of this study is to examine the results of applying crystallized phenol in a two-stage manner.

Material and Methods: In this study, demographic information, pilonidal sinus characteristics, and results of crystallized phenol treatment of primary pilonidal sinus patients treated with crystallized phenol at Ankara Yıldırım Beyazıt Education and Research Hospital General Surgery Clinic between January 2016 and July 2021 were retrospectively analyzed.

Results: The average age of 185 patients who underwent phenol treatment for pilonidal sinus was 26.75±6.21 years. 53.2% of the patients were ≤25 years old. 80.5% of the patients were male. 65.0% of all patients had a BMI <30 kg/m2. The follow-up period for patients was 31 months (min 6, max 60). The patients had 1-3 pits. In the final evaluation of patients who received crystallized phenol treatment twice, abscesses developed in 3 patients (1.6%) and recurrences occurred in 8 patients (4.3%). A statistically significant relationship was found between age and recurrence (p=0.027) and between BMI and recurrence (p=0.003). The incidence of recurrence increased significantly as the number of pits increased (p<0.001).

Conclusions: In our study, we did not encounter any serious complications with the application of crystallized phenol in two stages. We observed that our patients returned to their routine lives painlessly in the early period and that our recurrence rates were low. Based on our findings, we can say that the application of crystallized phenol as a minimal invasive procedure is still a safe and valid method for the treatment of pilonidal sinus.
Different Pain Types at Coccygodynia and its Relation with Vitamin D Level
Authors: Güler Emel , Unal Hanzade Aybuke
Published: July 2023

Background;  Coccygodynia is a musculoskeletal disease that affects quality of life. The main complaint of coccygodynia is nociceptive and/or neuropathic pain. Vitamin D deficiency has been associated with the development of pain in various diseases. 

Aims; In this study we aimed investigate the pain types (nociceptive, neuropathic, mixed) and the relationship between pain types and Vitamin D level in patients with coccygodynia. 

Study design; Observational study

Materials and Methods; A total of 54 patients diagnosed with coccygodynia were included.  Pain intensity, disablity and pain type were evaluated by Visual Analogue Scale (VAS), the Oswestry Disability Index (ODI), and the PainDETECT questionnaire, respectively. All participants had their vitamin D levels measured. 

Results; Neuropathic pain was detected in 27.8% of the patients with coccygodynia. Vitamin D was determined to be insufficient or deficient in 81.5% of the patients. A statistical significant correlation was found between neuropathic pain and prolongation of coccygodynia and increased ODI values (p<0.05). The Vitamin D values were determined to show statistically similar distribution in the nociceptive, mixed type, and neuropathic pain groups (p=0.532). 

Conclusion; The frequency of neuropathic pain in coccygodynia increases with increasing disability and disease duration. Although vitamin deficiency or insufficiency is common in coccygodynia, it is not associated with the type of pain.
Characterization and Prevalence of Pediatric Ramp Lesions Associated with Anterior Cruciate Ligament Tears.
Authors: Borici Neritan , Ezeokoli Ekene , Loyd Nathaniel Gray , McKay Scott
Published: July 2023

Background: Ramp lesions correspond to posterior meniscocapsular tears of the medial meniscus and are common with anterior cruciate ligament (ACL) tears. They cannot be recognized easily on preoperative magnetic resonance imaging (MRI) scans and are difficult to visualize even using standard arthroscopic approaches. We aim to (1) characterize and evaluate the prevalence of ramp lesions in pediatric patients at a major tertiary children's hospital, providing important insights into demographics, diagnosis, treatment, and functional disability and (2) evaluate the efficacy of MRI in its diagnosis.

Materials and Methods: We retrospectively reviewed patients under 21 years old undergoing posterior medial meniscal injuries and anterior cruciate ligament ruptures with arthroscopic examination and positive ramp lesions from 2018 to 2021. Patient demographics (including gender and age), initial presentation, physical examination findings, mechanism of injury, pre-operative radiologic findings, and treatment were collected and reviewed via electronic medical record. Exclusion criteria included patients over 18 years old, patients, that did not have an MRI, and patients that were not treated surgically.

Results: There were 117 patients that met the inclusion criteria out of 690 patients. The mean age at diagnosis was 15.6±1.6 years and the mean BMI was 26.7±6.4. 83% of injuries occurred secondary to sporting activities. Ramp lesions were only detected on preoperative MRI in 63% of cases, suspected in 3%, and not detected in 33%. The sensitivity of the MRI was 63%.

Conclusions: Ramp lesions were found in 117/690 (16.9%) of patients undergoing ACL reconstruction. MRI had a low sensitivity rate of 63%. During ACL reconstruction, a careful review of the posteromedial compartment is important to recognize less obvious trauma. Lack of treatment may lead to continued instability and risk of complications in these patients.
Bedside Ultrasonographic Assessment of the Optic Nerve Sheath Diameter to Assess Intracranial Pressure in Patients Given Ketamine in Emergency Department
Authors: Yılmaz Fevzi , Akça Erdi , Baltacıoğlu Bora , Tiftikçi İffet , Arslan Engin Deniz , Kavalcı Cemil , Beydilli İnan
Published: July 2023

Background: There is an ongoing debate if ketamine exerts any effect on intracranial pressure (ICP). ICP can be evaluated noninvasively by means of optic nerve sheath diameter (ONSD) measurement. In the present study, we aimed to determine if ketamine has any perceivable effect on ICP using ONSD.

Material and Methods: In this single-center observational study, we prospectively enrolled patients who were admitted to the ED and received intravenous ketamine for induction, analgesia, procedural sedation for any procedure (ie, fracture reduction, laceration repair, pacemaker implantation). ONSD was used to rate ICP changes noninvasively both before and after ketamine application.

Results: There were a total of 75 patients with a mean age of 59.8 ± 20.5 years. The majority of patients were applied Procedural Sedation (53.3%). In patients who were administered ketamine for induction, the median ONSD before and after ketamine were 5.10 (IQR: 1) mm and 5.00 (IQR: 1.30) mm, respectively. There occurred no significant diameter change (p=0.832). In patients who were administered ketamine for analgesia, the median ONSD 3.70 (IQR: 0.40) mm and 3.65 (IQR: 0.23) mm prior to and after the procedure, respectively. There occurred no significant diameter change (p=0.549). In patients who were administered ketamine for procedural sedation, the median ONSD before and after the procedure were 4.05 (IQR:0.67) mm and 3.97 (IQR: 0.69) mm, respectively. This time, however, ONSD was significantly reduced after ketamine administration (p=0.001).

Conclusions: In this patient population, ketamine did not cause any incremental effect on ONSD, a surrogate marker of ICP.
The Origin of Pilonidal Sinus Disease – 10 wrong Theories and one Recent Discovery
Authors: Dettmer Marius , Degiannis Konstantinos , Braun-Münker Myriam , Doll Dietrich , Maak Matthias
Published: July 2023

Introduction: In the last two centuries, many theories have been proposed to explain the origin of pilonidal sinus disease (PSD) – congenital and acquired.

Materials and Methods: A PubMed literature review was conducted and looked at different proposed theories on the origin of PSD; this overview was then compared to research results from more recent studies.

Results: Initially it was postulated, that PSD was of embryonic origin. This however changed during World War II as more 78.000 American soldiers were diagnosed and treated for PSD. Thereafter, the perception of the origin of PSD changed to an acquired one. New data has shown that short hair fragments, which have fallen from the scalp may be the origin of PSD – therefore disproving the theory of folliculitis and fatty gland obstruction.

Conclusion: These new findings may explain why recurrences/new diseases occur within follicle-free areas – such as scars and without any preceding infection. This may aid in the prevention of PSD.
The Key Role of Splenectomy in Fever of unknown Origin which Resulted to be B-cell primary Splenic Lymphoma.
Authors: Muco Ermira , Osmenaj Renato , Bode Rovena , Blloshmi Amarildo , Prendi Jona , Berdica Leart
Published: July 2023

Background: The term ‘fever of unknown origin’ (FUO) was first introduced by Petersdorf and Beeson in 1961, and it is defined as recurrent fever >38.3°C, lasting for >3 weeks, remaining undiagnosed after 1 week of in-hospital evaluation. The etiologies of classic FUO include mainly infections, malignancies, non-infectious inflammatory diseases, and miscellaneous causes, while some cases remain undiagnosed. Primary splenic lymphoma (PSL) is a rare malignant lymphoma. In many cases, splenectomy is the treatment of choice for massive splenomegaly.

Case presentation: A 54-year-old woman presented with a history of high fever up to 39°C, sweating, fatigue, and weight loss for one month. She had been treated by her family physician with antibiotics (cephalosporin) for 10 days but without improvement. On admission, the patient had palpable splenomegaly but no palpable lymphadenopathy. The patient had increased markers of inflammation. The indicators of autoimmune disease were all negative. Screening for specific infectious diseases and the blood cultures all came out negative. Abdominal computerized tomography (CT) revealed an enlarged spleen. The splenectomy was performed and the spleen was sent for histological analysis. Meanwhile, the patient was subject to a complex treatment. Histological and immunohistochemical analysis confirmed the diagnosis of diffuse large B-cell non-Hodgkin lymphoma with diffuse red pulp infiltration. Afterward, the patient underwent systemic chemotherapy.

Conclusion: We strongly suggest that clinicians should have a high index of suspicion for malignancies in cases with FUO. Sometimes splenectomy can be the key to solving the problem.
Ventral Hernias in Kalyana Karnataka Teaching Hospital: A Prospective Study.
Authors: Patil Sunil Kumar , Reddy Anil , Shafiuddin Mohd , Aziz Abu Hasim Abdul , Abhijith H M
Published: July 2023

A ventral hernia is a protrusion of the abdominal viscus through the anterior abdominal wall occurring at any site other than the inguinal and femoral areas and is a common problem encountered by surgeons.
Aims & Objective: Due to the lack of prospective cohorts to determine the natural history of untreated ventral hernias, most surgeons recommend that these hernias be repaired as soon as they are discovered. The purpose of this study was to determine the proportion of ventral hernias occurring in both sexes, various age groups, various risk factors, and complications, as well as their clinical presentations and treatment.
Material and Methods: During the period August 2020 to August 2021 (12 months), a prospective study was conducted at our tertiary care hospital. The study included 50 cases of anterior abdominal hernias excluding groin hernias and posterior abdominal wall hernias. A detailed history and a thorough clinical examination were used to collect data. In the proforma, data was entered, tabulated, and analyzed using statistical software (SPSS 2015).
Results: Ventral hernias accounted for 5% of surgical admissions. Among the ventral hernias, para umbilical hernias were the most prevalent (48%). An infra umbilical midline herniation accounted for 36% of cases, followed by an umbilical region herniation in 18% of cases. Constipation and obesity were found to be the major risk factors. Most defects are small (>2cm). 48% of inlay mesh repairs were made.
Conclusion: 50 cases of ventral hernias were studied in the present study, which was conducted in our tertiary care hospital. Five percent of all admissions to the surgical ward were due to ventral hernias. The females to males ratio was 1:17, and the mean age was 41. The mean total duration for surgery in sublay group was 75.4±9.23 minutes compared to 63.7±10.58 minutes in onlay group, which was statistically significant (p<0.05).
Chylothorax Management Four Years Post Spine Surgery: A Successful Conservative Treatment
Authors: Skenduli Ilir , Mezini Arjan , Caushi Fatmir , Tanka Arben , Gjati Laert
Published: July 2023

Background: Chylothorax is a pathological condition associated with a high mortality and morbidity rate. The first observation of chylothorax associated with thoracic vertebral injury was documented by Krabbell in 1885. Since then, several cases have been described in the literature.

Non traumatic chylothorax several years after spine surgery is a rare condition. We described a case of a patient who sustained a thoracic spine fracture-dislocation and presented with a right sided chylothorax as a late complication to his thoracic spine trauma. A right thoracentesis was performed, providing partial relief of respiratory symptoms. The collected fluid was sent to the laboratory for further examination. Biochemical analysis of the milky pleural fluid confirmed the suspicion of chylothorax, with elevated levels of triglycerides and lymphocytes. These findings supported the diagnosis of chylothorax.

Conclusion: Non-traumatic chylothorax occurring several years after spine surgery is a rare condition, and there is limited literature available on this particular pathology. The diagnosis can be simplified through laboratory examination of the milky fluid. Conservative treatment is typically the approach of choice in the majority of cases, involving total parenteral nutrition and the insertion of a chest tube into the chest cavity, followed by chemical pleurodesis.
Comparative Analysis of Knee Replacement Surgery who follow up by Physical Therapy and Intra-articular Steroid Injections for Obese Patients.
Authors: Avdulaj Eugerta
Published: July 2023

Knee osteoarthritis (KOA) is the most common chronic articular disease, and its prevalence has doubled since the mid-20th century. It affects 16% of the adult population over 50 years of age in the post-industrial era [1].

Obesity is one of the only modifiable risk factors for both incidence and progression of Osteoarthritis (OA).[2]

Although OA was previously regarded as a disease of the elderly, its development starts much earlier than originally thought, and OA is ranked among the top 20 diseases in the 40–45 years age group [3].

This review aims to provide a comprehensive analysis of the outcomes of knee replacement surgery following up physical therapy, versus intra-articular steroid injections for obese patients (BMI >30)

The study design employed in this review is narrative, and articles published after 2010 from PubMed were considered for inclusion. The review examines the impact of each intervention on the complete regain of knee function in this specific population.

Through the analysis of relevant studies, this review seeks to inform clinical decision-making and guide the management of obese patients with knee osteoarthritis.

Conclusion. 

Based on the reviewed literature, knee replacement surgery appears to offer a better chance of achieving complete regain of knee function in obese patients (BMI >30) undergoing physical therapy compared to intra-articular steroid injections. However, the findings are limited by the availability of studies and the heterogeneity in the research methodologies.