bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep stimulation in neurosurgery
Authors: Kalinkin Aleksandr A. , Vinokurov Alexey G. , Kalinkina Olga N. , Ilinykh Alexander S. , Bocharov Andrey A. , Durov Oleg V. , Isaev Evgeny N. , Chupalenkov Sergey M.
Published: June 2019

The technique of deep brain stimulation is used to treat patients with various diseases of the central nervous system who are not amenable to conservative therapy, while open interventions in them are associated with a high risk of complications. In the review, we evaluate the efficiency of the deep stimulation of different regions of the brain in some pharmacoresistant forms of diseases.
Paseo, sancocho y río. Memorias y olvidos sobre el conflicto armado en Pance, Cali
Authors: Medina-Vargas Inés Marcela , Bolaños-Martínez Yamileth , Barón Luis Fernando
Published: June 2019

This article explores the memoirs of entrepreneurs from the Pance River, in Cali, Colombia, by using an ethnographic perspective. The journey through their memories emphasizes two moments: the violence they experienced during three confrontations between guerrilla groups and the police, which left civilians in the crossfire, and the link with the socio-environmental projects in the region. The interviewees reminiscencestend to make invisible their experiences in the armed conflict in order to protect the survival of the community, of their ecosystems, and of the traditional Sunday trips to the river; these are their main sources of living in the present and future. This study offers significant clues on the hegemonies of the memoirs and on how some daily experiences within the armed conflict became culturally trivial.
THE ROLE OF ISLAMIC BANKING IN AGRICULTURE FINANCING (CASE STUDY OF INDONESIAN AGRICULTURE SECTOR)
Authors: Utama Satria , Suwarsi Aqidah Asri , . Listiono
Published: June 2019

Purpose: This paper aims to analyze the role of Islamic banking in improving the agricultural sector as well as providing alternative solutions such as financing scheme for agricultural financing.

Methodology: The research method is qualitative. A review of the extant literature was carried out for collecting primary and secondary data. In-depth interviews with key informants such the farmer and Islamic bank financing manager were also conducted. Data analysis was performed by adopting data reduction, data display with SWOT matrix, verification, and conclusion.

Main findings: This paper finds that Islamic banking allocates financing for agricultural sector which is less than 10 percent of total financing. The finding is in line with the problem faced by the farmer. Based on the interview, it is known that the main problem of agriculture industry is limited access to the source of capital. The second finding pertains to the lack of Islamic banking’s role in agricultural financing caused by high risk perception and minimum competence of human resources to maintain the agricultural financing.

Applications: This paper suggests the implementation of Ba'I As Salam scheme as an alternative for agricultural financing. Salam Financing Scheme is more suitable for agricultural financing than the murabaha financing that are commonly used today. Because the salam financing scheme intends to finance the sale and purchase of new commodities that are to be processed or produced and the delivery of their goods in the future, as well as allow for irregular payment schemes made in the harvest. Some of these advantages can be agricultural financing solution that is more in line with the characteristics of agricultural sector cash flow.

Novelty/Originality of this study: Previous Studies related to the agricultural sector only deals with the impact of agricultural finance without offering low cost financing models as the solution to the main problem in the agricultural sector. This study provides solutions to these problems.
THE MUSTAHIQ EMPOWERMENT MODEL: A COLLABORATION BETWEEN SHARIA BANK AND OPZ IN OPTIMIZING ZAKAT FUNDS
Authors: Manggala Putri Syah Amelia , Firmansyah Eka Jati Rahayu , Hamid Homaidi
Published: June 2019

Purpose of the study: To find a Zakat fund management scheme based on sharia banking for sustainable mustahiq empowerment.

Methodology: This research is qualitative research using grounded theory method.

Main Findings: Zakat funds collected are used as collaterals for deposits for the development of mustahiq businesses. The profit sharing ratio from the deposits will reduce the mustahiq installment expense. While deposit guarantees will make mustahik get financing easily from Islamic banking.

Applications of this study: The research findings can be used in studies on productive zakat, philanthropic studies and the development of Islamic banking.

Novelty/ Originality of this study: With this model, mustahik which is not bankable will receive financing for business development. On the other hand, mustahik will get payments in installments so that it will ease the burden.
Comparison of 0.2 Mg/kg Vs. 1.0 Mg/kg of Oral Meloxicam for Safe and Effective Analgesia in Domestic Rabbits
Authors: Nield Katherine , Govendir Merran
Published: June 2019

PICO question

In domestic rabbits, how does 1 mg/kg of oral meloxicam compare with 0.2 mg/kg of oral meloxicam for significant changes in pain behaviour, and kidney and liver biochemical analytes?
Clinical bottom line

Based on current available evidence, oral meloxicam at a dosage of 0.2 mg/kg daily when used as the sole analgesic does not provide adequate pain relief in rabbits. A dosage of 1 mg/kg daily is more efficacious, but it is unclear whether this is sufficient for postoperative pain management. The literature supports the safety of meloxicam at both 0.2 mg/kg and 1 mg/kg daily for healthy rabbits, based on liver and kidney biochemical analytes.

Five studies have been reviewed, which are a mix of randomised controlled trials and prospective clinical trials.

  
Predictors of Session Attendance in Intimate Partner Violence Treatment for Trauma-Exposed Veterans
Authors: LaPosta Gina M. Poole , Creech Suzannah K. , Macdonald Alexandra , Taft Casey T.
Published: June 2019

Understanding factors associated with intimate partner violence (IPV) treatment attendance is of particular importance given high rates of attrition from IPV counseling programs. Individuals who drop out from IPV counseling remain at an increased risk for recidivism. Although numerous studies have examined correlates of IPV treatment completion in civilian samples, no study to date has examined IPV treatment attendance in veterans. Thus, we sought to examine demographic, military, and diagnostic correlates of IPV session attendance in Veterans seeking IPV treatment. The current study examined data from 135 veterans presenting to IPV treatment within the Veteran Affairs (VA) healthcare system. Analyses were conducted from data collected as part of a randomized controlled trial evaluating the efficacy of a 12-session trauma-informed IPV intervention with veterans, Strength at Home. Results indicated that age, courtinvolvement, treatment condition, and substance use disorder were unique predictors of IPV session attendance above and beyond other demographic, military, and diagnostic predictors. Substance use disorder emerged as the most robust predictor of session attendance. These findings suggest that similar to civilian studies, routine assessment of substance use is indicated in IPV programs delivered within the VA healthcare system and that coordinated care between substance abuse and IPV treatment is needed. Our findings also suggest the need for additional efforts to enhance treatment initiation and retention among younger veterans.
A Group-Centered Approach to Exploring Sexual Respect in Batterer Intervention Programs
Authors: Fall Kevin , Flasch Paulina
Published: June 2019

Intimate partner violence is a serious social and public health issue often treated via psychoeducational groups in batterer intervention programs. The topic of sexual respect is a universal component in these groups, but traditional approaches may be too structured to address its complexity. This article outlines examples of how to select and process issues related to sexual violence and sexual respect in a way that honors group dynamics and process and accounts for various stages of offender accountability. We offer a curriculum that uses a careful selection of topics that is related to the skills deficit of the members, while utilizing the power of the group to facilitate the discussion. Specifically, we outline how sexual respect can be addressed in the low-accountability forming stage, the medium-to-high accountability norming/storming stage, and the high accountability performing stage in batterer intervention programs.
HALAL TOURISM: DEVELOPMENT, CHANCE AND CHALLENGE
Authors: Satriana Eka Dewi , Faridah Hayuun Durrotul
Published: June 2019

The tourism sector is one sector that is able to increase employment and increase economic growth. At present, halal tourism  is starting to become popular. This is in line with the increase in Muslim tourists from year to year. The development of halal tourism began to be carried out by various countries, muslim and non-muslim countries. This article will explore the development of halal tourism in several countries, reviewing the concepts and principles of halal tourism, and discuss the chances and challenges.
IDENTIFICATION OF ALCOHOL CONTENT IN MEDICINES AT THE PHARMACY THROUGH OBSERVATION ON SECONDARY PACKAGING
Authors: Rahem Abdul
Published: June 2019

Demand of halal medicine in the world is an interesting issue to be discussed, considering that there are still many medicines that are intended to contain impermissible  (haram) ingredients. The halal medicine depends on the active ingredients and additives of medicine, including the production process and storage of medicine. Alcoholic medicine are a polemic in the community, especially about halal medicine. This study aims to identify the alcohol content of syrup preparations in Yakersuda Pharmacy of Bangkalan. An observational study was conducted to observe alcohol content on secondary medicine packaging. The results showed that there were 8 (eight) items of medicine which listed the alcohol content in the secondary packaging, namely: Actifed Plus Dry Cough + Colds with alcohol content (9.9%); Actifed Plus Expektoran (6.93%); Benacol DTM (4%); Benacol Syr (4%); OBH Combi Syr Phlegm (2%); Vicks formula 44 (10%); and Woods Exp Syr (6%). The conclusion is alcohol content in medicine at the Yakersuda Pharmacy more then 1%. Medicines that do not include the composition of alcohol cannot be sure the drug is alcohol free.
THE CONCEPT OF HALAL AND THAYYIB AND ITS IMPLEMENTATION IN INDONESIA
Authors: Nafis Muhammad Cholil
Published: June 2019

The issue of halal and haram is regarded by Muslims as the basis concept. The word halal is derived from Arabic word, permissibility (in the sense of what is permitted in the Shariah). For Muslims, the basis of every action must be worship, which is worshipping to God Almighty. The eating activity is also a means of worship with rules and procedures according to the Sharia. The Holy Quran says eating is not just enough for halal but it should be thayyib. Therefore, the guarantee of halal products is important. The tremendous advances in science and technology in the fields of food, medicine and cosmetics are growing. This condition affects many things in the processing and use of basic ingredients. In order to keep Muslim’s food from haram contaminations, espicially from basic ingredients, the Indonesia Ulema Council (MUI) has been the pioneer in obtaining Halal certification. In Indonesia, the efforts to award Halal certificates have taken a quarter of a century. MUI has been granted a Halal certificate to ensure the nation's access to food, beverages and halal materials. MUI has also established the standards of halal according to Islamic law. The examination and study are then conducted to issue a fatwa and then a Halal certificate is issued. Halal certification process was not maximized in Indonesia because politics was not integrated and facilities and infrastructure were inadequate.
Prevalensi Parasit Cacing Saluran Pencernaan Pada Kucing Liar di Kota Banyuwangi
Authors: Yudhana Aditya , Praja Ratih Novita
Published: June 2019

Penelitian ini bertujuan untuk mengetahui angka prevalensi kasus infeksi cacing saluran cerna dan mengidentifikasi jenis cacing pada kucing liar di wilayah Kota Banyuwangi. 126 sampel feses kucing yang berasal dari wilayah Kota Banyuwangi dikoleksi dan disimpan dalam larutan formaldehide 10%. Seluruh sampel feses tersebut diperiksa dengan dua metode berbeda yaitu metode natif dan metode pengapungan untuk mengidentifikasi telur cacing yang terdapat pada feses kucing. Pada penelitian ini teridentifikasi tiga genus cacing yang menginfeksi kucing liar di wilayah Kota Banyuwangi yaitu Toxocara, Ancylostoma, dan  Diphyllobothrium. Hasil penelitian ini menunjukkan bahwa prevalensi kasus infeksi cacing saluran cerna pada kucing liar wilayah Kota Banyuwangi masih tinggi, yaitu Toxocara Spp (43,65%), Ancylostoma Spp (3,96%), dan Diphyllobothrium Spp (52,38%). Untuk itu diperlukan program pengendalian yang tepat terhadap kasus infeksi cacing saluran cerna pada kucing liar di wilayah Kota Banyuwangi.
Identifikasi Limbah Pertanian dan Perkebunan Sebagai Bahan Pakan Inkonvensional Di Banyuwangi
Authors: Agustono Bodhi , Lamid Mirni , Ma’ruf Anwar , Purnama Muhammad Thohawi Elziyad
Published: June 2019

Penelitian ini bertujuan untuk mengumpulkan data bahan pakan inkonvensional dari limbah pertanian dan perkebunan di Kabupaten Banyuwangi. Pakan merupakan aspek terpenting dalam pengelolaan peternakan. Ketersediaan pakan baik di musim hujan maupun musim kemarau harus tetap ada. Penelitian ini menggunakan metode purposive sampling sehingga sampel diambil di Kecamatan Kalibaru, Genteng, Purwoharjo, Songgon, Banyuwangi, Licin, Glagah dan Wongsorejo. Sampel bahan selanjutnya dianalisis proksimat untuk mengetahui kadar serat kasar (SK), protein kasar (PK), lemak kasar (LK), bahan ekstrak tanpa nitrogen (BETN) dan kadar abu. Hasil menunjukkan bahwa limbah jerami padi, jerami kedelai, nanas, rumput gajah, alang-alang, rumput lapang, kaliandra, turi dan lamtoro memiliki dominasi kandungan gizi yang bervariasi. Simpulan penelitian bahwa bahan limbah dapat diformulasikan sebagai pakan ternak inkonvensional.
Laporan Pertama Spesies Kutu Craspedorrhynchus platystomus dari Elang Ular Bido (Spilornis cheela bido) di Banyuwangi
Authors: Yudhana Aditya , Praja Ratih Novita
Published: June 2019

Ectoparasit seperti kutu dapat memainkan peran penyebaran penyakit antar hewan, ini bisa lebih buruk jika ektoparasit bertindak sebagai vektor. Hilangnya mulai dari penurunan berat badan, penurunan produksi, rambut rontok atau bulu, trauma, iritasi, anemia, hingga kematian dan sering terjadi pada hewan liar di hutan. Belum ada penelitian yang menjelaskan sebelumnya tentang infestasi kutu pada elang ular bido (Spilornis cheela bido) di Banyuwangi. Penelitian ini bertujuan untuk melaporkan infestasi kutu yang dikumpulkan dari elang ular bido di Banyuwangi. Elang ular bido diperiksa dengan hati-hati untuk mengambil kutu pada permukaan tubuh, hanya satu spesies kutu yang diamati yaitu Craspedorrhynchus platystomus. Spesies lain dari ektoparasit tidak diisolasi dari elang yang terinfestasi selama periode penelitian.
Analisis Kelayakan Usaha Secara Finansial dan Efisiensi Produksi di Peternakan Sapi Perah PT. Fructi Agri Sejati Kabupaten Jombang
Authors: Khafsah Khafsah , Warsito Sunaryo Hadi , Prastiya Ragil Angga , Sardjito Trilas , Saputro Amung Logam , Agustono Bodhi
Published: June 2019

Penelitian ini bertujuan untuk mengetahui tentang analisis kelayakan usaha secara finansial dan efisiensi produksi peternakan sapi perah di PT. Fructi Agri Sejati Kabupaten Jombang yang mempunyai 100 ekor sapi Peranakan Fries Holland (PFH). Jenis penelitian deskriptif yang dilaksanakan di Dusun Komboh Desa Sambirejo Kecamatan Wonosalam Kabupaten Jombang. Penelitian menggunakan metode survey yang kemudian diperoleh data primer dan sekunder dari PT. Fructi Agri Sejati melalui wawancara dengan menggunakan kuesioner. Analisis kelayakan usaha berdasarkan kriteria kelayakan investasi meliputi Net Present Value (NPV), Net Benefit Cost Ratio (Net B/C), Internal Rate Return (IRR), Payback Periode (PP) dan R/C Ratio untuk analisis efisiensi produksi. Hasil penelitian menunjukkan besar pendapatan rata-rata per tahun sebesar Rp.141.669.425, dengan rata-rata penerimaan sebesar Rp.898.382.687 yang bersumber dari hasil penjualan susu, pedet jantan, sapi afkir, pejantan, sapi laktasi dan pupuk kandang. Berdasarkan hasil penelitian usaha layak untuk dijalankan karena semua kriteria investasi mampu dicapai, memiliki NPV>0 yaitu Rp.181.016.633, Net B/C>0 yaitu 1,15, IRR sebesar 12,3% lebih besar dari tingkat diskonto yang digunakan dan PP selama 7,2 tahun. Efisiensi produksi dinyatakan sudah efisien karena nilai R/C>0 yaitu 1,18.
Potensi Ekstrak Daun Afrika (Vernonia amygdalina Delile) Sebagai Antibakterial Terhadap Bakteri Escherichia coli ATCC 25922
Authors: Murjianingsih Fitriani , Sarudji Suryanie , Saputro Amung Logam , Tyasningsih Wiwiek , Hamid Iwan Sharial , Yunita Maya Nurwartanti
Published: June 2019

Tujuan dari penelitian ini adalah untuk mengetahui potensi ekstrak metanol daun Afrika (Vernonia amygdalina Delile) sebagai antibakteri terhadap bakteri Escherichia coli ATCC 25922. Isolat E. coli dibiakan pada media Muller Hinton Agar (MHA). Uji antibakteri menggunakan metode difusi sumuran. Kontrol negatif (K-) pada lubang sumuran hanya diberikan pengencer ekstrak CMC Na 0,5%. Kontrol positif (K+) pada lubang sumuran diberi dengan eugenol. Perlakuan (P1, P2, P3, P4) diberikan ekstrak metanol daun Afrika (Vernonia amygdalina Delile) dengan masing - masing konsentrasi 100%, 75%, 50% dan 25%. Rancangan penelitian menggunakan metode Rancangan Acak Lengkap (RAL), dengan enam perlakuan dan empat pengulangan. Data dianalisis dengan ANOVA, dilanjutkan dengan uji Duncan. Hasil analisis zona hambat menunjukkan, K+ memiliki perbedaan yang nyata dengan semua perlakuan K-, P1, P2, P3, dan P4. Serta K- ditemukan tidak berbeda nyata dengan perlakuan P1, P2, P3 dan P4. Hasil penelitian menunjukkan bahwa setiap perlakuan tidak menghasilkan zona hambat sehingga tidak berbeda nyata dengan kontrol negatif (CMC Na 0,5%).
Efektivitas Ekstrak Daun Afrika (Vernonia amygdalina) Secara Topikal Terhadap Kepadatan Kolagen dalam Penyembuhan Luka Insisi Pada Tikus Putih (Rattus norvegicus)
Authors: Rachmanita Rona Taufiqul , Primarizky Hardany , Fikri Faisal , Setiawan Boedi , Agustono Bodhi , Saputro Amung Logam
Published: June 2019

Tujuan dari penelitian ini adalah untuk mengetahui efektivitas pemberian ekstrak daun Afrika (Vernonia amygdalina) secara topikal terhadap kepadatan kolagen dalam penyembuhan luka insisi pada tikus putih (Rattus norvegicus). Dua puluh ekor tikus putih dibagi secara acak ke dalam lima kelompok, yaitu kontrol negatif (K-) yang diberi basis salep, kontrol positif (K+) yang diberi salep povidone iodine 10%, kelompok perlakuan (P1, P2, P3) yang diberi perlakuan dengan salep ekstrak daun Afrika 16,8%, 28%, dan 39,2%. Perlakuan diberikan secara topikal pada lokasi luka insisi sebanyak dua kali sehari selama empat belas hari. pada hari keempat belas tikus dieuthanasi dan daerah insisi dieksisi untuk preparasi histopatologi. Data yang didapatkan dianalisis menggunakan Kruskal-Wallis dengan SPSS 20. Hasil uji menunjukkan p=0,077 yang berarti tidak terdapat perbedaan yang nyata (p>0,05) antara keseluruhan perlakuan. Berdasarkan hasil tersebut rata-rata P1 menunjukkan hasil skoring kepadatan kolagen tertinggi dibandingkan perlakuan yang lain. Kesimpulan penelitian ini yaitu bahwa daun Afrika (Vernonia amygdalina) tidak efektif meningkatkan kepadatan kolagen dalam penyembuhan luka insisi pada tikus putih (Rattus norvegicus).
Pengaruh Subtitusi Tepung Biji Bunga Matahari (Helianthus Annuus L.) dalam Pakan Komersial dengan Konsentrasi Tertentu Terhadap Performa Ayam Pedaging
Authors: Hermansyah Beta , Lokapirnasari Widya Paramita , Fikri Faisal
Published: June 2019

Penelitian ini bertujuan untuk mengetahui pengaruh penggantian tepung biji bunga matahari (Helianthus annuus L.) di pakan komersial dengan konsentrasi tertentu pada kinerja ayam pedaging. Penelitian ini menggunakan desain acak lengkap. Sampel terdiri dari 20 ekor ayam broiler dibagi secara acak menjadi 5 kelompok. Perlakuan adalah P1, P2, P3, dan P4 masing-masing CP511 pakan komersial yang mengandung tepung biji bunga matahari 25%, 30%, 35%, dan 40% serta kontrol tanpa substitusi P0 tepung biji bunga matahari. Variabel yang digunakan adalah konsumsi pakan, bobot akhir dan konversi pakan kemudian hasilnya dianalisis dengan Analisis Varians. Hasil yang diperoleh rata-rata nilai konsumsi pakan P0 adalah 79,76 gram, P1 adalah 77,90 gram, P2 adalah 77,35 gram, P3 adalah 77,98 gram, P4 adalah 77,58 gram. Hasil nilai rata-rata berat akhir 1545,5 gram yaitu P0, P1 adalah 1296,5 gram, P2 1325,75 gram, P3 1256 gram, P4 1203 gram. Hasil yang diperoleh dari nilai rata-rata konversi pakan adalah P0 1,37, P1 1,69, P2 1,61, P3 1,71, P4 1,88. Berdasarkan hasil dapat disimpulkan bahwa substitusi tepung biji bunga matahari dalam diet komersial tidak meningkatkan asupan pakan, berat badan dan dapat meningkatkan konversi pakan.
Activity-Based Costing and Its Derivatives and Significance in the Cutting-Edge Environment
Authors: Hakim Tito IM. Rahman
Published: June 2019

The purpose of this article is to explore activity-based costing with its derivative, that is time-driven activity-based costing and fuzzy time-driven activity-based costing via some relevant researches and observe significance of this systems in sophisticated business environment. Activity-based costing is a costing system with two phases that track cost from activity to product. The emergence of activity-based costing is driven by irrelevance calculation of traditional costing system that cause information distortion. Therefore, activity-based costing emerges as a alternative problem solving of this distortion. But activity-based costing as a system has its drawbacks. These drawbacks try to be covered later with the emergence of model development of former activity-based costing. Through time-driven activity-based costing, activity-based costing that previously complex and expensive become simpler and more economic. Subsequently, through uzzy time-driven activity-based costing, calculation of time-driven activity-based costing that previously in-absolute and ambiguity become less. Through three tradeoff analysis, that is cost-benefit, complexity-simplify, and first-secondary, it is known that activity-based costing and its derivative still have a great significance in business environment that full of sophistication and recency.
The Impact of Game Avatar Customization in Improving User Experience and Gamer Loyalty: Experiment in Role Playing Game (RPG) Based Video Game
Authors: Kristanto Damar
Published: June 2019

The increasing number of video game titles raises competition between video game developers getting tighter and more competitive, this encourages the game developers to be more creative in designing their games so that players become loyal to play and not quickly switch to playing other games. While we know that game development is very difficult, time consuming and requires a lot of costs for the RPG genre. So that the loyalty of game players in playing games becomes a crucial problem.This study aims to explain how the customization of game avatars can increase the loyalty of video game players in playing role-playing games (RPGs).This study uses the within-subject experimental method with participants who are RPG video game players who have played for at least 1 year, 24 participants participated in the 8 experiment session throughout the study. The results of this study indicate that avatar customization is very important because it can improve the player's self-identification in the game, improve the playing experience, improve the perceived quality of the video game played, increase the flow and immersion of players, and increase gamer loyalty. Another result that was raised was that the use of avatars that were the same gender with players (male players using male avatars) did not have higher flow and immersion than when using different genders (male players use female avatars) so that this raises new issues of gander swapping in the role playing video game that can be continued for further research.
A Study of Culinary Brand Identity in Banyuwangi District with the Gastronomic Tourism Concept
Authors: Febrian Ayu Wanda
Published: June 2019

Banyuwangi is a city with varieties of culture. One of its well-known culture is relating to culinary diversity. Nowadays, it is undeniable that tourism in this city develops very quickly. To improve the development of tourism, the people of Banyuwangi need to focus on the concept of gastronomic tourism in creating a brand identity in order to increase the tourist buying intention. This research is a qualitative descriptive study with a case study approach. The result of this study showed that Pecel Pitik was selected as Banyuwangi gastronomic tourism brand identity. This was supported by (a) if combined with previous assessments, we found that Pecel Pitik got 84%, while Ayam Kesrut was only 37%, (b) Pecel Pitik Menu was the best-selling menu, ordered by many consumers, (c) The Philosophy of the origin of Pecel Pitik was more complete and had historical value compared to the Ayam Kesrut.
Risk Management System in PT. Unilever Indonesia, Tbk
Authors: Sinulingga Rizky Amalia
Published: June 2019

Unilever is a multinational company produced various products which are foods, beverages, cleaning agents and personal care. One most important BoD duty are responsible for identifying and evaluating the company’s exposure to risks, and ensuring that potential risks are effectively mitigated. Effective risk management is fundamental for great business management, and Unilever Indonesia’s success as an organization depends on company ability to identify and exploit the key risks and opportunities for the business. Internal assurance and compliance monitoring are in place to review the strategy risk setting. Internal independent re-assurance (internal audit and corporate audit) and external re-assurance play a key role in ensuring that operational risks and business execution risks are properly addressed and managed. This research aims to describe the Unilever business risk matrix in the recent risk environment and concerned were assigned to manage the risks within their respective streams. The result show, the highest risk that Unilever faced is high competition because competitors have more differentiated products and declining demand for the company product. The mitigation must be implemented to reduce the loss. The company should monitor external market trends and collect feedback from consumer, Implemented research and development function to translate the trends, Regularly update business forecast of business results and cash flows and rebalance investment priorities, and also Flexible business model allows the company to adapt all portfolio and respond to develop new offerings.
Functional Electrical Stimulation‐Assisted Cycle Ergometry in Critically Ill. Protocol of Randomised Controlled Trial
Authors: Waldauf Petr , Gojda Jan , Urban Tomáš , Hrušková Natália , Blahutová Barbora , Hejnová Marie , Jiroutková Kateřina , Fric Michal , Jánský Pavel , Kukulova Jana , Stephens Francis , Řasová Kamila , Duška František
Published: June 2019

Intensive care unit-acquired weakness is the most important cause of failed functional outcome in survivors of critical care. Most damage occurs during the first week when patients are not cooperative enough with conventional rehabilitation. Functional-electrical stimulation-assisted cycle ergometry (FES-CE) applied within 48 of ICU admission may improve muscle function and long-tem outcome. Methods: Assessor-blinded pragmatic single-centre randomized controlled trial. Adults (n=150) mechanically ventilated for <48 hours from 4 ICUs who are estimated to need >7 days of critical care will be randomized (1:1) to receive either standard of care or FES-CE-based intensified rehabilitation, which will continue until ICU discharge. Primary outcome: Quality of life measured by SF-36 score at 6 months. Secondary outcomes: functional performance at ICU discharge, muscle mass (vastus ultrasound, N-balance) and function (MRC score, insulin sensitivity). In a subgroup (n=30) we will assess insulin sensitivity and perform skeletal muscle biopsies to look at mitochondrial function, fibre typing and regulatory proteins expression.
Capsular Warning Syndrome: Clinical Analysis and Treatment
Authors: He Lanying , Xu Ronghua , Wang Jian , Zhang Lili , Zhang Lijuan , Zhou Fangfang , Dong Weiwei
Published: June 2019

Background: Capsular warning syndrome (CWS) was a rare clinical syndrome, which was defined as recurrent transient lacunar syndromes. The mechanism and clinical management of CWS were not clear. The purpose of this study was to discuss the clinical characteristics, treatment and prognosis of the CWS.
Methods: This was a multicenter retrospective study that involved three medical centers, we collected clinical data from patients with CWS between January 2013 and December 2018. We analyzed the clinical characteristics of the CWS. Patients with CWS were divided into two groups: rt-PA and no rt-PA groups. We analyzed the therapeutic effects and prognosis between different groups.
Results: This study included 72 patients, 27 in rt-PA group, 45 in no rt-PA group, hypertension and dyslipidemia were the most common risk factors. The mean number of episodes before an irreversible neurological impairment or the symptoms completely disappeared was 5 times(3-11). 59 (81.94%) patients had acute infarction lesions on the diffusion weighted imaging (DWI). The most common infarct location was the internal capsule (76.38%,55), followed by the thalamus and pons. The difference in therapeutic effects between rt-PA, single and double antiplatelet groups was not significant(P>0.05). A good prognosis was observed in 61 (84.72%) patients at 3-month, 23 (23/27, 85.19%) patients in rt-PA group and 38 (38/45,84.44%) patients in no rt-PA group(P>0.05). After 3 months of follow-up, 2 patients had recurrent ischemic stroke.
Conclusions: The most effective treatment of CWS remains unclear. Despite the high incidence of infarction in CWS patients, more than 80% patients had favorable functional prognosis
Four collateral circulation pathways were observed after common carotid artery occlusion
Authors: Wang Jianan , Zheng Chengrong , Hou Bei , Huang Aihua , Zhang Xiongwei , Du Bin
Published: June 2019

Background: Common carotid artery (CCA) occlusion (CCAO) is a rare condition. Owing to collateral circulation, ipsilateral internal carotid artery (ICA) and external carotid artery (ECA) are often patent.
Methods: This study included 16 patients with unilateral CCAO and patent ipsilateral ICA and ECA. The pathways which supplied ICA were investigated by digital subtraction angiography (DSA), transcranial Doppler (TCD), magnetic resonance angiography (MRA) and computed tomography angiography (CTA).
Results: TCD found antegrade blood flow in ipsilateral ICA in all 16 patients, which was supplied by retrograde blood flow in ipsilateral ECA through carotid bifurcation. We call this phenomenon “ICA steal”. DSA and CTA discovered four pathways of ICA steal, including 1) ipsilateral vertebral artery – occipital artery – ECA – ICA, 2) ipsilateral thyrocervical trunk or costocervical trunk – ascending cervical artery or deep cervical artery – occipital artery – ECA – ICA, 3) contralateral ECA – contralateral superior thyroid artery – ipsilateral superior thyroid artery – ipsilateral ECA – ICA, and 4) ipsilateral thyrocervical trunk – inferior thyroid artery – superior thyroid artery – ECA – ICA.
Conclusions: ICA is possible to be patent and supplied by several collateral circulation pathways after CCAO.
Surveying the Prevalence of Lower Urinary Tract Symptoms Based on Individual and Clinical Parameters in Patients with Multiple Sclerosis
Authors: Nazari Fatemeh , Shaygannejad Vahid , Sichani Mehrdad Mohammadi , Gharaagozlou Marjan Mansourian , Hajhashemi Valiollah
Published: June 2019

Background

Most patients with multiple sclerosis (MS) suffer from bladder dysfunction during the course of the disease. This study was conducted to examine the prevalence of these complications among patients with MS.

Methods

This cross-sectional study was performed on 603 patients with MS who referred to the neurology clinics of Kashani and Alzahra Hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. The sampling was performed by multi-stage random cluster sampling method and the informed consent form was filled in by the subjects. Then, all the data were collected through interviews using the Lower Urinary Tract Symptom Score (LUTSS) developed in accordance with the definitions presented by the International Continence Society (ICS) and the International Prostate Symptom Score (I-PSS). The data were analyzed using descriptive and inferential statistical tests in SPSS and the significance level was considered to be less than 0.050.

Results

The prevalence rate of lower urinary tract symptoms (LUTS) was 87.6% among all the subjects, with a similar rate among women (88.0%) and men (86.0%). There was a significant difference between the two groups of men and women in terms of the prevalence of stress urinary incontinence (SUI), intermittent urine flow, hesitancy, straining, and dribbling (P < 0.050). There was no significant difference between the two groups of women and men in terms of the prevalence of other symptoms (P > 0.050). Moreover, there was a significant difference between the degree of LUTS with age, marital status, education, duration of illness, clinical course, and disability (P < 0.05).

Conclusions

A high prevalence of LUTS was found among patients with MS, with similar rates in men and women, and the nature of the urinary complaints and LUTS was different among men and women with MS. Therefore, it is recommended that the health system take necessary measures regarding timely detection and treatment of LUTS among these patients in order to prevent secondary outcomes and improve the quality of life (QOL) of patients with MS.
Increased C-reactive protein levels in participants with frequent headache. The HUNT Study 2006-2008
Authors: Hagen Knut , Stovner Lars Jacob , Nilsen Kristian Bernhard , Winsvold Bendik Slagsvold
Published: June 2019

Background Increased high sensitivity C- reactive protein (hs-CRP) levels have been found in many earlier studies on migraine, and recently also in persons with migraine and insomnia. The aim of this study was to see whether these findings could be reproduced in a large-scale population-based study.
Methods A total of 50,807 (54%) out of 94,194 invited aged ≥ 20 years or older participated in the third wave of the Nord-Trøndelag Health Study study performed in 2006-2008. Among these, 38,807 (41%) had valid measures of hs-CRP and answered questions on headache and insomnia. Elevated hs-CRP was defined as >3.0 mg/L. The cross-sectional association with headache was estimated by multivariate analyses using multiple logistic regression. The precision of the odds ratio (OR) was assessed with 95% confidence interval (CI).
Results In the fully adjusted model, elevated hs-CRP was associated with migraine (OR 1.14, 95% CI 1.04-1.25) and migraine with aura (OR 1.15, 95% CI 1.03-1.29). The association was stronger among individuals with headache ≥ 7 days/month for any headache (OR 1.19, 95% CI 1.08-1.31), migraine (OR 1.30, 95% CI 1.10-1.54), migraine with aura (OR 1.47, 95% CI 1.20-1.80), and other headaches (OR 1.16, 95% CI 1.03-1.30). No clear relationship was found between elevated hs-CRP and headache less than 7 days/month or with insomnia.
Conclusions Cross-sectional data from a large-scale population-based study showed that elevated hs-CRP was associated with headache ≥ 7 days/month, especially frequent migraine with aura.
Experiences of people with Multiple Sclerosis using textured insoles: an interpretive phenomenological exploration
Authors: Baron Yael Jennifer , Hatton A. , McKeon P. O. , Rome K. , Martin D. , Dixon J.
Published: June 2019

Background

Impaired balance and mobility is one of the most concerning symptoms experienced by people with Multiple Sclerosis as it reduces their independence. It can be caused by reduced plantar sensation. Textured insoles may have the potential to improve balance and mobility by increasing plantar sensory input but their acceptability has not been investigated. This study aimed to investigate the experience of people with Multiple Sclerosis who wore textured insoles in free living for three months.

Method

A qualitative study embedded within an exploratory randomised controlled trial. Seven participants with Multiple Sclerosis who were ambulatory with a unilateral walking aid were identified from a larger group in a study into the effects of textured insoles on balance and mobility. Participants who wore textured insoles for three months in free living were recruited to participate in focus groups or individual semi-structured interviews about their experience of wearing the insoles. Themes in the data were identified using interpretive phenomenological analysis.

Results

Three overarching themes were identified from transcribed data; perceived benefit of the insoles, comfort of the insoles and participants’ awareness of their feet. Participants’ experiences were individual; some found the insoles beneficial and experienced increased mobility confidence whilst others did not. Several participants experienced increased awareness of their foot position. Only those participants who experienced benefits from wearing the insoles would continue to engage with them as an intervention.

Conclusions

Participants reported different experiences of wearing textured insoles, some experienced significant benefits to mobility confidence and awareness of their feet whilst others did not experience any benefit.

Trial registration

ISRCTN reference number ISRCTN85766784, date of registration 7th April 2014.
https://doi.org/10.1186/ISRCTN85766784
Transcriptomic analysis of Verbena bonariensis roots in response to cadmium stress
Authors: Wang Meng-qi , Bai Zhen-yu , Xiao Ya-fang , Li Yan , Liu Qing-lin , Zhang Lei , Pan Yuan-zhi , Jiang Bei-bei , Zhang Fan
Published: June 2019

Background: Cadmium (Cd) has caused serious heavy metal (HM) pollution in the soil and finding suitable plants to remediate HM pollution is an environmentally friendly approach. Verbena bonariensis is a kind of garden plant with excellent ornamental, good environmental adaptability, which has great potential for future development. This study firstly reported Cd tolerance and an overall analysis of transcriptome in V. bonariensis.
Results: In this study, the tolerance of V. bonariensis to Cd stress was investigated in four ways, including germination, growth response, physiological and molecular changes. The results showed that V. bonariensis is not a hyperaccumulator, but it is tolerant to Cd and has the ability to enrich Cd. In the transcriptome data of V. bonariensis roots under Cd stress, 237, 866 transcripts and 191, 370 unigenes were constructed. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis revealed that differentially expressed genes (DEGs) under Cd stress are predominately involved in cell structure, ROS scavenging system, chelating reaction and secondary metabolites, transpiration and photosynthesis. DEGs encoding lignin synthesis, chalcone synthase (CHS) and anthocyanidin synthase (ANS) were prominent in V. bonariensis response to Cd stress. The expression patterns of 10 DEGs, validated by quantitative real-time PCR (qRT-PCR), were highly accordant with the RNA-seq results. This study provided novel strategies for further studies on tolerance to Cd exposure and functional genomics in V. bonariensis，which was useful information in improving molecular breeding to Cd and phytoremediation.
Addressing Patient-Reported Barriers to Advance Care Planning in Family Practice
Authors: Bernard Carrie , Tan Amy , Slaven Marissa , Elston Dawn , Heyland Daren K. , Howard Michelle
Published: June 2019

Background

Although patient-centred care has become increasingly important across all medical specialties, when it comes to end of life care, research has shown that treatments ordered are not often concordant with people’s expressed preferences. Patient and family engagement in Advance Care Planning (ACP) in the primary care setting could improve the concordance between patients’ wishes and the healthcare received when patients cannot speak for themselves. The aim of this study was to better understand the barriers faced by older patients regarding talking to their family members and family physicians about ACP.

Methods

In this multi-site cross-sectional study, three free text questions regarding reasons patients found it difficult to discuss ACP with their families or their family physicians were part of a self-administered questionnaire about patients’ knowledge of and engagement in ACP. The questionnaire, which included closed ended questions followed by three probing open ended questions, was distributed in 20 family practices across 3 provinces in Canada. The free text responses were analyzed using thematic content analysis and form the basis of this paper.

Results

102 participants provided an analyzable response to the survey when asked why they haven’t talked to someone about ACP. 254 answered the question about talking to their physician and 340 answered the question about talking to family members. Eight distinct themes emerged from the free text response analysis: 1. They were too young for ACP; 2. The topic is too emotional; 3. The MD should be responsible for bringing up ACP 4. A fear of negatively impacting the patient-physician relationship; 5. Not enough time in appointments; 6. Concern about family dynamics; 7. It’s not a priority; and 8. A lack of knowledge about ACP.

Conclusions

Patients in our sample described many barriers to ACP discussions, including concerns about the effect these discussions may have on relationships with both family members and family physicians, and issues relating to patients’ knowledge and interpretation of the importance, responsibility for, or relevance of ACP itself. Family physicians may be uniquely placed to leverage the longitudinal, person- centred relationship they have with patients to mitigate some of these barriers.
Comparison of refractive stability and myopic regression after photorefractive keratectomy with different optical zones using Mel 90 excimer laser
Authors: Shin Dae Hwan , Lee Yong Woo , Choi Chul Young
Published: June 2019

Background: To compare the changes in clinical outcomes and the degree of regression between a 6.0 mm optical zone (6.0 OZ) and 6.5 mm optical zone (6.5 OZ) following photorefractive keratectomy (PRK).
Methods: The records of 95 eyes that had undergone PRK with a 6.0 OZ (n = 40) and a 6.5 OZ (n = 55) were retrospectively reviewed. We compared data including the spherical equivalent of manifest refraction (SE of MR), simulated K (Sim K), thinnest corneal thickness, change in thinnest corneal thickness (the initial value divided by corrected diopter [ΔTCT/CD]), Q value, corneal higher order aberrations (HOAs) and spherical aberration (SA) pre-operation, at 3 and 6 months postoperative and at the last follow-up visit (Mean; 20.71 ± 10.52, 17.47 ± 6.57 months in the 6.0 and 6.5 OZ group, respectively).
Results: There were no significant differences in the SE of MR, Sim K and UCVA between the 6.0 OZ group and the 6.5 OZ group over 1 year of follow-up after PRK, and the 6.0 OZ group required less ΔTCT/CD than the 6.5 OZ group. The 6.5 OZ group showed better results in terms of post-operative HOAs of RMS, SA and Q value. When comparing that pattern of change in Sim K, there was no significant difference between the 6.0 OZ group and the 6.5 OZ group.
Conclusions: The clinical refractive outcomes and regression after PRK using Mel 90 excimer laser with a 6.0 OZ were comparable to those with a 6.5 OZ.
Application of the critical incident technique in refining an initial programme theory
Authors: Cunningham Una , De Brún Aoife , McAuliffe Eilish
Published: June 2019

Abstract
Introduction
As realist methodology is still evolving, there is a paucity of guidance on how to conduct theory driven interviews. Novice realist researchers can therefore struggle to collect interview data that can make a meaningful contribution to refining their initial programme theory (IPT). In addition, researchers often face challenges when trying to conduct interviews with healthcare staff due to their busy work schedules.
In this case study of team interventions in acute hospital contexts, we explore the benefits of using the Critical Incident Technique (CIT) in order to build and refine an IPT.
Methods
The five steps of the CIT were mapped against realist methods guidance and adapted into an interview framework. Specifications to identify an incident as “critical” were agreed. We embedded probes in the interview framework to confirm, refine and/or refute previous theories synthesised from the literature and to extrapolate new theories.
Seventeen key informants were interviewed and recordings were transcribed and imported for analysis into NViVo software. Using RAMESES guidelines, Context-Mechanism-Outcomes configurations were extrapolated from a total of 31 incidents.
Results
We found that the CIT facilitated construction of an interview format that allowed KIs to reflect on specific positive or negative team interventions. We demonstrate how the CIT strengthened initial programme theory development as it facilitated the reporting of the specifics of team interventions and the contexts and mechanisms characteristic of those experiences. As new data emerged, it was possible to evolve previous theories synthesised from the literature as well as to explore new theories.
Conclusions
Utilising a CIT framework paid significant dividends in terms of the relevance and usefulness of the data for refining the IPT. Adapting the CIT questioning technique helped to focus the KIs on the specifics relating to an incident allowing the interviewers to concentrate on probes to explore theories during the interview process. The CIT interview format therefore achieved its purpose and the interview framework developed can be adapted for other research topics for use within realist methodology

Key words: Critical Incident Interview, Realist, Programme Theory, Team, Intervention, Hospital, Methods