bluuebunny/crossref_metadata_2025 huggingface dataset:
PERAN KOMUNITAS DALAM PENANGANAN TEMUAN BARU PRASASTI (STUDI KASUS KOMUNITAS KANDANG KEBO)
Authors: A. Sambodo Goenawan , Widayati Maria Tri , Purnawali Hery S.
Published: June 2019

The aim of this study is to identify and analyze the efforts of the Kandang Kebo Community in handling new found inscriptions. The method used is descriptive-qualitative, combined with inductive reasoning. Structural analytic, especially Internal Criticism (transliteration, translation and interpretation) is also applied to analyse the new found inscription.  Information for this study were collected from the members of Kandang Kebo community, stakeholders, and local community. Data collection were done by observation, literature study, interviews, and documentation. This study found that community which participate in maintaining cultural heritage objects is a provision in the Cultural Heritage Act no. 11 of 2010. Kandang Kebo as a society's community has been trying to apply this Act. The using of social media becomes one of the methods, with its quick and easy way; it makes new artifacts discovery easier to be known by others. Kandang Kebo then proceed this news to the office of BPCB. There are some inscriptions that are successfully saved and read by Kandang Kebo, followed by positive responses from the government.
El género Pyxine (Lecanorales, Physciaceae) en la Reserva de la Biosfera Yaboty (Misiones Argentina).
Authors: Sarlej Maria Ines
Published: June 2019

Introducción y objetivos: Pyxine (Lecanorales, Physciaceae), es un género interesante, poco conocido en el territorio argentino, por ello se presenta un estudio de las especies, presentes en la Reserva de la Biosfera Yaboty (Misiones, Argentina).M&M: La identificación de las especies fue realizada siguiendo la metodología convencionalmente utilizada para el estudio de los líquenes, que incluye un análisis morfológico y químico. Los caracteres macroscópicos fueron estudiados con un microscopio estereoscópico. Para determinar el tipo de plecténquima y estudiar la morfología de las ascosporas se realizaron cortes a mano alzada, que fueron posteriormente montados en hidróxido de potasio al 5% para ser observados en microscopio óptico. La identificación de las sustancias liquénicas presentes fue realizada mediante reacciones puntuales de color con hidróxido de potasio al 10%, test en cámara de luz ultravioleta y cromatografía de capa delgada con solvente A. Resultados & conclusiones: En esta contribución se citan por primera vez para la Argentina: Pyxine daedalea, Pyxine katendei, Pyxine maculata y Pyxine sorediata. Se presenta una clave dicotómica y una breve descripción para las especies en el área, distribución geográfica, observaciones e ilustración de cada una de ellas. Se considera que este trabajo es un gran aporte para posteriores trabajos taxonómicos y ecológicos.
"Distribución de nanofanerófitas de hojas suculentas en dos comunidades leñosas del Chaco semiárido salino "
Authors: Figueroa María E. , Moglia Juana G. , Lorenz Guido , Giménez Ana M.
Published: June 2019

Introducción y objetivos: En los hábitats salinos del Chaco semiárido es frecuente la forma de vida nanofanerófita y tipo de consistencia de hoja suculenta. Para determinar si la ocurrencia de ambos rasgos está relacionada a la salinidad del suelo, en este trabajo se describe la distribución de formas de vida y tipos de consistencia de hoja en relación a la salinidad del suelo entre dos comunidades leñosas. M&M: Se realizó un censo de leñosas y un muestreo de suelo en un matorral halófilo y en un bosque xerófilo sobre 25 subparcelas de 100 m2 en cada sitio. Se determinó pH y conductividad eléctrica del suelo hasta 50 cm de profundidad. Se describieron la cobertura y estratificación de vegetación, riqueza, abundancia e índice de diversidad para especies leñosas. Se evaluó el grado de similitud entre sitios según la cantidad de especies de nanofanerófita y de hoja suculenta compartidas, mediante el coeficiente de Sørensen. Las especies fueron agrupadas considerando simultáneamente su forma de vida y tipo de consistencia de hoja. La relación entre salinidad y grupos de leñosas se evaluó mediante un análisis de redundancia. Resultados: La riqueza, diversidad y complejidad estructural fueron mayores en el bosque. La similitud entre sitios fue baja. Las nanofanerófitas de hojas suculentas dominaron en el matorral con elevada salinidad y pH. Las microfanerófitas de hojas semi-coriáceas fueron dominantes en el bosque con baja salinidad y pH. Conclusión: La distribución de las nanofanerófitas de hojas suculentas presentó diferencias según la salinidad del suelo de ambas comunidades leñosas.
La Ratio Studiorum y su vínculo con la primera universidad argentina
Authors: Lovay Silvana M.
Published: June 2019

El trabajo que presento apunta a reflexionar sobre la incidencia de la Ratio Studiorum en la formación humanística de la Universidad de san Ignacio de Córdoba (Argentina). Pretende contextualizar el modelo ignaciano concluido en 1599 y su aplicación en este centro académico, ubicado en la sede de la Provincia Jesuítica del Paraguay. El modelo de la Ratio se vinculó con las Constituciones de la universidad dictadas en 1663, formando un cuerpo teórico-práctico de funcionamiento pedagógico que se extendió hasta la Supresión en 1773. La,por la época, novedosa estructura organizativa es uno de los factores de relevancia de este sistema de enseñanza-aprendizaje. Cada actor, desde el provincial, pasando por el rector, los profesores y alumnos se desarrollaban dentro de un marco de armonía. Incluso el procurador, cuya misión era hacer que la enseñanza fuera gratuita a través del sostenimiento de una red de medios que proporcionaban lo necesario para ese fin. La organización escolar partía del pensum, o plan de estudios, cuyas estructuras básicas eran la filosofía y la teología. En ese marco se encuadran los textos inclinados al sistema filosófico propuesto por Aristóteles en la Antigüedad y desarrollado e interpretado desde la perspectiva cristiana por Santo Tomás. Pero también abordo la cotidianeidad institucional en el ingreso y promoción del alumno, el calendario escolar, los actos públicos y demás recursos que conformaban una formación integral que educó a una élite que llegó a cuestionar el sistema político de su tiempo.
La relación del P. Francisco Javier Guevara sobre chiquitos
Authors: Page Carlos A.
Published: June 2019

El presente trabajo es parte de un proyecto sobre el estudio crítico de una serie de relaciones encargadas por el jesuita navarro Pedro Antonio de Calatayud (1689-1773). Desde su exilio en Bolonia, intentó escribir una historia de la provincia jesuítica del Paraguay, para lo cual requirió de la ayuda de los expulsos de aquella región radicados en Faenza. Colaboraron más de una docena de jesuitas con trabajos de alta calidad que quedaron inéditos, pues no tenían como fin ser publicados. El presente texto es del P. Guevara, sobre las reducciones de chiquitos. La obra del P. Calatayud quedó inconclusa e inédita, junto a estos textos que se encuentran en un mismo legajo en el Archivo de Loyola en Aspeitia.
A Comparative Study of Pointing Techniques for Eyewear Using a Simulated Pedestrian Environment
Authors: Roy Quentin , Zakaria Camelia , Perrault Simon , Nancel Mathieu , Kim Wonjung , Misra Archan , Cockburn Andy
Published: June 2019

Eyewear displays allow users to interact with virtual content displayed over real-world vision, in active situations like standing and walking. Pointing techniques for eyewear displays have been proposed, but their social acceptability, efficiency, and situation awareness remain to be assessed. Using a novel street-walking simulator, we conducted an empirical study of target acquisition while standing and walking under different levels of street crowdedness. We evaluated three phone-based eyewear pointing techniques: indirect touch on a touchscreen, and two in-air techniques using relative device rotations around forward and a downward axes. Direct touch on a phone, without eyewear, was used as a control condition. Results showed that indirect touch was the most efficient and socially acceptable technique, and that in-air pointing was inefficient when walking. Interestingly, the eyewear displays did not im- prove situation awareness compared to the control condition. We discuss implications for eyewear interaction design.
The Environmental Context of the Earliest Acheulean at Olduvai Gorge, Tanzania
Authors: Patalano Robert , Mercader Julio
Published: June 2019

Water, vegetation, and human habitats are tightly coupled, and Olduvai Gorge, Tanzania is an exceptional locality for examining evolutionary events that associate with water availability and environmental stability or change. This project investigates interactions between and among paleo-hydrology, habitat type, and the human response to changing environmental settings. The objective is to interpret the climate and environmental context of the oldest Acheulean stone tool industry at Olduvai Gorge using plant leaf wax lipid marker molecules, or biomarkers, as a source for carbon and hydrogen isotopes. The emphasis is on a roughly 200,000-year period (1.83 to 1.66 Ma), a timeframe that includes a key transition in stone tool technology from the Oldowan to the Acheulean, and the widespread distribution of the genus Homo.To investigate the human-environment interactions for Olduvai’s earliest Acheulean, terrestrial sediments from Beds I and II were systematically sampled and processed for normal (n-) alkanes and n-alkanoic acids. The focus is on the Frida Leakey Korongo North (FLK-N) and West (FLK-W) archaeological sites, which contain Oldowan and Acheulean tools, respectively, the geologic feature known as the Castle, and multiple landscape geological samples. From a methodological perspective, the innovation lies in the detailed environmental analyses using leaf wax biomarkers as a proxy record for paleo- hydrology and vegetation, and for the assessment of changes in precipitation, temperature, atmospheric CO2, aridity/humidity and plant type.The results indicate that both Oldowan and Acheulean assemblages were predominantly used within woodland settings with abundant freshwater nearby. The archaeological sites were situated within a mosaic environment of open grassland, closed riparian and groundwater-fed woodlands, lacustrine habitats, and ecotones. Both technological types were most likely used to process plant material such as hard-shelled nuts and fruits, but the Acheulean was also utilized for exploiting underground tubers as well as meat obtained in open settings.
Kepemimpinan Dalam Administrasi Pendidikan
Authors: armelia yola , Afriansyah Hade
Published: June 2019

The purpose of this study was the first purpose of this study to find out how the conditions of leadership in the world of education (headmaster) were described, in addition to knowing the leadership styles in education, to find out the leadership role of principals to face obstacles in carrying out their duties including coordinating their luggage. The research method used is literacy collection in the form of papers, books, articles and other readings. This paper complements the discussion about leadership. The existence of leaders is needed in an organization, this is because leaders will determine where they will be taken to the organization, in this case the author focuses on the field of education. In addition, leadership is needed in supporting the process of improving the quality of education, because the style or characteristics associated with leaders can influence and move individuals or groups within the organization they lead. The current leadership style in school management is no longer a force of coercion but uses commitment based on togetherness so that all parties under educational leadership can contribute to achieving the educational goals to be achieved. While the quality of education outcomes is approved by educational institutions at a certain time period. Supportive achievement or educational outcomes (student achievement) can consist of results of academic ability tests, or achievements in sports, senior or certain skills, and can also involve complexity or conditions that are not tangible (intangible) such as discipline, comfort, value respect noble values and so on. In improving the quality of this educational institution, the leadership role has a very strategic function. A leader from an educational institution will be a support for other educational institutions, especially communities, where educational institutions can get quality educational institutions.
Peningkatan Mutu Pendidikan Luar Sekolah
Authors: ilham mhd , Rusdinal  , Afriansyah Hade
Published: June 2019

This article is made to be an illustration in carrying out education outside of school that is useful for improving human resources. In the implementation of education, both by the government and the foundation, it will be a spotlight for the public regarding the quality or service that is carried out at school. The implementation of education must be of high quality and have high accountability, this is what makes the community hope. Education that involves the community will give rise to participation and sense of belonging and responsibility of the community.
HOAXS KASUS RATNA SARUMPAET
Authors: Gunawan Dery
Published: June 2019

Kasus Ratna sarumpaet merupakan menyebarkan berita hoax melalui pertama kali viral media sosial facebook akun yang menyebar melalui facebook Swary Utami Dewi Yang berisi tangkapan layar dari aplikasi pesan WhatsApp pada 2 Oktober 2018 serta foto Ratna.Ratna Sarumpaet mengaku dianiaya sejumlah orang di Bandung, Jawa Barat pada Selasa 21 September 2018.Semua manusia tak luput dari kesalahan,untuk dapat tidak melakukan kebohongan atau tindakan yang kurang baik lagi,Ratna Sarumpaet dapat melakukan refleksi hati nurani menurut buku Filsafat Moral.Semua tindakan atau prilaku tidak dapat hilang jika tidak dilakukan dengan setiap hari sampai menjadi karakter.
Konsep Dasar,Proses dan Ruang Lingkup Administrasi Pendidikan
Authors: Januardi Yoko , Afriansyah Hade
Published: June 2019

This article discusses educational administration material about the basic concepts, processes and scope of educational administration
Penerapan Metode Certainty Factor Pada Diagnosa Penyakit Saraf Tulang Belakang
Authors: Sucipto Adi , Fernando Yusra , Borman Rohmat Indra , Mahmuda Nisa
Published: June 2019

Dalam menganalisa sebuah informasi dimungkinkan seorang pakar mengungkapkan informasi berupa pernyataan yang tidak pasti seperti mungkin, kemungkinan besar dan hampir pasti. Salah satu metode yang dapat digunakan dalam mengatasi ketidak pastian adalah metode certainty factor. Certainty factor merupakan metode yang mendefinisikan ukuran kepastian terhadap fakta atau aturan untuk menggambarkan keyakinan seorang pakar terhadap masalah yang sedang dihadapi. Untuk membantu dan mempermudah masyarakat dalam mendiagnosa penyakit saraf tulang belakang dapat menerapkan metode certainty factor pada sistem pakar. Saraf bagian tulang belakang merupakan organ yang penting bagi manusia. Terbatas dan tidak meratanya dokter spesialis saraf tulang belakang di Indonesia mengakibatkan masyarakat kesulitan dalam mendiagnosa penyakit tersebut. Sistem pakar dapat membantu untuk diagnosa penyakit, dimana sistem ini untuk merekonstruksi keahlian dan penalaran kemampuan seorang pakar. Pada penelitian ini, certainty factor diimplementasikan pada aplikasi diagnosa penyakit saraf tulang belakang. Sistem diujicobakan pada sejumlah masukan, hasil pengujian didapatkan memberikan hasil sesuai dengan perhitungan manual. Hasil pengujian dengan uji coba pada sejumlah masukan yang dilakukan didapatkan bahwa pengujian memberikan hasil sesuai dengan perhitungan manual. Sedangkan pengujian akurasi kesesuaian dari data testing yang didapatkan oleh pakar dengan output sistempakar didapatkan hasil output yang sesuai sebanyak sebesar 90%.
Peningkatan Mutu Pendidikan di Era Otonomi Pendidikan
Authors: PUTRI SRI DIANA , Afriansyah Hade , Rusdinal
Published: June 2019

This article is very useful for readers because here they can observe, practical education and also academics to understand how to find the right solution in developing the quality of education especially in the era of regional autonomy and autonomy of education by applying various implementation of management principles, namely: good governance, internal and external efficiency of education. Through the application of three approaches, it is expected that: (1) institutional capacity building and all programs in the education sector can be implemented, (2) developing the quality of education through inputs, processes, and outputs based on regional autonomy, (3) benefits and impacts of basic education towards regional autonomy. it can be concluded that some things are efforts that need to be done in managing institutions to improve the quality of education in each region and region throughout the Republic of Indonesia: 1. Efforts to empower and increase institutional capacity based on 8 themes and principles of good governance which are normative rules to realize the entire program of decentralization and regional autonomy especially in the field of education. 2. Efforts to implement aspects of internal education efficiency with a focus on: input, process and output. 3. Efforts to implement external aspects of education by taking into account the benefits and impacts of educational outcomes. Improving the quality of education has not been in line with expectations because it is caused by several factors including the education development strategy that is more "input oriented" and "macro oriented" which tends to be regulated by the central bureaucracy To improve the quality of education in each region through a clear, directed, and effective approach, it is necessary to apply management principles in educational autonomy.
MEMOTRET RADIKALISME AGAMA DALAM KONTEKS INDONESIA YANG AGAMIS DAN BERPANCASILA “ RELEVANSI BERHIJAB SEBAGAI SYARAT UNTUK BEKERJA ”
Authors: Chrisnanto Benediktus Ferry Patria
Published: June 2019

Setiap manusia dalam masyarakat akan saling ketergantungan dengan manusia yang lainnya. Hal ini sesuai dengan kodrat dan kedudukan manusia sebagai mahluk sosial yang suka hidup berkelompok atau berteman dengan manusia lainnya. Hidup bersama merupakan salah satu sarana untuk memenuhi kebutuhan hidup manusia, baik kebutuhan yang bersifat jasmani maupun bersifat rohani. . Sebagai contohnya saja, dalam dunia bekerja sekarang ini yang sudah berkembang, masih ada saja beberapa perusahaan yang masih memegang teguh persyaratan-persyaratan agamis sebagai bentuk kepercayaan dan tanggungjawab yang lebih. Dalam pembahasan kali ini penulis lebih menekankan kepada pokok pembahasan kasus dimana masih adanya pekerjaan yang masih memegang syarat tersebut sebagai hal yang wajib dipatuhi. Disini penulis ingin memperdalam “RELEVANSI BERHIJAB SEBAGAI SYARAT UNTUK BEKERJA” sebagai bentuk media pembelajaran dimana sebagai negara yang agamis perlunya sikap untuk saling mengerti dalam hal-hal perbedaan sebagai negara yang memiliki berbagai kultur.
MARAKNYA KORUPSI DI INDONESIA
Authors: Lavenia Irene Yessica
Published: June 2019

Indonesia memiliki masalah tindak pidana yang sulit untuk dipecahkan dan sulit diatasi oleh pemerintah yaitu masalah korupsi. Korupsi bukan lagi merupakan persoalan yang biasa, melainkan sebuah persoalan yang sudah tersebar dimana-mana. Penegakan hukum tindak pidana korupsi di Indonesia masih menjadi hal yang disorot karena masih lemah. Korupsi merupakan perilaku menyimpang yang dilalukan sesorang untuk memenuhi kepentingan pribadi yang dapat merugikan negara dan masayrakat luas. Korupsi terjadi karena ada penyalagunaan jabatan dan wewenang yang dimiliki pejabat atau pegawai dengan mengatasnamakan keluarga. Korupsi terjadi bukan hanya pada tingkat pusat tetapi juga pada tingkat daerah samapai ketingkat pemerintahan yang paling kecil di suatu wilayah atau daerah.
HUKUM INDONESIA TAJAM KEPADA RAKYAT KECIL DALAM KONTEKS ORDO RATIONIS (TATANAN AKAL BUDI)
Authors: lestari Indri
Published: June 2019

Negara Indonesia berbentuk pemerintahan yang demokrasi, sistem presidensial yang terdiri dari beberapa provinsi dan ribuan pulau yang terbesar dari Sabang sampai Merauke. Negara Indonesia sebagai negara hukum. Indonesia sebagai negara hukum, memiliki karakteristik mandiri yang berarti kemandirian. Kosep yang dianut dinegara Indonesia disesuaikan dengan kondisi yang berdasarkan pada Pancasila. Negara demokrasi adalah negara yang menganut bentuk atau mekanisme pemerintahan dengan mewujudkan kedaulatan rakyat atas negara untuk dijalankan oleh pemerintah negara tersebut. Demokrasi bukanlah hanya sebatas hal sipil dan politik rakyat, namun dalam perkembangannya demokrasi juga terkait erat dengan sejauh mana terjaminnya hak-hak ekonomi dan sosial budaya dari rakyat. Ordo rtionis: artinya tata/ keteraturan; rationis artinya akal budi. Artinya hukum tidak boleh sekedar dilihat sebagai aturan yang diberlakukan oleh penguasa. Kareana katerpautan antara kebenaran akal budi, hukum itu menyatu dengan moralitas. Hukum adalah aturan yang didasarkan pada tatanan akal budi, sehingga hukum harus masuk akal.
Administrasi Peserta Didik
Authors: Andrizoan Rezhi Dwi , Afriansyah Hade
Published: June 2019

This article discusses educational administration material about student administration.
What Can 100,000 Books Tell Us about the International Public Library e-lending Landscape?
Authors: Giblin Rebecca , Kennedy Jenny , Pelletier Charlotte , Thomas Julian , Weatherall Kimberlee , Petitjean Francois
Published: June 2019

Introduction: We investigated the relative availability of e-books to libraries for e-lending in five English-language countries, and analysed their licence terms and prices. Method: We created a unique dataset recording author, publisher, price and terms for 100,000 titles and 388,045 e-lending licences across Australia, New Zealand, Canada, the United States and United Kingdom via aggregator Overdrive. We developed new algorithms to estimate the original publication year for each title, and to match titles across jurisdictions.Analysis: We examined the relationships between title price, age, terms, jurisdiction, publisher and publisher type using various statistical analyses and machine learning. Results: Price and licence differences across countries are largely attributable to ‘Big 5’ publishers. Prices are largely independent of title age (unless the title is in the public domain) or the rights libraries obtain in exchange. Licence terms are not affected by age either, meaning that the most restrictive terms are often applied to older, less demanded books. Conclusions: By setting terms independent of titles’ value to libraries, publishers may discourage libraries from adding older and less-demanded books to their collections. We will test this hypothesis in a follow-up library survey.
The History of Intellectual Property Taxation: Promoting Innovation and Other Intellectual Property Goals?
Authors: Nguyen Xuan-Thao
Published: June 2019

64 SMU Law Review 795 (2011)
Bankrupting Trademarks
Authors: Nguyen Xuan-Thao
Published: June 2019

37 UC Davis Law Review 1267 (2004)
The Digital Trademark Right: A Troubling New Extraterritorial Reach of United States Law
Authors: Nguyen Xuan-Thao
Published: June 2019

81 North Carolina Law Review 483 (2003)
Shifting the Paradigm in E-Commerce: Move Over Inherently Distinctive Trademarks--The E-brand, I-brand and Generic Domain Names Ascending to Power?
Authors: Nguyen Xuan-Thao
Published: June 2019

50 American University Law Review 937 (2001)
Connecting concrete objects and abstract symbols promotes children's mathematics learning
Authors: Donovan Andrea Marquardt , Fyfe Emily
Published: June 2019

Young children often learn mathematics concepts with concrete manipulatives (e.g., blocks, counters); yet, the mere use of manipulatives does not ensure successful learning. The current study compared different ways of using manipulatives (i.e., base-ten blocks) in conjunction with written symbols. Children (N = 138, M age = 6.86) learned about place value in one of four conditions: Concrete Only, Direct Comparison, Two-Step Fading, and Three-Step Fading. Condition differences at posttest favored the fading conditions in which problem formats transitioned from concrete objects to written numerals. More robustly, children who learned the connections between the objects and symbols exhibited higher posttest and transfer test scores relative to children who did not, over and above general learning during the lesson.
Physical activity profiling during pregnancy: Application of the Theory of Planned Behaviour by scrutinising the role of past behaviour.
Authors: DE VIVO Marlize , Mills Hayley
Published: June 2019

Objectives: To examine the predictive utility of the Theory of Planned Behaviour (TPB) in explaining pregnant women’s physical activity intentions and behaviour and to scrutinise the role of past behaviour within this context. Method: A repeated measures design required pregnant women to complete the Pregnancy Physical Activity Questionnaire (PPAQ) and TPB questionnaires on two occasions. Using published guidance, both formative and definitive stages were implemented as part of a comprehensive and robust approach to the construction of a TPB questionnaire. Results: Firstly, when considering the original TPB, intention emerged as the strongest determinant of pregnant women’s PA behaviour. Secondly, controlling for past behaviour attenuated the influence of intention and PBC on behaviour with neither of the original variables providing a unique influence. Finally, the addition of past behaviour led to an increase in the predictive utility of the TPB. Conclusion: Utilising the TPB as a flexible framework revealed the importance of contextual changes in the explanation of PA intention and behaviour during pregnancy. Physical activity profiling of pregnant women is proposed as a novel concept to present healthcare professionals and researchers with the opportunity to introduce tailored support based on motivation and behaviour status.
Heavy metals in groundwater resources of Kathmandu Valley, Nepal
Authors: Shrestha S M , Rijal K , Pokhrel M R
Published: June 2019

Available with full text.
Comparision of success rate of arterio-venous fistula in patients with diabetes vs non-diabetes
Authors: Karki Kushal , Banepali Niroj , Hirachand Sujita , Mukhiya Rupesh , Shrestha Rhishikesh Narayan
Published: June 2019

Introduction: Definition of chronic renal disease is based on the presence of kidney damage or glomerular filtration rate (GFR 60 ml/min per 1.73 m2) for 3 months, irrespective of cause. Once they are diagnosed as CKD, they are kept either on hemodialysis or peritoneal dialysis or patient undergo renal transplant. With this research we may prove that even in a similar circumstances failure rate of AVF is more in diabetes patient.

Methods: Total 50 patients of either gender were taken in this study. Inclusion criteria: CRF with GFR <30ml/min. Arterial diameter >1.5mm and venous diameter >2mm. Preoperative radial artery blood flow >30cm/min. Exclusion criteria: arterial diameter <1.5mm venous diameter <2mm. Written consent was taken from the patient. After preoperative workup surgery was done by 1st author. Arterio-venous fistula was scanned by color Doppler imaging after 4 weeks.

Result: There were 31 [62%] male, 19 [38%] female. Mean age of patients was 55.8 years. 18(36%) were dialysis dependent. Cause of renal failure were diabetes 16(32%), unknown 15(30%), glomerulonephritis 8(16%) and obstructive uropathy 3(6%). Mean internal diameter of radial artery was 1.91mm (1.5-2.6) and cephalic vein 2.57mm (1.9-3.2). 7 patients had swelling of arm, 5 patients has surgical site infections and 15 patients had primary failure; 11 were from diabetic group and 4 from non-diabetic group. Mean duration of surgery was 60.95 minutes (50-75). Average preoperative velocity in radial artery was 32.94(30-39) cm/sec. Average flow of blood at the end of 4 weeks was 461.42ml/min (0-654). Between two groups failure rate was significantly high in diabetic patients (p = 0.02). Failure rate was significantly higher in patients with diabetes more than 10 years (p=0.01).

Conclusion: Failure rate of arterio-venous fistula is significantly high in diabetic patients.
Random thoughts of a (palliative care) surgeon
Authors: Gongal Rajesh N
Published: June 2019

Prof. Dr Rajesh N Gongal ,FRCS (Eng) returned to Nepal from UK completing his surgical training in 1998 and has been working in Patan Hospital, initially as a Consultant and then as a Medical Director. Following the establishment of Patan Academy of Health Sciences (PAHS), he was appointed the Founding Dean of School of medicine. At present, he serves as the Rector of PAHS. He also served as the Chief Editor of Journal of Society of Surgeons (JSSN). He initiated Primary Trauma Care (PTC) Training in the country as the Founding Chair of PTC, Nepal. He was the Founding President of Nepal Ambulance Service (NAS), a non- profit initiative as the first proper Emergency Medical Service (EMS) with trained EMTs and a call centre accessed by calling a three-digit number 102. He is the Founding Chairperson of Hospice Nepal, the first palliative care centre in Nepal established in the year 2000. His interest in palliative care led him to Northern Ireland where he worked as fulltime trainee and completed fellowship in palliative care in 2016 under the auspices of Royal College of Physician of Edinburgh. He recently completed MSc in palliative from Ulster University.

He has worked as an Instructor for HOPE (Hospital Preparedness for Emergency) Course, ‘Primary Trauma Course; and the ‘Palliative care’ courses. He has presented in numerous national and International conferences and numerous publications in national and international journals such as Palliative Medicine and has published handbooks on ‘Basic surgical skills’ and ‘Palliative care’ as well.

He is an active member of the Society of surgeons of Nepal and has contributed to its establishment and development in the early days. He also served as the Chief editor of the Journal of Society of Surgeons of Nepal and has played a crucial role in the establishment of the journal encouraging scientific writing and paper publication culture amongst the fraternity. He is an important member of the society and serves as a mentor in the capacity of the advisory board of the journal.
Efficacy of Tamsulosin in Relieving Double-J Stentrelated Symptoms: a Randomized Controlled Study
Authors: Thakur Deepak K , Chapagain Suman , Luitel Bhojraj , Chalise Pawan Raj , Sharma Uttam Kumar , Gyawali Prem Raj
Published: June 2019

Introduction: Ureteral stent placement is an increasingly common procedure in urological practice. They are used for both prevention and treatment of ureteral obstruction. Despite improved design and materials, many patients still develop stent-related symptoms which commonly affect quality of life and sometimes necessitate early removal. Tamsulosin improves stent-related symptoms and quality of life. But such study has not been conducted in Nepalese context. In the present study, the effect of Tamsulosin in improving double-J stent-related symptoms and quality of life following ureteral stent placement was studied.

Methods: This study was carried out in the Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal from February 2015 to January 2016. Forty six patients were included in the study and randomized into Tamsulosin (T) group and Control (C) group each having 23 patients. In addition to standard postoperative care, Tamsulosin group received 0.4 mg Tamsulosin daily for 2 weeks and Paracetamol on demand and control group received only Paracetamol (1gram/dose). Stent related symptoms and quality of life was assessed by International prostate symptom score (IPSS) at discharge (day2) and at the time of DJ stent removal (2 weeks). Pain was evaluated by visual analog scale (VAS) and analgesic requirement was documented. Data were analysed using Statistical Package for the Social Sciences (SPSS) 20, chisquare test and Student’s t- test was used. A p-value of <0.05 was considered significant.

Results: Mean age in Tamsulosin group was 37.96±12.98 years and Control group 36.43± 10.99 years (p=0.67).There was no significant difference in IPSS (p=0.141), QoL index (p=0.089) and VAS (p=0.59) in the two groups at the time of discharge. At the time of DJ stent removal, IPSS (p<0.001), QoL index(p<0.001), VAS(p=0.004) and analgesic needed(p<0.001) was significantly lower in T group than in C group.

Conclusion: Tamsulosin lowers stent related symptoms, pain and improves quality of life in patients with indwelling DJ stent though the effect is not immediate.
Chemical Analysis of Urinary Stones
Authors: Sigdel Ghanshyam , Lamichhane Nirmal , K.C. Sudeep Raj , Belokar W.K.
Published: June 2019

Introduction: Urinary stone disease is a common urological problem. Chemical analysis of the urinary stones is a part of metabolic evaluation of first time or recurrent stone formers. The report of chemical analysis of stones may obviate the need for complete metabolic evaluation or can direct metabolic evaluation. In this study we aim to find out the chemical compositions of urinary stones in our population, so that the result might serve as a baseline for the related research in future.

Methods: A prospective study was carried out in our institute with the qualitative chemical analysis of urinary stones. All patients operated for different urinary stones by various methods were included in the study. Statistical analysis was done by using Statistical Package for the Social Sciences Software (SPSS) Program for windows ® version 18.

Results: A total of 55 patients were included in the study. Male to female ratio was 1.75. Mean age was 41.45 years. Ureteric and renal stones were most common accounting to 49 and 31 percentage respectively. All stones contained calcium. Calcium, phosphate, oxalate and uric acid were the major constituents of the stones representing 100, 94.5, 85.5 and 80 percentage of the stone specimen. Other constituents were amino acids, carbonate, magnesium and cystine.

Conclusions: Urinary stones are of mixed chemical compositions. Further large scale prospective studies along with other parameters of metabolic work up are recommended to know more about the chemical compositions of urinary stones and its utility in clinical practice.
Factors affecting conversion of laparoscopic to open cholecystectomy
Authors: Chhetri Raj Kumar , Shrestha Muza , Shrestha Ram Prasad
Published: June 2019

Introduction: Laparoscopic cholecystectomy is the gold-standard operation for the treatment of cholelithiasis. Various factors affect the conversion of laparoscopic to open cholecystectomy.

Methods: In this prospective analytical study one hundred and sixty consecutive patients who underwent laparoscopic cholecystectomy were studied to see the factors that affect the conversion to open cholecystectomy. Factors contributing to conversion of laparoscopic to open cholecystectomy were analyzed.

Result: In this study the conversion rate of laparoscopic to open cholecystectomy was 6.25%. The most common cause for conversion was unclear anatomy and adhesion at the Calot’s triangle and abnormal course of the cystic artery.

Conclusion: Proper knowledge about the anatomical variations of cystic duct and artery and timely conversion in cases of confusion can help prevent bile duct injuries during cholecystectomy.
Safety of laparoscopic cholecystectomy in children using conventional instruments in a general teaching hospital by general surgeons: 14 years review
Authors: Maharjan Shantabir , Shah Jay Narayan , Gurung Rajan , Shah Shailedra , Mandal Rajesh , Baral Reetu
Published: June 2019

Introduction: There is limited specialist facility and lack of data on gallstone and laparoscopic cholecystectomy (LC) in children locally and in the region. With one government children hospital in Nepal, specialist service is far from adequate. Utilizing existing facilities to provide service is the need. We analyzed 14 years data to look in to the safety of LC in children provided by general surgeons in a general teaching hospital with conventional LC instruments used for adults.

Methods: This descriptive review included children up to 14 y of age who had cholecystectomy during 14 y period from 2002 to 2015. Data on sex, age; clinical and ultrasonography findings; risk factors for gallstone; types of surgeries; bile duct injury, would infection and in-hospital mortality were analyzed.

Results: There were 61 children, 0.8% of total 7469 cholecystectomy during 14 years study period. Average age was 9 years and females were 56 (84%). Out of 58-attempted LC, 56 were completed successfully. All children had history of right upper quadrant pain. Two presented with acute calculous cholecystitis. We did not find associated risk factors for stones. There was no bile duct injury. One wound infection occurred in LC converted to open. In-hospital mortality was nil.

Conclusion: Cholelithiasis and cholecystectomy in children was low at 0.8% of total. With 3.4% conversion, no bile duct injury, no hospital mortality LC was safely provided by general surgeon in a general hospital using conventional facility.
Improving quality of life for women with incurable fistula in Uganda
Authors: Tripathi Vandana , Emasu Alice , Arnoff Elly , Mukisa Rose , Kanakulya Hassan , Kirya Fred
Published: June 2019

Aims: To understand whether reintegration services can improve quality of life (QoL) for women with incurable fistula (WIF) in Uganda.
Methods: Standardized tools measuring health/psychosocial status and QoL were administered before and after intervention to assess impacts: Self-Reporting Questionnaire (SRQ-20), WHO QoL-BREF, and modified King’s Health Questionnaire (KHQ).
Results: Before intervention, all participants had SRQ-20 scores >8, indicating psychological distress. After intervention, there was significant reduction (to 37%) in the proportion of participants with scores indicating distress (p=0.0003). As measured by WHO QoL-BREF, self-reported QoL and health satisfaction improved significantly after intervention (p=0.0003 and p<0.0001, respectively). Mean scores on specific domains (physical health, psychological, social relationships, and environment) also significantly increased (p<0.001). Physical health showed the largest increase and psychological the smallest. As measured by modified KHQ, participants’ perception of their health improved significantly after intervention (p<0.0001) as did their perception of how much fistula affects their life (p<0.0001). The KHQ also assesses seven functional domains. Mean scores significantly increased in each after intervention (p<0.01).
Conclusions: TERREWODE’s intervention was associated with significant positive changes in participants’ perception of and satisfaction with health and wellbeing. While many effects of incurable fistula cannot be eliminated, individualized support may mitigate QoL impacts. Such interventions may be adapted in other settings; standardized measures enable comparison of approaches.
Prevalence, aetiology and management of ureteric injuries in Mulago National Referral Hospital, Kampala, Uganda
Authors: Obore Susan , Barageine Justus
Published: June 2019

Aims: To determine the prevalence, aetiology and management of ureteric injuries in the Urogynecology unit of Mulago National Referral Hospital.
Methods:  Records of patients operated for ureteric injuries from January 2005 to December 2017 were reviewed. The type of operations associated with the injury, duration of injury and mode of management of the injuries was reviewed.
Results: There were 140 patients operated for ureteric injuries during the study period and this constituted 9.1% of all operations for urinary incontinence. Records of 125 patients were reviewed. The mean age of the patients at admission was 30.9 years and the mean duration of leakage was 19.8 months. In 100 (80%) of patients the leakage followed delivery and 25(20%) followed gynecological operations. Most of the patients 80 (64%) presented with vaginal leakage of urine/fistula while 7(5.6%) presented with transection of the ureter. The commonest site of injury was the left ureter (73.7%) and 17(13.6%) had bilateral injury.  All the patients were managed by surgical repair with a success rate of 90.6%.
Conclusions:  Iatrogenic ureteric injuries following c/section and c/section hysterectomy are a cause of morbidity and effort should be made to improve on surgical skills and ensure early recognition of injury.
Keywords: fistula,iatrogenic, ureter injury
A retrospective survey on the duration of leakage and patient perceived bottlenecks to seeking fistula treatment in Uganda
Authors: Shane Asiimwe Ian , Alphonsus Matovu
Published: June 2019

Aims: To assess the duration of leaking urine and patient perceived reasons for delay to seek repair among genitourinary fistula mothers who presented in fistula camps from June-2017 to July-2018 at Mubende and Hoima fistula treatment centers.
Methods: This was a retrospective study in which qualitative and quantitative data was collected from standardized patient records of patient chats and registers filled by fistula surgeons.
Results: We had a total of 125 mothers from 19 districts and of age between 16 to 72 years with genital urinary fistula operated. The majority (47.4%) of the clients were 25 years or less, of low parity with 41% (para 1+0) and without formal employment. Only 59.5% of the clients presented within one year from the time they developed the fistula. Perception was that fistulas are only treated during camps; ill health results from difficult labour; and lack of awareness that the bladder can be repaired.
Conclusions: With the low turn up of mothers seeking repair, there is need to reduce leaking time and lessen suffering of obstetric fistula patients by creating more awareness, promoting routine repairs and continued financial support to care for fistula clients.
Management of the Obstetric Fistula in Burundi: the experience from a multidisciplinary approach over 5 years
Authors: Mareschal Gaetan , Morren Geert , Vanden Boogaard Wilma , Dominguez Eva
Published: June 2019

Aims: To reduce maternal morbidity and improve the quality of life of women with obstetric fistula (OF) in Burundi.
Methods: A permanent multidisciplinary OF Center was opened in 2010 offering comprehensive care to women with OF including nursing, surgery/anesthesia, medical care, physiotherapy, psycho-social support and education on family planning and nutrition. Outreach activities were conducted to detect patients together with awareness campaigns. Referral system was strengthened through health workers orientation.
Results: There were 1559 first admissions and 479 re-admissions. Closure rates and continence rates at discharge after OF surgery were 77% and 61% respectively at the first intervention, and 58% and 41% at repeated intervention. All women with closed OF but incontinences 3 days after bladder catheter removal received physiotherapy. 260 vulnerable women received personal psycho-social support. 4760 health’s workers were given OF orientation and referral from health facilities increased from 14 to 40% in 5 years.
Conclusions: OF Center’s care was efficient, affordable and to a certain degree sustainable. Lessons learned on the management of clinical data, the simultaneous offer of different interventions and the provision of diverse trainings show that providing multidisciplinary OF care is very complex and demands specific expertise and continuous monitoring.
Iatrogenic Fistula: Types, Causes and Post-repair outcome – 70 cases
Authors: Begum Bilkis
Published: June 2019

Aims: In Bangladesh since iatrogenic fistula is gradually increasing so aim of this study is to find out the types, causes and post-repair outcome of iatrogenic fistula.
Methods: 70 cases in Bangladesh were reviewed between periodof January 2012 to April 2018. Detailed history, clinical examination and investigations were done to find out the causes. Proper evaluation was done for diagnosis of type of fistula and treatment plan.
Results: Among 70 cases, 48 were vault fistulae, 10 intracervical, 7 juxta-cervical, 2 mid-vaginal and 2 at neck region, 1 uretero-vaginal and 1 extensive from neck to cervix.  Regarding causes, among 70 cases, 47 fistulae developed after hysterectomy of which 38 following TAH, 6 following caesarean hysterectomy and 3 after vaginal hysterectomy. Rest 16 cases were due to caesarean section, 1 case was following coitus and 6 were due to other than gynecological-obstetric causes. 65 patients were repaired vaginally, 1 abdominally and 4 through combined route. Among 70 cases, 68 patients were successfully repaired at 1st attempt without any significant complication. 2 cases failed at 1st attempt and were dropped out.
Conclusions: Almost all of these causes are preventable. So emphasis should be given to identify the causes of iatrogenic fistula to prevent the event. At the same time, our aim is to make these patients free of urinary smell by applying appropriate surgical technique.
Experience of Partnership with Fistula Program in Bangladesh: University Fistula Center, Bangabandhu Sheikh Mujib Medical University
Authors: Alam Farhana , Chowdhury Saleha Begum , Mahmud Sharmeen
Published: June 2019

Aims: The aim of this paper is to share the performance data of University Fistula Center (UFC), BSMMU as well as the partnership experience of UFC with national fistula program at different levels and various activities. 
Methods: UFC uses an aggregated DHIS2 database and Safe Surgery Toolkit, two dedicated systems for record keeping of fistula activities introduced by the Fistula Care Plus (FC+) project at EngenderHealth. UFC fistula service data have been compiled using DHIS2 and SPSS.
Results:  From 2015 to 2018, UFC has provided surgical care to 98 cases fistula and 72 cases of complete perineal tear. UFC has provided technical assistance in field testing of the 4Q checklist- a novel tool for fistula case identification at the field level developed and refined by the FC+ project. UFC has contributed developing and testing a model for Community Based Fistula Diagnosis events (CFDEs) and to drafting the 2nd national fistula strategy of Bangladesh.
Conclusions: The UFC is now recognized as a key contributor to national fistula programming in Bangladesh and in defining standards of care.
Experience of using Community Radio for Fistula Communication in Bangladesh
Authors: Biswas Nitta , Huda Sk Nazmul
Published: June 2019

Aims: To share the experience of using community radio networks for female genital fistula communication in Bangladesh.
Methods: We selected 11 community radio stations from remote areas in Bangladesh.  Four hours orientation training was provided to manager and fistula focal person per radio station. We provided pre-recorded education and advocacy materials for fistula prevention and communication. Station staffs were provided with a manual for fistula communication.
Results: 32 key staff members of community radios were trained. At least 33 episodes were broad casted focusing on prevention of early marriage, care of obstructed labor, treatment and rehabilitation of fistula. Information about fistula prevention, case identification, repair center and rehabilitation were provided to an estimated number 660,000 people living in hard to reach places through community radio stations. They incorporated fistula messages song, dramas and talk shows on fistula throughout the year.
Conclusions: Community radio is a low cost, effective media for fistula communication in hard to reach areas. It is capable of linking a range of stakeholders and can be a strong force for facilitation of social movement for fistula free communities.