bluuebunny/crossref_metadata_2025 huggingface dataset:
Analisis Pendapatan dan Beban Jasa Konstruksi Berdasarkan Psak 72 pada CV Rizky Akbar Contruction di Ponorogo
Authors: Wahyuni Dwi , Hartono Arif , Hidayah Nurul
Published: November 2024

Penelitian ini mempunyai tujuan untuk Mengevaluasi pengakuan pendapatan dan beban berdasarkan PSAK 72 pada CV. Rizky Akbar Construction Ponorogo dengan metode penelitian kualitatif. Objek penelitian adalah pengakuan pendapatan dan beban pada CV. Rizky Akbar Construction. Metode pengumpulan data yang digunakan dalam penelitian ini dengan melakukan observasi, wawancara dan dokumentasi. Dalam penelitian kualitatif, data diperoleh dari berbagai sumber, dengan menggunakan teknik pengumpulan data yang bermacam-macam (triangulasi), dan dilakukan secara terus menerus sampai datanya jenuh. Hasil penelitian diperoleh pengakuan pendapatan dan beban belum sepenuhnya menerapkan PSAK 72.
Evaluating didactic strategies for teaching mathematics: A Policy–Driven approach to gender equity in Panama’s education system
Authors: Morales–Maure Luisa , González Rosa Elena Durán , Vega Arlette Vite , Alvarado Gabisel Barsallo , Alfaro–Ponce Berenice , Vázquez Evelyn García , Gutiérrez Jaime
Published: November 2024

This article evaluates the Didactic Strategies for Teaching Mathematics (DSTM) program, designed to enhance the teaching of mathematical content in primary and secondary education in a hybrid modality. In alignment with SENACYT’s Gender-STEM-2040 Policy, which emphasizes gender equality as a foundational principle of education, this study aims to assess whether initial teacher training aligns with this policy through the use of mathematical strategies promoting gender equality. A descriptive-correlational approach was applied to a sample of 64 educators, selected based on their responses during the training, with the goal of improving teaching and data collection methodologies. Findings indicate that, although most teachers actively engage in training, an androcentric approach persists, with sexist language and a curriculum that renders girls invisible, hindering the fulfillment of the National Gender Equality Policy in Science, Technology, and Innovation of Panama (Gender-STEM Policy 2040). Additionally, through a serendipitous finding, a significant gap in student activity levels, especially in secondary school, was discovered. While in primary school, activity levels were similar between genders, a decline in active participation among girls in secondary school was observed. This discovery, not initially contemplated in the study’s objectives, provides valuable insights into gender differences in active participation, particularly in higher educational stages. The serendipity suggests the need for further exploration of social, environmental, and family factors that may influence this decrease in girls’ active participation. The article concludes with a preliminary diagnosis and a call to deepen gender equality training and the effective implementation of coeducation in Panama’s educational system.
Role of innovation and human capital in regional economic growth and progress
Authors: Cai Wei , Jusoh Sufian , Rahman Radin Siti Aishah Radin A. , Liu Xiaoyu , Wang Siya
Published: November 2024

Since 1999, China’s higher education has experienced significant growth, with the government dramatically increasing college enrollment rates, thereby enhancing the overall quality of education. However, most existing studies have primarily focused on the quantity of education, with little attention having been given to the impact of higher education quality (HEQ) on economic growth. This study aims to explore how higher education quality (HEQ) contributes to regional economic growth through scientific and technological innovation (STI) and human capital accumulation. Using panel data from 31 Chinese provinces from the period 1999 to 2022, panel regression models and instrumental variable methods were employed to analyze both the direct and indirect impacts of higher education quality (HEQ) on economic growth. The results confirm that improving higher education quality (HEQ) is crucial for sustaining China’s economic growth. More specifically, higher education promotes regional economic expansion both directly, by enhancing labor productivity, and indirectly, by facilitating scientific and technological innovation. Furthermore, the study suggests that the balanced distribution of educational resources across regions should be prioritized to support coordinated regional development. This research provides insights for policymakers on how balanced regional economic development can be achieved through educational and technological policies. This work also lays a foundation for future studies.
Legality extent of therapeutic cloning in Islamic Fiqh and comparative laws—A comparative analytical study
Authors: Awwad Ahmed , Bejeawi Imad
Published: November 2024

The rapid advancement of biotechnologies involves human subjects that brings forth intricate ethical, legal, social, and religious challenges. Recent breakthroughs in cloning and stem cell research have generated new hopes as well as presents considerable promise for treating severe diseases and regenerative medicine. In this regard, for advancements in biotechnology to be clinically applicable in medicine, it’s essential to comprehend both scientific principles and ethical implications, taken into consideration the scientific roadblocks impeding advancement in therapeutic cloning such as tumorigenicity, epigenetic reprogramming and interspecies pathogen transfer. As research in this area progresses, it will clarify that stem cells can be obtained from various sources, including therapeutic cloning, which involves cloning embryos from the nuclei of somatic cells or cloning individual organs in the laboratory. This article studies  the legitimacy extent of therapeutic cloning in Islamic Fiqh and comparative law, using the comparative analytical approach. Thus, we have reached a number of results, the most important of which is that the Islamic Fiqh perspective on the illegality of extracting stem cells by creating therapeutic embryos using Somatic Cell Nuclear Transfer (SCNT). It is deemed unacceptable to create an embryo for the purpose of its development and then destroying it for the purpose of stem cells, as this is unacceptable that turns the human being into a source for spare parts. Conversely, cloning specific organs and tissues in the laboratory for medical purposes is considered permissible, provided that it does not harm anyone or violate their sanctity that is consistent with many comparative laws.
Família multiespécie: uma reflexão a partir do reconhecimento da senciência animal
Authors: Hansen Juliana , Ningeliski Adriane de Oliveira
Published: November 2024

O presente artigo científico explora o conceito de família multiespécie, com foco no reconhecimento da senciência animal, na proteção constitucional concedida aos animais e às famílias no Brasil, com enfoque nos princípios da afetividade, solidariedade e proteção do ser humano. A pesquisa adota como método de pesquisa o dedutivo, uma vez que a família é reconhecida pelo Direito através das relações de afetividade e cuidado (solidariedade), logo se há afetividade e cuidado entre tutores e seus animais de estimação, pode haver o enquadramento desse agrupamento como família dentro do ordenamento jurídico. A família multiespécie reflete a realidade de muitos lares brasileiros onde os animais de estimação são considerados membros da família. O seu reconhecimento valida o vínculo afetivo humano-animal e garante a proteção garantida às famílias pela Constituição Federal. Além disso, altera a perspectiva dos animais de meras propriedades para seres sencientes. A pesquisa contribui para a discussão em curso sobre os direitos dos animais e a transformação das estruturas familiares. Defende a estrutura legal da família multiespécie, abrangendo tanto o bem-estar dos animais quanto os laços emocionais que eles formam com seus companheiros humanos. Por fim, conclui-se que a família multiespécie deve ser reconhecida pelo ordenamento jurídico brasileiro, a fim de receber a devida proteção constitucional.
Equity Concentration, Internal Equity Structure and Company Performance
Authors: Xuantong Huang , Wang Zhang
Published: November 2024

Under the background of improving the modern enterprise system with Chinese characteristics and accelerating the development of new quality productive forces, discussing the equity structure and salary incentive mechanism of listed companies in hydrogen energy, an emerging energy source, can provide reasonable and effective development paths for improving the performance of hydrogen energy companies. Based on the research sample of 289 hydrogen energy companies listed on the A-share market from 2013 to 2023, this paper analyzes effectiveness using the coefficient of variation method, conducts empirical research using multiple linear regression, and tests the robustness, endogeneity, and heterogeneity of the results. Research Findings: There is a positive correlation between the shareholding ratio of the largest shareholder and company performance, but it is not significant; the shareholding ratios of the top five and top ten shareholders are significantly positively correlated with company performance, respectively; the shareholding ratio of the supervisory board is significantly positively correlated with company performance; and the remuneration of the supervisory board is significantly positively correlated with company performance.
An Investigation of Physical Education Teachers’ Teaching-Learning Conceptions and Professional Satisfaction Levels
Authors: Oruç Süleyman , Aslan Şehmus
Published: November 2024

Introduction:
The level of professional satisfaction in teachers is an important issue in terms of high work motivation and employee performance. In addition, high professional satisfaction is a factor that contributes to teachers’ more positive approach to the education process.

Methods:
This study aims to examine the teaching-learning conceptions and professional satisfaction levels of physical education teachers. A total of 310 physical education teachers, 129 female and 181 male, working in primary and high schools participated in the study. A relational scanning model was used in this research. The Teaching and Learning Conceptions Scale and Minnesota Job Satisfaction Scale were used as data collection tools.

Results:
It has been observed that there is a positive relationship between teachers’ understanding of teaching-learning and their level of professional satisfaction.

Discussion:
The constructivist understanding levels of the teachers participating in the research regarding the teaching-learning process were high, while their traditional understanding levels were below the medium level.

Limitations:
This research was limited to 310 physical education teachers working at different education levels.

Conclusions:
It can be said that the teaching-learning understanding of physical education teachers is a determinant of professional satisfaction.
Developing Distractors for Mathematics Multiple Choice Items: A Literature Review
Authors: Arhin Ato Kwamina
Published: November 2024

Introduction:
This article aimed at digging deep into distractors used for mathematics multiple-choice items. The quality of distractors may be more important than their number and the stem in a multiple-choice question. Little attention is given to this aspect of item writing especially, mathematics multiple-choice questions. This article provides an engaging but succinct literature review on the development of plausible distractors for mathematics multiple choice items.

Methods:
A literature review was conducted on developing effective distractors for mathematics tests. The review explored potential strategies for generating distractors that effectively assess students’ understanding and problem-solving skills in mathematics.

Results:
Alternative sources of distractors other than students’ misconceptions are provided to aid the development of plausible distractors for mathematics multiple-choice items.

Discussion:
Practical guidelines for judging distractors fit for mathematics questions are provided to help teachers improve their item writing skills based on literature and experience as a mathematics teacher. Common pitfalls in distractor development were identified to enable mathematics teachers to have a clear path for their work.

Limitations:
This article focused on the development of plausible distractors specifically for mathematics multiple choice questions.

Conclusions:
Test constructors must ensure aligning the distractors with the objectives of each lesson in order to make the distractors relevant to the demands of the item.
Inductive Knowability of the Modal
Authors: Roca-Royes Sonia
Published: November 2024

This paper scrutinises the limits of a posteriori induction in acquiring modal knowledge. I focus on my similarity-based account (Roca-Royes [2017]); an inductive, non-rationalist epistemology of modality about concrete entities. Despite the explanatory merits of the account in relation to a vast range of modal claims, this inductive epistemology has been found incapable of yielding knowledge of a certain, other range of modal claims. Here, two notions of knowability are distinguished which reveal some of these limitations to be not only accidental to the method but also virtuous. Additionally, the scrutiny suggests a recipe for increasingly pushing back, as modal enquirers, some of these limits. Limits will irremediably remain. But, as modal epistemologists, it is to explain what lies beyond these irremediable limits (not within) that we should look somewhere else.
Kulturjudentum in der Geschichte der Juden in Deutschland: von der Bildung zur Erinnerungskultur
Authors: Goldblum Sonia
Published: November 2024

Der vorliegende Artikel soll einen Überblick über die verschiedenen Aspekte des kulturellen Judentums in Deutschland geben. Es geht darum, das Verhältnis der Juden in Deutschland zur Kultur in seiner Vielfalt zu skizzieren. Seit der Aufklärung folgt dieses Verhältnis immer weniger einem religiösen oder theologischen Paradigma und lässt sich immer mehr aus einem kulturellen Blickwinkel heraus betrachten. In einem ersten Schritt wird das Verhältnis der Juden in Deutschland zur Bildung zu berücksichtigen sein, das für das 19. Jahrhundert zentral ist. Dann muss das neue Interesse an der jüdischen Tradition, das der Bewegung der „Jüdischen Renaissance“ eigen ist, in den Blick genommen werden. Sie nahm in den 1910er Jahren ihren Aufschwung und entwickelte sich in der Weimarer Republik weiter. Schließlich wird die zentrale Rolle der Erinnerung sowohl für die jüdische Identität als auch für die Beziehung der Juden in Deutschland zur Kultur untersucht. Sie erlaubt es, zwischen dem Kulturjudentum vor 1933 und demjenigen, das sich nach 1945 entwickelt, eine Brücke zu schlagen.

Le présent article vise à présenter un panorama des différents aspects du judaïsme culturel en Allemagne. Il s’agira de rendre compte des différentes manières d’envisager le rapport des Juifs d’Allemagne à la culture, dès lors, qu’à partir des Lumières ils s’envisagent eux-mêmes de moins en moins à partir d’un paradigme religieux ou théologique, mais d’un point de vue culturel. Dans un premier temps, il faudra prendre en compte le rapport des Juifs d’Allemagne à la culture, comprise au sens de Bildung, notion centrale pour le XIXe siècle. Puis le regain d’intérêt pour la tradition juive, propre au mouvement de la « Renaissance juive » qui prend son essor dans les années 1910 et se développe sous la République de Weimar devra être analysé. Enfin le rôle central de la mémoire à la fois dans l’identité juive et dans le rapport des Juifs d’Allemagne à la culture permettra de jeter un pont entre le judaïsme culturel d’avant 1933 et celui qui se développe après 1945.

The present article aims at presenting a panorama of the different aspects of cultural Judaism in Germany. The aim is to give an account of the different ways in which the relationship of German Jews to culture is viewed, since, from the Enlightenment onwards, they see themselves less and less from a religious or theological paradigm, but from a cultural point of view. Initially, the relationship of German Jews to culture, understood in the sense of Bildung, which is central to the nineteenth century, must be considered. Then, the renewed interest in the Jewish tradition of the “Jewish Renaissance” movement which took off in the 1910s and developed under the Weimar Republic will have to be analyzed. Finally, the central role of memory both in Jewish identity and in the relationship of German Jews to culture will be considered in order to bridge the gap between cultural Judaism before 1933 and that which developed after 1945.
005. The Role of Interleukin-8 in Assisting the Diagnosis of Necrotizing Enterocolitis (NEC) Bell’s Stage I and II in Premature Infants: Literature Review
Authors: Tamba Riana Pauline , Karnanda Andriansyah
Published: November 2024

Background: Necrotizing enterocolitis (NEC) is one of the leading causes of morbidity and mortality in infants, commonly associated with extremely low birth weight (ELBW), low birth weight (LBW), and prematurity. The clinical symptoms are nonspecific and various. This poses a challenge in the early diagnosis. The incidence worldwide ranges from 0.3 to 2.4 per 1,000 live births, with mortality rates reaching 50%. This study aims to assess the role of biomarker IL-8 in diagnosing NEC Bell's stage I and II. Methods: This study is a literature review, conducted electronically in databases including Cochrane Library, PubMed, ScienceDirect, and EBSCO using the keywords: ("Interleukin-8" OR "IL-8") AND ("Necrotizing enterocolitis" OR "NEC" OR “Early NEC” OR “Stage I-II NEC”). Inclusion criteria are study in human, English fulltext within 5 years. Exclusion criteria is comparing NEC any stage with control patients, Results: Based on a review of 23 literatures, there were 6 studies met the inclusion criteria for analysis. IL-8 shows varying sensitivity and specificity as a serum biomarker for diagnosing NEC. Statistical evaluations in previous studies emphasized that significantly elevated levels of biomarker IL-8 were predominantly found in the serum of premature infants with NEC, indicating it could be a potential biomarker for diagnosis with NEC Bell's stage I and II.  Conclusion: The measurement of biomarker IL-8 in blood has not yet been established as a reliable diagnostic modality for NEC Bell's stage I and II, indicating the need for further investigation.
006. Wilm’s Tumor with Obstructive Ileus in A Newborn
Authors: Soebagio Sanjaya , Jaya I Made Darma
Published: November 2024

Background: Wilms' tumor is the most common kidney malignancy in the pediatric population. Wilms' tumor can spread to other organs, pressing on surrounding organs, and causing kidney damage and high blood pressure. This case report aims to report on neonatal patients with Wilms' tumor which complicate into obstructive ileus. This study aims to explore the effect of wilm’s tumor on causing obstructive ileus which can be detrimental to a newborn. Methods: A 21-day-old baby boy was brought in with complaints of a lump in the left abdomen that had been felt since birth. The lump was felt to be growing rapidly and feels hard. Physical examination revealed sunken eyes, dry lips, holosystolic murmur on parasternal line intercostal II-IV, and a solid mass sized 5x4 cm in the left hypochondrium up to left iliac region. Abdominal ultrasound and CT scan confirmed a renal mass. Results: The patient was diagnosed with partial obstructive ileus due to left kidney tumor suppression, suspected Wilms tumor and low intake malnutrition with moderate to severe dehydration. The patient was managed with laparotomy and left nephrectomy. The procedure alleviated all symptoms and upon 1 month follow up, the patient was healthy with good nutrition status. Conclusion: The presence of large abdominal mass in neonates can be a sign of Wilms tumor. This disease can lead to obstructive ileus and can be treated with laparotomy and nephrectomy.
014. Localized Meconium Peritonitis Due to Perforation of Ileum Atresia: Case Report
Authors: Amalia Gina , Wardhani Avriana Pety
Published: November 2024

Background: Ileal atresia is a congenital disorder that can cause serious complications such as intestinal obstruction, intestinal ischemia, and intestinal rupture. The worldwide incidence rate is 1 in 5,000 - 10,000 births, which can be influenced by various factors such as the use of certain drugs during pregnancy, a family history of similar complaints, and premature birth which can increase the risk. One of the rare features is spontaneous walling off of the abdominal wall which resembles a cyst. From this case we found a patient who had this rare clinical presentation. Case: 3 days old baby was referred to Dr. Kariadi Semarang with a greenish lump in the epigastric region since birth, accompanied by the appearance of small intestinal obstruction. The patient was born via vaginal delivery at 39 weeks' gestation with a normal Apgar score and weight. From the history and examination that had been carried out, it was concluded that there was ileal atresia and an exploratory laparotomy was performed. A green mass was obtained which was the walling off of the ileal perforation. During the operation, another finding was found, ileal perforation caused by atresia and severe adhesions (Grade IV). The patient then underwent the Santulli procedure and laceration repair. Conclusion: Ileal atresia is diagnosed from anamnesis taking from baby has signs of obstruction such as flatulence and vomiting. The incidence of ileal atresia associated with perforation and causing peritonitis is still rare due to lack of reporting of these cases. Peritonitis, which occurs due to intestinal perforation in the jejunoileal segment, can cause the release of intestinal products, meconium, into the intra-abdominal cavity. Spontaneous walling off in this case is quite rare, and because the perforation product is sterile, it does not give a picture of inflammation.
015. A Gastrointestinal Infantile Hemangioma: A Rare Case Report and Literature Review
Authors: Kusuma Faizurrahman Andi , Raharjo Rudiyuwono
Published: November 2024

Background: Small intestinal hemangioma in children is a rare case. The most common predilection is jejunum area. History taking, physical examination, and supporting examinations are needed to help establish the diagnosis. Case: 1 year old girl came with complaints of vomiting with blood since the age of 6 months with frequency 10x/day everytime she eats and drinks. The patient has been given treatment according to the diagnosis of pulmonary tuberculosis and digestive problem, then referred to dr. Kariadi hospital because there was no improvement. Based on examinations, the patient was diagnosed with obstructive ileus at the level of jejunum and exploratory laparotomy was performed. Multiple hemangiomas of 14 x 5 cm were found in the jejunum and confirmed by anatomic pathological examination. Six days after the operation, the child was allowed to go home.  Conclusion: Although this case is a rare case in children and include benign tumors, it is necessary to perform a quick diagnosis and appropriate management to prevent mortality and morbidity in children due to gastrointestinal bleeding.
016. Case Report: Torsion of the Testicular Appendix in Pediatric
Authors: Akbar Yundie Andrea , Balela Naisya , Poerwasusanta Hery
Published: November 2024

Background: The testicular appendix or hydatidosa sessile Morgagni is a congenital disorder consisting of residual vestigial tissue of the mesonephric and Müllerian ducts1. Commonly it is attached to the testis and caput epididymis. Its presence can lead to twist around their own axis, causing acute scrotal pain. Case: A 8-year-old boy presented with gradual onset of left scrotal pain that worsened with movement and improved with rest. Other symptoms included scrotal swelling and redness/hyperemis. The ultrasonography examination revealed torsion of the testicular sinistra with mild hydrocele. During surgical intervention, testicular of the appendix torsion was found and appendiceal excision was performed. Conclusion: Torsion of thetesticulsr appendix is a benign condition that commonly affects prepubertal males. Its atypical symptoms of acute scrotal pain can lead to misdiagnosis as testicular torsion.
023. Isolated Calvarial Tuberculosis in An Immunocompromised Patient: A Case Report
Authors: Yapari Dennis , Hosea Nathania , Abidin Zainal , Lahdimawan Ardik
Published: November 2024

Background: Isolated Calvarial tuberculosis is a rare occurrence, first reported by Reid in 1842, with majority of cases (75-90%) appearing under the age group of 20-30 years and involving frontal and parietal bones because of the greater amount of cancellous bone with diploic channels. The Human Immunodeficiency Virus (HIV) Infection is currently a huge threat to Indonesia, with Tuberculosis (TB) infection is one example of opportunistic infection that can lead to death in People living with HIV. The objective of this article is to report a rare case of Isolated Calvarial Tuberculosis in an Immunocompromised Patient Case: A 26-year-old male, known to be immunocompromised with HIV infection, presented to hospital with chief complaint of a painless lump on the left temple since 1 month prior. Head CT-Scan examination revealed osteolytic appearance in the left frontal area and swelling of the surrounding soft tissue. The patient then underwent surgery with intraoperative findings of a cystic mass filled with yellowish fluid. A craniotomy of the surrounding healthy bone including the dura mater and excision of the overlying soft tissue were performed, and histopathological result revealed a chronic tuberculosis inflammation. Conclusion: Calvarial Tuberculosis is a rare form of skeletal tuberculosis occurring in younger population, but can also present in older patient with immunocompromised state, that present with main complaint of painless swelling or lump in the frontal or parietal area because of its favourable bone structure. Diagnostic including X-ray and CT-Scan with microbiologic findings of multiple epithelioid granulomas with Langerhans type giant cells. Preferred treatment including both surgical and antituberculosis therapy to achieve favourable outcome.
024. Case Report: Giant Cell Tumor Intravertebra
Authors: Nababan Arthur Gospel , Suhendar Agus
Published: November 2024

Background: Giant cell tumor is a rare neoplasm that most frequently occurs at the end of long bones and accounts for approximately 5% of all primary bone tumors in adults. The prevalence of spinal giant cell tumors is estimated at 2%–15% of all spinal giant cell tumors. However, Giant cell tumor is a rare finding in the spine, especially in the pediatric population. Case: A 6-year-old male patient presented with back pain that had spread to both legs for 1.5 years and had worsened in the past 4 months. The pain is intermittent. The patient also felt tingling in the waist and legs, which then turned into a thickening feeling from the waist to the toes since the last 6 months. The patient also complained of weakness in both legs since 1 year ago. Currently the patient is only on bed rest. The patient cannot walk but can still stand with assistance. Defecation and urination remain within normal limits. History of previous trauma (-) Prolonged cough (-), bed wetting (-), headache (-), seizures (-), decreased consciousness (-), progressive weight loss (-), nausea (-) vomiting (-), history of contact with TB sufferers (-). Conclusion: Complete resection of tumor by laminectomy was performed successfully followed by spinal fusion with a pedicle screw. The screws were placed correctly at all four levels of Vertebrae. The decision was made to give stability for spine and it was scheduled to remove the pedicle screw one year follow-up after surgery. Histopathology results showed characteristic findings of  giant cell tumor.
032. Infective Endocarditis with Right Atrium Vegetative Due to Infection of Catheter Double Lumen: A Case Report
Authors: Riendra Muhammad , Rahman Aulia , Ardiansyah Ardiansyah , Jayanti Ranti
Published: November 2024

Background: Infective endocarditis (IE) associated with Catheter Double Lumen (CDL) is uncommon. This condition is masked by suspicion of common CDL infection which is treated with CDL replacement. CDL-related IE in chronic kidney disease (CKD) patients who routinely undergo hemodialysis is a condition that requires integrated management among multi-disciplines, especially in children patient. Until now, open heart surgery with cardiopulmonary bypass is still the standard procedure for vegetation evacuation in IE. Endovascular modality is a challenging intervention because of the risk of pulmonary embolism due to the detachment of vegetation. Case: We report a case of a 13-year-old girl with a history of repeated CDL placement who came to the emergency room with high fever since 2 weeks before admission. The patient is known as CKD with a history of the last CDL placement 4 months ago. Yellowish fluid with positive pus came out of the catheter site. Echocardiography showed a 2.5 cm right atrial vegetation surrounding the CDL and had protruded into the tricuspid valve and right ventricle.  After IE management, the vegetation was still large and we decided to evacuated the vegetation. There were no difficulties or complications either intraoperatively or postoperatively and the patient was discharged with good results. Conclusion: Infection in CDL should be suspected as endocarditis until proven otherwise because it will affect the management and surgical intervention required.
035. Short-Term Outcomes for Catheter-Directed Thrombolysis for Non-Threatening Acute Limb Ischaemia: A Systematic Review and Meta-Analysis
Authors: Trihatmaja I Gst Ngurah A Bayu , Yuana I Ketut Wisudana
Published: November 2024

Background: Acute limb ischemia (ALI) is a rapid reduction in arterial blood flow to a limb, which may jeopardize its viability, particularly in sensory loss or motor impairment. Catheter-directed thrombolysis (CDT) is the preferred treatment in numerous centers for patients with marginally threatening acute limb ischemia (ALI). This meta-analysis examined the short-term effects of catheter-directed thrombolysis (CDT) for patients with non-imminent limb ischemia. Methods: We searched PubMed, ScienceDirect, and the Cochrane Library to locate observational papers and trials published from 2014 up to early 2024 that report on the outcomes of CDT in patients with ALI. The outcome of this study was mortality rate, amputation rate, and major bleeding. We utilized R Studio to perform the meta-analysis. Results: Nine trials were included, involving 1,067 patients receiving CDT for non-imminent acute limb ischemia. Our results indicate that the pooled mean short-term amputation rate was 10% (95% CI [0.06; 0.15], p < 0.01), the major bleeding rate was 5% (95% CI [0.00; 0.09], p = 0.03), and the short-term death rate was 4% (95% CI [0.03; 0.06], p = 0.08). Our findings indicate a low incidence of short-term death, amputation, and major bleeding in patients undergoing CDT. Conclusion: This meta-analysis reveals a low incidence of short-term mortality, amputation, and major bleeding in patients undergoing Catheter-directed thrombolysis. Further investigations are necessary to determine if CDT should be utilized for the revascularization of limbs with non-urgent ischemia.
038. Association Between High Body Mass Index and Smoker in Shopkeepers with Chronic Venous Insufficiency in Sederhana Market Bandung
Authors: Pertiwi Dista Yuristia , Djajakusumah Teguh Marfen
Published: November 2024

Background: Chronic venous insufficiency (CVI) is a condition that encompasses several pathological changes such as lower extremity edema, skin trophic changes, and discomfort than secondary to venous hypertension. It is estimated that 73% of women and 56% of men are affected by CVI. Shopkeepers are the jobs that have a high risk of becoming a risk factor for CVI such as high BMI > 25 (body mass index) and smokers. The study aims to know the association between high BMI and smoker in shopkeepers with CVI in the Sederhana Market, Bandung. Methods: The cross-sectional study was conducted on shopkeepers in the Sederhana Market from March to September 2023. Data from shopkeepers that met the inclusion criteria was collected through history taking, physical examination, and filling out the research questionnaire. Results: Among 48 shopkeepers in Sederhana Market, 37 had CVI (79.2%), with a demographic of 73% male and 27% female, and the mean age of the patients was 44.9 (30-59) years. The average sitting time during trading was 15.1 (10-20) hours, and the average standing time during trading was 5.3 (2-13) hours. The association between high BMI and smoker with CVI in shopkeepers was carried out, and it was found that there was a association between high BMI (p = 0.0006), and smokers (p = 0.0023) with CVI among the shopkeepers. Conclusion: There are association between high BMI and smoker in shopkeepers with CVI in the Sederhana Market, Bandung.
049. Recurrence Factors of Early-Stage Colon Cancer Post-Colectomy: A Literature Review
Authors: Sultani Adil , Giamour Vania Myralda , Mazni Yarman
Published: November 2024

Background: Colon cancer is more prevalent in men than in women, with an incidence rate of 131/100,000 in men and 10/100,000 in women. The incidence of new cases and mortality has decreased over recent years, except in younger adults (<50 years), which may be associated with increased cancer screening and improved therapeutic modalities. The rise in incidence is linked to obesity, physical inactivity, alcohol consumption, high red meat intake, and smoking. Some data suggest that colon cancer carcinogenesis is related to imbalances in the gut microbiota. The validation of individual risk factors and multivariable predictive models for metastasis, local or distant recurrence, is crucial. This study aims to determine the risk factors for recurrence of early-stage colon cancer post-colectomy. A literature review discussing the factors of colon cancer recurrence. Literature was searched using online databases such as Cochrane, PubMed, EBSCO, and ProQuest. Case: Based on the review of seven studies discussing colon cancer recurrence factors, the statistical results varied, with each article having its own research limitations. Overall, the risk of colon cancer recurrence post-colectomy was present in patients with risk factors discussed in this literature review. Conclusion: Post-colectomy recurrence of colon cancer shows the presence of relapse at the anastomosis site. High-risk patients for early recurrence include those with elevated CA 19-9 levels post-surgery, venous tumor invasion, or advanced N stage. Vitamin D supplementation can be added to standard colorectal cancer treatment. Preoperative CEA levels are an independent prognostic factor for both overall and oncological outcomes.
060. Chronic Megacolon with Recto Vaginal Fistulo Associated with Atresia Ani: A 26-Year History and Case Report
Authors: Arditayasa I Gede Ryan , Antara Gede Eka Rusdi
Published: November 2024

Background: Large bowel obstruction and megacolon formation with rectovaginal fistule ascociated with atresia ani is rare. abnormal colon dilatation that falls into one of three categories: toxic, chronic, or acute. Acute megacolon, sometimes called Ogilvie syndrome, is a condition that frequently affects sick or postoperative individuals and is linked to autonomic nervous system dysfunction. Its source is unknown. On the other hand, intestinal dysfunction brought on by neurological or muscle conditions is the cause of chronic megacolon. The symptoms of all three kinds include bloating, stomach pain, and constipation. Case: We present a case of an 26-year-old woman surviving large bowel obstruction and mega-megacolon formation secondary atresia ani and fistulo rectovagina for 26years alive, with an presentation of abdominal distention. Results The patient’s symptoms, laboratory test results, and imaging were consistent with large bowel obstruction. The patient underwent urgent exploratory laparotomy. Upon entry in the abdomen, it was unexpected that the extreme colonic wall thickening, indicating the longtime course of illness. In this instance, we performed a number of procedures, including ligation of the obstructed colon, anus repair, and vaginal fistula repair. Conclusion: This report aims to point out the atypical and in-extremes presentation of an otherwise common disease.
064. Overview of Bacterial Patterns and Antibiotic Resistance on Cholangitis Patients at Hasan Sadikin General Hospital from January to December 2023
Authors: Evan Cecilia , Rudiman Reno
Published: November 2024

Background: Cholangitis is a serious infection of the bile ducts that requires prompt treatment, often with antibiotic therapy. Although antibiotic use, especially ceftriaxone and metronidazole, is vital in treatment, antibiotic resistance remains a significant challenge. Unfortunately, data on bacterial resistance patterns in cholangitis patients treated at Doctor Hasan Sadikin Hospital in Bandung is still limited. This study aims to describe the bacterial patterns and antibiotic resistance in cholangitis patients at Doctor Hasan Sadikin General Hospital. Another objective is to assess the effectiveness of ceftriaxone and metronidazole therapy in patients with moderate to severe cholangitis. Methods: This research employed a retrospective descriptive design by collecting data from the medical records of acute cholangitis patients treated at Doctor Hasan Sadikin General Hospital from January to December 2023. A total of 126 patient samples meeting the inclusion criteria were analyzed through blood cultures, and sensitivity tests were conducted against various antibiotics. Data were analyzed using SPSS software. Results: The results showed that Escherichia coli (26.3%) was the most commonly found bacterium, followed by Staphylococcus haemolyticus and Klebsiella pneumoniae (each at 13.2%). The highest resistance was observed against ampicillin (78.9%), while the most effective antibiotic was tigecycline (92.1% sensitivity). Conclusion: In conclusion, ceftriaxone and metronidazole as empiric therapy remains effective for most cholangitis patients, although resistance to certain antibiotics like ampicillin warrants attention. This study highlights the importance of regular monitoring of antibiotic resistance patterns to ensure proper treatment and reduce morbidity and mortality rates among cholangitis patients.
065. Ileoileal Small Bowel Intussusception in Adult
Authors: Angwarmase Alfonsa , Wijaya Alma
Published: November 2024

Background: Intestinal Intussusception is invagination of a proximal segment of the gastrointestinal tract into the distal. In adults, ileoileal intussusception is a rare case and diagnostically challenging. We present four cases of ileoileal small bowel intussusception in adults. Case: a 19-year-old man with complaint of abdominal pain. An exploratory laparotomy was performed, an ileoileal invagination was found. Second case : a 29-year-old woman with complaint of not being able to defecate or flatus. An ileal dilatation up to 240 cm from the ligament of treitz and ileoileal invagination with an ileal tumor was found in exploratory laparotomy. Third case : a 51-year-old man with complaint of difficulty defecating since 1 day before admission. A 30 cm long ileoileal invagination and tumor in the invaginated ileum was found. Fourth case : a 77-year-old man with a difficulty in defecating. A dilatation of the bowel starting from jejunum-ileum and a 20 cm long invagination was found. Conclusion: Clinical presentation of bowel obstruction is helpful to diagnose adult ileoileal small bowel intussusception. The mainstay of treatment is surgical intervention.
068. Revealing the Hidden Giant: When Giant Appendicitis Mimics A Mesenteric Cyst in Recurrent Sigmoid Volvulus – A Case Report
Authors: Wari Deastri Anjeas , Mujiburrahman Husnan , Setyawan Nurcahya
Published: November 2024

Background: Giant appendicitis is an exceptionally rare condition that can mimic other intra-abdominal pathologies, including mesenteric cysts, due to its unusual size and presentation. Distinguishing between these entities is chalenging due to its resemblances. Case: A 56-year-old woman with a history of chronic constipation who was admitted to the emergency department with abdominal distension and inability to defecate. Abdominal examination revealed a distended abdomen with visible bowel contour and an abdominal X-ray showed coffee bean appearance, suggestive of sigmoid volvulus. An exploratory laparotomy revealed twisting of the sigmoid colon. After reducing the volvulus and confirming viability of the sigmoid, a loop sigmoidostomy was performed to prevent recurrent volvulus. Intraoperatively, a mass resembling a mesenteric cyst was identified, which was subsequently confirmed to be a case of giant appendicitis. Conclusion: Considering giant appendicitis in the differential diagnosis of abdominal masses resembling mesenteric cysts is important, particularly in patients with chronic constipation and recurrent volvulus, to ensure timely and appropriate surgical management.
074. Pulmonary Lacunae Due to Chemotherapy-Induced Pneumothorax in Metastatic Breast Cancer: A Rare Case Report and Review of Literature
Authors: Indiwirawan Luthfi , Budiwinata Winardi
Published: November 2024

Background: Chemotherapy plays a major role in treating breast cancer patients who develop hematogenous spread or disseminated metastase. Spontaneous pneumothorax is a rare complication of chemotherapy and is commonly associated with chemosensitive tumours such as germ-cell tumours, lymphomas, and sarcomas and rarely with lung and gynaecological malignant disease. Pneumothorax seems to occur 2–7 days after chemotherapy treatment and can be unilateral or bilateral. To present the rare case of a A 56-year-old woman with breast cancer on chemoterapy who had secondary pneumothorax after undergo chemotherapy and treated with chest tube insertion. Methods:  Clinical and imagery review of a secondary pnuemothorax after several chemoterapy outlined in case report also review of literature. Results: The patient underwent a chest tube insertion and hospitalized 10 days. She was discharged and responds well to therapy. Conclusion: This is the case of secondary penumothorax due to chemoterapy in breast cancer patient. The mechanisms involved in chemotherapy-related pneumothorax have been proposed because of tumor necrosis inducing the formation of a fistula. Our patient underwent chest tube insertion and other pharmacology therapy to decreased patient her complaint.
080. Clinical Complete Resolution of Breast Cancer Achieved After Four Cycles of Chemotherapy: A Case Report of A 44-Year-Old Woman
Authors: Napitupulu Aretti Sari , Siregar Kamal Basri
Published: November 2024

Background: Breast cancer is a major cause of cancer-related deaths in women, with early detection critical for improving outcomes. In resource-limited settings, delayed diagnosis is common, leading to more advanced disease at presentation. This case report details a 44-year-old woman who achieved clinical complete resolution of her breast cancer after four cycles of chemotherapy. Case: The patient first noticed a marble-sized lump in the upper lateral quadrant of her left breast in August 2023. Despite the growing size of the mass, which increased to 5 cm over four months and became immobile, she delayed seeking medical care. Upon presentation, a biopsy confirmed a diagnosis of breast cancer. The patient was started on chemotherapy, receiving four cycles as a neoadjuvant treatment. Post-treatment examinations revealed a clincal complete resolution of the tumor, and she was subsequently scheduled for a mastectomy to remove any remaining disease and prevent recurrence. The post operative histopathology result; some viable tumor cells are still present in the left breast specimen and Sinus histiocytosis is present (no tumor cells are found) in all the lymph nodes examined. Conclusion: The clinical complete resolution observed in this patient following chemotherapy underscores its effectiveness in breast cancer treatment. Even though histopathological stated that there was minimal leftover cancer cells detected, which can be further treated with adjuvant chemoterapy. This case supports the need for increased awareness, early diagnosis, and access to chemotherapy for improving breast cancer outcomes.
081. Radiofrequency Ablation for Retrosternal Thyroid Tumour: A Rare Case Report
Authors: Soeseno Stephen William , Irawan Hendry
Published: November 2024

Background: Retrosternal thyroid tumours, though uncommon, present complex diagnostic and therapeutic challenges due to their location behind the sternum. These tumours can cause significant symptoms, such as difficulty breathing and chest pressure, which can impact patient quality of life. Radiofrequency ablation (RFA) has emerged as a minimally invasive treatment option, offering potential benefits over conventional surgical methods for retrosternal thyroid tumor. Case: A 54-year-old male with a history of right thyroid isthmolobectomy presented with a rapidly growing left-sided neck mass, causing increasing chest pressure and shortness of breath. Imaging studies, including ultrasound and CT scans, revealed a large tumour extending retrosternally and compressing the trachea. The patient opted for RFA over surgery. A core biopsy confirmed a benign struma adenomatosa. RFA was performed using the moving shoot technique, resulting in effective tumor ablation. Follow-up imaging showed a significant reduction in tumor size and symptom relief. Conclusion: This case demonstrates that RFA is a safe and effective alternative to conventional surgery for retrosternal thyroid tumours. It provides substantial symptom relief and tumour reduction with fewer complications. RFA should be considered a valuable treatment option for patients who are not ideal candidates for surgery or who prefer less invasive approaches. Continued research and long-term studies are needed to confirm its broader efficacy.