bluuebunny/crossref_metadata_2025 huggingface dataset:
Marktrecherchen und Informationsrechercheleitfaden für Start-ups (in Deutschland)
Authors: Seidler-de Alwis Ragna
Published: May 2024

Die Zahl der innovationsorientierten Unternehmensgründungen in Deutschland ist in den letzten Jahren rückläufig. Eine häufige Ursache für das Scheitern von Gründungen ist, dass für die angebotenen Produkte und Dienstleistungen kein Marktbedarf besteht und diesem Thema zu wenig Aufmerksamkeit geschenkt wird. Marktrecherchen sind jedoch eine wichtige Voraussetzung für erfolgreiche Unternehmensgründungen. Daher wird ein Informationsrechercheleitfaden für Marktrecherchen vorgestellt, der ein methodisches und strukturiertes Vorgehen beinhaltet sowie die einzelnen Untersuchungsbereiche im Marktrechercheprozess aufzeigt. Der Informationsrechercheleitfaden basiert auf umfangreichen praktischen und theoretischen Erfahrungen aus dem Hochschul- und Beratungsumfeld. Er wird ergänzt durch eine Literatur- und Informationsressourcenrecherche in Universitätsbibliotheken im Silicon Valley, die ihre Studierenden im Hinblick auf Start-ups von Beginn des Studiums an in vielfältiger Weise erfolgreich unterstützen.
Food habits of invasive masked palm civets (Paguma larvata) in northern Japan
Authors: Shimoyama Mizuki , Tsuji Yamato
Published: May 2024

We examined the feeding habits and seasonal changes in invasive masked palm civets (Paguma larvata) in northern Japan, to understand their feeding strategies. Between 2020 and 2022, we collected 98 fecal samples from masked palm civets and analyzed their content. The civets fed mainly on fruits (78 % in terms of the point-frame method) and arthropods (15 %); fruits were consumed throughout the year, but increased in winter when arthropods were not available. The feeding plasticity of masked palm civets, in addition to their physical and behavioral adaptations, enables them to expand their distribution in introduced habitats in temperate regions.
The Space of the Stylite
Authors: Boero Dina
Published: May 2024

For scholars and students of Late Antiquity, the stylite’s column exerts a special appeal. Scholars have examined literary representations of stylites and sought out visual parallels for the phenomenon of column-standing. This article shows that topographical contexts were central to establishing the potency of the column as a holy object and the trajectory of stylitism in history. I employ the term topography broadly to encompass the physical characteristics of an area, the ways in which humans augmented physical characteristics through the built environment, and specific architectural organizations. I examine three topographical contexts and make three interconnected arguments. By selecting the hill adjacent to Telanissos as the location for his columns, the premier stylite Symeon (d. 459) participated in a long-standing regional tradition of activating the numinous power of high places and stone through cultic activity. The monumental pilgrimage complex built after Symeon’s death made the column a relic and integrated veneration of Symeon into liturgical ritual. The incorporation of stylites into northern Syria’s cenobitic communities circumscribed stylitism as a distinctly monastic vocation. These three contexts illustrate that the significance of the column was located in processes of production and reception. At the same time, stylite columns were not passive objects. They faced the gods of old; they enriched ecclesiastical rituals; they molded the bodies of those who activated them; they proclaimed the ascendancy of monastic institutions. As both products of their topography and agents within it, stylite columns constructed a distinctive Christian landscape in Syria’s limestone massif.
India, Repression, and Ecologically Unequal Exchange of Wood
Authors: Shandra John M. , Restivo Michael , Sommer Jamie M. , Harper Marion
Published: May 2024

A recent cross-national article by Sommer, Restivo, and Shandra finds that wood exports to India from peripheral nations are related to levels of forest loss in the peripheral nations. While it suggests new insights into how semi-peripheral nations engage in ecologically unequal exchange, we contend this finding is incomplete and offers only a partial explanation of forest loss. We draw on Evans’s idea of a “triple alliance” to argue that in an effort to promote industrialization, repressive nations in the periphery try to create a “good business climate” for foreign firms by offering investors economic incentives, regulatory concessions, and (imposed) political stability. Thus we hypothesize that greater wood exports to India are related to forest loss in peripheral nations with worse repression. We find support for this hypothesis by regressing data on 67 peripheral nations.
α-Tocopherol inhibits atherogenesis and improves cardiac function in mice independently of its antioxidant properties
Authors: Coornaert Isabelle , Breynaert Annelies , Hermans Nina , De Meyer Guido R Y , Martinet Wim
Published: May 2024

The impact of α-tocopherol on atherosclerosis is unclear and controversial. While some studies suggest potential benefits, such as antioxidant properties that may reduce oxidative stress, other studies indicate no significant preventive effects. The intricate interplay of various factors, including dosage, individual differences, and study methodologies, contributes to the ongoing uncertainty surrounding α-tocopherol’s role in atherosclerosis. Further research is needed to clarify its impact and establish clearer guidelines. Therefore, we aimed to evaluate the impact of α-tocopherol on atherogenesis in ApoE−/− fibrillin (Fbn)1C1039G/+ mice, which is a unique mouse model of advanced atherosclerosis with typical features, such as large necrotic cores, high levels of inflammation, and intraplaque neovascularization, that resemble the unstable phenotype of human plaques. ApoE−/− Fbn1C1039G+/− mice were fed a western-type diet (WD) supplemented with a high dose of α-tocopherol (500 mg/kg diet), while control mice were fed a WD containing a low dose of α-tocopherol (50 mg/kg diet). The high dose of α-tocopherol reduced plaque thickness and necrotic core area in the right common carotid artery (RCCA) after 24 weeks WD. Moreover, α-tocopherol decreased plaque formation and intraplaque neovascularization in the RCCA. In addition to its antiatherogenic effect, chronic supplementation of α-tocopherol improved cardiac function in ApoE−/− Fbn1C1039G/+ mice. However, chronic supplementation of α-tocopherol did not decrease lipid peroxidation. On the contrary, α-tocopherol acted as a prooxidant by increasing plasma levels of oxidized LDL and plaque malondialdehyde, an end product of lipid peroxidation. Our data indicate that α-tocopherol inhibits atherogenesis and improves cardiac function independent of its antioxidant properties.
Role Of Intellectual Property Theories in Addressing Anomalies Created By The Intersection of Artificial Intelligence and Intellectual Property Rights: An Analysis
Authors: Jaiswal Reena , Singh Anu , Rathore Saloni , Verma Alpika , Saxena Prakhar , Mishra Megha , . Moiz
Published: May 2024

Globally, the use of artificial intelligence (AI) is expanding exponentially. The issue of managing intellectual property in AI is raised by this surge. Discussions and moderating have taken place, but no resolution has been reached. The issue of whether the work created by an AI should get a special status still exists. When it comes to the control of IPR in artificial intelligence, there are a few oddities. The ownership of patents and copyrights is in doubt, and there are serious worries about the consequences of violation. With the development of technology, there is no certainty on the law, despite existing international accords and conventions. In the absence of artificial intelligence (AI), intellectual property (IP) rules have, up to this point, treated IP as a product of human cognition. The current boom in AI, which has seen the development of IP from the "intelligence" of software, has upended this base. But the non availability of law on works created by artificial intelligence the law is left far behind to deal with the anomalies created by the intersection of “Artificial intelligence and intellectual property rights”. This research paper examines the role of intellectual property theories in addressing AI anomalies, focusing on copyright, patent, and trademark laws. It analyzes utilitarianism, labour theory  and personality theory, examining authorship and ownership in AI-generated works and potential conflicts between human creators and machine-generated content. In this research paper researcher(s) will- Analyse various theories of Intellectual properties to tackle the anomolities created by the intersection of IPR and AI. Criticize and suggest changes in the theories to make them helpful for emerging frameworks on AI and IPR.
Visual stimulation in the neonatal and pediatric intensive care
Authors: Aguiar Catarina Pestana , Cortez Liliana , Valério Patrícia , Pereira Pedro , Paiva Catarina
Published: May 2024

Introduction: In the first months of life, children are strongly sensitive to conditions that interfere with visual development. There is evidence that impoverished developmental conditions can lead to delays in visual development. We focused on patients with prolonged hospitalization during their first months of life, whose delayed visual maturation may be consequence of a poorly visual environment at the hospital intensive care units. Our main purpose was to develop a visual stimulation kit that could be implemented in these situations in order to create a visual enriched environment. Materials and methods: Creation of a reproductible visual stimulation kit using high contrast black-and-white patterns. Images were created through the software Adobe Illustrator® and impressed in plates with 30 x 30 cm and 15 x 15 cm in a material appropriated to the hospital ambient. An awareness session at the time of the kit’s delivery was conducted and a booklet with important advices was created. Results: The visual stimulation kit, intended to be applied to the surrounding environment of children until 8 months-old with prolonged hospitalizations (more than 1 month long) and children demonstrating lack of visual interaction, was created with two bigger plates destined to be placed in the lateral walls of the cribs and four smaller plates destined to be hanged in the supports surrounding the crib. Discussion and conclusion: Stimulation through an environmental enrichment can modulate brain development and induce modification in the neural circuits. Simple high contrast black and white images are one of the main interventions to stimulate children’s vision. Our main purpose with this project is to create a systematic guideline to be applied in children with prolonged hospitalizations in order to prevent the onset of a delayed visual maturation and sensitize healthcare providers, caregivers and parents to this aspect of the development.
Common symptoms can uncover a rare tumor: A case report of pleomorphic xanthoastrocytoma
Authors: Maglione Ashley Kay , Jeschke Kiera
Published: May 2024

Transient visual disturbances (VD), such as flashing lights and scotomas, can occur in relatively benign ocular and neurologic diseases, such as migraine with aura. However, VD can also be a manifestation of visually threatening eye conditions and life-threatening neurologic conditions. The case of a 44-year-old woman is presented to highlight the importance of comprehensive ocular and neurologic examination in the diagnosis and management of patients with VD.
Giant condyloma, buschke-löwenstein tumor in the penis, presentation of a case and review of the literature
Authors: Vargas-Hernández Víctor Manuel , Sanchez-Rodriguez Sandra , Ibarra Ordoñez Alejandro Omar , Vargas Hernandez Victor Manuel
Published: May 2024

Background: Buschke-Löwenstein tumor is a presentation of condyloma acuminata; caused by human papillomavirus infection presenting as an exophytic, polypoid, cauliflower-like lesion; characterized by slow growth, local infiltration, contiguous tissue destruction; with a tendency to recurrence and produce fistulas or abscesses around the affected area. The most frequent location is the vulva, scrotum, penis, perineum and perianal region; Transmitted by sexual contact and more common in men, it is controversial whether it should be considered premalignant or a verrucous carcinoma; It does not present cellular atypia and a third can become malignant; recurrences are frequent. The risk factors are HPV, continuous irritation and poor hygiene of the genital area, phimosis, immunosuppression, smoking and drug addiction. Objective: review literature and case description. Case presentation: 45-year-old male with condylomatous lesion on the genitals of 4 months' duration, on the foreskin and ligament of the glans penis, and other minor lesions on the shaft of the penis; morbid obesity, uncontrolled type 2 diabetes mellitus. He is scheduled for circumcision and removal of the satellite lesions. Conclusion: Giant Buschke-Löwenstein condyloma is considered a low-grade squamous cell carcinoma, locally invasive, with aggressive behavior; Surgical treatment is the option.
The Structures of Non-Coprime Graphs for Finite Groups from Dihedral Groups with Regular Composite Orders
Authors: Aulia Sita Armi , Wardhana I Gede Adhitya Wisnu , Irwansyah Irwansyah , Salwa Salwa , Misuki Wahyu Ulyafandhie , Nghiem Nguyen Dang Hoa
Published: May 2024

AbstractFor any finite group, the non-coprime graph of the group is a graph with vertices consisting of all non-identity elements of the group. Two different vertices are considered adjacent if their orders are not coprime, meaning their greatest common divisor (gcd) is not equal to one. Misuki provides the structure of the non-coprime graph for the dihedral group when the order is a prime power. We establish a more general property for cases where the order of the group is a regular composite number, discovering that the structure of the non-coprime graph for a dihedral group can be partitioned into some number of complete subgraphs.Keywords: dihedral group; disjoint subgraph; non-coprime graph. AbstrakUntuk sebarang grup hingga, graf non-coprime dari grup tersebut adalah graf dengan simpul yang terdiri dari semua elemen non-identitas dari grup tersebut. Dua simpul yang berbeda dianggap bertetangga jika orde mereka tidak saling prima, artinya pembagi terbesar bersama (gcd) mereka tidak sama dengan satu. Misuki memberikan struktur graf non-coprime untuk grup dihedral ketika ordenya adalah pangkat prima. Pada studi ini didapatkan sifat yang lebih umum ketika orde grup adalah bilangan komposit biasa. Didapatkan juga bahwa struktur graf non-coprime dari grup dihedral dapat dipartisi menjadi beberapa subgraf lengkap.Kata Kunci: graf non-koprima; grup dihedral; subgraph disjoin. 2020MSC: 05C25, 05C69, 20D60.
Morphological Characteristics of Kecombrang (Etlingera elatior (Jack) R. M. Smith) in Several Regions in Aceh Province, Sumatra
Authors: Rayhannisa Rayhannisa , Zumaidar Zumaidar , Amalia Amalia , Sari Widya , Saudah Saudah
Published: May 2024

AbstractKecombrang (Etlingera elatior) is one of the plant species of the Zingiberaceae family is widely used by the community as food and medicine. Not much research has been done on the morphological diversity of kecombrang plants in Aceh, so scientific information about these plants is still minimal. Therefore, this research needs to be carried out to enrich knowledge about these plants in the Aceh region. Sampling was conducted from January to April 2022 at three places in Central Aceh, Banda Aceh, Weh Island, and Simeulue Island. This research was carried out according to the survey method by roaming and direct collection. A total of 12 groves were collected from wild and cultivated area and observed for 43 characters consisting of quantitative and qualitative data. Based on these observations, two variations of the kecombrang plant have been found based on the color of the bracts, namely the red and pink variants. Based on morphological characters of vegetative organs, all samples of Etlingera elatior had a similarity distance coefficient from 67 to 86%. In addition, the kecombrang plants found in the highlands of Central Aceh have a larger size in leaf and inflorescent compared to samples from other locations.AbstrakKecombrang (Etlingera elatior) adalah salah satu jenis tumbuhan famili Zingiberaceae yang secara luas penggunaanya dikenal oleh masyarakat sebagai makanan dan obat. Belum banyak penelitian terkait keanekaragaman morfologi tumbuhan kecombrang di Aceh, sehingga informasi ilmiah tentang tumbuhan ini masih sedikit. Oleh karena itu penelitian ini perlu dilakukan untuk memperkaya pengetahuan tentang tumbuhan tersebut di daerah Aceh. Pengambilan sampel dilakukan pada bulan Januari hingga April 2022 di tiga tempat yaitu di Aceh Tengah, Banda Aceh, Pulau Weh, dan Pulau Simeulue. Penelitian ini dilakukan dengan metode survei dengan cara jelajah dan pengumpulan langsung. Sebanyak 12 rumpun dikumpulkan dari kawasan liar dan budi daya dan diamati sebanyak 43 karakter yang terdiri dari data kuantitatif dan kualitatif. Berdasarkan pengamatan tersebut, ditemukan dua variasi tanaman kecombrang berdasarkan warna braktea, yaitu varian merah dan merah jambu. Berdasarkan karakter morfologi organ vegetatif, seluruh sampel Etlingera elatior memiliki koefisien kemiripan dari 67 hingga 86%. Selain itu, kecombrang yang ditemukan di dataran tinggi Aceh Tengah mempunyai ukuran daun dan perbungaan yang lebih besar dibandingkan sampel dari lokasi lain.
New Records for the Bryophyte Flora of Vietnam, 5
Authors: Pócs T.
Published: May 2024

In November 1998, guided by Prof. Trấn Ninh we revisited the Tam Đảo mountain range, extensively researched by him before. Since than it was converted into a National Park, with areas stretching to three provinces, Vĩnh Phúc, Thái Nguyên, and Tuyên Quang. The previous collections indicated that many more novelties can be expected from there. As a result, we collected 38 epiphyllous liverwort species. Among these 6 were new to the flora of Vietnam: Cololejeunea fructu-marginata, C. papillosa, C. spathulifolia, Colura bisvoluta, Lejeunea dipterota and Microlejeunea sechuanensis. One species is new to science: Cololejeunea dinhensis. Furthermore, Cololejeunea rotundilobula proved to be a new synonym of Cololejeunea sigmoidea.
Results and cost analysis of Amplatzer® Ductal Occluder-ii, Nit Occlud® Lê Coil, and Konar-MF® ventricular septal defect occluder for percutaneous ventricular septal defect closure
Authors: Eka Gunawijaya  , Ni Putu Veny Kartika Yantie  , Anlidya Permatasari Gunawijaya
Published: May 2024

Background: A number of devices have been used for percutaneous closure of ventricular septal defect (VSD) in this era of Jaminan Kesehatan Nasional. The aim of this study is to describe the differences in results and cost analysis of various devices used for percutaneous closure of VSD.
Patients and methods: This retrospective study was done in 88 patients underwent transcatheter VSD closure between May 2015-April 2019 at Sanglah Hospital Indonesia (regional 2, medical service level 3). Three types of devices were compared: Amplatzer® Ductal Occluder-II (ADO-II®), Nit Occlud® Lê Coil, and KONAR-MF® VSD Occluder (MFO®). Total cost and hospital earnings from Indonesia Case Based Groups (INA-CBG’s), procedure outcomes, and complications were recorded. Statistical analysis was done using Kruskal-Wallis test and Mann-Whitney test.
Results: Successful deployment of ADO-II® Nit Occlud, ® Lê Coil, and MFO® were 33, 32, and 21 cases respectively. Procedure and fluoroscopy time were shorter in ADO-II® compared to other groups (p=0.001 and 0.003). Complication rate was equally similar in all groups. Real cost was higher in Nit Occlud® Lê Coil compared to other groups. Negative hospital earnings was smaller in ADO-II® and MFO® groups than Nit Occlud® Lê Coil group (median -1,633,850 vs -14,006,600 vs -1,247,900 respectively), adjustment for length of stay found similar result. Adjustment by admission class found no difference of hospital earnings.
Conclusion: The ADO-II® and MFO® have the smallest cost. Considering the cost-effectiveness and feasibility, ADO-II® can be chosen in small defects (<6 mm), meanwhile MFO® in larger defects. All devices described have equal success rate and complications.
Effect of Spiritual Emotional Model (SPIEM) dhikr on cortisol and IgG levels of drug abusers during rehabilitation programs
Authors: Istiqomah  , Anies  , Yudianto Ahmad , Adi Mateus Sakundarno
Published: May 2024

Background: Drug rehabilitation requires efforts to manage the participants' stress, one of which is through psycho-education. Spiritual Emotional Model (SPIEM) dhikr is one of the psycho-education that can be given as part of rehabilitation for drug abusers.
Purpose: This study aims to determine the effect of SPIEM dhikr on cortisol and immunoglobulin G (IgG) levels of drug abusers during rehabilitation programs.
Patients and methods: This research used a quasi-experimental design with multiple intervention designs using a confirmatory factor analysis (CFA) approach. The affordable population that was also used as all subjects in this study were 31 police officers who underwent rehabilitation at Prof. Awaloedin Djamin Bhayangkara Hospital, Semarang, Central Java, Indonesia. The intervention of SPIEM dhikr consists of three phases for 3 weeks with 3 different dhikr methods, jaher, sirr and ruh/fi'ly, respectively. Each phase is carried out for 7×90 minutes/day. Cortisol and IgG levels were measured in the blood serum before and after the intervention.
Results: SPIEM dhikr intervention for 3 weeks showed a significant effect (p<0.05) on decreasing cortisol levels from 107.65±7.43 ng/ml (before the intervention) to 77.84 ±3.99 ng/ml (after the intervention). IgG levels of the 31 subjects were significantly increased (p<0.05) from 80,61±4.66 ng/ml to 92,97±6.82 ng/ml after 3 weeks of intervention of SPIEM dhikr.
Conclusion: Psychoeducation using SPIEM dhikr improves the stress and immunology responses of drugs abuser thus, it can be recommended as a rehabilitation program for drug abusers.
Revealing the artemisinin and piperaquine treatment failure: a systematic review
Authors: Farindira Vesti Rahmasari  , Imwong Mallika , Chakim Irfanul , Setyonugroho Winny , Tri Wulandari Kesetyaningsih  , Gunadi Agus , Arisandi Desto
Published: May 2024

Background: Artemisinin-based combination therapy (ACT) consists of a potent artemisinin component. Since the dihydroartemisinin performance effectiveness depends on piperaquine interaction still challenging, further research needs to establish the current status of artemisinin resistance relative to its geography and recognize any drug resistance interaction between dihydroartemisinin and piperaquine. 
Aim: This systematic review was aimed to find out the effect of dihydroartemisinin and piperaquine interaction concerning resistance, recurrence, parasitological failure, clinical failure, parasite clearance time, parasite reduction ratio, cure rate, which may affect treatment failure of patients with uncomplicated P. falciparum.
Method: The article was not limited to year and country. This study analyzed any effect of interaction. Pubmed and Scopus were used as electronic databases, and MeSH terms and keywords were used to find specific studies. A total of 2131 studies were initially identified; however, 20 were eligible for qualitative synthesis.
Result: The dihydroartemisinin piperaquine cure rate reported in Asia and Africa was above 98%. Eight RCTs, eleven prospective cohort studies, and one retrospective and prospective cohort study were included in this review. Design studies did not compare the same anti-malarial drug pattern, so it was difficult to do a pooled analysis. Even though this drug combination did not show a clear description of piperaquine resistance can affect artemisinin resistance, the adequate clinical and parasitological failure (ACPR) from this research reached above 93%, and for early treatment failure (ETF), late clinical failure (LCF), and late parasitological failure (LPF), were almost 0 %.
Conclusion: The dihydroartemisinin-piperaquine combination still has highly efficacious therapy to fight malaria in some areas based on these multiple factors and reviews.
Infant temperament with anxiety postpartum mothers in primary health care Sleman, Indonesia
Authors: Oktafia Riski , Berliyanti Ema Anindita , Indriastuti Nur Azizah , Rahmayanti Rini
Published: May 2024

Introduction: Changes in psychological conditions after childbirth often occur, one of which is anxiety. During the postpartum period, anxiety is a common disorder that occurs in as many as 30% of women, with at least one episode of anxiety in their lifetime. Anxiety in postpartum mothers is caused by the infant, who has an easy or difficult temperament. Therefore, this study aims to determine the relationship between infant temperament and anxiety in postpartum mothers in ​​the Sleman Yogyakarta Public Health Center.
Methods: This type of research is a non-experimental quantitative with a cross-sectional approach involving 80 samples of postpartum mothers aged up to the first six weeks in the Sleman Yogyakarta Public Health Center. Sampling with a purposive sampling technique. The instruments used were the Infant Characteristics Questionnaire (ICQ) and the Hamilton Anxiety Rate Scale (HARS). The statistical test used in this research is Chi-Square.
Results: Most infant temperaments were easy (68.8%) and mild postpartum anxiety (50%). Statistical test results show a p-value of 0.001.
Conclusion: An infant's temperament influences anxiety in postpartum mothers. Nurses must improve the quality of maternity nursing care services through education and early detection to prevent postpartum anxiety.
Overcoming relapse experience in acute coronary syndrome patients
Authors: Al Afik  , Yuni Sufyanti Arif  , Abu Bakar  , Riza Fikriana
Published: May 2024

Introduction: Recurrence in patients with the acute coronary syndrome is still common. An appropriate strategy is needed for the patient to overcome the recurrence so that further complications do not occur. The purpose of this study was to explore the experience of acute coronary syndrome patients in dealing with recurrence during a heart attack.
Methods: Qualitative design with a phenomenological approach is the method used in this study. Samples were 10 patients with acute coronary syndrome and were taken using purposive sampling technique. Data collection was carried out using semi-structured interviews. The data from the interviews were analysed to get the theme of the research results.
Results: The results of the study obtained four themes of experience overcoming recurrence during a heart attack, namely by taking medicine, drinking water, resting, and praying. The results of the interview found four themes of steps taken by ACS patients when having a heart attack, namely taking medicine, drinking water, resting and praying. In addition, it was also found that the role of the family in preventing patient relapse, there were two themes, namely the family supporting the patient's treatment and playing a role in regulating the patient's dietary pattern.
Conclusions: Quick treatment measures when a heart attack occurs, accompanied by prayer and decreased activity through rest and drinking water are the initial measures that are often used to treat heart attacks.
Mayo Endoscopic Score (MES) as a reference for the histological active disease of ulcerative colitis
Authors: Wibowo Agung Ary , Vijaya Hendy Buana , Sanyoto Didik Dwi , Sutapa Hendra , Putera Husna Dharma , Sikumbang Kenanga Marwan
Published: May 2024

Background: The degree of inflammation dramatically affects the morbidity of ulcerative colitis. Local and systemic inflammation features are modalities to determine disease severity and evaluation. Furthermore, local inflammation can be seen from endoscopic and histological examinations. This study aimed to examine the relationship of histological inflammatory profile with endoscopic scoring in ulcerative colitis patients.
Method: A retrospective study was conducted using colonoscopic and histologic data from 68 ulcerative colitis patients. The endoscopic grade was assessed based on the Mayo Endoscopic Score (MES). The histological grade was analyzed using a microscope by assessing acute and chronic inflammatory cells and the presence of ulceration and crypt changes based on the Nancy Score Index and Geboes Score Index. Furthermore, the analysis test used Spearman and Mann-Whitney.
Results: There is a significant positive relationship between endoscopic and histology scoring. The Nancy Score Index and MES combination yields 95% CI: 0.000-0.043, p=0.000, Correlation coefficient (r)=0.810, and odds ratio (OR)=3.272. Meanwhile, the combination of the Geboes Score Index with MES yields 95% CI: 0.000-0.043; p=0.000; r=0.727; and OR=1.347. In each histological scoring, there was a significant difference between the Nancy Score Index and Geboes Score Index tα (r = 0.018; p<0.05).
Conclusion: There is a significant relationship between histological and endoscopic scoring. Therefore, an endoscopic examination can be a reference for histologically active disease.
Triple-layered composite mesh for managing anterior abdomen wall defects in ventral hernia
Authors: Tamba Riana Pauline , Candy  , Yani Ahmad , Amaliah Rizky
Published: May 2024

Introduction: In managing ventral hernia, using mesh for the anterior abdominal wall defect closure has become a standard. Different types of materials have been used as a mesh, each with its own benefits and drawbacks. This study aimed to investigate the potential of a triple-layered composite mesh made from amniotic membrane-coated polypropylene mesh (AMPM)  with an adhesion barrier as an alternative for anterior abdominal wall defect closure.
Methods: An experimental study was conducted using Sprague-Dawley mice, imposed with a mechanical ventral hernia and divided into four groups with different treatments: sham surgery, mesh polypropylene, AMPM composite, and AMPM with adhesion barrier (triple-layered composite mesh). After 7 and 30 days of the procedure, the mice were evaluated for the recurrence of anterior abdominal wall defects, the histological profile of polymorphonuclear (PMN) cells, foreign body giant cells (FBGC), fibroblast cells, neovascularization, and adhesion of mesh to surrounding tissue in each group.
Results: No anterior abdominal wall defect recurrence was observed in all groups at  7- and 30-days post-procedure. We found no significant difference in histological profiles of PMN, FBGC, and fibroblast cells from each group. There was a statistically significant difference in the neovascularization (p=0.025) and adhesion (p=0.034) between the polypropylene mesh group and the triple-layered composite mesh group.
Conclusion: Triple-layered composite mesh has the potential to be an alternative to cover anterior abdominal wall defects, with triple-layered composite mesh and AMPM mesh groups showing a significantly higher rate of neovascularization and a lower rate of adhesion than the polypropylene mesh group.
Herpes Zoster: a case series with different manifestations
Authors: Mappamasing Hasnikmah , Indramaya Diah Mira , Setyanigrum Trisniartami , Rahmadewi
Published: May 2024

Background: The incidence of herpes zoster appears to correlate inversely with the host's ability to mount a cellular immune response. The disease is characterized clinically by an acute rash with herpetiform blisters on the skin and mucous membranes. This case series presented the different clinical presentations of herpes zoster infection in three patients with different underlying diseases in the ophthalmic, trigeminal, cervical, and thoracic dermatomes.
Case Presentation: Three cases of herpes zoster were observed in this case series. The first case involved the ophthalmic division of the trigeminal nerve. The second case involved the cervical nerve, and the last case involved the thoracic nerve. All had undergone varicella infection in childhood and suffered from various states leading to immunosuppression. Tzanck smears were performed in all cases, which showed multinucleated giant cells. After treatment following the herpes zoster protocol, all cases healed without complications.
Conclusion: Reactivation of the varicella-zoster virus may occur spontaneously or when host immunity is weakened. Increasing age, a physical trauma (including dental procedures), psychological stress, malignancy, and immunocompromised conditions, including transplant recipients, pregnancy, and HIV infection, are predisposing factors for varicella-zoster virus reactivation.
Association between IL-6 rs1800795 and IL-1β rs 16944 gene polymorphisms with clinical severity of COVID-19 patients in Surakarta, Central Java, Indonesia
Authors: Hendrastutik Apriningsih  , - Betty Suryawati , Reviono  , - Tonang Dwi Ardyanto , Dewi Pratiwi  , Hafi Nurinasari
Published: May 2024

Background: Cytokine plays a pivotal role in the pathogenesis of coronavirus disease 2019 (COVID-19). Cytokine storm is characterized by rapid elevation of an inflammatory circulating cytokine such as interleukin-6 (IL-6) and IL-1. However, according to evidence, genetic variables may affect the development and course of infectious diseases. Multiple genetic polymorphisms, mostly single-nucleotide polymorphisms (SNPs), have been linked to this setting's predisposition to viral infections. This study aimed to determine the frequency distribution of IL-6 SNPs rs1800795 and IL-1β SNPs rs16944 and rs1143627 gene polymorphisms and their association with the clinical severity of COVID-19 patients in Surakarta, Indonesia. This study aims to determine the association between IL-6 rs1800795 and IL-1β rs16944 with COVID-19 clinical severity.
Methods: This study used a cross sectional design conducted at Universitas Sebelas Maret Hospital and centralized isolation of the Donohudan Hajj Dormitory from May to November 2021. A total of 120 COVID-19 patients were divided into 3 groups: asymptomatic, mild-moderate, and severe-critical. The detection of IL-6 SNPs rs1800795 and IL-1β SNPs rs16944 was carried out by quantitative PCR (qPCR) examination, and IL-6 and IL-1β were determined by the ELISA method.
Result: There was no significant association between IL-6 SNPs rs1800795 (p=1.000) and IL-1β SNPs rs16944 (p=0.119) with clinical severity. In IL-1β SNPs rs16944 gene polymorphisms, the GG genotype was more commonly found in the asymptomatic group. AG genotype was commonly found in the symptomatic group (mild to critical). There was a significant association between IL-1β levels and clinical severity (p=0.03), whereas the association between IL-6 levels and clinical severity is not significant (p=0.103).
Conclusion: There was a correlation between IL-1β levels with clinical severity. In IL-1β SNPs rs16944, the GG genotype may act as a protective factor, whereas the AG genotype may act as a factor that increases the clinical severity of COVID-19.
Comparison of agility between the flat foot and normal foot in East Java Puslatda athletes
Authors: Kennedy Bobby , Tinduh Damayanti , Utami Ditaruni Asrina , Pawana I Putu Alit , Melaniani Soenarnatalina
Published: May 2024

Background: Flat foot, also known as pes planus, is a postural deformity characterized by the fall of the foot's arch, with all or almost all of the soles of the foot in contact with a flat surface. A flat foot is related to the function of the lower leg, increases the likelihood of sports injuries, and affects the motor abilities of the lower limbs. This study aims to compare the agility of the athletes of the East Java Puslatda with flat feet and normal feet.
Method: This study is an observational retrospective study using the medical records of athletes who underwent sports injury risk screening at the Sports Clinic RSUD dr. Soetomo Surabaya. Subjects were divided into the flat foot and normal foot groups. The agility of both groups was measured using Agility T-drill test tools and compared between the two groups.
Results: There were 46 subjects divided into 23 subjects in the flat foot group (14 males and 9 females aged 17-33 years) and 23 subjects in the normal foot group (12 males and 11 females aged 16-31 years). The average agility in the flat foot group was 11.23 ± 0.19 seconds (9.62 seconds - 12.74 seconds), while in the normal foot group, it was 11.12 ± 0.21 seconds (9.16 seconds - 13.38 seconds). There was no significant difference in agility between the two study groups. Analysis of each sport showed no significant difference in agility between the flat foot and normal foot groups. Analysis according to intrinsic factors showed a significant positive correlation with moderate strength between agility and gender.
Conclusion: There was no significant difference in agility between athletes with flat foot and normal foot.
The association of Hs-Troponin I with cardiac dysfunction and structural changes in chronic heart failure with reduced ejection fraction patients
Authors: Suastika Luh Oliva Saraswati , Widiana I Gde Raka , Wita I Wayan , Pranoto Agung , Wibhuti Ida Bagus Rangga , Sari Ni Made Ayu Wulan , Dharmawan Melissa , Darmawan Rizky , Saputra Bagus Made Indrata
Published: May 2024

Introduction: Cardiomyocyte death is the key pathological feature of heart failure with reduced ejection fraction (HFrEF). One of the circulating markers which represent myocardial cell death is cardiac troponin. High sensitivity-troponin I (hs-TnI) has been validated as an acute coronary syndrome diagnostic criteria. But its value and role in chronic heart failure, specifically HFrEF, has been variable in different studies. The aim of this study was to determine whether hs-TnI, an indicator of cardiomyocyte injury, is associated with functional and structural changes in HFrEF patients.
Methods: A hospital-based cross-sectional analytic study was conducted on 72 patients with stable chronic HFrEF between April and October 2022. All subjects underwent echocardiography (Philips EPIQ7 and Affinity 70) and hs-troponin I serum measurement (Abbott Architect assay). Spearman’s test was used to evaluate the correlation between hs-troponin I and left ventricular ejection fraction (LVEF), E/A ratio, left ventricular end-diastolic volume (LVEDV), tricuspid annular plane systolic excursion (TAPSE) and left atrial volume index (LAVI).
Results: hs-TnI concentrations were quantifiable in all samples ranging from 10 to 280.9 pg/mL. hs-TnI was associated significantly with LVEF (r=-0.39; p<0.01), E/A ratio (r=0.328, p=0.01), and LVEDV (r=0.278, p=0.04). hs-TnI was not correlated with TAPSE and LAVI (r=0.241; p=0.07 and r=-0.13; p=0.429, respectively). The correlation between hs-troponin I with LVEF, E/A ratio and LVEDV proved that the degree of myocardial injury is directly associated with left ventricle (LV) systolic and diastolic dysfunction and also with LV dilatation. While it is not correlated with right ventricle (RV) systolic function. Hs-TnI may represent the injury in LV better than RV.
Conclusion: These findings support the association of hs-TnI as a circulating marker of cardiomyocyte injury with LV dysfunction (systolic and diastolic) and dilatation in chronic HFrEF patients. This has expanded the role of hs-TnI in chronic heart disease.
Extent of resection and histopathology grading as a survival risk factor in a patient with medulloblastoma
Authors: Prastikarunia Resi , Parenrengi Muhammad Arifin , Lestari Pudji , Turchan Agus , Subagio Eko Agus , Irwanto
Published: May 2024

Background: Medulloblastoma is a common neoplasm in the pediatric population with a poor prognosis. Incomplete resection has been reported to be related to second-look surgery and subsequent more malignant clinical course, while certain histopathological is said to have a more favorable prognosis.
Methods: This study retrospectively analyzed data from patients with medulloblastoma who underwent tumor resection in our hospital between 2016 to 2020. Histopathologic information and the extent of resection were collected. Survival analysis was done with log-rank and Kaplan-Meier to determine the overall and progression-free survival.
Results: There were 42 patients with medulloblastoma with mean overall survival of 16.5 months and a mean progression-free survival of 12.43 months. Patient with subtotal resection has the longest mean overall survival and progression-free survival compared with others. Patient with classical medulloblastoma has the longest mean overall survival and progression-free survival compared to other types of histopathology.
Conclusion: The extent of resection and histopathology grading is statistically significantly related to the outcome of a patient with medulloblastoma
The impact of transcutaneous auricular vagus nerve stimulation on C-reactive protein in patients with chronic low back pain
Authors: Uzlifatin Yaniar , Andriana Raden Ayu Meisy , Wardhani Indrayuni Lukitra , Subadi Imam , Sugianto Paulus , Melaniani Soenarnatalina
Published: May 2024

Background: The purpose of this study is to evaluate the impact of transcutaneous auricular vagus nerve stimulation (tVNS) as an additional therapy to exercise program on C-reactive protein (CRP) in patients with chronic low back pain.
Methods: Twenty-two patients between the ages 18-55 with chronic low back pain (CLBP) were randomly divided into 2 groups. The intervention group was assigned 10 sessions of tVNS and 4 sessions of exercise program (EXC + tVNS), while the control group was assigned 4 sessions of exercise program (EXC). Patients were assessed before and 2 weeks after treatments using C-reactive protein (CRP).
Results: Transcutaneous auricular vagus nerve stimulation was well tolerated, and no side effects were reported. The mean CRP was slightly increased in both groups. In the intervention group was from 0.22 ± 0.13 mg/dl to 0.39 ± 0.30 mg/dl (P=0.074), and in the control group was from 0.21 ± 0.18 mg/dl to 0.22 ± 0.18 mg/dl (P=0,813). The between-group comparison showed no significantly different. Following Cohen’s D, the effect size of the intervention group (0.735) was higher than the control group (0.055).
Conclusion: Based on the analysis data, we conclude that tVNS therapy did not give additional benefit together with exercise on CRP levels in patients with CLBP. It was determined that additional research is required to study the effect of tVNS and exercise independently in CLBP with longer follow-up times and other tVNS methodological approaches.
Ultrasonography (USG)-guided corticosteroid injection with needle release of the A1 pulley: serial case report
Authors: Sahlan Anshory , Aisyah  , Herman Bumi
Published: May 2024

Background: Trigger finger is associated with limited flexion and extension of the finger due to inflammation in the flexor tendon pulley and leads to a loss of functional capacity in the hands. There is a need for safe, fast management and a low risk of recurrence in managing this disease. This study aims to evaluate the clinical effectiveness of the USG-guided corticosteroid injection with needle release of the A1 pulley in treating the trigger finger, particularly in pain degree, joint function, and adverse effects. The parameters were evaluated, including the NRS, Quinnell grading system, and inflammation or infection signs from the physical examination.
Case Presentation: There were seven trigger fingers in five patients with various Quinnell grades ranging from 2 to 3. They received a single treatment of USG-guided corticosteroid injection with needle release of the A1 pulley. Follow-up was carried out immediately after the procedure (day 0), 1 day, and 30 days after. Improvement was seen in all fingers immediately and one day after the procedure. After 30 days, all patients no longer experienced pain, snapping, or locking sensations. No adverse events were observed during the follow-up period.
Conclusion: USG-guided corticosteroid injection with needle release of the A1 pulley in treating trigger fingers is safe and has a good effect on reducing pain and improving joint finger function.
Profile of matrix metalloproteinase activity, markers of collagen and elastin degradation and remodeling during pregnancy, delivery, and puerperium in pelvic organ prolapse 3 months after childbirth
Authors: Priyatini Tyas , Santoso Budi Iman , Irianta Trika , Herqutanto  , Siregar Nuryati , Harahap Alida , Sadikin Mohamad
Published: May 2024

Background: This study aims to assess the condition of pelvic organ prolapse related to changes in matrix metalloproteinase activity, elastin degradation and markers of collagen, and remodeling observed during pregnancy, childbirth, and the puerperal period 3 months postpartum. This study included 39 primigravida women who underwent vaginal delivery with a gestational age >36 weeks. This study conducted laboratory tests using blood and urine samples including procollagen type I N-propeptide (PINP), procollagen type-III N-propeptide (PIIINP), telopeptide carboxyl-terminal collagen type I (ICTP), matrix metalloproteinase-9 (MMP). -9), desmosin, and tropoelastin. The second and third blood samples will be examined 24-48 hours postpartum and 6 weeks postpartum.
Method: The Mann-Whitney test and Repeated ANOVA were used to assess the median differences between biomarkers.
Results: In the pelvic floor dysfunction and control groups, a significant relationship was found between serum MMP-9 levels 6 weeks postpartum (p=0.025). There were changes in biomarker levels of collagen and elastin during pregnancy, post-partum, and six weeks postpartum. The amount of degradation (MMP-9) seems to be correlated with the event of POP after childbirth.
Conclusion: There were changes in the biomarker levels of collagen and elastin from pregnancy, post-partum, and six weeks postpartum. In addition, the difference was significant in MMP-9 level six weeks after postpartum in POP group compare to control.
Correlation between clinical characteristics of colorectal cancer and nutritional status in patients undergoing surgery
Authors: Irianto Hengky Prabowo , Putranto Agi Satria
Published: May 2024

Background: The incidence of colorectal cancer in Indonesia reaches 12.8 per 100,000 adult population and is the cause of 9.5% of cancer deaths. 40–80% of all colorectal cancer patients are malnourished. This study aims to determine the prevalence of nutritional status in colorectal cancer and the correlation between clinical characteristics of colorectal cancer and nutritional status in patients undergoing surgery.
Methods: This research is an observational study with a cross sectional method. The reachable population of this study was colorectal cancer patients who underwent surgery at dr. Cipto Mangunkusumo Hospital, Jakarta and admission will occur from September-December 2022 with predetermined inclusion and exclusion criteria. The instrument used is the Mini Nutritional Assessment (MNA)—bivariate data analysis using Chi-square followed by a multivariate logistic regression test.
Results: There were 71 patients diagnosed with colorectal cancer at RSUPN dr. Cipto Mangunkusumo, in the September-December 2022 period, will undergo surgery. Clinical characteristics of colorectal cancer patients showed that most patients were 64-78 years old (57.7%) and male (52.1%). For clinical stages, it can be seen that the majority of patients have stages III and IV (78.9%), with a large tumor mass of 1-10.9 cm (76.1%), and the location of the cancer is in the rectum (59.2%) ). The results of CA19-9 levels show that most patients with normal CA19-9 levels (62.0%) and CEA levels were increased (66.2%). While the nutritional status of colorectal cancer, most of them have at risk of being malnourished (52.1%), followed by having malnourished (43.7%). The bivariate test results showed that the tumor size was significant (p <0.05).
Conclusion: Most colorectal cancers are at risk of malnourished and there is a statistically strongest correlation between tumor mass and nutritional status in patients undergoing surgery.