bluuebunny/crossref_metadata_2025 huggingface dataset:
STELLARATOR RESEARCH AT IPP KIPT: STATUS AND PROSPECTS
Authors: Moiseenko V.E. , Glazunov G.P. , Lozin A.V. , Konotopskiy A.L. , Baron D.I. , Beletskii A.A. , Bondarenko M.N. , Chechkin V.V. , Dreval M.B. , Grigor’eva L.I. , Kozulya M.M. , Maznichenko S.M. , Mironov Yu.K. , Pavlichenko R.O. , Romanov V.S. , Shapoval A.N. , Korovin V.B. , Konovalov V.G. , Zamanov N.V. , Turianska E.V. , Kulyk Yu.S. , Wauters T. , Lyssoivan A.I. , Ågren O. , Garkusha I.E. , Team Uragan TwoM
Published: July 2022

Features of the recent Uragan-2M campaign are reviewed together with some theoretical advances. They include experiments with B4C limiter, studies of various 1…20 kHz oscillations, development of a new in-situ diagnostics for wall conditions, i.e. the thermal desorption probe, the improved numerical model of RF plasma production in stellarators in the ion cyclotron and electron-cyclotron frequency ranges, a new positive-definite form of time-harmonic Maxwell’s equations and plasma start-up studies.
FINDIF CODE SIMULATIONS OF OP 1.1 WENDELSTEIN 7-X DISCHARGES
Authors: Pełka G. , Stepniewski W. , Zagórski R. , Team WSeven X
Published: July 2022

The current development state of the finite difference, multi-fluid, 3D plasma code Findif is detailed. The code was run on four meshes prepared for the OP 1.1 wall geometry of the Wendelstein 7 X stellarator. The meshes were produced for 4 magnetic configurations; two of them are finite-beta (non vacuum). The simulated volume covers plasma edge; the computations of limiter heat load distributions were the main goal. Plasma radiation was not taken into account.
A SCENARIO OF PULSED ECRH WALL CONDITIONING IN HYDROGEN FOR THE WENDELSTEIN 7-X HELIAS
Authors: Moiseenko V.E. , Beletskii A.A. , Shapoval A.M. , Wauters T. , Goriaev A. , Brunner K. J. , Buttenschön B. , Drewelow P. , Winters V. , Brakel R. , Dinklage A. , Brezinsek S. , Stange T. , Laqua H. , Lazersson S. , Team WSeven X
Published: July 2022

A new wall conditioning scenario in hydrogen atmosphere for the Wendelstein 7-X stellarator-helias (W7-X) has been proposed and tested in part. Feasibility of the proposed scenario has been demonstrated on W7-X at OP1.2b experimental campaign during investigation of a chain of ultra-short pulsed electron cyclotron resonance heating plasma discharges.
New Government’s Challenges on Higher Education Finance
Authors:   The Korean Society For The Economics And Finance Of Education, Lee Heesook
Published: July 2022

The purpose of this study is to propose a new government task on higher education finance. For the study, related literature, financial data, and media reports were analyzed.
The results are as follows: First, the cost per student in the higher education stage is lower than in OECD countries, and even lower than the elementary level. Despite the increase in the higher education budget over the past decade, the government's financial investment has been mainly on the National Scholarship and universities' tuition income has been effectively decreasing. Second, as a result of evaluating the 10-year basic plan for higher education financial investment, it was analyzed that the government's overall fiscal investment in higher education was quite close to the original target. However, most indicators failed to achieve their goals as the method of financing was achieved through restructuring of existing budgets. Finally, as a plan to expand higher education finances, it was proposed to improve the legal suitability of tuition policies and to prepare a legal basis for stable securing higher education finances.
Despite the inadequate level of financial investment in higher education, discussions on higher education finances have mainly focused on the allocation issues, and practical efforts have been insufficient to expand the size of finance itself. According to the 2021-2025 National Financial Management Plan, the government's investment in higher education is unlikely to be improved. Based on the results of the 10-year basic plan for higher education, the government needs to set specific level of financial investment goals in the basic plan for higher education and implement stable higher education finances with a legal foundation beyond securing restructuring levels.
Job satisfaction, Work-family balance and Time-flexible work arrangements
Authors:   The Korean Society For The Economics And Finance Of Education, Jung Hanna
Published: July 2022

This study analyzes the effects of time-flexible work (flexible working system and reduced working hours during childcare) on job satisfaction and work-family balance satisfaction. According to the resource theory, time-flexible work has a positive effect on workers' lives by allowing them to flexibly allocate time and energy. On the other hand, according to the self-control theory, time flexibility has a negative effect on workers' lives by increasing the tasks they have to do at home. The result shows that the flexible working system increases job satisfaction and work-family balance satisfaction. The result also shows that the reduced working hours for childrearing do not have a significant effect on job satisfaction while increasing work-family balance satisfaction. It is interpreted that the work-family balance satisfaction of workers with young children is significantly high, but this does not lead to job satisfaction.
THE EFFECT OF BREASTFEEDING ON THE HEALTH INDICATORS OF YOUNG CHILDREN
Authors: Mkrtchyan Siranush А. , Dunamalyan Razmik А. , Mardiyan Marine A. , Ghukasyan Lilit E. , Mirijanyan Gagik M.
Published: July 2022

Promotion and coverage of breastfeeding are considered to be the cost-effective public health measures in terms of Healthcare System. The aim of the research is to assess an influence of breastfeeding on infants’ health and quality of life (QL) parameters. This observational prospective study included 1790 newborns selected from Yerevan State Medical University’s Polyclinics (“Mouratsan”, sample=746, and “Heratsi”, sample=1044). Data collection took a period between January 2016 and December 2017. Evaluation of children’s quality of life was performed with the help of the validated and adapted QUALIN questionnaire. The data related to child’s health condition were collected from the “Child Development History” cards available at the polyclinics of the investigated area. Among 1770 one year old children 1681 were ever breastfed, 1224 (69.1%) were exclusively breastfed up to 3 months, the median duration of breastfeeding was 6–7 months, 45% were breastfed for more than 6 months, and 15% were breastfed for more than 1 year. There is a significant difference between the QL scores of the ever breastfed and the never breastfed subgroups. Duration of the breastfeeding also have an influence on QL scores. The given study’s results confirm that breastfeeding among the early aged Armenian children is of great importance in their health, influencing on quality of life and morbidity rates.
Time for Action on Viral Hepatitis
Authors: Lim Seng Gee
Published: July 2022

The recent outbreak of hepatitis C virus (HCV) at Singapore General Hospital (SGH) has highlighted the dangers of viral hepatitis. In this case, infection control and environmental contamination were the culprits, particularly, a drop of blood containing 5 million IU HCV. From a broader perspective, there has been a revolution in HCV therapy with the recent rapid evolution of short-term (12 weeks) safe, all oral directly-acting antiviral (DAA) therapy leading to cure rates of 90% to 100%, even in previously difficult to treat patients with liver cirrhosis, previous treatment failure and those on immunosuppression. Consequently, treating HCV in risk groups such as renal dialysis and haemophiliacs can eliminate a pool of infected patients to prevent future outbreaks. A seroprevalence study is needed to identify a possible “birth cohort” effect that could aid screening. For HBV, vaccination has reduced prevalence to 3.8%, but these patients are prone to complications such as HBV flares. Since 2014, 13 patients developed liver failure and were listed for liver transplantation at National University Hospital (NUH) but 6 died beforehand. This avoidable catastrophe is due to undiagnosed HBV infection or patients who did not return for follow-up. Good antiviral therapy is available, but the issues are similar to HCV, identification of patients and linkage to care. A cure seems likely in the future as pharmaceutical companies are developing new agents. Singapore has joined in this initiative with a recent award of a national research translational grant to better understand the pathophysiology and the processes needed for a cure of HBV.

Key words: Eradication, Hepatitis C, Linkage to care, Outbreaks, Screening, Treatment
Efficacy, Immunogenicity and Safety of a Human Rotavirus Vaccine RIX4414 in Singaporean Infants
Authors: Phua Kong Boo , Lim Fong Seng , Quak Seng Hock , Lee Bee Wah , Teoh Yee Leong , Suryakiran Pemmaraju V , Han Htay Htay , Bock Hans L
Published: July 2022

Introduction: This was the first study conducted to evaluate the efficacy of 2 oral doses of the human rotavirus vaccine, RIX4414 in Singaporean infants during the first 3 years of life. Materials and Methods: Healthy infants, 11 to 17 weeks of age were enrolled in this randomised (1:1), double-blinded, placebo-controlled study to receive 2 oral doses of RIX4414 vaccine/placebo following a 0-, 1-month schedule. Vaccine efficacy against severe rotavirus (RV) gastroenteritis (Vesikari score ≥11) caused by wild-type RV strains from a period starting from 2 weeks post-Dose 2 until 2 and 3 years of age was calculated with 95% confidence interval (CI). Immunogenicity and safety of the vaccine were also assessed. Results: Of 6542 infants enrolled, 6466 were included in the efficacy analysis and a subset of 100 infants was included in the immunogenicity analysis. Fewer severe RV gastroenteritis episodes were reported in the RIX4414 group when compared to placebo at both 2 and 3 year follow-up periods. Vaccine efficacy against severe RV gastroenteritis at the respective time points were 93.8% (95% CI, 59.9 to 99.9) and 95.2% (95% CI, 70.5 to 99.9). One to 2 months post-Dose 2 of RIX4414, 97.5% (95% CI, 86.8 to 99.9) of infants seroconverted for anti-RV IgA antibodies. The number of serious adverse events recorded from Dose 1 until 3 years of age was similar in both groups. Conclusion: Two oral doses of RIX4414 vaccine was immunogenic and provided high level of protection against severe RV gastroenteritis in Singaporean children, during the first 3 years of life when the disease burden is highest. Key words: Diarrhoea, G and P types, Gastroenteritis, Intussusception
Long-Term Oncological Safety of Minimally Invasive Hepatectomy in Patients with Hepatocellular Carcinoma: A Case-Control Study
Authors: Chang Stephen KY , Tay Chee Wei , Shen Liang , Iyer Shridhar Ganpathi , Kow Alfred WC , Madhavan Krishnakumar
Published: July 2022

Introduction: Minimally invasive hepatectomy (MIH) for patients with hepatocellular carcinoma (HCC) is technically challenging, especially with large posteriorly located tumours or background of liver cirrhosis. This is a case-control study comparing the long-term oncological safety of HCC patients who underwent MIH and open hepatectomy (OH). Most of these patients have liver cirrhosis compared to other studies. Materials and Methods: Sixty patients were divided into 2 groups, 30 underwent MIH and 30 underwent OH for HCC resection. The patients in both groups were matched for extent of tumour resection, age and cirrhosis status. Patient characteristics, risk factors of HCC and all oncological data were studied. Results: Negative resection margins were achieved in 97% of patients in both groups. The mean blood loss during surgery was significantly lower in the MIH group compared to the OH group (361 mL vs 740 mL; 95% CI, 222.2, 734.9; P= 0.04). Hospitalisation is significantly shorter in MIH group (7 days vs 11 days; 95% CI, 6.9, 12.2,; P = 0.04). Eight patients (27%) in the MIH group and 13 patients (43%) in the OH group developed HCC recurrence (P = 0.17). One, 3 and 5 years disease-free survival between MIH and OH groups are 76% vs 55%, 58% vs 47%, and 58% vs 39% respectively (P = 0.18). One, 3 and 5 years overall survival between MIH and OH groups are 93% vs 78%, 89% vs 70%, and 59% vs 65% respectively (P = 0.41). Conclusion: MIH is a safe and feasible curative treatment option for HCC with similar oncological outcomes compared to OH. MIH can be safely performed to remove tumours larger than 5 cm, in cirrhotic liver, as well as centrally and posterior located tumours. In addition, MIH patients have significant shorter hospitalisation and intraoperative blood loss.

Key words: Laparoscopy, Liver cirrhosis, Primary liver cancer
A Practical Guide to Ordering and Interpreting Coagulation Tests for Patients on Direct Oral Anticoagulants in Singapore
Authors: Wong Wan Hui , Yip Christina YC , Sum Christina LL , Tan Chuen Wen , Lee Lai Heng , Yap Eng Soo , Kuperan Ponnudurai , Ting Wen Chang , Ng Heng Joo
Published: July 2022

Introduction: Direct oral anticoagulants (DOACs) are establishing themselves as principle choices for the treatment of a variety of thrombotic disorders. DOACs are also known to affect common coagulation tests which are routinely performed for patients in clinical practice. An understanding of their varied effects is crucial for the appropriate ordering of coagulation tests and their interpretation. Materials and Methods: Laboratories in public and private healthcare institutions and commercial sectors were surveyed on coagulation tests offered and their methods. A Medline and bibliography search, including a search on search engines, was performed for publications reporting the effects of dabigatran, apixaban and rivaroxaban on these coagulation tests. These papers were reviewed and summarised for consensus recommendations. Results: Prothrombin time (PT) and activated partial thromboplastin time (aPTT) are variably affected by the DOACs and dependent of the coagulation assays used. Clinicians must know which laboratory has performed these tests to logically interpret test results. A normal PT or aPTT does not exclude the presence of residual DOACs effect. The thrombin time is sensitive to dabigatran but not apixaban or rivaroxaban. Specialised coagulation tests such as thrombophilia tests are also variably affected by the DOACs. All laboratories in Singapore however, employ similar test methods permitting a common set of recommendations for specialised coagulation testing. Conclusion: Knowledge of the effects of DOACs on coagulation testing is essential to determine the appropriateness of performing such tests and interpreting them coherently. Practical recommendations which are tests and location-specific are set out in this paper. Key words: Apixaban, Dabigatran, Laboratory testing, Rivaroxaban
Prevalence of Depression among Older Adults—Results from the Well-being of the Singapore Elderly Study
Authors: Subramaniam Mythily , Abdin Edimansyah , Sambasivam Rajeswari , Vaingankar Janhavi A , Picco Louisa , Pang Shirlene , Seow Esmond , Chua Boon Yiang , Magadi Harish , Mahendran Rathi , Chong Siow Ann
Published: July 2022

Introduction: Depression is a significant public health issue across all sociodemographic groups and is identified as a common and serious mental health problem particularly among the older adult population. The aims of the current study were to determine the prevalence of depression and subsyndromal depression among older adults in Singapore. Materials and Methods: The Well-being of the Singapore Elderly (WiSE) study was a comprehensive single phase, cross-sectional survey. Stage 1 Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) depression syndrome was used for this analysis. Association of depression and subsyndromal depression with sociodemographic characteristics, social support as well as comorbidity with chronic physical illnesses and quality of life was assessed. Results: The prevalence of GMS-AGECAT depression and subsyndromal depression was 3.7% and 13.4%, respectively. The odds of depression were significantly higher among those aged 75 to 84 (2.1) as compared to those aged 60 to 74 years and in those who had a history of depression diagnosis by a doctor (4.1). The odds of depression were higher among those of Indian and Malay ethnicities (5.2 and 3.2 times, respectively) as compared to those of Chinese ethnicity. Those with depression and subsyndromal depression were associated with more disability, poorer life satisfaction, and medical comorbidities. Conclusion: Our study suggests that the prevalence of depression seems to have decreased as compared to a decade ago wherein the prevalence of depression was estimated to be 5.5%. This positive trend can be ascribed to concerted efforts across various disciplines and sectors, which need to be continually strengthened, monitored and evaluated.

Key words: Comorbidity, GMS-AGECAT, Social support, Subsyndromal depression
Alcohol Use Disorders amongst Inpatients in a General Hospital in Singapore: Estimated Prevalence, Rates of Identification and Intervention
Authors: Tay Andre TS , Peh Andrew LH , Tan Sheng Neng , Chan Herng Nieng , Guo Song , Chan Yiong Huak
Published: July 2022

Introduction: Many alcohol-related problems often go undetected and untreated. In Singapore, no epidemiological studies have been done in general hospitals on alcohol use disorders (AUD), i.e. alcohol dependence and abuse (DSM-IV-TR). Such findings are useful in planning AUD liaison services. In this study, we aim to estimate the prevalence of AUD among non-psychiatric inpatients and to determine the rates of identification and intervention rendered by medical staff. Materials and Methods: Non-psychiatric medical and surgical wards inpatients aged 21 years and above were recruited over a 3-month period. The Alcohol Use Disorders Identification Test (AUDIT) was used to screen for AUD and the MINI International Neuropsychiatric Interview (MINI English Version 5.0.0) was administered to diagnose AUD if the AUDIT score was 8 or above. Case notes were independently reviewed for AUD identification and if interventions were offered during admissions. Results: A total of 5599 inpatients were screened, of which 673 (12%) completed the screening using the AUDIT, and of these, 154 (2.8% of total sample) were positive for AUDIT. In this group, 107 were diagnosed with AUD. The estimated prevalence was 1.9% (approximately 400 cases per year per hospital). The medical staff identified only 25 (23.4%) cases of AUD, out of which, majority of them (76%) were rendered interventions. Conclusion: The rate of AUD identification by medical staff was low. Of those identified, majority were given interventions. Thus, the training of health care staff to identify AUD together with the implementation of brief interventions should be considered.

Key words: Alcoholism, Consultation liaison, Epidemiology
Clinical Ward Rounds—Challenges and Opportunities
Authors: Rajasoorya C
Published: July 2022

Hospitalised patients’ needs are complex and the ward environment is demanding of time and resources that must be optimised. Clinical ward rounds in hospitalised patients are fundamental to patient care. Ward rounds in recent years have undergone changes which have contributed to reduced professionalism and opportunities to learn as well as increased distrust of patients of the care they receive. Calls for a revival of the traditional ward rounds have been sounded which we must contextualise in modern settings. This commentary calls for a clearer definition of the purpose of ward rounds, outlines the roles and responsibilities of those involved in rounds, defines a 4-step process in the conduct of a ward round, and seeks support from hospitals’ management in the facilitation and implementation of these.

Key words: Patients, Process, Professionalism, Teaching
Prevention and Management of Adverse Reactions Induced by Iodinated Contrast Media
Authors: Wu Yi-Wei , Leow Kheng Song , Zhu Yujin , Tan Cher Heng
Published: July 2022

Iodinated radiocontrast media (IRCM) is widely used in current clinical practice. Although IRCM is generally safe, serious adverse drug reactions (ADRs) may still occur. IRCM-induced ADRs may be subdivided into chemotoxic and hypersensitivity reactions. Several factors have been shown to be associated with an increased risk of ADRs, including previous contrast media reactions, history of asthma and allergic disease, etc. Contrast media with lower osmolality is generally recommended for at-risk patients to prevent ADRs. Current premedication prophylaxis in at-risk patients may reduce the risk of ADRs. However, there is still a lack of consensus on the prophylactic role of premedication. Contrast-induced nephropathy (CIN) is another component of IRCM-related ADRs. Hydration remains the mainstay of CIN prophylaxis in at-risk patients. Despite several preventive measures, ADRs may still occur. Treatment strategies for potential contrast reactions are also summarised in this article. This article summarises the pathophysiology, epidemiology and risk factors of ADRs with emphasis on prevention and treatment strategies. This will allow readers to understand the rationale behind appropriate patient preparation for diagnostic imaging involving IRCM.

Key words: Contrast-induced nephropathy, Hypersensitivity, Premedication
Prevalence and Correlates of Internet Gaming Problem among Internet Users: Results from an Internet Survey
Authors: Subramaniam Mythily , Chua Boon Yiang , Abdin Edimansyah , Pang Shirlene , Satghare Pratika , Vaingankar Janhavi A , Verma Swapna , Ong Say How , Picco Louisa , Chong Siow Ann
Published: July 2022

Introduction: The current study aimed to establish the prevalence of internet gaming disorder (IGD) and its association with demographic characteristics, game genre, game use (time spent on gaming), as well as psychological distress, social phobia and well-being among current online gamers in Singapore. Materials and Methods: A total of 1251 participants aged 13 to 40 years completed the study which was administered as a web survey. The online questionnaire was designed using QuestionPro, and consisted of 8 sections and 105 questions. The 9-item Internet Gaming Disorder Questionnaire was used to establish the prevalence of IGD in the study. A series of logistic regression models were used to examine the associations between IGD, demographic characteristics and game genre, as well as IGD and psychological distress, social phobia and well-being. Results: The prevalence of IGD established using a cutoff of 5 among those who were current online gamers was 17.7%. Multiple logistic regressions revealed that those meeting criteria of IGD were more likely to be older, reported an earlier age of onset of playing online games, had primary and secondary education versus tertiary education, were currently students versus being currently employed and played massively multiplayer online role-playing games. Distress and social anxiety were higher while satisfaction with life was significantly lower among those who met criteria for IGD than those who did not meet the criteria. Conclusion: The prevalence of IGD and its negative consequences in our sample of current online gamers was significant and point towards the need for further clinical studies and innovative interventions to address the problem. Key words: Gamers, Massively multiplayer online role-playing games, Psychological distress
Prevalence of Tobacco Smoking and Accuracy of Self-Reporting in Pregnant Women at a Public Hospital for Women and Children
Authors: Tan Pamela YF , Utravathy Vasuki , Ho Lin Yoke , Foo Soo Geok , Tan Kelvin KH
Published: July 2022

Introduction: Denial of smoking status by pregnant women presents a missed opportunity for referral to smoking cessation programmes that are shown to be effective in helping them quit smoking. Materials and Methods: A cross-sectional epidemiological survey was conducted to detect the true prevalence of active smoking pregnant patients and the accuracy of self-reporting, investigate the sociodemographic risk factors and test the knowledge of pregnant patients on adverse effects of smoking. This involved 972 antenatal patients of a maternity hospital where participants completed a sociodemographic data survey and answered a knowledge questionnaire. Urine cotinine testing was carried out after informed consent. Results: The prevalence of active smokers was 5.2% (n = 50) with 3% (n = 29) being light smokers and 2.2% (n = 21) being heavy smokers. This was significantly higher than self-reported active smoking status of 3.7% (n = 36; P = 0.02). The Malay race, being aged less than 20 years and not having tertiary level qualifications independently increased the likelihood of being an active smoker. Knowledge of the adverse effects of smoking was generally good with a mean total score of 8.18 out of 10 but there were differences amongst the non-smokers, passive smokers, light smokers and active smokers (P = 0.012). Conclusion: While the prevalence of active smoking among pregnant women is low in Singapore compared to other countries, this study substantiated the unreliability of self-reporting of smoking status in the pregnant population which could complicate referral to smoking cessation programmes. The lower awareness of the harms of smoking during pregnancy among smokers highlights a potential area for improvement.

Key words: Pregnancy, Reproducibility of results, Truth disclosure, Urine cotinine
A Retrospective Review of Imaging and Operative Modalities Performed in Patients with Primary Hyperparathyroidism at a Mid-Volume Surgical Centre in Southeast Asia
Authors: Tan Matthew ZW , Ng Jeremy CF , Eisman John A , Ng David CE , Hansen Louise , Chandran Manju
Published: July 2022

Introduction: A paradigm shift appears to have occurred worldwide in surgery for primary hyperparathyroidism with the advent of sensitive preoperative imaging techniques. Preoperative imaging for parathyroid adenoma localisation was not found to be useful in a study conducted in Singapore in the 1990s. This study aimed to explore what the change has been in preoperative localisation tools compared to the previous study and if the ability of these tools to correctly localise pathologic parathyroid glands has improved. Materials and Methods: A retrospective review of patients who had surgery for primary hyperparathyroidism at our institution during the period 2005 to 2014 was carried out. Individuals with positive, as opposed to those with negative preoperative imaging, were compared with regard to whether they underwent limited focal or bilateral neck exploration. Length of hospital stay (LOHS) was also compared between patients who underwent limited versus bilateral exploration. Results: Fifty-eight patients who had preoperative imaging and surgery were evaluated. True positive rates of sestamibi, ultrasound and 4-dimensional (4D) computed tomography (CT) scans were 63.8%, 72.4% and 90%, respectively. Eighty percent of patients who had positive localisation had limited exploration. LOHS was 2.8 days (1.6, 4.8) and 4.3 days (2.1, 9.0) for limited and bilateral exploration respectively, P = 0.011. Conclusion: Our study highlights the marked change in the surgical landscape for primary hyperparathyroidism in the last 2 decades in Singapore. Improved preoperative localisation has resulted in a swing from predominantly bilateral, to limited exploration in almost all cases of primary hyperparathyroidism due to solitary adenoma. LOHS was significantly shorter in patients who had limited as compared to those who had bilateral exploration.

Key words: 4D-CT, Localisation, MIBI, Parathyroid, Sestamibi, Ultrasound
The Impact of Education Reform: An Asian Medical School’s Experience
Authors: Koh Gerald CH , Lee Jeremy NE , Agrawal Neelima , Tam John KC , Samarasekera Dujeepa , Koh Dow Rhoon , Wong John EL , Tan Chay Hoon
Published: July 2022

This study assessed the effectiveness of education reforms on student-reported learning outcomes at the end of the 5-year medical school (M5) and 1-year internship (HO) in 2006, 2007 and 2008. A self-administered anonymous survey with 17 learning outcomes assessed, derived from Harden’s Three-Circle Outcomes Model for outcomes-based education, was administered to 683 students at the end of medical school (M5) and internship (HO) from 2006, 2007 and 2008. We identified learning outcomes which changed significantly for internship (Cohorts A, B and C) and medical school (Cohorts B, C and D) between cohorts from 2006 to 2008, and compared learning outcomes between medical school and internship within cohorts (i.e. Cohort B which was M5 in 2006 and HO in 2007; Cohort C which was M5 in 2007 and HO in 2008). The proportion of students who agreed that medical school helped them achieve learning outcomes increased significantly from 2006 to 2008 for 15 out of 17 learning outcomes assessed. The proportion of students who agreed that internship helped them achieve learning outcomes increased significantly from 2006 to 2008 for 6 learning outcomes assessed. For Cohorts B and C, internship was more effective than medical school in achieving 8 learning outcomes. Cohort C reported that internship was more effective than medical school in 3 additional learning outcomes than Cohort B: patient management, humility and dedication. We conclude that a successful journey of education reform is an ongoing process that needs to comprehensively address multifaceted components such as faculty, administration and curriculum.

Key words: Harden’s Three-Circle Outcomes Model, Housemanship, Internship
The Use of Parenteral Nutrition Support in an Acute Care Hospital and the Cost Implications of Short-term Parenteral Nutrition
Authors: Wong Alvin TC , Ong Jeannie PL , Han Hsien Hwei
Published: July 2022

Introduction: Parenteral nutrition (PN) is indicated for patients who are unable to progress to oral or enteral nutrition. There are no local studies done on estimating the cost of PN in acute settings. The aims of this study are to describe the demographics, costs of PN and manpower required; and to determine the avoidable PN costs for patients and hospital on short-term PN. Materials and Methods: Patient data between October 2011 and December 2013 were reviewed. Data collected include demographics, length of stay (LOS), and the indication/duration of PN. PN administration cost was based on the cost of the PN bags, blood tests and miscellaneous items, adjusted to subsidy levels. Manpower costs were based on the average hourly rate. Results: Costs for PN and manpower were approximately S$1.2 million for 2791 PN days. Thirty-six cases (18.8%) of 140 PN days were short-term and considered to be avoidable where patients progressed to oral/enteral diet within 5 days. These short-term cases totalled $59,154.42, where $42,183.15 was payable by the patients. The daily costs for PN is also significantly higher for patients on short-term PN (P <0.001). Conclusion: In our acute hospital, 90% of patients referred for PN were surgical patients. Majority of the cost comes from the direct daily cost of the bag and blood tests, while extensive manpower cost was borne by the hospital; 18.8% of our cohort had short-term avoidable PN. Daily PN may cost up to 60% more in patients receiving short-term PN. Clinicians should assess patient’s suitability for oral/enteral feeding to limit the use of short-term PN. Key words: Hospitalised, Avoidable, Nutrition support team
In Vitro Efficacy of Six Alternative Antibiotics against Multidrug Resistant Escherichia Coli and Klebsiella Pneumoniae from Urinary Tract Infections
Authors: Chen Yu Ting , Ahmad Murad Katzrin , Ng Lily SY , Seah Jonathan TH , Park Joon-Jae , Tan Thean Yen
Published: July 2022

Introduction: Increasing resistance in Escherichia coli and Klebsiella pneumoniae to firstline antibiotics makes therapeutic options for urinary tract infections (UTIs) challenging. This study investigated the in vitro efficacies of 6 antibiotics against multidrug resistant (MDR) uropathogens. Materials and Methods: Minimum inhibitory concentrations to ceftibuten, cefpodoxime, fosfomycin, mecillinam, temocillin, and trimethoprim were determined against 155 MDR-isolates of E. coli and K. pneumoniae. The presence of extended-spectrum beta-lactamases (ESBL) and plasmid-borne AmpC enzymes was determined by phenotypic testing with genotyping performed by multiplex polymerase chain reaction. Results: Temocillin demonstrated highest susceptibility rates for both E. coli (95%) and K. pneumoniae (95%) when breakpoints for uncomplicated UTIs were applied; however, temocillin susceptibility was substantially lower when “systemic infection” breakpoints were used. Fosfomycin demonstrated the best in vitro efficacy of the orally available agents, with 78% and 69% of E. coli and K. pneumoniae isolates susceptible, respectively. The next most effective antibiotics were ceftibuten (45%) and mecillinam (32%). ESBL and ampC genes were present in 47 (30%) and 59 (38%) isolates. Conclusion: This study demonstrated few oral therapeutic options for MDR-uropathogens, with fosfomycin demonstrating the best in vitro activity.

Key words: Extended-spectrum beta-lactamases, Fosfomycin, Temocillin, Ceftibuten
Aortic Dilatation at Different Levels of the Ascending Aorta in Patients with Bicuspid Aortic Valve
Authors: Huang Fei Qiong , Guo Kenneth WQ , Zhong Liang , Gao Fei , Tan Ju Le
Published: July 2022

Introduction: Bicuspid aortic valve (BAV) is the most common form of adult congenital heart disease. When compared to patients with a normal trileaflet aortic valve, dilatation of the aortic root and the ascending aorta (Asc Ao) are the common findings in patients with BAV, with consequent higher risk of developing aortic aneurysm, aortic dissection and rupture. We aim to determine the site of the Asc Ao where maximum dilatation occurs in Asian adult patients with BAV. Materials and Methods: All subjects underwent full echocardiography examination. The diameter of the Asc Ao was measured at 3 cm, 4 cm, 5 cm, 6 cm and 7 cm from the level of aortic annulus to the Asc Ao in 2D from the parasternal long-axis view. Results: A total of 80 patients (male/female: 45/35; mean age: 45.3 ± 16.2 years) with congenital BAV and 30 normal control group (male/female: 16/14; mean age: 45.9 ± 15.1 years) were enrolled. The indexed diameters of the Asc Ao were significantly larger than the control group. In patients with BAV, maximum dilatation of Asc Ao occurred around 6 cm distal to the aortic annulus. Conclusion: In patients with BAV, dilatation of Asc Ao is maximal at the mid Asc Ao region around 6 cm distal to the aorta annulus.

Key words: Valvular heart disease
LQ45 Companies: Determinant Deviden Policy To The Value Of Companies With Cash Holding As A Moderation Variable
Authors: Widiasmara Anny , Nadya Mayang Resqita Ayu
Published: July 2022

The rapid development of the business world at this time, which can be seen from the emergence of various competing companies with their respective advantages makes each company must continue to make changes and updates. This makes the competition in the business world continue to move and experience the dynamics of change very quickly. Each company will continue to compete to increase and maximize its profits and profits. The purpose of this study is to determine the influence of dividend policy, cash holding on company value and the influence of dividend policy on the value of companies moderated by cash holdings in LQ45 companies on the Indonesian stock exchange in 2012 - 2019. The data used in this study is secondary data from the Indonesia Stock Exchange (IDX). Sampling techniques using purposive sampling methods so that 22 companies were obtained. This research data analysis technique is multiple linear regression and Moderetted regression analysis test, data processed using IBM SPSS Statistics. The results of this study showed that dividend policies had a significant effect on the value of the company, and cash holding had no effect on the value of the company, and cash holding did not moderate the dividend policy on the value of the company.
Determination of Geographical and Seasonal Variations of Heavy Metals in Swordfish (Xiphias gladius) and Yellowfin Tuna (Thunnus albacares)
Authors:   DDepartment of Livestock Production, Sabaragamuwa University of Sri Lanka, D.A.S.U. igoarachchi,
Published: July 2022

Bioaccumulation of heavy metals in marine fish is a major concern worldwide and it leads to some economical burdens for the tropical fish exporters. However, data is yet to be unavailable in Sri Lanka in this regard. Hence this study was conducted to explore geographical variation of heavy metal accumulation in the Swordfish (Xiphias gladius) and Yellowfin tuna (Thunnus albacares) as they play a predominant role in the export fish market in Sri Lanka. Secondary heavy metal analysis data of Mercury, Led, Arsenic and Cadmium were collected from two major fish export companies in Sri Lanka during the period of 2015 to 2017. Particular points were traced with the aid of log sheets and heavy metal variations were mapped against fish species and heavy metal concentrations by using QGIS software. Heavy metal analysis data were concentrated between 64 to 70 longitudes and 0 to 8 latitudes, 76 to 80 longitudes and 0 to 8 latitudes, 88 to 92 longitudes and 14 to18 latitudes and 82 to 90 longitudes and 6 to 14 latitudes. Heavy metals such as Cd, As and Pb were not detected in the fish samples. Mercury was the major heavy metal accumulated among the tested and high concentration was detected in Swordfish. Mercury accumulation was highest in longitudes between 64 to 70 and latitudes of 0 to 8.This shows serious health issues that are challenging to humans and provides clear evidence on marine pollution. It is recommended to prevent fishing in these particular areas. Proactive measures and techniques need to be applied to fix safe limits of heavy metals in these natural aquatic ecosystems and protect the organisms in the environment.
Adverse Childhood Experience Relationship With Depression In Adolescents
Authors:   Doctoral Program on Development Extension / Community Empowerment
Published: July 2022

This study aims to determine the relationship between adverse childhood experience and depression in adolescents. This research uses quantitative method. The sampling technique used was random sampling, and analyzed by t-test with the Stata 13 program. The population in this study were teenagers who were in SMA Batik 1 Surakarta at the time this research was conducted, and were willing to be the sample in this study. So that the sample used in this study amounted to 150 respondents. Sample selection using random method. Data collection in this study was carried out using a questionnaire instrument. The data analysis technique used is simple linear regression analysis, then the data is processed using the SPSS 20 . software application. Based on the results of the analysis, it can be concluded that ACE has a positive and significant effect on depression experienced in adolescence. Status as the youngest child and aged between 15 years - 17 years, is an accompaniment to the onset of depression in adolescents. It was further stated that in this study family conditions were not the cause of depression in adolescents, from 150 respondents there were 125 respondents who came from divorced families and one or both of their parents remarried but experienced depression caused by ACE.
Forestry Partnership as an Alternative for Settlement of Forestry Disputes in Indonesia
Authors:   Master of Notary Student at the Faculty of Law, Sebelas Maret University, Surakarta
Published: July 2022

This study examines the forestry partnership, which is one of the government's social forestry programs. This forestry partnership program focuses on community empowerment and provides an alternative to the frequent occurrence of forestry disputes in forest utilization and/or management areas. Forestry Partnership includes the state and its people in an agreement with stipulations that each side must meet and implement. However, there is an unequal bargaining stance (bargaining power) between the state and its citizens, and this is one of the causes of disputes. This study is a descriptive normative legal study. Secondary data are utilized in this study, i.e., data that is not gathered directly from the field or the community, but rather through literature review by evaluating and analyzing books, journals, and internet data. The forest partnership agreement between LMDH Banyurip Lestari and KPH Surakarta is a manifestation of the employment of civil law instruments, according to the findings of this legal study. As a result, the government's position as a representative of a legal entity is identical to that of a person or civil legal entity in general, which is subject to civil legislation and can take actions in the civil sector, which in this case are carried out by KPH Surakarta as a legal entity .Thus, the fairness aspect of this forestry partnership agreement has been met, as the actions taken by the government in the forestry partnership agreement are an exercise of authority as a government organ that is also bound by juridical provisions, incorporates general principles of good governance, and effectively functions as an alternative dispute resolution mechanism in the field of forest utilization and/or management.
Development of Dispute Resolution Procedures for Regional Head Elections in the Republic of Indonesia According to Positive Legislation
Authors:   Postgraduate Student of Master of Law UPN Veteran Jakarta
Published: July 2022

The dispute resolution of the results of Regional Head Elections in Indonesia is currently being examined and tried by the Constitutional Court of the Republic of Indonesia, which according to Law Number 10 of 2016 should be investigated by Special Judicial Body to examine and adjudicate disputes on the results of Regional Head Elections.This journal aims to describe the development of dispute resolution procedures for Regional Head Elections in the Republic of Indonesia according to the regulations of the invitation applies to the moment, due to the non-implementation of the principle of lex posteriori derogate lex priori in the handling of disputes on the results of Regional Head Elections and the urgency of establishing a Special Judicial Bodyto handle disputes of the Regional Head Elections.This research was used normative juridical, through statutory approach and case approach with the case of Constitutional Court Verdict No. 97/PUU-XI/2013. Conclusion is based on the principle of Lex Posteriori Derogate Lex Priori of Law Number 10 of 2016 that provides a thorough description about dispute resolution for Regional Head Elections in the Republic of Indonesia.
Enforcement of Human Rights in Providing Children Protection in the School Educational Environment in the City of Surabaya)
Authors:   Faculty of Law, Universitas Diponegoro, Semarang
Published: July 2022

Human Rights are a gift from God Almighty to every human being who is owned even before humans are born into the world. In Indonesia, the position of Human Rights itself has been regulated in the Republic of Indonesia Law no. 39 of 1999 concerning Human Rights. Human rights must be respected, upheld and protected by the state, government and every other human being. Even though it has been protected by law, violations of human rights still occur, one of which is in the protection of children's rights in the field of education. In terms of providing protection for children's rights, the Indonesian State quickly and responsively formed the Child Protection Commission (KPAI). This action is an obligation of the state in terms of protecting children from violence. Based on the facts on the ground that the protection provided to children in the school environment has not worked optimally. The case of violations of human rights that occurred at SMP N 49 Surabaya is one of the portraits of the enforcement of cases of violations of human rights in Indonesia, where the government shows its seriousness to handle and resolve cases of human rights violations.
Changes in the Role of the Community in the Preparation of Environmental Impact Analysis Based on Law Number 11 of 2020 Concerning Job Creation
Authors:   Faculty of Law, Universitas Pembangunan Nasional Veteran Jakarta
Published: July 2022

The purpose of this study is to determine the changes that occur to the prerequisites for making decisions about the implementation of an environmental impact analysis business based on Law Number 11 of 2021 concerning Job Creation. To find out the ease of obtaining a business permit and the impact that will occur, be it positive / or negative for the environment. The Job Creation Law amends a number of articles related to amdal regulation. Such as the amendment of Article 24 of Law No. 32 of 2009, the amdal document becomes the basis for environmental feasibility tests or business and/or activity plans. This environmental feasibility test is carried out by an environmental feasibility test team formed by the central government. Community participation in providing suggestions and responses that must be involved in the preparation of the EIA is narrowed down to only communities that are directly affected whereas in the Law before it was amended mentions environmental observers and/or those affected by all forms of decisions in the amdal process. This research method is carried out by normative juridical research approach in this legal research by means of a statutory approach and legal research which is carried out by examining literature materials or secondary data. Amdal will be able to find out whether a business activity plan has a negative impact or positively serves to secure the environment from negative impacts thus it should be seen as a future security instrument for environmental management efforts and needs to be improved in its position in the development process, not weakening it.
The Effect of Recruitment and Selection on Employee Productivity with Social Media as Intervening Variable (Case Study on the Clients of Professional Leadership Center (PROLC)
Authors:   STIE Malangkucecwara Malang, East Java, Indonesia
Published: July 2022

This study aims to determine the effect of recruitment and selection on productivity with social media as an intervening variable. This research used quantitative approach with Partial Least Square (PLS) technique. Sample of this study is 31 respondents of various companies and various positions that are being carried out by the respondents. The hypotheses are examined using the Smart PLS program version 3.0. The results in this study indicate that social media has a significant effect on productivity; recruitment has a significant effect on social media while selection has no effect on social media. Toward productivity, recruitment and selection have no effect on productivity. Related with the social media, recruitment and selection has an effect on productivity through social media. The insignificance of the results of the study was also made possible by the background of respondents who did not maximize the overall function of social media.