bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers and facilitators for interventions to improve ART adherence in Sub-Saharan African countries: A systematic review and meta-analysis
Authors: Buh Amos , Deonandan Raywat , Gomes James , Krentel Alison , Oladimeji Olanrewaju , Yaya Sanni
Published: November 2023

Background

The HIV/AIDS pandemic remains a significant public health issue, with sub-Saharan Africa (SSA) at its epicentre. Although antiretroviral therapy (ART) has been introduced to decrease new infections and deaths, SSA reports the highest incidence of HIV/AIDS, constituting two-thirds of the global new infections. This review aimed to elucidate the predominant barriers and facilitators influencing ART adherence and to identify effective strategies to enhance ART adherence across SSA.

Methods

A comprehensive review was conducted on studies examining barriers to ART adherence and interventions to boost adherence among HIV-positive adults aged 15 and above in SSA, published from January 2010 onwards. The research utilized databases like Medline Ovid, CINAHL, Embase, and Scopus. Included were experimental and quasi-experimental studies, randomized and non-randomized controlled trials, comparative before and after studies, and observational studies such as cross-sectional, cohort, prospective and retrospective studies. Two independent reviewers screened the articles, extracted pertinent data, and evaluated the studies’ methodological integrity using Joanna Briggs Institute’s standardized appraisal tools. The compiled data underwent both meta-analysis and narrative synthesis.

Results

From an initial pool of 12,538 papers, 45 were selected (30 for narrative synthesis and 15 for meta-analysis). The identified barriers and facilitators to ART adherence were categorized into seven principal factors: patient-related, health system-related, medication-related, stigma, poor mental health, socioeconomic and socio-cultural-related factors. Noteworthy interventions enhancing ART adherence encompassed counselling, incentives, mobile phone short message service (SMS), peer delivered behavioural intervention, community ART delivery intervention, electronic adherence service monitoring device, lay health worker lead group intervention and food assistance. The meta-analysis revealed a statistically significant difference in ART adherence between the intervention and control groups (pooled OR = 1.56, 95%CI:1.35–1.80, p = <0.01), with evidence of low none statistically significant heterogeneity between studies (I2 = 0%, p = 0.49).

Conclusion

ART adherence in SSA is influenced by seven key factors. Multiple interventions, either standalone or combined, have shown effectiveness in enhancing ART adherence. To optimize ART’s impact and mitigate HIV’s prevalence in SSA, stakeholders must consider these barriers, facilitators, and interventions when formulating policies or treatment modalities. For sustained positive ART outcomes, future research should target specific underrepresented groups like HIV-infected children, adolescents, and pregnant women in SSA to further delve into the barriers, facilitators and interventions promoting ART adherence.
Modelling the historical distribution of schistosomiasis-transmitting snails in South Africa using ecological niche models
Authors: Ayob Nisa , Burger Roelof P. , Belelie Monray D. , Nkosi Ncobile C. , Havenga Henno , de Necker Lizaan , Cilliers Dirk P.
Published: November 2023

Schistosomiasis is a vector-borne disease transmitted by freshwater snails and is prevalent in rural areas with poor sanitation and no access to tap water. Three snail species are known to transmit schistosomiasis in South Africa (SA), namely Biomphalaria pfeifferi, Bulinus globosus and Bulinus africanus. In 2003, a predicted prevalence of 70% was reported in tropical climates in SA. Temperature and rainfall variability can alter schistosomiasis-transmitting snails’ development by increasing or decreasing their abundance and geographical distribution. This study aimed to map the historical distribution of schistosomiasis from 1950 to 2006 in SA. The snail sampling data were obtained from the historical National Snail Freshwater Collection (NFSC). Bioclimatic variables were extracted using ERA 5 reanalysis data provided by the Copernicus Climate Change Service. In this study, we used 19 bioclimatic and four soil variables. The temporal aggregation was the mean climatological period pre-calculated over the 40-year reference period with a spatial resolution of 0.5° x 0.5°. Multicollinearity was reduced by calculating the Variance Inflation Factor Core (VIF), and highly correlated variables (> 0.85) were excluded. To obtain an "ensemble" and avoid the integration of weak models, we averaged predictions using the True Skill Statistical (TSS) method. Results showed that the ensemble model achieved the highest Area Under the Curve (AUC) scores (0.99). For B. africanus, precipitation-related variables contributed to determining the suitability for schistosomiasis. Temperature and precipitation-related variables influenced the distribution of B. globosus in all three models. Biomphalaria pfeifferi showed that Temperature Seasonality (bio4) contributed the most (47%) in all three models. According to the models, suitable areas for transmitting schistosomiasis were in the eastern regions of South Africa. Temperature and rainfall can impact the transmission and distribution of schistosomiasis in SA. The results will enable us to develop future projections for Schistosoma in SA based on climate scenarios.
AddBiomechanics: Automating model scaling, inverse kinematics, and inverse dynamics from human motion data through sequential optimization
Authors: Werling Keenon , Bianco Nicholas A. , Raitor Michael , Stingel Jon , Hicks Jennifer L. , Collins Steven H. , Delp Scott L. , Liu C. Karen
Published: November 2023

Creating large-scale public datasets of human motion biomechanics could unlock data-driven breakthroughs in our understanding of human motion, neuromuscular diseases, and assistive devices. However, the manual effort currently required to process motion capture data and quantify the kinematics and dynamics of movement is costly and limits the collection and sharing of large-scale biomechanical datasets. We present a method, called AddBiomechanics, to automate and standardize the quantification of human movement dynamics from motion capture data. We use linear methods followed by a non-convex bilevel optimization to scale the body segments of a musculoskeletal model, register the locations of optical markers placed on an experimental subject to the markers on a musculoskeletal model, and compute body segment kinematics given trajectories of experimental markers during a motion. We then apply a linear method followed by another non-convex optimization to find body segment masses and fine tune kinematics to minimize residual forces given corresponding trajectories of ground reaction forces. The optimization approach requires approximately 3-5 minutes to determine a subject’s skeleton dimensions and motion kinematics, and less than 30 minutes of computation to also determine dynamically consistent skeleton inertia properties and fine-tuned kinematics and kinetics, compared with about one day of manual work for a human expert. We used AddBiomechanics to automatically reconstruct joint angle and torque trajectories from previously published multi-activity datasets, achieving close correspondence to expert-calculated values, marker root-mean-square errors less than 2 cm, and residual force magnitudes smaller than 2% of peak external force. Finally, we confirmed that AddBiomechanics accurately reproduced joint kinematics and kinetics from synthetic walking data with low marker error and residual loads. We have published the algorithm as an open source cloud service at AddBiomechanics.org, which is available at no cost and asks that users agree to share processed and de-identified data with the community. As of this writing, hundreds of researchers have used the prototype tool to process and share about ten thousand motion files from about one thousand experimental subjects. Reducing the barriers to processing and sharing high-quality human motion biomechanics data will enable more people to use state-of-the-art biomechanical analysis, do so at lower cost, and share larger and more accurate datasets.
Antimicrobial peptide-producing dermal preadipocytes defend against Candida albicans skin infection via the FGFR-MEK-ERK pathway
Authors: Wang Jianing , Duan Zhimin , Zeng Rong , Yang Lu , Liu Weizhao , Liu Yiman , Yao Qian , Chen Xu , Zhang Ling-juan , Li Min
Published: November 2023

Dermal fibroblasts (dFBs) defend against deep bacterial skin infections by differentiating into preadipocytes (pAds) that produce the antimicrobial peptide cathelicidin; this differentiation is known as the dermal reactive adipogenesis response. However, the role of dFBs in fungal infection remains unknown. Here, we found that cathelicidin-producing pAds were present in high numbers in skin lesions from patients with cutaneous Candida granulomas. Second, we showed that dermal Candida albicans (C. albicans) infection in mice robustly triggered the dermal reactive adipogenesis response and induced cathelicidin expression, and inhibition of adipogenesis with pharmacological inhibitors of peroxisome proliferator–activated receptor γ (PPARγ) impaired skin resistance to C. albicans. In vitro, C. albicans products induced cathelicidin expression in pAds, and differentiating pAds markedly suppressed the growth of C. albicans by producing cathelicidin. Finally, we showed that C. albicans induced an antimicrobial response in pAds through the FGFR-MEK-ERK pathway. Together, our data reveal a previously unknown role of dFBs in the defense against skin infection caused by C. albicans.
THE COMPOSITION OF THE ORGANIC MATTER AND MICROELEMENTS OF SPHAGNUM PEATS IN THE NORTHERN PART OF THE VASYUGAN PEAT DEPOSIT AND DIRECTIONS FOR THEIR USE
Authors: Maslov Stanislav Grigor'yevich , Inisheva Lidiya Ivanovna , Porokhina Ekaterina Vladimirovna
Published: November 2023

The results of studies of sphagnum peats in the northern part of the Vasyugan peat deposit are presented. Peat sampling points were planned based on the materials of detailed exploration. The samples were collected in the form of mixed samples, which were taken at 3–4 points from the middle of the genetic layer of the peat deposit, the core height was 0.5 m. The peat quality assessment was carried out on the requirements for peat as a raw material for different uses. It is shown that the ash of different types of sphagnum peats may have elevated values of Ca, Mg and Fe. It is revealed that the elemental analysis of sphagnum peats has individual features of their content. It was found that the group composition of the organic matter of sphagnum peats is characterized by a high content of water-soluble and easily hydrolyzed  matters and a low content of humic and fulvic acids. At the same time, in two samples, an increased content of bitumen was noted (samples 2 and 11), and in sample 9, a high content of humic and fulvic acids was detected and at the same time a low content of water-soluble and easily hydrolyzed  matters. It is revealed that it is impossible to reduce all the variety of peat properties only to the species characteristic and the degree of decomposition due to the wide variability of the leading and subordinate peat-forming agents in the peat composition. It is shown that the properties of sphagnum peats of the oligotrophic type of the studied territory show their suitability for the production of many types of products, and the duration of operation of these reserves stretches up to 200 thousand years.
ISOLATION AND STUDY OF THE PHYSICOCHEMICAL PROPERTIES OF POLYSACCHARIDES FROM PLANT MATERIALS GENTIANA OLIVIERI GRISEB
Authors: Toshtemirova Charos Toshtemirovna , Turaboev Abdulhamid Abdulvohid ugli , Normakhamatov Nodirali Sokhobatalievich , Kodiralieva Fotimahon Akbarovna
Published: November 2023

Methods for isolating and purifying polysaccharides of the aerial part from plant materials of the Gentian Olivier – Gentiana. Olivieri Griseb (family Gentianaceae ) have been developed and studied for the qualitative and quantitative content of polysaccharides in the herb as biologically active components that determine its anti-inflammatory and sequestering (moisture retention agents) effects in the normalization of gastrointestinal disorders. The qualitative and quantitative characteristics of the content of the polysaccharide complex were determined, including water-soluble polysaccharides obtained from a neutral medium with a yield of 6.4%, water-soluble polysaccharides obtained from an acidic medium with a yield of 0.9%, and pectin substances with a yield of 3.8%. The monomeric composition of water-soluble polysaccharides from both neutral and acidic treatments is represented by D-galactose, L-arabinose, and D-glucose. Pectin substances consisting of D-galactose, L-arabinose and D-glucose, D-galacturonic acid dominate the polysaccharide composition of the medicinal plant. They turned out to be highly esterified. The absorption bands of the infrared spectrum of the polysaccharide indicate the presence of α-glycosidic bonds between the residues of D-galacturonic acid in the polysaccharide.
ANTIMICROBIAL ACTIVITY OF BUTANOL COMPLEXES AND ISOLATED SECONDARY METABOLITES OF SOME SPECIES OF GENUS SILENE OF THE FAMILY CARYOPHYLLACEAE
Authors: Zibareva Larisa Nikolayevna , Filonenko Elena Sergeevna , Andreeva Irina Sergeevna , Solovyanova Nadezhda Alekseevna , Nesterova Svetlana Vladimirovna
Published: November 2023

Extracts of 9 species of the Caryophyllaceae family were screened for antimicrobial activity on the example of 17 types of strains of microorganisms. The inhibitory activity of 7 butanol extracts has been shown against a number of pathogenic strains belonging to the species Mycobacterium smegmatis, Phroteus mirabilis, Serratia marcescens, Staphylococcus aureus, Streptococcus faecalis. The extracts studied were most effective on the bacteria Bacillus cereus and Bacillus subtilis. It was found that all the studied plant species of the genera Lychnis and Silene contain ecdysteroids and flavonoids. The isolated individual compounds contained in all the studied species showed antimicrobial action on strains of a number of bacteria: the ecdysteroid 20-hydroxyecdysone suppressed the growth of the strain of R. mirabilis, while the flavonoid shaftoside inhibited strains of bacteria S. aureus, B. cereus, B. subtilis, R. mirabilis, M. smegmatis. Gram-negative bacteria Salmonella typhimurium, Klebsiella pneumoniae, Shigella sonnei, Pseudomonas aeruginosa are not susceptible to the antimicrobial action of extracts under experimental conditions.

Determination of antimicrobial activity was carried out by methods – diffusion and joint incubation of plant extracts and cells of test strains of microorganisms in a liquid nutrient medium LB at the ratio sample : medium 1 : 2 and 1 : 1. Increase in the concentration of secondary metabolites of ecdysteroids and flavonoids in experiments with butanol complexes of substances with a sample ratio the 1 : 1 environment led to an increase in antimicrobial activity up to the complete inhibition of Gram-positive bacteria B. subtilis and B. cereus by extracts of plant species Silene graefferi, S. colpophylla, S. sendtneri, S. linicola, S. jenisseensis S. viridiflora (seeds) and individual shaftoside.
Continuing Medical Education Questions: December 2023
Authors: Dirweesh Ahmed M.
Published: November 2023

Article Title: Lactated Ringers Use in the First 24 Hours of Hospitalization Is Associated with Improved Outcomes in 999 Acute Pancreatitis Patients
Development of Digital Distance Measurement Instrument Based on Arduino Uno for Physics Practicum
Authors: Muzayyanah Esti , Megananda Amelia , Darmayanti Hervina Puspita , Priana Zihan Ika
Published: November 2023

Measurement in physics is absolute because it affects the results of theoretical and experimental proofs. Retrieval of distance measurement data for physics experiments also requires high accuracy and a relatively long time because the accuracy in the measurements determines the valid results. Sometimes the available measurement instrument is difficult to access for novice researchers because of the high cost of these measurement instruments. These problems often result in errors and limitations in the implementation of measurements. The relatively long time also slows down data retrieval. This study aims to develop a digital distance measurement instrument based on Arduino Uno for physics practicum. This research is qualitative research using library research methods, field research, designing instruments, and testing hardware and software instruments. Instruments and materials used in this research include the ultrasonic sensor HC-SR04, Arduino Uno r3 kit, LCD, potentiometer, and Arduino IDE software. The result of this research is the digital distance measurement instrument based on Arduino Uno for physics practicum can be a solution for measuring objects with large distances and lengths. This measurement instrument has the smallest value of 1 cm. The design of the Arduino uno-based digital distance measuring device for physics practicum is a practical measurement instrument with the smallest measuring value of 1 cm which can assist students in measuring distances in physics practicum.
Facilitating Physics Problem-Solving Skills with Geometry Optics E-Module Flipbook View: A Reliability Test
Authors: Ima Puspita Rukmi  , Sindy Chintyawati  , Bayu Setiaji
Published: November 2023

Students' physics problem-solving skill is still low, especially in physics problems related to everyday life, not simple quantitative problems. This is because the learning modules used today still do not invite students to solve real problems around them related to physics. This study aims to test the feasibility of the E-Module with a flipbook view which was developed to improve students' problem-solving skills on the material of reflection and refraction of light. The research method used is Research and Development (R&D) with a 4-D development model. The stages of E-Module development in this research are only the define, design, and development stages. The research instrument was in the form of an E-Module feasibility test questionnaire via google form which was tested by 50 prospective physics teacher students. The results showed that the feasibility level of the developed E-Module was within the very feasible criteria. Thus, the developed E-Module is very feasible to improve students' problem-solving skills and can proceed to the broad trial stages.
Interactive E-Modules as Teaching Materials on Diffraction and Interference Materials: A Feasibility Test
Authors: Kasanah Putri Nur'aini , Kusumawati Nuryuana Dwi
Published: November 2023

The selection of learning teaching materials must be carried out as needed and can also utilize technology as a means of making interesting teaching materials. One of the learning teaching materials that can be used to easily understand the concepts of diffraction and interference and utilize technology is an interactive e-module equipped with learning videos. This is because learning about diffraction material and interference with physics requires visualization to improve students' understanding of the material. The research method used is Research and Development or R&D (Research and Development) with the ADDIE (Analysis, Design, Development, Implementation, Evaluation) model. Research and development of education (research and development) aims to produce new products through the development process. In this study, there was a limitation of steps from five steps to four steps to due diligence according to development needs. The results showed that the interactive e-module on the diffraction and interference material made by the researcher was suitable for use
Skilled in Creating Power Products for Electronic Instruments Size E Guitar String (Star Missiles) Through Project Based Learning Models
Authors: Murdhiastuti Henny
Published: November 2023

This research was conducted in mathematics and sciences class XII-2 high school 1 Sigaluh, on electromagnetic induction material. The data of this research are data improving science process skills and scientific attitudes.  The research instruments are in the form of observation sheets for project implementation assessments and questionnaires. The results of the questionnaire show that 63% of respondents use electricity-saving lamps, 31% have not used electricity-saving lamps, and 6% choose to be absent. The results of observation on the star missile PjBL showed an average of 81 categories of the high predicate. The results of the science teacher's response questionnaire obtained a score with the predicate category that strongly agrees with the star missile project-based learning. While the results of the cognitive assessment of the Star Missile PjBL have an average of 85, project appraisal with an average of 83.8 for star missile product appraisal has an average score of 85.8. Based on the results, it can be concluded that the application of the star missile project-based learning model can improve science process skills and scientific attitudes and is expected to can provide input for Physics teachers in implementing the star missile project-based learning model on KD 4.5.
Implementation of an Inquiry Model Assisted with PHET and Teaching Aids to Improve Vocational Students' Learning Outcomes in The Sound Waves Concept
Authors: Mambai Naomi , Triwiyono  , Lumbu Albert
Published: November 2023

Physics learning still tends to be conventional and very rarely takes place using practicum media, so students become less enthusiast. This is contrary with students in vocational schools who tend to learn through practice. This study aims to determine the effect of guided inquiry model assisted with PhET media and teaching aids in physics learning outcomes of class X students of SMKN 3 Technology and Engineering Jayapura on the sound waves concept. This study used the pre-experimental method with one group pretest-posttest design, the research sample was selected from two (control and experimental class) of nine classes through a purposive sampling technique with 25 students each group. The study used pretest and posttest essay questions which were validated by experts. The pretest and posttest data were then tested for normality and the results were normal, then N-gain analysis and hypothesis testing α = 5% significance value were performed. The results of the N-gain analysis obtained were 0.70 where the average value of the posttest>pretest ranged from moderate to high for the experimental class while the N-gain was 0.57 where the average posttest>pretest ranged from low to moderate for the experimental of class control. The results of the hypothesis test were found (tcount < ttable) = (0,000 < 0,05) where H0 was rejected, so that there was an improvement in learning outcomes and there were differences in learning outcomes before and after learning with treatment in experimental class. The success of this treatment can be seen from the enthusiasm of the students who are involved independently in operating the PhET application on computer media and visual aids during learning. This learning pattern can be applied by readers/teachers in researchers but also in the development of teacher learning towards students' understanding of physics concepts.
USER ENGAGEMENT COMBINED ASSESSMENT SYSTEM
Authors: Voronina A. A. , Shabalina O. A. , Sadovnikova N. P. , Kataev A. V. , Molodtsova I. A.
Published: November 2023

The article discusses methods for assessing engagement as a characteristic of human activity. Existing systems for assessing engagement that are designed to assess either the activities of a software user or the quality of the software itself with which this user interacts are described. A method for the combined assessment of the engagement of software users based on heterogeneous data obtained during the user’s interaction with the software is described. Engagement indicators are proposed, defined as numerical interpretations of oculographic data, data on the emotional state of the user, and web analytics data. Due to the subjective nature of any interpretation, the combined assessment of engagement is defined using a fuzzy inference mechanism. Three linguistic variables characterizing each indicator are defined. A base of fuzzy production rules for a fuzzy inference system and a method for combining them based on fuzzy rules have been developed. The proposed method is implemented in a system that includes subsystems for collecting and sending user data and evaluating engagement, interacting with each other through the API. An experiment conducted to evaluate the effectiveness of the proposed method using the developed system is described. The experiment consisted in assessing the engagement of the software user, first by each indicator separately, then by their combination, and analyzing the degree of compliance of these assessments with the assessments received from an external expert and the user himself (self-assessment). An analysis of the results of the experiment showed that 63 % of the ratings obtained by the combined assessment method coincided with at least one of the assessments received from an external expert or the user himself, compared with 55 % of coincidences obtained using only the oculographic indicator, and 17 % of coincidences obtained using the “emotional involvement” indicator. Thus, the proposed method provides a higher degree of confidence in the results of the engagement assessment for making a decision based on this assessment than methods for assessing involvement that use each indicator separately.
Perbandingan Luaran Penggunaan Protokol Enhanced Recovery After Surgery (ERAS) dengan Perawatan Perioperatif Konvensional pada Pembedahan Umum di RSUP H. Adam Malik Medan
Authors: Saputra Moch. Iqbal , Tanjung Qadri Fauzi , Hamdi Tasrif
Published: November 2023

Latar Belakang: Protokol enhanced recovery after surgery (ERAS) merupakan kondisi pemulihan yang lebih cepat setelah operasi dan anestesi. Semua elemen ERAS secara terpisah telah terbukti meningkatkan luaran pasien. Di Indonesia, beberapa pusat pendidikan telah menggunakan ERAS sebagai protokol dalam penatalaksanaan perioperatif.Tujuan: Penelitian ini bertujuan untuk menilai perbandingan luaran antara penerapan protokol ERAS dengan perawatan perioperatif konvensional pada pembedahan umum.Metode: Penelitian prospektif analitik dengan metode case control ini dilakukan di Rumah Sakit Umum Pusat (RSUP) H. Adam Malik Medan pada bulan Agustus sampai November 2022. Sampel adalah pasien berusia antara 18 sampai 65 tahun yang menjalani operasi elektif digestif dan ginekologi dengan anestesi umum. Pasien yang dirawat di intensive care unit (ICU) dan pasien relaparotomi dieksklusi dari penelitian. Subjek secara acak dibagi menjadi 2 kelompok: subjek pada kelompok ERAS akan menerima perlakuan protokol ERAS pada periode perioperatif, sedangkan kelompok konvensional menjalani persiapan perioperatif seperti biasa. Luaran yang dinilai dalam penelitian ini adalah skala nyeri pascaoperasi, kejadian post operative nausea and vomiting (PONV), waktu mobilisasi, waktu flatus, dan lama rawat.Hasil: Penelitian ini terdiri dari 2 kelompok dengan jumlah sampel sebanyak 23 pasien pada masing-masing kelompok. Berdasarkan jenis operasi, 29 (63%) sampel menjalani operasi pencernaan, dan 17 (37%) sampel menjalani operasi ginekologi. Terdapat perbedaan yang signifikan pada skala nyeri pascaoperasi, dengan rata-rata skor VAS 1,9 ± 0,7 (kelompok ERAS) dibandingkan dengan 2,5 ± 0,8 (kelompok konvensional), p = 0,034. Luaran waktu mobilisasi yang dibutuhkan pasien untuk dapat duduk di tempat tidur adalah 26,17 ± 4,05 jam pada kelompok ERAS dan 38,91 ± 16,53 jam pada kelompok konvensional (p = 0,01). Selanjutnya, lama rawat lebih pendek pada kelompok protokol ERAS, 7,25 ± 2,2 hari dibandingkan 10,5 ± 3,6 hari pada kelompok konvensional (p = 0,0001).Kesimpulan: Implementasi protokol ERAS memberikan hasil pascaoperasi yang lebih baik daripada perawatan konvensional pada pasien yang menjalani operasi pencernaan dan ginekologi.
Teknik Anestesia Epidural Dalam Operasi Herniotomi pada Pasien Atrial Septal Defect dengan Hipertensi Pulmonal
Authors: Christine Christine , Pradhana Adinda Putra , Dewi Dewa Ayu Mas Shintya
Published: November 2023

Latar Belakang: Atrial septal defect (ASD) merupakan kelainan jantung asianotik yang paling sering terjadi, sekitar 10% dari pasien dewasa dengan kelainan jantung kongenital. Atrial septal defect (ASD) di klasifikasikan menjadi 4 tipe berdasarkan bagian atrium septum yang gagal terbentuk, yaitu ostium sekundum (85%), ostium primum (10%), sinus venosus (5%) dan defek koronari sinus (jarang).Kasus: Laki laki usia 55 tahun dengan kasus hernia inguinalis lateralis dekstra reponible dengan ASD dan hipertensi pulmonal derajat sedang. Pasien dilakukan insersi epidural kateter di L4-L5 setelah di konfirmasi dengan loss of resistance dengan saline dan test dose. Regimen epidural yang diberikan bupivacaine 0,25% + lidocaine 1% volume 10 mL. Intraoperatif diberikan titrasi norepinephrine dengan dosis titrasi 0,15-0,3 mcg/kgBB/menit dan tirasi dobutamine 2,5-5 mcg/kgBB/menit. Pengobatan postoperatif analgesia pengobatan epidural bupivacaine 0,0625% + morfin 0,5 mg volume 10 mL tiap 12 jam, dan parasetamol 500 mg tiap 6 jam tablet untuk obat analgesia.Pembahasan: Teknik anestesi epidural dipilih karena memiliki onset yang lebih lama dan hemodinamik variasi yang lebih kurang dibandingkan dengan teknik anestesi spinal atau kombinasi teknik spinal-epidural. Sedangkan teknik general anestesi tidak dipilih karena berisiko terhadap resistensi vaskular pulmonal dan dapat mengubah arah shunting. Prinsip dari penanganan ASD adalah untuk mempertahankan cardiac output dan menghindari adanya penurunan dari resistensi sistemik vaskular. Mempertahankan resistensi sistemik vaskular berdsarkan dengan mean arterial pressure sehingga menghindari adanya perubahan arah shunt.Kesimpulan: Pada laporan kasus ini dapat kami simpulkan bahwa teknik anestesi epidural dapat diterapkan secara aman pada kasus herniotomi dengan komorbid ASD dengan hiperetensi pulmonal.
Double Whammy Cases of Severe Mitral Stenosis in Peripartum: A Survival Case Series
Authors: Praha Lourensia Brigita Astern , Rohmatussadeli Rizqon , Ahnaf M. Fauziar , Pramono Besari Adi , Wicaksono Rahmad Rizal , Hadijono R. Soerjo
Published: November 2023

Background: Valvular heart disease in pregnancy is still not widely studied. The combination of mitral stenosis and the physiology of pregnancy for both mother and fetus often result in poor hemodynamics, and management during labor and peripartum period greatly determines the prognosis of both lives.Case: A 42 years old G3P2A0 (Case A) and A 33 years old G3P1A1 (Case B) both had a history of previous SC labor, presented worsening shortness of breath since 2nd trimester, coughing and swelling in both legs, also unable to rest in a flat position. especially, case B was frequent re-hospitalized with prolonged LOS during 2nd – the 3rd trimester due to acute lung edema. We found a mid-diastolic murmur grade II/IV at the apex. Electrocardiography (ECG) of case A: sinus rhythm, left atrial enlargement (LAE), while case B: AF rapid response. The echocardiography of case A revealed severe MS, while case B revealed severe MS, moderate tricuspid regurgitation and, a high probability for PH. Those findings support the diagnosis of severe mitral stenosis and rheumatic heart disease in pregnancy, then they were programmed to do balloon mitral valvuloplasty (BMV) in 3rd trimester.Discussion: The BMV was performed, and succeeded in case A reducing the mitral valve pressure gradient (MV PG) from 24.7mmHg to 12.1mmHg by using local anesthesia along the procedure, while in case B specifically done BMV with general anesthesia due to supraventricular tachycardia (SVT) and pulmonal congestive during procedure, reducing the MV PG from 17.7mmHg to 8.6mmHg, as well as improvement in symptoms, up to pregnancy was terminated as obstetric indication by SC on 36-37 weeks' gestation in both cases. The baby born was healthy with weights of each case 2340gr and 2630gr. Conclusion: Mitral stenosis in the peripartum needs to be managed by interprofessional collaboration properly, to decrease the risk of morbidity and mortality for the mother and fetus.
The Void Ab Initio Theory in Comparative Perspective: J Marshall, H Kelsen, and Beyond
Authors: Tassopoulos Ioannis A
Published: November 2023

The void ab initio theory is traditionally associated with the retroactive effect of the unconstitutionality of a statute, in diffused systems of judicial review; as opposed to the prospective effect of unconstitutionality, in Austria, the archetype of centralized judicial review. The paper argues that the void ab initio theory goes far beyond the time-factor of judicial review, having two complementary aspects: 1) The void ab initio theory is tied to a robust theory of negative liberty; and substantive criminal law is its privileged field of application. The void ab initio theory goes back to Marbury v Madison (1803). 2) The void ab initio theory was strongly criticized by Kelsen, whose criticism is accurate, when the theory is unduly extended to the unconstitutionality of laws curtailing positive rights of the welfare state, eg, salaries and pensions, as happened recently in Greece. The act which abolishes the unconstitutional statute retroactively, has ‘the character of a legislative act.’ Indeed, the void ab initio theory in the field of positive social rights encroaches on legislative competence. The paper cocludes that the void ab initio theory is a strong expression of the ethos of legality; The void ab initio is most adequate for (cases involving) legal sanctions, on legal grounds, over adjudicative facts.
Constitutional Court and Politics: The Case of Georgia
Authors: Nakashidze Malkhaz
Published: November 2023

The paper deals with the relationship between the Constitutional Court of Georgia and politics. The paper discusses the various stages of the development of the Constitutional Court of Georgia, changes in the composition and legislation. The paper analyzes politically relevant cases, focuses on the various mechanisms of influencing the judiciary using the rule of court formation and legislative changes, criticism of international and national experts and the decisions made by the Court itself to protect its own independence.
Passiveness, Activism and Constitutional Bullying: The Supreme Federal Court and Brazil’s Fragile Rule of Law
Authors: Leite Glauco Salomão
Published: November 2023

The paper identifies the different roles played by the Brazilian Supreme Federal Court under the 1988 Constitution, adopted after 21 years under authoritarian rule. The aim is to shift the focus of the discussion regarding the counter-majoritarian difficulty, which insists on the illegitimacy of judicial review, to the difficulty of being counter-majoritarian, examining the institutional obstacles and limitations attendant upon judicial independence.
Recycling waste polymer packaging materials as effective active carbon porous materials for uranium removal from commercial phosphoric acid
Authors: Ibrahim Saber , Masoud Ahmed M. , El-Maadawy Mahmoud M. , Fahmy Hager , Taha Mohamed
Published: November 2023

Plastic packaging waste is considered a serious threat to the environment due to its non-biodegradable nature. Transforming plastic waste into active carbons using pyrolysis methods could be a valuable option to solve the challenge of plastic waste. Synthesized active carbon was differentiated using zeta potential, particle size, SEM, BET, and DSC. This study also investigates the use of obtained active carbons for U(VI) removal from commercial phosphoric acid. The kinetics of adsorption were found to follow the pseudo-second-order model and intra-particle diffusion as one of the controlling mechanisms. Langmuir, and Freundlich, isotherms were employed to explore the equilibrium data. Furthermore, thermodynamic investigations revealed that uranium uptake is an endothermic, feasible, and spontaneous process. The present study concludes that plastic waste-based activated carbon could be employed as a low-cost alternative to commercial activated carbon for uranium removal from phosphoric acid and the production of green fertilizers.
Mary Ashraf and the “Research Group on Working Class Literature”: The Programmatic Pursuit of a New Research Field in the GDR Anglistik
Authors: Schwalm Helga
Published: November 2023

Aiming to contribute to the historiography of English Studies, this essay explores the research agenda and collective work of a particular network of academics that made a committed and systematic effort to implement working-class literature and culture as a new research field in (GDR) English Studies. Set up as a “Research Group on Working Class Literature” in 1965, its key actors were a group of academics based at the Humboldt University or Pädagogische Hochschule Potsdam who had come to the GDR from the UK or US as immigrants or remigrants. The driving force was Dr. Mary Ashraf, whose papers contained in the Bundesarchiv [Federal Archives] shed light on the Group’s work. On the basis of these archival papers and the Group’s publications, this essay studies the programmatic and conceptual nature as well as the praxeological dimension of their work, including their teaching legacy.
“To this Silent Paper I May Confess it”: Diary Writing and Trauma in The Tenant of Wildfell Hall
Authors: Kuglin Ayşegül
Published: November 2023

The diary section in Anne Brontë’s The Tenant of Wildfell Hall is often criticized. However, Helen’s diary is an essential element of the novel: recording and processing her traumatic first marriage in her diary is an important means of character development, making it possible for Helen to heal, and to experience what experts term posttraumatic growth. According to Herman as well as Tedeschi and Calhoun, the only way to recover from, and grow beyond, trauma is to narrate it. In the novel, Helen does this through recording and confronting her traumatic experiences in her diary.
Population characteristics and movements of striped bass Morone saxatilis (Walbaum, 1792) in the Mira River estuary, Cape Breton Island, Nova Scotia, Canada
Authors: Dadswell Michael J. , Buhariwalla Colin F. , Andrews Samuel N. , Stokesbury Michael J.W. , MacMillan John L.
Published: November 2023

The occurrence of striped bass outside the immediate vicinity of known spawning rivers in Canada is neither widely understood nor well studied. Striped bass in Canada are managed and assessed within three distinct units, the Bay of Fundy, the Gulf of St. Lawrence, and the St. Lawrence River; but stocks that may occur outside these units are unrecognized. We document a previously unstudied aggregation of striped bass in the Mira River estuary (MRe), Cape Breton Island (46° 01′N, 60° 03′W), a location on the east coast of Nova Scotia omitted from present management units but which has been long reported to host an aggregation. From July 2012 to November 2014, 62 striped bass within MRe were sampled and 31 were surgically implanted with VEMCO acoustic transmitters. Striped bass ranged in size from 31.6 to 125.0 cm total length and age 3 to 24 years. Acoustic telemetry from 2012 to 2015 elucidated residency and fidelity to the MRe with mid-estuary overwintering every year, freshwater residency of the adult population during spring, and a summer through autumn aggregation in the lower estuary. Of the 31 acoustically tagged striped bass, 24 remained in MRe throughout the study, six exhibited mid-summer departures to the Atlantic Ocean but returned by mid-autumn, while one left the MRe and was never detected again. Mira River SB with acoustic tags were never detected at nearby Ocean Tracking Network telemetry infrastructure. Striped bass stocks exhibit similar residency and fidelity patterns to their natal rivers and estuaries elsewhere in its Atlantic coast range which suggests the Mira River aggregation constitutes a possible distinct stock yet unrecognized by Canadian fisheries managers.
The Secret World of Lichens: A Young Naturalists Guide
Authors: Driscoll Kendra
Published: November 2023

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Pengaruh Dewan Komisaris, Ukuran Perusahaan, Profitabilitas Perusahaan, dan Risiko Perusahaan Terhadap Audit Fee
Authors: Izzani Ahmad Fadhil , Khafid Muhammad
Published: November 2023

Tujuan penelitian ini adalah untuk menemukan bukti empiris mengenai pengaruh dewan komisaris, ukuran perusahaan, profitabilitas perusahaan, dan risiko perusahaan terhadap audit fee. Populasi penelitian ini adalah perusahaan sektor keuangan yang terdaftar di Bursa Efek Indonesia selama periode tahun 2016-2019. Teknik pengambilan sampel yang digunakan adalah purposive  sampling. Perusahaan yang memenuhi kriteria sampel sebanyak 28 perusahaan sehingga total data penelitiannya yaitu 112 unit analisis. Metode analisis yang digunakan untuk menguji  hipotesis yaitu analisis regresi berganda dengan alat bantu IBM SPSS Statistic 25. Hasil penelitian membuktikan secara empiris bahwa variabel dewan komisaris, ukuran perusahaan, profitabilitas perusahaan, dan risiko perusahaan mampu berpengaruh secara signifikan terhadap audit fee. Dewan komisaris dan ukuran  perusahaan mampu berpengaruh secara positif terhadap audit fee, sedangkan profitabilitas perusahaan dan risiko perusahaan berpengaruh secara negatif terhadap audit fee.The purpose of this study was to find empirical evidence regarding the effect of the board of commissioners, company size, company profitability, and company risk on audit fee. The population of this study is the financial sector companies listed on the Indonesia Stock Exchange in 2016-2019. The sampling technique used is purposive sampling. Companies that meet the sample criteria are 28 companies so that the total research data is 112 units of analysis. The analytical method used to test the hypothesis is multiple regression analysis with the tools of IBM SPSS Statistic 25. The results of the study prove empirically that the variables of the board of commissioners, company size, company profitability, and company risk are able to have a significant effect on audit fee. The board of commissioners and company size have a positive effect on audit fee, while company profitability and company risk negatively affect audit fee.
Efisiensi Produksi dan Saluran Pemasaran Kopi Robusta di Kecamatan Gemawang Kabupaten Temanggung: Pendekatan Stochastic Frontier Analysis dan Descriptive Analysis
Authors: Pratamasari Wening Elly , Prajanti Sucihatiningsih Dian Wisika
Published: November 2023

Pertumbuhan industri makanan, minuman, farmasi dan industri lainnya yang berbahan dasar tapioka Penelitian ini bertujuan untuk: 1) menganalisis pengaruh faktor produksi luas lahan, jumlah tenaga kerja, umur tanaman, jumlah pupuk dan jumlah tanaman terhadap produksi kopi Robusta di Kecamatan Gemawang Kabupaten Temanggung, 2) menganalisis tingkat pencapaian efisiensi teknis, efisiensi harga dan efisiensi ekonomi pada produksi perkebunan kopi Robusta di Kecamatan Gemawang Kabupaten Temanggung, 3) menganalisis saluran pemasaran produksi Kopi Robusta di Kecamatan Gemawang Kabupaten Temanggung. Metode analisis dalam penelitian ini adalah dengan mix method antara deskriptif kuantitatif yaitu fungsi produksi Cobb – Douglas dengan pendekatan frontier stokastik. Terdapat tiga uji efisiensi, yaitu efisiensi teknis (ET), efisiensi harga atau alokatif (EH), dan efisiensi ekonomi (EE). Teknik analisis kedua yang digunakan adalah analisis diskriptif untuk menganalisis saluran pemasaran. Hasil penelitian menunjukkan bahwa hanya variabel luas lahan dan tenaga kerja yang secara positif berpengaruh signifikan terhadap produksi kopi robusta, sedangkan variabel umur tanaman, jumlah pupuk, jumlah tanaman secara statistic tidak berpengaruh signifikan terhadap produksi kopi robusta di Kecamatan Gemawang. Hasil dari analisis diskriptif saluran pemasaran kopi robusta di Kecamatan Gemawang adalah, bahwa terdapat 6 rantai saluran pemasaran kopi robusta di Kecamatan Gemawang.
Determinan Kinerja Penyerapan Anggaran Unit Kerja Perguruan Tinggi Negeri di Kota Semarang
Authors: Septantri Lidiadni , Khafid Muhammad , Wahyudin Agus
Published: November 2023

Absorption of the budget has a significant role as a driver of the economy and driving the pace of economic growth, especially government spending. The Covid-19 pandemic affected the health and economic sectors, which experienced a decline in economic growth. The delay in the absorption of the government budget will impact the preparation of benefits that the community will obtain. Apart from being a lever for economic growth, optimal budget absorption is a measure of the government's success in financial management to realize Good Governance. This study focus on analyzed the effect of participation, planning, and human resources on the performance of budget absorption with organizational commitment as a moderating variable. This research is a quantitative research design. The data collection method used a questionnaire or questionnaire. The population in this study is a budget work unit that manages finances as a whole at the Public Service Agency State Universities in Semarang City. The data analysis used descriptive analysis and inferential analysis technique Moderated Regression Analysis (MRA) with absolute difference value test method using IBM SPSS software. The results of this study indicate that budgetary participation and planning positively affect the performance of budget absorption. In contrast, the competence of human resources does not affect the performance of budget absorption. The study's results partially show that the participation, planning, and competence of human resources positively affect the performance of budget absorption. Empirically also proves that organizational commitment and moderating the effect of participation, planning, and competence of human resources on the performance of budget absorption.
Analisis Faktor Dermatitis Kontak pada Pekerja Pengepul Botol Bekas
Authors: Maharani Indra , Koesyanto Herry
Published: November 2023

Latar Belakang: Dermatitis kontak akibat kerja merupakan penyakit dermatitis kontak yang didapatkan dari pekerjaan akibat interaksi antara kulit dengan substansi yang digunakan dilingkungan kerja. Penelitian ini bertujuan untuk mengetahui analisis faktor yang berhubungan dengan kejadian dermatitis kontak.Metode: Jenis penelitian ini adalah observasional analitik dengan pendekatan cross sectional menggunakan metode total sampling yaitu sejumlah 40 pekerja, instrumen yang digunakan adalah kuisioner dan pemeriksaan dokter.Hasil: Hasil uji statistik Chi-square menunjukkan bahwa variabel yang berhubungan dengan kejadian dermatitis kontak adalah masa kerja(0,033), personal hygiene(0,001), dan riwayat penyakit kulit(0,016). Tidak terdapat hubungan antara jenis kelamin (p=0,435), lama kontak(p=0,484) dan penggunaan APD(p=1,000). Simpulan penelitian ini adalah terdapat hubungan antara masa kerja, personal hygiene, dan riwayat penyakit kulit dengan kejadian dermatitis kontak.Kesimpulan: Tidak terdapat hubungan antara jenis kelamin, lama kontak, dan penggunaan APD dengan kejadian dermatitis kontak.