bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of pulmonary tuberculosis on neurocognitive function in HIV infected adult patients in Lusaka, Zambia
Authors: Chinyama Jonathan , Ngoma MS , Menon AJ. , Hestad K , Heaton RK
Published: September 2023

Objective: To explore the effects of Pulmonary Tuberculosis on neurocognitive functions in HIV+ adults in Lusaka, Zambia.

Materials and methods: In a retrospective and prospective case-control study, Global Deficit Score (GDS) was used as an overall measure for cognitive impairments between groups and also within the PTB+/HIV+ group, and Domain Deficit Scores (DDS) were used to summarize cognitive impairments within each of the seven domains. To examine group differences in neurocognitive status, we used Wilcoxon ranked sum tests to compare the performance between groups on neuropsychological test battery.

Results: Out of 324, only 244 were studied. Results indicated significant neurocognitive impairment in PTB+/HIV+ group than PTB-/HIV+ in the GDS, p<.001, significant lower CD4 cell count with a mean of 323 cells/μl compared to 510 cells//μl for the control group. The PTB+/HIV+ group, CD4 cell count was in the range 201-499 cells//μl compared to their cohort CD4 cell count above 500 cells//μl indicating immune compromise in the PTB+/HIV+. 95% of PTB+ were stages 3 and 4 indicating AIDS defining stage, whereas 95% of PTB negative were stage 1 suggesting immunocompetent. Linear regression model (p<.01), PTB status was predictive of GDS even while accounting for demographic and medical variables that have previously been associated with neurocognitive impairments. Specifically, a linear regression model identified PTB status (F=6.26, p < .02) as a significant predictor of Global Deficit Score (GDS). Age (F =3.21, p <.08) approached significance, while years of schooling (F =0.54), current WHO stage (F=1.41) and gender (F= .13) were not significant independent predictors of GDS (all ps > .10).

Conclusion: This study highlights the fact that PTB has neurocognitve impairment in HIV+ adult individuals. Findings of the present study show the presence of neuropsychological impairments in all the seven domains except motor in the PTB+/HIV+ adults in Lusaka district, Zambia.
A comparative study of Mycobacterium Tuberculosis in hospitalised adult HIV infected patients with normal and abnormal renal function at the University Teaching Hospital, Lusaka, Zambia
Authors: Liusha Namakando , Mulenga L , Chirwa L , Chanda D , Mweemba A
Published: September 2023

Background: Mycobacterium tuberculosis (TB) remains a leading cause of mortality and morbidity worldwide, including Zambia, especially among those infected with the Human Immunodeficiency Virus (HIV). Both kidney dysfunction and TB have been shown to be highly prevalent among hospitalised HIV infected patients. Little is known about how TB and kidney dysfunction impact each other in HIV patients, and whether there is any association between the occurrence of kidney dysfunction and active TB infection in this population. This study was aimed at determining the prevalence and risk factors of active TB infection in HIV positive patients with and without kidney dysfunction.

Methods: This was an analytical cross-sectional study. Using simple random sampling, HIV positive patients on the medical wards were recruited in two arms (74 with & 59 without kidney dysfunction). Urine Lipoarabinomannan (LAM), TB blood culture, sputum culture and genexpert MTB/Rif were used for TB diagnosis. Data was analysed using STATA version 13.

Results: TB prevalence in all HIV positive hospitalized patients was 45%, and more prevalent in the kidney disease than non-kidney disease group (54% vs 35.59%; p=0.034). TB diagnosis pick up was comparable in the kidney disease and the non-kidney disease group using urine LAM and blood culture at 31.1% vs 22.2% and 8.9% vs 3.1% respectively, but lower using sputum culture; 12.5% vs 24.1%. Among kidney disease patients, a higher CD4 count > 200cells/μl was protective for active TB (P = 0.011). Severe immunosuppression (CD4 count < 200cells/μl) was 18.64% higher in the kidney dysfunction group compared to the non-kidney disease group (P=0.026). The only factor associated with active TB was male gender (P = 0.029); while Proteinuria in a TB patient was strongly associated with kidney disease (P < 0.001). Patients with WHO stage III/IV were likely to present with TB in both groups (P=0.004, 95% CI 1.47 - 7.20). Kidney dysfunction severity (measured by estimated glomerular filtration rate), age, antiretroviral therapy status and duration on combination antiretroviral therapy, history of TB contact and current cough, had no significant association with active TB in the two groups.

Conclusion: Patients with kidney disease are more likely to present with active TB infection than HIV infected  patients with no kidney disease. Among patients with active TB, urinalysis can help predict renal dysfunction; while determinants of active TB in the general population are not similar to those in kidney disease patients.
¿Es necesaria la micción previa al egreso en cirugía anorrectal ambulatoria?: Ensayo clínico Acute Urinary Retention in Anorectal Ambulatory Surgery (AURAAS)
Authors: Vásquez Chirinos Félix Luis Edgar , Angarita A. Luis H.
Published: September 2023

El objetivo es establecer si es necesaria la micción postoperatoria previo al egreso en cirugía anorrectal ambulatoria electivos en patología benigna. Este es un estudio experimental de tipo ensayo clínico aleatorizado de centro único (Centro Médico Docente La Trinidad), en pacientes sometidos a cirugía ambulatoria electiva por la unidad de coloproctologia con patología anorrectal benigna en el período comprendido entre agosto 2021 y octubre 2022. Se incluyen para el estudio un total de 39 pacientes que fueron asignados de forma aleatoria en 2 grupos, un grupo experimental conformado por 20 pacientes y un grupo control conformado por 19 pacientes. Desde el punto de vista epidemiológico (edad y sexo) ambos grupos de estudio fueron comparables p=0,4. La tasa global de retención urinaria aguda fue de 2,6% (n=1), el cual surgió en el grupo control, lo cual no representó significancia estadística p=0,47. La mediana de estancia postoperatoria fue menor en el grupo experimental obteniéndose una mediana de 130 minutos (120-160 min) en contraste con el grupo control que experimentó estancias más largas 220 min (150-360 min). Este estudio logró demostrar que la micción postoperatoria no es necesaria para el egreso en cirugía anorrectal electiva por patología benigna, en pacientes seleccionados utilizando analgesia multimodal, restricción de líquidos perioperatorios y con anestesia general obteniendo una tasa baja de retención urinaria aguda postoperatoria.
Community Development Practices through Corporate Social Responsible (CSR) Program
Authors: Handoyo Rahmad , Darsono  , Kartono Drajat Tri , Suminah
Published: September 2023

Conflicts that occur between companies and communities often have detrimental impacts, both for companies, communities and local governments. Conflicts that occur are usually over land ownership or customary land issues, while one of the main factors causing conflict is community dissatisfaction with companies that are considered to have less attention and contribution to society. The conflict that occurred between the company and the community was in accordance with the media coverage of klip.com (2022) which stated that the Tebo Regency Government mediated to resolve conflicts between the community and two companies in the area which had been going on for a long time. This research is aimed at finding solutions to conflicts involving communities and companies through community empowerment schemes in the CSR program. As a result, the implementation of community empowerment in CSR programs is proven to reduce conflict between communities and companies. In essence, community development must not create dependency, but must be able to encourage the creation of more creativity and self-reliance in society.
Social Innovation through Shrimp Shell Waste Management: Concept, Implementation, and Results
Authors: Dani Nur Hadiyanto  , Hanafi Ahmar  , Fernando Depari  , Firdaus Ahda
Published: September 2023

Pekan Labuhan Village, Medan Labuhan District, as one of the areas that has economic potential in the form of a household-scale shrimp processing industry (Ngopek). The research question is how is the concept, implementation, and results of solving the problem of shrimp shell waste? This research was conducted in Pekan Labuhan Neighborhood Village 25 where the majority of people here produce shrimp shell waste. The research method is descriptive qualitative with a constructivist approach. Data collection techniques using interviews, observation, and documentation studies. The results of this study show that the concept applied in this program is that the management of shrimp shell waste has the potential to develop an industry for processing shrimp waste into chitin and chitosan. This program is run by a group called the Amanah Workers Group (PEMANAH). In its implementation, as a form of response to these problems, a program was created that can be said to solve these problems with the concept of integrated waste management ecosystem. Finally, the results of this program can be realized in the form of added value in at least three aspects, namely social, economic and environmental aspects.
The Impact of Community Empowerment Through Biofloc Catfish Cultivation in Hagu Tengah Village, Banda Sakti District, Lhokseumawe City
Authors: Golwinner Sihombing
Published: September 2023

Community empowerment is a process to encourage people to be able to position themselves proportionally and become the main actors in utilizing the strategic environment in achieving long-term goals. PT Pertamina Patra Niaga Fuel Terminal Lhokseumawe has a community empowerment program in the form of the biofloc catfish program. This program has been implemented since 2021 and is aimed at the people of Hagu Tengah Village, Banda Sakti District, Lhokseumawe City. This study uses a qualitative descriptive approach, namely analyzing the impact of the biofloc catfish program that has been implemented in Hagu Tengah Village. The impact is the impact from the individual side, such as a sense of responsibility, perseverance and also increased social interaction. Impact from a group perspective in responding to community needs. such as increasing people's income, the need for work, and the need for social interaction. In addition, the Biofloc Catfish Cultivation Program also helps overcome social problems in society, such as the problem of underprivileged people and the problem of unemployment.
Solar Cell Innovation: Energy Source Drive Sewing Machine in D'Kartinis Group Eco-Friendly Sewing House
Authors: Fakri  , Syafrianto Sitanggang  , Farhan Hamdi  , Wisnu Setiadi
Published: September 2023

The economic level of the people of Teluk Kabung Utara, Padang City, West Sumatra Province is still at the middle to lower level. Its location close to the beach makes the majority of people work as fishermen, farmers, and casual laborers. In addition, industrial growth has an impact on increasing electricity consumption. This study aims to describe the Eco-Friendly Sewing House program fostered by PT Pertamina Patra Niaga Integrated Terminal Teluk Kabung in the economic sector to improve the economic level of the community. The research method used is descriptive-qualitative with data collection techniques in the form of interviews, observations, and documentation. The results of this study show that activities and innovations in the Eco-Friendly Sewing House program carried out by the D'kartinis group have an impact on improving the economy of the North Kabung Bay community. On the other hand, this program is a medium in preserving the environment by utilizing renewable energy in the form of solar cells as alternative electric power to drive sewing machines. The goal is to become a sustainable development program that is environmentally friendly and prospers the community. The existence of this program is expected to empower the community to get out of problems and maximize their potential, and the implementation of the program is not only felt by the people of North Teluk Kabung but also outside Padang City.
Implementation of the Pertamina Niaga Terminal Dumai CSR through a Community-Based Mangrove Tourism Program (Study on Tourism Awareness Groups)
Authors: Bram Harya Prima  , Hasna Fillari Sofia
Published: September 2023

The problem in Indonesia that until now has become a topic of conversation is the issue of environmental damage. The existence of the issue of environmental damage due to low public awareness of the potential that exists in the area. One of the causes of the issue of environmental damage, namely mining in Indonesia is increasing from year to year. The presence of CSR PT Pertamina IT Dumai gives its social responsibility to the community to help develop mangrove ecotourism in Dumai Riau. Through programs, assistance, and infrastructure assistance. Pertamina Niaga CSR (Corporate Social Responsibility) IT Dumai provides assistance in the process of developing mangrove tourism to make it more optimal. The role of CSR (Corporate Social Responsibility) Pertamina IT Dumai chose this location because of the potential of mangrove plants which have many functions, one of which is the prevention of natural disasters. For this reason, the establishment of Mangrove Ecotourism aims to exploit the potential of mangrove forests to increase the economic value of the local community. Through the development of ecotourism. The Mangrove Ecotourism Development Program also helps create new jobs for people in the area through the POKDARWIS (Tourism Awareness Group) community. The group is supported by Pertamina IT Dumai CSR and is provided with infrastructural facilities, assistance. The goal is that mangrove ecotourism can develop and be known by foreign circles.
Mangrove: Collaboration and Conflict Between Companies and Communities
Authors: Chamidah Nurul
Published: September 2023

Mangroves play an important role in the defense of natural disasters from the sea, economic value benefits and protection of biodiversity. This study aims to explain the program of PT. Telkom Indonesia in conducting a corporate social responsibility program in Ambulu Village, Losari District, Cirebon Regency. This study seeks to explain the conflict between companies and communities in mangrove management. This study uses a qualitative perspective with collaborative participatory data collection where researchers are the main key in conducting research. The results showed that differences in the perspective of the implementation of the mengrove program in Ambulu occurred between the company and the Grow Up Institute community as program facilitators and Ambulu mangrove forest farmer groups. Groups and facilitators focus more on mangrove sustainability according to ecosystems and climate-based planting, while companies tend to focus on program reporting limited to annual work months/calendars
Experiential Learning Practices and Career Courses: Predictors of First Destination Outcomes
Authors: Buckley Burnell Addye , Cordie Leslie A.
Published: September 2023

This study examined connections between experiential learning practices, mandatory career courses, and positive first destination outcomes of graduates from a large public institution prior to and during the COVID-19 pandemic. The rising cost of education and competition among universities has led to consumer demands for information pertaining to their return on investment. Universities have been encouraged to provide first-destination outcomes for graduates as a way to show the value of their degree programs. To strengthen these outcomes, many programs encourage or mandate experiential learning known as high-impact practices (HIPs) and career courses to prepare emerging adult learners for the transition to employment or further education. However, little is known as to the impact these practices have on the first-destination outcomes of these graduating students. This study identified specific experiential practices which proved beneficial to securing employment or acceptance to continued education, with an important caveat that career courses added only limited benefit for some respondents. These findings will better inform the allocation of university teaching resources and are a basis for further study of career practices in higher education.
ESPETÁCULO DAS VIDAS OCULTAS
Authors: Galindo Sobral Ronaldo
Published: September 2023

Este trabalho apresenta uma análise da obra A vida que ninguém vê, da escritora gaúcha Eliane Brum. Os textos que embasaram esta produção são relatos reais publicados na coluna “A vida que ninguém vê”, do Jornal Zero Hora, da cidade de Porto Alegre, Rio Grande do Sul. Neste artigo, busca-se evidenciar o olhar atento da narradora aos detalhes da vida cotidiana e banal de pessoas comuns da sociedade; pessoas que não são celebridades, porém vivem ou já viveram situações extraordinárias em suas rotinas. Com o registro das histórias desses cidadãos comuns, a autora faz referência a indivíduos anônimos, à margem de uma sociedade classista e excludente. A abordagem de Brum é humanizada, impregnada de sensibilidade para com aqueles que dirige seu olhar. Este artigo explora a capacidade de Brum em construir sua narrativa a partir dos relatos pessoais dos entrevistados, enquanto reforça o caráter extraordinário de cada uma das vidas retratadas, convidando-nos a observar tais sujeitos com um olhar diferente do habitual; olhar direcionado para o homem simples, que metaforicamente pode representar qualquer brasileiro. Os textos analisados são relacionados às teorias de filósofos e escritores que abordaram a complexidade e o comportamento humano em sociedade.
O’ZBEKISTONDA LAKTOZA INTOLERANSI VA LAKTOZASIZ YOGURT ISHLAB CHIQARISHDA SIFAT KO’RSATKICHLARI
Authors: Otaxonov Qobiljon Qaxramonovich , Habibullayev Jamshidbek Asatillo o’g’li , Asqarov Ibrohimjon Rahmonovich
Published: September 2023

Ushbu maqolada O’zbekiston respublikasi va dunyoda laktoza intoleransi muammolari va yechimlari muhokama qilingan. Yurtimizda aholisining ko’pchilik qismi sut mahsulotlarini sevib iste’mol qiladi ayniqsa yogurt(mahalliy tilda “qatiq” nomi bilan mashxur). Biroq sut tarkibidagi laktozaning hazmi bilan bog’liq muammolar tufayli iste’molchilar o’rtasida turli xila so’gliqdagi muammolar paydo bo’ladi. Buni oldini olish va laktozasiz sifatli yogurt yetkazib berish maqsadida bu tajribada yogurt ishlab chiqarishda keng qo’llaniladigan starter(mikroorganizm) Yoflex acidifix 1.0 va Nola Fit 5500 ferment o’rtasidagi fermentatsiya jarayonlari va sifat ko’rsatkichlari taxlil qilingan.
LAKTOZASIZ YOGURT NAMUNALARINING MIKROSTRUKTUR XUSUSIYATLARI
Authors: Habibullayev Jamshidbek Asatillo o’g’li , Otaxonov Qobiljon Qaxramonovich , Asqarov Ibrohimjon Rahmonovich
Published: September 2023

Yogurtning sifat ko’rsakichlarini belgilashda turli omillar inobatga olinadi va ulardan biri mikrostruktur taxlili natijalari hisoblanadi. Ushbu maqolada laktozasi parchalangan yogurtlarning mikrostruktur xususiyatlari tahlil qilingan.
OʻZBEKISTON RESPUBLIKASI TASHQI IQTISODIY FAOLIYATIDA POLIMERLARNI IMPORT VA EKSPORTI TAHLILI
Authors: Isroilova Xusnidaxon Vaxobjon qizi , Abdug'aniyev Baxtiyor Yormaxamatovich , Perdebayev Aybek Bayrambay uli , Muqimjonova Umidaxon Vaxobjon qizi
Published: September 2023

Polimer materialining 2018-2022-yillardagi Oʻzbekiston Respublikasiga importi va undan eksportining statistik tahlili amalga oshirilgan. Tahlillar polimer mahsulotlarining turiga qarab davlatlar kesimida bojxona yuk deklaratsiyalarining miqdori va tovarning qiymati boʻyicha oʻtkazilgan. Ushbu tahlillar polimer mahsulotlarining tashqi iqtisodiy faoliyatda identifikatsiya qilish zarurati va dolzarbligini aniqlash maqsadida amalga oshirilgan.
GINKGO BILOBANING KIMYOVIY TARKIBI VA XALQ TABOBATIDA QO‘LLANILISHI
Authors: Asqarov Ibrohimjon Rahmonovich , Razzaqov Nabijon Alijonovich
Published: September 2023

Ushbu maqolada Ginkgo biloba deb nomaladigan dorivor o‘simlikning kimyoviy tarkibi, uning biologik faolligi hamda isbotli tabobatda kasalliklarni davolash o‘rinlari haqida. Markaziy nerv sistemasining oziqlanishining buzilishi va shuning oqibatida xotiraning pasayishi hamda asabiylashish kabi xastaliklarda Ginkgo biloba  o‘simligidan foydalanish yaxshi samara beradi.
PROSTATIT KASALLIGIDA QO‘LLANILADIGAN DORI VOSITALARI VA ULARNI KIMYOVIY TARKIBI
Authors: Asqarov Ibrohimjon Rahmonovich , To‘ychiyev G‘ofurjon O‘rmonovich
Published: September 2023

Maqolada prostatit kasalligida qo‘llaniladigan bir necha zamonaviy dori vositalarini tasir qiluvchi moddalari va aynan bu kasallikni davolashda ishlatiladigan dorivor o‘simliklarning kimyoviy tarkiblari o‘rganilgan. Ularning tasiri doirasi,bir biriga yaqinligi va farqi ko‘rib chiqilgan. Bu kimyoviy preparatlarni nojo‘ya tasiri atoroflicha taxlil qilingan.
Tinjauan Hukum Ekonomi Syariah Terhadap Khiyar dalam Jual-Beli Online Sistem cash on delivery Pada Mandiri Elektronik Baradatu
Authors: Widiya Astuti Ervina Widiya Astuti
Published: September 2023

Penelitian ini bertujuan untuk mengetaahui tinjun hukum ekonimi syariah terhadap Khiyar dalam Jual-Beli Online Sistem cash on delivery Pada Mandiri Elektronik Baradatu. Penelitian ini merupakan jenis penelitian klualitatif dengan metode pengambil data wawancara, observasi dan dokumentasi. Hasil penelitian menunjukkan bahwa 1) Dalam jual beli online ini bentuk hak khiyar yang telah diterapkan atau digunakan oleh penjual maupun pembeli adalah khiyar ‘aib dan khiyar Syarat. Dan khiyar syarat berlaku ketika syarat yang diajukan oleh penjual yang melakukan transaksi dengan mensyaratkan untuk pengembalian apabila barang yang dipesan tidak sesuai. 2) Mengenai Tinjauan Hukum Ekonomi Syariah terhadap hak khiyar dalam Jual-Beli Online Sistem COD (cash on delivery) ini maka hukumnya boleh, karena akad yang dilaksanakan jelas, dibuktikan dengan kontrak perjanjian antara penjual dan pembeli pada saat melaksanakan ijab dan qabul secara langsung maupun diwakilkan dengan pihak ekspedisi, dimana ia dikategorikan sebagai jenis jual-beli Ba’i As-Salam.
Analisis Hukum Ekonomi Syari’ah Tentang Akad Ijarah Alat Pemanen Padi Combine Harvester (Studi Kasus di Kampung Simpang Asam Kecamatan Banjit)
Authors: Yansya Febri Yansya , Andriansyah Andriansyah
Published: September 2023

Tujuan penelitian adalah Untuk mengetahui praktek akad ijarah alat panen padi combine harvester di Kampung Simpang Asam Kecamatan Banjit Kabupaten Way Kanan. Untuk mengetahui analisis hukum ekonomi syaria’ah terhadap praktek akad ijarah dalam alat panen padi combine harvester di Kampung Simpang Asam Kecamatan Banjit Kabupaten Way Kanan.    Jenis penelitian ini adalah penelitian lapangan (field research) yang sifatnya deskriptif analisis, yaitu memaparkan fakta-fakta yang ada untuk selanjutnya dianalisis secara kualitatif dengan pola pikir induktif dan atau deduktif. Hasil  penelitian didapat bahwa akad sewa mesin combine harvester di Kampung Simpang Asam berdasarkan adat kebiasaan masyarakat setempat yang dituangkan dalam perjanjian lisan antara pemilik mesin dan pemilik lahan, dilihat dari landasan hukum ekonomi syaria’ah yang bersumber dari Al-Qur’an dan As-Sunnah tentang sewa menyewa, maka sewa menyewa mesin pemanen padi di Kampung Simpang Asam Kecamatan Banjit Kabupaten Way Kanan dipandang sah dan dibenarkan, dengan alasan sewa menyewa mesin pemanen padi ini telah memenuhi syarat-syarat yang ditetapkan oleh hukum ekonomi syari’ah, terutama yang berkaitan dengan subyek yang berakad dan obyek sewa menyewa asalkan itu tidak mengubah nashnya.
Dampak Merek Dagang Terhadap Efektifitas Manajemen UMKM Perspektif Hukum Bisnis Syari’ah (Studi Kasus UMKM Barlian Makrame Di Desa Sidowarek Kecamatan Ngoro Kabupaten Jombang)
Authors: Fatihatul Azza Mefa Fatihatul Azza , Pratanto Rahayu Wedi Pratanto Rahayu
Published: September 2023

UMKM adalah salah satu lembaga yang bergerak dalam dunia bisnis untuk memenuhi kebutuhan hidup. UMKM mempunyai peranan yang penting dalam perekonomian Negara. UMKM dituntut memiliki manajemen yang efektif, bila ingin bersaing. Berkaitan dengan manajemen yang efektif, UMKM yang memasarkan produk home made (buatan tangan) penting memiliki merek dagang yang sudah terdaftar. UMKM Barlian Makrame pernah mengalami kerugian materi maupun immateri yang terkait merek dagang yang belum terdaftar. Dalam asas kepemilikan hokum bisnis syariah, terdapat asas infiradiyah yaitu hak eksklusif yang harus dihormati oleh setiap orang atas suatu kepemilikan. Jenis penelitian yang digunakan adalah kualitatif dengan metode pengumpulan data dari wawancara, observasi dan dokumen. Analisisnya secara deskriftif dengan pendekatan yuridis Empiris dan fenomenologi, menghubungkan teori Hukum Bisnis Syariah dengan fakta di lapangan terkait dampak Merek Dagang Terhadap Efektifitas Manajemen UMKM Barlian Makrame. Hasil penelitian menemukan bahwa ada dampak kerugian bagi UMKM Barlian Makrame dikarenakan pengelolaan yang tidak efektif yang terkait belum terdaftarnya merek dagang. Dalam perspektif hukum bisnis syariah, hal tersebut membuat UMKM Barlian Makrame tidak memilki hak eksklusif atas produknya yang disebut dengan asas infiradiyah. Sehingga penting bagi UMKM mendaftarkan merek dagangnya agar asas infiradiyah dapat terwujud secara jelas dan legal
De geo-constitutionele rechtsstaat: een hervormingsagenda
Authors: Somsen J. (Han)
Published: September 2023

De geo-constitutionele rechtsstaat: een hervormingsagenda

In deze bijdrage gaat de auteur in op de constitutionele vraag over de verhouding tussen de mens en de natuur.
De stand van de stelselherziening: op weg naar 1 januari 2024
Authors: Gierveld H.A.J. (Henk)
Published: September 2023

De stand van de stelselherziening: op weg naar 1 januari 2024

Het artikel biedt een overzicht van hetgeen met name in de Eerste Kamer aan de orde is geweest ten aanzien van de besluitvorming over het ontwerp koninklijk besluit tot inwerkingtreding van de Omgevingswet met ingang van 1 januari 2024. Daarnaast gaat het artikel in op de verhouding tussen de minister en de Afdeling bestuursrechtspraak en de Eerste Kamer.
Reoperative and Non Reoperative Hirschsprung’s Disease in Associated with Clinicopathological Profile of the Proximal End of Resection in the Department of Anatomical Pathology, FMUI/CMH 2015-2019
Authors: Permata Warastridewi Arie , Krisnuhoni Ening
Published: September 2023

Background

Hirschsprung’s disease (HD) is a developmental disorder of the enteric nervous system, which is characterized by the absence of ganglion cells in the submucosal and myenteric plexuses. The success of surgery is influenced by many factors, one of which is the presence of histopathological abnormalities in the proximal part of the HD rectosigmoid resection. The aim of this study is to determine whether there are any histological characteristics associated with Hirschsprung's disease that would necessitate reoperation at the Department of Anatomical Pathology Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital (FMUI/CMH).

Methods

This was an analytical study using a cross-sectional design and secondary data from the Department of Anatomical Pathology Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital (FMUI/CMH) archives between 2015 and 2019. At the proximal end, histopathological examinations were performed to determine mature ganglion, nerve thickening, normal ganglion number, perineural inflammation, and serositis. The patient's age at the time of surgery, gender, the type of surgery, and the patient's age at the time of reoperation were all recorded.

Results

From the 64 resection cases, 15 reoperation resection cases and 49 non-reoperation resection cases were obtained. Of the 15 reoperation cases, the histopathological investigation revealed fifteen cases of mature ganglion, ten cases of nerve thickening, and fourteen cases of normal ganglion. There was no perineural inflammation in fifteen cases, and no serositis in fourteen cases. A p value of 0.026 was obtained for the patient's age at the time of the operation.

Conclusion

There are several factors that determine pasients with Hirschsprung disease who undergo reoperation after resection. The age of the patient at the time of resection is one of the factors that can affect the occurence of reoperation in patients with Hirschsprung disease.
Anti-inflammatory Effect of Tamarillo (Solanum betaceum Cav.) Fruit Peel Ethanol Extract: Study of Carrageenan-Induced Buccal Mucosa on Rats
Authors: Syarafina Amiretta , Sudiono Janti
Published: September 2023

Background

Inflammation is a local protective response by tissue damage. Tamarillo fruit peel ethanol extract has flavonoid as anti-inflammatory, anti-oxidant, inhibit cyclooxygenase and lipoxygenase as well as leukocyte accumulation. This study aims to determine anti-inflammatory effect of Tamarillo fruit peel ethanol extract on carrageenan-induced buccal mucosa of rats.

 

Methods

Extraction was done by maceration with 70% ethanol. The 30 rats divided into five groups, namely positive control (diclofenac sodium), negative control (NaCl), and extract doses of 70, 140 and 280 mg/kgBW. Carrageenan was injected as inflammation inducer in the right buccal mucosa. Macroscopic and microscopic observations were performed at three times, 24, 48, and 72 hours after carrageenan injection.

 

Results

At 24 hours, inflammatory cells of 70 mg/kg extract were 37, at 140 and 280 mg/kgBW were 18; positive and negative control as 35 and 405. At 48 hours, inflammatory cells of positive control were 22; extract of 70, 140, and 280 mg/kgBW were 21, 17, and 16 while negative control was 26. At 72 hours, positive and negative controls were 18 and 27. Extract of 70, 140, and 280 mg/kgBW had 20, 12 and 9 cells. Extract groups had no significant differences with the positive control (p>0.05) except for the 48th hours of 70 mg/kgBW however the extract groups showed significance with negative control (p<0.05). The lowest number cells (6) was at 280 mg/kgBW on 72 hours.

 

Conclusion

Tamarillo fruit peel ethanol extract is effective anti-inflammatory agent especially dose of 280 mg/kgBW on 72 hours.
Clinicopathological Profile of Ampulla of Vater and Pancreas Malignancies at Cipto Mangunkusumo Hospital in 2015-2019
Authors: Pramono Meike , Rini Handjari Diah
Published: September 2023

Background

Malignancies of ampulla of vater and pancreas are often difficult to distinguish. Malignancies in ampulla of vater include malignancies in major duodenal papilla, distal common bile duct and pancreatic duct opening (Wirsung). The origin of the primary tumor, histopathological diagnosis and staging play a role in therapy and prognosis. WHO Classification of tumors of the digestive system, 2019 made changes in tumor staging following the system of the American Joint Committee on Cancer (AJCC), 8th edition. This study was conducted to determine types of pancreatic and ampullary malignancies, demographic distribution, location, profile, histomorphology and tumor staging changes in the 7th edition of the AJCC to 8th edition of the AJCC in the WHO Classification of tumors of the digestive system, 2019. The aim to determine clinicopathological profile of malignancies of ampulla of vater and pancreas as well as tumor staging changes based on AJCC edition 8.

Methods

Observational descriptive study on pancreatic and ampulla vater malignancy resection preparations at Department of Anatomic Pathology FKUI/RSCM, period January 2015 to December 2019 that met the inclusion criteria. Demographic evaluation, tumor location, histopathological profile and patient staging changes were carried out based on the 8th edition of AJCC.

Results

There were 27 cases of adenocarcinoma in ampulla of vater, 10 cases of pancreatic ductal adenocarcinoma, 1 case of mucinous cystic neoplasm with adenocarcinoma focus, 1 case of serous cystadenocarcinoma, 7 cases of PanNET, 2 cases of PanNEC, 3 cases of SPN, 1 case of MiNEN. Changes in pT were present in 29 cases. Changes in pN were present in 6 cases.

Conclusion

The diagnosis and pathological staging are in accordance with the 2019 WHO digestive system tumor classification. Tumor differentiation, presence or absence of lymphovascular invasion, perineural invasion and lymph node metastases and incision margin status are important histopathological parameters.
Enhancing Practice Efficiency
Authors: Baum Neil
Published: September 2023

Successful practices are placing an emphasis on enhancing efficiency and being able to see more patients in the same period while preserving patient satisfaction and preventing physician burnout. This article discusses the importance of efficiency and offers multiple suggestions for increasing efficiency that can be implemented into every medical practice. It identifies common inefficiencies and roadblocks; offers several ways to improve employee efficiency; discusses leadership, communication, and best practices to enhance workflow; and offers suggestions on how to structure a medical office to maximize patient satisfaction and provider and employee workflow.
The Importance of a Healthcare Practice Corporate Vision Statement
Authors: Boden Timothy
Published: September 2023

If your front-line staff members understand your most important goals and values, they can represent you, the physician, much more effectively (and accurately). Deliberately incorporate your vision and mission into every aspect of your training, your leadership, and your example, and you will discover the practical aspects of those esoteric statements.
Is Hospital Consolidation Leading to Higher Value?
Authors: Smoldt Robert , Landman Natalie , Weinstock Benjamin , Cortese Denis
Published: September 2023

Hospital consolidation is on the rise, driven by the combination of government provisions that aim to move the system from volume to value and the financial impacts of the pandemic. The key argument in favor of consolidation is that larger systems are better positioned to achieve higher value through dissemination of best practices and economies of scale. So, are these systems delivering consistently high value? Our analysis of the CMS Hospital Value-Based Purchasing Total Performance Score (TPS) for two cohorts of health systems — those in the state of California and those top ranked by U.S. News & World Report— suggests that the answer is: it depends. Although in some systems, most hospitals have higher-than-average TPS, all systems show opportunities for improvement. Given that patients often assume within-brand equivalence in healthcare value judgements, hospital systems must assume responsibility for delivering truly consistent and high value healthcare across their entire network.
Desempenho no teste FMS® em mulheres e homens praticantes de exercício resistido
Authors: Teixeira Otávio Augusto , Beck Jader Alfredo , Silva Affonso Celso Kulevicz da , Câmara Deivison Fellipe da Silva , Souza Amandda de , Liz Carla Maria de , Ruschel Caroline
Published: September 2023

Introdução: Os exercícios resistidos (ER) compõem o programa de condicionamento físico de um grande número de indivíduos. Nesses programas são realizadas avaliações periódicas para planejamento e acompanhamento dos efeitos do treinamento. Recentemente, além das avaliações físicas tradicionais tem sido recomendada a inclusão de testes funcionais para avaliação do padrão de movimento dos indivíduos.Objetivo: Avaliar o desempenho funcional de mulheres e homens praticantes de ER. Métodos: Cinquenta e sete participantes (27 mulheres, 26,2 ± 5,1 anos; e 30 homens, 26,3 ± 5,8 anos) fisicamente ativos e experientes na prática de ER foram avaliados através da bateria de testes Functional Movement Screen (FMS®). O escore total foi comparado entre os sexos através do teste U de Mann-Whitney; já a distribuição dos escores parciais (escores de cada teste) e a proporção de escores assimétricos entre os grupos foram realizadas através do teste do Qui-Quadrado (p < 0,05).Resultados: O escore total das mulheres foi 14,6 ± 1,5 pontos, e o dos homens, 15,3 ± 1,4 pontos, de modo que não houve diferença significativa entre os grupos. Considerando os escores parciais, os homens apresentaram melhor desempenho no teste de estabilidade de tronco (p = 0,001) e de agachamento (p = 0,024), enquanto as mulheres apresentaram melhor desempenho no teste de mobilidade de ombros (p = 0,001). Neste último, além de apresentarem piores resultados, os homens foram significativamente mais assimétricos (p = 0,002).Conclusões: Os resultados deste estudo sugerem a necessidade de uma observação mais detalhada dos escores parciais para o planejamento de programas de treinamento personalizados, que atendam às necessidades de cada indivíduo.
Violência contra a mulher na área rural na percepção de Agentes Comunitários da Saúde (ACS)
Authors: Cetolin Sirlei Favero , Bervian Gabriela , Trissoldi Lediane Paula , Simon Cleonice , Brandemburg Eliane Carla
Published: September 2023

A violência contra a mulher tem se apresentado como um grave problema de saúde pública em várias partes do mundo. O estudo tem como objetivo analisar a percepção de Agentes Comunitários da Saúde (ACS) sobre a violência contra a mulher no meio rural. Trata-se de uma pesquisa com abordagem qualitativa, tendo como participantes 10 Agentes Comunitários de Saúde (ACS) da Região de Saúde do Extremo Oeste no Estado de Santa Catarina. A pesquisa foi feita no decorrer do mês de fevereiro de 2023, aplicando-se a técnica da entrevista. Os resultados demonstraram prevalência dos casos de violência doméstica na área rural, estando relacionados a desafios que dificultam a denúncia e favorecem a estigmatização do tema, como a localização geográfica que interfere no acesso das mulheres aos centros de suporte. Sugere-se ampliar a qualificação dos ACS para que possam identificar casos e/ou suspeitas de violência doméstica, remetendo a equipe de profissionais da Atenção Primária para a ampliação da assistência destinada as mulheres. Frente ao cenário, entende-se a importância do trabalho do ACS como ator importante para a diminuição dos casos, fazendo-se necessário pensar em políticas e programas que visam desenvolver ações especificas para as mulheres do meio rural.
Parâmetros cinéticos e elétricos observados em bicicletas modificadas
Authors: Borges Heloiza Santos , Nunes Lucas Mateus Coelho , Do Nascimento Leonardo Silva , Amazonas Jarlesson Gama
Published: September 2023

A energia elétrica tem grande representatividade no desenvolvimento de uma sociedade de modo que compreender os seus conceitos é de suma importância. Nesse sentido, uma bicicleta conectada a um dínamo se apresenta como uma ferramenta em potencial para gerar energia em pequena escala, mas o suficiente para manter um sistema de iluminação, por exemplo. A geração de energia através da bicicleta pode ainda ser utilizada no ensino de física, uma vez que aborda conceitos como tipos de energia, tensão, corrente elétrica, indução eletromagnética e transformação de energia. Este trabalho apresenta a conversão de energia mecânica em elétrica por meio de bicicletas adaptadas mensurando os dados mecânicos através do software Tracker e elétricos por meio da plataforma arduino. Para estimar a geração de energia elétrica produzida através da bicicleta, adaptou-se duas bicicletas, possibilitando estabilidade para facilitar a aquisição de dados. Em uma utilizou-se um gerador (dínamo) de 24 V DC 120 W vinculado à bicicleta. Na segunda bicicleta, possuiu  um gerador de energia de 90 V CC 775 W Os. dados de tensão, corrente, potência elétrica e velocidade foram realizados via plataforma Arduino (Sensor de tensão DC 25 V, Sensor de corrente ACS712 5A e Sensor de velocidade LM393)  e software Tracker (velocidade por videoanalise). Na bicicleta 1 nota-se que o valor da potência aumenta linearmente com a velocidade, alcançando seu valor máximo de 1,39 W quando a velocidade atinge 3,79 m/s pelo sensor de velocidade, enquanto pela videoanálise da velocidade pelo Tracker o valor máximo atingido é 4,16 m/s para produzir 1,39 W. .Em relação a transferência  de energia para uma  bateria e alimentação do inversor, é necessário manter uma velocidade maior ou igual a 3,79 m/s medido pelo sensor de velocidade e 4,16 pelo Tracker para ligar uma lâmpada fluorescente de 127 V. Na  bicicleta 2, alcançou seu valor máximo de 2,30 W quando a velocidade atinge 4,15 m/s pela videoanálise da velocidade pelo software Tracker, superando assim o valor de potência observada na bicicleta 1 para essa mesma velocidade. Enquanto para acender uma lâmpada fluorescente de 127 V é necessário manter uma velocidade maior ou igual a 2,79 m/s. Para funcionamento da entrada USB (5V) é preciso estar pedalando em uma velocidade de no mínimo 1,70 m/s. Finalmente, pode-se afirmar que a plataforma arduini e o software tracker são instrumentos confiáveis para mensuração de grandezas físicas mecânicas e que também pode ser utilizado ensino de física, facilitando o entendimento dos conceitos estudados. Ainda, comprovou-se que através do consumo de energia mecânica ou esforço físico empregado no pedal de uma bicicleta adaptada é possível produzir energia elétrica limpa e sustentável.
Diagnóstico dos incêndios florestais nas unidades de conservação estaduais de São Paulo nos anos de 2014 e 2015: ferramenta para redução de riscos de desastres
Authors: Santana Sergio Murilo D'Arruiz , Christofoletti Sergio Ricardo , Ruffino Paulo Henrique Peira
Published: September 2023

A Declaração de Sendai, firmada na 3ª Conferência Mundial sobre Redução do Risco de Desastres, prioriza a adoção e a implementação de planos locais de redução de riscos de desastres, a fim de prevenir o surgimento de novos riscos e minimizar os riscos existentes, fortalecendo a resiliência econômica, social e ambiental. Os incêndios florestais causam numerosos danos à biodiversidade e à sociedade, pois resultam em perdas ambientais, econômicas, afeta vidas humanas e contribui para o efeito estufa.   Este trabalho teve como objetivo avaliar as ocorrências de incêndios florestais em Unidades de Conservação Estaduais (UC) no Estado de São Paulo nos anos de 2014 e 2015 e fornecer subsídios para redução desses eventos. Os resultados mostram que no período ocorreram 135 incêndios florestais em UC, atingindo 4.138 hectares de vegetação. Os meses de agosto a outubro concentraram o maior número de eventos.  A causa “desconhecida” foi apontada em 50% das ocorrências.
Seleção de aplicações em renda variável por meio de programação linear multiobjetivo usando Garch univariado para o Valor em Risco (VaR)
Authors: Maluf Luiz Augusto Finger França
Published: September 2023

Aplicações financeiras no mercado de ações tem um componente de risco muitas vezes mal dimensionado por uma grande parte dos pequenos investidores individuais. O presente trabalho apresenta uma proposta de adaptação simples de um modelo Mean-VaR inicialmente proposto por Benati e Rizzi [2007], adaptado de modo a considerar a volatilidade condicional dos ativos a partir de estimativas de modelos GARCH univariados e então formulado como um problema de programação linear (PPL) multiobjetivo para a seleção de ações negociadas na B3. Apesar de que no modelo proposto neste trabalho cada escolha eficiente de Pareto ficar limitada a um único ativo, dado que não considera as covariâncias entre seus os retornos, apresenta a vantagem de considerar modelos para o VaR que são adequados em termos de aderência e independência das violações, ao contrário dos modelos que utilizam volatilidade incondicional como medida de risco da carteira.
O uso de secadores solares no combate ao desperdício de alimentos
Authors: Oliveira Marcos José Ribeiro , De Lima Júnior Claudemiro , Costa Nancy Lima
Published: September 2023

O processo de secagem é uma técnica utilizada na conservação de alimentos. Esta técnica pode ocorrer de forma natural ou artificial. Neste último caso, a secagem pode ser feita por meio de secadores solares de construção simples e baixo custo que utilizam energia solar térmica como principal fonte de energia. O objetivo deste trabalho foi investigar, por meio de uma revisão de literatura, como as características dos diferentes tipos de secadores solares utilizados na redução do desperdício podem influenciar no tempo de secagem dos alimentos processados. Os artigos selecionados nesta pesquisa foram extraídos das bases de dados Scopus, ScienceDirect e Web of Science. Foram utilizados como parâmetros as palavras chaves "solar dryer", "drying time", "food" e "waste", limitadas ao período de 2013 a 2023. Foram encontrados um total de 270 artigos, 9 na base Scopus, 258 na ScienceDirect e 3 na Web of Science. Os artigos duplicados e em desacordo com os critérios de inclusão foram excluídos. Após a leitura dos títulos e resumos, 40 trabalhos foram escolhidos para serem analisados e aplicados nesta revisão, mostrando que, a depender de como o secador solar é construído e do tipo de material utilizado, o processo de secagem pode levar mais ou menos tempo. Os secadores solares indiretos e/ou com algum tipo de armazenamento de calor auxiliar se mostraram mais eficientes, contribuindo para um produto desidratado com maior qualidade. Além disso, todos os equipamentos encontrados na literatura analisada ajudaram na redução do desperdício de alimentos.
Точка равновесия и фазовый портрет модели течения тиксотропных сред, учитывающей эволюцию структуры
Authors: Хохлов Андрей Владимирович , Khokhlov Andrew Vladimirovich
Published: September 2023

Продолжено системное аналитическое исследование математических свойств предложенной ранее автором нелинейной модели сдвигового течения тиксотропных вязкоупругопластических сред, учитывающей взаимовлияние процессов деформирования и эволюции структуры. При произвольных шести материальных параметрах и (возрастающей) материальной функции, управляющих моделью, аналитически изучен фазовый портрет нелинейной системы двух дифференциальных уравнений для безразмерных напряжения и степени сшитости, к которой сведена модель, в окрестности единственного положения равновесия системы. Доказано, что положение равновесия всегда устойчиво и возможны только три случая: положение равновесия - устойчивый узел, или вырожденный узел, или устойчивый фокус. Найдены критерии реализации каждого из случаев в виде явных ограничений на скорость сдвига, материальную функцию и материальные параметры модели.
О моментах ветвящегося блуждания в случайной среде с гумбелевским потенциалом
Authors: Куценко Владимир Александрович , Kutsenko Vladimir Aleksandrovich
Published: September 2023

Рассматривается ветвящееся случайное блуждание по многомерной решетке в случайной среде с непрерывным временем. В основе процесса лежит простое симметричное случайное блуждание. Случайная среда в каждой точке решетки определяется неотрицательными, независимыми и одинаково распределенными случайными интенсивностями деления и гибели частиц. Предполагается, что разность интенсивностей деления и гибели частиц имеет асимптотически гумбелевское распределение. Получены результаты о предельном поведении моментов, усредненных по среде.