bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the impact of COVID-19 on maritime supply chain sustainability and technology: a review
Authors: Keshta Jilan , Elmesmary Hebatallah , Obrecht Matevz
Published: December 2020

Despite the increasing interest toward sustainability issues in supply chain over the academic and practitioners' perspectives, a comprehensive and updated assessment of the existing literature is still negotiated. Epidemic outbreaks are a unique case of supply chain (SC) risks which is particularly characterized by using a long-time period interruption lifestyle, and extreme uncertainty. As international transport stands at the front of trade and is mainly dependent on travel and human interaction, the shipping industry has been affected substantially from the epidemic of COVID-19 directly and indirectly. This paper represents a review that aims to investigate the impact of COVID-19 on the sustainability of maritime supply chains in general and also in selected geographical areas in terms of the regulations and restrictions imposed by specific organizations in some countries as well as the effect on the supply chain sustainability. In addition, the paper highlights the recent technologies that are currently applied in maritime supply chains and how they can be employed as proposed solutions to facilitate the supply chain flow, overcome the negative effect caused by the COVID-19, and provide further managerial insights to cope with this situation in the most efficient and effective way.
Innovative ecological processes with recovery of chemicals and water for reuse in leather sector - an economical and sustainable approach
Authors: Rajamani Sengoda Gounder
Published: December 2020

The effluent discharged from conventional process in textile dyeing and tanneries are unable to meet some of the discharge parameters such as Total Dissolved Solids (TDS) in the existing physiochemical & biological treatment units. In addition to TDS management the control of volatile solids in hazardous category sludge is also becoming a necessity. To overcome these challenges faced by tanneries in the world leather, improved cleaner production, segregation of saline soak liquor and separate treatment, modified chrome recovery system and recovery of chromium & sodium chloride salt in the form of powder and quality water with TDS less than 500mg/l for reuse by tanneries have been developed for field application. Physiochemical treatment is converted into total biological treatment with sulphide oxidation using enzyme and biomass which resulted in 50% reduction in sludge generation. The secondary treated effluent and supernatant from chrome recovery system are processed with membrane units for recovery of high saline stream and quality salt for reuse in pickling process and other industrial requirement. These developments are being implemented at field level for cluster of nearly 400 tanneries in India which is first of its kind in the world.
Application of the "SIX SIGMA" method for the analysis of the improvement of the environmental air quality parameters at the municipality of Bucharest, by monitoring the pollutances of NOX pollutants
Authors: Durbaca Ion , Sporea Nicoleta , Farcas-Flamaropol Dana-Claudia , Surdu Elena
Published: December 2020

This paper analyzes the improvement of ambient air quality indicators by monitoring the NOx concentration in one of the most polluted areas of Bucharest, using the statistical method "SIX SIGMA" (6σ). By applying the methodology of this statistical approach, the aim is to reduce non-conformities within the specified limits (according to the standards and legislative norms in force) and respectively, to ensure maximum efficiency (99,99%), equivalent to a yield of 3.4 defects per million opportunities (DPMO). As high concentrations of air pollutants have a major impact on human health, the most harmful effect has been found to be caused by nitrogen dioxide (NO2), mainly from ground-level ozone. Using the "6σ" method, the optimal solutions for eliminating non-conformities and implicitly for reducing the NO2 concentration and ensuring the improvement of the ambient air quality can be identified.
Factors affecting startups survival in the MENA region in the presence of COVID19
Authors: Gohar Nermin , Hanna Hany , Haroun Mai H.
Published: December 2020

A great percentage of the world economy is driven by entrepreneurs, start-ups and Small - and Medium - sized Enterprises (SMEs), as they are the driving forces of economic stability. This paper attempts to gain a full understanding of the environment in which entrepreneurs and SMEs operate; the so-called entrepreneurial ecosystem in MENA region to gather and collect information related to the needs examination on promoting entrepreneurial important criteria with the focus on Specific Region. The methodology proposed follows a qualitative approach using semi-structured interviews directed to owners and managers of startups in the MENA region. The process will be to observe, analyze, visualize the entrepreneurial ecosystem, including surrounding criteria’s and factors that effects the startup survival. The proposed ecosystem is then ‘mapped’ to enable to see the gaps and constrains in the ecosystem in the MENA region, and to devise the most relevant measures to energize the ecosystem in MENA region. The proposed methodology and conceptual frame work not only will look at traditional indicators as business environment and investment climate, but also focus on creating optimal ecosystem that is well structured and ready for any unexpected events or occasions, like COVID19, which might have its impact on startups.
Research on consumer portraits of offline fast fashion shoe stores based on IoT smart hardware
Authors: Hou Keyu , Li Shunxun , Li Jingjing , Xu Wei , Wang Rui , Zhou Jin
Published: December 2020

There is a close relationship between consumer’s portrait and product’s attributes. Consumer portraits are usually obtained from information provided by consumers or by using data analysis of computer vision technology when they were in store. However, there was few concerns on the product’s attribute which was a critical factor affecting consumer portrait establishment. Therefore, the purpose of this study was to establish IoT based product attributes’ data collection system then to use this system to portrait consumers behaviors. Firstly, we used our own developed smart hardware to collect consumers' attention data on products of fast fashion shoe stores. Then the product attention index was obtained by combining sales data, and the quantitative attributes of the products with the highest attention index were analyzed, including the age, style and price. At last, improved the TOFA model to make it suitable for the conversion analysis of product attributes to consumer portraits. The results showed that there were core hedonic middle-aged consumer groups and potential thrifty youth consumer groups in the store, and the styles of shoes tend to be fashionable and casual. The conclusion was that the new model can effectively analyze the core consumer portraits of shoe stores and provide strategies for shoe store positioning and supply.
Development and characterization of biodegradable polymeric composites based on butadiene-co-acrylonitrile rubber and functionalized postconsumer wood waste
Authors: Alexandrescu Laurentia , Georgescu Mihai , Sonmez Maria , Nituica Mihaela , Stelescu Maria Daniela
Published: December 2020

In a circular economy, the value of products and materials is maintained as much as possible; waste and resource use are kept to a minimum, and resources do not leave the economic flow once they reach the end of their life, but are reused and create further value. The paper presents the obtaining and characterization of a composite based on butadiene-co-acrylonitrile rubber - continuous phase, where are added post-consumer recycled wood particles, with dimensions of 500 nm - discontinuous phase, and ingredients, such as: active fillers, plasticizers, vulcanizing agents, antioxidants. Wood waste acts as a filling material which leads to the biodegradability of the composite and the decrease in density. The small size of the waste particles and their functionalization with potassium oleate leads to the formation of bonds between the matrix and the particles so that the physical-mechanical characteristics of the composite correspond to the requirements of the products obtained from it.
Efficient poultry industry waste management approach in the bioeconomy framework
Authors: Lazaroiu Gheorghe , Grigoriu Rodica-Manuela , Ciupageanu Dana-Alexandra , Simion Iulia
Published: December 2020

In order to ensure EU’s transition to a climate-neutral energy environment, in accordance with the Paris Agreement, enhanced energy efficiency of waste utilization emerges as an important tool to achieve carbon neutrality goals. Several technologies for renewable waste treatment are investigated lately, researches worldwide focusing on exploiting their energy potential and diminishing the environmental impact. It is remarkable that, solid renewable waste is suitable to supply in particular grate or layer combustion plants. This energy valorization solution reached the technical maturity, experimentally and numerically proven. Further, to support regional development incentives implementation, local utilization of different wastes is strongly encouraged. Considering the fairly uniform territorial spread of poultry farms in Romania, this paper presents a case study aiming to provide a sustainable solution for bird waste management and local energy recovery from it, avoiding significant additional costs, as well as storage and transportation issues. The energy independence level is assessed in two scenarios. To this regard, the energy consumption of a real poultry production hall of 910 m2 (located in Giurgiu County, having 4650 birds/operating cycle, with a poultry waste flow of 558 𝑘𝑔waste ⁄day) is taken into account. The first scenario analyzes the disposal (for energy recovery purposes) of poultry waste as an individual raw material, while the second scenario investigates a mixture of poultry waste and agricultural biomass residues. It is demonstrated that the electricity and heating requirements of the hall can be partially satisfied in the first scenario and fully in the second one. Therefore, the multi-waste management concept investigated in this paper represents a sustainable solution to reduce industry’s carbon footprint, answering multiple requirements in the environmentally friendly energy sector development.
Biodegradable polymeric composite based on EPDM rubber and functionalized elastomeric waste
Authors: Nituica Mihaela , Alexandrescu Laurentia , Georgescu Mihai , Sonmez Maria , Stelescu Maria Daniela , Gurau Dana , Curutiu Carmen , Stoleriu Stefania
Published: December 2020

Elastomeric and plastic materials are used in different sectors of the European Union, and their recycling and reuse is still at a low level, compared to other types of waste (paper, glass, etc.). By approaching an efficient global strategy related to waste management, it is possible to make the transition to a circular economy with low CO2 emissions, offering the population a cleaner and safer environment. Due to the transformation of waste by various methods into new value-added products, we can say that their life cycle contributes to the efficiency of the economy and to the reduction of the negative impact on the environment. Research can make a difference in preventing the generation of technological and post-consumer polymeric waste by making biodegradable polymer composites that are harmless to the environment and ecosystem. The biodegradable polymer composites based on EPDM elastomer and rubber waste (rubber powder) were made on equipment specific to elastomers and characterized rheologically and physically-mechanically according to the standards in force.
Development and characterization of biodegradable compound based on EPDM and wood waste
Authors: Nituica Mihaela , Alexandrescu Laurentia , Georgescu Mihai , Sonmez Maria , Stelescu Maria Daniela , Gurau Dana , Curutiu Carmen , Stoleriu Stefania
Published: December 2020

In the European Union, the potential for recycling technological and post-consumer polymeric waste is untapped. Their recycling and reuse are very low, compared to other types of waste such as glass, paper, etc., and the rates of storage, even of incineration, is very high in terms of percentage. Therefore, by reusing them, but also making use of new advanced technologies, we can contribute to improving the quality of products, and to environmental protection by recycling waste, protecting human health by eliminating toxins during their incineration, but also increasing turnover for global economic agents. Thus, this paper presents the obtaining and characterization of an antibacterial compound based on EPDM elastomer and wood waste (sawdust). The antibacterial compound is characterized from a physical-mechanical and structural point of view (FT-IR), all according to standards in force.
Comparative life cycle assessment study for fabric based electromagnetic shielding
Authors: Radulescu Ion Razvan , Visileanu Emilia , Scarlat Razvan , Constantin Catalin , Mitu Bogdana
Published: December 2020

Life Cycle Assessment (LCA) studies represent the scientific approach for elaborating modern policies and supporting management decisions in the field of Sustainable Production and Consumption. The goal of many LCA studies undertaken for research are related to an exhaustive comparison of a modern, innovative product or process with respect to an initial, conventional one. This paper deals with such an approach for fabric based electromagnetic shielding. Electrically conductive textile fabrics are used in applications of electromagnetic shielding. Two basic types of technology for imparting electro- conductive properties to textiles are available, namely: insertion of conductive yarns in the fabric structure and coating with conductive layers. Magnetron plasma coating is a modern technology for achieving thin metallic layers on fabrics. Therefore, we focused the LCA study to the comparison between cotton woven fabrics with inserted conductive yarns out of stainless steel in warp and weft direction and cotton fabrics coated with thin layers of copper by magnetron plasma laboratory equipment. Functional unit of the comparative study was one square meter of EM textile shield with 5.2 dB at 1 GHz. A modelling of the fabric with inserted conductive yarns was performed in order to reach same shielding effectiveness at a certain frequency, as in the case of the coated fabric. Inventory data was collected for the fabric with conductive yarns from the textile company SC Majutex SRL, while for the plasma coated fabric from INFLPR. Impact assessment was performed by INCDTP, by using the LCA software SimaPro7 and the data basis EcoInvent 3.0. Interpretation of results shows that weaving of conductive yarns has a smaller impact on the environment than magnetron plasma coating using laboratory equipment, in a ratio of 1:2. This fact is explained by the industrial process of weaving as compared to laboratory process of coating, whereas brings the idea that upon utilization of industrial magnetron equipment for coating one may achieve in the end better environmental impact due to the process optimization for large area plasma processing.
Sustainable products in the leather industry
Authors: Ballus Olga , Bacardit Anna
Published: December 2020

Protecting the environment is one of the three objectives of sustainability. One way to achieve this is to preserve natural resources by using renewable or residual raw materials. These products have a shorter lifespan and a lower carbon footprint, are highly biodegradable, and are therefore considered to be sustainable products. In this paper, three retanning agents and two oils classified as sustainable products were studied. First, biobased carbon content (an indicator of renewable raw material content) was determined. Then, the physical and organoleptic properties of the leathers treated with each product (degree of softness, firmness and fullness) were evaluated. The COD of residual baths was also determined in oils. The products presented in this paper meet the sustainability requirements, i.e., high renewable raw material content, short lifespan, and low carbon footprint. In addition, these products show high fixation and therefore have a low COD in residual baths, thus also contributing to their sustainability.
Smart biopolymers from protein wastes used in agriculture
Authors: Constantinescu Rodica Roxana , Zainescu Gabriel , Caniola Iulia
Published: December 2020

The area of interest is the synthesis and study of properties of new types of hydrogels made from pelt waste, in order to recover waste from tanneries. The complex aspects related to protein projects in the leather industry are addressed by accurately determining a chemical composition, a skin designer and a different possibility of recovery and claiming a value, the use of biotechnology. The complex aspects related to protein waste in the leather industry are addressed by accurately determining the chemical composition of leather waste and the different possibilities of recovery and recycling using biotechnology. The technologies used in order to obtain a smart hydrogel based on collagen and natural polymers are non-polluting and waste-free. An important aspect to note is that the smart hydrogel is obtained through an almost identical technological process to the one used for medical collagen. An extensive study of the potential for reuse and recycling of leather protein waste in ecological conditions by developing innovative procedures for obtaining an NPK collagen matrix to be used successfully as smart fertilizer for modifying nutrient-poor soils. Hydrogels with collagen structure are characterized by a high-performance instrumental analysis system (FT-IR-ATR, SEM, EDAX, etc.).
Design thinking in product development - case study: leather library
Authors: Pop Marlena
Published: December 2020

Called "design thinking", this human-centered method is the most advanced way to meet the requirements of clients or target groups. In the elaboration of the Leather Library, this method was experimented and verified, proving its efficiency in the development of creativity, problem solving and accountability of designers.
Micro DSC and NMR MOUSE studies of collagen–vegetable tannin interaction mechanism during leather making
Authors: Sendrea Claudiu , Micu Maria-Cristina , Hadimbu Emanuel , Paunescu Simona Maria , Caniola Iulia Maria , Ignat Madalina , Miu Lucretia , Badea Elena
Published: December 2020

In this study NMR MOUSE and micro DSC techniques were used to investigate the interaction between collagen and various vegetable tannins during leather making process with the aim of gaining a deeper understanding of different water environment in relation to tannin type. We have previously showed that relaxation times may provide useful information on collagen matrix properties. The vegetable tanned leathers were obtained by patented techniques inspired from ancient recipes at the National R&D Institute for Textile and Leather, ICPI Division, Bucharest using various vegetable extracts such as myrobalan, gambier and chestnut. Longitudinal and transversal relaxation times T1 and T2eff were measured using a PM2 portable NMR-MOUSE with 20.05 MHz frequency. Micro DSC measurements were carried out with a high-sensitivity SETARAM Micro-DSC III in the temperature range (5 to 95) °C at 0.5 K min-1 heating rate. The investigated leathers showed significant differences in the values of spin-spin (T2eff) and spin-lattice (T1) relaxation times depending on tannin type that well corelates with the variation of the calorimetric parameters (denaturation temperature and enthalpy, peak shape). These results highlight the complementarity of the information obtained by the two techniques and open new ways for both designing new leather assortments and analyses of historical and archaeological leather.
The influence of TiO2 and N-TiO2 nanopowders in natural leather finishing for heritage or modern binding
Authors: Ignat Madalina , Miu Lucretia , Hadimbu Emanuel , Sendrea Claudiu , Micu Maria-Cristina , Paunescu Simona Maria , Caniola Iulia Maria , Badea Elena
Published: December 2020

The methods for processing raw hides over time, have been numerous: smoke, fat, fermented milk, egg, volcanic soils, plants (shells, fruits, leaves) and so on. The books binding with leather has its origins in the Orient and are known various types of goatskin and calfskin, tanned with sumac finished marbled (sapphire), in black (Moroccan), by floating and dyeing in various colors (Cordoba leathers). Preoccupations regarding the assurance of optimal characteristics for the binding leathers, respectively the durability of the leathers for the restoration of the patrimony objects or of the modern binding were of the most topicality in the last decades, abroad and also in our country. The paper describes the finishing of vegetable and alum tanned leather samples that have been functionalized with titanium dioxide (TiO2) or nitrogen-doped titanium dioxide (N-TiO2) nanopowders, in different concentrations. To simulate soiling in real conditions, four types of soiling agents were applied: tea, coffee, beetroot extract and pen paste. The samples were exposed to irradiation in a photoreactor with various light sources for up to 192 hours. The evaluation of the photocatalytic degradation was performed by the CIELab technique.
Product development of the leather good using Walton's matrix
Authors: Iovan Dragomir Alina , Luca Alexandra
Published: December 2020

One of the most popular activities included in creative industries in Romania is leather goods craft. Nowadays the consumer needs are very high that’s why the companies are facing many challenges and will resist on the market only those who will be the first to launch a certain product or surprise the market. In this paper was used Walton's matrix in order to identify a product that will provide a high profit and is useful for developing production strategies and the long-term development plan of the company's portfolio. This method was applied on a leather good product for women, made from leather. The opinions of the customers about the product, as well as the problems identified by them are very important for the development team in order to obtain new improved products. Modular matrix helps to obtain a technological design model from the design phase. The main advantage of the matrix is the fact that the development is focused on the module without having an impact on the relationships with the other parts. The modular matrix was developed using DSMMatrix program.
Aspects regarding the effectiveness of volatile oils of the Tanacetum vulgare kind in the conservation of heritage objects
Authors: Miu Lucretia , Constantinescu Rodica Roxana , Kaya Alpaslan Durmus , Hadimbu Emanuel , Sendrea Claudiu , Micu Maria-Cristina , Paunescu Simona Maria , Caniola Iulia Maria , Badea Elena
Published: December 2020

The paper refers to a composition with antifungal and antibacterial effect in order to test new materials for preserving heritage objects on collagen support with bactericidal/antifungal role, essential oils-based from Vetrice (Tanacetum vulgare, Compositae family), having antifungal and antibacterial properties. The biocidal effect of plant extracts is due to the presence of constituent agents, such as alcohols, ethers, phenols, aldehydes, ketones, which makes them extremely effective against a wide range of microbial strains. The essential oil was obtained by boiling the plants through continuous hydrodistillation with Clevenger refrigerant. The testing of the antimicrobial efficiency of the plant extracts was performed on two strains of pathogenic fungi, respectively Trichophyton interdigitale and Epidermophyton floccosum. The microbial inoculum was mixed with the plant extract from various sources (leaves, flowers and mixed flower-leaves). All extracts were tested in duplicate according to the specific test standards, and the results were expressed as a mean percentage and logarithmic reduction between the readings on the two Petri plates corresponding to each sample. To quantify the antimicrobial efficacy, the degree of microbial and logarithmic reduction of each sample was calculated, relative to the initial cell concentration. The results of antimicrobial tests showed a high antifungal character of the extracts obtained from flowers, leaves and mixed flower-leaves.
Chemical and physico-mechanical characterizations of leather for restoration
Authors: Miu Lucretia , Paunescu Simona-Maria , Micu Maria-Cristina , Caniola Iulia-Maria , Ignat Madalina , Sendrea Claudiu , Badea Elena
Published: December 2020

Leather is a complex material mostly consisting of a matrix of collagen, chemically stabilized by various tannins. This matrix, sooner or later undergoes alterations as a consequence of interactions between their structure and environment. A comprehensive study based on multiple chemical and physico-mechanical standard tests regarding leather samples which were artificially aged from 7 to 112 days has been made at 70°C. The behavior in artificial aging of calf leather samples tanned at pilot level with two different vegetal tannins, mimosa and quebracho, were investigated due to its’s similarity to the natural degradation of historical leather samples. Physico-mechanical characteristics of historical leather can be corelated with the high impact of degree of deterioration even though there are no standard regulations. To be able to choose the proper way to achieve compatibility with an appropriate material in the restoration-conservation process, multiple sample characteristic must be known. The condition of historical leather can be assessed by a series of simple visual and physical examinations which determine the flexibility, strength and coherency of the fibers and then correlate these assessments with the condition of leather as determined by various chemical and physical-chemical analyses. Therefore, the following chemical standard tests were made: volatile substances, shrinkage temperature, extractable substances, total soluble substances and the following physico-mechanical tests: tensile strength, elongation at breaking and tear resistance.
Design and manufacture of products with Romanian cultural identity
Authors: Pantazi-Bajenaru Mirela , Foiasi Traian
Published: December 2020

In the current context, research on cultural identity unfolds as an uninterrupted process of modeling and remodeling, constituting the link between past, present and future. The issue of cultural identity has become an increasingly important topic in recent years, especially in the European context, due to the need to legitimize European cultural identity as a link between European citizens and as a unifying principle of different cultural heritage. The current processes of social and economic globalization provide major challenges on the world market of consumer-oriented production sectors. The increase of competition in the market, as well as consumers' exigency, calls for the manufacture of innovative products in the field of footwear as well. Thus, the approached topic appeared as a necessity to make footwear products with innovative design, in order to sustainably develop the competitiveness of companies through the strategic development of footwear production. The research that is the object of this article consists in the creative reinterpretation of footwear, creating a new product concept with Romanian cultural identity. The aim is, on the one hand, to identify and analyze the product concept and, on the other hand, to develop the product with the help of creative industries, highlighting cultural identity.
ANEMIA DAN DEFISIENSI BESI PADA SISWA SLTP NEGERI I CURUG, TANGERANG
Authors: Henrika Fify , Silangit T. , Wirawan Riadi
Published: December 2020

A research was conducted to 69 female students from a junior high school (SLtP) Negeri I Curug, tangerang aged 12–14 yearsto obtain percentages of anemia and iron deficiency in female adolescents. Anemia was found on 10.2% of the students, with 4.3%of normocytic normochromic anemia and 5.8% of microcytic hypochromic anemia. Microcytic hypochromic erythrocytes was foundon 21.7% of the subjects which consist of 2.9% iron deficiency anemia, 1.4% phase 2 iron deficiency (latent) with possibility ofhemoglobinopathy, and 2.9% phase 1 iron deficiency (pre-latent) with possibility of hemoglobinopathy. Anemia without iron deficiencywith possibility of chronic diseases and/or hemoglobinopathy was 2.9%, and without anemia nor iron deficiency but with possibility ofhemoglobinopathy was 11.6%. Iron deficiency was found among 26.1% of subjects which consist of 11.6% pre-latent iron deficiency,8.7% latent iron deficiency, and 5.8% iron deficiency anemia with 2.9% and 2.9% were normocytic normochromic anemia andmicrocytic hypochromic anemia, respectively.
GLUCOSE LEVEL ANALYSIS ON STORED PACKED RED CELLS
Authors: Wongsari Melissa Heidy , Muhiddin Rachmawati , Arif Mansyur
Published: December 2020

The main source of energy for red cell metabolism is glucose via glycolytic pathway. Red cells metabolism slows down during storage at 2–6OC. Biochemical changes during storage are called storage lesions, i.e. decreased pH, glucose, and ATP, lactic acid accumulation, and loss of red cells function. Samples taken from the tip of PRC bags in CPDA-1 of the same code are divided into four sections, and stored in the blood bank refrigerator at 2–6OC. Glucose level is measured using ABX Pentra 400 (Horiba, Japan) on storage day 3 as a control, day 7, day 14, and day 21. Glucose levels during storage decreased significantly between day 3, and day 7 (p < 0.001), between day 7, and day 14 (p < 0.001), and between day 14, and 21 (p < 0.001). Glucose levels of Packed Red Cells (PRC) decrease during storage. Glycolysis occurs during storage although metabolism slows down.
TOTAL CHOLESTEROL ANALYSIS FOR DIFFERENTIATING EXUDATES AND TRANSUDATES IN PLEURAL FLUIDS
Authors: Sutanto Efelina , Kurniawan Liong Boy , Mangarengi Fitriani
Published: December 2020

The aimed of this study is to compare the diagnostic value of pleural fluid total cholesterol and Light's criteria to determine exudate or transudate. The samples used in this cross-sectional study were pleural fluid specimens sent to the Clinical Pathology Laboratory of the Dr.Wahidin Sudirohusodo Hospital Makassar during the period of August-September 2016. Data were grouped according to the type of effusion then statistically analyzed using nonparametric Mann Whitney U-test. The result of this study showed from 55 samples, there were 22 transudates and 33 exudates. The mean total cholesterol levels of exudate is higher than transudate (p=0.006). By using cut-off value of total cholesterol pleural fluid 56 mg/dL, it had sensitivity 72.7%; specificity 78.8%; Positive Predictive Value (PPV) 81.3% and Negative Predictive Value (NPV) 69.6% while Light's criteria had sensitivity 97%; specificity 63.6%; PPV 80% and NPV 93.3%. Pleural fluid total cholesterol level with cut-off 56 mg/dL is proposed to be used for differentiating exudate and transudate because it is easier and more simple to perform than Light's criteria.
DIAGNOSTIC VALUE OF URIC ACID IN PLEURAL EFFUSION
Authors: Hartono Saraswati Wulandari , Sennang Nurhayana , Mangarengi Fitriani
Published: December 2020

Pleural effusion is excessive pleural fluid accumulation in the aimed pleural cavity, are categorized into exudate and transudate. Light's criteria (1972) has become a classic criteria to distinguish pleural effusion types. Other criteria were evaluated such as pleural fluid uric acid. The aimed of this study was to analyze the difference of uric acid level between transudate and exudate and to compare it with Light's criteria. A cross-sectional study was conducted in Clinical Pathology Laboratory of the Dr. Wahidin Sudirohusodo Hospital Makassar in September 2016. Uric acid level of pleural effusion samples was measured by ABX Pentra 400. Statistical analysis used Mann-Whitney U test, significance was indicated if p<0.05. Cut-off, sensitivity and specificity of uric acid used ROC curve. Total subjects were 56 patients, mean age 49.54+13.63 years-old, 31 males (55.4%) and 25 females (44.6%). Most cases were exudative effusion (58.9%) with 19 malignancy cases (33.9%). Uric acid level median was 6.6 mg/dL (3.24-17.50 mg/dL) higher in transudate than exudate 5.01 mg/dL (0.6-9.40 mg/dL) (p=0.001). The cut-off point for pleural fluid uric acid was 5.845 mg/dL, with a sensitivity of 78.3% and specificity of 66.7%. Sensitivity and specificity of Light's criteria was 97% and 60.9%. There was a significant difference between pleural fluid uric acid level in transudate and exudate, higher in transudate than exudate. Light's criteria were higher in sensitivity than uric acid, but lower in specificity. Further research is needed with better sampling method to reduce bias.
Correlation between Plasma Osteopontin and Alkaline Phosphatase in Type 2 Diabetes Mellitus Patients
Authors: Sinambela Josua TH , Pramudianti M.I Diah , Ariningrum Dian
Published: December 2020

Diabetes Mellitus (DM) is a chronic disease caused by pancreas the inability to produce insulin or ineffectively insulin use.Fracture risk in type 2 DM patients increases even though the bone density is normal. This study aimed to examine thecorrelation of osteopontin (OPN) and alkaline phosphatase (ALP) in type 2 DM patients. An observational analytical studywas conducted in 73 type 2 DM patients in Dr. Moewardi Hospital, Surakarta from October to November 2018. The subjectswere examined for blood pressure, fasting blood glucose, two hours postprandial blood glucose, HbA1c, OPN, and ALPlevels. P-value <0.05 was statistically significant with a 95% confidence interval. Poorly controlled type 2 DM had higher OPNlevels than well-controlled (20.5±2.8 vs. 14.8±3.1 ng/mL, p <0.001). The ALP concentration was also higher in poorlycontrolled type 2 DM patients (79.9±31.7 vs. 61.1±25 U/L, p=0.003). The levels of OPN and ALP were significantly correlatedin type 2 diabetes (r=0.273; p=0.020) and in well-controlled patients (r=0.353; p=0.047) but no correlation was found inpoorly controlled type 2 DM patients (r= -0.073; p= 0.652). In this study, a significant correlation was found between OPNand ALP in patients with type 2 DM and well-controlled. Further study involving healthy controls and bone ALPmeasurement is needed.
Thyroid Crisis and Septic Suspected Sepsis in the First Trimester of Pregnancy
Authors: Hidayati Mahmudah , Rachmawati Banundari
Published: December 2020

A normal pregnancy with physiological and hormonal changes can change thyroid function, accordingly, there are difficulties to establish the diagnosis of thyroid abnormality. The prevalence of hyperthyroidism in pregnancy is 0.6%. Approximately 1-2% of hyperthyroidism develops into a thyroid crisis. Knowledge of the diagnosis of the thyroid crisis in a pregnant female is very important to avoid complications. The 22-year-old female of thirteen weeks presented with vomiting, since two days before hospitalized, weakness, and decreased consciousness. During treatment, patients had diarrhea, melena, and was irritable. Physical examination showed blood pressure of 136/112 mmHg, pulse of 110 times/minute, respiration of 24 times/minute, and temperature of 38.3oC. Exophthalmos was found at the patient's eyes, but there was no enlargement of the thyroid and the patient often screamed hysterically. Routine urine examination showed proteinuria 1+, blood 3+, leukocytes 1+ in urinalysis, FT4 35.18 pmol/L and TSH <0.05 uIU/mL, leukocytes 15.2 x103/uL, SGOT 245 U/L, SGPT 366 U/L. The final diagnosis of this patient is a thyroid crisis and suspect sepsis in the first trimester of pregnancy. Thyroid Receptor Antibody (TRAb) examination should be performed to assure Graves disease or hyperthyroidism due to pregnancy (transient hyperthyroidism) as the cause.
The Effects of the Supplementation with Snakehead Fish and Sea Cucumber Extracts on Platelet-Derived Growth Factor in Post-Operative Patients
Authors: Wahono Otniel Wendy , Suparyatmo JB. , Ariningrum Dian
Published: December 2020

Wound healing is a complex process that involves the interaction between Extracellular Matrix (ECM) cells and mediated by cytokines and various growth factors, especially platelet-derived growth factor (PDGF) which plays a role in almost every phase of wound healing. Applying snakehead fish and sea cucumber extract containing amino acids and fatty acids in post-operative patients is expected to increase PDGF levels and enable the acceleration of the wound healing process. This study was a double-blind randomized control trial with a pre and post-treatment approach which involved 34 post-operative patients divided into two groups; the control group (K1) and treatment group (K2) and was carried out from April to June 2019 at Dr. Moewardi Hospital in Surakarta. Independent sample T-test was used for data with normal distribution to determine the mean differences between the control and treatment groups, while the Mann-Whitney test was used for data with the abnormal distribution. Also, to determine the mean difference before and after the treatment of one paired group, a paired T-test was used for data with normal distribution, while the Wilcoxon test was used for data with the abnormal distribution. p < 0.05 was significant with 95% Confidence Intervals (CI). The supplementation of snakehead fish and sea cucumber extract significantly increased PDGF levels in the treatment group (K2) compared to the controls group (K1) (p <0.001). Our findings showed that snakehead fish and sea cucumber extract were able to increase PDGF levels in post-operative patients on the fourth day.
Assessment of Small Dense Low-Density Lipoprotein and Apolipoprotein B/Apolipoprotein A-I Ratio to Predict the Peripheral Arterial Disease in Patients with Hypertension
Authors: Prihutomo Kurniawan , Pramudianti MID. , Kurniati Amiroh
Published: December 2020

Small Dense Low-Density Lipoprotein (sdLDL) and the ApoB/ApoA-I ratio has greater atherogenic potential and is a better marker to predict atherosclerotic blood vessel disease. The purpose of this study was to determine the relationship between the sdLDL and ApoB/ApoA-I ratio to assess the prevalence risk of Peripheral Arterial Disease (PAD) in hypertensive patients. A cross-sectional observational analytic study was performed in 51 hypertension patients with age> 18 years old in Dr. Moewardi Hospital Surakarta from May until June 2018. Patients have measured ABI scores, BMI, blood pressure, lipid profile, ApoB, and ApoA levels. Data were statistically analyzed was using bivariate analysis and multivariate analysis. P-value <0.05 was statistically significant. The prevalence of PAD was 54.90%. Bivariate analysis of age variables (PR: 3.15; 95%Cl: 1.128-8.811; p=0.005), sdLDL (PR: 2; 95%Cl: 0.997-4.013; p=0.03), the ratio of ApoB/ApoA-I (PR: 5.786; 95%Cl: 0.899-37.224; p=0.007), and smoking (PR: 1.896; 95%Cl: 1.210-2.971; p=0.015) was significantly related with PAD. After adjustment of age, smoking, and dyslipidemia variables using multivariate logistic regression analysis, PAD was still related with sdLDL (PR: 10.55; 95%CI: 1.80-61.73; p=0.009), age (PR: 11. 61; 95%CI: 1.83-61.73; p=0.009), and smoking (PR: 11.96; 95%CI: 1.71-83.81; p= 0.013). sdLDL and ApoB/ApoA-I ratio were related to PAD. However, sdLDL, age, and smoking are independent variables of PAD in hypertension patients.
The difference of Reticulocyte Hemoglobin Equivalent Pre- and Post-Ultrafiltration Hemodialysis in Patients with Chronic Kidney Disease
Authors: Hermawathi Ni Made Rindra , Hajat Arifoel , Hernaningsih Yetti , Widodo Widodo
Published: December 2020

Chronic Kidney Disease (CKD) is a condition characterized by kidney damage and a decrease of Glomerular Filtration Rate of less than 60 mL/ min/1.73 m2 in more than three months. Anemia is the most common complication in patients with CKD who regularly undergo hemodialysis. Reticulocyte Hemoglobin Equivalent (Ret-He) is a new parameter that can reflect the storage of iron for erythropoiesis. This study compared the Ret-He level pre and post-hemodialysis and evaluated the effect of ultrafiltration (UF) hemodialysis to Ret-He level in CKD patients. This research was an observational analytical study. Samples were 50 patients with CKD who underwent hemodialysis regularly in Dr. Soetomo Hospital Surabaya by consecutive sampling from August–September 2017. The measurement of the Ret-He level pre ultrafiltration hemodialysis was divided into UF < 2 L and UF â‰¥ 2 L. Both groups showed homogenous results. The group with UF < 2 L increased significantly from pre to post ultrafiltration (p=0.010). The group with UF â‰¥ 2 L was not increased considerably from 30.57±3.62 to 32.69±3.45 (p=0.413). Ret-He level in the group with UF < 2 L was 0.81±1.10, significantly higher than the group with UF  â‰¥ 2 L  0.12±0.83 (p=0.017). The difference of Ret-He level pre and post ultrafiltration was significant in UF < 2 L. There was a significant increase of the Ret-He level in hemodialysis with  UF < 2 L compared to UF â‰¥ 2 L. The measurement of Ret-He should be performed before hemodialysis due to an increase in Ret-He after ultrafiltration hemodialysis.
Laboratory Diagnostic Approach and Interpretation in Gram-Negative Bacterial Infection: A-Case Report of Sepsis in Secondary Hospital Settings
Authors: Sugianli Adhi Kristianto , Parwati Ida
Published: December 2020

Gram-Negative Bacteria (GNB) have been widely reported to cause worldwide infections and life-threatening. The high prevalence of drug-resistant GNB causes the treatment of GNB to become difficult. This case report describes a stepwise laboratory approach and interpretation for Gram-negative bacteria infection in sepsis patients. An 84-year-old female patient with a history of congestive heart failure, after three weeks of hospitalization, GNB was proven as the cause of sepsis. Laboratory approach for inflammation (C-reactive protein, procalcitonin) was made and confirmed with a positive culture of several specimens (sputum, urine, and blood). The identification of bacterial-culture revealed as Carbapenem-resistance Klebsiella pneumoniae and Extended-spectrum Beta-lactamases Escherichia coli. This case highlights GNB as a potential agent to worsen the infection (sepsis) and also a useful approach for the detection of multidrug-resistant bacteria, particularly in secondary hospital settings. The application and interpretation of integrated clinical and laboratory criteria may bring out better and effective patient management.
Hemoglobin, Hematocrit, Leukocyte, and Platelet Changes Due To Ultrafiltrationhemodialysis in Chronic Kidney Disease Patients
Authors: Kartikasari Nathalya Dwi , Notopuro Paulus Budiono , Widodo Widodo , Hernaningsih Yetti
Published: December 2020

Managing anemia in Chronic Kidney Disease (CKD) patients with hemodialysis (HD) is a challenge to physicians. The present consensus does not address the proper time of blood sampling in HD patients, but higher ultrafiltration (UF) volume (a process of removing fluid excess during HD) may alter hematologic parameters. The objective of this study was to compare some parameters of the Complete Blood Count (CBC); hemoglobin (Hb), hematocrit (Hct), leukocyte (WBC), and platelet counts (Plt) before and after HD. This method was a cross-sectional study performed in the HD Unit, Dr.Soetomo Hospital, including 51 CKD patients selected consecutively, divided into two groups based on the UF volume (2 L and >2 L). Complete blood count pre- and post-HD were measured using Sysmex XN 1000. The results were 25 males and 26 females in this study, age ranged from 20 to 74-year-old, and 36 patients with UF volume >2 L. Only HD with UF >2 L showed significant increases for Hb (9.35g/dL to 10.00 g/dL), Hct (29.80% to 31.15 %), and Plt (209.00x103/µL to 213.00x103/µL) but WBC did not change significantly. These changes were believed to be caused by ultrafiltration. The conclusion was Hb, Hct, and Plt increased significantly with UF â‰¥2 L in HD CKD patients.
Diagnostic Value of Determination Blast Cell Population Lineage Using WPC Scattergram Hematology Analyzer
Authors: Ratnasari Nina , Hajat Arifoel , Bintoro S. Ugroseno Yudho
Published: December 2020

The diagnosis of hematology malignancies requires examination that includes morphology, immunophenotyping, and cytogenetics. Immunophenotyping is the most trusted examination in determining hematology malignancies lineage, but it is only available in large hospitals and the costs are relatively expensive, so the determination of lineage depends on bone marrow aspiration examination. Therefore it is necessary to have an easier and more reliable alternative to assist BMA morphology. White Precursor Cell (WPC) scattergram Sysmex XN-1000 has the capability to differentiate malignancy lineage. The purpose of this study was to determine the diagnostic value of determining lineage generated by WPC scattergram compared to the lineage from BMA examination. BMA blood samples were simultaneously examined by BMA morphology interpretation using microscope and WPC scattergram Sysmex XN-1000 examination. The hematology malignancies lineage resulting from BMA and WPC scattergram examination was then analyzed statistically to determine the suitability, sensitivity, and specificity. The results of determining the lineage of blast cell population based on WPC scattergram resulted in a suitability with a sensitivity of 93.75% and specificity of 94.74% for determining the hematological malignancy of myeloid lineage and 94.74% and 93.75% for lymphoid lineage, with a diagnostic accuracy of 94.91%. Based on this study it can be concluded that the WPC scattergram can determine the lineage of hematological malignancies with a suitability and high diagnostic value of lineage based on BMA morphology.
Analysis of Smear Microscopy and Culture Conversion Results in Multidrug-Resistant Tuberculosis Patients with and without Type 2 Diabetes Mellitus
Authors: Fauziah Henny , S Aprianti , I Handayani , NA Kadir
Published: December 2020

The World Health Organization (WHO) recommended microscopic AFB smear examination and culture as follow-ups to the response of MDR TB therapy. Analyzed the results of microscopic AFB smear and culture conversion as well as treatment outcome in Multidrug-Resistant Tuberculosis (MDR-TB) patients with and without Diabetes Mellitus (DM). This is a retrospective study involved 70 MDR-TB patients with (27 patients) with DM and without DM (43 patients) who had microscopic AFB smear and culture results at the start of the follow-up therapy. This research was conducted at Labuang Baji Regional Public Hospital, Makassar, from June to July 2019, used medical records of MDR-TB patients the period of June 2016 to December 2017. The results showed that 52 out of 70 MDR-TB patients had microscopic AFB smear and culture conversion in MDR-TB with DM (21 patients) and without DM (31 patients). The duration of microscopic AFB smear conversion in MDR TB patients with DM (3.33±0.54 months) was longer than patients without DM (2.07±0.05 months), p=0.001. While in culture conversion, there was no significant difference between MDR-TB with DM (1.28±0.64 months) and without DM (1.25±0.59), p=0.648. The recovery outcome between MDR-TB with (48.1%) and without DM (48.8%) was not significantly different. However, the output of treatment failure was greater in DM (11.2%) than without DM (2.3%), although statistically, there was no significant difference (p=0.568). Multidrug-resistant tuberculosis patients with DM experienced slower microscopic AFB smear conversion than MDR-TB patients without DM. However, in culture, there was no significant difference in the conversion period between the two groups. MDR-TB patients, both of with and without DM, had the same chance of recovery.