bluuebunny/crossref_metadata_2025 huggingface dataset:
THE INFLUENCE OF INCOME RATIO ON INDEPENDENCE RATIO DURING COVID-19 AT LANGSA GENERAL HOSPITAL BLU
Authors: Maimun Maimun , Khaddafi Muammar , Naz’aina Naz’aina
Published: September 2023

The Regional Public Service Agency (BLUD) is a regional work unit and has a legal status that is not separate from the regional government. BLUD is formed to provide services to the community in the form of providing goods and services that are sold without prioritizing seeking profit.The population to be studied in this study is the Total Revenue of BLUDs until 2021 (during the COVID-19 pandemic). Annual BLUD income which describes its ability to cover operational expenditures for one year so that the hospital's financial independence can be seen clearly. The sample of this study uses data from the Langsa Hospital BLUD Revenue report for the period January 2019 to June 2021.GPM has a positive and significant effect on financial independence. The positive coefficient means that if the GPM increases, financial independence during the Covid-19 BLU of the Langsa Regional General Hospital will also increase. NPM has a positive and insignificant effect on financial independence. A negative coefficient means that if the NPM increases, financial independence during the Covid-19 BLU of the Langsa Regional General Hospital will decrease, and vice versa. ROI has a positive and significant effect on financial independence, a positive coefficient means that if the ROI increases, financial independence during the Covid-19 BLU of the Langsa Regional General Hospital will also increase. ROE has a negative and insignificant effect on financial independence, a negative coefficient means that if ROE increases, financial independence during Covid-19 BLU Langsa Regional General Hospital will decrease.
Drainage intensity in paddy rice fields : nitrogen flows, salinity, rice yield and greenhouse gas emissions
Authors: Tuyishime Olive
Published: September 2023

Managing drainage intensity is important in controlling soil moisture and nutrient losses and improving crop yields. This thesis evaluated the effects of drainage intensity on nitrogen losses, salinity and rice grain yield in three cropping seasons, and on gaseous emissions of methane (CH4) and nitrous oxide (N2O) from rice flowering to ripening in one season, on a marshland in semiarid region of Rwanda. Three drainage treatments were compared in a randomised complete block design: drainage to 0.6 m depth, weir open four times per week (S4); drainage to 1.2 m depth, weir open four times per week (D4); and drainage to 1.2 m, weir open twice per week (D2). In seasons 1 and 3, treatment D4 had higher drainage outflow and higher salt loads than treatments D2 and S4, but in season 2 treatment D2 had higher drainage outflow and higher salt loads than D4 and S4. Drainage water salinity (ECwd) decreased by around 41-57% from season 1 to season 2, and by 29-37% from season 2 to season 3. Soil salinity decreased by one electrical conductivity (EC) unit (dS m-1) from season 1 to season 2, and by a similar amount from season 2 to season 3. Nitrogen uptake and rice grain yield were significantly greater in the deep drainage treatments (D4, D2) compared with shallow drainage (S4). Deep drainage (D4, D2) reduced CH4 emissions but had no marked effect on N2O emissions. These findings suggest that deep drainage performs better than shallow drainage in semi-arid paddy fields, as it enables a balance between maintaining water in the soil and having sufficient drain outflow to leach salts, reduce CH4 emissions and achieve high rice yield.
Carbon pricing policies in China: Comparative analysis of carbon tax and emission trading systems
Authors: Yang Yan
Published: September 2023

Carbon pricing has gained significant attention as a market-based approach to tackle carbon emissions and mitigate climate change. In the context of China, the world's largest emitter of carbon dioxide, the implementation of effective carbon pricing policies is of paramount importance. This paper conducts a comparative analysis of China's two primary carbon pricing mechanisms: the carbon tax and the emission trading system (ETS). The analysis delves into the design, implementation, and outcomes of both policies, assessing their effectiveness, challenges, and potential for achieving carbon emission reduction targets. By examining case studies, policy documents, and empirical data, this study aims to provide insights into the strengths and weaknesses of each policy approach, offering recommendations for policymakers and stakeholders to optimize China's carbon pricing strategy and contribute to global climate goals.
Development and validation of students’ satisfaction survey in flexible learning
Authors: Cabanilla Jr. Angelito
Published: September 2023

This study aims to develop and validate students’ satisfaction in flexible learning modality. A systematic literature review was conducted to craft the survey instrument. 21-item researcher-made questionnaire was crafted with five factors emerged that may affect students’ satisfaction. Face and content validity were done to test the validity of the instrument. The validated instrument was pilot-tested to 37 participating students in a state university. Results were used to test the Cronbach’s alpha reliability to test the internal consistency of the instrument. It was shown that two items were deleted since it did not pass the content validity ratio. The overall Cronbach’s alpha of the instrument after the deletion of 2 items were found to be 0.966 which indicates that the instruments’ internal consistency is excellent. It is concluded that the instrument is shown to be valid and reliable. Hence, it is recommended that higher education institution to further validate the instrument using a bigger sample size in further studies.
O DIREITO À EDUCAÇÃO E O FINANCIAMENTO DA CIÊNCIA, TECNOLOGIA E INOVAÇÃO EM TEMPOS DE PANDEMIA POR COVID-19
Authors: Viella Milene Cristina da Costa , Silva Juvêncio Borges
Published: September 2023

O objetivo desse artigo é refletir sobre o direito à educação científica (Ciência, Tecnologia & Inovação) enquanto um desdobramento do direito fundamental e social à educação, bem como apontar que as constantes reduções de financiamento de pesquisas científica, além de violações constitucionais, dificultam as possibilidades de saída da crise sanitária causada pelo vírus covid-19. Discutimos, ainda, com base nos aportes teóricos de Barcellos (2008), a possibilidade de controle jurídico e jurisdicional de políticas públicas voltadas à efetivação de direitos fundamentais, tal qual é o caso do direito à educação científica. Para tanto, realizamos uma pesquisa de caráter exploratório, a partir da coleta de dados sobre os cortes de investimentos na educação e, mais especificamente, na Ciência, Tecnologia & Inovação. O método utilizado é hipotético-dedutivo e baseou-se na revisão bibliográfica sobre direito à educação e produção de conhecimento científico no Brasil e durante a pandemia de Covid-19.
Phenotypic and genotypic study of antibiotic-resistant Escherichia coli isolates from a wastewater treatment plant in Zulia state, Venezuela.
Authors: Guerrero Elba , Caraballo Lizeth , Takiff Howard , García Dana , Montiel Marynes
Published: September 2023

Antibiotic-resistance in bacteria is a global health problem, and wastewater treatment plants can play a role in their dissemination. In this work, we used PCR and plasmid transformation to characterize antibiotic-resistance and the phylogenetic groups of Escherichia coli isolated from a treatment plant in Zulia, a state in western Venezuela. Thirty-six bacteria isolates were analyzed, of which 27 resulted resistant by disc diffusion primarily to tetracycline and sulfisoxazole but also to trimethoprim, chloramphenicol, ampicillin, and cip-rofloxacin. The tetA, sul2, floR, and blaTEM resistance genes were frequently present and, in most cases, transferable. dfrA12, tetB, sul3, sul1, and aadA2genes also were detected. The integrase gene intI1 was common in multidrug-resistant isolates. These results suggest that E. coli from the treatment plant is a reservoir of antibiotic-resistance genes, which signify a potential health threat. Additionally, the phylogroup C was predominant, which is unusual and may represent an adaptation of this group to environmental conditions or per-haps the most frequent phylogroup entering from the influent.
Modified High-Intensity Interval Training and its effects on immunometabolic regulation in sedentary young adults with overweight and obesity.
Authors: Rodríguez-López Carmen Paulina , González-Torres María Cristina , Nájera-Medina Oralia
Published: September 2023

Sedentary lifestyles can contribute to obesity and other diseas-es; while chronic low-grade inflammation associated with obesity can lead to metabolic alterations. As physical activity is an alternative to decrease excess weight and its related comorbidities, High-Intensity Interval Training (HIIT) has recently emerged as effective in regulating whole-body metabolism and inflam-matory processes in people with excess weight.The objective was to compare the effects of a modified HIIT program on peripheral blood leukocytes (PBL), metabolic profile, insulin resistance (IR), andbody composition (BC) in sed-entary adults with excess weight. PBL, biochemical variables, IR, and BC were analyzed in 37 participants, 23 sedentary young adults (17 with overweight and six with obesity), before and after eight weeks of a modified HIIT program and compared with those of 14 healthy-weight participants. The results showed that after HIIT, total lymphocytes, TCD3+, and TCD8+ lymphocytes decreased; granulocytes and naïve TCD3+ cells increased in patients. Regarding partial correlations, we found that changes (Δ) in TCD8+ lymphocytes correlated posi-tively with glucose and LDL -c, while naïve TCD3+ cells correlated with total cholesterol and LDL -c. Δ in TCD4+CD45RA+ cells correlated negatively with Δ in subcutaneous fat tissue and body fat mass. This study reports that sedentary young adults who completed the modified HIIT program showed lymphocyte levels similar to those in healthy-weight individuals and positive changes in the study variables. Such changes suggest immunometabolic regulation through the implementation of HIIT in participants with overweight and obesity.
Effect of anakinra, tocilizumab, and the combination thereof on bladder ischemia-reperfusion damage in albino Wistar-type rats.
Authors: Bicer Senol , Suleyman Bahadir , Mammadov Renad , Yavuzer Bulent , Cicek Betul , Altuner Durdu , Coban Taha , Suleyman Halis
Published: September 2023

Several studies have reported that oxidative stress, and proinflam-matory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-one beta (IL -1β), and interleukin-six (IL -6) are the main factors underlying bladder ischemia-reperfusion (I/R) damage. Anakinra and tocilizumab are known to be antioxidants and proinflammatory cytokine inhibitors. Our study aims to investigate if anakinra, tocilizumab, and the combination (ATC) thereof have a protective effect against oxidative and inflammatory bladder damage induced through the I/R procedure in rats, and evaluate by comparing these compounds. Male rats were divided into five groups: bladder sham-operation applied group (SG); bladder only I/R applied group (IRG); anakinra+bladder I/R applied group (AIR); tocilizumab+bladder I/R applied group (TIR); and ATC+bladder I/R applied group (ATIR). An atraumatic clamp was placed on the abdominal aorta of animals in all groups (except SG), and one hour of ischemia followed by two hours of reperfusion was performed. Our biochemical find-ings showed that anakinra and tocilizumab significantly inhibited the increase of oxidant malondialdehyde (MDA) and the decrease of antioxidants such as total glu-tathione (tGSH), superoxide dismutase (SOD), and catalase (CAT) in bladder tissue by I/R, both at the same levels. Furthermore, anakinra and tocilizumab significantly suppressed the I/R-associated increase of TNF-α, IL -1β, and IL -6 in bladder tissue. ATC was the one that best prevented the I/R-related increase in MDA, TNF-α, IL -1β, and IL -6 and the decrease in tGSH, SOD, and CAT in the bladder tissue. ATC was more beneficial than anakinra or tocilizumab alone in treating bladder I/R damage.
ANALISIS WACANA BERITA “KABAR WENGI” DI TATV
Authors: Yuliastuti Kinasih , Indrayanto Bayu
Published: September 2023

Analisis wacana berita “Kabar Wengi” di TATV merupakan kajian di bidang wacana, dengan mengkaji aspek gramatikal dan aspek leksikal. Jenis penelitian yang digunakan ialah deskriptif kualitatif, Data penelitan yang diperlukan dalam penelitian adalah data tulis berupa Wacana Berita “Kabar Wengi” di TATV. Data tulis diperoleh dari sumber tertulis Wacana Berita “Kabar Wengi” di TATV. Sumber data dalam penelitian ini adalah sumber data tulis yang berupa Wacana Berita “Kabar Wengi” di TATV. Pengumpulan data dalam penelitian ini menggunakan metode simak. Adapun teknik dasar yang dipakai adalah teknik sadap, sedangkan teknik lanjutan yang penulis gunakan yaitu teknik catat. Metode yang digunakan dalam menganalisis data adalah metode distribusional. Piranti/alat wacana aspek gramatikal yang ditemukan adalah pengacuan persona, pengacuan demonstratif, penyulihan (substitusi), pelesapan (elipsis), dan perangkaian (konjungsi). Piranti/alat wacana aspek gramatikal yang paling dominan adalah pengacuan persona. Piranti/alat wacana aspek leksikal adalah repetisi (pengulangan), sinonimi (padan kata), antonimi (oposisi makna), kolokasi (sanding kata). Piranti/alat wacana aspek leksikal yang paling dominan adalah kolokasi (sanding kata).
PENINGKATAN KETERAMPILAN MENULIS PUISI SISWA KELAS X IPS 2 SMA N 1 KALASAN DENGAN MEDIA AUDIOVISUAL MUSIKALISASI PUISI
Authors: Arda Sedyoko  , Wirawati Denik , Anggraini Pipit Ristiana
Published: September 2023

Abstrak

Terdapat empat keterampilan berbahasa yang harus dikuasai oleh peserta didik, yakni (1) menyimak, (2) membaca dan memirsa, (3) berbicara dan mempresentasikan, serta (4) menulis. Salah satu permasalahan yang timbul di kelas X IPS 2 SMA N 1 Kalasan adalah peserta didik tidak memiliki kecakapan yang baik dalam hal keterampilan menulis puisi. Maka, tujuan penelitian tindakan kelas ini adalah untuk meningkatkan keterampilan menulis puisi siswa kelas X IPS 2 SMA N 1 Kalasan dengan media audiovisual musikalisasi puisi. Penelitian tindakan kelas ini memiliki empat tahapan tiap siklus, yakni (1) penyusunan rencana, (2) tindakan, (3) observasi, dan (4) refleksi. Kesemua tahapan tersebut dijabarkan dalam 3 siklus pembelajaran, yakni prasiklus, serta siklus 1 dan siklus 2 dengan perlakuan atau tindakan. Berdasarkan data hasil penelitian yang telah dilakukan, dapat disimpulkan bahwa penerapan media pembelajaran audiovisual musikalisasi puisi dapat meningkatkan keterampilan menulis puisi siswa. Hal tersebut dibuktikan dengan sebelum tindakan, persentase siswa yang tuntas pada pembelajaran menulis puisi hanya 21,9 %. Namun, setelah adanya tindakan, pada siklus 1 sebanyak 56,1% siswa tuntas. Terlebih lagi pada siklus 2 sebanyak 84,4 % siswa tuntas dalam pembelajaran menulis puisi.

 

Kata Kunci: menulis puisi, media audiovisual, musikalisasi puisi, keterampilan berbahasa
PEMBELAJARAN SECARA DARING SELAMA PANDEMI COVID-19 (STUDI KASUS DI KELAS VI SDN BARENGLOR 02 KLATEN UTARA, KLATEN)
Authors: Yuliantoro Agus , BUDIYONO SRI , Putut Setiyadi Dwi Bambang , Hersulastuti Hersulastuti , Herawati Nanik
Published: September 2023

Abstrak

Pembelajaran online adalah sesuatu yang baru bagi pendidik dan siswa, serta orang tua. Kebaruan ini menimbulkan permasalahan sekaligus tujuan dari penelitian ini, yaitu 1) untuk mengetahui bagaimana pelaksanaan pembelajaran daring; 2) untuk mengetahui kendala apa saja yang dihadapi oleh peserta pembelajaran. Penelitian ini merupakan penelitian studi kasus, dengan sumber data berupa dokumen/arsip, observasi, dan wawancara. Teknik analisis data berupa analisis interaktif yaitu analisis secara terus menerus, dimulai dari penemuan data, pengumpulan data, reduksi data sampai pada kesimpulan dan verifikasi secara deskriptif. Hasil penelitian menunjukkan bahwa 1) pembelajaran daring melibatkan banyak pihak (beberapa komponen), seperti guru, siswa, orang tua, jaringan internet, perangkat, teknik penyampaian, dan media elektronik yang tersedia; 2) Penyebab belum sempurnanya pembelajaran daring karena a) guru sudah terbiasa dengan pembelajaran luring dan gagap dalam menghadapi pembelajaran daring; b) siswa menggunakan kebebasan belajar yang negatif dan sangat bergantung pada peran orang tua; c) orang tua juga gagap dalam menghadapi teknologi pembelajaran daring dan sangat bergantung pada ekonomi keluarga; d) gangguan listrik dan kekurangan kuota/pulsa menjadi alasan utama tidak dapat mengikuti pembelajaran daring; e) perangkat standar menjadi alasan siswa/orang tua tidak dapat mengikuti pembelajaran daring; f) penerapan metode kuliah luring tidak sesuai untuk pembelajaran daring karena guru tidak dapat mengontrol aktivitas siswa; g) guru belum memiliki kemampuan dalam menggunakan media elektronik dalam pembelajaran menggunakan Google Meet.

Kata kunci: daring, google meet, tautan
Biodegradation of Synthetic Reactive Orange 16 Dye in Anaerobic Reactor Conditions
Authors: Syahmi Mohamad Adib , Ariffin Fazilah
Published: September 2023

Industrial use of azo dyes has been linked to severe environmental damage in the textile and apparel sectors. The breakdown products of many azo dyes are poisonous and mutagenic, posing a threat to human health and the environment. Hence, azo dye wastewater bioremediation is gaining interest. The objective of this study was focused on the biodegradation of an azo dye, Reactive Orange 16 (RO16), in an anaerobic continuous tank reactor operated with digested sludge sample. The digested sludge was used as the organic biodegradation agent for azo dye. The aim was to investigate the fate of the anaerobic RR16 breakdown products during the degradation process. Gas Chromatography-Mass Spectrophotometry (GC-MS) was used to identify RO16 biodegradation metabolites and their corresponding molecular weight. As a result, RO 16 showed about 85.91% decolorization capacity, and the degradation metabolites were detected as pentanoic acid and phenol after seven days of incubation. The degradation mechanism was completed as the azo bond of RO16 was successfully cleaved based on the result of GC-MS, and the proposed pathway of the degradation mechanism is described. The digested palm oil sludge with dye degradation enzymes may provide new avenues for biological waste treatment, especially wastewater bioremediation.
INFOPRODUTOS NO MERCADO DE COACHING: UMA ANÁLISE DA MARCA NATALI CHAPLIN
Authors: Carneiro Jéssica Alana , Kieling Ana Paula , Hoffmann Estela Maria
Published: September 2023

Atualmente, a utilização das redes sociais como forma de impulsionar os resultados das empresas vem crescendo. Nesse contexto, a oferta de infoprodutos no Brasil está em evidência. Este artigo tem como objetivo principal compreender a percepção dos consumidores e a sua relação de compra com os influenciadores digitais que desenvolvem infoprodutos. A pesquisa visa apresentar a análise de dados sob a perspectiva do consumidor e da gestora da marca. Para tal, foi escolhido como objeto de estudo a marca Natali Chaplin, que atua como mentora e coaching de mulheres que estão em busca da construção de um estilo de vida mais saudável, com emagrecimento sustentável e duradouro, através da estratégia do marketing de conteúdo. Como método, utilizou-se a abordagem qualitativa, com a realização de entrevistas semiestruturadas com a proprietária e os consumidores, bem como uma análise da marca no Instagram utilizando técnicas netnográficas. Os resultados demonstram que o marketing de conteúdo tem papel fundamental para que os leads sejam convertidos em vendas.
Characteristics of people brought in dead at the Ndola Teaching Hospital in Zambia between 2012 and 2016
Authors: Hachizovu S , Chaponda M , Manyando C , Mubikayi D , Mulenga M , Makupe A
Published: September 2023

Background: Death is the end spectrum of everyone's life. From a policy maker's point of view, the cause of death and the place of death are important variables as they have a bearing on the diagnostic capacity of a health system and the level of health services utilization by a population respectively. A study done in Zambia showed that 51 per cent of the adult deaths occurred in a health facility, 41.5% occurred at home and 7.7% happened elsewhere. This finding contrasted those of a systematic review of statistics on cause of deaths in hospitals: strengthening the evidence for policy makers by the WHO which reported that more than 50% of deaths in most developing countries occur outside hospitals. It is common to see people brought in dead (BID) in hospitals in Zambia. A literature review showed that no study has been done to characterize the people who are brought into health facilities already dead in Zambia. Our study proposes to collect the age and sex distribution of the people brought in dead, as well as their area of residence and cause of death as is captured in the registers.

Objectives1. To describe the sex and age distribution of the people brought in dead in Ndola Teaching Hospital

2. To determine the areas of residence of these cases

3. To establish the causes of death for these cases of BID

4. To assess the completeness of the information recorded in the register

Methods: This study was done at the Ndola Teaching Hospital in the Copper-belt province of Zambia. It was a cross sectional, retrospective record review of the mortuary registers where all people brought in dead or dying within 24 hours  of admission to Ndola Teaching Hospital are recorded. All cases of BIDs recorded in the Mortuary registers of Ndola Teaching Hospital between 2012 and 2016 were eligible. The age, sex, area of residence and the recorded cause of death were entered on a standardized form designed for the study. The data was entered on an excel sheet and  double checked for completeness. It was then analyzed using excel

Results: There were 6931 cases of brought in dead at the Ndola Teaching Hospital between 2012 and 2016 with the average number of 1386 cases per year. The age group affected most was 24-55 years (60.34%), mainly comprised of males (61.81%) and coming from densely populated areas (81.50%). 96.75% of cases had undetermined mode of death while 2.35% of cases died of road traffic accidents

Conclusion: A big number of people are still dying outside health facilities or within 24 hours of admission to hospitals in Zambia today. The most affected group is males in their most productive period of their lives and mainly residing in densely populated areas. Additionally, our data capturing tools are not adequate and need revision.
Indication for Doppler evaluation in the management of intrauterine growth restriction of vascular origin in Sub-Saharan Africa
Authors: Blé Rémy Konan , Luc Olou , Perel Konan , Abdoul Koffi , Stéphane Adjoussou , Mohamed Fanny , Appolinaire Horo , Mamourou Koné
Published: September 2023

Objective: To assess the contribution of Doppler in foetal monitoring and decision-making during delivery in case of in-utero vascular growth retardation.

Design: We conducted a retrospective cohort study from January 2015 to December 2017 in the Gynaecology and Obstetrics Department of the Yopougon University Hospital (Abidjan, Ivory Coast). It included 130 patients who gave birth in a setting of pre-eclampsia with intrauterine growth restriction (IUGR) from 28 weeks of amenorrhoea.

Results: The average age of patients was 31years. Nulliparous (33% of our patients) and pauciparous (41% of our patients) women were the group most affected. The mean gestational age at the first Doppler examination was 32 weeks of amenorrhoea. Doppler abnormalities were 65% in uterine Doppler and 90% in umbilical Doppler. The meancerebrovascular ratio was reversed in 90% of the cases. Perinatal mortality was 22.3% (n = 29) with 21 foetal death in utero and 8 neonatal deaths. The time interval between absent end-diastolic or reverse flow velocity and in-utero foetal death was 3.8 days.

Conclusion: Foetal and umbilical Doppler ultrasound greatly modified the management of intrauterine growth retardation related to hypertension.
Spousal Participation During Pregnancy and Delivery in Ilorin, Nigeria
Authors: Adeniran Abiodun S. , Fawole Adegboyega A. , Adesina Kikelomo T. , Aboyeji Abiodun P. , Balogun Olayinka R. , Ijaiya Munirdeen A.
Published: September 2023

Background: The potential benefits of the active involvement of men in antenatal and intrapartum events remain largely unexplored in low-resource countries despite the reported benefits from high income areas.

Aim: To evaluate male partners' attitudes and experience on their level of involvement during pregnancy, labour and delivery.

Methods: A cross-sectional study conducted at four health facilities in North Central Nigeria from 1st February to 30th July 2017. Participants were male partners of women who were pregnant during the study period; recruitment was after informed consent, data management was with SPSS (version 21.0); p <0.05 was significant.

 

Results: The male partners were aged 23 to 60 years (mean 35.96±6.76), 173 (69.2%) accompanied the partner to antenatal clinic and 150(60.0%) to ultrasound scan examination. The commonest hindrance to men's antenatal participation was commuter marriage (29; 37.7%); 171(68.4%) participants supported the presence of the man atdelivery while 32(40.5%) opined that men may disturb the health provider during delivery. Also, 137(54.8%) men have   requested to be present at delivery previously while 46(33.6%) were obliged; among those obliged, 25(54.3%) described the experience as satisfactory while 28(60.9%) intend to be present at future deliveries. In all, 212(84.8%) suggested antepartum education classes for male partners, 202(80.8%) intend to attend such classes while 143(57.2%) suggested health facility restructuring to facilitate men's participation.

Conclusion: Men are increasingly desirous of active participation at antenatal and intrapartum events; increasing male partner education, male-friendly facility infrastructures and health providers' cooperation will encourage them to fulfil these roles.
Socio-Economic Conditions in Relation to Seaweed Farmers' Income and Independence
Authors: Bakarbessy Derek
Published: September 2023

ground: With the potential of natural resources, seaweed become one of promising commodities which can improve and accelerate national development in general and marine and fishery sector development particularly. Marine and fishery sector development is not only exploitation approach but it is directed toward attempt to improve added value of cultivation.
Aim: This study aims to analyze the effect of social economic factor toward income and independence of seaweed farmer in Maluku Tenggara Barat Region.
Method: This study was designed with the type of model combination sequential explanatory design. The population in this study was all seaweed farmers in Maluku Tenggara Barat region as 1.485 people. The determination of sample was 10% from total population, so that sample of 148 seaweed farmers. The data was analyzed by using path analysis.
Findings: The result of reference study shows that (1) capital is the most affecting variable toward independence of cultivation as 55,6% (2) Land Area was the second affecting variable toward independence as 45,2% ; (3) the number of dependent family member  is the third affecting variable toward independence as 29,9%; (4) interaction education and counseling is the forth affecting variable toward independence as 24.4% ;experiences was the fifth affecting variable toward independence as 24.3%; (6) age is the sixth affecting variable toward independence as 18.5%; (7) counseling intensity is the seventh affecting variable toward independence as 14.1%; (8) education is the eighth affecting variable toward independence as 11.8%.
Analysis of the Role of Oil and Gas Companies in Implementing the Achievements of SDGs 14 and 17 Through the Fish Cultivation Program in the Kepulauan Anambas District
Authors: Tambunan Imran Gunawan , Sofilda Eleonora
Published: September 2023

Kepulauan Anambas District, with 98% of its territory consisting of waters, has promising fisheries potential, However, is inversely proportional to the performance achievement of the fisheries sector during the 2016-2020 period, which decreased. Nevertheless, overfishing continues to occur in Anambas waters. This study aims to analyze the role of oil and gas companies in efforts to develop aquaculture in Kepulauan Anambas District, the intended role focuses on how aquaculture practices are carried out, the involvement of fishing communities, also the benefits and challenges faced, this research method uses a mixed methods approach, by gathering information from relevant sources, both from the company side as program administrators, and fishermen groups as beneficiaries. The Information gathering was carried out qualitatively with in-depth interviews and quantitatively with questionnaires. The data was collected and analyzed by content analysis techniques and descriptive statistics related to the perceptions of fishermen groups towards sustainable fisheries by measuring using a Likert scale. The object of this research consists of entities of two oil and gas companies that have community development programs in the aquaculture sector, namely Medco E&P Natuna, Ltd and PT. Primer Oil BV-Harbour energy. The sample determined in this study consisted of 19 people divided into managers and company personnel in the CSR department, and cultivator community groups. The results of this study explain that through aquaculture, fishing companies make a positive contribution to the implementation of SDG number 14 concerning life below water, and number 17 concerning partnerships for the goals. Strategically, companies interpret these development goals by providing guidance in the form of investment, infrastructure, transfer of knowledge, technology, and management of aquaculture management which is carried out periodically, in particular, this research also identifies the forms of involvement of the two companies fostered groups, towards the achievements of the community development program, the results of this study also identified that only certain people have an interest in being involved Farther in management.
Simulación de escenarios clínicos como estrategia de enseñanza-aprendizaje para el reconocimiento y clasificación de crisis epilépticas
Authors: Flores María José , Rangel Luz Marina
Published: September 2023

El cambio de paradigma de la educación médica hacia los currículos basados en competencias, ha generado la implementación de múltiples estrategias para formar profesionales capaces de realizar actividades profesionales confiables. Entre estas estrategias, se encuentra la simulación de escenarios clínicos. Se realizó una simulación de escenarios clínicos como estrategia de enseñanza-aprendizaje para el reconocimiento y clasificación de las crisis epilépticas según la Liga Internacional contra la Epilepsia en 2017. Participaron 13 médicos residentes que realizaron una primera simulación clínica atendiendo un caso de crisis epilépticas generalizadas y otro de crisis epilépticas focales para evaluar sus habilidades clínicas y comunicativas durante la consulta, posteriormente se dictó un taller teórico sobre semiología y clasificación de las crisis epilépticas con discusión de casos clínicos y finalmente se realizó una segunda simulación con los mismos casos anteriores para evaluar el desempeño posterior a la sesión académica. Se evidenció una diferencia estadísticamente significativa entre los promedios de evaluación de habilidades clínicas entre ambas simulaciones, así como del acierto diagnóstico en el caso 1 y la cantidad de aprobados en el caso 2. No hubo diferencia significativa en la evaluación de habilidades comunicativas. La experiencia fue catalogada en su mayoría como agradable y útil tanto por los médicos residentes como por los simuladores voluntarios. La simulación de escenarios clínicos es una herramienta útil para el aprendizaje en epilepsia y su uso es extensible a otras especialidades médicas y de la salud.
Solidarización Clavo-Placa-Guaya como tratamiento de fractura peri-implante de fémur proximal
Authors: Aguilera Elías , Romero Rafael , Pinto Leonardo , Hurtado Rolando
Published: September 2023

Resumen

En pacientes frágiles, generalmente ancianos, las caídas son la principal causa de visitas a las emergencias. Un tercio de las personas ≥65 años se cae cada año, y en 1 a 5% de estas caídas ocurre una fractura, siendo las de fémur proximal muy frecuentes. La incidencia de fracturas femorales proximales, así como los dispositivos de osteosíntesis asociados a estas, continúa en ascenso, al igual que la incidencia de caídas recurrentes y fracturas reincidentes, conocidas como peri-implante y peri-protésicas. La literatura reporta escasamente estas lesiones, por lo que no existe estandarización en el tratamiento.

Presentamos el caso de paciente femenino de 92 años, quien 20 meses posterior a enclavado endomedular por fractura pertrocantérica de femur derecho sufre nueva caída y re-fractura, de tipo peri-implante en fémur proximal. En vista de tratarse de hueso osteopénico y de ser una paciente activa, se decide realizar nueva síntesis de fractura combinando clavo-placa-guayas bajo el principio de solidarización o solapamiento de implantes con resultados satisfactorios y retorno a sus actividades cotidianas. Concluimos que la aplicación de dicho principio es reproducible y segura, sin embargo, el tratamiento debe ser personalizado en estos patrones y patologías infrecuentes, tomando en consideración las demandas biomecánicas de cada paciente.
Heterogeneidad fenotípica en el diagnóstico de MODY. Una aproximación basada en la evidencia para el diagnóstico clínico
Authors: Carrera Fernando , Aure Gestne , Camperos Paul , Silva de Casanova María Inés
Published: September 2023

Hasta la fecha se reconocen 14 genes relacionados con MODY, sin embargo, es bien conocido la variabilidad epidemiológica con respecto a la Diabetes de inicio en la madurez de la juventud (MODY) que actualmente, se refiere a un grupo heterogéneo de formas monogénicas de diabetes causadas principalmente por defectos de secreción de insulina. Los subtipos MODY individuales son entidades distintas que se definen por sus mutaciones subyacentes. La MODY causada por mutaciones en la glucoquinasa (GCK-MODY, MODY2) y el factor nuclear de hepatocitos 1-alfa (HNF1A-MODY, MODY3) son las formas más prevalentes, que involucran alrededor de las tres cuartas partes de todos los pacientes con MODY. El papel de las pruebas genéticas generalizadas para detectar MODY es controvertido, dado el costo asociado, aunque eso ha disminuido drásticamente. Además, el impacto de un diagnóstico MODY definitivo puede ser significativo, especialmente para individuos jóvenes diagnosticados erróneamente con diabetes tipo 1; Estos pacientes a menudo pueden detener la insulina y hacer la transición a la terapia SU, con un control glucémico mejorado. En medio de una realidad social que impone limitaciones para establecer diagnósticos de elevada complejidad técnica como es el caso de MODY, se hace imperativo, proponer alternativas clínicas y paraclìnicas básicas que permitan establecer el mayor grado de precisión al menor costo, de esta premisa parte es revisión narrativa que permitirá al médico clínico afinar el diagnostico en diabetes.
Inmunohistoquímica como método de evaluación de la sobre-expresión de EGFR, PD-L1 y reordenamiento ALK en carcinomas pulmonares
Authors: Sánchez Rut , García de Barriola Victoria
Published: September 2023

Objetivo: Evaluar el rendimiento diagnóstico de la inmunohistoquímica para determinar la sobreexpresión del EGFR, PD-L1 y reordenamiento ALK en los carcinomas de pulmón en biopsias del laboratorio de Anatomía Patológica del Centro Médico Docente la Trinidad  en el periodo enero 2010- octubre 2020. Métodos: se realizó un estudio descriptivo y retrospectivo, observacional y experimental en el que se evaluó todos los casos de carcinomas pulmonares recibidos en laboratorio de Anatomía Patológica del Centro Médico Docente la Trinidad  en el periodo enero 2010-octubre 2020, realizando estudio de IHQ con los anticuerpos EGFR, ALK y PD-L1 para su análisis histológico. Resultados: La edad promedio fue 67,88 años (±12,171  DE, rango 50 a 99 años). El 48,28 % fueron de sexo masculino y 34,48 % de sexo femenino. El diagnóstico más común previo al estudio inmunohistoquímico fue carcinoma de células no pequeñas (23,08 %). Un total de 20,6 % de los casos mostraron inmunomarcaje positivo para EGFR. La positividad para ALK se observó en 24,13 % de los casos. La inmunoreactividad para PD-L1 se observó en 34,48 % de los casos.  La expresión de EGFR está relacionada positivamente con la expresión de ALK y PD-L1. La expresión de ALK presentó asociación positiva con la expresión de EGFR. No se observó significancia estadística con la asociación tipo histológico y alguno de estos tres anticuerpos Conclusión: El estudio de inmunohistoquímica es un método confiable para la determinación de mutaciones EGFR, ALK, y expresión PD-L1 importante como factores pronósticos y predictivos en pacientes con carcinomas pulmonares.
Amiloidosis de Andrade: a propósito de un caso
Authors: Pernía Néstor , Fuenmayor Vladimir
Published: September 2023

Objetivo: La enfermedad de Andrade, (Polineuropatía Amiloidótica Familiar por transtiretina), es una enfermedad rara, hereditaria, autosómica dominante, caracterizada por mutación de una proteína llamada transtiretina. Se sintetiza principalmente en el hígado y se deposita como amiloide, afectando riñón, corazón, SNC y humor vítreo. Existe historia familiar en el 85% de los casos y se manifiesta en la tercera década de la vida. La supervivencia media sin tratamiento es de 10 años, siendo el compromiso cardíaco, renal, desnutrición e infecciones, las principales causas de muerte. La afectación renal ocurre en 50% de los casos, menos del 10% llegan a desarrollar insuficiencia renal. Caso clínico:Paciente masculino de 73 años de edad, con antecedentes de Hipertensión arterial sistémica, quien fue evaluado en la unidad de neurología, por presentar debilidad y parestesias en miembros inferiores, olvidos, inatención, disnomia para las caras, sin precisar desorientación y/o confusión. RMN de cerebro, con cambios involutivos cortico subcorticales, sugestivos de microangiopatia vasogénica. EMG compatible con polineuropatía sensitivo-motora de miembros inferiores. Holter compatibles con taquicardia ventricular, Además de un Ecocardiograma Transtoracico con hallazgos deCardiopatía dilatada biventricular con patrón de tensión con deterioro apical sugestivo/compatible con amiloidosis, miocardiopatía restrictiva/infiltrativa. Es ingresado bajo el contexto de ICC descompensada y ERC estadio 3b-4 (creatinina basal 2,4). Conclusión: En Venezuela hasta la fecha no se ha descrito casos de amiloidosis de Andrade siendo importante su divulgación para mejorar la compresión de esta enfermedad y estimular las investigaciones futuras para lograr un diagnóstico precoz y con terapéutica adecuada.
Experiencia de Reconstrucción Funcional en Cirugía de Cabeza y Cuello
Authors: Sánchez Aída del Carmen , Mijares Briñez Alirio Jose
Published: September 2023

Objetivo: Evaluar preservación funcional pacientes sometidos a cirugías reconstructivas de cabeza y cuello de la unidad de cabeza y cuello del CMDLT, enero-diciembre 2021. Metodología: Estudio observacional, descriptivo, tipo serie de casos, longitudinal contemporáneo. Se evaluaron pre y post quirúrgica las funciones de apertura y cierre oral, fase I y II deglutoria, articulación del lenguaje oral, competencia velofaríngea, indemnidad de nervios laríngeos recurrentes y superior por aducción y abducción de cuerdas vocales, indemnidad motora branquial del nervio facial, espinal e hipogloso. Resultados:40 pacientes que totalizan 52 procedimientos. 55% pacientes masculinos y 45% femeninas; promedio de edad 49, 95 años. Los procedimientos fueron 7 resecciones oncológicas de tumores en cavidad oral, 5 resecciones en pirámide nasal y senos paranasales, 2 resecciones oncológicas de tumores faríngeos, 2 laringectomías parciales, 11 tiroidectomías, 15 disecciones cervicales, 10 resecciones oncológicas de tumores de glándulas salivales mayores. 4 pacientes con eventualidades post operatorias; 2 compromiso de la articulación de la palabra y 2 pacientes con parálisis transitoria del nervio facial; 90% de mantenimiento de función en el postoperatorio inmediato y 98% en el postoperatorio mediato. Conclusiones: Modalidades reconstructivas van desde el cierre primario hasta colgajos libres.  Mejores resultados oncológicos, y funcionales se traducen en mejor en la calidad de vida de los pacientes y reinserción social. Palabras claves: Reconstrucción, resultados funcionales, cáncer de cabeza y cuello.
Trombosis portal posterior a cirugía bariátrica laparoscópica tipo gastrectomía vertical: Reporte de un caso
Authors: Gómez Rengel María de los Ángeles , Dagher Lucy
Published: September 2023

Objetivo: La trombosis venosa portal (TVP) posterior a la cirugía bariátrica es una complicación poco frecuente asociad a un alto índice de morbimortalidad (20-50%). El diagnóstico se realiza mediante angiotomografía abdominal o eco doppler abdominal y el tratamiento va a depender del tiempo y las complicaciones presentes.  Caso clínico: Se trata de paciente femenina de 46 años, natural y procedente del Distrito Federal, con antecedentes de hipertensión arterial sistémica, hiperinsulinismo, obesidad mórbida con un imc 30% y antecedentes quirúrgicos de cirugía bariátrica tipo manga gástrica el 26 de Julio del 2020. Siendo llevada a mesa operatoria con un asa 1, ecosonograma abdominal y gastroscopia normal. Actualmente en control con cirugía bariátrica cada 3 meses, ultimo control en Julio 2021 encontrándose una paciente normotensa, con analítica sanguínea normal, realizan ecosonograma abdominal evidenciando trombosis portal, motivo por el cual es referida al servicio de Hepatología. Posteriormente se realiza angiotomografía evidenciando trombosis portal y cavernomatosis portal, asintomática y con 1 año de evolución, se descartan patologías hematológicas de base por lo que se decide no indicar tratamiento anticoagulante, y la paciente es dada de alta con controles periódicos ecográficos y de funcionalismo hepático. Conclusión: La trombosis venosa portal es una complicación infrecuente posterior a las cirugías bariátricas laparoscópicas pero aun así se debe tener en cuenta en caso de presentar dolor abdominal sin etiología aparente ya que la detección y tratamiento oportuno es crucial para prevenir complicaciones como la isquemia o necrosis intestinal, cavernomatosis portal o hipertensión portal y disminuir la morbimortalidad.
Análisis macroscópico, histopatológico e inmunohistoquímico de placentas de gestantes con infección por sars-cov-2
Authors: Infante Dale Dimar Natali , García de Barriola Victoria
Published: September 2023

Se ha descrito que el virus SARSCoV-2 tiene predilección por el receptor ECA II (Enzima Convertidora de Angiotensina II)  presente en neumocitos, enterocitos y en las células trofoblásticas de la  placenta.  Estudiamos seis casos de placentas de gestantes PCR positivas para SARSCov2. Cinco, con, antecedentes patológicos importantes se infectaron en el tercer trimestre. El peso placentario fue menor de 750 gramos en cuatro. Los hallazgos morfológicos fueron inespecíficos: envejecimiento placentario, hemorragia intervellosa, corioamnionitis aguda. No observamos trombos. ACE II fue positivo en  la decidua y en el endotelio en cinco  de los seis casos. Las células del trofoblasto resultaron negativas. Dos casos tuvieron malformaciones congénitas, dos casos fueron dados de alta luego de observación, un caso presentó hipoxia neonatal atribuido a insuficiencia placentaria (la madre presentó preeclampsia) y un caso fue muerte fetal intrauterina (la madre se infectó en el segundo trimestre, la placenta presentó villitis crónica inespecífica y las membranas mostraron  corioamnionitis aguda). Consideramos que estos hallazgos sugieren la presencia del virus en los tejidos maternos y no en las vellosidades coriales. Sin embargo la perfusión placentaria si se comprometió en estos casos estudiados.  Estudios posteriores de las placentas nos permitirán conocer la fisiopatología de ésta enfermedad.
Manifestaciones imagenológicas de infarto del miocardio en resonancia cardiaca
Authors: Molina Alvarado Omar Jose , Guinand Carlos , Machado Ivan
Published: September 2023

El infarto agudo de miocardio es una de las primeras causas de morbimortalidad a nivel mundial y las consecuencias estructurales tipo remodelamiento que conllevan a insuficiencia cardiaca crónica y otras complicaciones que devienen en el empeoramiento sistemático del paciente, representan un desafío diagnóstico y terapéutico en los diferentes pacientes. En tal orden de ideas la implementación, de terapéuticas tempranas favorece al retardo y/o no aparición de estos cambios agudos y crónicos, siendo así que en la actualidad, la cardioresonancia permite la evaluación de los cambios tempranos y tardíos de la injuria miocárdica, tales como el no realce de las zonas isquémicas, en fase aguda y tardía, permite evaluar los cambios cinéticos de la pared miocárdica, así como además determinar la fracción de eyección del ventrículo izquierdo, funcionabilidad de las válvulas sigmoideas y semilunares, presencia de derrame pericárdico, velocidades de flujo, entre otras. Permitiendo la clarificación del escenario estructural ante el infarto miocárdico y facilitando al clínico, el implementar las herramientas de terapéutica y seguimiento apropiadas para cada paciente en base a los hallazgos imagenológicos.
Células en anillo de sello, Tumor de Krukenberg de primario gástrico: A propósito de un caso.
Authors: Lugo A Dariana K , Garcia de Barriola Victoria
Published: September 2023

Objetivo: El tumor de Krukenberg se define como un adenocarcinoma metástasico al ovario que contenga células en anillo de sello productoras de mucina. El 70 a 90% de los adenocarcinoma mucosecretores que causan el tumor de Krukenberg se originan en la mucosa gástrica como lo es el siguiente caso a presentar, de femenino con 35 años que manifiesta primeramente síntomas gastrointestinales. Siendo el 30% de los casos de este tumor como manifestación primaria.  Suele presentarse a una edad promedio de 45 años o menos y el 80% de los casos suele ser bilateral, además de que la localización del primario se desconoce en el 40% los casos. Los tumores de Krukenberg se asocian con un mal pronóstico; por lo tanto, examen ginecológico regular en pacientes femeninas con antecedentes de cáncer gástrico es muy importante para el diagnóstico precoz y tratamiento de esta enfermedad. Conclusión: El diagnóstico de esta patología requiere una evaluación anatomopatológica exhaustiva, con el fin de no dar falsas expectativas a la paciente con un diagnóstico benigno o menos agresivo que el de tumor de Krukenberg. Los pacientes generalmente fallecenen 2 años.  La mediana de supervivencia global de los pacientes con tumor de Krukenberg es de 11 - 19 meses para aquellos tumores de origen gástrico.