bluuebunny/crossref_metadata_2025 huggingface dataset:
The Conceptual Apparatus of Semiotics of Modern European History
Authors:   the Institute of History of Ukraine, the National Academy of Sciences of Ukraine, Martynov Andriy
Published: December 2022

The article analyses the conceptual apparatus of semiotics of modern European history. The social sciences, unlike the natural sciences, which deal with realities that do not call themselves, deal with the phenomena of human life. Names change in time and space without any connection to the immanent changes of things themselves, which indicates a persistent search for an adequate name for many things and signs. Historical meanings become the main subject of semiotic analysis. History becomes a way of scientific reconstruction of the past. In historical science, facts, signs and symbols come through individual and collective memory. Various narratives are a treasure trove of semiotic meanings. Texts in different contexts give different semantics. Everyone is a participant in this exciting process, the end result of which, in principle, is not. Under these circumstances, the analysis of instability becomes more important than finding a "fulcrum". This thesis is especially important for the mosaic history of the peoples of Europe. Communism and fascism are united not only by totalitarian practices but also by political "syntax", while liberalism in general is a different political language. Every event starts at the information level. Postmodernism leads to anti-intellectual pre-modern thinking. Semantic boundaries between categories are blurred; they are flexible, open to change and constant socio-economic transformation. The self-consciousness of the modern era was based on the achievements of economics and classical sociology, which promoted the values of a single universal progress for all mankind. Postmodern self-consciousness is based on the principles of cultural anthropology and ethnology, of sciences that emphasize the heterogeneity of the socio-cultural field of mankind. Historical semiotics works with stereotypes of perception of signs and symbols, decodes them and adapts them for scientific use
Election of Ferdinand Coburg to the Bulgarian Throne in the Socio-Political and Scientific Discourse of the Russian Empire
Authors:   V.N. Karazin Kharkiv National University, Mykolenko Dmytro
Published: December 2022

The paper characterizes the reflections of Russian historians, journalists and publicists regarding the election of Ferdinand Coburg as Prince of Bulgaria. These reflections are part of the socio-political discourse of the Russian Empire in 1887–1917. The concept of “socio-political and scientific discourse” is understood by us as a complex of texts – articles, monographs, news reports, cartoons, journalism, as well as the result of social, political, international, cultural, pragmatic, cognitive and philosophical factors characteristic of the Russian Empire in the late 19th and early 20th centuries. The reflection of the election to the Bulgarian throne of Ferdinand Coburg in the socio-political and scientific discourse of Russia has not previously been the subject of specific historical research. The public interest of the Russian Empire in the election of Ferdinand to the Bulgarian throne in 1887 was determined by the great importance of this Balkan country in the geopolitical plans of the empire. The assessments of the Russian public of this event depended on its perception by the official Russian government. The autocratic government had a decisive influence on the opinion of intellectuals, and the imperial narrative, even after the 1905 Revolution, continued to largely determine the evaluative approaches of both liberal and conservative authors. We can trace the differences in the perception of the fact of the election of Coburg to the Bulgarian throne by representatives of the liberal and conservative trends
Indicators of the Interrelation between the Education System and the Labor Market: Development and Testing
Authors: Stepus Irina S. , Averyanov Aleksandr O. , Gurtov Valery A.
Published: December 2022

Introduction. Ensuring the consistency of regional vocational education systems with the labor markets demands is a nationwide task of strategic importance. It causes the development of methodological tools instrumental in a quick and objective assessment of the current state of regional educational systems in the context of their interaction with the region’s labor markets. The aim of the article is to develop indicators of the relationship between the system of vocational education and the labor market and to test the calculation of these indicators in the Russian regions.
Materials and Methods. The research methodology includes substantiation, development and formalization of indicators of the interrelation between the education system and the labor market. The first indicator characterizes the potential of the regional vocational education system to provide places for the admission of its own graduates of the 9th and 11th grades of schools. The second indicator assesses the supply of the regional labor market with graduates of the regional system of vocational education. To calculate the proposed indicators, official statistical reporting data are used.
Results. In the course of research, using statistical data for 2018–2020, the proposed indicators were calculated for all Russian regions. Based on the cluster analysis of the indicators calculated values, a typology of Russian regions was made, during which five types of stable regions associations with homogeneous characteristics were identified. The strengths and weaknesses of regional educational systems are identified, including in the context of their interaction with the region’s labor markets.
Discussion and Сonclusion. The developed indicators allowed to quickly assess the potential of the regions, on the one hand, to provide school graduates with vocational education, and on the other hand, to meet the economy staffing needs by graduates of universities and vocational educational organizations. The results of the study are of undoubted practical significance and will be useful to executive authority in developing recommendations for bringing education systems in line with regional development priorities, strengthening and developing regional educational systems.
Professional Reflexivity in Thai Teachers’ Understanding of Asperger’s Syndrome
Authors: Kruanopphakhun Juthathip , Ditcharoen Nadh
Published: December 2022

Introduction. The aim of this research is to investigate changes in Thai educators’ attitudes towards their understanding of Asperger’s Syndrome before and after a teacher-training session. Currently, opportunities for professional training regarding Asperger’s Syndrome are very scarce in Thai educational communities. Educators may not be able to provide optimum education and guidance for their students with Asperger’s Syndrome. Meanwhile, these students’ learning outcomes are significantly affected by their educators lacking knowledge of evidence-based intervention methods. Therefore, based on a needs assessment, a teacher-training session was developed to minimize the gaps in pedagogical knowledge and practice.
Materials and Methods. A quasi-experimental, embedded mixed-methods design was used to obtain data. This study employed a one-group, pre-test/post-test design, as there were no control groups involved due to the novel learning subject matter. The limitations of the current study – its structure and participant recruitment – were identified and discussed. An availability sampling method was used for this study, resulting in the recruitment of 12 in-service teachers and 32 pre-service teachers from the northeastern region of Thailand. Questionnaires and interviews were used as measurement tools to comprehensively capture participants’ learning experiences. For the statistical analysis, the paired sample t-test (alpha = .05) was used. Meanwhile, for the descriptive analysis, the deductive approach was used.
Results. Our results corroborate our sequential hypotheses regarding a teacher-training session and educators’ perceived levels of understanding of Asperger’s Syndrome. The training session was developed with a hypothesis that teachers needed educational opportunities to acquire proper knowledge of Asperger’s Syndrome, so that their students could be fully benefited from the pedagogy. As a result of attending the session, a statistically significant increase in correct response rates was indicated. Indeed, this increase in knowledge fulfilled the second hypothesis that by having proper knowledge of Asperger’s Syndrome, teachers’ professional reflexivity can be improved.
Discussion and Conclusion. The outcomes of this study indicate that a teacher-training session has played a crucial role in cultivating Thai educators’ understanding of Asperger’s Syndrome. The outcomes present an interesting correlation between teachers’ knowledge acquisition and their increased professional and personal reflections. Simultaneously, the findings of this study suggest the potential benefits of improving research methodology, including an employment of randomized control trial, a larger sample size, and diversity within the sample population.
Beliefs about Multilingualism with Respect to Translanguaging: A Survey among Pre-Service EFL Teachers in Indonesia
Authors: Putrawan Gede E. , Mahpul  , Sinaga Tuntun , Poh Son K. , Dekhnich Olga V.
Published: December 2022

Introduction. Recently, multilingualism and translanguaging have received considerable attention and are always a topic of interest and public debate in language education. However, to our knowledge, studies on pre-service EFL teachers’ beliefs about multilingualism with respect to translanguaging in the Indonesian context have not appeared in the literature. Therefore, to address this gap, this research investigated beliefs about multilingualism with respect to translanguaging, including language separation, language use/mixing, and language support, among pre-service EFL teachers in the Indonesian context.
Materials and Methods. This study is quantitative in nature, adopting a survey research design. We collected data from 270 pre-service EFL teachers using an online Likert scale questionnaire that lacked any potentially sensitive questions. They were between the ages of 17 and 26, and were English teacher candidates majoring in English education at higher education institutions on the Indonesian islands of Sumatra, Java, Sulawesi, and Kalimantan. The collected data were analyzed using descriptive statistics, which included the percentages and frequency distributions of the participants’ Likert scale responses.
Results. The current study’s findings corroborate previous research indicating that teachers believe multilingualism and collaborative use of languages are potential assets that can benefit their students’ language learning.
Discussion and Conclusion. Language separation in EFL classrooms appears to be a point of contention for the majority of pre-service EFL teachers surveyed, with a preference for and support for multilingualism and translanguaging over language separation in EFL classrooms. They agree on the importance of using or mixing other languages in their classes. On the one hand, they believe that it is critical to avoid other language support in classrooms; on the other hand, they believe that other language support can benefit students, offering a wave of optimism about future language education. Therefore, there is a need to gradually introduce and include pedagogical translanguaging to the existing curricula. The integration of new multilingual facts and the implementation of translanguaging pedagogies are part of a larger educational renewal. There is a need to intentionally create a multilingual space (translanguaging space) in EFL classrooms to fully utilise studentsʼ multilingual capabilities creatively and critically because today many teachers struggle to reconcile the disparities between monolingual educational policies and the realities of multilingual classrooms.
Prevalence of poultry Escherichia coli isolates producing extended-spectrum beta-lactamases and their public health importance
Authors: Stefanova R. D.
Published: December 2022

Recently, different reports highlighted the problem with dissemination of Escherichia coli producing extended spectrum beta-lactamases (ESBL) in poultry farms in Europe. The high incidence of Escherichia coli among poultry in Europe harbouring blaCTX-M-1 and the occurrence of ESBL and AmpC-producing Escherichia coli in raw meat samples collected from slaughterhouses in Europe have been discussed. ESBL-producing Enterobacteriaceae can be transmitted along the broiler production chain. Plasmids responsible for ESBL production frequently carry genes coding resistance to other antimicrobial classes, such as fluoroquinolones, aminoglycosides, sulphonamides. Resistance to cephalosporins in Enterobacteriaceae is of special concern for public health, because these anti­microbial agents are critically important. The aim of this mini review was to describe the mechanisms of resistance and prevalence of ESBL-producing E. coli. It is important to investigate the spread of these bacteria among poultry, the role of farm birds as reservoir of E. coli and the risk for people.
Sogdian Elements in Yenisei Inscriptions
Authors: Bai Yudong , Che Juanjuan
Published: December 2022

In several Runic Yenisei inscriptions dating from the 8th and 9th centuries, there are words related to Sogdian, such as Arγu in monument E42, Čač (Tashkent) in E52, Čaγar (柘羯, ‘warrior’) in E55, Pülüs (Paulus / Paul, personal name) in E69, etc. Among them, Pülüs (Paul), the tomb owner of E69, comes from the Shi 石 Kingdom (Tashkent) in Sogdiana. This provides key historical data for understanding the relationship between the Sogdians and Kirghizs,and indicates that there was a material and cultural exchange between them in the Yenisei basin at that time.
The constitutional identity of the member states: False evidence or constitutive element of a new architecture of the Union?
Authors: Delcamp Alain
Published: December 2022

The notion of ‘identity’ once seemed perfectly obvious and applied mainly to individuals. A spectacular evolution of the notion could have been considered in recent years. In the social sciences where it was associated with the notion of group but, after having invaded the public debate, it has now reached the law domain. It now appears in the debates and even the decisions of the constitutional courts of the member states of the European Union. This is a general movement which is part of a climate in which, to varying degrees, there is expressed dissatisfaction with regard to the operation of the institutions of the Union and, more particularly, their mode of creation of law, as soon as it benefits from the principle of primacy affirmed by the Treaties.

The purpose of this article is to gather and evaluate the information available through the various case law and comments, in order to better clarify the notion of constitutional identity and assess its effectiveness. The concept remains contested, and its use has not yet resulted in significant consequences, but its study is an opportunity to suggest improvements in the dialogue between the constitutional courts and the Court of Justice of the European Union; to also ask whether the notion of ‘constitutional identity’ could not be a valuable tool in redefining the relationship between the Union and the Nations that compose it.
Constitutional identity as a normative constitutional concept
Authors: Szente Zoltán
Published: December 2022

Although constitutional identity is nowadays invoked by European states primarily against the extension of the powers of the EU institutions, it can also be understood as a substantive concept of national constitutional law. This article deals with constitutional identity as a normative constitutional concept. In this respect, the problem is the same as that which arises in the relationship between EU law and domestic law: namely, its fundamental indeterminacy and the possible arbitrariness of its application. The author argues that, therefore, constitutional identity can only be plausibly invoked if satisfactory answers can be given to the questions of exactly whose identity it is, what its source is, who and how its content may define, and what the constitutional function of this category is. The second part of the study examines the Hungarian constitutional identity according to this analytical framework, and concludes that, although its subject is the Fundamental Law, its definition, content and constitutional function are unclear and contradictory. Consequently, the current concept of constitutional identity in Hungary raises a number of problems for which no plausible answers have yet been found, and it is highly doubtful whether the doctrinal and practical difficulties related to it can be resolved at all.
Lower facial skin hydration level increases acne vulgaris severity level
Authors: Yolanda Maya Oktari , Jusuf Nelva Karmila , Putra Imam Budi
Published: December 2022

Backgrounds: Acne vulgaris is a chronic sebaceous gland inflammatory disorder that predominantly affects adolescents and young adults. Increased sebum, alterations in follicular keratinization, Cutibacterium acnes colonization, and inflammation are the critical pathways in the pathogenesis of acne vulgaris. Facial skin hydration can affect the primary pathogenesis mechanism of acne vulgaris. This study aimed to examine the correlation between the level of facial skin hydration and the severity of acne vulgaris. Methods: This study was an observational analytical study of 40 subjects with acne vulgaris and 40 subjects without acne vulgaris, using a cross-sectional design. The subjects' facial skin hydration was analyzed using a CM 825 corneometer, and the severity of acne vulgaris was assessed based on Lehmann's criteria. Data were analyzed using the Spearman correlation test. Health Research Ethics Committee of the Faculty of Medicine at the University of North Sumatra has approved this study.Results: Of the 40 subjects with acne vulgaris, women dominated (65 %) with a mean age of 19.6 ± 1.86 years old. Most subjects had moderate (50 %) degrees of acne vulgaris, followed by mild (42.5 %) and severe (7.5 %) degrees. In acne vulgaris subjects, the considered normal level of facial skin hydration was 92.5 %. The facial skin hydration found in acne vulgaris subjects was lower than non-acne vulgaris subjects with a p-value of 0.002. The degree of facial skin hydration is associated with the severity of acne vulgaris with moderate strength correlation values (p=<0.001, r= -0.453).Conclusions: A significant correlation exists between the level of hydration of the facial skin and the severity of acne vulgaris. The lower facial skin hydration level could promote the more severe form of acne vulgaris.
Factors of the elderly being exposed to COVID-19: a scoping review
Authors: Indah Rahayu Asih , Huriah Titih
Published: December 2022

Background: The world today and public health problems ahead of the pandemic respiratory syndrome or commonly called COVID-19. It is important to identify the risk, especially for mortality understanding, nutrition status of elderly and dementia. This study literature review aims to understand the risk factors of the elderly when pandemic COVID-19.Method: This literature uses the scoping review method and searches PubMed, Proquest, and Sciencedirect. Criteria for determining the literature review done using the words “Risk OR Factors OR Elderly Get OR Covid-19”. The study's inclusion criteria are articles for the last two years is 2020-2021, and the type of article includes a suitable journal, first select the title, abstract, journal content, and cohort study, chi-square cross-sectional, and case-control.Result: After these inclusion criteria based on the categories and filtered, the database is used in the journal is five literature reviews. The risk factors for the elderly exposed to COVID-19 include problems understanding COVID-19, nutritional status of problems, dementia experienced by the elderly. Conclusion: Two risk factors are often faced by the elderly during the COVID pandemic, namely problems with understanding and dementia in the elderly.
The implementation of precision personalized care to improve diabetes patients’ self-management at taipei veteran general hospital: an observational study
Authors: Pranata Satriya , Shing Lin Chun , Vranada Aric , Chun Lee Ya , Armiyati Yunie , Khoiriyah Khoiriyah
Published: December 2022

Introduction: Precision Personalized Care (PPC) defines as a new approach to health care service on improving diabetes patients’ self-management. To date, Taipei Veterans General Hospital has started implement the program of PPC. The purpose of this study was to observe the implementation of PPC and its’ beneficial on the improvement of self-management among diabetes patients at the Taipei Veteran General Hospital, Taiwan.Methods: This study applied a clinical observational-exploration method such as supervision by visiting the wards, examination rooms and laboratories in the hospital and further discussing with the health professionals’ and patients with diabetes by direct interview while observing each PPC implementation from April 18th to May 2nd, 2019. The participants of this observational study included three nurses, a nutritionist, a doctor and 3 patients. Descriptive and explorative methods were attempted to analyze the data.Results: The comprehensive and continuous implementation of diabetes self-management education (DSME) and diabetes self-management support (DSMS) programs were the target and focus point of activities to improve diabetes patients’ self-management. It focused on the patient centered-care, tailored, and more precise to find patients’ personal meet as defined as PPC. Clinical laboratory tests (e.g., blood sugar, hemoglobin A1C counts, low-density cholesterol, kidney functions, proteinuria, fundus and peripheral neuropathy examinations) were carried out regularly to support the program. Both programs and clinical assessment test were integrated with the Diabetes Pay for Performance (diabetes -P4P), a large-fund government program which supported by Taiwan National Health Insurance (NHI).Conclusion: The continuous and comprehensive PPC can successfully reduce the incidence of diabetes complications in Taiwan. The PPC approach can be used as a magnificent reference for the development of quality health services and research development for diabetes patients in Indonesia.
The integrated intervention of early childhood education and stunting prevention program in increasing pre-school age children's food intake
Authors: Huriah Titih , Lestari Anisyah Arum , Rahmawati Agustina , Prasetyo Yoyok Bekti
Published: December 2022

Introduction: Indonesia's stunting rates are staggering, with more than 30% of stunted children. The government has conducted several stunting treatment programs, but the number of stunted children in Indonesia is still more than 20%. On the other hand, Indonesia has an education system for pre-school children. Stunting prevention can integrate with this system by providing nutrition education to pre-school children. The experiment aims to prevent stunting in children by integrating early childhood education and nutrition education to increase food intake.Methods: The population is pre-school-age children in Bantul Regency Yogyakarta. The research sample was 20 pre-school children given the program and 19 pre-school children in the control group. The integration program was given to children for three months (February - April 2021). The activities are education to improve children's developmental abilities and provide nutrition-related education. The food intake measuring instrument used a food recall analyzed by the Nutri-survey software. Data analysis used central tendency and t-test.Results: The average food intake was still below the Recommended Dietary Allowances (RDA), namely 1064 kcal in the intervention group and 1182 kcal in the control group. However, there was an increase in food intake in total daily food intake, breakfast intake, and dinner with a p-value of 0,001, 0,028, and 0,022, respectively, while at lunch intake, there was no difference with p-value 0,069.Conclusion: The integrated early childhood education and nutrition education programs can increase food intake for pre-school children. Therefore, this program is critical to be continued in all early childhood education systems in Indonesia as one of the stunting prevention programs.
The differences in maternal and child health factors amongst leprosy patients in endemic and non-endemic areas
Authors: Prakoeswa Flora Ramona Sigit , Maharani Faradiba , Puspitasari Erlita , Listiawan Muhammad Yulianto , Endaryanto Anang , Prakoeswa Cita Rosita Sigit
Published: December 2022

Introduction: Leprosy, a chronic infectious disease caused by Mycobacterium leprae infection arise new concern in pediatrics health problems. Total number of pediatric leprosy cases are hard to eliminate due to dominance of parenting and household position of mothers. In this study, we evaluated the roles of maternal and child health factors amongst leprosy patients in endemic and non-endemic areas.Methods: Cross sectional study was conducted on Tuban Regency, East Java through interview guided by questioner on 106 pairs mother-child selected from local primary health center’s registry data and selection through inclusion and exclusion criteria. Several parameters were analyzed: mother’s age, children’s age, gender of children, antenatal care, breastfeeding, and childbirth methods. Data were analyzed using ANOVA test.Results: Statistically significant results were found in the age of mother (p = 0.007) and child (p =0.001) with older ages observed in the population lived in the endemic area. Gender of children (p=0.997), childbirth methods (p=0.172), antenatal care (p= 0.353), and breastfeeding (p=0.507) in this study showed insignificant results.Conclusions: The differences in mothers and children ages are associated with leprosy among the population lived in leprosy endemic areas compared to the control group with delayed in diagnosis and long incubation period should be considered as factors contributed in this findings.
A severe COVID-19 patient with diabetes mellitus getting dexamethasone with depression disorders: a case report
Authors: Ammar Ammar , Rusli Musofa
Published: December 2022

Background: Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus, known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The SARS-CoV-2 coronavirus requires host cells to replicate, leading to rapid and uncontrollable viral replication and could end in increased production of pro-inflammatory cytokines. This case study aims to evaluate a severe COVID-19 patient with diabetes mellitus getting dexamethasone with depression disorders.Case Presentation: A-56 years old Javanese female who lives in Sidoarjo was admitted to the emergency room of Dr. Soetomo Public Regional Hospital, Surabaya due to shortness of breath from the patient’s anamnesis. The shortness of breath was getting worse in the last 3 days before being admitted to the hospital. The patient had a fever in the previous 3 days before being admitted to the hospital. She also had a cough with phlegm for 1 week before being admitted to the hospital. The patient’s condition is oxygen saturation at 93% with a simple mask 6-8 lpm (oxygen saturation at 72% in free air. Her medical history revealed that she had suffered from diabetes since approximately 8 years ago and routinely took 5 mg of glibenclamide once a day. She also had high blood pressure from 5 years ago and routinely took 10 mg of amlodipine once a day. Treatment for this patient in severe condition requires comprehensive management such as symptomatic therapy, oxygenation, and adequate nutritional therapy. In addition, the patient received dexamethasone and antidepressant drugs such as fluoxetine 10 mg.Conclusion: The oxygenation therapy, symptomatic, antiviral, supportive, and adequate nutritional treatment can improve the clinical outcome regarding a severe COVID-19 patient with diabetes mellitus getting dexamethasone with depression disorders.
The role of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in determining the prognosis of patients with testicular cancer
Authors: Warli Syah Mirsya , Ringoringo David Ralph Lienhardt , Sihombing Bungaran , Siregar Ginanda Putra , Prapiska Fauriski Febrian
Published: December 2022

Background: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as systemic inflammatory response markers, have been shown to play a role in prognostic factors for patients with malignancies in recent years. However, their application as the prognostic factors of testicular cancer remains unknown. This study aims to evaluate the prognostic role of testicular malignancies using preoperative hematological parameters, NLR and PLR, and their pre-diagnostic role in the staging of testicular cancer.
Methods: This was a cross-sectional retrospective study of thirty-nine patients who underwent radical orchiectomy due to testicular cancer at the Department of Urology Haji Adam Malik General Hospital between January 2014 and December 2018. For each patient, clinical features including age, sex, clinical stage, chemotherapy, radiology report, pre-treatment neutrophil count, lymphocyte count, platelet count, NLR, PLR, and postoperative histopathological report were collected. Then we analyzed the association between NLR, PLR and the testicular cancer metastasis incidence.
Result: The mean age of the patients was 27.56 ± 17.47 years. Seventeen patients had seminoma (42.5%), 16 others were yolk sac type of cancer (40.0%), and the rest six patients were teratoma (3 patients), lymphoma (2 patients), and embryonal carcinoma (1 patient). More than half (66.48%) of the patients received chemotherapy after radical orchiectomy, with 48.70% in clinical stage III. PLR was associated with testicular cancer metastases (p=0.024), while NLR was not (p=0.729).
Conclusion: High pre-treatment PLR levels are associated with the occurrence of metastasis in testicular cancer patients. Hematological parameters will become critical in the preoperative evaluation of such testicular cancer cases. The potential prognostic significance of NLR and PLR in testicular cancer should be tested with further studies.
Changes in plasma levels of IL-6 and D-dimer in high-risk thrombosis cancer patients undergoing chemotherapy
Authors: Setiawan Budi , Manurung Amelia KW , Zulizar Alif Adlan , Budianto Widi , Sukarnowati Tri Wahyu , Pangarsa Eko Adhi , Santosa Damai , Setiabudy Rahajuningsih Dharma , Suharti Catharina
Published: December 2022

Background: Cancer and chemotherapy are venous thromboembolism (VTE) risk factors. The immune system and inflammation are essential in cancer-associated thrombosis's pathogenesis. Chemotherapy can induce inflammatory conditions that trigger the nuclear factor kappa B (NF-κB) signaling pathway to produce proinflammatory cytokines. Interleukin 6 (IL-6) improves procoagulant status primarily by inducing tissue factor (TF) expression. Tissue factor expression triggers the coagulation system, characterized by increased levels of D-dimer. This study assessed the change in plasma levels of IL-6 and D-dimer changed in high-risk thrombosis cancer patients undergoing chemotherapy.
Methods:  This study was a prospective cohort study of 54 newly diagnosed high-risk thrombosis cancer patients undergoing chemotherapy in Dr. Kariadi General Hospital from January 2021 to September 2021 based on inclusion and exclusion criteria. IL-6 and D-dimer concentrations were collected a day before and after chemotherapy. IL-6 measured by ELISA method and D-dimer measured by the turbidimetry chromogenic immunoassay method. We did correlation test, compared mean, and subgroup analysis. The p-value<0.05 was significant.
 
Results: There was a positive correlation between plasma levels of IL-6 and D-dimer both pre- and post-chemotherapy (r=0.36; 95% CI (0.1-0.6); p=0.006 and r=0.45; 95% CI (0.2-0.6); p=<0.001, respectively). Post-chemotherapy plasma IL-6 (61.0±84.9 pg/mL) was significantly lower (p=0.022) than pre-chemotherapy (102.4±141.6 pg/mL). Subgroup analysis based on risks of thrombosis showed a significant decrease in plasma levels of IL-6 in the higher risk cancer group of thrombosis post-chemotherapy compared with the low risk cancer group (77.7±144.1 pg/mL vs -0.9±127.8 pg/mL; p=0.037). There was an increase in D-dimer plasma levels post-chemotherapy, but it was not statistically significant (2598.1±2487.8 µg/ml vs 3098.6±3547.4 µg/ml; p=0.512). The subgroup analysis based on blood type, tumor stage, chemotherapy regimen, and risk of thrombosis showed no significant differences in delta plasma IL-6 and D-Dimer levels pre- and post-chemotherapy.
Conclusion: In high-risk thrombosis cancer patients who underwent chemotherapy, there was a statistically significant decrease in plasma levels of IL-6 post-chemotherapy. There was an increase in D-dimer plasma levels post-chemotherapy, but it was not statistically significant.
Role of malnutrition inflammation score and interleukin-6 on quality of life of regular hemodialysis patients
Authors: Wardani Ni Wayan Sri , Widiana I Gde Raka , Kandarini Yenny
Published: December 2022

Background: Malnutrition, systemic inflammation, and atherosclerosis known as MIA syndrome occurs in patients who have undergone regular hemodialysis (HD) and can lower their quality of life (QoL). Current study aimed to determine the interrelation of malnutrition and inflammation to QoL.
Methods: A cross-sectional analytic study was conducted in our hemodialysis installation. We performed Malnutrition Inflammation Score (MIS) and measure serum IL-6 to determine malnutrition and inflammation conditions in regular HD patients and utilized ‘Kidney Disease Quality of Life-Short Form (KDQOL-SF) to assess QoL MIS. IL-6 cut-off point were determined by the Receiver Operating Curves (ROC) then we performed linear regression to analyze the relationship level of MIS and IL-6 with level of QoL. We also used path analysis to prove the mechanism model of MIS and IL-6 to QoL on regular HD patients.
Results: This study consisted of 60 regular HD patients, 40 (66.7%) of men with mean age of 51.8 years and 78 months average of dialysis vintage. Good QoL was obtained ≥60 overall health (above the median value) and high level of MIS was obtained ≥5 with 75% sensitivity and 21.8% specificity, while high IL-6 level were ≥47.21 pg/mL, with 62.2% sensitivity and specificity of 78.3%. This study found the prevalence of protein-energy wasting (PEW) in regular HD patients was 81.7% by using high level of MIS. MIS were significantly correlated to IL-6 (r = 0.376, p = 0.003) however high level of MIS were uncorrelated to poor QoL. The mechanism of the interrelation of MIS, IL-6, and QoL showed on path analysis that MIS was 15% directly correlated to QoL, however, IL-6 indirectly correlated to QoL on regular hemodialysis patients.
Conclusion: MIS and IL-6 were correlated to QoL and MIS also correlated to IL-6. Malnutrition inflammatory score directly affected QoL but IL-6 indirectly affected QoL in regular HD patients.
A comparison of walking ability between the dynamic hip screw and cephalomedullary nailing fixations in intertrochanteric femur fracture
Authors: Karya Triko Biakto  , Idrus Andi Paturusi  , Harry Supratama Azis  , Luky Tandio Putra  , Jorvin Kurniawan
Published: December 2022

Introduction: Fractures of the hip are common injuries; approximately 50% of fractures occur in the intertrochanteric region. The treatment is to restore patients to their pre-injury level of mobility. Secure fixation is required to allow immediate return to unrestricted weight-bearing. The common fixation methods are dynamic hip screw (DHS) and proximal femoral nail anti-rotation (PFNA). This study compared postoperative walking ability in femoral intertrochanter fractures treated with DHS and PFNA and evaluated the confounding factors.
Methods: We conducted a retrospective cross-sectional conducted at Wahidin Sudirohusodo General Hospital and Universitas Hasanuddin Hospital for patients from 2018 to 2021. The sample was patients with intertrochanteric femoral fracture based on x-ray treated with DHS and PFNA using the purposive sampling method. A total of 107 patients with complete medical record data were included in this research, consisting of 81 DHS cases and 26 PFNA cases. Obtained data from these patients were then statistically analyzed by Chi-square and Fischer exact test. The p-value <0.05 was significant.
Results: In bivariate analysis, the percentage of weight-bearing subjects was higher in DHS (61.7%) than in PFNA (46.2%), although not statistically significant (p>0.05). By controlling for confounding factors such as age, gender, type of fracture, and length of stay, it turns out that there is no significant difference in the results of the postoperative walking ability comparison.
Conclusion: It was concluded that there was no difference in weight-bearing walking ability (full and partial) at discharge between PFNA and DHS.
Development of patient safety learning module based on problem based learning for nursing students at the College of Health Sciences
Authors: Gunahariati Ni Nyoman , Sutajaya I Made , Arnyana Ida Bagus Putu , Sudirtha I Gede
Published: December 2022

Background: Media education as a means of improving the quality of education is very important in the learning process. The patient safety module learning media is not widely available in accordance with the conditions of field practice used by students as a learning guide for patient safety courses. This study aims to develop a patient safety learning module based on problem-based learning.
Methods: The model used in this development is the ADDIE model. The validity test was evaluated by 3 media experts and 3 content experts. The field test was carried out at STIKES Wira Medika involving 3 student learners one to one, 9 small groups. The effectiveness test uses a quasi-experimental design, non-equivalent pretest and post-test control group design, which were selected purposely involving 2 classes of students, 1 class each as the experimental group and 1 group as the control class.
Results: The media expert test, content expert, learner and design expert were in the valid category. The mean score of the small group trial results was 0.94 in the good range. There was a difference in the ability to implement (p = 0.0001), pre-test of critical thinking skills (p = 0.003), post-test critical thinking skills (p = 0.001) and learning outcomes (p = 0.0001).
Conclusion: The learning module developed has high validity and is effectively used in patient safety learning, so it is recommended to use this learning module in patient safety courses.
Medical Management of Kidney Stones: a review
Authors: Felizio Jody , Atmoko Widi
Published: December 2022

The incidence of kidney stone disease has been rising in past decades. The prevalence has doubled in both genders, andthe prevalence ratio is shrinking from 3.4 to 1.3 between males and females. This condition greatly impacts individuals, thehealth care system, and socioeconomic levels. Kidney stone diseases are related to various risk factors and medical conditions.A detailed diagnosis through history taking, urinalysis, metabolic evaluation, and stone analysis is important to direct thetherapy approach. The therapy in managing kidney stone diseases comprises dietary and pharmacological treatment. Inaddition to general advice on sufficient fluid intake, citrate intake, maintaining ideal body weight, and restricting sodium andanimal protein, the therapy should be adjusted based on the specific type of stones.
Lived experience of nurses at two covid-19 designated hospitals: a phenomenological study
Authors: Togatorop Lina Berliana , Eka Ni Gusti Ayu , Silitonga Ester , Ndruru Alberta Adina
Published: December 2022

Introduction: The COVID-19 pandemic has fundamentally altered how society functions, including the conditions under which health professionals work. Nurses, who are at the forefront of providing care to COVID-19 patients, spend extended periods in close contact with infected patients. These stressful conditions may increase nurses' risk of developing depression and other mental health problems. This study aimed to explore the experiences of Indonesian nurses working in two COVID-19-designated hospitals that provide direct patient care.
Methods: The qualitative phenomenological design was used in this study. Between June and December 2020, 15 nurses at two COVID-19-designated hospitals participated in in-depth telephone interviews, and four nurses were selected to participate in a focus group discussion for data triangulation. Following that, data were analyzed according to Colizzi's phenomenological method.
Results: The data were categorized into four themes: 1) Responsibility to maintain nursing professionalism; 2) Challenges in caring for COVID-19 patients; 3) Support in caring for COVID-19 patients; 4) Increase insights while caring for COVID-19 patients. These themes indicate that, while nurses felt supported by hospital administration and close family members, they were also affected by the high workload, which resulted in behavioral changes associated with mental illness.
Conclusion: These findings shed light on the benefits and drawbacks of nurses caring for COVID-19 patients. These findings can serve as a starting point for hospital administration in developing policies and systems that promote nursing staff well-being.
Recording and reporting information system model integrated from midwife practices to public health center
Authors: Masruroh Nur , Fasya Abdul Hakim Zakkiy , Handayani Dwi , Santoso Andreas Putro Ragil
Published: December 2022

Introduction: Maternal and child health problems (MCH) are still a health problem in Indonesia. The high rate of maternal and child mortality requires intensive intervention and monitoring by the health department through health facilities available in the community. The recording and reporting of the MCH program at the Jagir and Wonokromo Health Centers has not been well documented because most of the MCH program recording and reporting is done manually. The purpose of this research is to produce a model of recording and reporting information system that is useful in handling the recording and reporting process of the integrated MCH program from the Independent Midwife Practice to the Puskesmas.
Method: The method used in the development of this software is the Scrum Management Framework. The result of this research is the SISKIA (Maternal and Child Health Information and Surveillance System) software application which is integrated from the Independent Midwife Practice to the Puskesmas which can be used to manage maternal and child health data.
Results: The SISKIA software application makes it easier to map Maternal and Child Health data, including in high-risk cases, in order to get health services according to the schedule determined by the midwife. SISKIA can directly assess the condition of mothers and children reported by the midwife and can be accurately displayed on the map included in SISKIA installed at the Jagir and Wonokromo Health Centers. Mobilization of the entire community in reducing MMR and IMR in the Jagir and Wonokromo Health Centers can be carried out by monitoring maternal health conditions in the surrounding environment by using this software application.
Conclusion: The Maternal and Child Health Information and Surveillance System (SISKIA) has proven useful for obtaining regular and up-to-date maternal and child health data.
The complexity of perioperative management of acute limb ischemia in elderly with multiple comorbidities and underlying diseases: A case report
Authors: Aditya Riadi Syafei  , Jusri Ichwani  , Novira Widajanti  , Hadiq Firdausi
Published: December 2022

Background: Aging process commonly associated with multiple comorbidities such as metabolic disorders, vascular, visual, gait, balance and psycho-social problems. Atherosclerosis is one of comorbidities that could occur as a pre-existing condition in elderly with peripheral artery disease (PAD). Elderly patients associated with complex and multi-factorial medical conditions need to be addressed in a comprehensive approach. Here we report the complexity of perioperative management of an elderly with acute limb ischemia in elderly with multiple comorbidities and underlying diseases.

Case Presentation: An elderly woman, 77-year-old, was referred to emergency room due to decreased level of consciousness. There were complaints of loss appetite, inactivity, bedridden, pain, paresthesia and muscle weakness in the right lower limb. There was history of chronic hypertension and dyspepsia. Since there was a sign of right lower limb acute limb ischemia, the patient was discussed with the multi-discipline team, planned for primary amputation, and received systemic anticoagulant treatment. Due to multiple comorbidities and underlying diseases, the patient died prior to amputation surgery.

Conclusion: Surgery is not contraindication to elderly; however, from this case it shed light the needs of multi-discipline approach to decide the best treatment options for patient’s needs. Utilizing a Comprehensive Geriatric Assessment (CGA) could be an alternative to non-invasive, simple, and effective approach available in any healthcare setting.
Determination of total phenol and total flavonoid, and antioxidant activities of chocolate leaves (Zephyranthes candida (Lindl.) Herb.)
Authors: Noviyanti  , Martiani Isye , Perdana Farid , Rahmaniah
Published: December 2022

Introduction: Zephyranthes candida plants or known as chocolate flowers are usually only used as ornamental plants, many people in Indonesia do not know that this plant has medicinal properties. The purpose of this study was to determine total phenol levels, and total flavonoids and determine the antioxidant activity of chocolate flower plants.
Methods: This study was an experimental study using cacao flower leaves, ethanol, aqua dest, ABTS, gallic acid, quercetin, AlCl3, Folin-Ciocalteu reagent, Na2CO3, FeCl3, sodium acetate, and Vitamin C. Samples of cacao flower leaves (Zephyranthes candida) were collected from Leles, Garut Regency, West Java. The material taken is collected and then sorted wet to separate the plant parts that are not needed, then washed with running water until clean. Then dried in a drying cabinet at a temperature of 40-50°C to dry. Furthermore, dry sorting is carried out to separate foreign objects that enter during drying. The dried samples were mashed using a blender. Then the simplicia powder is stored in a tightly closed container at room temperature and is ready to be extracted. Then the extract will be analyzed to determine the total phenol content, flavonoid content, antioxidant activity, and thin layer chromatography.
Results: The results of the determination of total phenol and total flavonoid levels and the antioxidant activity of brown flower leaves showed that the total phenol content of the brown flower ethanol extract was 20.5803 ± 0.15 mgGAE/gram. And the total flavonoid content of the brown flower ethanol extract was 1.8411 ± 0.0641 mgQE / g. The test results of the antioxidant activity of brown flower leaves showed that these plants had a very strong antioxidant activity with IC50 of 18.2106.
Conclusions: The results of the research to determine the total phenol and total flavonoid content and antioxidant activity of cacao flower leaves showed that the total phenol content of the ethanol extract of cacao flower was 20.5803 ± 0.15 mgGAE/gram. Moreover, the total flavonoid content of the cacao flower ethanol extract showed a very strong antioxidant activity.