bluuebunny/crossref_metadata_2025 huggingface dataset:
Death in Philadelphia, 1958
Authors: Kim Hannah
Published: April 2020

In 1958, In-Ho Oh, a foreign student from South Korea, was beaten to death in West Philadelphia by a group of black youths. The brutal murder shocked people all over the nation who wrote hundreds of letters to the newspapers and the mayor about the incident. Some letter writers focused on the implications of the murder for Cold War diplomacy, while some believed there were moral lessons to be learned from the generous actions of Oh’s family. Yet other letter writers focused on race and juvenile delinquency and constructed an idealized “model” minority in the Korean student, contrasting him to the young suspects. The death of In-Ho Oh came to have different meanings to different groups and challenged America’s self-perception about racial equality and exceptionalism.
“Hardhats May Be Misunderstood”
Authors: Brantley Allyson P.
Published: April 2020

Drawing on organizational records, the progressive press, and oral history archives, this article explores the development of a multiracial, coalition-backed boycott of Coors beer in the 1970s and 1980s. It focuses on the boycott’s expansion from a localized labor dispute in the San Francisco Bay Area to a national, politicized campaign. It argues that the Coors boycott and its array of backers, representing labor, Chicana/o, queer, black, Native American, and leftist circles, demonstrate the vibrancy, creativity, and evolution of activism in the decades following the civil rights movements. Instead of seeing the move to coalition and consumer movements as conservative, this article identifies the Coors boycott as an example of ongoing grassroots efforts to forge solidarity and oppose business conservatives and the New Right.
Construção de um “Dispositivo Colimador” para câmara de cintilação (SPECT) de aplicação in vivo para realização de exames in vitro na prática de Medicina Nuclear
Authors: Onusic Daniel Massaro , Brunetto Sérgio Querino , Ramos Celso Darío
Published: April 2020

Introdução: Este trabalho consistiu no desenvolvimento de um dispositivo de baixo custo para testes e protocolos de exames de medicina nuclear in vitro. Foi desenvolvido e validado inicialmente para medir a taxa de filtração glomerular (TFG) com EDTA-51Cr usando apenas uma câmera de cintilação. O dispositivo consiste de 5 cilindros de chumbo (com tampas) fixados perpendicularmente e espaçadamente sobre uma placa de chumbo, que ao ser acoplado na câmara de cintilação torna-se equivalente a um contador-gama tipo poço, com sensibilidade de 300Bq. Esse dispositivo foi testado para as quantidades usuais de EDTA-51Cr das amostras de plasma sanguíneo de 8 pacientes (6 homens, 2 mulheres, idades de 43-68 anos, média 54 anos) que fizeram o exame de modo convencional. Resultados: Os valores de TFG obtidos com o método convencional e com o dispositivo variaram respectivamente, de 27 a 73 ml/min/1,73m2 (média 56,7±14,0) e de 31 a 82 ml/min/1,73m2 (média 60,9±14,5), expressando uma correlação de r=0,9010 e p=0,5628 (95% de confiança). Conclusão: O dispositivo proposto é uma alternativa confiável ao uso do “Contador Gama Tipo Poço” convencional para medir a TFG usando o método EDTA-51Cr. Devido ao seu custo muito baixo, tem o potencial de promover o uso deste procedimento em qualquer serviço de medicina nuclear que possua uma câmera de cintilação. Esta tecnologia foi depositada no Instituto Nacional de Propriedade Industrial (INPI) sob o processo de patente BR:10.2015.020347-0.
Um comparativo entre a utilização de redes neurais perceptron e redes neurais profundas na identificação de radionuclídeos em espectrometria gama
Authors: Gomes Lamas Otero André , Potiens Junior Ademar , Takehiro Marumo Júlio
Published: April 2020

Apresentamos os resultados da comparação entre uma Rede Neural Profunda e uma Rede Neural Perceptron na classificação de espectros gama obtidos utilizando um detector de germânio hiper-puro. Utilizando dados de diversas fontes seladas  (Am-241, Ba-133, Cd-109, Co-57, Co-60, Cs-137, Eu-152, Mn-54, Na-24, and Pb-210) foram gerados uma lista extensa de espectros para treino e validação contendo, respectivamente, 500 e 160 espectros, onde foram mesclados até três radionuclídeos em um único espectro. Depois de 250 épocas de treino foram validadas a acurácia de cada um dos modelos utilizando o conjunto de validação. O modelo de rede neural profunda obteve uma acurácia de classificação de 96,25% enquanto a rede neural perceptron obteve uma acurácia de 80,62%. Os resultados mostram um desempenho robusto e consistentemente melhor das redes neurais profundas, frente as redes neurais perceptron.
Riscos que comprometem a segurança do paciente no tratamento de teleterapia conformacional
Authors: Salvador Caroline , Borges Laurete Medeiros , Dorow Patrícia Fernanda , Felipe Daniel Souza , Rodrigues Paulo Marcelo , Pereira José Gilmar , Pizzio Adalberto Tavares
Published: April 2020

O objetivo deste estudo foi analisar os riscos que comprometem a segurança do paciente no tratamento de teleterapia conformacional. Para isso, realizou-se uma pesquisa de campo, quali-quantitativa-exploratória, descritiva. Somente as etapas executadas por profissionais das técnicas radiológicas fizeram parte da análise de risco. Para a coleta de dados, utilizou-se observação assistemática com anotações em diário de campo e, diretamente nos quadros da ferramenta Análise do Modo e do Efeito de Falhas na Assistência à Saúde (HFMEA). Participaram dezesseis profissionais, quatro destes integraram a Equipe HFMEA, que realizou a aplicação da ferramenta. Os processos foram divididos em: 1- deslocamento; 2- primeiro dia de tratamento e; 3- demais dias de tratamento. Os resultados constataram que o maior número de etapas e modos de falhas potenciais ocorre no primeiro dia de tratamento, e que a maioria dos modos de falhas potenciais dos três processos foi considerada tolerável e é relacionada, principalmente, a erros humanos. Na análise dos modos de falhas potenciais intoleráveis, constatou-se que em 59,37% a intervenção era necessária, sendo propostas ações preventivas às falhas.
Blindagem multilaminada aplicada a um reator modular de pequeno porte hipotético.
Authors: Talon João Domingos , Neto Alberto Teixeira , Lopes Thomaz Jacintho , Duarte Gabriela Martins , De Oliveira Claudio Luiz , Fiel João Claudio Batista , Fontes Gladson Da Silva , Cabral Ronaldo Glicério , Vellozo Sergio De Oliveira , Barroso Dalton Ellery Girão
Published: April 2020

Neste trabalho, o núcleo de um reator modular de pequeno porte (SMR) hipotético do tipo PWR, com um enriquecimento do combustível de 20% e potência de 50 MWe (150MWt)[1], foi simulado na condição de criticalidade. A 300cm do vaso de pressão do SMR foi medida a dose efetiva de 1,33E+9mSv, que mostrou a necessidade de calcular e instalar uma blindagem multilaminada no contexto do plano de proteção radiológica da instalação nuclear para fins de licenciamento e cumprimento das diretrizes pertinentes. Os dados disponíveis foram utilizados no dimensionamento do projeto básico do serviço de proteção radiológica da instalação, além da possibilidade de serem aplicados na elaboração do respectivo PSAR[2].[1] MWe: megawatt elétrico e MWt: megawatt térmico.[2] PSAR: Preliminary Safety Analysis Report.
Adaptations of a Mobile Lab for Analysis of Th-232 in Soil Samples Using Well-Type NaI (Tl) Scintillation Gamma Spectrometry
Authors: Oliveira Luciano Santa Rita , De Amorim Aneuri Souza , Santos Avelino dos , Balthar Mario Cesar Viegas , De Vilela Paulo Ricardo Teles , Izidório Ana Carolina dos Anjos da Cruz , Da Conceição Dayana Azeredo , Santa Brigida Zuila Augusta Amaral da Gama , Vital Hélio de Carvalho , Paixão Sergio Barros
Published: April 2020

The identification of the occurrence of 232Th, by measuring the energies of the children radioisotopes 228Ac, 208Tl, 212 Bi and 212Pb, in their places of origin, using the Mobile Lab for Identification of Radiological and Nuclear Agents - LabMovelRN, by discriminating their environmental concentration normal and NORM [1] is important for the performance of the operational teams of the Brazilian Army Chemical, Biological, Radiological and Nuclear Defense Institute (IDQBRN), optimizing their time of action, and reducing the chain of custody of the sample. Due to the operational difficulty of using HPGe detectors in LabMovelRN, an adaptation is being carried out in the laboratory in order to allow the analysis of 232Th in soil samples by the gamma spectrometry technique using scintillation detectors [2] of NaI (Tl) type well as the characterization of the response of this scintillator detector in energy, resolution and energy efficiency up to 3,000 keV.
Developing EFL Students’ Writing Skill Through Self-Assessment Integrated With E-Portfolio
Authors: Taufik Moh. , Cahyono Bambang Yudi
Published: April 2020

ABSTRACTWriting is one of the language skills that should be mastered by students of English as a foreign language (EFL). In order to write well, EFL students should understand the content of their writing. They should also be able to discover some writing errors they may have. Therefore, it is necessary for the students to practice writing frequently and to be willing to review their writing products. This study aimed to develop EFL students’ writing skill through self-assessment integrated with e-portfolio. It used action research design and it was conducted in a classroom consisting of 25 ten graders of Islamic Senior High School (Madrasah Aliyah Negeri) at Sumenep, East Java. The findings showed that the students’ writing skill could be improved after the implementation of self-assessment integrated with e-portfolio. It is suggested that EFL teachers consider using self-assessment integrated with students’ e-portfolio to help improve EFL students’ writing skill.ABSTRAKMenulis merupakan kemampuan berbahasa yang harus dimiliki oleh pelajar bahasa Inggris sebagai bahasa asing (EFL). Dalam mengembangkan kemampuan menulis, pelajar dituntut untuk mengerti isi tulisan mereka dan mampu menemukan kesalahan-kesalahan yang mungkin terdapat dalam tulisan mereka. Maka dari itu, pelajar dipandang perlu untuk sesering mungkin melatih kemampuan menulis, mengulas kembali dan merevisi karya mereka. Penelitian ini bertujuan untuk mengembangkan kemampuan menulis siswa menggunakan self-assessment melalui elektronik portofolio. Penelitian ini merupakan Penelitian Tindakan Kelas (PTK) dengan subjek 25 siswa kelas X MAN Sumenep, Jawa Timur. Penemuan penelitian ini menunjukkan bahwa kemampuan menulis siswa membaik setelah penerapan self-assessment melalui elektorinik portofolio. Dengan demikian, guru bahasa Inggris disarankan untuk mempertimbangkan penerapan sefl-assessment melalui elektronik portfolio siswa untuk mengembangkan kemampuan menulis siswa. How to Cite: How to Cite: Taufik,M., Cahyono, B. Y. (2019). Developing EFL Students’ Writing Skill Through Self-Assessment Integrated With E-Portfolio. IJEE (Indonesian Journal of English Education), 6(2), 171-186. doi:10.15408/ijee.v6i2.12019
Development of a fuel consumption measurement methodology for light duty vehicles in Colombia, based on metrology principles
Authors: Castillo Herrera Juan Carlos , López Restrepo Juan Camilo , Serrato Tobón David Andrés , Tibaquirá Giraldo Juan Esteban , Carvajal Perdomo Sergio Andrés
Published: April 2020

In this study, a methodology to measure fuel consumption for light duty vehicles (LDV) in Colombia was elaborated based on existing methodologies from road transportation worldwide. This methodology was proposed as a tool for the evaluation of energy efficiency strategies applied to vehicles, as well as establishing the baseline for measurement, control, and regulation of consumption of fossil fuels based on metrological criteria. Additionally, the capacities for measurement within Colombia were analyzed, and procedures stated by the Code of Federal Regulations of the United States of America were adopted for measuring fuel consumption of LDV by gravimetric methods. An uncertainty model based on the Guide to the expression of Uncertainty in Measurement (GUM) was elaborated, and the contribution of different variables associated to the measurement process the instruments, the equipment, and the ambient conditions over the uncertainty of the measurand, were analyzed.
Design of an antenna array for a LFM-CW synthetic aperture radar prototype
Authors: Zozaya Alfonso José , Del Pino Pettinare Paulino Jesús
Published: April 2020

This paper deals with the design of two identical 1 × 4 patch antenna arrays for a linear frequency modulated (LFM) continuous wave (CW) synthetic aperture radar (SAR) prototype. The theoretical design is carried out by using the empirical equations available in the literature, while the design optimization is performed by numerical methods using two commercial full wave simulators. Once the antennas are built they are experimentally characterized and incorporated into a radar prototype implemented at the Ecuadorian Space Institute. The radar is tested in a probing polygon and the horizontal resolution is estimated. A measured azimuthal resolution value very close to the theoretical one is achieved
Optimization of the flocculating capacity of natural coagulants in water treatment
Authors: Choque Quispe David , Ligarda-Samanez Carlos A. , Ramos-Pacheco Betsy S. , Solano-Reynoso Aydeé M. , Choque-Quispe Yudith , Peralta-Guevara Diego E. , Quispe-Quispe Yadyra
Published: April 2020

The objective was optimize the flocculating capacity of three varities of cacti Echinopsis pachanoi (San Pedro), Neoraimondia arequipenses (Ulluquite) and Opuntia ficus (Tuna) in the artificial wastewater treatment. They were applied 1%, 2% and 3% coagulant doses of the three varieties of cactaceae extracted with 96% ethanol. It was evaluated the flocculating activity (FA) and removal percentage (%R); a significant increase was observed (p-value < 0.05) with the increase in the coagulant dose. The optimization was carried out considering as objective function the %R which were subjected to FA, pH, hardness, alkalinity and BOD5 of water treatment. Which were reported values of 99.09 %R for San Pedro variety, 92.42 %R for Ulluquite variety and 98.98 %R for tuna variety, for doses of 0.207%, 0.246% and 0.754% of coagulant respectively.
Ensino Além da Visão: ferramentas e estratégias que auxiliam a inclusão do deficiente visual em sala de aula
Authors: Thomas Juliana
Published: April 2020

O sistema de educação nacional está passando por algumas mudanças em relação às estratégias de ensino e a abordagem dos alunos em sala de aula. A inclusão de alunos com algumas dificuldades, dentre elas os visuais, foco desta escrita, é uma constante no ambiente pedagógico. A legislação nacional visa garantir o direito da inserção de todos na sociedade, sem discriminação e de um modo íntegro e de qualidade. Porém, os professores ainda sentem insegurança, enfrentamentos e algumas dúvidas em relação ao processo inclusivo na sala de aula. Com o objetivo de identificar quais recursos a Universidade do Vale do Taquari (UNIVATES) disponibiliza para incluir alunos com dificuldades visuais em sala de aula, o presente estudo traz como temática central a discussão sobre os recursos educativos voltados para discentes com deficiência visual. A metodologia de pesquisa empregada foi o estudo de caso, alicerçado em pesquisa bibliográfica e instrumentos de pesquisa, como entrevista e questionário. A proposta envolveu profissionais da UNIVATES, localizada em Lajeado-RS, que compartilharam diferentes situações vivenciadas com alunos com comprometimento visual, ao longo de um semestre letivo. Os resultados desta investigação mostraram que, apesar da referida Instituição de Ensino Superior (IES) viabilizar recursos e ferramentas que auxiliam o aluno deficiente visual em sala de aula, ainda é muito baixa a adesão deste público nos cursos técnicos e de graduação.
Os sentidos do ensino de Filosofia no Ensino Médio: uma abordagem fenomenológica
Authors: Da Cunha Junior Williams Nunes
Published: April 2020

O presente artigo apresenta os resultados obtidos em nossa pesquisa realizada junto ao grupo de estudos Filosofia e Educação/Ensino de Filosofia, do Programa de Pós-Graduação em Educação, da Universidade Federal de Alagoas. O objetivo de nossa investigação foi compreender os sentidos que professores e alunos detêm sobre a prática do ensino de Filosofia na qual estes sujeitos estão inseridos. Por meio do método fenomenológico aplicado à pesquisa, descrito por Moreira (2002), realizamos entrevistas das quais recolhemos um conjunto de assertivas significativas com as quais desenvolvemos nosso trabalho. O sentido do ensino de Filosofia aparece nas falas dos sujeitos de nossa pesquisa como compreensão do mundo, como um saber mais, uma abertura para o conhecimento, como capacidade de buscar conhecimentos. Entende-se ainda que esse ensino tem o potencial de auxiliar os estudantes a crescerem pessoalmente e fazerem escolhas mais acertadas. A pesquisa sobre os sentidos do ensino de Filosofia encontra sua razão de ser na contribuição que pode oferecer para a formação dos futuros professores e professoras de Filosofia, trazendo novos elementos para pensar e repensar constantemente a nossa prática.
Silver Nanoparticles with Bronchodilators Through Nebulisation to Treat COVID 19 Patients.
Authors: Sarkar Dr. Subhasish
Published: April 2020

There are no effective antiviral drugs available against the pandemic causing COVID 19 virus. The complex protein - protein interaction between the virus and host is yet to be determined for designing of precise antiviral drugs against corona virus. The pandemic had claimed several thousand lives and had resulted most devastating effects on our mankind. In this scenario a potent drug is needed which will kill the viruses with minimal side effects on human body. Here I propose a novel antiviral therapy for effective killing of COVID19 with minimal side effects.
Prenatal cigarette smoke exposure slightly alters neurobehavioral development in neonatal rats: Implications for developmental origins of health and disease (DoHAD)
Authors: Mammel B. , Kvárik T. , Szabó Zs. , Gyarmati J. , Ertl T. , Farkas J. , Helyes Zs. , Atlasz T. , Reglődi D. , Kiss P.
Published: April 2020

Numerous studies indicate that smoking during pregnancy exerts harmful effects on fetal brain development. The aim of this study was to determine the influence of maternal smoking during pregnancy on the early physical and neurobehavioral development of newborn rats. Wistar rats were subjected to whole-body smoke exposure for 2 × 40 min daily from the day of mating until day of delivery. For this treatment, a manual closed-chamber smoking system and 4 research cigarettes per occasion were used. After delivery the offspring were tested daily for somatic growth, maturation of facial characteristics and neurobehavioral development until three weeks of age. Motor coordination tests were performed at 3 and 4 weeks of age. We found that prenatal cigarette smoke exposure did not alter weight gain or motor coordination. Critical physical reflexes indicative of neurobehavioral development (eyelid reflex, ear unfolding) appeared significantly later in pups prenatally exposed to smoke as compared to the control group. Prenatal smoke exposure also resulted in a delayed appearance of reflexes indicating neural maturity, including hind limb grasping and forelimb placing reflexes. In conclusion, clinically relevant prenatal exposure to cigarette smoke results in slightly altered neurobehavioral development in rat pups. These findings suggest that chronic exposure of pregnant mothers to cigarette smoke (including passive smoking) results in persisting alterations in the developing brain, which may have long-lasting consequences supporting the concept of developmental origins of health and disease (DoHAD).
The Correlation between leucocyte CD64, Immature Granulocyte and Presepsin with Procalcitonin in Bacterial Sepsis Patient
Authors: Novita Citra , Hernaningsih Yetti , Wardhani Puspa , Veterini Anna Surgean
Published: April 2020

Background: Sepsis is a critical emergency that causes morbidity and mortality worldwide. The latest sepsis diagnosis is made by using quick Sepsis-Related Organ Failure Assessment (qSOFA). Cluster of Differentiation 64 (CD64) is a surface antigen leukocyte that is deregulated during infection and sepsis. The percentage of immature granulocyte (IG) could rise in patients with infection and sepsis, mainly in severe circumstances. Procalcitonin (PCT) is a calcitonin prohormone that increases in sepsis and is already known as a bacterial infection marker. Presepsin (CD14) is a glycoprotein that is known to increase in bacterial infection. This study aimed to determine the correlation of leucocyte CD64, IG, and presepsin with PCT in bacterial sepsis patients.Method: This cross-sectional study was performed from June to September 2018 at Dr. Soetomo General Academic Hospital. Twenty-five patients who met the qSOFA criteria with positive bacterial blood cultures were included. All samples underwent examinations of leucocyte CD64, IG, presepsin, and PCT. The correlation of leucocyte CD64, IG and presepsin with PCT was analyzed using Spearman correlation.Results: The samples comprised 17 males (68.0%) and 8 females (32.0%). The mean age was 51.24 Â± 14.85 years. The mean Â± SD of leucocyte CD64 was 6.95 Â± 2.13%, the median (min-max) of IG, presepsin and PCT was 3.67 (0.33â€“17.33)%, 2,641(487-20,000) pg/mL and 5.96 (0.39â€“181.5) ng/mL respectively. There was no correlation between leucocyte CD64 with PCT (p = 0.281). There was a significant correlation between IG and presepsin with PCT (p < 0.0001).Conclusions: Presepsin and IG can be used as alternative bacterial sepsis markers that are supported by other examinations. leucocyte CD64 still needs to be studied further before it can be used as a bacterial sepsis marker.
Anti-Mullerian Hormone (AMH) as a Novel Marker for Ovarian Function: A Review
Authors: Herawati Sianny
Published: April 2020

Background: Anti-Mullerian Hormone (AMH) is a homodimeric glycoprotein linked by disulfide bonds which belongs to the Transforming Growth Factor (TGF) beta superfamily. AMH is produced by gonadal tissue namely testicular Sertoli cells and ovarian granulosa cells especially pre-antral and antral follicles. AMH involved in embryonic sexual differentiation in male, while it has an inhibitory effect on primordial follicle recruitment and responsiveness of the growing follicles to FSH, in female. Current studies show promising clinical utilities of AMH measurement in predicting ovarian function.Objective: This review aims to explore further about the physiology of AMH and its role as a novel marker for ovarian function.Method: A review of relevant literature was performed to elaborate AMH involvement in ovarian function. A total of 14 qualified published literature of all years until 2018 were collected from several electronic database and manual search and included in this review.Results: AMH level reflected ovarian follicular reserve, an important indicator in infertility treatment (assisted reproduction technique) and a sensitive marker for ovarian aging. AMH is also a valuable tool in diagnosis and recognition of recurrence granulosa cell tumors, and a marker of ovarian dysfunction particularly polycystic ovary syndrome. A low circulating AMH level is observed in obesity and male with fertility problems.Conclusion: AMH level can be used as primary or supplementary markers to aid in the diagnosis and treatment of several reproductive related conditions in males and females. A set of guidelines about sample storage and handling and age-specific standardized reference values are needed to optimize clinical application of AMH.
The description of corrected count increment on one hour and 24 hours after platelet apheresis transfusion in Sanglah General Hospital Denpasar
Authors: Prawita Anak Agung Ayu Lydia , Mulyantari Ni Kadek , Herawati Sianny
Published: April 2020

Introduction: Evaluating the response after platelet transfusion is vital to measure the success rate of the therapy and plan the subsequent management of patients. The evaluation can be done by calculating the corrected count increment (CCI) at 1 hour and 24 hours after transfusion. The purpose of this study was to determine the therapeutic response to apheresis platelet transfusion by measuring the CCI at 1 hour and 24 hours after transfusion.Methods: This study was a cross-sectional descriptive study of patients who received apheresis platelet transfusions. In total, 35 samples were examined for platelet counts before and after transfusion. The CCI was measured at 1 hour and 24 hours after transfusion. Descriptive statistical analysis was performed to calculate the percentage and mean count.Result: The mean count of transfused platelets was 2.7 Ã— 10Â¹Â¹ / unit. The mean platelet count before transfusion was 18.5 Ã— 10Â³ / Î¼L. The mean platelet increment at 1 hour was 25.4 10Â³ / Î¼L and 24 hours was 22.6 Ã— 10Â³ / Î¼L. The mean CCI Â± SD at 1 hour and 24 hours was 15,036.63 Â± 13,709.73 and 13,625.60 Â± 13,580 respectively. A total of 63% of samples reached the target CCI at the 1-hour measurement, while the remaining 37% did not. Meanwhile, 60% of the samples reached the CCI target at the 24-hour measurement, while 40% did not.Conclusion: The response to apheresis platelet transfusion by measuring the CCI reached the target in 63% of patients at 1 hour after transfusion and 60% of patients at 24 hours after transfusion.
A T-acute lymphoblastic leukemia in children with CD 117 expression: a case report
Authors: Endrawati Komang Juwita , Mahartini Ni Nyoman , Herawati Sianny
Published: April 2020

Background: Leukemia is a group of clonal disorders originating from single cells with genetic changes in the bone marrow or peripheral lymphoid tissue.Â Acute T-cell lymphoblastic leukemia is estimated to be 12-15% of ALL cases.Â Immunotyping examination is essential in establishing the diagnosis of T-ALL, CD 1a, CD 2, CD 3 (membranous and cytoplasm), CD 4, CD 5, CD 7, and CD 8 as T- cell antigen markers. CD 33, CD 117, CD 34 and CD 56Â are a myeloid-related antigen.Â The occurrence of co-expression of T cell markers with markers myeloid isÂ infrequent. This study aimed toÂ report cases of T-Â Acute Lymphoblastic LeukemiaÂ (ALL)Â in children with CD 117 expression.Case description:Â A-13 years boy had a fever and bruising on the skin one year ago.Â Physical examination found a blood pressures 150/70 mmHg , axillary temperature 37.8Â Â°Â C, right and left enlargement of the glands of the neck and inguinal, enlarged liver and petechiae in both lower extremities.Â Complete blood tests showed leukocytosis, anemia, and thrombocytopenia.Â Edge blood smear suggests the presence ofÂ cigarÂ cells, target cells and lymphoblasts > 50%.Â Bone marrowÂ aspiration smearÂ revealed lymphoblastÂ >30% and concludes an ALL (L2). Immunophenotyping examination found CD 3, CD 5, CD 117 positively supported T-ALL with co-expression of CD 117. During treatment, the patient experienced seizures due to spontaneous intracerebral bleeding that caused the patient to die.Conclusion:Â The case of a 13-year-old boy suffering from T-ALL (L2) with co-expression of CD 117 had a poor prognosis.
Hemostasis changes and its relationship with SOFA score in sepsis patients
Authors: Nadya Giri Sarah Hanna , Aman Adi Koesoema , Hanafie Achsanuddin
Published: April 2020

Introduction: Sepsis is a major health problem, and the incidence is still increasing. Generally, sepsis occurs in about 2% of all inpatients in developed countries. The immunologic response that causes sepsis is a systemic inflammatory response that causes activation of the inflammatory and coagulation pathways. If sepsis untreated, it can lead to organ failure then death. Organ dysfunction is expressed as an acute change of Sequential Organ Failure Assesment (SOFA) score >2 points as a consequence of infection.Methods: This is a cohort prospectiveâ€™s study. Prothrombin time (PT), activated partial thromboplastin time (aPTT), Thrombin time (TT), Fibrinogen, D-dimer were examined 3 times (first, second, third day), and then assessed to see its relation with the corresponding SOFA score. Twenty-four subjects of the study were ICU patients in H. Adam Malik Hospital who matched the inclusion and exclusion criteria.Results: There were significant differences of PT on the first, second and third day (p =0.03). There were no significant differences in aPTT, TT, Fibrinogen, D-dimer on the first, second, third day. There were no significant correlations of PT, aPTT, TT, Fibrinogen with the corresponding SOFA score on the first, second, third day. There was a moderate positive correlation between D-dimer and SOFA score in the first, second and third day of examinations (p <0.05).Conclusion: PT changes occurred significantly on the first, second, third day of sepsis and D-dimers can be used to asses the risk of organ failure in septic patients.
Increasing the quality of life of post-shackling patients through multilevel Health promotion of shackling prevention
Authors: Widodo Arif , Prabandari Yayi Suryo , Sudiyanto Aris , Rahmat Ibrahim
Published: April 2020

Introduction:Â  Shackling still poses a significant obstacle to rehabilitate patient with mental disorder and often resorted by family or community. Shackling could have a negative impact toward patientâ€™s mental health and often resorted due to lack of information. Therefore, this study aimed to evaluate the effect of multilevel health promotion to shackling prevention (MHPSP) toward the behavioral component of family/caregivers, neighbors, cadres, and health workers (stakeholders) and also evaluating its effect toward patientâ€™s quality of life. Method:Â  This study uses a quasi exeperimental method with pre-test and post-test model with repetead measures design. The research subjects were 32 post-shackling patients lived in Sukoharjo Regency and 31 from Klaten Regency as well as. MHPSP was given to 32 caregivers and stakeholders who come from Sukoharjo Regency as a treatment group and psychoeducation only to 31 caregivers of control group from Klaten Regency. Quality of life measurments were carried out before treatment and four months after giving MHPSP.Result : The result showed that MHPSP significantly enhance the behavioral component of the family/caregivers as well as neighbors, cadres and health workers (p<0.05). Furthermore, patient quality of life was significantly improved in the treatment group (MHPSP) compared to the control. Conclusion: It can be concluded that MHPSP could significantly enhance the behavioral aspects of the families, neighbors, and health workers toward post-shackled PMD patients and significantly improved their quality of life. Therefore, MHPSP is needed to be implemented not only to the patient but also to the people that directly interact with them.
Intraarterial heparin flushing effect on motor evoked potentials in chronic ischemic stroke patients
Authors: Putranto Terawan Agus , Ratmono Tugas , Yusuf Irawan , Murtala Bachtiar , Wijaya Andi
Published: April 2020

Background: Stroke has always been a complicated disease which affects not only the patient quality of life but also the patient family. In ischemic stroke patients, one of the most complicated outcomes was the disruption of motor function. Increased motor function is a visible positive outcome of stroke patients.Aim: This study aims to measure the motor evoked potentials values which the results might give us more insights into how this disease affects the motor neuron pathway.Methods: This study was an experimental pre-posttest study involved 75 patients diagnosed with chronic ischemic stroke (onset of more than 30 days). The MEPs value was measured by adjusting the IAHF procedure in 2015.Results: There was no significant difference between motor evoked potential value (amplitude, latency, central motor conduction time) pre and post intraarterial heparin procedure (IAHF) (p>0.05). Occasionally, there was a significant difference in latency value in lacunar, subcortical, and cortical-subcortical area after IAHF (p<0.05).Conclusion: This study shows that the size and localization of the affected area might determine the results of IAHF.
Cardiac Myxoma Resection in Sanglah General Hospital Denpasar, Indonesia: Serial Case Report
Authors: Semadi I Nyoman , Sulistyaningsih Ni Kadek , Sudarma I Wayan , Dewi IGA Sri Mahendra
Published: April 2020

Background: Cardiac myxoma is a primary tumor that grows intracardiac. Primary heart tumors are rare, and incidents range from 0.0017 to 0.03%. Around 75% of primary heart tumors are benign, and 50-80% are cardiac myxoma. Echocardiography is the gold standard in detecting tumor mass in the heart. With the development of diagnostic modalities and cardiac surgery techniques, cardiac myxoma can be detected and treated correctly and leading to a better prognosis.Objective: To report a series of cases of cardiac myxoma resection carried out by the Cardiac Surgery team of Sanglah General Hospital Denpasar.Cases: Data collected from 2016 to March 2019 cased based on Sanglah General Hospital Denpasar. Six cases were diagnosed based on the clinical, electrocardiographic, radiological, and histopathological basis.Conclusion: This series of cases reported six intracardiac tumor patients who were found through echocardiographic examination and five patients had open heart surgery for tumor resection; also all histopathological examination results were following cardiac myxoma. There were no reported post-treatment complications and the patients were discharged hemodynamically stable after hospitalized for approximately one week. Until now, there have been no reports of recurrence in patients who have taken resection and patients have normal daily life activities.
The characteristics of neurocognitive function in farmers exposed to chronic pesticides at Banjar Tengah Kelod, Kerambitan, Tabanan, Bali, Indonesia
Authors: Samatra Dewa Putu Gde Purwa , Putri Ni Luh Putu Dirasandhi Semedi
Published: April 2020

Purpose: This study aims to evaluate the characteristics of neurocognitive function in farmers exposed to chronic pesticides.Material and Methods: This study uses a descriptive cross-sectional design with total sampling methods. The study was conducted from 1st January 2019 until 31st January 2019 located in Banjar Tengah Kelod, Kerambitan sub-district, Tabanan district, Bali, Indonesia.Results: A total of 60 samples, consisted of 36 samples (60%) were women and 24 samples (40%) were men were obtained. The median age of the study sample was 55 year-old. Most of the samples who experienced neurocognitive impairment used organophosphate pesticides (60%), followed by organochlorine (20%), carbamate (13.3%), and pyrethroid (6.7%). Organophosphate users experienced neurocognitive impairment in both memory domain (mean score of 1.5 what scoring was used?) and visuospatial executive functions (mean score of 1, what scoring system?). The mean memory function score in the organochlorine user group was the highest compared to other groups of pesticide users while the average score of visuospatial function was 1. The samples of the study using carbamate pesticides had the same average score in both domains of neurocognitive function. The mean score of memory function in pyrethroid user was 2.5 and the average score of executive visuospatial function was 1.Conclusion: Chronic exposure to the four types of pesticides provided a picture of neurocognitive function impairment, including memory, visuospatial and executive functions.Â This result did not show clinical significance. The addition of sample size and analytic method studies should be considered for further research.
Comparing the effect of Angiotensin-Converting Enzyme Inhibitors versus Angiotensin Receptor Blockers in heart failure patients with type 2 diabetes mellitus: a systematic review
Authors: Febrinasari Ratih Puspita , Martohusodo Bambang Irawan , Kristin Erna , Nindrea Ricvan Dana , Dwiprahasto Iwan
Published: April 2020

Abstract:Introduction: Heart failure is a prevalent world wide. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are widely prescribed. The aim of this study was to determine the effect of the two drugs in heart failure patients with type 2 diabetes mellitus.Methods: This meta-analysis was performed on research articles on the drugs of heart failure patients in PubMed, ProQuest and EBSCO database published between 2008-2018. Pooled odds ratio (OR) are calculated using fixed and random effects models. Data were processed using Review Manager 5.3 (RevMan 5.3).Results: From total 209 articles, 10 studies met the criteria for systematic review. Meta-analysis result showed that there were no difference effect of angiotensin-converting enzyme inhibitors versus angiotensin receptor blockers in heart failure patients with type 2 diabetes mellitus (RR = 1.73 [95% CI 0.88-3.40], p=0.11). Heterogeneity test for studies (Pheterogeneity = <0.00001) showed variation of heterogeneous research. There is no publication bias on this study Eggerâ€™s test (p = 0.334) and Beggâ€™s test (p = 0.180).Conclusion: This analysis confirmed there were no difference effect of angiotensin-converting enzyme inhibitors (ACEi) versus angiotensin receptor blockers (ARBs) in heart failure patients with type 2 diabetes mellitus
An advanced gastric cancer with peritoneal dissemination: complete response achieved with FLOT combination chemotherapy
Authors: Hartono Anita , Lesmana Tomy
Published: April 2020

Introduction: Although chemotherapy is the first recommended treatment of metastatic gastric cancer, a complete response is a rare event.Case: A 56-year-old male was diagnosed as gastric cancer with gastric outlet obstruction, large bowel obstruction and peritoneal dissemination. The patient underwent gastrojejunostomy bypass and ileostomy diversion, and chemotherapy with FLOT (5FU, leucovorin, oxaliplatin, docetaxel) regimen subsequently. After 6 courses of chemotherapy, a computed tomography showed disappearance of gastric mass and disseminated nodules in pelvic cavity, and no visible lesion in gastric mucosa, suggesting a complete clinical response.Conclusion: FLOT regiment in our case succeed to achieve complete clinical response.
Colorectal cancer in young adults: two case reports
Authors: Yusuf Muhammad , Paterasari Bellinda
Published: April 2020

Background: Colorectal cancer (CRC) in young adults is low, but for unclear reasons, a rise in CRC incidence has been reported in patients aged <50 years. The incidence of CRC in young individuals has increased by 2% to 8% annually over the past two decades. CRC diagnosis in young people is always difficult, early detection of colorectal cancer is important for early diagnosis and improve clinical management.Case Description: Twenty four-year-old woman presented with symptoms of abdominal pain and vomiting for 5 months and weight loss. Thirty three-year-old man was hospitalized due to the symptoms of persistent abdominal pain for 5 months, fecal changes, bloody stools and weight loss. Both of them have no chronic disease or familial history of malignancy. The woman underwent an ileostomy and adhesiolysis through laparotomy due to a history of previous appendicitis. Intraoperative, colon was found dilated starting from the duodenum up to 10 cm proximal to the transverse colon so an extended right hemicolectomy is performed. The man underwent colostomy and Hartmann's procedure by laparotomy but the mass was failed to resected and followed by receiving adjuvant chemotherapy. Pathological finding post operative confirmed adenocarcinoma colorectal invasive for the woman and adenocarcinoma rectosigmoid for the man.Conclusion: Within a young group, CRC is usually diagnosed later and potentially associated with worst prognosis. Detecting CRC at an early, more treatable stage is important for cure and survival. This report suggest a greater suspicion rate and early screening that necessary when evaluating young patients with common symptoms.
A network meta-analysis on comparative efficacy of statins focusing for prevention of contrast-induced acute kidney injury in chronic kidney disease patients undergoing percutaneus coronary intervention
Authors: Rahman Ilham Akbar , Purnamasari Yeni , Rewa Vicky Nanu , Kasyim Hasyim , Umar Abd Rahman , Kasim Firdaus
Published: April 2020

Background: The use of interventional diagnostic and therapeutic procedures required intravascular iodinated contrast are performed in millions of patients worldwide and are steadily increasing the risks of contrast-induced acute kidney injury (CI-AKI). Statins are primarily used in cardiovascular medicine for their lipid-lowering effects but they possess remarkable pleiotropic effects such as improving endothelial function as well as decreasing oxidative stress and inflammation. A network meta-analysis was carried out to evaluate the effect of different statins in prevention of CI-AKI and also to investigate which type and dose of statins maybe the best choice specifically in CKD patients who have higher risk.Â  Methods: We performed a pairwise and network meta analysis of 14 randomized studies (9847 patients) comparing a total of 6 different statins: rosuvastatin high dose, atorvastatin high dose, simvastatin high dose, rosuvastatin regular dose, atorvastatin regular dose, pravastatin regular dose versus each other and versus placebo in CKD patients undergoing PCI with iodinated contrast for prevention of CIAKI. Google Scholar, Pubmed, Science Direct databases were searched up to May 2019. The data were pooled using STATA, and R version statistics calculating odds ratios (ORs) with 95% confidence intervals. Results: Statin loading before contrast administration was associated with a significantly reduced risk of CI-AKI in patients with CKD undergoing cardiac catheterization (pooled OR= 0.51; P=0.0001). Regular dose pravastatin comprised the best effect size for a reduction in CIAKI risk (OR = 0.32, 95% CI 0.14-0.72, p=0.006). Regular dose pravastatin and high dose atorvastatin were ranked as the highest probability to be the best treatment (Pbest) with 44% and 31% respectively for effect on CIAKI prevention.Conclusion: Preloading with statins is associated with significantly reduced risk of CI-AKI in patients with CKD undergoing cardiac catheterization. Regular dose pravastatin and high dose atorvastatin have the highest probability to be the most effective prevention strategy.
Rhabdoid adrenocortical carcinoma with brain metastasis: a case report
Authors: Yudiana I Wayan , Prawira Made Moniaga , Pramana Ida Bagus Putra , Tirtayasa Pande Made Wisnu , Santosa Kadek Budi , Duarsa Gede Wirya Kusuma , Oka Anak Agung Gede
Published: April 2020

Introduction: Adrenocortical carcinoma (ACC) is a rare disease with the incidence about 0,02-0,2% from all case of malignancies. The number of malignancies cases reported annually being about 0,7-2 cases per million people. ACC can be functional or nonfunctional tumors, being diagnosed incidentally because of loco-regional symptoms or distant metastases. The overall 5-year survival rate after diagnosis was 15% to 47% and there are no significant differences in survival based on patient age, gender or tumor functional status.Case Report: A 47 years old male came into emergency room with nauseous, vomiting, headache and weakness for 4 weeks. From the physical examination, there were slight hypertension and tenderness on left hypochondric region. Abdominal ultrasound showed a solid mass with central necrotic on upper left abdominal cavity. Then, contrast abdominal CT revealed a well defined heterogeneous solid mass, contrast enhancement with necrotic area that attached on the upper pole of left kidney suspicious on left adrenal organ. He was performed left radical adrenalectomy as initial treatment to determine the histopathology result and tumor staging. After surgery complains of his headache remained, thus head CT was performed and it concluded an intracranial metastatic process at right parietal region, left temporal brain parenchymal and cerebellum which pressing ventricle IV. Steroid and neurotrophic treatment were given by neurologic division. This patient was also consulted to neurology, hemato-oncology, neurosurgery and radiotherapy for further treatment.Conclusion: ACC is a progressive disease with a poor prognosis because of its initial presentation with advance disease (tumor burden or distant metastases), high incidence of local recurrence, and systemic therapy still controversial. The patient has to do a complete physical examination, imaging and laboratory work-up. Multimodality treatment with a multidisciplinary approach is needed to manage the patient for optimal outcome.
Cerebrospinal fluid contents and risk of shunt exposure in hydrocephalus
Authors: Arifin Muhamad Thohar , Purnomo Febriyanto , Muttaqin Zainal , Bakhtiar Yuriz , Andar Erie , Priambada Dody , Kurnia Happy , Risdianto Ajid , Tsaniadi Krisna , Kusnarto Gunadi , Bunyamin Jacob
Published: April 2020

Background: Exposure of the shunt is a rare but severe complication after ventriculoperitoneal (VP) shunt placement. It is unclear whether particular levels of cerebrospinal fluids (CSF) protein, glucose, or polymorphonuclears (PMNs) may influence theÂ shuntÂ exposure in high-risk individuals.This study aims to find the relation between CSF parameters and shunt exposure.Methods: Examined preoperative CSF characteristics included CSF colour, protein, glucose, and PMNs content in 513 patients with hydrocephalus. Mann-Whitney test was used to determine the correlation between CSF parameters and shunt exposure.Results: Shunt exposure was detected in 25 cases (4.87%). There was a significant relationship betweenÂ distal tip exposure with preoperative glucose (p=0.000), protein level (p=0.007), or PMNs count (p=0.043).Conclusion: Preoperative CSF contents had a significant correlation with shunt exposure in hydrocephalus patients.
The 3rd Aceh Surgery Update 2019 in Conjugation with The 1st Indonesian General Surgeon Society (PABI) Aceh Chapter Meeting and The 1st Ikatan Alumni Bedah Unsyiah (IABU) Meeting
Authors: Habibie Yopie Afriandi
Published: April 2020

Assalamuâ€™alaikum Wr. WbÂ Â Praise and gratitude we pray the presence of Allah SWT for all His mercy and guidance we can still work and work to help in the field of education and humanity. With our greetings and prayers, we are praised to the Holy Prophet Rahmatan lil alamin Rasulullah Muhammad SAW who has brought us from the realm of darkness to a world full of knowledge.Â In itâ€™s third year, the 2019 Aceh Surgery Update will be held in conjunction with The 1st Indonesian General Surgeon Society (PABI), Aceh Chapter Meeting and The 1st Unsyiah Surgical Alumni Association (IABU) Annual Meeting, on December 06th â€“ 08th December 2019 at Dr. Zainoel Abidin Hospital and Building D Multipurpose Auditorium F-MIPA Universitas Syiah Kuala Banda Aceh, with the theme of Tips and Traps in Emergency Surgical Daily Practice. The scientific program this time was very special with the presence of the Bali Medical Journal indexed by Web of Science in scientific publications for all topics presented, both in symposium sessions and free papers.Â I would like to welcome all the experts who have been willing to attend to be the resource persons at this scientific event. A big thank you to all the committees and sponsors who helped to make this big activity a great success. Finally, I also welcome to all delegates, I hope you all get a high valuable scientific experience in the Banda Aceh, the City of Gemilang.Â Wassalam,Sincerely yours,Â Â Yopie Afriandi Habibie, MD, SpBTKV-E, FIHA, FICS, FACSChairmanÂ Â