Search

The prospective leaders who live in the era of Internet of Things, certainly will not experience difficulties to digital equipment. Their sufficient knowledge and skill of digital world, would become a strong foundation as a future leaders. The massive technology development, social media as one mean, has become a necessity that cannot be stopped nor avoided. This condition creates the huge and wide opportunities to enhance the credibility and competency of future leader. Recently, no one leader could move forward in their succeed without the information technology knowledge. However, those knowledge and skills will not enabling some one to automatically produce a positive and maximum performance for the organization. Hence, the agile management approach is needed to fill the gap for Z-generation to improve their performance. This paper use qualitative method through studying scientific sources such as books, journals and articles, to formulate a guideline or management concept to prepare Z-generations to face the millennium era. The research result that can be transformed for human resources management are 4 activities. They are collection (doing inventory through out topics and materials that has role to human resource quality improvement); clustering (doing identification and grouping of the inventory results with the similarities, and sort them by priority); process (doing a set of activities in cluster items that is arranged as priority set before0; and release (implementation through training for employees run by the human resource department).

Introduction Anterior temporal lobectomy (LTA) is a surgical procedure commonly used for the treatment of temporal lobe epilepsy refractory to medical management, with high success rates in the control of seizures. However, an important association with psychiatric illnesses has been described that can alter the postoperative outcome in these patients. Methods A series of 2 cases of patients who, despite successful crisis control, developed psychiatric complications in the postoperative period of anterior temporal lobectomy. Results The cases included a male patient with no history of previous mental illness, who developed a major depressive episode in the postoperative period, and a female patient with previous psychosis who presented as a surgical complication exacerbation of psychosis, diagnosed with paranoid schizophrenia. Conclusions Psychiatric disorders can occur in postoperative temporal lobe epilepsy patients with or without a history of mental illness. The most frequent alterations reported are depression, anxiety, psychosis and personality disorders. The inclusion of psychiatric evaluations in the pre- and post-surgical protocols can lead to an improvement in the prognosis of the neurological and mental outcomes of the patients undergoing the intervention.

Peningkatan Ekspresi PD-L1 pada Squamous Cell Carcinoma Nasofaring Tipe Undifferentiated Non Keratinizing Franky Yusuf1*, Awal Prasetyo2, Vega Karlowee3, Meira Dewi Kusuma Astuti4, Rizky Widya Nur5 1,2,3,4,5Departemen Patologi Anatomik Fakultas Kedokteran Universitas Diponegoro/ RSUP Dr. Kariadi Semarang Korespondensi : franq_yu@yahoo.co.id ABSTRAK LATAR BELAKANG: PD-L1 yang diekspresikan oleh sel tumor pada karsinoma nasofaring (KNF) dapat digunakan oleh sel tumor tersebut untuk menghindari sistem imun penderita. Hal ini dapat mempengaruhi prognosis pasien seperti usia, jenis kelamin, tipe histopatologi, stadium tumor dan kualitas hidup melalui aktivitas imunosupresif. Ekspresi PD-L1 diharapkan dapat menjadi biomarker untuk penilaian faktor prognostik dan imunoterapi. TUJUAN: Untuk mengetahui apakah terdapat hubungan antara tingkat ekspresi PD-L1 dan faktor prognostik pada KNF. METODE: Penelitian ini menggunakan studi observasional analitik dengan desain cross sectional. Ekspresi PD-L1 diperiksa secara imunohistokimia dengan menggunakan 61 sampel blok parafin, yang telah terdiagnosis sebagai KNF di laboratorium Patologi Anatomi Rumah Sakit Dr. Kariadi dari bulan Januari 2017 sampai Juni 2020. Data klinis pasien yang digunakan sebagai faktor prognostik yaitu usia, jenis kelamin, tipe histopatologi, stadium tumor dan kualitas hidup. Dilakukan analisis dengan uji Chi-Square untuk mengetahui hubungan antara tingkat ekspresi PD-L1 dengan faktor prognostik. HASIL: Terdapat hubungan yang bermakna antara ekspresi PD-L1 dan tipe histopatologi (p= 0.001). Tidak terdapat hubungan yang bermakna antara ekspresi PD-L1 dan usia (p=0.405), jenis kelamin (p=0. 41), stadium tumor (p=0.928), dan kualitas hidup (p=0.103). KESIMPULAN: Ekspresi PD-L1 pada penelitian ini tidak dapat dijadikan sebagai faktor prognostik pada pasien KNF, walaupun tipe histopatologi menunjukkan hubungan yang bermakna, sehingga diperlukan penelitian lebih lanjut dengan sampel yang lebih besar dan periode yang lebih lama. Kata kunci : Faktor prognostik; Karsinoma nasofaring; PD-L1

As a result of COVID-19, the world is experiencing shocks and the risk of increasing uncertainty affecting various sectors, like the health, social and economic sectors. In the economic sector, economic activity has decreased. Numerous companies have laid off their employees because their businesses could not survive, and there is decreased business productivity, which has resulted in reduced public consumption and reduced economic growth. In a situation like this, humans are required to be able to adapt to existing conditions, by innovating to create new business fields or trying to become entrepreneurs to encourage economic growth. The economic activity amid the pandemic’s challenges has been initiated by the government in order for the Indonesian economy to revive, and universities in Jakarta, Tangerang, and Bekasi ( Jabeka) are trying to create new entrepreneurs in the economic sector. The purpose of this research was to describe the strategy of universities in creating students as entrepreneurs amid the COVID-19 pandemic. The research subjects were the program managers and the entrepreneurs’ lecturers. Descriptive qualitative methods were used, with Miles and Huberman data. Based on the results of the research, it can be concluded that universities prepared students very well in terms of the curriculum, teaching, entrepreneurial activities, and soft skills that students must have before graduating from tertiary education, such as requiring students to carry out entrepreneurship activities while being students. Keywords: strategy, universities, entrepreneurs.

This study analyses significant factors affecting the level of preparation for the industry 4.0 era related to anxiety about the COVID-19 pandemic on employees in DKI Jakarta. Apart from being influenced by the anxiety of the COVID-19 pandemic, the level of preparation for the industry 4.0 is also differentiated by gender, age, education, marital status, decreasing income, and loyalty. Therefore, companies can arrange the planning related to preparing the industry 4.0 during the COVID-19 pandemic if those factors have been figured out. This study used a quantitative method, and the population of this study is full-time employees in DKI Jakarta. The sample was selected by using the snowball sampling technique distributed to 12 companies in DKI Jakarta. The distribution was conducted through the WhatsApp application for a month, and it was gained 228 respondents. Snowball sampling technique used in correlation with the implementation of large-scale social restrictions caused by COVID-19 pandemic. The data analysis used a multiple linear regression model. The results show that factors affecting the level of employees’ preparation in DKI Jakarta for industry 4.0 related to the anxiety of the COVID-19 pandemic are loyalty and a decrease in income.

This study aims to model stunting cases in children under five in Gorontalo city in 2018. In this model, it can be seen that the significant factors that affect stunting cases in children under five in Gorontalo city in 2018. This study uses data on stunting cases in 9 (nine) districts in the city of Gorontalo and the factors that influence it. The research data were obtained from the Public Health in Gorontalo city. This study used one response variable, namely the number of cases of stunting and four predictor variables, namely number of toddlers who received exclusive breastfeeding, the percentage of low birth weight (LBW), the percentage toddlers who received complete basic immunization, and number of proper sanitation. The results obtained were the variables of number of toddlers who received exclusive breastfeeding and the percentage toddlers who received complete basic immunization which had a significant effect on stunting cases in children under five in the city of Gorontalo in 2018. This was indicated by the P-value of the variable for number of toddlers who received exclusive breastfeeding of 0.00283 and P-value of variable the percentage toddlers who get complete basic immunization is 0.06564.

Background Correct dosing and therapeutic drug monitoring (TDM) practices are essential when aiming for optimal vancomycin treatment. Objective To assess target attainment after initial dosing and dose adjustments, and to determine compliance to dosing and TDM guidelines. Setting Tertiary care university hospital in Belgium. Method A chart review was performed in 150 patients, ranging from preterm infants to adults, treated intravenously with vancomycin. Patient characteristics, dosing and TDM data were compared to evidence-based hospital guidelines. Main outcome measures Target attainment of vancomycin after initial dosing and dose adjustments. Results Subtherapeutic concentrations were measured in 68% of adults, in 76% of children and in 52% of neonates after treatment initiation. Multiple dose adaptations (median 2, Q1 1-Q3 2) were required for target attainment, whilst more than 20% of children and neonates never reached targeted concentrations. Regarding compliance to the hospital guideline, some points of improvement were identified: omitted dose adjustment in adults with decreased renal function (53%), delayed sampling (16% in adults, 31% in children) and redundant sampling (34% of all samples in adults, 12% in children, 13% in neonates). Conclusion Target attainment for vancomycin with current dosing regimens and TDM is poor in all age groups. Besides, human factors should not be ignored when aiming for optimal treatment. This study reflects an ongoing challenge in clinical practice and highlights the need for optimization of vancomycin dosing strategies and improvement of awareness of all health care professionals involved.

ObjectivesThe WHO Access, Watch and Reserve (AWaRe) classification has been developed to support countries and hospitals in promoting rational use of antibiotics while improving access to these essential medicines. We aimed to describe patterns of worldwide antibiotic use according to the AWaRe classification in the adult inpatient population.MethodsThe Global Point Prevalence Survey on Antimicrobial Consumption and Resistance (Global-PPS) collects hospital antibiotic use data using a standardized PPS methodology. Global-PPS 2015, 2017 and 2018 data, collected by 664 hospitals in 69 countries, were categorized into AWaRe groups to calculate proportional AWaRe use, Access-to-Watch ratios and the most common indications for treatment with selected Watch antibiotics. Only prescriptions for systemic antibiotics on adult inpatient wards were analysed.ResultsRegional Access use ranged from 28.4% in West and Central Asia to 57.7% in Oceania, whereas Watch use was lowest in Oceania (41.3%) and highest in West and Central Asia (66.1%). Reserve use ranged from 0.03% in sub-Saharan Africa to 4.7% in Latin America. There were large differences in AWaRe prescribing at country level. Watch antibiotics were prescribed for a range of very different indications worldwide, both for therapeutic and prophylactic use.ConclusionsWe observed considerable variations in AWaRe prescribing and high use of Watch antibiotics, particularly in lower- and upper-middle-income countries, followed by high-income countries. The WHO AWaRe classification has an instrumental role to play in local and national stewardship activities to assess prescribing patterns and to inform and evaluate stewardship activities.

The determining or the implementation of occupational safety and health management system is an obligation for all companies as is already mandated in Government Regulation Number 50 in 2012. The implementation have an aim to reduce the risk level of work accident noraltough the occupational illness which may be happening in work environment. The aim of this research is to cover the implementation of occupational safety and health management system at PT. PLN (Persero) Rayon Rote Ndao. This research is using descriptive analysis method with total five informants which are consist of the manager of PT.PLN (Persero) Rayon Rote Ndao, supervisor K3, office employee, field employee and engineer. The research result shows that theoccupational safety and health management system’s commitment and the policy, the occupational safety and health management system’s planning, the occupational safety and health management system’s implementation, the occupational safety and health management system’s measurement and evaluation, and the occupational safety and health management system’s review and improvement in PT.PLN (Persero) Rayon Rote Ndao have already been well applyed.

Highlights • Medial Uni-compartmental Knee Arthroplasty (MUKA) is a newer minimally invasive procedure that gained recent spotlight. • Cheaper, less blood loss, faster hospitalization and less pain and makes it more favorable compared to the conventional TKA (Total Knee Arthroplasty). • Fewer studies compared to TKA have been reporting its complication. • Meniscal bearing dislocation is one of the most common complication in UKA. • We reported simple open reduction technique which is lest costly, effective with satisfying result., Introduction Dislocation of polyethylene insert is one of the most common complications of mobile bearing-medial unicompartmental knee arthroplasty (MUKA). Bearing dislocation was diagnosed by radiograph examination in these cases upon trivial injury. Case presentation We reported one case of meniscal bearing dislocation after an Oxford MUKA treated with a simple open reduction technique. Clinical discussion Simple open reduction surgery without change of the bearing and the use of knee brace for 6 months was effective in preventing re-dislocation. Conclusion Mobile bearing dislocation is one of the most common complications in mobile-bearing MUKA. Besides the prevention of technical errors, usage of UKA with a frequency of 10–15 per year is recommended to increase the surgeon’s learning curve.

Perovskite light-emitting diodes have been gaining attention in recent years due to their high efficiencies. Despite of the recent progress made in device efficiency, the operation mechanisms of these devices are still not well understood, especially the effects of ion migration. In this work, the role of ion migration is investigated by measuring the transient electroluminescence and current responses, with both the current and efficiency showing a slow response in a time scale of tens of milliseconds. The results of the charge injection dynamics show that the slow response of the current is attributed to the migration and accumulation of halide ions at the anode interface, facilitating hole injection and leading to a strong charge imbalance. Further, the results of the charge recombination dynamics show that the slow response of the efficiency is attributed to enhanced charge injection facilitated by ion migration, which leads to an increased carrier density favoring bimolecular radiative recombination. Through a combined analysis of both charge injection and recombination dynamics, we finally present a comprehensive picture of the role of ion migration in device operation.

Introduction High‐resolution magnetic resonance imaging (MRI) of the cervical spinal cord is important to provide accurate diagnosis and pathological assessment of injuries. MEDIC (Multiple Echo Data Image Combination) sequences have been used in clinical MRI; however, a comparison of the performance of 2D and 3D MEDIC for cervical spinal cord imaging has not been reported. The aim of this study is to compare axial 2D and 3D MEDIC for the visualisation of the grey matter (GM) and white matter (WM) of the human cervical spinal cord. Methods Eight healthy participants were scanned using Siemens Prismafit 3T MRI. T2*‐weighted gradient spoiled 2D and 3D MEDIC sequences were acquired at 0.4 × 0.4 × 3.0 and 0.3 × 0.3 × 3.0 mm resolutions, with the acquisition times of 6 and 7 min, respectively. Quantitative analyses of the images were made based on the image signal‐to‐noise ratio (SNR), contrast‐to‐noise ratio (CNR) and non‐uniformity (NU). Two independent radiologists (CS and FN), each provided Likert scoring assessments of anatomical visibility of the GM and WM structures and image clarity for all samples. Results Quantitative evaluation showed that 3D MEDIC provided higher SNR, higher CNR and lower NU than 2D MEDIC. However, 2D MEDIC provided better anatomical visibility for the GM, WM and CSF, and higher image clarity (lower artefacts) compared to 3D MEDIC. Conclusions 2D MEDIC provides better information for depicting the internal structures of the cervical spinal cord compared to 3D MEDIC., 2D MEDIC provided better quality images for depicting the cervical spinal cord's white and grey matter structures with reduced artefacts and superior clarity compared to the 3D MEDIC. This paper showed that the 2D MEDIC can potentially be used to obtain reliable measurements of atrophy and lesions in the internal spinal cord structures, which is important for diagnosis in diseases such as multiple sclerosis and spinal cord injury.

Similar to an electronic lattice determining the motion of electrons in solids, photonic crystals (PhCs) are periodic photonic nanostructures that determine the propagation of photons. By incorporating PhCs into organic light-emitting diodes (OLEDs), the device efficiency and emission spectra can be modified, which can be explained and predicted by the mode dispersion. In this work, we experimentally measure the mode dispersion of 1-D and 2-D PhC OLEDs at different azimuthal angles with angle-resolved electroluminescence spectra. The results are explained using an intuitive geometry approach, which shifts and slices the cone-shaped optical modes to obtain the mode dispersion of PhC OLEDs. We note that the weak cavity mode and a narrow photonic band gap are visible only after eliminating the intrinsic emitter spectrum in the air mode dispersion. In the end, we discuss the implication of mode dispersion on the OLED light extraction.

Background: With growing popularity and experience in laparoscopic liver surgery, the options for more difficult procedures increase. Only small case series have been published regarding laparoscopic liver resection (LLR) for tumours in proximity to major vessels (MVs). The aim was to compare outcomes of LLR for tumours located less or more than 15 mm from MVs. Methods: This was a retrospective analysis of a prospectively collected database of consecutive LLR (October 2011–August 2017). Proximity to MVs (PMV) was defined as lesions located within 15 mm to the caval vein, hepatic veins and portal vein (main trunk and first branches). The control group were all lesions located more than 15 mm from MVs. Results: Some 60/235 LLR were performed for lesions in proximity to major vasculature (24%). In the PMV group, median IWATE Difficulty Score was higher (8.5 (IQR: 6.0–9.0) VS 5.0 (IQR: 3.0–6.0), p < 0.001) as was the use of CUSA® (45.0% VS 8.6%, p < 0.001) and Pringle manoeuvre (8.3% VS 1.7%; p = 0.028). Operative time was longer (180min (IQR: 140–210) VS 120min (IQR: 75–150), p < 0.001) and blood loss was higher (190 ml (IQR: 100–325) VS 75 ml (IQR: 50–220), p < 0.001) in the PMV group. There was no difference in perioperative blood transfusion (3.3% VS 1.7%, p = 0.60) or postoperative morbidity (15.0% VS 14.3%, p = 0.89). There was no mortality in both groups. On mean follow-up of 21 months, no significant differences could be found in disease free (p = 0.77) and overall survival (p = 0.12). Conclusion: In experienced hands, LLR of lesions in proximity to MVs is safe and feasible with acceptable short and long-term results.

Introduction: Laparoscopic resection of the hepatic caudate lobe (LRCL) requires a high level of expertise due to its challenging anatomical area. Only case reports, case series, and single-center cohort studies have been published. The aim of this study was to assess the safety and feasibility of this laparoscopic procedure. Methods: A multicenter retrospective cohort study including all patients who underwent LRCL in 4 high-volume hepatobiliary units between January 2000 and May 2018 was performed. Perioperative, postoperative, and survival outcomes were assessed. Postoperative morbidity was stratified according to the Clavien-Dindo classification with severe complications defined by grade III or more. The Kaplan-Meier method was used for survival analysis. Results: A total of 32 patients were included, including 22 (68.8%) with colorectal liver metastasis (CRLM), one (3.1%) with cholangiocarcinoma, four (12.5%) with other malignancies, and five (15.6%) with symptomatic benign lesions. Simultaneous colorectal and/or additional liver resection was performed in 20 (62.5%) patients. The median (IQR) operative time was 155 (121–280) minutes, blood loss was 100 (50–275) ml, conversion rate was 9.4% (n = 3), severe complications were observed in 2 patients (6.3%), and median (range) length of hospital stay was 3 [1–39] days. No 90-day postoperative mortality was noticed. The median (IQR) follow-up for the CRLM group was 14 [10–23] months. Five-year overall survival rate was 82% in this subgroup. Small interinstitutional differences were observed without major impact on surgical outcomes. Conclusion: LRCL is safe and feasible when performed in high-volume centers. Profound anatomical knowledge, advanced laparoscopic skills, and mastering intraoperative ultrasound are essential. No major interinstitutional differences were ascertained.

The Indonesian society are still put respect and hope higher to one profession’s who work at the government agencies, in Indonesia they are known as Aparatur Sipil Negara (ASN). Based on this reason, the Indonesian government urged to have a new paradigm in recruiting their employees. By knowing factors that drives someone to choose ASN as their profession the government can get expertises both in skill and scholarly. This study has resulting some factors that affect respondents to join ASN such as their: current job, parent’s job, pension factor, low work load, and lastly proud. Their willing to join ASN mostly not affected by their: gender, present allowances, not because working as an ASN will be relaxed, not because of the allowance available, not because of their parents’ demand nor no dismissal. Respondents will not join the ASN because lack of fighting spirit and struggles. They will not join ASN because of lack of creativity, not because of bounded, not because hard resignation, not because of slow carier path nor the low salary rate. Among those factors which affect respondents to join ASN or not affecting is their present job. If their present job is not ASN or jobless, then the probability to become an ASN is 41.3%. If their present job is ASN or college students then the probability of desire to be ASN is 84.4%. The profile of the respondents who are desired to be ASN observed from Tree Diagram. The method used in this study are Crosstab and Classification Tree.

BPJS is a type of insurance that helps the community, especially the poor. Nonetheless, complaints from patients participating in the BPJS often arise, especially towards administrative services and hospital facilities. These complaints need to be considered especially for complaints that come from patients who need intensive care. Each hospital has different administrative services and facilities. In this research, hospital that provides the highest satisfaction for ICU patients who are participating in BPJS, on administrative services and facilities among eight type A hospitals in Jakarta will be searched. The hospital that are included in this research are Hospital B, C, F, G, H, P, S and T. The hospital found can be used as an example for other hospitals. Therefore ICU-BPJS patient complaints can be reduced. Respondents from this study consist of 124 families of ICU-BPJS patients who were treated at the eight hospitals above, taken by purposive sampling method during October to December 2018. Data analysis methods used are the Kruskall Wallis and Least Significant Difference (LSD) methods. The findings of this study are: hospital S has the highest level of satisfaction on facilities for ICU-BPJS patients. The satisfaction on administration between the eight-hospital included in this research is the same.

Highlights • The first case report of a 27 years follow up congenital insensitivity of pain in Indonesia. • Unrecognizing of the clinical pictures in the past, misleads to a late diagnosis and management. • Both patients suffered from debilitating consequence of amputation and death of the male patient. • Open reduction and internal fixations of metaphyseal fractures may eventually lead to non-union. • Diaphyseal fractures more likely result in bony unions with casting immobilization., Introduction Congenital insensitivity to pain with anhidrosis (CIPA; OMIM 256,800) is a rare autosomal recessive disease. Although the clinical symptoms are known, the consensus of CIPA treatment has not been recognized. This is the first report of CIPA in Indonesia, a case of two siblings, male and female, whom we followed-up for 27 years. Presentation of case After a series of multiple fractures from an early age, both patients who lived wheelchair-bound with their parents had been suffering from a recurrent debilitating infection on their lower extremities. The male patient eventually died from sepsis due to bronchopneumonia, years after the nonunion of both legs. The female patient underwent double above knee amputation. Discussion Observation showed that fracture in joint and metaphysis treated with open reduction ultimately end in disastrous outcomes like infection and non-union. On the contrary, the diaphyseal fracture has a better expectation to unite with casting immobilization. Conclusion Unrecognizing of the clinical pictures of CIPA and minimal literature references in the past, misleads to late diagnosis and management. Genetic evaluation should be done for infants with unknown causes of high fever, anhidrosis combined with insensitivity to pain. Surgical intervention of metaphyseal fractures should be avoided due to tendencies of implants loosening, metal failures, recurrent infections followed with non-union, and instability.

The purpose of this paper is to recognize the practices of care and attention of the agents of the traditional medical system responsible for female reproductive health in the south of the Colombian Amazon. In-depth interviews, focus groups and ethnographic observation with local health agents from five rural communities and urban areas of the Municipalities of Leticia and Puerto Nariño were conducted. The results showed that the formation of people, their bodies and good treatment, mediated by a constant control of the relationships between humans and non-humans and the search for good living, are established as the determinants of care practices and attention to women’s reproductive health. Likewise, there is a deep respect for the mother’s decisions during her procreative process, which coincides with the recent international provisions. These data serve as the basis for the understanding of the local medical culture and its incorporation into the therapeutic processes of health in a framework of interculturality. El objetivo del presente trabajo consiste en reconocer las prácticas de cuidado y atención de los agentes del sistema médico tradicional responsables de la salud reproductiva femenina en el sur de la Amazonia colombiana. Para ello, se realizaron entrevistas a profundidad, grupos focales y observación etnográfica con agentes locales de salud de cinco comunidades rurales y cascos urbanos de los municipios de Leticia y Puerto Nariño. Los resultados mostraron que la formación de personas, sus cuerpos y el buen trato, mediados por un constante control de las relaciones entre humanos y no humanos, se establecen como los determinantes de las prácticas de cuidado y atención a la salud reproductiva femenina. Igualmente, se evidencia un profundo respeto por las decisiones de la madre durante su proceso procreativo, lo que coincide con las recientes disposiciones internacionales. Estos datos sirven como base para la comprensión de la cultura médica local y su incorporación en los procesos terapéuticos de salud en un marco de interculturalidad.

El síndrome de Achenbach es una condición de etiología desconocida, caracterizado por cambios en la coloración de la piel de los dedos y asociado a dolor agudo. Existen pocos datos epidemiológicos, pero se estima que es una condición rara, que excepcionalmente aparece por debajo de los 40 años de edad. Presentamos el caso de una mujer joven a quien se dio el diagnóstico de síndrome de Achenbach por sus antecedentes y después de descartar patología reumática, vascular y metabólica. Comentamos datos sobre la patología y las diferencias que se encuentran con el caso que describimos.

El objetivo es ilustrar al lector sobre un tumor infrecuente en la literatura medica y resumir los conocimientos actuales que se tienen sobre esta patologia. Caso clinico: Reportamos el caso de un varon en la quinta decada de la vida, a quien se realizo ecocardiograma transtoracico por deterioro de la clase funcional. La ultrasonografia evidencio un tumor que ocupaba el 95% de la auricula izquierda, con compromiso hemodinamico e hipertension pulmonar grave. Luego de estudios de extension, fue llevado a cirugia para extraccion de la masa por esternotomia media. La patologia revelo sarcoma de alto grado indiferenciado sin compromiso linfovascular. This text aimed to illustrate the reader about one of the most infrequent tumors in the medical literature and discuss based on current literature what is known to date of this pathology. Case report: We report the case of a male in the fifth decade of life, who underwent transthoracic echocardiography due to impairment of the functional class. Ultrasound showed tumor lesion that occupied 95% of the left atrium, with hemodynamic compromise and severe pulmonary hypertension. After extension studies, he was taken to surgery with total mass extraction by middle stereotomy. The pathology revealed undifferentiated high-grade sarcoma without lymphovascular involvement.

Results have been reported previously of a model describing the performance of photoelectrochemical reactors, which utilize semiconductor | liquid junctions. This model was developed and verified using SnIV-doped α-Fe2O3 as photoanodes. Hematite films were fully characterized to obtain parameter inputs to a model predicting photocurrent densities. Thus, measured photocurrents were described and validated by the model in terms of measurable quantities. The complete reactor model, developed in COMSOL Multiphysics, accounted for gas evolution and desorption in the system. Hydrogen fluxes, charge yields and gas collection efficiencies in a photoelectrochemical reactor were estimated, revealing a critical need for geometric optimization to minimize H2-O2 product recombination as well as undesirable spatial distributions of current densities and “overpotentials” across the electrodes. Herein, the model was implemented in a 3D geometry and validated using solid and perforated 0.1 × 0.1 m2 planar photoanodes in an up-scaled photoelectrochemical reactor of 2 dm3. The same model was then applied to a set of simulated electrode geometries and electrode configurations to identify the electrode design that would maximize current densities and H2 fluxes. The electrode geometry was modified by introducing circular perforations of different sizes, relative separations and arrangements into an otherwise solid planar sheet for the purpose of providing ionic shortcuts. We report the simulated effects of electrode thickness and the presence or absence of a membrane to separate oxygen and hydrogen gases. In a reactor incorporating a membrane and a photoanode at 1.51 V vs RHE and pH 13.6, an optimized hydrogen flux was predicted for a perforation geometry with a separation-to-diameter ratio of 4.5 ± 0.5; the optimal perforation diameter was 50 µm. For reactors without a membrane, this ratio was 6.5 and 8.5 for a photoanode in a “wired” (monopolar) and “wireless” (photo-bipolar) design, respectively. The results and methodologies presented here will serve as a framework to optimize composite photoelectrodes (semiconductor | membrane | electrolyte), and photoelectrochemical reactors in general, for the production of hydrogen (and oxygen) from water using solar energy.

OLEDs are thin-film devices consisting of multilayers of organic thin films sandwiched between a metal and an ITO electrodes. Because of the different refractive indices of the layers in the thin film stack, different optical modes are trapped in the device. In this talk, we will first discuss the physics of these optical modes and describe techniques to characterize them. We will then describe how to use various photonic structures to maximize the light output and manipulate these optical modes to control the polarization as well as directionality to achieve beam shaping.

Narrow bandgap lead sulfide (PbS) quantum dots (QDs) are solution-processed materials used for optoelectronic applications in the short-wavelength infrared (SWIR) range (1400 - 3000 nm). The PbS QDs based photodetector has achieved comparable detectivity with current commercial SWIR sensors. However, there are still obstacles towards commercialization in commonly used layer by layer (LbL) deposition, such as high material consumption and low reproducibility. Here, we developed a new ligand exchange strategy to prepare ligand exchanged QD inks for single-step PbS film deposition. Compared with LbL deposition, the EQE of PbS QD photodetector made by single-step deposition has improved from 31% to 53%. The EQE and responsivity can be further improved to 95% with IR transparent electrode.

Introduction Spontaneous quadriceps tendon rupture (SQTR) is a rare injury to the knee extensor mechanism that is usually associated with systemic diseases such as end stage renal diseases (ESRD) and it is more prevalent in the elderly. Due to the underlying pathology, quadriceps tendon rupture warrants special considerations and management in its repair. Case report We present two cases of quadriceps tendon rupture in end-stage renal disease (ESRD) patients. The first case; a 57 years old female who had bilateral SQTR and is undergoing hemodialysis. The second patient, a 26 years old male had unilateral quadriceps tendon rupture caused by minimal trauma. The first patient had a trans-osseous repair by direct suturing the quadriceps tendon stump to the proximal pole patella. The second patient was repaired with a modified Bunnel suture and anchor placement on the proximal pole patella. The first case had a re-rupture of the right quadriceps tendon and the second case has recovered with improved outcomes. Discussion Spontaneous quadriceps tendon rupture is usually underlined by degenerative changes of the tendons. Special care is needed to address the pathologic tendon underlying SQTR. The current surgical literature still lacks the statistical data that shows which surgical approach is most optimal for SQTR in ESRD patients. Conclusion SQTR rupture is generally an injury of brittle tendons caused by underlying diseases. A multidisciplinary and comprehensive approach including a proper surgical approach and postoperative managements are crucial for good functional outcomes of the extensor mechanism., Highlights • SQTR are commonly associated with brittle tendons due to systemic diseases. • A multidisciplinary and comprehensive repair is crucial for a good functional outcome for SQTR rupture in ESRD. • Surgical augmentations are needed for the brittle tendon of SQTR. But statistical data for the best surgical approach for SQTR in ESRD is still lacking.

Many micro and small business owners do not carry out accounting properly because they do not have a good understanding of basic accounting principles. Poor accounting causes the owners do not know the health of their businesses and cannot make the right decisions to improve the efficiency and effectiveness of their businesses. To help micro and small business owners improve their knowledge of accounting, Postgraduate Program, Universitas Prof. University Dr. Moestopo organized community engagement activities in the form of training in basic accounting principles. The training participants consisted of 28 micro and small business owners who were domiciled or residing in the Larangan Indah Subdistrict. The training was conducted using lecture or classroom methods. To evaluate training, the Kirkpatrick’s Model is used with evaluations carried out in the reaction and learning areas. Based on the results of evaluating the reaction using the satisfaction questionnaire, it is known that the participants showed positive reactions while based on the results of the evaluation of learning using a comparison between pre-test and post-test scores it is known that the participants experienced an increase in knowledge. The aspects that will be improved in the next training are audiovisual aids, facilities, and schedule.

Background: The prognostic value of chromogranin-A (CHGA) as a biomarker of prostate cancer (PCa) has been evaluated extensively. However, to date the results still remain controversial. This study aims to perform a meta-analysis on previous studies in order to determine whether CHGA would be a biomarker for survival in PCa patients. Methods: MEDLINE, Embase, Web of Science, and Cochrane Library databases were searched to identify eligible studies published before September 2018, regarding the association of CHGA gene expression with survival outcomes in patients with PCa. Multivariate adjusted HRs and associated 95% CIs were calculated using random effects models. Results: Ten cohort studies involving 3,172 patients were finally included. According to the included studies, circulating CHGA levels were tested in serum, plasma, and tissues. The results showed an association between high CHGA expression and worse overall survival (OS) (HR=1.24, 95% CI: 1.07–1.44; P=0.004; I2=77.6%) in PCa patients. However, no significant association was observed between increasing CHGA expression and shorter progression-free survival (HR=1.73, 95% CI: 0.92–3.28; P=0.090; I2=73.9%). The results of sensitivity analysis validated the rationality and reliability of our analysis. Conclusion: Current evidence indicates that high CHGA expression is a potential marker for poor OS in PCa. Future studies are needed to explore tailored treatments that directly target CHGA for the improvement of survival in men with PCa.

The flat band potential is one of the key characteristics of photoelectrode performance. However, its determination on nanostructured materials is associated with considerable uncertainty. The complexity, applicability and pitfalls associated with the four most common experimental techniques used for evaluating flat band potentials, are illustrated using nanostructured synthetic hematite (α-Fe2O3) in strongly alkaline solutions as a case study. The motivation for this study was the large variance in flat band potential values reported for synthetic hematite electrodes that could not be justified by differences in experimental conditions, or by differences in their charge carrier densities. We demonstrate through theory and experiments that different flat band potential determination methods can yield widely different results, so could mislead the analysis of the photoelectrode performance. We have examined: (a) application of the Mott–Schottky (MS) equation to the interfacial capacitance, determined by electrochemical impedance spectroscopy as a function of electrode potential and potential perturbation frequency; (b) Gärtner–Butler (GB) analysis of the square of the photocurrent as a function of electrode potential; (c) determination of the potential of transition between cathodic and anodic photocurrents during slow potentiodynamic scans under chopped illumination (CI); (d) open circuit electrode potential (OCP) under high irradiance. Methods GB, CI and OCP were explored in absence and presence of H2O2 as hole scavenger. The CI method was found to give reproducible and the most accurate results on hematite but our overall conclusion and recommendation is that multiple methods should be employed for verifying a reported flat band potential.

Highlights • Neglected femoral neck fracture led to severe disuse osteoporos is resulting very brittle acetabulum floor and proximal femur shaft. • The decision to use uncemented Total Hip Replacement was taken to reduce the risk of pulmonary embolism. • Plasticity of the osteoporotic acetabulum floor caused bouncing effect in every single hit resulting in cup fixation failure and massive acetabulum floor. • In emergency situation, an acceptable result could be achieved by constructing an unusual cup composite, made from the remaining cancellous chondral shell of the femoral head as a base, the failed uncemented cup as a cage and a cemented cup fixed together with gentamycine loaded bone cement., Introduction Uncemented total hip for neglected nonunion femoral neck fracture hopefully could minimize the post operative complications. Nevertheless, due to plasticity of the brittle osteoporotic bone, unexpected fracture may occur. We presented an unusual reconstruction of acetabulum which was accidently perforated during uncemented cup insertion. Presentation of case A 76 years old wheelchair bound female showed a nonunion fracture of the right femoral neck due to a fall 7 years ago. She had right hip instability with 5 cm leg shortening. Uncemented total hip replacement was originally planned, however, due to unexpected perforation of the acetabulum, it was ended in total hip after creating a composite layers to fix a cemented cup. Patient was full ambulatory with walker at 4 months. Harris Hip Score at 15 months showed 71.3%, compared with 20.2% before surgery. Discussion The plasticity of the osteoporotic acetabulum floor was the reason why the uncemented cup could not be fixed, instead it caused massive perforation of the floor. The acetabulum reconstruction was done by composite layers made from remaining chondral bone shell, absorbable hemostatic gelatin sponge and cancellous bone of the femoral head, porous collagen matrix and uncemented titanium acetabulum cup fixed with two screws. Conclusion In unexpected acetabulum perforation, the remaining chondral shell of femoral head together with uncemented cup as a cage support and bone cement can be used to reconstruct the acetabulum floor. More stability can be achieved using reconstruction cage with allograft and or metal augments or using a cemented total hip arthroplasty.

Many photoelectrodes produce a gaseous product, such as hydrogen or oxygen, from a liquid electrolyte and require light transmission directly through the two-phase mixture forming at the semiconductor–electrolyte interface. Consequently, incidence solar photons will be scattered and reflected from the bubbly mixture leading to an additional optical loss. In this work, these optical losses are quantified for a population of bubbles that evolved from the vertical surface of a transparent conductive electrode (F-SnO2) by measuring the amount of light transmitted. The transmitted photons were collected in an integrating sphere placed directly behind the 15 mm × 15 mm electrode to capture the forward scattered light. The empirical results were compared with a simple dimensionless model. Finally, mitigation strategies are suggested and critically discussed. With progress in the development of large scale prototype photoelectrochemical devices comes the need to understand, quantify, and potentially resolve the i...

This community service activity was carried out to provide understanding as well as anticipation to teachers in Oebelo village, Kupang Tengah, Kupang, East Nusa Tenggara, Indonesia regarding news that contains false and misleading contents (hoax). Teachers who have more time with their students, are expected to transfer their understanding so that they will not easily believe unverified news. These understanding and anticipation were also delivered to junior high school students (grade VIII to IX) that in reality had started to know information technology – social media. The development of information technology – social media that has positive and negative impacts must be seen as important and urgent matter to be handled properly. This development should be directed towards improving the quality of human resources (human capital development) in this millennium era. However, in reality, even false news or messages have a detrimental effect on a person or community. Therefore, as the final result of this activity, two guidelines will be made; how to anticipate hoax news and how to utilize abundant information sources through the development of information technology, especially internet media. This is done as part of the effort to improve the quality of human resources.

The COVID-19 pandemic has brought many fundamental changes in running atourism business. Many countries need to reformulate their post-19 strategy so that the tourismsector will revive. This study aims to formulate a strategy for developing e-tourism by utilizinginformation technology. The method used is a competitive intelligence approach. This researchtakes samples from tourist destinations in Indonesia. The results of this study indicate that theright strategy can encourage the tourism industry to grow back in the post-COVID-19 period.The resulting strategy is based on campaign, content, community, cooperation, andcompetitiveness. These five basic strategies are implemented with an e-tourism model and asimple management pattern utilizing information technology. The results of this research canhave implications for the formulation of e-tourism policies and produce recommendations forpolicymakers.

Introduction and importance A patient presented with complex perianal fistula treated with fistula laser closure (FILAC) combined with suction catheters. Case presentation Male, 29 years old, presented in our department, presented with complex perianal fistula with a history of fistulectomy and tight seton for 6 months in another health facility. Intraoperative findings were a tract of 4,5 cm long, 4 external openings, and 1 internal opening. Definitive treatment of Fistula Laser Closure (FILAC) with 13-watt power laser diode produces by BIOLITEC German. Conclusion The patient recovers within 6 months. Promising results have been shown by combining FILAC and suction catheter for complex perianal fistula., Highlights • Complex perianal fistula is a hard-to-treat diagnosis, careful approaches for its complication are needed. • FILAC is a new sphincter-saving technique, Combination with a suction catheter promotes FILAC to achieved primary closure. • FILAC procedure was chosen because it is a safe and effective treatment for transphinteric anal fistula • Promising result have been shown by combining FILAC and suction catheter for complex perianal fistula

Photoelectrodes enable simultaneous light absorption and catalysis of water splitting reactions. Their performance is established using electrochemical characterisation methods. Besides basic characterisation techniques such as voltammetry and chronoamperometry, employed in the dark or under illumination, more advanced techniques, including (photo-)electrochemical impedance spectroscopy, intensity-modulated impedance spectroscopy and transient absorption spectroscopy, can be used to evaluate key parameters and processes. For some of these techniques, data is often interpreted using over-simplified models, leading to the calculation of unreliable parameters. The values of the flat band potential and charge transfer efficiency depend heavily on the methods used to determine them, and it is recommended that the values are corroborated using multiple techniques. Lastly, certain ‘efficiencies’ defined in the literature for electrically biased systems should be revised.

The prevalence of erectile dysfunction (ED) was reported to vary from 37.5 to 52% in men above 40. Type 2 diabetes mellitus (T2DM) maycause the nerves and blood vessels damages that worsened the ED. This study aimed to evaluate the correlation between the glucose control index and the erection hardness score (EHS) among T2DM patients. The cross-sectional observational study was conducted in two district hospitals i.e. Manambai Abdulkadir District Hospital, Sumbawa, and Dompu District Hospital, Dompu, West Nusa Tenggara, Indonesia. Forty-five patients with T2DM were involved in this study. Data were collected using structural questioners during the period from June 1st to August 1st, 2017 and were analyzed using SPSS 24.0. Pearson correlation and logistic regression analysis were used to determine the odds ratio (OR). Among 45 patients having age 57.38± 7.22 years involved in this study, 38 (84.4%) patients had ED, 26 (57.8%) uncontrolled DM, 5 (11.1%) congestive heart failure (CHF), 4 (8.9%) chronic kidney diseases (CKD), and 7 (15.6%) neuropathy diabetic. A strong correlation between random glucose level and IIEF-5 score (r=0.91; p=0.01) was observed. The overall odds ratio of ED in this study was 4.3 (95% CI: 0.73 to 25.1) for uncontrolled DM, 2.5 (95% CI: 0.1 to 51.1) for CHF, 2 (95% CI: 0.01 to 41.6) for CKD, and 1.2 (95% CI: 0.1 to 11.5) for neuropathy diabetics. In conclusion, there is a strong correlation between random glucose level, duration of diagnosed DM and EHS. Active screening is recommended for this population.

COVID-19 is a widespread global pandemic with nearly 185 million confirmed cases and about four million deaths. It is caused by an infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which primarily affects the alveolar type II pneumocytes. The infection induces pathological responses including increased inflammation, oxidative stress, and apoptosis. This situation results in impaired gas exchange, hypoxia, and other sequelae that lead to multisystem organ failure and death. As summarized in this article, many interventions and therapeutics have been proposed and investigated to combat the viral infection-induced inflammation and oxidative stress that contributes to the etiology and pathogenesis of COVID-19. However, these methods have not significantly improved treatment outcomes. This may partly be attributable to their inability at restoring redox and inflammatory homeostasis, for which molecular hydrogen (H2), an emerging novel medical gas, may complement. Herein, we systematically review the antioxidative, anti-inflammatory, and antiapoptotic mechanisms of H2. Its small molecular size and nonpolarity allow H2 to rapidly diffuse through cell membranes and penetrate cellular organelles. H2 has been demonstrated to suppress NF-κB inflammatory signaling and induce the Nrf2/Keap1 antioxidant pathway, as well as to improve mitochondrial function and enhance cellular bioenergetics. Many preclinical and clinical studies have demonstrated the beneficial effects of H2 in varying diseases, including COVID-19. However, the exact mechanisms, primary modes of action, and its true clinical effects remain to be delineated and verified. Accordingly, additional mechanistic and clinical research into this novel medical gas to combat COVID-19 complications is warranted.