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There are many Buddhist religious rituals in Indonesia. One of them is Tribuana Manggala Bakti which contains universal values in nature conservation. The purpose of this study is to describe the dynamics of the Menoreh community in terms of managing the natural environment, to describe Tribuana Manggala Bakti as Buddhist spirituality, and to analyze the role of Tribuana Manggala Bakti spirituality with universal values in Menoreh environmental management. This research is a qualitative research with library research. This study uses the theory of using Capra's holistic spiritual theory in understanding the function and purpose of Tribuana Manggala Bakti. Menoreh's natural resource management started from an ideational culture to a sensate culture. Sensate culture is seen when people begin to exploit natural resources. Tribuana Manggala Bakti originated from the concern of Buddhists towards the Menoreh nature. Tribuana Manggala Bakti is a series of Vesak events in the form of taking Vesak holy water followed by tree planting, and releasing fish and birds. The release of animals and the planting of trees as a tangible form of awareness of the importance of nature underlies the behavior of an environmentally friendly lifestyle, protecting and caring for the environment. As said by Fritjof Capra as one of the real solutions to the environmental crisis. In Ecoliteracy Capra, realizing the importance of nature has an impact on environmentally friendly lifestyle behavior, protecting and caring for the environment.

Nutrition education with animated media to improve hemoglobin levels and nutritional intake of anemic pregnant women Background: The prevalence of anemia among pregnant women in 2018 increased compared to 2013. Anemic pregnant women need to receive nutrition education. Nutrition education requires media and various studies that report the success of nutrition education using various media. Objective: This study aimed to analyze the effect of animated media nutrition education on improving hemoglobin and nutrient intake of anemic pregnant women. Methods: The study was quasi-experimental with a pretest-posttest one-group design on 31 anemic pregnant women. Nutrition education media, namely animated videos, were prepared based on interviews with cadres and pregnant women. Hemoglobin levels, knowledge, attitudes, iron tablet consumption compliance, and nutrient intake were measured before and after being given animated media nutrition education. Results: The mean hemoglobin level of pregnant women after the intervention increased by 1.75 g/dl; knowledge score 3.52; behavior score 4.06; iron tablet consumption 28 grains; energy intake 574.62 Kcal; protein intake 19.46 g; vitamin C intake 25.98 mg; and iron intake 3.17 mg. Conclusion: Nutrition education intervention using animated video can improve hemoglobin level, knowledge, attitude, iron tablet consumption, and nutritional intake of pregnant women.

Paraoxonase-2 (PON2) is a ubiquitously expressed intracellular protein that is localized in the perinuclear region, the endoplasmic reticulum (ER), and mitochondria, and is also associated with the plasma membrane. PON2 functions as an antioxidant enzyme by reducing the levels of reactive oxygen species (ROS) in the mitochondria and ER through different mechanisms, thus having an anti-apoptotic effect and preventing the formation of atherosclerotic lesions. While the antiatherogenic role played by this enzyme has been extensively explored within endothelial cells in association with vascular disorders, in the last decade, great efforts have been made to clarify its potential involvement in both blood and solid tumors, where PON2 was reported to be overexpressed. This review aims to deeply and carefully examine the contribution of this enzyme to different aspects of tumor cells by promoting the initiation, progression, and spread of neoplasms.

Indonesia and Malaysia share contiguous territories and are renowned for their honey production. In addition, they possess extensively published studies on honey. This study aims to present a comprehensive analysis of the many types of honey found in Indonesia and Malaysia, as well as their health-promoting components. The employed methodology entails conducting a comprehensive review of both primary and secondary literature. The literature search employed online tools, including NCBI-PubMed, Google Scholar, and Elsevier. Indonesia and Malaysia share similar species of bees, including Apis Dorsata, Apis Mellifera, Apis Trigona, and Apis Cerana. The phenolics and antioxidants have garnered the most focus among the components. Notable health advantages encompass the facilitation of diabetic wound healing, enhancement of reproductive health, and promotion of mental well-being.

The purpose of the present paper is to assess if Ponte osteotomies (POs) allow for a better correction in adolescent idiopathic scoliosis (AIS) surgery and to investigate their safety profile. A systematic search of electronic databases was conducted. Inclusion criteria: comparative studies that reported the outcomes of AIS patients who underwent surgical correction through posterior-only approach with and without POs. Clinical and radiographic outcomes were extracted and summarized. Meta-analyses were performed to estimate the differences between patients treated with and without POs. p < 0.05 was considered significant. In total, 9 studies were included. No significant difference in thoracic kyphosis (TK) change between patients treated with and without POs was found (+3.8°; p = 0.06). Considering only hypokyphotic patients, a significant difference in TK change resulted in POs patients (+6.6°; p < 0.01), while a non-significant TK change resulted in normokyphotic patients (+0.2°; p = 0.96). No significant difference in coronal correction (2.5°; p = 0.10) was recorded. Significant estimated blood loss (EBL) (142.5 mL; p = 0.04) and surgical time (21.5 min; p = 0.04) differences were found with POs. Regarding complications rate, the meta-analysis showed a non-significant log odds ratio of 1.1 (p = 0.08) with POs. In conclusion, POs allow for the restoration of TK in hypokyphotic AIS, without a significantly greater TK change in normokyphotic patients, nor a significantly better coronal correction. Considering the significantly greater EBL and the trend toward a higher complications rate, the correct indication for POs is crucial.

This study aims to examine and compare request strategies and politeness of two groups of native speakers from two different ethnic groups in Indonesia, i.e., Javanese and Sundanese. The data were collected by using Discourse Completion Task (DCT) with 60 participants from 30 Javanese (East Java) and 30 Sundanese (West Java) speakers. The data were analyzed by using the classification of request strategies by Blum-Kulka et al., 1989) and social contexts in terms of social power, social distance, and degree of imposition by Brown and Levinson (1987) to reveal the levels of directness and politeness of request employed by each group of speakers. The result of this study indicates that Direct Strategy in the form of mood derivable and Conventionally Indirect Strategy in the form of query preparatory are two request strategies that are mainly employed by both Javanese and Sundanese speakers. In particular, Javanese speakers employ a more Direct Strategy than Sundanese speakers. However, the patterns of request strategies employed by Javanese and Sundanese speakers in most social contexts are similar. In addition, both groups of speakers can also adapt to the situations and employ appropriate requests to the hearer. Therefore, politeness and appropriateness in requests employed by each group of speakers in their DCT responses can reflect the local wisdom of each culture. Keywords: requests; social contexts; politeness; Javanese; Sundanese

SUMMARY: Small-scale egg production is a growing industry in New England. However, foodborne illness risk exists from small-scale pastured eggs due to lack of guidelines for safe handling and management practices. A survey was distributed to backyard poultry owners and producers in the Northeast and indicated a variety of management practices were used. Based on these results, we developed a set of experiments to determine if these management practices influenced eggshell bacteria levels and cuticle deposition. We hypothesized that the manure level (ML) of the eggs and management practices will affect both the total bacterial levels (measured in relative light units = RLU) and the cuticle deposition (CD) of the eggshell. The management practices tested were nest box type (rollaway and conventional style), nest box location (mounted vs. floor level access), nesting substrate (straw, shavings, and AstroTurf Nest Pads), and time/frequency of egg collection. The CD experiments involved nest box type and nest substrate management practices only. In conclusion, management practices that minimize manure levels on eggs, like time of egg collection as found in this study, can help to maintain lower eggshell bacteria levels to reduce food safety risk.

ABSTRACT: Salmonella Enteritidis is a major foodborne pathogen that causes enteric illnesses in humans, primarily through the consumption of contaminated poultry meat and eggs. Despite implementation of traditional disinfection approaches to reduce S. Enteritidis contamination, egg-borne outbreaks continue to occur, raising public health concerns and adversely affecting the popularity and profitability for the poultry industry. Generally Recognized as Safe (GRAS) status phytochemicals such as Trans-cinnamaldehyde (TC) have previously shown to exhibit anti-Salmonella efficacy, however, the low solubility of TC is a major hurdle in its adoption as an egg wash treatment. Therefore, the present study investigated the efficacy of Trans-cinnamaldehyde nanoemulsions (TCNE) prepared with emulsifiers Tween 80 (Tw.80) or Gum Arabic and lecithin (GAL) as dip treatments, at 34°C, for reducing S. Enteritidis on shelled eggs in presence or absence of 5% chicken litter. In addition, the efficacy of TCNE dip treatments in reducing trans-shell migration of S. Enteritidis across shell barrier was investigated. The effect of wash treatments on shell color were evaluated on d 0, 1, 7, and 14 of refrigerated storage. TCNE-Tw.80 or GAL treatments (0.06, 0.12, 0.24, 0.48%) were effective in inactivating S. Enteritidis by at least 2 to 2.5 log cfu/egg as early as 1 min of washing time (P < 0.05). In presence of organic matter, nanoemulsions (0.48%) reduced S. Enteritidis counts by ∼ 2 to 2.5 log cfu/egg as early as 1 min, (P < 0.05). Nanoemulsion wash also inhibited trans-shell migration of S. Enteritidis, as compared to control (P < 0.05). The nanoemulsion wash treatments did not affect shell color (P > 0.05). Results suggest that TCNE could potentially be used as an antimicrobial wash to reduce S. Enteritidis on shelled eggs, although further studies investigating the effect of TCNE wash treatments on organoleptic properties of eggs are necessary.

Abstract Survival has been considered the cornerstone for clinical outcome evaluation in critically ill patients admitted to intensive care unit (ICU). There is evidence that ICU survivors commonly show impairments in long-term outcomes such as quality of life (QoL) considering them as the most relevant ones. In the last years, the concept of patient-important outcomes has been introduced and increasingly reported in peer-reviewed publications. In the present systematic review, we evaluated how many randomized controlled trials (RCTs) were conducted on critically ill patients and reporting a benefit on survival reported also data on QoL. All RCTs investigating nonsurgical interventions that significantly reduced mortality in critically ill patients were searched on MEDLINE/PubMed, Scopus and Embase from inception until August 2021. In a second stage, for all the included studies, the outcome QoL was investigated. The primary outcome was to evaluate how many RCTs analyzing interventions reducing mortality reported also data on QoL. The secondary endpoint was to investigate if QoL resulted improved, worsened or not modified. Data on QoL were reported as evaluated outcome in 7 of the 239 studies (2.9%). The tools to evaluate QoL and QoL time points were heterogeneous. Four interventions showed a significant impact on QoL: Two interventions improved survival and QoL (pravastatin in subarachnoid hemorrhage, dexmedetomidine in elderly patients after noncardiac surgery), while two interventions reduced mortality but negatively influenced QoL (caloric restriction in patients with refeeding syndrome and systematic ICU admission in elderly patients). In conclusion, only a minority of RCTs in which an intervention demonstrated to affect mortality in critically ill patients reported also data on QoL. Future research in critical care should include patient-important outcomes like QoL besides mortality. Data on this topic should be collected in conformity with PROs statement and core outcome sets to guarantee quality and comparability of results.

This study investigated factors determining students' performance in the Introductory Accounting classes. It was carried out using a mixed-method approach. Three research hypotheses based on the results of prior studies were tested using regression analysis. Additionally, a qualitative approach using thematic analysis was used to identify factors influencing students' performance. The study involved 90 students who were selected using the purposive sampling method. Secondary data related to those students were gathered through a documentation procedure, whereas primary data were obtained through interviews and observation involving those sample students. The results of the quantitative analysis showed that motivation had a positive impact on students' performance in Introductory Accounting classes. It was also observed that female students had better performance than male students. However, this study did not find accounting educational background as a significant variable in determining students' performance. For the thematic analysis, the study observed nine factors influencing the students' performance in Introductory Accounting classes. Those factors were related to lecturers, learning method, classroom, family background, references, assignments, tutor, and group study. This study contributes to the upward literature in accounting education. It also provides an insight for the Accounting Study Program in higher education institutions in designing accounting curricula, for lecturers in designing learning processes, and for accounting students in understanding the determinants of their performance.

Abstract Background Deep learning applied to ultrasound (US) can provide a feedback to the sonographer about the correct identification of scanned tissues and allows for faster and standardized measurements. The most frequently adopted parameter for US diagnosis of carpal tunnel syndrome is the increasing of the cross-sectional area (CSA) of the median nerve. Our aim was to develop a deep learning algorithm, relying on convolutional neural networks (CNNs), for the localization and segmentation of the median nerve and the automatic measurement of its CSA on US images acquired at the proximal inlet of the carpal tunnel. Methods Consecutive patients with rheumatic and musculoskeletal disorders were recruited. Transverse US images were acquired at the carpal tunnel inlet, and the CSA was manually measured. Anatomical variants were registered. The dataset consisted of 246 images (157 for training, 40 for validation, and 49 for testing) from 103 patients each associated with manual annotations of the nerve boundary. A Mask R-CNN, state-of-the-art CNN for image semantic segmentation, was trained on this dataset to accurately localize and segment the median nerve section. To evaluate the performances on the testing set, precision (Prec), recall (Rec), mean average precision (mAP), and Dice similarity coefficient (DSC) were computed. A sub-analysis excluding anatomical variants was performed. The CSA was automatically measured by the algorithm. Results The algorithm correctly identified the median nerve in 41/49 images (83.7%) and in 41/43 images (95.3%) excluding anatomical variants. The following metrics were obtained (with and without anatomical variants, respectively): Prec 0.86 ± 0.33 and 0.96 ± 0.18, Rec 0.88 ± 0.33 and 0.98 ± 0.15, mAP 0.88 ± 0.33 and 0.98 ± 0.15, and DSC 0.86 ± 0.19 and 0.88 ± 0.19. The agreement between the algorithm and the sonographer CSA measurements was excellent [ICC 0.97 (0.94–0.98)]. Conclusions The developed algorithm has shown excellent performances, especially if excluding anatomical variants. Future research should aim at expanding the US image dataset including a wider spectrum of normal anatomy and pathology. This deep learning approach has shown very high potentiality for a fully automatic support for US assessment of carpal tunnel syndrome.

Abstract Background Genetic alterations of somatic cells can drive non-malignant clone formation and promote cancer initiation. However, the link between these processes remains unclear and hampers our understanding of tissue homeostasis and cancer development. Results Here, we collect a literature-based repertoire of 3355 well-known or predicted drivers of cancer and non-cancer somatic evolution in 122 cancer types and 12 non-cancer tissues. Mapping the alterations of these genes in 7953 pan-cancer samples reveals that, despite the large size, the known compendium of drivers is still incomplete and biased towards frequently occurring coding mutations. High overlap exists between drivers of cancer and non-cancer somatic evolution, although significant differences emerge in their recurrence. We confirm and expand the unique properties of drivers and identify a core of evolutionarily conserved and essential genes whose germline variation is strongly counter-selected. Somatic alteration in even one of these genes is sufficient to drive clonal expansion but not malignant transformation. Conclusions Our study offers a comprehensive overview of our current understanding of the genetic events initiating clone expansion and cancer revealing significant gaps and biases that still need to be addressed. The compendium of cancer and non-cancer somatic drivers, their literature support, and properties are accessible in the Network of Cancer Genes and Healthy Drivers resource at http://www.network-cancer-genes.org/ .

The government prioritizes health as one of the areas in which it seeks to boost the country's growth, but the referral system in place has failed to deliver high-quality health care. The purpose of this study was to assess and empirically demonstrate the extent to which the health referral system has been implemented in Kendari Health Center and Bau-Bau City. The study was held in the Kendari City Health Center and the Bau-Bau City Health Center, and it lasted from February 2020 to February 2021. This research method is a qualitative approach based on postpositivism's theory, in which the researcher is the primary instrument, triangulation is used to collect data, inductive data analysis is used to analyze data, and qualitative research results emphasize meaning rather than generalization. Informants in this study amounted to 15 informants. Qualitative data were analyzed using the NVIVO 12 QSR application. The research findings indicate that there is a conceptual link between the health system and the concept of implementing a referral system. This research emphasizes to the health service center the importance of increasing the knowledge of health workers through training for both doctors and advocacy for policymakers regarding the improvement of health facilities.

In the Mediterranean, experiments and technical measures aimed at improving the selectivity of bottom trawl nets mostly concern modifications to the codend. Grids have been tested in various areas, but have not been adopted for management purposes so far. The present study aims to evaluate whether the adoption of diamond meshes turned by 90° (T90 configuration) and a selection grid with 2 cm bar spacing, both placed in the extension piece of a commercial bottom trawl net, can contribute in reducing the capture of specimens under the Minimum Conservation Reference Size (MCRS) for the main commercial species. The results indicated that the T90 configuration has no effect compared to the commercial net commonly used by fishers. The grid showed a reduction of the catches of European hake individuals between 11 and 19 cm Total Length (TL). However, the use of this device reduced the catch of many species, such as red mullet, deep-water rose shrimp and broad tail short fin squid. This reduction was observed also for specimens above MCRS. In conclusion, the T90 applied to the extension piece does not provide any improvement in selectivity, contrary to what has been observed when the T90 is placed at the codend. In contrast, the grid could be a possible way to increase selectivity. However, the use of grid should be further investigated to identify settings that can avoid the loss of a substantial fraction of commercial catch.

Oritavancin (ORI) is a semisynthetic lipoglycopeptide approved as a single 1200 mg dose intravenous infusion for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) caused by Gram-positive organisms in adults. The pharmacokinetic/pharmacodynamic (PK/PD) linear kinetic profile and long terminal half-life (~393 h) of ORI make it therapeutically attractive for the treatment of other Gram-positive infections for which prolonged therapy is needed. Multidose regimens are adopted in real-world clinical practice with promising results, but aggregated efficacy data are still lacking. A comprehensive search on PubMed/Medline, Scopus, Cochrane and Google Scholar databases was performed to include papers published up to the end of January 2023. All articles on ORI multiple doses usage, including case reports, with quantitative data and relevant clinical information were included. Two reviewers independently assessed papers against the inclusion/exclusion criteria and for methodological quality. Differences in opinion were adjudicated by a third party. From 1751 potentially relevant papers identified by this search, a total of 16 studies met the inclusion criteria and were processed further in the final data analysis. We extracted data concerning clinical response, bacteriologic response, mortality and adverse events (AEs). From the 16 included papers, 301 cases of treatment with multidose ORIs were identified. Multidose regimens comprised an initial ORI dose of 1200 mg followed by 1200 mg or 800 mg subsequent doses with a varying total number and frequency of reinfusions. The most often treated infections and isolates were osteomyelitis (148; 54.4%), ABSSSI (35; 12.9%) and cellulitis (14; 5.1%); and MRSA (121), MSSA (66), CoNS (17), E. faecalis (13) and E. faecium (12), respectively. Clinical cure and improvement by multidose ORI regimens were observed in 85% (231/272) and 8% (22/272) patients, respectively. Multidose ORI was safe and well tolerated; the most frequent AEs were infusion-related reactions and hypoglycemia. A multidose ORI regimen may be beneficial in treating other Gram-positive infections besides ABSSSIs, with a good safety profile. Further studies are warranted to ascertain the superiority of one multidose ORI scheme or posology over the other.

Candida auris has become a major concern in critical care medicine due to the increasing number of immunocompromised patients and candidiasis is the most frequent cause of fungal infections. C. auris and other fungal pathogens are responsible for at least 13 million infections and 1.5 million deaths globally per year. In immunocompromised patients, infections can quickly become severe, causing wound infections, otitis and candidemia, resulting in high morbidity and mortality. The clinical presentation of C. auris is often non-specific and similar to other types of systemic infections; in addition, it is harder to identify from cultures than other, more common types of Candida spp. Some infections are particularly difficult to treat due to multi-resistance to several antifungal agents, including fluconazole (and other azoles), amphotericin B and echinocandins. This entails treatment with more drugs and at higher doses. Even after treatment for invasive infections, patients generally remain colonized for long periods, so all infection control measures must be followed during and after treatment of the C. auris infection. Screening patients for C. auris colonization enables facilities to identify individuals with C. auris colonization and to implement infection prevention and control measures. This pathogenic fungus shows an innate resilience, enabling survival and persistence in healthcare environment and the ability to rapidly colonize the patient’s skin and be easily transmitted within the healthcare setting, thus leading to a serious and prolonged outbreak.

The SARS-CoV-2 pandemic caused an increase in intensive care unit (ICU) hospitalizations with a rise in morbidity and mortality; nevertheless, there is still little evidence on the impact of the pandemic on antibiotic resistance in ICUs. This is a retrospective, monocentric epidemiological study. The aim of the study was to describe and analyze the impact of the SARS-CoV-2 pandemic on ICU bacterial resistance patterns. All bacteria isolated from all patients admitted to the E.O. Galliera ICU from January 2018 to December 2022 were included. Antibiotic resistance (AR) profiles were evaluated. A total of 1021 microorganisms were identified, of which 221 (12.47%) had a resistance pattern (resistant organisms; ROs). In this time, there were 1679 patients with a total of 12,030 hospitalization days. The majority of microorganisms were Gram-negative (79.66% in 2018, 77.29% in 2019, 61.83% in 2020, 62.56% in 2021, and 60.75% in 2022), but an increase in Gram-positive microorganisms was observed (20.34 to 39.25% between 2018 and 2022). The prevalence of AR was 19.44% in 2018, 11.54% in 2019, 38.04% in 2020, 34.15% in 2021, and 39.29% in 2022 for Gram-positive microorganisms and 19.86% in 2018, 13.56% in 2019, 18.12% in 2020, 12.41% in 2021, and 12.31% in 2012 for Gram-negative microorganisms. The incidence of ROs showed a COVID-19-related increase in 2020–2021, followed by a lowering trend since 2021, and a new increase in 2022. Possible explanations are antibiotic overtreatment and a decrease in containment measures. An interesting finding was the cumulative lowering trend of carbapenem-resistant K. pneumoniae and P. aeruginosa, probably due to different patient features.

Direct endoscopic necrosectomy (DEN) is a challenging procedure for the debridement of walled-off pancreatic necrosis (WOPN), which may be complicated by several adverse events, primarily bleeding which may require radiological embolization or even surgery. The lack of dedicated devices for this purpose largely affects the possibility of safely performing DEN which increases the risk of complications. We present the case of a 63 years-old man who underwent an endoscopic ultrasound (EUS)-guided drainage of a WOPN, and who was readmitted one month after stent removal with clinical, endoscopic, and radiological signs of infected necrosis involving the splenic artery. A second EUS-guided drainage was performed, with clear visualization of the arterial vessel in the midst of a large amount of solid necrosis. Due to the high risk of major bleeding during DEN, a hybrid procedure in the angiographic room was performed, in order to identify and avoid, under fluoroscopic control, the splenic artery during the entire procedure guide, which was successfully performed using the EndoRotor system. We hereby review the current literature regarding DEN using the EndoRotor system. The case reported, with a literature overview, may help the management of these patients affected by benign but life-threatening conditions which involve a multidisciplinary setting.

Abstract Background It is encouraging to see a substantial increase in individuals surviving cancer. Even more so since most of them will have a positive effect on society by returning to work. However, many cancer survivors have unmet needs, especially when it comes to improving their quality of life (QoL). Only few survivors are able to meet all of the recommendations regarding well-being and there is a body of evidence that cancer survivors’ needs often remain neglected from health policy and national cancer control plans. This increases the impact of inequalities in cancer care and adds a dangerous component to it. The inequalities affect the individual survivor, their career, along with their relatives and society as a whole. The current study will evaluate the impact of the use of big data analytics and artificial intelligence on the self-efficacy of participants following intervention supported by digital tools. The secondary endpoints include evaluation of the impact of patient trajectories (from retrospective data) and patient gathered health data on prediction and improved intervention against possible secondary disease or negative outcomes (e.g. late toxicities, fatal events). Methods/design The study is designed as a single-case experimental prospective study where each individual serves as its own control group with basal measurements obtained at the recruitment and subsequent measurements performed every 6 months during follow ups. The measurement will involve CASE-cancer, Patient Activation Measure and System Usability Scale. The study will involve 160 survivors (80 survivors of Breast Cancer and 80 survivors of Colorectal Cancer) from four countries, Belgium, Latvia, Slovenia, and Spain. The intervention will be implemented via a digital tool (mHealthApplication), collecting objective biomarkers (vital signs) and subjective biomarkers (PROs) with the support of a (embodied) conversational agent. Additionally, the Clinical Decision Support system (CDSS), including visualization of cohorts and trajectories will enable oncologists to personalize treatment for an efficient care plan and follow-up management. Discussion We expect that cancer survivors will significantly increase their self-efficacy following the personalized intervention supported by the m-HealthApplication compared to control measurements at recruitment. We expect to observe improvement in healthy habits, disease self-management and self-perceived QoL. Trial registration ISRCTN97617326. https://doi.org/10.1186/ISRCTN97617326 . Original Registration Date: 26/03/2021.

Simultaneous observations of reproductive physiology and behaviour were conducted on a group of two male and two female belugas under professionally managed care for one year to explore potential mating strategies. Weekly blow sampling for progesterone in females was used to define the breeding season by detecting three oestrous cycles in one female. Twice weekly blow sampling for testosterone and twice monthly testes measurements via ultrasonography were used to detect reproductive seasonality in both males. Female–male association frequency varied longitudinally, with 70% of all interactions occurring during the 16-week breeding season. Male–male associations did not vary seasonally. Male display behaviours towards the female occurred 14.8 times more frequently during the breeding season (0.164 ± 0.188 behaviours/min) than outside of the breeding season (0.011 ± 0.042 behaviours/min). The cycling female responded variably to male display behaviours by altering swim speed or body orientation towards the male. Although this small sample size limits broad conclusions, the frequent display behaviours, low copulation rate and lack of serious male–male aggression are consistent with predictions for pre-copulatory female mate choice developed from the current knowledge of beluga reproductive physiology. These observations, which are not feasible for wild belugas, provide important management considerations because reduced opportunities for mate choice could limit the reproductive rate, especially in small populations.

Introduction: Roselle (Hibiscus sabdariffa L.) calyces possess natural antioxidants that may provide therapeutic benefits. This study aimed to investigate the protective effects of Roselle calyx water extract against isoniazid (INH) and rifampicin (RIF) induced liver and renal toxicities.Methods: Male Wistar rats (150-250 g) were designated into five groups: control group, INH-RIF group that was treated with INH-RIF at the toxic doses (50-100 mg/kg for 4 weeks, followed by 100-200 mg/kg for 2 weeks), and Roselle groups that were treated daily with Roselle extract at the doses 62.5, 125, and 250 mg/kg, respectively prior to INH-RIF administration. Blood samples were withdrawn weekly for 6 weeks before removing rats’ livers and kidneys for tissue malondialdehyde (MDA) and histopathological analysis.Results: The results showed all rats in the INH-RIF group experienced marked elevations of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea, creatinine, and tissue MDA levels compared to the controls (P

Background: Incomplete functional recovery following traumatic peripheral nerve injury is common, mainly because not all axons successfully regenerate and reinnervate target muscles. Exercise can improve functional outcomes increasing the terminal sprouting during the muscle reinnervation. However, exercise is not a panacea per se. Indeed, the type of exercise adopted dramatically impacts the outcomes of rehabilitation therapy. To gain insight into the therapeutic effects of different exercise regimens on reinnervation following traumatic nerve lesion, we evaluated the impact of different clinically transferable exercise protocols (EPs) on metabolic and functional muscle recovery following nerve crush.Methods: The reinnervation of soleus muscle in adult nerve-crushed rats was studied following 6 days of different patterns (continuous or intermittent) and intensities (slow, mid, and fast) of treadmill running EPs. The effects of EPs on muscle fiber multiple innervation, contractile properties, metabolic adaptations, atrophy, and autophagy were assessed using functional and biochemical approaches.Results: Results showed that an intermittent mid-intensity treadmill EP improves soleus muscle reinnervation, whereas a slow continuous running EP worsens the functional outcome. However, the mid-intensity intermittent EP neither enhanced the critical mediators of exercise-induced metabolic adaptations, namely, PGC-1α, nor improved muscle atrophy. Conversely, the autophagy-related marker LC3 increased exclusively in the mid-intensity intermittent EP group.Conclusion: Our results demonstrated that an EP characterized by a mid-intensity intermittent activity enhances the functional muscle recovery upon a nerve crush, thus representing a promising clinically transferable exercise paradigm to improve recovery in humans following peripheral nerve injuries.

Objective: To evaluate the effect of ellagic acid on the inhibition of matrix metalloproteinase by analyzing the quality of the adhesive interface with bond strength measures in periods of 24 hours and six months of storage. Method: 40 healthy human third molars were prepared with class I cavities (5x4x3mm). The teeth were divided into four experimental groups: Group 1- without application of ellagic acid and storage time of 24 hours; Group 2- with ellagic acid/24 hours; G3- without ellagic acid/six months; Group 4- with ellagic acid/six months. Then, the cavities were restored with Single Bond Universal adhesive and Z350 composite resin, with and without the previous application of ellagic acid. Subsequently, hourglass-shaped specimens were obtained and subjected to the bond strength (BS) test (n = 10) in a universal testing machine. The bond test was performed after 24 hours and six months of storage. For the standard evaluation (n = 3) the samples were infiltrated with silver nitrate and placed in a developing solution for analysis in a Scanning Electron Microscope (SEM). The data obtained were analyzed with the Kruskal-Wallis non-parametric test, showing a statistically significant difference. Results: The highest bond strength values were found for the 24-hour groups followed by the groups with six months of storage. For nano-infiltration, groups G1 and G2 showed lower infiltration than groups G3 and G4. Conclusion: The previous application of ellagic acid did not affect the BS of the adhesive interface of the adhesive system analyzed, regardless of storage time.

The aim of this randomized double-blinded study was to evaluate the enamel surface roughness and color change after one month of whitening toothpaste use and the color stability obtained 1 month after its interruption. 30 volunteers were divided into 3 groups (n = 10) corresponding to the dentifrices: 1) Colgate Total 12 Clean Mint (TD) (Control), 2) Colgate Luminous White (LW) and 3) Sensodyne Whitening Extra Fresh (SB). The volunteers were impression with addition silicone to obtain an epoxy resin replica of the upper central incisor for the initial surface roughness evaluation using a profilometer and the initial color of the incisors and canines was evaluated with a spectrophotometer after one week of wash-out. After 1 month, the color of the central incisors and canines was measured again, and the volunteers were molded to obtain a second replica to the final roughness analysis. Data were submitted to ANOVA-one way (p≤0.05). The results showed that there was no statistical difference between the dentifrices for color difference and surface roughness for all the studied conditions. It was possible to conclude that the whitening dentifrices used in this study were not able to alter the initial color of the teeth and did not cause changes in the surface roughness of enamel.

This study evaluated the effects of progressive time delay (PTD) to teach four elementary students with intellectual disability on how to self-instruct using a video activity schedule. A single-case multiple probe across participants design with a multiple probe across environments design for each participant was used to assess the generalization of the self-instruction behavior to novel environments. All participants acquired the self-instruction behavior in their target environments. One participant generalized this behavior to a novel environment by the completion of the study, and the other three participants required introduction of the independent variable (PTD) to master acquisition in the two generalization environments. Implications for practitioners and suggestions for effective programming of generalization in future research are discussed.

Globally, the increase of pathogenic bacteria with antibiotic-resistant characteristics has become a critical challenge in medical treatment. The misuse of conventional antibiotics to treat an infectious disease often results in increased resistance and a scarcity of effective antimicrobials to be used in the future against the organisms. Here, we discuss the rise of antimicrobial resistance (AMR) and the need to combat it through the discovery of new synthetic or naturally occurring antibacterial compounds, as well as insights into the application of various drug delivery approaches delivered via various routes compared to conventional delivery systems. AMR-related infectious diseases are also discussed, as is the efficiency of various delivery systems. Future considerations in developing highly effective antimicrobial delivery devices to address antibiotic resistance are also presented here, especially on the smart delivery system of antibiotics.

Reports on hand dysfunction and rehabilitation in SSc are quite scarce in the literature and mainly focus on functional assessment tools, such as the Duruoz Hand Index and the HAMIS test for evaluating hand mobility by simulating specific grasps with nine different objects. This study aimed to provide an adequate assessment methodology for hand grasp dysfunctions in patients suffering from systemic sclerosis (SSc) through the 16-grasp test. Case-control study. Ninety-seven consecutive SSc patients were recruited at our Scleroderma Unit, where a 16-grasp test was performed by all patients and supervised by an experienced hand therapist. Sixteen different patterns of grasp have been divided into power grasps and precision pinch and two more modalities: static and dynamic prehension evaluation on scale from 0 to 4. We also compared previous evaluations on 19 of patients recruited. The majority of SSc patients (84 females and 13 males; mean age 56.0±12.0 years; mean disease duration 8.0±6.0 years) displayed grasp dysfunctions; in particular 48% and 54% reported slight difficulty in the right and left grasps respectively, 6% medium difficulty in both hands, and only 3% and 1% experienced severe difficulty respectively, while 31.5% had no issues in either hand. Our results showed that the limited cutaneous subset (lcSSc) scored a lower deficit for either grasp compared to diffuse form (dcSSc). No statistically significant differences in total grasp deficit had been noticed when comparing patients having a disease duration < 5 years or longer. In the retrospective study on 19 of these patients, 8 out of 10 lcSSc patients showed no significant changes, while in 2 out of 10, slight improvements were observed in both hands. However, in the dcSSc group, 4 out of 9 worsened bilaterally while the grasp scores for 5 of them remained unchanged. Our study reported hand involvement in both lcSSc and dcSSc forms, more significantly in dcSSc patients. This test is intended to be a more objective means of assessing grasp alterations linked to scleroderma hand deformities. Furthermore, thanks to its intuitiveness, the test may be useful for engineers designing personalized ergonomic assistive devices. [ABSTRACT FROM AUTHOR]

The emergence of pathogenic bacteria with β-lactam antibiotics-resistant profile has threatened the continued use of such antibiotics in the future. This research was conducted to investigate the antimicrobial activity of green tea ethanol extract (GTE) and its ability to improve the antibacterial action of several β-lactam antibiotics against Enterobacter cloacae clinical isolates. The simplicia of green tea was extracted by sonication for 30 minutes using 50% ethanol solvent, and the total phenolic content of the GTE was subsequently determined. Next, the GTE used in testing against two clinical isolates of E. cloacae was obtained from the Pathology Laboratory of Wahidin Sudiro Husodo Hospital in Makassar. The sensitivity of bacteria to GTE was confirmed using the agar diffusion method, the Vitek® rapid method, and the double-disk synergistic test. Antibacterial activity of antibiotics, GTE, and combination of antibiotics with GTE were then tested against clinical isolates of E. cloacae using the checkerboard microdilution assay. The results showed that GTE contained 51.64 ± 0.21 % measured as gallic acid equivalent and 37.95 + 5.17 % Epigallocatechin gallate (EGCG). The confirmatory test results indicated that one clinical isolate of E. cloacae (code 13/04) was resistant to amoxicillin-clavulanate but did not produce an extended-spectrum β-lactamase (ESBL). Another clinical E. cloacae isolate (code 275B/06) was indicated to produce ESBL and demonstrated to yield resistance to amoxicillin-clavulanate and cefotaxime. The minimum inhibitory concentration of GTE against the two clinical isolates of E. cloacae was >8000 ppm (8 mg/ml). In conclusion, GTE could not increase the antibacterial activity of amoxicillin and cefotaxime, but it was sufficient to improve the activity of imipenem against the tested isolates of E. cloacae.

Abstract Disease progression of myeloproliferative neoplasms is the result of increased genomic complexity. Since the ability to predict disease evolution is crucial for clinical decisions, we studied single-cell genomics and transcriptomics of CD34-positive cells from a primary myelofibrosis (PMF) patient who progressed to acute myeloid leukemia (AML) while receiving Ruxolitinib. Single-cell genomics allowed the reconstruction of clonal hierarchy and demonstrated that TET2 was the first mutated gene while FLT3 was the last one. Disease evolution was accompanied by increased clonal heterogeneity and mutational rate, but clones carrying TP53 and FLT3 mutations were already present in the chronic phase. Single-cell transcriptomics unraveled repression of interferon signaling suggesting an immunosuppressive effect exerted by Ruxolitinib. Moreover, AML transformation was associated with a differentiative block and immune escape. These results suggest that single-cell analysis can unmask tumor heterogeneity and provide meaningful insights about PMF progression that might guide personalized therapy.

Background: In the first wave of the novel coronavirus (severe acute respiratory syndrome coronavirus 2) infections, Italy experienced a heavy burden of hospital admissions for acute respiratory distress syndromes associated with the novel coronavirus disease (COVID-19). Early evidence suggested that females are less affected than males. Objective: This study aimed to assess the gender-related differences in presentation and severity among COVID-19 patients admitted to IRCCS San Raffaele Hospital, Milan, Italy. Materials and Methods: This prospective observational study included all patients admitted to the hospital between February 25 and April 19, 2020, with a positive real-time reverse-transcriptase polymerase chain reaction for COVID-19. The following data were collected: date of admission, gender, age and details of intensive care unit admission and outcomes. Results: A total of 901 patients with COVID-19 were admitted to the hospital and provided consent for the study. Of these, 284 were female (31.5%). The percentage of admitted female patients significantly increased over time (25.9% of all admissions in the first half of the study period vs. 37.1% in the second half; P < 0.001). Females accounted for 14.4% of all COVID-19 intensive care unit admissions. There was no gender-based difference in the overall hospital mortality: 20.1% for females and 19.2% for males (P = 0.8). Conclusions: In our hospital, which was in the epicenter of the first wave of COVID-19 pandemic in Italy, female patients were few, presented late and were less critical than male patients.

Context: Methicillin-resistant Staphylococcus aureus (MRSA) has been a significant challenge in health problems. Aims: To investigate synergistic properties of green tea extract that can potentially enhance the antibacterial activity of amoxicillin against methicillin-resistant Staphylococcus aureus (MRSA) in vitro and ex vivo. Methods: Green tea coarse powder was extracted by distilled water using high-pressure extraction. The total of phenolic and tannin contents was determined using spectrophotometry, and epigallocatechin gallate (EGCG) content was analyzed using Ultra-Fast Liquid Chromatography. Minimum Inhibitory Concentration (MIC) against MRSA was determined using a microdilution assay. Antibacterial assay of the combination of the extract and amoxicillin was performed using employing-checkerboard microdilution and agar diffusion assays. Results: The results exhibited that the green tea extract (GTE) contained total phenolic content of 545.6 ± 4.7 mg GAE/g extract; total tannin content of 356.6 ± 4.1 mg EGCG equivalent /g extract and EGCG of 221.1 ± 11.6 mg/g extract. The MICs combinatorial of GTE and ¼ MIC of amoxicillin was 75 µg/mL. Fractional Inhibitory Concentration Index value was 0.28, indicating that there was a synergy effect between amoxicillin and green tea extract. Essentially, the inhibitory zone diameter obtained by amoxicillin combined with ¼ MIC of GTE was two-fold than the zone produced by only amoxicillin. Although not significant, in ex vivo study, this combination was able to enhance the antibacterial activity of rat’s plasma against MRSA in vivo after the oral administration of GTE and amoxicillin. Conclusions: The results presented here serve as proof of concept for the enhancement of the antimicrobial activity of synthetic antibiotics when combined with a natural product.

Abstract We investigated whether the internal gantry components of our computed tomography (CT) scanner contain severe acute respiratory syndrome 2 (SARS-CoV-2) ribonucleic acid (RNA), bacterial or fungal agents. From 1 to 27 March 2020, we performed 180 examinations of patients with confirmed SARS-CoV-2 infection using a dedicated CT scanner. On 27 March 2020, this CT gantry was opened and sampled in each of the following components: (a) gantry case; (b) inward airflow filter; (c) gantry motor; (d) x-ray tube; (e) outflow fan; (f) fan grid; (g) detectors; and (h) x-ray tube filter. To detect SARS-CoV-2 RNA, samples were analysed using reverse transcriptase-polymerase chain reaction (RT-PCR). To detect bacterial or fungal agents, samples have been collected using “replicate organism detection and counting” contact plates of 24 cm2, containing tryptic soy agar, and subsequently cultured. RT-PCR detected SARS-CoV-2 RNA in the inward airflow filter sample. RT-PCR of remaining gantry samples did not reveal the presence of SARS-CoV-2 RNA. Neither bacterial nor fungal agents grew in the agar-based growth medium after the incubation period. Our data showed that SARS-Cov-2 RNA can be found inside the CT gantry only in the inward airflow filter. All remaining CT gantry components were devoid of SARS-CoV-2 RNA.

GLOBAL-LOCAL CONCEPT AS A CULTURAL BASIS FOR ART IN SANGGAR DEWATA INDONESIA Abstract: The face of Indonesian art contains multicultural, intercultural, and diverse values in the dialectics of regional arts and global culture. The rise of local culture is often caused by global cultural friction. The attraction and tension between global culture and local culture results in the 'glocalization' of culture. This article aims to explore the values of locality and global culture as a creative foundation for art in the Balinese diaspora art community, Sanggar Dewata Indonesia (SDI) which is culturally and philosophically insightful. The Balinese diaspora gradually has a new cultural identity as a result of the acculturation of Balinese culture with the local culture. Likewise, in the aspect of the language of art, Balinese diaspora artists in Yogyakarta are accommodative, experiencing visual transformation, syncretic, and contain hybridization of cultural values. This study utilizes qualitative methods with a formal study of cultural philosophy through an interpretive approach. The cultural interpretive approach has resulted that the culture and art process of the SDI art community are symbolically the result of the legacy of the collective conception system both in communicating, perpetuating and developing knowledge to attitudes towards artistic life. The mission and vision of SDI includes the spirit of nationalism, Pancasila nationalism, multiculturalism, in order to achieve the international art world, which is more heterogeneous and competitive. Thus the local-global spirit is accompanied by a process of reinterpretation and re-contextualization of a time that presents a thinking discourse, creative vision through creative dialectics that is filled with local-global acculturation shock power towards world-class global art competition. Keywords: Globalization, Locality values, Multiculturalism, Sanggar Dewata Indonesia KONSEPSI LOKAL-GLOBAL SEBAGAI BASIS KULTURAL BERKESENIAN SANGGAR DEWATA INDONESIA Abstrak: Wajah seni rupa Indonesia mengandung nilai multikultur, interkultural, serta berbhineka dalam dialektika kesenian daerah dan kebudayaan global. Kebangkitan kebudayaan lokal sering disebabkan oleh gesekan budaya global. Tarikan dan tegangan antara budaya global dan budaya lokal menghasilkan ‘glokalisasi’ kebudayaan. Artikel ini bertujuan mendalami nilai-nilai lokalitas dan kultur global sebagai landasan kreatif berkesenian dalam komunitas seni diaspora Bali, Sanggar Dewata Indonesia (SDI) yang berwawasan budaya serta filosofis. Diaspora Bali lambat laun memiliki identitas kultur baru hasil dari akulturasi kebudayaan Bali dengan kebudayaan lokal setempat. Demikian juga dalam aspek bahasa berkesenian seniman diaspora Bali di Yogyakarta, bersifat akomodatif, mengalami transformasi visual, sinkretis, dan mengandung hibridasi nilai-nilai budaya. Artikel ini diteliti menggunakan metode kualitatif dengan kajian formal filsafat kebudayaan melalui pendekatan interpretatif. Pendekatan interpretatif kebudayaan telah menghasilkan pembacaan bahwa kebudayaan dan proses berkesenian komunitas seni SDI secara simbolik merupakan hasil dari warisan sistem konsepsi kolektif baik dalam mengomunikasikan, mengabadikan dan mengembangkan pengetahuan hingga sikap terhadap kehidupan kesenian. Visi dan misi SDI adalah semangat kebangsaan, nasionalisme Pancasila, multikultur, demi menuju dunia kesenian internasional yang lebih heterogen dan kompetitif. Dengan demikian semangat lokal-global ini disertai proses reinterpretasi dan rekontekstualisasi zaman menghadirkan wacana pemikiran, visi kreatif melalui dialektika kreatif yang penuh daya kejut akulturasi lokal-global menuju persaingan dunia seni global. Kata kunci: Globalisasi, Nilai lokalitas, Multikulturalisme, Sanggar Dewata Indonesia Permalink/DOI: dx.doi.org/10.17977/um015v48i22020p118

Abstract Background Poland syndrome (OMIM: 173800) is a disorder in which affected individuals are born with missing or underdeveloped muscles on one side of the body, resulting in abnormalities that can affect the chest, breast, shoulder, arm, and hand. The extent and severity of the abnormalities vary among affected individuals. Main body The aim of this work is to provide recommendations for the diagnosis and management of people affected by Poland syndrome based on evidence from literature and experience of health professionals from different medical backgrounds who have followed for several years affected subjects. The literature search was performed in the second half of 2019. Original papers, meta-analyses, reviews, books and guidelines were reviewed and final recommendations were reached by consensus. Conclusion Being Poland syndrome a rare syndrome most recommendations here presented are good clinical practice based on the consensus of the participant experts.

More than half of the Indonesian people use herbal medicines to maintain their health, including ones that are served immediately after preparation or also known as jamu gendong. This plant-based medicine is prepared traditionally by boiling using different ratios of leaves to water and heating time. The study was designed to determine the heating time and the fresh leaf-to-water ratio that exhibited the highest antioxidant and antifungal activities against Candida albicans. Fresh betel leaves were extracted by boiling and infusion methods, with the ratio of 1:5 and 1:10 and the heating time of 5 and 10 minutes for boiling and 15 minutes for infusion. The excess water in the resulting extract was removed using a freeze dryer, then the total phenolic content was determined by Folin-Ciocalteu spectrophotometry. Meanwhile, the antioxidant and antifungal activities were tested by the DPPH method and microdilution, respectively. The results showed that betel leaf extract with the highest yield and polyphenol content was obtained by infusion with the sample-to-water ratio of 1:10, and this was positively correlated with antioxidant activity against DPPH (IC50= 17.4 ppm) and antifungal effect against Candida albicans (MIC= 0.5%)

The objective of this study was to determine whether there is effect of religiosity and love of money on the ethical perceptions of students. The population this study is accounting students. The sampling technique uses purposive sampling, with criteria of accounting students sitting in sixth, seventh, eighth, and soon semester. This is because sixth, seventh, eight, and so on semester students who are close to the world of work. The sample of this study amounted to 230 students. This study uses survey techniques in data collection. This study uses SPSS analysis tools. This study obtained results that religiosity and love of money have no effect on student’s ethical perceptions. Keywords: Love of Money, Religiosity, Student’s Ethical Perceptions

This paper investigates the adaptation of Arabic loanwords in the Indonesian language semantically. The data were taken from Kamus Basar Bahasa Indonesia (KBBI) fifth edition. 1,870 words are listed in the KBBI as Arabic loan words. The definitions of these words were compared with their original Arabic definitions found in Almaany Arabic dictionary (2019) to determine the semantic adaptations. The analysis shows that most of the Arabic loanwords in the Indonesian language have retained the same meanings as their originals in the Arabic language. However, there have been semantic adaptations in which eighteen words have been narrowed, nine words have been extended, and seven words have gone through the shifting process. The narrowing was due to absorbing of only one meaning of a word that had many meanings in Arabic , borrowing the old meanings of the words that have been extended recently due to the advent of technology, filling any existing gap or borrowing of new words along with cultural concepts. The extending was due to overgeneralizing some Arabic affixes and forms ,leaving one form of a word to represent the meanings of the others or assigning names to things by the way people perceive them by their five senses . The shifting occurred mainly because of borrowing of new words along with cultural concepts, assigning names to things by the way they are perceived by the five senses or overgeneralizing of forms that occurred in Arabic loanwords.It is hoped that the findings of this study will be useful to researchers interested in semantic adaptation of loanwords.

Aldose reductase is a key enzyme in the development of long term diabetic complications and its inhibition represents a viable therapeutic solution for people affected by these pathologies. Therefore, the search for effective aldose reductase inhibitors is a timely and pressing challenge. Herein we describe the access to a novel class of oxyimino derivatives, obtained by reaction of a 1,5-dicarbonyl substrate with O-(arylmethyl)hydroxylamines. The synthesised compounds proved to be active against the target enzyme. The best performing inhibitor, compound (Z)-8, proved also to reduce both cell death and the apoptotic process when tested in an in vitro model of diabetic retinopathy made of photoreceptor-like 661w cell line exposed to high-glucose medium, counteracting oxidative stress triggered by hyperglycaemic conditions.