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Performance evaluation is essential for an industry's ability to operate successfully. Efficiency management is becoming crucial and important to enhancing the sustainability of the industry. The industry needs to measure its performance for the following reasons: (i) develop the economy and its operation efficiency in a sustainable way; (ii) supply data for decision-making units (DMUs); and (iii) optimize output using the fewest resources. Performance measurement indicators relate to the performance of the industry itself, such as: added value/cost of production factors, indirect taxes, number of workers, input costs, number of companies, added value/market prices, and production index. The purpose of this research is to measure the performance of large and medium-sized industries (LMIs) in Indonesia. LMIs have a strategic role as the main engine and driver of the economy. Measuring LMI performance is very necessary so that LMI can grow and develop sustainably. Data envelopment analysis (DEA) is a method for measuring performance. DEA is a non-parametric linear programming technique and used to determine comparisons between DMUs with different inputs and outputs. The research results indicate that there are three DMU classification categories, namely: Category 1 (ES = 1), Category 2 (ES = 0.9986-0.9998), and Category 3 (ES = 0.9971-0.9974). The percentages for each category are 50%, 37.5%, and 12.5%.

Summary: Background: Limited data exist from southeast Asia on the impact of SARS-CoV-2 variants and inactivated vaccines on disease severity and death among patients hospitalised with COVID-19. Methods: A multicentre hospital-based prospective cohort was enrolled from September 2020 through January 2023, spanning pre-delta, delta, and omicron periods. The participant hospitals were conveniently sampled based on existing collaborations, site willingness and available study resources, and included six urban and two rural general hospitals from East Nusa Tenggara, Jakarta, and North Sumatra provinces. Factors associated with severe disease and day-28 mortality were examined using logistic and Cox regression. Findings: Among 822 participants, the age-adjusted percentage of severe disease was 26.8% (95% CI 22.7–30.9) for pre-delta, 50.1% (44.0–56.2) for delta, and 15.2% (9.7–20.7) for omicron. The odds of severe disease were 64% (18–84%) lower for omicron than delta (p

Indramayu is one of the regencies in West Java Province that produces food crop production in the agricultural and plantation sectors. Many people work in the agricultural sector, one of which is by growing vegetables on their land. Planting vegetables on land in the Indramayu area often experiences problems, for example the land used is not in accordance with the type of vegetables grown. Some farmers have difficulty in evaluating land due to their lack of understanding of the land to be planted so that farmers rely on the system of planting habits that they usually do. The wrong land selection can result in energy and financial losses used for maintenance. Vegetables will develop imperfectly, even vegetables can die because of the inappropriateness of the land used. This study aims to assist farmers in determining what types of vegetable crops can be planted on their land using the k-means clustering method. There are 7 data criteria used for processing k-means so that later it can produce output a recommendation of vegetable types that can be planted by farmers according to the criteria they enter into the system. The results of this study produce an expert system that can provide information about vegetables selected according to the criteria selected by each user and with this system, ordinary people can find out how the selection of types of vegetables is practically on the land to be planted with vegetables.

In this research, researchers aspire to examine the theory of whether there is a cash flow effect on stock changes. Stock returns which are used as stock measurement tools are a reflection of market reactions to what happens within the company in terms of fundamentals. Therefore to measure the fundamental factors that exist within the company researchers utilise operating cash flow. Operating cash flow is seen as being able to represent because operating cash flow data exists in every company. Moreover, hence that the comparison is balanced the researchers choose to use the population of companies in the LQ 45 area. After being tested using simple linear regression, the results are as previously thought that there are influences on the company's Fundamental factors which in this study is the Operating Cash Flow with market factors which in this study represented by Stock Return. Keywords: financial statements, operating cash flow, stock return.

Abstract Objective:To determine the incidence of postpartum urinary retention (PUR) after vaginal delivery and to specify any obstetric risk factors that contributing PUR. Methods: Case control study. Six hours after vaginal delivery, urethral catheterization was implemented for estimation of post void residual bladder and diagnosis PUR. Patient data, including age, gestational age, body mass index, parity, mode of delivery, labor duration, perineal laceration or episiotomy, and fetal birth weight, were compared between women with and those without PUR to determine which obstetric factors that develops PUR. Results: Of the 365 participants recruited, 38 (10,67%) had PUR: 33 (9,27%) with covert PUR and 5 (1,4%) with overt PUR. Women with perineal laceration or episiotomy (p

Writing is one of the efforts made by the writer to express ideas and ideas to others. But sometimes when writing, there are many errors in typing spelling, especially English spelling, resulting in errors in capturing the meaning and meaning of the writing. To overcome this problem, we need a system that can detect word spelling errors. Damerau Levenshtein and Jaro Winkler Distance Algorithms are algorithms that can be used as a solution to detect English typing errors. From the test results, it can be concluded that the Damerau Levenshtein and Jaro-Winkler Distance are able to optimally detect word mismatches and look for similarities of words compared. The Damerau Levenshtein Distance works by finding the smallest distance value, while the Jaro-Winkler Distance works by finding the greatest proximity value of the string being compared. Using this algorithm, errors in writing the spelling of words can be minimized. Keywords— Algorithm; Damerau Levenshtein; Jaro Winkler; Spelling Cheker; String Matching.

Polymer is an insulating substance that has become increasingly popular in recent years due to its benefits. Light density, superior dielectric and thermal properties, and water-resistant or hydrophobic properties are only a few of the benefits. The presence of impurities or pollutants on the insulator’s surface lowers its dielectric capacity, which can lead to current leakage. The influence of seawater and fly ash pollutants on the distribution of the electric field and the current density of the insulator was simulated in this study. The finite element method was used to execute the simulation (FEM). Polymer insulators are subjected to testing in order to gather current leakage statistics. The tested insulator is exposed to seawater pollution, which varies depending on the equivalent salt density deposit value (ESDD). The pollutant insulator for fly ash varies depending on the value of non-soluble deposit density (NSDD). The existence of a layer of pollutants increased the value of the electric field and the value of the surface current density, according to the findings. Both in simulation and testing, the ESDD value of seawater pollutants and the NSDD value of fly ash contaminants influenced the value of the leakage current that flowed. The greater the ESDD and NSDD values are, the bigger the leakage current will be.

This study examines a new attachment concept called job embeddedness as antecedent of organizational citizenship behavior (OCB). Firstly, we tested hypothesis concerning positive relationship between job embeddedness and OCB as predicted by Mitchell et al. (2001). Secondly, we tested hypothesis concerning the mediation effect of sense of responsibility in the relationship between job embeddedness and OCB. Nurses (N = 170) and their immediate supervisors ( N = 41) from five privately owned hospital in Jogjakarta participated in this study. Of 340 questionnaires distributed to the respondents, 339 were returned yielding a response rate of 99 percent. Of those returned, 300 questionnaires were available for further analyses. Nurses were asked to respond to a questionnaire of 40 items concerning perception of embeddedness and 4 item concerning sense of responsibility to their employing organization. Nurses’ citizenship behavior were measured using 12 items as rated by their immediate supervisors. The results support the hypothesis that job embeddedness correlates positively with OCB. However, our result failed to support the prediction of the mediating effect of employees’ sense of responsibility in causal relationship between job embeddedness and OCB. The implications of the findings for further research on relationship between job embeddedness and OCB research are discussed.

Epigenetic mechanisms stabilize gene expression patterns during CD8+ T cell differentiation. Although adoptive transfer of virus-specific T cells is clinically applied to reduce the risk of virus infection or reactivation in immunocompromised individuals, the DNA methylation pattern of virus-specific CD8+ T cells is largely unknown. Hence, we here performed whole-genome bisulfite sequencing of cytomegalovirus-specific human CD8+ T cells and found that they display a unique DNA methylation pattern consisting of 79 differentially methylated regions (DMRs) when compared to memory CD8+ T cells. Among the top demethylated DMRs in cytomegalovirus-specific CD8+ T cells was TBKBP1, coding for TBK-binding protein 1 that can interact with TANK-binding kinase 1 (TBK1) and mediate pro-inflammatory responses in innate immune cells downstream of intracellular virus sensing. Since TBKBP1 has not yet been reported in T cells, we aimed to unravel its role in virus-specific CD8+ T cells. TBKBP1 demethylation in terminal effector CD8+ T cells correlated with higher TBKBP1 expression at both mRNA and protein level, independent of alternative splicing of TBKBP1 transcripts. Notably, the distinct DNA methylation patterns in CD8+ T cell subsets was stable upon long-term in vitro culture. TBKBP1 overexpression resulted in enhanced TBK1 phosphorylation upon stimulation of CD8+ T cells and significantly improved their virus neutralization capacity. Collectively, our data demonstrate that TBKBP1 modulates virus-specific CD8+ T cell responses and could be exploited as therapeutic target to improve adoptive T cell therapies. Author summary: Human cytomegalovirus (CMV) is a herpesvirus that infects a significant portion of the global population. While it usually causes asymptomatic or mild infections, CMV can have severe consequences for individuals with a weakened immune system, such as stem cell or organ transplant recipients or individuals with HIV/AIDS. The immune response to CMV is characterized by expansion of virus-specific CD8+ T cells, which recognize and eliminate CMV-infected cells, thereby controlling the infection. Studies have shown that the pathogen-induced differentiation of naive to effector memory CD8+ T cells is accompanied by epigenetic changes. In order to identify the major genes involved in the functionality of CMV-specific CD8+ T cells, which are also regulated by DNA methylation, we compared the methylation profiles of CMV-specific CD8+ T cells with memory CD8+ T cells. As a result of this, we found that TBK-binding protein 1 (TBKBP1) plays a crucial role in the function of CMV-specific CD8+ T cells and enhances virus neutralization capacity upon overexpression, which has not been reported previously. This study opens the possibility of not only identifying unknown genes that contribute to the functionality of CMV-specific CD8+ T cells, but also potentially lead to improvements in adoptive T cell therapies. [ABSTRACT FROM AUTHOR]

In accordance with the provisions of Article 48 of Law Number 5 of 1986 concerning the State Administrative Court which has been last amended by Law Number 51 of 2009 concerning the Second Amendment of Law Number 5 of 1986 concerning the State Administrative Court ("Peratun Law") which states that not every State Administrative Decision (beschikking) as the object of the State Administrative dispute can be directly sued through the State Administrative Court, because if there are administrative remedies, the state administrative dispute must be resolved first through administrative efforts before being resolved through the State Administrative Court. This research uses a qualitative normative method, which is a process to find a legal rule, legal principles, and legal doctrines to answer the legal issues faced. The result of this study is that Sema No. 1 of 2017 has been affirmed through Perma No. 6 of 2018, thus according to the Court, as long as the administrative effort is intended to file a lawsuit to the PTUN or at least related to the procedural law of the PTUN, the word "can" must be interpreted as "mandatory" to take administrative efforts first. Then the PTUN plays a role in ensuring that law enforcement occurs effectively, by paying attention to the principles of justice and legal certainty that are the basis for every decision taken, and the PTUN plays the role of a court that has the authority to resolve state administrative disputes after the administrative efforts have been passed, in accordance with applicable regulations. [ABSTRACT FROM AUTHOR]

BACKGROUND. Adoptive transfer of EBV-specific T cells can restore specific immunity in immunocompromised patients with EBV-associated complications. METHODS. We provide results of a personalized T cell manufacturing program evaluating donor, patient, T cell product, and outcome data. Patient-tailored clinical-grade EBV-specific cytotoxic T lymphocyte (EBV-CTL) products from stem cell donors (SCDs), related third-party donors (TPDs), or unrelated TPDs from the allogeneic T cell donor registry (alloCELL) at Hannover Medical School were manufactured by immunomagnetic selection using a CliniMACS Plus or Prodigy device and the EBV PepTivators EBNA-1 and Select. Consecutive manufacturing processes were evaluated, and patient outcome and side effects were retrieved by retrospective chart analysis. RESULTS. Forty clinical-grade EBV-CTL products from SCDs, related TPDs, or unrelated TPDs were generated for 37 patients with refractory EBV infections or EBV-associated malignancies with and without a history of transplantation, within 5 days (median) after donor identification. Thirty-four patients received 1-14 EBV-CTL products (fresh and cryopreserved). EBV-CTL transfer led to a complete response in 20 of 29 patients who were evaluated for clinical response. No infusion-related toxicity was reported. EBV-specific T cells in patients' blood were detectable in 16 of 18 monitored patients (89%) after transfer, and their presence correlated with clinical response. CONCLUSION. Personalized clinical-grade manufacture of EBV-CTL products via immunomagnetic selection from SCDs, related TPDs, or unrelated TPDs in a timely manner is feasible. Overall, EBV-CTLs were clinically effective and well tolerated. Our data suggest EBV-CTL transfer as a promising therapeutic approach for immunocompromised patients with refractory EBV-associated diseases beyond HSCT, as well as patients with preexisting organ dysfunction. TRIAL REGISTRATION. Not applicable. FUNDING. This study was funded in part by the German Research Foundation (DFG, 158989968/SFB 900), the Deutsche Kinderkrebsstiftung (DKS 2013.09), Wilhelm-Sander-Stiftung (reference 2015.097.1), Ellen-Schmidt-Program of Hannover Medical School, and German Federal Ministry of Education and Research (reference 01E00802)., Introduction Morbidity and mortality in patients with hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) are frequently caused by graft rejection or graft-versus-host disease (GvHD) and increased by [...]

Complications due to HCMV infection or reactivation remain a challenging clinical problem in immunocompromised patients, mainly due to insufficient or absent T‐cell functionality. Knowledge of viral targets is crucial to improve monitoring of high‐risk patients and optimise antiviral T‐cell therapy. To expand the epitope spectrum, genetically‐engineered dendritic cells (DCs) and fibroblasts were designed to secrete soluble (s)HLA‐A*11:01 and infected with an HCMV mutant lacking immune evasion molecules (US2‐6 + 11). More than 700 HLA‐A*11:01‐restricted epitopes, including more than 50 epitopes derived from a broad range of HCMV open‐reading‐frames (ORFs) were identified by mass spectrometry and screened for HLA‐A*11:01‐binding using established prediction tools. The immunogenicity of the 24 highest scoring new candidates was evaluated in vitro in healthy HLA‐A*11:01+/HCMV+ donors. Thus, four subdominant epitopes and one immunodominant epitope, derived from the anti‐apoptotic protein UL36 and ORFL101C (A11SAL), were identified. Their HLA‐A*11:01 complex stability was verified in vitro. In depth analyses revealed highly proliferative and cytotoxic memory T‐cell responses against A11SAL, with T‐cell responses comparable to the immunodominant HLA‐A*02:01‐restricted HCMVpp65NLV epitope. A11SAL‐specific T cells were also detectable in vivo in immunosuppressed transplant patients and shown to be effective in an in vitro HCMV‐infection model, suggesting their crucial role in inhibiting viral replication and improvement of patient's outcome. The developed in vitro pipeline is the first to utilise genetically‐engineered DCs to identify naturally presented immunodominant HCMV‐derived epitopes. It therefore offers advantages over in silico predictions, is transferable to other HLA alleles, and will significantly expand the repertoire of viral targets to improve therapeutic options. [ABSTRACT FROM AUTHOR]

Opportunistic viral infections in individuals with severe immunodeficiency can lead to fatal conditions such as progressive multifocal leukoencephalopathy (PML), for which treatment options are limited. These infections pose significant risks, especially when co-infections with other viruses occur. We describe a combined therapy approach using directly isolated allogeneic Human Polyomavirus 1 (also known as BKV) and Epstein–Barr virus (EBV) specific cytotoxic T-cells for the treatment of PML in conjunction with identified EBV in the cerebrospinal fluid (CSF) of a male patient infected with human immunodeficiency virus (HIV). A 53-year-old HIV-positive male, recently diagnosed with PML, presented with rapidly worsening symptoms, including ataxia, tetraparesis, dysarthria, and dysphagia, leading to respiratory failure. The patient developed PML even after commencing highly active antiretroviral therapy (HAART) 3 months prior. Brain magnetic resonance imaging (MRI) revealed multifocal demyelination lesions involving the posterior fossa and right thalamus suggestive of PML. In addition to the detection of human polyomavirus 2 (also known as JCV), analysis of CSF showed positive results for EBV deoxyribonucleic acid (DNA). His neurological condition markedly deteriorated over the following 2 months. Based on MRI, there was no evidence of Immune Reconstitution Inflammatory Syndrome contributing to this decline. The patient did not have endogenous virus-specific T-cells. We initiated an allogeneic, partially human leukocyte antigen-matched transfer of EBV and utilizing the cross-reactivity between BKV and JCV–BKV specific T-cells. This intervention led to notable neurological improvement and partial resolution of the MRI lesions within 6 weeks. Our case of a patient with acquired immune deficiency syndrome demonstrates that PML and concurrent EBV co-infection can still occur despite undergoing HAART treatment. This innovative experimental therapy, involving a combination of virus-specific T-cells, was demonstrated to be an effective treatment option in this patient. [ABSTRACT FROM AUTHOR]

Despite the advantages, The All-on-four concept has the disadvantage that the bone around the posterior (tilted) implant receives the highest pressure distribution. This study analyzed various implant-supported denture designs in the maxilla developed from the All-on-four concept using short implants as an alternative to the All-on-four concept. This study uses the Finite Element Method. All implants were placed parallel to the axial axis. Design A (All-on-four) was the control design. Design B: eliminate the tilted implant in the posterior and place one 6 mm implant in each of the left and right permanent maxilla first molar regions. Design C: same as Design B but place one 6 mm implant in each of the left and right permanent maxilla second Premolar, and first Molar regions. Design D (All-on-short) same as Design C but uses short implants both anterior and posterior. Designs B, C, and D had no distal cantilever. The axial load of 80N and an oblique load of 50Nx3 were applied separately. The simulation results showed that Design C has the lowest stress and Design B has the highest stress. It can be concluded that biomechanically, short implants can be used to treat patients with complete edentulous. [ABSTRACT FROM AUTHOR]