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AbstractThis article analyzes the negative impact of cryptocurrency mining activities on the environment and analyzes the urgency of cryptocurrency mining policy to protect the environment. This analysis was carried out by conducting a comparative study of regulations in countries open to the development of cryptocurrency, including Indonesia, the United States, China, and Iran. The results of this comparison are used as material for constructing environmentally friendly cryptocurrency mining regulations to be implemented in various countries. This type of research is legal research. The research approaches are the statutory, comparative, and case approaches. Data was collected using the literature study method, and technical data analysis was carried out using a qualitative juridical method. The results of this research are how to prevent and combat the negative impacts of cryptocurrency mining activities on the environment, including implementing several policies including minimizing greenhouse gas emissions, ensuring reliable energy, encouraging transparency and increasing environmental performance, data search to understand, monitor, and reduce impact, enactment of energy efficiency standards, besides that it is necessary to implement transaction fees and carbon taxes for cryptocurrency mining.

Introduction: Insufficient training in antimicrobial resistance (AMR) and antimicrobial stewardship (AMS) in the pharmacy curricula limits pharmacists’ participation in AMS activities in India. We explored the potential impact of an AMR curriculum implemented as part of a research project in one of the pharmacy colleges in Kerala, India. Methods: Data were collected using documentary analysis (minutes of meetings and the AMR curriculum developed) and semi-structured qualitative interviews with key informants face-to-face or via the Zoom platform at the participant's convenience. Anonymized interview transcripts were thematically analyzed aided by NVivo 12 software. Results: We interviewed faculty (n = 4), clinical pharmacists (n = 3), and students (n = 6) involved in the design, implementation, and use of the new curriculum. The development and implementation of the new curriculum was conducted through strategically planned and established methodology with equal involvement from the pharmacy college and the research project team. Challenges in this process included a lack of human resources to take classes, time, limited interactions, and motivation of students during the online classes. Despite this, students who attended the classes agreed that the curriculum introduced them to AMS and AMR concepts which helped them during their clinical postings. They agreed that it would be beneficial if a similar curriculum was implemented in other pharmacy colleges. Conclusion: Learnings from this study would be beneficial for other pharmacy colleges to implement a similar AMR curriculum for training pharmacy students to take key roles in AMS, especially in countries like India where postgraduate training for pharmacists remains limited.

Background and Aim: Antibiotic resistance (ABR) is one of the most pressing public health issues. Resistant pathogens originate from antibiotic misuse and unsustainable socioeconomic patterns. Co-financed by the European Commission, the Erasmus + capacity building project, PREVENT IT | Risk Management and Prevention of ABR, aims to improve the effectiveness of the study programs of Indian universities vis-à-vis ABR. This study aimed to evaluate the impact of the ABR training programs on the knowledge, attitude, and practice (KAP) reflection of undergraduate and postgraduate students from five Indian universities. Materials and Methods: In this multicentric study, the KAP reflection of the students was assessed before (pre) and after (post) the intervention of experiential ABR training. Paired t-test and one-way analysis of variance were used to analyze the impact of intervention using the Statistical Package for the Social Sciences software. Results: A total of 515 students participated in the study. The findings indicate a significant improvement in the knowledge and attitude scores, while a minor change was observed in practice reflection. Conclusion: The intervention conducted within the framework of the project could set a good practice for the prevention and risk management of antibiotic-resistant bacteria.

AbstractThe rapid growth of the digital economy in Indonesia provides a positive trend for startups. The valuation of Indonesia’s digital economy is the highest in Southeast Asia. This paper aims to identify problems and legal issues regarding startups. This research also tries to formulate regulations that can support the development of startups in Indonesia. The data collection technique used is library research by examining books, journals, reports, and laws related to startups. The data analysis technique used is the legal norm method by analyzing laws and regulations related to startups. Based on the results of the research, it was found that startups in Indonesia still face various legal problems such as the absence of startup regulations and the complicated and lengthy startup licensing process. Based on these problems, it is recommended that Indonesia has regulations that specifically regulate startups. The regulation regulates the process of facilitating business licensing for startups, financial support and capital raising schemes. To overcome these problems, Indonesia needs to reformed regulations in the startup sector and apply the licensing concept through a risk-based approach.

Indonesia is the second largest food waste disposer after Saudi Arabia. The potential increase in waste and food waste is an essential issue for Indonesia, given the problem’s economic, social, and environmental implications. However, the implementation of the circular economy concept still faces various problems compared to Germany, Netherlands, and China.This paper aims to formulate an ideal policy to implement the circular economy concept through policy comparisons between countries especially to overcome the problem of food waste in Indonesia. This is legal politics research that takes a conceptual and comparative approach. A comparative study was conducted on circular economy policies relating to food waste in Indonesia, Germany, the Netherlands, and China. Data was collected through a literature study analyzing various circular economy regulations. According to the research findings, the Circular Economy Act has to be implemented in Germany, Netherlands, and China has been proven effective as a guideline and policy direction to provide solutions for the problems of waste and food waste. The Circular Economy Act serves as a guide and policy direction for the government, private sector, communities, and parties to address environmental issues and help realize sustainable development goals.

Abstract Background Central nervous system (CNS) infection has been an ongoing concern in paediatrics. The FilmArray® Meningoencephalitis (FAME) panel has greater sensitivity in identifying the aetiology of CNS infections. This study’s objective was to compare the aetiological identification and hospitalization costs among patients with suspected CNS infection before and after the use of FAME. Methods An analytical observational study was carried out using a retrospective cohort for the pre-intervention (pre-FAME use) period and a prospective cohort for the post-intervention (post-FAME use) period in children with suspected CNS infection. Results A total of 409 CSF samples were analysed, 297 pre-intervention and 112 post-intervention. In the pre-intervention period, a total of 85.5% of patients required hospitalization, and in the post-intervention period 92.7% required hospitalization (p

Digital payments are proliferating along with a massive and rapid digital transformation. However, the characteristics of transactions using digital payments, which are real-time, not face-to-face, and borderless create potential risks for financial crimes, including, Money Laundering and Funding Terrorism. The potential for abuse occurs in the registered and licensed digital payments sector and illegal digital payments that are not registered with the Bank Indonesia. Undoubtedly, this condition can threaten economic stability and financial system integrity. This article seeks to identify the potential for digital payment use for financial crime and construct a legal framework to prevent the misuse of FinTech for financial crime in Indonesia. This type of research is legal research. The research method used was a statutory comparative approach. The legal materials used were primary and secondary legal materials. The findings have been analyzed using qualitative data analysis techniques. The results of the study show that several cases of terrorism financing have been proven to have used FinTech digital payments as a means of online funding. In this regard, to maintain the integrity of the financial system and strengthen the government’s control functions, a comprehensive legal framework is needed through the establishment of Law on FinTech.

Introduction: A quality night sleep is essential for physical, cognitive, and emotional well-being. The amount of sleep may have an effect on both weight and metabolism. In India, for the last few years, decline in sleep duration has been noted with an average sleep duration of 7 hours per night and one-third sleeping less than 7 hours per night. Televisions and smartphones which came into households as remarkable source of information and entertainment has caused the voluntary sleep restriction. Aim: To evaluate the sleep quality, Body Mass Index (BMI) and Blood Pressure (BP) of the healthcare students and also to find the correlation of sleep quality with BMI and BP. Material and Methods: The present cross-sectional study was conducted on 138 healthy males and females healthcare students residing in hostel premises of Yenepoya (Deemed to be University), Karnataka, India from November to December 2021. Pittsburgh Sleep Quality Index (PSQI) questionnaires administered to assess the sleep quality by adding the seven components of PSQI score ranging from 0 to 21. A weighing scale, sphygmomanometer, and stadiometer instruments were used to record the weight, BP, and height. Data were computed in International Business Management (IBM) Statistical Package for Social Sciences (SPSS) software version 23.0 to analyse descriptive and inferential statistics. Results: The mean age in present study was 23±0.72 years and 71 (51.4%) belonged to 22-23 years, majority 112 (81.2%) were female students. In present study, moderately obese students (33.15±0.72) and severely obese (35.39±0.10) had mean sleep score of 6.00±3.46 and 11 respectively indicating poor sleep quality. The underweight (16.91±1.17), normal weight (21.49±2.04) and overweight (26.49±1.48) had mean sleep score of 3.08±1.62, 3.08±1.12 and 4.66±3.05 respectively, which indicated good sleep quality. Students with hypotension, normal BP and hypertension stage-1 showed mean sleep score of 3.52, 2.71 and 4.77 respectively, showing good sleep quality. A statistically significant positive correlation of BMI was found with SBP (r-value 0.273, p-value 0.001) and DBP (r-value 0.181, p-value 0.033). Conclusion: BMI and BP were positively correlated with sleep quality. Therefore, creating awareness among healthcare students on healthy lifestyles such as exercise, healthy sleep and regular health supervision is essential to prevent pre-hypertension and maintain normal BMI status.

Background Evidence shows that a gap in the documentation of patients’ past medical history leads to errors in, or duplication of, treatment and is a threat to patient safety. Home-based or patient-held records (HBR) are widely used in low and middle-income countries (LMIC) in maternal and childcare. The aim is to systematically review the evidence on HBRs in LMICs for (1) improving informational continuity for providers and women/families across health care visits and facilities, (2) to describe the perceived usefulness by women/families and healthcare providers, and (3) maternal and child health outcomes of using HBRs for maternal and child health care. Methods The protocol was registered in PROSPERO (CRD42019139365). We searched MEDLINE, EMBASE, CINAHL, and Global Index Medicus databases for studies with home-based records from LMICs. Search terms pertained to women or parent-held records and LMICs. Two reviewers assessed studies for inclusion using a priori study selection criteria- studies explaining the use of HBRs in LMIC for maternal and child health care. The included study quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Results from all study designs were summarised narratively. Results In total, 41 papers were included in the review from 4514 potential studies. Included studies represented various study designs and 16 countries. The least evaluated function of HBR was information continuity across health care facilities (n = 6). Overall, there were limited data on the usefulness of HBRs to providers and mothers/families. Home-based records were mostly available for providers during health care visits. However, the documentation in HBRs varied. The use of HBRs is likely to lead to improved antenatal visits and immunisation uptake, and skilled birth delivery in some settings. Mothers’ knowledge of breastfeeding practices and danger signs in pregnancy improved with the use of HBRs. One randomised trial found the use of HBRs reduced the risk of cognitive development delay in children and another reported on trial lessened the risk of underweight and stunted growth in children. Conclusion There is limited literature from LMICs on the usefulness of HBRs and for improving information transfer across healthcare facilities, or their use by women at home. Current HBRs from LMICs are sub-optimally documented leading to poor informational availability that defeats the point of them as a source of information for future providers.

Objective To review the available evidence on the benefit of patient-held health records (PHRs), other than maternal and child health records, for improving the availability of medical information for handover communication between healthcare providers (HCPs) and/or between HCPs and patients in low-income and middle-income countries (LMICs).Methods The literature searches were conducted in PubMed, EMBASE, CINAHL databases for manuscripts without any restrictions on dates/language. Additionally, articles were located through citation checking using previous systematic reviews and a grey literature search by contacting experts, searching of the WHO website and Google Scholar.Results Six observational studies in four LMICs met the inclusion criteria. However, no studies reported on health outcomes after using PHRs. Studies in the review reported patients’ experience of carrying the records to HCPs (n=3), quality of information available to HCPs (n=1) and the utility of these records to patients (n=6) and HCPs (n=4). Most patients carry PHRs to healthcare visits. One study assessed the completeness of clinical handover information and found that only 41% (161/395) of PHRs were complete with respect to key information on diagnosis, treatment and follow-up. No protocols or guidelines for HCPs were reported for use of PHRs. The HCPs perceived the use of PHRs improved medical information availability from other HCPs. From the patient perspective, PHRs functioned as documented source of information about their own condition.Conclusion Limited data on existing PHRs make their benefits for improving health outcomes in LMICs uncertain. This knowledge gap calls for research on understanding the dynamics and outcomes of PHR use by patients and HCPs and in health systems interventions.PROSPERO registration number CRD42019139365.

The present study seeks to analyze the functions of civil registration in poverty reduction and to identify various problems encountered in civil registration in Indonesia. This study was conducted by using an empirical law research. Primary data and legal materials are analyzed qualitatively with empirical juridical approach. The results conclude that civil registration yields demographic data that play a strategic role in the utilization of public services and development planning. Improving the quality of human life, either in the field of education, health or revenue requires demographic data as the policy focus. This gives implications that the basis of development program interventions in the three sectors refer to the aforementioned demographic data. Therefore, the use of demographic data and expansion of the coverage of ownership of demographic documents present as strategic steps for poverty reduction. However, the low attainment of document ownership in some regions and the limited number of civil registration apparatuses become an indicator of the absence of roles of demographic data in development. This has an impact on improperly targeted development planning. Several strategies that need to be implemented include: (1) Strengthening regulations at the regional level that regulate the utilization of demographic data in development planning; (2) establishing study program of civil registration law as an attempt of population-based development in Indonesia.

Background: The objective of the study was to describe participants’ and providers’ perspectives of barriers and facilitators of enrolment, participation and adherence to a structured lifestyle modification (SLM) interventions as part of the PROLIFIC trial in Kerala, India. Methods: Family members who had been enrolled for 12-months or more in a family-based cardiovascular risk reduction intervention study (PROLIFIC Trial) were purposively sampled and interviewed using a semi-structured guide. The non-physician health workers (NPHWs) delivering the intervention were also interviewed or included in focus groups (FGDs). Thematic analysis was used for data analysis. Results: In total, 56 in-depth interviews and three FGDs were conducted. The descriptive themes emerged were categorised as (a) motivation for enrolment and engagement in the SLM interventions, (b) facilitators of adherence, and (c) reasons for non-adherence. A prior knowledge of familial cardiovascular risk, preventive nature of the programme, and a reputed organisation conducting the intervention study were appealing to the participants. Simple suggestions of healthier alternatives based on existing dietary practices, involvement of the whole family, and the free annual blood tests amplified the adherence. Participants highlighted regular monitoring of risk factors and provision of home-based care by NPHWs as facilitators for adherence. Furthermore, external motivation by NPHWs in setting and tracking short terms goals were perceived as enablers of adherence. Nonetheless, home makers expressed difficulty in dealing with varied food choices of family members. Young adults in the programme noted that dietary changes were affected by eating out as they wanted to fit in with peers. Conclusions: The findings suggest that a family-based, trained healthcare worker led SLM interventions are desirable and feasible in Kerala. Increasing the number of visits by NPHWs, regular monitoring and tracking of lifestyle goals, and targeting young adults and children for dietary changes may further improve adherence to SLM interventions.

BackgroundActive surveillance is necessary for improving the management and outcome of patients with candidemia. The aim of this study was to describe epidemiologic and clinical features of candidemia in children and adults in tertiary level hospitals in Chile.MethodsWe conducted a prospective, multicenter, laboratory-based survey study of candidemia in 26 tertiary care hospitals in Chile, from January 2013 to October 2017.ResultsA total of 780 episodes of candidemia were included, with a median incidence of 0.47/1,000 admissions. Demographic, clinical and microbiological information of 384 cases of candidemia, from 18 hospitals (7,416 beds), was included in this report. One hundred and thirty-four episodes (35%) occurred in pediatric patients and 250 (65%) in adult population. Candida albicans (39%), Candida parapsilosis (30%) and Candida glabrata (10%) were the leading species, with a significant difference in the distribution of species between ages. The use of central venous catheter and antibiotics were the most frequent risk factors in all age groups (> 70%). Three hundred and fifteen strains were studied for antifungal susceptibility; 21 strains (6.6%) were resistant to fluconazole, itraconazole, voriconazole, anidulafungin or micafungin. The most commonly used antifungal therapies were fluconazole (39%) and echinocandins (36%). The overall 30-day survival was 74.2%, significantly higher in infants (82%) and children (86%) compared with neonates (72%), adults (71%) and elderly (70%).ConclusionsOur prospective, multicenter surveillance study showed a low incidence of candidemia in Chile, with high 30-day survival, a large proportion of elderly patients, C. glabrata as the third most commonly identified strain, a 6.6% resistance to antifungal agents and a frequent use of echinocandins.

We report a case of a 47-year-old female who presented with breathlessness and palpitations for two weeks. On clinical evaluation, bilateral pedal edema was noticed. A CT pulmonary angiogram showed a mass in the left atrium causing significant obstruction to cardiovascular outflow. After extensive work-up, the mass was surgically resected. Histopathological findings from the acquired specimen revealed a high-grade leiomyosarcoma with extensive necrosis and heterologous (cartilaginous) differentiation. The early postoperative period was complicated by cardiac tamponade and the patient died on the second postoperative day due to ventricular arrhythmia, shock and multiorgan failure. SIMILAR CASES PUBLISHED: No similar cases published.

Urinoma (or perirenal uriniferous pseudo cyst) occurs due to extravasation of urine in the perirenal space. Common causes include traumatic renal injury or an obstruction in the outflow tract as in a posterior urethral valve. Though rare, such diagnosis should be considered in neonates presenting with expanding cystic masses in the abdomen. Here, we present a case of a four-day-old neonate, who presented to us with abdominal distension and bilious vomiting. The initial radiographic studies showed a cystic mass surrounding the right kidney. Urine was aspirated from the mass and Micturating Cysto-Urethrogram (MCU) showed the presence of a Posterior Urethral Valve (PUV). A diagnosis of urinoma secondary to PUV was confirmed. After relieving the obstruction by vesicostomy, symptoms of intestinal obstruction resolved. On later follow up, size of urinoma also gradually decreased. This proves that not every case of a distended abdomen and bilious vomiting in a neonate, necessarily points towards Necrotising Enterocolitis (NEC) or intestinal obstruction.

Modern vehicles are enhanced with increased computation, communication and sensing capabilities, providing a variety of new features that pave the way for the deployment of more sophisticated services. Specifically, smart cars employ hundreds of sensors and electronic systems in order to obtain situational and environmental information. This rapid growth of on-vehicle multi-sensor inputs along with off-vehicle data streams introduce the smart car era. Thus, systematic techniques for combining information provided by on- and off-vehicle car connectivity are of remarkable importance for the availability and robustness of the overall system. This paper presents a new method to employ service oriented agents that cohesively align on- and off-vehicle information in order to estimate the current status of the car. In particular, this work combines, integrates, and evaluates multiple information sources targeting future smart cars. Specifically, the proposed methodology leverages weather-based, on-route, and on-vehicle information. As a use case, the presented work informs the driver about the recommended speed that the car should adapt to, based on the current status of the car. It also validates the proposed speed with real-time vehicular measurements.