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The COVID-19 pandemic brought abrupt changes to teaching that caused increased stress amid an already difficult time. Whether teaching remote, hybrid, or in-person, university faculty were expected to continue teaching throughout the pandemic, despite personal challenges at home. In addition, there were expectations that faculty show greater levels of compassion towards their students. Multiple articles brought attention to these struggles and questioned whether university faculty might be experiencing compassion fatigue--a state of emotional exhaustion brought on by secondary traumatic stress and characterized by a reduced capacity for empathy. Using data from a larger, longitudinal qualitative study of faculty members' experiences during the pandemic, the present study aims to understand faculty experiences of emotional labor and compassion fatigue during this time. Unsurprisingly, most participants reported an increase in emotional labor during the early pandemic; however, roughly one in four described their emotional labor loads as unchanged or even decreased. In those cases, participants often described active disengagement practices in the workplace, or methods of "guarding one's time." Overall, compassion fatigue was less evident than anticipated, but there were identifiable signs of burnout among participants. This finding alone suggests a need for additional research to better conceptualize and operationalize the two terms.

This article presents an exploratory genre-based writing lesson conducted in a third-year collegiate German language course. While genre-based approaches to writing have gained recognition in second language (L2) contexts, little attention has been given to learner perceptions of genre-based writing activities. Additionally, there is a lack of pedagogical strategies and materials for intermediate-level German language classes. This article addresses these gaps by introducing a lesson on consumer music reviews designed following genre-based pedagogical principles, the flipped classroom approach, and the use of language corpora. The lesson, consisting of two 75-min class periods, aimed at familiarizing students with the structure and style of consumer music reviews, culminating in the writing of their own reviews. Using authentic texts and incorporating the "Digitales Wörterbuch der deutschen Sprache" corpus tool for vocabulary building, students engaged with contemporary German-language music. Data from student surveys indicated positive perceptions of the lesson, particularly regarding vocabulary acquisition, lesson structure, and topic relevance. Students also found the corpus tool beneficial for contextual understanding and word usage. This exploratory lesson highlights the potential of genre-based writing pedagogy, the flipped classroom model, and corpus tools for L2 writing development and contributes to the growing body of literature on genre-based writing in L2 classrooms.

Ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) expression correlates with poor prognosis in many cancers, and we previously discovered that ENPP1 is the dominant hydrolase of extracellular cGAMP: a cancer-cell-produced immunotransmitter that activates the anticancer stimulator of interferon genes (STING) pathway. However, ENPP1 has other catalytic activities and the molecular and cellular mechanisms contributing to its tumorigenic effects remain unclear. Here, using single-cell RNA-seq, we show that ENPP1 in both cancer and normal tissues drives primary breast tumor growth and metastasis by dampening extracellular 23-cyclic-GMP-AMP (cGAMP)-STING-mediated antitumoral immunity. ENPP1 loss-of-function in both cancer cells and normal tissues slowed primary tumor growth and abolished metastasis. Selectively abolishing the cGAMP hydrolysis activity of ENPP1 phenocopied ENPP1 knockout in a STING-dependent manner, demonstrating that restoration of paracrine cGAMP-STING signaling is the dominant anti-cancer mechanism of ENPP1 inhibition. Finally, ENPP1 expression in breast tumors deterministically predicated whether patients would remain free of distant metastasis after pembrolizumab (anti-PD-1) treatment followed by surgery. Altogether, ENPP1 blockade represents a strategy to exploit cancer-produced extracellular cGAMP for controlled local activation of STING and is therefore a promising therapeutic approach against breast cancer.

Abstract Introduction Scaling up public health interventions in the health systems of resource poor settings come with technical and operational challenges. Little is documented on scaling up complex health financing interventions and their related outcomes, especially the voluntary health insurance schemes. This study aimed to analyse the scale-up steps, successes and challenges of the improved community health fund (iCHF), a voluntary health insurance scheme in Tanzania, Methods In this paper, guided by the Expand Net framework (a scale-up framework for health system interventions), we present a systematic analysis of countrywide scale-up of the iCHF that started in 2019 and implemented in partnership between the government and development partners. We systematically collected information on the scale-up steps and the success and challenges. The collected data was analysed using descriptive statistics. Results The scale-up involved multiple steps and actions at different levels of the health system. The initial step involved gathering stakeholders’ views on scale-up options and strategies. The subsequent steps focused on mobilizing resources for scale-up, advocacy and promotion of the scheme through media, community leaders and role models, capacity building to implementing organs, institutionalizing the scale-up processes, intensifying the scale-upscale-up activities for expansion and spontaneous scale-up and technical backstopping to lower levels of the health system on the scale-up process. We found success and challenges as the scale-upscale-up progressed to mature stages. The success included acceptability and institutionalization of the scale-up activities and growing enrolments and funds in the scheme. The challenges included: the costs to sustaining advocacy and enrolments, equity in scale-upscale-up activities across regions, relying on top-down scale-upscale-up approaches, influence of contextual factors and lack of implementation research alongside the scale-upscale-up process. Conclusion This paper underscores the scale up steps and success and challenges of scaling-up a voluntary health insurance scheme in a resource-constrained health system. Sustaining the scale-upscale-up gains will require utilizing program data and experiences to sustainably improve the scheme performance while also harnessing support from stakeholders. Further research is needed to assess equity and quality of outcomes of the scale up.

Polyethylene terephthalate (PET) is utilized in the containment of potable water, nonetheless, it is susceptible to impairment due to temperature and duration of storage. Migration of formaldehyde from PET arises as a consequence of thermal deterioration. This study aims to ascertain the extent of formaldehyde transference in PET-contained drinking water of varying condition, subjected to diverse temperature setting and storage durations. An examination into the levels of formaldehyde migration in polyethylene terephthalate (PET) bottled drinking water was effectively carried out employing a validated high-performance liquid chromatography (HPLC) technique. A total of 162 water samples from three different PET bottled water brands sourced from supermarkets in Palu City, Central Sulawesi, Indonesia, underwent analysis. The formaldehyde assessment was executed utilizing a mobile phase composition of methanol:acetonitrile:water (48:12:40 v/v) for 12.97 minutes at a flow rate of 0.8 mL/minute on the 1st day, the 14th day, and the 42nd day while stored at room temperature and exposed to sunlight. Formaldehyde, lacking effective chromophoric entities and not readily ionizable, necessitated derivatization with 2,4-dinitrophenylhydrazine before HPLC analysis. The findings of the study demonstrated exceptional method linearity within the concentration span of 0.5 to 1321 µg/mL, exhibiting a commendable correlation coefficient of 0.999. The limit of detection (LOD) and quantification (LOQ) were determined to be 17.33 and 57.76 µg/mL, correspondingly. Precision evaluations displayed average intraday and interday values of 128.46±3.48% and 103.19±0.12%, respectively (%RSD < 2/3 CV Horwitz ratio). The intraday and interday %recovery values were computed at 97.22±3.48% and 96.83±0.14% (n = 6). The scrutiny of formaldehyde concentrations in the water samples unveiled the absence of formaldehyde migration.

This study aims to determine how competence and motivation affect the business performance of MSMEs partially and simultaneously in Cicurug District. The population is 105 business actors in Cicurug District in 2022. A sample of 70 individuals was obtained by purposive sampling. The primary data utilized in this research is from primary sources. Data analysis employs quantitative techniques, namely multiple linear regression analysis. The research findings indicate a simultaneous effect of competence and motivation on business success and a partial influence of each factor on business success individually. Keywords: Competence; Motivation; Business Success

The inflammatory response to wear particles derived from hip prothesis is considered a hallmark of periprosthetic osteolysis, which can ultimately lead to the need for revision surgery. Exosomes (Exos) have been associated with various bone pathologies, and there is increasing recognition in the literature that they actively transport molecules throughout the body. The role of wear particles in osteoblast-derived Exos is unknown, and the potential contribution of Exos to osteoimmune communication and periprosthetic osteolysis niche is still in its infancy. Given this, we investigate how titanium dioxide nanoparticles (TiO2 NPs), similar in size and composition to prosthetic wear particles, affect Exos biogenesis. Two osteoblastic cell models commonly used to study the response of osteoblasts to wear particles were selected as a proof of concept. The contribution of Exos to periprosthetic osteolysis was assessed by functional assays in which primary human macrophages were stimulated with bone-derived Exos. We demonstrated that TiO2 NPs enter multivesicular bodies, the nascent of Exos, altering osteoblast-derived Exos secretion and molecular cargo. No significant differences were observed in Exos morphology and size. However, functional assays reveal that Exos cargo enriched in uPA stimulates macrophages to a mixed M1 and M2 phenotype, inducing the release of pro- and anti-inflammatory signals characteristic of periprosthetic osteolysis. In addition, we demonstrated the expression of uPA in exosomes derived from the urine of patients with osteolysis. These results suggest that uPA can be a potential biomarker of osteolysis. In the future, uPa may serve as a possible non-invasive biomarker to identify patients at risk for peri-implant osteolysis.

Objective: Anti-pathogenic potential of a polyherbal formulation Enteropan® was investigated against a multidrug-resistant strain of the bacterium Pseudomonas aeruginosa. Methods: Growth, pigment production, antibiotic susceptibility, etc., were assessed through appropriate in vitro assays. Virulence of the test pathogen was assessed employing the nematode worm Caenorhabditis elegans as a model host. Molecular mechanisms underlining the anti-pathogenic activity of the test formulation were elucidated through whole transcriptome analysis of the extract-exposed bacterial culture. Results: Enteropan-pre-exposed P. aeruginosa displayed reduced (~70%↓) virulence towards the model host C. elegans. Enteropan affected various traits like biofilm formation, protein synthesis and secretion, quorum-modulated pigment production, antibiotic susceptibility, nitrogen metabolism, etc., in this pathogen. P. aeruginosa could not develop complete resistance to the virulence-attenuating activity of Enteropan even after repeated exposure to this polyherbal formulation. Whole transcriptome analysis showed 17% of P. aeruginosa genome to get differentially expressed under influence of Enteropan. Major mechanisms through which Enteropan exerted its anti-virulence activity were found to be generation of nitrosative stress, oxidative stress, envelop stress, quorum modulation, disturbance of protein homeostasis and metal homeostasis. Network analysis of the differently expressed genes resulted in identification of 10 proteins with high network centrality as potential targets from among the downregulated genes. Differential expression of genes coding for five (rpoA, tig, rpsB, rpsL, and rpsJ) of these targets was validated through real-time polymerase chain reaction too, and they can further be pursued as potential targets by various drug discovery programmes.

Abstract The present study aimed to study the entrepreneurial innovation among entities in Singapore. It evaluated the various obstacles that affect entrepreneurial innovation within entities. Further, it has also analysed the various elements that are crucial to overcome the obstacles that affect entrepreneurial innovation within entities. Various factors related to various sources of information fostering innovation activities in an organization were also studied. Difference between the product innovation and process innovation was studied. Furthermore, organizational innovation and marketing innovation were also studied. Lastly, organizational innovation’s degree of observed effect in the organization was also studied. Cross-sectional analysis using realism as epistemological view was undertaken in this study. Deductive research approach along with web-based survey using descriptive research design is the research methods followed in this study. Tools for results’ analysis include descriptive analysis, Q–Q plots, KMO and Bartlett's test, factor analysis and Chi-square tests. The study concluded that enterprises need to work aggressively in the new product development, market opportunities, organization capabilities to ensure that the organizations grow. It is highlighted that process innovation and product innovation have effects on the economic performance of the organization. It does flag that the market innovations are linked with the ways the enterprises change, evolve and develop their fundamental capabilities, which are part of the organizational innovations. Also, the study showed that organizational innovation has greatly helped to improve the quality of the goods or services and reduced costs per unit output. The reduced time to respond to customer or supplier needs and improved employee satisfaction and/or reduced rates of employee turnover is also seen as a significant observed effect of entrepreneurial innovation. Managerial and theoretical implications along with Ideas for future research is also provided.

Sustainable intensification is considered an efficient alternative to conventional agriculture to feed a growing population while maintaining and benefitting the environment. Intercropping is one of the most studied practices to obtain production gains and other ecosystem services. Most intercrops involve legumes and cereals, but other species combinations should be explored to further increase the diversity of intercropping systems. Buckwheat (Fagopyrum esculentum Moench.; Polygonaceae) is an emerging minor crop which is gaining attention in alternative intercropping systems. This review provides a comprehensive view of the state of the art on the role of buckwheat as a companion crop in arable cropping systems. Despite buckwheat being well-known for its weed-suppressive ability, intercropping using buckwheat for weed control has received little attention. Few crops have so far been considered in relation to the introduction of buckwheat in annual cropping systems. This review uncovers a largely untapped research field involving buckwheat. The research perspectives are multiple as buckwheat consumption is increasing and its attractive flower resources and rapid growth offer the provision of several agro-ecosystem services that directly and indirectly benefit crop yield stability.

Objective: This study aimed at investigating whether the duration of fermenting Panchagavya (PG) preparation in copper vessel affects its biological activity and microbiome composition. Materials and methods: Prophylactic potential of PG against bacterial infection was assessed through an in vivo assay employing the nematode worm Caenorhabditis elegans as a model host. Bacterial diversity of the PG samples was revealed through metagenomic analysis. Results: Duration of fermentation was found to affect biological activity as well as microbiome composition of the PG samples. PG-samples fermented ≥60 min lost their prophylactic potential, and develop anthelmintic activity. Bacterial phyla whose relative abundance was significantly different between the prophylactic and anthelmintic PG samples were Planctomycetota, Proteabacteria, Bacteroidota, Verrucomicrobiota, Patescibacteria, Acidobacteriota, Chloroflexi, Firmicutes and Campilobacterota. Conclusion: This study validates the prophylactic potential of Panchagavya against bacterial pathogens, and shows that duration of the fermentation time while preparing PG can have profound effect on its biological activities. Biological activities of PG samples seem to have a correlation with their inherent microbial community. Metagenomic profiling can be an effective tool for standardization of PG formulations.

Abstract Background Pseudomonas aeruginosa is a notorious pathogen. Its multidrug resistant strains are listed among priority pathogens against whom discovery of novel antibacterial agents and, elucidation of new anti-pathogenicity mechanisms are urgently warranted. This study describes multiple antibacterial effects of a colloidal nano-silver formulation- Silversol® against a multi-drug resistant strain of P. aeruginosa. Results Minimum inhibitory concentration (MIC) of Silversol® against P. aeruginosa was found to be 1.5 ppm; and at sub-MIC of 1 ppm, it was able to alter quorum-sensing regulated pigmentation (pyocanin 82%↓; pyoverdine 48%↑), exopolysaccharide synthesis (76%↑) and biofilm formation, susceptibility to antibiotics (streptomycin and augmentin), protein synthesis and export (65%↑), nitrogen metabolism (37%↑ nitrite accumulation), and siderophore production in this pathogen. Network analysis of the differentially expressed genes in the transcriptome of the silversol-treated bacterium identified ten genes as the potential molecular targets: norB, norD, nirS, nirF, nirM, nirQ, nosZ, nosY, narK1, and norE (all associated with nitrogen metabolism or denitrification). Three of them (norB, narK1, and norE) were also validated through RT-PCR. Conclusions Generation of nitrosative stress and disturbance of iron homeostasis were found to be the major mechanisms associated with anti-Pseudomonas activity of Silversol®.

Abstract Objective In the background of a very small number of effective anthelmintics available today with a narrow activity spectrum, and a rise in resistance against them among parasitic helminths, there is an urgent need for discovery of novel broad-spectrum anthelmintics displaying no or minimal toxicity towards the host. Silver being used since centuries for therapeutic purposes and considered safe for human consumption, we investigated anthelmintic activity of a colloidal nanosilver formulation Silversol®. Anthelmintic efficacy of the test formulation was assayed employing the nematode Caenorhabditis elegans as a model worm through a live-dead count. Results Silversol® exerted anthelmintic action superior to one of the positive controls (Benzimidazole), and almost at par to another positive control (Ivermectin). At concentrations ≥ 2 ppm, it could kill all the worms present in the experimental well. Lower concentrations of silver were found to have a cuticle-damaging action on worms. Further investigation is warranted to assess whether Silversol® can exert similar potent activity against different species of parasitic helminths, and elucidate the underlying molecular mechanisms of action.

Due to the COVID-19 pandemic, many in-person classes shifted to emergency remote learning, with Zoom being the adopted software choice of communication for many schools. Despite its accessibility, students have expressed fatigue and challenges with conversations using Zoom. Additionally, emergency remote learning has led to decreased interpersonal interactions. Thus, we wondered whether Gather.town, a teleconferencing software with proximity-chat features, might lead to a more positive learning environment than Zoom. We utilized both software in an inquiry and problem-based course, Science of Fictional Characters, at McMaster University during the Fall 2021 semester. We surveyed students’ preference between Gather.town and Zoom across five different domains: engagement, enjoyment, social connectedness, ease of use, and willingness to communicate using each software. Twelve out of 30 enrolled students responded to the survey. Participants reported more engagement (58%), higher enjoyment (58%), and greater social connectedness (92%) to their peers using Gather.town compared to Zoom, despite participants also reporting Zoom being easier to use (92%). The results further revealed no preference towards either software in terms of willingness to communicate. Although our sample size is small, our results nonetheless suggest a software with proximity chat features such as Gather.town could be a potential alternative to Zoom for fostering positive learning environments.

BackgroundLow-and middle-income countries (LMICs) are implementing health financing reforms toward Universal Health Coverage (UHC). In Tanzania direct health facility financing of health basket funds (DHFF-HBF) scheme was introduced in 2017/18, while the results-based financing (RBF) scheme was introduced in 2016. The DHFF-HBF involves a direct transfer of pooled donor funds (Health Basket Funds, HBF) from the central government to public primary healthcare-PHC (including a few selected non-public PHC with a service agreement) facilities bank accounts, while the RBF involves paying providers based on pre-defined performance indicators or targets in PHC facilities. We consider whether these two reforms align with strategic healthcare purchasing principles by describing and comparing their purchasing arrangements and associated financial autonomy.MethodsWe used document review and qualitative methods. Key policy documents and articles related to strategic purchasing and financial autonomy were reviewed. In-depth interviews were conducted with health managers and providers (n = 31) from 25 public facilities, health managers (n = 4) in the Mwanza region (implementing DHFF-HBF and RBF), and national-level stakeholders (n = 2). In this paper, we describe and compare DHFF-HBF and RBF in terms of four functions of strategic purchasing (benefit specification, contracting, payment method, and performance monitoring), but also compare the degree of purchaser-provider split and financial autonomy. Interviews were recorded, transcribed verbatim, and analyzed using a thematic framework approach.ResultsThe RBF paid facilities based on 17 health services and 18 groups of quality indicators, whilst the DHFF-HBF payment accounts for performance on two quality indicators, six service indicators, distance from district headquarters, and population catchment size. Both schemes purchased services from PHC facilities (dispensaries, health centers, and district hospitals). RBF uses a fee-for-service payment adjusted by the quality of care score method adjusted by quality of care score, while the DHFF-HBF scheme uses a formula-based capitation payment method with adjustors. Unlike DHFF-HBF which relies on an annual general auditing process, the RBF involved more detailed and intensive performance monitoring including data before verification prior to payment across all facilities on a quarterly basis. RBF scheme had a clear purchaser-provider split arrangement compared to a partial arrangement under the DHFF-HBF scheme. Study participants reported that the RBF scheme provided more autonomy on spending facility funds, while the DHFF-HBF scheme was less flexible due to a budget ceiling on specific spending items.ConclusionBoth RBF and DHFF-HBF considered most of the strategic healthcare purchasing principles, but further efforts are needed to strengthen the alignment towards UHC. This may include further strengthening the data verification process and spending autonomy for DHFF-HBF, although it is important to contain costs associated with verification and ensuring public financial management around spending autonomy.

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Antibiotic-resistant strains of Staphylococcus aureus are being viewed as a serious threat by various public health agencies. Identifying novel targets in this important pathogen is crucial to the development of new effective antibacterial formulations. We investigated the antibacterial effect of a colloidal nanosilver formulation, Silversol®, against an antibiotic-resistant strain of S. aureus using appropriate in vitro assays. Moreover, we deciphered the molecular mechanisms underlying this formulation’s anti-S. aureus activity using whole transcriptome analysis. Lower concentrations of the test formulation exerted a bacteriostatic effect against this pathogen, and higher concentrations exerted a bactericidal effect. Silversol® at sub-lethal concentration was found to disturb multiple physiological traits of S. aureus such as growth, antibiotic susceptibility, membrane permeability, efflux, protein synthesis and export, biofilm and exopolysaccharide production, etc. Transcriptome data revealed that the genes coding for transcriptional regulators, efflux machinery, transferases, β-lactam resistance, oxidoreductases, metal homeostasis, virulence factors, and arginine biosynthesis are expressed differently under the influence of the test formulation. Genes (argG and argH) involved in arginine biosynthesis emerged among the major targets of Silversol®’s antibacterial activity against S. aureus.

Femtosecond (fs) laser technology is currently being considered in innovative fields such as osteotomy and treatment of hard tissue thanks to the achievable high resolution and ability to prevent tissue damage. In a previous study, suitable process parameters were obtained to achieve competitive ablation rates on pork femur processing. Nevertheless, a better control of thermal accumulation in the tissue during laser ablation could further improve the postoperative regeneration of the treated bone compared with conventional procedures and push forward the exploitation of such technology. This study presents methods for real time analyses of bone tissue temperature and composition during fs laser ablation and highlights the importance of implementing an efficient cooling method of bone tissue in order to achieve optimized results. Results show that it is possible to achieve a larger process window for bone tissue ablation where bone tissue temperature remains within the protein denaturation temperature in water-based processing environment. This is a key outcome towards a clinical exploitation of the presented technology, where higher process throughputs are necessary. The effects of process parameters and environments on bone tissue were confirmed by LIBS technique, which proved to be an efficient method by which to record real-time variation of bone tissue composition during laser irradiation.

Purpose: To prove the effect of Miana (M), Quercetin (Q), and the combination as an anti-inflammatory agent and Cefixime (C) as an antibiotic in Balb/c mice infected with Salmonella enterica serovar Typhi (S. Typhi) and related to the dynamics of NF-κB mRNA expression and NF-κB protein levels. Methods: A cohort study on male Balb/c mice with subjects consisted of 8 groups with 5 each group by administration of M, Q, M + Q, M + C, Q + C, M + Q + C, C only and sterile distilled water group as negative control. The statistical significance of the difference group was defined as P values less than 0.05. Results: Decreased mRNA expression of NF-κB, NF-κB protein levels, and bacterial load after administration of M + C, Q + C, or M + Q + C showed significant differences when compared to the negative control. The decline in NF-κB was stronger when M + Q + C was given compared to M, Q, M + Q, or C only. Conclusion: The effects of NF-κB suppression appear to be the same between the administration of M, Q and the M + Q when C added. However, the suppression of NF-κB was not significant without adding C.

Carbon sequestration in soil has been extensively sought in the agroecosystems through practices which increase organic carbon inputs and/or decrease soil organic carbon (SOC) degradation processes. Less is known about the extent of shallow water table influences in mineral soils, despite being soil moisture a major driver in modifying the C cycle. To examine its effects, a 4-yr lysimetric experiment was set up to measure the C balance components under free drainage and shallow water table at 60 and 120 cm depth. Two levels of N input (250 and 368 kg N ha−1 y−1) were also studied, using dry manure in 2011 and 2012 and fresh manure in 2013 and 2014. Carbon balance was estimated through the difference between inputs (C from organic inputs and root residues and exudates) and outputs (heterotrophic respiration, methane, and C leaching). A negative C balance was measured under all treatments (−3487 kg C ha-1), being respiration not compensated by the consistent C input of organic fertilizer. Furthermore, high N inputs increased SOC mineralization, decreasing the C balance. The role of soil was also observed by the SOC analyses, which confirmed the losses estimated through C balance. The study substantiated also the interacting effect between shallow water table and type of organic carbon, which was revealed crucial for C balance in mineral soils. To conclude, results suggested that water table level around 120-cm depth could limit SOC depletion.

Introduction: Antibiotic-resistant Pseudomonas aeruginosa strains cause considerable morbidity and mortality globally. Identification of novel targets in this notorious pathogen is urgently warranted to facilitate discovery of new anti-pathogenic agents against it. This study attempted to identify small-molecule inhibitors of two important proteins LasR and nitric oxide reductase (NOR) in P. aeruginosa. ‘Las’ system can be said to be the ‘master’ regulator of quorum sensing in P. aeruginosa, whose receptor protein is LasR. Similarly, NOR is crucial to detoxification of reactive nitrogen species. Methods: In silico identification of potential LasR or NOR inhibitors was attempted through a virtual screening platform AtomNet® to obtain a final subset of

Abstract Introduction Recent evidence confirms that the treatment of acute appendicitis is not necessarily surgical, and selected patients with uncomplicated appendicitis can benefit from a non-operative management. Unfortunately, no cost-effective test has been proven to be able to effectively predict the degree of appendicular inflammation as yet, therefore, patient selection is too often left to the personal choice of the emergency surgeon. Our paper aims to clarify if basic and readily available blood tests can give reliable prognostic information to build up predictive models to help the decision-making process. Methods Clinical notes of 2275 patients who underwent an appendicectomy with a presumptive diagnosis of acute appendicitis were reviewed, taking into consideration basic preoperative blood tests and histology reports on the surgical specimens. Variables were compared with univariate and multivariate analysis, and predictive models were created. Results 18.2% of patients had a negative appendicectomy, 9.6% had mucosal only inflammation, 53% had transmural inflammation and 19.2% had gangrenous appendicitis. A strong correlation was found between degree of inflammation and lymphocytes count and CRP/Albumin ratio, both at univariate and multivariate analysis. A predictive model to identify cases of gangrenous appendicitis was developed. Conclusion Low lymphocyte count and high CRP/Albumin ratio combined into a predictive model may have a role in the selection of patients who deserve appendicectomy instead of non-operative management of acute appendicitis.

Menurut International Diabetes Federation (IDF), terdapat 463 juta orang dewasa, 20–79 tahun, hidup dengan diabetes mellitus pada tahun 2019 yang menyumbang 9,3 %. Diabetes Mellitus adalah penyakit metabolik kronis, ditandai dengan tingginya kadar glukosa dalam darah. Tujuan penelitian ini adalah melakukan asuhan keperawatan Diabetes Mellitus Tipe 2 pada Ny. R Dengan Masalah Keperawatan Ketidakstabilan Kadar Glukosa Darah Dengan Penerapan Relaksasi Autogenik Di Rumah Sakit Harapan Bunda Batam Tahun 2022. Metode yang digunakan adalah studi kasus bersifat Deskriptif. Sampel yang digunakan pada studi kasus ini hanya 1 responden yang dilakukan berdasarkan tahap-tahap asuhan keperawatan meliputi pengkajian kadar glukosa darah meningkat (326 mg/dl), diagnosa keperawatan utama ketidakstabilan kadar glukosa darah berhubungan dengan hiperglikemia. Intervensi dan implementasi keperawatan yang dilakukan penerapan teknik Relaksasi Autogenik dari tanggal 12 Oktober 2022 – 16 Oktober 2022 selama 5 hari diperoleh hasil evaluasi akhir asuhan keperawatan pada Ny. R klien pusing tidak ada, pandangan sudah tidak kabur. Hasil pemeriksaan kadar glukosa darah terakhir pada tanggal wib 122 mg/dl. melalui teknik Relaksasi Autogenik dapat membantu dalam menurunkan, menstabilkan kadar glukosa darah dalam rentang normal. Saran pada penderita Diabetes Mellitus Tipe 2 melakukan Teknik Relaksasi Autogenik agar mampu membantu mengontrol dan menurunkan Kadar Gula Darah.

The treatment of bone metastatsis as primary bone cancer itself is still a challenge. The use od radium dichloride ([223Ra] RaCl2) has emerged in the last few years as one of the best treatment choice for bone cancer, with especial focus in bone metastasis. The alpha-emitter radiopharmaceutical has showed potent and efficient results in several clinical trials. In this study we have formulated radium dichloride ([223Ra] RaCl2) nanomicelles in order to evaluate and compare with pure radium dichloride ([223Ra] RaCl2). The results showed that nanomicelles at the same dose had a superior effect (20% higher efficient) when compared with pure radium dichloride ([223Ra] RaCl2). The results corroborated the effectiveness of the nanosystem validating the application of nanotechnology in alpha-radiotherapy with radium dichloride ([223Ra] RaCl2).

In Li-ion batteries, ion diffusion kinetics represent a limitation to combine high capacity and a fast charging rate. To bypass this, textured electrodes have been demonstrated to increase the active surface, decrease the material tortuosity and accelerate the electrolyte wetting. Amongst the structuring technologies, ultrashort pulse laser processing may represent the key option enabling, at the same time, high precision, negligible material deterioration and high throughput. Here, we report a study on the structuring of electrodes with both holes and grooves reaching the metallic collector. Electrochemical models emphasize the importance of hole and line dimensions for the performances of the cell. We demonstrate that we can control the hole and line width by adjusting the applied fluence and the repetition rate. In addition, results show that it is possible to drill 65 µm-deep and ~15 µm-wide holes in nearly 100 µs resulting in up to 10,000 holes/s. To further reduce the takt time, bursts of 40 MHz pulses were also investigated. We show that bursts can reduce the takt time by a factor that increases with the average power and the burst length. Moreover, at comparable fluence, we show that bursts can shorten the process more than theoretically expected.

Background: The diagnosis of acute spondylodiscitis can be very difficult because clinical onset symptoms are highly variable. The reference examination is MRI, but very often the first diagnostic investigation performed is CT, given its high availability in the acute setting. CT allows rapid evaluation of other alternative diagnoses (e.g., fractures), but scarce literature is available to evaluate the accuracy of CT, and in particular of multi-detector computed tomography (MDCT), in the diagnosis of suspected spondylodiscitis. The aim of our study was to establish MDCT accuracy and how this diagnostic method could help doctors in the depiction of acute spondylodiscitis in an emergency situation by comparing the diagnostic performance of MDCT with MRI, which is the gold standard. Methods: We searched our radiological archive for all MRI examinations of patients who had been studied for a suspicion of acute spondylodiscitis in the period between January 2017 and January 2021 (n = 162). We included only patients who had undergone MDCT examination prior to MRI examination (n = 25). The overall diagnostic value of MDCT was estimated, using MRI as the gold standard. In particular, the aim of our study was to clarify the effectiveness of CT in radiological cases that require immediate intervention (stage of complications). Therefore, the radiologist, faced with a negative CT finding, can suggest an elective (not urgent) MRI with relative serenity and without therapeutic delays. Results: MDCT allowed identification of the presence of acute spondylodiscitis in 13 of 25 patients. Specificity and positive predictive value were 100% for MDCT, while sensitivity and negative predictive value were 68% and 50%, respectively, achieving an overall accuracy of 76%. In addition, MDCT allowed the identification of paravertebral abscesses (92%), fairly pathognomonic lesions of spondylodiscitis pathology. Conclusions: The MDCT allows identification of the presence of acute spondylodiscitis in the Emergency Department (ED) with a satisfactory accuracy. In the case of a positive CT examination, this allows therapy to be started immediately and reduces complications. However, we suggest performing an elective MRI examination in negative cases in which pathological findings are hard to diagnose with CT alone.

Introduction: Antimicrobial Resistance (AMR) is a serious global threat. Identification of novel antibacterial targets is urgently warranted to help the antimicrobial drug discovery programmes. This study attempted identification of potential targets in two important pathogens Pseudomonas aeruginosa and Staphylococcus aureus. Methods: Transcriptome of Pseudomonas aeruginosa and Staphylococcus aureus exposed to two different quorum-modulatory polyherbal formulations were subjected to network analysis to identify the most highly networked differentially expressed genes (hubs) as potential anti-virulence targets. Results: Genes associated with denitrification and sulfur metabolism emerged as the most important targets in P. aeruginosa. Increased build-up of nitrite (NO2) in P. aeruginosa culture exposed to the polyherbal formulation Panchvalkal was confirmed through in vitro assay too. Generation of nitrosative stress and inducing sulfur starvation seemed to be effective anti-pathogenic strategies against this notorious gram-negative pathogen. Important targets identified in S. aureus were the transcriptional regulator sarA, immunoglobulin-binding protein Sbi, serine protease SplA, the saeR/S response regulator system, and gamma-haemolysin components hlgB and hlgC. Conclusion: Further validation of the potential targets identified in this study is warranted through appropriate in vitro and in vivo assays in model hosts. Such validated targets can prove vital to many antibacterial drug discovery programmes globally.

Sponge is an invertebrate animal in the Porifera phylum, which potentially produces bioactive compounds that are known as potential agents in producing antimicrobial compounds. This research aims to determine the antimicrobial activity of bacteria isolates obtained from the samples of the sponge of Kodingareng Keke Island-Makassar Indonesia. Samples were isolated by the pour plate method using NA (Nutrient Agar) media and incubated for 1 x 24 hours. A total of 8 bacteria were isolated with code KDR-02-01, KDR-02-02, KDR-02-03, KDR-02-04, KDR-02-05, KDR-02-06, KDR-02-07, KDR-02-08, KDR-02-09 and KDR-02-10. Each isolate of bacteria is purified by using quadrant streaks method until it is obtained by a pure isolate bacteria followed by an antagonistic test. From the antagonist test, bacteria KDR-02-07 continue to be fermented because they have the best inhibition compared to other isolates capable of inhibiting E. coli, S. aureus and C. albicans. Active isolate fermented for 8 days to produce secondary metabolite. After fermentation of 8 days the fermentation medium was separate by filtration then supernatant was extraction using ethyl acetate (1:1) and biomass macerated using methanol. Ethyl acetate extracts and methanol extracts that have been obtained are continued on antimicrobial activity test with diffusion method in order to microbial test microbes E. coli, S. aureus, B. subtilis, C. albicans and A. niger. The results of the study showed that ethyl acetate extract in concentration of 10% can inhibit E. coli and B. subtilis, in concentration of 5% inhibit B. subtilis and in concentrations of 1.25% inhibit A. niger, whereas in methanol extracts not acquired antimicrobial activity. Based on the results of a microscopic test it was obtained that the bacteria were isolated is Gram-positive and basil bacteria.

The use of ultra-short pulse lasers in the kW range, combined with an appropriate beam engineering approach, enables the achievement of high-throughput production of laser-functionalised surfaces. However, the manufacturing of complex parts still faces various challenges, such as difficulties in accessing regions with high aspect ratio shapes or intricate profiles, which often leads to the necessity of adapting the laser processing workstation to specific geometries. The forming process is a well-established technique for producing parts of any shape from metallic foils by imposing specific constraints. In this study, we aimed to assess the feasibility of producing laser-functionalised 3D complex products by the forming of laser-treated flat thin metallic sheets. Two-hundred micrometre-thick stainless-steel foils were textured with laser-induced periodic surface structures (LIPSS) through a roll-to-roll pilot line. First, we optimized the morphology of LIPSS. Subsequently, we conducted three types of mechanical tests on both laser-treated and untreated foils: standard tensile tests, fatigue tests, and cruciform specimen tests. We measured and compared parameters such as ultimate tensile strength, breaking strength, maximum elongation, and area reduction between specimens with and without LIPSS, all obtained from the same foil. Additionally, we utilized scanning electron microscopy (SEM) to compare the LIPSS morphology of laser-treated samples before and after mechanical tests.

Germline de novo mutations can impact individual fitness, but their role in human male infertility is understudied. Trio-based exome sequencing identifies many new candidate genes affecting male fertility, including an essential regulator of male germ cell pre-mRNA splicing.

TNI and Polri are state instruments in charge of maintaining the country's defenses. Both are the main pillars in maintaining state security and sovereignty, both for disturbances that come from within and outside. For this reason, both are required to be coordinative in each carrying out state duties. However, this does not mean that the positions of the TNI and Polri can be included in the same structure as the one that took place in 1961-1999. The research method used is the historical method. Consists of four stages: heuristics, criticism, interpretation, and historiography. The results showed that the integration of Polri into ABRI was based on historical reasons. Since the beginning of independence, physical revolution, until the threat of rebellions that threatened the disintegration of the nation at that time: DI / TII, PRRI / Permesta, and PKI, for example. Instead of strengthening the country's defense and security sector, the National Police was combined with ABRI to maintain militancy in maintaining the integrity of the country. TNI dan Polri merupakan alat negara yang bertugas menjaga pertahanan-kemanan negara. Keduanya menjadi pilar utama dalam memelihara keamanan dan kedaulatan negara, baik gangguan-gangguan yang datangnya dari dalam maupun luar. Untuk itu keduanya dituntut koordinatif dalam tiap-tiap menjalankan tugas negara. Walau demikian, tidak berarti bahwa kedudukan TNI dan Polri dapat dimasukkan ke dalam satu struktur yang sama sebagaimana yang pernah berlangsung antara 1961-1999. Bagaimana kedudukan Polri dalam struktur ABRI menjadi latar belakang kajian ini dilakukan. Pertanyaan itu kemudian dirumuskan ke dalam beberapa pertanyaan: apa latar belakang integrasi Polri dalam struktur ABRI?; bagaimana keberadaan Polri ketika di bawah ABRI?; apa dampak akibat pengintegrasian Polri dengan ABRI? Metode penelitian yang digurnakan adalah metode sejarah. Terdiri dari empat tahap: heuristik, kritik, interpretasi dan historiografi. Hasil penelitian menunjukkan bahwa integrasi Polri ke dalam ABRI dilatari oleh alasan historis. Sejak awal kemerdekan, revolusi fisik, hingga sering kali terjadinya ancaman pemberontakan-pemberontakan yang mengancam terjadinya disintegrasi bangsa kala itu: DI/TII, PRRI/Permesta dan PKI, misalnya. Alih-alih untuk memperkuat sektor pertahanan dan keamanan negara, kemudian Polri digabungkan dengan ABRI guna menyamakan semangat juang dalam memelihara keutuhan negara. Akan tetapi, integrasi Polri dalam struktur ABRI menjadikan tugas dan peran Polri menjadi tumpang tindih. Tidak jarang peran dan tugas yang seharusnya ditangani oleh Polri diselesaikan oleh TNI. Hal ini mengakibatkan menurunnya kepercayaan masyarakat terhadap Polri. Polri dipandangnya sebagai institusi yang tidak profesional dan mandiri. Di lain pihak karakter dan mental anggota Polri yang cenderung militeristik karena hasil pembinaan, doktrinasi yang diterima Polri disamakan dan disejajarkan dengan unsur ABRI lainnya seperti TNI AD, AL dan AU semakin memperburuk citra Polri di mata masyarakat.

This study aimed to compare the effects of simvastatin, rosuvastatin, and fenofibrate therapies on the body weight and lipid profiles of the female rats receiving a combination of oral contraceptives (COC) and a high-fat diet (HFD). Twenty female Wistar rats (130-200 g) were divided equally into four groups. The rats received a standard diet for seven days, and their baseline lipid profiles were analyzed. All rats also received COC containing 15.1 µg/kg levonorgestrel/3.1 µg/kg estradiol with HFD for 60 days. Starting on day 31, the rats were given the respected treatment. The control group received the vehicle, whereas the others were treated with either simvastatin (2.1 mg/kg), rosuvastatin (0.5 mg/kg), or fenofibrate (8.2 mg/kg). Blood samples were taken on days 30 and 60. The results showed that the administration of COC+HFD and vehicle for 30 days increased the rats’ body weight and dyslipidemia, characterized by a significant decrease in Low-Density Lipoprotein (HDL) and an increase in total cholesterol (TC) and triglycerides (TG) levels (P0.05). Among the treatments, only fenofibrate was found to be able to prevent a significant weight gain in rats. Both fenofibrate and rosuvastatin inhibited a significant rise in TG and TC levels. Meanwhile, the simvastatin administration failed to do the same. Although statistically insignificant, all treatments increased rats’ HDL levels. Thus, it can be concluded fenofibrate was the most effective treatment among all in reducing weight gain and improving the lipid profile of dyslipidemic rats induced by oral contraceptives and a high-fat diet.

AimTo investigate the role of minimally invasive surgery for gastric cancer and determine surgical, clinical, and oncological outcomes.MethodsThis is a propensity score-matched case-control study, comparing three treatment arms: robotic gastrectomy (RG), laparoscopic gastrectomy (LG), open gastrectomy (OG). Data collection started after sharing a specific study protocol. Data were recorded through a tailored and protected web-based system. Primary outcomes: harvested lymph nodes, estimated blood loss, hospital stay, complications rate. Among the secondary outcomes, there are: operative time, R0 resections, POD of mobilization, POD of starting liquid diet and soft solid diet. The analysis includes the evaluation of type and grade of postoperative complications. Detailed information of anastomotic leakages is also provided.ResultsThe present analysis was carried out of 1026 gastrectomies. To guarantee homogenous distribution of cases, patients in the RG, LG and OG groups were 1:1:2 matched using a propensity score analysis with a caliper = 0.2. The successful matching resulted in a total sample of 604 patients (RG = 151; LG = 151; OG = 302). The three groups showed no differences in all baseline patients characteristics, type of surgery (P = 0.42) and stage of the disease (P = 0.16). Intraoperative blood loss was significantly lower in the LG (95.93 ± 119.22) and RG (117.91 ± 68.11) groups compared to the OG (127.26 ± 79.50, P = 0.002). The mean number of retrieved lymph nodes was similar between the RG (27.78 ± 11.45), LG (24.58 ± 13.56) and OG (25.82 ± 12.07) approach. A benefit in favor of the minimally invasive approaches was found in the length of hospital stay (P < 0.0001). A similar complications rate was found (P = 0.13). The leakage rate was not different (P = 0.78) between groups.ConclusionLaparoscopic and robotic surgery can be safely performed and proposed as possible alternative to open surgery. The main highlighted benefit is a faster postoperative functional recovery.

(1) The aim of our study is to evaluate the capacity of the Visually AcceSAble Rembrandt Images (VASARI) scoring system in discerning between the different degrees of glioma and Isocitrate Dehydrogenase (IDH) status predictions, with a possible application in machine learning. (2) A retrospective study was conducted on 126 patients with gliomas (M/F = 75/51; mean age: 55.30), from which we obtained their histological grade and molecular status. Each patient was analyzed with all 25 features of VASARI, blinded by two residents and three neuroradiologists. The interobserver agreement was assessed. A statistical analysis was conducted to evaluate the distribution of the observations using a box plot and a bar plot. We then performed univariate and multivariate logistic regressions and a Wald test. We also calculated the odds ratios and confidence intervals for each variable and the evaluation matrices with receiver operating characteristic (ROC) curves in order to identify cut-off values that are predictive of a diagnosis. Finally, we did the Pearson correlation test to see if the variables grade and IDH were correlated. (3) An excellent ICC estimate was obtained. For the grade and IDH status prediction, there were statistically significant results by evaluation of the degree of post-contrast impregnation (F4) and the percentage of impregnated area (F5), not impregnated area (F6), and necrotic (F7) tissue. These models showed good performances according to the area under the curve (AUC) values (>70%). (4) Specific MRI features can be used to predict the grade and IDH status of gliomas, with important prognostic implications. The standardization and improvement of these data (aim: AUC > 80%) can be used for programming machine learning software.