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Organizational factors determine patient satisfaction, since nursing care depends on organizations, in which the majority of actions involve nurses to provide holistic nursing care. Spirituality can be an important key, because patients feel all needs are fulfilled, making Sharia-Based Nursing Care (SBNC) a mediator of organizational factors for patient satisfaction. The aim of this paper is analyzing the role of organizational consolidation factors and SBNC model to determine patient satisfaction in Sharia hospitals. This analytical correlation study used a cross-sectional design and cluster sampling technique on 260 respondents as the samples, consisting of nurses and patients in patient rooms in X Islamic Hospital, Indonesia. The variables of this study, the organizational factors, SBNC, and patient satisfaction were collected using a questionnaire; all variables were assessed through the use of a questionnaire, and permission to modify or employ the instrument was obtained from the original authors, and analyzed using Smart Partial Least Squares (SmartPLS). Organizational factors have significant influence on SBNC (p-value=0.000; β-value=0.786; t-value>1.96), organizational factors have moderately significant influence on patient satisfaction (p-value=0.000; β-value=0.508; t-value>1.96), SBNC has significant influence on patient satisfaction (p-value=0.000; β-value=0.430; t-value>1.96), the consolidation of organizational factors with SBNC influences patient satisfaction (p-value=0.001; β-value=0.338; t-value>1.96). Nurses with good leadership, culture, and who give appropriate rewards can shape the quality of the profession by implementing SBNC; patients feel all needs are fulfilled, especially the spiritual aspect, and satisfaction with the nursing services.

IntroductionCanine Parvovirus 2 (CPV-2) infection poses a significant global health risk to susceptible dogs. Hypocobalaminemia, defined as reduced serum cobalamin (CBL) concentrations, is a recognized complication in chronic enteropathies in adult dogs but remains poorly understood in the context of acute enteropathies, especially in young dogs. The aim of this study was to investigate the frequency and severity of hypocobalaminemia in young dogs with parvovirus enteritis and evaluation of CBL as a predictor of outcome.Materials and methodsThirty client-owned dogs diagnosed with parvovirus infection and thirty healthy controls were enrolled. Clinical, hematological, and biochemical tests, including CBL and serum methylmalonic acid (MMA) concentrations, were assessed.ResultsResults indicated a significantly higher prevalence of hypocobalaminemia in dogs with parvovirus enteritis compared to healthy controls, as well as a significant correlation with a disease severity score. Moreover, survivors demonstrated higher CBL concentrations than non-survivors, suggesting an eventual prognostic value of CBL status. However, parenteral CBL supplementation showed no significant effect on serum CBL or MMA concentrations, highlighting potential challenges in CBL uptake at the cellular level.DiscussionHypocobalaminemia in this population is caused by multiple factors such as reduced nutritional absorption, gastrointestinal losses, and increased metabolic demands. Further research is needed to develop tailored management strategies, evaluate the effectiveness of CBL supplementation, and understand the mechanisms behind hypocobalaminemia in parvovirus infection.

Abstract We aim to determine the safety and efficacy of clevidipine for neurocritical patients. To comprehensively identify relevant studies, a systematic search strategy was employed using the following keywords: “clevidipine”, “high blood pressure”, “hypertension”, “Neuroscience Intensive Care”, “neuro critical”, and “neurosurgical patients”. Searches were conducted in the Clinicaltrials.gov, PubMed, and EuroPMC databases, with the search extending until September 1, 2023. The primary outcomes of interest were the time needed to achieve the target systolic blood pressure (SBP) and the percentage of time a patient remained within the targeted SBP range. Secondary outcomes included SBP values, duration of intensive care unit (ICU) stay in days, rates of hypotension, and rates of tachycardia. We included five retrospective cohort studies (n = 443), utilizing nicardipine as the primary comparator. Comparison of the time to reach target systolic blood pressure (SBP) revealed no significant difference between medications (SMD = − 1.09, p = 0.33). Likewise, the achieved SBP target showed no notable distinction (RR = 1.15, p = 0.81). However, clevidipine exhibited a slightly higher percentage of time within the target SBP range (SMD = 0.33, p = 0.04), albeit with moderate heterogeneity. Importantly, all included studies were retrospective cohort studies, underscoring the methodological context of the investigation. Clevidipine and the control group were found to be comparable in terms of achieving target SBP. Clevidipine may have a slight advantage in maintaining blood pressure within the desired range, but further research is needed to confirm this finding.

Abstract Epithelial damage due to gastrointestinal disorders frequently causes severe disease in horses. To study the underlying pathophysiological processes, we aimed to establish equine jejunum and colon enteroids (eqJE, eqCE) mimicking the in vivo epithelium. Therefore, enteroids were cultivated in four different media for differentiation and subsequently characterized histomorphologically, on mRNA and on protein level in comparison to the native epithelium of the same donor horses to identify ideal culture conditions for an in vitro model system. With increasing enterocyte differentiation, the enteroids showed a reduced growth rate as well as a predominantly spherical morphology and less budding compared to enteroids in proliferation medium. Combined or individual withdrawal of stem cell niche pathway components resulted in lower mRNA expression levels of stem cell markers and concomitant differentiation of enterocytes, goblet cells and enteroendocrine cells. For eqCE, withdrawal of Wnt alone was sufficient for the generation of differentiated enterocytes with a close resemblance to the in vivo epithelium. Combined removal of Wnt, R-spondin and Noggin and the addition of DAPT stimulated differentiation of eqJE at a similar level as the in vivo epithelium, particularly with regard to enterocytes. In summary, we successfully defined a medium composition that promotes the formation of eqJE and eqCE consisting of multiple cell types and resembling the in vivo epithelium. Our findings emphasize the importance of adapting culture conditions to the respective species and the intestinal segment. This in vitro model will be used to investigate the pathological mechanisms underlying equine gastrointestinal disorders in future studies.

Background: In 2020, the World Health Organization (WHO) estimated that 466 million people worldwide are affected by hearing loss, with 34 million of them being children. Indonesia is identified as one of the four Asian countries with a high prevalence of hearing loss, specifically at 4.6%. Previous research was conducted to identify diseases related to the Ear, Nose, and Throat, utilizing the certainty factor method with a test accuracy rate of 46.54%. The novelty of this research lies in the combination of two methods, the use of genetic algorithms for optimization and learning vector quantization to improve the level of accuracy for early identification of Ear, Nose, and Throat diseases. Objective: This research aims to produce a hybrid model between the genetic algorithm and the learning vector quantization neural network to be able to identify Ear, Nose, and Throat diseases with mild symptoms to improve accuracy. Methods: Implementing a 90:10 ratio means that 90% (186 data) of the data from the initial sequence is assigned for training purposes, while the remaining 10% (21 data) is allocated for testing. The procedural stages of genetic algorithm-learning vector quantization are population initialization, crossover, mutation, evaluation, selection elitism, and learning vector quantization training. Results The optimum hybrid genetic algorithm-learning vector quantization model for early identification of Ear, Nose, and Throat diseases was obtained with an accuracy of 82.12%. The parameter values with the population size 10, cr 0.9, mr 0.1, maximum epoch of 5000, error goal of 0.01, and learning rate (alpha) of 0.5. Better accuracy was obtained compared to backpropagation (64%), certainty factor 46.54%), and radial basic function (72%). Conclusion: Experiments in this research, successed identifying models by combining genetic algorithm-learning vector quantization to perform the early identification of Ear, Nose, and Throat diseases. For further research, it's very challenging to develop a model that automatically adapts the bandwidth parameters of the weighting functions during trainin Keywords: Early Identification, Ear-Nose-Throat Diseases, Genetic Algorithm, Learning Vector Quantization

Introduction: This study aimed to the development of an Islamic nursing care model to improve patient satisfaction. Methods: Cross-sectional design random sampling technique on 134 respondents, consisting of patients and nurses in the surgical inpatient room, internal medicine inpatient room, and postpartum and gynecology inpatient rooms, using simple random techniques. The variables of this study were the nursing factors, Islamic nursing care, and patient satisfaction and were collected using questionnaire. The data were collected using questionnaire in December 2021 at Islamic Hospital, Indonesia, and processed using a Smart Partial Least Squares (SmartPLS) analysis and Sommers' correlation test. Results: The Sommers' test results show significant relationship between nursing factor (nurse knowledge, nurse’s attitude, nurse competence, nurse personality) and patient satisfaction; nurse knowledge (p=0.000); nurse attitude (p=0.000); nurse competence (p=0.000); nurse personality (p=0.000; α 1.96). Then for Islamic nursing care with patient satisfaction, it has a very strong significant effect (p value 0.000; β value 0.753; t value> 1.96). Conclusions: Islamic nursing care as a mediator of nurse factors with patient satisfaction can be described in this study model because Islamic nursing care is a real form of care by nurses that is felt by the patient and the application of Islamic values so that the form of nursing care makes patients feel satisfied.

This research aims to analyze educational innovations carried out by leaders at Private Islamic Universities in Jambi Province. Using a descriptive qualitative approach with case studies at two institutes in Jambi Province, this research involved observation, interviews, and documentation as data collection techniques. Research locations include the Yasni Muaro Bungo Islamic Institute and the Tebo Islamic Institute. Research subjects included the IAI Chancellor, lecturers, and staff. The research results show that higher education leaders in Jambi Province have innovated in Islamic religious education through several leadership patterns. They optimize the internal and external potential of the campus, implement superior strategies for lecturers and students, and activate communication between campus leaders and employees. Obstacles include limited human resources, inadequate facilities, and an insufficient budget to support quality lecture activities. To overcome these obstacles, the Leadership has established a systematic work structure, explained job descriptions clearly, carried out collaboration and comparative studies with academic and government institutions, both private and state, and designed a qualification-based national curriculum. They also provide opportunities for lecturers to continue their education to the doctoral level and participate in certification programs, training and research seminars, and community service. Recommendations include competent support, management improvements, and adaptive leadership development. Government support and the development of quality and adaptive Leadership are also recommended.

Knowing the level of SARS-CoV-2 transmission is crucial for decision-making on Coronavirus disease (COVID-19) handling. Guidelines for measuring SARS-CoV-2 antibodies to estimate seroprevalence are conceptually straightforward and internationally available. However, challenges exist for developing countries with limited laboratory capacity, diverse geographical topography, fragmented health information systems and limited resources such as Indonesia. One year after the first case was confirmed in Indonesia, approximately ten infections were undiagnosed or underreported for every reported case. Under those circumstances, we described the method and lessons learned in conducting nationwide cohort COVID-19 serology surveys in a nation with limited resources, such as Indonesia. • Strong cross-sectoral collaboration between ministries and levels of governance (central and subnational) enables strategic use of civil registration database for efficient sampling. • All agglomeration districts (highly dense population and urban area) were selected as study sites, and additional non-agglomeration districts were selected using probability-proportional-to-size (PPS). • Involving the experienced phlebotomist in community health service provider and district laboratory cut down preparation time.

ABSTRACT Introduction: Trauma primarily affects the economically active population, causing social and economic impact. The non-operative management of solid organ injuries aims to preserve organ function, reducing the morbidity and mortality associated with surgical interventions. The aim of study was to demonstrate the epidemiological profile of patients undergoing non-operative management in a trauma hospital and to evaluate factors associated with mortality in these patients. Methods: This is a historical cohort of patients undergoing non-operative management for solid organ injuries at a Brazilian trauma reference hospital between 2018 and 2022. Included were patients with blunt and penetrating trauma, analyzing epidemiological characteristics, blood transfusion, and association with the need for surgical intervention. Results: A total of 365 patients were included in the study. Three hundred and forty-three patients were discharged (93.97%), and the success rate of non-operative treatment was 84.6%. There was an association between mortality and the following associated injuries: hemothorax, sternal fracture, aortic dissection, and traumatic brain injury. There was an association between the need for transfusion and surgical intervention. Thirty-eight patients required some form of surgical intervention. Conclusion: The profile of patients undergoing non-operative treatment consists of young men who are victims of blunt trauma. Non-operative treatment is safe and has a high success rate.

Penggunaan Teknologi Internet of Things (IoT) dalam meningkatkan efisiensi energi di bangunan pintar telah menjadi topik penelitian yang semakin mendapat perhatian. Penelitian ini bertujuan untuk menyelidiki peran dan potensi IoT dalam meningkatkan efisiensi energi di berbagai jenis bangunan. Metode studi literatur digunakan untuk mengumpulkan dan menganalisis informasi dari berbagai sumber yang relevan. Hasil penelitian menunjukkan bahwa integrasi IoT memungkinkan bangunan untuk menjadi lebih cerdas dalam memantau, mengelola, dan mengoptimalkan penggunaan energi. Berbagai aplikasi praktis IoT dalam manajemen energi bangunan, seperti penggunaan sensor pintar dan sistem manajemen energi terintegrasi, telah membuktikan kemampuannya dalam menghasilkan penghematan energi yang signifikan. Meskipun demikian, tantangan seperti keamanan data, biaya investasi awal, dan kurangnya pemahaman teknis masih menjadi hambatan dalam penerapan IoT. Oleh karena itu, kolaborasi antar pemangku kepentingan dan upaya dalam penyediaan pelatihan dan edukasi yang lebih luas sangat diperlukan untuk memastikan kesuksesan implementasi IoT di masa depan.

IntroductionBloodwork is a widely used diagnostic tool in veterinary medicine, as diagnosis and therapeutic interventions often rely on blood biomarkers. However, biomarkers available in veterinary medicine often lack sensitivity or specificity. Mass spectrometry-based proteomics technology has been extensively used in the analysis of biological fluids. It offers excellent potential for a more comprehensive characterization of the plasma proteome in veterinary medicine.MethodsIn this study, we aimed to identify and quantify plasma proteins in a cohort of healthy dogs and compare two techniques for depleting high-abundance plasma proteins to enable the detection of lower-abundance proteins via label-free quantification liquid chromatography-mass spectrometry. We utilized surplus lithium-heparin plasma from 30 healthy dogs, subdivided into five groups of pooled plasma from 6 randomly selected individuals each. Firstly, we used a commercial kit to deplete high-abundance plasma proteins. Secondly, we employed an in-house method to remove albumin using Blue-Sepharose.Results and discussionAmong all the samples, some of the most abundant proteins identified were apolipoprotein A and B, albumin, alpha-2-macroglobulin, fibrinogen beta chain, fibronectin, complement C3, serotransferrin, and coagulation factor V. However, neither of the depletion techniques achieved significant depletion of highly abundant proteins. Despite this limitation, we could detect and quantify many clinically relevant proteins. Determining the healthy canine proteome is a crucial first step in establishing a reference proteome for canine plasma. After enrichment, this reference proteome can later be utilized to identify protein markers associated with different diseases, thereby contributing to the diagnosis and prognosis of various pathologies.

Real-time video surveillance, especially CCTV systems, requires fast and accurate face detection. Object detection models with slow inference times are ineffective in real-time. This study addresses this challenge by improving the inference speed of the YOLOv8 model, a leading object detection framework known for its accuracy and speed. We focus on pruning the model's architecture, particularly the P5 head section, which detects larger objects. According to Bochkovskiy's 2020 research, this modification enhances the model's performance specifically for medium and small objects in CCTV footage. The standard YOLOv8 model and its modified version were compared for inference time, mean Average Precision (mAP), and model weight. The pruned YOLOv8 model cuts inference time by 15.56%, from 4.5 ms to 3.8 ms, and reduces model weight. The advantages mentioned above are offset by a 1.6% decrease in mean average precision. This research advances object detection technology by demonstrating architectural modifications' efficacy. These changes make the model faster and lighter, making it suitable for real-time surveillance. The accuracy trade-off is slight. The implications of these findings are crucial for implementing efficient object detection systems in CCTV surveillance. These findings also lay the groundwork for future research to improve such systems' speed-accuracy trade-off.

Work fatigue is an important aspect and is very influential in determining the level of accidents, especially motorbike accidents. According to WHO, almost 30% of all deaths due to road accidents involve two- and three-wheel­ed motorized vehicles, such as motorbikes, mopeds, scooters and electric bicycles (e-bikes), and the number continues to increase. Motor­cycles dominate road deaths in many low- and middle-income countries, where nine out of ten traffic accident deaths occur among motorcyclists, as in Indonesia. However, until now, in Indonesia, there has been no monitor­ing system capable of identifying fatigue in motorbike drivers in the transportation sector. This research aims to determine fatigue patterns based on driver working hours and create a sensor system to monitor fatigue measurements in real-time to reduce the number of accidents. The research began with processing questionnaire data with Pearson correlation, which showed a close relationship between driver fatigue and driving time and a close relationship between fatigue and increased heart rate and sweating levels. From calibration tests with an error of 3% and direct measurements of working conditions, it was found that two-wheeled vehicle driver fatigue occurs after 2-3 hours of work. With a measurement system using the Box Whiskers analysis method, respondents' working conditions can also be de­ter­mined, which are divided into 4 zones, namely zone 1 (initial condition or good condition), zone 2 a declining condition, zone 3 a tired condition and zone 4 is a resting condition. Hopefully, this research will identify fati­gue zones correctly and reduce the number of accidents because it can iden­tify tired drivers so they do not have to force themselves to continue working and driving their motorbikes. As a conclusion from this research, a measure­ment system using two sensors, such as ECG and GSR can identify work fatigue zones well and is expected to reduce the number of accidents due to work fatigue.

Acute haemorrhagic diarrhoea is a common complaint in dogs. In addition to causes like intestinal parasites, dietary indiscretion, intestinal foreign bodies, canine parvovirus infection, or hypoadrenocorticism, acute haemorrhagic diarrhoea syndrome (AHDS) is an important and sometimes life-threatening differential diagnosis. There is some evidence supporting the link between Clostridium perfringens toxins and AHDS. These toxins may be partially responsible for the epithelial cell injury, but the pathogenesis of AHDS is still not fully understood. Recent studies have suggested that severe damage to the intestinal mucosa and associated barrier dysfunction can trigger chronic gastrointestinal illnesses. Besides bloodwork and classical markers for AHDS such as protein loss and intestinal bacterial dysbiosis, we focused mainly on the plasma-proteome to identify systemic pathological alterations during this disease and searched for potential biomarkers to improve the diagnosis. To accomplish the goals, we used liquid chromatography-mass spectrometry. We compared the proteomic profiles of 20 dogs with AHDS to 20 age-, breed-, and sex-matched control dogs. All dogs were examined, and several blood work parameters were determined and compared, including plasma biochemistry and cell counts. We identified and quantified (relative quantification) 207 plasmatic proteins, from which dozens showed significantly altered levels in AHDS. Serpina3, Lipopolysaccharide-binding protein, several Ig-like domain-containing proteins, Glyceraldehyde-3-phosphate dehydrogenase and Serum amyloid A were more abundant in plasma from AHDS affected dogs. In contrast, other proteins such as Paraoxonase, Selenoprotein, Amine oxidases, and Apolipoprotein C-IV were significantly less abundant. Many of the identified and quantified proteins are known to be associated with inflammation. Other proteins like Serpina3 and RPLP1 have a relevant role in oncogenesis. Some proteins and their roles have not yet been described in dogs with diarrhoea. Our study opens new avenues that could contribute to the understanding of the aetiology and pathophysiology of AHDS.

BackgroundMost neonatal deaths occur during the first week of life (i.e., early neonatal deaths). In this analysis, we aimed to investigate the determinants of early neonatal deaths in a nationally representative sample of births in Indonesia over the five years before each survey.MethodsData were obtained from the 2012 and 2017 Indonesia Demographic and Health Survey (IDHS), including information from 58,902 mothers of children aged

Background: COVID-19 pandemic in Indonesia has increased. Therefore, some efforts are needed including the COVID-19 Vaccination Program to overcome this issue. Until June 29th, 2021, 28.304.774 Indonesians have received the first dose of the vaccine, and 13.329.738 for the second dose of vaccine, out of the national target of 181.554.465. It indicates that the coverage is still far from the target. The knowledge and attitude of the individual are one of the key factors for a person to participate in the program. Purpose: To analyze the correlation between the level of knowledge and attitudes toward their participation in the COVID-19 Vaccination Program among medical students. Methods: This is descriptive analytic with cross-sectional approach. The samples were 339 Medical Students Universitas Lambung Mangkurat. Sampling technique was collected using stratified random sampling technique. Data was retrieved online using Google Forms. Data were then analyzed using statistical software the IBM SPSS version 23. The fisher exact test was used to test the significance of the relationship. Results: We included 339 medical students, in which 264 students (77.9%) participated in the vaccination program but 75 students (22.1%) didn’t. The statistical test showed that p-value of the relationship between knowledge and attitudes with participation of medical student in the COVID-19 vaccination program with p-value= 0.055 and p-value= 0.025. Conclusion: There is no correlation between knowledge and participation of medical students in the COVID-19 Vaccination Program, but there is a correlation between attitudes toward the participation of medical students in the COVID-19 Vaccination Program.

We evaluated the redox status, precisely glutathione levels, which have a major impact in cellular detoxification and antioxidant defence in IBD-derived and healthy intestinal organoids. Therefore, we wanted to explore the differences in terms of their redox balance and mitochondrial fitness. To this end, we introduced a Grx1-roGFP2 construct into the organoids by lentiviral transduction before performing a stress assay by treating the organoids with hydrogen peroxide and examined the GSH/GSSG ratio using confocal imaging. Using ratio imaging, we could detect statistically significant differences between healthy and IBD-derived samples. To gain more insight, we also performed a GSH/GSSG assay, which directly measured glutathione levels. This analysis revealed that both organoid lines had higher levels of oxidized glutathione due to the stress treatment demonstrated by a lower GSH/GSSG ratio compared to the untreated control. Nevertheless, the results showed no significant difference between healthy and IBD-derived organoids. We further challenged organoids with hydrogen peroxide after incubation with MitoTracker® to see if mitochondrial fitness might be different in IBD-derived organoids. However, these results were also very comparable. In summary, our preliminary findings indicate that both organoid lines demonstrate a well-functioning system in terms of analysis but show no clear difference between healthy and IBD-derived samples.

Abstract Bear bile-farming is common in East and Southeast Asia and this farming practice often results in irreversible health outcomes for the animals. We studied long-term effects of chronic bacterial and sterile hepatobiliary inflammation in 42 Asiatic black bears (Ursus thibetanus) rescued from Vietnamese bile farms. The bears were examined under anesthesia at least twice as part of essential medical interventions. All bears were diagnosed with chronic low-grade sterile or bacterial hepatobiliary inflammation along with pathologies from other systems. Our main finding was that the chronic low-grade inflammatory environment associated with bile extraction in conjunction with the suboptimal living conditions on the farms promoted and accelerated the development of age-related pathologies such as chronic kidney disease, obese sarcopenia, cardiovascular remodeling, and degenerative joint disease. Through a biomimetic approach, we identified similarities with inflammation related to premature aging in humans and found significant deviations from the healthy ursid phenotype. The pathological parallels with inflammageing and immuno-senescence induced conditions in humans suggest that bile-farmed bears may serve as animal models to investigate pathophysiology and deleterious effects of lifestyle-related diseases.

This study aims to to measure and explain the practice of implementing Sustainable HRM to improve Organizational Citizenship Behavior by using the variables of Quality of Work-Life (QWL) and Affective Commitment, especially in the automotive retail industry. Data analysis uses a path to show a specific relationship between exogenous variables, which are variables (X), endogenous variables which are effect variables (Y), and implicit variables (ϵ). This data was collected through an array of questions to be answered by replies from as many as 59 motorcycle automotive retail company employees. The QWL and affective commitment have a favourable and considerable impact on OCB in employees. External influences still need to be followed up by further research, which can complement the determination of OCB in addition to QWL and Affective Commitment. Subsequent research focuses on environmental performance management, the design of training and development, and environmental organizational culture.

The Solar Dryer Dome (SDD), an independent energy system equipped with Artificial Intelligence to support the drying process, has been developed. However, inaccurate state-of-charge (SOC) predictions in each battery cell resulted in the vulnerability of the battery to over-charging and over-discharging, which accelerated the battery performance degradation. This research aims to develop an accurate neural network model for predicting the SOC of battery-cell level. The model aims to maintain the battery cell balance under dynamic load applications. It is accompanied by a developed dashboard to monitor and provide crucial information for early maintenance of the battery in the SDD. The results show that the neural network estimates the SOC with the lowest MAE of 0.175, followed by the Random Forest and support vector machine methods with MAE of 0.223 and 0.259, respectively. A dashboard was developed to help farmers monitor batteries efficiently. This research contributes to battery-cell level SOC prediction and the dashboard for battery status monitoring. Doi: 10.28991/ESJ-2023-07-03-02 Full Text: PDF

Pariwisata saat in menjadi salah satu sektor primadona yang diharapakan dapat memberikan dampak positif pada pertumbuhan dan perkembangan wilayah. Kebangkitan sektor pariwisata setelah pandemi memerlukan upaya-upaya baru agar kegiatan wisata memiliki ketangguhan dalam menghadapi segala situasi yang mungkin terjadi di masa yang akan dating. Desa Wisata Sermo Hargowilis yang terletak di Kapanewon Kokap merupakan salah satu desa wisata yang saat ini sedang berupaya mengembangkan alternative-alternatif wisata untuk menarik kehadiran wisatawan domestic maupun mancanegara. Desa wisata tersebut memiliki beragam atraksi wisata, salah satunya atraksi wisata alam yang terdapat di Kawasan Kalitaji, Dusun Soka. Lembah Kalitaji memiliki potensi wisata alam yang sangat baik, didukung oleh kekayaan biodiversitas yang memadai, salah satunya adalah potensi fauna berupa burung. Wisata minat khusus seperti kegiatan pengamatan burung telah berkembang di beberapa tempat, dengan melahirkan banyak komunitas pecinta burung, potensi wisata ini dikenal dengan sebutan Avitourism. Kegiatan pengabdian kepada masyarakat bertujuan untuk mengembangkan avitourism sebagai salah satu alternatif atraksi wisata di Desa Wisata Sermo sekaligus menjadi upaya pemberdayaan ekonomi lokal. Metode yang digunakan adalah pendampingan dalam pemetaan potensi avitourism, melalui identifikasi jenis dan habitat burung, serta peningkatan kapasitas SDM dalam mengelola avitourism kedepan. Hal ini menjawab kebutuhan desa wisata untuk pemetaan potensi dan penguatan kapasitas sumberdaya manusia pariwisata melalui pelatihan dan pembekalan pengetahuan. Berdasarkan hasil observasi lapangan selanjutnya dilaksanakan pembekalan dan pelatihan tentang avitourism untuk warga masyarakat.

Background: Healthcare services in Islamic hospitals are becoming increasingly important due to the growing global Muslim population and the demand for spiritually sensitive healthcare. Understanding the factors contributing to patient satisfaction in this context is paramount. Objective: This research aimed to investigate the relationships between nurses’ work factors, Sharia-based nursing care, and patient satisfaction in an Islamic hospital in Indonesia. Methods: This study employed a cross-sectional design involving 260 respondents, comprising 130 patients and 130 nurses in inpatient rooms. Data collection took place in August 2022 at an Islamic Hospital in Indonesia using validated questionnaires. SmartPLS 3.2.8 was used to generate Partial Least Square Structural Equation Modeling (PLS-SEM) to assess and analyze relationships between research variables. Results: Nurses’ work factors had a significant impact on Sharia-based nursing care (β = 0.813, t = 18.582, p

This research will examine and comprehend the function and impact of technology usage in the context of education management in Southeast Asian schools. In the rapidly evolving digital and information technology era, education in the region faces many obstacles and opportunities. This research employs a qualitative literature review methodology to comprehend how schools in Southeast Asia use and manage technology in educational contexts. Data collection requires searching for, selecting, and analyzing relevant literature based on topic accuracy, relevance, reliability, and quality standards. Data analysis entails identifying central themes, methods utilized in the literature, and pertinent findings. The findings indicate that education resource management is essential for enhancing the quality of education in Southeast Asia. Faced with obstacles such as unequal access to education, varying quality of education, and policy shifts, the efficient management and application of technology have emerged as a viable solution. The equitable distribution of educational resources such as facilities, teachers, and learning materials among schools in different regions ensures that every student has access to a quality education.

Background: Dental procedures, such as injections, usually cause pain and make children uncomfortable and uncooperative. One approach for reducing pain is the use of buffered anesthetics. Purpose: The research objective was to assess the pain parameters between buffered and non-buffered anesthetic injections, based on oxygen saturation, pulse rate, and the self-reporting of pain by the children. Methods: The research method was quasi-experimental, with purposive sampling of 19 children. Pain parameters, based on oxygen saturation and pulse rate, were measured using a pulse oximeter. The self-reporting of pain used the Wong–Baker FACES® pain rating scale. Statistical analysis used a t-test and Mann–Whitney test with P < 0.01 taken as statistically significant. Results: The results showed a significant difference in oxygen saturation before and after the injection of buffered and non-buffered anesthetics (P = 0.0002). Delivering the buffered anesthetics were reported to be less painful than non-buffered anesthetics. The oxygen saturation and pulse rate were inversely proportional to the self-reporting of pain in children. Statistical analysis showed no significant difference between oxygen saturation (P = 0.5) and pulse rate (P = 0.4886) in those receiving buffered and non-buffered anesthetics. However, there was a significant difference in the self-reporting of pain between the two groups (P = 0.00000262). Conclusion: Pain parameters could be measured physiologically and psychologically. This research concludes that physiologically, there was no difference in pain parameters, based on oxygen saturation and children’s pulse rate. Psychologically, there was a difference in the self-reporting of pain; 14 children reported that delivering the buffered anesthetic was painless.

Abstract The role of the gut microbiome in developing Inflammatory Bowel Disease (IBD) in humans and dogs has received attention in recent years. Evidence suggests that IBD is associated with alterations in gut microbial composition, but further research is needed in veterinary medicine. The impact of IBD treatment on the gut microbiome needs to be better understood, especially in a breed-specific form of IBD in Yorkshire Terriers known as Yorkshire Terrier Enteropathy (YTE). This study aimed to investigate the difference in gut microbiome composition between YTE dogs during disease and remission and healthy Yorkshire Terriers. Our results showed a significant increase in specific taxa such as Clostridium sensu stricto 1, Escherichia-Shigella, and Streptococcus, and a decrease in Bacteroides, Prevotella, Alloprevotella, and Phascolarctobacterium in YTE dogs compared to healthy controls. No significant difference was found between the microbiome of dogs in remission and those with active disease, suggesting that the gut microbiome is affected beyond clinical recovery.

The main issue in this research is the weak Quality of private universities in utilizing digital media in the industrial era 4.0, which leads to the formation of professionalism in the form of an innovative campus, which according to researchers, is influenced by organizational Commitment and digital organizational communication. Target group private universities in Bandung. This study's descriptive survey research design is based on a verification methodology. Data was collected through survey techniques by distributing questionnaires to as many as 69 respondents, all employees. Analysis in data processing using path analysis. It is based on the findings of the verification analysis, with r2 = 0.587, or 58.7%, as the coefficient of determination. The results show that the Quality of digital services is influenced by organizational Commitment and digital communication, both simultaneously and simultaneously. In comparison, there is still the influence of other external factors, which has not been studied, and is 41.3% academically recognized. Research findings also reveal that optimizing digital services can be done by first improving the Commitment of human resources to utilizing digital media in communication.

Inflammatory bowel disease (IBD) is a chronic inflammatory condition that affects humans and several domestic animal species, including cats and dogs. In this study, we have analyzed duodenal organoids derived from canine IBD patients using quantitative proteomics. Our objective was to investigate whether these organoids show phenotypic traits of the disease compared with control organoids obtained from healthy donors. To this aim, IBD and control organoids were subjected to quantitative proteomics analysis via liquid chromatography–mass spectrometry. The obtained data revealed notable differences between the two groups. The IBD organoids exhibited several alterations at the levels of multiple proteins that are consistent with some known IBD alterations. The observed phenotype in the IBD organoids to some degree mirrors the corresponding intestinal condition, rendering them a compelling approach for investigating the disease and advancing drug exploration. Additionally, our study revealed similarities to some human IBD biomarkers, further emphasizing the translational and comparative value of dogs for future investigations related to the causes and treatment of IBD. Relevant proteins such as CALU, FLNA, MSN and HMGA2, which are related to intestinal diseases, were all upregulated in the IBD duodenal organoids. At the same time, other proteins such as intestinal keratins and the mucosal immunity PIGR were depleted in these IBD organoids. Based on these findings, we propose that these organoids could serve as a valuable tool for evaluating the efficacy of therapeutic interventions against canine IBD.

Chronic diarrhea is a hallmark sign of canine chronic inflammatory enteropathy (CIE), leading to fluid and electrolyte losses. Electrolyte homeostasis is regulated by the renin-angiotensin-aldosterone-system (RAAS), which might be involved in (counter-)regulating electrolyte losses in canine CIE. Whether and which electrolyte transporters are affected or if RAAS is activated in canine CIE is unknown. Thus, intestinal electrolyte transporters and components of the RAAS were investigated in dogs with CIE. Serum RAAS fingerprint analysis by mass spectrometry was performed in 5 CIE dogs and 5 healthy controls, and mRNA levels of intestinal electrolyte transporters and local RAAS pathway components were quantified by RT-qPCR in tissue biopsies from the ileum (7 CIE, 10 controls) and colon (6 CIE, 12 controls). Concentrations of RAAS components and mRNA expression of electrolyte transporters were compared between both groups of dogs and were tested for associations among each other. In dogs with CIE, associations with clinical variables were also tested. Components of traditional and alternative RAAS pathways were higher in dogs with CIE than in healthy controls, with statistical significance for Ang I, Ang II, and Ang 1–7 (all p

Pendahuluan : Edukasi melalui pendidikan kesehatan menjadi salah satu dari upaya pencegahan penyakit diare pada anak. Kunci keberhasilan pendidikan kesehatan pada anak terketak pada media yang digunakan, media ular tangga dan media audio visual menjadi media yang dapat digunakan dalam pendidikan kesehatan pada anak, namun belum ada penelitian terkait perbedaan efektivitasnya pada pengetahuan tentang cuci tangan pada anak usia sekolah. Tujuan: membandingkan efektivitas dan membandingkan perbedaan efektivitas media ular tangga dan media audio visual terhadap pengetahuan anak tentang cuci tangan pada anak usia sekolah. Metode: Eksperimen dengan desain quasi experimental dengan teknik nonequivalent pretest posttest, random sampling menjadi teknik pengambilan sampel, dengan responden anak usia sekolah dan jumlah 80 yang terdiri dari 40 kelompok intervensi pendidikan kesehatan dengan media ular tangga dan 40 kelompok intervensi media audio visual, data diukur sebelum dan sesudah intervensi pada kelompok kedua kelompok, data dianalisa dengan uji Wilcoxon, serta uji Manwhitney. Hasil : Media ular tangga efektif meningkatkan pengetahuan anak dengan p value 0,0010,05. Simpulan: Media ular tangga dan media audio visual sama efektif dalam meningkatkan pengetahuan anak tentang cuci tangan, sehingga ini dapat menjadi landasan media untuk health promotion oleh stake holder yang terkait.

Latar Belakang: Masalah morbiditas dan mortalitas pada pasien dengan spektrum plasenta akreta (SPA) berkaitan erat dengan perdarahan masif perioperatif, sehingga diperlukan strategi pemberian transfusi darah yang tepat. Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran jumlah perdarahan pada seksio sesarea atas indikasi dengan spektrum plasenta akreta. Subjek dan Metode: Penelitian ini adalah deskriptif observasional dengan desain potong lintang. Penelitian dilakukan di RSUP Dr. Hasan Sadikin Bandung dari Januari 2020 sampai Desember 2021 dengan sampel penelitian berjumlah 50 orang yang terbagi dua berdasarkan skor Placenta Accreta Index (PAI), yaitu kelompok skor PAI 5. Dicatat kadar hemoglobin pra dan pascabedah, jenis tindakan penjepitan aorta dan yang tidak dilakukan penjepitan, jumlah perdarahan, serta jumlah pemberian transfusi darah. Hasil: Penelitian ini memperoleh hasil perdarahan rata-rata sebesar 3.135 cc dan Hb pascaoperasi rata – rata 8,32 pada kelompok skor PAI 5. Simpulan: Dari hasil penelitian ini dapat disimpulkan bahwa pasien dengan gangguan spektrum plasenta akreta dengan skor PAI ≥ 5 memiliki jumlah perdarahan yang lebih banyak dan tindakan penjepitan aorta dilakukan lebih dari 80% pasien

Agriculture is the largest sector in almost every developing country economy. This sector produces food for most of the population in the country. Some Indonesian people work as farmers who have an important role to ensure the availability of basic ingredients, namely rice from rice. However, the limited number of experts, namely Field Agricultural Extension Officers (PPL) results in limited counseling that will be obtained by farmers, because to overcome all the problems faced by farmers, it is constrained by time and the number of farmers who have problems with their crops. In this case, farmers find it difficult to deal with problems of pests and diseases that attack rice, therefore a tool or an expert application is needed that can help farmers to diagnose pests and diseases of rice in order to provide solutions to overcome them. In connection with that, this study aims to develop an application design of an expert system for diagnosing rice pests using the Fuzzy Tsukamoto algorithm which is a method for classifying objects based on the most similar data, and adding the Dempster Shafer algorithm as a comparison of the methods used to obtain data. maximum result validation. By using the Fuzzy Tsukamoto Algorithm, the author classifies similar objects, in this case the symptoms that often occur during the rice harvest season, then compares them with the Dempster Shafter Algorithm to obtain validation of diseases that occur in rice plants based on the classification of symptoms that have been mapped. . Furthermore, the system will provide the best decision to provide advice related to diseases experienced by rice plants so that farmers can immediately resolve them.

Tofu industry, which consider as a small and medium scale industry (UMKM), use a lot of water in its production process. In order to increase its profit, they need to increase the efficiency of clean water usage. One method is through recycling the wastage water into a clean water so it can be used in the production process. In order to recycle the wastage water, people make use of a passive filter to reduce the dissolved solid and acidity in wastage water so it can be similar with fresh water. From the results of our experiment, an average of 30 litres of recycled water can be used in the production process which reflect to increment efficiency of 5% per day in production process. Therefore, as an impact of the economy, this water recycling process will reduce the production cost of making tofu using of recycled water. And from the social aspect it affects the reduction of fresh water from the ground and reduce odours that will occur in environment.

Indonesia merupakan negara agraris yang banyak ditanami tumbuhan salah satunya yaitu tanaman kopi. Dalam budidaya tanaman kopi terdapat halangan seperti hama dan cuaca ekstrim yang bisa membuat tanaman layu atau terkena penyakit. Dengan kemajuan teknologi yang pesat di masa kini, banyak sistem yang membantu para petani untuk membantu mengidentifikasi penyakit pada daun kopi. Sistem ini menggunakan teknologi salah satu arsitektur Convolutional Neural Network, yaitu ResNet-50 untuk mengidentifikasi dan mengklasifikasi penyakit pada daun kopi robusta. Dalam melatih model ResNet-50 diperlukan proses pelatihan dan validasi model yang kemudian model yang telah dilatih akan dilakukan pengujian. Pengujian model akan digunakan untuk mengukur kinerja model yang akan dihitung dengan menggunakan Confusion Matrix yang variabel output nya akan digunakan untuk menghitung Akurasi, presisi, recall, Spesifisitas, dan F1 Score. Penelitian ini akan berfokus pada perhitungan nilai kinerja akurasi dan F1 Score dari model tersebut. Penelitian dilakukan dengan dua kasus yaitu binary class dan multiclass dimana binary class untuk mengklasifikasi gambar daun kopi robusta sehat dan sakit dan multiclass untuk mengklasifikasikan gambar daun kopi robusta pada setiap jenis kategori dari daun yang berpenyakit dan sehat. Hasil dari penelitian menunjukan pada kasus binary class mencapai akurasi 92,68% dan f1-score mencapai 92,88%, sedangkan pada kasus multiclass akurasi hanya mencapai 88,98% dan f1-score mencapai 88,44%. Kedua kasus tersebut diukur menggunakan data testing dengan model yang telah dilatih.

Purpose – This study investigated factors in the retail supply chains that were disrupted by the flow of the product distribution process from suppliers to retail stores and finally to consumers during the COVID-19 pandemic. Design/methodology/approach – This qualitative study involved 12 key informants from two manufacturing industries and three retail industries in Indonesia. Meanwhile, the analysis of empirical conditions employed qualitative content analysis to discover facts of the inbound and outbound supplies in retail supply chains. Findings – This study revealed high demands for certain products and a shift in consumer purchase trends during the pandemic screwed merchandising planning in retail stores. These conditions have brought continuous impacts on the production processes of manufacturing industries that also faced constrained raw material supplies. Container shortage in the global supply chain has increasingly aggravated the crisis of retail supply chains. 10; Practical implications – Retailers and all related parties are ready to anticipate the changing of the supply chain by preparing strategies to overcome the crisis. Originality/value – A contribution is made to the global retail supply chain in times of crisis and can serve as a framework for further research in each region.

This study aims to determine the effect of intrinsic and extrinsic rewards on teacher job satisfaction at a junior high school in Batanghari. This research is a quantitative study. The population of this study is the number of all teachers who teach at that school, with a sample of 32 teachers. The analysis used is multiple regression analysis, and the data is processed with the help of the SPSS version program 20.0. The results showed that intrinsic reward significantly affected job satisfaction with count t table (4,564 1699). This shows Ha is rejected and Ho is accepted, which means the extrinsic reward had a significant effect on job satisfaction with the value tcount ttable (3.213 1699). This shows that Ha is rejected and Ho is accepted. It can be said that there is a partial influence between intrinsic reward and extrinsic reward on job satisfaction by looking at the results of the coefficient of determination (r square) of 0.965, which means that the intrinsic reward and extrinsic reward variables can increase job satisfaction by 96.5% and 3.5% are variables residual (residual) which are influenced by other variables.

The SARS-CoV-2 transmission dynamics in low- and middle-income countries remain poorly understood. This study aimed to estimate the SARS-CoV-2 antibodies seroprevalence in Jakarta, Indonesia, and to increase knowledge of SARS-CoV-2 transmission in urban settings. A population-based serosurvey among individuals aged one year or older was conducted in Jakarta. Employing a multistage sampling design, samples were stratified by district, slum, and non-slum residency, sex, and age group. Blood samples were tested for IgG against three different SARS-CoV-2 antigens. Seroprevalence was estimated after applying sample weights and adjusting for cluster characteristics. In March 2021, this study collected 4,919 respondents. The weighted estimate of seroprevalence was 44.5% (95% CI = 42.5-46.5). Seroprevalence was highest among adults aged 30-49 years, with higher seroprevalence in women and the overweight/obese group. Respondents residing in slum areas were 1.3-fold more likely to be seropositive than non-slum residents. It was estimated that4,717,000 of Jakarta's 10.6 million residents had prior SARS-CoV-2 infection. This suggests that approximately 10 infections were undiagnosed/underreported for every reported case. About one year after the first COVID-19 case was confirmed, close to half of Jakarta's residents have been infected by SARS-CoV-2.

Abstract Background Abortion is highly restricted in Indonesia; self-administered misoprostol can safely induce an abortion. Brick and mortar pharmacies, a common place to purchase misoprostol off-label in other parts of the world, are monitored closely by the government authority in Indonesia which controls drugs so that they cannot function outside the law without risking arrest and prosecution. An online marketplace has sprung up in response that sells misoprostol through in-country distributors. Such procurement offers a level of safety and anonymity to the buyer and seller. So as to understand online access to misoprostol, we created a protocol to identify the most visible universe of sellers. Methods We carried out a mystery client methodology to replicate the experiences of women procuring misoprostol online. Our study consisted of five stages: (1) identify the universe of online sellers using the most common search terms, drawn from multiple platforms to capture diversity in interactions as well as products sold (2) remove duplicates across sites as determined by their telephone numbers (3) draw a roughly probability proportional to size sample (4) contact sellers as mystery clients through text/chat, depending on the platform, and engage with them and (5) attempt to purchase drugs offered by the seller. Descriptive statistics are presented. Results The listing generated 727 sites: 441 websites, 153 marketplace sellers, and 133 Instagram profiles. After removing duplicate listings, we identified 281 unique sellers. We selected all sellers with greater than 12 listings, 60% of sellers with 4–12 listings, 50% of sellers with 2–3 listings, and 40% of sellers with only one listing. Mystery clients were able to send initial messages to 110 sellers, of which 16 never responded. The interaction progressed to purchasing misoprostol with 76 sellers, 64 of whom sent drugs. Conclusions As women seek to terminate unwanted pregnancies in legally restrictive settings, online sales of misoprostol must be considered. With the Covid pandemic constraining movement, the importance of this way of procuring misoprostol will likely become more appealing. Understanding this unregulated landscape is important if we are to try to improve women’s ability to safely conduct an abortion in highly restrictive settings.

Abstract Dysbiosis and perturbations of fecal metabolic profiles have been reported in dogs with inflammatory bowel disease. Currently the incidence of dysbiosis and the fecal metabolomic profile in Yorkshire Terriers with chronic enteropathy (YTE) and the effects of treatment are unknown. This prospective observational study analyzed the dysbiosis index (DI) and fecal bile acid, sterol and fatty acid profiles in 14 Yorkshire Terriers with active YTE, 11 dogs in clinical remission, and 26 healthy Yorkshire Terriers. YTE was associated with dysbiosis and a significant increase in fatty acids (docosanoate, p = 0.002; gondoate, p = 0.026; erucate, p

Chronic idiopathic intestinal inflammation is an increasing worldwide problem that affects companion animals, especially dogs, and human patients. Although these disease entities have been intensely investigated recently, many questions remain, and alternative therapeutic options are needed. Diarrhea caused by dysregulation of intestinal electrolyte transport and subsequent fluid and electrolyte losses often leads to secondary consequences for the patient. Currently, it is not exactly clear which mechanisms are involved in the dysregulation of intestinal fluid absorption, but differences in intestinal electrolyte shifts between human and canine patients suggest species-specific regulatory or counterregulatory mechanisms. Several intestinal electrolyte transporters are differentially expressed in human patients with inflammatory bowel disease (IBD), whereas there are virtually no studies on electrolyte transporters and their endocrine regulation in canine chronic inflammatory enteropathy. An important mechanism involved in regulating fluid and electrolyte homeostasis is the renin-angiotensin-aldosterone-system (RAAS), which may affect intestinal Na+ transport. While RAAS has previously been considered a systemic regulator of blood pressure, additional complex roles of RAAS in inflammatory processes have been unraveled. These alternative RAAS pathways may pose attractive therapeutic targets to address diarrhea and, thus, electrolyte shifts in human IBD and canine chronic inflammatory enteropathy. This article comparatively summarizes the current knowledge about electrolyte transport in human IBD and canine chronic inflammatory enteropathy and the role of RAAS and offers perspectives for novel therapeutic avenues.

There are many teachers do not have skill on operating computer specially to make materials interesting for their students. This study was to improve the technological skills of students, particularly those who teach online. In this study, we attempted to determine how students may utilize YouTube as a medium to strengthen their technological skills. This study was carried out by us with the help of students who took the Education Management Course as the subject of study. The data collection technique used in this study was observation sheets, which were then used to answer the formulation of how the student responses related to the video-making project in the Education Management Course uploaded on YouTube; then, to answer the formulation of how the student’s activities on Education Management, we asked students to complete their video projects and upload them on YouTube; and to answer the formulation of whether the use of YouTube can develop technological skills of students, observation sheets was used. This study concludes that respondents are able to edit and upload video about Education Management on YouTube.

Purpose: Local fashion brands are an important issue for millennial consumers. To create their love of local fashion brands, social media marketing is necessary. The study also examines brand love's effects on local fashion brands' centrality. This study also investigates brand love and centrality’s impact on the repurchase intention. Design/ Methodology/Approach: The data were taken using survey methods with questionnaires developed by previous researchers. A partial least squares regression was used to test the hypotheses. Findings: This study shows that social media marketing can create conditions for consumers to develop brand love, but brand love still needs to be able to develop brand centrality. This study also shows that although brand love has yet to create brand centrality, the concept of brand love can influence the repurchase intention. At the same time, brand centrality also affects the repurchase intention. Originality/value: This is the first study analyzing millennials’ brand love toward fashion clothing brands and the analysis of the influence of social media marketing on brand love and its impact on brand centrality.

Covid-19 has affected the world, and its impact is not limited to medical and health aspects. It has also affected social, educational, business, economic, and work environments. The spread of the virus has forced most companies to implement work-from-home (WFH) policies to reduce the mobility of employees and curb the virus's spread, despite potential adverse effects on employees' productivity and performance. This research aims to rank the criteria for improving employees' productivity during WFH using the Fuzzy- method. Four criteria and eight sub-criteria were identified to promote employees' productivity. The four main criteria are Income, Work Schedule, Work Environment, and Work Partner. Data processing results show that these criteria rank from top to bottom as follows: Work Schedule, Work Environment, Work Partner, and Income. We hope that the rankings observed in this research will help managers set policies to increase their employees' productivity when working from home.

Cedera otak traumatik pada geriatri memiliki insiden 7–34% dengan penyebab utama adalah jatuh. Perdarahan subdural merupakan jenis cedera yang paling sering terjadi pada populasi geriatri. Hal ini sesuai dengan proses penuaan yang terjadi pada jaringan otak sehingga menyebabkan populasi ini sering mengalami perdarahan subdural jika mengalami cedera. Pasien perempuan berusia 72 tahun datang dengan keluhan nyeri kepala pasca terjatuh 6 hari sebelum masuk rumah sakit. Dari pemeriksaan fisik ditemukan kesadaran E3M5V6, tanpa adanya kelainan dan defisit neurologis dan hemodinamika stabil. Dari pemeriksaan penunjang Computed Tomography (CT) scan ditemukan subdural hematoma di regio frontotemporoparietalis dextra dan regio frontalis et temporalis sinistra yang menyebabkan midline shift ke arah sinistra, perdarahan subarahnoid di regio frontalis sinistra, perdarahan intraserebral di lobus temporalis sinistra. Operasi kraniotomi evakuasi hematoma dilakukan selama 3 jam dengan anestesi umum. Pertimbangan anestesi pada pasien ini adalah neuroanestesi dan anestesi geriatri dengan memperhatikan proses penuaan yang mempengaruhi perubahan fisiologi dan farmakologi pada pasien geriatri, riwayat komorbiditas dan polifarmasi. Tatalaksana perioperatif yang baik penting untuk mencegah cedera sekunder pada jaringan otak. Anesthetic Management of Geriatri Patient with Subdural, Intracerebral, and Subarachnoid Hemorrhage Underwent Craniotomy for Hematoma Evacuation Abstract Worldwide, the incidence of traumatic brain injury in geriatrics is 7–34%, with falls as the most common cause. Subdural hemorrhage is the most common injury that occur and is associated with the aging process of the brain, making geriatric patients prone developing subdural hemorrhage. A 72-years-old female came with a headache after fell to the ground 6 days before hospital admission. Physical examination revealed E3M5V6 without neurologic deficits and hemodynamically stable. A computed tomography scan resulted in subdural hematoma in right frontotemporoparietal region causing midline shifting to the left, subarachnoid hemorrhage in the left frontal region, intracerebral hemorrhage in the left temporal lobe. The patient underwent craniotomy evacuation of hematoma and lasted for 3 hours under general anesthesia. Anesthetic concerns are neuroanesthesia and geriatric patient considering the aging process affects physiologic and pharmacologic changes, comorbidities and polypharmacy. Comprehensive perioperative management is essential to prevent secondary brain injury and improve the outcome.

Urbanization is closely related to regional development. The population migration in Palu City is mostly caused by the people’s needs to fulfill their needs. This study aims to identify the migration pattern of the residents of Sigi Regency to Palu City. This study used a descriptive quantitative method and gathered data from secondary data on the Labor Force (AK) from the Center Bureau of Statistics of Palu City in 2015 and 2019. Meanwhile, the data analysis was carried out using gravity analysis to see the interactions and linkages between Palu City and Sigi Regency. Our data analysis results indicate that the migration pattern of the non-permanent population in Palu City was daily, weekly and monthly pattern and dominated by circular migration. Based on the gravity analysis, as a center of development, Palu City has an intensive and close interaction with Sigi Regency. Factors that influence this pattern of migration are accessibility, distance, facilities, and infrastructure. Meanwhile, population and the amount of regional income are the reasons for the interaction between regions. This research can be used as a reference in the learning related to urban village Geography.

BackgroundOptimal early infant feeding practices are critical to ensure adequate nutrition for infants’ growth and development. This study aimed to examine the determinants of suboptimal early feeding practices (i.e., delayed initiation of breastfeeding, prelacteal feeding, and non-exclusive breastfeeding) among infants aged 0–5 months in Indonesia.MethodsWe used data collected in the 2012 and 2017 Indonesia Demographic and Health Surveys. Analyses were conducted using information from 3,198 live-born singleton infants aged 0–5 months. The primary outcomes used were: (1) delayed initiation of breastfeeding in the first hour after birth, (2) prelacteal feeding in the first 3 days, and (3) non-exclusive breastfeeding in the last 24 h preceding the survey. Potential predictors analyzed were categorized into the environmental, household, maternal, pregnancy, delivery, and child characteristics. Logistic regression analyses were performed to identify factors significantly associated with each outcome.ResultsApproximately 78,6% of infants aged 0–5 months in Indonesia had at least one of the three suboptimal early infant feeding practices. We found a strong association between the three outcome indicators analyzed. The determinants of delayed initiation of breastfeeding included infants from Sumatera region (adjusted odds ratios (aOR) = 2.02, p

The application of digital technology to business processes brings a new atmosphere in the era of technological disruption. The increasing number of transportation users makes all air transportation industry operators compete to provide services and facilities without neglecting safety. Personnel working in the aviation sector are keys to successful service delivery. Good quality education begins with the management of the aviation campus. The application of ICT or digital technology in aviation schools in the digital transformation era will bring a fresher atmosphere and innovation. This paper aims to make the concept of digital transformation on aviation campuses based on business processes. Based on the dimensions of digital transformation, which consists of 9 aspects, as well as the value chains of the five porters, a matrix for the concept of digital transformation for aviation campuses can be created. By paying attention to customer experience, processes and business models that make it possible to create new businesses; the implementation of Digital Transformation can be achieved. A simple concept of IT Architecture, this paper can provide a plan for making a smart aviation campus

Tumor hipofisis dapat disertai gejala neuropsikiatri. Apopleksia pituitari (AP) merupakan kejadian jarang akibat infark dan perdarahan tumor hipofisis. Pemulihan total masih mungkin terjadi walaupun pada kasus berat dengan terapi pembedahan maupun konservatif. Terapi pembedahan dipilih bila adanya tanda peningkatan intrakranial dengan kondisi klinis dan neurologis yang tidak stabil. Seorang laki laki, umur 36 tahun dengan keluhan gangguan bicara mendadak sehari sebelum masuk RS, dengan riwayat terapi skizofrenia selama 8 bulan. Pasien mengalami penurunan kesadaran dalam perawatan dan didiagnosis tumor hipofisis anterior dengan komponen apopleksia dari CT-scan kepala. Pasca operasi transphenoid urgensi diterapi vasopresin intramuskular akibat poliuria. Penatalaksanaan anestesi pada pembedahan AP tidak berbeda dengan tumor hipofisis lainnya, hanya saja kondisi AP dapat bersifat urgensi. Satu bulan pasca pembedahan, pasien sudah lebih mudah berbicara, mulai beraktifitas fisik, dan halusinasi suara sudah tidak ada. Tatalaksana AP memberikan tantangan dalam manajemennya. Keluhan yang ditemukan dapat berupa halusinasi. Hingga kasus ini dilaporkan, ada satu publikasi kasus AP dengan psikosis akut dan keterlambatan diagnosis masih mungkin terjadi. Kecurigaan gangguan organik tetap perlu dipikirkan pada gangguan neuropsikiatri. Gangguan produksi urin bisa terjadi pasca operasi yang disebabkan beberapa hal sehingga memerlukan pemantauan ketat status hidrasi untuk menghindari morbiditas dan mortalitas yang mungkin terjadi. Anesthesia Management in Urgency Transsphenoidal Tumor Resection with Pituitary Apoplexy Presenting and Schizophrenia Abstract Pituitary tumors may be accompanied by neuropsychiatric symptoms. Pituitary Apoplexy (PA) is a rare condition due to infarct or bleeding in pituitary tumors. Complete recovery is still possible even in severe cases with either surgical or conservative therapy. Surgery is a choice if there is evidence of increased intracranial pressure with unstable clinical and neurological conditions. Adult man, 36 yo, with sudden difficulty to speak a day before, with history of schizophrenia since 8 months ago. The patient suffered a decrease in consciousness in hospitalization and was diagnosed with anterior hypophysis tumor with apoplexy by CT-scan results. Post transsphenoidal urgency surgery, the patient was treated with vasopressin IM due to polyuria. Anesthesia management in PA surgery is the same as other pituitary tumor surgery, however, PA can be urgent. One month after surgery, the patient is more easier to talk, start physical activities, and auditory hallucination is not heard again. Management PA had its own challenge. Symptoms can be hallucinations. Until this case was reported, there was one published case of AP with acute psychosis and delay in diagnosis is still possible. Suspicion of organic disorders still needs to be considered in neuropsychiatric disorders. Impaired urine production might occur postoperatively due to several reasons so it requires close monitoring of hydration status to prevent possible morbidity and mortality.

Perdarahan Intraserebral (PIS) adalah ekstravasasi darah yang masuk kedalam parenkim otak, yang dapat berkembang ke ruang ventrikel dan subarahnoid, terjadi spontan dan bukan disebabkan oleh trauma (non traumatis) dan merupakan salah satu penyebab tersering pada pasien yang dirawat di unit perawatan kritis saraf. Kejadian PIS 10-15% dari semua stroke dengan tingkat angka kematian tertinggi dari subtipe stroke dan diperkirakan 60% tidak bertahan lebih dari satu tahun. Kasus: Laki-laki 57 tahun, datang dengan keluhan penurunan kesadaran yang terjadi pada saat mau makan. Pada pemeriksaan didapatkan kesadaran GCS E1M4V1 dengan hemodinamik stabil, dan terdapat hemiplegi sinistra. Pasien diintubasi dan memakai ventilator di ruangan Instalasi Gawat Darurat Disaster sambil menunggu hasil skrining Covid 19 dengan swab polymerase chain reaction (PCR). Pada CT-scan ditemukan adanya PIS 48,93 cc di basal ganglia, capsula eksterna sampai periventrikel lateralis kanan, terjadi distorsi midline sejauh 1 cm ke kiri. Ventrikulomegali disertai perdarahan intraventrikel yang mengisi ventrikel lateralis kanan dan kiri, ventrikel III dan IV. Laboratorium menunjukkan gula darah di atas 200 mg/dl setelah dilakukan koreksi gula darah diputuskan untuk dilakukan tindakan kraniotomi evakuasi segera dengan pemeriksaan penunjang yang cukup. Tindakan kraniotomi evakuasi pada pasien PIS menjadi tantangan bagi seorang anestesi, sehingga diperlukan pengetahuan akan patofisiologi, mortalitas PIS dan tindakan anestesi yang harus dipersiapkan dan dikerjakan dengan tepat. Anesthesia Management in Intracerebral Hemorrhage with Hydrocephalus and Diabetes Mellitus Abstract Intracerebral hemorrhage (ICH) is the extravasations of blood into the brain parenchyma, which may develop into ventricular and subarachnoid space, there was spontaneous and not caused by trauma (nontraumatic), and one of the most common cause in patients treated in the neurological critical care unit. ICH represents perhaps 10–15% of all strokes with the highest mortality rates of stroke subtypes and about 60% of patients with ICH do not survive beyond one year. Case: a man 57 years, came with complaints of loss of consciousness when he just want to eat. On examination of consciousness obtained GCS E1M4V1 with hemodynamic was stable, there left hemiplegic. Patients is intubated and connected with ventilator at Emergency Room Disaster while waiting for result from PCR. From the CT Scan we found 48,93 cc at basal ganglia, capsula externa until lateral periventricle dextra there is a midline distortion 1 cm to the left. Ventriculomegali with intraventricle hemorrhage wich is fill the lateral ventricle right and left, third ventricular and fourth ventricular. The laboratorium result show the glucose up to 200 mg/dl. After glucose correction, it was decided to evacuate immediately craniotomy action with adequate investigation. Procedure of craniotomy evacuation in ICH patients be a challenge for an anesthesiologist, so knowledge of the pathophysiology, mortality ICH and anesthetic procedure that should be prepared and done properly.

Vasospasme cerebral merupakan penyebab morbiditas dan mortalitas utama pada pasien dengan perdarahan subarahonid. Delayed ischemic neurologic deficit yang berhubungan dengan vasospasme serebral menyebabkan kematian pada 50% pasien yang bertahan pada periode awal setelah aneurisma ruptur yang ditangani. Onset vasospasme serebral yang bervariasi, mulai dari 24 jam pasca perdarahan subarahnoid atau subarahcnoid hemorrhage (SAH) sampai dengan 14 hari, patofisiologi vasospasme serebral yang kompleks dan cara diagnosis yang masih kontroversial, turut berkontribusi terhadap morbiditas dan mortalitas yang tinggi pada pasien dengan SAH. Evaluasi ketat selama perawatan di ICU untuk mendeteksi kejadian vasospasme serebral awal sangat penting, setiap gejala neurologis baru yang muncul harus diperiksa dan ditangani secepatnya. Banyak obat-obatan yang diteliti untuk mengatasi vasospasme serebral namun efektifitasnya masih dipertanyakan. Tatalaksana utama yang dulu diketahui adalah dengan melakukan terapi triple H, namun hal ini sudah ditinggalkan. Induced hypertension menjadi satu-satunya bagian dari terapi triple H yang masih digunakan, namun belum banyak dipergunakan secara luas. Oleh karena itu perlu dikaji lebih lanjut bagaimana tatalaksana SAH untuk mencegah luaran yang buruk. Management of Cerebral Vasospasm after Subarachnoid Hemorrhage Abstract Cerebral vasospasm is the main etiology of morbidity and mortality in aneurysmal subarachnoid hemorrhage (SAH) patients. Delayed ischemic neurologic deficits associated with vasospasm may account for as high as 50% of the deaths in patients who survive the initial period after aneurysm rupture and its treatment. The variant onset of cerebral vasospasm, start from 24 hours after SAH up to 14 days after, complex pathophysiology, and the diagnosis of vasospasm has still been met with some controversy, contribute to the high morbidity and mortality in these patients. Vigilance evaluation during ICU care to detect cerebral vasospasm as early as posssible is essential, any new onset of neurological symptoms need to be investigated and treated immediately. Many studies reported some agents for the treatment of cerebral vasospasm, however their roles remain uncertain. Triple H therapy was known as a main treatment for vasospasm, however it is no longer applied nowadays. Induced hypertension become the only part of Triple H therapy used yet it is not well recognized. Therefor, there is a need for thorough evaluation regarding treatment of SAH to prevent poor outcomes.

Abstract In late 2015, an epizootic of Highly Pathogenic Avian Influenza (H5Nx) was registered in Southwestern France, including more than 70 outbreaks in commercial poultry flocks. Phylogenetic analyses suggested local emergence of H5 viruses which differed from A/goose/Guangdong/1/1996 clade 2.3.4.4b lineage and shared a unique polybasic cleavage site in their hemagglutinin protein. The present work provides an overview of the pathobiological picture associated with this epizootic in naturally infected chickens, guinea fowls and ducks. Upon necropsy examination, selected tissues were sampled for histopathology, immunohistochemistry and quantitative Real Time Polymerase Chain Reaction. In Galliformes, HPAIVs infection manifested as severe acute systemic vasculitis and parenchymal necrosis and was associated with endothelial expression of viral antigen. In ducks, lesions were mild and infrequent, with sparse antigenic detection in respiratory and digestive mucosae and leukocytes. Tissue quantifications of viral antigen and RNA were higher in chickens and guinea fowls compared to duck. Subsequently, recombinant HA (rHA) was generated from a H5 HPAIV isolated from an infected duck to investigate its glycan-binding affinity for avian mucosae. Glycan-binding analysis revealed strong affinity of rHA for 3’Sialyl-LacNAc and low affinity for Sialyl-LewisX, consistent with a duck-adapted virus similar to A/Duck/Mongolia/54/2001 (H5N2). K222R and S227R mutations on rHA sequence shifted affinity towards Sialyl-LewisX and led to an increased affinity for chicken mucosa, confirming the involvement of these two mutations in the glycan-binding specificity of the HA. Interestingly, the rHA glycan binding pattern of guinea fowl appeared intermediate between duck and chicken. The present study presents a unique pathobiological description of the H5 HPAIVs outbreaks that occurred in 2015–2016 in Southwestern France.