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In an effort to solve the P availability issue in Inceptisols, fermentation is one method used to enhance the quality of liqiuid organic fertilizer (LOF) made from Moringa (Moringa oleifera). The type and concentration determine the effectiveness of LOF on nutrient uptake and plant yields. This study aims to evaluate the impact of LOF types, concentrations, and their interactions on P uptake and rice grain yield in Inceptisols. The research was conducted in a greenhouse using a completely random design (CRD) with two factors. The first factor is the type of LOF, consisting of two levels, i.e., fresh and fermented Moringa extract. The second factor is the LOF concentration, with four levels (i.e., 0, 20, 40, 60, and 80 ml/l) and three replications. Data analysis using ANOVA, DMRT, and correlation. The study revealed that the interaction between LOF types and concentrations affects P uptake. The highest P uptake shown by fermented Moringa with a concentration of 60 ml/l was 20.02 mg/plant and 40 ml/l was 18.73 mg/plants., or 1.5 times higher than the control. Grain yield was not affected by type, LOF concentration, or interaction. Fermented Moringa has good potential as LOF, while the effect on grain yield needs further research.

Purpose – This research is the background of the low creative thinking skills of class XII TKJ in PKK subjects at SMKN Sukaresik. This study aimed to determine the differences in creative thinking skills of experimental class students who applied the project-based learning model with the control class who used the conventional model. Method – The model used in this research is a quasi-experiment with Nonequivalent Control Group Design. Data collection techniques in this study were questionnaires through pretest and posttest, observation, and documentation. The data analysis techniques consist of descriptive analysis, normality test, homogeneity test, independent sample t-test, and N-Gain test. Findings – The results of the data analysis showed that the sig value (two-sided p) < 0.001 and it is smaller than 0.005, so there is a significant difference in the creative thinking ability of the experimental class using the project-based learning model with the control class using the conventional model. Based on the n-gain value of 0.75, the project-based learning model is proven to be better at improving creative thinking skills. Research Implications – The impact of this research is to provide references to teachers in determining the proper learning model to apply in PKK learning. Teachers must build a learning environment that can stimulate learners' creativity. One of these efforts is embracing learners to be directly involved in the learning process through group discussions, collaborative projects, or presentations.

The performance of solar energy based apparatus in various locations is inseparable from the determination of the orientation direction and tilt angle. This study aims to determine an optimal tilt angle in Mataram city area. Photovoltaic Geographical Information System from European Commission (online) was used as the database to obtain global radiation and monthly average diffusion radiation on the horizontal surface with locus coordinates at Latitude/Longitude: -8.583°/116,107° South Latitude. That data was then processed mathematically using Microsoft Excel software. As the result, for the application of solar-based apparatus with a fixed structural configuration throughout the year, the optimal tilt angle (β) was 15° with the orientation facing north, and it was estimated that total solar radiation received throughout the year on average was 115,195 MJ/m2.

The decision to Go Public has a great influence in enhancing the company’s performance particularly the company’s financial performance. The purpose of this research is to test whether there are significant differences in the financial performance of PT Phapros Tbk before and after going public through financial ratios. The financial ratios used are Current Ratio (CR), Quick Ratio (QR), Debt to Asset Ratio (DAR), Debt to Equity Ratio (DER), Return on Investment (ROI), Return on Equity (ROE), Total Asset Turnover (TATO), and Fixed Asset Turnover (FATO). The population of this research is the financial statements of PT Phapros Tbk, while the sample used is the financial statements for the 2016-2021 period. The data analysis technique used is ratio analysis and then quantitative analysis using the IBM SPSS version 26 application, the tests carried out include descriptive statistical analysis, normality testing, and hypothesis testing. The results of this research state that the financial performance of Current Ratio (CR), Quick Ratio (QR), Debt to Asset Ratio (DAR), Debt to Equity Ratio (DER), Return on Investment (ROI), Return on Equity (ROE), and Total Asset Turnover (TATO) have significant difference between before and after going public. While the financial performance of Fixed Asset Turnover (FATO) did not have a significant difference after going public.

The transient scrutiny of a batch arrival feedback queueing system with balking and two stages of varying service with contrasting levels of service subjected to Bernoulli vacation has been examined in this study. Customers also have the option to decline services and leave the service area if the server is unable to fulfill their request when they arrive. The server may continue to serve the customers, if any, after each service with probability ω, or it may undergo a vacation with probability (1−ω). The service channel may fail temporarily when the server is operating in any phase of service, which is then directed straight to the repair process. The model's steady state results and time-dependent probability generating functions in terms of their Laplace transforms have been derived. The mean queue length and the average time spent in the queue are explicitly determined as performance indicators in the various system states. A few unique cases and specific circumstances have also been presented. Finally, the effect of different parameters on the system's efficiency is then numerically analyzed.

Tujuan dari penelitian ini adalah untuk mengetahui bagaimana pengaruh keberagaman gender dan struktur kepemilikan terhadap kinerja perusahaan. Perusahaan real estate yang terdaftar di Bursa Efek Indonesia tahun 2016-2020 digunakan sebagai sampel perusahaan. Regresi data panel digunakan dalam penelitian ini dan diuji menggunakan SPSS versi 28. Dalam penelitian ini, terbukti bahwa keberagaman gender berpengaruh negatif terhadap kinerja perusahaan dan kepemilikan institusional berpengaruh positif terhadap perusahaan. Namun, kepemilikan manajerial terbukti tidak berpengaruh terhadap kinerja perusahaan. Penelitian mendatang sebaiknya membandingkan dengan negara lain di kawasan Asia Tenggara dan menambahkan variabel lain seperti keberagaman latar belakang pendidikan dan kepemilikan keluarga. Kata kunci: keberagaman gender, struktur kepemilikan, kinerja perusahaan.

Dampak dari Covid-19 yang terjadi di seluruh dunia mengakibatkan terjadinya penurunan motivasi belajar siswa terhadap pelajaran matematika. Pada saat itu, semua orang melakukan aktivitas di rumah sehingga peserta didik menggunakan gadget untuk belajar yang mengakibatkan peserta didik terkena Hallyu. Hallyu merupakan kebudayaan yang ada di Korea Selatan. Korea Selatan merupakan salah satu negara yang menjadi pusat perhatian di dunia maya saat ini. Pada generasi gen Z saat ini mereka lebih menggemari para aktor atau artis dari negara tersebut. Penelitian ini menganalisis hubungan antara logika dan cinta di drama Korea terhadap motivasi belajar matematika siswa dengan pendekatan pragmatisme. Dengan menonton salah satu konten drama Korea yang berjudul “Melancholia” sebagai studi kasus, penelitian ini menggunakan metode kualitatif dengan rancangan etnografi berdasarkan pola pikir remaja terhadap pendidikan. Hasil analisis menunjukkan bahwa logika dapat meningkatkan motivasi belajar dalam matematika dan membantu berpikir secara analisis, sementara faktor emosional seperti cinta antarpribadi dapat mempengaruhi motivasi belajar siswa. Pendekatan pragmatisme relevan dalam konteks pendidikan matematika. Implikasi penelitian ini memperkuat motivasi belajar siswa dalam pendidikan matematika untuk pembelajaran yang efektif. Oleh karena itu, logika dan cinta dalam drama Korea "Melancholia" dapat memberikan dampak positif dan negatif terhadap motivasi belajar siswa pada pembelajaran matematika.

One of the most prevalent lifestyle diseases, diabetes mellitus (DM) is brought on by an endocrine issue. DM is frequently accompanied by hyperglycemia, a disease that typically results in an excess of free radicals that stress tissues. The medical community is currently concentrating on creating therapeutic medications with roots in nature to lessen the damage associated with hyperglycemia. Solanum xanthocarpum has a number of medicinal benefits. The investigation aimed to produce and analyze niosomal formulations containing S. xanthocarpum extract (SXE). Niosomes were made by implementing the solvent evaporation process, which was further optimized using Box-Behnken design. Drug release, DPPH assessments, α-amylase inhibition assay, α-glucosidase inhibition assay, and confocal laser scanning microscopy (CLSM) investigation were all performed on the developed formulation (SXE-Ns-Opt). SXE-Ns-Opt displayed a 253.6 nm vesicle size, a PDI of 0.108, 62.4% entrapment efficiency, and 84.01% drug release in 24 h. The rat's intestinal CLSM image indicated that the rhodamine red B-loaded SXE-Ns-Opts had more intestinal penetration than the control. Additionally, the antioxidant effect of the obtained formulation was demonstrated as 89.46% as compared to SXE (78.10%). Additionally, acarbose, SXE, and SXE-Ns-Opt each inhibited the activity of α-amylase by 95.11%, 85.88%, and 89.87%, and also suppressed the enzyme of α-glucosidase by 88.47%, 81.07%, and 85.78%, respectively. To summarise, the establishment of the SXE-Ns-Opt formulation and its characterization demonstrated the legitimacy of the foundation. A promising candidate for the treatment of diabetes mellitus has been shown as in vitro studies, antioxidant against oxidative stress, CLSM of rat's intestine and a high degree of penetration of formulation.

Introduction: Hip fractures in elderly people are increasing. A five-year Integrated Hip Fracture Care Pathway (IHFCP) was implemented at our hospital for seamlessly integrating care for these patients from admission to post discharge. We aimed to evaluate how IHFCP improved process and outcome measures in these patients. Methods: A study was conducted over a five-year period on patients with acute fragility hip fracture who were managed on IHFCP. The evaluation utilised a descriptive design, with outcomes analysed separately for each of the five years of the programme. First-year results were treated as baseline. Results: The main improvements in process and outcome measures over five years, when compared to baseline, were: (a) increase in surgeries performed within 48 hours of admission from 32.5% to 80.1%; (b) reduced non-operated patients from 19.6% to 11.9%; (c) reduced average length of stay at acute hospital among surgically (from 14.0 ± 12.3 days to 9.9 ± 1.0 days) and conservatively managed patients (from 19.1 ± 22.9 to 11.0 ± 2.5 days); (d) reduced 30-day readmission rate from 3.2% to 1.6%; and (e) improved Modified Functional Assessment Classification of VI to VII at six months from 48.0% to 78.2%. Conclusion: The IHFCP is a standardised care path that can reduce time to surgery, average length of stay and readmission rates. It is distinct from other orthogeriatric care models, with its ability to provide optimal care coordination, early transfer to community hospitals and post-discharge day rehabilitation services. Consequently, it helped to optimise patients’ functional status and improved their overall outcome.

The oral cavity is a niche for diverse microbes, including viruses. Members of the Herpesviridae family, comprised of dsDNA viruses, as well as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an ssRNA virus, are among the most prevalent viruses infecting the oral cavity, and they exhibit clinical manifestations unique to oral tissues. Viral infection of oral mucosal epithelia triggers an immune response that results in prolonged inflammation. The clinical and systemic disease manifestations of HHV have been researched extensively, and several recent studies have illuminated the relationship between HHV and oral inflammatory diseases. Burgeoning evidence suggests the oral manifestation of SARS-CoV-2 infection includes xerostomia, dysgeusia, periodontal disease, mucositis, and opportunistic viral and bacterial infections, collectively described as oral post-acute sequelae of COVID-19 (PASC). These diverse sequelae could be a result of intensified immune responses initially due to the copious production of proinflammatory cytokines: the so-called “cytokine storm syndrome”, facilitating widespread oral and non-oral tissue damage. This review explores the interplay between HHV, SARS-CoV-2, and oral inflammatory diseases such as periodontitis, endodontic disease, and peri-implantitis. Additionally, the review discusses proper diagnostic techniques for identifying viral infection and how viral diagnostics can lead to improved overall patient health.

Drowsy driving is a common occurrence and a major cause of traffic accidents. This study aimed to examine the prevalence of and the reasons why people engage in drowsy driving and to develop a model of the factors that influence drowsy driving in Indonesia. Two hundred and fifteen respondents voluntarily participated in this study by completing an online questionnaire. The questionnaire, which comprised 36 items, was developed based on the theory of planned behavior and the health belief model. Convenience sampling was utilized to select respondents, as they had to fulfill the requirements of being able to drive and having a driving license for at least one year. The results showed that 79% of respondents had had at least one experience of drowsy driving. In addition, 32% of the respondents had experienced a near-miss accident during drowsy driving. Their reported reasons for drowsy driving were eagerness to arrive at the destination quickly, lack of availability of proper rest areas, and lack of awareness of sleepiness. The demographic characteristics that differentiated drowsy driving behaviors included age, sex, and living area. The factors influencing drowsy driving were attitude, perceived behavioral control, and perceived barriers. The implications of these results are discussed.

This paper presents a reconfigurable dielectric image line leaky wave antenna at W-band. Reconfigurability is achieved by applying bias to anisotropic liquid crystal (LC) filled into the antenna. Instead of separating RF components and DC-bias network by complex or space consuming methods, the bias electrodes are simultaneously used as radiation elements. In order to evaluate this concept, a non-reconfigurable antenna with isolated unit cells is compared to a reconfigurable antenna, which has its unit cells connected by a metallic line. The non-reconfigurable demonstrator shows gain of up to $\mathrm{18}$ dBi and can scan through broadside from −30$\mathrm{^{\circ }}$ to +10$\mathrm{^{\circ }}$ in the investigated frequency range from $75 \,\mathrm{G}\mathrm{Hz}\,\mathrm{to}\, 102 \,\mathrm{G}\mathrm{Hz}$. This frequency scanning sector can be shifted by $10\mathrm{^{\circ }}$ when utilizing the reconfigurable LC antenna, while gain of up to $15$ dBi is maintained. Since the bias electrodes are directly mounted on the image line, less than $50 \,\mathrm{V}$ is necessary to control the LC. The antenna is comparably easy to fabricate, and only one bias voltage is directly related to a steering angle, which can be advantageous compared to complex phased arrays with multiple LC phase shifters.

BackgroundOf around 2 billion Muslims worldwide, approximately 1.5 billion observe Ramadan fasting (RF) month. Those that observe RF have diverse cultural, ethnic, social, and economic backgrounds and are distributed over a wide geographical area. Sleep is known to be significantly altered during the month of Ramadan, which has a profound impact on human health. Moreover, sleep is closely connected to dietary and lifestyle behaviors.MethodsThis cross-sectional study collected data using a structured, self-administered electronic questionnaire that was translated into 13 languages and disseminated to Muslim populations across 27 countries. The questionnaire assessed dietary and lifestyle factors as independent variables, and three sleep parameters (quality, duration, and disturbance) as dependent variables. We performed structural equation modeling (SEM) to examine how dietary and lifestyle factors affected these sleep parameters.ResultsIn total, 24,541 adults were enrolled in this study. SEM analysis revealed that during RF, optimum sleep duration (7–9 h) was significantly associated with sufficient physical activity (PA) and consuming plant-based proteins. In addition, smoking was significantly associated with greater sleep disturbance and lower sleep quality. Participants that consumed vegetables, fruits, dates, and plant-based proteins reported better sleep quality. Infrequent consumption of delivered food and infrequent screen time were also associated with better sleep quality. Conflicting results were found regarding the impact of dining at home versus dining out on the three sleep parameters.ConclusionIncreasing the intake of fruits, vegetables, and plant-based proteins are important factors that could help improve healthy sleep for those observing RF. In addition, regular PA and avoiding smoking may contribute to improving sleep during RF.

This study aims to determine how to develop appropriate and effective flashcards and to find out whether flashcards can improve students' English vocabulary. The developed media is flashcards. The subjects in this study were fourth-grade students of SD MIS Nurul Hidayah Medan. This type of research was R & D research using a 4-D model. Finding out the feasibility of the media is obtained from an expert validator. Meanwhile, finding out the effectiveness of the media is obtained by testing the media. The trial was carried out twice. The trial was conducted on fourth-grade students consisting of 30 students. Based on the conclusion of the expert, it was stated that the flashcard is worthwhile and effective. While based on the results of the students’ assessment test on the flashcard showed that there was an increase in students' English vocabulary in the first and second trials. Thus, it can be concluded that the development of flashcard as media is feasible and effective for students to use in the teaching and learning process.

This study aims to determine the correlation between the anatomical variations of nasal cavity and paranasal sinuses and the quality of life based on SNOT-22 score in the patients who underwent paranasal sinuses CT scan. The samples are 36 patients with age ≥ 18 years. The method is Chi Square test / Fisher's test and Spearman’s rho test. The results showed that anatomical variations of the nasal cavity and paranasal sinuses from most of the patients who underwent paranasal sinuses CT scan had septal deviation n = 29, p = 0.007 (p

Penelitian ini bertujuan untuk mengetahui tingkat minat membaca siswa kelas VIII A dan VIII D SMP Neggeri 5 Muaro Jambi. Pendekatan yang digunakan dalam penelitian ini adalah pendekatan kuantitatif. Sedangkan jenis penelitian yang digunakan yaitu jenis penelitian survei dengan instrumen penelitian berupa angket. Subjek penelitian ini adalah peserta didik kelas VIII A dan VIII D SMP Negeri 5 Muaro Jambi, dengan jumlah total subjek penelitian sebanyak 50 responden. Teknik analisis data yang digunakan yaitu teknik analisis uji asumsi dan uji hipotesis (uji-T). Sebelum dilakukan uji-T, peneliti telah melakukan uji asumsi berupa uji normalitas dan uji homogenitas sebagai pra syarat untuk melakukan uji selanjutnya, pada uji-T hasil penelitian menunjukkan bahwa kelas VIII A memiliki tingkat minat membaca yang lebih baik dari pada kelas VIII D, dimana hasil nilai mean yaitu 62,04 dan 66,82 untuk kelas VIII D, standar deviasi kelas VIII A lebih kecil dari nilai standar deviasi kelass VIII D yaitu 3,305 4,667. Hal ini lah yang menjadi tolak ukur perhitungan di dapatkannya hasil penelitian tersebut. Berdasarkan hasil penelitian tersebut dapat diketahui bahwa minat membaca kelas VIII A lebih baik dari kelas VIII D.

Penduduk Indonesia seperti yang kita tahu mayoritas adalah seorang muslim. hal ini juga yaang membuat masyarakat mulai sadar akan pentingnya bank syariah untuk mengindari transaksi-transaksi yang tentunya melenceng dari hukum atau ajaran islam. Akad musyarakah merupakan suatu akad kerja sama antara pemilik modal yang dimana hal ini dapat terjadi antara dua orang maupun beberapa orang didalam berbagai bentuk guna melaksanakan suatu kegiatan yang halal dan produktif dengan kesepakatan yang telah ditentukan secara adil dan proposional dalam pembagian margin maupun keuntungannya. Untuk memahami bagaimana akad musyarakah tentu kita harus mengetahui bagaimana teori dan konsepnya terlebih dahulu. Laporan ini ditulis guna mengetahui bagaimankah teori maupun konsep dalam akad musyarakah serta penerapannya dalam perbankan syariah. Apakah perbankan syariah di Indonesia telah menerapkan akad musyarakah dengan baik sesuai dengan teori dan konsepnya dalam kegiatan sehari-hari, dan nasabah yang melakukan transaksi di bank syariah menggunakan akad musyarakah apakah telah mendapatkan haknya sesuai konsep dan teori yang ada.

Aims: The study compared changes in implant stability and bone loss of implants with different designs using early loading at 6 weeks. Setting and Design: In vivo-comparative study. Materials and Methods: Forty subjects were selected and divided randomly by sealed envelope method in Group X and Group A for early loading for missing single posterior tooth in mandible. Implants in Group X had flared crest module and buttress thread design, whereas implants in Group A had parallel crest module and V-shaped thread design. All subjects were evaluated by Ostell for implant stability at the interval of baseline, 6 weeks, 3 months, and 6 months. ImageJ software was used for measurement of crestal bone loss in intraoral periapical radiographs at the interval of 6 weeks, 3 months, and 6 months. Statistical Analysis Used: Unpaired t test, repeated ANOVA, Tukey post hoc test. Results: The mean bone loss values of Group X at predetermined interval were 1.51 ± 0.20 mm, 2.11 ± 0.21 mm and 2.13 ± 0.21 mm. The mean bone loss values of Group A were 1.79 ± 0.16 mm, 2.92 ± 0.23 mm and 2.95 ± 0.23 mm. The mean bone loss was statistical significant (P < 0.05) at 6 weeks, 3 months and 6 months. It was highly significant in Group A at 6 months (P < 0.001). Conclusions: It was concluded that Group X implants design showed better implant stability and less bone loss when compared to Group A implants design.

Background: Mechanical thrombectomy (MT) is a widely proven method to treat acute ischemic stroke (AIS) during mechanical thrombectomy and acute stenting and angioplasty is a topic discussed till this day regarding safety and efficacy. However, intravenous glycoprotein IIb/IIIa agents such as Tirofiban have become a more common thing. We report the analysis of all AIS patients treated with Tirofiban + MT vs. MT alone. Methods: Using a prospectively collected endovascular database at a CSC between 2013 and 2019, workflow, and outcomes were recorded. Patients are given Tirofiban undergoing mechanical thrombectomy and patients undergoing mechanical thrombectomy alone were analyzed to obtain baseline demographics, modified Ranking Scale (mRS) at discharge, and 90 days follow up, pre and post thrombolysis in cerebral infarction (TICI), mortality rate, and hemorrhage rates. Results: There was a total of 169 patients during the study period (average age 68.18 ± 14, 41.42% female). Analysis of 36 patients from the Tirofiban + MT group (average age 69.25 ± 14.18, 27.77% female), and 133 patients from the MT alone was performed (average age 67.89 ± 13.99, 45.11%), see Table 3 for baseline characteristics and outcomes. Four patients (11.11%) in the Tirofiban + MT group had symptomatic hemorrhage versus fourteen patients (10.53%) in the MT alone group (p = .919). There was no significant difference in mortality between the two groups (p = .622). Conclusions: Tirofiban in addition to MT does not increase the risk of symptomatic hemorrhage or mortality. More extensive studies are warranted to prove the safety and efficacy of tirofiban and MT in AIS with tandem lesions.

This study aims to examine the effect of supply chain information integration consisting of internal and exter-nal Information Integration on organizational performance, which consists of customer satisfaction, supply chain performance, and financial performance. The technique of collecting data is based on a questionnaire distributed to 185 small food industry owners. Methods of data analysis is based on using SEM-PLS. The results show that internal information integration affected customer satisfaction, supply chain, and financial performance. External information integration is proven to have a nonlinear effect on customer satisfaction and on the performance of the supply chain. Customer satisfaction and supply chain performance affect financial performance. Internal information integration is more dominant and plays an important role in increasing the performance of the organization.

Background: Glycoprotein IIb/IIIa inhibitor use in acute ischemic stroke (AIS) during mechanical thrombectomy (MT) and acute stenting and angioplasty is a topic consistently debated due to concerns over safety and efficacy. Tirofiban is a glycoprotein IIb/IIIa used throughout the world now more commonly used during MT. We report the analysis of all AIS patients treated with Eptifibatide + MT vs. Tirofiban + MT. Methods: Using a prospectively collected endovascular database at a CSC between 2013 and 2019, workflow, and outcomes were recorded. Patients are given Tirofiban, and patients given Eptifibatide were analyzed to obtain baseline demographics, modified Ranking Scale (mRS) at discharge, and 90 days follow up, pre and post thrombolysis in cerebral infarction (TICI), mortality rate, and hemorrhage rates. Results: A total of 571 MT patients were treated: of those, 89 patients (average age 69.25 ± 14.21, 25.84% female) with underlying intracranial atherosclerosis were treated with a GpIIb/IIIa inhibitor. Analysis of 40.45% (36/89) patients treated with Tirofiban + MT and 59.55% (53/89) patients with Eptifibatide + MT was performed. There was no statistically significant difference in NIHSS upon admission (p = .441). Four patients (11.11%) in the Tirofiban + MT cohort had symptomatic hemorrhage versus four patients (7.55%) in the Eptifibatide + MT cohort (p = .564). There was no significant difference in mortality (p = .573) or final recanalization (p = .678) between the two cohorts. Conclusion: Tirofiban use in MT does not increase the risk of symptomatic hemorrhages or mortality compared to Eptifibatide use in MT with acute stenting. Large prospective studies are warranted to confirm the safety/efficacy of Tirofiban in acute ischemic stroke patients treated with mechanical thrombectomy and acute stenting.

Background and Purpose: Intracranial atherosclerotic disease (ICAD) is a common cause of stroke worldwide. Although there are different endovascular options for the treatment of symptomatic ICAD (sICAD), it is still controversial. Herein, we aim to study the safety and efficacy of a new generation of drug-eluting balloon-mounted stent (DES); Resolute (R) onyx DES in the treatment of sICAD.Methods: A prospectively maintained neuroendovascular procedures database in a high-volume comprehensive stroke center was reviewed from October 2019 through January 2020. Patients were included if they had sICAD (≥70% stenosis), failed medical management, and underwent intracranial stenting with R-onyx DES. Technical success was defined as the ability to deploy the device at the desired location and achievement of

Expert system is an aplication that can perform activities. This system can make a diagnosis like humans, foe example diagnosing hardware and software damage on laptops. This system is widely used in the field of science. This system contains the knowledge of the experts which transferred into the aplications. This system is mode to find a solution as an experts. Expert system can also provide an explanation of steps taken, and provide advice or conclusions on the type or damage to the laptop. This system is developed with purpose to help the users, from hadware and software damage. The case of damageneeden an expert in the settlement with her or his (expert) knowledge already transferred into the application. This system using forward chaining search method. This reasoning is used to examine the factors that are incorperated by rules stored in system, so that it can be concluded from factors collected. The software used to build that is dreamweaver, and to process the database using apache. The evaluation of system performance is using quesioner which elistributed to 100 respondents. The functionality criteria, a total is 861 and average is 86,1. The efficiency 843 and average is 84,1. The uasbility 824 and an average is 82,4 and then total portability is 810 with an average is 81,0.

21st century learning demands the integration of Information and Communication Technology (ICT) in teaching and learning process. Regarding this issue, this research is aimed at investigating English as a foreign language (EFL) teacher’s belief and practices on the integration of ICT in English language teaching. To reach the objective, a case study on an individual teacher was used in this research. The participant was purposively and theoretically selected because she was considered as the informant who could give sufficient information to answer the research questions. Teacher’s interview and classroom observation were used as the data collecting techniques. Iterative data collection and analysis were conducted continuously till theoretical pattern of concepts and categories were achieved. The Substitution Augmentation Modification Redefinition (SAMR) model was used as the data analysis tool resulted from the classroom observation to reveal to what extent the teacher implements ICT integration. The results of this research indicate that the teacher believes that integrating ICT is very important as ICT has ability to make transformation of all educational aspects by making use of it to reach instructional objectives then the quality of teaching and learning will improve. The results also indicate that there is no discrepancy between belief and practice as the teacher has been integrating ICT in the classroom. However, the teacher is still on the substitution and augmentation stages in integrating ICT and hardly achieves modification and redefinition stages. These results suggest that teachers be prepared for ICT integration to create more meaningful learning in the classroom.

A serious environmental problem has occurred due to the negative impact of household waste. Lack of knowledge and awareness of waste processing must be improved through an effective counseling method provided for housewives. The aim of this research was to determine different counseling methods about garbage toward housewives’ knowledge about processing of the household waste. This research carried out on Kampung Pulo, Jakarta Timur on April 2013. A quasi-experiment method with a randomized control group pretest-posttest design was used. Counseling methods of demonstration and movie display were given in two different groups as the treatment. Instrument of knowledge test was used to collect data. The normality testing of Kolmogorov-Smirnov test and the Homogeneity testing of F-test at α = 0.05 resulted a normal distribution and homogenous data. The hypothesis testing of t-test showed t count > t table on 3.34 > 2.03 which rejected the H0, meaning that different knowledge level about processing of the household waste obtained from different method of counseling. It is concluded that, demonstration method was more effective than movie display to increase the housewives’ knowledge about processing of the household waste.

Traditionally, (k, n) secret image sharing is an approach of breaking down a secret image into n number of shadow images to assign them to n number of users, so that any k or more then k users can bring back the secret image. But in case of less than k, users cannot reveal any partial information about the original image. We have proposed a significant secret image sharing technique based on XOR with arithmetic operations that upgrade the performance of traditional secret image sharing approaches by serving importance to shadow images according to user’s significance. This scheme also conserves the fault tolerance property which plays a vital role in image sharing field.

Antibacterial tests were carried out using ethanol extract of kelubi meat (Eleidoxa conferta), extraction using the Microwave-Assisted Extraction method with a ratio of 2: 20 for 30 minutes at 60 °C. Antibacterial tests using diffusion methods with concentrations of 20%, 40%, 60%, 80%, and 100%; positive control of 0.005% amoxillin and DMSO negative control. Antibacterial test results showed that the inhibition zone of ethanol extract in E. coli bacteria with a concentration of 20% was in the moderate category, for a concentration of 40% including the strong category while the concentration of 60%, 80% and 100% was very strong. The inhibition zone of ethanol extract for the S. aureus bacterium with a concentration of 20% is included in the strong category while the concentration of 40%, 60%, 80%, and 100% is categorized as very strong. From these results it can be concluded that the inhibitory zone in Stapylococcus aureus bacteria is greater than that of E. coli bacteria.

Color matching to the surrounding skin is extremely important in patients wearing maxillofacial prostheses. It is of utmost importance to know the different techniques of color matching and coloring in maxillofacial prostheses. The purpose of this study is to review the literature data with regard to color matching in maxillofacial prosthetics. An electronic search of peer review restricted to English language dental literature was conducted to identify the relevant scientific article on color matching and coloring in maxillofacial prostheses. The publication year was up to December 2015 so that the search could include all the articles provided in that particular database. Two independent observers independently read the abstracts and later preselected full-text articles. A full-text review was carried out only for 15 articles. Out of the 15 articles, 7 were related to coloring using tinting, spraying, milling, and use of commercial cosmetics. Three studies were related to shade matching in maxillofacial prostheses. Two studies conducted the measurement of color in maxillofacial prostheses. Only one study had explained color and its relevance in maxillofacial prosthetics. Only one study was done for reproducing silicone shade guide matching Indian skin color. In addition, a single pilot study was done to measure facial skin and lip color in a human population sample stratified by race, gender, and age. Currently, there is no evidence discussing the best technique available for perfectly matching the color for the fabrication of maxillofacial prostheses. However, the latest instruments such as spectrophotometer and colorimeters are believed to have improved efficiency in matching the color.

Growing demand of invisible braces byesthetically conscious patients has led to remarkable inventions in materials for esthetic labial archwires. Archwires with excellent optical clarity and mechanical properties comparable to conventional archwires have been manufactured by almost all the leading companies of orthodontic products in the past two decades, but their clinical use is still limited. Esthetic archwires can be divided into two main types, which are transparent non-metallic archwires (composite wires) and metallic wires with esthetic coatings. This article intends to provide an overview of various types of esthetic archwires available, and to gather evidence from the literature regarding their clinical applicability.

In this paper we investigate the temperature dependent behavior of a liquid crystal (LC) loaded tunable dielectric image guide (DIG) phase shifter at millimeter-wave frequencies from 80 GHz to 110 GHz for future high data rate communications. The adhesive, necessary for precise fabrication, is analyzed before temperature dependent behavior of the component is shown, using the nematic LC-mixture GT7-29001. The temperature characterization is conducted by changing the temperature of the LC DIG’s ground plane between −10∘C and 80 ∘C. The orientation of the LC molecules, and therefore the effective macroscopic relative permittivity of the DIG, is changed by inserting the temperature setup in a fixture with rotatable magnets. Temperature independent matching can be observed, while the insertion loss gradually increases with temperature for both highest and lowest permittivity of the LC. At 80 ∘C the insertion loss is up to 1.3dB higher and at −10∘C it is 0.6dB lower than the insertion loss present at 20 ∘C. In addition, the achievable differential phase is reduced with increasing temperature. The impact of molecule alignment to this reduction is shown for the phase shifter and an estimated 85% of the anisotropy is still usable with an LC DIG phase shifter when increasing the temperature from 20 ∘C to 80 ∘C. Higher reduction of differential phase is present at higher frequencies as the electrical length of the phase shifter increases. A maximum difference in differential phase of 72∘ is present at 110 GHz, when increasing the temperature from 20 ∘C to 80 ∘C. Nevertheless, a well predictable, quasi-linear behavior can be observed at the covered temperature range, highlighting the potential of LC-based dielectric components at millimeter wave frequencies.

Purpose: Early surgery for older adults with hip fracture has been shown to improve outcomes. We aim to study the factors contributing to delay in surgery (defined as surgery performed more than 48 h after admission) and its associated outcomes in a tertiary hospital in Singapore with an integrated hip fracture program. Methods: This is a prospective cohort study of hip fracture patients aged more than 60 years over 1 year. We collected data on demographics, premorbid mobility and functional status, time to surgery, postoperative complications, and inhospital mortality. Mortality data and functional performance were reviewed at 1 year. Results: High American Society of Anaesthesiologists score independently predicted delay in surgery (odd ratio (OR) = 9.52, 95% confidence interval (CI): 1.69–53.68). Delayed surgery was significantly associated with longer length of stay (median 12.8 days with interquartile range (IQR) 9.7–17.6 days vs. 8.35 days with IQR 5.9–10.9 days, p < 0.01). Surgery within 48 h significantly reduced functional decline (Modified Barthel Index change −3.89 ± 17.23 vs. −9.29 ± 20.30, p = 0.01) and 1-year mortality (3.5% vs. 9.3%, p = 0.03). Surgical delay was an independent risk factor for early postoperative complications (OR = 3.21, 95% CI: 1.21–8.49), and patients were significantly less likely to return to premorbid mobility at 1 year (OR = 0.62, 95% CI: 0.39–0.97). Conclusions: Delayed hip fracture surgery in older adults is associated with worse short- and long-term outcomes, including early postoperative complications and poorer functional recovery.

Orthognathic surgery in conjunction with fixed orthodontics is a common indication for interdisciplinary management of severe skeletal Class III malocclusion. A thorough analysis of pretreatment investigations and development of a surgical visual treatment objective is essential to plan the type of surgical technique required. Bimaxillary orthognathic surgery is the most common type of surgical procedure for severe skeletal discrepancies. The present case report is a combined ortho-surgical team management of a skeletally Class III patient. The severity of the case required bilateral upper first premolar extraction for dentoalveolar decompensation and simultaneous “Two-jaw surgery” with maxillary advancement of 4 mm and mandibular setback of 7 mm. Postsurgery, a pleasing good facial profile was achieved with Class II molar relation and positive overjet.

This study aims to determine the effect of Return on Assets and Debt to Equity Ratio of Stock Price on Financial Institutions in Indonesia Stock Exchange. This study used secondary data, with samples 2 financial companies in Indonesia Stock Exchange during the study period 2004-2010. Independent variables in this study are Return on Assets and Debt to Equity Ratio. This study used purposive sampling technique. The method of data analysis used classical assumption test, hypothesis test, multiple regression analysis, the F test and t test. Based on results of the study, Return on Assets and Debt to Equity Ratio have no significant effect on stock price. Meanwhile, the F test result shows that Return on Assets and Debt to Equity Ratio jointly have no effect on stock price.

Some investors prefer dividend yield than capital gain, information signal follows to dividend policy that describes the earnings volatility in the future, which affects the stock price volatility on the Jakarta Stock Exchange.

METODE KEPERAWATAN KOMPLEMENTER HIPNOTERAPI UNTUK MENURUNKAN EFEK STRESS PASCA TRAUMA TINGKAT SEDANG PADA FASE REHABILITASI SISTEM PENANGGULANGAN KEGAWATDARURATAN TERPADU (SPGDT) Hypnotherapy complementary nursing method can reduce the effects of moderate levels of post traumatic stress in a rehabilitation phase of integrated emergency management system Rani Rakhmawati(1) , Kuswantoro Rusca Putra(2) , Fa Rizki Bayu Perdana(3), Hardiyanto(4) (1)Program Studi Ilmu Keperawatan Fakultas Ilmu Kesehatan Universitas Muhammadiyah Malang(2)Jurusan Keperawatan Fakultas Kedokteran Universitas Brawijaya Malang(3,4)Pascasarjana Jurusan Keperawatan Fakultas Kedokteran Universitas Brawijaya Malangemail : 1)rani.rakhmawati@yahoo.com ABSTRAK Bencana di Indonesia mempunyai prevalensi yang cukup tinggi. Efek yang ditimbulkan dari bencana diantaranya stress pasca trauma yang merupakan gangguan psikologi dari korban bencana. Sebagai tenaga kesehatan terutama dalam hal ini adalah perawat mempunyai peranan penting dalam Sistem Penanggulangan Kegawatdaruratan Terpadu (SPGDT), Tujuan dari penulisan karya ini adalah untuk mengidentifikasi apakah metode hipnoterapi bisa menurunkan efek stress pasca trauma tingkat sedang. Metode penulisan karya tulis ini adalah dengan deskriptif dan metode pengumpulan datanya menggunakan metode studi pustaka melalui literatur yang relevan. Sedangkan metode analisis data dan pemecahan masalah menggunakan metode eksposisi dan analitik serta rumusan masalah kami dapatkan dengan diskusi kelompok berlandaskan literatur yang relevan dengan topik karya tulis. Hipnoterapi ini menitikberatkan pada pemberian sugesti-sugesti positif pada klien yang akan menimbulkan perilaku mekanisme koping konstruktif pada klien. Kesimpulan dari karya tulis ini adalah metode keperawatan komplementer dengan hipnoterapi sangat efektif untuk menurunkan stress tingkat sedang pada stress pasca trauma. Disarankan untuk dilakukan pengkajian lebih lanjut terkait faktor-faktor lain yang mempengaruhi hasil terapi pada hipnoterapi ini. Kata kunci: Metode Keperawatan komplementer, Hipnoterapi , Efek stress pasca trauma ABSTRACT Disaster in Indonesia has a high prevalence. The effects of the disaster such as post traumatic stress disorder which is the psychology of disaster victims. As health professionals, especially in this case the nurse has an important role in Sistem Penanggulangan Kegawatdaruratan Terpadu (SPGDT). The purpose of this paper is to identify whether the method of hypnotherapy can reduce the effects of moderate levels of post traumatic stress. The writing method of this paper is descriptive and data collection method is using literature through the relevant literature. While the data analysis and problem solving is using exposition and analytical method and formulation of the problem we get from a group of discussion based on the relevant literature to the topic of paper. Hypnotherapy is focused on providing positive suggestions in client that will lead to constructive behavior on the client’s coping mechanisms. The conclusion of this paper is hypnotherapy as complementary nursing was very effective for moderate stage of post traumatic stress disorder. It is recommended to do further study related to other factors that influence the outcome of hypnotherapy. Keywords: Complementary nursing therapies, Hypnotherapy, Post Traumatic Stress Disorder (PTSD).

The effect of temperature and length of storage on vitamin C concentration of chili (Capsicum frustescens) was observed on this study. Samples were taken from farmer’s field around Gianyar Regency of Bali. The chilies were treated with temperature such as 10ºC, 20ºC, and 29ºC (room temperature) and stored for 5, 10, and 15 days. Jacobs method was applied for vitamin C determination. The highest vitamin C content was obtain from control (59,9 mg/100 ml). On the other hand, the lowest was from chili that stored at room temperature for 15 days (23,6 mg/100 ml). For weight loss, the highest of loss was from chili which stored at room temperature for 15 days.

Background: Vitamin D deficiency is common in older adults in Western countries with seasonal winters, when the amount of sunlight is much reduced. There is a paucity of data on the prevalence of vitamin D deficiency in patients with hip fracture in countries such as Singapore where the climate is predominantly tropical. Objectives: In this study, our aims were to ascertain the prevalence of vitamin D deficiency and risk factors associated with vitamin D deficiency in hospitalized elderly patients with hip fracture in Singapore. Methods: We prospectively studied 485 patients with hip fracture admitted to the orthopedic department over a 1-year period. Nonfragility fractures and younger patients (patients

Introduction: Equitable healthcare delivery is essential and requires resources to be distributed, which include assets and healthcare workers. To date, there is no gold standard for measuring the correct number of physicians to meet healthcare needs. This rapid review aims to explore measurement tools employed to optimise the distribution of hospital physicians, with a focus on ensuring fair resource allocation for equitable healthcare delivery., Materials and Methods: A literature search was performed across PubMed, EMBASE, Emerald Insight and grey literature sources. The key terms used in the search include 'distribution', 'method', and 'physician', focusing on research articles published in English from 2002 to 2022 that described methods or tools to measure hospital-based physicians' distribution. Relevant articles were selected through a two-level screening process and critically appraised. The primary outcome is the measurement tools used to assess the distribution of hospital-based physicians. Study characteristics, tool advantages and limitations were also extracted. The extracted data were synthesised narratively., Results: Out of 7,199 identified articles, 13 met the inclusion criteria. Among the selected articles, 12 were from Asia and one from Africa. The review identified eight measurement tools: Gini coefficients and Lorenz curve, Robin Hood index, Theil index, concentration index, Workload Indicator of Staffing Need method, spatial autocorrelation analysis, mixed integer linear programming model and cohortcomponent model. These tools rely on fundamental data concerning population and physician numbers to generate outputs. Additionally, five studies employed a combination of these tools to gain a comprehensive understanding of physician distribution dynamics., Conclusion: Measurement tools can be used to assess physician distribution according to population needs. Nevertheless, each tool has its own merits and limitations, underscoring the importance of employing a combination of tools. The choice of measuring tool should be tailored to the specific context and research objectives.

Metabolic-associated fatty-liver disease (MAFLD), previously known as non-alcoholic fatty liver disease, is the most widespread and emerging chronic liver disease worldwide, with increasing prevalence rates also in the Asia-Pacific region. The disease has a high socio-economic burden as it negatively impacts the finances and quality of life of individuals affected and has a major burden on healthcare systems. The most important pathological event in MAFLD aetiopathogenesis is oxidative stress, which leads to functional and structural abnormalities in the liver as well as being involved in the development of other concomitant cardiometabolic diseases. MAFLD is a rather complex multisystemic clinical condition involving liver damage and a wide spectrum of extrahepatic manifestations such as obesity, type 2 diabetes, metabolic syndrome and cardiovascular diseases. This complexity requires the cooperation of multiple experts to identify MAFLD at an early stage, treat associated comorbidities, and promptly refer the patient to the hepatologist when needed. This review summarizes the current knowledge about MAFLD and reports the opinion of a group of experts on the increasing prevalence and burden of the disease in the southeast Asia region, the current journey of patients with MAFLD in developing countries, the role of oxidative stress and antioxidant treatment, and the importance of a multidisciplinary approach for early diagnosis and disease management. This article is part of the Current clinical use of silymarin in the treatment of toxic liver diseases: a case series Special Issue: https://www.drugsincontext.com/special&#95;issues/current-clinical-use-of-silymarin-in-the-treatment-of-toxic-liver-diseases-a-case-series., Competing Interests: Disclosure and potential conflicts of interest: FA: Speaker fee for webinars from Viatris. DP: Speaker fee from SV More, Echosens, Inopgen, Otsuka, Biocare, Zuellig, Gilead. RAR: Received grant for research support from Viatris via Navistas Healthcare. Speaker fee from Mylan, Pfizer, Ferring, AbbVie. NM: None. NT: Speaker fee for Viatris, Zuellig Pharma, Novartis, Abbot. RC: Speaker fee for Roche. CB: Speaker fee from Takeda, Viatris, Sandoz, Thai-Otsuka. AS: None. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2023/12/dic.2023-9-3-COI.pdf, (Copyright © 2024 Angelico F, Alcantara-Payawal D, Rani RA, Mustafa N, Thongtang N, Chaiteerakij R, Bunchorntavakul C, Sukonthasarn A.)

Introduction: In light-emitting diode (LED) and LASER colonoscopy, linked color imaging (LCI) and blue light/laser imaging (BLI) are used for lesion detection and characterization worldwide. We analyzed the difference of LCI and BLI images of colorectal lesions between LED and LASER in a multinational study., Methods: We prospectively observed lesions with white light imaging (WLI), LCI, and BLI using both LED and LASER colonoscopies from January 2020 to August 2021. Images were graded by 27 endoscopists from nine countries using the polyp visibility score: 4 (excellent), 3 (good), 2 (fair), and 1 (poor) and the comparison score (LED better/similar/LASER better) for WLI/LCI/BLI images of each lesion., Results: Finally, 32 lesions (polyp size: 20.0 ± 15.2 mm) including 9 serrated lesions, 13 adenomas, and 10 T1 cancers were evaluated. The polyp visibility scores of LCI/WLI for international and Japan-expert endoscopists were 3.17 ± 0.73/3.17 ± 0.79 (p = 0.92) and 3.34 ± 0.78/2.84 ± 1.22 (p < 0.01) for LED and 3.30 ± 0.71/3.12 ± 0.77 (p < 0.01) and 3.31 ± 0.82/2.78 ± 1.23 (p < 0.01) for LASER. Regarding the comparison of lesion visibility about between LED and LASER colonoscopy in international endoscopists, a significant difference was achieved not for WLI, but for LCI. The rates of LED better/similar/LASER better for brightness under WLI were 54.5%/31.6%/13.9% (International) and 75.0%/21.9%/3.1% (Japan expert). Those under LCI were 39.2%/35.4%/25.3% (International) and 31.3%/53.1%/15.6% (Japan expert). There were no significant differences in the diagnostic accuracy and the comparison score of BLI images between LED and LASER., Conclusions: The differences of lesion visibility for WLI/LCI/BLI between LED and LASER in international endoscopists could be compared to those in Japanese endoscopists., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The use of gelatin microspheres (GMs) as a cell carrier has been extensively researched. One of its limitations is that it dissolves rapidly in aqueous settings, precluding its use for long-term cell propagation. This circumstance necessitates the use of crosslinking agents to circumvent the constraint. Thus, this study examines two different methods of crosslinking and their effect on the microsphere's physicochemical and cartilage tissue regeneration capacity. Crosslinking was accomplished by physical (dehydrothermal [DHT]) and natural (genipin) crosslinking of the three-dimensional (3D) GM. We begin by comparing the microstructures of the scaffolds and their long-term resistance to degradation under physiological conditions (in an isotonic solution, at 37°C, pH = 7.4). Infrared spectroscopy indicated that the gelatin structure was preserved after the crosslinking treatments. The crosslinked GM demonstrated good cell adhesion, viability, proliferation, and widespread 3D scaffold colonization when seeded with human bone marrow mesenchymal stem cells. In addition, the crosslinked microspheres enhanced chondrogenesis, as demonstrated by the data. It was discovered that crosslinked GM increased the expression of cartilage-related genes and the biosynthesis of a glycosaminoglycan-positive matrix as compared with non-crosslinked GM. In comparison, DHT-crosslinked results were significantly enhanced. To summarize, DHT treatment was found to be a superior approach for crosslinking the GM to promote better cartilage tissue regeneration.

Background and Aim: High-grade dysplasia (HGD) and T1 lesions are accidentally resected by cold snare polypectomy (CSP) and the characteristics, and follow-up of them has not been reported. In this study, we analyzed the histopathological findings and recurrence of them., Methods: This was a multicenter retrospective-cohort study. We collected HGD and T1 lesions of ≤ 10 mm resected by CSP among 15 520 patients receiving CSP from 2014 to 2019 at nine related institutions, and we extracted only cases receiving definite follow-up colonoscopy after CSP of HGD and T1 lesions. We analyzed these tumor's characteristics and therapeutic results such as R0 resection and local recurrence and risk factors of recurrence., Results: We collected 103 patients (0.63%) and extracted 80 lesions in 74 patients receiving follow-up colonoscopy for CSP scar. Mean age was 68.4 ± 12.0, and male rate was 68.9% (51/80). The mean tumor size (mm) was 6.6 ± 2.5, and the rate of polypoid morphology and rectum location was 77.5% and 25.0%. The rate of magnified observation was 53.8%. The rates of en bloc resection and R0 resection were 92.5% and 37.5%. The local recurrence rate was 6.3% (5/80, median follow-up period: 24.0 months). The recurrence developed within 3 months after CSP for four out of five recurrent cases. Comparing five recurrent lesions to 75 non-recurrent lesions, a positive horizontal margin was a significant risk factor (60.0% vs 10.7%, P < 0.001)., Conclusions: High-grade dysplasia and T1 resected by CSP were analyzed, and the local recurrence rate of them was substantially high., (© 2021 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)

Competing Interests: There are no conflicts of interest.

Long urethral strictures are often treated with autologous genital skin and buccal mucosa grafts; however, risk of hair ingrowth and donor site morbidity, restrict their application. To overcome this, we introduced a tissue-engineered human urethra comprising adipose-derived stem cell (ASC)-based self-assembled scaffold, human urothelial cells (UCs) and smooth muscle cells (SMCs). ASCs were cultured with ascorbic acid to stimulate extracellular matrix (ECM) production. The scaffold (ECM) was stained with collagen type-I antibody and the thickness was measured under a confocal microscope. Results showed that the thickest scaffold (28.06 ± 0.59 μm) was achieved with 3 × 10 4 cells/cm 2 seeding density, 100 μg/mL ascorbic acid concentration under hypoxic and dynamic culture condition. The biocompatibility assessment showed that UCs and SMCs seeded on the scaffold could proliferate and maintain the expression of their markers (CK7, CK20, UPIa, and UPII) and (α-SMA, MHC and Smootheline), respectively, after 14 days of in vitro culture. ECM gene expression analysis showed that the ASC and dermal fibroblast-based scaffolds (control) were comparable. The ASC-based scaffold can be handled and removed from the plate. This suggests that multiple layers of scaffold can be stacked to form the urothelium (seeded with UCs), submucosal layer (ASCs only), and smooth muscle layer (seeded with SMCs) and has the potential to be developed into a fully functional human urethra for urethral reconstructive surgeries.

COVID-19 rarely causes lower gastrointestinal bleeding even though its RNA has been detected in patient's stool. Urgent colonoscopy in a COVID-19 patient with massive bloody stool requires various procedural and equipment considerations. Here, we present a case of colonoscopic hemostasis of a cecal hemorrhagic ulceration in a patient on heparin for COVID-19 coagulopathy. We also share various management methods for the prevention of COVID-19 contamination. A 71-year-old man was diagnosed with COVID-19 pneumonia and subsequently underwent hemodiafiltration. Heparin was initiated for COVID-19 coagulopathy. At day 42, the patient experienced 2000 mL of bloody stool. An operator performed urgent colonoscopy with three assistants in a negative-pressure room with full personal protective equipment. A hemorrhagic ulceration was detected at the cecum, and endoscopic hemostasis was performed. Immunohistochemistry was positive for cytomegalovirus. Postprocedure, the endoscopic systems were thoroughly cleaned, and specific measures for endoscope reprocessing and disinfection were performed to prevent contamination with COVID-19., (© 2020 The Authors. JGH Open published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)

Materials and Methods: This was a multicenter retrospective cohort study. The subjects were patients aged ≥20 years treated for chronic constipation from May 2018 to November 2019 at 12 related institutions. Patients were divided into ≤74 years and ≥75 years old. Elobixibat at 10 mg/day was prescribed for two weeks. We then analyzed the discontinuation due to ineffectiveness, change of spontaneous bowel movements (SBM), stool consistency, the time until the first SBM, adverse events, and effect-related factors., Results: There were 140 cases (61 males) evaluated, with an average age of 72.1 ± 13.6 years (≤74 years: 71 cases; ≥75 years: 69 cases). The discontinuation rate was 7.9%. The SBM (times/week) increased from 2.86 to 6.08 ( p < 0.001). The overall SBM improvement rate was 74.0% (≤74 years: 78.2% vs. ≥75 years: 68.9%, p = 0.31; male: 75.0% vs. female: 73.3%, p = 0.78). The overall improvement rate of stool consistency was 59.6% (≤74 years: 62.9%, ≥75 years: 56.1%, p = 0.42). The time until the first SBM (hours) for those ≤74 years and ≥75 years was 17.2 ± 14.3 and 11.2 ± 8.4 ( p = 0.04). Adverse event rates for those ≤74 years and ≥75 years were 28.2% and 10.1% ( p < 0.01). There were no significant effect-related factors for gender, age, and use of laxatives., Conclusions: Short-period elobixibat is shown to be effective also for the elderly and male., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Akira Tomie et al.)

Recent advancement in cartilage tissue engineering has explored the potential of 3D culture to mimic the in vivo environment of human cartilaginous tissue. Three-dimensional culture using microspheres was described to play a role in driving the differentiation of mesenchymal stem cells to chondrocyte lineage. However, factors such as mechanical agitation on cell chondrogenesis during culture on the microspheres has yet to be elucidated. In this study, we compared the 2D and 3D culture of bone-marrow-derived mesenchymal stem cells (BMSCs) on gelatin microspheres (GMs) in terms of MSC stemness properties, immune-phenotype, multilineage differentiation properties, and proliferation rate. Then, to study the effect of mechanical agitation on chondrogenic differentiation in 3D culture, we cultured BMSCs on GM (BMSCs-GM) in either static or dynamic bioreactor system with two different mediums, i.e., F12: DMEM (1:1) + 10% FBS (FD) and chondrogenic induction medium (CIM). Our results show that BMSCs attached to the GM surface and remained viable in 3D culture. BMSCs-GM proliferated faster and displayed higher stemness properties than BMSCs on a tissue culture plate (BMSCs-TCP). GMs also enhanced the efficiency of in-vitro chondrogenesis of BMSCs, especially in a dynamic culture with higher cell proliferation, RNA expression, and protein expression compared to that in a static culture. To conclude, our results indicate that the 3D culture of BMSCs on gelatin microsphere was superior to 2D culture on a standard tissue culture plate. Furthermore, culturing BMSCs on GM in dynamic culture conditions enhanced their chondrogenic differentiation.

Pes anserine syndrome is a cause of inferomedial knee pain. It occurs in patients with diabetes mellitus, osteoarthritis, rheumatoid arthritis and in overweight patients. It is a challenge to identify the causes of knee pain following knee replacement surgery. We present a case report of pes anserine syndrome in a 79-year-old female who had undergone knee arthroplasty 13 years prior. She was pain free until one year ago when her knee pain resurfaced without any symptoms of infection or history of trauma. She was successfully treated with a combination of stretching exercise and steroid local steroid injection. We want to highlight that such common condition as pes anserine syndrome, could occur in total knee arthroplasty, and should be considered as one of the possible diagnosis., (© 2018 Delhi Orthopedic Association. All rights reserved.)