Big Centers Research Articles

Rapid on-site evaluation of fine-needle aspiration specimens using cytotechnologist-performed telecytology: Insights and advantages.

With multiple health care centres expanding and implementing remotely controlled technologies, the role of cytopathology laboratories will become crucial in optimizing collection and assessment of small biopsy specimens for diagnosis and personalized treatment. Cytopathology services provide rapid assessments of samples obtained from fine-needle aspirations and occasionally core needle biopsies (analysed by touch imprints). Over the past few decades, the cost barrier for hospitals, especially small ones, to support a cytopathologist or cytotechnologist for rapid on-site evaluation (ROSE) has been reduced by the introduction of computerized microscopes that allow cytopathologists to perform ROSE without being present at the satellite laboratory (i.e. remotely). Utilization of the cytotechnologist's experience in ROSE alongside these technologies made it possible to perform ROSE with telecytology (ROSE-TC), which positively impacts diagnosis and treatment and also lowers the cost of care. The satellite laboratories that successfully implemented ROSE-TC operate with experienced cytotechnologists who, working independently between the cytopathology laboratory and the biopsy suite, prepare the smears and stain the slides on site for the distant cytopathologists, who can evaluate the slides remotely (usually from their office) simply using the facility intranet. This article aims to encourage big and small centres to use senior-level cytotechnologists for both ROSE and ROSE-TC. This article also defines different types of ROSE, explains our institution's approach to ROSE procedures, and outlines some experience-driven considerations for successful ROSE-TC and its future evolution.

Does Timepoint of Surgical Procedure Affect the Outcome in Simultaneous Pancreas-Kidney Transplantation? A Retrospective Single-Center Analysis over 20 Years.

Background: Sleep deprivation and disturbances in circadian rhythms may hinder surgical performance and decision-making capabilities. Solid organ transplantations, which are technically demanding and often begin at uncertain times, frequently during nighttime hours, are particularly susceptible to these effects. This study aimed to assess how transplant operations conducted during daytime versus nighttime influence both patient and graft outcomes and function. Methods: simultaneous pancreas-kidney transplants (SPKTs) conducted at the University Hospital of Leipzig from 1998 to 2018 were reviewed retrospectively. The transplants were categorized based on whether they began during daytime hours (8 a.m. to 6 p.m.) or nighttime hours (6 p.m. to 8 a.m.). We analyzed the demographics of both donors and recipients, as well as primary outcomes, which included surgical complications, patient survival, and graft longevity. Results: In this research involving 105 patients, 43 SPKTs, accounting for 41%, took place in the daytime, while 62 transplants (59%) occurred at night. The characteristics of both donors and recipients were similar across the two groups. Further, the rate of (surgical) pancreas graft-related complications and reoperations (daytime 39.5% versus nighttime 33.9%; p = 0.552) were also not statistically significant between both groups. In this study, the five-year survival rate for patients was comparable for both daytime and nighttime surgeries, with 85.2% for daytime and 86% for nighttime procedures (p = 0.816). Similarly, the survival rates for pancreas grafts were 75% for daytime and 77% for nighttime operations (p = 0.912), and for kidney grafts, 76% during the day compared to 80% at night (p = 0.740), indicating no significant statistical difference between the two time periods. In a multivariable model, recipient BMI > 30 kg/m2, donor age, donor BMI, and cold ischemia time > 15 h were independent predictors for increased risk of (surgical) pancreas graft-related complications, whereas the timepoint of SPKT (daytime versus nighttime) did not have an impact. Conclusions: The findings from our retrospective analysis at a big single German transplant center indicate that SPKT is a reliable procedure, regardless of the start time. Additionally, our data revealed that patients undergoing nighttime transplants have no greater risk of surgical complications or inferior results concerning long-term survival of the patient and graft. However, due to the small number of cases evaluated, further studies are required to confirm these results.

Urbanization and Future Development of Satellite Towns through Gis: A Case Study of Bagru Block, Rajasthan, India

Urban agglomerations in India support more than 30% of its population today and are expanding rapidly. The metropolitan city of Jaipur supports nearly 30 lakh population and attracts millions every day towards the wide range of economic and employment opportunity it provides. Such big urban centre drains and absorbs all the available resources of the nearby area which supplements its expansion as major economic hub, “as a mother city”. Growth triggered expansion in developing countries like India is mostly so haphazard, unplanned and unchecked that it consumes surrounding small cities/towns. Therefore, the planning of these smaller municipalities adjacent to a major city (Satellite towns) becomes inevitable for the sustainable growth of urban centers and equitable resource allocation in future. “Bagru” is one such satellite town located along the south western fringes of Jaipur city, 30kms away on NH-8 .The study tries to contemplate “Bagru” as a satellite town along with other 15 towns for the master plan of Jaipur 2025 including parameters like economic potential, socio-economic and physical structure, connectivity, population.

Enhancing Coal Mining Efficiency

Coal is a prominent energy resource for several countries. Of late, exploring the automatic management and control of coal mining has been a significant task. This article presents a framework for a mine-wide integrated automation management and control platform with the goal of advancing coal mining through unified data, models, platforms, and plans. Utilizing cutting-edge technologies, the platform offers resource management, real-time monitoring, remote control, statistical analysis, and intelligent alarm systems. Data access design ensures standardized data collection and exchange, fostering interoperability. A big data storage center manages heterogeneous data sources. The platform interface design emphasizes flexibility and scalability through containerized applications and microservices frameworks, streamlining deployment. The functional design encompasses subsystem configuration access, real-time monitoring, remote access, etc. A detailed evaluation is presented to demonstrate the significance of the proposed platform in terms of functionality, performance, and scalability.

Результаты качественного исследования представлений учителей и родителей учащихся начальной школы о профилактике и преодолении школьной неуспешности учащихся

<p>We present the results of a qualitative research of the perceptions, attitudes, experiences of teachers and parents of elementary school students on the practices used to overcome school failure. We comapred these practices with the recommended methods that have been shown to be effective in various studies. The sample consisted of 35 female informants living in big cities, regional centers, districts, and rural areas, with different levels of education: 20 teachers (M=38) and 15 parents (M=29) of primary school-aged children were recruited for this study. We gathered information by in-depth interview method, teachers and parents shared their views on the methods which help to overcome and prevent school failure in the context of elementary school. Collected interviews were studied using the method of content analysis and comparison of the obtained data by using the coding technique (A. Strauss and J. Corbin). The date revealed the attitudes of teachers and parents about the concept of school failure, reasons for its occurrence and ways to overcome it, we compared the results with the results of national and international researches on this topic. Summarizing the results of the study, we can conclude that, in general, teachers and parents use school failure overcoming strategies according to their own experience, intuition and sometimes use tools and approaches described in scientific studies. The results of this study can be used for building strategies of interaction between schools and families and for planning professional development of teachers.</p>

A Descriptive Study on- Scope of Space Research for Start-up With Reference to Indian Space Research Opportunities

The space research scene in India is on the rise, and this study takes a closer look at what's happening. We explore how big the space research market is, what's making it grow, and who the key players are. In India, space research is booming thanks to cool projects and better technology. We check out the main players, from new start-ups to the big research centres, and see how they're making their mark in this busy space. The city is home to lots of space research spots, each doing different things like making satellites and exploring outer space. We look at the city's tech strengths and skilled pros, predicting that India is all set for more growth and cool stuff in space research. This study gives you a peek into what's happening now and what's in store for India as it becomes a major player in India's space exploration dreams.

Methods for Ensuring Quality and Protecting Patients: A Comparative Longitudinal Analysis

Objective: To find out if the actions taken have an effect on the results on quality assurance and safety culture in a healthcare company. Setting: Health insurance for accidents and illnesses that happen at work. Methods: The research looked at the link between Safety Culture and Quality Assurance measurements over time. It was a longitudinal observational study. People who took part came from small centers with less than eight employees (N = 52), big centers with eight or more employees (N = 707), and centers with quality managers (N = 91). Things were gathered between 2015 and 2016. Results: In 2015, 595 health care workers answered, and in 2016, 491 did. Good progress was seen in both Quality Assurance (T-test = 3.5, p = 0.001) and Safety Culture (T-test = 5.6, p < 0.0001). Because of this, the quality culture improved more quickly (by an average of 5.5%) than the safety culture did (2.1%). Conclusions: The reviews of the quality assurance goals and the reviews of the safety mindset were in line with each other. Because of this, the Safety Culture scores were seen to stay the same over time.

Cosmologic Representations on the Late Antique Mosaics from Bulgaria

The article traces the cosmologic structure and its separate components, reflected on the Late Antique mosaic pavements from the ancient provinces of present-day Bulgaria. Distinguished are three basic historical periods of development. The observations reveal that these lands were receiving ready cosmogonic structure’s schemes after the act of cosmogony from the big artistic centers of Italy, Greece, Asia Minor and North Africa. For several reasons, the cosmologic structure and the components of the Late Antique mosaic pavements from Bulgaria are not full, but limited and adapted, with many missing figural representations in the mosaic pavements and the tomb wall paintings, differently to the Western and the Eastern Mediterranean. This is considered a kind of proto-iconoclasm, due to the influence of heresies and the concrete historical, religious and artistic development. The joyful picture of the Christian Universe changes and disintegrates after the Justinianic period, and the previous Order and Harmony, including the place of each sphere and cosmologic element, is already not fixed, but in free mixture with other figural and symbolic images. The old cosmologic picture comes to its logical end and is replaced by a new one after the beginning of 7th century.

Artificial Intelligence: A Ray of Hope for a Sustainable Future

Abstract: Artificial intelligence (AI) has a significant impact on the global economy. From eradicating hunger and poverty to establishing sustainable energy and gender equality, AI plays a crucial role in achieving environmental sustainability. Artificial intelligence is undeniably the best course of action for the protection and preservation of biodiversity. The rapid development of artificial intelligence and its wide-ranging effects on numerous industries call for an assessment of how these factors will affect the achievement of the Sustainable Development Goals (SDGs). The three subcategories of the SDGs are society, economics, and the environment. AI is used in a variety of environmental fields, including waste management, pollution control, agriculture, energy management, wildlife preservation, and natural resource conservation. In the long run, AI will assist energy systems that are more energy efficient and have a low carbon footprint, which is necessary to combat climate change. AI can assist in properly regulating the intricate ecosystem's structure and activities. In addition to the aforementioned uses, it can aid in decision-making and environmental planning by spotting trends in desertification across vast areas. Due to the development of numerous new technologies, AI can now be used in nations with diverse cultural values and economic statuses. The technique has become more well-known as a result, worldwide. Advanced AI-based product design, technology, and research may need a lot of computer power, which can be provided by big data centres. Such facilities have a significant carbon footprint and a high energy need. Although this kind of resource abuse has not been extensively reported, AI-based ecosystem knowledge may lead to resource exploitation.

EARLY MENTAL HEALTH SELF-DETECTION USING SMART-SENYUM APPLICATION

Mental health is a state of mental well-being that enables people to cope with stresses, develop their capabilities, perform well in school or work settings, and contribute to their communities. However, mental health problems among adolescents and early adults are high, with an estimated 12 million cases worldwide. Not to mention that access to mental health professionals is still limited, as they are generally only available in big hospitals or health centers. Thus, mental health understanding and access to mental health professionals are major problems. The aim of this study was to examine adolescents’ understanding of mental health and develop a mental help self-screening assessment tool based on the Smart-Senyum application. The mental health self-screening application was adapted from the Self-Report Questionnaire, which was translated into Indonesian and validated for the adolescent age group in Indonesia. The population and sample of this study were adolescents aged 15 – 18 years (N = 36; M-age =16.3), who were students of the learning center Sanggar Kegiatan Belajar (SKB) 26 Bintaro, West Jakarta. The results showed that there was an increase in 5-pointers in understanding mental health. It was also found that 40% of the students showed symptoms of non-psychotic mental problems and 60% of the students were in a mentally healthy condition. The conclusion of the study, that early screening youth mental health is important and need further research as program implementation to prevent mental disorder

Mobile Money Services and the Income-Earning of Women Second-hand Cloth Entrepreneurs in Dodoma City

The diffusion of mobile money technology has changed the financial landscape across countries in Sub–Saharan Africa, including Tanzania. Women entrepreneurs can use mobile money services to improve business performance by increasing income earning. The study adopted a capability approach to investigate the effect of mobile money services on the income-earning of women’s second-hand cloth entrepreneurs in Dodoma City. Triangulation mixed method was used to collect both qualitative and quantitative data from Sabasaba and Machinga complexes as big market centers. The research surveyed a total of 50 women second-hand cloth entrepreneurs and interviewed 15 key informants. The quantitative data were analyzed by using both descriptive and inferential statistics with the aid of SPSS while qualitative data used content analysis. The result revealed a significant relationship between mobile money saving and the income-earning of women second-hand cloth entrepreneurs. The findings further show that entrepreneurs use informal help groups for borrowing and bank services transactions as coping strategies for solving the challenges of using mobile money services for income earning. The study recommends the collaboration between regulators, entrepreneurs, and private stakeholders to solve challenges that hinder business efforts of increasing income by using mobile money services.

Deindustrialization, Tertiarization and Suburbanization in Central and Eastern Europe. Lessons Learned from Bucharest City, Romania

This paper intends to delve deeply into the current understanding of the ways in which the transition from a central-based economy to an economy relying on free competition has led to changes in the big urban centers, bringing about a change in the relationships with the suburban areas. The authors take into account the high population density, the lack of space, and the elevated price of land within the big cities, which leads to urban functions migrating beyond the administrative boundaries, thus favoring the process of suburbanization. Given the context, commercial forces shift, migrating from the center to the urban peripheries or even outside them. This research is based on a comprehensive process of participative investigation (2012–2022) in Bucharest, Romania’s capital city. The research relies on field investigation, statistical and quantitative analyses and bibliographical sources. The conclusions rely primarily on the idea that political changes cannot be separated from economic, cultural and environmental ones, highlighting globalizing flows and the development of big cities. Industrial activities, strongly developed within a central-based economy, have significantly declined, which is partly compensated for by the development of the tertiary sector and, in particular, of commercial services leading to a functional reconversion of the urban peripheries and of suburban areas. The conclusions suggest that it is very important to be highly careful regarding the dilemmas and challenges ensuing from uncontrolled urban growth; therefore, several measures of urban planning should be taken with a view to achieving a better cooperation between urban stakeholders and those from the metropolitan areas so as to attain some common objectives in infrastructure in order to reach an integrated regional development.

APPRAISAL OF LIVESTOCK FARMING SYSTEM IN PERIURBAN AREAS OF FAISALABAD-PUNJAB

Local governments in big cities of the Punjab (Pakistan) have moved animals out of cities in order to avoid severe difficulties of congestion, hygiene, safety and traffic. This move resulted in development of dairy colonies in the peri-urban areas of big urban centers. Peri-urban dairy colonies provide an important link between peripheries of big cities and urban centers through provision of milk and meat. This important peri-urban production system needs to be studied in detail in terms of collecting basic data about its economic viability, ascertaining major constraints and suggesting policy options for its improvement. Keeping the above in view, the present research investigated peri-urban dairy production system in third largest city of Pakistan i.e., Faisalabad during the year 2021. About sixty respondents from seven different peripheries of Faisalabad were chosen purposively and interviewed. The data collected from peri-urban milk producers was analyzed using descriptive statistics such as frequency distribution, percentages, averages, mean values and cross-tabulation. The study revealed that net income from livestock farming on overall basis was Rs.1108 per day while net income on farm size categories wise were Rs. 170, Rs. 910 and Rs. 2005 for small, medium and large livestock owners respectively. Major proportion of farmers (about 38 percent) from all three categories consider ed costly inputs as a major issue in peri-urban livestock farming followed by poor veterinary services (about 16 percent). Peri-urban dairy production system needs improvement in the form of various key factors such as proper feeding, availability of quality veterinary services, improved marketing of milk etc.

Development and validation of a deep learning-based model to distinguish acetabular fractures on pelvic anteroposterior radiographs.

Objective: To develop and test a deep learning (DL) model to distinguish acetabular fractures (AFs) on pelvic anteroposterior radiographs (PARs) and compare its performance to that of clinicians. Materials and methods: A total of 1,120 patients from a big level-I trauma center were enrolled and allocated at a 3:1 ratio for the DL model's development and internal test. Another 86 patients from two independent hospitals were collected for external validation. A DL model for identifying AFs was constructed based on DenseNet. AFs were classified into types A, B, and C according to the three-column classification theory. Ten clinicians were recruited for AF detection. A potential misdiagnosed case (PMC) was defined based on clinicians' detection results. The detection performance of the clinicians and DL model were evaluated and compared. The detection performance of different subtypes using DL was assessed using the area under the receiver operating characteristic curve (AUC). Results: The means of 10 clinicians' sensitivity, specificity, and accuracy to identify AFs were 0.750/0.735, 0.909/0.909, and 0.829/0.822, in the internal test/external validation set, respectively. The sensitivity, specificity, and accuracy of the DL detection model were 0.926/0.872, 0.978/0.988, and 0.952/0.930, respectively. The DL model identified type A fractures with an AUC of 0.963 [95% confidence interval (CI): 0.927-0.985]/0.950 (95% CI: 0.867-0.989); type B fractures with an AUC of 0.991 (95% CI: 0.967-0.999)/0.989 (95% CI: 0.930-1.000); and type C fractures with an AUC of 1.000 (95% CI: 0.975-1.000)/1.000 (95% CI: 0.897-1.000) in the test/validation set. The DL model correctly recognized 56.5% (26/46) of PMCs. Conclusion: A DL model for distinguishing AFs on PARs is feasible. In this study, the DL model achieved a diagnostic performance comparable to or even superior to that of clinicians.

Factors associated with low utilisation of cervical cancer screening among urban women in Lilongwe, Malawi: a cross sectional study

BackgroundIn 2012, more than half a million women (528,000) were diagnosed with cervical cancer around the world. More than 80% of cervical cancer occurs in developing nations, such as Malawi, where estimates of the disease’s burden show an incidence of 75.9 per 100,000 women and a mortality rate of 49.8 per 100,000 women (both age-adjusted). Despite its case fatality rate, cervical cancer can be avoided through immunization, early detection and screening. Malawi however, has low immunization and screening rates with coverage as low as 9% and 15%, respectively. Here our aim is to uncover factors that contribute to low utilization of cervical cancer screening services among women in Lilongwe, a large urban center.MethodsThis was a qualitative cross-sectional study. Participants were chosen at random from a big metropolitan health center. In-depth interviews and two observations were undertaken by the researchers. Interviews were taped, transcribed verbatim, and content assessed.ResultsA total of 24 women and 5 health workers, with an average age of 34.8 years, were questioned. 50% of women had completed secondary school, 33.3% had completed primary school, and 4% had completed no formal education. The majority of the women were housewives and entrepreneurs. 62.5% of the respondents had fewer than four children, 25% had four to six children, and 8.3% had more than six children. 91 − 6% of those surveyed were married, with 78% of Christians and 20% of Muslims. The majority of women were unaware of the importance of cervical cancer screening. Some people were concerned about marital troubles, pain during the process, “laziness,“ and the amount of time necessary. The majority of people would come for a test as a result of signs and symptoms. Male health personnel would be unable to screen Muslim women. All of the medical personnel had at least two years of experience. Women’s low involvement in cervical cancer screening has been linked by health workers to a lack of resources and a lack of community awareness.ConclusionCervical cancer can be prevented by early detection and treatment. Women, on the other hand, are uninformed about cervical cancer. Myths, misconceptions, cultural and religious beliefs, as well as service restrictions and community sensitization, influence the use of cervical cancer screening services. Addressing these issues has the potential to boost cervical cancer screening rates.

Learning through play or learning sexism through play? Why critical gender literacy matters in kindergarten education

ABSTRACT Play is a highly valued pedagogy in early learning settings around the world. Supporters of play have emphasised the benefits of this approach in promoting children’s development and learning and their alleged freedom to choose, explore, and follow their interests. Feminist research, however, has shown that play contexts can be key sites that perpetuate gender inequalities. Building on this scholarship, I apply a critical feminist lens to examine the gendered effects of a recent shift in a Canadian province towards full-day play-based learning in kindergarten. Analysis of ethnographic data collected in two classrooms reveals that not all children may benefit from play-based learning. Instead, the findings show that the play settings in this study implicitly propagated patriarchal values that upheld hierarchal gender divisions and legitimized sexist practices among children in play. Specifically, in this paper I examine the subordination of girls through role allocations in the big blocks center. Given these findings, I discuss the need for critical gender literacy and transformative action among early education stakeholders.

Impact of Mining and Ore Processing on Soil, Drainage and Vegetation in the Zambian Copperbelt Mining Districts: A Review

The regional environmental–geochemical surveying of the long-term impacts of mining and ore processing on a large part of the Zambian Copperbelt mining district was carried out by the Czech Research Group with cooperation of the Geology Department, University of Zambia, and the Geological Survey of Zambia in the period 2002–2018. This included the characterization of various sources of contamination, the extent of contamination of soils and crops, and the degree of contamination of river water and sediments. Solid speciation studies of potentially harmful chemical elements (PHEs), plant and human bioaccessibility studies, and a range of mineralogical techniques were used to assess the pathways of PHE cycling in terrestrial and aqueous systems and their impacts on human health. Ores of the Zambian Copperbelt mining district are mined for Cu and Co, but a number of other trace elements (Pb, As, Cd, Hg, Pb, Zn) gradually accumulated in soils and stream sediments. It was concluded that the most important problems related to ore mining and processing are the contamination of soil and crops due to dust fall out from tailing facilities and emissions from smelters. Moreover, leakages of solutions from tailing dams, insufficient technological control of their stability and breakdowns on pipelines transporting slurry from treatment plants to tailing impoundments cause contamination of water courses and deposition of metal(loids) in stream sediments. However, the contamination of the Kafue River water is relatively limited due to its high neutralization capacity. In contrast, in some Kafue River tributaries, especially those close to big mining centers, the concentrations of dissolved Cu and Co are high (up to 14,752 μg/L and 1917 μg/L) and exceed Zambian effluent limits. We also recommend measures that could contribute to minimizing the impact of ore mining and processing on the environment and the health of the local population.

Social stigma of people with mental disorders and attitude to psychiatric treatment in Polish society

Introduction People with mental disorders (MD) may experience social stigma in various spheres of their lives. This phenomenon is based on negative social beliefs and hostile perceptions about mental disorders. Stigma may lead to social exclusion and discrimination (unjust treatment compared to people without MD). It may also result in resistance to using professional medical help (psychiatrist, psychotherapist) by people who experience symptoms of MD. Objectives The study aims to analyze the attitude of Polish society toward people with mental disorders and the attitude toward psychiatric treatment. The study investigates the correlation between the abovementioned attitudes and socioeconomic parameters of the respondents. Methods The study was conducted on a group of 1,230 respondents with the anonymous, authorial questionnaire disseminated by the CAWI technique. The questionnaire consisted of 10 single-choice questions concerned with the socioeconomic parameters of the respondents (age, place of residence, education, gender) and their attitudes toward mental health problems. The chi-square test and Kendall’s tau-b correlation coefficient (τb) were used to analyze the correlations between the above parameters (with p<0,05). Results Over 33% of respondents believes that people with MD are more aggressive than people who do not present this type of disorder. In turn, 16.4% of respondents admitted that they would feel uncomfortable in the presence of a person with mental disorders. There was no statistically significant correlation between the above beliefs and any socioeconomic parameter. Every tenth respondent would not hire a person with MD. Resistance to employment increased with the respondents’ age and level of education, whereas it decreased with the population of respondents’ domiciles. More than 17% of respondents would feel resistance to contacting with psychiatrist, and 4.1% of them already hide the fact of treatment from their family. The resistance to using psychiatric help was higher in villages and smaller towns than in bigger centers. Conclusions The study shows negative attitudes towards people with MD are still relatively frequent in Polish society. The stereotypical perception of this group of entities is generally not dependent on any analyzed socioeconomic parameter. Such correlations exist only in some areas (employment). Because of the negative perception of MD, some people who struggle with these problems do not use a psychiatrist’s professional help. In effect, these entities remain undiagnosed and untreated. Treatment delay may lead to exacerbating symptoms, prolong treatment time (including the necessity of hospitalization), and increase its cost. Reducing the stigma is necessary for counteracting discrimination against people with mental disorders and improving the mental health condition of Polish society. It requires educational activities and appropriate legal regulations. Disclosure of Interest None Declared

Fortaleza: The emergence of a network hub

Digitalisation, accelerated by the pandemic, has brought the opportunity for companies to expand their businesses beyond their geographic location and has considerably affected networks around the world. Cloud services have a better acceptance nowadays, and it is foreseen that this industry will grow exponentially in the following years. With more distributed networks that need to support customers in different locations, the model of one-single server in big financial centres has become outdated and companies tend to look for alternatives that will meet their needs, and this seems to be the case with Fortaleza, in Brazil. With several submarine cables connections available, the city has stood out as a possible hub to different regions, and this is what this paper explores. Making use of real traffic data through looking glasses, we established a latency classification that ranges from exceptionally low to high and analysed 800 latencies from Roubaix, Fortaleza and Sao Paulo to Miami, Mexico City, Frankfurt, Paris, Milan, Prague, Sao Paulo, Santiago, Buenos Aires and Luanda. We found that non-developed countries have a big dependence on the United States to route Internet traffic. Despite this, Fortaleza proves to be an alternative for serving different regions with relatively low latencies.

JUSTICE IN THE IMPLEMENTATION OF NATIONAL HEALTH INSURANCE IN INDONESIA

This article provides an analysis of the implementation of the National Health Insurance (JKN) based on the Law of the Republic of Indonesia Number 40 of 2004 concerning the National Social Security System. In the implementation of the National Health Insurance, which is part of social security, only provides guarantees to the poor, this is contrary to the purpose of the establishment of social security legislation which guarantees to provide Jamian to all Indonesian citizens without being based on the social, cultural and economic conditions of citizens which causes injustice because it is contrary to the constitution of the republic of Indonesia. Another fact that can be observed is the gap in health facilities and health resources between provinces, districts/cities. The number of doctors who are only scattered in big cities, hospital facilities and health centres between the island of Java and eastern Indonesia which creates a very large gap and is very influential in health services. People in cities and on the island of Java can enjoy all the benefits of health insurance, this is inversely proportional to JKN participants on the islands, especially those in eastern Indonesia.