Mac Version Research Articles

Cytotoxicity test of Bovine Gelatin- based hydrogel with Hibiscus rosa-sinensis L. leaf extract in topical drug development

Introduction: Herbal drugs have healing properties to prevent and treat various health conditions, including topical treatments, which contain therapeutic active ingredients like Hibiscus rosa-sinensis L. leaf extract combined with a carrier substance such as bovine gelatin hydrogel. Hibiscus rosa-sinensis L. extract also exhibits other pharmacological effects including antioxidant, antibacterial, antifungal, anti- inflammatory, antidiabetic, and anticancer properties. Bovine gelatin-based hydrogels have non-immunogenic properties derived from natural materials, with controlled drug release, as well as good biodegradability and biocompatibility, making them non-toxic. The combination of bovine gelatin hydrogel with Hibiscus rosa-sinensis L. leaf extract has been studied to develop a new topical drug. This research focuses on assessing the safety of this combination through cytotoxicity testing. Materials and Methods: This in vitro experimental study, utilized a post-test only control group design. The control group utilizes a bovine gelatin-based hydrogel, while the treatment group uses the same hydrogel combined with Hibiscus rosa-sinensis L. leaf extract on BHK-21 fibroblast cell cultures. Preclinical testing using the MTT assay served as a cytotoxicity test to validate the safety of this topical drug. Comparative study using a T-test with a significance level of p<0.05. Data analysis was carried out using Statistical Product and Service Solution (SPSS) Software for Mac version 29. Results: The cytotoxicity test results for bovine gelatin hydrogel and the combination with the extract of Hibiscus rosa-sinensis L. leaves were shown in the percentage of viable cells of 92.3% and 96.4%. The parametric T-test revealed no significant difference between the two groups (p = 0.754). Conclusions: The combination of bovine gelatin hydrogel with the extract of Hibiscus rosa-sinensis L. leaves in the development of herbal drugs are non-toxic

Italian research on anterior cruciate ligament: a bibliometric analysis.

This study analysed thetrend of publications on anterior cruciate ligament(ACL) in Italy. It was hypothesised that publications on this topic have quickly increased in recent years due to increased knowledge of both clinical and radiological pathology. PubMed and Scopus were accessed on 29/11/2023. This retrieved 838 articles from PubMed and 1050 from Scopus. We analysed the top 10 authors, and journals in publication numbers, citation numbers, and citations per year. We have also looked at the top 10 institutions publishing on anterior cruciate ligament from Scopus as PubMed does not give this information in the output. Data mining was performed using the Orange software, Mac version 3.32.0 ( https://orangedatamining.com/ ) from the titles of all articles. A word cloud analysis of titles, authors, journals and universities was performed. The peak of citations was in 2017 with 1529, whilst the peak of publications was in 2019 with 59 articles published. Analysing the number of publications and citations for the journal, the most impacted journal is Knee Surgery, Sports Traumatology, Arthroscopy with 5472 citations and 183 articles, followed by The American Journal of Sports Medicine, with 2722 citations and 56 articles and Arthroscopy with 1990 citations and 62 articles. Considering also international collaborations, the most cited author is Della Villa F. in 2020 with 43.67 citationsper year.The Italian author with the major number of publications is Zaffagnini S. with 39 articles, whilst the author with the higher number of citations is Aglietti P. with 1612 citations. ACL reconstruction has gained growing interest amongst the scientific community. Publications and citations presented a rising trend, the majority of the highly cited papers were contributed by few centres, and clinical trials were the most cited study designs. The long-term outcomes of ACL lesions have attracted interest. The authors hypothesised that shortly there will be an increase in articles analysing the results of ACL revisions, the use of lateral extra-articular tenodesis, and meniscus transplants. Cross-Sectional Study.

Effect Of Job Analysis, Competency, And Compensation On Employee Performance


 This study aims to determine and analyze the effect of job analysis, competency, and compensation on employee performance of Bureau of Organization and Governance Ministry of Finance. The population of this study were all employees of the Bureau of Organization and Management. The independent variables in this study are job analysis, competence, and compensation, while the dependent variable in this study is employee performance. This study uses a descriptive method with a quantitative approach. The sampling technique used is saturated sampling with a total of 55 employees. Sources of data obtained from the results of the distribution of questionnaires with the analytical technique used is multiple linear regression analysis with the help of the SPSS for mac version 28 statistical program. The results show that (1) Position Analysis has a negative and significant effect on employee performance; (2) Competence has a positive and significant effect on employee performance; (3) Compensation has a positive and significant effect on employee performance

Trends of Publications on Single- and Double-Bundle ACL Reconstructions over the Last 20 Years: A Bibliometric Analysis of the PubMed Literature

PurposeTo improve the clinical outcomes of anterior cruciate ligament reconstruction (ACLR), there have been attempts to reproduce anatomic reconstruction by modifying the single-bundle (SB) and double-bundle (DB) techniques. Although DB ACLR restores better rotational control compared to SB ACLR, it is still debatable whether there are higher clinical outcomes in favor of DB ACLR. We aimed to study the trends of publications on SB and DB ACLR techniques over the last 20 years.MethodsFor this bibliometric study, we performed a PubMed search on 31/05/2022 with a well-defined search strategy. The articles were downloaded into Excel software, and citations were determined from the iCite website for PubMed. The analysis was performed using SPSS software version 28.0.1. Data mining was performed using Orange software, Mac version 3.32.0, from the titles of all articles and each group of SB and DB ACLR. The output is presented as word clouds.ResultsA total of 10,530 publications were identified, of which 9699 publications (92.1%) pertained to SB-ACLR and 831 publications (7.9%) to DB-ACLR. There was a steady increase in the publications on SB-ACLR until 2012, followed by a steep increase that peaked in 2021. The highest number of publications on DB-ACLR was in 2012 (n = 76; 9.1%). The mean citations per year for SB-ACLR and DB-ACLR were 2.87 ± 4.31 and 2.74 ± 3.17, respectively. The most prolific journals publishing on this topic were Knee Surgery Sports Traumatology Arthroscopy, American Journal of Sports Medicine, and Arthroscopy. The top three articles that received the maximum number of citations were from Japanese authors.ConclusionThe number of publications related to SB-ACLR was significantly higher than that related to DB-ACLR in the last 20 years. The publications related to DB-ACLR have decreased in the recent past, after reaching a peak in 2012. The citations per year of SB-ACLR and DB-ACLR were similar.

Treatment of Acute Diarrhea in Children Aged 1–5 Years Provided by Doctors in Surabaya

Highlights: 1. The focus of this study was on the treatment methods for acute diarrhea, which have not been extensively investigated in the region studied.2. This study can provide an overview of doctors' adherence to the available guidelines for the treatment of acute diarrhea in children aged 1–5 years in Surabaya, Indonesia. Abstract: Diarrhea is the second leading cause of death among children under five, following pneumonia. Insufficient knowledge of diarrhea and dehydration management may contribute to this high mortality rate. Implementing prompt and effective management and prevention strategies has the potential to decrease morbidity and mortality associated with diarrhea. Therefore, this cross-sectional study aimed to investigate the treatment methods used by doctors for children aged 1–5 suffering from acute diarrhea in Surabaya, Indonesia. Data were collected from doctors in Surabaya using an online form containing case-based questions. Microsoft Excel for Mac version 16.17 (Microsoft Inc., Redmont, WA, USA) was used to process the binary data by calculating frequencies and percentages with a point estimate of 95% confidence interval (CI). A descriptive method was used in the data analysis, and the findings were presented in tables. From a total of 51 respondents who participated in this study, 18 (35.29%) only administered oral rehydration therapy. In addition, 49 respondents (96.08%) prescribed zinc supplementation for ten days, while 10 respondents (19.61%) opted for antibiotics. Interestingly, 49 respondents (96.08%) recommended both breast milk and food for the patients, and nearly all respondents provided guidance to the mother or caregiver of the patient. The findings of this study suggested that the respondents primarily used rehydration therapy to treat children suffering from acute diarrhea with moderate dehydration. However, some respondents still relied on antibiotics despite the available recommendations to use oral rehydration therapy. Nearly all respondents agreed on zinc supplementation, breast milk and food provision, and advice for the mother or caregiver of the patient. While certain aspects of the disease management for diarrhea align with the recommended guidelines, there is room for improvement in promoting the exclusive use of oral rehydration therapy and reducing unnecessary antibiotic prescriptions.

Does dental rehabilitation under general anaesthetic contribute to the development of temporomandibular disorders in children and adolescents? A scoping review.

Temporomandibular disorders (TMDs) have multiple aetiological factors. Although some evidence suggests invasive and lengthy dental procedures may contribute towards TMD development, there is a relative paucity in the literature regarding an association between elements of paediatric dental general anaesthesia (pDGA) and TMDs. This review aims to consider the impact of dental rehabilitation (and its constituent elements) performed under general anaesthesia on the development of TMDs in childhood and adolescence and identify theories and/or gaps in knowledge which may benefit from future research. Due to the need to preliminarily examine the nature and extent of the current evidence base, a scoping review approach was chosen. The review was conducted based on the framework provided by the methodological working group of the Joanna Briggs Institute (JBI) for conducting systematic scoping reviews. Electronic databases MEDLINE, Embase, Scopus, Web of Science and Cochrane Library were searched as well as the grey literature using OpenGrey, Nexis, Ethos, Google Scholar and ProQuest, with eligible studies uploaded onto Zotero (Mac Version 5.0.96.2). A total of 810 records were identified. After removing duplicates and those not available in English, 260 were identified for title and abstract screening. Seventy-six records underwent full-text review of which only one met the broad inclusion criteria. The most common reasons for exclusion were no specific relation to general anaesthesia, not specifically relating to dental treatment and only being concerned with TMD management. The included study found that while development of TMDs following dental rehabilitation under GA did occur in children, whether the problems caused by treatment were exacerbated by other elements of the pDGA process remains unknown. This review has confirmed a distinct paucity of research in this field. While there is no current tangible scientific evidence that common and routine dental procedures lead to TMD, the literature shows that alterations to any one or a combination of critical factors can contribute to TMD development, which may be collectively exacerbated by iatrogenic macrotrauma during the pDGA process. We have highlighted elements of pre-, peri- and post-operative pDGA, alongside biopsychosocial factors, which may contribute to TMD development in childhood and adolescence and may benefit from future research.

Surgical treatment of Crohn's disease: the risk of complications

Aim: assessment of the impact of biological therapy on risk factors for postoperative complications. Materials and methods: the study included 116 patients operated on for Crohn's disease. The mean age of the patients was 38.2 years, among them 65 men (56 %) and 51 women (44 %). The influence of various factors on complications in the postoperative period was analyzed using the IBM-SPSS software for Mac version 22.0 and Microsoft Excel 1997-2003. Results: 32.7 % of the patients received biological therapy, and postoperative complications developed in 31 % of the operated patients. There was no association between receiving biological therapy and the risk of postoperative complications. The risk factor was the formation of a stoma and surgery for emergency indications. Conclusion: an important task before surgical treatment for Crohn's disease is a thorough preoperative preparation and assessment of all risk factors for complications of surgical intervention by a multidisciplinary team.

Increasing Efficiency in Addressing Patient Portal Messaging Demands on Healthcare Systems (P6-7.006)

<h3>Objective:</h3> To evaluate healthcare value of messaging through patient portals based on the relationship of maximum patient message length versus content communicated. <h3>Background:</h3> Patient portals are designed to empower individuals to be partners in their care and reduce administrative burdens. Overall adoption has been positive with studies demonstrating improvement in outcomes with increased use. However, recent studies have shown that high volume of messages increases physician workload and contributes to burnout. Specifically, length of the message has been described as a contributing factor. Here we evaluate a database of messages to determine key descriptive statistics towards identifying methods to increase efficiency in addressing messaging demands. <h3>Design/Methods:</h3> Retrospective review of patient portal messages through the Epic MyChart platform from January 1 to June 30, 2022 at a single large academic outpatient neurology clinic (general &amp; subspecialities). Message character length was obtained through a basic character count using Microsoft Excel (MAC version 16.65). Descriptive statistics were calculated from the sample to derive insights on patterns. Through an optimization scenario - maximum message length was reduced in order to determine number of messages affected versus content reduced. <h3>Results:</h3> There were 10,118 messages from 2,646 patients. Length ranged from 1 to 1500 characters resulting in a total of 2,946,290 characters. Message length followed a decreasing exponential distribution, with majority of messages in lower character ranges. Quartiles from first to fourth were: 88, 202 (median), 386, and 1500 (max). Limiting character count to 750 characters, affected 807 (8%) messages. Reducing these messages to 750 characters decreased the overall character count by 11%. <h3>Conclusions:</h3> Patient portal messaging has become an important part of the patient-physician partnership. This analysis evaluated an optimization strategy of reducing character count in order to determine workload impact. Limiting maximum length to 750 characters led to a disproportionate reduction in workload compared to a smaller number of messages affected. <b>Disclosure:</b> An immediate family member of Dr. Gordon-Kundu has received personal compensation for serving as an employee of Ceretype . An immediate family member of Dr. Gordon-Kundu has received personal compensation in the range of $0-$499 for serving as a Consultant for Hyperfine. An immediate family member of Dr. Gordon-Kundu has stock in Hyperfine. Dr. Khokhar has nothing to disclose.

District-Level Patterns of Health Insurance Coverage and Out-of-Pocket Expenditure on Caesarean Section Deliveries in Public Health Facilities in India

Reducing catastrophic out-of-pocket expenditure (OOPE) and increasing the rates of institutional deliveries are part of the Sustainable Development Goals (SDGs). India has made significant progress on the maternal and child health front in recent years. India’s National Health Mission (NHM) has been able to increase rates of institutional deliveries. In the present study, we aim to ascertain district-level patterns of percentage of health insurance coverage in the National Family Health Surveys NFHS 4 and NFHS 5. We also aim to ascertain district-level patterns of out-of-pocket expenditure on C-section deliveries in public health facilities in NFHS 4 and NFHS 5. The present study explores district-level data associated with health insurance coverage (%) and out-of-pocket expenditure in a public health facility (in INR) observed across NFHS 4 and NFHS 5. A spatial analysis was carried out using QGIS 3.26 (Mac version) and GeoDA 1.20.0.8. A visual assessment of the maps across NFHS 4 and NFHS 5 shows improvement in insurance coverage at the district level across the two surveys. Despite an increase in insurance coverage, North East India has experienced an increase in OOPE for C-section deliveries. Rajasthan and various parts of South India have experienced a decrease in OOPE for C-section deliveries. Kerala has experienced a rise in insurance coverage and OOPE for C-section deliveries. Univariate LISA cluster and significance maps revealed that Kerala and Tamil Nadu, the eastern coast of India and parts of Mizoram are hot spots, whereas Jammu and Kashmir and parts of Uttar Pradesh and Gujarat are cold spots. Both these findings are significant. Rajasthan emerges as a significant hot spot along with parts of Assam and a few districts on the eastern coast of India in Tamil Nadu and Andhra Pradesh. Jammu and Kashmir, Ladakh, parts of Uttar Pradesh, Maharashtra, and Karnataka have emerged as significant cold spots. The South Indian states of Kerala and Tamil Nadu are no longer hot spots indicating geospatial variations across time. An increase in the number of hot spots across NFHS 4 and NFHS 5 indicates rising out-of-pocket expenditure for C-sections despite growth in health insurance coverage. The present study does not offer any evidence to suggest that health insurance coverage decreases OOPE on C-section deliveries at government facilities. With RSBY having been launched in 2008 and Ayushman Bharat in 2018, high levels of OOPE on C-section deliveries at government facilities raise serious concerns about the efficacy of PFHIs in reducing OOPE. The government would need to plug the well-documented weaknesses of PFHIs, such as fraud, double charging, poor enrolment, and lack of awareness in addition to the unfortunate phenomena of “tips” and “tie ups” mentioned earlier that plague the public healthcare system, if we are to see any reduction in OOPE in the foreseeable future.

Plasma marker ACTH, cortisol, and beta-endorphins profile on pregnant women as targeted marker of approach for antenatal depression

Background: Antenatal depression is a frequent mental disorder with much less attention, and most women remain undiagnosed. Altered hypothalamic-pituitary-adrenal (HPA)-axis function mediates maternal depressive symptoms and has been widely reported. The present research aimed to determine the plasma marker HPA-axis including Adrenocorticotropic hormone (ACTH), cortisol, and beta-endorphin, as a suitable representation of mental health in pregnancy by evaluating the psychometric properties. Methods: Therefore, we examined a case-control study of 216 Bontang pregnant women. Psychological measures were conducted during the 27th week of pregnancy, including the Patient Health Questionnaire-9 (PHQ-9) assessment and Depression Anxiety Stress Scale (DASS). Blood samples were collected for plasma ACTH, Cortisol, and beta-endorphins assay as a marker of the HPA axis profile. Data were analyzed Stata for Mac version 14 (StataCorp, USA). Results: our finding showed that DASS scores correlated with PHQ-9 (r=0.79), ACTH (r=0.22), and beta-endorphin (r=54). PHQ-9 score significantly related to ACTH (r=0.27), cortisol (r=0.36) and beta-endorphin (r=0.71). Women with the highest DASS score and PHQ-9 depression scores at 27 weeks of pregnancy had significantly lower baby birth weight (P=0.000) than those women whose stress improved to or normal state. Plasma ACTH, cortisol, and beta-endorphin concentrations were significantly higher in pregnant women with antenatal depression compared to normal pregnancy (p&lt;0.01). All effects remain without controlling unwanted pregnancy. Conclusion: Our study demonstrates a role for circulating ACTH in regulating maternal cortisol secretion and a significant correlation between the HPA-axis profile and antenatal depression at 27 weeks of pregnancy.

Associations of secretory activation breast milk biomarkers with breastfeeding outcome measures.

The objective of this study was to explore associations between day 10 postpartum (D10) secretory activation biomarkers and the breastfeeding outcome measures. This prospective longitudinal descriptive study collected antepartum, D10, and day 60 postpartum (D60) questionnaire data and D10 milk samples. Protein, lactose, and citrate were analyzed with enzymatic spectrophotometric assays. Sodium and potassium were analyzed with inductively coupled plasma optical emission spectrophotometry. Group comparison data were analyzed using χ2, Fisher exact, and independent sample t tests, as appropriate, using SPSS for Mac (version 28). Participants (n=92) provided a D10 breastmilk sample and completed D10 questionnaires, and 83 completed D60 questionnaires. Participants with D10 impaired secretory activation sodium (>23.0mM) were more likely to report D10 perceived insufficient milk supply, χ2=7.002, P<.05; and less D10 feeding/pumping frequency a day, P<.05; and partial breastfeeding at D60, P<.05. Additionally, participants with D10 impaired secretory activation sodium-to-potassium ratio (sodium: potassium)>0.8 were more likely to partially breastfeed at D60, P<.05. Elevated milk sodium and sodium: potassium are biomarkers related to variables indicative of low milk supply. Therefore, immediate milk testing can be useful in identifying lactation compromise and improving breastfeeding duration. Because breastfeeding affords maternal and infant health benefits, clinicians should identify ways to measure lactation compromise in conjunction with an examination and clinical history to provide early interventions to increase breastfeeding duration and exclusivity.

Machine driven classification of open-ended responses (MDCOR): An analytic framework and no-code, free software application to classify longitudinal and cross-sectional text responses in survey and social media research

Open-ended questions in survey research allow participants to respond freely using their own words. Because such questions offer the possibility of learning how or why respondents may have achieved a goal or behaved in certain ways, these responses can address some of the inherent limitations of quantitative research, which typically does not allow researchers to understand processes or reasons. But such knowledge-based benefits come at the cost of having to label text data into categories or codes to ease their comparison and reach meaningful understandings. Manually classifying open-ended responses is not only time consuming—potentially taking weeks or even months, depending on sample size—but also risks introducing human errors or inconsistencies that can reduce the contribution of these responses in strengthening our understandings. In this study, we discuss the unresolved issue of how to close open-ended responses as rigorously and efficiently as possible relying on machine learning and text classification techniques, without losing context nor the original voices of our research participants, and while leveraging the nuances that human reasoning brings to the qualitative and mixed methods analytic tables. To this end, we offer a rigorous, user-friendly, no-code, and cost-free software application that implements our mixed equal-status design analytic framework: machine driven classification of open-ended responses (MDCOR). To test the performance of MDCOR, we analyzed tens of thousands of open-ended responses from two different surveys—one publicly available and one federally-protected. In all instances, MDCOR consistently offered time-efficient and reliable results and even tested whether non-response was associated with respondents’ attributes. Among its multiple outputs, MDCOR allows researchers to access the fully classified responses that can then be used in traditional quantitative modeling. Since MDCOR runs locally, its versatility to handling cross-sectional and longitudinal responses, enables the analysis of a variety of data, from federally protected/restricted sources to the classification of social media posts. By removing manual classification burdens and computer programming expertise, MDCOR opens the possibility of efficiently and rigorously reaping the knowledge-based benefits of open-ended responses in survey research without losing or altering our participants’ voices. We offer access to the public data analyzed (https://cutt.ly/YNmBOAL or González Canché, 2022c) and the software (Mac version here https://cutt.ly/xv6nnuN, Windows version https://cutt.ly/Lv6nTLG, Code Ocean version at González Canché (2022f)) so that researchers can interact first-hand with MDCOR and start using this tool and analytic framework in their own studies (see also González Canché, 2022a, 2022b, 2022d, 2022e, for related no-code data science applications to analyze qualitative data dynamically).

Making the Case for Cross-Border Public Health Strategies: A comparativie Assessment of Covid-19 Epidemiological Trends in the Balkan Countries Across 17 Months

Introduction: COVID-19 spread globally, including across the Balkans, resulting in different morbidity and mortality outcomes in different countries. The aim of this study was to review the impact of COVID-19 over 17 months with regards to pandemic progression, implemented mitigation strategies, and COVID-19 vaccination programs across the Balkan countries, while identifying any valuable pieces of information acquired serendipitously throughout the pandemic that can be implemented in future action plans.&#x0D; Methods: A longitudinal ecological study was conducted across the Balkan countries from the onset of COVID-19 in these countries up until 1st August 2021. Epidemiological data was obtained from Our World in Data databases, while Ministry of Health websites for each respective country as well as local newspapers were utilized to review COVID-19-related mitigation and vaccination strategies. Comparisons of vaccination coverage, incident cases and mortality were made across neighboring countries, by converting the respective data to rates per 100,000 population for each country using Microsoft® Excel for mac (Version 16.59).&#x0D; Results: More than 10 million positive COVID-19 cases and 164,470 deaths were observed across the Balkan countries up until 1st August 2021. Trends in COVID morbidity and mortality outcomes were evident across neighbouring countries. A staggered vaccination rollout was observed, with various rollout speeds, although gradual decline in both morbidity and mortality occurred.&#x0D; Conclusion: Results obtained from this study strongly indicate that COVID-19 outcome for a particular country is not only dependent on the country’s own level of viral transmission, mitigations, and vaccination rates but also on neighbouring countries’ COVID-19 situation. Hence, cross-border governance action and recovery plans are recommended along with targeting vaccination hesitance.

P134 Produce Prescription Projects: Challenges, Solutions, and Emerging Best Practices - Perspectives from Health Care Providers Across the United States

<h3>Background</h3> Produce prescription programs (PPR) have become increasingly common to address the poor health outcomes associated with food insecurity and diet-related chronic disease. These programs involve "prescriptions" for fruits and vegetables within a routine medical visit for eligible individuals. Benefits of PPRs include increased fruit and vegetable purchasing and consumption, reduced household food insecurity, and improved clinical health outcomes. However, only a few regionally bound studies focus on experience of those health care providers (HCP) who make the ‘prescription.' <h3>Objective</h3> The purpose of this study is to explore HCP perspectives and experiences with PPRs funded by the United States Department of Agriculture Gus Schumacher Nutrition Incentive Program (USDA GusNIP). <h3>Study Design, Setting, Participants</h3> Multiple methods including descriptive survey (n = 34) followed by individual key-informant interviews. Interviewees were HCPs (n = 16) from across the United States recruited through USDA GusNIP PPR networks. Interviews were conducted via videoconference, recorded, and transcribed verbatim. <h3>Measurable Outcomes/Analysis</h3> Transcripts were coded using thematic qualitative analysis methods by three independent coders using Atlas.ti (Mac Version 8.1.1). <h3>Results</h3> Three cross-cutting key themes emerged. First, HCPs shared challenges of PPRs including: lack of time/staff, difficulty with provider and patient engagement, steep "trial and error" learning curve, and formidable barriers related to data sharing and research-related requirements (e.g., Institutional Review Board approval). Second, HCPs elucidated best practices/lessons learned (e.g., establishing a ‘program champion') as a response to the experienced challenges. Third, HCPs expressed robust program satisfaction and desire to expand sustainable PPRs. HCPs also provided a shared understanding of the need for rigorous program evaluation to establish sustained funding and policies, but contextualized this need with the aforementioned challenges with collecting and sharing patient-related data outcomes. <h3>Conclusions</h3> Findings provide emergent best practices and indicate what additional resources are needed to sustainably implement and rigorously evaluate PPRs. <h3>Funding</h3> USDA

Dyslipidemia in Patients with Xanthelasma Palpebrarum Visiting the Department of Dermatology of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Xanthelasma palpebrarum refers to lipid deposition that occurs on eyelids and inner canthi. It is an important cutaneous manifestation of hyperlipidemia, atherosclerosis and coronary artery disease. Few studies have been done in Nepal regarding lipid abnormality in xanthelasma patients. The aim of this study was to find out the prevalence of dyslipidemia among patients with xanthelasma palpebrarum visiting the Department of Dermatology of a tertiary care centre. This is a descriptive cross-sectional study conducted among 80 patients from January, 2021 to February, 2022 in the Department of Dermatology of a tertiary care centre. Ethical approval was taken from the Institutional Review Committee (Reference number: 60512021). Convenience sampling was used. Lipid profile analysis was done among patients with clinical diagnosis of xanthelasma palpabrarum. Data was collected using Microsoft Excel for Mac version 16.16.27 and analyzed using the Statistical Package for the Social Sciences version 22.0. Point estimate at 90% Confidence Interval was calculated along with frequency and proportion for binary data. Out of 80 patients with xanthelasma palpebrarum, the prevalence of dyslipidemia was 64 (80.00%) (74-86 at 90% Confidence Interval). Among them, 29 (45.31%) were males and 35 (54.69%) were females. In our study, the prevalence of dyslipidemia among patients with xanthelasma palpebrarum was found to be higher than in similar studies conducted in similar settings. dyslipidemia; gender; lipid.

PENGARUH KREDIBILITAS CELEBRITY ENDORSER, CITRA MEREK, DAN KUALITAS PRODUK TERHADAP KEPUTUSAN PEMBELIAN

In the current era of globalization, which is growing rapidly, it is the main attraction for local and foreign entrepreneurs to invest in the industrial sector, one of which is in the culinary industry in Indonesia which has an important role in economic growth in the country. This research aims to discover the effect of Celebrity Endorser’s Credibility, Brand Image, and Product Quality on Purchase Decision. The type of this research is the explanatory research which explains the relationship and influence between one variable and other through hypothesis testing. The samples of this research consist of 120 respondents. Furthermore, the respondents are the visitors and have been consume Geprek Bensu Malang City. Thus, this research uses a sampling technique with a non-probability sampling method. This research using multiple linear regression. The data were analyzed using SPSS (Statistic Product and Services Solution) for Mac version 24. The result of this research indicates that partially and simultaneously celebrity endorser’s credibility, brand image, and product quality have a significant effect on purchase decision.

Analysis of 87 Nephrectomies in a Tertiary Healthcare Center in Nigeria.

Nephrectomy is one of the most frequently performed operations on the kidney. It is necessary for treatment of malignant as well as some benign renal conditions. This was a five-year retrospective review of all adult patients who had open nephrectomy in Lagos University Teaching Hospital, Lagos, Nigeria between January 2014, and December 2019. The cases were traced using clinic, ward, and theatre records. The clinical and operative details of these patients were retrieved and analysed. Clinical information extracted included patients' demography, clinical presentations, diagnosis, procedures performed, complications and the immediate treatment outcome. Data were analysed using SPSS for Mac Version 25.0. Results were displayed in simple proportions using tables and charts. A total of 87 patients' records were available for review. Age range was15-76years with a mean and median age of 49.415 and 52 years, respectively. Majority, 73(83.9%) of the patients presented with at least one symptom, whereas14(17.7%) were asymptomatic. Loin pain was the commonest presentation in 72(82.8%). Indication for nephrectomy were benign in 28(32.2%) and malignant in 59(67.8%) patients. Overall, renal cell carcinoma was the most common indication for nephrectomy accounting for 59.8% of all nephrectomies. A total of thirty-one morbidities occurred in sixteen patients with a complication rate of 18.4% while transfusion rate was 40.2%. Reoperation and mortality rates were 2.3 and 3.4%, respectively. Malignant renal tumors are predominant indications for nephrectomy in our institution. Though associated with a high transfusion rate, open nephrectomy remains a safe procedure with a good short-term outcome.

OPTIMIZATION OF PRODUCTION AND BENEFITS OF USING LINEAR PROGRAMMING IN THE LINGGARJATI FURNITURE BUSINESS

Massive exploitation of natural forests and concentration in the plywood industry until the late 1980s caused Indonesia to currently experience a shortage of raw materials for the secondary (meuble) industry. Especially for teak, currently many furniture industries depend on the supply of sawn wood from the surrounding community forests. This study intends to determine the level of furniture production from PT. Linggarjati which relies on the sawn timber industry from the surrounding community forests in order to generate optimum profits. The secondary data used in this study were obtained from the company with interviews for data clarification which include, the production process, raw materials, supporting materials and implementation time related to each type of furniture produced. The analysis method uses Linear Programming with the help of ExcelQM software for Mac version 5.3. The constraint function used is teak wood raw material, various supporting materials for making furniture and labor hours. The results showed that only some types of furniture can be produced to provide optimal profit for Linggarjati furniture, among others; 3 three-door cabinets, 4 table sets with 6 chairs and 10 beds measuring 180 x 200 cm. From the combination of these products, it can produce an optimal profit of Rp. 33,518,275,- The results of this analysis show that the three types of furniture alone can provide a greater profit of 78.5% compared to producing and selling the 11 types of furniture that currently exist, the profit is only Rp. 18,776,693,- or with a difference of Rp. 14,741,582,-

Issues and Difficulties in Essay Writing When Learning Malay as a Second Language

This study aims to examine the difficulties encountered by non-native Malay speakers when writing Malay essays in primary school. Eight primary school teachers who taught Malay Language subjects were chosen to participate in the study. Participants must have led the Malay Language to level two students for at least five years. To this end, all study participants were randomly recruited from eight primary schools in the Semporna area of Sabah. The schools chosen as research locations have most kids who are not native Malay speakers (Bajau ethnic). The interview instruments are semi-structured, and the results are processed using the Atlas.ti 8.24 software (Mac version). The findings indicate that the most challenging Malay language skill for non-native speakers to learn is essay writing. Non-native speakers face difficulties with concept production, technical parts of essay writing, and limited vocabulary proficiency. Several critical points should be addressed. First, to address the issue of non-native speakers writing essays. Increasing students’ language proficiency encourages students to think and produce ideas and improves students’ command of the essay style and varieties of student essays. The data from this study are critical for students who are not native speakers of Malay to enhance their teaching and learning writing of Malay essays.

A Cross-sectional Survey on Dentist’s Knowledge and Attitude towards the Application of Arnica Montana in Dental Practice

Introduction: Postsurgical oedema (PSE) is a common complication encountered in the dental field following different surgical procedures including wisdom teeth extraction and other periodontal and implant surgeries. Arnica Montana (AM) is a homeopathic agent which may represent as a safe, effective and an alternative agent for Non Steroidal Anti-Inflammatory (NSAID) medications to prevent or decrease the risk of PSE. Aim: The aim of this study was to evaluate the knowledge of practicing dentists and their experiences using AM supplements in their daily practice for management of PSE. Materials and Methods: This was an observational, crosssectional self reported electronic based study to survey practicing dentists on the application of AM in daily dental practice conducted from January to September 2021. The electronic survey included 13 questions on: 1) dentist’s demographics and educational backgrounds; 2) knowledge related to AM supplement; and 3) previous experience, if any, with AM use for management of PSE. The survey was distributed to potential subjects and descriptive statistics was used to summarise the data, and presented as percentages and frequencies using Microsoft Excel for mac (Version 16.40). Results: A total of 84 subjects participated in the survey, out of which 23 (27.3%) were familiar with AM use in dentistry. Overall, 15 participants (65.2%) indicated preventions or reduction of PSE risk and pain and seven participants reported prevention and reduction of postsurgical discolouration and bleeding (30.4%) as potential indications for AM use. In total, eight participants (34.7%) have prescribed AM to patients before, mainly for external and internal sinus grafting (4/8; 50% for both) and surgical extraction of impacted teeth (2/8; 25%). Out of all, five participants (5/8; 62.5%) reported significant benefit with using AM following a surgical procedure and four participants (50%) reported numbness of the lips, altered taste sensation and increased bleeding as associated toxicities. Conclusion: From the present study the uses and user based experienced of the material AM in the field of dentistry can be well understood and analysed. This was the first survey to discuss the knowledge and application of AM among dentists from various specialties.