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Introduction: A textbook outcome patient is one in which the operative course passes uneventful, without complications, readmission or mortality. There is a lack of publications in terms of TO on acute cholecystitis. Objetive: The objective of this study is to analyze the achievement of TO in patients with urgent early cholecystectomy (UEC) for Acute Cholecystitis. and to identify which factors are related to achieving TO. Materials and methods: This is a post hoc study of the SPRiMACC study. It ́s a prospective multicenter observational study run by WSES. The criteria to define TO in urgent early cholecystectomy (TOUEC) were no 30-day mortality, no 30-day postoperative complications, no readmission within 30 days, and hospital stay ≤ 7 days (75th percentile), and full laparoscopic surgery. Patients who met all these conditions were taken as presenting a TOUEC. Outcomes: 1246 urgent early cholecystectomies for ACC were included. In all, 789 patients (63.3%) achieved all TOUEC parameters, while 457 (36.6%) failed to achieve one or more parameters and were considered non-TOUEC. The patients who achieved TOUEC were younger had significantly lower scores on all the risk scales analyzed. In the serological tests, TOUEC patients had lower values for in a lot of variables than non-TOUEC patients. The TOUEC group had lower rates of complicated cholecystitis. Considering operative time, a shorter duration was also associated with a higher probability of reaching TOUEC. Conclusion: Knowledge of the factors that influence the TOUEC can allow us to improve our results in terms of textbook outcome.

Alzheimers disease (AD) is a neurodegenerative disease that commonly causes dementia. Identifying biomarkers for the early detection of AD is an emerging need, as brain dysfunction begins two decades before the onset of clinical symptoms. To this end, we reanalyzed untargeted metabolomic mass spectrometry data from 905 patients enrolled in the AD Neuroimaging Initiative (ADNI) cohort using MS-DIAL, with 1,304,633 spectra of 39,108 unique biomolecules. Metabolic profiles of 93 hydrophilic metabolites were determined. Additionally, we integrated targeted lipidomic data (4873 samples from 1524 patients) to explore candidate biomarkers for predicting progressive mild cognitive impairment (pMCI) in patients diagnosed with AD within two years using the baseline metabolome. Patients with lower ergothioneine levels had a 12% higher rate of AD progression with the significance of P = 0.012 (Wald test). Furthermore, an increase in ganglioside (GM3) and decrease in plasmalogen lipids, many of which are associated with apolipoprotein E polymorphism, were confirmed in AD patients, and the higher levels of lysophosphatidylcholine (18:1) and GM3 d18:1/20:0 showed 19% and 17% higher rates of AD progression, respectively (Wald test: P = 3.9 × 10-8 and 4.3 × 10-7). Palmitoleamide, oleamide, diacylglycerols, and ether lipids were also identified as significantly altered metabolites at baseline in patients with pMCI. The integrated analysis of metabolites and genomics data showed that combining information on metabolites and genotypes enhances the predictive performance of AD progression, suggesting that metabolomics is essential to complement genomic data. In conclusion, the reanalysis of multiomics data provides new insights to detect early development of AD pathology and to partially understand metabolic changes in age-related onset of AD.

Objectives:Gender norms embedded in communities may restrict opportunities and harm the mental health of older adults, yet this phenomenon has received little attention. This study investigates the connection between older adults' perceptions of community gender norms and mental health and suicide-related outcomes.Design:Cross-sectional.Setting:This study analyzed data from the 2019 wave of the Japan Gerontological Evaluation Study.Participants:In total, 25,937 participants aged 65 years or older in 61 municipalities.Measurements:Perceptions of community gender norms were assessed by the respondents' perceptions of the gender-differentiating language used by those around them such as You should/should not do XXX, because you are a man/woman.Results:The prevalence of all mental health outcomes was higher among both men and women who perceived community gender norms as restrictive. These associations remained in fully adjusted multivariable analyses. Prevalence ratios for men were 1.36 [95% confidence interval: 1.13, 1.65] for psychological resistance to obtaining help, 1.85 [1.54, 2.23] for depressive symptoms, 1.99 [1.34, 2.96] for suicidal ideation, and 2.15 [1.21, 3.80] for suicide attempts. The corresponding figures for women were 1.39 [1.17, 1.65], 1.80 [1.55, 2.10], 2.13 [1.65, 2.74], 2.62 [1.78, 3.87]. There was a more pronounced association between perceiving community gender norms as restrictive and depressive symptoms and suicidal behaviors among those with nonconventional gender role attitudes compared to those with conventional attitudes.Conclusions:Considering the effects of community gender norms, in addition to individual gender role attitudes, may be critical in designing effective public health interventions for improving mental health.

Tujuan dari dilakukannya penelitian ini yaitu untuk menguji seberapa spesifiknya pengaruh dari profesionalisme kerja, kompetensi dan loyalitas kerja terhadap kinerja pegawai di LPD Di Kecamatan Buleleng. Penelitian ini menggunakan metode kuantitatif, jumlah sample pada penelitian ini sebanyak 101 pegawai yang dipilih menggunakan teknik sample jenuh. Teknik pengumpulan data menggunakan observasi, dokumentasi,dan angket/kuesioner dengan menggunakn skala likert 1-5. Teknik analisis data pada penelitian ini menggunakan aplikasi SPSS Versi 21.0 for windows. hasil Penelitian menunjukkan bahwa profesionalisme kerja, Kompetensi,  Loyalitas Kerja berpengaruh positif dan signifikan terhadap kinerja pegawai LPD di Kecamatan Buleleng.

This think about explores the part of inspiration in interceding the impact of administration, technology usage, and work discipline on employee performance. The research employs quantitative data collected from 58 employees at the Abiansemal District Office using a questionnaire. The data analysis was conducted using multiple linear regression with the PLS program. The comes about uncover that authority and innovation utilization emphatically influence representative execution, whereas work teach does not have a critical coordinate affect. However, inspiration is found to intercede the relationship between authority, innovation utilization, and worker execution. The findings of this study suggest that enhancing motivation can strengthen the positive effects of leadership and technology usage on performance, indicating the importance of motivational strategies in organizational management. These insights emphasize the necessity for managers to focus on creating a motivating work environment that supports effective leadership and the adoption of advanced technologies to drive employee performance and overall organizational success. This approach can lead to sustainable improvements and foster a culture of continuous development and innovation.

Background: This study to show about comparative effectiveness of regional anesthesia and nerve block techniques in reducing chronic post-surgical pain in adults undergoing inguinal hernia surgery. Methods: By the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. Result: Eight publications were found to be directly related to our ongoing systematic examination after a rigorous three-level screening approach. Subsequently, a comprehensive analysis of the complete text was conducted, and additional scrutiny was given to these articles. Conclusion: CPSP is a multifactorial and complex condition that can significantly affect the quality of life of patients undergoing surgery. General anesthesia plus ilioinguinal nerve block is better than spinal anesthesia (SA) regarding postoperative analgesia, time to mobilization and discharge, side-effect profile and satisfaction experienced by the patients. Regional block anesthesia (RBA) is superior to conventional spinal anesthesia (CSA) for pain relief at 24 hours post-surgery.

Latar Belakang: Penyakit tidak menular yang menjadi masalah kesehatan yang sangat serius saat ini adalah hipertensi, asam urat, diabetes melitus dan kolesterol yang mana jika tidak diatasi dari awal dapat menimbulkan komplikasi. Dengan kita melakukan Pemeriksaan Kesehatan secara berkala, potensi penyakit yang datang ke tubuh kita pun akan diketahui lebih dini. Untuk itu perlu dilakukan pemeriksaan kesehatan pada masyarakat. Metode: Metode pengabdian masyarakat ini mengacu pada action research dengan pemeriksaan kesehatan di kantor camat Padang Barat. Pemeriksaan kesehatan dan edukasi terkait penyakit tidak menular, dilaksanakan dan bekerja sama dengan Puskesmas Padang Pasir sebagai tindak lanjut kegiatan ini. Hasil: Hasil pengabdian di dapatkan sebanyak 44 peserta mendapatkan pemeriksaan kesehatan dan edukasi tentang penyakit tidak menular.

Latar Belakang: Lansia merupakan kelompok rentan yang memiliki risiko terjadinya masalah kesehatan. permasalahan kesehatan yang terjadi pada lansia sebagai akibat bertambah usia, pola hidup dan lingkungan sehingga menyebabkan terjadinya penyakit degeneratif salah satunya adalah Hipertensi yang mengakibatkan nyeri kepala, mual muntah dan gangguan kesehata reproduksi . RW 09 Kelurahan Gunung Sarik, Kuranji adalah RW yang memiliki banyak Lansia hipertensi dengan jumlah 32 orang dan memiliki kader 4 orang Berdasarkan survey awal yang dilakukan pada 12 orang Lansia hipertensi di RW 12 Kelurahan Gunung Sarik, Kuranji Padang didapatkan keterangan selama ini usaha yang mereka lakukan untuk mengatasi hipertensinya yaitu dengan mengunakan terapi herbal dan farmakologis. Penerapan terapi komplementer akupresur belum dilakukan di tatanan perawatan pada Lansia Hipertensi. Metode: Masalah hipertensi pada lansia diatasi dengan pendampingan dan pelatihan akupresur awam anggota keluarga lansia dengan kegiatan meliputi edukasi mengenai akupresur awam untuk pengendalian hipertensi pada lansia, pelatihan dan pendampingan akupresur awam pada anggota keluarga. Hasil: Setelah kegiatan pendampingan dan pelatihan akupresur awam didapatkan hasil terdapat peningkatan pengetahuan dan keterampilan keluarga dalam melakukan terapi akupresur untuk masalah hipertensi

Currently, the implementation of legal education in Indonesia has completed by including Clinical Legal Education (CLE). Legal higher education is expected to prepare law graduates who do not only serve as guardians of laws or the rule of law or, more extreme, known as (la bouche de la loi). Consequently, such law enforcement will only be subject to established procedures. Thus, a CLE development concept is needed that prepares lawyers who are committed to substantial justice. To development concept of developing CLE based on an equitable legal approach. The conclusion that can be conveyed is that the ideal CLE to apply is to use a doctrinal approach that puts forward a juridical-philosophical approach. This approach uses an analysis of the basic tenets of a norm to realize the settlement of legal cases based on the values of justice. In addition to the doctrinal approach, introduce a non-doctrinal approach that is based on the constructivism paradigm. Law in this approach is conceptualized contextually, relatively or plurally based on social, individual, local and specific experience. With this approach, it is hoped that later the values of justice will be realized as the main goal, in solving legal problems faced by them.

Restorative justice is an alternative to solving criminal cases, which in the resolution mechanism involves the perpetrator, victim, perpetrator’s family, victim’s family, community leaders, or stakeholders to jointly find a fair solution and emphasize returning to the situation as before. The implementation of the concept of restorative justice is needed in an effort to reform the law of the criminal justice system. This study aims to understand, explain, analyze, and make a comparison with the implementation of the concept of restorative justice as an effort to reform criminal law. The method used in this study is normative legal research. There are efforts to reform the law or legal findings in a criminal justice system regarding the resolution of criminal cases. The concept of restorative justice can be adopted and simultaneously applied. In addition to minimizing the accumulation of case files, restorative justice prioritizes the rights of perpetrators and victims and the restoration of the situation.

We report the results of the CO $\textit J$=1-0 and SiO $\textit J$=2-1 mapping observations towards the broad-velocity-width molecular feature CO 16.134-0.553 with the Nobeyama Radio Observatory 45 m telescope. The high quality CO map shows that the 5-pc size broad-velocity-width feature bridges two separate velocity components at $\textit V_{\rm{LSR}}$$\quad$$\simeq$ 40 km s$^{-1}$ and 65 km s$^{-1}$ in the position-velocity space. The kinetic power of CO 16.134-0.553 amounts to $7.8\times10^2$ $\textit L$$_\odot$ whereas no apparent driving sources were identified. Prominent SiO emission was detected from the broad-velocity-width feature and its root in the $\textit V_{\rm{LSR}}$$\quad$$\simeq$ 40 km s$^{-1}$ component. In the CO Galactic plane survey data, CO 16.134-0.553 appears to correspond to the Galactic eastern rim of a 15-pc diameter expanding CO shell. An $1\deg$-diameter H I emission void and $4\deg$-long vertical H I filament were also found above and below the CO shell, respectively. We propose that the high-velocity plunge of a dark matter subhalo with a clump of baryonic matter was responsible for the formation of the H I void, CO 16.134-0.553/CO shell, and the H I filament., Comment: 7 pages, 6 figures, 2 table, accepted for publication in ApJ

A compact source, G0.02467-0.0727, was detected in ALMA \threemm observations in continuum and very broad line emission. The continuum emission has a spectral index $\alpha\approx3.3$, suggesting that the emission is from dust. The line emission is detected in several transitions of CS, SO, and SO$_2$ and exhibits a line width FWHM $\approx160$ \kms. The line profile appears Gaussian. The emission is weakly spatially resolved, coming from an area on the sky $\lesssim1"$ in diameter ($\lesssim10^4$ AU at the distance of the Galactic Center; GC). The centroid velocity is $v_{LSR}\approx40$-$50$ \kms, which is consistent with a location in the Galactic Center. With multiple SO lines detected, and assuming local thermodynamic equilibrium (LTE) conditions, $T_\mathrm{LTE} = 13$ K, which is colder than seen in typical GC clouds, though we cannot rule out low-density, subthermally excited, warmer gas. Despite the high velocity dispersion, no emission is observed from SiO, suggesting that there are no strong ($\gtrsim10~\mathrm{km~s}^{-1}$) shocks in the molecular gas. There are no detections at other wavelengths, including X-ray, infrared, and radio. We consider several explanations for the Millimeter Ultra-Broad Line Object (MUBLO), including protostellar outflow, explosive outflow, collapsing cloud, evolved star, stellar merger, high-velocity compact cloud, intermediate mass black hole, and background galaxy. Most of these conceptual models are either inconsistent with the data or do not fully explain it. The MUBLO is, at present, an observationally unique object., Comment: Submitted to ApJL

We statistically investigate high-frequency whistler waves (with frequencies higher than $\sim 10$ % of the local elect ron cyclotron frequency) at Earth's bow shock using Magnetospheric Multi-Scale (MMS) spacecraft observations. We focus specifically on the wave power within the shock transition layer, where we expect electron acceleration via stochastic sh ock drift acceleration (SSDA) to occur associated with efficient pitch-angle scattering by whistler waves. We find that the wave power is positively correlated with both the Alfv\'en Mach number in the normal incidence frame $M_{\rm A}$ and in the de Hoffmann-Teller frame $M_{\rm A}/\cos \theta_{Bn}$. The empirical relation with $M_{\rm A}/\cos \theta_{Bn}$ is compared with the theory of SSDA that predicts a threshold wave power proportional to $(M_{\rm A}/\cos \theta_{Bn})^{-2}$. The result suggests that the wave power exceeds the theoretical threshold for $M_{\rm A} / \cos \theta_{Bn} \gtrsim 30-60$, beyond which efficient electron acceleration is expected. This aligns very well with previous statistical analysis of electron acceleration at Earth's bow shock (M. Oka, G eophys.~Res.~Lett., 33, 5, 2006). Therefore, we consider that this study provides further support for SSDA as the mechanism of electron acceleration at Earth's bow shock. At higher-Mach-number astrophysical shocks, SSDA will be able to inject electrons into the diffusive shock acceleration process for subsequent acceleration to cosmic-ray energies., Comment: 15 pages, 12 figures. Accepted for publication in Physics of Plasmas

Although the MeV gamma-ray band is a promising energy-band window in astrophysics, the current situation of MeV gamma-ray astronomy significantly lags behind those of the other energy bands in angular resolution and sensitivity. An electron-tracking Compton camera (ETCC), a next-generation MeV detector, is expected to revolutionize the situation. An ETCC tracks each Compton-recoil electron with a gaseous electron tracker and determines the incoming direction of each gamma-ray photon; thus, it has a strong background rejection power and yields a better angular resolution than classical Compton cameras. Here, we study ETCC events in which the Compton-recoil electrons do not deposit all energies to the electron tracker but escape and hit the surrounding pixel scintillator array (PSA). We developed an analysis method for this untapped class of events and applied it to laboratory and simulation data. We found that the energy spectrum obtained from the simulation agreed with that of the actual data within a factor of 1.2. We then evaluated the detector performance using the simulation data. The angular resolution for the new-class events was found to be twice as good as in the previous study at the energy range 1.0--2.0~MeV, where both analyses overlap. We also found that the total effective area is dominated by the contribution of the double-hit events above an energy of 1.5~MeV. Notably, applying this new method extends the sensitive energy range with the ETCC from 0.2--2.1 MeV in the previous studies to up to 3.5~MeV. Adjusting the PSA dynamic range should improve the sensitivity in even higher energy gamma-rays. The development of this new analysis method would pave the way for future observations by ETCC to fill the MeV-band sensitivity gap in astronomy., Comment: 11 pages, 8 figures, Accepted for publication in NIM A

Uranus and Neptune have intrinsic magnetic fields generated via convection in a molten H2O layer, where the field strength is determined by its electrical conductivity (EC) along with convection size and velocity. Previous shock experiments reported that the EC of molten H2O is high enough to generate magnetic fields of these ice giant planets with adiabatic thermal structures. Here we measured the EC of ionic H2O fluid for the first time by static compression experiments up to 45 GPa and 2,750 K. The EC determined is lower by a few orders of magnitude than earlier data by shock compression measurements and not capable of generating a magnetic field with the conventional interior thermal structures. Our results necessitate recently-suggested fewfold hotter interiors of Uranus and Neptune to explain their magnetic fields.

The purpose of this research is to find out and analyze the influence of motivation and incentives on the job satisfaction of Badung Regency Government ASN, then to find out and analyze the influence of motivation, incentives and job satisfaction on the professionalism of Badung Regency Government ASN, then to find out and analyze the influence of the role of job satisfaction in mediating the influence of motivation and incentives on the professionalism of Badung Regency Government ASN. The population of this research is the State Civil Apparatus (ASN) in the Badung Regency Government, totaling 6,890 employees. The number of respondents in the sample was between 90 and 180 respondents. Data collection in this research used a questionnaire. The data analysis technique consists of descriptive analysis and inferential analysis using the Partial Least Square (PLS) approach. The results show that: Motivation has a positive and significant effect on job satisfaction. Incentives have a positive and significant effect on job satisfaction. Motivation has a positive and significant effect on professionalism. Incentives do not have a significant effect on professionalism. Job satisfaction has a positive and significant effect on professionalism. The influence of motivation on professionalism through job satisfaction is positive and significant. The effect of incentives on professionalism through job satisfaction is positive and significant.

A comprehensive study of the $S$-wave heavy tetraquark states with identical quarks and antiquarks, specifically $QQ{\bar Q'}\bar Q'$ ($Q, Q'=c,b$), $QQ\bar s\bar s$/$\bar Q\bar Q ss$, and $QQ\bar q\bar q$/$\bar Q\bar Q qq$ ($q=u,d$), are studied in a unified constituent quark model. This model contains the one-gluon exchange and confinement potentials. The latter is modeled as the sum of all two-body linear potentials. We employ the Gaussian expansion method to solve the full four-body Schr\"{o}dinger equations, and search bound and resonant states using the complex-scaling method. We then identify $3$ bound and $62$ resonant states. The bound states are all $QQ\bar q\bar q$ states with the isospin and spin-parity quantum numbers $I(J^P)=0(1^+)$: two bound $bb\bar{q}\bar{q}$ states with the binding energies, 153 MeV and 4 MeV below the $BB^*$ threshold, and a shallow $cc\bar{q}\bar{q}$ state at $-15$ MeV from the $DD^*$ threshold. The deeper $bb\bar q \bar q$ bound state aligns with the lattice QCD predictions, while $cc\bar q\bar q$ bound state, still has a much larger binding energy than the recently observed $T^+_{cc}$ by LHCb collaboration. No bound states are identified for the $QQ\bar Q'\bar Q'$, $QQ\bar s\bar s$ and $QQ\bar q\bar q$ with $I=1$. Our analysis shows that the bound $QQ\bar Q'\bar Q'$ states are more probable with a larger mass ratio, $m_Q/m_{Q'}$. Experimental investigation for these states is desired, which will enrich our understanding of hadron spectroscopy and probe insights into the confinement mechanisms within tetraquarks., Comment: 38 pages, 18 figures

Background: The term sampradaya is used to denote the Hindu spiritual community in Bali with new traditions and ways originating in India starting in 1980. The debate about sampradaya also took place on social media, resulting in contesting discourses. Research on sampradaya discourse on social media is still very poorly conducted. Based on this, the study aims to determine the strategy of sampradaya discourse in the battle of discourse about sampradaya on Facebook. Methods: This research uses a combination of critical di methods Teun Van Dijk model and netnographic methods. Research data in the form of discourse was collected by copying communication between participants in the Facebook community environment. Result: Based on research, the strategies used by discourse in combat are symbolic capital strategies, reproduction strategies, distinctive strategies, rejection and exclusion strategies, and transformation strategies. Conclussion: The strategies employed in the discourse battles of the Sampradaya on Facebook encompass symbolic capital, reproduction, distinction, rejection and exclusion, and transformation strategies. The use of these strategies in discourse battles aims to maintain and, in some cases, alter the distribution of symbolic resources in relation to power hierarchies, thereby influencing the online community.

Purpose: Having identified a gap in the literature, this study aimed to determine the role of Islamic Work Ethics (IWE) in creating high Academic Performance (APE) and Entrepreneurial Intention (ENI) among Indonesian undergraduate students.   Theoretical framework: The motivation for entrepreneurship is a popular topic investigated in many studies. Previous studies showed that entrepreneurial activities are strongly connected to individuals' values. In this situation, Muslims should be inspired to become entrepreneurs because the Qur’an and Hadith discuss entrepreneurship. However, Islamic Work Ethics (IWE) has received less attention from scholars about its role in developing the Entrepreneurial Intention (ENI) of students as potential entrepreneurs.   Design/ methodology/approach: This is a qualitative study that used structural equation modelling (SEM) to process data from 150 samples of Indonesian undergraduate students Findings: This study discovered that IWE played a significant role in driving all TPB factors, including ATB, SUN, and PCB, to promote ENI. which means IWE would encourage Muslims to embrace entrepreneurship as a means of sustaining Islamic teaching.   Research, Practical & Social Implications: This study may serve as the foundation for Indonesian educational institutions to incorporate IWE into their curriculum. It is because the religious values as inherent in IWE will foster a positive attitude and spirit of achievement.

Penelitian ini bertujuan untuk mengeksplorasi dampak kesehatan, keselamatan kerja, dan stres kerja terhadap kinerja pegawai non medis di RS Parama Sidhi dalam upaya meningkatkan kinerja mereka. Metode yang digunakan adalah pendekatan kuantitatif dengan jenis penelitian quasi eksperimen. Data dikumpulkan melalui angket menggunakan Skala Setuju dan Tidak Setuju, dan dianalisis menggunakan model persamaan SEM Partial Least Square (PLS) Visual versi 3.0. Populasi penelitian terdiri dari 79 orang, dan sampel sebanyak 44 orang dipilih menggunakan teknik Purposive Random Sampling. Hasil penelitian menunjukkan bahwa kesehatan kerja memiliki pengaruh positif dan signifikan terhadap kinerja pegawai non medis, dengan koefisien sebesar 0,459 dan nilai t statistik 4,165, keselamatan kerja juga memiliki pengaruh positif dan signifikan terhadap kinerja pegawai non medis, dengan koefisien sebesar 0,329 dan nilai t statistik 3,359, Stres kerja memiliki pengaruh positif dan signifikan terhadap kinerja pegawai non medis di RS Parama Sidhi, dengan koefisien sebesar 0,227 dan nilai t statistik 2,313.Temuan ini menekankan pentingnya faktor-faktor seperti kesehatan kerja, keselamatan kerja, dan manajemen stres dalam meningkatkan kinerja pegawai non medis di Rumah Sakit Parama Sidhi.

Species classified in the genus Ulva are important foundational marine primary producers distributed worldwide. These species are particularly abundant and diverse through the northwest Pacific (NWP) where they experience marked latitudinal gradients of environmental heterogeneity. It is unclear, however, to what extent such dynamic conditions can modulate phenotypic and genetic patterns in these organisms, potentially reflecting the influence of historical and contemporary biotic and abiotic factors. Here, we assessed inter- and intra-specific genetic patterns of Ulva species through the NWP using plastid rbc L and tuf A gene sequences. Although we initially targeted Ulva australis based on morphological identification, we recovered eight Ulva genetic entities masked by morphological similarities. Except for the Ulva linza–procera–prolifera and U. lactuca–reticulata complexes, six of these genetic entities were recovered as individual species (i.e., U. australis , U. ohnoi , U. californica , U. compressa , U. lacinulata , and U. arasakii ), and showed biogeographic patterns likely explained by clines in sea surface temperature and ocean current dispersal. At intra-specific level, all the genetic entities showed low genetic variation and divergence based on rbc L (0–0.3 %) and tuf A (0–0.9 %) data. Our results provide insights regarding intra- and inter-specific genetic patterns characterizing morphologically similar Ulva species through the NWP. However, further studies are needed to understand the mechanisms underpinning such patterns and the associated ecological and evolutionary implications.

Large Language Models (LLMs) have demonstrated a number of human-like abilities, however the empathic understanding and emotional state of LLMs is yet to be aligned to that of humans. In this work, we investigate how the emotional state of generative LLM agents evolves as they perceive new events, introducing a novel architecture in which new experiences are compared to past memories. Through this comparison, the agent gains the ability to understand new experiences in context, which according to the appraisal theory of emotion is vital in emotion creation. First, the agent perceives new experiences as time series text data. After perceiving each new input, the agent generates a summary of past relevant memories, referred to as the norm, and compares the new experience to this norm. Through this comparison we can analyse how the agent reacts to the new experience in context. The PANAS, a test of affect, is administered to the agent, capturing the emotional state of the agent after the perception of the new event. Finally, the new experience is then added to the agents memory to be used in the creation of future norms. By creating multiple experiences in natural language from emotionally charged situations, we test the proposed architecture on a wide range of scenarios. The mixed results suggests that introducing context can occasionally improve the emotional alignment of the agent, but further study and comparison with human evaluators is necessary. We hope that this paper is another step towards the alignment of generative agents., Comment: 14 pages, 6 figures

While generative AI is now widespread and useful in society, there are potential risks of misuse, e.g., unconsciously influencing cognitive processes or decision-making. Although this causes a security problem in the cognitive domain, there has been no research about neural and computational mechanisms counteracting the impact of malicious generative AI in humans. We propose DecNefGAN, a novel framework that combines a generative adversarial system and a neural reinforcement model. More specifically, DecNefGAN bridges human and generative AI in a closed-loop system, with the AI creating stimuli that induce specific mental states, thus exerting external control over neural activity. The objective of the human is the opposite, to compete and reach an orthogonal mental state. This framework can contribute to elucidating how the human brain responds to and counteracts the potential influence of generative AI.

Audit komunikasi internal menjadi aspek penting dalam upaya peningkatan komunikasi di lingkungan internal Pemerintah Kabupaten Tegal. Media sosial telah menjadi alat komunikasi yang signifikan dalam menyampaikan informasi kepada berbagai pihak, termasuk pegawai pemerintahan dan masyarakat umum. Dalam konteks ini, penelitian ini bertujuan untuk melakukan audit komunikasi internal media sosial yang dilakukan oleh Humas Pemerintah Kabupaten Tegal. Penelitian ini menggunakan metode penelitian kualitatif yang melibatkan analisis konten dari pesan-pesan yang disampaikan melalui media sosial, serta wawancara dengan staf Humas untuk memahami strategi dan tujuan komunikasi internal. Hasil audit ini memberikan gambaran komprehensif tentang efektivitas kampanye komunikasi internal melalui media sosial. Temuan ini dapat memberikan masukan berharga bagi Humas Pemerintah Kabupaten Tegal dalam meningkatkan strategi komunikasi internalnya. Potensi kendala dan peluang yang teridentifikasi dapat dijadikan dasar untuk merumuskan rencana komunikasi yang lebih baik di masa depan. Humas Pemerintah Kabupaten Tegal telah memanfaatkan media sosial sebagai media komunikasi Humas Pemerintah Kabupaten Tegal dengan maksimal. Pemanfaatan media sosial tersebut bertujuan untuk menyampaikan informasi kepada masyarakat Kabupaten Tegal dan mengelola aduan yang disampaikan masyarakat Kabupaten Tegal. Adapun media sosial Humas Pemerintah Kabupaten Tegal yaitu Twitter, Facebook, Instagram, YouTube, dan TikTok. Konten Humas Pemerintah Kabupaten Tegal memuat informasi berdasarkan fakta yang didapat dari hasil riset dan sumber dinas terkait. Media sosial Humas Pemerintah Kabupaten Tegal yang memiliki interaksi tinggi yaitu Facebook. Sedangkan, Youtube menjadi media sosial dengan interaksi rendah. Demi menjaga kualitas konten, Humas Pemerintah Kabupaten Tegal mengadakan evaluasi setiap minggu serta memfasilitasi admin media sosial untuk berkembang dengan memberikan pelatihan atau kursus tertentu. Sebagai co

Background: Existing guidelines for predicting common bile duct stones (CBDS) are not specific for acute calculous cholecystitis (ACC). This paper is a posthoc analysis of the S.P.Ri.M.A.C.C study aiming to prospectively validate on a large independent cohort of patients the Israeli Score (IS) in predicting CBDS in patients with ACC. Methods: The S.P.Ri.M.A.C.C. study is an observational multicenter prospective study endorsed by the World Society of Emergency Surgery (WSES). Between September 1st, 2021, and September 1st, 2022, 1201 participants were included. The Chi-Square test was used to compare categorical data. A Cochran-Armitage test was run to determine whether a linear trend existed between the IS and the presence of CBDS. To assess the accuracy of the prediction model, the receiver operating characteristic (ROC) curve was generated, and the area under the ROC curve (AUC) was calculated. Logistic regression was run to obtain Odds Ratio (OR). A two-tailed p < 0.05 was considered statistically significant. Results: The rate of CBDS was 1.8% in patients with an IS of 0, 4.2% in patients with an IS of 1, 24.5% in patients with 2 and 56.3% in patients with 3 (p < 0.001). The Cochran-Armitage test of trend showed a statistically significant linear trend, p < 0.001. Patients with an IS of 3 had 64.4 times (95% CI 24.8–166.9) higher odds of having associated CBDS than patients with an IS of 0. The AUC of the ROC curve of IS for the prediction of CBDS was 0.809 (95% CI 0.752–0.865, p < 0.001). By applying the highest cut-off point (3), the specificity reached 99%, while using the lowest cut-off value (0), the sensitivity reached 100%. Conclusion: The IS is a reliable tool to predict CBDS associated with ACC. The algorithm derived from the IS could optimize the management of patients with ACC.

Particles are accelerated to very high, non-thermal energies during explosive energy-release phenomena in space, solar, and astrophysical plasma environments. While it has been established that magnetic reconnection plays an important role in the dynamics of Earth's magnetosphere, it remains unclear how magnetic reconnection can further explain particle acceleration to non-thermal energies. Here we review recent progress in our understanding of particle acceleration by magnetic reconnection in Earth's magnetosphere. With improved resolutions, recent spacecraft missions have enabled detailed studies of particle acceleration at various structures such as the diffusion region, separatrix, jets, magnetic islands (flux ropes), and dipolarization front. With the guiding-center approximation of particle motion, many studies have discussed the relative importance of the parallel electric field as well as the Fermi and betatron effects. However, in order to fully understand the particle acceleration mechanism and further compare with particle acceleration in solar and astrophysical plasma environments, there is a need for further investigation of, for example, energy partition and the precise role of turbulence.

Redox-active covalent organic frameworks (RACOFs) can be employed in various functional materials and enesrgy applications. A crucial performance or efficiency indicator is the percentage of redox centres that can be utilised. Herein, the term redox-site accessibility (RSA) is defined and shown to be an effective metric for developing and optimising a 2D RACOF (viz., TpOMe-DAQ made from 2,4,6-trimethoxy-1,3,5-benzenetricarbaldehyde [TpOMe] and 2,6-diaminoanthraquinone [DAQ]) as an anode material for potential organic-battery applications. Pristine TpOMe-DAQ utilises only 0.76% of its redox sites, necessitating the use of conductivity-enhancement strategies such as blending it with different conductive carbons, or performing in situ polymerisation with EDOT (3,4-ethylenedioxythiophene) to form a conductive polymer. While conductive carbon-RACOF composites showed a modest RSA improvement of 4.0%, conductive polymer-RACOF composites boosted the redox-site usage (RSA) to 90% at low mass loadings. The material and electrochemical characteristics of the conductive polymer-RACOF composite containing more-than-necessary conductive polymer showed a reduced surface area but almost identical electrochemical behaviour, compared to the optimal ratio. The high RSA of the optimally loaded composite was replicated in a RACOF-air battery with over 90% active redox sites. We believe that the reported approach and methods, which can be employed on a milligram scale, could serve as a general guide for the electrification and characterisation of RACOFs, as well as for other redox-active porous polymers.

Latar Belakang: Pembatasan asupan cairan merupakan masalah yang umum muncul pada pasien gagal ginjal kronik (GGK) yang menjalani terapi hemodialisa (HD). Salah satu faktor yang mempengaruhi kepatuhan pembatasan asupan cairan pada pasien gagal ginjal kronik adalah adanya dukungan keluarga. Dukungan dari keluarga sangat diperlukan agar pasien tetap konsisten terhadap pengontrolan cairan. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan dukungan keluarga dengan kepatuhan pembatasan asupan cairan pada pasien gagal ginjal kronik yang menjalani hemodialisa di RSUD Tabanan. Metode: Metode penelitian yang digunakan yaitu deskriptif korelational dengan pendekatan cross sesctional. Teknik sampel menggunakan simple random sampling. Jumlah sampel 73 responden. Alat ukur yang digunakan dalam penelitia ini yaitu kuesioner dukungan keluarga dan IDWG pasien. Analisa data menggunakan analisis korelasi Lambda. Hasil: Hasil uji statistik didapatkan nilai signifikansi sebesar 0,005 (p value < 0,05) hasil ini menunjukkan bahwa terdapat hubungan yang bermakna antara dukungan keluarga dengan kepatuhan pembatasan asupan cairan pada pasien gagal ginjal kronik yang menjalani hemodialisa di RSUD Tabanan. Dengan nilai koesfisiensi didapatkan sebesar r = 0,500 yang menandakan bahwa kekuatan hubungan kuat. Kesimpulan: Dukungan keluarga disarankan menjadi alternatif yang digunakan untuk meningkatkan kepatuhan pembatasan asupan cairan pada pasien gagal ginjal kronik yang menjalani hemodialisa.

Growth traits, such as body weight and height, are essential in the design of genetic improvement programs of dairy cattle due to their relationship with feeding efficiency, longevity, and health. We investigated genomic regions influencing height across growth stages in Japanese Holstein cattle using a single-step random regression model. We used 72,921 records from birth to 60 mo of age with 4,111 animals born between 2000 and 2016. The analysis included 1,410 genotyped animals with 35,319 single nucleotide polymorphisms, consisting of 883 females with records and 527 bulls, and 30,745 animals with pedigree information. A single genomic region at the 58.4 megabase pair on chromosome 18 was consistently identified across 6 age points of 10, 20, 30, 40, 50, and 60 mo after multiple testing corrections for the significance threshold. Twelve candidate genes, previously reported for longevity and gestation length, were found near the identified genomic region. Another location near the identified region was also previously associated with body conformation, fertility, and calving difficulty. Functional Gene Ontology enrichment analysis suggested that the candidate genes regulate dephosphorylation and phosphatase activity. Our findings show that further study of the identified candidate genes will contribute to a better understanding of the genetic basis of height in Japanese Holstein cattle.

VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is caused by UBA1 somatic mutations and is characterized by late-onset systemic autoimmune inflammation and blood abnormalities such as cytopenia, vacuolation of myeloid/erythroblastic cells, and myelodysplastic syndrome (MDS). It is often resistant to immunosuppressive therapy, and no treatment strategy has been established. A 65-year-old man presented with palpable erythema, fever, macrocytic anemia, and arthralgia. He was subsequently diagnosed with MDS complicated by Sweet's disease. Treatment with azacitidine was initiated due to suspected skin invasion by MDS cells and resistance of the skin rash to steroid therapy. Next-generation sequencing of bone marrow samples prior to treatment initiation revealed the presence of UBA1 p.M41L (VAF 0.38) and DNMT3A p.L605fs mutations (VAF 0.184). Based on the findings of systemic inflammation, a diagnosis of VEXAS syndrome was made. The fever and skin rash improved with azacitidine therapy. In conclusion, somatic mutations in UBA1 should be explored in patients with MDS exhibiting systemic autoimmune inflammation. Furthermore, azacitidine may be a good treatment option for systemic autoinflammation in MDS associated with VEXAS syndrome.

Nonalcoholic steatohepatitis (NASH) can lead to cirrhosis and hepatocellular carcinoma in their advanced stages; however, there are currently no approved therapies. Here, we show that microRNA (miR)-33b in hepatocytes is critical for the development of NASH. miR-33b is located in the intron of sterol regulatory element–binding transcription factor 1 and is abundantly expressed in humans, but absent in rodents. miR-33b knock-in (KI) mice, which have a miR-33b sequence in the same intron of sterol regulatory element–binding transcription factor 1 as humans and express miR-33b similar to humans, exhibit NASH under high-fat diet feeding. This condition is ameliorated by hepatocyte-specific miR-33b deficiency but unaffected by macrophage-specific miR-33b deficiency. Anti-miR-33b oligonucleotide improves the phenotype of NASH in miR-33b KI mice fed a Gubra Amylin NASH diet, which induces miR-33b and worsens NASH more than a high-fat diet. Anti-miR-33b treatment reduces hepatic free cholesterol and triglyceride accumulation through up-regulation of the lipid metabolism–related target genes. Furthermore, it decreases the expression of fibrosis marker genes in cultured hepatic stellate cells. Thus, inhibition of miR-33b using nucleic acid medicine is a promising treatment for NASH.

In the United States, most of the workers who earn at or below the minimum wage are either less educated, young, orfemale. We examine the extent to which the minimum wage influences the wage differential among workers with different observed characteristics and the wage differential among workers with the same observed characteristics. Our results suggest that changes in the real value of the minimum wage account in part for the patterns of changes in education, experience, and gender wage differentials and for most of the changes in within-group wage differentials for workers with lower levels of experience.

Background: Total knee arthroplasty (TKA) is a widespread surgical procedure for severe arthritis. By 2030, primary TKA would reach over 1.2 million procedures annually in the United States. In Indonesia, the prevalence of joint disease is about 19.5 million cases. This study aims to evaluate the clinical demographics characteristics of TKA in Prof. Ngoerah General Hospital, Bali, Indonesia.Subjects and Method: This is a descriptive study using a Cross-Sectional method with a total 57 adult patients undergoing TKA caused by Osteoarthritis grade III/IV in Prof IGNG Ngoerah Hospital from June 2020-June 2022. The dependent variable is the TKA procedure. Independent Variable is Age, gender, grade of knee osteoarthritis, comorbidities, and complications Data from the medical record was collected and stored in a Microsoft Office Excel 365 spreadsheet, the distributive table was analyzed and collected by using SPSS.Results: Patient characteristic is dominated by an elderly female (84.2%), with age group 61-70 (38.6%). Comorbidities in this study include hypertension (28.1%), type II diabetes (10.5%), and rheumatoid disease (1.8%). The main complication recorded in this study includes joint stiffness (3.5%), and persistent pain (5.3%).Conclusion: After Total Knee Arthroplasty was performed on 57 patients with a wide range of comorbidities, only a small number of complications occurred. This study implied that TKA could be performed even if the patient had some comorbidities as long as the patient pursued a complete pre and post-operative evaluation algorithm of the procedure.Keywords: knee arthroplasty, osteoarthritis, human and medicine, rehabilitationCorrespondence: IGN Wien Aryana, Consultant of Sports Medicine, Dept. Orthopaedic and Traumatology, Prof IGNG Ngoerah General Hospital, Faculty of Medicine, Udayana University. Jl. Diponegoro, Dauh Puri Klod. Denpasar City, Bali 80113 Email: wienaryanaortho@gmail.com. Mobile: +62811385263.Indonesian Journal of Medicine

Pneumonia is a frequent complication in patients with acute and subacute stroke. Hence, pneumonia prevention is a prominent issue. Although previous reports have demonstrated the efficacy of various swallowing therapies in preventing pneumonia, details of their efficacy profiles have not been fully elucidated. This study aimed to compare the effectiveness of behavior interventions （BI）, metoclopramide （MCP）, prophylactic antibiotics （PA）, and pharyngeal electrical stimulation （PES） in preventing pneumonia between patients with acute to subacute stroke and a control group （N）. A network meta-analysis of randomized controlled trials was conducted. The primary endpoint was the frequency of pneumonia. Integrated estimates were expressed as odds ratios （ORs） and 95％ credible intervals （CIs）. Five studies （n＝1,179） were included in the analysis. The frequency of pneumonia was significantly lower in group MCP than in groups BI, PA, and N （OR ［95％ CI］ of MCP vs. BI, PA vs. MCP, and MCP vs. N: 0.127 ［0.018 to 0.450］, 24.15 ［3.653 to 84.50］, and 0.081 ［0.013 to 0.273］, respectively）. There was no significant difference in the frequency of pneumonia between each treatment pair among the BI, PA, PES, and N groups. MCP showed good pneumonia prophylaxis in patients with acute to subacute stroke compared to BI or PA. Further clinical studies to verify the efficacy and safety profile of MCP in preventing pneumonia are warranted.

This paper describes NAIST’s system for the English-to-Japanese Simultaneous Text-to-text Translation Task in IWSLT 2021 Evaluation Campaign. Our primary submission is based on wait-k neural machine translation with sequence-level knowledge distillation to encourage literal translation., Proceedings of the 18th International Conference on Spoken Language Translation, Bangkok, Thailand (Online), August 5–6, 2021.

Objectives: Mammalian DNA methyltransferases are essential to re-establish global DNA methylation patterns during implantation, which is critical for transmitting epigenetic information to the next generation. In contrast, the significance of methyl-CpG binding proteins (MBPs) that bind methylated CpG remains almost unknown at this stage. We previously demonstrated that Zbtb38 (also known as CIBZ)—a zinc finger type of MBP—is required for mouse embryonic stem (ES) cell proliferation by positively regulating Nanog expression. However, the physiological function of Zbtb38 in vivo remains unclear.Materials and Methods: This study used the Cre-loxP system to generate conditional Zbtb38 knockout mice. Cell proliferation and apoptosis were studied by immunofluorescence staining. Quantitative real-time PCR, immunoblotting and immunofluorescence were performed to investigate the molecular mechanisms.Results: Germline loss of the Zbtb38 single allele resulted in decreased epiblast cell proliferation and increased apoptosis shortly after implantation, leading to early embryonic lethality. Heterozygous loss of Zbtb38 reduced the expression of Nanog, Sox2, and the genes responsible for epiblast proliferation, differentiation, and cell viability. Although this early lethal phenotype, Zbtb38 is dispensable for ES cell establishment and identity.Conclusions: These findings indicate that Zbtb38 is essential for early embryonicdevelopment via the suppression of Nanog and Sox2 expression.

The present study aimed to clarify the regional characteristics of the diurnal variation of localized heavy rainfall frequency in the Tokyo metropolitan area and Saitama Prefecture based on the dense hourly rainfall data acquired from 290 stations across summers of 15 years between 1994–2010 (June to September). The obtained results can be summarized as follows. The central to western parts of Saitama Prefecture (Cluster 2) displayed a single peak with a large maximum from the evening till the early night hours. In comparison, the western and southern parts of the Tama region (Cluster 4) and the western Tokyo area (Cluster 5) indicated a bimodal pattern with two peaks during the day and night. Moreover, central Tokyo, the northern Tama region, and southeastern Saitama Prefecture (Cluster 3) are located between these areas and can be considered a transition zone between the single-peak and bimodal areas. Despite the moderate increase in the frequency of heavy rainfall from evening to night in the eastern part of the Tokyo metropolitan area as well as the Saitama Prefecture (Cluster 1), it did not exhibit a clear maximum.

In 1961, we published a report on 608 patient s with cancer of the mouth treated at the Section of Oral Surgery in the Tokyo Medical and Dental University Hospital between 1930 and 1960 with a reference to the incidences of oral malignancies 1). In this paper, the same 81 patients with cancer of the tongue were reviewed again from a different point of view on their treatment and results adding 28 newly treated patients with cancer of the tongue, who called us for treatement until December 1963.

Ecohydrological studies in tropical peatland have mostly focused on a small number of non-native commercial species. However, studies of native species are urgently needed as they are considered to be a possible solution in the restoration of millions of hectares of degraded tropical peatlands. We investigated peatland species on Padang Island, Indonesia, to assess their responses to changing environmental factors, particularly the high fluctuation of the water table due to intensive peatland draining. We monitored the sap-flux velocity and radial growth of six trees (four native and one non-native peatland species) in high temporal resolution using sap-flux meters and dendrometers up to seven months. Monitoring also included hydrological and micrometeorological parameters. We found that sap-flux velocity in the monitored species was mainly controlled by air vapor pressure deficits, photosynthetic active radiation, and to some extent, by wind speed and water-table depth. We also observed a species-specific correlation between daily sap-flux velocity and daily radial growth. Non-native Acacia crassicarpa had up to twice the radial growth of native species. This growth of non-native species was significantly higher at a shallow water-table depth, while native species did not show the same relationship. The interaction between water-table depth, sap-flux velocity, and radial growth in daily timescale was not straightforward, presumably because of the complex carbon-allocation mechanism in trees.

type:Case Report, source:https://igakkai.kms-igakkai.com/wp/wp-content/uploads/2022en/KMJ-E202248183.pdf

type:Regular Article, source:https://igakkai.kms-igakkai.com/wp/wp-content/uploads/2022en/KMJ-E202248191.pdf

There is a systematic discrepancy between the measured radionuclide activation yieldsin materials exposed to neutrons from the Hiroshima atomic bomb (A-bomb) and the calculated activation based on the Dosimetry System 1986 (DS86). The data at lkm are 2-10-times greater than the calculation and this implies that the actual level of exposure from the A-bomb must be higher than previously thought. In this paper, these activity data, including 152Eu, 60Co, 36C1 and 32P, were analyzed using a computer code (the Monte Carlo neutron and photon (MCNP) transport code system) to investigate the cause of the discrepancy. We present a possible mechanism of the neutron emission in Hiroshima which can reproduce the activity yields of 152Eu, 60Co, 36C1 and 32P assuming a small amount of leakage in the lateral direction (leakage except that in the direction to the hypocenter area). The DS86 calculation did not take such leakage into account. In addition to this leakage, we assume increase of the burst height about 90 m to adjust the activity yields at relatively short ground distances. Taking these two assumptions into account and using a simple bomb model and leakage, it is shown that our calculation reproduces reasonably both the slopes and the absolute yield data of 152Eu, 32P, 60Co and 36C1 within about 1 km ground range. Over the ground range of about 1 km, it seems that further consideration is necessary concerning not only the calculation but also the data themselves to explain the DS86 discrepancy.

Long-lived residual radioactivity 63Ni produced by the (n, y) reaction was detected for the first time from a steel plate sampled at near the hypocenter of the Hiroshima atomic bomb. Nickel and cobalt were chemically separated and enriched from the steel sample. Low energy beta rays of 63Ni were measured with a low-background liquid scintillation counter and gamma-rays of 60Co were measured with a low background Ge detector. Specific activities were determined as 0.0063±0.0004 Bq mg-1 for 63Ni/Ni and 8.70±0.46 Bq mg-1 for 60Co/Co at the time of the bomb explosion. Comparisons with the calculated yield based on the current dosimetry system DS86 neutrons were also given.

Low energy nucleon-antinucleon annihilation into two mesons is examined in a distorted wave, "effective" perturbative QCD, approach. Both velocity-independent and first-order velocity-dependent terms are kept in the basic interaction responsible for the quark-antiquark annihilation. Interesting selection rules are predicted. Cross sections are evaluated.