USAGE OF SUPPORTING PAD FOR SUPINE PCNL: A SINGLE CENTER EXPERIENCE

Objective: This study aims to compare the safety, efficacy, and other surgical outcomes of supine PCNLs performed with and without the use of supporting pad. Material & Methods: We enrolled 27 patients who undergone PCNL procedure with supine position for renal stones with all sizes between January - December 2019. Divided into two groups, operated with and without supporting pad, with 13 and 14 patients respectively. Inclusion criteria are patients with renal stones, including staghorn, multiple calyx, and proximal ureteral stones. Meanwhile, pediatric patients under 12 years old, uncorrectable bleeding disorders, active urinary infection, and pregnancy are excluded. Results: Our observation showed no statistically significant difference between the two groups, although blood loss and length of stay in supporting pad showed better results. A statistically significant difference was found in stone-free-rate (P = 0.006) favoring in supine PCNL with supporting pad. Conclusion: Supine PCNL with support padding may be a safe and more effective choice to treat renal stones. Nevertheless, the patient’s anatomic variations may influence this. Thus, a prospective study with a larger population is needed to verify our outcomes.

Government support measures: an effective choice process

The article discusses issues related to the ability of industrial enterprises to navigate the existing range of government support measures and make their effective choice. The author proposes an algorithm that will allow enterprises, after analyzing their strategic goals, to identify projects that allow them to implement priority areas for a particular enterprise and select the most effective measures of state support. The algorithm has been tested on the basis of support measures provided by the industrial development fund, practices for the successful implementation of support measures at industrial enterprises are given.

Hormonal Approach for Postmenopausal Vulvovaginal Atrophy

Menopause is a physiological and progressive phenomenon secondary to decreased ovarian follicular reserve that significantly affects the genital tract. Although postmenopausal vulvovaginal atrophy primarily affects postmenopausal women, it is also seen in premenopausal women. The hypoestrogenic condition results in hormonal and anatomical changes, with the main symptoms, are dryness, burning and genital irritation, decreased lubrication, urinary urgency, dysuria, and recurrent urinary tract infections. This review aims to update hormone therapy for urogenital atrophy, both local and systemic, and discusses the importance of understanding and the need for active treatment of this condition. The main therapeutic objective is the relief of symptoms, and hormonal therapy (HT) is still the most effective choice for treating clinical manifestations, despite the side effects of its use. HT should be used in an individualized way to the needs of the women and appropriate to the stage in which she is menopausal, perimenopausal, or after menopause.

Agglomerative likelihood clustering

We consider the problem of fast time-series data clustering. Building on previous work modeling, the correlation-based Hamiltonian of spin variables we present an updated fast non-expensive agglomerative likelihood clustering algorithm (ALC). The method replaces the optimized genetic algorithm based approach (f-SPC) with an agglomerative recursive merging framework inspired by previous work in econophysics and community detection. The method is tested on noisy synthetic correlated time-series datasets with a built-in cluster structure to demonstrate that the algorithm produces meaningful non-trivial results. We apply it to time-series datasets as large as 20 000 assets and we argue that ALC can reduce computation time costs and resource usage costs for large scale clustering for time-series applications while being serialized, and hence has no obvious parallelization requirement. The algorithm can be an effective choice for state-detection for online learning in a fast non-linear data environment, because the algorithm requires no prior information about the number of clusters.

Pengenalan Digital Marketing, Pelatihan Sosial Media Dan E-Commerce Dan Merancang Konten Pemasaran Yang Baik Bagi Pelaku Usaha Umkm Di Yayasan Amal Bakti Sudjono Taruno Baki Sukoharjo

Pertumbuhan untuk industri e-Commerce di Indonesia diprediksi dapat mencapai sebesar US$ 130 miliar pada tahun 2020. Pertumbuhan industri e-commerce per tahun yang dapat mencapai 50 persen dan ditambah dengan pengguna smartphone yang terus bertumbuh merupakan peluang yang sangat besar untuk pelaku UMKM dalam meningkatkan penjualan produk mereka. Digital marketing memungkinkan pembeli memperoleh seluruh informasi mengenai produk dan bertransaksi melalui internet, dan memungkinkan penjual untuk memantau dan menyediakan kebutuhan serta keinginan calon pembeli tanpa batasan waktu dan geografis. Media promosi digital diharapkan menjadi pilihan yang efektif untuk pelaku UMKM dalam mengembangkan bisnis dan menjangkau pasar nasional maupun internasional. Media promosi konvensional yang membutuhkan banyak biaya dan jauh lebih rumit dengan sendirinya tidak lagi menjadi perhatian utama bagi pelaku UMKM karena adanya digital marketing. Pelaku UMKM dengan menggunakan e-commerce atau marketplace dapat menjangkau calon costumer yang lebih luas dan lebih banyak, tidak hanya terbatas pada suatu wilayah promosi saja. Digital marketing dan e-commerce atau marketplace dapat menjangkau wilayah yang lebih luas dibanding pemasaran secara konvensional, sehingga hal ini menjadi pilihan yang solutif untuk ekspansi bisnis.Kata Kunci: UMKM, Digital Marketing, E-CommerceGrowth for the e-commerce industry in Indonesia is predicted to reach US$ 130 billion by 2020. The annual growth of the e-commerce industry which can reach 50 percent and coupled with smartphone users who continue to grow is a huge opportunity for MSME players to increase sales of their products. Digital marketing allows buyers to obtain all information about products and transact via the internet, and allows sellers to monitor and provide for the needs and desires of potential buyers without time and geographical restrictions. Digital promotion media is expected to be an effective choice for MSME players in developing business and reaching national and international markets. Conventional promotional media that require a lot of money and are much more complicated by themselves are no longer a major concern for MSME actors because of digital marketing. MSME actors by using e-commerce or marketplaces can reach a wider and more potential customer, not only limited to a promotional area. Digital marketing and e-commerce or marketplaces can reach a wider area than conventional marketing, so this is a solution choice for business expansion.Keywords: MSME, Digital Marketing, E-Commerce

Dimethyl fumarate as a safe and effective therapy for recalcitrant psoriasis in comorbid patients

Psoriasis is a chronic condition for which multiple therapies are currently available. In particular, in cases of moderate-severe psoriasis, traditional systemic drugs or the new biological drugs can be administered. However, the treatment of patients who require systemic therapy and have multiple comorbidities can be particularly complex. Some treatment options may be in fact contraindicated or may lose effectiveness over time, reducing the options available to the dermatologists. In such circumstances, dimethyl fumarate may represent a safe and effective choice, also in patients who have already attempted biological therapies. In this regard, we report the case of a patient with moderatesevere psoriasis treated over time with various therapies (including topicals, phototherapy, traditional and biological drugs) that were discontinued due to ineffectiveness or incompatibility caused by the occurrence of concomitant diseases, who finally achieved clinical remission with dimethyl fumarate.

METHODOLOGY OF FORMATION OF STRATEGY FOR DEVELOPMENT OF MACHINE BUILDING ENTERPRISES ON THE BASIS OF VALUE COMPETENCIES IN THE CONDITIONS OF GLOBALIZATION

It is established that an effective development strategy contributes to the rapid adaptation of enterprises to changes in the environment and conditions of globalization, and vice versa, the development of globalization processes allows to maintain a competitive level of entrepreneurship. The result of the work should be a focused strategy of the enterprise, ie the concept is developed and defined by it a system of measures aimed at achieving competitive advantage. Therefore, the development of an effective competitive strategy for all enterprises is an important necessity and has undeniable practical value. However, it is important to note the difficulty of choosing the optimal competitive strategy from a variety of strategies, provided that all important aspects are taken into account. The next step of the study should be to develop a model of effective choice of competitive strategy, which takes into account a number of factors, allows for critical quantitative and qualitative analysis of strategic alternatives and involves the use of optimal tools. This will form a truly competitive strategy of the enterprise and ensure its successful practical implementation. Speaking about the choice and feasibility of a competitive strategy, it is important to mention the value chain of the company’s product. The main goal of each enterprise is not just its survival in the market, but stable operation and constant economic growth. To achieve this goal, it is necessary to develop an effective development strategy on the basis of which to create and implement competitive advantages. All this will give the company the opportunity to answer vital questions: where to operate (in what industry or in which markets), how to allocate resources, how to compete effectively with other companies, how to develop stably in the future.

Interfacial Mass Transfer in Trichloroethylene/Surfactants/ Water Systems: Implications for Remediation Strategies

The fate of dense non-aqueous phase liquids (DNAPLs) in the environment and the consequential remediation problems have been intensively studied over the last 50 years. However, a scarce literature is present about the mass transfer at the DNAPL/water interface. In this paper, we present a fast method for the evaluation of the mass transfer performance of a surfactant that can easily be employed to support an effective choice for the so-called enhanced remediation strategies. We developed a lab-scale experimental system modelled by means of simple ordinary differential equations to calculate the mass transfer coefficient (K) of trichloroethylene, chosen as representative DNAPL, in the presence and in the absence of two ethoxylated alcohols belonging to the general class of Synperonic surfactants. Our findings revealed that it exists an optimal surfactant concentration range, where K increases up to 40% with respect to pure water.

Insights on carbapenem-resistant Acinetobacter baumannii

Acinetobacter baumannii (A. baumannii) is an important nosocomial pathogen, which may be a causative agent in a wide-range of human pathologies. Carbapenems are usually considered the last safe and effective choice of drugs for the treatment of Gram-negative infections. The emergence of carbapenem-resistant A. baumannii (CRAB) is a critical public health issue as they leave clinicians with limited therapeutic options. In this study, phenotypic methods were used to characterize sixty-two (n = 62) A. baumannii isolates, which were included based on their suspected non-susceptibility to meropenem. Minimum inhibitory concentrations (MICs) of meropenem, levofloxacin, gentamicin, sulfamethoxazole/trimethoprim, tigecycline were determined using E-tests, while colistin MICs were determined using broth microdilution. The isolates were subjected to the modified Hodge test (MHT), the modified carbapenem-inactivation method (mCIM) and the imipenem/EDTA combined disk test (CDT). Efflux pump overexpression was studied using agar plates containing phenylalanine-arginine β-naphthylamide (PAβN). Assessment of biofilm-formation was carried out using the crystal violet tube-adherence method. 64.5% of the strains showed meropenem MICs in the resistant range (>8 mg/L), resistance rates were similarly high to the other tested antibiotics. The MHT and mCIM assay were positive in 79.0% and 67.7% of cases, respectively; the presence of an MBL was suggested for 29.0% of isolates. Efflux-pump overexpression was seen in 12.9% of isolates. 54.8% of the isolates were characterized as strong biofilm-producers. Microbiology laboratories have an important role in differentiating the distinct mechanisms by which these pathogens develop the CRAB phenotype, as plasmid-borne carbapenemases are significant from the standpoint of public health microbiology.