KONDISI DAN RESPON KEBIJAKAN EKONOMI MAKRO SELAMA KRISIS EKONOMI TAHUN 1997-98

Merosot tajamnya kondisi perekonomian nasional sejak terjadinya gejolak nilai tukar pertengahan 1997, diyakini sebagai dampak kombinasi antara besarnya aliran modal asing, lemahnya sektor keuangan,  serta lemahnya penilaian kegiatan usaha. Tulisan ini ditujukan untuk melihat pengaruh aliran modal keluar terhadap perekonomian nasional serta efektifitas respon kebijakan yang ditempuh. Dengan menggunakan model sederhana perekonomian terbuka, hasil pengujian membuktikan bahwa aliran modal keluar secara mendadak dan dalam jumlah yang sangat besar telah mengakibatkan kinerja perekonomian dengan cepat merosot serta dengan dampak yang cukup lama. Berbagai permasalahan yang timbul selama krisis seperti perekonomian yang terkontraksi, inflasi yang melambung dan nilai tukar yang melemah secara empiris dapat dibuktikan pada studi ini. Dari hasil studi ini juga terlihat bahwa respon kebijakan ekonomi yang ditempuh dengan titik berat pada stabilisasi jangka pendek terbukti cukup berhasil meskipun dengan pengorbanan semakin terkontraksinya perekonomian. Pengujian counterfactual memperkuat hasil ini yaitu bilamana kebijakan suku bunga tinggi segera diterapkan pada saal awal terjadinya krisis dan secara konsisten dipertahankan maka hasil yang terjadi adalah inflasi yang lebih rendah dan nilai tukar yang lebih kuat, meskipun di sisi lain kebijakan ini berdampak pada semakin merosotnya aktifitas perekonomian. Sedangkan apabila kebijakan fiscal dilakukan lebih ekspansif maka kontraksi perekonomian dapat lebih tertahan, kendati menciptakan trade off pada melemahnya nilai tukar dan melonjaknya inflasi.Dengan demikian, kombinasi kebijakan yang sebaiknya diterapkan dalam kaitannya dengan upaya mempercepat pemulihan perekonomian adalah kombinasi kontraksi di sisi moneter sejak terjadi tekanan aliran modal keluar dan ekspansif dari sisi fiskal yang dilakukan secara bertahap. Hal ini didukung dari hasil pengujian yang memperlihatkan bilamana kombinasi kebijakan tersebut diterapkan, laju inflasi yang dicapai relatif lebih rendah dengan nilai tukar yang lebih kuat. Namun demikian, kebijakan yang ditempuh tersebut dalam kaitannya dengan upaya stabilisasi nilai tukar tetaplah harus memperhatikan faktor-faktor yang mempengaruhi pergerakannya.Akhirnya implikasi lebih jauh dari tulisan ini adalah pentingnya upaya mengurangi ketergantungan pembiayaan pembangunan ekonomi yang bersumber dari dana asing, dengan belajar pada pengalaman yang dialami saat ini, maka dapat diyakini bahwa pembangunan yang lebih bersifat ‘indigenous process’ akan lebih tahan terhadap gangguan

THE GENERAL EQUILIBRIUM MODEL OF BANK INDONESIA (GEMBI)

Sampai saat ini Bank Indonesia telah memiliki model makro ekonometrik yang cukup paripurna seperti MODBI. Model makro seperti MODBI tersebut bersifat statik dan sangat berguna bagi kepentingan proyeksi makro jangka pendek. Namun, berdasarkan beberapa alasan fundamental model ekonometrik tersebut secara teoritis tidak dapat dipakai sebagai alat penunjuk arah gerak dinamis dari berbagai variable makro jangka menengah dan panjang. Untuk itu suatu model makro yang dinamis (dynamic macro model) yang digenerate dengan data artifisial (artificial generated data) yang bersifat random telah dikembangkan dan diberi nama General Equilibrium Model of Bank Indonesia (GEMBI)

Varicella-Zoster viruses associated with post-herpetic neuralgia induce sodium current density increases in the ND7-23 Nav-1.8 neuroblastoma cell line

Post-herpetic neuralgia (PHN) is the most significant complication of herpes zoster caused by reactivation of latent Varicella-Zoster virus (VZV). We undertook a heterologous infection in vitro study to determine whether PHN-associated VZV isolates induce changes in sodium ion channel currents known to be associated with neuropathic pain. Twenty VZV isolates were studied blind from 11 PHN and 9 non-PHN subjects. Viruses were propagated in the MeWo cell line from which cell-free virus was harvested and applied to the ND7/23-Nav1.8 rat DRG x mouse neuroblastoma hybrid cell line which showed constitutive expression of the exogenous Nav 1.8, and endogenous expression of Nav 1.6 and Nav 1.7 genes all encoding sodium ion channels the dysregulation of which is associated with a range of neuropathic pain syndromes. After 72 hrs all three classes of VZV gene transcripts were detected in the absence of infectious virus. Single cell sodium ion channel recording was performed after 72 hr by voltage-clamping. PHN-associated VZV significantly increased sodium current amplitude in the cell line when compared with non-PHN VZV, wild-type (Dumas) or vaccine VZV strains ((POka, Merck and GSK). These sodium current increases were unaffected by acyclovir pre-treatment but were abolished by exposure to Tetrodotoxin (TTX) which blocks the TTX-sensitive fast Nav 1.6 and Nav 1.7 channels but not the TTX-resistant slow Nav 1.8 channel. PHN-associated VZV sodium current increases were therefore mediated in part by the Nav 1.6 and Nav 1.7 sodium ion channels. An additional observation was a modest increase in message levels of both Nav1.6 and Nav1.7 mRNA but not Nav 1.8 in PHN virally infected cells

Collection of tracheal aspirate: safety and microbiological concordance between two techniques

Objective: To evaluate the safety of the performance of the traditional and protected collection techniques of tracheal aspirate and to identify qualitative and quantitative agreement of the results of microbiological cultures between the techniques. Method: Clinical, prospective, comparative, single-blind research. The sample was composed of 54 patients of >18 years of age, undergoing invasive mechanical ventilation for a period of ≥48 hours and with suspected Ventilator Associated Pneumonia. The two techniques were implemented in the same patient, one immediately after the other, with an order of random execution, according to randomization by specialized software. Results: No significant events occurred oxygen desaturation, hemodynamic instability or tracheobronchial hemorrhage (p<0.05) and, although there were differences in some strains, there was qualitative and quantitative agreement between the techniques (p<0.001). Conclusion: Utilization of the protected technique provided no advantage over the traditional and execution of both techniques was safe for the patient

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly

WSES guidelines for management of Clostridium difficile infection in surgical patients

In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency Surgery (WSES) guidelines for management of CDI in surgical patients.Peer reviewe