598 research outputs found
Analisis Pengenaan Pajak Final dan Non Final pada Perusahaan Jasa Konstruksi di Bei
Penelitian ini dilakukan untuk mengetahui perbedaan antara pengenaan pajak final dan pajak non final. Penelitian ini menggunakan data laporan keuangan yang telah dipublikasi selama kurun waktu 2010-2014 (lima tahun). Metode statistik dalam penelitian ini menggunakan uji normalitas, uji homogenitas, uji ANOVA, dan Uji Independent t-Test. Berdasarkan hasil analisis statistik bahwa terdapat perbedaan yang signifikan antara pengenaan pajak final dan pajak non final dalam menentukan besarnya pajak yang terutang. Pengenaan pajak final lebih besar secara signifikan dibandingkan dengan pengenaan pajak non final. Bagi pemerintah, pengenaan pajak secara final dinilai sangat menguntungkan karena dapat menambah sumber penerimaan dalam keuangan negara. Namun, disisi lain bagi wajib dinilai sangat merugikan karena pengenaan pajak secara final tidak memperhatikan biaya-biaya yang dikeluarkan dalam memperoleh penghasilan tersebut
Pengaruh Iradiasi Gamma Pada Aktivitas Sitotoksik Daging Buah Mahkota Dewa (Phaleria Macrocarpa (Scheff) Boerl.)
Iradiasi gamma telah digunakanoleh industri obat herbal untuk pengawetan simplisia tanaman obat, tetapi pengaruh iradiasiterhadap khasiatnya belum diteliti. Tujuan penelitian adalah memperoleh dosis iradiasi optimaluntuk pengawetan simplisia daging buah mahkota dewa tanpa merusak khasiatnya. Telahdilakukan iradiasi gamma terhadap simplisia daging buah kering mahkota dewa pada variasidosis 0; 5; 7,5 ; 10; 15; 20 kGy. Cemaran mikroba diuji dengan metode yang mengacu padaSNI, yang menunjukkan bahwa dosis 5 kGy telah dapat membunuh seluruh mikroba. Masingmasingsampel dimaserasi dengan etanol, lalu ekstrak yang diperoleh difraksinasi dengankromatografi kolom, diperoleh 8 fraksi. Uji sitotoksisitas fraksi-fraksi terhadap sel leukemiaL1210 menunjukkan bahwa Fr.3 merupakan fraksi paling sitotoksik. Untuk menentukan dosisiradiasi optimal dalam menghambat pertumbuhan serta membunuh semua bakteri dankapang/khamir pada simplisia daging buah mahkota dewa tanpa menurunkan aktivitassitotoksik, dilakukan analisis kromatografi lapis tipis (KLT) dan kromatografi cair kinerja tinggi(KCKT) terhadap Fr.3. Hasil penelitian menunjukkan bahwa iradiasi dengan dosis > 5 kGy padasimplisia daging buah mahkota dewa dapat menghambat pertumbuhan dan membunuh semuabakteri serta kapang khamir yang ada tanpa menurunkan aktivitas sitotoksik ekstrak etanolsecara nyata terhadap sel leukemia L1210. Penurunan aktivitas sitotoksik ekstrak etanolterhadap sel leukemia L1210 secara nyata terjadi setelah iradiasi pada dosis > 10 kGy. Padadosis 10 kGy, aktivitas sitotoksik sudah terlihat menurun meskipun belum melampaui batassuatu fraksi dinyatakan tidak aktif dan hasil analisis profil kromatogram KLT menunjukkanbahwa Fr. 3 sedikitnya mengandung 10 komponen. Iradiasi sampai dengan dosis 20 kGymengakibatkan intensitas salah satu puncak mayor menurun, dan penurunannya sebandingdengan besarnya dosis. Dosis 5 sampai 10 kGy merupakan dosis optimum untuk tujuanpengawetan tanpa merusak aktivitas sitotoksiknya
The Effect of Health Insurance on Institutional Delivery in Indonesia
Institutional delivery has an impact on the decline in maternal mortality rate. In Indonesia, institutional delivery increases every year, but there are still 30%-37% mothers who deliver at home. Unfortunately, the increase is not in line with maternal mortality reduction, so that Indonesia does not achieve the fifth MDGs goal. To achieve Universal Health Coverage, Indonesia implements National Health Insurance (NHI). NHI integrates four types of health insurance, namely Askes/ASABRI, Jamsostek, Jamkesmas and Jamkesda. One of its benefits is maternal health services. Health insurance can address financial barriers on delivery in health facility. By using secondary data of National Basic Health Research 2013 and Village Potential 2011 data, this study aimed to analyze effect of health insurance on institutional delivery in Indonesia. Samples were 39,942 women aged 15-49 years old who gave birth to their last child during 2010-2013. The study used econometric approach by applying probit and bivariate probit as estimation model to estimate the effect with consideration to endogeneity issue of health insurance. The results found that health insurance was likely to increase institutional delivery by 39.52%. In conclusion, women who have health insurance prefer to deliver birth at health facility compared to those who do not have health insurance
First in man in-situ augmented reality pedicle screw navigation
Background
Augmented reality (AR) is a rising technology gaining increasing utility in medicine. By superimposing the surgical site and the operator's visual field with computer-generated information, it has the potential to enhance the cognitive skills of surgeons. This is the report of the first in man case with "direct holographic navigation" as part of a randomized controlled trial.
Case description
A pointing instrument was equipped with a sterile fiducial marker, which was used to obtain a digital representation of the intraoperative bony anatomy of the lumbar spine. Subsequently, a previously validated registration method was applied to superimpose the surgery plan with the intraoperative anatomy. The registration result is shown in situ as a 3D AR hologram of the preoperative 3D vertebra model with the planned screw trajectory and entry point for validation and approval by the surgeon. After achieving alignment with the surgery plan, a borehole is drilled and the pedicle screw placed. Postoperativ computer tomography was used to measure accuracy of this novel method for surgical navigation.
Outcome
Correct screw positions entirely within bone were documented with a postoperative CT, with an accuracy similar to current standard of care methods for surgical navigation. The patient was mobilized uneventfully on the first postoperative day with little pain medication and dismissed on the fourth postoperative day.
Conclusion
This first in man report of direct AR navigation demonstrates feasibility in vivo. The continuation of this randomized controlled study will evaluate the value of this novel technology
Knowledge sharing between elementary teacher education students in online discussion
In online discussion activities, there are knowledge-sharing activities in which the factors are trust, equality, intrinsic motivation, and the use of technology. This type of research is descriptive quantitative. Here the researcher wants to explain the factors that influence knowledge-sharing activities among elementary teacher education students in online discussions. The sample of this study was 221 elementary teacher education students in Sumatra, Java, Kalimantan, and Sulawesi. Data analysis technique applied Multiple Linear Regression analysis techniques by using SPSS software version 21.0 with a significance level of 0.05. The results of this study indicated that similarity and technology use are factors that greatly influence knowledge-sharing activities, while trust and intrinsic motivation factors are factors that do not significantly affect knowledge-sharing activities. Equality factors such as age, background, and gender provide a major role in the success of knowledge-sharing activities. In order to support knowledge-sharing activities among elementary teacher education students to be effective and efficient, it is necessary to use technology with supportive frequency use
Modes of Overinitiation, dnaA Gene Expression, and Inhibition of Cell Division in a Novel Cold-Sensitive hda Mutant of Escherichia coli
The chromosomal replication cycle is strictly coordinated with cell cycle progression in Escherichia coli. ATP-DnaA initiates replication, leading to loading of the DNA polymerase III holoenzyme. The DNA-loaded form of the {beta} clamp subunit of the polymerase binds the Hda protein, which promotes ATP-DnaA hydrolysis, yielding inactive ADP-DnaA. This regulation is required to repress overinitiation. In this study, we have isolated a novel cold-sensitive hda mutant, the hda-185 mutant. The hda-185 mutant caused overinitiation of chromosomal replication at 25{degrees}C, which most likely led to blockage of replication fork progress. Consistently, the inhibition of colony formation at 25{degrees}C was suppressed by disruption of the diaA gene, an initiation stimulator. Disruption of the seqA gene, an initiation inhibitor, showed synthetic lethality with hda-185 even at 42{degrees}C. The cellular ATP-DnaA level was increased in an hda-185-dependent manner. The cellular concentrations of DnaA protein and dnaA mRNA were comparable at 25{degrees}C to those in a wild-type hda strain. We also found that multiple copies of the ribonucleotide reductase genes (nrdAB or nrdEF) or dnaB gene repressed overinitiation. The cellular levels of dATP and dCTP were elevated in cells bearing multiple copies of nrdAB. The catalytic site within NrdA was required for multicopy suppression, suggesting the importance of an active form of NrdA or elevated levels of deoxyribonucleotides in inhibition of overinitiation in the hda-185 cells. Cell division in the hda-185 mutant was inhibited at 25{degrees}C in a LexA regulon-independent manner, suggesting that overinitiation in the hda-185 mutant induced a unique division inhibition pathway
A systematic analysis of preprints in Trauma & Orthopaedic surgery
AIMS
Preprint servers allow authors to publish full-text manuscripts or interim findings prior to undergoing peer review. Several preprint servers have extended their services to biological sciences, clinical research, and medicine. The purpose of this study was to systematically identify and analyze all articles related to Trauma & Orthopaedic (T&O) surgery published in five medical preprint servers, and to investigate the factors that influence the subsequent rate of publication in a peer-reviewed journal.
METHODS
All preprints covering T&O surgery were systematically searched in five medical preprint servers (medRxiv, OSF Preprints, Preprints.org, PeerJ, and Research Square) and subsequently identified after a minimum of 12 months by searching for the title, keywords, and corresponding author in Google Scholar, PubMed, Scopus, Embase, Cochrane, and the Web of Science. Subsequent publication of a work was defined as publication in a peer-reviewed indexed journal. The rate of publication and time to peer-reviewed publication were assessed. Differences in definitive publication rates of preprints according to geographical origin and level of evidence were analyzed.
RESULTS
The number of preprints increased from 2014 to 2020 (p < 0.001). A total of 38.6% of the identified preprints (n = 331) were published in a peer-reviewed indexed journal after a mean time of 8.7 months (SD 5.4 (1 to 27)). The highest proportion of missing subsequent publications was in the preprints originating from Africa, Asia/Middle East, and South America, or in those that covered clinical research with a lower level of evidence (p < 0.001).
CONCLUSION
Preprints are being published in increasing numbers in T&O surgery. Depending on the geographical origin and level of evidence, almost two-thirds of preprints are not subsequently published in a peer-reviewed indexed journal after one year. This raises major concerns regarding the dissemination and persistence of potentially wrong scientific work that bypasses peer review, and the orthopaedic community should discuss appropriate preventive measures.Cite this article: Bone Jt Open 2022;3(7):582-588
Augmented reality navigation for spinal pedicle screw instrumentation using intraoperative 3D imaging
BACKGROUND CONTEXT
Due to recent developments in augmented reality with head-mounted devices, holograms of a surgical plan can be displayed directly in the surgeon's field of view. To the best of our knowledge, three dimensional (3D) intraoperative fluoroscopy has not been explored for the use with holographic navigation by head-mounted devices in spine surgery.
PURPOSE
To evaluate the surgical accuracy of holographic pedicle screw navigation by head-mounted device using 3D intraoperative fluoroscopy.
STUDY DESIGN
In this experimental cadaver study, the accuracy of surgical navigation using a head-mounted device was compared with navigation with a state-of-the-art pose-tracking system.
METHODS
Three lumbar cadaver spines were embedded in nontransparent agar gel, leaving only commonly visible anatomy in sight. Intraoperative registration of preoperative planning was achieved by 3D fluoroscopy and fiducial markers attached to lumbar vertebrae. Trackable custom-made drill sleeve guides enabled real-time navigation. In total, 20 K-wires were navigated into lumbar pedicles using AR-navigation, 10 K-wires by the state-of-the-art pose-tracking system. 3D models obtained from postexperimental CT scans were used to measure surgical accuracy. MF is the founder and shareholder of Incremed AG, a Balgrist University Hospital start-up focusing on the development of innovative techniques for surgical executions. The other authors declare no conflict of interest concerning the contents of this study. No external funding was received for this study.
RESULTS
No significant difference in accuracy was measured between AR-navigated drillings and the gold standard with pose-tracking system with mean translational errors between entry points (3D vector distance; p=.85) of 3.4±1.6 mm compared with 3.2±2.0 mm, and mean angular errors between trajectories (3D angle; p=.30) of 4.3°±2.3° compared with 3.5°±1.4°.
CONCLUSIONS
In conclusion, holographic navigation by use of a head-mounted device achieve accuracy comparable to the gold standard of high-end pose-tracking systems.
CLINICAL SIGNIFICANCE
These promising results could result in a new way of surgical navigation with minimal infrastructural requirements but now have to be confirmed in clinical studies
Operator independent reliability of direct augmented reality navigated pedicle screw placement and rod bending
Background
AR based navigation of spine surgeries may not only provide accurate surgical execution but also operator independency by compensating for potential skill deficits. “Direct” AR-navigation, namely superposing trajectories on anatomy directly, have not been investigated regarding their accuracy and operator's dependence.
Purpose of this study was to prove operator independent reliability and accuracy of both AR assisted pedicle screw navigation and AR assisted rod bending in a cadaver setting.
Methods
Two experienced spine surgeons and two biomedical engineers (laymen) performed independently from each other pedicle screw instrumentations from L1-L5 in a total of eight lumbar cadaver specimens (20 screws/operator) using a fluoroscopy-free AR based navigation method. Screw fitting rods from L1 to S2-Ala-Ileum were bent bilaterally using an AR based rod bending navigation method (4 rods/operator). Outcome measures were pedicle perforations, accuracy compared to preoperative plan, registration time, navigation time, total rod bending time and operator's satisfaction for these procedures.
Results
97.5% of all screws were safely placed (<2 mm perforation), overall mean deviation from planned trajectory was 6.8±3.9°, deviation from planned entry point was 4±2.7 mm, registration time per vertebra was 2:25 min (00:56 to 10:00 min), navigation time per screw was 1:07 min (00:15 to 12:43 min) rod bending time per rod was 4:22 min (02:07 to 10:39 min), operator's satisfaction with AR based screw and rod navigation was 5.38±0.67 (1 to 6, 6 being the best rate). Comparison of surgeons and laymen revealed significant difference in navigation time (1:01 min; 00:15 to 3:00 min vs. 01:37 min; 00:23 to 12:43 min; p = 0.004, respectively) but not in pedicle perforation rate.
Conclusions
Direct AR based screw and rod navigation using a surface digitization registration technique is reliable and independent of surgical experience. The accuracy of pedicle screw insertion in the lumbar spine is comparable with the current standard techniques
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