Lembaga Keuangan Mikro dan Manajemen Risiko Kredit: Sebuah Perspektif dari Perempuan Usaha Mikro

This paper develops framework of women micro entrepreneurs empower in order to analyze the contribution of 60% from 41 million of them in economic growth. The aims of this research are (1) analyze the impact of micro credit services towards business development among women micro entrepreneurers, (2) observes the relationships between micro finance institution and women micro entrepreneurs performance, (3) analyze the degree of credit risk faced by women micro entrepreneurs

Single-incision laparoscopic splenectomy

Single-incision laparoscopic surgery (SILS) is a rapidly evolving field as a bridge between traditional laparoscopic surgery and natural orifice transluminal endoscopic surgery. We present a case of SILS splenectomy performed with conventional laparoscopic instruments in a 7-month-old boy with the diagnosis of multiple splenic abscesses. A 3-cm umbilical incision was used for the placement of two (5 mm) trocars and one 10-mm videoscope (30°). Conventional laparoscopic dissector and grasper were the main tools during surgical procedure. Spleen was removed through the umbilical incision. Although procedures like aingle-incision cholecystectomy have been reported, to the best of our knowledge this is the first report of SILS splenectomy using conventional laparoscopic instruments reported from India and is perhaps the first in an infant in the world literature

Inflammatory and tissue injury marker dynamics in pediatric acute respiratory distress syndrome

BACKGROUND The molecular signature of pediatric acute respiratory distress syndrome (ARDS) is poorly described, and the degree to which hyperinflammation or specific tissue injury contributes to outcomes is unknown. Therefore, we profiled inflammation and tissue injury dynamics over the first 7 days of ARDS, and associated specific biomarkers with mortality, persistent ARDS, and persistent multiple organ dysfunction syndrome (MODS).METHODS In a single-center prospective cohort of intubated pediatric patients with ARDS, we collected plasma on days 0, 3, and 7. Nineteen biomarkers reflecting inflammation, tissue injury, and damage-associated molecular patterns (DAMPs) were measured. We assessed the relationship between biomarkers and trajectories with mortality, persistent ARDS, or persistent MODS using multivariable mixed effect models.RESULTS In 279 patients (64 [23%] nonsurvivors), hyperinflammatory cytokines, tissue injury markers, and DAMPs were higher in nonsurvivors. Survivors and nonsurvivors showed different biomarker trajectories. IL-1α, soluble tumor necrosis factor receptor 1, angiopoietin 2 (ANG2), and surfactant protein D increased in nonsurvivors, while DAMPs remained persistently elevated. ANG2 and procollagen type III N-terminal peptide were associated with persistent ARDS, whereas multiple cytokines, tissue injury markers, and DAMPs were associated with persistent MODS. Corticosteroid use did not impact the association of biomarker levels or trajectory with mortality.CONCLUSIONS Pediatric ARDS survivors and nonsurvivors had distinct biomarker trajectories, with cytokines, endothelial and alveolar epithelial injury, and DAMPs elevated in nonsurvivors. Mortality markers overlapped with markers associated with persistent MODS, rather than persistent ARDS.FUNDING NIH (K23HL-136688, R01-HL148054)