Untangling the socio-political knots: A systems view on Indonesia's inclusive energy transitions

National energy transitions face complex socio-political challenges, ranging from inertia to exacerbated inequalities. There are limited studies investigating these dimensions, especially in developing economies. This paper presents Indonesia, a country with high fossil fuel dependency, as a valuable case study to investigate the societal interplay affecting transitions. Interviews and literature analyses were conducted to assess barriers and levers to success. The findings are further analysed with systems thinking (ST), highlighting dynamic patterns and interdependencies. It is found that conflicting interests, inconsistent regulation, and low capability at the implementation level are among the most persistent barriers creating disparities between intentions and reality. These leave some groups disproportionately disadvantaged; notably, regions with fossil fuel-dependent income, informal sectors, and indigenous and local communities. Recommendations include the creation of an independent agency for the energy transition, and empowering regional participation. Addressing inclusion is imperative for social justice as well as to ensure adoptability and acceptance from all

Incorporating social mechanisms in energy decarbonisation modelling

The achievement of national pledges that are compatible with the Paris Agreements warming limit of 1.5C is a massive challenge, as it requires not only an acceleration of technological innovation, but also a socio-economic and cultural transformation. Reducing uncertainties demands a better integration of behavioural evolutions in models exploring future energy pathways, including non-monetary barriers and drivers to technology diffusion. This study provides suggestions on incorporating social mechanisms of change such as resistance to change and the diffusion of environmental values into a UK-focused probabilistic energy system model, with a focus on people's attitudes towards residential heating technologies. We also offer a comprehensive literature review on interdisciplinary energy transitions modelling and exploratory scenarios embedding climate risks perceptions. We argue that efficient policy-making to meeting net-zero emissions targets must fully embrace whole-system approaches, support the more constrained segments of society, and account for interconnected socio-political factors

Invasive maxillary sinus aspergillosis: a case report successfully treated with voriconazole and surgical debridement

Introduction: Invasive aspergillosis of the paranasal sinuses is a rare disease and often misdiagnosed; however, its incidence has seen substancial growth over the past 2 decades. Definitive diagnosis of these lesions is based on histological examination and fungal culture. Case Report: An 81-year-old woman with a history of pain in the left maxillary region is presented. The diagnosis was invasive maxillary aspergillosis in immunocompetent patient, which was successfully treated with voricona - zole and surgical debridement. Possible clinical manifestations, diagnostic imaging techniques and treatment used are discussed. Since the introduction of voriconazole, there have been several reports of patients with invasive aspergillosis who responded to treatment with this new antifungal agent. Conclusions: We report the importance of early diagnosis and selection of an appropriate antifungal agent to achie - ve a successful treatment

Cavernous hemangioma of the parotid gland in adults

Hemangiomas account for 0.4-0.6% of all tumors of the parotid gland and most of them occur in children, never - theless in adults hemangiomas are very rare. We report the case of a 62 year old woman with a mass in the parotid right tail associated with fluctuating swelling episodes unrelated to meals and with a slowly progressive growth. The provisional diagnosis was a pleomorphic adenoma, so a right superficial parotidectomy was performed. During surgery, the macroscopic appearance makes suspect a vascular lesion. The histopathological result was a cavernous hemangioma. The classic clinical presentation of a parotid hemangioma is an intraglandular mass associated or not with skin lesions characterized by reddish macules and/or papules, and a vibration or pulsation when palpating the parotid region. In imaging tests, phleboliths could be observed which are very suggestive of a hemangioma or a vascular malformation. In the absence of these signs, the diagnosis could be difficult, particularly in an adult due to its low prevalence, with about 50 cases reported worldwide. However a hemangioma should be considered in the differential diagnosis of parotid tumors in adults

Decreased lung ischemia-reperfusion injury in rats after preoperative administration of cyclosporine and tacrolimus

AbstractObjectives: Calcineurin inhibitors reduce experimental reperfusion injury in the liver, brain, heart, kidney, and small bowel. These studies were undertaken to determine whether these agents are similarly protective against lung ischemia-reperfusion injury. Methods: Left lungs of male rats were rendered ischemic for 90 minutes and reperfused for as long as 4 hours. Treated animals received cyclosporine A (INN: ciclosporin; 1 or 5 mg/kg) or tacrolimus (0.2 mg/kg) 6 hours before ischemia, at reperfusion, or 2 hours after reperfusion. Injury was quantitated in terms of tissue polymorphonuclear leukocyte accumulation (myeloperoxidase content), vascular permeability (iodine 125-labeled bovine serum albumin extravasation), and bronchoalveolar lavage leukocyte content. Separate tissue samples were processed for nuclear protein and cytokine messenger RNA. Results: Treatment with cyclosporine (5 mg/kg) or tacrolimus (0.2 mg/kg) 6 hours before reperfusion reduced lung vascular permeability by 54% and 56% relative to control animals (P <.03). The protective effects of cyclosporine and tacrolimus treatment before reperfusion correlated with 42% and 43% reductions in tissue polymorphonuclear leukocyte (myeloperoxidase) content (P <.008) and marked reductions in bronchoalveolar lavage leukocyte accumulation (P <.01). Administration of cyclosporine or tacrolimus at the time of reperfusion or 2 hours into the reperfusion period offered little or no protection. Animals treated before reperfusion also demonstrated marked reductions in nuclear factor κB activation and expression of proinflammatory cytokine messenger RNA. Conclusion: Cyclosporine and tacrolimus treatment before reperfusion was protective against lung ischemia-reperfusion injury in rats. The mechanism of these protective effects may involve the inhibition of nuclear factor κB, a central transcription factor mediating inflammatory injury. The decreased expression of cytokine messenger RNA indicates that both cyclosporine and tacrolimus may exert their protective effects at the pretranscriptional level.J Thorac Cardiovasc Surg 2002;123:756-6

Beyond the social license to operate: Whole system approaches for a socially responsible mining industry

The demand for minerals, metals and rare-earth elements is rapidly growing to support the transition to low-carbon energies, and the mining industry must increase its supply while facing complex Environmental, Social and Governance (ESG) risks. Traditionally relying on its engineering expertise to maximize ore extraction, the sector must now find ways to sustain its production while facing increased scrutiny from the public, civil societies and shareholders alike. The paper reviews current practice in sustainability assessment to highlight sector-specific characteristics and the notion of trust as central to effective project developments. Because the social interface of extractive operations is complex, dynamic and non-linear in nature, we recommend going beyond the aim of obtaining a social license to operate and use Systems Thinking to fully embed Corporate Social Responsibility (CSR) at the core of strategic mine planning. System Dynamics can foster interdisciplinary collaborations by bridging together social and technical flows within simulation models to identify sustainable levers of change. We present the development of a stock and flow model quantifying causal mechanisms between the use of cyanide, the environment, communities and public trust, and operational productivity. Industry practitioners, researchers and facilitators can use the model as an adaptable framework to engage with systems modelling in mining. We recommend its use in conjunction with meaningful stakeholder's engagement to ensure shared understanding, reduced uncertainty and long-term benefits for all

Frontal sinus mucocele with intracranial and intraorbital extension

ABSTRACT Introduction: Frontal sinus mucoceles can present with a multitude of different symptoms including ophthalmic disturbances. Even benign, they have a tendency to expand by eroding the surrounding bony walls that displaces and destroys structures by pressure and bony resorption. Case report: A 32-year-old man with diplopia, proptosis of the right eye and headache was presented. The diagnosis was frontal sinus mucocele with intracranial and intraorbital extension. Possible clinical manifestations of mucoceles, diagnostic imaging techniques and treatment used are discussed. Conclusion: Frontal mucoceles are benign and curable, early recognition and management of them is of paramount importance, because they can cause local, orbital or intracranial complications