Validation of the Monitoring Efficacy of Neurogenic Bowel Treatment on Response (MENTOR) Tool in a Japanese Rehabilitation Setting

Study design: Prospective observational study. Objective: To validate the Monitoring Efficacy of NBD Treatment On Response (MENTOR) tool in individuals with a spinal cord injury (SCI) or spina bifida, suffering from neurogenic bowel dysfunction (NBD) in a rehabilitation center in Japan. Methods: First, the MENTOR tool was translated from English to Japanese using a validated translation process. Second, the MENTOR tool was validated in a rehabilitation clinic in Japan. Participants completed the MENTOR tool prior to a consultation with an expert physician. According to the results of the tool, each participant was allocated to one of three categories regarding change in treatment: “adequately treated,” “further discussion,” and “recommended change.” The results of the MENTOR tool were compared with the treatment decision made by an expert physician, who was blinded to the results of the MENTOR tool. Results: A total of 60 participants completed the MENTOR tool. There was an acceptable concordance between individuals allocated as respectively, being adequately treated (100%) and recommended change in treatment (61%) and the physicians’ decision on treatment. The concordance was lower for individuals allocated as requiring further discussion (48%). Conclusions: In this study the MENTOR tool was successfully validated in a Japanese rehab setting. The tool will help identify individuals with SCI that need further treatment of their NBD symptoms

Interaction of threat expressions and eye gaze: an event-related potential study

he current study examined the interaction of fearful, angry, happy, and neutral expressions with left, straight, and right eye gaze directions. Human participants viewed faces consisting of various expression and eye gaze combinations while event-related potential (ERP) data were collected. The results showed that angry expressions modulated the mean amplitude of the P1, whereas fearful and happy expressions modulated the mean amplitude of the N170. No influence of eye gaze on mean amplitudes for the P1 and N170 emerged. Fearful, angry, and happy expressions began to interact with eye gaze to influence mean amplitudes in the time window of 200–400 ms. The results suggest early processing of expression influence ERPs independent of eye gaze, whereas expression and gaze interact to influence later ERPs

HAL-HAL YANG MERINGANKAN PUTUSAN PENGADILAN TINDAK PIDANA KORUPSI PADA PENGADILAN TINGGI JAKARTA ATAS NAMA DR. PINANGKI SIRNA MALASARI, SH., MH. (Putusan Nomor: 10/PID.TPK/2021/PT DKI)

Juridically analyzing the Corruption Court Decision at the Jakarta High Court on behalf of the Defendant Pinangki Sirna Malasari, SH., MH. (Number: 10/PID.TPK/2021/PT DKI) aims to see whether the judge in deciding the case has complied with the principles -principles of justice and principles that apply in criminal law. Method The research approach used is a sociological juridical approach, which means that this research examines the problem by examining it in terms of legal science. In addition, it also provides an objective assessment of the considerations and decisions handed down by the Corruption Court. It also provides an overview of the demands of the Public Prosecutor in the case. This is done to see whether the demands of the Public Prosecutor, judges' considerations and decisions have a balance and correlation that builds a comprehensive logic of thinking. The three elements must be in line and proportional so as to produce quality and accountable decisions. This analysis is also expected to provide input for judges and other law enforcement officers in viewing and resolving similar problems or cases. So that it can also improve the quality of law enforcement for criminal acts of corruption. The results of this analysis indicate that there is a Misconduct of Judge carried out by the panel of judges in their considerations and decisions. The panel of judges was not careful in formulating the judge's considerations by looking at the portion of guilt and the role of the defendant. The Panel of Judges also deviated from the special minimum rules in the Corruption Crime Act where the minimum penalty as stipulated in Article 12 letter c is 4 years in prison. The defendant, who is a prosecutor who in fact understands and is a practitioner of law enforcement, should be considered by the Corruption Court to impose the harshest possible penalties for law enforcement officers who are proven to have committed such crimes. However, in reality what is happening in the field, there is a gap in sentencing that needs to be questioned and studied juridically and theoretically.Keywords: Judge Decision, Justice, Corruptio

Cost-Effectiveness Analysis of Transanal Irrigation for Managing Neurogenic Bowel Dysfunction in Japan.

BACKGROUND: Neurogenic bowel dysfunction (NBD) is a common sequela in Spinal Cord Injury (SCI) patients. Bowel dysfunction symptoms have a significant negative impact on quality of life (QOL) and are often socially disabling. Transanal irrigation (TAI) is a bowel management procedure that significantly mitigates NBD symptoms in patients refractory to standard bowel care (SBC) by reducing the incidence of fecal incontinence, ameliorating constipation, and improving QOL. TAI devices are used across many countries such as the United Kingdom, Germany, and France, and introduction of the devices is being considered in Japan. In this context, a cost-effectiveness analysis specific to Japanese settings is relevant. OBJECTIVES: To analyze the cost-effectiveness of TAI for bowel management of SCI patients with NBD in a Japanese clinical setting. Methods: A modified version of a previously developed and published Markov model was used to evaluate the cost-effectiveness of TAI. In the model, SCI patients using TAI due to NBD were compared with SCI patients not responding to TAI and continuing with SBC. Quality-adjusted Life Years (QALYs) were used as the primary effectiveness measure, and the analysis was conducted from the payer's perspective. RESULTS: The model predicts a lifetime incremental cost of TAI to be 3 198 687 yen compared with SBC. TAI provided an additional 0.8 QALY, which leads to an incremental cost-effectiveness ratio (ICER) of TAI vs SBC of 4 016 287 yen/QALY. CONCLUSIONS: An ICER of 4 million yen falls within the range of reported willingness to pay (WTP) per QALY gain (5-6.7 million yen) in Japan, and TAI is therefore found to be a cost-effective treatment strategy compared to SBC. The result should be further corroborated in future Japanese trials of TAI

Pengaruh Komunikasi Guru Terhadap Hasil Belajar Ekonomi Siswa Melalui Perilaku Siswa Sebagai Variabel Moderating Kelas X IPS SMA Gajah Mada Tahun Pelajaran 2022/2023

Penelitian ini bertujuan untuk mengetahui pengaruh komunikasi guru terhadap hasil belajar ekonomi siswa melalui perilaku siswa sebagai variabel moderasi siswa kelas X IPS SMA Gajah Mada T.A 2022/2023. Jenis penelitian ini adalah jenis penelitian deskriptif kuantitatif dengan populasi penelitian adalah seluruh siswa kelas X IPS SMA Gajah Mada T.A 2022/2023 dengan teknik total sampling. Instrumen yang digunakan adalah angket (angket) dan tes hasil belajar siswa berupa pilihan ganda yang telah diuji validasi instrumennya. Hasil penelitian menunjukkan bahwa hasil komunikasi guru thitung 5,857? 2,109 dengan nilai signifikansi 0,00 < 0,05 maka Ha1 diterima. Artinya komunikasi guru berpengaruh positif dan signifikan terhadap hasil belajar ekonomi siswa kelas X IPS SMA Gajah Mada T.A 2022/2023. Selanjutnya berdasarkan uji hipotesis simultan F diperoleh nilai Fhitung Ftabel sebesar 15,312?3,68 dengan taraf signifikansi 0,000?0,05. Berdasarkan hasil uji F dapat disimpulkan bahwa komunikasi guru dan perilaku siswa secara bersama-sama berpengaruh positif dan signifikan terhadap hasil belajar siswa di SMA Gajah Mada T.A 2022/2023 atau Ha2 diterima. Nilai koefisien determinasi sebesar 70,5% kontribusi komunikasi guru dan perilaku siswa terhadap hasil belajar siswa di SMA Gajah Mada T.A 2022/2023. Sehingga dapat disimpulkan bahwa perilaku siswa sebagai variabel pemoderasi menguat dalam memoderasi komunikasi guru terhadap hasil belajar. Sedangkan sisanya, yaitu 29,5% hasil belajar dijelaskan oleh variabel lain yang tidak termasuk dalam penelitian ini

Memorandum on Mississippi House Bill 1523

As legal scholars with expertise in matters of religious freedom, civil rights, and the interaction between those fields, we offer our opinion on the scope and meaning of Mississippi House Bill 1523, which was signed into law today by Governor Phil Bryant. Specifically, we wish to call attention to language in the law that we believe conflicts with the Establishment Clause of the U.S. Constitution. We share the view of Justice Kennedy when he expressed that “a bare . . . desire to harm a politically unpopular group cannot constitute a legitimate governmental interest,” and would add that neither can such a desire be justified in the name of religious liberty. HB 1523 presents a conflict with First Amendment religious freedom doctrine by providing for religious exemptions that will meaningfully harm the rights of others, particularly LGBT Mississippians

The side effect profile of Clozapine in real world data of three large mental hospitals

Objective: Mining the data contained within Electronic Health Records (EHRs) can potentially generate a greater understanding of medication effects in the real world, complementing what we know from Randomised control trials (RCTs). We Propose a text mining approach to detect adverse events and medication episodes from the clinical text to enhance our understanding of adverse effects related to Clozapine, the most effective antipsychotic drug for the management of treatment-resistant schizophrenia, but underutilised due to concerns over its side effects. Material and Methods: We used data from de-identified EHRs of three mental health trusts in the UK (>50 million documents, over 500,000 patients, 2835 of which were prescribed Clozapine). We explored the prevalence of 33 adverse effects by age, gender, ethnicity, smoking status and admission type three months before and after the patients started Clozapine treatment. We compared the prevalence of adverse effects with those reported in the Side Effects Resource (SIDER) where possible. Results: Sedation, fatigue, agitation, dizziness, hypersalivation, weight gain, tachycardia, headache, constipation and confusion were amongst the highest recorded Clozapine adverse effect in the three months following the start of treatment. Higher percentages of all adverse effects were found in the first month of Clozapine therapy. Using a significance level of (p< 0.05) out chi-square tests show a significant association between most of the ADRs in smoking status and hospital admissions and some in gender and age groups. Further, the data was combined from three trusts, and chi-square tests were applied to estimate the average effect of ADRs in each monthly interval. Conclusion: A better understanding of how the drug works in the real world can complement clinical trials and precision medicine

Testimony Regarding the First Amendment Defense Act (FADA)

My testimony today is delivered on behalf of twenty leading legal scholars who have joined me in providing an in depth analysis of the meaning and likely effects of the First Amendment Defense Act (FADA), were it to become law. We feel particularly compelled to provide testimony to this Committee because the first legislative finding set out in FADA declares that: “Leading legal scholars concur that conflicts between same-sex marriage and religious liberty are real and should be addressed through legislation.” As leading legal scholars we must correct this statement: we do not concur that conflicts between same-sex marriage and religious liberty are real, nor do we hold the view that any such conflict should be addressed through legislation. On the contrary, we maintain that religious liberty rights are already well protected in the U.S. Constitution and in existing federal and state legislation, rendering FADA both unnecessary and harmful