Impact of the Affordable Care Act on the Cooper Women’s Care Center

Background: The Affordable Care Act (ACA) increased access to women’s health care by expanding Medicaid eligibility and requiring that insurance plans cover many gynecologic preventive services at no cost to patients. Before implementation of the ACA, pregnant women with low incomes qualified for Medicaid but childless adults of the same income did not, and though prenatal obstetrical visits were covered by plans at no or low cost to patients, most gynecologic services required out of pocket payments. Objective: This study aimed to identify changes in the types of visits (gynecologic or obstetric) and patient demographics (including age, race, and insurance type) at the Cooper Women’s Care Clinic (WCC) as markers of the impact of the ACA. Methods: This is a cross-sectional study that utilized billing data from the Cooper WCC to understand the changes in visit type and demographics (age, race, and insurance type) over two pre-selected time periods, pre-ACA (2005-2009) and post-ACA (2011-2015). Our primary outcome was the proportion of total visits for each time period that were gynecologic vs. obstetrical. Our secondary outcomes were patient demographics, including age, race, and insurance type. Results: The proportion of gynecology visits in the post-ACA time period increased (71.4%) compared to the pre-ACA time period (62.7%), a statistically significant change (p\u3c0.0001) Conclusions: Our study demonstrates measurable changes that occurred in an urban Ob/Gyn practice as a result of the implementation of the ACA. Using gynecology visit volume as a marker of expanded access to Medicaid and free preventive services, it is clear that the ACA is changing the type of care provided by ob/gyns

Decitabine in the treatment of acute myeloid leukemia in elderly patients

Priya Malik, Amanda F CashenWashington University School of Medicine, St Louis, MO, USAAbstract: The majority of patients with acute myeloid leukemia (AML) are elderly and have a poor prognosis despite induction therapy. Decitabine, a DNA-hypomethylating agent that induces differentiation and apoptosis of leukemic cells, is a well-tolerated alternative to aggressive chemotherapy. It is currently FDA-approved for myelodysplastic syndrome, including patients with 20%–30% bone marrow blasts. Recent clinical attention has focused on evaluating decitabine as frontline therapy for untreated high-risk elderly AML patients. A large randomized international phase III study comparing decitabine to supportive care and cytarabine in elderly AML patients demonstrated significantly improved complete remission rates, but the survival difference did not reach significance. Due to this, decitabine did not achieve FDA approval for AML, but continues to be used off-label. Current research is focused on further defining subgroups of elderly AML patients who may derive greater benefit from decitabine therapy and combining it with other low-intensity active agents for AML.Keywords: decitabine, elderly, AM

The Effectiveness of Taro Compost Fertilizer on Soil pH, Growth and Yield of Pak Choy (Brassica rapa L.) in Tasikmalaya

Lack of awereness about the use of agriculture waste in increasing soil fertility leading to high use of inorganic fertilizer. Continuous use of inorganic fertilizer can reduce soil fertility in the future. This research aims to determine the impact of providing taro compost fertilizer on soil pH, growth and yield of pak choy In Tasikmalaya. This research was carried out in experimental field of Agriculture Faculty, Universitas Perjuangan Tasikmalaya from October until November 2023. Experimental design used a randomized block design of one factor with six treatments and three replications. The treatments consist of without taro compost fertilizer, 100, 150, 200, 250 and 300 g/polybag taro compost fertilizer. Reseach results show taro compost fertilizer can increase plant height,  fresh weight of the plant, plant root length,  fresh weight of roots and plant canopy weight. The best treatment was 300 g/polybag with plant height 16,8 cm, fresh weight of plant 55,63 g, plant root length 15,83 cm, fresh weight of roots 8,63 g, and plant canopy weight 47 g compared to control treatment without taro compost fertilizer. However, addition various doses taro compost fertilizer hasn’t effect for soil pH. The conclution of this research is that giving various doses of compost fertilizer can increase the growth and yield of pak choy in Tasikmalaya

Dissecting Distinct Roles of NEDDylation E1 Ligase Heterodimer APPBP1 and UBA3 Reveals Potential Evolution Process for Activation of Ubiquitin-related Pathways.

Despite the similar enzyme cascade in the Ubiquitin and Ubiquitin-like peptide(Ubl) conjugation, the involvement of single or heterodimer E1 activating enzyme has been a mystery. Here, by using a quantitative Förster Resonance Energy Transfer (FRET) technology, aided with Analysis of Electrostatic Similarities Of Proteins (AESOP) computational framework, we elucidate in detail the functional properties of each subunit of the E1 heterodimer activating-enzyme for NEDD8, UBA3 and APPBP1. In contrast to SUMO activation, which requires both subunits of its E1 heterodimer AOS1-Uba2 for its activation, NEDD8 activation requires only one of two E1 subunits, UBA3. The other subunit, APPBP1, only contributes by accelerating the activation reaction rate. This discovery implies that APPBP1 functions mainly as a scaffold protein to enhance molecular interactions and facilitate catalytic reaction. These findings for the first time reveal critical new mechanisms and a potential evolutionary pathway for Ubl activations. Furthermore, this quantitative FRET approach can be used for other general biochemical pathway analysis in a dynamic mode

Pengembangan Ekowisata di Distrik Supiori Timur, Kabupaten Supiori Papua: Ecotourism Development in Supiori Timur District, Supiori Regency Papua

Abstrak Wilayah Distrik Supiori Timur merupakan administrasi Kabupaten Supiori, Provinsi Papua, yang terdiri dari 10 Kampung, untuk pengembangan ekowisata mangrove terdapat di kampung Waryesi dan Sorendidori. Pengembangan ekowisata mangrove di Distrik Supiori Timur Kabupaten Supiori, dari data lapangan dan informasi masyarakat dinilai kurang maksimal dalam mendukung program pengembangan daerah, karena beberapa hal yaitu ; pengembangan hanya berfokus pada kawasan mangrove tanpa melihat potensi yang ada disekitar kawasan, maka penelitian ini bertujuan daya tarik wisata ekowisata mangrove yang ada di Distrik Supiori Timur, serta strategi pengembangan ekowisata di Distrik Supiori Timur Kampung Waryesi dan Sorendidori, Kabupaten Supiori Papua. Teknik analisis deskriptif kualitatif, menganalisis mempergunakan acuan ADO-ODTWA (analisis daerah operasi -objek dan daya Tarik) dan analisis SWOT Kata kunci : Pengembangan ekowisata, ADO-ODTWA, Strategi Pengembangan Abstract The East Supiori District area is the administration of Supiori Regency, Papua Province, which consists of 10 villages, for the development of mangrove ecotourism located in Waryesi and Sorendidori villages. The development of mangrove ecotourism in Supiori Timur District, Supiori Regency, from field data and community information is considered less than optimal in supporting regional development programs, due to several things, namely; development only focuses on mangrove areas without looking at the potential that exists around the area, so this study aims to attract mangrove ecotourism tourism in East Supiori District, as well as ecotourism development strategies in East Supiori District Waryesi and Sorendidori Villages, Supiori Regency Papua. Qualitative descriptive analysis technique, analyzing using ADO-ODTWA reference (analysis of operating area - object and attraction) and SWOT analysis Keyword: Development of ecotourism, ADO-ODTWA, Development Strateg

Disability status, individual variable pay, and pay satisfaction: does relational and institutional trust make a difference?

Although prior research suggests that disabled employees have different needs in the context of some human resource management (HRM) practices, we know little about their reactions to reward systems. We address this gap in the literature by testing a model using the 2011 British Workplace Employee Relations Survey (disabled employees n=1,251; nondisabled employees n=9,959; workplaces n=1806) and find that disabled employees report lower levels of pay satisfaction than nondisabled employees, and when compensated based on individual performance, the difference in pay satisfaction is larger. We suggest that relational (derived from trust in management) and institutional (derived from firm-wide policies and HRM practices, both intended to provide equitable treatment to disabled employees) forms of trust play important roles. The results of multilevel analyses show that when trust in management is high, the difference in pay satisfaction under variable pay is reduced. We find just the opposite for employees who work in organizations with a formal disability policy but without supportive HRM practices; the gap in pay satisfaction is exacerbated. However, the combination of the presence of a firm-wide policy and HRM practices reduced the difference in pay satisfaction. Implications of the findings for theory, future research, and management practice are discussed

Permisive Parenting and Extrovert Personality With Consumtive Behavior in Indonesian Workers (TKI / TKW) Children in Bandung Tulungagung District

The purpose of this study was to examine the relationship between permissive parenting and extroverted personality with consumptive behavior in TKI / TKW children in Bandung Tulungagung District. The research subjects were 70 students of class X and XI of SMK Negeri 1 Bandung Tulungagung. The research method uses Quantitative by using Non-Parametric Kendall analysis. Based on the analysis, it was obtained results that permissive parenting and extroverted personality with consumptive behavior had a significant correlation. Extroverted personality with consumptive behavior has a significant relationship, but permissive parenting with consumptive behavior is not significantly associate

Investigating the impacts of various solvents fractions of Bupleurum lancifolium on the antimicrobial and antioxidant potentials

In the last thirty years, interests in searching for plants with potential antimicrobial and antioxidant activities have been increased due to their probable health benefits. This study aimed to investigate the antimicrobial and antioxidant effects of various solvents fractions of Bupleurum lancifolium. Methods: The antioxidant activities of four fractions of Bupleurum lancifolium were assessed by 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging assay, while the antimicrobial activity was assessed by broth microdilution method. The antimicrobial activity of four plant fractions was examined against Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Shigella sonnie and Enterococcus faecium American Type Culture Collection reference strains. Results: The fractionation extraction method succeeds in the assessment of the antibacterial and antioxidant activity of B. lancifolium plant. Hence the methanolic fraction has antioxidant potential with 33.03% of inhibition according to the Trolox antioxidant standard molecule, while n-hexane and methanol fractions showed powerful antibacterial activity against E. faecium and S. sonnie strains with Minimum Inhibitory Concentration (MIC)1.5625 mg/ml for both fractions. Conclusion: All plant fractions have potent antioxidant and antibacterial activities. Further investigations, i.e. isolation, identification, and clinical assessment, of the active compound(s) are needed for the possible formulation of new therapeutic alternatives.The authors acknowledge the assistance of the technicians Mohamad Arar and Linda Esa