The issue of dual citizenships has been in much of the debate over the years. Many developed countries such as US, UK, Australia, and Switzerland have no restrictions on holding dual nationality, ...whereas countries such as Singapore, Austria, India, and Saudi Arabia do not “recognize” or “restrict” dual citizenships, leading to automatic loss of citizenship upon acquiring other. Some countries such as Austria, Spain may still grant dual citizenships upon certain special conditions under exceptional cases like celebrities. The implementation of dual citizenship nowadays is not something strange or unusual things internationally. By considering the international environment that is nowadays being wider and no limit, everyone has an easy access to go abroad. In Indonesia, the concept of dual citizenship still limited to the children from inter-marriage, while consider the amount of Indonesian diaspora in another country this is the time for Indonesia to upgrade or revise the citizenship system in Indonesia.
Objective: In the acute stage of ruptured cerebral aneurysms, limited devices are available, making the treatment difficult. We aimed to evaluate the outcomes of the coil embolization with stenting ...for the ruptured cerebral aneurysms in the acute stage.Methods: We assessed 22 cases treated with stenting among 134 of 169 consecutive patients with subarachnoid hemorrhages undergoing an endovascular treatment between April 2014 and December 2021, of which 134 underwent an embolization during the acute stage. A stent was used in the patients wherein the treatment with the balloon-assisted or double catheter technique was difficult. Stenting was performed under the loading of two or more antiplatelet agents.Results: The mean age of the patients was 68.9 years, of which five were male and 14 (63.6%) had severe grade (World Federation of Neurosurgeons grade IV, V). The aneurysm site was the anterior communicating artery in four cases, internal carotid artery in nine, middle cerebral artery in two, vertebrobasilar artery in six, and posterior cerebral artery in one. The aneurysm shape was saccular in 13 cases, dissection in seven, and fusiform in two. Stents were used for wide-neck aneurysms in 12 cases, vascular preservation in seven, and rescue in three. The mean maximum diameter was 9.6 mm. The mean neck size was 6.4 mm. Complete occlusion and neck remnant were found in eight and seven cases, respectively. The perioperative complication rate was 45.5% (thromboembolism in five cases, stent occlusion in two, re-bleeding in two, and cerebral hemorrhage in one). The outcomes included modified Rankin Scale 0–2 in seven cases, 4–5 in five, and 6 in nine. Stent-related death occurred in one case. The rate of morbidity and mortality was 18.2%. Although stents were used in the acute stage of rupture, they were used for the right reasons. However, a high rate of complications occurred: two cases of re-bleeding, in which an incomplete occlusion was a factor.Conclusion: Stent placement in patients with the acute ruptured cerebral aneurysms should be carefully determined and efforts should be made to reduce the embolic and hemorrhagic complications. However, it may be an effective treatment option when other options could be extremely difficult.
Objective: In the acute stage of ruptured cerebral aneurysms, limited devices are available, making the treatment difficult. We aimed to evaluate the outcomes of the coil embolization with stenting ...for the ruptured cerebral aneurysms in the acute stage.Methods: We assessed 22 cases treated with stenting among 134 of 169 consecutive patients with subarachnoid hemorrhages undergoing an endovascular treatment between April 2014 and December 2021, of which 134 underwent an embolization during the acute stage. A stent was used in the patients wherein the treatment with the balloon-assisted or double catheter technique was difficult. Stenting was performed under the loading of two or more antiplatelet agents.Results: The mean age of the patients was 68.9 years, of which five were male and 14 (63.6%) had severe grade (World Federation of Neurosurgeons grade IV, V). The aneurysm site was the anterior communicating artery in four cases, internal carotid artery in nine, middle cerebral artery in two, vertebrobasilar artery in six, and posterior cerebral artery in one. The aneurysm shape was saccular in 13 cases, dissection in seven, and fusiform in two. Stents were used for wide-neck aneurysms in 12 cases, vascular preservation in seven, and rescue in three. The mean maximum diameter was 9.6 mm. The mean neck size was 6.4 mm. Complete occlusion and neck remnant were found in eight and seven cases, respectively. The perioperative complication rate was 45.5% (thromboembolism in five cases, stent occlusion in two, re-bleeding in two, and cerebral hemorrhage in one). The outcomes included modified Rankin Scale 0–2 in seven cases, 4–5 in five, and 6 in nine. Stent-related death occurred in one case. The rate of morbidity and mortality was 18.2%. Although stents were used in the acute stage of rupture, they were used for the right reasons. However, a high rate of complications occurred: two cases of re-bleeding, in which an incomplete occlusion was a factor.Conclusion: Stent placement in patients with the acute ruptured cerebral aneurysms should be carefully determined and efforts should be made to reduce the embolic and hemorrhagic complications. However, it may be an effective treatment option when other options could be extremely difficult.
Recently, Higher Order Thinking Skills is a new issues in Indonesia, because the government was inserted HOTS question into national exam in order to develop Indonesian education. One of the problem ...occuring that the students are not familiar to the question given, as the result, the student confuse and complait about it.. Thereby, the need to the assessment instrument that could help teacher and students to challenge it is the must. This study aimed to describe the use of G-form as a assessment instrument in arabic language teaching based on Higher Order Thinking Skills (HOTS), to ascertain availability of g-form features as an assessment instrument in arabic language teaching based on Higher Order Thinking Skills (HOTS), and to analyze the advantages and disadvantages of it. The research used a library research. The data was taken by interview the arabic teacher that use gmail as a test instrument in arabic language teaching based on HOTS, by reading books, national as well as international journals, and other references related to this discussion, and small experiment of g-form made. The result of this study claim that g-form can be used as an assessment instrument in Arabic language teaching based on Higher Order Thinking Skills (HOTS). The second are, although it has many advantages, in the other side, the disadvantages were found as well
Osteonecrosis of the femoral head (ONFH) is a devastating disease affecting young adults, resulting in significant pain, articular surface collapse, and disabling dysfunction. ONFH can be divided ...into two broad categories: traumatic and non-traumatic. It has been established that ONFH results from an inadequate blood supply that causes the death of osteocytes and bone marrow cells. Nonetheless, the precise mechanism of ONFH remains to be elucidated. In this regard, preclinical animal and cell models to study ONFH have been established to assess the efficacy of various modalities for preventing and treating ONFH. Nevertheless, it should be borne in mind that many models do not share the same physiologic and metabolic characteristics as humans. Therefore, it is necessary to establish a reproducible model that better mimics human disease.
We systematically reviewed the literatures in regard to ONFH experimental models over the past 30 years. The search was performed in PubMed and Web of Science. Original animal, cell studies with available full-text were included. This review summarizes different methods for developing animal and cell experimental models of ONFH. The advantages, disadvantages and success rates of ONFH models are also discussed. Finally, we provide experimental ONFH model schemes as a reference.
According to the recent literatures, animal models of ONFH include traumatic, non-traumatic and traumatic combined with non-traumatic models. Most researchers prefer to use small animals to establish non-traumatic ONFH models. Indeed, small animal-based non-traumatic ONFH modeling can more easily meet ethical requirements with large samples. Otherwise, gradient concentration or a particular concentration of steroids to induce MSCs or EPCs, through which researchers can develop cell models to study ONFH.
Glucocorticoids in combination with LPS to induce ONFH animal models, which can guarantee a success rate of more than 60% in large samples. Traumatic vascular deprivation combines with non-traumatic steroids to induce ONFH, obtaining success rates ranging from 80% to 100%. However, animals that undergo vascular deprivation surgery may not survive the glucocorticoid induction process. As for cell models, 10-6mol/L Dexamethasone (Dex) to treat bone marrow stem cells, which is optimal for establishing cell models to study ONFH.
This review aims to summarize recent development in experimental models of ONFH and recommended the modeling schemes to verify new models, mechanisms, drugs, surgeries, and biomaterials of ONFH to contribute to the prevention and treatment of ONFH.
Die Alzheimer-Krankheit (Alzheimer's disease, AD) wird inzwischen als ein Kontinuum aufgefasst, bei dem vor dem Auftreten der klinisch manifesten (Alzheimer-)Demenz ein prodromales Vorstadium ...(objektivierbare leichte kognitive Beeinträchtigungen) und davor ein präklinisches Stadium (mit oder ohne subjektive Symptome) auftritt. Die verschiedenen Stadien der AD sind mit unterschiedlicher Häufigkeit mit neuropathologischen Korrelaten assoziiert. Ziel der Frühdiagnostik, also einer Diagnostik vor dem Auftreten der Demenzsymptomatik, ist es, derartige Korrelate in den Vorstadien der Demenz festzustellen und daraus eine Vorhersage für eine spätere Alzheimer-Demenz abzuleiten. Hierbei spielt die Frage der Genauigkeit der Vorhersage eine wesentliche Rolle. Aus der Perspektive der Betroffenen, also der Menschen, die sich Sorgen machen, dass sie später einmal eine „Demenz bekommen“ könnten, oder die bereits mehr oder weniger deutlich ausgeprägte subjektive kognitive Einbußen bei sich wahrnehmen, stellen sich ganz andere Fragen, etwa: Was bedeutet diese Diagnose für mein Leben? Welche Präventions- bzw. Therapiemöglichkeiten gibt es? Auch wenn die Alzheimer-Demenz bei Weitem die häufigste Demenzform ist, lässt sich das Thema aus Betroffenenperspektive nicht auf die AD reduzieren. Das Ziel dieser Übersichtsarbeit ist es deshalb, einen literaturbasierten Überblick über die Vor- und Nachteile der Demenz-Frühdiagnostik auch in Abgrenzung der AD von anderen Demenzformen zu geben. Darauf aufbauend sollen Handlungsempfehlungen für die Gewichtung der frühdiagnostischen Vor- und Nachteile in der Beratungssituation der klinischen Praxis formuliert werden.
Es wurden drei Datenbanken nach aktuellen Übersichtsarbeiten durchsucht, welche die Vor- und Nachteile sowie die ethischen Aspekte der AD-Frühdiagnostik thematisieren. Die Suche wurde auf aktuelle deutsche oder englische Arbeiten im Publikationszeitraum zwischen dem 01.01.2018 und dem 30.11.2022 beschränkt. Die systematische Suchstrategie orientierte sich am PICO-Schema und inkludierte sowohl eine Boolesche als auch eine fokuserweiternde Stichwortsuche mithilfe zuvor festgelegter Suchbegriffe. Hinzu kam eine Recherche entsprechend dem Schneeballsystem. Die Aussagen zu den Vor- und Nachteilen wurden nach der Methode der zusammenfassenden Inhaltsanalyse nach Mayring analysiert. Nach Zusammenfassung inhaltsgleicher/-ähnlicher Aussagen wurden die Argumente den Kategorien soziale, individuelle oder klinische Aspekte zugeordnet. Zum Zweck der Fokuserweiterung wurde zusätzlich eine Unterscheidung zwischen Argumenten vorgenommen, die spezifisch für die Frühdiagnostik der AD sind, und solchen, die für die frühe Diagnostik aller Demenzformen gelten.
Insgesamt konnten sieben Reviews eingeschlossen werden. Soziale Argumente reichen vom Schutz des Betroffenen und der Gesellschaft bis hin zu einer möglichen Stigmatisierung nicht nur des Betroffenen, sondern auch der An- und Zugehörigen aufgrund der AD- oder Demenz-Diagnose. Individuelle Argumente erstrecken sich vom Recht auf einen „rationalen Suizid“ inklusive Abwendung finanzieller und Versorgungsbelastungen für Familienmitglieder bis zum Anrecht, die Diagnose nicht wissen zu wollen („right not to know“). Klinische Argumente beginnen beim wissenschaftlichen Forschungskontext im Sinne der erleichterten Identifikation geeigneter Personen für klinische Studien und enden bei verschiedenartigen negativen Auswirkungen einer falsch positiven oder falsch negativen Frühdiagnose.
Die Frühdiagnostik der AD sowie anderer Demenzformen ist durch zahlreiche Vor- und Nachteile sozialer, individueller und klinischer Art gekennzeichnet. Die Entscheidung für oder gegen eine Demenz-Frühdiagnostik sollte immer auf der Grundlage des Abwägens gegenwärtiger Vor- und Nachteile im Einzelfall getroffen werden. Dabei sind insbesondere die Wünsche des Betroffenen, die Gültigkeit der verfügbaren Diagnoseverfahren und vor allem auch die Verfügbarkeit wirksamer Präventions- oder Therapieverfahren zu berücksichtigen.
The continuum of Alzheimer's disease (AD) comprises three stages: the pre-clinical stage (with few to no subjective symptoms), the prodromal stage (measurable mild cognitive impairment) and the final stage of clinically manifest (AD) dementia. Neuropathological correlates in accordance with these stages have been found with varying frequency. The aim of early AD diagnosis is to determine such correlates in these preclinical and prodromal stages and to determine the probability of the manifestation of a later AD dementia. In this regard, the prognostic validity is of vital importance. From the perspective of those affected, the issue of early diagnosis cannot be reduced to AD, although Alzheimer's dementia is by far the most common form of dementia. The aim of this review is to provide a literature-based overview of the advantages and disadvantages of early AD diagnosis in contrast to other types of dementia. Based on this, recommendations will be formulated for the prioritisation of early diagnostic advantages and disadvantages in the patient counselling situation in clinical practice.
Three databases were searched for current reviews addressing the advantages, disadvantages and ethical aspects of early AD diagnosis. The search was limited to current German or English reviews published between January 1, 2018 and November 30, 2022. The systematic search strategy was based on the PICO model and included both a Boolean and a focus-expanding keyword search using previously defined search terms. In addition, snowballing was used as a search strategy. Qualitative synoptic content analysis in accordance with Mayring was used to analyse both advantages and disadvantages. Similar arguments were combined into single statements. The resulting statements were categorized into three main groups: social, individual or clinical aspects. To emphasize the aforementioned aims, arguments were additionally distinguished into “only valid for early AD diagnosis” and ”valid for early diagnosis of all types of dementia“.
Overall, seven reviews with suitable content were included. Social aspects of early AD diagnosis comprise the protection of the affected person and the society as well as potential stigmatisation of the affected and their family members. Individual arguments range from the right to a “rational suicide”, including the avoidance of financial and caregiving burdens on family members, to the right not to know the diagnosis. Clinical arguments include, for example, the scientific research context (facilitating the identification of suitable clinical trial participants) and various negative effects of a false positive or false negative early diagnosis.
Early diagnosis of AD as well as of other forms of dementia is characterised by numerous advantages and disadvantages of a social, individual and clinical nature. The decision for or against early diagnosis should always be made by weighing the current advantages against the disadvantages in a specific case. In particular, the desires of the person affected, the validity of the diagnostic procedures available and, above all, the availability of effective preventive or therapeutic measures must be taken into account.
The term collaborative economy encompasses various activities that have emerged and developed rapidly in recent years through online collaboration platforms. In this article, we will review what the ...sharing economy means, what are the positive and negative consequences of such a phenomenon, what are the organizations that support the sharing economy. It can be said that the sharing economy is a reconversion of the traditional economy, which supports a society based on sustainability but, at the same time, must be prepared to respond to the challenges and criticisms brought. In the second part, we examine recent trends in the use of collaboration platforms in Romania and in the European Union (EU-28), focusing on general and more specific features regarding the profile of users, the type of services used and the main advantages and disadvantages of the collaborative economy in relation to traditional trade in goods and services. The data used in this analysis comes mainly from the recently published European Commission survey on the use and provision of services through collaborative platforms, as well as from the corresponding survey previously published in 2016 on the same topic.
Osteosarcopenia(OS) is a significant health concern resulting from the ageing process. Currently, as the population grows older, the prevalence of OS, a disease that entails the synchronous ...degeneration of muscles and bones, is mounting. This poses a serious threat to the health of the elderly while placing an enormous burden on social care. In order to comprehend the pathological mechanism of OS and develop clinical drugs, it is pertinent to construct an efficient animal model of OS. To investigate the modeling techniques of diverse experimental models of OS and elucidate their respective benefits and drawbacks, with the purpose of furnishing a theoretical foundation to advance experimental research on OS.
We searched PubMed, Embase database, China Knowledge Network, Wanfang data platform and Vipshop journal platform databases from 2000 through to September 1, 2023. We included animal studies on sarcopenia or osteoporosis or osteosarcopenia or sarcopenia-osteoporosis, modeling methods for osteosarcopenia. Two independently screened study abstracts and full reports and complete data extraction.
Eventually, Of 112, 106 citations screened. 4938 underwent full-text review and 38 met the inclusion criteria. we reviewed and analyzed the literature and categorized the animal models of OS into the following five categories: Aging OS models; Hormonal deficiency model of OS;Chemical injection to induce OS;Disuse OS models and Genetic engineering OS models.
This review outlines animal modeling approaches for OS, providing a comprehensive summary of their advantages and disadvantages. The different models were evaluated and selected based on their respective strengths and weaknesses to enable higher quality research outcomes in various research directions. The most widely used and established approach is considered to be the ageing and chemical injection OS model, which has the advantages of excellent reproducibility and low cost.
To gain a profound comprehension of the pathological mechanism of OS and to devise efficacious clinical treatments, it is imperative to establish a viable laboratory animal model of OS. This article surveys various modeling techniques assessing their benefits, drawbacks and areas of applicability while predominantly employing mice as the primary model animal. Additionally, the evaluation indicators of OS models are briefly described.
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