A Prospective Survey on Adequacy of Information Conveyed to Consenters Prior to Obtaining an Informed Consent for Anaesthesia

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Background: Ensuring adequate information conveyance to consenters prior to obtaining consent for anaesthesia is an ethical necessity.

Objective: To ascertain the adequacy of information conveyed to consenters prior to obtaining informed consent for anaesthesia, in the University of Port Harcourt Teaching Hospital (UPTH).

METHOD: Ethical clearance secured and written consent obtained, 385 subjects, aged ≥18 years, were served questionnaires addressing 19 points totally, 5 of which (section A) elicited socio-demographic data, while 14 (section B) assessed the comprehensiveness and adequacy of information conveyed prior to obtaining consent. A “yes, very much” option score ≥80%, or combined “yes, very much” and “yes, but little” options score ≥90%, was considered adequate information in each of the 14 points addressed in section B.

Results: There was less than 80% score of the “yes, very much” option, and  <90% combined score from the “yes, very much” and “yes, but little” options under knowledge of involvement of anaesthesia for the planned surgery, reason, type, advantages, problems, alternative forms of anaesthesia, sufficiency of time spent and information conveyed, as well as under allowance of expression, ease of understanding of language used and satisfaction; the combined proportion of consenters who chose the “yes, but very little” and “no, not at all” options ranged 16.88 –  78.44%.

Conclusion: Adequacy of information conveyed to consenters for obtaining informed consent was <80% in the depth of information conveyed, allowance of expression, ease of understanding of language and satisfaction.

Strategy Design Dynamic System-Based Circular Supply Chain Management on Waste Management in Sleman Regency, Yogyakarta

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This study aims to design a dynamic system-based Circular Supply Chain Management (CSCM) strategy for waste management in Sleman Regency, Yogyakarta. The increase in population and economic activity has led to a significant increase in waste volume, necessitating a sustainable and efficient management model. The CSCM approach is used because it integrates circular economy principles through the 5R concept (Reduce, Reuse, Recycle, Recover, and Redesign) to create a closed-loop supply chain system for waste management. The research method uses a system dynamics approach. Modeling with qualitative and quantitative analysis stages through the creation of Causal Loop Diagrams (CLD) and Stock and Flow Diagrams (SFD). Research data were obtained from field observations, interviews with the Environmental Agency, and supporting literature. Simulation results show that the existing waste management model in Sleman has implemented some CSCM principles but is still semi-linear. Through the development of four simulation scenarios, Scenario 4, which integrates the Organic Processing Center (OPC), the Plastic Shredding 3RWPS (Reduce, Reuse, Recycle (3R) Waste Processing Site), and the Compost IWPS (Integrated Waste Processing Site), is considered the most optimal in reducing waste generation and increasing management efficiency. This scenario successfully forms a multi-loop circular chain system that minimizes waste, maximizes resource utilization, and shifts the paradigm from waste management to resource management. The resulting model is expected to be a strategic reference for local governments in formulating long-term policies towards sustainable waste management.

Impact of Freight Transport Packaging on Energy Consumption and Climate Change

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The research “Impact of Freight Transport Packaging on Energy Consumption and Climate Change” examines energy efficiency in freight transportation (TCC) through the Green Vehicle Routing Problem (G-VRP) and eco-friendly packaging. Using a mixed-methods approach, combining quantitative data (distances, energy consumption, CO2 emissions) and qualitative information (operator and the community perceptions), it includes a literature review and a pilot study in 10 cities in Hidalgo, Mexico. Results show that optimized routes with electric vehicles reduce the total distance of traveling, energy consumption, and emissions by 23.87%, and up to 97.86% compared to diesel fleets. Gaps in charging infrastructure and green technology adoption are identified. Integrating ecolabels and heuristic algorithms, like a modified Clarke-Wright, offers sustainable and promising solutions, though it requires a deep restructuring of the production processes. The study suggests public policies and business strategies to promote green logistics, advocating for tailored algorithms and mixed-methods to enhance sustainability in TCC.

Redesigning Digital Photographic Assets to Optimize Website Presentation at the Faculty of Art and Design Education, Universitas Pendidikan Indonesia

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The rapid development of digital communication technologies requires higher education institutions to present professional, informative, and visually representative media particularly through institutional websites, which serve as the primary public interface. Preliminary observations indicate that photographic assets displayed on the website of the Faculty of Art and Design Education (FPSD) at Universitas Pendidikan Indonesia have not met aesthetic and communicative standards. The majority of images consist of low-quality documentation with minimal digital processing and limited adherence to visual communication and photojournalistic principles, resulting in insufficient representation of institutional identity. This study aims to redesign photographic assets to optimize the visual performance of the FPSD website using a Design Thinking methodology. The research process included the stages of empathize, define, ideate, prototype, and test, conducted through website observation, interviews, surveys, and visual quality assessments. Findings reveal that 78.1% of respondents expressed the need for professional-standard photographic production. The prototyping stage produced redesigned photographic assets that fulfilled technical photography standards, visual branding principles, and institutional communication needs. Prototype evaluation demonstrated significant improvements in aesthetic quality, communication effectiveness, and user experience within website display. The study concludes that enhancing photographic assets results not only in better visual aesthetics but also strengthens institutional credibility, professionalism, and authenticity of academic information. Practical implications emphasize the importance of establishing structured guidelines and standardized procedures for documentation and visual asset management in art and design education environments.

Designing A Creative Business Model for Outdoor Photographers Through Business Model Innovation

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Photography at Tangkuban Perahu Nature Tourism Park is one of the creative industry-based Micro, Small and Medium Enterprises (MSMEs) included in the creative economy and engaged in photography. Tangkuban Perahu Nature Tourism Park is one of the tourist destinations whose position is located not far from the center of Bandung City so that it can be easily reached by tourists in Bandung City. Currently, photographers at Tangkuban Perahu Nature Tourism Park face problems in the form of fluctuating trends in the use of direct photography services due to constraints in human resources, promotion, product quality, and business partnerships. To solve this problem is to evaluate in depth the business model that is currently being run. In this study, an evaluation of the business model currently being run by outdoor photographers using the Business Model Canvas (BMC) framework was conducted. To obtain data, interviews with photographers and observations in the field were conducted. Then interviews with visitors to understand visitor profiles and business environment data. From the data obtained, the results will be used to design strategies, which are then used to design the proposed Creative Business Model Canvas (CBMC). Based on the design results, there are several additions to the creative business model canvas for outdoor photographers. In artistic identity, two new values were added: photos that highlight the natural beauty of Indonesia and the mystical charm of Tangkuban Perahu. In the Your audience block, an additional segment was added: groups. In channels, there are options to work with travel agents or local guides, as well as promotion through social media such as Instagram and TikTok. In revenue stream, additional group and pre-wedding photo packages are available. In key resources, added a photo booth directly in the tourist area as a new asset. In key activities, promotional activities through social media are included. In key partners, new partners were added, namely travel agents and local guides. Meanwhile, in the cost structure, additional costs for purchasing photo frames (operational costs) and digital promotions (investment costs) were added. In addition, there are two new blocks, namely art products and artistic services, which help photographers better understand the creative value that can be offered through photo services.

Soil Actinomycetes as Potential Producers of L-Asparaginase: Qualitative, Quantitative and Fermentation Studies

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Actinomycetes are a group of filamentous, Gram-positive bacteria widely distributed in soil and recognized as prolific producers of bioactive secondary metabolites, including antibiotics and enzymes of therapeutic importance. Among these, L-asparaginase is a clinically significant enzyme used as an antineoplastic agent in the treatment of acute lymphoblastic leukemia. The enzyme catalyzes the hydrolysis of L-asparagine into L-aspartic acid and ammonia, thereby depriving tumor cells of an essential amino acid required for their growth and survival. Although L-asparaginase derived from Escherichia coli and Erwinia carotovora is commercially available, these bacterial sources often cause hypersensitivity and other side effects. Hence, there is a growing need to explore alternative microbial sources such as actinomycetes, which can produce the enzyme with better therapeutic efficiency and fewer side effects. This study aims to identify potent L-asparaginase-producing actinomycetes and their production under submerged fermentation conditions. The   study was designed with four major objectives, to isolate actinomycetes from soil samples, to perform qualitative and quantitative assays for L-asparaginase production, and to evaluate the production of L-asparaginase by submerged fermentation using boiled rice water as the substrate. Soil sample was collected, and actinomycetes were isolated using standard microbiological techniques. The qualitative screening of isolates was carried out using a plate assay method to identify potential L-asparaginase-producing strains based on the formation of color zones. Quantitative estimation of enzyme activity was performed by measuring the amount of ammonia released during enzymatic reaction. For enzyme production, submerged fermentation was employed, utilizing boiled rice water as a nutrient-rich, cost-effective substrate to enhance enzyme yield.

Right Femoral Lengthening: A Case Report

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We present the case report of a 34-year-old female patient with a history of epilepsy, presenting with a 10-cm congenital shortening and varus deformity of the right femur, in addition to a 1-cm tibial shortening resulting from a previous open fracture during adolescence. Surgical correction was performed using diaphyseal osteotomy and bone lengthening with a monoplanar external fixator (Orthofix). Following a 6-day latency period, progressive distraction was initiated at a rate of 0.75 mm/day. A total femoral lengthening of 9 cm and axis correction were achieved over 4 months. The consolidation phase lasted 9 months. Complications included superficial pin-tract infection and knee stiffness, both successfully managed with medical treatment and physical therapy. The fixator was removed after 14 months of evolution. Upon discharge, the patient achieved stable functional recovery without significant claudication.

Analysis of Farmer Capacity in the Freshwater Fish Farming Subsystem in Palas Subdistrict, South Lampung Regency

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Indonesia has great potential in the freshwater aquaculture sector, particularly in South Lampung Regency, which contributes significantly to the supply of freshwater fish. However, the inability of farmers to meet consumer and market demand has led to stagnation in the development of freshwater fish farming businesses. Based on these issues, the researchers hypothesized that there were constraints on the capacity of farmers in the freshwater fish farming process. This study aimed to determine the level of capacity of farmers in the freshwater fish farming subsystem in Palas Subdistrict, South Lampung Regency. The study was conducted in March–April 2025 with 94 respondents. The method used was descriptive analysis with a quantitative approach. The results showed that the capacity of farmers in the aquaculture subsystem was good in the stages of seedling distribution and harvest handling, but improvements were needed in the stages of seedling and pond water selection, pond preparation, feeding, water quality and fish health management, waste management, market analysis, and product promotion so that production could be optimal and sustainable.

Pediculicide Resistance and Current Therapeutic Effectiveness in Pediculus Humanus Capitis: A Literature Review

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Pediculus humanus capitis infestation remains a persistent global public health burden, with recent evidence showing a sharp decline in treatment success due to widespread pediculicide resistance. Over the past decade, molecular studies have consistently identified a high frequency of voltage-gated sodium channel (kdr) mutations—particularly T917I, L920F, T929I, and L932F—which significantly reduce lice sensitivity to pyrethroid-based agents such as permethrin and fenothrin. These mutations are often accompanied by increased activity of detoxification enzymes, including acetylcholinesterase, glutathione S-transferase, and cytochrome P450 oxidase, which contribute to cross-resistance and explain repeated treatment failures in communities. Clinical and laboratory bioassays conducted between 2020 and 2025 in Indonesia, Thailand, Iran, India, Saudi Arabia, Turkey, and several African regions consistently reported low mortality and longer survival after pyrethroid exposure, confirming that resistance is now globally entrenched. In contrast, emerging non-pyrethroid therapies such as dimethicone formulations, 0.5% topical ivermectin, squalane-based preparations, and standardized botanical shampoos demonstrate strong and sustained pediculicidal activity with minimal evidence of resistance, reduced reinfestation, and a good safety profile. These alternatives primarily work through physical mechanisms or neuro-inhibitory pathways unaffected by kdr mutations, making them promising first-line options. This literature review synthesizes findings from 10–12 primary studies supported by 26 recent publications to provide an up-to-date overview of resistance mechanisms, kdr mutation distribution, and the comparative effectiveness of existing therapies. Overall, the available evidence highlights the need to revise treatment guidelines, enhance molecular surveillance, and prioritize non-pyrethroid agents.