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This study aims to evaluate the effectiveness of various doses of 6.25% Poly Aluminium Chloride (PAC) and 0.1% polymer flocculant in reducing Total Suspended Solids (TSS) and assessing pH changes in coal stockpile wastewater at PT PLN Nusantara Power UP Paiton Unit 9. Stockpile wastewater typically contains high levels of suspended solids originating from water spray activities that carry fine coal particles. The coagulation–flocculation process was performed using the jar test method with PAC dosages of 35 ppm, 50 ppm, and 65 ppm, along with flocculant dosages of 6 ppm and 7 ppm. pH and TSS were analyzed before and after treatment to assess process effectiveness. The results indicate that a PAC dosage of 35 ppm combined with a 6 ppm flocculant achieved the highest TSS removal efficiency of 98.15%. Increasing PAC dosage resulted in reduced performance due to overdosing effects, leading to charge destabilization and impaired floc formation. These findings highlight the importance of optimizing coagulant dosage to improve stockpile wastewater quality for safe reuse in operational activities.

Hypothermia during surgery is a common occurrence among pediatric patients due to their immature thermoregulation system, higher body surface area-to-weight ratio, and thinner subcutaneous fat layer. This condition can lead to several complications, including increased bleeding, coagulation disorders, surgical wound infections, and delayed healing. Prevention strategies include active and passive warming methods. The purpose of this study is to evaluate the effectiveness of active and passive warming in preventing intraoperative hypothermia in pediatric patients. A scoping review approach was applied to interpret the evidence based on predetermined inclusion and exclusion criteria, followed by data exploration, analysis, and synthesis of findings. The results indicate that active warming methods—such as forced-air warming, blanket warming, and warmed intravenous fluids—are more effective than passive warming in maintaining normothermia during surgery. Moreover, combining both approaches provides optimal prevention against hypothermia. Overall, active warming plays a vital role in stabilizing body temperature and enhancing patient safety during pediatric surgery. Therefore, its implementation should be considered a standard practice in perioperative nursing care.

Mozzarella cheese is traditionally made using rennet, an enzyme derived from the stomach lining of ruminant animals that plays a key role in coagulating milk. While effective, rennet has certain limitations such as its limited availability, relatively high cost, and concerns among vegetarians and certain religious groups regarding its animal origin. As a result, alternative coagulants that are easier to obtain, plant-based, and more environmentally friendly have gained interest. One such natural ingredient is lemon juice, which contains citric acid and can mimic the coagulation effect of rennet. This study aims to explore the effectiveness of lemon juice as a rennet substitute in the production of mozzarella cheese, specifically when applied in a food product like cheese-stuffed potato balls. The research involved organoleptic testing by 30 panelists to evaluate five sensory aspects: color, aroma, taste, texture, and overall acceptance. Several formulations were tested, and the sample containing 20 ml of lemon juice, 2 grams of citric acid, and an additional herb mix (Sample C) was rated the highest in preference across most parameters. The findings suggest that lemon juice is a viable alternative to rennet in mozzarella cheese making, particularly for small-scale or home-based production. It not only delivers acceptable sensory qualities but is also more accessible and affordable. Moreover, using lemon juice supports the development of more sustainable and vegetarian-friendly food options. In conclusion, lemon juice can successfully replace animal-based rennet, making mozzarella cheese production more inclusive, cost-effective, and environmentally conscious.

Blood transfusion is a critical medical procedure that requires the blood to be at a temperature close to normal human body temperature, approximately 36– 38°C. Transfusing cold blood can lead to serious complications such as hypothermia, coagulation disorders, and even cardiac arrest. Therefore, a reliable and automated blood warming device is essential to ensure safe transfusions. This study aims to design and modify a Blood Warmer Thawing device based on the Arduino Uno microcontroller as an innovative and cost- effective solution, particularly for healthcare facilities with limited resources. The system integrates a DS18B20 temperature sensor to monitor the temperature of the heating medium in real time, with data displayed on a 20x4 I2C LCD. Users can set the desired temperature via a 4x4 keypad, and the system automatically adjusts the heater performance based on the detected temperature. To enhance safety and operational efficiency, the device is also equipped with a buzzer as a warning indicator when the temperature exceeds the safe threshold, and utilizes a DC motor and cooling fan to maintain proper heat circulation. Test results indicate that the device is capable of maintaining the liquid temperature within the ideal range for blood transfusions, with high stability and fast response to temperature changes. This innovation offers a practical, affordable, and easy-to-implement solution to support effective and safe blood transfusion procedures in various healthcare settings.

Warfarin (commonly known by its trade name, Coumadin) is an oral anticoagulant that has been widely used for the prevention and treatment of thromboembolic disorders. Despite its clinical benefits, warfarin therapy is complicated by a very narrow therapeutic index and wide inter-individual variability in dose requirements. This variability represents a major challenge for clinicians, as inappropriate dosing may lead to serious adverse outcomes such as bleeding or thrombotic events. A growing body of evidence suggests that genetic polymorphisms are among the most important factors contributing to this variability, particularly those involving the Vitamin K Epoxide Reductase Complex Subunit 1 (VKORC1) gene. VKORC1 encodes a key enzyme that functions as a bottleneck in the vitamin K cycle, playing an essential role in the regeneration of reduced vitamin K (VKH). This active form of vitamin K is required for the γ-carboxylation of vitamin K–dependent clotting factors, including prothrombin and other coagulation proteins. Polymorphisms within VKORC1 can significantly alter the enzyme’s expression and activity, thereby modifying an individual’s sensitivity to warfarin. One of the most clinically relevant variants is the -1639G>A (rs9923231) polymorphism, which reduces VKORC1 transcription and subsequently decreases enzyme activity. Patients carrying the A allele often exhibit increased sensitivity to warfarin and therefore require lower maintenance doses compared to those with the G allele. Understanding these genetic influences not only improves our knowledge of warfarin pharmacogenomics but also highlights the importance of personalized medicine in anticoagulant therapy. Incorporating VKORC1 genotyping into clinical practice could optimize dose prediction, minimize adverse events, and enhance the safety and effectiveness of warfarin therapy. This narrative review aims to provide an in-depth discussion of the complex role of VKORC1 in vitamin K metabolism and its impact on warfarin sensitivity, thereby underscoring the critical relevance of genetic factors in guiding individualized anticoagulation therapy.

The impacts of wastewater (liquid waste) include contamination and pollution of surface water and other water bodies utilized by humans, as well as disruption to aquatic life. Wastewater generated from plate washing processes in offset printing industries contains toxic substances that can harm the environment, such as ink pigments, additives, alcohol, and other hazardous chemicals. This study aims to reduce the environmental impact caused by plate washing wastewater. The method used in this research is the Jar Test, which is commonly applied to evaluate the effectiveness of coagulants in water and wastewater treatment. Based on the findings, this method successfully reduced the Total Dissolved Solids (TDS) level by 18%. These results indicate that the use of alum as a coagulant has a significant effect on altering the chemical composition of the plate washing wastewater, thereby contributing to pollution reduction

The pharmaceutical industry produces solid, liquid, and gaseous waste containing active pharmaceutical ingredients that pose serious environmental risks. These wastes can disrupt ecosystems and accelerate antimicrobial resistance. This systematic literature review examines pharmaceutical waste concepts, classifications, characteristics, and relevant regulatory frameworks. It also addresses ecotoxicological effects on aquatic and terrestrial ecosystems, antibiotic contamination and resistance, water and soil pollution, treatment technologies, industrial policies, and best practices. Findings show that conventional wastewater treatment is largely ineffective at removing pharmaceutical residues, resulting in their presence in surface water, soil, and even drinking water. Compounds such as β-blockers, cytostatics, antibiotics, and hormones harm aquatic life by impairing reproduction and causing mutations. Antibiotic-laden industrial waste contributes to the emergence of resistant bacteria. Recommended treatment methods include biothermal processes, advanced oxidation (e.g., UV/H₂O₂, ozonation), adsorption (activated carbon), coagulation-flocculation, and controlled incineration. Stronger enforcement of hazardous waste regulations (e.g., Government Regulation No. 101/2014, Ministry of Environment and Forestry Regulation No. 56/2015) and adherence to WHO (2025) guidelines are essential. In conclusion, multisectoral collaboration (One Health), improved waste treatment capacity, and adoption of best practices are crucial to preventing pharmaceutical pollution and promoting environmental sustainability.

Using a descriptive method with a triangulation approach including observation, document analysis, and interviews this study ensures data reliability. Daily monitoring is conducted on wastewater flow and pH levels, while monthly laboratory analysis covers eight key parameters: Total Suspended Solids (TSS), iron (Fe), copper (Cu), zinc (Zn), total chromium (Cr), phosphate (PO³), oil and grease, and pH to evaluate the perfomance of the treatment system. The treatment process begins with the inflow of 960 m³ of wastewater per day into the storage pond, where aeration is applied to ensure homogenization before being transferred to the neutralization unit. pH adjustment is carried out by adding NaOH or HCl before the wastewater undergoes coagulation and flocculation stages. The study’s findings indicate that the WWTP meets the environmental quality standards established in accordance with the Decree of the Head of the Investment Coordinating Board of the Republic of Indonesia (2020), Number SK.214/1/KLHK/2020 concerning the Permit for Wastewater Disposal into the Sea on Behalf of PT Pembangkit Jawa Bali Unit Pembangkitan Gresik. This study emphasizes the importance of systematic monitoring and treatment in wastewater management.

The presence of heavy metals in waste is one of the variables that can pollute and damage the environment. Lead is one of the chemical contents that can be found in hospital liquid waste. Hospital liquid waste comes from work unit processes throughout the hospital environment which contains dangerous chemicals so it needs to be processed before being discharged into the environment. Research has been carried out using the coagulation-flocculation method using sugar palm seeds as a biocoagulant. The aim of this research is to find out how the palm seed coagulant mass influences in reducing lead (Pb) levels. hospital wastewater with the addition of variations in coagulant mass, namely 0.3%, 0.4%, 0.5%, 0.6% and 0.7%. From the filtrate resulting from coagulation-flocculation which was then analyzed based on the Regulation of the Minister of Environment and Forestry of the Republic of Indonesia Number P.68 of 2016 concerning Domestic Wastewater Quality Standards, from the results of this research it is known that sugar palm seeds as a biocoagulant are able to reduce the most optimal PB concentration when the coagulant concentration is added to 0.6%.

Hemophilia is a genetic disorder resulting from impaired blood clotting. This disorder can be caused by coagulation factor abnormalities due to a deficiency of clotting factors, including vitamin K. A lack of vitamin K disrupts the coagulation process, increasing the tendency for bleeding. This article aims to determine whether there is an influence of vitamin K levels on the blood clotting factors in hemophilia patients. Searching any information needed by analyzing kinds of papers of recent research from the year of 2014 until 2024. Online databases like PubMed, ScienceDirect, Google Scholar, Scopus, and ResearchGate  are utilized by inserting relevant keywords, such as hemophilia, blood clotting factors, vitamin K deficiency and extraction. From 10 articles reviewed, a relationship was identified between vitamin K levels and blood clotting factors in hemophilia patients. Individuals with severe hemophilia experience bleeding episodes characterized by delayed onset, as well as bleeding into muscles, joints, and other internal structures, including the brain. Hemophilia is typically diagnosed through the identification of low or absent levels of FVIII:C or FIX:C. The genes encoding FVIII and FIX are located on the long arm of the X chromosome. Hemophilia A and B are the only hereditary clotting disorders inherited in a sex-linked recessive pattern. Vitamin K levels can influence the blood clotting factors in hemophilia patients, particularly those factors synthesized artificially.