bluuebunny/crossref_metadata_2025 huggingface dataset:
Training in Integrative Therapies Increases Self-Efficacy in Providing Nondrug Therapies and Self-Confidence in Offering Compassionate Care
Authors: Kemper Kathi J. , Hill Ellie
Published: January 2017

Background.

Patient demand and clinician interest have driven professional training in integrative therapies, but few rigorous evaluations have been published.

Methods.

This project evaluated the proof of concept of training in acupressure, guided imagery, massage, and Reiki on clinicians’ sense of self-efficacy in providing nondrug therapies, self-confidence in providing compassionate care, and engagement with work.

Results.

Three out of 4 topics met minimum enrollment numbers; 22 of 24 participants completed follow-up as well as pretraining surveys. All would recommend the training to others and planned changes in personal and professional care. There were significant improvements in self-efficacy in using nondrug therapies, confidence in providing compassionate care, and unplanned absenteeism ( P < .05 for each).

Conclusion.

Training in integrative therapies is feasible and associated with significant improvements in clinicians’ sense of self-efficacy, confidence in providing compassionate care, and engagement with work. Additional studies are needed to determine the impact on quality of care and long-term workforce engagement.
Encountering Spaces of Resistance When Implementing Research-Based Strategies for English Language Learners (ELLs)
Authors: Reyes Xaé Alicia , Rojas Eliana Delas
Published: January 2017

This article discusses research findings from follow-up studies on the effects of purposeful programming designed to prepare educators who participated in either of two professional development federal grants funded by the U.S. Department of Education (REALL 2007 and LEAD 2012) to address the needs of English Language Learners (ELLs). The qualitative data gleaned through focus group interviews and responses to questionnaires collected in these studies describe both educators’ sense of self-efficacy (Bandura, 1994) and their students’ transformations as they experience success. The longitudinal data collected over a 6-year period include narratives of resistance encountered by the grant participants in spaces such as schools, districts, and the broader community, and how these challenges were approached.
Modifying and Pilot Testing the Pap Smear Belief Questionnaire
Authors: Ackerson Kelly , Doane Lisa Stines , McNutt Robert , Shao Yuanyuan
Published: January 2017

This study is a report on modifications and pilot testing of a measurement tool to predict Pap testing based on the Interaction Model of Client Health Behavior. Women have been found to avoid routine cervical cancer screening (CCS) due to personal influencing factors. For this study, the Pap Smear Belief Questionnaire (PSBQ) was modified by adding items and evaluated through content validity index (CVI = .89) and cognitive interviews (think-aloud protocol), resulting in a 31-item instrument with four subscales (Benefits, Barriers, Vulnerability, Experiences). Pilot testing the modified PSBQ was conducted at a local agency. Fifty-three women completed and returned the PSBQ, which had good internal consistency, with a Cronbach’s alpha coefficient of .81 (Benefits α = .51; Barriers α = .85; Vulnerability α = .78; Experiences α = .87). Test–retest reliability of the 31-item PSBQ was also good (.878). Univariate logistic regression indicated that the only significant predictor of seeking/avoiding routine screening by women’s background characteristics was social influence ( p = .04). Subscales found to be significant predictors in Pap testing were Barriers ( p = .003) and Gynecological Exam Experiences ( p = .04). The refined 31-item PSBQ has good psychometric data supporting its use in predicting CCS. However, this research should be replicated in a larger sample enabling further validity and reliability testing of the PSBQ. Understanding women’s attitudes toward CCS will help health care providers, who deal with gynecological health, develop more effective screening programs and interventions facilitating better experiences for women contributing to an increase in routine screening.
Recognizing Early Dementia in the Workplace: A Case Study
Authors: Lurati Ann R.
Published: January 2017

A case study of diagnosis of early dementia is presented and recommendations for educating health care professionals to recognize and treat this condition among workers are offered.
Smoking Behavior among Nurses in Rural Greece
Authors: Stamatopoulou Eleni , Stamatiou Konstantinos , Voulioti Stefania , Christopoulos George , Pantza Eleni , Stamatopoulou Athanasia , Giannopoulos Dimitris
Published: January 2017

Evidence suggests that rural health care providers may be at increased risk for tobacco addiction. Few researchers have studied the habitual use of tobacco in rural Greece and no published studies have examined sustained tobacco use by nurses working in these areas or their knowledge and attitudes toward smoking cessation. To explore the above, the authors conducted a questionnaire-based study in 40 health centers in rural mainland and island Greece. Two hundred twenty nurses were surveyed (65% response rate). Thirty-two percent of the nurse respondents were smokers, 54% were non-smokers, and 14% were former smokers. Only 8% of respondents had been trained to assist clients with smoking cessation.
When Does Differential Treatment Become Perceived Discrimination? An Intersectional Analysis in a Southern Brazilian Population
Authors: Bastos João L. , Harnois Catherine E. , Bernardo Carla O. , Peres Marco A. , Paradies Yin C.
Published: January 2017

Despite ideals of equality and “racial democracy,” high levels of social inequality persist in contemporary Brazil. In addition, while the majority of the Brazilian population acknowledges the persistence of racism, high proportions of socially disadvantaged groups do not regard themselves as victims of discrimination. This study seeks to shed light on this issue by investigating the processes through which individuals come to interpret their experiences of mistreatment as discrimination. We ask: (1) How frequently do respondents perceive being treated differently due to a variety of social statuses alone and in combination? and (2) What factors are associated with respondents interpreting this differential treatment as “discrimination”? Data come from an ongoing cohort investigation, which included a representative sample of adults living in the urban area of Florianópolis. Results show that 45 percent of respondents experienced mistreatment and attributed it to two or more factors, such as social class, age, gender, and race. Perceptions of mistreatment based on social class were positively correlated with perceived mistreatment due to gender, place of residence, weight, race, and the way one dresses. Regression analyses revealed that interpreting differential treatment as stemming from multiple social statuses was the strongest predictor of respondents classifying their mistreatment as discrimination. Our findings highlight the importance of disentangling perceptions of mistreatment from perceptions of discrimination and show that the relationship between the two is structured in large part by the ways in which individuals interpret their experiences at the intersection of multiple inequalities.
Mestizaje and the Significance of Phenotype in Guatemala
Authors: Paredes Cristian L.
Published: January 2017

Ethnic issues in Guatemala are commonly analyzed using theoretical frameworks that underscore the role of Maya activism in promoting Mayan identification. However, these frameworks often pay insufficient attention to the local significance of phenotype. In this study, I propose an alternative framework to explain ethno-racial status in contexts of mestizaje. Based on this framework, I investigate whether phenotype, captured by skin color, is a significant dimension of ethno-racial status in Guatemala using nationally representative survey data and regression analysis. I specifically examine the association between skin color and ethnic self-identification, and differences by ethno-racial characteristics in the perception of skin color discrimination and in the desire for a whiter skin color. I find evidence of a direct association between skin color and ladino self-identification, evidence of a greater perception of skin color discrimination by individuals with more indigenous characteristics, and evidence of a direct association between indigenous ancestry, captured by indigenous first language, and the desire for a whiter skin color. These findings reveal the significance of phenotype as a distinct dimension of ethno-racial status in Guatemala beyond ancestry and ethnic self-identification.
Endovascular Abdominal Aortic Aneurysm Repair in Patients with Challenging Anatomy: Utility of the Hybrid Endograft
Authors: Jordan William D. , Naslund Thomas C. , Adelman Mark A. , Simoni Gene , Wirthlin Douglas J.
Published: January 2017

Commercially available aortic stent grafts differ in construction and clinical advantage such that creating hybrid endografts by combining components from different manufacturers is sometimes useful. We describe a multicenter experience using hybrid endografts to treat patients with challenging anatomy.

Hospital records and office charts were reviewed from four institutions. Hybrid endografts were defined as those with two types of covered stents in continuity to treat an abdominal aortic aneurysm (AAA). Indications for hybrid grafts were defined by type of endoleak and whether an endoleak was expected or unexpected as determined by the preoperative radiographic evaluation. Endpoints include intraoperative endoleaks, late endoleaks, change in aneurysm size, and rupture.

Hybrid endografts were used to treat AAA (endovascular aneurysm repair [EVAR]) in 90 patients, representing 7.9% of the total multicenter experience. In 7 patients (7.8%), a hybrid graft construction as a secondary procedure successfully corrected a type 1 endoleak. In the remaining 83 patients (92.2%), hybrid grafts were created at the time of original EVAR to treat expected challenging anatomy or unexpected endoleaks.

Hybrid endografts corrected 88 (97.8%) type 1 endoleaks, but 2 patients (2.2%) persisted with a proximal type 1 leak requiring conversion. During follow-up of 1 to 24 months, computed tomography and ultrasound surveillance, available for 73 patients (81.1%), detected one unresolved distal type 1 (1.1%) and seven type 2 (7.8%) endoleaks. Aneurysm size decreased at least 0.5 cm in 23 of 50 patients (46.0%) at 6 months and in 19 of 31 patients (61.3%) at 12 months. Aneurysm size increased at least 0.5 cm in 4 of 50 patients (8.0%) at 6 months and in 1 of 31 patients (3.2%) at 12 months. There were no ruptures.

Hybrid endografts have favorable early and intermediate results in the treatment of AAA. Long-term follow-up will be needed to confirm the absence of significant adverse biomaterial interaction and the effect on AAA exclusion. We advocate the use of hybrid endografts as endovascular therapy for patients whose anatomy may be unsuitable for a single endograft type.
Clinically Diagnosed Nonocclusive Mesenteric Ischemia after Cardiopulmonary Bypass: Retrospective Study
Authors: Huwer Hanno , Winning J. , Straub U. , Isringhaus H. , Kalweit G.
Published: January 2017

This retrospective study evaluates our experience with clinically diagnosed nonocclusive mesenteric ischemia after cardiopulmonary bypass.

Twenty-three of 3,600 consecutive patients suffered from splanchnic malperfusion. Symptoms developed between day 2 and 6 postoperatively in 18 of 23 patients. Four of 23 patients had no abdominal symptoms. Laboratory evaluation revealed significantly higher serum lactate and creatine phosphokinase levels in the 18 symptomatic patients compared with those of a control group. Arteriography was performed in 20 cases and revealed nonocclusive splanchnic hypoperfusion. Risk factors for development of mesenteric ischemia include arrhythmias and low cardiac output. Patients with angiographically proven nonocclusive mesenteric ischemia were treated with intra-arterial bolus injection and subsequent intra-arterial infusion of tolazoline combined with heparin sodium. The overall mortality rate was 30% (7 of 23).

Infusion therapy with tolazoline and heparin seems to be a successful treatment modality for clinically diagnosed mesenteric ischemia.
Delayed Paraplegia Following Infrarenal Abdominal Aortic Endograft Placement: Case Report and Literature Review
Authors: Fortes Daniel L. , Atkins B. Zane , Chiou Andy C.
Published: January 2017

The treatment of abdominal aortic aneurysms (AAAs) has changed over the past 12 years, with increased numbers of endovascular procedures being performed. Early morbidity is decreased following endovascular abdominal aortic aneurysm repair (EVAR) compared with open repair, and long-term studies of EVAR have focused on freedom from death, rupture, and conversion to open repair. Other less commonly encountered complications of EVAR are rarely reported. For instance, spinal cord ischemia (SCI) is a devastating complication infrequently seen after open AAA repair. This report discusses a case of delayed paraplegia after EVAR and reviews the pertinent literature. The incidence of SCI after EVAR is similar to open repair, but the mechanisms may be different. Atheroembolization and occlusion of pelvic inflow appear to be the predominant etiologies for SCI after EVAR. Careful consideration of the potential for SCI should be made in elderly patients undergoing EVAR, particularly if difficult arterial anatomy is present.
Intraoperative Venous Balloon Angioplasty during Surgical Thoracic Outlet Decompression in Paget-Schrötter Syndrome
Authors: Cancer Susana , Luján Salvador , Puras Enrique
Published: January 2017

The management of primary subclavian-axillary vein thrombosis is controversial. Indications and time of operative or endovascular intervention after successful thrombolysis remain unresolved. To improve the long-term functional outcomes in patients with primary subclavian-axillary vein thrombosis, early reestablishment of venous patency and prevention of recurrent thrombosis are required. We present a case in which, after catheter-directed thrombolysis, positional venography showed costoclavicular compression of the subclavian vein. At the time of surgical thoracic outlet decompression, transluminal venous angioplasty was performed.
Does the Vascular Surgery Board of the American Board of Surgery Work?
Authors: Calligaro Keith D.
Published: January 2017

Recommendations to form an independent American Board of Vascular Surgery were made several years ago by leaders in vascular surgery. All major vascular societies in the United States voted by majority rule to approve the formation of this organization. Although the Vascular Surgery Board of the American Board of Surgery is well intentioned, its focus and intentions are outdated because it is subservient to the American Board of Surgery.
Genetic Therapy for Vein Bypass Graft Disease: Current Perspectives
Authors: Simosa Hector F. , Conte Michael S.
Published: January 2017

Although continued progress in endovascular technology holds promise for less invasive approaches to arterial diseases, surgical bypass grafting remains the mainstay of therapy for patients with advanced coronary and peripheral ischemia. In the United States, nearly 400,000 coronary and 100,000 lower extremity bypass procedures are performed annually. The autogenous vein, particularly the greater saphenous vein, has proven to be a durable and versatile arterial substitute, with secondary patency rates at 5 years of 70 to 80% in the extremity.1 However, vein graft failure is a common occurrence that incurs significant morbidity and mortality, and, to date, pharmacologic approaches to prolong vein graft patency have produced limited results.

Dramatic advances in genetics, coupled with a rapidly expanding knowledge of the molecular basis of vascular diseases, have set the stage for genetic interventions. The attraction of a genetic approach to vein graft failure is based on the notion that the tissue at risk is readily accessible to the clinician prior to the onset of the pathologic process and the premise that genetic reprogramming of cells in the wall of the vein can lead to an improved healing response. Although the pathophysiology of vein graft failure is incompletely understood, numerous relevant molecular targets have been elucidated. Interventions designed to influence cell proliferation, thrombosis, inflammation, and matrix remodeling at the genetic level have been described, and many have been tested in animal models. Both gene delivery and gene blockade strategies have been investigated, with the latter now reaching the stage of advanced clinical trials.
Totally Subcutaneous Hemodialysis Access: Experience with the LifeSite Hemodialysis System
Authors: Comerota Anthony J.
Published: January 2017

The LifeSite Hemodialysis System (Vasca, Inc., Tewksbury, MA, USA)is totally subcutaneous, incorporating two silicone catheters positioned in the central venous system and connected to a stainless steel-titanium valve implanted in a subcutaneous pocket. A randomized trial and nonrandomized clinical experience have demonstrated lower rates of infection and longer device survival when 70% isopropyl alcohol is used as the antimicrobial solution with the LifeSite. Internal jugular vein placement with positioning of the valve on the anterior chest wall further improves results.
Phylogeny and classification of Davalliaceae on the basis of chloroplast and nuclear markers
Authors: Tsutsumi Chie , Chen Cheng-Wei , Larsson Anders , Hirayama Yumiko , Kato Masahiro
Published: January 2017

Davalliaceae have been classified on the basis of morphological data or morphological and molecular data. The family has been divided into various genera, the circumscription of which may differ between authors. Previous phylogenetic analyses used limited numbers of genes and taxa. We studied the molecular phylogeny of the family by using two nuclear markers (LEAFY intron 1, gapCp intron) and a long chloroplast marker (atpB‐rbcL‐accD) in 55 specimens of 41 species. The results indicated that Davalliaceae are divided into seven clades, six of which coincide with the genera and sections sensu Kato & Tsutsumi. The relationships among the clades were inconsistent with respect to the markers analyzed, and a species tree derived from all datasets did not resolve the relationships. In addition, the clades were not well characterized to be classified at the genus level. Therefore, we propose to classify Davalliaceae in the single genus Davallia with seven sections, i.e., sect. Araiostegiella, sect. Davallia (comprising only D. canariensis), sect. Davallodes (including Araiostegia p.p. and Paradavallodes), sect. Humata (including Pachypleuria and Parasorus), sect. Scyphularia (s.l. = sect. Davallia sensu Kato & Tsutsumi excluding the type), sect. Trogostolon (s.l. = sect. Trogostolon sensu Kato & Tsutsumi), and sect. Cordisquama (s.l. = Wibelia sensu Kato & Tsutsumi). A key to the sections and a table of characters for the sections are provided.
A molecular phylogeny of the Laelia alliance (Orchidaceae) and a reassessment of Laelia and Schomburgkia
Authors: Peraza-Flores Lizandro N. , Carnevali Germán , van den Berg Cássio
Published: January 2017

We provide a molecular phylogenetic analysis of the Laelia alliance based on sampling of 20 of an estimated 24 species, and seven plastid regions plus nrITS 1 & 2 analyzed using maximum parsimony, maximum likelihood, and Bayesian inference. Furthermore, we used coded indels to evaluate their effect on the phylogenetic relationships and/or support values (bootstrap and posterior probabilities). Our results confirm the existence of two clades, the long known Laelia (endemic to México at middle to high elevations) and Schomburgkia (a more widely distributed taxon). Both clades were strongly supported by PP values and moderate BS; thus, we preferred to recognize them as separate genera with a reappraised morphology and taxonomic delimitation. The inclusion of coded indels in the analyses was of great utility; we could identify the probable hybrid origin of L. gouldiana and L. halbingeriana. We propose new combinations to accommodate the taxonomic changes resulting from our study. We transfer L. anceps subsp. anceps, L. anceps subsp. dawsonii, L. aurea, L. mottae, and L. rubescens to Schomburgkia, with the second taxon elevated to species level; the molecular evidence together with previous published work on the morphology, phenology and geography of the group support these decisions. Lastly, the recently described genus Encabarcenia is considered as a synonym of Schomburgkia and, as a result, a new combination is proposed.
Frozen Elephant Trunk and Antegrade Visceral Debranching in the Surgical Treatment of Type B Aortic Dissection: An Alternative Method
Authors: Tuncer Altug , Akbulut Mustafa , Adademir Taylan , Tas Serpil , Ak Adnan , Arslan Özgür , Erden Benay , Şişmanoğlu Mesut
Published: January 2017

Intervention is inevitable in complicated Type B aortic dissections. Classical surgical procedures and endovascular interventions are far from ideal treatments due to their high risk of periprocedural complications and mortality. There is often a need for alternative method in cases of difficult anatomy. We present the combined use of frozen elephant trunk and antegrade visceral debranching methods in the treatment of a 54-year-old male patient with complicated Type B aortic dissection.
David-V Procedure in a Patient with Aortic Dilation and Competent Quadricuspid Aortic Valve: Are Genetics to Blame?
Authors: Hebeler Katherine , Squiers John , Baumgarten Heike , DiMaio J. Michael , Brinkman William
Published: January 2017

Quadricuspid aortic valves (QAVs) are extremely rare. In this case study, we report a David-V valve-sparing aortic root replacement with reimplantation of a native QAV in a patient with aortic dilation, normal valve function, and a family history of aortic dissection. Microscopic pathological examination of the excised section of the aorta revealed scattered small foci of cystic medical degeneration throughout. A genetic predisposition for aortic dilation may be present in patients with QAV, even in the setting of a competent valve. Regular screening for aortic dilation in patients with known QAV should therefore be considered.
Development of bio-rights incentive scheme for participatory restoration and conservation of mangrove resources
Authors: SUHARTI SRI
Published: January 2017

Abstract. Suharti S. 2017. Development of bio-rights incentive scheme for participatory restoration and conservation of mangrove resources. Biodiversitas 18: 121-128. Bio-rights incentive scheme is one strategy to accommodate efforts to increase economic benefits with efforts to prevent counterproductive activities to the environment (through restoration and conservation of natural resources). This study aims to assess the implementation of bio-rights incentive schemes, its achievements, and challenges in its implementation. The research was done by using survey method in Pesantren Village, Ulu Jami Sub-district, Pemalang, Central Java, Indonesia, which is the location of the pilot project established by Wetland International Indonesia (WII). The research was done in August to December 2014. The results showed that bio-rights incentives scheme could encourage the community to participate actively in restoration and conservation of mangrove resources. Implementation of bio-rights scheme was done through the provision of micro-credits to the community groups to develop activities that can generate sustainable income. Loan repayments and its interest was not in cash, but in the form of conservation service activities such as reforestation, habitat protection and the prevention of unsustainable land use. Through the bio-rights scheme, besides gaining financial benefits, villagers in Pesantren also received other benefits such as improvement of environmental conditions (widespread mangrove plantation, improvement in land productivity and the intensity of mangrove aquaculture).

Keywords: Bio-rights, conservation, mangrove, participatory, restoration
Forest type diversity on carbon stocks: Cases of recent land cover conditions of tropical lowland, swamp, and peatland forests in West Kalimantan, Indonesia
Authors: ASTIANI DWI , MUJIMAN MUJIMAN , RAFIASTANTO ANDJAR
Published: January 2017

Abstract. Astiani D, Mujiman, Rafiastanto A. 2017. Forest type diversity on carbon stocks: Cases of recent land cover conditions of tropical lowland, swamp, and peatland forests in West Kalimantan, Indonesia. Biodiversitas 18: 137-144.Tropical forests constitute for a large concentrated carbon pools, ultimately in tropical peatland forest since this forest type sink carbon both in the vegetation and its underlying peat. However, these forests recently experienced a lot of pressures from anthropogenic disturbances. A study was conducted to estimate carbon stocks of degraded tropical lowland, swamp, and peatland forests in Kayong Utara West Kalimantan. Above ground survey was conducted using stratified sampling based on the differences in spectra of Landsat 7 ETM+ according to the land cover gradation or vegetation formations. The study area was classified based on the canopy closures and forest/landcover types and grouped into low and high degraded lowland forest, low and high degraded peat forest, low and high degraded swamp forest, shrub land, and mixed agricultural land. Aboveground carbon stocks in each group was estimated by purposively assessing all carbon sources within 5-11 plots of 20 m x 100 m area. Belowground carbon was also measured on peatland. Results show that among the groups, the highest to the lowest order of aboveground carbon sink consecutively were low degraded swamp, low degraded lowland, low degraded peatland, high degraded swamp, high degraded peatland, high degraded lowland forests, mixed agricultural land, and shrub land (269.1 to 46.3 ton C/ha) plus other biomass sources recruited from belowground roots. It is demonstrated that forest degradation and land cover changes reduce amount of above ground carbon stocks and thus could result large amount of carbon loss from forests. Surprisingly, our results demonstrated that 0.5-5.2 m belowground carbon in peatland contribute to large amount of carbon Each meter depth of those fibrist to hemist peat sinked ~634 ton C/ha. It is estimated that the 22,600 ha area of overall forest types/ land covers sink ~2.5 million of aboveground and ~5,570 ha peatland area hold ~9.2 million of below ground carbon. This amount of carbon is potential sink of carbon yet could be a huge losses if peatland forest and land cover changes continued.

Keywords: Aboveground carbon, belowground carbon stocks, degraded forest, land cover change, forest typesÂ
Spore germination and early gametophyte development of Platycerium wandae (Polypodiaceae) from Papua, Indonesia
Authors: PRAPTOSUWIRYO TITIEN NGATINEM
Published: January 2017

Abstract. Praptosuwiryo TNg. 2017. Spore germination and early gametophyte development of Platycerium wandae (Polypodiaceae) from Papua, Indonesia. Biodiversitas 18: 175-182. Studies on gametophyte development in ferns are very important, as the data generated is often useful for supporting taxa delimitation in ferns and fern-allies. This data is also very important for understanding the ecology, reproductive biology, evolution and distribution of ferns. The study reported here aimed to develop a deeper understand of morphogenesis in the fern Platycerium wandae Racib. by investigating the process of spore germination and early gametophyte development of the species on natural media. Fresh spores of P. wandae were germinated in a mixed media consisting of minced roots of Cyathea contaminans and charcoaled rice hulls (1: 1) under green house condition. Spores of P. wandae are monolete, ellipsoid, non-chlorophyllous, dark brown, and lacking perine. Spores germinated between 7 to 14 days after sowing (DAS). Spore germination of P. wandae is of the Vittaria-type and the prothallial development is of the Aspidium-type, characterized by early development of unicelullar trichomes (30-40 DAS). Only unisexual gametophytes were observed at 60-80 DAS. New data is provided concerning the morphogenesis of P. wandae from Papua, Indonesia, on natural media. The findings are relevant to reproductive biology, would contribute to establish an efficient ex situ propagation strategies for the conservation of epiphyitic ferns and to facilitate further in situ studies of gametophyte ecology.

Keywords: Gametophyte development, Platycerium wandae, spore germination, staghorn fern
Genetic diversity of red and black upland rice accessions from East Nusa Tenggara, Indonesia as revealed by agro-morphological characters
Authors: MAU YOSEP S. , MARKUS JENNY E.R. , SHIRLY SHIRLY , OEMATAN S. , NDIWA A. S.S. , HANDOKO DODY D. , NASUTION ANGGIANI , MAKBUL KISMAN
Published: January 2017

Abstract. Mau YS, Markus JER, Shirly, Oematan S, Ndiwa ASS, Handoko DD, Nasution A, Makbul K. 2017. Genetic diversity of red and black upland rice accessions from East Nusa Tenggara, Indonesia as revealed by agro-morphological characters. Biodiversitas 18: 197-211. A number of upland red and black rice accessions were collected from various locations of East Nusa Tenggara Province, Indonesia. This germplasm collection is invaluable genetic resource that can be utilized to generate new improved varieties. The objective of the present study was to elucidate genetic diversity of the rice germplasm based on agro-morphological characters. The study was carried out in the Glasshouse involving 40 upland red and black rice accessions. Observed variables included qualitative and quantitative agro-morphological characters. A total of 26 qualitative and 16 quantitative characters were observed. Qualitative characters were descriptively analyzed while quantitative characters were subjected to analysis of variance. Both data were also subjected to cluster analysis. Research results revealed a significant difference among rice accessions in both qualitative and quantitative characters. The tested rice accessions exhibited substantial differences in most of the observed qualitative and quantitative variables. Cluster analysis employing qualitative variables classified the rice accessions into 4 clusters and 15 sub-clusters. The same analysis using quantitative characters placed the 40 rice accessions into 5 clusters and 8 sub-clusters. Evaluation of agro-morphological characters demonstrated that the rice germplasm under the present study possessed a high genetic diversity.

Keywords: upland rice, agro-morphology, characters, diversity
Perubahan Kadar Natrium dan Kalium Serum Akibat Pemberian Glukosa 40% pada Latihan Fisik Akut
Authors: Wahyudi Wahyudi , Ginting Suryani , Siregar Charles , Yoel Chairul , Pasaribu Syahril , Lubis Munar
Published: January 2017

Latar belakang. Glukosa sumber energi untuk latihan fisik dan berpengaruh pada keseimbangan metabolisme tubuh. Glukosa menyebabkan masuknya ion natrium ke dalam sel. Sewaktu ATP terhidrolisis menjadi ADP, protein pembawa mengalami fosforilasi dan perubahan konformasi yang menyebabkan ion natrium dilepaskan ke cairan ekstrasel. Kemudian dua ion kalium berikatan di sisi ekstrasel masuk ke sel.Tujuan. Untuk mengetahui dan membandingkan perubahan kadar natrium dan kalium serum sebelum dan setelah latihan fisik akut pada kelompok yang diberikan air putih dan air berglukosa 40%.Metode. Empat puluh anak SLTP sehat yang dipilih secara acak sederhana mendapat minuman glukosa 40% (dosis 1 g/kgBB yang dilarutkan dalam 300cc air) (n=20) dan air putih sebanyak 300 cc (n=20). Semua anak diberi minum 10 menit sebelum latihan fisik, kemudian dilakukan latihan fisik selama 10 menit. Sampel darah vena diambil sebelum anak minum dan setelah melakukan latihan fisik.Hasil. Terjadi perubahan penurunan natrium serum berbeda bermakna setelah latihan fisik akut (p<0,05) pada kelompok air putih, sedangkan pada kelompok air berglukosa 40% terjadi peningkatan natrium serum. Perbandingan kadar natrium serum kedua kelompok berbeda bermakna (p<0,05). Kadar kalium serum tidak mengalami perubahan (p>0,05) pada kedua kelompok.Kesimpulan. �� � � � � � � ��� � � � � � -Pemberian minuman berglukosa 40% sebelum latihan fisik akut dapat menyebabkan peningkatan kadar natrium serum.
Hipoksia Jaringan dan Kadar Laktat pada Leukemia Limfoblastik Akut dengan Demam Neutropenia dalam Fase Induksi
Authors: Ramadhina Nusarintowati , Windiastuti Endang , Budiman H.I.
Published: January 2017

Latar belakang. Pada Leukemia limfoblastik akut (LLA), proses fagositosis oleh neutrofil kurang atau tidak efektif(kondisi neutropenia) memungkinkan bertahannya bakteri yang tidak dapat didigesti, sehingga timbul prosesinflamasi yang selanjutnya dapat menimbulkan gangguan mikrosirkulasi.Tujuan. Mengetahui gangguan mikrosirkulasi pada pasien LLA dengan demam neutropenia dalam fase induksidengan menggunakan 2 parameter yaitu kadar oksigen darah vena (SvO2) dan kadar laktat darah.Metode. Penelitian potong lintang, Maret 2007-Maret 2008 pada pasien LLA berusia 0-18 tahun. Pengambilansampel secara consecutive sampling, pada pasien LLA baru yang mendapat terapi sitostatika dalam fase induksi denganjumlah absolut neutrofil <1000/uL dan terdapat satu kali episode demam.Hasil. Lima belas dari 49 subjek (31%) memiliki kadar oksigen darah vena di bawah 60%. Rerata SvO2 64,11±9,24%,pada neutropenia berat rerata SvO2 lebih rendah dibandingkan pada neutropenia sedang (56,78±7,99% vs.69,16±6,18%). Tidak tampak hubungan antara beratnya neutropenia dengan kadar SvO2. Pada pemeriksaankadar laktat, 38 dari 49 subjek (78%) memiliki kadar laktat di atas 2 mmol/L. Rerata kadar laktat darah 3,04±1,14mmol/L, pada neutropenia berat rerata kadar laktat darah lebih tinggi dibandingkan neutropenia sedang (3,52±1,33mmol/L vs. 2,72±0,87 mmol/L). Beratnya neutropenia mempengaruhi kadar laktat darah, 15 subjek dengan SvO2< 60%, 13 subjek (87%) mengalami pula peningkatan kadar laktat darah di atas 2 mmol/L, 27 dari 34 subjek(79%) memiliki kadar laktat darah lebih dari 2 mmol/L meskipun kadar SvO2 dalam batas normal.Kesimpulan. Pada pasien LLA dengan demam neutropenia, kadar neutropenia mempengaruhi kadar laktat darahnamun tidak mempengaruhi kadar SvO2 sehingga hasil kadar laktat lebih dapat digunakan dengan segera untukmenunjukkan gangguan mikrosirkulasi dibandingkan hasil SvO2
Neuroblastoma pada Anak Usia 7 Tahun Laporan Kasus
Authors: Mulatsih Sri , Diba Vicka Farah
Published: January 2017

Neuroblastoma merupakan neoplasma dari sel embrional neural dan salah satu tumor padat terseringpada anak. Paling sering neuroblastoma berasal dari kelenjar supra renal, tetapi dapat juga dijumpai disepanjang jalur syaraf simpatis. Ditemukan kasus neuroblastoma pada usia anak yang lebih tua (7 tahun).Gejala pembesaran perut merupakan gejala awal yang harus diwaspadai adanya suatu tumor jaringanpadat neuroblastoma. Perjalanan sangat cepat, dengan ditandainya penyebaran di rongga pleura, kelenjargetah bening dalam waktu satu bulan. Semua hasil analisis gejala klinis dan pemeriksaan penunjang sangatmendukung diagnosis neuroblastoma stadium IV.
Platelet Distribution Width dan Mean Platelet Volume: Hubungan dengan Derajat Penyakit Demam Berdarah Dengue
Authors: Gunawan Stefanus , Sutanto Felix Candra , Tatura Suryadi N.N. , Mantik Max F.J.
Published: January 2017

Latar belakang. Diperlukan petanda klinis praktis yang dapat digunakan untuk memprediksi progresivitas demam berdarah dengue (DBD) dan sindrom syok dengue (SSD).Tujuan. Mencari hubungan antara platelet distribution width (PDW) dan mean platelet volume (MPV) dengan derajat penyakit infeksi dengue.Metode. Penelitian dilakukan dengan desain potong lintang. Didiagnosis DBD atau SSD berdasarkan kriteria WHO 1997. Data berupa hematokrit, jumlah trombosit, PDW, dan MPV dikumpulkan selama penelitian. Analisis statistik menggunakan t-test dan regresi linear.Hasil. Didapatkan delapan puluh sembilan anak yang mengikuti penelitian, 71 (79,8%) didiagnosis DBD dan 18 (20,2%) SSD. Korelasi negatif didapatkan antara PDW dan jumlah trombosit (r=-0,77; p<0,05); serta antara MPV dan jumlah trombosit (r=-0,52; p< 0,05). Rerata nilai PDW berbeda secara bermakna pada kelompok trombositopenia dan non trombositopenia (10,46 vs 8,07%; p<0,05) begitu juga nilai MPV (10,12 vs 8,84fl; p<0,05). PDW didapatkan lebih tinggi pada SSD dibanding dengan DBD (11,64 vs. 9,72%; p<0,05) begitu MPV (10,38 vs 8,53 fl; p<0,05). Didapatkan korelasi positif antara hemokonsentrasi dan PDW (r=0,217; p<0,05) begitu juga antara hemokonsentrasi dan MPV (r=0,118; p<0,05).Kesimpulan. PDW dan MPV dapat digunakan sebagai prediktor progresivitas dari DBD.
Small Dense Low Density Lipoprotein Sebagai Prediktor Risiko Penyakit Jantung Koroner pada Anak Lelaki Obes Pra-Pubertal
Authors: Hendarto Aryono
Published: January 2017

Latar belakang. Meningkatnya prevales obesitas pada anak menyebabkan meningkatnya komorbiditasakibat penyakit lain, salah satunya adalah penyakit kardiovaskular. Penyakit kardiovaskular merupakansalah satu penyakit penyebab kematian yang penting. Small Dense LDL (sdLDL) pada obesitas dewasaterbukti dapat dijadikan prediktor risiko penyakit jantung koroner. Penelitian serupa pada obesitas anakbelum pernah dilakukan.Tujuan. Mengetahui faktor risiko PJK pada obesitas anak dengan menggunakan sdLDL, serta kaitan adipositokindengan timbulnya faktor risiko penyakit jantung koroner (PJK).Metode. Penelitian potong lintang untuk mendeteksi risiko PJK dan peran indeks massa tubuh (IMT),masa lemak tubuh (MLT), leptin, adiponektin dan TNF-􀄮 terhadap risiko PJK pada anak lelaki obes prapubertalusia 5-9 tahun. Indeks massa tubuh ditentukan dengan menggunakan kurva CDC, massa lemaktubuh dihitung dengan alat body fat analyzer. Profil lipid, CRP, leptin, adiponektin, dan TNF-􀄮 diperiksasetelah subjek puasa selama 12 jam. Leptin, adiponektin, dan TNF-􀄮􀀃diperiksa dengan cara ELISA.Hasil. Seluruh subjek mempunyai IMT di atas nilai normal demikian pula MLT. Sebagian besar subjekmempunyai kadar TG, kolesterol total dan LDL meningkat dengan kadar kolesterol HDL menurun.Small dense LDL ditemukan pada sebagian kecil subjek. Kadar leptin dan TNF-􀁁 meningkat, sedangkankadar adiponektin menurun. Hanya sebagian kecil subjek mengalami inflamasi kronik derajat rendah yangditentukan dengan memeriksa CRP.Kesimpulan. Risiko PJK telah tampak pada anak lelaki obes pra-pubertal. Indeks massa tubuh, MLT, leptin,adiponektin dan TNF-􀁁 tidak berhubungan dengan terjadinya sd LDL.
Penilaian CAT (cognitive adaptive test)/CLAMS (clinical linguistic & auditory milestone scale) pada Anak di Tempat Penitipan Anak Werdhi Kumara I Denpasar
Authors: Windiani I Gusti Ayu Trisna , Soetjiningsih Soetjiningsih
Published: January 2017

Latar belakang. Gangguan perkembangan dan perilaku didapatkan pada 12%-16% anak di Amerika Serikat.Sedangkan gangguan komunikasi dan kognitif didapatkan 8% dari gangguan perkembangan. Deteksi dini sangatpenting untuk mencegah terjadinya gangguan perkembangan.Tujuan. Menentukan prevalensi anak yang mungkin memiliki gangguan kognitif dan bahasa di TPA Werdhi KumaraI Denpasar dengan menggunakan tes skrining perkembangan cognitif adaptive test (CAT)/clinical linguistic& auditory milestone scale (CLAMS).Metode. Desain penelitian deskriptif potong lintang dilakukan di TPA Werdhi Kumara I Denpasar. Data diperolehmelalui kuesioner dan dari hasil pemeriksaan CAT/CLAMS pada bulan September 2009.Hasil. Empat puluh sembilan anak ikut dalam dalam penelitian. Empat puluh satu (83,7%) anak memilikihasil skrining normal, 7 (14,3%) anak didapatkan hasil skrining suspek, dan 1 (2,0%) anak didapatkan denganketerbelakangan mental. Kedua orangtua subyek yang bekerja di luar rumah 46 (93,9%) orang, dan 32 subyek(65,3%) memiliki 1-2 saudara kandung.Kesimpulan. Didapatkan 14,3% anak di TPA Werdi Kumara I Denpasar menunjukkan gangguan kognitif danbahasa melalui pemeriksaan CAT/CLAMS, diperlukan penilaian lebih lanjut untuk diagnosis dan tata laksanaselanjutnya.
Pengaruh Obat Anti Epilepsi Terhadap Gangguan Daya Ingat pada Epilepsi Anak
Authors: Mustarsid Mustarsid , Nur Fadhilah Tia , Setiawati Shinta Riana , Salimo Harsono
Published: January 2017

Latar belakang. Epilepsi merupakan penyakit kronik yang dapat menurunkan kualitas hidup, di antaranyagangguan daya ingat.Tujuan. Mengetahui prevalensi gangguan daya ingat, serta pengaruh lama pengobatan, dan jumlah obatanti epilepsi.Metode. Penelitian potong lintang untuk mengetahui prevalensi gangguan daya ingat, serta pengaruh lamapengobatan, dan jumlah obat anti epilepsi terhadap gangguan daya ingat pada pasien epilepsi anak. Penelitinadilakukan di Poliklinik Neurologi Anak RSUD Dr Moewardi Surakarta dalam kurun waktu September2010 – November 2010, pada 50 subyek.Hasil. Gangguan daya ingat dialami 46% subyek di antara 50 subyek yang diteliti. Analisis bivariat mendapatkanpengaruh lama pengobatan lebih dari 2 tahun dengan OR 13,14 (CI 95% 3,29-2,47), jumlahobat anti epilepsi lebih dari satu obat dengan OR 0,6 (CI 95% 0,18-2,02). Analisis regresi logistik gandamendapatkan faktor yang mempengaruhi daya ingat adalah lama pengobatan lebih dari 2 tahun denganOR 17,3 (CI 95% 1,13- 279,17).Kesimpulan. Gangguan daya ingat dialami 46% pasien epilepsi anak. Lama pengobatan lebih dari duatahun berpengaruh terhadap terjadinya gangguan daya ingat pada pasien epilepsi anak.
Karakteristik Klinis dan Epidemiologis Avian Influenza A (H5N1) Anak Di Indonesia, Tahun 2005-2007
Authors: Murniati Dewi , Giriputro Sardikin , Hadinegoro Sri Rezeki S.
Published: January 2017

Latar belakang. Indonesia merupakan negara tertinggi di dunia yang melaporkan kasus avian influenzaA(H5N1) dengan proporsi kematian yang tinggi (83%). Sampai saat ini belum banyak penelitian kasusavian influenza A(H5N1) anak di Indonesia.Tujuan. Mengetahui pola epidemiologis, klinis, laboratoris, dan radiologis dalam hubungannya dengankesembuhan atau kematian kasus avian influenza A (H5N1) anak.Metode. Studi retrospektif dari 37 kasus konfirmasi avian influenza anak di Indonesia berdasarkan dataBadan Litbangkes dan Dirjen P2PL, Depkes RI serta WHO Indonesia dan disajikan secara deskriptif.Hasil. Riwayat kontak secara langsung dan tidak langsung dengan unggas (37,84%) sebanding dengankontak pada kasus konfirmasi avian influenza (35,14%), 12 kasus diantaranya merupakan anggota klusterkeluarga. Kasus terbanyak pada kelompok umur 5-<12 tahun (50,62%). Domisili kasus anak terutama ditiga propinsi Indonesia yaitu DKI Jakarta, Jawa Barat dan Banten. Proporsi kematian avian influenza anakIndonesia lebih rendah (67,57%) dibanding proporsi kematian nasional (82,8%) tetapi masih sedikit lebihtinggi dari proporsi kematian global (59,45%). Gejala klinis utama yaitu demam (100%), batuk (86,49%),sesak (81,08%), serta penurunan kesadaran (62,16%). Pneumonia terjadi pada 59,46% kasus dengan proporsikematian 68,18%. Kelompok yang mendapat oseltamivir (37%) mempunyai peluang hidup lebih besardari pada kelompok yang tidak mendapat oseltamivir (20%), demikian pula lama awitan sakit dan dosisawal oseltamivir pada kelompok nonfatal lebih pendek (median 5,5 hari dengan rentang waktu 2-10 hari)dibanding kelompok yang fatal (median 8,5 hari, rentang 3-22 hari) menunjukkan makin cepat mendapatterapi oseltamivir memberi peluang hidup lebih baik.Kesimpulan. Spektrum klinis avian influenza yang luas menempatkan penyakit ini sebagai diagnosis bandingyang perlu dipertimbangkan termasuk kematian yang tidak jelas penyakitnya pada kluster keluarga atausakit berat lainnya. Terapi oseltamivir memberi peluang hidup lebih baik disamping penemuan kasus diniserta perawatan secepatnya.
Peran Transforming Growth Factor-B1 pada Penyakit Ginjal
Authors: Trihono Partini Pudjiastuti
Published: January 2017

Peran sitokin dan faktor pertumbuhan(growth factor)sangat penting dalam proses inflamasi yang mendasari pembentukan jaringan sklerotik dan fibrosis pada glomerulonefritis. Transforming growth factor(TGF)-E1merupakan sitokin multipoten yang disekresi oleh berbagai sel dalam tubuh. Sitokin TGF- E1 mempunyai kapasitas untuk mengaktivasi fibroblas interstisial, menginduksi apoptosis (yang menyebabkan sel intrinsik ginjal hilang, digantikan dengan jaringan fibrotik), dan diferensiasi sel tubulus menjadi miofibroblas, sehingga terjadi pembentukan jaringan parut ginjal. Jumlah (TGF)-E1 di daerah tubulo-interstisial berkorelasi dengan derajat inflamasi interstisial dan atrofi tubulus. Keterlibatan TGF-E1 pada pembentukan jaringan parut ginjal juga melalui peningkatan sintesis matriks ekstra selular. Diketahui bahwa TGF-E1 berperan dalam progresivitas penyakit ginjal. Kadar TGF-E1 di dalam urin kasus glomerulonefritis dengan proteinuria berat, sangat meningkat, dan kadarnya sebanding dengan derajat proteinuria. Peran TGF-E1 dalam progresivitas penyakit ginjal juga melalui terjadinya hipertensi. Angiotensin II sebagai hasil aktivasi sistim renin-angiotensin menstimulasi produksi TGF-E1. Inhibitor enzim konvertase (ACEI) dan atau antagonis reseptor angiotensin II terbukti dapat menurunkan proteinuria dan produksi TGF-E1, sehingga kedua obat tersebut dikenal mempunyai efek reno-proteksi.
Latar Belakang Penyakit pada Penggunaan Transfusi Komponen Darah pada Anak
Authors: Nency Yetty Movieta , Sumanti Dana
Published: January 2017

Latar belakang.Aplikasi transfusi darah dalam klinis sehari-hari dapat sebagai terapi pengganti maupun suportif. Sesuai pertimbangan risiko dan manfaat tranfusi komponen darah seperti thrombocyt concentrate(TC) packed red cell(PRC), fresh frozen plasma(FFP), platelete rich plasma (PRP), dan cryoprecipitate/kriopresipitat lebih direkomendasikan daripada whole blood(WB). Tujuan.Mengetahui hubungan antara latar belakang penyakit dengan penggunaan transfusi komponen darah.Metode.Penelitian retrospekstif dilakukan di Ruang Anak Rumah Sakit Dr Kariadi Semarang. Data diperoleh dari register bank darah rumah sakit tahun 2008-2010. Latar belakang penyakit ditentukan dengan mengidentifikasi diagnosis pada setiap kasus transfusi. Komponen darah yang diteliti PRC, TC, FFP, PRP, dan kriopresipitat. Utilisasi dengan menghitung total jumlah komponen darah yang dipakai per diagnosis penyakit, dan rerata pemakaian produk darah per jumlah kasus terindikasi transfusi per tahun. Analisis uji statistik hubungan dengan menggunakan Chi square.Hasil.Terdapat peningkatan rerata utilisasi darah 5678 unit darah per tahun. Terdapat peningkatan penggunaan selama 3 tahun terakhir, secara berurutan adalah 3751, 6496, dan 6787 unit darah (p<0.001). Komponen darah yang paling banyak digunakan berturut-turut adalah TC 3228 unit, PRC 1682 unit, FFP 295 unit, PRP 224 unit, dan cryo133 unit. Pasien leukemia merupakan pengguna komponen darah terbanyak dengan rerata pemakaian per tahun 2098 unit, diikuti oleh sepsis 893 unit, dan thalassemia 568 unit. Rasio kebutuhan PRC terbanyak untuk kasus penyakit jantung (2,23) diikuti penyakit ginjal (2,25) dan thalassemia (1,7). Untuk penggunaan TC, terbanyak berturut-turut adalah ITP (14,70 unit), anemia aplastik (9,8 unit), dan leukemia (6 unit). Terdapat hubungan antara diagnosis penyakit dengan penggunaan transfusi komponen PRC, TC, dan plasma (p<0,001).Kesimpulan.Terdapat hubungan antara latar belakang penyakit penyebab dengan penggunaan transfusi komponen darah. Leukemia, sepsis, dan thalassemia adalah latar belakang penyakit yang paling banyak menggunakan transfusi komponen darah. Berturut turut komponen darah yang banyak digunakan adalah konsentrat trombosit, komponen sel darah merah, serta plasma darah segar.