bluuebunny/crossref_metadata_2025 huggingface dataset:
PERBEDAAN KEJADIAN DEPRESI PADA PRIA DAN WANITA PADA LANSIA YANG MENDERITA DIABETES MELLITUS
Authors: Ainiyah Nur , Noventi Iis , Zahroh Chilyatiz
Published: April 2021

Elderly is the final stage of the human life cycle. The process of aging is a process that shows a decline in human physical function, emotional changes, as well as social interactions that will  change gradually. Diabetes Mellitus (DM) is a metabolic disease that occurs chronically due to interference with insulin and has various complications for sufferers, both acute and chronic. Decreased physical, unstable emotional, interaction of social abilities decrease, anda also  metabolic disorders and its complications make the elderly had depression which is manifested in the quality of sleep of the elderly. The purpose of this study was to determine the differences in the incidence of depression in men and women in the elderly who suffer from diabetes mellitus. The method in this research was comparative. The population of this study were all elderly in Region X as many as 60 elderly consisting of 27 elderly men and 33 elderly women. The sample in this study was a research of 60 members, using total sampling / depression data collection was done by giving a questionnaire based on the Beck depression scale. Data analysis used elderly depression scores in men and elderly women collected from the results of data collection will be measured the difference with a two-mean difference test (T-test). The results showed the mean depression score for men = 1.59 and the standard deviation = 1.575 and the mean depression score for women = 3.54 the standard deviation was 1.96, the level of significance (p = 0.001; p <0.05). Its shows a significant difference between depression in elderly men and women who suffer from DM. Therefore, it is expected that all members of the elderly family as one of the support systems for the elderly can provide support so that the elderly do not experience depression.
PENGARUH TERAPI KOGNITIF DAN TERAPI PSIKOEDUKASI KELUARGA TERHADAP TINGKAT ANSIETAS KLIEN KANKER
Authors: Mulia Madepan
Published: April 2021

Introduction: Cancer is a group of diseases characterized by the uncontrolled growth and spread of abnormal cells that can lead to death. The physical impact caused by cancer will affect a person's psychological condition, causing psychosocial problems. Purpose: This study aims to determine the effect of cognitive therapy and family psychoeducation therapy on the anxiety level of cancer clients at the Regional General Hospital (RSUD) Dr. Hi. Abdul Moeloek, Lampung Province. Methods: This study used a quasi-experimental design with pre-post test control group with a total sample of 35 people for each group. The instrument used was hamilton anxiety rating scale (HARS). The analytical test used was repeated ANOVA test and independent t-test. Results: The results showed that cancer client anxiety decreased significantly (p value <0.05) after receiving nurse nursing action, but after being given cognitive therapy and family psychoeducation therapy, it decreased significantly than after receiving nurse nursing action. Conclusion: The implication of this research is that cognitive therapy and family psychoeducation therapy reduce the anxiety level of cancer clients, so that the hospital can add interventions related to psychosocial problems, especially for cancer clients who experience anxiety at the Regional General Hospital (RSUD) Dr. Hi. Abdul Moeloek, Lampung Province.
PROGRAM KESEHATAN IBU HAMIL DENGAN METODE SPP (SENAM, PEYULUHAN DAN PEMERIKSAAN)
Authors: Suparni Suparni , Zuhana Nina , Ersila Wahyu
Published: April 2021

Pendahuluan : Program kelas ibu hamil adalah salah satu bentuk pendidikan prenatal yang dapat meningkatkan pengetahuan ibu hamil, terjadi perubahan perilaku positif sehingga ibu memeriksakan kehamilan dan melahirkan ke tenaga kesehatan dengan demikian akan meningkatkan persalinan ke tenaga kesehatan dan menurunkan angka kematian ibu dan Anak. Berdasarkan hasil wawancara bidan desa kutosari, kelas hamil di desa tersebut sudah berjalan, namun kurang nya fasilitator menyebabkan kelas hamil kurang maksimal dan monoton terhadap informasi yang diberikan pada ibu hamil

Metodologi : Metode yang digunakan dalam kegiatan pengabdian masyarakat ini antara lain pendidikan kesehatan/ penyuluhan, diskusi dan tanya jawab, pemeriksaan, pemutaran video dan demonstrasi senam bersama.

Hasil : Setelah diberikan materi secara intensif, jumlah ibu hamil yang mempunyai pengetahuan baik mengalami peningkatan dari 4 (26,7%) meningkat menjadi 12 (80%). Hasil uji marginal homogeniety, diketahui p value=0,013 (p value < 0,05). Hal ini menunjukkan terdapat perbedaan yang signifikan pengetahuan ibu hamil sebelum dan sesudah diberikan penyuluhan tentang perawatan kehamilan, persiapan persalinan, gizi ibu hamil, anemia dan  tanda bahaya kehamilan.

Diskusi/pembahasan: kegiatan pengabdian kepada masyarakat ini terbukti bahwa pelaksanaan kelas ibu hamil ini merupakan sarana untuk belajar bersama tentang kesehatan ibu hamil, dalam bentuk tatap muka dalam kelompok yang bertujuan untuk meningkatkan pengetahuan ibu mengenai perawatan kehamilan, persiapan persalinan, gizi ibu hamil, anemia dan  tanda bahaya kehamilan. Penggunaan media alat bantu penyuluhan dan metode penyuluhan yang variatif mampu meningkatkan pemahaman ibu hamil terhadap informasi dan materi yang diberikan serta memberikan motivasi pada ibu hamil untuk selalu mengikuti kelas ibu hamil.

Kata Kunci : Program Kesehatan Ibu Hamil, metode SPP (Senam. Penyuluhan dan pemeriksaan)
MASALAH KESEHATAN PENYINTAS GEMPA DAN TSUNAMI DI DONGGALA, SIGI DAN PALU, SULAWESI TENGAH
Authors: Wiseno Bambang
Published: April 2021

ABSTRACT

 

Indonesia is an archipelago country located on the Ring of Fire has experienced many natural disasters. On September 28, 2018 a earthquake with magnitude 7.7 caused a tsunami in Donggala, Sigi and Palu in Province of Sulawesi Tengah. Declared a national disaster, the government and many humanitarian organizations (NGOs) domestic and foreign, who are help to deal the problems caused. For this matter, writers is a llecturer and one’s of memberf the NGO Indonesian Red Crescent Society (BSMI) after two weeks of disaster have conduct health services and provide assistance to alleviate the bio, psychological, socio and cultural burden. Nearly 845 residents checked their health conditions at health posts created. Health problems found were diarrhea and digestive disorders, respiratory tract infections, hypertension, skin diseases and various post-traumatic syndroma disorder problems. Based on the literature and these findings it can be concluded, the problems needs more attention in the handling and prevention, and helper / voluntere should be readiness  to provide mental health / psychosocial support after the disaster.
OPTIMALISASI PERAN KELUARGA DALAM MENGURANGI RESIKO NEGLECT PADA LANSIA
Authors: Nurmalisyah Fitri Firranda , Anjar sari Desy siswi , Zuliani Zuliani , Pitaloka Dyah
Published: April 2021

Menjadi tua merupakan suatu proses alamiah yang berarti seseorang telah melalui tahap-tahap kehidupannya, yang dimulai dari  neonatus, toddler, pra school, school, remaja, dewasa dan lansia. Tahap berbeda ini di mulai baik secara biologis maupun psikologis. Kondisi yang dialami oleh lansia dengan pertambahan usia dan perubahan-perubahan kondisi tubuh pada lansia, menyebabkan lansia dikategorikan dalam kelompok resiko tinggi. Perubahan- perubahan yang terjadi pada lansia baik perubahan fisiologis maupun psikososial menyebabkan lansia mengalami kelemaham dan keterbatasan fungsi. Perubahan fungsi fisiologik berupa keterbatasan, kelemahan dan ketergantungan akan mempengaruhi kondisi psikososial lansia  berupa gangguan atau perubahan fungsi psikososial. Perubahan fungsi psikososial pada lansia akan berdampak terhadap terjadinya kerusakan fungsi psikososial pada lansia. Kerusakan fungsi  psikososial menjadi faktor resiko bagi lansia. Kerusakan fungsi psikososial pada lansia menjadi faktor resiko terhadap kejadian pengabaian  pada lansia. Tujuan dari pengabdian masyarakat ini adalah menanggulangi permasalahan pengabaian lansia yang sering terjadi di masyarakat. Untuk mencegah terjadinya neglect pada lansia, maka perlu diberikan pendidikan kesehatan tentang neglect atau pengabaian lansia agar keluarga dapat melakukan perawatan pada lansia, sehingga tidak terjadi neglect atau pengabaian pada lansia.

 

Kata kunci : peran keluarga, neglect, lansia
Senam Diabetes SENAM DIABETES SEBAGAI UPAYA MENURUNKAN KADAR GULA DARAH
Authors: Binarti Dwi Wahyuningsih Binarti Dwi Wahyuningsih,S.Kep.Ns,M.Kes
Published: April 2021

SENAM DIABETES SEBAGAI UPAYA MENURUNKAN KADAR GULA DARAH  Binarti Dwi Wahyuningsih1, Sri Sudarsih2, Moch Zainuddin3   

             Senam diabetes melitus merupakan jenis senam aerobic low impact yang penekanannya pada gerakan ritmik otot, sendi, vaskuler dan saraf dalam bentuk peregangan dan relaksasi. Senam ini merupakan senam fisik yang dirancang menurut usia dan status fisik serta merupakan bagian dari pengobatan diabetes mellitus. Senam mempunyai efek menaikkan aksi insulin di jaringan, sehingga kebutuhan akan insulin menurun. Latihan jasmani yang berupa olah raga dapat menyebabkan terjadinya peningkatan aliran darah, pembuluh kapiler lebih banyak terbuka sehingga lebih banyak tersedia reseptor insulin dan reseptor menjadi akan lebih aktif yang akan berdampak terhadap penurunan glukosa darah pada pasien diabetes. Senam diabetes mellitus tipe 2 berperan dalam pengaturan kadar glukosa darah karena glukosa otot yang sedang bekerja dapat mencapai kenaikan sampai 15-20 kali lipat akibat peningkatan laju metabolic pada otot yang aktif dan hal ini dapat memperbaiki profil lemak, meningkatkan sensitivitas insulin sehingga akan menurunkan glukosa darah. Tahapan kegiatan yang akan dilakukan dalam kegiatan pengabdian kepada masyarakat ini adalah menyiapkan materi yang akan disampaikan pada saat penyuluhan dan berkoordinasi dengan kepala Desa Gayaman serta kader keehatan di Desa Gayaman. Rencana selanjutnya adalah melaksanakan senam diabetes bersama penderita diabetes tipe 2.
PEMBERDAYAAN MASYARAKAT DESA ADAT DALAM PENCEGAHAN PENYEBARAN COVID 19 DI DESA ADAT APIT YEH MANGGIS KARANGASEM BALI
Authors: Sulisnadewi Ni Luh Kompyang
Published: April 2021

Kasus pandemi Covid-19 di Indonesia kian hari terus meningkat. Sampai 3 Mei  2020 sudah tercatat yang positif ada 11.192 kasus, sembuh 1876 kasus, dan meninggal 845 kasus. Di Provinsi Bali data sampai dengan tanggal 3 Mei 2020 menunjukkan  jumlah kumulatif pasien positif 262 orang , jumlah pasien yang telah sembuh sejumlah 151 orang dan jumlah pasien yang meninggal sejumlah 4 orang.  Salah satu upaya yang dillakukan pemerintah propinsi Bali dalam memutus mata rantai penyebaran covid-19 adalah dengan memberdayakan Satgas Gotong Royong yang dimiliki oleh setiap desa adat di Bali. Tugas utama Satgas Gotong Royong yakni memberdayakan Krama Desa Adat dan Yowana untuk bergotong royong sesama Krama Desa Adat dalam melakukan pencegahan Covid-19.

Poltekkes Denpasar merupakan salah satu perguruan tinggi kesehatan yang tentunya memiliki tugas dan peran melakukan pengabdian kepada masyarakat dan perannya sangat dibutuhkan dalam rangka mitigasi pandemic covid-19. Kegiatan pendampingan dan pemberdayaan masyarakat bertujuan untuk  untuk mendampingi masyararkat dalam proses penguatan potensi masyarakat dan kapasitas desa adat dalam antisipasi penyebaran covid -19. Sasaran dari pengabdian masyarakat ini adalah satgas covid-19 desa adat Apit Yeh Manggis Karangasem yang berjumlah 25 orang dan masyarakat Desa yang berjumlah 921 KK. Kegiatan yang dilakukan yaitu pemberian edukasi kepada satgas, pemberian poster, masker, dan juga penambah daya tahan tubuh untuk anggota satgas covid 19.

 

 

Kata Kunci : Pemberdayaan – Desa Adat - Pencegahan Covid -19
Pelatihan Konseling Menyusui Dalam Rangka Pencegahan Stunting Melalui Pemberian Air Susu Ibu Dengan Dinas Kesehatan Kabupaten Jombang Di Kabupaten Jombang
Authors: Probowati Ririn , Sawitri Prihatini Monika , Ratnawati Mamik
Published: April 2021

Counseling is a series of contacts or direct relationships with individuals whose purpose is to provide assistance in changing their attitudes and behavior (Taufik, 2010). In order for mothers to maintain exclusive breastfeeding for 6 months, WHO recommends initiating breastfeeding within the first hour of life, babies only receive breast milk without additional food or drink, including water, breastfeed as requested or as often as the baby wants, and do not use bottles or pacifiers. (WHO, 2018). Based on data from the Ministry of Health, there is an increase in the provision of breastfeeding (breast milk) during a pandemic COVID-19 by 52 percent. This figure has increased significantly compared to last year. "Compared to the 2019 period, there is an increase in breastfeeding in 2020. It increases from 20 percent to 52 percent in the first trimestes of 2020. East Java is currently not far from the national figure, reaching 26.91 percent with the highest risk of stunting in the districts of Probolinggo, Trenggalek, Jember, Bondowoso and Pacitan . The stunting rate in Jombang Regency has decreased by 1 percent compared to 2019. Namely from 18 percent to 17 percent in 2020. According to her, the highest stunting cases in Jombang are in five areas, namely Plabuhan, Plandaan, Mayangan and Distance Kulon districts, Jogoroto, Kabuh, districts. and Blimbing Kesamben District. The purpose of this activity is to provide guidelines for members of the   counselor group at PONED puskesmas in the Jombang district health office . The results of this activity , terbetuknya breastfeeding counselor groups in each puskesmas PONED in Jombang district, a group of counselors will provide assistance to the motivator and mother - pregnant women and nursing mothers in order to give exclusive breastfeeding are one factor un tuk prevent stunting in bali ta . In this activity the number of participants who took part in the Breastfeeding Counseling Training in the Context of Stunting Prevention through Breastfeeding in Jombang district was 19 participants during the pandemic period . .

 

Keywords : Breastfeeding Counseling , Stunting , Breastfeeding
The Training of English TOEFL Equivalent for students in SMA Muhammadiyah Jombang
Authors: Noviana I'in
Published: April 2021

Sebuah Pendidikan merupakan proses pembelajaran yang dilakukan disekolah sebagai lingkungan formal yang melibatkan siswa dan guru. Salah satu cara yang paling mudah untuk menguatkan proses pembelajaran adalah pemahaman bahasa. Bahasa merupakan alat komunikasi yang terpenting. Di Negara kita Bahasa Indonesia yang menjadi bahasa persatuan dan Bahasa daerah yang menjadi bahasa ibu, serta Bahasa inggris yang menjadi Bahasa Asing. Bahasa Inggris adalah bahasa internasional yang menghubungkan orang-orang di seluruh dunia. Metode yang digunakan pada pengabdian masyarakat ini adalah pemberian perlatihan kepada guru dan siswa dalam memahami Bahasa Inggris yang ber ekuivalensi TOEFL untuk membantu menyelesaikan soal dalam Ujian akhir nasional. Luaran dari hasil pengabdian masyarakat ini adalah peningkatan pemahaman Bahasa Inggris guru dan siswa SMA terutama Bahasa Inggris grammatical errors nya serta publikasi pada jurnal yang terakreditasi dan ber ISSN.
Hubungan Kecemasan, Pengetahuan, dan Interaksi dengan Stigma Perawat terhadap Pasien HIV/AIDS di RSUD Dr. H. Abdul Moeloek Provinsi Lampung
Authors: Aryastuti Nurul , Yanti Dhiny Easter , Renitasari Renitasari
Published: April 2021

Stigma perawat pada Orang Dengan HIV/AIDS (ODHA) dapat menurunkan kualitas layanan kesehatan pasien HIV/AIDS. Data di RSUD Dr. H. Abdul Moeloek Provinsi Lampung diketahui kasus HIV/AIDS dirawat tahun 2016 sampai 2018 meningkat (189 orang, 195 orang, 343 orang). Salah satu cara meningkatkan kualitas hidup ODHA dengan menghilangkan stigma dan diskriminasi. Tujuan penelitian untuk mengetahui hubungan kecemasan, pengetahuan, dan interaksi dengan stigma perawat terhadap pasien HIV/AIDS di Rumah Sakit Umum Daerah Dr. H. Abdul Moeloek Provinsi Lampung Tahun 2020. Jenis penelitian menggunakan rancangan survey analitik dengan pendekatan cross-sectional. Populasi penelitian adalah perawat di ruang Anyelir, Nuri, PBH, Mahammunyai, dan Sudhanirmala A RSUD Dr. H. Abdul Moeloek Provinsi Lampung sejumlah 109 perawat. Sampel sebanyak 97 perawat diambil dengan teknik simple random. Uji statistik yang digunakan adalah uji chi square. Hasil Penelitian didapatkan stigma perawat sebagian besar negatif sebanyak 52 (53,6%); sebagian besar kecemasan perawat dalam batas normal sebanyak 64 (66%); sebagian besar perawat memiliki pengetahuan rendah sebanyak 85 (87,6%); sebagian besar perawat memiliki interaksi baik sebanyak 57 (58,8%). Ada hubungan antara kecemasan perawat dengan stigma perawat terhadap pasien HIV/AIDS (p value=0,039, OR=2,78); Ada hubungan antara interaksi dengan stigma perawat terhadap pasien HIV/AIDS (p value=0,12, OR=3,21). Pihak manajemen rumah sakit diharapkan dapat memfasilitasi perawat melalui seminar atau pelatihan tentang HIV/AIDS secara berkala agar dapat meningkatkan layanan atau asuhan keperawatan dalam penatalaksanaan pasien HIV/AIDS sehingga dapat menghilangkan stigma negatif terhadap pasien dengan HIV/AIDS.
Pengaruh Terapi Konseling Realitas dalam Mengurangi Stigma Diri pada Penderita TB
Authors: Sari Nur Maya , Amirus Khoidar , Febriani Christin Angelina
Published: April 2021

Bandar Lampung menempati urutan kedua tertinggi penemuan kasus TB. Promosi kesehatan berbentuk konseling realitas memiliki pengaruh dalam mengurangi stigma diri pada  pasien TB untuk peningkatan kesehatan. Tujuan dari penelitian ini diketahui Pengaruh Terapi Konseling Realitas Dalam Mengurangi Stigma Diri pada Penderita TB di Wilayah Kerja Puskesmas Satelit Bandar Lampung. Penelitian kuantitatif dengan pendekatan quasy experiment dengan two group pretest-posttest design. Sampel penelitian ini adalah Pasien TB di Wilayah Kerja Puskesmas Satelit Bandar lampung sebesar 26 orang. Teknik pengambilan sample menggunakan purposive sampling. Sample dibagi menjadi dua kelompok yaitu kelompok yang diberikan konseling realitas dan kelompok kontrol. Analisis yang digunakan yaitu analisis univariat dan bivariat dengan uji T-Dependen (Paired-Samples T-Test dan uji T-Independen (Samples T-Test). Ada perbedaan stigma pada kelompok kontrol dan eksperimen sebelum dan sesudah diberikan konseling realitas dengan nilai p-value <0.001. Konseling realitas memiliki pengaruh dalam mengurangi stigma pada pasien TB. Saran untuk penelitian selanjutnya agar membandingkan dengan metode terapi konseling kognitif dan aktifitas kelompok.
Hubungan Pekerjaan dengan Perilaku Merokok di Wilayah Kerja Puskesmas Bumi Emas Lampung Timur
Authors: Yanti Dhiny Easter , Aprilia Aprilia , Jaya Arnan , Pratama Randy Yusuf , Candesa Natasya Beggy
Published: April 2021

Sejak 2013 prevalensi merokok pada penduduk Indonesia terus meningkat. Hal ini dapat merugikan kesehatan perokok sendiri, kesehatan lingkungan sekitarnya (sebagai merokok pasif), dan merugikan negara (meningkatnya biaya kesehatan). Tujuan penelitian diketahuinya hubungan pekerjaan dengan prilaku merokok pada masyarakat di wilayah kerja puskesmas Bumi Emas, Lampung Timur 2020. Jenis penelitian kuantitatif, dengan rancangan cross sectional. Sampel 288 responden (data mawas diri Puskesmas Bumi Emas, Lampung Timur 2020). Analisis data secara univariat dan bivariat dengan uji Somers’D. Penelitian menujukkan perokok aktif lebih banyak (70,8%) dibandingkan dengan tidak merokok (29,2%). Jenis pekerjaan responden pada umumnya petani dan buruh (72,2%), paling sedikit jenis pekerjaan pensiunan. Hasil uji Somers’D diperoleh nilai  = 0,071 artinya terdapat hubungan lemah antara pekerjaan dengan perilaku merokok, berpola positif. Disimpulkan pekerjaan berpengaruh terhadap perilaku merokok namum pengaruhnya lemah. Disarankan puskesmas dapat  berkerjasama dengan lintas sektoral untuk meningkatkan penerapan kawasan tanpa rokok (KTR) di wilayah kerja Puskesmas Bumi Emas Lampung Timur.
THE DIDACTIC POTENTIAL OF SPOILS CARDS
Authors:   Khabarovsk regional Institute of education development, Khabarovsk, Panevina Galina N.
Published: April 2021

The article deals with the specifics of using spils cards as an educational and visual aid.
GEOECOLOGICAL STATE OF FLUVIOGLACIAL-TECTONIC LAKES OF THE PENINSULA OF THE YAMAL
Authors:   Novosibirsk State Agrarian University, Novosibirsk, Savchenko Nikolay V.
Published: April 2021

The paper discusses the geochemical and hydrobiological criteria of the geoecological assessment of lakes.
THE HETEROGENEITY OF THE URBAN SPACE
Authors:   Udmurt State University, Izhevsk, Sidorov Valery P.
Published: April 2021

The article is contains an assessment of the inequality of the residential space of the city of Izhevsk, based on a comparison of the comfort of the urban environment using digital technologies.
PROBLEMS OF DETERMINING FLUCTUATIONS IN THE LEVEL OF THE WHITE SEA ON THE KOLA PENINSULA IN THE HOLOCENE
Authors:   Petersburg state University, Saint Petersburg, Zadneeva Anastasia A. , Anisimov Mikhail A. ,   Federal state University (Arctic and Antarctic research Institute), Saint Petersburg
Published: April 2021

The article discusses the specifics of determining the level of the White Sea and also considers some of the difficulties that arise during paleogeographic reconstructions.
AMPHIBIANS AND REPTILES OF AQUATIC AND NEAR-WATER LANDSCAPES OF THE ULYANOVSK REGION
Authors:   Ulyanovsk State Pedagogical University named after I.N. Ulyanov, Ulyanovsk, Krivosheev Vladimir A.
Published: April 2021

The article considers the species composition of amphibians and reptiles living in water and near-water ecosystems of the Ulyanovsk region. The environmental status of herpetofauna is given.
THE STEPPE TRACE IN CENTRAL ARCTIC AND ANTARCTIC
Authors:   Ural Branch of Russian Academy of Sciences, Orenburg, Levykin Sergey V. , Kazachkov Grigoriy V. ,   Ural Branch of Russian Academy of Sciences, Orenburg, Yakovlev Ilya G. ,   Ural Branch of Russian Academy of Sciences, Orenburg, Grudinin Dmitriy A. ,   Ural Branch of Russian Academy of Sciences, Orenburg
Published: April 2021

Considerations about steppe elements in modern Arctic and Antarctic high latitudes, about problematic sofy edoma, which was the ground for Late Pleistocene cryoarid mammoth prairies and their genetic relations to modern steppes are expounded. Taking the Antarctic hair grass (Deschampsia antarctica) Antarctic expansion into consideration, the steppe trace spreading is acknowledged for both Hemispheres high latitudes. The grass expansion in both Central Arctic and Antarctic is considered a compensation for steppe loss in their geographical zone and future potential for agricultural economy.
THE CONTENT OF OIL PRODUCTS AND ORGANIC MATTER IN THE DEBRIS CONE OF GULLY IN THE CITY OF SARATOV
Authors:   Saratov State University, Saratov, Sheshnev Aleksandr S. , Majeed Majeed Dler Salam ,   Saratov State University, Saratov, Reshetnikov Mikhail V. ,   Saratov State University, Saratov
Published: April 2021

The article discusses the results of a study of the content of organic matter in the removal cone of a city ravine located on the territory of Saratov.
THEORY AND ESTABLISHING PRACTICE OF ECOLOGICAL TOURIST TRAIL EXEMPLIFIED BY THE NATIONAL PARK «SENGILEY MOUNTAINS»
Authors:   Ulyanovsk State Pedagogical University named after I.N. Ulyanov, Ulyanovsk, Aksenova Marina Y. , Kalacheva Galina E. ,   Ulyanovsk State Pedagogical University named after I.N. Ulyanov, Ulyanovsk, Letyarina Natalya Y. ,   Ulyanovsk State Pedagogical University named after I.N. Ulyanov, Ulyanovsk
Published: April 2021

The paper presents the technology of creating an ecological-tourist trail. This technology includes several successive stages: organizational; theoretical; practical. This technology has been tested on the example of compiling the ecological-tourist trail “Walking along the Pushkin Trail” in the territory of the Sengileevsky Mountains National Park.
INTEGRATION IN THE CONTENT OF TRAINING GEOGRAPHY
Authors:   Ulyanovsk State Pedagogical University named after I.N. Ulyanov, Ulyanovsk, Aksenova Marina Y. , Letyarina Natalya Y. ,   Ulyanovsk State Pedagogical University named after I.N. Ulyanov, Ulyanovsk
Published: April 2021

The paper considers the importance of intersubject communications in geography training. Particular attention is paid to the integration of geography with physics and mathematics, specific examples of intersubject communications of these disciplines are given.
LITERARY EXCURSIONS AS A FORM OF EXTRACURRICULAR WORKS ON GEOGRAPHY
Authors:   Ulyanovsk State Pedagogical University named after I.N. Ulyanov, Ulyanovsk, Anastasova Anastasia S. , Letyarina Natalya Y. ,   Ulyanovsk State Pedagogical University named after I.N. Ulyanov, Ulyanovsk
Published: April 2021

This article reveals the role and importance of extracurricular work which comprehensively develops the personality of the student.
The Alburquerque Ducal Court and the Literary Patronage of Hernán López de Yanguas during Charles V’s Reign
Authors: Pacheco Landero Diego
Published: April 2021

This article investigates the political and cultural practices of the ducal House of Alburquerque to demonstrate its commitment to one of the basic principles of Charles V’s foreign policy, that of maintaining peace among Christians and warring against the Turk. It studies the specific conditions of the emperor’s reign that allowed the high noble courts of Castile to flourish. Among these courts, the ducal House of Alburquerque at Cuéllar is exemplary for its literary patronage of the humanist and dramatist Hernán López de Yanguas (1487–1547?), whose plays served to express the duchy’s involvement in imperial politics.
Kentsel Mültecilerin Kente Uyum Süreçlerinde Konuta Erişimleri: Hatay Örneği
Authors: Güngördü Zehra , Özbakır Buket Ayşegül
Published: April 2021

İçinde bulunduğumuz çağ kitlesel göç hareketlerinin pek çok farklı gerekçeyle ve dinamiklerle gerçekleştiği süreçleri barındırmaktadır. Kitlesel göçün, kentler ve kentsel politikalar üzerinde pek çok etkisi olduğu birçok araştırmada tespit edilmiştir.  Türkiye 2011 yılından beri, Suriye’den gelen zorunlu kitlesel göç hareketinin sosyal, ekonomik, kültürel ve mekânsal etkilerini deneyimlemektedir. Dört milyona yakın Suriyeli mültecinin konuta erişiminin nasıl gerçekleştiği, barınma sorununun nasıl çözüldüğü ve bunların Suriyeli mültecilerin kente uyum süreçlerine nasıl yansıdığı araştırılması gereken ve önemli boyutları olan konulardır. Bu çalışma, Hatay’da yaşayan Suriyeli mültecilerin kente uyum süreçlerinde önemli bir faktör olan, konut deneyimlerini; yerleştikleri mahalleyle ve kentle kurdukları ilişki üzerinden incelemeyi hedeflemektedir. Bu araştırmadan elde edilen en önemli sonuç, konuta erişim faktörünün, Suriyeli mültecilerin kentsel uyum süreçlerinde, önemli bir politika başlığı olarak geliştirilmesi gereken bir husus olduğudur. Bu çalışmanın bulguları “Kentsel Mültecilerin Adaptasyon ve Uyum Süreçlerine Yeni Bir Bakış Açısı: Kapsayıcı Kent İnşası Amaçlı Sosyal İnovasyon Deneyi” başlıklı, 117K826 Kodlu ve TÜBİTAK 1003- Öncelikli Alanlar AR-GE Projeleri Destekleme Programı kapsamındaki araştırma projesinden elde edilmiştir.
Теоретизация Внешней Политики Китая: Концептуальные Положения в Историческом Континууме
Authors: VALİYEVA Kamala , ASAL Uğur Yasin
Published: April 2021

Одним из основных детерминантов, определяющих внешнеполитическое видение и поведение Китая, а также идейное строение китайского самовосприятия является фактор истории. Внешняя политика Китая и его стратегия подъема характеризуются совокупностью исторической преемственности и изменений в континууме. В данной статье была предпринята попытка обосновать идею о том, что внешнеполитическая идентичность и поведение Китая, как возвышающейся или по выражению Генри Киссинджера, возвращающейся силы, определяется его историческим прошлым. Как внутриполитический нарратив, так и внешнеполитическая стратегия глобального возвышения Китая, существующего и развивающегося «в тени своего прошлого», содержит множество ссылок на исторический опыт китайской нации, наиболее полно проецированных в концепции председателя КНР Си Цзиньпина «китайской мечты», осуществление которой, как представляется, должно привести к «великому национальному возрождению» страны и нации. В этом контексте традиция установления связи между внешнеполитическим поведением (и целями) Китая и его историей, вновь обрела значимость. Изложив в ретроспективном порядке процесс развития внешнеполитических подходов Китая с периода учреждения КНР вплоть до сегодняшнего дня, статья предприняла попытку резюмировать существующие концептуальные подходы к теоретизации внешней политики и феномена глобального возвышения Китая, акцентируя внимание на дихотомии ревизионизма и приверженности статус-кво в отношении структуры мировой системы и разделяя существующие теоретические разработка на две категории: конвенциональное и эклектичное теоретизирование. Подчеркивается, что глобальное присутствие Китая и его подъем в контексте воздействия на структуру и принципы существующего международного порядка рассматривается в диапазоне восприятий Китая как «угроза» и как «возможность».
Дослідження впливу полісорбату-80 на біофармацевтичні та реологічні властивості назальної лікарської форми з антагоністом інтерлейкіну-1β (IL-1Ra)
Authors: Бурлака Б. С. , Бєленічев І. Ф. , Фаді Ал Зедан , Супрун Е. В.
Published: April 2021

Мета дослідження – вивчити вплив полісорбату-80 на біофармацевтичні та реологічні властивості назальної лікарської форми з антагоністом інтерлейкіну-1 β.Як матеріали використовували розроблену нами інтраназальну лікарську форму з ІL-1Ra. Біофармацевтичні дослідження in vitro проводили за планом однофакторного дисперсійного аналізу з повторними спостереженнями, змінний фактор (А) – різна концентрація полісорбату-80 в досліджуваній назальній формі (А1 – 0 %, А2 – 0,5 %, А3 –1 %, А4 – 2 %, А5 – 3 %). Параметром оптимізації обрали визначену концентрацію активної речовини в діалізаті (воді очищеній) після 30 хв рівноважного діалізу крізь напівпроникну мембрану – целофанову плівку «Купрофан» у вертикальних чарунках дифузії Франца (Perme Gear, Inc., США). Реологічні дослідження проводили на модульному компактному реометрі МCR 302 (Anton Paar GmbH). Для проведення ротаційних тестів використовували коаксіальні циліндри CC27/T200/SS як вимірювальний пристрій. Виконували ініціалізацію приладу та вказували температуру дослідження (37,0 ± 0,2) °С), яка забезпечувалась вбудованим термостатом (Peltier temperature control for concentric cylinder systems, C-PTD 200). Протягом усього дослідження програмне забезпечення (Rheo Compass) реєструвало показники швидкості зсуву (Shear rate •g, s–1), напруги зсуву (Shear stress τ, Pa) та в’язкості (viscosity η, Pas (mPas). Отримані результати відображались як табличні дані та візуалізувались у реограмах плину. У результаті досліджень встановлено, що полісорбат-80 достовірно впливає на інтенсивність вивільнення IL-1Ra з інтраназального засобу. Оптимальна концентрація полісорбату-80 у розробленій назальній формі – 2 %. Виявлено, що полісорбат-80 у концентраціях від 0 до 3 % достовірно не впливає на характер структурно-механічних властивостей розробленої назальної лікарської форми.
Street art y regeneración urbana en Italia
Authors: Areddu Andrea
Published: April 2021

Contribución al debate de revista PH
TÜRKİYE’DE SON 10 YILDA FİZİK EĞİTİMİNDE KAVRAM YANILGILARIYLA İLGİLİ YAPILAN ÇALIŞMALARIN DEĞERLENDİRİLMESİ
Authors: YELTEKİN ATAR Betül Şeyma , AYKUTLU Işıl , BAYRAK Celal
Published: April 2021

Bu araştırmada, fizik eğitimi alanındaki kavram yanılgıları ile ilgili makalelerin belirli temalar altında incelenmesi amaçlanmıştır. Bu amaçla 2010-2019 yılları arasında 32 eğitim fakültesi dergilerine ek olarak ULAKBİM Sosyal Bilimler Veri Tabanı (UVT) ve google akademik kullanılarak 84 çalışma incelenmiştir. Tarama yapılırken belirtilen aralıktaki eğitim fakültesi dergilerinin tüm sayıları incelenmiş ve anahtar kelimeler olarak fizik eğitimi, kavram yanılgısı ve kavramsal anlama kelimeleri kullanılarak diğer arama motorlarında taranmıştır. Doküman analizine göre yapılan araştırmada makaleler, fizik konu içeriği, kavram yanılgılarını belirlemek ve gidermek için kullanılan yöntem ve teknikler ve çalışma grupları açısından yıllık bazda incelenmiştir. Araştırma sonucunda incelenen makalelerin daha çok kavram yanılgılarını belirlemeye yönelik olduğu tespit edilmiştir. Kavram yanılgıları ile ilgili en çok makalenin 2018 yılında yayınlandığı tespit edilmiştir. Makaleler fizik konu içeriği açısından değerlendirildiğinde, en fazla çalışmanın mekanik sonrasında optik üzerine olduğu görülmektedir. Araştırmada kavram yanılgılarını tespit etmek için kullanılan veri toplama araçları açısından en çok açık uçlu sorular ve çoktan seçmeli testlerin kullanıldığı belirlenmiştir. Araştırmada elde edilen bir diğer sonuç da incelenen makalelerde çalışma grubu olarak daha çok öğretmen adaylarının tercih edildiği tespit edilmiştir. Kavram yanılgılarının gidermede kullanılan yöntem açısından, kavram karikatürlerinin ve kavramsal değişim metinlerinin daha çok kullanıldığı araştırma kapsamında elde edilen sonuçlardan biridir.
ORMANDA YÜKSEKTE ÇALIŞMA: “TIRMANICI/BUDAYICI” ORMAN ÇALIŞANLARININ GÜVENLİK PERFORMANSININ GELİŞTİRİLMESİNE YÖNELİK ÖNLEMLER
Authors: ENGÜR Muvaffak
Published: April 2021

Ormancılıkta ağaca tırmanma farklı amaçlar için gerçekleştirilen bir iştir. Dalları budama, bağlantı oluşturma, ağacı iki veya daha çok parçada kesme, tohum ya da odun dışı orman ürünlerini toplama vb. nedenlerle yapılan ağaca tırmanma çok tehlikeli işlerden birisidir. Araştırmada ele alınan kişiler, çocuk yaştan itibaren “alaylı” olarak ifade edilen bir şekilde yetişmiş ve deneyim kazanmış orman köylüleridir. Bu çalışanların eğitim, güvenlik ve teknik donanım bakımından kabul edilemez eksiklikleri bulunmaktadır. Çalışmanın amacı, yüksek fiziksel güç gerektiren “tırmanıcı/budayıcı” orman çalışanlarını organizasyon, ergonomik iş donanımı, kişisel koruyucular ve güvenli çalışma teknikleri konusunda geliştirmektir. Arazi çalışmaları ve ofis ortamında görüntüler incelenerek çalışanların da ortak edildiği bir risk değerlendirme çalışması yapılmıştır. Matris yöntemiyle yapılan bu risk değerlendirme çalışmasında motorlu testere zinciriyle temas, gürültü, titreşim, fırlayan ve düşen objeler, yüksekte çalışma, kaygan gövde/dal, basılan dalların kırılması, halatın kesilmesi/ kopması, taşınan testerenin düşmesi, halat bağlantılarının kopması gibi tehlikeler tespit edilmiştir. Yüksekten düşerek ölüm, kırıklar, kesikler, baş travmaları ve işitme kaybı gibi birçok yüksek risk düzeyine yol açan tehlikelerin kontrolüne yönelik önlemler belirlenmiştir. İstanbul Üniversitesi Cerrahpaşa uygulama ormanında ve Kastamonu-Tosya ormanlarında organizasyonel ve operasyonel anlamda bazı davranış değişiklikleri konusunda da çalışanlar eğitilmiştir. Sonuç olarak düşme, kesilme ve kayma risklerini ortadan kaldıran uygulama pratiği sağlanmış ve bunun yanında günlük çalışma verimi %20 artırılmıştır.
Physiological potential of the chlorophyte Caulerpa prolifera for proliferation across the Mediterranean-Atlantic basins in a warmer ocean
Authors: Olivé I , Varela-Álvarez E , Silva J , Serrão EA , Santos R
Published: April 2021

Ocean warming is altering the metabolic balances of organisms, favouring the expansion of thermo-tolerant individuals. The fast-growing macroalga Caulerpa prolifera is rapidly expanding in the Ria Formosa lagoon (Portugal), a connection area between Mediterranean and Atlantic basins. We investigated the metabolic capacity of C. prolifera to cope with ocean warming, to elucidate its expansion potential. The photosynthetic and respiratory plasticity of 4 populations of C. prolifera spread along the Mediterranean-Atlantic basins was assessed under a temperature range of 20 to 30°C. In addition, molecular markers were used to investigate the genetic identity of the strain found in Ria Formosa, which confirmed its Mediterranean origin. All examined populations showed large physiological thermo-tolerance and metabolic plasticity to warming. The photosynthetic efficiency of C. prolifera improved by 50% with temperature, and the maximum photosynthetic production doubled along the temperature range tested. Respiration did not vary with temperature, whereas the metabolic quotient increased by more than 70%when temperature increased from 20 to 25-30°C. Minor differences in the photosynthetic descriptors were detected among populations, reflecting light- and dark-adapted physiology of Mediterranean and Atlantic populations, respectively. Our results show that all tested populations of C. prolifera have the physiological potential to cope with temperature increases up to 30°C, which indicates that ocean warming may contribute to the expansion of C. prolifera in the Mediterranean-Atlantic basins.
Violence against nurses: A serious issue in Indonesia
Authors: Tosepu Ramadhan , Nuru Hasanuddin , Irfani Tri Hari
Published: April 2021

N/A
Penerapan Aplikasi Location Based Service Dalam Penangganan Gangguan Jaringan Berbasis Mobile
Authors: Capah Dwi Ade Handayani , Herdi Tazkiyah
Published: April 2021

Location Based Service is the ability to find the geographic location of a mobile device and provide services based on the location it gets. The development of location base service applications has been widely used today, one part that needs attention to be applied by this application is the handling of network disturbances in service companies. In the field of handling network disturbances, there are problems, namely where there are still delays in handling disturbances, this is due to the length of time searching for the location of the disturbance. This paper aims to improve the handling of network disturbances using mobile devices. With a mobile device that is integrated with location base service, it can solve the problem of delay in handling network disturbances.
Investigation of the Use of Zeolite (Clinoptilolite) As Aquarium Filtration Material for Electric Blue Hap (Sciaenochromis ahli)
Authors: ÖZ Meryem , ŞAHİN Dilek , KARSLI Zafer , ARAL Orhan , BAHTİYAR Mehmet
Published: April 2021

In this study, the effects of using zeolite, both inside and outside the filter, on water quality and the growth of electric blue hap (Sciaenochromis ahli) were investigated. The 3-month study consisted of 7 groups in triplicate. One of the groups was designated as the control, and zeolite was not used in this group. For the remaining 6 groups, zeolite was placed in tulle bags and used both inside and outside the filter in 3 various ratios (0.35, 0.70, 1.05 g l-1). The statistical differences between groups for certain water quality parameters pH, NH3) were significant (P<0.05), while the statistical differences between groups for other parameters (water temperature, dissolved oxygen) were found to be insignificant (P>0.05). Furthermore, the growth parameters, feed conversion ratio, and survival rate of the electric blue hap were determined. At the end of the study, the differences between weight gain, specific growth rate and feed conversion ratio were determined as statistically insignificant (P>0.05). At the end of the study, when the data were evaluated, no negative effects on the growth parameters and water parameters of the ahli cichlid fish were determined. Therefore, it is advisable to place zeolite in mesh bags at the bottom of the aquarium and in the aquarium filter to prevent ammonia from reaching high concentrations. Thus, when the findings on pH and NH3 of the present study were evaluated, it can be suggested that low ratios as 0.35 g l-1 of zeolite may be used in tulle bags on floor or inside the filter to prevent ammonia rising to high concentrations.
Inflation in China during the economic reforms of the 1980s: causes and effects
Authors:   Kyiv National Economic University named after Vadym Hetman, KHOKHYCH Dmytro
Published: April 2021

The article studies the development of inflationary processes in China in the period of 1979-1989, their causes and effects. In particular, based on the analysis of statistical data, it is established that inflation in China is manifested in price and non-price forms, and also has a pronounced directive nature. This means that even excessive public investment can cause inflation. Two ways of reforming the fixed price system are considered: 1) simultaneous weakening of all prices 2) gradual weakening of prices, their slow adjustment towards the market. The relationship between inflation and macroeconomic indicators, including capital investments, wages and economic growth rates, is given. The inflation transmission mechanism of excess demand in China manifests itself due to overinvestment of state-owned enterprises, which leads to budget deficits and surplus issuance of the Yuan and causes inflation. Three phases of the Chinese phenomenon of "money illusion" are considered: the illusion of strong money without inflationary expectations (1979-1984); weakening of money illusion with some inflationary expectations (1985-1986); the formation of expectations without money illusion (since 1988). The method of using inflation to regulate the distribution of income is analyzed.. With the reform, income distribution became more uneven. To some extent, this is a desirable outcome, but the intensification of the public sector reforms resulted in not just inequality but injustice. Thus, the problem to be solved immediately is whether China can use inflation to regulate income distribution. Statistics show that per capita consumption in China in the late 1980s was only 640 Yuan. The proposed reduction in inflationary pressures views monetary policy as regulating the money supply and curbing inflation. Setting an inflation target is considered an effective tool to achieve the planned inflation rates.
Small-Angle X-Ray and Neutron Scattering on Photosynthetic Membranes
Authors: Jakubauskas Dainius , Mortensen Kell , Jensen Poul Erik , Kirkensgaard Jacob J. K.
Published: April 2021

Ultrastructural membrane arrangements in living cells and their dynamic remodeling in response to environmental changes remain an area of active research but are also subject to large uncertainty. The use of noninvasive methods such as X-ray and neutron scattering provides an attractive complimentary source of information to direct imaging becausein vivosystems can be probed in near-natural conditions. However, without solid underlying structural modeling to properly interpret the indirect information extracted, scattering provides at best qualitative information and at worst direct misinterpretations. Here we review the current state of small-angle scattering applied to photosynthetic membrane systems with particular focus on data interpretation and modeling.
Duration of Parathyroid Function Recovery in Patients With Protracted Hypoparathyroidism After Total Thyroidectomy for Papillary Thyroid Carcinoma
Authors: Qiu Yuxuan , Xing Zhichao , Xiang Qiao , Yang Qianru , Su Anping , Luo Yan
Published: April 2021

Purpose

The aim of the present study is to investigate the time to recovery of parathyroid function in patients with protracted hypoparathyroidism at 1 month after total thyroidectomy of papillary thyroid carcinoma.

Materials and Methods

Adult patients who underwent total thyroidectomy for papillary thyroid cancer were included. Cases of long-term hypoparathyroidism were studied for recovery of parathyroid function during the follow-up. The duration of recovery and associated variables were recorded.

Results

Out of the 964 patients, 128 (13.28%) developed protracted hypoparathyroidism and of these, 23 (2.39%) developed permanent hypoparathyroidism and 105 (10.89%) recovered: 86 (8.92%) before 6 months, 11 (1.14%) within 6 and 12 months and 8 (0.83%) after 1 year follow-up. Variables significantly associated with the time to parathyroid function recovery were number of autotransplanted parathyroid glands (HR, 1.399; 95% CI, 1.060 – 1.846; P = 0.018), serum calcium concentration >2.07 mmol/L (Hazard ratio [HR], 1.628; 95% confidence interval [CI], 1.009 – 2.628; P = 0.046) and PTH level > 1.2 pmol/L (HR, 1.702; 95% CI, 1.083 – 2.628; P = 0.021) at 1 month postoperatively.

Conclusion

Permanent hypoparathyroidism should not be diagnosed easily by time, since up to one-fifth of the patients will experience recovery after a period of 6 months and a few patients even beyond one year. The number of autotransplanted parathyroid glands is positively associated with the time to parathyroid function recovery.
Diabetes and Bone Involvement in Primary Hyperparathyroidism: Literature Review and Our Personal Experience
Authors: Castellano Elena , Attanasio Roberto , Boriano Alberto , Borretta Valentina , Tassone Francesco , Borretta Giorgio
Published: April 2021

Background

Primary hyperparathyroidism (PHPT) and type 2 diabetes mellitus (T2DM) are common endocrine disorders impacting on skeletal health, whose concomitant occurrence is becoming more frequent.

Patients and Methods

We searched the PubMed database from the National Library of Medicine about the relationship between T2DM and its treatment and bone manifestations of PHPT. Thereafter, we retrospectively evaluated a consecutive series of 472 PHPT patients. Among them 55 were also affected by T2DM. At the diagnosis of PHPT we compared bone turnover markers and bone densitometry between 55 patients with and 417 without T2DM and in the former group according to antidiabetic treatment.

Results

Few data are available about T2DM and PHPT bone involvement, studies about T2DM treatments and PHPT bone manifestations are lacking. Among patients with PHPT of our series, those with T2DM were older, had a lower prevalence of osteitis fibrosa cystica, higher lumbar and femoral T-scores than the remaining patients. No difference was disclosed among the diabetic patients according to ongoing antidiabetic treatment, even though modern treatments were under-represented.

Conclusions

No clinical study specifically evaluated the impact of T2DM on bone involvement in PHPT. In our experience, diabetic patients resulted more frequently “mild asymptomatic” than non-diabetic patients and showed a lower prevalence of radiological PHPT bone manifestations. The treatment of T2DM does not seem to affect the biochemical or clinical features of PHPT in our series. Further studies are needed to fully disclose the influence of T2DM and antidiabetic treatment on bone health in patients with PHPT.
Case Report: An Atypical Form of Familial Partial Lipodystrophy Type 2 Due to Mutation in the Rod Domain of Lamin A/C
Authors: Cecchetti Carolina , D’Apice M. Rosaria , Morini Elena , Novelli Giuseppe , Pizzi Carmine , Pagotto Uberto , Gambineri Alessandra
Published: April 2021

Purpose

Familial partial lipodystrophy type 2 (FPLD2) patients generally develop a wide variety of severe metabolic complications. However, they are not usually affected by primary cardiomyopathy and conduction system disturbances, although a few cases of FPLD2 and cardiomyopathy have been reported in the literature. These were all due to amino-terminal heterozygous lamin A/C mutations, which are considered as new forms of overlapping syndromes.

Methods and Results

Here we report the identification of a female patient with FPLD2 due to a heterozygous missense variant c.604G>A in the exon 3 of the LMNA gene, leading to amino acid substitution (p.Glu202Lys) in the central alpha-helical rod domain of lamin A/C with a high propensity to form coiled-coil dimers. The patient’s cardiac evaluations that followed the genetic diagnosis revealed cardiac rhythm disturbances which were promptly treated pharmacologically.

Conclusions

This report supports the idea that there are “atypical forms” of FPLD2 with cardiomyopathy, especially when a pathogenic variant affects the lamin A/C head or alpha-helical rod domain. It also highlights how increased understanding of the genotype-phenotype correlation could help clinicians to schedule personalized monitoring of the lipodystrophic patient, in order to prevent uncommon but possible devastating manifestations, including arrhythmias and sudden death.