bluuebunny/crossref_metadata_2025 huggingface dataset:
Autoimmune Hepatitis and Primary Sclerosing Cholangitis: An Overlap Syndrome Resistant to Azathioprine and Intolerant to Tacrolimus with Sepsis Mimicking Flare UP-A Clinical Dilemma
Authors:   Assistant Professor, Department of Medicine, Maulana Azad Medical College, New Delhi, India, Mathews Sharon T
Published: February 2021

Patients with autoimmune liver disease in a frequency of 7% -18% fit into the diagnostic criteria for more than one condition. Up to 12.5% of Autoimmune Hepatitis (AIH) and Primary Sclerosing Cholangitis (PSC) cohorts have a label of AIH/PSC overlap. There can be an unpredictable interval of many years between the diagnosis of the two conditions. There are scoring systems but no established criteria for the diagnosis of AIH/PSC overlap. Therefore, a diagnosis based on combination of biochemistry, autoantibody profile, cholangiogram, and liver histologyis made. Histopathology staging of AIH/PSC overlap influences therapeutic options and prognosis. There is beneficial role of immunosuppression, even though there is a higher relapse rate and evidence of progressive liver disease despite immunosuppression in some cases. Liver related outcomes in this overlap are better than PSC alone but are poorer than AIH. We herein report a rare presentation of an overlap syndrome with AIH and PSC in a patient in whom, treatment with first line therapy showed incomplete response and the salvage therapy was not tolerated, presenting with Acute Kidney Injury (AKI) and a clinical picture of sepsis resembling AIH flare.
Effectiveness of Webinar based Teaching for Physiotherapy Interns during COVID-19 in India- A Pilot Study
Authors:   Associate Professor, F/o AHS, Department of Rehabilitation Sciences, Jamia Hamdard University, New Delhi, India, Zutshi Kalpana
Published: February 2021

Introduction: SARS Covid II pandemic has consistently spread and has severely disrupted the lives of more than the three quarters of the world’s population. Their system is unable to effectively respond to the current challenges in the present day pandemic, which has put forth another challenge for medical educators across the world to deal with the huge responsibility of rethinking how to carry on delivering high quality medical education due to social isolation strategies and enormous clinical responsibilities. Webinars have become an essential component of Physiotherapy teaching during the pandemic periods. Lecturers have reported about satisfaction and enjoyable sessions during webinars. Materials and Method: An intern’s physiotherapy attitude form, student’s satisfaction questionnaire, smooth delivery and intuitive interface scores were dependent variables and Teaching Method (participation in a webinar or classroom teaching) is the independent variable. Result: Descriptive analysis and Students t-test were done for inter-group comparison of Webinar Group Vs Classroom group which were found to be statistically significant at p≤0.5. The scores for Webinar group vs Classroom group respectively are Physiotherapy attitude questionnaire Test scores (54.17±8.8 & 39.38±10.8, t=5.7*), Student’s satisfaction questionnaire scores (4.54±0.59 & 4.29±0.69, t=1.45), Smooth Delivery Scores (4.5±0.5 & 5.0±0, t= 4.79*), Students intuitive interface scores (4.63±0.4 & 3.04±0.2 t=13.2*) and Action taken scores (4.58±0.4 & 3.25±0.43, t=11.56*). Conclusion: The webinar based teaching is more effective as compared to classroom teaching for Physiotherapy Interns with a limitation to teaching practical skills especially in fields like Physiotherapy where it is essential.
A Scientific Review on Kuposhanajaya Vikara W.S.R. to Protein Energy Malnutrition and its Treatment in Children
Authors:   Assistant Professor, Department of Kaumarabhritya, Dayanand Ayurvedic College and Hospital, Jalandhar, Punjab, India, Sharma Sudheer
Published: February 2021

The preservation of children’s health is the prime duty of humanity. In every country, children constitute a priority group. Current Indian population according to a survey is 1.21 billion. (2011census) and about 37.3% of total populations are children. Among which 158.8 million children are of 0-6 year’s age group (13.12 % of Indian population). The health status of adult population is a continuation of health status of children in terms of Growth, Nutrition and Development. Health of a child is a growing concern all over, with rapid economic growth and social changes both in developed and developing parts of the world. Therefore, vital importance towards these children is felt in need. Malnutrition mainly arises from inadequate diet and frequent infection, leading to insufficient intake of calories, protein, vitamins and minerals. Malnourished children suffer more frequent and severe infectious illnesses; furthermore, even mild under-nutrition increases a child’s risk of morbidity and mortality. Chronic under-nutrition in children can also lead to long-term developmental problems. Ahara Dosha is the main predisposing factor of this disorder and Alpasana and Vishamasana (false habits of intake) especially results in the development of Karshya. Meaning of Balasosha is “Emaciation of child”. According to Ayurvada it originates from nutritional deficiency in children, which is called as protein energy malnutrition . Although exact correlation of Balasosha with any specific disease of modern medicine is not possible but keeping in view the various clinical signs and symptoms of P.E.M., it can be equated with karshaya, phakka roga, parigarbhika, to some extent.
Conceptual Analysis of Nasya Karma in Netra Rogas
Authors:   P.G. Scholar, Department of Shalakya Tantra, Sri Sri College of Ayurvedic Science & Research Hospital, Bangalore, Karnataka, India, AC Swathi
Published: February 2021

Panchakarma plays an important role in Ayurveda, which does the function of cleansing the body from Doshas. Among them, Nasya is mainly indicated for UrdhwajatrugataVikaras, in which Doshas are eliminated by means of the nearest possible opening, the nose. Netra, being considered as the important Indriya among others, should be protected with utmost care. Considering Ama-Nirama concept of Netra, treatment of NetraRoga is decided in which SthanikaDoshaShodhanais very essential. For that, NasyaKarma is considered as an option among other ShodhanaKarmas. A proper Shodhana at proper stage of a disease can avoid unnecessary surgeries even. Benefits of NasyaKarmain NetraRogas are already proved through various previous studies. This article is an attempt to conceptually analyze the role of NasyaKarma in NetraRogas through various literature sources of Ayurvedaand contemporary science.
National Institute of Rural Health for India: Need of the Hour
Authors:   Director, Rural Health Training Centre (RHTC), Najafgarh, Directorate General of Health Services, Ministry of Health & Family Welfare, Kumar Anil
Published: February 2021

India being predominantly a rural country, striving hard to provide quality healthcare services to more than 890 million people who lives there. The importance given to rural health care by Govt. of India is visible through the implementation of dedicated submission under NHM, i.e., NRHM. However, there are still several rural health challenges, i.e., specific needs, belief/ superstition, scarcity of human resources in rural areas, lack of quality research/ coordination and collaboration between various sectors. The possible solutions to these challenges lie in strengthening research in rural health epidemiology, agricultural health, enhancing use of Information Technology & Telemedicine, designing specific clinical services, field practices, applying the biostatistics & mathematical modelling in decision making and mentoring the human resources in specific need of rural health. This article is an attempt to elucidate various rural health challenges and need for development of National Institute of Rural Health in India, to address the challenges of rural health and conduct before mentioned activities as an apex body.
Factors Associated with Quality of Life among Diabetes Mellitus Patients in Prolanis
Authors:   Department Health Promotion, Poltekkes Kemenkes RI Padang, West Sumatera Province, Indonesia, Sidiq Rapitos
Published: February 2021

Background: Diabetes mellitus is a major public health problem is approaching epidemic proportions in the world today, including Indonesia. Various types of government programs in the health sector were launched to overcome them, one of which was prolanis aimed at improving the quality of life of patients. Objectives: The objective of the study was to determine the factors associated with quality of life among diabetes mellitus patients in prolanis. Methods: This is a analytical study with a cross sectional study design. The data was collected on May 20 to June 3, 2018 by interviewing using the WHOQOL-BREF questionnaire and secondary data observation conducted on 52 respondents. Multivariate analysis using logistic regression. Results: The results showed that the patients activeness factor in prolanis was related to their quality of life among diabetes mellitus patients with p-value 0.003 <0.05, with the highest OR Exp (B) value of 0.863 and 95% CI = 0.782-0.9953. Conclusions: It was concluded that the patients activeness factor in prolanis was related to their quality of life among diabetes mellitus patients in Lambaro Meurasi General Clinic of Ingin Jaya District, Aceh Besar, Aceh Province.
Postnatal Care Based on ICM’s Global Standards among Nursing Students Studying in a Selected College in Delhi
Authors:   M.Sc., Obstetrical and Gynaecological Nusring, Srinagar, Jammu and Kashmir, India, Nazir Nusrat
Published: February 2021

Background: Postnatal period is considered as the most critical phase which can lead to various complications and even maternal deaths. Midwives and nurses have an important role to play in the postnatal care of a mother hence they must have exceptional knowledge and skill to address the complications that arise in mothers during postnatal period. The competence level of midwives and nurses must be earned by set criteria of ICM Global standards of Midwifery. Objectives: To assess the knowledge and skills among nursing students in selected college of Delhi on Postnatal Care as per ICM Global Standards by using Checklist and Questionnaire and to find out an association of Knowledge and skill on postnatal care with selected demographic variables regarding ICM’ s Global standards. Materials and Methods: A quantitative research approach with descriptive exploratory design was used to achieve the objectives of the study. Total enumerating sampling technique was employed to select 56 students of DGNM interns posted in postnatal wards of hospital. A structured questionnaire and checklist were formulated to assess the knowledge and skills of Nursing Students. Result and Findings: The study showed that Maximum students i.e. 45 (80.35%) had inadequate knowledge related to postnatal care of mother whereas 11 (19.64%) nursing students had adequate knowledge. Maximum students i.e. 34 (61%) had inadequate knowledge related to postnatal care of newborn whereas 22 (39%) had adequate knowledge regarding the same. The calculated ‘r’ value was 0.32; value at degree of freedom (54) is 0.27 which is lower than 0.0 e ‘r’ 5 level of significance. Conclusion: The study shows that the students need more emphasis on skill improvement. There is a need to up skill the existing skills of nursing students in order to provide comprehensive and prompt Nursing Care.
Prevalence of Gender Based Violence for having Girl Child, Women’s Reaction and Empowerment among Mothers Attending Postpartum OPD in a Selected Medical College, West Bengal
Authors:   Department of Obstetrics and Gynaecological Nursing, College of Nursing, Medical College and Hospital, Kolkata, Bengal, India, Mukherjee Soujita
Published: February 2021

Background: Gender based violence is a global problem and is still a key concern in developing countries. A survey was undertaken to assess prevalence of gender based violence for having girl child, women’s reaction and empowerment among mothers. Methods: The conceptual framework was based on “The Duluth Model”. Clearance from the institutional ethical committee and individual consent were taken. Descriptive survey design was adopted. From the population of postnatal women 162 were selected as sample by purposive sampling technique from postnatal OPD. Final data were collected for 6 weeks by using a validated and reliable semi-structured interview schedule (r = 0.98) and structured interview schedule (r = 0.83). Result: The study findings revealed that 22.83% women faced gender based violence. Majority faced emotional violence (59%) and sexual violence (57%). Women’s no rejection towards girl child was 91.35% whereas only 8.64% had indifferent view. In the domain of women empowerment 64.19% expressed as well empowered but decision making in the area of political (38.8%), economical (19.75%) and educational (12.96%) was poor. The association between gender based violence and women empowerment is statistically significant (chi2 value = 48.03*, p<0.05). Conclusion: It can be concluded that gender based violence is till now a case of concern for our society and country. The study has it’s implication in the field of nursing practice for awareness on violence and women’s right during pregnancy and after child birth.
Nurses’ Approach during ‘Unprecedented Times’
Authors:   Surgical Nurse, East Surrey Hospital, Surrey and Sussex Healthcare NHS Trust, Redhill, Surrey, United Kingdom, James Merlin Mary
Published: February 2021

Life may throw surprises which may delve us into the depths of sorrow during uncertainties. Uncertainty is a fact of life and cannot be avoided. Nurses are an integral part of the healthcare delivery system and share responsibilities in collaboration with other allied health professions for the attainment of optimal health for all members of the society. They don several hats and perform multiple tasks whilst at work which maps across being at the bedside with the patient to be a voice to lead at the boardroom. It is very heartening to see that on the coronavirus frontline these unsung and quiet heroes are being recognized and noticed at last. This paper highlights four-fold strategic approaches that enabled nurses and will enable them in the future to deal with uncertainty.
A Descriptive Study to Assess Attachment Styles, and Emotional Stability in Relation to Marital Satisfaction among Couples Residing in Selected Residential Areas of Gurugram, Haryana
Authors:   M. Sc. Nursing Student, Jamia Hamdard, New Delhi, India, Kumari Kavita
Published: February 2021

Background: Marriage is one of the main decisions that an individual make in their life. Marital satisfaction constitutes the main determinant of life. There are several factors which predict marital satisfaction among couple like their attachment styles, emotional stability and demographic variables. Objective: To assess attachment styles, emotional stability of married couples, to seek relationship between marital satisfaction with their attachment styles and emotional stability and to seek relationship of marital satisfaction with selected demographic variables. Material and Method: A descriptive research design including 50 married couples via purposive sampling. Tools used were- For Attachment styles -Adult attachment scale, For marital satisfaction-ENRICH marital satisfaction scale, For emotional stability-Schutte Self Report Emotional Intelligence Test . Analysis and interpretation was done through SPSS version 16.0. Result: The findings revealed that out of 50 subjects, maximum 80% had Secure attachment style, maximum 100% male and 98% females were emotionally stable and maximum 96% males and 94% females had moderate marital satisfaction. All attachment styles and emotional stability had non significant positive relationship with marital satisfaction. Regarding demographic variables all had non significant relationship with marital satisfaction except age and family income. Conclusion: The study concluded that majority of married couples had moderate marital satisfaction and attachment style and emotional stability are predictors of marital satisfaction among married couples.
Physical examination, serum biochemical, and coagulation abnormalities, treatments, and outcomes for dogs with toxicosis from α-amanitin–containing mushrooms: 59 cases (2006–2019)
Authors: Kaae Jennifer A. , Poppenga Robert H. , Hill Ashley E.
Published: February 2021

OBJECTIVE

To report history, physical examination findings, clinicopathologic abnormalities, treatments, and outcomes of dogs with confirmed α-amanitin toxicosis resulting from ingestion of α-amanitin–containing mushrooms, and to report whether any differences were significant between survivors and nonsurvivors.

ANIMALS

59 dogs.

PROCEDURES

Medical records of all dogs with confirmed α-amanitin toxicosis presented to a northern California emergency and specialty veterinary hospital between January 2006 and July 2019 were reviewed for signalment; body weight; history; physical examination findings including rectal temperature at presentation; results of serum biochemical analyses, coagulation tests, and a test for the detection of α-amanitin in urine; treatments; and outcomes. Differences for each were compared between survivors and nonsurvivors.

RESULTS

Among the 59 dogs, 36 were < 1 year of age; 56 had variable clinical signs that included vomiting, diarrhea, anorexia, and weakness or lethargy; and 22 had rectal temperatures > 39.2°C (102.5°F) at presentation. Cases were seen throughout the calendar year. At presentation, alanine aminotransferase activity was mildly to markedly increased in 97% of dogs, hypoglycemia was noted in 78%, and coagulation times were prolonged in 91%. Most dogs that rapidly decompensated died; however, 13 dogs survived to hospital discharge and completely recovered.

CONCLUSIONS AND CLINICAL RELEVANCE

Ability to recognize dogs with α-amanitin toxicosis on the basis of clinical signs, physical examination findings, and clinicopathologic test results is essential because mushroom ingestion is rarely observed and immediate treatment is necessary. Dogs that have marked hypoglycemia or coagulopathy may have a poor prognosis.
Zmiany strukturalne przemysłu na tle przewozów kolejowych
Authors: Majewski Jakub
Published: February 2021

Obserwacje i badania zmian zachodzących w przemyśle w jego rozwoju, strukturze, czy rozmieszczeniu przestrzennym - mogą opierać się na bardzo różnych miarach i wskaźnikach. Obok wartości bezpośrednio charakteryzujących poszczególne gałęzie przemysłu, takich jak wielkość produkcji, liczba zatrudnionych, wydajność pracy podczas badań warto sięgnąć również: po miary pośrednie. Mają one między innymi także tę zaletę, że przedstawiają przemysł nie jako zjawisko samoistne, ale osadzone w szerszym kontekście gospodarczym i powiązane z pozostałymi działami gospodarki.
Wybrane problemy transformacji struktur przemysłowych w Federacji Rosyjskiej
Authors: Szot Zygmunt
Published: February 2021

W Rosji realizowane są współcześnie bardzo trudne reform y polityczne i gospodarcze. Szczególnie złożone problemy dawnych struktur ujawniły się w przemyśle. Istnieje jednakże obecnie silna wola polityczna, przejawiana głównie przez prezydenta i rząd, aby kontynuować zmiany struktur przemysłowych w Rosji, dokonujące się w procesie przechodzenia do gospodarki rynkowej. Oczekiwany wzrost wartości i wielkości produkcji będzie możliwy do osiągnięcia jedynie wówczas, gdy wdrożone zostaną głębokie reformy w całym sektorze przemysłowym.
Wyniki realizacji programów restrukturyzacji górnictwa węgla kamiennego po 1989 r.
Authors: Makieła Zbigniew
Published: February 2021

Procesy restrukturyzacji przemysłu pociągają za sobą konieczność przystosowanie się poszczególnych firm i gałęzi do nowych warunków. Szczególnie trudna sytuacja zaznacza się w przemyślę węglowym, a w reformowaniu tej gałęzi występuje wiele trudności. Przedmiotem niniejszej analizy jest zaprezentowanie wyników działań związanych z reformowaniem górnictwa węgla kamiennego w wyniku wdrażania kolejnych programów naprawczych.
Przemysł Nowej Gospodarki
Authors: Wieloński Andrzej
Published: February 2021

drugiej połowie XX wieku nauka przekształciła się w bezpośrednią siłę wytwórczą.Dotychczasowe dwa etapy procesu produkcji: inwestycja i produkcja, zostały rozszerzoneo trzeci, poprzedzający je etap badań naukowych i prac rozwojowych – R+D (Researchand Development). W Stanach Zjednoczonych, Japonii, Korei, Izraelu i wielu krajach EuropyZachodniej udział nakładów na R+D zwiększył się do 2–3% produktu krajowegobrutto (w Szwecji – 3,7%), natomiast ich wartość w przeliczeniu na jednego pracownikanaukowego – do 200–300 tys. USD (w Szwajcarii – 322 tys. USD).
Bitki Mikrop Etkileşiminin Sekonder Metabolitler Üzerindeki Etkisi
Authors: Çetiz Mehmet Veysi , Memon Abdulrezzak
Published: February 2021

Bitkilerde ve üzerinde yaşayan mikroplar (bitki mikrobiyomu) bitki sağlığı için kritik öneme sahiptir ve besin alımını kolaylaştırarak, bitki hormon seviyelerini düzenleyerek ve patojen saldırısına karşı koymaya yardımcı olarak etkilerini gösterirler. Bitkiler karmaşık mikrobiyomlarla ilişkili meta organizmalardır. Bitki yüzeylerinde (epifitler) veya bitki dokuları (endofitler) içinde bulunan mikroorganizmaların çoğu, herhangi bir bitki hastalığına neden olmaz, ancak genellikle konakçı bitkilerinin besin tedarikine önemli ölçüde katkıda bulunur. Ayrıca bitki mikrop etkileşimi sekonder metabolit miktarında değişimlere neden olur. Bu derlemede, bitki sekonder metabolit miktarını artıran bitki ve kökle ilişkili mikrop (Rizosfer) arasındaki etkileşimine odaklanarak bu fenomeni destekleyen mekanizmalar hakkında anlayışımızı geliştirecek detaylı bilgiler verilmektedir.
Effect of Milk and Hydro-priming on Seed Germination Characteristics of Bitter Gourd (Momordica charantia L.)
Authors: Rahman Md. Sadiqur , Ahmed Istiak , Biswas Suman , Morshed Monjur , Chandra Sarker Parimal , Hossain Md. Arafat , Islam Maria , Jahan Taslima
Published: February 2021

To meet the demand for an appropriate soaking duration and priming type, there is a need to embrace cheap, fast, natural, accessible, and adaptable physiological techniques as soaking of seeds in water and fresh cow milk. Fresh cow milk contains hormones that relieve seeds from photo, thermo, physiological and mechanical dormancy. In light of this, this study was conducted to assess the effect of hydration and fresh cow milk on different seed quality attributes like germination percentage, mean germination time, the uncertainty of germination process, and synchrony of germination process of bitter gourd seeds. The study involved two factors namely hydropriming and different concentrations of fresh cow milk (viz. 60%, 80% and 100%), and the other factor was seed soaking duration with 4 levels (i. e., 0, 12, 18 and 24 hours). The experiment was conducted in a Complete Randomized Design (CRD) with three replicates. Results revealed that the percentage germination value of seeds soaked in all concentrations of fresh cow milk was better than hydropriming. A significant germination percentage value of 96% and 93% were recorded for seeds treated for 18 hours in 80% and 100% concentrations of fresh cow milk respectively. Maximum uncertainty of the germination process and minimum synchrony of germination the process was recorded in untreated seed.
Yonca Silajlarında Atık Reçel Karışımı İlavesinin Silaj Fermantasyonu ve İn Vitro Sindirilebilirlik Üzerine Etkileri
Authors: Soycan Önenç Sibel , Yayla Damla
Published: February 2021

Bu araştırma, atık reçel karışımı ilavesinin yonca silajlarının fermantasyonu ve in vitro sindirilebilirlik üzerine etkilerini belirlemek amacıyla planlanmıştır. Yonca, ekim ayında çiçeklenme başlangıcında hasat edilerek soldurulmuştur. Atık reçel karışımı önce bir süzgeç yardımıyla katı ve sıvı olarak iki kısıma ayrılmıştır. Kontrol grubuna, 20 ml saf su ilavesi yapılmıştır. Sıvı kısım; Reçel-I silajı (RI), 50 mg sıvı reçel+20 ml saf su /kg yonca; Reçel-II silajı (RII), 100 mg sıvı reçel+20 ml saf su /kg yonca olacak şekilde ilave edilmiştir. Katı kısım ise; Reçel Parçacık-I silajı (RPI), 30 mg reçel parçacıkları +30 ml saf su /kg yonca; Reçel Parçacık-II silajı (RPII), 60 mg reçel parçacıkları +60 ml saf su /kg yonca olacak şekilde hazırlanmıştır. Silajlar, kapalı bir depoda 60 gün süresince fermantasyona bırakılmıştır. Reçel ve reçel parçacıkları ilave edilmesi yonca silajının pH ve nötral deterjanda çözünmeyen lif (NDF) içeriklerini düşürmüştür. Araştırmada, en yüksek laktik asit (LA) içeriği RII grubunda kuru madde (KM) de 100,28 g/kg olarak belirlenirken en düşük ise kontrol grubunda 23.07 g/kg KM olarak belirlenmiştir. Yoncaya reçel ve reçel parçaçıkları ilavesi, kontrol grubuna göre enzimde çözünen organik madde (EÇOM) içeriğini önemli düzeyde arttırmıştır (P
Impact and Sustainability of a 10-year Community Pharmacy Disease Management Service
Authors: Lopez Tammy , Nuffer Wesley
Published: February 2021

Background. Community pharmacy practice needs to demonstrate services beyond traditional dispensing roles to continue to function in a changing marketplace. Pharmacists have established themselves as being capable of improving patient outcomes and saving healthcare dollars by providing disease management services to patients. This paper describes a sustained community pharmacy-run disease management program that continued after a grassroots grant-funding effort in 2007.
Methods. The city of Colorado Springs recognized the successes shown by the pharmacy during the Ten City Challenge funded project, and decided to financially support pharmacy diabetes care services. Partnering with the local School of Pharmacy, the pharmacist obtained advanced training and continued to deliver individualized counseling and management to approximately 100 patients per year for the past 14 years. Objective lab measurements (systolic and diastolic blood pressures, A1C values, total lipid profiles) were obtained or performed, and clinical goals were set based on national guidelines. Patients received a series of appointments to learn how to control their diabetes, and later their cardiovascular disease. Financial estimates were calculated using 2008 baseline numbers and adding estimated inflation based on published Segal rates.
Results. The pharmacy services successfully maintained participation of approximately 100 patients annually each year since its inception. Average lab value markers for disease control were at or close to clinical guideline recommendations for the population. Services were associated with estimated cost savings for the health system. Positive results led to expansion in services to include cardiovascular disease in 2017.
Conclusions. A community pharmacy has successfully sustained a disease management program for patients for over 14 years, demonstrating high patient enrollment, health outcomes at or near clinical guidelines for control, and positive financial outcomes associated with the program.
Intelligent Design and Imaginary Worlds in Cost-Effectiveness Claims: An Overview of Commentaries in INNOVATIONS in Pharmacy from July 2016 to February 2017
Authors: Langley Paul C
Published: February 2021

Over the past 30 years, thousands of modeled cost-effectiveness studies have been published. Whether this effort has been worthwhile is debatable. For supporters of modeled cost-effectiveness studies, this effort has been worthwhile because the modeled claims are intended to inform health care decision makes. To opponents, the effort is seen as largely a waste of time because the claims are typically non-evaluable. Rather than subscribing to the standards of normal science in its focus on hypothesis testing through experimentation and replication, opponents have viewed practitioners in health technology assessment as being content to develop imaginary worlds with no thought to their role in practical decision-making. Given this ongoing commitment to constructing imaginary worlds, the purpose of this commentary is bring together the various commentaries, together with supporting publications that have appeared in INNOVATIONS in Pharmacy since mid-2016. This is in response to requests from faculty and graduate students at the College of Pharmacy, University of Minnesota for an overview of the arguments presented to date in support of a new research program that rejects imaginary constructs in favor of credible, evaluable and replicable claims to support formulary decision making.

 

Type: Commentary
FACTORS AFFECTING THE VISUAL INSPECTION OF ACETIC ACID EXAMINATION (IVA) IN PADANG CITY 2019
Authors: Sinta B Lusiana El , Rahmi Laila , Iffah Uliy
Published: February 2021

Cervical cancer is the fourth most common cancer in women with a mortality rate of 6.8% (WHO, 2015; Globocan, 2012). The incidence of cervical cancer ranks second after breast cancer in Southeast Asia and Indonesia. Based on data from the Republic of Indonesia Ministry of Health 2015, cervical cancer is the cancer with the highest prevalence of 0.8 per 1000 population (Ministry of Health Republic of Indonesia, 2015). The high prevalence of cancer in Indonesia requires prevention and early detection by health service providers. The purpose of this study was to determine the factors that influence the inspection of Acetic Acid Visual Inspection (IVA) in Padang City.This type of research is quantitative with cross sectional design. The study was conducted at the Padang City Health Center in April-November 2019. The population was all women aged 30-50 years who were at the Padang City Health Center, amounting to 10,670 people, with a sample of 73 people taken by consecutive sampling technique. Data were collected by questionnaire and analyzed by univariate and bivariate analysis.More than half (64.4%) of women of childbearing age (WUS) have never had an IVA examination, more than half (58.9%) of women have a risk age, less than half (39.7%) women have low levels of education , more than half (60.3%) WUS with working status, there was no relationship between the age of WUS with IVA examination (p value = 0.182), there was a relationship between WUS education level and IVA examination (p value = 0.031), there was no relationship between the status of WUS work and IVA examination (p value = 0.404). It is expected that officials and leaders of puskesmas will develop more attractive ways to be able to convince and increase awareness and concern of the WUS themselves in conducting IVA examinations.
Academic Health System in West Java in Strengthening Primary Health Care
Authors: Syukriani Yoni Fuadah
Published: February 2021

Academic Health System (AHS) has been developed in many countries to strengthen the relationship between medical education and health professions with the health care system, which is essential to improve health outcome. Indonesia has chosen to establish AHS in several provinces, each with the autonomy to develop the system in accord with regional needs. Health cluster faculties in Universitas Padjadjaran, with its two main teaching hospitals, the West Java provincial government strived to develop AHS to overcome health services problem and medical education in the province that has enormous geographical and demographic challenges. The strategy used focuses on two things: distributed medical education (DME) and the development of a more effective referral system. The goals are dividing the province into seven regionals, upscaling one local hospital in each to become a regional referral hospital, expanding learning opportunities for medical students, and endorsing research to strengthen the primary healthcare services. Activities were carried out through the distribution of medical students and residents to local hospitals and primary healthcare facilities along with the education of local medical professionals as supervisors. Grants were provided for research that focus on quality primary healthcare, construction of data portal for patient management referral systems, telemedicine, and tele-education. The challenges faced are mainly related to the different mindset between institutions that have different work cultures and the wide variance of situations between regions. It is therefore recommended to build a more straightforward AHS system with addition of sub-networks, besides continue to maintain close communication and policy development.
Breasts and Lymphatic Tissue ; A Literature Review
Authors: Iqbal Muhammad , Harahap Wirsma Arif
Published: February 2021

The breasts begin to grow from the sixth week of the embryo in the form of ectodermal thickening along the milk line that lies from the axilla to the middle of the groin (inguinal). The blood supply comes from the internal mammary artery, which is a branch of A. subclavian. Additional bleeding originated from A. axillary through the branches of A. thoracic lateral, A. thoraco dorsalis, and A. thoraco acromialis. The return of blood through the veins follows the passage of the artery to the internal mammary V. and the axillary vein branches to the superior V. kava. Lymph capillaries are located under the epidermis with a diameter between 20 and 70 mm. Lymphangion, as a pacemaker is limited by valves and lymphatic endothelial cells, will initiate an intrinsic pulsation of lymph fluid flow. Extrinsic factors such as contraction of the skeletal muscles, massage, increased hydrostatic pressure by postural gravity can also affect the lymphatic flow rate.5,6 These lymphatic vessels run on the lateral side of the upper arm, parallel to the cephalic vein and drain into the supraclavicular nodes. 4 The LVC is an important anatomical structure for the physiology of vascular lymph node transplantation (VLNT) .8 Lymph vessels in the upper limb travel axially from the fingers to the back of the hand and make direction to the elbow, travel to the anteromedial area at the top of the arm and connect to the axillary lymph nodes in the lateral area. An alternative route directly to the supraclavicular node can be identified. These lymphatic vessels run on the lateral side of the upper arm, parallel to the cephalic veins and drain into the supraclavicular nodes. 4 The LVC is an important anatomical structure for the physiology of vascular lymph node transplantation (VLNT) .8An alternative route directly to the supraclavicular node can be identified. These lymphatic vessels run on the lateral side of the upper arm, parallel to the cephalic veins and drain into the supraclavicular nodes. 4 An alternative route directly to the supraclavicular node can be identified. These lymphatic vessels run on the lateral side of the upper arm, parallel to the cephalic veins and drain into the supraclavicular nodes.
ANALYSIS OF EXPOSURE OF REPRODUCTIVE HEALTH INFORMATION TOWARDS ADOLESCENT SEXUAL BEHAVIOR
Authors: Verawati Bernadeta , SW Kenik
Published: February 2021

range of 10 to 19 years. Adolescents are the population in the age range of 10-18 years. Rapid physical changes and hormonal changes are triggers for sexual motivation. Stimulation from the environment such as TV and the internet about sexual behavior and nutritional factors causes sexual hormones to appear earlier so that adolescents tend to experience sexual development more quickly. The rise of adolescent sexual behavior at this time is increasingly concerning and tends to increase both in terms of the quantity and sharpness of cases that occur.Method: This type of research is an observational analytic with a cross-sectional study design, to analyze the exposure to reproductive health information on adolescent sexual behavior in Sleman Regency. Samples were taken from adolescents who were in class XI SMAN 2 Ngaglik with a purposive sampling technique of 198 students. Data collection using a questionnaire via google form. Data were analyzed using univariate, bivariate, and multivariate analyzes.Results: There is a relationship between reproductive health information from parents with adolescent sexual behavior (P value 0.00), there is a relationship between information from peers and adolescent sexual behavior (P value 0.00), there is a relationship between media access and adolescent sexual behavior ( P value 0.06) Adjusted RSquare value = 0.541.Conclusion: Of the three variables, information from parents and from peers has the same relationship with sexual behavior in adolescents, and media access is smaller than the other two variables.
Pemetaan Spectral Accelaration Daerah Yogyakarta Dengan Pendekatan Probabilistic Seismic Hazard Analysis
Authors: Nurhidayatullah Eka Faisal , Kurniati Dwi
Published: February 2021

Daerah Istimewa Yogyakarta (DIY) memiliki tingkat aktivitas seismik yang tinggi, sudah berulang kali mengalami kejadian bencana gempa yang merugikan. Berbagai upaya untuk meminimalisir dampak bencana gempa bumi sudah dilakukan sebelumnya. Salah satunya yaitu dengan menerbitkan dan memperbaharui peta gempa secara berkala. Indonesia sedari lama menggunakan gempa sebagai acuan perencanaan infrastruktur, yaitu sejak tahun 1983 hingga yang terbaru yaitu peta gempa tahun 2017. Namun gempa berkekuatan 6,3 SR yang terjadi pada bulan Mei 2006 menunjukkan masih banyak bangunan terutama engineered yang hancur. Melihat begitu dahsyatnya dampak yang ditimbulkan oleh gempa tersebut maka mitigasi lebih lanjut terkait dengan bencana gempa perlu dilakukan untuk meminimalisir kerugian apabila bencana sejenis kembali terjadi dikemudian hari. Perlu dilakukan pembuatan peta gempa berskala mikro (daerah) guna perencanaan, estimasi kerusakan bangunan, korban jiwa dan kerugian secara ekonomi akibat kejadian gempa dimasa datang mengingat peta gempa yang dirilis pemerintah sampai saat ini masih berskala makro (nasional). Tujuan penelitian ini yaitu menganalisis angka percepatan tanah permukaan dengan luaran berupa peta gempa berskala mikro pada wilayah provinsi Yogyakarta. Data gempa diperoleh dari rekaman gempa dengan maksimum radius 500 km dari pusat kota Yogyakarta yang telah dipublikasi oleh USGS antara tahun 1900 sampai dengan 2020. Declustering dilakukan terhadap data historis dan sebaran peta gempa sehingga hanya digunakan gempa utama dengan magnitude ≥ 5 Mw. Dalam studi ini digunakan fungsi atenuasi Campel-Bozorgonia NGA (2008) untuk gempa Sesar, Atkinson-Boore Worldwide Data NGA (2003) intraslab dan interface untuk gempa subduksi benioff serta megahtrust. Nilai spectral acceleration (Sa) diperoleh dengan  menggunakan pendekatan Probabilistic Seismic Hazard Analysis (PSHA). Hasil analisis probabilistik percepatan gerakan tanah kemudian dikembangkan menjadi peta pada beberapa periode ulang gempa. Berdasarkan hasil penelitian diperoleh peta probabilitas terlampaui 7% dalam 75 tahun didapatkan nilai spectral acceleration percepatan tanah puncak (PGA) berada dikisaran 0,525 – 0,688g, periode pendek 1,055 – 1,7g serta periode 1 detik 0,535 -0,695g. Pada peta probabilitas terlampaui 2% dalam 50 tahun diperoleh nilai spectral acceleration PGA yaitu 0,6 – 0,79g, periode pendek 1,325 – 2,1 g serta periode panjang 0,65 -0,85 g. Sedangkan pada peta probabilitas terlampaui 2% dalam 100 tahun, nilai spectral acceleration PGA berada diantara 0,66 – 0,86g, periode pendek  1,625 – 2,465g serta periode 1 detik 0,755 -0,995g. Tingkat aktivitas kegempaan pada klaster subduksi megathrust 1 serta sesar opak dilihat dari a-value, b-value  serta Mc ditengarai memicu adanya peningkatan nilai spectral acceleration wilayah Yogyakarta dibanding peta hazard tahun 2017.
DNA bioelectric field: a futuristic bioelectric marker of cancer, aging and death – A working hypothesis
Authors:   Independent Physics Researcher, Rinnekatu 2-4 8A, Karkkila 03620, Finland, Pitkänen Matti , Rastmanesh Reza ,   Member of The Nutrition Society, London, UK & Member of The American Physical Society, USA & Independent Nutrition and Biology Researcher, Tehran, Iran & Member of Society for Conservation Biology, USA
Published: February 2021

Telomeres are associated with the ends of DNA double strands. The lengths of the telomeres are controlled by the telomerase enzyme. The shortening of the telomeres is known to relate to aging. In cancers, telomere lengths are abnormally short. Telomeres could act as buffers shielding the part of DNA coding for the proteins. For cancer cells, germ cells and stem cells the length of the telomeres is not varying. There is an analogy with microtubules, which are highly dynamical and carry a longitudinal electric field, whose strength correlates with the microtubule length. Could sticky ends generate a longitudinal field along DNA double strand with strength determined by the lengths of the sticky ends? In the standard picture the flux of the longitudinal electric field would be proportional to the difference of the negative charges associated with the sticky ends. In TGD framework, DNA strands are accompanied by the dark analog of DNA with codons realized as 3-proton units at magnetic flux tubes parallel to DNA strands and neutralizing the negative charge of ordinary DNA except at the sticky ends. This allows considering the possibility that opposite sticky ends carry opposite charges generating a longitudinal electric field along the magnetic flux tube associated with the system. DNA/Telomere bioelectric field could serve as a novel bioelectric marker to be used for prognostic and diagnostic purposes in researches of cancer, aging, surgery grafts and rejuvenation. We propsed that DNA bioelectric field can be used as a futuristic bioelectric marker of cancer, aging and death.
Analisis Model Pemilihan Moda Akibat Rencana Penerapan Skema Ganjil Genap di Kota Bekasi
Authors: Putri Ari Ananda
Published: February 2021

ABSTRACTAnalysis of Mode Choice Models as The Effect Plan Implementation of Odd-Even Schemes In Bekasi City: One strategy to reduce the use of automobile is implementing the policy of odd-even on the road sections are unidentified has an unworthy performance. With the implementation of the odd-even scheme, it is expected that the automobile user will switch to using public transportation. In Indonesia, this scheme has already conducted trials on corridor Sudirman Thamrin, Jakarta, and had a positive response towards the implementation of this policy, which is about 13.3% citizens moved to use TransjakartaBusway. If the same scheme was implemented in TheCity Bekasi, was going to have the same response with the city before? How the selection of the mode of the community, when done the policy plan simulation. Quantitative research is conducted by calculating the probability of mode choice the odd-even scheme implementation plan simulations The City of Bekasi using binary logit analysis in the SPSS 17.0 software. The result is plan the implementation of this scheme, it is noted that the people of The City of Bekasi tend to continue using automobile with a probability of 61%, while opportunities will use public transport around 39%. Even so, simulation of the scheme is able to improve the use of public transportas much as 10%.Keywords: Mode Choice; Planning; Odd-Even Scheme.ABSTRAKSalah satu strategi dalam mengurangi penggunaan kendaraan pribadi adalah dengan menerapkan kebijakan ganjil genap pada ruas jalan yang teridentifikasi memiliki kinerja yang tidak layak. Dengan diterapkannya skema ganjil genap, diharapkan para pengguna kendaraan pribadi akan beralih menggunakan transportasi massal. DI Indonesia, skema ini sudah dilakukan uji coba pada koridor Sudirman-Thamriin, Jakarta, dan memiliki respon yang positif terhadap penerapan kebijakan ini, yaitu sekitar 13.3% warga berpindah untu menggunakan Bus Transjakarta. Jika skema yang sama diterapkan di Kota Bekasi, apakah akan memiliki respon yang sama dengan kota sebelumnya? Bagaimana pemilihan moda masyarakat, saat dilakukan simulasi rencana kebijakan tersebut. Penelitian ini bersifat kuantitatif yang dilakukan dengan menghitung probabilitas pemilihan moda masyarakat saat dilakukan simulasi rencana penerapan skema ganjil genap Kota Bekasi dengan menggunakan analisa binary logit dengan bantuan software SPSS 17.0. Hasilnya adalah dengan rencana penerapan skema ini, diketahui bahwa masyarakat Kota Bekasi cenderung tetap menggunakan kendaraan pribadi dengan probabilitas sebesar 61%, sedangkan peluang yang akan menggunakan transportasi umum sekitar 39%. Meskipun demikian simulasi skema ini mampu meningkatkan penggunaan transportasi umum sebanyak 10%.Kata Kunci: Pemilihan Moda; Perencanaan; Skema Ganjil Genap
Perancangan Sistem Peringatan Longsor dan Deteksi Pergeseran Tanah Menggunakan Metode Telemetri
Authors: Sunardi Sunardi , Arifianto Teguh , Hartisa Anindira Listy , Darmawan Arief , Wirawan Willy Artha
Published: February 2021

ABSTRACTDesign of Landslide Potential Warning System and Land Shifting Using Telemetry Method: According to the 2019 BNBP Performance Report, landslides are the fourth most frequent disaster in Indonesia, so we need a telemetry tool for land shifting. This system consists of ATMega328 Microcontroller, Linear Variable Differential Transformer sensor and rheostat, accelerometer sensor, rain gauge tipping bucket, and HC-12 wireless communication module. Normally, LVDT sensor reads ground shift in the 0-20 mm range, rheostat shifting up to 66 mm, accelerometer sensor reads data less than 20 deg and  rain gauge tipping bucket sensor generates the amount of rainfall below 50 mm/hour which is sent data regularly to user. Warning alarms installed in these prone area will sound if the LVDT sensor reads ground shift30 mm, rheostat51 mm, accelerometer sensor reads data more than 45°, and rain gauge tipping bucket sensor reads more than 70 mm/hour. This test produces measurable parameter data so that it can be displayed and provide warning information.Keywords: alarm warning; ATMega 328; land shifting; landslides; telemetry.ABSTRAKMenurut Laporan Kinerja BNBP 2019, tanah longsor merupakan bencana yang sering terjadi urutan keempat di Indonesia, sehingga perlu suatu alat telemetri terhadap pergeseran tanah. Sistem ini terdiri atas Mikrokontroler ATMega328, sensor Linear Variable Differential Transformer dan rheostat, sensor accelerometer, sensor rain gauge tipping bucket, dan modul komunikasi wireless HC-12. Normalnya, sensor LVDT membaca pergeseran tanah pada range 0-20 mm, rheostat mampu melakukan pergeseran hingga 66 mm, sensor accelerometer membaca data kurang dari 20 deg, dan sensor rain gauge tipping bucket menghasilkan jumlah curah hujan dibawah 50 mm/jam yang kemudian data dikirim secara rutin ke user. Alarm peringatan yang terpasang di daerah rawan tersebut akan berbunyi jika sensor LVDT membaca pergeseran tanah 30 mm, rheostat 51 mm, sensor accelerometer membaca data lebih dari 45 derajat, dan sensor rain gauge tipping bucket membaca data lebih dari 70 mm/jam. Pengujian ini menghasilkan data parameter yang terukur sehingga dapat ditampilkan dan memberikan informasi peringatan.Kata Kunci: alarm peringatan; ATMega 328; pergeseran tanah; tanah longsor; telemetri