bluuebunny/crossref_metadata_2025 huggingface dataset:
INCREMENTO EN EL CONSUMO DE FIBRA DIETÉTICA COMPLEMENTARIO AL TRATAMIENTO DEL SÍNDROME METABÓLICO
Authors: GARCIA-MONTALVO IVAN ANTONIO
Published: May 2018

Introducción: la fibra ingerida por la población en Latinoamérica es inferior (10-20 g/d) a lo recomendado de 35 g/d, su consumo se debe promover para pacientes con Síndrome Metabólico, ya que reduce el riesgo cardiovascular, previene la obesidad y alteraciones asociadas.Objetivo: evaluar sí el incremento del consumo de fibra dietética como coadyuvante para el tratamiento de Síndrome Metabólico (SM) en sujetos del Centro de Salud de San Martín Mexicapam “La Joya”, Oaxaca, México, mejora los parámetros clínicos y laboratoriales de los mismos.Métodos: se trató de un estudio analítico-longitudinal, llevado a cabo desde Enero hasta Abril/2017, evaluando el estado nutricional antes y después de la intervención con fibra dietética, y midiendo los niveles de colesterol, triglicéridos y glucosa en sangre en ayuno. Se indicó un incremento de 15 g de fibra (frutas-verduras y/o salvado de avena y/o salvado de trigo) a la dieta habitual por un lapso continuo de 8 semanas.Resultados: la muestra fue de 30 participantes del Grupo de Ayuda Mutua diagnósticados con SM, cuya media de edad fue 37.26 años, al inicio IMC de 30.75 Kg/cm2, glucemia de ayuno de 153.87 mg/dL, triglicéridos de 209.67 mg/dL, colesterol de 213.81 mg/dL. Al finalizar la intervención se obtuvo una diferencia estadísticamente significativa (P<0.05), IMC de 29.7 Kg/cm2 , glucemia de ayuno de 127.77 mg/dL, triglicéridos de 179.71 mg/dL, colesterol de 207.13 mg/dL.Conclusión: el incremento del consumo de fibra dietética (salvado de avena) funciona como complemento al tratamiento del Síndrome Metabólico, para disminuir los parámetros clínicos y laboratoriales de los sujetos de estudio, sin embargo, se requiere de más estudios para generar recomendaciones más claras.
Influence of Culture on HRM Practices with Reference to Information Technology Industry, Bangalore
Authors: B. Anitha , Nagabhushanam Manasa
Published: May 2018

In this globalised world IT industries have gained competitive advantage over their competitors through Human capital. To manage such human assets, we require vibrant HR practices amongst such industries. Many researchers have identified the importance of culture in developing suitable HRM practices. This empirical research is to make an attempt to study the influence of culture on HRM practices in IT industries, Bangalore. To study the influence The Model of Cultural Fit (Aycan, Sonha & Kanungo 1999) was adopted with three main variables such as Social – cultural dimensions, Employee related assumptions & HRM practices. The results indicates that cultural dimensions of paternalism and power distance has a positive influence on HRM practices such as Job Design, Supervision & Control& Performance reward Contingency.
Rapid Decompensation to Systemic Inflammatory Response Syndrome in Children with Osteomyelitis
Authors: Minkowitz Barbara , Ristic Jennifer R. , Murphy Lauren , Pierce Todd , Baorto Elizabeth
Published: May 2018

Case:

We present 3 pediatric cases of osteomyelitis with delayed diagnosis, which resulted in systemic inflammatory response syndrome (SIRS) and complicated hospital stays.

Conclusion:

These 3 cases illustrate that early treatment of osteomyelitis is imperative in order to avoid fatal complications, which can occur with SIRS. Subtle signs and symptoms should not be dismissed. Patients with fever, pain, and no history of trauma should be scrutinized.
Heterotopic Ossification Formation Following a Simple Concussion
Authors: O’Callaghan Patrick K. , Carter Elliott , Walton Zeke , Chapin Russell , Bruner Evelyn
Published: May 2018

Case:

A 19-year-old woman presented with a 3-month history of an enlarging lesion on the proximal aspect of the femur. After imaging studies and a biopsy had been performed, the mass was determined to represent heterotopic ossification (HO). The only known risk factor was a history of concussion. The mass was resected and, as of the 12-month follow-up, had not recurred.

Conclusion:

HO is a potentially serious complication of ossification in soft tissues that can develop secondary to several disease states; it commonly occurs following traumatic brain injury. To our knowledge, this is the only case report that describes HO associated with a concussion and no other risk factors.
An Evaluation of Maleic‐Itaconic Copolymers as Urease Inhibitors
Authors: Mazzei Luca , Broll Valquiria , Ciurli Stefano
Published: May 2018

Core Ideas

Maleic‐Itaconic Polymers (MIPs) strongly and rapidly inactivate urease at pH 5.0.

MIPs favour the release of the essential Ni(II) ions from the active site of urease.

The urease inactivation by MIPs is comparable with that attained using NBPT.

Urea hydrolysis in soil is accelerated 1015–fold by the nickel‐dependent enzyme urease to yield a source of N that can be assimilated by plants. This reaction determines an overall soil pH increase and significant ammonia volatilization, decreasing the efficiency of urea‐based fertilization. A control of urease activity is thus required for agronomic purposes. Maleic‐Itaconic Polymers (MIPs) have been claimed to decrease the N loss as ammonia volatilization by inhibiting urease activity. To investigate this matter, we performed an in vitro study using urease from jack bean (Canavalia ensiformis, JBU) at pH 7.5 and pH 5.0. Urease is not affected by MIPs at pH 7.5, but the enzyme is completely inactivated in 20 min at pH 5.0 using MIPs in the 0.4 to 2.4 μmol L–1 range. This inactivation is comparable to that attained using similar concentrations of N‐(n‐butyl)‐thiophosphoric triamide (NBPT). In vivo assays conducted using Sporosarcina pasteurii as a model for a widespread soil bacterium and urea, in the presence of either MIPs or NBPT at pH 7.5, revealed that NBPT significantly inhibits both cellular growth and urease activity, while MIPs have no effect. To elucidate the mechanism of extracellular urease inactivation by MIPs in vitro, their Ni(II) sequestration capability was investigated. The MIPs (50 μmol L–1) completely extract the essential Ni(II) ions from the active site of urease at pH 5.0, in 3 h. This phenomenon is related to the capability of MIPs to shift the Ni(II)‐urease dissociation equilibrium through binding and chelation of the Ni(II) ions off the active site.
Soil‐Test Biological Activity with the Flush of CO2: II. Greenhouse Growth Bioassay from Soils in Corn Production
Authors: Franzluebbers Alan J. , Pershing Mary R.
Published: May 2018

Core Ideas

Grass growth in the greenhouse was dependent on soil nitrogen mineralization.

Soil‐test biological activity was a valuable indicator of nitrogen mineralization.

Biological activity, residual inorganic nitrogen, and total nitrogen were most important.

Soil nitrogen (N) mineralization is variably affected by management and edaphic conditions. A routine soil test that reflects both soil biological activity and N mineralization could improve predictions for N fertilizer recommendations to cereal grains on different soil types and landscape settings. We collected soils from 47 corn production fields in North Carolina and Virginia at depths of 0 to 10, 10 to 20, and 20 to 30 cm and evaluated soil C and N characteristics in association with sorghum‐sudangrass [Sorghum bicolor (L.) Moench ssp. Drummondii] dry matter production and N uptake during 6 to 8 wk of growth in the greenhouse. Plant dry matter and N uptake were strongly associated, as expected. Plant available N (sum of net N mineralization during 24 d of aerobic incubation + residual inorganic N) had the strongest association with plant dry matter production (r2 = 0.76) and N uptake (r2 = 0.85). However, the flush of CO2 during a 0‐ to 3‐d period following rewetting of dried soil was nearly equally effective at r2 = 0.74 and r2 = 0.76, respectively. Multiple regression models with 4 ± 2 additional variables led to r2 = 0.88 ± 0.10 among different separations of data based on depth, region, and soil textural class. We suggest the optimum combination of variables to predict soil N availability would be the flush of CO2, residual inorganic N, and total soil N concentration, as they balance relevant scientific information with limited soil‐testing resources (time and labor). We demonstrated that the flush of CO2 was a rapid and reliable indicator of soil N availability.
Life insurance company efficiency: best method and proxies
Authors: Wise William
Published: May 2018

Life insurance is a very important segment of the economy of most countries as demonstrated by the investments, premium revenue and numbers employed. Hence, it is paramount to determine accurately how well life insurance companies (LICs) perform and how viable they are for the benefit of both other industries and national economies.Three papers that investigate LIC efficiency directly analyze how efficiency affects LIC profits. One critical feature is that they show that the inefficiency of LICs can greatly affect their (financial) outcome and ultimately their survivorship. Thus, said research clearly indicates that life insurer efficiency is a crucial area to investigate and assess and that it could greatly enhance the ability to properly monitor and inspect the life insurers.This article co-ordinates information regarding life insurance efficiency studies to help researchers learn which approaches, methods and output/input proxies to use. While some papers do so for some of the aspects that are important and necessary for life insurance efficiency studies, this is the first to deal with said aspects together. More specifically, this paper especially considers and evaluates the different methods and output proxies used in life insurance efficiency studies, as they seem to be the elements where the most disagreement exists between researchers. In addition, this article is unique in examining how input (proxy) prices are used in life insurance efficiency studies.
Occurrence and fate of 27 triazines and metabolites within French drinking water treatment plants
Authors: Guillon Amélie , Videloup Christyne , Leroux Clara , Bertin Héloïse , Philibert Marc , Baudin Isabelle , Bruchet Auguste , Esperanza Mar
Published: May 2018

Twenty-seven triazines and metabolites were screened throughout six advanced drinking water treatment plants (DWTP) in France and their respective resources. Seven molecules were quantified in raw waters with a maximum concentration of 91 ng/L reached for desethyl-atrazine. No metabolites generated through advanced degradation pathways were quantified. Concentration profiles for five DWTP treating ground or surface waters were very similar and remained stable over time. Only one DWTP treating groundwater presented differences between sampling periods due to variations in wells' operations. As expected, most treatment units (settling, ozonation, nitrification, sand filtration, chlorination) did not allow for efficient removal of these micropollutants. Adsorption on granular or powdered activated carbon (PAC) was highlighted as the best available technology for the majority of quantified compounds. Combined PAC and ultrafiltration treatment was especially adapted for the removal of hydroxy-atrazine, one of the most refractory components evaluated during this study. Indeed, among quantified pesticides, only hydroxy-atrazine and desethyl-deisopropyl-atrazine were measured in treated water, with concentrations below 12 ng/L.
Factors Associated with Poor Hemoglobin A1c Control in Patients with Type 2 Diabetes
Authors: Alqudah Salam , Jarab Anan S. , Alefishat Eman A. , Mayyas Fadia , Khdour Maher , Pinto Sharrel
Published: May 2018

Background:

The limited implementation of clinical pharmacy service programs and the
lack of studies identifying barriers to achieve blood glucose control have all attributed to the increased
proportion of type 2 diabetes patients who have poor glycemic control in Jordan.

Objective:

To explore factors associated with higher HbA1c in patients with type 2 diabetes in Jordan.

Methods:

Variables including socio-demographics, disease and treatment factors were collected
from171 patients with type2 diabetes at an outpatient diabetes clinic in Amman. Validated questionnaires
were used to assess medication adherence, self-care activities, diabetes knowledge and healthrelated
quality of life in addition to data collected from medical records. After the single-predictor
analysis, stepwise linear regression was performed to develop a model with variables that best predicted
hemoglobin A1c.

Results:

Medication adherence was inversely associated with HbA1c values (β = -0.275; t = 2.666; P <
0.01), indicating better glycemic control. Receiving insulin therapy was also associated with less
HbA1c values and better glycemic control (β = - 0.184; t = 2.080; P < 0.05). Patients who had one or
more comorbid conditions (β = 0.215; t = 2.264; P < 0.05) and those with longer diabetes duration (β =
0.092; t = 1.339; P < 0.05) were found to have significantly higher HbA1c values.

Conclusion:

Emphasizing medication adherence, particularly for patients with longer duration of diabetes
and those with multiple comorbid diseases should be strongly considered in future diabetes management
programs implemented to improve glycemic control in patients with type 2 diabetes.
Preventing Fire-Related Occupational Deaths: Residential Sprinklers save Civilians, Property, and Firefighters
Authors: Pollack Keshia M. , Frattaroli Shannon , Somers Scott
Published: May 2018

Residential fires are an important public health problem, with proven strategies to prevent death and injury. Residential sprinkler systems are one such strategy. While the benefits of this technology tend to center on civilian lives and property, there are also benefits for firefighters. The purpose of this article is to describe these benefits and discuss residential sprinkler systems as a strategy to reduce the risk of firefighter injury and death. Because of the benefits for firefighter safety, firefighters' knowledge about fire prevention, and their authority on this topic, firefighters are an essential stakeholder for raising awareness among the public and policymakers about the existence of and benefits associated with residential sprinkler systems.
A Growing Fire Hazard Concern in Communities: Home Oxygen Therapy and Continued Smoking Habits
Authors: Galligan Catherine J. , Markkanen Pia K. , Fantasia Linda M. , Gore Rebecca J. , Sama Susan R. , Quinn Margaret M.
Published: May 2018

The Safe Home Care Project investigated both qualitatively and quantitatively a range of occupational safety and health hazards, as well as injury and illness prevention practices, among home care aides in Massachusetts. This article reports on a hazard identified by aides during the study's initial focus groups: smoking by home care clients on long-term oxygen therapy. Following the qualitative phase we conducted a cross-sectional survey among 1,249 aides and found that medical oxygen was present in 9 percent of aide visits (314 of aides' 3,484 recent client visits) and that 25 percent of clients on oxygen therapy were described as smokers. Based on our findings, the Board of Health in a local town conducted a pilot study to address fire hazards related to medical oxygen. Medical oxygen combined with smoking or other sources of ignition is a serious fire and explosion hazard that threatens not only workers who visit homes but also communities.
Climate Change and Wildland Firefighter Health and Safety
Authors: Withen Patrick
Published: May 2018

The author examines how climate change is impacting wildland firefighters. Climate change has made wildland fires more frequent and more intense. The increase in frequency and intensity of fires has pushed the number of fatalities and injuries higher in recent decades. The most common hazards on fires follow the trend of fire in general in that these hazards become more frequent and intense. Burnovers, heat exhaustion, tree hazards, and many other common fire hazards are more likely. The fire suppression agencies are making every effort to improve health and safety on fires by improving communication, weather forecasting, mapping, fire shelters, decision making and more. Despite these efforts, wildfires are becoming ever more hazardous because of climate change and the increasing frequency and intensity of wildfires.
Heart rate variability changes as an indicator of decompression-related physiological stress
Authors:   Department of Physiology, Biosciences Institute, University of São Paulo, Schirato Sérgio Rhein , El-Dash Ingrid , El-Dash Vivian , Natali José Eduardo , Starzynski Paulo Nogueira , Chaui-Berlinck José Guilherme
Published: May 2018

Many aspects of the physiological stress related to the exposure to the hyperbaric environment have been studied, but no research has been made to evaluate the impacts of scuba diving on heart rate variability (HRV). We investigated the effects of a simulated dive to 557 KPa (45 meters of salt water) for a 30-minute bottom time on the frequency and time domains estimators of HRV. Electrocardiogram records were obtained with superficial electrodes for 30 minutes before the simulated dive and, subsequently, for one hour after the dive. Each of these time-series was then subdivided into non-overlapping windows of 256 consecutive R-R in- tervals. A control group was submitted to the same proto- col, breathing the same gases used in the simulated dive, while not being exposed to the hyperbaric environment. In the control group we observed a significant increase in SDNN (the square root of the variance of the R–R intervals), RMSSD (the square root of the mean squared differences of successive R-R intervals), and in two bands (high and low) of the power spectrum of frequencies. The subjects in the simulated dive presented only an increase in the low frequency estimator without any further relevant changes in other estimators of HRV. This study suggests that the low frequency increase without concomitant high frequency increase might be an indicator of the physiological stress caused by decom- pression and that such a dissimilarity in responses might be correlated to the dive-related impairment of the endothelial function.
A historical review of the U.S. Navy’s busiest recompression chamber in the Pacific theater with a current perspective on caring for civilian divers within its area of responsibility: short communication
Authors:   USNH Guam Occupational Medicine, U.S. Naval Hospital Guam, BLDG 50 Farenholt Ave, Agana Heights, GU 96910, Rendina Christopher
Published: May 2018

On the island Nation of Guam, the United States Department of Defense has stationed military personnel from every service branch. Guam is utilized as a strategic waypoint for the U.S. military in the Pacific theater. As the largest service branch in the region, the Navy has placed a few Diving Medical Officers in Guam to collectively manage and treat patients with recompression therapy. Guam is also a popular tourist destination, with multiple recreational diving companies certifying individuals who are looking to take advantage of the beautiful warm water and exotic marine life. Unfortunately, with an increase in training and certifying inexperienced divers, came an increase in the operational tempo of the U.S. Navy’s recompression chamber on Guam. The recompression chamber on Naval Base Guam (NBG) has been treating patients since 1971. With the only multiplace chamber in the Mariana Islands, Diving Medical Officers, with the accompanying chamber staff, treat military personnel, active-duty sponsored patients and civilian patients. Treating civilian patients by military providers through military treat- ment facilities presents multiple issues that must be addres- sed in an effort to provide efficient quality medical care. This article reviews the records, documents, and activity of the NBG chamber over the last four decades. Through the obtained data the information provides projected financial reimbursement from civilian patients. The article also sheds light on areas of needed improvement with regard to data collection, third-party financial collection efforts and the necessity of an inclusive electronic health record (EHR) for military and civilian patients.
Can my patient dive after a first episode of primary spontaneous pneumothorax? A systematic review of the literature
Authors:   Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center,  Durham, North Carolina, U.S., Alvarez Villela M. ,   Division of Cardiology, Montefiore Medical Center –Albert Einstein College of Medicine, Bronx,  New York, U.S., Dunworth S. ,   Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center,  Durham, North Carolina, U.S.,   Department of Anesthesiology, Stanford University, Palo Alto, California, U.S., Harlan N.P. ,   Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center,  Durham, North Carolina, U.S.,   Division of Pulmonary Medicine University of Utah, Salt Lake City, Utah, U.S., Moon R.E. ,   Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center,  Durham, North Carolina, U.S.,   Department of Anesthesiology, Duke University, Durham, North Carolina, U.S.
Published: May 2018

Introduction: Patients with prior primary spontaneous pneumothorax (PSP) frequently seek clearance to dive. Despite wide consensus in precluding compressed-air diving in this population, there is a paucity of data to support this decision. We reviewed the literature reporting the risk of PSP recurrence. Methods: A literature search was performed in PubMed and Web of Science using predefined terms. Studies published in English reporting the recurrence rate after a first PSP were included. Results: Forty studies (n=3,904) were included. Risk of PSP recurrence ranged 0-67% (22 ± 15.5%; mean ± SD). Mean follow- up was 36 months, and 63 ± 39% of recurrences occurred during the first year of follow-up. Elevated height/weight ratio and emphysema-like changes (ELCs) are associated with PSP recurrence. ELCs are present in 59%-89% (vs. 0-15%) of patients with recurrence and can be detected effectively with high-resolution CT scan (sensitivity of 84-88%). Surgical pleurodesis reduces the risk of recurrence substantially (4.0±4% vs. 22±15.5%). Conclusions: Risk of PSP recurrence seems to decline over time and is associated to certain radiological and clinical risk factors. This could be incremented by the stresses of compressed-air diving. A basis for informed patient-physician discussions regarding future diving is provided in this review.
Hyperbaric oxygen therapy as treatment for bilateral arm compartment syndrome after CrossFit: case report and literature review
Authors:   Orthopedics and Traumatology Service, Hospital Universitário da Universidade Federal de Juiz de Fora  Juiz de Fora, Minas Gerais, Brasil, Mendes Jr Adriano Fernando ,   Orthopedics and Traumatology Service, Hospital e Maternidade Terezinha de Jesus, Juiz de Fora,  Minas Gerais, Brasil, da Mota Neto José ,   Orthopedics and Traumatology Service, Hospital Universitário da Universidade Federal de Juiz de Fora  Juiz de Fora, Minas Gerais, Brasil,   Orthopedics and Traumatology Service, Hospital e Maternidade Terezinha de Jesus, Juiz de Fora,  Minas Gerais, Brasil, Heringer Erica Maciel ,   School of Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brasil, de Simoni Leandro Furtado ,   Orthopedics and Traumatology Service, Hospital e Maternidade Terezinha de Jesus, Juiz de Fora,  Minas Gerais, Brasil, Pires Diego Demolinari ,   Cedimagem Radiology Clinic, Hospital Monte Sinai, Juiz de Fora, Minas Gerais, Brasil, Labronici Pedro José ,   School of Medicine, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil
Published: May 2018

Introduction: CrossFit is a physical fitness program characterized by high-intensity workouts that can be associated with serious injury. Acute compartment syndrome in the upper limbs is a rare occurrence. It may occur after intense physical exercise, and its usual treatment is surgical. Hyperbaric oxygen therapy is a treatment described as adjunctive in cases of compartmental syndrome. Presentation: We describe the case of a CrossFit practitioner who, after intense training, developed progressive symptoms of rhabdomyolysis and acute bilateral arm compartment syndrome, who was successfully treated with hyperbaric oxygen therapy and required no fasciotomy as surgical treatment. Conclusion: Acute compartment syndrome in the arms after intense physical exercise is a rare occurrence that should be suspected by practitioners of physical activity experiencing intense, disproportionate and progressive pain. In the case presented, hyperbaric oxygen therapy was successfully used in the treatment of the disorder, with satisfactory progress, and without the need for a surgical fasciotomy as therapy.
Navigating the Open Educational Practice Landscape
Authors: Weller Martin
Published: May 2018

Open education is an evolving term that covers a range of philosophies and practices aimed at widening access to education for those wishing to learn, with the current focus predominantly on practices based around reuse and sharing. This current focus can be traced back to the Open Educational Resources (OER) movement, and the use of open licences, such as Creative Commons licences. However, it also has links to open universities, open access publishing, MOOCs, open source software and open approaches to teaching.The current interpretation of open education is heavily influenced by the OER movement with an emphasis on the ‘5Rs of reuse’ (Reuse, Revise Remix, Redistribute and Retain - Wiley 2014). The profile of open education has been further raised in recent years by the popularity of Massive Open Online Courses (MOOCs). Although they do not always meet the 5Rs criteria, MOOCs are open to all and freely available, and have gained considerable attention and funding. Another growth area is that of open textbooks, which can be viewed as a specific form of OER, and is particularly prevalent in North America through projects such as OpenStax and BC Campus
Financial planning in the public sector and the Newsvendor problem
Authors: Brimberg Jack , Mansur Abdalla , El-Refae Ghaleb
Published: May 2018

The purpose of this paper is to study the phenomenon of lapsed funding that occurs within the public sector using the framework of the Newsvendor Problem. Under this framework, we observe that lapsed funding is a natural outcome of the planning system when the financial manager is trying to maximize the value added to his unit. Centralizing control of operating budgets of homogeneous units is shown to reduce lapsed funds and improve their overall performance.
Regulation of Insulin Receptor Pathway and Glucose Metabolism by CD36 Signaling
Authors: Samovski Dmitri , Dhule Pallavi , Pietka Terri , Jacome-Sosa Miriam , Penrose Eric , Son Ni-Huiping , Flynn Charles Robb , Shoghi Kooresh I. , Hyrc Krzysztof L. , Goldberg Ira J. , Gamazon Eric R. , Abumrad Nada A.
Published: May 2018

During reduced energy intake, skeletal muscle maintains homeostasis by rapidly suppressing insulin-stimulated glucose utilization. Loss of this adaptation is observed with deficiency of the fatty acid transporter CD36. A similar loss is also characteristic of the insulin-resistant state where CD36 is dysfunctional. To elucidate what links CD36 to muscle glucose utilization, we examined whether CD36 signaling might influence insulin action. First, we show that CD36 deletion specific to skeletal muscle reduces expression of insulin signaling and glucose metabolism genes. It decreases muscle ceramides but impairs glucose disposal during a meal. Second, depletion of CD36 suppresses insulin signaling in primary-derived human myotubes, and the mechanism is shown to involve functional CD36 interaction with the insulin receptor (IR). CD36 promotes tyrosine phosphorylation of IR by the Fyn kinase and enhances IR recruitment of P85 and downstream signaling. Third, pretreatment for 15 min with saturated fatty acids suppresses CD36-Fyn enhancement of IR phosphorylation, whereas unsaturated fatty acids are neutral or stimulatory. These findings define mechanisms important for muscle glucose metabolism and optimal insulin responsiveness. Potential human relevance is suggested by genome-wide analysis and RNA sequencing data that associate genetically determined low muscle CD36 expression to incidence of type 2 diabetes.
HUBUNGAN ANTARA OBESITAS DENGAN RESEPTOR HORMONAL (Reseptor Estrogen dan Progesteron) DAN EKSPRESI HER-2/NEU PADA PASIEN KANKER PAYUDARA DI RS X SURAKARTA
Authors: Hakim Andi , Widyanti Widyanti , Alfianto Untung
Published: May 2018

Peningkatan berat badan atau Body Mass Index (BMI) bisa meningkatkan risiko kanker payudara. Wanita gemuk dengan kanker payudara berisiko 30% lebih tinggi mengalami rekurensi dan 50% lebih tinggi berisiko mengalami kematian akibat kanker payudara dibandingkan wanita dengan berat badan normal. Obesitas pada pasien kanker payudara dengan reseptor hormonal negatif dan HER-2 memiliki prognosis yang lebih buruk. Kami ingin mengetahui hubungan obesitas dengan reseptor hormonal dan ekspresi HER-2/Neu pada pasien kanker payudara di RS X Surakarta. Subjek penelitian adalah wanita pra dan pasca menopause yang diperiksa di Klinik Bedah Onkologi RS X Surakarta, dengan total sampel sebanyak 105 orang. Sampling kebetulan digunakan sebagai teknik pengambilan sampel. Jenis penelitian ini adalah analisis korelasi dengan desain penelitian cross sectional. Sumber data primer dikumpulkan dengan pengukuran langsung tinggi badan, berat badan, dan pemeriksaan reseptor hormonal dan HER-2/Neu dengan Immunohistokimia (IHC) dari biopsi langsung Jaringan payudara responden. Teknik yang digunakan dalam penelitian ini adalah statistik non parametrik karena data ordinal dan menggunakan analisis korelasi untuk mendapatkan hubungan antara 2 jenis variabel. Penelitian ini menunjukkan bahwa tidak ada hubungan yang signifikan antara obesitas dengan reseptor estrogen positif (RE) dan ekspresi reseptor HER-2/Neu. Namun, ada hubungan yang signifikan antara ekspresi obesitas dan ekspresi progesteron positif (RP). Tidak ada hubungan yang signifikan antara obesitas dengan reseptor hormon ER (p= 0,991 dan OR1,005) dan ekspresi hormon HER-2/Neu (p= 0,853 dan OR 1,007). Namun, ada hubungan yang signifikan antara obesitas dengan reseptor hormonal PR (p= 0,026 dan OR 2,46). Kata kunci: kanker payudara, obesitas, reseptor hormonal, ekspresi HER-2/Neu
HUBUNGAN INDEX MASSA TUBUH DENGAN GRADING PADA KANKER PAYUDARA
Authors: Prawirohardjo Arif Nurhidayat , Soewoto Widyanti , Alfianto Untung
Published: May 2018

Kanker payudara merupakan kanker paling umum pada wanita di seluruh dunia dan merupakan kanker paling banyak terjadi pada wanita. WHO telah merekomendasikan klasifikasi IMT termasuk derajat underweight atau overweight berhubungan dengan peningkatan risiko beberapa penyakit tidak menular. Differensiasi tingkat keganasan untuk kanker payudara, menggunakan kriteria WHO yaitu system grading Nottingham (juga disebut modifikasi Elston_Ellis dari sistem grading Scarff-Bloom-Richardson). Penelitian ini bertujuan untuk mengetahui hubungan Index Massa Tubuh dengan Grading pada kanker payudara. Penelitian ini merupakan studi observasional analitik dengan desain Cross Sectional untuk mempelajari hubungan Indeks Massa Tubuh dengan Grading kanker payudara. Karaktersitik berdasarkan umur minimum 28 tahun dan usia maksimum 64 tahun, berat badan pasien minimum 40 kg dan maksimum 75 kg. Tinggi badan pasien minimum 141 cm dan maksimum 163 cm,skor IMT minimum 17.22 dan maksimum 31.18. Berdasarkan IMT dalam kategori Underwight ada 2 orang (6,7%), IMT dalam kategori normowight ada 18 orang (60,0%), dan pasien dengan IMT dalam kategori overwight ada 10 orang (33.3%), dengan demikian responden mayoritas dengan hasil pengukuran IMT dalam kategori normowight. Derajat diferensiasi sel dalam kategori Grade I ada 2 orang (6,7%), derajat diferensiasi sel dalam kategori Grade II ada 8 orang (26,7%), dan derajat diferensiasi sel dalam kategori Grade III ada 20 orang (66.7%), dengan demikian responden mayoritas dengan hasil pengukuran derajatdiferensiasiseldalam kategori Grade III. Pasien dengan grading kanker payudara grade 1 dengan IMT underweight ada 1 orang dan normowight ada 1 orang, pada grading kanker payudara grade II yang normoweight ada 7 orang dan overweight ada 1 orang, dan pada grading kanker payudara grade III dengan IMT underweight ada 1 orang normoweight ada 10 orang dan overweight ada 9 orang. IMT overwight lebih berisiko terhadap tingginya grade pada grading kanker payudara, nilai koefisen korelasi sebesar 0,396 dengan nilai p=0,045 (p<0,05) yang berarti terdapat hubungan yang signifikan antara Index Masa Tubuh dengan Grading pada kanker payudara. Kata Kunci: Kanker Payudara, Index Masa Tubuh, Differensiasi Histopatologi
PENGARUH EKSTRAK PROPOLIS TERHADAP EKSPRESI CYCLIN D1 DAN BAX PADA SEL HELA
Authors: Febrina Irma , Maryono Suradi , Purwanto Bambang
Published: May 2018

Kanker serviks merupakan kanker ginekologi tertinggi di dunia dengan infeksi Human Papilloma Virus sebagai penyebab terseringnya. Di Indonesia, kanker serviks merupakan keganasan yang paling banyak ditemukan dan penyebab kematian utama pada perempuan dalam tiga dasawarsa terakhir. Di Indonesia, setiap tahun terdeteksi lebih dari 15.000 kasus kanker serviks dan sekitar 8.000 kasus di antaranya berakhir dengan kematian. Terdapat beberapa jenis pengobatan yang biasa diberikan pada penderita kanker serviks, namun hasilnya relatif belum optimal. Keadaan ini mendorong usaha penemuan dan pengembangan strategi terapi baru dalam melawan kanker. Pendekatan yang menarik untuk dikembangkan adalah penggunaan kombinasi kemoterapi atau ko-kemoterapi. Ko-kemoterapi merupakan strategi terapi kanker dengan mengombinasikan suatu senyawa kemopreventif yang bersifat tidak toksik dengan agen kemoterapi. Salah satu produk natural yang potensial untuk dikembangkan sebagai agen ko-kemoterapi adalah propolis. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian propolis yang berasal dari Kerjo, Karanganyar, Indonesia terhadap induksi proses apoptosis dan aktivitas antiproliferasi, terutama terkait dengan penekanan ekspresi protein Cyclin D1 dan peningkatan ekspresi protein Bax pada kultur sel HeLa (cell line kanker serviks). Penelitian ini merupakan penelitian eksperimental laboratorik dengan menggunakan post test with control group design. Penelitian dilakukan pada kultur sel HeLa (sel kanker serviks) dengan pemberian propolis. Pengamatan ekspresi protein Cyclin D1 dan ekspresi protein Bax dilakukan dengan metode imunositokimia. Hasil penelitian menemukan bahwa ekspresi rata-rata Cyclin D1 pada kelima kelompok yaitu kontrol 84,13± 1,34µg/ml, EEP 1/2 IC 60,76±4,21, EEP IC 36,56± 3,63µg/ml, EEP 2 IC  24,92± 5,14µg/ml, 5-FU 13,15±3,66µg/ml. Terdapat perbedaan bermakna ekspresi Cyclin D1 antara kelompok perlakuan dibandingkan kelompok kontrol (p < 0,001). Rata-rata ekspresi Bax pada kelima kelompok yaitu kontrol 1,89± 0,46µg/ml, EEP 1/2 IC 69,44± 1,39, EEP IC 80,07± 3,52µg/ml, EEP 2 IC 83,96± 3,26µg/ml, 5-FU 92,78± 4,68µg/ml. Terdapat perbedaan bermakna ekspresi Bax antara kelompok uji dibandingkan kelompok kontrol (p < 0,001). Penelitian ini menyimpulkan bahwa pemberian ekstrak etanol propolis mempunyai pengaruh terhadap penekanan ekspresi Cyclin D1 dan peningkatan ekspresi Bax pada kultur sel kanker serviks (HeLa Cell line). Kata kunci: EEP, Protein Cyclin D1, Protein Bax, HeLa cell line
PENGARUH EKSTRAK ETHANOL PROPOLIS TERHADAP EKSPRESI PROTEIN Bcl2, CYCLIN D1 DAN INDUKSI APOPTOSIS PADA KULTUR SEL KANKER KOLON
Authors: Yuniarto Haryono , Maryono Sumardi , Purwanto Bambang
Published: May 2018

Kanker kolorektal menempati urutan kejadian kanker ketiga di seluruh dunia, dengan lebih dari 1 juta angka kejadian tiap tahunnya. Berbagai strategi terapi pengobatan kanker kolorektal tetapi relatif belum optimal. Oleh karena itu, terdapat kebutuhan mengembangkan terapi alternatif sebagai pendamping. Propolis menunjukkan aktivitas proapoptosis pada berbagai jenis sel kanker. Mengetahui pengaruh pemberian propolis yang berasal dari Kerjo, Karanganyar, Indonesia terhadap induksi proses apoptosis dan aktivitas antiproliferasi, terutama terkait dengan penekanan ekspresi protein Bcl 2 dan cyclin D1 pada kultur sel WiDr (cell line kanker kolon). Penelitian eksperimental laboratorik menggunakan post test with control group design. Penelitian dilakukan pada kultur sel WiDr (sel kanker kolon) dengan pemberian propolis. Pengamatan ekspresi protein Cyclin D1 dan Bcl2 dilakukan dengan metode imunositokimia, sedangkan pengamatan induksi apoptosis dilakukan dengan flowcytometry. Analisis statistik dengan uji Kruskal-Wallis, signifikan bila p <0,05. Rata-rata ekspresi Bcl2 pada kelima kelompok yaitu kontrol 83.40 ± 0.69 μg/ml, EEP 1/2 IC50 60.63 ± 0.40, EEP IC50 33.77 ± 1.08 μg/ml, EEP 2 IC50 24.28 ± 1.91 μg/ml, 5fluorouracil 12.74 ± 2.19 μg/ml. Terdapat perbedaan bermakna ekspresi Bcl2 antara kelompok uji dibandingkan kelompok kontrol (p < 0,001). Rata-rata ekspresi cyclin D1 pada kelima kelompok yaitu kontrol 83.77 ± 0.39 μg/ml, EEP 1/2 IC50 61.44 ± 0.41, EEP IC50 36.67 ± 1.18 μg/ml, EEP 2 IC50 24.50 ± 0.38 μg/ml, 5fluorouracil 13.42 ± 1.04μg/ml. Terdapat perbedaan bermakna ekspresi cyclin D1 antara kelompok uji dibandingkan kelompok kontrol (p < 0,001). Pemberian ekstrak etanol propolis mempunyai pengaruh menekan ekspresi Bcl2, cyclin D1, dan menginduksi apoptosis pada kultur sel kanker kolon (WiDr Cell Line). Kata Kunci: Ekstrak Ethanol Propolis, Bcl2, cyclin D1, Sel WiDr
PROFIL KOAGULASI PASIEN PENDERITA DIABETES MELLITUS DI RS X, KEBUMEN, JAWA TENGAH
Authors: Rahayu Ester Tri , Arjana Adika Zhulhi , Juwariyah Juwariyah , Mulyaningrum Utami , Irfan Rozan Muhammad
Published: May 2018

Ulkus diabetes mellitus (DM) adalah komplikasi dari diabetes mellitus yang menimbulkan dampak sosioekonomi yang besar. Morbiditas yang ditimbulkan cukup besar dan secara epidemiologi penderita DM memiliki resiko 25 % untuk terjadinya ulkus DM. Secara patofisiologinya, ulkus DM terjadi atas 3 kondisi yaitu neuropathy, gangguan vaskular, dan infeksi. Gangguan vaskular yang terjadi dimungkinkan disebabkan karena adanya gangguan dalam proses koagulasi. Penelitian ini bertujuan untuk mengetahui kondisi koagulasi pasien DM penderita ulkus DM. Penelitian ini menggunakan data sekunder rekam medis. Subyek yang masuk dalam penelitian ini adalah penderita dewasa ulkus DM. Data rekam medis subyek mengenai kondisi diabetes dan ulkus DM diambil peneliti dan dianalisis secara deskriptif. Hasil penelitian menunjukkan adanya perbedaan yang bermakna pada waktu pembekuan dan kadar SGOT pada berbagai derajat ulkus diabetikum. Akan tetapi perbedaan tidak dijumpai pada waktu perdarahan dan kadar SGPT. Kata Kunci: Ulkus, koagulasi, diabetes mellitus
FORMULASI TABLET EFFERVECENT DARI EKSTRAK ETANOL DAUN TALAS (Colocasia esculenta L.) SEBAGAI ANTISEPTIK TOPIKAL
Authors: Dewangga Ardian , Meirani Siti Fatimah , Apriliany Rizky , Darojati Ulfa Afrinurfadhilah , Yudha Awan Indra
Published: May 2018

Tablet effervescent merupakan salah satu bentuk sediaan tablet yang dibuat dengan cara pengempaan bahan-bahan aktif dengan campuran asam-basa organik, seperti asam sitrat atau asam tartrat dan natrium bikarbonat. Tanaman talas (Colocasia esculenta L.) memiliki kandungan senyawa kimia diantaranya flavonoid yang merupakan senyawa polifenol yang mempunyai fungsi sebagai senyawa antiseptik. Penelitian ini bertujuan untuk mengetahui formulasi sediaan tablet effervecent yang optimal untuk kulit dari aktivitas antiseptik ekstrak etanol daun talas terhadap bakteri penyebab permasalahan kulit. Pada formulasi sediaan tablet effervescent dibuat 3 formula dengan 3 variasi konsentrasi asam sitrat dan asam tartrat ( 1:3, 1:1, 3:1). Ekstraksi dilakukan dengan maserasi menggunakan pelarut etanol 96%. Metode yang digunakan untuk pembuatan tablet effervescent adalah granulasi basah. Penelitian ini melakukan evaluasi sifat fisik pada tablet effervescent meliputi uji keseragaman bobot, uji kekerasan, uji kerapuhan, dan uji waktu larut guna diperoleh tablet effervescent dengan perbandingan asam sitrat asam tartrat yang paling baik. Hasil yang diperoleh dari ketiga formula yang diuji, menunjukkan formula 1 dengan perbandingan asam sitrat dan asam tartrat (3:1) menghasilkan sifat fisik yang paling baik.Kata Kunci: Tablet Effervescent, Daun Talas, Antiseptik, Asam Sitrat, Asam Tartrat.
PENGARUH EKSTRAK PROPOLIS TERHADAP EKSPRESI PROTEIN Bcl2, p21, DAN INDUKSI APOPTOSIS PADA SEL HELA
Authors: Susanto Tri Hardi , Maryono Suradi , Purwanto Bambang
Published: May 2018

Kanker serviks merupakan penyebab kematian ketiga akibat kanker pada wanita di dunia. Di Indonesia, kanker serviks merupakan penyebab kematian utama perempuan dalam tiga dasa warsa terakhir. Berbagai strategi terapi pengobatan kanker serviks dengan menggunakan terapi bedah, radioterapi, dan kemoterapi maupun kombinasi ketiganya relatif belum optimal. Setiap abnormalitas pada jalur apoptosis dapat sebagai target terapi kanker. Pendekatan yang menarik untuk dikembangkan adalah penggunaan kombinasi kemoterapi atau ko-kemoterapi. Propolis yang menunjukkan aktivitas proapoptosis pada berbagai jenis sel kanker, meliputi : kanker laring, kanker paru, kanker pankreas, kanker tiroid, kanker kolorektal, kanker payudara, kanker prostat dan glioma. Propolis merupakan salah satu produk natural yang potensial untuk dikembangkan sebagai agen ko-kemoterapi. Tujuan penelitian ini untuk mengetahui pengaruh pemberian propolis yang berasal dari Kerjo, Karanganyar, Indonesia terhadap induksi proses apoptosis dan aktivitas antiproliferasi, terutama terkait dengan penekanan ekspresi protein Bcl2 dan peningkatan aktivasi p21 pada kultur sel HeLa (cell line kanker servik). Penelitian ini merupakan penelitian eksperimental laboratorik dengan menggunakan post test with control group design. Penelitian dilakukan pada kultur sel HeLa (sel kanker servik) dengan pemberian propolis. Pengamatan ekspresi p21 dan ekspresi protein Bcl2 dilakukan dengan metode imunositokimia, sedangkan pengamatan induksi apoptosis dilakukan dengan flowcytometry. Hasil penelitian menunjukkan ekspresi rata-rata Bcl2 pada kelima kelompok yaitu kontrol 84,60 ± 1,34 µg/ml, EEP 1/2 IC50  62,33 ±4,58, EEP IC50  33,98 ± 2,11 µg/ml, EEP 2 IC50 22,16 ± 3,41 µg/ml, Cisplatin 13,09±4,38 µg/ml. Terdapat perbedaan bermakna ekspresi Bcl2  antara kelompok uji dibandingkan kelompok kontrol (p < 0,001). Rata-rata ekspresi p21 pada kelima kelompok yaitu pada grup kontrol 1,70 ± 0,67 µg/ml, EEP 1/2 IC50  65,92 ± 0,40, EEP IC50  82,76 ± 3,03 µg/ml, EEP 2 IC50  86,86 ± 3,33 µg/ ml, Cisplatin 93,19 ± 3,02 µg/ml. Terdapat perbedaan bermakna ekspresi p21  antara kelompok uji dibandingkan kelompok kontrol (p < 0,001). Penelitian ini menyimpulkan bahwa pemberian ekstrak etanol propolis mempunyai pengaruh terhadap penekanan ekspresi Bcl2, peningkatan ekspresi p21, dan induksi apoptosis pada kultur sel kanker servik (HeLa cell line).Kata Kunci: EEP, p21, protein Bcl2, HeLa cell line
PENGARUH TERAPI N-ASETIL SISTEIN TERHADAP EKSPRESI INTERLEUKIN 17 DAN FIBROSIS INTERSTISIAL PADA MENCIT NEFRITIS LUPUS
Authors: Atmoko Warigit Dri , Purwanto Bambang , Sugiarto Sugiarto
Published: May 2018

Lupus nefritis (LN) terkait dengan penebalan membran basal glomerulus. Pengendapan kompleks imun  memicu kaskade respon inflamasi disertai aktivasi reactive oxygen species (ROS), kemudian menyebabkan fibrosis yang mendorong terjadinya kerusakan ginjal. Interleukin 17 merupakan sitokin yang sangat berperan pada reaksi inflamasi tipe-lambat. Produksinya dipicu oleh peningkatan produksi kemokin oleh sejumlah jaringan untuk merekrut monosit dan netrofil ke sisi inflamasi. IL-17 diproduksi sel Th17 dan diinduksi oleh IL-23. IL-17 berespon terhadap invasi patogen ekstraseluler dan menginduksi perusakan matriks seluler patogen. IL-17 akan merangsang sel B untuk memproduksi dan mensekresikan autoantibodi, selanjutnya akan terbentuk kompleks atigen-autoantibodi. Kompleks antigen-autoantibodi yang berada di sirkulasi akhirnya akan terdisposisi pada sel target, termasuk sel fibroblas, sel mesangial, podosit, sel tubulus dan sel endotel di glomerulus. Kompleks ini akan menyebabkan terjadinya glomerulosklerosis dan fibrosis interstisial pada ginjal, kemudian selanjutnya menyebabkan kerusakan pada ginjal dan terjadilah mikroalbuminuria. Disamping itu, akan terjadi disfungsi endotel kapiler glomerulus yang akan menyebabkan albuminuria. Suplemen N-asetil sistein (NAS) pada lupus nefritis dapat mengurangi efek nefrotoksik pada ginjal, melalui penurunan ekspresi IL-17 dan derajat fibrosis interstisial. Penelitian ini merupakan penelitian eksperimental laboratoris, dengan sampel 24 ekor mencit Balb/C betina yang dibagi menjadi kelompok kontrol, LN, dan LN+NAS. Untuk membuat model LN, hewan coba diberikan injeksi 0,5 ml pristan intraperitoneal dosis tunggal. NAS diberikan secara peroral dengan dosis 4,7 mg/hari (setara dengan dosis manusia 1.800 mg) selama delapan minggu. Ekspresi IL-17 diperiksa secara imunohistokimia dengan antibodi monoklonal terhadap IL-17. Cara ukur dinilai secara kuantitatif, dihitung jumlah sel positif IL17 terhadap 100 sel, secara visual dengan mikroskop cahaya pembesaran 400 x. Penilaian fibrosis interstisial ditentukan secara kuantitatif dengan cara mengukur tebal jaringan interstisial dengan menggunakan micrometer yang telah dikalibrasi pada pembesaran 400 x. Analisis data menggunakan analysis of variance (Anova) dan untuk menentukan perbedaan kemaknaan digunakan p<0,05. Hasil Penelitian menunjukkan bahwa pemberian NAS menurunkan ekspresi IL-17 (23,8±14,1 vs 10,6±6,8 per 100 sel netrofil imunoreaktif; p =0,042)  dan menurunkan fibrosis interstisial (22,3±5,7 vs 15,5±5,4; p =0,030) dibandingkan kelompok LN. Berdasarkan penelitian ini dapat disimpilkan bahwa NAS secara bermakna menurunkan ekspresi IL-17 dan fibrosis interstisial ginjal pada mencit model LN.Kata Kunci: fibrosis interstisial, lupus nefritis, interleukin 17, pristan