bluuebunny/crossref_metadata_2025 huggingface dataset:
Further evidence of high level of persistence of pediatric bipolar-I disorder from childhood onto young adulthood: a five-year follow up
Authors: Wozniak Janet , Wolenski Rebecca , Fitzgerald Maura , Faraone Stephen V. , Joshi Gagan , Uchida Mai , Biederman Joseph
Published: July 2018

Background: Pediatric bipolar (BP)-I disorder affects a sizeable minority of children and is associated with high levels of morbidity. Relatively few studies have assessed the persistence of the disorder over time.

Objective: The main aim of this study was to extend our findings from our 4-year follow-up study examining rates of persistence of pediatric BP-I disorder onto late adolescent years and young adulthood 5 years after our original study.

Methods: We conducted a 1-year extension to our original prospective study of 78 youth, ages six to 17 years, with BP-I disorder at ascertainment, who were followed up into their adolescent and young adult years (14.9 ± 3.8). All subjects were comprehensively assessed with structured diagnostic interviews and psychosocial, educational, and treatment history assessments.

Results: Of the 78 BP-I participating youth, 68 were re-accessioned one year following the 4-year follow-up study, thus effectively 5 years since the original study. Of these, 63% continued to meet full (50%) or subthreshold (13%) diagnostic criteria for BP-I and 18% continued to have full or subthreshold major depressive disorder. Only 19% of BP-I youth were euthymic at the 5-year follow up.

Discussion: This 1-year extension study further documents the high level of persistence of pediatric BP-I from childhood onto late adolescence and young adulthood. The results provide compelling evidence of the morbidity and dysfunction associated with this disorder and its many forms.

Clinical significance: This study adds to a small amount of literature on the persistence of pediatric BP disorder and the critical need for early identification and intervention.
Fall Applications of Proxy (Ethephon) Suppress Spring Seedheads of ‘Meyer’ Zoysiagrass
Authors: Patton Aaron J. , Schortgen Geoffrey P. , Hoyle Jared A. , Harrell Michael S. , Reicher Zachary J.
Published: July 2018

Core Ideas

Early fall Proxy (ethephon) applications effectively suppress Meyer zoysiagrass seedheads in spring.

Apply Proxy in late‐September when days are approximately 12 hours long to suppress zoysiagrass seedheads.

Tank‐mixtures of Proxy with large patch fungicides reduce application labor and equipment costs.

‘Meyer’ zoysiagrass (Zoysia japonicaSteud.) is used on golf courses throughout the transitional climatic zone because of its aesthetic and functional quality and tolerance to abiotic stresses. However, a key problem with Meyer zoysiagrass is that it produces seedheads in the spring that reduce aesthetics and increase golf course maintenance costs. The objective of this experiment was to quantify the efficacy of Proxy (ethephon) on Meyer zoysiagrass seedhead suppression at three locations when applied in fall before winter dormancy and in spring prior to seedhead production. The early fall application timing of Proxy provided > 90% suppression of zoysiagrass seedheads with < 10% injury. Late fall and spring Proxy applications provided little seedhead suppression. The early fall application timing that successfully suppressed Meyer zoysiagrass seedheads in our experiment was applied from 23 to 29 September across locations to 100% green zoysiagrass; on dates with a photoperiod of 11.9 to 12.1 h; and following the accumulation of < 14 cooling degree days (20°C base temperature). This research provides turf managers insight on how to best suppress Meyer zoysiagrass seedhead production.
Present and Future Human Emissions of Rotavirus and Escherichia coli to Uganda's Surface Waters
Authors: Okaali Daniel A. , Hofstra Nynke
Published: July 2018

Rotavirus (RV) and diarrheagenic Escherichia coli are waterborne pathogens commonly causing diarrhea in children below five years old worldwide. Our study is a first step toward a loads–concentrations–risk modeling and scenario analysis framework. We analyzed current and future human RV and indicator E. coli (EC) emissions from sanitation facilities to surface waters in Uganda using two process‐based models. Emissions were estimated for the baseline year 2015 and for three scenarios in 2030 using population, excretion rates, sanitation types, and wastewater treatment. The first model is a downscaled GloWPa‐Rota H1 version, producing emissions at a 1‐km2 resolution. The second model is newly developed for Kampala and adds emissions from pit latrines and septic tanks excluded in the first model. The scenarios Business as Usual, Industrious, and Low Emissions reflect government prospects in sanitation coverage and wastewater treatment. For the first model, 6.14 × 1014 RV particles d−1 and 1.31 × 1012 EC colony‐forming units (CFU) d−1 are emitted to surface waters in 2015. The RV emissions are expected to increase in 2030 by 75% for Business as Usual and 212% for Industrious and decrease by 58% in Low Emissions. Emissions from the second model are higher for Kampala than in the first model, at 3.74 × 1014 vs. 5.95 × 1013 RV particles d−1 and 8.18 × 1011 vs. 1.75 × 1011 EC CFU d−1 in 2015, most of which come from the onsite‐not‐contained category. Simulated emissions for Kampala show the importance of including onsite sanitation in our modeling. Our study is replicable in other locations and helps identify key emission sources, their hotspots, and the importance of wastewater treatment. The scenarios can guide future sanitation safety planning.

Core Ideas

Rotavirus and E. coli emissions from sanitation facilities reach surface water.

Using modeling and scenario analysis, we simulated these emissions for Uganda.

High‐emission areas are Kampala and other urban areas.

A new model including onsite sanitation shows higher emissions in Kampala.

Future emissions are reducible through sanitation planning.
Genetic Gains for Grain Yield in CIMMYT's Semi‐Arid Wheat Yield Trials Grown in Suboptimal Environments
Authors: Crespo-Herrera L. A. , Crossa J. , Huerta-Espino J. , Vargas M. , Mondal S. , Velu G. , Payne T. S. , Braun H. , Singh R. P.
Published: July 2018

Wheat (Triticum aestivum L.) is a major staple food crop grown worldwide on >220 million ha. Climate change is regarded to have severe effect on wheat yields, and unpredictable drought stress is one of the most important factors. Breeding can significantly contribute to the mitigation of climate change effects on production by developing drought‐tolerant wheat germplasm. The objective of our study was to determine the annual genetic gain for grain yield (GY) of the internationally distributed Semi‐Arid Wheat Yield Trials, grown during 2002–2003 to 2013–2014 and developed by the Bread Wheat Breeding program at the CIMMYT. We analyzed data from 740 locations across 66 countries, which were classified in low‐yielding (LYE) and medium‐yielding (MYE) environments according to a cluster analysis. The rate of GY increase (GYC) was estimated relative to four drought‐tolerant wheat lines used as constant checks. Our results estimate that the rate of GYC in LYE was 1.8% (38.13 kg ha−1 yr−1), whereas in MYE, it was 1.41% (57.71 kg ha−1 yr−1). The increase in GYC across environments was 1.6% (48.06 kg ha−1 yr−1). The pedigrees of the highest yielding lines through the coefficient of parentage analysis indicated the utilization of three primary sources—‘Pastor’, ‘Baviacora 92’, and synthetic hexaploid derivatives—to develop drought‐tolerant, high and stably performing wheat lines. We conclude that CIMMYT's wheat breeding program continues to deliver adapted germplasm for suboptimal conditions of diverse wheat growing regions worldwide.
Crystal Engineering for Enhanced Solubility and Bioavailability of Poorly Soluble Drugs
Authors: Varshosaz Jaleh , Ghassami Erfaneh , Ahmadipour Saeedeh
Published: July 2018

Background:

Crystal engineering is dealing with the creation of new structures and new properties in
drug molecules through inter-molecular interactions. Researchers of pharmaceutical sciences have used this
knowledge to alter the structure of crystalline medications in order to remedy the problems of more than 40% of
the new designed drugs which suffer from low solubility and consequently, low bioavailability which have limited
their clinical application.

Methods:

This review covers a broad spectrum of aspects of the application of crystal engineering in pharmaceutics
and includes a comprehensive wide range of different techniques used in crystal engineering of active
pharmaceutical ingredients (API) to compensate the low water solubility and bioavailability of drugs related
specially to class II of biopharmaceutical classification system (BCS).

Results:

These techniques include; crystalline habit modification, polymorphism, solvates and hydrates, cocrystals,
surface modification, crystallization, spherical agglomeration, liquisolid crystals and solid dispersions
which are introduced and discussed in this review article.

Conclusion:

Each of these techniques has advantages and limitations which are emphasized on them.
(-)-Phenserine and Inhibiting Pre-Programmed Cell Death: In Pursuit of a Novel Intervention for Alzheimer’s Disease
Authors: Becker Robert E. , Greig Nigel H. , Lahiri Debomoy K. , Bledsoe Joseph , Majercik Sarah , Ballard Clive , Aarsland Dag , Schneider Lon S. , Flanagan Douglas , Govindarajan Ramprakash , Sano Mary , Ferrucci Luigi , Kapogiannis Dimitrios
Published: July 2018

Background:

Concussion (mild) and other moderate traumatic brain injury (TBI) and Alzheimer's
disease (AD) share overlapping neuropathologies, including neuronal pre-programmed cell
death (PPCD), and clinical impairments and disabilities. Multiple clinical trials targeting mechanisms
based on the Amyloid Hypothesis of AD have so far failed, indicating that it is prudent for new drug
developments to also pursue mechanisms independent of the Amyloid Hypothesis. To address these issues,
we have proposed the use of an animal model of concussion/TBI as a supplement to AD transgenic
mice to provide an indication of an AD drug candidate’s potential for preventing PPCD and resulting
progression towards dementia in AD.

Methods:

We searched PubMed/Medline and the references of identified articles for background on the
neuropathological progression of AD and its implications for drug target identification, for AD clinical
trial criteria used to assess disease modification outcomes, for plasma biomarkers associated with AD
and concussion/TBI, neuropathologies and especially PPCD, and for methodological critiques of AD
and other neuropsychiatric clinical trial methods.

Results:

We identified and address seven issues and highlight the Thal-Sano AD ‘Time to Onset of Impairment'
Design for possible applications in our clinical trials. Diverse and significant pathological cascades
and indications of self-induced neuronal PPCD were found in concussion/TBI, anoxia, and AD
animal models. To address the dearth of peripheral markers of AD and concussion/TBI brain pathologies
and PPCD we evaluated Extracellular Vesicles (EVs) enriched for neuronal origin, including
exosomes. In our concussion/TBI, anoxia and AD animal models we found evidence consistent with the
presence of time-dependent PPCD and (-)-phenserine suppression of neuronal self-induced PPCD. We
hence developed an extended controlled release formulation of (-)-phenserine to provide individualized
dosing and stable therapeutic brain concentrations, to pharmacologically interrogate PPCD as a drug
development target. To address the identified problems potentially putting any clinical trial at risk of
failure, we developed exploratory AD and concussion/TBI clinical trial designs.

Conclusions:

Our findings inform the biomarker indication of progression of pathological targets in
neurodegenerations and propose a novel approach to these conditions through neuronal protection
against self-induced PPCD.
Interaction of Stigmasterol with Trypanosomal Uridylyl Transferase, Farnesyl Diphosphate Synthase and Sterol 14α-demethylase: An In Silico Prediction of Mechanism of Action
Authors: Ibrahim Mohammed Auwal , Isah Murtala Bindawa , Tajuddeen Nasir , Hamza Saadatu Auwal , Mohammed Aminu
Published: July 2018

Background:

Trypanosomiasis is one of the neglected tropical diseases and continues to cause serious morbidity, mortality and economic loss. Current anti-trypanosomal drugs are antiquated and suffer from a number of serious setbacks, thereby necessitating the search for new drugs. Stigmasterol has previously demonstrated in vitro and in vivo anti-trypanosomal activity.

Methods:

Herein, stigmasterol was docked into three validated anti-trypanosomal drug targets; uridylyl transferase, farnesyl diphosphate synthase and sterol 14α-demethylase, in order to elucidate the possible biochemical targets for the observed anti-trypanosomal activity.

Results:

The binding free energy between stigmasterol and the enzymes was in the order; sterol 14α-demethylase (-8.9 kcal/mol) < uridylyl transferase (-7.9 kcal/mol) < farnesyl diphosphate synthase (-5.7 kcal/mol). At the lowest energy docked pose, stigmasterol interacts with the active site of the three trypanosomal enzymes via non-covalent interactions (apart from hydrogen bond) while highly hydrophobic stigmasterol carbon atoms (21 and 27) were crucial in the interaction with varying residues of the three anti-trypanosomal targets.

Conclusion:

Therefore, results from this study might suggest that stigmasterol mediated the antitrypanosomal activity through interaction with the three anti-trypanosomal targets but with more preference towards sterol 14α-demethylase.
How Women Use Digital Technologies for Health: Qualitative Interview and Focus Group Study (Preprint)
Authors: Lupton Deborah , Maslen Sarah
Published: July 2018

BACKGROUND

A range of digital technologies are available to lay people to find, share, and generate health-related information. Few studies have directed attention specifically to how women are using these technologies from the diverse array available to them. Even fewer have focused on Australian women’s use of digital health.

OBJECTIVE

The Australian Women and Digital Health Project aimed to investigate which types of digital technologies women used regularly for health-related purposes and which they found most helpful and useful. Qualitative methods—semistructured interviews and focus groups—were employed to shed light on the situated complexities of the participants’ enactments of digital health technologies. The project adopted a feminist new materialism theoretical perspective, focusing on the affordances, relational connections, and affective forces that came together to open up or close off the agential capacities generated with and through these enactments.

METHODS

The project comprised two separate studies including a total of 66 women. In study 1, 36 women living in the city of Canberra took part in face-to-face interviews and focus groups, while study 2 involved telephone interviews with 30 women from other areas of Australia.

RESULTS

The affordances of search engines to locate health information and websites and social media platforms for providing information and peer support were highly used and valued. Affective forces such as the desire for trust, motivation, empowerment, reassurance, control, care, and connection emerged in the participants’ accounts. Agential capacities generated with and through digital health technologies included the capacity to seek and generate information and create a better sense of knowledge and expertise about bodies, illness, and health care, including the women’s own bodies and health, that of their families and friends, and that of their often anonymous online social networks. The participants referred time and again to appreciating the feelings of agency and control that using digital health technologies afforded them. When the technologies failed to work as expected, these agential capacities were not realized. Women responded with feelings of frustration, disappointment, and annoyance, leading them to become disenchanted with the possibilities of the digital technologies they had tried.

CONCLUSIONS

The findings demonstrate the nuanced and complex ways in which the participants were engaging with and contributing to online sources of information and using these sources together with face-to-face encounters with doctors and other health care professionals and friends and family members. They highlight the lay forms of expertise that the women had developed in finding, assessing, and creating health knowledges. The study also emphasized the key role that many women play in providing advice and health care for family members not only as digitally engaged patients but also as digitally engaged carers.
Feasibility of a Therapist-Supported, Mobile Phone–Delivered Online Intervention for Depression: Longitudinal Observational Study (Preprint)
Authors: Goldin Philippe R , Lindholm Riku , Ranta Kristian , Hilgert Outi , Helteenvuori Tiia , Raevuori Anu
Published: July 2018

BACKGROUND

Depression is a very common condition that impairs functioning and is often untreated. More than 60% of the treatments for depressive disorder are administered in primary care settings by care providers who lack the time and expertise to treat depression. To address this issue, we developed Ascend, a therapist-supported, mobile phone–delivered 8-week intervention administered at the Meru Health Online Clinic in Finland.

OBJECTIVE

We conducted two pilot studies to examine the feasibility of the Ascend intervention, specifically, dropout rates, daily practice, weekly group chat use, and changes in depression symptoms. We also explored whether daily practice and weekly group chat use were associated with changes in depression symptoms.

METHODS

A total of 117 Finnish adults with elevated depressive symptoms enrolled in Ascend, a program that included daily cognitive behavioral and mindfulness meditation exercises delivered through a mobile phone app, anonymous group chat with other users, and chat/phone access to a licensed therapist. Eight weekly themes were delivered in a fixed, sequential format. Depression symptoms were measured at baseline, every second week during the intervention, immediately after the intervention, and 4 weeks after completion of the intervention. Data were analyzed using intent-to-treat repeated-measures analysis of variance and linear regression models.

RESULTS

For studies 1 and 2, we observed dropout rates of 27% and 15%, respectively, decreasing daily practice and group chat use, and decreased depression symptoms from baseline to immediately and 4 weeks after the intervention (P<.001). We found that both more daily practice and chat group use predicted the occurrence of fewer depressive symptoms at 4 weeks postintervention (Study 1: ∆R2 =.38, P=.004 and ∆R2 =.38, P=.002, respectively; Study 2: ∆R2 =.16, P<.001 and ∆R2 =.08, P=.002, respectively).

CONCLUSIONS

This therapist-supported, mobile phone–delivered treatment for depression is feasible and associated with reduced depression symptoms. Design features that enhance daily practice and group chat use are areas of future investigation. Validation of these results using a controlled study design is needed to establish the evidence base for the Ascend intervention.
Risks and Benefits of Direct Oral Anticoagulants across the Spectrum of GFR among Incident and Prevalent Patients with Atrial Fibrillation
Authors: Shin Jung-Im , Secora Alex , Alexander G. Caleb , Inker Lesley A. , Coresh Josef , Chang Alex R. , Grams Morgan E.
Published: July 2018

Background and objectives

All randomized trials of direct oral anticoagulants in atrial fibrillation excluded patients with severe kidney disease. The safety and effectiveness of direct oral anticoagulants across the range of eGFR in real-world settings is unknown. Our objective is to quantify the risk of bleeding and benefit of ischemic stroke prevention for direct oral anticoagulants compared with warfarin in patients with atrial fibrillation with and without CKD.

Design, setting, participants, & measurements

We created a propensity score–matched cohort of 3206 patients with atrial fibrillation and direct oral anticoagulant use and 3206 patients with atrial fibrillation using warfarin from October of 2010 to February of 2017 in an electronic health record (Geisinger Health System). The risks of bleeding and ischemic stroke were compared between direct oral anticoagulant and warfarin users using Cox proportional hazards regression, stratified by eGFR (≥60 and <60 ml/min per 1.73 m2).

Results

The mean (SD) age of the 6412 participants was 72 (12) years, 47% were women, and average eGFR was 69 (21) ml/min per 1.73 m2. There were 1181 bleeding events and 466 ischemic strokes over 7391 person-years of follow-up. Compared with warfarin use, the hazard ratios (HRs) (95% confidence interval [95% CI]) of bleeding associated with direct oral anticoagulant use were 1.01 (0.88 to 1.17) and 1.23 (1.02 to 1.48) for those with eGFR≥60 and eGFR<60 ml/min per 1.73 m2, respectively (P-interaction=0.10). There was no difference between direct oral anticoagulant and warfarin users in the risk of ischemic stroke: HRs (95% CI) of 0.94 (0.74 to 1.18) and 1.02 (0.76 to 1.37) for those with eGFR≥60 and eGFR<60 ml/min per 1.73 m2, respectively (P-interaction=0.70). Similar findings were observed with individual drugs.

Conclusions

In a large health care system, patients with eGFR<60 ml/min per 1.73 m2 who took direct oral anticoagulants for atrial fibrillation had slightly higher risk of bleeding compared with those on warfarin, but similar benefits from prevention of ischemic stroke.
APPLICATION OF NANOSTRUCTURES IN ANTIMICROBIAL THERAPY
Authors: Mahavir Joshi , Sneh Lata , Preeti Kanwar , Tulika Mishra
Published: July 2018

There are many infectious diseases that may be biofilm mediated, medical device-mediated or from some other agent, are now becoming life-threatening. Despite of availability of many antimicrobial agents, new drugs or therapeutics, these infections have continued to be a global health challenge. Nowadays, conventional antimicrobial agents have failed against many infections due to the emergence of multiple drug-resistant strains. Even, if there is a therapeutic efficacy of these drugs, there inappropriate amounts are resulting in an adequate therapeutic index, local and systematic side effects, including irritation, reduction in gut flora and other manifestations. To overcome such situations, nanostructures have exclusive physicochemical properties as they are ultra small, their size can be controlled, greater surface area to mass ratio, high reactivity and functionalizable structure. Encapsulation of antimicrobial drugs in these nanoparticle systems helps in reducing many side effects. It also helps in the sustained release of drug for a larger time period. Several metal and metal oxide nanoparticles such as silver, gold, zinc, etc. have shown a promising antimicrobial activity. Liposomes, polymeric nanoparticles, dendrimers, and solid lipid nanoparticles have achieved great success as efficient antimicrobial drug delivery systems. These nanoparticles use multiple biological pathways to exert their antimicrobial mechanism such as cell wall disruption, inhibition of RNA synthesis, protein synthesis, etc. Moreover,these preparations of nanoparticles are more cost-effective than that of antibiotic synthesis with lesser or no side effects.
DEVELOPMENT AND VALIDATION OF NOVEL RP-HPLC METHOD FOR THE SIMULTANEOUS ESTIMATION OF ELLAGIC ACID AND QUERCETIN IN AN AYURVEDIC FORMULATION
Authors: Jain Vandana , Shaikh Sultana
Published: July 2018

Objective: To develop a novel, accurate, precise and linear reverse phase high performance liquid chromatographic (RP-HPLC) method for simultaneous qualitative and quantitative estimation of ellagic acid and quercetin in an ayurvedic formulation and validate as per international conference on harmonization (ICH) guidelines.Methods: In the present work, good chromatographic separation was achieved isocratically using a shim-pack HPLC C18 column (4.6 x 250 mm, 5μm) and a mobile phase consisting of 0.02 M potassium dihydrogen orthophosphate buffer (pH adjusted to 3.5 with orthophosphoric acid) and acetonitrile in the ratio 60:40, at flow rate of 1.2 ml/min and column temperature maintained at 35 °C. The effluents obtained were monitored at 255 nm with UV-visible detector.Results: The retention time of ellagic acid and quercetin were found to be 1.65 min and 2.94 min respectively. Linearity of ellagic acid and quercetin were tested in the range of 6-14 ppm and 3-11 ppm respectively. The correlation coefficient for ellagic acid and quercetin were 0.997 and 0.993 respectively. The high recovery values (98 %-102 %) indicate a satisfactory accuracy. The low percent relative standard deviation (% RSD) values in the precision study reveals that the method is precise.Conclusion: The developed method is novel, simple, precise, rapid, accurate and reproducible for simultaneous quantitative estimation of ellagic acid and quercetin in an ayurvedic formulation. Hence the developed method can be used for quantitative analysis and quality control of extracts and commercial samples of other plant species and formulation containing these two markers.
DESIGN AND DEVELOPMENT OF SELF-MICROEMULSIFYING DRUG DELIVERY SYSTEMS (SMEDDS) OF TELMISARTAN FOR ENHANCEMENT OF IN VITRO DISSOLUTION AND ORAL BIOAVAILABILITY IN RABBIT
Authors: Sahoo Suvendu Kumar , Suresh Padilam , Acharya Usharani
Published: July 2018

Objective: The main purpose of this investigation was to prepare self-microemulsifying drug delivery system (SMEDDS) for enhancement of oral bioavailability of a poorly water soluble drug telmisartan (TLS), a BCS class II drug by improving its dissolution rate. Methods: Self-Emulsifying Drug Delivery Systems (SEDDS) of TLS were formulated using cinnamon essential oil as the oil phase, Gelucire 44/14 as the surfactant and Transcutol HP as co-surfactant. Drug-excipient interactions were studied by FTIR spectroscopy. The formulations were evaluated for its self-emulsifying ability, clarity, and stability of the aqueous dispersion after 48 h and the phase diagram was constructed to optimize the system. Selected formulations were characterized in terms of droplet size distribution, zeta potential, cloud point and were subjected to in vitro drug release studies. The bioavailability of optimized formulation was assessed in New Zealand white rabbits.Results: By considering smaller droplet size, higher zeta potential and faster rate of drug release the formulation TF9 was chosen as optimized SMEDDS formulations. TF9 was robust to different pH media and dilution volumes, remained stable after three cooling-heating cycles and after stored at 4 °C and 25 °C for 3 mo without showing a significant change in droplet size. The pharmacokinetic study in rabbits showed SMEDDS have significantly increased the Cmax and area under the curve (AUC) of TLS compared to suspension (P<0.05).Conclusion: SMEDDS can be an effective oral dosage form for enhancing aqueous solubility and improving oral bioavailability of poorly water soluble drugs.
HUBUNGAN ANTARA POSISI MENGEMUDI TERHADAP LOW BACK PAIN PADA SOPIR ANGKOT DI KOTA MALANG
Authors: Ibrahim Sengadji Muhamad , . Rahayu , . Nurkaput
Published: July 2018

HUBUNGAN ANTARA POSISI MENGEMUDI TERHADAP LOW BACK PAIN PADA SOPIR ANGKOT DI KOTA MALANG. Latar Belakang: Posisi mengemudi para sopir angkot dalam waktu berjam-jam dalam posisi duduk tanpa adanya perpindahan menjadi salah satu penyebab terjadinya penyakit seperti nyeri punggung sebagai dampak yang merugikan terhadap tubuh akibat aktivitas tubuh yang salah. Tujuan Penelitian: Mengetahui hubungan antara posisi mengemudi dan nyeri punggung bawah (Low Back Pain) pada sopir angkot yang ada di Terminal Arjosari Kota Malang. Metode Penelitian: Penelitian observasional analitik dengan pendekatan secara cross-sectional, dengan besar sampel sebanyak 93 orang sopir angkot sebagai responden. Analisis data dengan menggunakan statistik uji chi-square dan korelasi spearman dengan α=0.05. Hasil dan Diskusi: Menunjukkan bahwa sopir angkot yang ada di Terminal Arjosari Malang yang menjadi responden lebih banyak yang membutuhkan perubahan segera pada posisi mengemudinya (62.4%), dan banyak yang mengalami nyeri ringan di punggung (63.4%). Hasil pengujian menunjukkan bahwa antara posisi mengemudi dan nyeri punggung bawah (Low Back Pain) pada sopir angkot yang ada di Terminal Arjosari Kota Malang mempunyai keeratan hubungan yang signifikan (bermakna), dimana terdapat kecenderungan yang jelas bahwa seorang sopir yang posisi mengemudinya tergolong berbahaya, mempunyai resiko yang lebih tinggi mengalami nyeri punggung yang lebih berat, daripada sopir yang membutuhkan perubahan segera pada posisi mengemudinya. Kesimpulan: Terdapat hubungan yangsignifikan (bermakna) antara posisi mengemudi dengan nyeri punggung bawah (Low Back Pain) pada sopir angkot yang ada di Terminal Arjosari Kota Malang.Kata Kunci: posisi mengemudi, sopir, Low back pain
HUBUNGAN USIA IBU HAMIL BERISIKO DENGAN KEJADIAN PREEKLAMPSIA/EKLAMPSIA DI RSU HAJI SURABAYA PERIODE 1 JANUARI 2013 - 31 DESEMBER 2013
Authors: Putri Haryani1 Ayu , Maroef Moch , Adilla N Sri
Published: July 2018

Hubungan Usia Ibu Hamil Berisiko dengan Kejadian Preeklampsia/Eklampsia di RSU Haji Surabaya Periode 01 Januari 2013-31 Desember 2013. Preeklampsia/eklampsia menjadi penyulit pada 5-10% kehamilan di dunia.Salah satu faktor risiko preeklampsia/eklampsia adalah usia <20 tahun atau >35 tahun.Usia ibu < 20 tahun dipengaruhi oleh immaturitas biologis, kehamilan tidak diinginkan, asuhan ante natal inadekuat, dan kecukupan nutrisi yang buruk. Usia >35 tahun berubungan dengan kerusakan sel endothel pembuluh darah karena proses penuaan. Penelitian ini bertujuan mengetahui hubungan usia ibu hamil berisiko dengan kejadian preeklampsia/eklampsia di RSU Haji Surabaya periode 01 Januari 2013-31 Desember 2013. Penelitian bersifat Observasional Analitik dengan pendekatan secara Cross Sectional Study. Sampel dalam penelitian ini adalah rekam medis ibu hamil yang terdiagnosis preklampsia/eklampsia di RSU Haji Surabaya peridoe 01 januari 2013-31 Desember 2013.Teknik pengambilan sampel menggunakan total sampling. Dan dianalisis dengan uji Chi-square. Hasil Uji Chi-Square didapatkan nilai p=0,000 . Nilai ini lebih kecil dari α=0,05 dan RR <1 (RR= 2,146). Sehingga dapat disimpulkan bahwa terdapat hubungan antara usia ibu hamil berisiko dengan kejadian preeklampsia/eklampsia. Wanita pada kelompok usia <20 tahun dan >35 tahun lebih berisiko mengalami Preeklampsia daripada kelompok usia 20-35 tahun. Kesimpulan ada hubungan antara usia ibu hamil berisiko  dengan kejadian preeklampsia/eklampsia di RSU Haji Surabaya periode 01 Januari 2013-31 Desember 2013.
HUBUNGAN ANTARA OVERWEIGHT DENGAN NYERI PUNGGUNG BAWAH DI RSUD KANJURUHAN KEPANJEN PERIODE JANUARI-DESEMBER TAHUN 2013
Authors: Aisyiah Fitriyani Nurhiqmah , EBS Febri , Andari Desy
Published: July 2018

HUBUNGAN ANTARA OVERWEIGHT DENGAN NYERI PUNGGUNG BAWAH DI RSUD KANJURUHAN KEPANJEN PERIODE JANUARI-DESEMBER TAHUN 2013. Latar Belakang: Nyeri punggung bawah merupakan suatu gangguan muskuloskeletal pada daerah punggung bawah yang banyak dikeluhkan penderita yang berkunjung ke dokter. Banyak faktor yang dapat memperberat resiko terjadinya nyeri punggung bawah, salah satunya adalahoverweight. Tujuan Penelitian: Mengetahui hubungan, kuatnya pengaruh dan besarnya factor resiko antara overweight dengan nyeri punggung bawah di RSUD Kanjuruhan Kepanjen periode Januari-Desember tahun 2013. Metode Penelitian: Penelitian observasional analitik dengan pendekatan cross sectional, dengan besar sampel sebanyak 82 orang yaitu 41 penderita nyeri punggung bawah dan 41 orang lainnya penderita non nyeri punggung bawah. Analisis data dengan menggunakan statistik uji chi-square dengan á=0.05 dan uji korelasi koefisien kontingensi. Hasil Penelitian: Menunjukkan bahwa penderita dengan diagnosis nyeri punggung bawah yang datang ke RSUD Kanjuruhan Kepanjen memiliki indeks massa tubuh kategori overweight (30.5%), sedangkan sampel yang overweight tapi non nyeri punggung bawah (13.4%). Kesimpulan: Terdapat hubungan yang signifikan antara overweight dengan nyeri punggung bawah di RSUD Kanjuruhan Kepanjen periode Januari-Desember tahun 2013 (p= 0.002). Overweight memberikan pengaruh yang tidak begitu kuat (lemah) terhadap nyeri punggung bawah (r= 0.325) dan seseorang yang overweight mempunyai resiko yang lebih besar untuk mengalami nyeri punggung bawah (OR= 4.261). Kata Kunci: Overweight, Nyeri punggung bawah
EKSTRAK NIGELLA SATIVA L MENINGKATKAN EKSPRESI HNF-4Α PADA TIKUS MODEL FIBROSIS HATI
Authors: Safithri Fathiyah
Published: July 2018

Latar Belakang : Sirosis hati merupakan stadium akhir fibrosis hati. Pasien sirosis hati yang mengonsumsi N. sativa mengalami perbaikan berupa berkurangnya udem tungkai dan ascites serta peningkatan kadar albumin serum. Peningkatan kadar albumin serum mungkin disebabkan terjadi regenerasi hepatosit melalui diferensiasi sel punca endogen menjadi hepatoblas dengan markernya berupa HNF-4α Tujuan penelitian : untuk membuktikan terjadi peningkatan ekspresi HNF-4α setelah pemberian N. sativa pada tikus yang diinduksi CCl4 Metode penelitian : ekspreimental dengan rancangan a randomized post test only control group design, menggunakan 35 ekor tikus yang dibagi menjadi lima kelompok, normal, kontrol fibrosis hati dan fibrosis hati yang mendapat terapi N. sativa dengan 3 dosis berbeda. Induksi fibrosis hati dengan injeksi CCl4 1ml/kgBB i.p tiga kali/minggu selama 8 minggu. Setelah induksi CCl4, diberikan ekstrak N. sativa p.o 1,2; 2,4; 4,8 g/kgBB selama 4 minggu. Pada akhir penelitian, tikus dimatikan, organ hati diambil untuk diamati ekspresi HNF-4α dengan immunohistokimia. Hasil penelitian dan diskusi: Pemberian ekstrak N sativa meningkatkan ekspresi HNF-4α (p<0,001) dibandingkan dengan kelompok kontrol. Ekstrak N sativa memberikan pengaruh pada ekspresi HNF-4α (p<0,001; R2=81%). Kesimpulan : Ekstrak N sativa dapat meningkatkan ekspresi HNF-4α pada tikus model fibrosis hatiKata kunci : Nigella sativa. liver fibrosis, ekspresi HNF-4α
SINDROMA HIPERVENTILASI
Authors: Sis Indrawanto Iwan
Published: July 2018

Sindroma hiperventilasi merupakan gangguan yang sering didapatkan di Unit Gawat Darurat dimana penderita mengeluh sesak dan nyeri dada. Penderita seringkali sangat panik dan ketakutan serta bernafas dengan cepat dan dalam. Tak jarang dokter dan penderitanya menduga terkena serangan jantung/ angina pectoris atau gangguan pernafasan serius, sehingga dilakukan berbagai pemeriksaan yang memberatkan secara finansial dan membuat penderita semakin meyakini bahwa ia mengalami gangguan organik/ fisik. Sindroma ini merupakan gangguan psikiatrik yang pada umumnya terjadi bersamaan/ mengikuti gangguan panik.Kata Kunci: Sindroma hiperventilasi, gangguan panik
SISTEM PEMBIAYAAN KESEHATAN
Authors: Endra Budi Setyawan Febri
Published: July 2018

Pembangunan kesehatan adalah bagian dari pembangunan nasional, dalam pembangunan kesehatan tujuan yangingin dicapai adalah meningkatkan derajat kesehatan masyarakat yang optimal. Kenyataan yang terjadi sampai saat ini derajat kesehatan masyarakat masih rendah khususnya pada masyarakat miskin. Hal ini dapat digambarkan bahwa derajat kesehatan masyarakat miskin berdasarkan indikator Angka Kematian Bayi (AKB) dan Angka Kematian Ibu (AKI) di Indonesia, masih cukup tinggi, yaitu AKB sebesar 35 per 1000 kelahiran hidup dan AKI sebesar 307 per 100.000 kelahiran hidup. Salah satu penyebabnya adalah karena mahalnya biaya kesehatan sehingga akses ke pelayanan kesehatan pada umumnyamasih rendah. Asuransi kesehatan adalah salah satu upaya untuk mengatasi masalah ketidakmampuan terhadap pembiayaan pelayanan kesehatan.
HUBUNGAN ANTARA RISIKO TERJADINYA KATARAK SEKUNDER DENGAN BERBAGAI TEKNIK OPERASI KATARAK DI RSUD dr.SAIFUL ANWAR MALANG PERIODE JANUARI – DESEMBER 2008
Authors: Wifaaq Thalib
Published: July 2018

Angka kejadian katarak sekunder akibat sisa kapsul lensa anterior yang menyebabkan kekeruhan lensa posterior pasca bedah katarak masih tinggi. Gangguan penglihatan yang ditimbulkan oleh katarak sekunder bisa lebih buruk dari gangguan penglihatan sebelum operasi katarak. Tujuan penelitian ini untuk mengetahui hubungan antara risiko terjadinya katarak sekunder dengan berbagai teknik operasi katarak. Metode penelitian yang digunakan adalah observasional analitik dengan pendekatan cross sectional study menggunakan data rekam medis. Sampel yang diambil adalah total sampling pasien yang menderita katarak sekunder sebanyak 16 orang di RSUD dr.Saiful Anwar Malang periode Januari – Desember 2008. Penelitian dilakukan pada Januari – Februari 2010. Pasien yang mengalami katarak sekunder dengan teknik operasi EKEKsebanyak 11 orang, dan pasien katarak sekunder dengan teknik operasi fakoemulsifikasi sebanyak 5 orang. Data yang di dapat diolah dengan uji Chi-Square didapatkan nilai P (signifikansi) untuk teknik EKEK sebesar 0,280 (p > 0,05) dan nilai P (signifikansi) untuk teknik fakoemulsifikasi sebesar 0,280 (p > 0,05) yang berarti kedua teknik tersebut tidak ada hubungan yang signifikan dengan terjadinya katarak sekunder. Kesimpulan dari penelitian ini, antara risiko terjadinya katarak sekunder dengan berbagai teknik operasi katarak tidak berhubungan.Kata Kunci: Katarak Sekunder dan Teknik Operasi Katarak.
JUS BELIMBING MANIS (AVERRHOA CARAMBOLA L.) SEBAGAI HEPATOPROTEKTOR PADA TIKUS PUTIH (RATTUS NOVERGICUS STRAIN WISTAR) YANG DIINDUKSI ANTITUBERKULOSIS RIFAMPISIN DAN ISONIAZID
Authors: Hermayanti Diah , Syafitri Fathiyah , Devi Iralawati Antia
Published: July 2018

Latar Belakang: Rifampisin dan isoniazid merupakan obat yang direkomendasikan dalam pengobatan Tuberkulosis yang memiliki efek samping hepatotoksisitas. Jus belimbing manis diduga mempunyai efek hepatoprotektor karena mengandung flavonoid, tanin, dan vitamin C. Tujuan: Membuktikan efek hepatoprotektor jus belimbing manis terhadap penurunan kadar SGOT, SGPT, dan MDA tikus putih jantan yang diinduksi rifampisin dan isoniazid. Metode: Eksperimental, Post Test Only Control Group Design. Sampel dibagi 5 kelompok perlakuan. Kontrol negatif, kontrol positif diberi rifampisin dan isoniazid masing-masing200 mg/KgBB/hari, dan 3 kelompok perlakuan yang diberi rifampisin, isoniazid, dan jus belimbing manis dengan dosis 4 ml/ hari, 8 ml/hari, 12 ml/hari selama 14 hari. Data dianalisis dengan uji One-Way ANOVA, uji korelasi, dan uji regresi. Hasil Penelitian dan Diskusi: Analisa statistik dilakukan untuk masing-masing variabel dependent SGOT, SGPT, dan MDA. Uji One-Way ANOVA Sig 0,000<p(0,05) menunjukkan adanya perbedaan yang bermakna antar perlakuan. Uji korelasi Sig 0,000< p(0,05) dengan koefisiensebesar -0,827 dan -0,852, dan -0,555 mempunyai korelasi yang sangat kuat, yaitu semakin tinggi dosis jus belimbing manis maka semakin rendah kadar SGOT dan SGPT. Hasil uji regresi menunjukkan jus belimbing manis berpengaruh terhadap penurunan kadar SGOT , SGPT, dan MDA sebesar 68,4%, 72,6%, dan 27,9%. Dosis jus belimbing manis 12 ml/hari merupakan dosis optimaluntuk menurunkan kadar SGOT dan SGPT. Kesimpulan: Jus belimbing manis memiliki efek hepatoprotektor terhadap penurunan kadar SGOT, SGPT, dan MDA tikus putih jantan yang diinduksi rifampisin dan isoniazid.Kata Kunci: Jus belimbing manis (Averrhoa carambola L.), hepatoprotektor, antituberkulosis
PENGARUH PEMBERIAN EKSTRAK DAUN KELOR (Moringa oleifera lam.) TERHADAP SEL KARDIOMIOSIT PADA TIKUS PUTIH (Rattus novergicus strain wistar) DENGAN DIET ATEROGENIK
Authors: Alverina Cindy , Andari Desy , Prihanti Gita Sekar
Published: July 2018

ABSTRAK Hiperkolesterolemia akan menyebabkan aterosklerosis yang menjadi faktor resiko yang kuat terhadap penyakit kardiovaskular yang ditandai dengan kerusakan kardiomiosit. Penyakit kardiovaskular menjadi salah satu penyebab kematian terbesar pada usia produktif. Ekstrak daun kelor (Moringa oleifera lam.) dengan kandungan vitamin C dan beta karoten diduga mencegah nekrosis kardiomiosit sehingga menurunkan resiko penyakit kardiovaskular. Penelitian ini bertujuan untuk mengetahui pengaruh ekstrak daun kelor (Moringa oleifera Lam.) terhadap sel kardiomiosit jantung pada tikus putih (Rattus novergicus strain wistar) dengan diet aterogenik. Penelitian ini menggunakan metode post test only control group design  yang terbagi dalam 4 kelompok acak yaitu kelompok kontrol (diet aterogenik) dan 3 kelompok perlakuan (ekstrak daun kelor 200mg/KgBB, 400mg/KgBB dan 600mg/KgBB). Setiap kelompok terdiri 5 hewan coba dengan perlakuan selama 35 hari. Setiap kelompok dibuat preparat histologi jantung (pewarnaan HE) dan diamati dibawah mikroskop(400x) dengan bimbingan ahli patologi anatomi. Hasil uji one-way ANOVA menunjukkan terdapat perbedaan antar kelompok tikus (p<0,05). Hasil uji post hoc menunjukkan dosis 600mg/KgBB yang paling signifikan dalam mencegah nekrosis kardiomiosit. Ekstrak daun kelor (Moringa oleifera lam.) berpengaruh sebesar 78,5% terhadap jumlah nekrosis kardiomiosit, hal ini diduga disebabkan adanya kandungan vitamin C, beta karoten, beta sitosterol, flavonoid dan polyphenol.Kata Kunci : Ekstrak daun kelor, Diet Aterogenik, Nekrosis Kardiomiosit.
PENGARUH PENGGUNAAN KONTRASEPSI ORAL TERHADAP KEJADIAN Fibrodenoma Mammae DI RUMAHSAKIT ANGKATAN DARAT BRAWIJAYA SURABAYA PERIODE 1 JANUARI – 31 DESEMBER 2014
Authors: Wahyuningsih Yuanita , Sander Mochamad Aleq , Suharto Dr
Published: July 2018

Fibroadenoma mammae merupakan tumor jinak, konsistensi solid, berbentuk bulat, terasa nyeri saat menstruasi, yang berasal dari salah satu lobulus payudara. Penggunaan kontrasepsi oral dapat menyebabkan terjadinya tumor jinak payudara dan fibroadenoma mammae. Mengetahui pengaruh penggunaan kontrasepsi oral terhadap angka kejadian fibroadenomamammae di Rumah Sakit Angkatan Darat Brawijaya Surabaya Periode 1 Januari – 31 Desember 2014.Penelitian observasional analitik dengan rancangan cross sectional. Teknik pengambilan sampel menggunakan total sampling  dengan besar sampel sebanyak 30 sampel. Data yang diambil meliputi usia dan penggunaan kontrasepsi oral. Data yang diperoleh dianalisis dengan menggunakan uji korelasi kontingensi. Hasil penelitian didapatkan 30 pasien fibroadenoma mammae yang juga menggunakan kontrasepsi oral. Pasien dengan usia terbanyak 26-30 tahun (14 pasien; 46,7%). Pasien yang menggunakan kontrasepsi oral tunggal (13 orang; 43,3%) dan kontrasepsi oral kombinasi (17 orang; 56,7%). Uji korelasi kontingensi didapatkan nilai p signifikan (<0,05) yang berarti terdapat pengaruh penggunaan kontrasepsi oral terhadap angka kejadian fibroadenomamammae di Rumah Sakit Angkatan Darat Brawijaya Surabaya.Terdapat pengaruh yang bermakna pada penggunaan alat kontrasepsi oral terhadap angka kejadian fibroadenoma mammae.Kata kunci : Usia, kontrasepsi oral, fibroadenoma mammae.
ANALISIS FAKTOR RISIKO HIPERTENSI PRIMER PADA LANSIA DI PUSKESMAS DINOYO MALANG
Authors: Putri Friska Ardiani , Budisetyawan Febri Endra , Rahayu Dr
Published: July 2018

Analisis faktor risiko hipertensi primer pada lansia di puskesmas Dinoyo Malang. Hipertensi primer merupakan penyakit degeneratif pertama yang banyak diderita oleh lansia. Modifikasi pola hidup dapat menurunkan faktor  risiko terjadinya hipertensi primer. Penelitian ini bertujuanmengetahui hubungan antara faktor risiko  hipertensi primer dengan timbulnya hipertensi primer pada lansia di puskesmas Dinoyo Malang. Metode yang digunakan adalah Analytical observation dengan pendekatan cross sectional yang dilakukan di Puskesmas Dinoyo Malang. Teknik pengambilan sampel menggunakan purposive random sampling dengan jumlah sampel 103 responden. Data dianalisis secara bivariat dan multivariate dengan regresi logistik. Faktor-faktor yang terbukti sebagai faktor risiko hipertensi adalah konsumsi asin p=0,000; konsumsi zat aditif p=0,000; konsumsi lemak p=0,000; konsumsi kopi p=0,000; merokok p=0,000;  stres psikologis p=0,000, jenis kelamin p=0,000, pendidikan p=0,000; olahraga p=0,000; indeks massa tubuh p=0,000; faktor layanan kesehatan p=0,526 tidak signifikan dikarenakan banyak faktor yang mempengaruhi kepatuhan seseorang untuk melakukan pengobatan hipertensi. Hasil uji regresi logistik signifikansi=0,95 (>0,1) berarti tidak ada faktor yang paling memengaruhi timbulnya hipertensi primer. Kesimpulannya adalah terdapat hubungan antara faktor risiko dengan timbulnya hipertensi primer pada lansia di puskesmas Dinoyo Malang, namun tidak ada hubungan yang bermakna antara faktor layanan kesehatan dengan hipertensi primer.Kata kunci : Faktor risiko, Hipertensi primer, Lansia
HUBUNGAN TINGKAT AKTIVITAS EKSTRAKURIKULER TERHADAP TINGKAT KECEMASAN ANAK USIA SEKOLAH DASAR
Authors: Hanifah Ilma
Published: July 2018

Anak-anak masa kini memiliki waktu bermain delapan jam lebih sedikit dibandingkan dua puluh tahun lalu dikarenakan aktivitas di luar jam sekolah yang padat. Salah satu akibatnya adalah muncul tanda-tanda kecemasan. Dari penelitian sebelumnya didapatkan siswa yang mengikuti banyak aktivitas di luar jam sekolah muncul adanya tanda-tanda kecemasan seperti jantung berdebar kencang dan keras (46,7%), merasa sukar berkonsentrasi pada saat melakukan kegiatan (43,3%) dan merasa sangat lemas/lesu/tidak memiliki tenaga (43,3%) dibandingkan dengan siswa yang tidak mengikuti banyak aktivitas di luar jam sekolah. Penelitian ini bertujuan untuk mengetahui hubungan tingkat aktivitas ekstrakurikuler terhadap tingkat kecemasan anak usia sekolah dasar. Metode yang digunakan dalam penelitian ini adalah observasional analitik dengan desain cross sectional. Kuesioner yang digunakan adalah kuesioner Revised Children’s Manifest Anxiety Scale (RCMAS). Analisis hubungan dilakukan dengan menggunakan uji komparasi Kruskal Wallis dan Mann-Whitney. Hasil penelitian menunjukkan sebanyak 56% responden memiliki tingkat aktivitas ekstrakurikuler tinggi. Responden yang mengalami kecemasan, sebanyak 27% , memiliki tingkat aktivitas ekstrakurikuler tinggi. Ekstrakurikuler terbanyak yang diikuti adalah tambahan mata pelajaran (53%).Kata kunci: Tingkat ekstrakurikuler, tingkat kecemasan, anak
HUBUNGAN PERSEPSI MASYARAKAT TENTANG KUALITAS PELAYANAN POSYANDU LANSIA TERHADAP KUNJUNGAN POSYANDU LANSIA DI PUSKESMAS X KOTA KEDIRI
Authors: Prihanti Gita Sekar , Rachmadana Genio , Ramadani Irvia Widya
Published: July 2018

Latar Belakang : Pembangunan kesehatan yang merupakan salahsatu program prioritas dalam mewujudkan agenda pembangunan nasional mempunyai arah kebijakan yaitu meningkatnya akses masyarakat terhadap pelayanan kesehatan masyarakat yang ditandai dengan meningkatnya angka harapan hidup, meningkatkankesejahteraanhidup, dan meningkatkan kesehatan masyarakat terutama, masyarakat lansia. Metode : Desain penelitian cross sectional. Pengambilan sampel dengan teknik total sampling. Jumlah sampel 81 orang. Pelaksanaan penelitian dilakukan di Bulan Mei 2016. Hasil Penelitian : Berdasarkan hasil kuesioner didapatkan laki-laki 13 orang (16%) dan wanita 68 orang (84%). Dari penelitian di dapatkan dimensi kualitas pelayanan empathy mempunyai pengaruh paling besar dengan rata-rata terbanyak sebesar 3.96. Hasil analisis multivariate regresi logistik didapatkan hubungan yang signifikan antara dimensi kualitas pelayanan empathy terhadap kunjungan posyandu lansia yaitu dengan (p =0,022). Kesimpulan : Terdapat hubungan antara persepsi masyarakat tentang kualitas pelayanan Posyandu Lansia terhadap kunjungan lansia lansia di Puskesmas X Kota Kediri. Kata Kunci: persepsimasyarakat, kualitaspelayanan, posyandulansia, Puskesmas X.