bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analisis Komposisi Jenis dan Kelimpahan Zooplankton di Perairan Kampung Nafri, Kota Jayapura
Authors: Sremsrem Nikodemus , Kubelaborbir Triana Mansye , Lewaherilla Niki Elistus 
Published: October 2023

This study aimed to determine the type, composition, and abundance of zooplankton in the waters of Kampung Nafri. Zooplankton were identified using zooplankton sample identification guidelines, and zooplankton abundance analysis was performed using the Sedgewick Rafter. Purposive sampling was used in this study. Zooplankton sampling was carried out horizontally on the surface of the water using a plankton net which was carried out in the morning around 08:00 - 10:30 WIT at 3 stations. Sampling at each station was done 2 times repetition and the water parameters were done 3 times repetition. In situ measurement of water quality parameters, such as salinity, pH, current speed, and temperature Based on the identification results, there are 11 types of zooplankton that inhabit the waters of Kampung Nafri. The highest value of zooplankton species composition in Nafri Waters was Naplius sp., which was 63%, and the lowest was Temora sp. and Corycaeus sp. by 1%. The highest abundance of zooplankton species in Nafri Waters was Nauplius sp. (Copepoda larvae), with a total abundance of 9,900 ind/l, and the lowest was Corycaeus sp. and Temora sp., with a total abundance of 200 ind/l.
IMPACTS OF CLIMATE CHANGE VARIABILITY ON LIVESDTOCK HEALTH IN ARID AND SEMI ARID LAND IN KENYA A CRITICAL LITERATURE REVIEW A LITERATURE REVIEW
Authors: Jones Japheth 
Published: October 2023

Purpose: Livestock plays a critical role in the livelihood of the pastoralists who inhabit the arid and semi- arid lands (ASAL) areas of Kenya. ASALs experiences erratic and unreliable rainfall that is normally interspersed by long and frequent droughts. Loss of dependable livelihood assets impoverishes the communities in ASALs areas and exposes them to the vagaries of food insecurity. The main objective of this study is to establish the impacts of climate variability on livestock health in ASALs.
Methodology: The paper used a desk study review methodology where relevant empirical literature was reviewed to identify main themes and to extract knowledge gaps.
Results: Climate change in ASALs is positively and significantly related to the occurrence of livestock diseases. Significance variations in certain weather elements may have modified the ecosystems of the diseases causing an increase in pathogens and vectors populations.
Unique Contribution to Theory and Practice: An early warning system, extension education, strategic disease management interventions, water provision and establishing a national pasture reserve for the pastoralists in ASALs in severe drought periods are ways in which cases of livestock diseases can be reduced.
Minimally invasive right axillary thoracotomy without cardiopulmonary bypass for repair of anomalous origin of the pulmonary artery arises from brachiocephalic trunk: A case report
Authors: Do Anh Tien , Nguyen Huy Hoang , Nguyen Viet Hung , Nguyen Tran Thuy 
Published: October 2023

Anomalous origin of the pulmonary artery is one of rarely congenital heart diseases (CHDs), accounts for about 0,096% CHDs. These leisons include: one pulmonary artery originates from ascending aorta and one pulmonary artery originates from truns pulmonary artery. Most patients undergo classic open heart surgery for repair. We present a case of anomalous origin of the pulmonary artery arises from brachiocephalic trunk. Successful repair was accomplished using a minimally invasive right axillary thoracotomy without Cardiopulmonary bypass.
Treatment result of secondary complications in arteriovenous shunting for haemodialysis
Authors: Nguyen Do Nhan , Do Kim Que 
Published: October 2023

Background: artery-vien fistula is useful. Complicated cases are variable and can lead to dead. Objectives: Characteristics of AVF complication cases. Treatment results.
Methodology: Retrospective, descriptive study on AVF complications cases, which were treated (surgical management or endovascular intervention) from 01/2015 to 01/2020 at Thong Nhat hospital. [1]
Results: 81 cases, male is 54%, male/female ratio is 1,19/1. Before treatment: shunting failure (43), increasing flow (13), aneurysm (07), infection (9) and narrow returning vien (8). After treatment: The average time was 92,8 + 45minutes. Good results for 69.1% (discharge from hospital), 54,3% (12 months). Post-operation complications cases: occlusions of the fistula (07), anastomotic stenosis (07), infections (07). Primary complication cases are failure.
Conclusion: primary complication cases are failure. Good results were achieved for 56 cases – 69,1% (early period), 44 cases – 54,3% (12 months).
Construção de um modelo teórico dejouriano destinado à avaliação da saúde do trabalhador - doi: 10.5020/18061230.2012.p374
Authors: Katsurayama Marilise de , Parente Rosana Cristina Pereira , Moretti-Pires Rodrigo Otávio 
Published: October 2023

Construir um modelo teórico destinado às pesquisas avaliativas da saúde do
trabalhador na Estratégia Saúde da Família, suportado pela teoria de Christophe Dejours.
Métodos: O modelo teórico foi construído entre o período de setembro a dezembro de 2010,
através da integração da teoria de Dejours com os fatos, a situação atual do trabalhador
da saúde, representada pelos documentos oficiais, o que permitiu a instrumentalização
do pensamento, tornando abordáveis as propriedades relativas à saúde do trabalhador.
Resultados: A teoria Dejouriana, por abordar a dinâmica dos processos psíquicos envolvidos
na confrontação do sujeito com a realidade do trabalho, voltando para o interesse das vivências
subjetivas dos sujeitos (principal fonte de prazer e sofrimento no trabalho), foi tomada
como base na construção deste modelo. Diante da influência da organização do trabalho
na saúde do trabalhador torna-se indispensável a análise das variáveis que influenciam o
processo prazer-sofrimento destes atores importantes nas práticas de saúde reorganizadoras
da atenção primária. Conclusão: Revela-se grande potencial na teoria de Christophe Dejours
para a análise dos processos psíquicos envolvidos na confrontação do trabalhador da atenção
primária com sua realidade, visto que é fundamental o entendimento de como se manifestam
as questões referentes ao trabalho em saúde e a forma com que este reagirá às dificuldades
das situações de trabalho.
ĐÁNH GIÁ KẾT QUẢ PHẪU THUẬT ĐIỀU TRỊ VIÊM TAI DÍNH CÓ TẠO HÌNH MÀNG NHĨ BẰNG SỤN VÀ CHỈNH HÌNH XƯƠNG CON
Authors: Nguyễn Thị Tố Uyên , Trịnh Đắc Chung 
Published: October 2023

Phương pháp: Sử dụng phương pháp mô tả từng trường hợp có can thiệp nhằm đánh giá kết quả sau tạo hình hệ thống xương con và phục hồi màng nhĩ bằng sụn ở bệnh nhân viêm tai dính. Kết quả: Có 15 bệnh nhân với 16 tai phẫu thuật. Độ tuổi trung bình là 40,06 ± 11,16 tuổi. Gián đoạn chuỗi xương con do mòn cành xuống xương đe ở 14/16 tai (87,5%), xương bàn đạp còn nguyên vẹn ở 16/16 tai. Vật liệu làm trụ dẫn đa dạng: xương đe 5/16 tai, sụn 7/16 tai và mảnh vỏ xương chũm 4/16 tai. Tất cả 13/13 tai tạo hình màng nhĩ toàn bộ bằng sụn không tái phát viêm tai dính, trong khi đó 2/3 tai tạo hình màng nhĩ một phần bằng sụn có tái phát viêm tai dính. Sau phẫu thuật, trung bình ngưỡng nghe đường xương tốt lên 6,01 ± 9,88 dB, trung bình PTA tốt lên 9,76 ± 13,58 dB, trung bình ABG cải thiện PT 3,67 ± 13,75 dB. Kết luận: Phẫu thuật điều trị viêm tai dính nên tạo hình màng nhĩ toàn bộ bằng sụn để tránh tái phát bệnh, việc kết hợp chỉnh hình xương con giúp cải thiện chức năng nghe.
ĐÁNH GIÁ MỐI LIÊN QUAN GIỮA MỨC ĐỘ SA SINH DỤC VỚI KÍCH THƯỚC KHE SINH DỤC TRÊN CỘNG HƯỞNG TỪ ĐỘNG HỌC SÀN CHẬU
Authors: Hoàng Đình Âu , Lục Thị Huyền Ngọc 
Published: October 2023

Mục đích: Mô tả mối liên quan giữa kích thước khe sinh dục (GH- Genital Hiatus) với mức độ sa sinh dục trên cộng hưởng từ động học sàn chậu ở nhóm bệnh nhân nữ đến khám tại Bệnh viện Đại học Y Hà nội vì rối loạn chức năng sàn chậu. Đối tượng và phương pháp nghiên cứu: nghiên cứu mô tả cắt ngang trên 52 bệnh nhân có rối loạn chức năng sàn chậu trên lâm sàng, được chụp cộng hưởng từ động học sàn chậu và được chẩn đoán sa sinh dục tại bệnh viện Đại học Y Hà Nội từ 10/2021 đến 05/2023. Sa sinh dục được phân làm 4 độ trên CHT dựa vào mốc cổ tử cung (hoặc vòm âm đạo) so với đường mu cụt ở thì tống phân (độ 0: không sa, độ 1: sa nhẹ, độ 2: sa vừa, độ 3: sa nặng. Tính trung bình ± độ lệch của sa cổ tử cung (vòm âm đạo) phía dưới đường mu cụt (PCL) và của khe sinh dục thì rặn. So sánh kích thước khe sinh dục với các mức độ sa sinh dục phân loại trên cộng hưởng từ và đánh giá mối liên quan giữa 2 yếu tố dựa vào kiểm định Pearson. Kết quả: Tuổi trung bình là 61.1±14.3, cao nhất là 90 tuổi và thấp nhất là 27 tuổi. Tỷ lệ sa sinh dục gặp nhiều nhất ở lứa tuổi 50-80 tuổi (chiếm 65.4%). Tỷ lệ BN đã mãn kinh là 76.9%. Phần lớn (92.3%) bệnh nhân sinh con theo đường âm đạo. Tỷ lệ sinh từ 2 con trở lên là 90.4%, tỷ lệ sinh từ 3 con trở lên là 40.4%. Có 4/52 BN có tiền sử cắt tử cung, chiếm 7.7%. Khoảng cách trung bình CTC (hoặc vòm âm đạo) phía dưới PCL thì rặn là 33.2±20 mm, thấp nhất là 6 mm, cao nhất là 90 mm. Có 22 BN sa sinh dục độ 1, chiếm 42.3%, có 23 BN sa độ 2, chiếm 44.2%, có 7 BN sa độ 3 chiếm 13.5%. Kích thước trung bình khe sinh dục là 50.7±10 mm. Kích thước khe sinh dục tương ứng với sa độ 1, độ 2, độ 3 lần lượt là 46.8±8.8, 52.8±8.5, 56 ±14.4 mm. Kiểm định Pearson cho thấy có mối tương quan giữa kích thước khe sinh dục với mức độ sa sinh dục với r=0.36, p=0.008. Có sự khác biệt có ý nghĩa thống kê về kích thước khe sinh dục giữa sa sinh dục độ 1 và độ 2 (p=0.026) nhưng không có sự khác biệt có ý nghĩa thống kê giữa các độ sa sinh dục còn lại. Kết luận: Cộng hưởng từ động sàn chậu cho thấy mối tương quan tương đối mạnh giữa kích thước khe sinh dục và mức độ sa sinh dục, từ đó giúp lựa chọn phương pháp điều trị.
Changes in biogenic volatile organic compound emissions in response to the El Niño–Southern Oscillation
Authors: Vella Ryan , Pozzer Andrea , Forrest Matthew , Lelieveld Jos , Hickler Thomas , Tost Holger 
Published: October 2023

Abstract. Emissions of biogenic volatile organic compounds (BVOCs) from the terrestrial biosphere play a significant role in major atmospheric processes. BVOCs are highly reactive compounds that influence the atmosphere's oxidation capacity and also serve as precursors for the formation of aerosols that influence global radiation budgets. Emissions depend on the response of vegetation to atmospheric conditions (primarily temperature and light), as well as other stresses, e.g. from droughts and herbivory. The El Niño–Southern Oscillation (ENSO) is a naturally occurring cycle arising from anomalies in the sea surface temperature (SST) in the tropical Pacific. ENSO perturbs the natural seasonality of weather systems on both global and regional scales and is considered the most significant driver of climate variability. Several studies have evaluated the sensitivity of BVOC fluxes during ENSO events using historical transient simulations. While this approach employs realistic scenarios, it is difficult to assess the impact of ENSO alone given the multiple types of climate forcing, e.g. from anthropogenic emissions of CO2 and aerosol. In this study, a global atmospheric chemistry–climate model with enabled interactive vegetation was used to conduct two sets of simulations: (1) isolated ENSO event simulations, in which a single ENSO event is used to perturb otherwise baseline conditions, and (2) sustained ENSO simulations, in which the same ENSO conditions are reproduced for an extended period of time. From the isolated ENSO events, we present global and regional BVOC emission changes resulting from the immediate response of vegetation to atmospheric states. More focus is given to the sustained ENSO simulations, which have the benefit of reducing the internal variability for more robust statistics when linking atmospheric and vegetation variables with BVOC flux anomalies. Additionally, these simulations explore long-term changes in the biosphere with potential shifts in vegetation in this possible climate mode, accounting for the prospect of increased intensity and frequency of ENSO with climate change. Our results show that strong El Niño events increase global isoprene emission fluxes by 2.9 % and that one single ENSO event perturbs the Earth system so markedly that BVOC emission fluxes do not return to baseline emissions within several years after the event. We show that persistent ENSO conditions shift the vegetation to a new quasi-equilibrium state, leading to an amplification of BVOC emission changes with up to a 19 % increase in isoprene fluxes over the Amazon. We provide evidence that BVOC-induced changes in plant phenology, such as the leaf area index (LAI), have a significant influence on BVOC emissions in the sustained ENSO climate mode.
Monitoring the spread of leptospirosis agent as one of the reasons of low-quality milk
Authors: Zaritskyi Ruslan , Zhuk Yurii , Kovpak Vitalii , Derkach Serhii , Masalovych Yurii , Mazur Valerii , Cheverda Ivan , Svyrydenko Nataliіa , Drachuk Ihor , Zhurenko Vitalii 
Published: October 2023

On the global scale of the zoonoses problem, leptospirosis is among the five diseases that pose the greatest threat to humankind today. Leptospirosis is a worldwide zoonotic disease caused by pathogenic Leptospira species. In general, leptospirosis has been registered in more than 150 species of mammals. There are about 300 serovars of Leptospira spp. Serovar Hardjo is one of the most common causes of leptospirosis among cattle globally. In cows, the infection can be completely asymptomatic or cause abortions, stillbirths, infertility, and mastitis. The study's relevance is determined by the negative impact on the economy – productivity loss, and high cost of medical-preventive activities. Leptospirosis also affects humans. In this regard, the present study aimed to determine the prevalence of antibodies to Leptospira interrogans serovar Hardjo in tank milk samples from cows selected from farms in different regions of Ukraine. The method of indirect enzyme-multiplied immunoassay was used for this problem to be investigated. We have investigated 114 tank samples from 66 Ukrainian farms, 63.2% positive, and 36.8% negative. It was established that antibodies to the causative agent of leptospirosis were recorded in different regions of Ukraine. It has been established that the largest number of positive samples was from Kyiv and Cherkasy regions. Our study results complement the study results of other authors and indicate the circulation of this causative agent among the cows in Ukraine, as well as being of practical value for diagnosing and controlling leptospirosis among the cattle.
HUBUNGAN LAMA PENGGUNAAN VENTILATOR MEKANIK DENGAN MORTALITAS DI INTENSIVE CARE UNIT (ICU) RSUD Dr. H. ABDUL MOELOEK
Authors: Noviyanti Dwi Wulan , Wahyuni Ari , Ramdini Dwi Aulia , Rahmayani Fidha 
Published: October 2023

Latar Belakang: Ventilator mekanik merupakan alat bantu napas yang digunakan pada pasien gagal napas. Penggunaan ventilator mekanik lebih dari 48 jam dapat menimbulkan komplikasi yang dapat meningkatkan mortalitas pada pasien. Mengetahui hubungan antara lama penggunaan ventilator mekanik dengan mortalitas di ICU dapat membantu dalam mengurangi faktor penyebab mortalitas pasien di ICU. Metode: Penelitian ini menggunakan metode observasional analitik dengan pendekatan cross sectional. Subjek merupakan 97 data rekam medik dengan teknik simple random sampling yang diproses menggunakan aplikasi SPSS. Penelitian ini menggunakan data sekunder berupa data rekam medik pasien ICU dengan penggunaan ventilator mekanik yang memenuhi kriteria inklusi dan eksklusi sampel. Analisis yang digunakan adalah chi-square. Hasil: Hasil penelitian menunjukkan mayoritas subjek berusia >65 tahun (37,1%),berjenis kelamin laki-laki (60,8%), pasien non bedah (56,7%), diagnosis utama terbanyak yaitu ICH (17,5%), CKD (10,3%), CHF (6,2%), dan peritonitis (6,2%), lama penggunaan ventilator ≥48 jam (61,9%), dan pasien meninggal (83,5%). Tidak terdapat hubungan antara lama penggunaan ventilator mekanik dengan mortalitas (p = 0,734). Simpulan: Lama penggunaan ventilator mekanik tidak memiliki hubungan dengan motalitas di ICU RSUD Dr. H. Abdul Moeloek.
Penatalaksanaan Holistik Pasien Wanita Usia 18 Tahun dengan Asma Bronkial Melalui Pendekatan Dokter Keluarga di Wilayah Puskesmas Satelit
Authors: Nur Pratiwi Jihan , Nusadewiarti Azelia 
Published: October 2023

Asma merupakan peradangan kronik saluran napas yang menyebabkan penyempitan saluran napas. Prevalensi penyakit asma di Indonesia menempati urutan tertinggi untuk kategori penyakit tidak menular. Asma merupakan penyakit yang perlu dikontrol untuk mencegah eksaserbasi dan meningkatkan kualitas hidup pasien. Baik pasien maupun keluarga diharapkan memiliki pengetahuan dan motivasi untuk melakukan modifikasi gaya hidup agar tujuan pengobatan dapat tercapai, sehingga diperlukan tatalaksana melalui pendekatan keluarga. Data primer diperoleh dari kunjungan rumah untuk melengkapi data keluarga, data psikososial, dan lingkungan. Data sekunder diperoleh dari rekam medis. Penilaian dilakukan berdasarkan diagnosis holistik dari awal, proses, dan akhir studi secara kuantitatif dan kualitatif. Pasien Ny. PF usia 18 tahun, memiliki keluhan utama sesak napas sejak 1 hari yang lalu. Sesak disertai bunyi ngik dan batuk, memberat terutama saat malam dan menjelang pagi, cuaca dingin, dan setelah membersihkan rumah. Pasien didiagnosis sebagai asma bronkial. Pada kasus ini telah dilakukan diagnosis dan tatalaksana sesuai dengan teori dan jurnal terkini. Setelah dilakukan intervensi, didapatkan penurunan gejala klinis dan peningkatan pengetahuan pasien dan keluarganya. Diagnosis asma bronkial pada pasien ini sudah sesuai dengan teori dari beberapa panduan dan jurnal, terlihat adanya perubahan pengetahuan pada pasien dan keluarganya setelah dilakukan intervensi berdasarkan Evidence-Based Medicine yang bersifat patient-centred dan family approach.
Identifikasi ¬Methicillin-Resistant Staphylococcus aureus (MRSA) pada Pasien Dermatitis Atopik RSUD Dr. H. Abdul Moeloek Bandar Lampung
Authors: Enjelina Enjelina , Warganegara Efrida , Mutiara Utari Gita 
Published: October 2023

Angka kejadian DA di Indonesia meningkat setiap tahunnya dan menempati peringkat pertama dari 10 besar penyakit kulit anak pada tahun 2010. Prevalensi DA di Lampung sendiri menempati urutan kesepuluh dalam daftar sepuluh besar penyakit provinsi Lampung pada tahun 2016 dengan jumlah 44.034 kasus. Pada lebih dari 90% kulit penderita dermatitis atopik didapatkan kolonisasi Staphylococcus aureus sebagai akibat dari gangguan sawar kulit dan imunitas alamiah. Sejak kemunculan galur S. aureus yang resisten terhadap antibiotik metisilin tahun 1961, MRSA mulai ditemukan pada lesi pasien dermatitis atopik. MRSA telah menjadi masalah kesehatan global yang sangat berhubungan dengan infeksi yang susah disembuhkan dan morbiditas yang tinggi. Penelitian ini bertujuan untuk mengetahui ada tidaknya MRSA pada lesi pasien dermatitis atopik yang berobat ke Poli Kulit dan Kelamin RSUD Abdul Moeloek Bandar Lampung. Penelitian ini merupakan penelitian observasional dengan rancangan potong lintang. Pengumpulan sampel diperoleh berupa swab dari lesi pasien pada periode Maret hingga Mei 2019, kemudian dilakukan identifikasi bakteri MRSA di laoratorium dengan dilakukan kultur pada media agar. 57,7% penderita DA memiliki kolonisasi Staphylococcus aureus dan 20% di antaranya adalah MRSA.
Malassezia Furfur Pada Pitriasis Versikolor Dan Malassezia Folikulitis
Authors: Tarigan Hendra , Graharti Risti 
Published: October 2023

Kulit merupakan salah satu organ terbesar tubuh yang menampung berbagai komunitas mikroba termasuk organisme yang tidak berbahaya tetapi juga dapat menjadi patogen potensial. Malassezia merupakan bagian dari flora normal kulit yang memiliki potensi patogen di mana dalam kondisi yang sesuai dapat menginvasi stratum korneumdan bermanifestasi pada berbagai penyakit tkulit diantaranya pitiriasis versikolor dan malasezia folikulitis. Infeksi ringan kronis pada kulit yang disebabkan oleh jamur malassezia furfur, ditandai dengan bercak hipopigmentasi atau depigmentasi disertai skuama, dikenal sebagai Pitriasis versicolor atau PVC. Folikulitis malassezia adalah kondisi peradangan yang disebabkan oleh malassezia yang melibatkan unit lebih dalam yaitu pilo-sebasea. Pitiriaris Versikolor dan malasezia folikulitis merupakan penyakit kulit yang mendunia. Pitiriasis versikolor dan malasezia folikulitis sering terjadi di daerah tropis dan iklim yang panas serta memiliki kelembaban dan suhu yang tinggi, seperti di Indonesia. Di Indonesia diperkirakan 50% penduduknya menderita PV. Penyakit ini dapat mengenai semua golongan mulai dari anak-anak sampai orangtua. Dengan banyaknya angka kejadian PV dan malasezia folikulitis di Indonesia, maka penulis tertarik untuk membuat referat ini. Penulisan referat ini bertujuan agar penulis dan pembaca lebih dapat memahami karakterisktik kedua penyakit ini sehingga dapat mendiagnosis dan menatalaksana dengan tepat serta melakukan pencegahan sehingga dapat mengurangi angka kejadian PV dan malassezia folikulitis di Indonesia.
Pengaruh Senam Kaki Diabetik terhadap Neuropati pada Pasien Diabetes Melitus
Authors: Qurotulnguyun Lutfia , Rahmayani Fidha , Sutarto Sutarto 
Published: October 2023

Prevalensi penderita diabetes melitus mengalami peningkatan setiap tahunnya. Indonesia menempati peringkat ke-7 dunia dengan jumlah penderita diabetes mencapai 10,7 juta jiwa. Diabetes dalam jangka waktu yang lama dapat menyebabkan komplikasi makrovaskular dan mikrovaskular. Salah satu komplikasi uatama diabetes melitus adalah neuropati diabetik. Neuropati diabetik adalah komplikasi mikrovaskuler yang menyebabkan disfungsi saraf perifer yang menyerang ekstrimitas bawah terutama tungkai. Sekitar 50% penderita diabetes melitus mengalami neuropati diabetik. Jika tidak ditangani dengan baik, kondisi ini dapat menurunkan kualitas hidup pasien, meningkatkan risiko amputasi, bahkan kematian pada penderita diabetes. Obat-obatan seringkali menjadi pilihan utama untuk terapi, namun kendala biaya dan efek samping menimbulkan minat untuk mencari alternatif pengobatan lain. Pengobatan yang dapat dilakukan adalah dengan berolahraga. Salah satu olahraga yang dianjurkan adalah senam kaki diabetik. Senam kaki diabetik merupakan olahraga ringan berfokus pada tungkai yang terdiri dari sepuluh langkah. Olahraga ini dapat dilakukan dengan mudah, tidak membutuhkan biaya, dan tidak memakan waktu yang lama. Beberapa studi menyatakan bahwa senam kaki diabetik dapat menjadi alternatif untuk mencegah dan menghambat perburukan neuropati pada pasien diabetes melitus dengan membantu memperlancar sirkulasi darah perifer serta menguatkan otot-otot pada ekstrimitas bawah untuk mencegah luka dan deformitas kaki.