41 research outputs found
Penilaian Formatif Berbasis Quizizz Pada Mata Kuliah Fisika Dasar Pada Masa Covid-19
Penelitian ini dilaksanakan di Universitas Musamus, Merauke. Subjek penelitiannya adalah mahasiswa yang mengambil mata kuliah fisika dasar pada tahun akademik 20192 yang berjumlah 39 orang. Metode penelitian yang digunakan adalah metode analisis deskriptif kuantitatif, yaitu mendeskripsikan hasil penilaian formatif berbasis Quiziz yang diperoleh mahasiswa pada materi fisika dasar khususnya Hukum Newton dan Penerapannya. Tujuan penelitiannya adalah mendeskripsikan hasil penilaian formatif berbasis Quizizz pada mata kuliah fisika dasar pada masa Covid-19 Instrumen yang digunakan adalah soal pilihan ganda dengan 5 pilihan jawaban yang berjumlah 12 nomor. Validitas instrumen penelitian menggunakan product momen dan reliabilitasnya menggunakan KR-20. hasil analisis data menunjukkan rata-rata kemampuan mahasiswa pada 4 indikator materi hukum Newton dan Penerapannya diketahui bahwa indikator 1 yang diwakili oleh 3 nomor soal memiliki rata-rata persentase 68,67%. Indikator 2 yang diwakili 3 butir soal mencapai rata-rata persentase 70,67%. Indikator 3 yang diwakili 3 butir soal memperoleh presentase 77,33%. Indikator 4 yang diwakili 3 butir soal mencapai persentase 69,33%. Secara keseluruhan indikator dengan rata-rata skor tertinggi adalah indikator 3 dengan rata-rata 77,33% dan indikator dengan skor terendah adalah indikator 1 dengan rata-rata skor 68,67%. Rata-rata skor yang diperoleh pada 4 indikator tersebut adalah 71,5% sehingga berada pada kategori bai
Serum levels and removal by haemodialysis and haemodiafiltration of tryptophan-derived uremic toxins in ESKD patients
Tryptophan is an essential dietary amino acid that originates uremic toxins that contribute to end-stage kidney disease (ESKD) patient outcomes. We evaluated serum levels and removal during haemodialysis and haemodiafiltration of tryptophan and tryptophan-derived uremic toxins, indoxyl sulfate (IS) and indole acetic acid (IAA), in ESKD patients in different dialysis treatment settings. This prospective multicentre study in four European dialysis centres enrolled 78 patients with ESKD. Blood and spent dialysate samples obtained during dialysis were analysed with high-performance liquid chromatography to assess uremic solutes, their reduction ratio (RR) and total removed solute (TRS). Mean free serum tryptophan and IS concentrations increased, and concentration of IAA decreased over pre-dialysis levels (67%, 49%, -0.8%, respectively) during the first hour of dialysis. While mean serum total urea, IS and IAA concentrations decreased during dialysis (-72%, -39%, -43%, respectively), serum tryptophan levels increased, resulting in negative RR (-8%) towards the end of the dialysis session (p < 0.001), despite remarkable Trp losses in dialysate. RR and TRS values based on serum (total, free) and dialysate solute concentrations were lower for conventional low-flux dialysis (p < 0.001). High-efficiency haemodiafiltration resulted in 80% higher Trp losses than conventional low-flux dialysis, despite similar neutral Trp RR values. In conclusion, serum Trp concentrations and RR behave differently from uremic solutes IS, IAA and urea and Trp RR did not reflect dialysis Trp losses. Conventional low-flux dialysis may not adequately clear Trp-related uremic toxins while high efficiency haemodiafiltration increased Trp losses
Widening the analysis of Energy Return on Investment (EROI) in agro-ecosystems: Socio-ecological transitions to industrialized farm systems (the Vallès County, Catalonia, c.1860 and 1999)
Energy balances of farm systems have overlooked the role of energy flows that remain within agro-ecosystems. Yet, such internal flows fulfil important socio-ecological functions, including maintenance of farmers themselves and agro-ecosystem structures. Farming can either give rise to complex landscapes that favour associated biodiversity, or the opposite. This variability can be understood by assessing several types of Energy Returns on Investment (EROI). Applying these measures to a farm system in Catalonia, Spain in 1860 and in 1999, reveals the expected decrease in the ratio of final energy output to total and external inputs. The transition from solar-based to a fossil fuel based agro-ecosystem was further accompanied by an increase in the ratio of final energy output to biomass reused, as well as an absolute increase of Unharvested Phytomass grown in derelict forestland. The study reveals an apparent link between reuse of biomass and the decrease of landscape heterogeneity along with its associated biodiversity
Opening the black box of energy throughputs in farm systems: A decomposition analysis between the energy returns to external inputs, internal biomass reuses and total inputs consumed (the Vallès County, Catalonia, c.1860 and 1999)
We present an energy analysis of past and present farm systems aimed to contribute to their sustainability assessment. Looking at agroecosystems as a set of energy loops between nature and society, and adopting a farm-operator standpoint at landscape level to set the system boundaries, enthalpy values of energy carriers are accounted for net Final Produce going outside as well as for Biomass Reused cycling inside, and External Inputs are accounted using embodied values. Human Labour is accounted for the fraction of the energy intake of labouring people devoted to perform farm work, considering the local or external origin of their food basket. In this approach the proportion of internal Biomass Reused becomes a hallmark of organic farm systems that tend to save External Inputs, whereas industrial farming and livestock breeding in feedlots tend to get rid of reuses replacing them with inputs coming from outside. Hence, decomposing the internal or external energy throughputs may bring to light their contrasting sociometabolic profiles. A Catalan case study in 1860 and 1990 is used as a test bench to show how revealing this decomposing analysis may be to plot the energy profiles of farm systems and their possible improvement pathways
The need for a multi-disciplinary reflection about frailty and cognitive impairment in chronic kidney disease
Cognitive disorders in patients with chronic kidney disease: Approaches to prevention and treatment
Background: Cognitive impairment is common in patients with chronic kidney disease (CKD), and early intervention may prevent the progression of this condition. Methods: Here, we review interventions for the complications of CKD (anemia, secondary hyperparathyroidism, metabolic acidosis, harmful effects of dialysis, the accumulation of uremic toxins) and for prevention of vascular events, interventions that may potentially be protective against cognitive impairment. Furthermore, we discuss nonpharmacological and pharmacological methods to prevent cognitive impairment and/or minimize the latter's impact on CKD patients' daily lives. Results: A particular attention on kidney function assessment is suggested during work-up for cognitive impairment. Different approaches are promising to reduce cognitive burden in patients with CKD but the availabe dedicated data are scarce. Conclusions: There is a need for studies assessing the effect of interventions on the cognitive function of patients with CKD
The state of health in the European Union (EU-27) in 2019: a systematic analysis for the Global Burden of Disease study 2019
Background: The European Union (EU) faces many health-related challenges. Burden of diseases information and the resulting trends over time are essential for health planning. This paper reports estimates of disease burden in the EU and individual 27 EU countries in 2019, and compares them with those in 2010.Methods: We used the Global Burden of Disease 2019 study estimates and 95% uncertainty intervals for the whole EU and each country to evaluate age-standardised death, years of life lost (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs) rates for Level 2 causes, as well as life expectancy and healthy life expectancy (HALE).Results:In 2019, the age-standardised death and DALY rates in the EU were 465.8 deaths and 20,251.0 DALYs per 100,000 inhabitants, respectively. Between 2010 and 2019, there were significant decreases in age-standardised death and YLL rates across EU countries. However, YLD rates remained mainly unchanged. The largest decreases in age-standardised DALY rates were observed for "HIV/AIDS and sexually transmitted diseases" and "transport injuries" (each -19%). "Diabetes and kidney diseases" showed a significant increase for age-standardised DALY rates across the EU (3.5%). In addition, "mental disorders" showed an increasing age-standardised YLL rate (14.5%).Conclusions: There was a clear trend towards improvement in the overall health status of the EU but with differences between countries. EU health policymakers need to address the burden of diseases, paying specific attention to causes such as mental disorders. There are many opportunities for mutual learning among otherwise similar countries with different patterns of disease
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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation