Penerapan Metode Waterfall pada Sistem Informasi Pendaftaran Pasien Rawat Jalan Berbasis Web Mobile

When the researchers conducted studies Implementation Method Waterfall In Registration Information System Web-Based Outpatient Mobile, researchers found that the health center belongs to the municipality located in the village of Lubuk Tanjung Lubuk Linggau felt the need for development in line with increased demand for health services for the community. PHC Tanjung Lubuk Housing is in the process of registration of outpatients manuallyor still use conventional manner, includes data recording the identity of the patient, make a list of queues, search medical records of patients, as well as card making patients. When enrollment of patients when treatment would still be written in a ledger and patient data and data ever experienced disease (medical records) was recorded in the general ledger and certain records and stored in a special file. This often times lead to errors and writing the name of the same patient when treated umpteenth time and the difficulty in grouping the data requires considerable time as well as the lack of assurance of data security. If we want to find the patient data needed to be looking in the archives of books one by one to determine such data. With the support of information technology, manual processing in the clinic can be replaced using a computer. In addition to fast and easy with the information system has been made of data processing has also become more accurate. The method used in the information system of registration of outpatient-based mobile web in BPS town Lubuklinggau this, and to know the running system, using a structured approach using several tools like Uml, use case diagrams, activity, sequence diagram, class diagram , while for the system development method using a sequential linear or often called "the development cycle of the classic" or "waterfall model / waterfall". Support software used is Xampp, Adobe Dreamweaver CS3, PHP, and MySQL databases as well as the builder of program documentation and reports. With a system based on the mobile web, which is already connected to the Internet, of course, would greatly facilitate the processing of census data suseda to be stored and will be very helpful in terms of data storage census suseda, because each finished data can be collected more quickly, accurately and save time with the specified schedule

Determining the minimal important differences in the International Prostate Symptom Score and Overactive Bladder Questionnaire:results from an observational cohort study in Dutch primary care

OBJECTIVES: To determine the minimal important difference (MID) of the International Prostate Symptom Score (IPSS) and the Overactive Bladder Questionnaire short form (OAB-q SF) assessed in primary care among patients treated for lower urinary tract symptoms (LUTS).DESIGN: Single-arm, open-label observational cohort study with a 6-week follow-up.SETTING: Twenty-two pharmacies in the Netherlands.PARTICIPANTS: We enrolled Dutch men with uncomplicated LUTS who received a new alpha-blocker prescription from their general practitioner or urologist.PRIMARY AND SECONDARY OUTCOMES: The IPSS and OAB-q SF were completed before and after 6 weeks of therapy. At 6 weeks, men also completed the Patient Global Impression of Improvement (PGI-I). The mean change scores of the IPSS and OAB-q SF were calculated for each PGI-I outcome category, with the category 'a little better' used to determine the MID. The SE of measurement (SEM) was calculated for each questionnaire.RESULTS: In total, 165 men completed follow-up. The MID was 5.2 points (95% CI 3.9 to 6.4; SEM 3.6) for the IPSS and 11.0 points (95% CI 7.1 to 14.9; SEM 9.7) for the OAB-q SF. For both questionnaires, CIs showed an overlap with the no-change categories. However, the MID for the IPSS was higher in men with severe baseline symptoms (7.1; 95% CI 5.3 to 9.0) than in men with moderate baseline symptoms (3.2; 95% CI 1.7 to 4.8).CONCLUSION: In this study, the MID for the IPSS was considerably higher than the MID of 3.1 reported in the only other study on this topic, but may be due to methodological differences. Interpretation of the MID for the OAB-q SF is hampered by the overlap with the SEM. Future studies are needed to confirm our results because correlations between the PGI-I and symptom questionnaires were suboptimal.</p

Peptic Fluorescent "Signal-On" and "Signal-Off" Sensors Utilized for the Detection Protein Post-Translational Modifications

Protein post-translational modifications (PTMs) are typically enzyme-catalyzed events generating functional diversification of proteome; thus, multiple PTM enzymes have been validated as potential drug targets. We have previously introduced energy-transfer-based signal-modulation method called quenching resonance energy transfer (QRET), and utilize it to monitor PTM addition or removal using the developed peptide-break technology. Now we have reinvented the QRET technology, and as a model, we introduced the tunable fluorescent "signal-on" and "signal-off" detection scheme in the peptide-break PTM detection. Taking the advantage of time-resolved fluorescence-based single-label detection technology, we were able to select the signal direction upon PTM addition or removal by simply introducing different soluble Eu3+-signal-modulating molecule. This enables the selection of positive signal change upon measurable event, without any additional labeling steps, changes in assay condition or Eu3+-reporter. The concept functionality was demonstrated with four Eu3+-signal modulators in a high-throughput compatible kinase and phosphatase assays using signal-on and signal-off readout at 615 nm or time-resolved Forster resonance energy transfer at 665 nm. Our data suggest that the introduced signal modulation methodology provides a transitional fluorescence-based single-label detection concept not limited only to PTM detection

Work at night and breast cancer - report on evidence-based options for preventive actions

In 2007, the International Agency for Research on Cancer classified shift work involving circadian disruption as probably carcinogenic to humans (group 2A), primarily based on experimental and epidemiologic evidence for breast cancer. In order to examine options for evidence-based preventive actions, 16 researchers in basic, epidemiological and applied sciences convened at a workshop in Copenhagen 26-27 October 2011. This paper summarizes the evidence from epidemiological and experimental studies and presents possible recommendations for prevention of the effects of night work on breast cancer. Among those studies that quantified duration of shift work, there were statistically significant elevations in risk only after about 20 years working night shift. It is unclear from these studies whether or not there is a modest but real elevated risk for shorter durations. Hence, restriction of the total number of years working night shift could be one future preventive recommendation for shift workers. The diurnal secretion of melatonin by the pineal gland with peak in secretory activity durin Work during the night is widespread worldwide. To provide additional evidence-based recommendations on prevention of diseases related to night shift work, large studies on the impact of various shift schedules and type of light on circadian rhythms need to be conducted in real work environments

Increased oxidative stress associated with the severity of the liver disease in various forms of hepatitis B virus infection

BACKGROUND: Oxidative stress can be defined as an increase in oxidants and/or a decrease in antioxidant capacity. There is limited information about the oxidative status in subjects with hepatitis B virus infection. We aimed to evaluate the oxidative status in patients with various clinical forms of chronic hepatitis B infection. METHODS: Seventy-six patients with hepatitis B virus infection, in whom 33 with chronic hepatitis, 31 inactive carriers and 12 with cirrhosis, and 16 healthy subjects were enrolled. Total antioxidant response and total peroxide level measurement, and calculation of oxidative stress index were performed in all participants. RESULTS: Total antioxidant response was significantly lower in cirrhotics than inactive HbsAg carriers and controls (p = 0.008 and p = 0.008, respectively). Total peroxide level and oxidative stress index was significantly higher in cirrhotic (p < 0.001, both) and chronic hepatitis B subjects (p < 0.001, both) than inactive HbsAg carriers and controls. Total antioxidant response was comparable in chronic hepatitis B subjects, inactive HbsAg carriers and controls (both, p > 0.05/6). Total peroxide level and oxidative stress index were also comparable in inactive HBsAg carriers and controls (both, p > 0.05/6). Serum alanine amino transferase level was positively correlated with total peroxide level and oxidative stress index only in chronic hepatitis B subjects (p = 0.002, r = 0.519 and p = 0.008, r = 0.453, respectively). CONCLUSION: Oxidative stress occurs secondarily to increased total lipid peroxidation and inadequate total antioxidant response and is related to severity of the disease and replication status of virus in hepatitis B infection

Prolonged sleep restriction induces changes in pathways involved in cholesterol metabolism and inflammatory responses

Sleep loss and insufficient sleep are risk factors for cardiometabolic diseases, but data on how insufficient sleep contributes to these diseases are scarce. These questions were addressed using two approaches: an experimental, partial sleep restriction study (14 cases and 7 control subjects) with objective verification of sleep amount, and two independent epidemiological cohorts (altogether 2739 individuals) with questions of sleep insufficiency. In both approaches, blood transcriptome and serum metabolome were analysed. Sleep loss decreased the expression of genes encoding cholesterol transporters and increased expression in pathways involved in inflammatory responses in both paradigms. Metabolomic analyses revealed lower circulating large HDL in the population cohorts among subjects reporting insufficient sleep, while circulating LDL decreased in the experimental sleep restriction study. These findings suggest that prolonged sleep deprivation modifies inflammatory and cholesterol pathways at the level of gene expression and serum lipoproteins, inducing changes toward potentially higher risk for cardiometabolic diseases

Optimization of Invasion-Specific Effects of Betulin Derivatives on Prostate Cancer Cells through Lead Development

The anti-invasive and anti-proliferative effects of betulins and abietane derivatives was systematically tested using an organotypic model system of advanced, castration-resistant prostate cancers. A preliminary screen of the initial set of 93 compounds was performed in two-dimensional (2D) growth conditions using non-transformed prostate epithelial cells (EP156T), an androgen-sensitive prostate cancer cell line (LNCaP), and the castration-resistant, highly invasive cell line PC-3. The 25 most promising compounds were all betulin derivatives. These were selected for a focused secondary screen in three-dimensional (3D) growth conditions, with the goal to identify the most effective and specific anti-invasive compounds. Additional sensitivity and cytotoxicity tests were then performed using an extended cell line panel. The effects of these compounds on cell cycle progression, mitosis, proliferation and unspecific cytotoxicity, versus their ability to specifically interfere with cell motility and tumor cell invasion was addressed. To identify potential mechanisms of action and likely compound targets, multiplex profiling of compound effects on a panel of 43 human protein kinases was performed. These target de-convolution studies, combined with the phenotypic analyses of multicellular organoids in 3D models, revealed specific inhibition of AKT signaling linked to effects on the organization of the actin cytoskeleton as the most likely driver of altered cell morphology and motility.</p

Investigating sensitivity, specificity, and area under the curve of the Clinical COPD Questionnaire, COPD Assessment Test, and Modified Medical Research Council scale according to GOLD using St George's Respiratory Questionnaire cutoff 25 (and 20) as reference

Background: In the GOLD (Global initiative for chronic Obstructive Lung Disease) strategy document, the Clinical COPD Questionnaire (CCQ), COPD Assessment Test (CAT), or modified Medical Research Council (mMRC) scale are recommended for the assessment of symptoms using the cutoff points of CCQ >= 1, CAT >= 10, and mMRC scale >= 2 to indicate symptomatic patients. The current study investigates the criterion validity of the CCQ, CAT and mMRC scale based on a reference cutoff point of St George's Respiratory Questionnaire (SGRQ) >= 25, as suggested by GOLD, following sensitivity and specificity analysis. In addition, areas under the curve (AUCs) of the CCQ, CAT, and mMRC scale were compared using two SGRQ cutoff points (>= 25 and >= 20). Materials and methods: Two data sets were used: study A, 238 patients from a pulmonary rehabilitation program; and study B, 101 patients from primary care. Receiver-operating characteristic (ROC) curves were used to assess the correspondence between the recommended cutoff points of the questionnaires. Results: Sensitivity, specificity, and AUC scores for cutoff point SGRQ >= 25 were: study A, 0.99, 0.43, and 0.96 for CCQ >= 1, 0.92, 0.48, and 0.89 for CAT >= 10, and 0.68, 0.91, and 0.91 for mMRC >2; study B, 0.87, 0.77, and 0.9 for CCQ >1, 0.76, 0.73, and 0.82 for CAT >10, and 0.21, 1, and 0.81 for mMRC >= 2. Sensitivity, specificity, and AUC scores for cutoff point SGRQ >= 20 were: study A, 0.99, 0.73, and 0.99 for CCQ >= 1, 0.91, 0.73, and 0.94 for CAT >= 10, and 0.66, 0.95, and 0.94 for mMRC >= 2; study B, 0.8, 0.89, and 0.89 for CCQ >= 1, 0.69, 0.78, and 0.8 for CAT >= 10, and 0.18, 1, and 0.81 for mMRC >= 2. Conclusion: Based on data from these two different samples, this study showed that the suggested cutoff point for the SGRQ (>25) did not seem to correspond well with the established cutoff points of the CCQ or CAT scales, resulting in low specificity levels. The correspondence with the mMRC scale seemed satisfactory, though not optimal. The SGRQ threshold of >= 20 corresponded slightly better than SGRQ >= 25, recently suggested by GOLD 2015, with the established cutoff points for the CCQ, CAT, and mMRC scale