ASUHAN KEBIDANAN KOMPREHENSIF PADA NY.N MASA HAMIL SAMPAI DENGAN NIFAS DAN KB DI BPM NUR SAADAH WIYUNG

Angka kematian ibu (AKI) dan angka kematian bayi (AKB) merupakan indikator untuk melihat derajat kesehatan dan menilai tingkat kemampuan penyelenggaraan pelayanan kesehatan suatu negara. AKI di Provinsi Jawa Timur tahun 2016 sebesar 91/100.000 KH (Dinkes Jatim, 2017) dan AKB tahun 2016 sebesar 23,6/100.000 KH (Dinkes Jatim, 2017). Terdapat dua faktor kematian ibu yaitu faktor penyebab langsung dan tidak langsung, sedangkan pada bayi baru lahir adalah asfiksia, BBLR, infeksi neonatorum dan trauma persalinan. Laporan tugas akhir bertujuan untuk memberikan asuhan kebidanan continuity of care dengan menggunakan manajemen kebidanan. Desain penelitian ini menggunakan continuity of care. Bertempat di BPM Nur Sa’adah Wiyung. Pelaksanaannya tanggal 14-05-2019 sampai 04-07-2019. Subjeknya yaitu Ny. “N” yang diberi pendampingan mulai hamil hingga KB. Pengumpulan data menggunakan data primer dan sekunder. Hasil asuhan kebidanan pada kunjungan kehamilan menunjukkan pemeriksaan LILA ibu mengalami KEK (Kekurangan Energi Kronis) 21 cm, Hal ini disebabkan karena banyaknya aktivitas ibu dan kurangnya asupan nutrisi ibu hamil, sedangkan dalam teori di jelaskan bahwa normal lingkar lengan ibu hamil 23,5 dengan demikian penulis menemukan kesenjangan antara teori dan praktik, ketika bersalin IMD hanya 30 menit, pada masa nifas pemenuhan nutrisi ibu sudah seimbang, bayi diberi Asi Ekslusif, dalam konseling KB ibu memutuskan menggunakan kontrasepsi suntik 3 bulan. Simpulan laporan tugas akhir ini adalah asuhan pada Ny. “N” berlangsung secara fisiologis. Oleh karena itu diharapkan klien dapat menerapkan anjuran bida

Pengaruh Model Pembelajaran Guided Inquiry terhadap Hasil Belajar Siswa pada Materi Momentum dan Impuls Kelas X Mia 5 SMA Negeri 1 Kota Ternate

Penelitian ini merupakan penelitian eksperimen, yang bertujuan untuk mengetahui pengaruh model pembelajaran guided inquiry terhadap hasil belajar siswa kelas X pada materi momentum dan impuls dengan menggunakan bentuk penelitian paradigma sederhana. Data hasil belajar siswa diperoleh melalui tes tertulis dengan skor terendah 35, skor tertinggi 96, rentang skor 61, skor rata-rata 63,42, standar deviasi 9,92 dan varians 281,56. Dari data tersebut dibuat distribusi frekuensi data variabel keterampilan hasil belajar siswa  SMA Negeri 1 Kota Ternate. Berdasarkan uji hipotesis diperoleh thit > ttab, atau 4,65 >2,03 pada taraf nyata  = 0,05 sehingga H0 ditolak dan Ha diterima, dengan demikian menunjukkan bahwa persamaan regresi tersebut signifikan sehingga dapat disimpulkan bahwa terdapat pengaruh penggunaan model pembelajaran inquiri terbimbing (guided inquiry) terhadap hasil belajar fisika siswa kelas X MIA 5 SMA Negeri 1 Kota Ternate pada materi Momentum dan Impuls. Besar pengaruh penggunaan model pembelajaran inquiri terbimbing (guided inquiry) terhadap hasil belajar fisika siswa kelas X MIA 5 SMA Negeri 1 Kota Ternate pada materi Momentum dan Impuls adalah 39,18% . Kata Kunci :Guided Inquiry, Hasil Belajar, Momentum dan Impuls

Efficient control of a nonlinear double-pendulum overhead crane with sensorless payload motion using an improved PSO-tuned PID controller

This paper proposes an efficient PID control of a highly nonlinear double-pendulum overhead crane without the need for a payload motion feedback signal. Optimal parameters of the PID controllers are tuned by using an improved particle swarm optimisation (PSO) algorithm based on vertical distance oscillations and potential energy of the crane. In contrast to a commonly used PSO algorithm based on a horizontal distance, the approach resulted in an efficient performance with a less complex controller. To test the effectiveness of the approach, extensive simulations are carried out under various crane operating conditions involving different payload masses and cable lengths. Simulation results show that the proposed controller is superior with a better trolley position response, and lower hook and payload oscillations as compared to the previously developed PSO-tuned PID controller. In addition, the controller provides a satisfactory performance without the need for a payload motion feedback signal

Immunomodulatory Effects of Dietary Polyphenols

Functional and nutraceutical foods provide an alternative way to improve immune function to aid in the management of various diseases. Traditionally, many medicinal products have been derived from natural compounds with healing properties. With the development of research into nutraceuticals, it is becoming apparent that many of the beneficial properties of these compounds are at least partly due to the presence of polyphenols. There is evidence that dietary polyphenols can influence dendritic cells, have an immunomodulatory effect on macrophages, increase proliferation of B cells, T cells and suppress Type 1 T helper (Th1), Th2, Th17 and Th9 cells. Polyphenols reduce inflammation by suppressing the pro-inflammatory cytokines in inflammatory bowel disease by inducing Treg cells in the intestine, inhibition of tumor necrosis factor-alpha (TNF-α) and induction of apoptosis, decreasing DNA damage. Polyphenols have a potential role in prevention/treatment of auto-immune diseases like type 1 diabetes, rheumatoid arthritis and multiple sclerosis by regulating signaling pathways, suppressing inflammation and limiting demyelination. In addition, polyphenols cause immunomodulatory effects against allergic reaction and autoimmune disease by inhibition of autoimmune T cell proliferation and downregulation of pro-inflammatory cytokines (interleukin-6 (IL-6), IL-1, interferon-γ (IFN-γ)). Herein, we summarize the immunomodulatory effects of polyphenols and the underlying mechanisms involved in the stimulation of immune responses

Antioxidant, Anti-inflammatory and Cytotoxicity of Phaleria macrocarpa (Boerl.) Scheff Fruit

<p>Abstract</p> <p>Background</p> <p><it>Phaleria macrocarpa </it>(Scheff.) Boerl (Thymelaceae) originates from Papua Island, Indonesia and grows in tropical areas. The different parts of the fruit of <it>P. macrocarpa </it>were evaluated for antioxidant, anti-inflammatory, and cytotoxic activities.</p> <p>Methods</p> <p><it>Phaleria macrocarpa </it>fruit were divided into pericarp, mesocarp and seed. All parts of the fruit were reflux extracted with methanol. The antioxidant activity of the extracts were characterized in various <it>in vitro </it>model systems such as FTC, TBA, DPPH radical, reducing power and NO radical. Anti-inflammatory assays were done by using NO production by macrophage RAW 264.7 cell lines induced by LPS/IFN-γ and cytotoxic activities were determined by using several cancer cell lines and one normal cell line</p> <p>Results</p> <p>The results showed that different parts (pericarp, mesocarp, and seed) of <it>Phaleria macrocarpa </it>fruit contain various amount of total phenolic (59.2 ± 0.04, 60.5 ± 0.17, 47.7 ± 1.04 mg gallic acid equivalent/g DW) and flavonoid compounds (161.3 ± 1.58, 131.7 ± 1.66, 35.9 ± 2.47 mg rutin equivalent/g DW). Pericarp and mesocarp showed high antioxidant activities by using DPPH (71.97%, 62.41%), ferric reducing antioxidant power (92.35%, 78.78%) and NO scavenging activity (65.68%, 53.45%). Ferric thiocyanate and thiobarbituric acid tests showed appreciable antioxidant activity in the percentage hydroperoxides inhibitory activity from pericarp and mesocarp in the last day of the assay. Similarly, the pericarp and mesocarp inhibited inducible nitric oxide synthesis with values of 63.4 ± 1.4% and 69.5 ± 1.4% in macrophage RAW 264.7 cell lines induced by LPS/IFN-γ indicating their notable anti-inflammatory potential. Cytotoxic activities against HT-29, MCF-7, HeLa and Chang cell lines were observed in all parts.</p> <p>Conclusions</p> <p>These results indicated the possible application of <it>P. macrocarpa </it>fruit as a source of bioactive compounds, potent as an antioxidant, anti inflammatory and cytotoxic agents.</p

In vitro and in vivo characterization of highly purified Human Mesothelioma derived cells

<p>Abstract</p> <p>Background</p> <p>Malignant pleural mesothelioma is a rare disease known to be resistant to conventional therapies. A better understanding of mesothelioma biology may provide the rationale for new therapeutic strategies. In this regard, tumor cell lines development has been an important tool to study the biological properties of many tumors. However all the cell lines established so far were grown in medium containing at least 10% serum, and it has been shown that primary cell lines cultured under these conditions lose their ability to differentiate, acquire gene expression profiles that differ from that of tissue specific stem cells or the primary tumor they derive from, and in some cases are neither clonogenic nor tumorigenic. Our work was aimed to establish from fresh human pleural mesothelioma samples cell cultures maintaining tumorigenic properties.</p> <p>Methods</p> <p>The primary cell cultures, obtained from four human pleural mesotheliomas, were expanded in vitro in a low serum proliferation-permissive medium and the expression of different markers as well as the tumorigenicity in immunodeficient mice was evaluated.</p> <p>Results</p> <p>The established mesothelioma cell cultures are able to engraft, after pseudo orthotopic intraperitoneal transplantation, in immunodeficient mouse and maintain this ability to after serial transplantation. Our cell cultures were strongly positive for CD46, CD47, CD56 and CD63 and were also strongly positive for some markers never described before in mesothelioma cell lines, including CD55, CD90 and CD99. By real time PCR we found that our cell lines expressed high mRNA levels of typical mesothelioma markers as mesothelin (MSLN) and calretinin (CALB2), and of BMI-1, a stemness marker, and DKK1, a potent Wingless [WNT] inhibitor.</p> <p>Conclusions</p> <p>These cell cultures may provide a valuable in vitro and in vivo model to investigate mesothelioma biology. The identification of new mesothelioma markers may be useful for diagnosis and/or prognosis of this neoplasia as well as for isolation of mesothelioma tumor initiating cells.</p

Is there a role for melatonin in fibromyalgia?

Fibromyalgia, characterised by persistent pain, fatigue, sleep disturbance and cognitive dysfunction, is a central sensitivity syndrome that also involves abnormality in peripheral generators and in the hypothalamic pituitary adrenal axis. Heterogeneity of clinical expression of fibromyalgia with a multifactorial aetiology has made the development of effective therapeutic strategies challenging. Physiological properties of the neurohormone melatonin appear related to the symptom profile exhibited by patients with fibromyalgia and thus disturbance of it’s production would be compatible with the pathophysiology. Altered levels of melatonin have been observed in patients with fibromyalgia which are associated with lower secretion during dark hours and higher secretion during daytime. However, inconsistencies of available clinical evidence limit conclusion of a relationship between levels of melatonin and symptom profiles in patients with fibromyalgia. Administration of melatonin to patients with fibromyalgia has demonstrated suppression of many symptoms and an improved quality of life consistent with benefit as a therapy for the management of this condition. Further studies with larger samples, however, are required to explore the potential role of melatonin in the pathophysiology of fibromyalgia and determine the optimal dosing regimen of melatonin for the management of fibromyalgia

The dominant Anopheles vectors of human malaria in the Asia-Pacific region: occurrence data, distribution maps and bionomic précis

<p>Abstract</p> <p>Background</p> <p>The final article in a series of three publications examining the global distribution of 41 dominant vector species (DVS) of malaria is presented here. The first publication examined the DVS from the Americas, with the second covering those species present in Africa, Europe and the Middle East. Here we discuss the 19 DVS of the Asian-Pacific region. This region experiences a high diversity of vector species, many occurring sympatrically, which, combined with the occurrence of a high number of species complexes and suspected species complexes, and behavioural plasticity of many of these major vectors, adds a level of entomological complexity not comparable elsewhere globally. To try and untangle the intricacy of the vectors of this region and to increase the effectiveness of vector control interventions, an understanding of the contemporary distribution of each species, combined with a synthesis of the current knowledge of their behaviour and ecology is needed.</p> <p>Results</p> <p>Expert opinion (EO) range maps, created with the most up-to-date expert knowledge of each DVS distribution, were combined with a contemporary database of occurrence data and a suite of open access, environmental and climatic variables. Using the Boosted Regression Tree (BRT) modelling method, distribution maps of each DVS were produced. The occurrence data were abstracted from the formal, published literature, plus other relevant sources, resulting in the collation of DVS occurrence at 10116 locations across 31 countries, of which 8853 were successfully geo-referenced and 7430 were resolved to spatial areas that could be included in the BRT model. A detailed summary of the information on the bionomics of each species and species complex is also presented.</p> <p>Conclusions</p> <p>This article concludes a project aimed to establish the contemporary global distribution of the DVS of malaria. The three articles produced are intended as a detailed reference for scientists continuing research into the aspects of taxonomy, biology and ecology relevant to species-specific vector control. This research is particularly relevant to help unravel the complicated taxonomic status, ecology and epidemiology of the vectors of the Asia-Pacific region. All the occurrence data, predictive maps and EO-shape files generated during the production of these publications will be made available in the public domain. We hope that this will encourage data sharing to improve future iterations of the distribution maps.</p

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112