PENGEMBANGAN POTENSI PULAU MANTEHAGE SEBAGAI KAWASAN STRATEGIS PROPINSI SULAWESI UTARA

Kawasan strategis merupakan kawasan yang didalamnya berlangsung kegiatan yang mempunyai pengaruh besar terhadap, Tata ruang di wilayah sekitarnya, kegiatan lain dibidang sejenis dan kegiatan lain dibidang lainnya, dan/atau peningkatan kesejahteraan masyarakat. Pulau Mantehage merupakan salah satu pulau kecil yang menjadi kawasan startegis Propinsi Sulawesi Utara dengan perannya sebagai zona inti konservasi Taman Nasional Bunaken.Sumberdaya alam dan ekosistem yang dimiliki Pulau Mantehage sangat potensial untuk dikembangkan. Namun kondisi Pulau Mantehage yang ada saat ini justru betolak belakang dengan status dan potensinya. Tingginya biaya pembangunan karena akses pencapaian yang melewati jalur laut berdampak pada infrastruktur dasar seperti jalan, drainase, fasilitas pendidikan, kesehatan, listrik dan komunikasi belum cukup memadai. Penelitian ini bertujuan untuk mengetahui potensi-potensi yang ada di Pulau Mantehage kemudian merekomendasikan potensi apa yang paling berpeluang dikembangkan. Alat analisis yang digunakan untuk penelitian ini adalah analisis deskriptif pada beberapa sumber, analisis SWOT  dengan menggunakan Matriks IFAS dan EFAS, Matriks SWOT serta analisis kebijakan. Hasil analisis deskriptif menemukan terdapat kurang labih enam potensi yang paling menonjol yakni potensi fisik alam, potensi sumberdaya pesisir dan laut, potensi perikanan, potensi perkebunan, potensi pariwisata dan potensi SDM. Hasil analisis Matriks IFAS dan EFAS menunjukkan potensi pariwisata yang paing berpeluang dikembangkan sesuai dengan karakteristik Pulau Mantehage. Hasil analisis kebijakan menunjukkan jenis wisata bahari yang perlu dikembangkan karena sesuai dengan daya tampung dan daya dukung Pulau Mantehage. Matriks SWOT menunjukan arahan dan strategi pengembangan potensi wisata bahari di Pulau Mantehage

Development of daily rhythmicity in heart rate and locomotor activity in the human fetus

BACKGROUND: Very little is known about the perinatal genesis of circadian rhythmicity in the human fetus. Some researchers have found evidence of rhythmicity early on in fetal development, whereas others have observed a slow development of rhythmicity during several years after birth. METHOD: Rhythms of fetal heartbeat and locomotor activity were studied in women with physiological course of pregnancy at 16 to 40 gestational weeks. Observations were conducted continuously for 24 h using the method of external electrocardiography, which provided simultaneous detection of the changes in maternal and fetal heartbeat as well as assessment of daily locomotor activity of the fetus. During the night-time, electroencephalogram, myogram, oculogram and respiration of the mother were registered in parallel with fetal external electrocardiography. RESULTS: Although we found no significant daily rhythmicity in heart rate per se in the human fetus, we developed a new method for the assessment of 24-h fetal cardiotachogram that allowed us to identify daily rhythmicity in the short-term pattern of heart beating. We found that daily rhythmicity of fetal electrocardiogram resembles that of the mother; however, the phase of the rhythm is opposite to that of the mother. "Active" (from 9 a.m. to 2 p.m. and from 7 p.m. to 4 a.m.) and "quiet" (from 4 a.m. to 9 a.m. and from 2 p.m. to 7 p.m.) periods of activity were identified. CONCLUSION: A healthy fetus at gestational age of 16 to 20 weeks reveals pronounced rhythms of activity and locomotion. Absence of distinct rhythmicity within the term of 20 to 24 weeks points to developmental retardation. The "Z"-type fetal reaction, recorded during the "quiet" hours, does not indicate unsatisfactory state, but rather is suggestive of definite reduction of functional levels of the fetal physiological systems necessary for vital activity

Helicobacter suis infection alters glycosylation and decreases the pathogen growth inhibiting effect and binding avidity of gastric mucins

Helicobacter suis is the most prevalent non-Helicobacter pylori Helicobacter species in the human stomach and is associated with chronic gastritis, peptic ulcer disease, and gastric mucosa-associated lymphoid tissue (MALT) lymphoma. H. suis colonizes the gastric mucosa of 60-95% of pigs at slaughter age, and is associated with chronic gastritis, decreased weight gain, and ulcers. Here, we show that experimental H. suis infection changes the mucin composition and glycosylation, decreasing the amount of H. suis-binding glycan structures in the pig gastric mucus niche. Similarly, the H. suis-binding ability of mucins from H. pylori-infected humans is lower than that of noninfected individuals. Furthermore, the H. suis growth-inhibiting effect of mucins from both noninfected humans and pigs is replaced by a growth-enhancing effect by mucins from infected individuals/pigs. Thus, Helicobacter spp. infections impair the mucus barrier by decreasing the H. suis-binding ability of the mucins and by decreasing the antiprolific activity that mucins can have on H. suis. Inhibition of these mucus-based defenses creates a more stable and inhabitable niche for H. suis. This is likely of importance for long-term colonization and outcome of infection, and reversing these impairments may have therapeutic benefits

Italian Society of Rheumatology recommendations for the management of gout.

Objective: Gout is the most common arthritis in adults. Despite the availability of valid therapeutic options, the management of patients with gout is still suboptimal. The Italian Society of Rheumatology (SIR) aimed to update, adapt to national contest and disseminate the 2006 EULAR recommendations for the management of gout. Methods: The multidisciplinary group of experts included rheumatologists, general practitioners, internists, geriatricians, nephrologists, cardiologists and evidence-based medicine experts. To maintain consistency with EULAR recommendations, a similar methodology was utilized by the Italian group. The original propositions were translated in Italian and priority research queries were identified through a Delphi consensus approach. A systematic search was conducted for selected queries. Efficacy and safety data on drugs reported in RCTs were combined in a meta-analysis where feasible. The strength of recommendation was measured by utilising the EULAR ordinal and visual analogue scales. Results: The original 12 propositions were translated and adapted to Italian context. Further evidences were collected about the role of diet in the non-pharmacological treatment of gout and the efficacy of oral corticosteroids and low-dose colchicine in the management of acute attacks. Statements concerning uricosuric treatments were withdrawn and replaced with a proposition focused on a new urate lowering agent, febuxostat. A research agenda was developed to identify topics still not adequately investigated concerning the management of gout. Conclusions: The SIR has developed updated recommendations for the management of gout adapted to the Italian healthcare system. Their implementation in clinical practice is expected to improve the management of patients with gout

Helicobacter suis binding to carbohydrates on human and porcine gastric mucins and glycolipids occurs via two modes

Helicobacter suis colonizes the stomach of most pigs and is the most prevalent non-Helicobacter pylori Helicobacter species found in the human stomach. In the human host, H. suis contributes to the development of chronic gastritis, peptic ulcer disease and MALT lymphoma, whereas in pigs it is associated with gastritis, decreased growth and ulcers. Here, we demonstrate that the level of H. pylori and H. suis binding to human and pig gastric mucins varies between individuals with species dependent specificity. The binding optimum of H. pylori is at neutral pH whereas that of H. suis has an acidic pH optimum, and the mucins that H. pylori bind to are different than those that H. suis bind to. Mass spectrometric analysis of mucin O-glycans from the porcine mucin showed that individual variation in binding is reflected by a difference in glycosylation; of 109 oligosaccharide structures identified, only 14 were present in all examined samples. H. suis binding to mucins correlated with glycans containing sulfate, sialic acid and terminal galactose. Among the glycolipids present in pig stomach, binding to lactotetraosylceramide (Gal beta 3GlcNAc beta 3Gal beta 4Glc beta 1Cer) was identified, and adhesion to Gal beta 3GlcNAc beta 3Gal beta 4Glc at both acidic and neutral pH was confirmed using other glycoconjugates. Together with that H. suis bound to DNA (used as a proxy for acidic charge), we conclude that H. suis has two binding modes: one to glycans terminating with Gal beta 3GlcNAc, and one to negatively charged structures. Identification of the glycan structures H. suis interacts with can contribute to development of therapeutic strategies alternative to antibiotics

Alma-Ata to Berlin: diabetes prevention and treatment to achieve healthy living

Bharti Hosp, Dept Endocrinol, Karnal, Haryana, IndiaAarhus Univ, Dept Publ Hlth, Aarhus, DenmarkKazakh Acad Nutr, Alma Ata, KazakhstanAcad Prevent Med, Alma Ata, KazakhstanKazakh Natl Med Univ, Alma Ata, KazakhstanDubai Hosp, Dept Endocrinol, Dubai, U Arab EmiratesPondicherry Inst Med Sci, Dept Med, Pondicherry, IndiaMinist Hlth, Directorate Epidemiol, Mexico City, DF, MexicoItalian Coll Gen Practitioners, Florence, ItalyUniv Hlth Network, Toronto, ON, CanadaSiberian State Med Univ, Tomsk, RussiaInst Diabet Endocrinol & Metab Dis, Endocrinol Res Ctr, Moscow, RussiaUniv Fed São Paulo, Dept Med, São Paulo, BrazilPrimary Care Diabet Europe, Barcelona, SpainDubai Hlth Author, Dubai, U Arab EmiratesPeking Union Med Coll, Beijing, Peoples R ChinaUniv Fed São Paulo, Dept Med, São Paulo, BrazilWeb of Scienc

Large-scale genome-wide association studies and meta-analyses of longitudinal change in adult lung function.

BACKGROUND: Genome-wide association studies (GWAS) have identified numerous loci influencing cross-sectional lung function, but less is known about genes influencing longitudinal change in lung function. METHODS: We performed GWAS of the rate of change in forced expiratory volume in the first second (FEV1) in 14 longitudinal, population-based cohort studies comprising 27,249 adults of European ancestry using linear mixed effects model and combined cohort-specific results using fixed effect meta-analysis to identify novel genetic loci associated with longitudinal change in lung function. Gene expression analyses were subsequently performed for identified genetic loci. As a secondary aim, we estimated the mean rate of decline in FEV1 by smoking pattern, irrespective of genotypes, across these 14 studies using meta-analysis. RESULTS: The overall meta-analysis produced suggestive evidence for association at the novel IL16/STARD5/TMC3 locus on chromosome 15 (P  =  5.71 × 10(-7)). In addition, meta-analysis using the five cohorts with ≥3 FEV1 measurements per participant identified the novel ME3 locus on chromosome 11 (P  =  2.18 × 10(-8)) at genome-wide significance. Neither locus was associated with FEV1 decline in two additional cohort studies. We confirmed gene expression of IL16, STARD5, and ME3 in multiple lung tissues. Publicly available microarray data confirmed differential expression of all three genes in lung samples from COPD patients compared with controls. Irrespective of genotypes, the combined estimate for FEV1 decline was 26.9, 29.2 and 35.7 mL/year in never, former, and persistent smokers, respectively. CONCLUSIONS: In this large-scale GWAS, we identified two novel genetic loci in association with the rate of change in FEV1 that harbor candidate genes with biologically plausible functional links to lung function

Genome-wide association and HLA fine-mapping studies identify risk loci and genetic pathways underlying allergic rhinitis

Allergic rhinitis is the most common clinical presentation of allergy, affecting 400 million people worldwide, with increasing incidence in westernized countries1,2. To elucidate the genetic architecture and understand the underlying disease mechanisms, we carried out a meta-analysis of allergic rhinitis in 59,762 cases and 152,358 controls of European ancestry and identified a total of 41 risk loci for allergic rhinitis, including 20 loci not previously associated with allergic rhinitis, which were confirmed in a replication phase of 60,720 cases and 618,527 controls. Functional annotation implicated genes involved in various immune pathways, and fine mapping of the HLA region suggested amino acid variants important for antigen binding. We further performed genome-wide association study (GWAS) analyses of allergic sensitization against inhalant allergens and nonallergic rhinitis, which suggested shared genetic mechanisms across rhinitis-related traits. Future studies of the identified loci and genes might identify novel targets for treatment and prevention of allergic rhinitis

Osservatorio comorbidità nei grandi anziani con Fibrillazione Atriale

La Fibrillazione Atriale (FA) è una patologia correlata all’età - colpisce il 16% degli ultra ottantacinquenni - che aumenta di circa cinque volte il rischio di ictus cerebrale. La terapia anticoagulante ha un ruolo centrale nel trattamento della FA, e la sua applicazione nel paziente anziano è ostacolata dalla presenza di comorbidità, di politerapia e dalla necessità di gestione delle possibili interazioni farmacologiche. Ulteriori elementi di difficoltà derivano dalla interazione tra diversi specialisti, dall’inerzia prescrittiva, dalla complessità del sistema di accesso alle cure e, non ultimo, anche dalle difficoltà di gestione del paziente anziano in terapia anticoagulante da parte dei caregiver familiari. Obiettivo dell’Osservatorio è stato identificare le problematiche dei pazienti con FA riguardo la gestione della terapia anticoagulante in presenza di diverse patologie e terapie concomitanti, attraverso il contributo del Board multistakeholder, dell’analisi della comunicazione on line sulla FA, nonché a due survey su medici e pazienti. È stato delineato un quadro della condizione dei pazienti anziani con FA e delle difficoltà nella gestione quotidiana della malattia, a partire dal quale sono state formulate alcune proposte di intervento rivolte ai decisori, ai clinici e in generale a tutti coloro che sono chiamati alla gestione concreta della malattia insieme a pazienti e caregive