Komunitas Tanoker Ledokombo: Pendorong Perubahan Sosial Pedesaan Melalui Pendekatan Budaya Di Kecamatan Ledokombo, Kabupaten Jember, Jawa Timur

Penelitian ini membahas tentang komunitas belajar dan bermain Tanoker Ledokombo sebagai agen yang mendorong Perubahan sosial pedesaan melalui pendekatan budaya di Kecamatan Ledokombo, Kabupaten Jember. Tujuan dari penelitian ini adalah mengetahui proses transfer nilai budaya sebagai bentuk pendekatan budaya yang diberikan oleh Tanoker Ledokombo untuk diterapkan dalam kehidupan sosial anak-anak di wilayah tersebut serta mengetahui bentuk-bentuk Perubahan individu dan Perubahan kolektif yang terjadi pada masyarakatnya. Landasan teoritis dalam penelitian ini adalah teori strukturasi dengan berdasarkan pada asumsi Anthony Giddens tentang dualitas antara struktur dengan pelaku (agen); tiga gugus struktur, yaitu struktur dominasi, struktur signifikasi, dan struktur legitimasi; serta tiga tahapan kesadaran mencakup motivasi tidak sadar, kesadaran diskursif, dan kesadaran praktis. Sedangkan metode yang digunakan adalah penelitian etnografi.Hasil penelitian menunjukkan bahwa Tanoker Ledokombo mendorong Perubahan sosial pedesaan melalui pendekatan budaya dengan cara melaksanakan kegiatan pembimbingan dengan media permainan tradisional egrang sekaligus nyanyian diiringi alat musik yang kemudian dipertajam membahas tema-tema tertentu dalam kehidupan sehari-hari. Akhirnya, materi pembimbingan mengenai nilai-nilai budaya yang terdapat pada setiap medianya dapat menciptakan Perubahan sosial pedesaan. Perubahan itu dimulai dari Perubahan individu berupa Perubahan kesadaran individu yang dapat nampak melalui pola pikir dan perilaku menuju kesadaran kolektif kearah Perubahan kolektif berupa kerja sama dalam keluarga, antar masyarakat desa di dalam Kecamatan Ledokombo, dan antara masyarakat Kecamatan Ledokombo dengan masyarakat luar Kecamatan Ledokombo

Adaptive optimal slip ratio estimator for effective braking on a non-uniform condition road

In this paper, an adaptive algorithm is developed which senses the road condition change and estimates a (time-varying) optimal braking slip ratio. This is conducted by two on-line simultaneously operating tire-road friction-curve slope calculators: one based on the accelerometer output and the other based on the wheel speed. The required vehicle speed is estimated using a robust sliding-mode observer. Enforcement of the online optimal braking reference is left to an adaptive sliding mode controller to cope with the system strong nonlinearity, time dependency and the speed and friction-coefficient estimation errors. The algorithm is applied to a half model car and the braking performance is examined. The results indicate that the proposed algorithm substantially reduces the stopping time and distance. The performance of the algorithm is verified using different vehicle initial speeds and especially non-uniform road condition where 8% improvement versus the nonadaptive optimal slip ratio algorithm is recorded

Non-coding RNAs and Exosomes: Their Role in the Pathogenesis of Sepsis

Non-coding RNAs and exosomes present an opportunity for early diagnosis as well as an ability to interact with key points of the biological mechanisms, suggesting that measurement of non-coding RNAs and exosomes are a promising approach for intensive care patients. © 2020 The Author(s) Sepsis is characterized as an uncontrolled host response to infection, and it represents a serious health challenge, causing excess mortality and morbidity worldwide. The discovery of sepsis-related epigenetic and molecular mechanisms could result in improved diagnostic and therapeutic approaches, leading to a reduced overall risk for affected patients. Accumulating data show that microRNAs, non-coding RNAs, and exosomes could all be considered as novel diagnostic markers for sepsis patients. These biomarkers have been demonstrated to be involved in regulation of sepsis pathophysiology. However, epigenetic modifications have not yet been widely reported in actual clinical settings, and further investigation is required to determine their importance in intensive care patients. Further studies should be carried out to explore tissue-specific or organ-specific epigenetic RNA-based biomarkers and their therapeutic potential in sepsis patients. © 2020 The Author(s

Phytochemicals, Antioxidant and Antifungal Properties of Acorus calamus, Curcuma mangga, and Allium sativum

The purpose of this study to determine the content of phytochemicals, antioxidant and antifungal properties of the combination of Acorus calamus, Curcuma mangga, and Allium sativum. This research was descriptive qualitative, extractions were done by maceration method with ethanol with 3 different combinations (C1, C2 and C3). Phytochemical test reagent included 4 kinds of test, namely: alkaloids, flavonoids, triterpenoids, saponins and tannins. As for the antioxidant test, the method used was DPPH. The concentration used at 25, 50, 100, 200, and 400 ppm. As for the antifungal test conducted on Candida albicans with Kirby-Bauer disc methods with a concentration of 100%, followed by the MIC and MBC test with a concentration of 50%, 25%, 12.5%, 6.25%, 3.13%, 1.56%, 0.78% and 0.39%. Phytochemical test results indicated the presence of the alkaloids, flavonoids and triterpenoids compounds in 3 different combinations (C1, C2 and C3). The highest antioxidant levels founded in C1 (61.75) followed by C3 (47.94) and the lowest levels founded in C2 (42.76). The antifungal test showed the inhibitory zone against C.  albicans. The highest inhibitory zone was found in C1 at 5.44 ± 1.78 mm (medium category), followed by C2 at  4.08 ± 0.86 mm (medium category), and C3 at 3.05 ± 0.23 mm (medium category). As for the minimum inhibitory concentration (MIC) value got on the concentration of 0:39% and minimum fungisidal concentration (MFC) values were at a concentration of 0.78%.    Key word: Acorus calamu, Allium sativum, Curcuma manga, Antioxidant, antifungal, Candida albican

The effects of clinical decision support system for prescribing medication on patient outcomes and physician practice performance: a systematic review and meta-analysis

Background: Clinical Decision Support Systems (CDSSs) for Prescribing are one of the innovations designed to improve physician practice performance and patient outcomes by reducing prescription errors. This study was therefore conducted to examine the effects of various CDSSs on physician practice performance and patient outcomes. Methods: This systematic review was carried out by searching PubMed, Embase, Web of Science, Scopus, and Cochrane Library from 2005 to 2019. The studies were independently reviewed by two researchers. Any discrepancies in the eligibility of the studies between the two researchers were then resolved by consulting the third researcher. In the next step, we performed a meta-analysis based on medication subgroups, CDSS-type subgroups, and outcome categories. Also, we provided the narrative style of the findings. In the meantime, we used a random-effects model to estimate the effects of CDSS on patient outcomes and physician practice performance with a 95 confidence interval. Q statistics and I2 were then used to calculate heterogeneity. Results: On the basis of the inclusion criteria, 45 studies were qualified for analysis in this study. CDSS for prescription drugs/COPE has been used for various diseases such as cardiovascular diseases, hypertension, diabetes, gastrointestinal and respiratory diseases, AIDS, appendicitis, kidney disease, malaria, high blood potassium, and mental diseases. In the meantime, other cases such as concurrent prescribing of multiple medications for patients and their effects on the above-mentioned results have been analyzed. The study shows that in some cases the use of CDSS has beneficial effects on patient outcomes and physician practice performance (std diff in means = 0.084, 95 CI 0.067 to 0.102). It was also statistically significant for outcome categories such as those demonstrating better results for physician practice performance and patient outcomes or both. However, there was no significant difference between some other cases and traditional approaches. We assume that this may be due to the disease type, the quantity, and the type of CDSS criteria that affected the comparison. Overall, the results of this study show positive effects on performance for all forms of CDSSs. Conclusions: Our results indicate that the positive effects of the CDSS can be due to factors such as user-friendliness, compliance with clinical guidelines, patient and physician cooperation, integration of electronic health records, CDSS, and pharmaceutical systems, consideration of the views of physicians in assessing the importance of CDSS alerts, and the real-time alerts in the prescription. © 2021, The Author(s)

Immunologic finding of disseminated granuloma reaction in patients with Mycobacterium tuberculosis and sarcoidosis

AbstractIntroductionNecrotizing sarcoid granulomatosis (NSG) is a rare syndrome with unknown etiology. The disease is frequently confused with sarcoidosis and other granulomatous diseases. Diagnosis is made based on typical histologic criteria. No specific laboratory finding can confirm NSG diagnosis. The gender ratio of women to men has been reported as being as high as 4:1 and has a good prognosis.Methods and resultsIn this report, the clinical and genetic features were surveyed of a 36-year-old male with extra-pulmonary NSG with unique manifestations, such as inguinal mass with positive smear and negative culture for the infection of Mycobacterium tuberculosis (MTB), which was not responsive to the first-line TB treatment and was characterized as a multidrug-resistant (MDR) tuberculosis (TB). Later on, he was admitted for the MDR cure, and he did not react to the gold standard of MDR treatment. Finally, he presented with a huge lymphoid granuloma with massive ascites that was diagnosed as an NSG by IHC. He cured well with prednisolone and all symptoms of the disease were gone. At the hospitalization time, all laboratory experiments were well planned, such as a workup for the detection of defects of loop IL-12/IFN-γ, HLA-DR typing, and immunologic workup by flow-cytometry analysis.ConclusionThis is the first case report from patients with unique features of NSG combined with MTB

Mycobacterium Bovis infection in children in the same family: transmission through inhalation

Two children in the same family were infected with Mycobacterium bovis (“M. bovis”). The molecular typing showed an identical source of infection. Althoughon school of thought was that the route of transmission was by ingestion of contaminated dairy milk, in other it was thought to be by air-borne transmission. The presentation highlighted the possibility of M. bovis infection in the pediatrics populations through aerosols

The Recent-Transmission of Mycobacterium tuberculosis Strains among Iranian and Afghan Relapse Cases: a DNA-fingerprinting using RFLP and spoligotyping

<p>Abstract</p> <p>Background</p> <p>Relapse of tuberculosis (TB) may develop as the result of reactivation of the endogenous primary infection, or as a result of a exogenous reinfection. This survey evaluated the rate of reactivation versus recent transmission among Iranian and Afghan relapse cases.</p> <p>Methods</p> <p>The sputum specimens were digested, examined microscopically for acid-fast bacilli, and inoculated into Löwenstein-Jensen slants by standard procedures. Thereafter, the susceptibility and identification tests were performed on culture positive specimens. Subsequently, the strains that were identified as <it>Mycobacterium tuberculosis </it>(258 isolates) were subjected to IS6110 restriction fragment length polymorphism (RFLP) and spoligotyping. Additional patient's information was collected for further epidemiological analysis. Patients whose isolates had identical genotyping patterns were considered a cluster with recent transmission episode.</p> <p>Results</p> <p>Out of 258 available isolates, 72(28%) had multi-drug resistant (MDR-TB) in ratio and 42 (16.2%) had other resistant. Notably, 38 of MDR-TB cases (52%) were isolated from Afghan patients. By IS6110-RFLP typing method, 65 patients (25%) were clustered in 29 clusters. In cluster cases, the intra-community transmissions between Iranian and Afghan patients were 41%. All MDR-TB patients in clusters had either Haarlem I or Beijing characteristic. The risk factors like sex, family history, close contact, living condition, PPD test result and site of TB infection were not associated with clustering. Although, the MDR-TB strains were more frequent in non-cluster cases (31%) than cluster one(18%) (P < 0.05). Majority of <it>M. tuberculosis </it>strains isolated from non-cluster cases were belong to EAI3 (51; 30%) and CASI(32;18.6%) superfamilies.</p> <p>Conclusion</p> <p>During the studied period, reactivation of a previous infection remain the more probable cause of recurrence. Although, the evidence of intra- community transmission between Iranian and Afghan TB cases, highlighted the impact of afghan immigrants in national tuberculosis control program (NTP) of Iran.</p

High-throughput Screening and Sensitized Bacteria Identify an M. tuberculosis Dihydrofolate Reductase Inhibitor with Whole Cell Activity

Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis, is a bacterial pathogen that claims roughly 1.4 million lives every year. Current drug regimens are inefficient at clearing infection, requiring at least 6 months of chemotherapy, and resistance to existing agents is rising. There is an urgent need for new drugs that are more effective and faster acting. The folate pathway has been successfully targeted in other pathogens and diseases, but has not yielded a lead drug against tuberculosis. We developed a high-throughput screening assay against Mtb dihydrofolate reductase (DHFR), a critical enzyme in the folate pathway, and screened a library consisting of 32,000 synthetic and natural product-derived compounds. One potent inhibitor containing a quinazoline ring was identified. This compound was active against the wild-type laboratory strain H37Rv (MIC99 = 207 µM). In addition, an Mtb strain with artificially lowered DHFR levels showed increased sensitivity to this compound (MIC99 = 70.7 µM), supporting that the inhibition was target-specific. Our results demonstrate the potential to identify Mtb DHFR inhibitors with activity against whole cells, and indicate the power of using a recombinant strain of Mtb expressing lower levels of DHFR to facilitate the discovery of antimycobacterial agents. With these new tools, we highlight the folate pathway as a potential target for new drugs to combat the tuberculosis epidemic