KAJIAN PEMANFAATAN ARANG KULIT PISANG (Musa Sp.) SEBAGAI ADSORBEN DALAM PENYISIHAN LOGAM SENG (Zn) DAN TEMBAGA (Cu) PADA AIR LIMBAH DENGAN PROSES ADSORPSI BATCH DAN KONTINU

Penelitian ini adalah kajian literatur tentang pemanfaatan arang kulit pisang (musa sp.) sebagai adsorben dalam menurunkan konsentrasi logam berat Zn dan Cu pada air limbah. Tujuan penelitian ini mengkaji faktor-faktor yang mempengaruhi proses adsorpsi pada sistem batch dan kontinu. Penelitian menggunakan data sekunder yang diperoleh dari artikel ilmiah yang terbit di beberapa jurnal. Hasil pengkajian menunjukkan bahwa pengaruh faktor-faktor yang mempengaruhi adsorpsi pada sistem batch diantaranya, setiap konsentrasi adsorbat dinaikkan maka efisiensi penyisihannya bertambah; setiap kenaikan dosis adsorben maka efisiensi penyisihannya juga naik; setiap kenaikan waktu kontak maka efisiensi penyisihannya meningkat;diameter yang berukuran kecil menghasilkan efisiensi penyisihan yang tinggi; setiap kenaikan pH adsorbat maka efisiensi penyisihannya naik. Pengaruh faktor-faktor yang mempengaruhi adsorpsi pada sistem kontinu diantaranya setiap kenaikan konsentrasi pada logam Zn efisiensi penyisihan menjadi berkurang sedangkan pada logam Cu efisiensi penyisihan naik; setiap kenaikan tinggi bed pada logam Zn efisiensi penyisihan menurun sedangkan pada logam Cu efisiensi penyisihan meningkat; setiap kenaikan laju alir pada logam Zn efisiensi penyisihan menjadi naik sedangkan pada logam Cu efisiensi penyisihan menjadi turun

Review Article: New Treatments for Advanced Differentiated Thyroid Cancers and Potential Mechanisms of Drug Resistance

The treatment of advanced, radioiodine refractory, differentiated thyroid cancers (RR-DTCs) has undergone major advancements in the last decade, causing a paradigm shift in the management and prognosis of these patients. Better understanding of the molecular drivers of tumorigenesis and access to next generation sequencing of tumors have led to the development and Food and Drug Administration (FDA)-approval of numerous targeted therapies for RR-DTCs, including antiangiogenic multikinase inhibitors, and more recently, fusion-specific kinase inhibitors such as RET inhibitors and NTRK inhibitors. BRAF + MEK inhibitors have also been approved for BRAF-mutated solid tumors and are routinely used in RR-DTCs in many centers. However, none of the currently available treatments are curative, and most patients will ultimately show progression. Current research efforts are therefore focused on identifying resistance mechanisms to tyrosine kinase inhibitors and ways to overcome them. Various novel treatment strategies are under investigation, including immunotherapy, redifferentiation therapy, and second-generation kinase inhibitors. In this review, we will discuss currently available drugs for advanced RR-DTCs, potential mechanisms of drug resistance and future therapeutic avenues

Profile of Teenage Pregnancy in H. Adam Malik Hospital Medan in 2011-2015

Many of the teenagers who enter pregnancy would cause a decline in health and nutritional status. Delivery at an early age was associated with a greater health risk for the mother. To assess the profile of teenage pregnancy in H. Adam Malik Hospital Medan year 2011-2015. This study was conducted with descriptive study design using secondary data from medical records. There were 128 patients who became pregnant in their teens. Then the data were tabulated and presented in the form of frequency distribution table and were analyzed descriptively. Most pregnant women came to the hospital for parturition (60.1%) followed by preeclampsia / eclampsia (14.8%). The way of delivery of pregnant adolescent women was vaginal (52.3%) followed by cesarean (36.7%). There was no significant relationship between adolescent age of pregnant and newborn weight. There was no significant relationship between the age of the adolescent and method of delivery. Most teenage pregnancy occured between 17-19 years. Most pregnant teenagers delivered vaginally, and most of the newborns were normoweigh

Prototype Smart Fish Farm in Koi Fish farming

Koi fish is one type of ornamental fish that is much loved because it has a beautiful shape, color, and pattern. Quality koi fish can be formed with a good maintenance pattern and do not rule out environmental factors and feed, especially when koi fish are still seed-sized and maintained in aquariums when feeding and controlling the state of water temperature should be done regularly. This research aims to create an intelligent fish farm system in the form of feeding and monitoring water temperature based on the internet of things that can be controlled through a smartphone in the Blynk application as an automation system that can increase efficiency in koi fish cultivation. In this prototype, the feeding process uses the HX711 Load Cell module, RTC DS3231 sensor, and DS18B20 sensor for water temperature monitoring controlled using Atmega 2560 Arduino microcontroller with connection access using ESP8266 WiFi module, which is then delivered to Blynk application. Feeding is carried out based on the time and weight of the feed that has been determined. In the temperature control system, if the temperature is less than 25°C, then the lamp will turn on, and if the temperature is more than 27°C, then the fan will turn on, and if the temperature ranges from 25-27°C, then the fan and lights are off. The result of this study is that it can monitor the feeding process and the temperature of aquarium water in koi fish cultivation automatically

Emerging Therapeutic Options for Follicular-Derived Thyroid Cancer in the Era of Immunotherapy

Although most follicular-derived thyroid cancers are well differentiated and have an overall excellent prognosis following treatment with surgery and radioiodine, management of advanced thyroid cancers, including iodine refractory disease and poorly differentiated/undifferentiated subtypes, is more challenging. Over the past decade, better understanding of the genetic drivers and immune milieu of advanced thyroid cancers has led to significant progress in the management of these patients. Numerous targeted kinase inhibitors are now approved by the U.S Food and Drug administration (FDA) for the treatment of advanced, radioiodine refractory differentiated thyroid cancers (DTC) as well as anaplastic thyroid cancer (ATC). Immunotherapy has also been thoroughly studied and has shown promise in selected cases. In this review, we summarize the progress in the understanding of the genetic landscape and the cellular and molecular basis of radioiodine refractory-DTC and ATC, as well as discuss the current treatment options and future therapeutic avenues

Review article: new treatments for advanced differentiated thyroid cancers and potential mechanisms of drug resistance

The treatment of advanced, radioiodine refractory, differentiated thyroid cancers (RR-DTCs) has undergone major advancements in the last decade, causing a paradigm shift in the management and prognosis of these patients. Better understanding of the molecular drivers of tumorigenesis and access to next generation sequencing of tumors have led to the development and Food and Drug Administration (FDA)-approval of numerous targeted therapies for RR-DTCs, including antiangiogenic multikinase inhibitors, and more recently, fusion-specific kinase inhibitors such as RET inhibitors and NTRK inhibitors. BRAF + MEK inhibitors have also been approved for BRAF-mutated solid tumors and are routinely used in RR-DTCs in many centers. However, none of the currently available treatments are curative, and most patients will ultimately show progression. Current research efforts are therefore focused on identifying resistance mechanisms to tyrosine kinase inhibitors and ways to overcome them. Various novel treatment strategies are under investigation, including immunotherapy, redifferentiation therapy, and second-generation kinase inhibitors. In this review, we will discuss currently available drugs for advanced RR-DTCs, potential mechanisms of drug resistance and future therapeutic avenues

Emerging therapeutic options for follicular-derived thyroid cancer in the era of immunotherapy

Although most follicular-derived thyroid cancers are well differentiated and have an overall excellent prognosis following treatment with surgery and radioiodine, management of advanced thyroid cancers, including iodine refractory disease and poorly differentiated/undifferentiated subtypes, is more challenging. Over the past decade, better understanding of the genetic drivers and immune milieu of advanced thyroid cancers has led to significant progress in the management of these patients. Numerous targeted kinase inhibitors are now approved by the U.S Food and Drug administration (FDA) for the treatment of advanced, radioiodine refractory differentiated thyroid cancers (DTC) as well as anaplastic thyroid cancer (ATC). Immunotherapy has also been thoroughly studied and has shown promise in selected cases. In this review, we summarize the progress in the understanding of the genetic landscape and the cellular and molecular basis of radioiodine refractory-DTC and ATC, as well as discuss the current treatment options and future therapeutic avenues

Multimodal population brain imaging in the UK Biobank prospective epidemiological study

Medical imaging has enormous potential for early disease prediction, but is impeded by the difficulty and expense of acquiring data sets before symptom onset. UK Biobank aims to address this problem directly by acquiring high-quality, consistently acquired imaging data from 100,000 predominantly healthy participants, with health outcomes being tracked over the coming decades. The brain imaging includes structural, diffusion and functional modalities. Along with body and cardiac imaging, genetics, lifestyle measures, biological phenotyping and health records, this imaging is expected to enable discovery of imaging markers of a broad range of diseases at their earliest stages, as well as provide unique insight into disease mechanisms. We describe UK Biobank brain imaging and present results derived from the first 5,000 participants' data release. Although this covers just 5% of the ultimate cohort, it has already yielded a rich range of associations between brain imaging and other measures collected by UK Biobank

Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM<inf>2·5</inf> air pollution, 1990–2019: an analysis of data from the Global Burden of Disease Study 2019

Background: Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution. Methods: We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure–response curve from the extracted relative risk estimates using the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals. Findings: In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68–4·83) deaths per 100 000 population and 167 (117–223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49–17·5) of deaths and 13·6% (9·73–17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22–9·53) of deaths and 5·92% (3·81–8·64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2·5. Interpretation: Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes. Funding: Bill & Melinda Gates Foundation

Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016–40

Background: Achieving universal health coverage (UHC) requires health financing systems that provide prepaid pooled resources for key health services without placing undue financial stress on households. Understanding current and future trajectories of health financing is vital for progress towards UHC. We used historical health financing data for 188 countries from 1995 to 2015 to estimate future scenarios of health spending and pooled health spending through to 2040. Methods: We extracted historical data on gross domestic product (GDP) and health spending for 188 countries from 1995 to 2015, and projected annual GDP, development assistance for health, and government, out-of-pocket, and prepaid private health spending from 2015 through to 2040 as a reference scenario. These estimates were generated using an ensemble of models that varied key demographic and socioeconomic determinants. We generated better and worse alternative future scenarios based on the global distribution of historic health spending growth rates. Last, we used stochastic frontier analysis to investigate the association between pooled health resources and UHC index, a measure of a country's UHC service coverage. Finally, we estimated future UHC performance and the number of people covered under the three future scenarios. Findings: In the reference scenario, global health spending was projected to increase from US$10 trillion (95$20 trillion (18 trillion to 22 trillion) in 2040. Per capita health spending was projected to increase fastest in upper-middle-income countries, at 4·2% (3·4–5·1) per year, followed by lower-middle-income countries (4·0%, 3·6–4·5) and low-income countries (2·2%, 1·7–2·8). Despite global growth, per capita health spending was projected to range from only $40 (24–65) to$413 (263–668) in 2040 in low-income countries, and from $140 (90–200) to$1699 (711–3423) in lower-middle-income countries. Globally, the share of health spending covered by pooled resources would range widely, from 19·8% (10·3–38·6) in Nigeria to 97·9% (96·4–98·5) in Seychelles. Historical performance on the UHC index was significantly associated with pooled resources per capita. Across the alternative scenarios, we estimate UHC reaching between 5·1 billion (4·9 billion to 5·3 billion) and 5·6 billion (5·3 billion to 5·8 billion) lives in 2030. Interpretation: We chart future scenarios for health spending and its relationship with UHC. Ensuring that all countries have sustainable pooled health resources is crucial to the achievement of UHC. Funding: The Bill & Melinda Gates Foundation