Computational neurorehabilitation: modeling plasticity and learning to predict recovery

Despite progress in using computational approaches to inform medicine and neuroscience in the last 30 years, there have been few attempts to model the mechanisms underlying sensorimotor rehabilitation. We argue that a fundamental understanding of neurologic recovery, and as a result accurate predictions at the individual level, will be facilitated by developing computational models of the salient neural processes, including plasticity and learning systems of the brain, and integrating them into a context specific to rehabilitation. Here, we therefore discuss Computational Neurorehabilitation, a newly emerging field aimed at modeling plasticity and motor learning to understand and improve movement recovery of individuals with neurologic impairment. We first explain how the emergence of robotics and wearable sensors for rehabilitation is providing data that make development and testing of such models increasingly feasible. We then review key aspects of plasticity and motor learning that such models will incorporate. We proceed by discussing how computational neurorehabilitation models relate to the current benchmark in rehabilitation modeling – regression-based, prognostic modeling. We then critically discuss the first computational neurorehabilitation models, which have primarily focused on modeling rehabilitation of the upper extremity after stroke, and show how even simple models have produced novel ideas for future investigation. Finally, we conclude with key directions for future research, anticipating that soon we will see the emergence of mechanistic models of motor recovery that are informed by clinical imaging results and driven by the actual movement content of rehabilitation therapy as well as wearable sensor-based records of daily activity

Hubungan Tingkat Pengetahuan Dengan Gaya Hidup Penyandang Diabetes Mellitus Tipe 2 Di Wilayah Kerja Puskesmas Purwosari Kota Surakarta

Diabetes mellitus is caused by insufficient pancreatic hormone insulin to neutralize blood sugar in the body. As a result, the pancreas can not produce enough hormone insulin to neutralize blood sugar. Diabetes mellitus is generally caused by uncontrolled food consumption or as a side effect of certain drugs. This study aims to determine the relationship between the level of knowledge with the lifestyle of people with Type 2 Diabetes Mellitus in the work area PurwosariPuskesmas Surakarta. This research is a quantitative research with descriptive correlative design, while data collection using cross sectional approach. The study population was all type 2 diabetes mellitus in PurwosariPurwosari working area of Surakarta city with population of 156 people, while the sample of the study were 60 diabetic patients with proportional random sampling technique. The data were collected using questionnaires, while data analysis used chi square test. The result of chi square test of relationship of knowledge level to lifestyle relationship of diabetics’ mellitus obtained 2value counted 10,713 with value of significance (p-value) equal to 0,005. The conclusion of this study is the level of knowledge of diabetes mellitus patients is mostly good, lifestyle in patients with diabetes mellitus is mostly good, and there is a relationship between knowledge with lifestyle in patients with diabetes mellitus in PurwosariPuskesmas Surakarta

Lung function indices for predicting mortality in COPD

Chronic obstructive pulmonary disease (COPD) is characterised by high morbidity and mortality. It remains unknown which aspect of lung function carries the most prognostic information and if simple spirometry is sufficient. Survival was assessed in COPD outpatients whose data had been added prospectively to a clinical audit database from the point of first full lung function testing including spirometry, lung volumes, gas transfer and arterial blood gases. Variables univariately associated with survival were entered into a multivariate Cox proportional hazard model. 604 patients were included (mean±sd age 61.9±9.7 years; forced expiratory volume in 1 s 37±18.1% predicted; 62.9% males); 229 (37.9%) died during a median follow-up of 83 months. Median survival was 91.9 (95% CI 80.8–103) months with survival rates at 3 and 5 years 0.83 and 0.66, respectively. Carbon monoxide transfer factor % pred quartiles (best quartile (>51%): HR 0.33, 95% CI 0.172–0.639; and second quartile (51–37.3%): HR 0.52, 95% CI 0.322–0.825; versus lowest quartile (<27.9%)), age (HR 1.04, 95% CI 1.02–1.06) and arterial oxygen partial pressure (HR 0.85, 95% CI 0.77–0.94) were the only parameters independently associated with mortality. Measurement of gas transfer provides additional prognostic information compared to spirometry in patients under hospital follow-up and could be considered routinely

Hubungan Olahraga Dengan Kejadian Komplikasi Diabetes Mellitus Tipe 2 Di RSUD Dr. Moewardi Surakarta

CORRELATION SPORTS ACTIVITY WITH EVENTS COMPLICATIONS IN DIABETES MELLITUS TYPE 2 AT DR. MOEWARDI HOSPITAL OF SURAKARTA Abstract By: Ratih Saralangi Complications in patients with type 2 diabetes mellitus sufferers may be harmful to the body if not treated properly, diabetes can lead to complications such as kidney failure, diabetic retinopathy, diabetic ulcers and hypertension that are harmful to the body. One attempt to control the quality of life of patients with diabetes mellitus type 2 is a sport. Exercise affects the improvement in insulin sensitivity so as to control blood glucose. The impact of sport on insulin sensitivity is not settled, so that sports that do patients with type 2 diabetes mellitus should be routine. This study aims to examine the relationship of sports to the incidence of complications of Type 2 diabetes mellitus in patients at Poli In Hospital Dr. Moewardi Surakarta. This research is descriptive analytic with cross sectional approach. Sample of research is diabetes patients in Poli In Hospital Dr. Moewardi central Java province in 2015. The research samples were 42 respondents using purposive sampling technique. Collecting data using interview quide were analyzed using correlation Kendal Tau. The results of research to test Kendal Tau obtained obs -0.420 (p-value 0.001) so the test decision was H0 rejected.Conclusion of the study were (1) the majority of patients with type 2 diabetes in Poli In Hospital Dr. Moewardi Surakarta exercise with less category, (2) half of patients with type 2 diabetes mellitus in Poli In Hospital Dr. Moewardi Surakarta had complications, and (3) there was a relationship between the sport with the incidence of complications of Type 2 diabetes mellitus in patients at Poli In Hospital Dr. Moewardi Surakarta. Keywords: sport, complications, type 2 diabetes patient

Monitoring the vascular response and resistance to sunitinib in renal cell carcinoma in vivo with susceptibility contrast MRI

Antiangiogenic therapy is efficacious in metastatic renal cell carcinoma (mRCC). However, the ability of antiangiogenic drugs to delay tumor progression and extend survival is limited, due to either innate or acquired drug resistance. Furthermore, there are currently no validated biomarkers that predict which mRCC patients will benefit from antiangiogenic therapy. Here, we exploit susceptibility contrast MRI (SC-MRI) using intravascular ultrasmall superparamagnetic iron oxide particles to quantify and evaluate tumor fractional blood volume (fBV) as a noninvasive imaging biomarker of response to the antiangiogenic drug sunitinib. We also interrogate the vascular phenotype of RCC xenografts exhibiting acquired resistance to sunitinib. SC-MRI of 786-0 xenografts prior to and 2 weeks after daily treatment with 40 mg/kg sunitinib revealed a 71% (P < 0.01) reduction in fBV in the absence of any change in tumor volume. This response was associated with significantly lower microvessel density (P < 0.01) and lower uptake of the perfusion marker Hoechst 33342 (P < 0.05). The average pretreatment tumor fBV was negatively correlated (R2 = 0.92, P < 0.0001) with sunitinib-induced changes in tumor fBV across the cohort. SC-MRI also revealed suppressed fBV in tumors that acquired resistance to sunitinib. In conclusion, SC-MRI enabled monitoring of the antiangiogenic response of 786-0 RCC xenografts to sunitinib, which revealed that pretreatment tumor fBV was found to be a predictive biomarker of subsequent reduction in tumor blood volume in response to sunitinib, and acquired resistance to sunitinib was not associated with a parallel increase in tumor blood volume

Dampak psikososial akibat kejadian pandemi Covid-19 pada tenaga medis : literature review

Covid-19 merupakan coronavirus jenis baru yang ditemukan di Wuhan, Hubei, Chinapadatahun 2019, semenjak kemunculannya hingga saat ini banyak dilaporkan ribuan bahkanjutaankasus terkait Covid-19, sehingga menyebabkan peningkatan beban kerja pada tenaga medisyang kemudian memunculkan respon kecemasan, stress, depresi, hingga PTSDpada tenagamedis. Tujuan dari penelitian ini adalah untuk mengetahui dampak psikososial yangdialami tenaga medis selama masa pandemi Covid-19 berlangsung. Litertur Review : cross sectional study menggunakan alur tabel prisma, dengan subjek adalah tenaga medis yang bekerja selamapandemi atau yang menangani kasus Covid-19, menggunakan naskah full teks, berbahasaIndonesia dan Inggris yang diterbitkan dari tahun 2020-2021. Dari jurnal yang dianalisisdidapatkan hasil bahwa dampak psikososial Covid-19 pada tenaga medis adalah ketakutan, kecemasan (anxiety), depresi, stres, gangguan tidur, burnout, beberapa tenaga medis jugamengubah kebiasaan berpakaian, beberapa juga menyatakan bahwa penggunaan APDdirasatidak nyaman, tidak merasa puas dengan ketersediaan APD selama masa pandemi, sertaketidakpuasaan terhadap jumlah tenaga medis dan dokter spesialis yang tidak sebandingdengan peningkatan jumlah kasus Covid-19. Dampak psikososial pada tenaga medis terbagi menjadi 3 aspek, diantaranya aspek psikologis, fisik, dan sosial. Yang termasuk dalamaspekpsikologis yaitu, ketakutan, kecemasan (anxiety), depresi dan stress. Pada aspek fisikberupa, gangguan tidur, burnout, mengubah kebiasaan perpakaian, serta merasa terganggu atautidaknyaman ketika menggunakan APD. Sedangkan pada aspek sosial petugas medis merasatidakpuas dengan ketersediaan APD, serta merasa kekurangan dokter ataupun dokter spesialisyangmembantu dalam penanganan pandemi Covid-19

DESKRIPSI KARAKTERISTIK RESPONDEN, PENYAKIT PENYERTA DAN KEPATUHAN KONTROL PENDERITA HIPERTENSI

Hypertension is a disease that is often found in primary health care. Risk factors that can cause high blood pressure include a history of high blood pressure, obesity, high salt levels, alcoholic beverages, a smoking lifestyle, and old age. This study aims to determine the description of the respondent's characteristics, comorbidities and control compliance of patients with hypertension. This type of research is descriptive quantitative involving 336 respondents obtained through purposive sampling technique. The instrument in this study was data collection containing age, gender, length of suffering, comorbidities and control compliance. The results of the research on the characteristics of the respondents obtained that the sex of the hypertension sufferers were mostly women (69%), the age of the patients with hypertension were 56-65 years (34%), the majority of the patients were 1-5 years old (90.5%), Hypertension co-morbidities with diabetes mellitus ( 39%), heart failure (6%), diabetes mellitus and heart failure (2%), hypertensive patients who do not have comorbidities (53%), the majority of patients with hypertension control compliance are not obedient (96%). Suggestions For health services are expected to improve nursing care on patient control compliance by providing education and motivation to patient

Hubungan Cardiothoracic Ratio dengan Kemampuan Aktivitas Fisik Pasien Congestive Heart Failure

Congestive Heart Failure (CHF) is a condition where the heart fails to pump blood throughout the body, causing the heart to work harder in order to meet the nutritional and circulatory needs of the body. This disease is the first cause of death in Indonesia. The purpose of this study was to determine the relationship between the Cardiothoracic Ratio and the ability of physical activity in patients with Congestive Heart Failure. The design of this study used a cross sectional method. Sampling was done by non-probability sampling with purosive sampling method, while the sample in this study were patients with heart failure who had control at the Cardiology Polyclinic of UNS Surakarta Hospital with a total of 153 respondents. The research instrument in this study used the IPAQ-LF questionnaire which consisted of 27 questions and was grouped into four domains including work, transportation, activities inside and outside the home, and leisure time. The results showed that there was a significant inverse relationship between the Cardiothoracic Ratio and the physical activity ability of Congestive Heart Failure patients at the Cardiology Polyclinic of UNS Hospital

Kepatuhan Diet Rendah Garam pada Penderita Hipertensi di Desa Drono Kecamatan Ngawen Kabupaten Klaten

Hypertension is a non-communicable disease that has an increased incidence every year. Hypertension alone is an increase in systolic blood pressure above 140 mmHg and an increase in diastolic blood pressure above 90 mmHg. Hypertension prevalence in the Ngawen Community Health Center work area was recorded as 1937 cases in 2018. Drono Village, Ngawen District, Klaten Regency was ranked second with hypertension sufferers as many as 190 people. Management of non-pharmacological hypertension is appropriate, one of which is by adhering to a low salt diet. The purpose of this study was to determine the description of hypertension diet compliance in Drono Village, Ngawen District, Klaten Regency. This study uses quantitative descriptive methods. The population is 190 people with hypertension. The sampling technique used purposive sampling technique, a sample of 71 patients with hypertension. This study 2 was analyzed using univariate analysis. The results obtained on average respondents are in the age range 51-60 years as much as 49.3%. Female sex dominates as much as 73.2%. The majority of the respondent's work in this study as laborers was 36.6%. Middle school education dominates in research as much as 36.6%. The majority of respondents were not obedient in choosing low salt foods as much as 69%. The frequency of compliance with hypertension patients chose low salt foods, the majority of respondents did not comply with as many as 39 people (55%). The frequency of compliance of hypertensive patients in avoiding the use of sodium-based herbs, the majority of respondents did not obey as many as 37 people (52%). The frequency of compliance with hypertension patients avoids sodium-preserved foods, the majority of respondents obey as many as 58 people (82%). The frequency of compliance with hypertension patients reduces the consumption of foods with high salinity, the majority of respondents obey as many as 60 people (85%). The frequency of compliance with hypertension patients reduces the sodium spice processed products, the majority of respondents are 56 people (78.9%

Gambaran Masalah Psikologis pada Pasien Gagal Jantung di RSUD Dr. Moewardi Surakarta

Abstrac Heart failure is a clinical syndrome that arises from ventricular dysfunction, where the heart cannot pump blood to meet the body's metabolic needs. This condition can result in shortness of breath, intolerance of activities that have an impact on the psychological condition of the sufferer. The psychological impact of heart failure is very complex and will trigger negative emotions such as depression, anger, hostility, stress and anxiety. To describe the psychological problems in heart failure patients at Dr. Moewardi Surakarta. Analytical quantitative design with cross sectional approach was used in this study. The number of research samples is 60 respondents taken by accidental sampling. The most gender average in this study sample is male sex that is equal to 32 respondents (53.3%). The age of the respondents in this study was the largest aged 56 - 65 years, as many as 25 respondents (41.7%). The biggest work in this study sample is working as an entrepreneur, which is 18 respondents (30.0%). Education in the largest sample of this study was elementary education with 23 respondents (38.3%). The biggest duration of illness in this study sample was 1-5 years, as many as 46 respondents (76.7%). The average stress on respondents is normal or not stressed by 46 respondents (76.7%). The biggest anxiety of respondents in this study was normal or those who did not experience anxiety by 23 respondents (38.3%). Depression respondents in this study were the largest normal or not depressed by 58 respondents (96.7%)