Hubungan Ukuran Lingkar Lengan Atas Ibu Hamil dengan Risiko Kejadian Persalinan Preterm di Puskesmas Kecamatan Kramat Jati Jakarta Timur

Kelahiran prematur tetap menjadi salah satu penyebab terbesar mortalitas dan morbiditas perinatal di seluruh dunia. Persalian preterm biasanya sangat berhubungan dengan kejadian infeksi. Tujuan dari penelitian ini adalah untuk mengidentifikasi hubungan ukuran lingkar lengan atas < 23 cm pada ibu hamil trimester pertama dengan resiko terjadinya persalinan preterm. Hal ini akan coba diteliti mengingat kelahiran preterm cenderung berkaitan dengan bayi BBLR danstatus nutrisi ibu yang buruk. Penelitian ini menggunakan desain studi kasus kontrol dengan jumlah total sampel sebanyak 105 yang dibagi ke dalam 2 kelompok kasus dan kontrol. Data yang digunakan berupa data sekunder, yaitu rekam medis pasien yang menjalani persalinan dan asuhanantenatal di Puskesmas Kecamatan Kramat Jati dalam rentang waktu Januari hingga Desember 2013. Data dianalisis dengan uji hipotesis Chi-Square (p<0,05) dan didapatkan rasio odds untuk setiap kelompok dengan menggunakan spss 11.5 for Windows. Dari analisis terhadap 105 sampel didapatkan hasil tidak terdapat hubungan antara LILA < 23 cm dengan resiko terjadinya persalinan preterm (p= 0,256). Odds rasio untuk kelompok kasus dan kontrol adalah 1,8 (95%CI 0,6-4,8). Karena CI melewati angka 1 maka tidak terdapat hubungan antara LILA < 23 cm dengan persalinanpreterm. Penelitian menunjukkan tidak terdapat hubungan yang bermakna secara statistik antara lingkar lengan atas kurang dari 23 cm dengan resiko kejadian persalinan preterm

Relaxed Current Matching Requirements in Highly Luminescent Perovskite Tandem Solar Cells and Their Fundamental Efficiency Limits

Perovskite-based tandem solar cells are of increasing interest as they approach commercialization. Here we use experimental parameters from optical spectroscopy measurements to calculate the limiting efficiency of perovskite–silicon and all-perovskite two-terminal tandems, employing currently available bandgap materials, as 42.0% and 40.8%, respectively. We show luminescence coupling between subcells (the optical transfer of photons from the high-bandgap to low-bandgap subcell) relaxes current matching when the high-bandgap subcell is a luminescent perovskite. We calculate that luminescence coupling becomes important at charge trapping rates (≤106 s–1) already being achieved in relevant halide perovskites. Luminescence coupling increases flexibility in subcell thicknesses and tolerance to different spectral conditions. For maximal benefit, the high-bandgap subcell should have the higher short-circuit current under average spectral conditions. This can be achieved by reducing the bandgap of the high-bandgap subcell, allowing wider, unstable bandgap compositions to be avoided. Lastly, we visualize luminescence coupling in an all-perovskite tandem through cross-section luminescence imaging

Role of the mesoamygdaloid dopamine projection in emotional learning

Amygdala dopamine is crucially involved in the acquisition of Pavlovian associations, as measured via conditioned approach to the location of the unconditioned stimulus (US). However, learning begins before skeletomotor output, so this study assessed whether amygdala dopamine is also involved in earlier 'emotional' learning. A variant of the conditioned reinforcement (CR) procedure was validated where training was restricted to curtail the development of selective conditioned approach to the US location, and effects of amygdala dopamine manipulations before training or later CR testing assessed. Experiment 1a presented a light paired (CS+ group) or unpaired (CS- group) with a US. There were 1, 2 or 10 sessions, 4 trials per session. Then, the US was removed, and two novel levers presented. One lever (CR+) presented the light, and lever pressing was recorded. Experiment 1b also included a tone stimulus. Experiment 2 applied intra-amygdala R(+) 7-OH-DPAT (10 nmol/1.0 A mu l/side) before two training sessions (Experiment 2a) or a CR session (Experiment 2b). For Experiments 1a and 1b, the CS+ group preferred the CR+ lever across all sessions. Conditioned alcove approach during 1 or 2 training sessions or associated CR tests was low and nonspecific. In Experiment 2a, R(+) 7-OH-DPAT before training greatly diminished lever pressing during a subsequent CR test, preferentially on the CR+ lever. For Experiment 2b, R(+) 7-OH-DPAT infusions before the CR test also reduced lever pressing. Manipulations of amygdala dopamine impact the earliest stage of learning in which emotional reactions may be most prevalent

Sensory Electrical Stimulation Improves Foot Placement during Targeted Stepping Post-Stroke

Proper foot placement is vital for maintaining balance during walking, requiring the integration of multiple sensory signals with motor commands. Disruption of brain structures post-stroke likely alters the processing of sensory information by motor centers, interfering with precision control of foot placement and walking function for stroke survivors. In this study, we examined whether somatosensory stimulation, which improves functional movements of the paretic hand, could be used to improve foot placement of the paretic limb. Foot placement was evaluated before, during, and after application of somatosensory electrical stimulation to the paretic foot during a targeted stepping task. Starting from standing, twelve chronic stroke participants initiated movement with the non-paretic limb and stepped to one of five target locations projected onto the floor with distances normalized to the paretic stride length. Targeting error and lower extremity kinematics were used to assess changes in foot placement and limb control due to somatosensory stimulation. Significant reductions in placement error in the medial–lateral direction (p = 0.008) were observed during the stimulation and post-stimulation blocks. Seven participants, presenting with a hip circumduction walking pattern, had reductions (p = 0.008) in the magnitude and duration of hip abduction during swing with somatosensory stimulation. Reductions in circumduction correlated with both functional and clinical measures, with larger improvements observed in participants with greater impairment. The results of this study suggest that somatosensory stimulation of the paretic foot applied during movement can improve the precision control of foot placement

Automatic construction of rule-based ICD-9-CM coding systems

Background: In this paper we focus on the problem of automatically constructing ICD-9-CM coding systems for radiology reports. ICD-9-CM codes are used for billing purposes by health institutes and are assigned to clinical records manually following clinical treatment. Since this labeling task requires expert knowledge in the field of medicine, the process itself is costly and is prone to errors as human annotators have to consider thousands of possible codes when assigning the right ICD-9-CM labels to a document. In this study we use the datasets made available for training and testing automated ICD-9-CM coding systems by the organisers of an International Challenge on Classifying Clinical Free Text Using Natural Language Processing in spring 2007. The challenge itself was dominated by entirely or partly rule-based systems that solve the coding task using a set of hand crafted expert rules. Since the feasibility of the construction of such systems for thousands of ICD codes is indeed questionable, we decided to examine the problem of automatically constructing similar rule sets that turned out to achieve a remarkable accuracy in the shared task challenge. Results: Our results are very promising in the sense that we managed to achieve comparable results with purely hand-crafted ICD-9-CM classifiers. Our best model got a 90.26 % F measure on the training dataset and an 88.93 % F measure on the challenge test dataset, using the micro-averaged Fβ=1 measure, the official evaluatio

Long-Dose Intensive Therapy Is Necessary for Strong, Clinically Significant, Upper Limb Functional Gains and Retained Gains in Severe/Moderate Chronic Stroke

Background. Effective treatment methods are needed for moderate/severely impairment chronic stroke. Objective. The questions were the following: (1) Is there need for long-dose therapy or is there a mid-treatment plateau? (2) Are the observed gains from the prior-studied protocol retained after treatment? Methods. Single-blind, stratified/randomized design, with 3 applied technology treatment groups, combined with motor learning, for long-duration treatment (300 hours of treatment). Measures were Arm Motor Ability Test time and coordination-function (AMAT-T, AMAT-F, respectively), acquired pre-/posttreatment and 3-month follow-up (3moF/U); Fugl-Meyer (FM), acquired similarly with addition of mid-treatment. Findings. There was no group difference in treatment response (P ≥ .16), therefore data were combined for remaining analyses (n = 31; except for FM pre/mid/post, n = 36). Pre-to-Mid-treatment and Mid-to-Posttreatment gains of FM were statistically and clinically significant (P \u3c .0001; 4.7 points and P \u3c .001; 5.1 points, respectively), indicating no plateau at 150 hours and benefit of second half of treatment. From baseline to 3moF/U: (1) FM gains were twice the clinically significant benchmark, (2) AMAT-F gains were greater than clinically significant benchmark, and (3) there was statistically significant improvement in FM (P \u3c .0001); AMAT-F (P \u3c .0001); AMAT-T (P \u3c .0001). These gains indicate retained clinically and statistically significant gains at 3moFU. From posttreatment to 3moF/U, gains on FM were maintained. There were statistically significant gains in AMAT-F (P = .0379) and AMAT-T P = .003

Deep-level defects in n-type GaAsBi alloys grown by molecular beam epitaxy at low temperature and their influence on optical properties

Deep-level defects in n-type GaAs1-x Bi x having 0 ≤ x ≤ 0.023 grown on GaAs by molecular beam epitaxy at substrate temperature of 378 °C have been injvestigated by deep level transient spectroscopy. The optical properties of the layers have been studied by contactless electroreflectance and photoluminescence. We find that incorporating Bi suppresses the formation of GaAs-like electron traps, thus reducing the total trap concentration in dilute GaAsBi layers by over two orders of magnitude compared to GaAs grown under the same conditions. In order to distinguish between Bi- and host-related traps and to identify their possible origin, we used the GaAsBi band gap diagram to correlate their activation energies in samples with different Bi contents. This approach was recently successfully applied for the identification of electron traps in n-type GaAs1-x N x and assumes that the activation energy of electron traps decreases with the Bi (or N)-related downward shift of the conduction band. On the basis of this diagram and under the support of recent theoretical calculations, at least two Bi-related traps were revealed and associated with Bi pair defects, i.e. (VGa+BiGa)(-/2-) and (AsGa+BiGa)(0/1-). In the present work it is shown that these defects also influence the photoluminescence properties of GaAsBi alloys

Cognitive health among older adults in the United States and in England

<p>Abstract</p> <p>Background</p> <p>Cognitive function is a key determinant of independence and quality of life among older adults. Compared to adults in England, US adults have a greater prevalence of cardiovascular risk factors and disease that may lead to poorer cognitive function. We compared cognitive performance of older adults in the US and England, and sought to identify sociodemographic and medical factors associated with differences in cognitive function between the two countries.</p> <p>Methods</p> <p>Data were from the 2002 waves of the US Health and Retirement Study (HRS) (n = 8,299) and the English Longitudinal Study of Ageing (ELSA) (n = 5,276), nationally representative population-based studies designed to facilitate direct comparisons of health, wealth, and well-being. There were differences in the administration of the HRS and ELSA surveys, including use of both telephone and in-person administration of the HRS compared to only in-person administration of the ELSA, and a significantly higher response rate for the HRS (87% for the HRS vs. 67% for the ELSA). In each country, we assessed cognitive performance in non-hispanic whites aged 65 and over using the same tests of memory and orientation (0 to 24 point scale).</p> <p>Results</p> <p>US adults scored significantly better than English adults on the 24-point cognitive scale (unadjusted mean: 12.8 vs. 11.4, P < .001; age- and sex-adjusted: 13.2 vs. 11.7, P < .001). The US cognitive advantage was apparent even though US adults had a significantly higher prevalence of cardiovascular risk factors and disease. In a series of OLS regression analyses that controlled for a range of sociodemographic and medical factors, higher levels of education and wealth, and lower levels of depressive symptoms, accounted for some of the US cognitive advantage. US adults were also more likely to be taking medications for hypertension, and hypertension treatment was associated with significantly better cognitive function in the US, but not in England (P = .014 for treatment × country interaction).</p> <p>Conclusion</p> <p>Despite methodological differences in the administration of the surveys in the two countries, US adults aged ≥ 65 appeared to be cognitively healthier than English adults, even though they had a higher burden of cardiovascular risk factors and disease. Given the growing number of older adults worldwide, future cross-national studies aimed at identifying the medical and social factors that might prevent or delay cognitive decline in older adults would make important and valuable contributions to public health.</p

Therapeutic suggestion helps to cut back on drug intake for mechanically ventilated patients in intensive care unit

Research was conducted on ventilated patients treated in an intensive care unit (ICU) under identical circumstances; patients were divided into two groups (subsequently proved statistically identical as to age and Simplified Acute Physiology Score II [SAPS II]). One group was treated with positive suggestions for 15-20 min a day based on a predetermined scheme, but tailored to the individual patient, while the control group received no auxiliary psychological treatment. Our goal was to test the effects of positive communication in this special clinical situation. In this section of the research, the subsequent data collection was aimed to reveal whether any change in drug need could be demonstrated upon the influence of suggestions as compared to the control group. Owing to the strict recruitment criteria, a relatively small sample (suggestion group n = 15, control group n = 10) was available during the approximately nine-month period of research. As an outcome of suggestions, there was a significant drop in benzodiazepine (p < 0.005), opioid (p < 0.001), and the α2-agonist (p < 0.05) intake. All this justifies the presence of therapeutic suggestions among the therapies used in ICUs. However, repeating the trial on a larger sample of patients would be recommended. © 2013 Akadémiai Kiadó, Budapest

Discussion on 'Tectonic and environmental controls on Palaeozoic fluvial environments: reassessing the impacts of early land plants on sedimentation'. Journal of the Geological Society, https://doi.org/10.1144/jgs2016-063

The first-order importance of tectonic and environmental controls for terrigenous sediment supply has rarely been questioned, but the role of vegetation in the modification of ancient alluvial signatures has been observed since the mid-20th century (Vogt 1941). Studies of sparsely vegetated rivers (Schumm 1968) and alluvial stratigraphic variation (Cotter 1978; Davies & Gibling 2010) led to observations of (1) plant modulation of alluvial signatures and (2) Palaeozoic facies shifts (PFS): unidirectional changes to facies diversity and frequency, in stratigraphic alliance with the plant fossil record. One PFS is the Siluro-Devonian appearance of mud-rich, architecturally complex alluvium, traditionally ascribed to meandering rivers, and sedimentologically distinct from pre-vegetation strata (Davies & Gibling 2010; Long 2011). Using selected secondary data, Santos et al. (2017) dispute the correlation of these observations using three key points, as follows. (1) The mid-Palaeozoic was typified by orogenic assembly of low-gradient equatorial continents and elevated sea-level, which led to tropical weathering (abundant fine sediment) and extensive alluvial plains. This drove the PFS by promoting river meandering independently of vegetation. (2) Meandering does not require vegetation; this is shown by examples in Precambrian deposits, on other planets, and in ‘non-vegetated’ deserts. Meandering rivers were more abundant than the pre-vegetation rock record suggests, owing to selective bypass and deflation of fine material. (3) Early Siluro-Devonian (meaning Ludlow–Early Devonian) land plants were too small, their biomass and cover too limited, and their wetland habitat too narrow to have stabilized meandering channels, influencing landscape little more than earlier microbial communities. We contest the conclusions and method of the paper, and deal with each point in turn