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Public service is the fulfillment of the wishes and needs of the community by state administrators. The basis of the establishment of the state is to meet the welfare of the people. It is the duty of the state to meet the needs of the people. One of them is the need for good health and easy access. To meet the community's need for access to health care, the Regent of Pamekasan, Baddrut Tamam, initiated a program called Pamekasan Call Care where the program is a priority program in Pamekasan. This program provides many cars spread over 178 villages located in 13 sub-districts in Pamekasan district. People who need assistance in accessing health simply call the available phone number and they will immediately be picked up to be delivered to the desired health facility. Although it has been implemented since 2020, it turns out that the implementation of this program has not been without obstacles. Problems such as the lack of the number and competence of existing human resources and limited accessibility make this a challenge for the Pamekasan Call Care program. [ABSTRACT FROM AUTHOR]

The mining industry provides benefits to the state in the mining sector as a source of state revenue and a foreign exchange earner. Utilization of natural resources, one of which is open-pit coal mining in forest areas, to obtain these benefits, but on the other hand causes environmental damage. Various regulations have been made, including the Law of the Republic of Indonesia No. 3 of 2020, Government Regulation No. 78 of 2010 and Government Regulation No. 22 of 2021 by requiring mining companies to submit a certain amount of funds as collateral for reclamation and post-mining. Mining operations have a significant impact on the environmental landscape. During the mining operation, the area that was previously covered with vegetation turns into open land with various topography, causing erosion and sedimentation of waterways/rivers around the mining site and other impacts that will be caused by KEPMEN ESDM No. 1827 of 2018 concerning the rules of good mining implementation and supervision of Mineral and Coal mining, the regulation above requires all mining business license holders to carry out reclamation activities to organize, restore and improve the quality of the ecosystem and environment at the IUP location in order to comply with the AMDAL document that has been mutually agreed upon., This reclamation activity can be carried out as long as the mining business permit is still valid, (Law of the Republic of Indonesia, 2020). The purpose of this research is to analyze the reclamation plan and reclamation guarantee of PT Tambulun Pangian Indah for the 2016-2019 period, to analyze the post-mining plan and post-mining costs of PT Tambulun Pangian Indah for the 2020-2024 period, to analyze the suitability of the reclamation and post-mining guarantee costs that have been implemented by PT. Tambulun Pangian Indah in order to improve the quality of the environment and obtain a good success rate. [ABSTRACT FROM AUTHOR]

Indonesia is a developing country that experiences high population growth every year. Population growth has an impact on the high demand for land use. Land use is often not in harmony with population growth, so land use does not align with regional spatial conditions. This study aims to determine land use in 2021 in Binjai City based on the 2020-2040 Regional Spatial Plan (RTRW) using Spot 6 imagery and determine the suitability of 2021 land use in Binjai City based on the 2020-2020 Regional Spatial Plan (RTRW) 2040 using Image Spot 6. This study is located in Binjai City, administratively flanked by two significant regencies: Langkat Regency and Deli Serdang Regency. The population of this research is the City of Binjai, with an area of 90.23 km². Data collection techniques are documentation study techniques, image interpretation, and field observations. Data analysis was carried out in a qualitative descriptive manner. The results of the study show that Land use in Binjai City in 2021 includes an agricultural area of 52.93 km² with a percentage of 58.66%, then a residential area of 33.85 km² with a percentage of 37.63%, area conservation has an area of 1.58 km² with a percentage of 1.75%, river bodies have an area of 0.90 km² with a percentage of 1%, local protected areas have an area of 0.38 km² with a percentage of 0.39%, defense and security areas have an area of 0.45 km² with the percentage of 0.42%, industrial designation area of 0.12 km² with a percentage of 0.15%, tourism area of 0.01 km² with a percentage of 0.01%, and lakes/situ area of 0.01% 0.01 km² with a percentage of 0.01%. The suitability of land use in 2021 with the Binjai City Spatial Plan (RTRW) for 2020-2040 is an area of 43.64 km² with a percentage of 48.36% which is suitable while that which is not suitable is 46, 59 km² with a percentage of 51.64%. [ABSTRACT FROM AUTHOR]

An increase in population increases the rate of urbanization. This results in changes in land cover from vegetation to artificial material. As a result, much of the land surface reflects the sun's energy. Consequently, this increases the surface temperature of the land. An increase in land surface temperature (LST) will increase the intensity of rainfall. Therefore, the present study aimed to investigate the relationship between the increase in LST and rainfall intensity. Changes in land cover can be detected by normalized difference vegetation index (NDVI) and normalized difference built-up index (NDBI) parameters. Landsat satellite imagery was used to detect NDVI, NDBI, and LST. Image processing was done for imageries scanned in 1995, 2015, 2017, and 2021. Two areas in the East Java Province of Indonesia, namely Malang City and Pasuruan Area, were selected. The daily rainfall intensity data were collected from related rainfall stations in the same year. The Mononobe method was applied to analyze hourly and minute rainfall intensity. IDF curves were drawn from the analyzed results. The relationship between both parameters was analyzed by comparing the LST and hourly rainfall intensity from the IDF curve. The studied results showed that the maximum temperature increase from 1995 to 2021 for the Malang City and Pasuruan Area was 2.60 C and 7.60 C, respectively. For rain, the maximum rainfall intensity increased by 58 mm for Malang City and 18 mm for the Pasuruan Area. LST and rainfall intensity change trends of the two areas had a positive coefficient of regression. The findings can be used to predict the rainfall intensity and floods based on the LST data. [ABSTRACT FROM AUTHOR]

Background: Congenital heart disease (CHD) is associated with high morbidity and mortality, especially among those with undernutrition. Evaluating risk factors associated with undernutrition is important to improve clinical outcomes. We aimed to evaluate the outcome and factors associated with undernutrition among children with CHD. Material and methods: A prospective cohort study was conducted among children with CHD at Dr. Sardjito Hospital, Yogyakarta, Indonesia during February 2016 to June 2018. Clinical and demographic data were collected at the time of diagnosis. Multivariate logistic regression analysis was used to identify independent factors associated with undernutrition using odds ratio (OR) and 95% confidence interval (CI). Significance was set as p<0.05. Results: We recruited 1,149 children with CHD, of those, 563 (49%) were underweight, 549 (47.8%) were stunting, and 361 (31.4%) were wasting. In the multivariate analysis, cyanotic CHD, delayed diagnosis, congestive heart failure, pulmonary hypertension, syndrome, young maternal age, history of low birth weight, and being first child were independently associated with undernutrition. Underweight and stunting were significantly associated with increased mortality with OR of 3.54 (95% CI: 1.62–7.74), p<0.001 and OR 3.31 (95% CI: 1.65–6.64), p<0.001, respectively. Conclusions: About half of the children with CHD were categorized with undernutrition. An increased risk of undernutrition was associated with cyanotic CHD, delayed diagnosis, congestive heart failure, pulmonary hypertension, syndrome, low birth weight, and being first child. Underweight and stunting were significantly associated with increased risk of death. [ABSTRACT FROM AUTHOR]

White vanamae shrimp is one of the superior commodities in aquaculture. Currently, the productivity of white vanamae shrimp has not yet reached its production target. So, it is necessary to increase the amount of production on a gradual scale carried out by the community. In shrimp farming activities, disease problems are often encountered. Namely is a white stool, white feces, or White Feces Disease (WFD). The clinical symptoms that arise when shrimp are attacked by White Feces Disease (WFD) are that the shrimp's appetite decreases, the shrimp's intestines change color to white and even look empty due to lack of food intake, white feces floating on the surface of the water, and the shrimp's growth becomes abnormal. This WFD disease can be caused by poor cultivation practices, unhealthy seeds, and poor water quality, causing the emergence of disease microorganisms such as Vibrio sp bacteria. One way to treat this disease is to provide alternative medicine, noni fruit extract. This research consisted of 3 noni extract treatments and consisted of 3 replications, namely Treatment A: 10 mL/L; Treatment B: 15 mL/L; Treatment C: 20 mL/L. The noni dose is given at the specified dose once daily for one month. The survival rate of shrimp increased to 86.7% [ABSTRACT FROM AUTHOR]

Objective: To investigate whether swimming exercise at the early age has any effect to the body system especially on the body weight and blood parameters of male rats. Subjects and method: Twenty male Sprague Dawley pups were divided into two groups as control and forced swimming test (FST) groups. Each group consists of ten pups. At the age of 7, 8 and 9 days, the pups were forced to swim in the warm water (30 ± 0.5 °C) for 60 sec and 90 sec, respectively. The pups were then removed from the water, dried with a towel and placed in a warm enclosure. They were returned to their mother after regained a pink color and able to move on their own. Blood smear was taken from the tail vein and their body weight was measured weekly. Results: There was no mortality rate occurs after the FST. Neutrophil/lymphocyte ratio was significantly increased in FST group (p< 0.05). The body weight of control and the FST groups were increased with the pups' age. However, the body weight for FST group was significantly decreased starting on days 14, 21, 28, 35 and 42 and returned to normal on days 49 and 56. Discussion and conclusion: This study shows that neonatal FST can cause the stress to the male rat pups but not up to kill them. For the future experimental works, we will evaluate any changes in the hippocampus on days 9, 16, 30 and 51 after the FST via neurogenesis. Analysis of the stress hormone level at the respective ages will be conducted and its relationship with the changes of hippocampus will be determined. [ABSTRACT FROM AUTHOR]

Introduction: This study was conducted to investigate the therapeutic role of Theobroma cacao in depressive disorders model on mice. The parameters used were forced swimming test (FST) and tail suspension test (TST). Theobroma cacao is locally known as chocolate, cacao or cocoa. Methodology: Fifty male mice were divided into 5 groups (n=5). Group 1 served as control group (vehicle treated), [N (F)] that exposed to FST and [N (T)] that exposed to TST. Group 2 was given antidepressant drug, Amitriptyline Hydrochloride (dose = 15mg/kg BW/day) that exposed to FST [Ax (F)] or TST [Ax (T)]. Group 3 treated with low concentration of Theobroma cacao extract (dose = 10 mg/kg BW/day) and exposed to FST [Tx1 (F)] or TST [Tx1 (T)]. Group 4 was treated with medium concentration of Theobroma cacao extract (dose = 30 mg/kg BW/day) and exposed to FST [Tx2 (F)] or TST [Tx2 (T)]. Group 5 was treated with high concentration of Theobroma cacao extract (dose = 100 mg/kg BW/day) and exposed to FST [Tx3 (F)] or TST [Tx3 (T)]. Anti-depressant drug and the three dosages of extract were fed for seven successive days by force-feeding. Results: Analysis of variance showed that [Ax(F)] and [Tx3(F)] reduced immobility time significantly as compared to control [N(F)] in FST group. While in TST, [Ax(T)], [Tx1(T)] and [Tx3(T)] reduced the immobility time significantly compared from the control [N(T)]. Conclusion: These findings showed that Theobroma cacao intake was able to reduce immobility time in animal model of depression, similar to Amitriptyline Hydrochloride. Thus, Theobroma cacao may have potential therapeutic value for the management of depressive disorders. [ABSTRACT FROM AUTHOR]

Rheumatic heart disease (RHD) is associated with high morbidity and mortality, especially in those with severe RHD or progression of valvular disease (VD). Evaluation of the factors that predict valvular progression is important in order to improve clinical outcome. To evaluate outcome and clinical predictors of valvular progression in children with newly diagnosed RHD. A retrospective cohort study was conducted in children with newly diagnosed RHD at Dr Sardjito Hospital, Yogyakarta, Indonesia during 2013–2020. Clinical and echocardiography data at the time of diagnosis were collected and patients were followed up for 1 year. Echocardiography evaluations were undertaken to determine the progression of VD. Independent predictors of valvular progression were identified by Cox regression analysis. A total of 77 patients were recruited, 36 (46.7%) of whom were male, and the median age (range) was 12.3 years (5.9–17.8). Thirty-three (42.8%) had progression of VD in the year after diagnosis. By multivariable analysis, an age at diagnosis of >10 years and high C-reactive protein (CRP) were independently associated with an increased risk of valvular progression with an adjusted hazard ratio (95% CI) of 3.23 (1.09–9.60) and 3.69 (1.45–9.67), respectively. After only 1 year of follow-up, approximately four in 10 children with newly diagnosed RHD developed progression of VD. An increased risk of valvular progression was associated with being over 10 years of age and a high level of CRP. [ABSTRACT FROM AUTHOR]

Background: Transmission of infection between patients by health workers, and the irrational use of antibiotics are preventable causes for healthcare-associated infections (HAI) and multi-resistant organisms. A previous study implementing a hand hygiene campaign and antibiotic stewardship program significantly reduced these infections. Sustaining such interventions can be challenging. Aims: To evaluate whether there was a sustained effect of a multifaceted infection control and antibiotic stewardship program on HAI and antibiotic use 5 years after it began. Methods: A prospective evaluation study was conducted over 26 months (from February 2016 to April 2018) in a teaching hospital in Indonesia, 5 years after the implementation of an antibiotic stewardship and infection control program, which was successful when initially evaluated. All children admitted to the pediatric ICU and pediatric wards were observed daily. Assessment of HAI was made based on the criteria from the Centers for Disease Control and Prevention. Assessment of rational antibiotic use was based on the WHO Pocket Book of Hospital Care for Children. Multivariable logistic regression analysis was used to quantify the relationship between the HAI and the multifaceted intervention. Results: We observed an increase in HAIs, from 8.6% (123/1419 patients) in the initial post-intervention period in 2011–2013 to 16.9% (314/1855) in the evaluation study (relative risk (RR) (95% CI) 1.95 (1.60 to 2.37)). After adjusting for potential confounders, we found that an increase in HAI in the evaluation period with adjusted OR 1.94 (95% CI 1.53 to 2.45). Inappropriate antibiotic use also increased, from 20.6% (182 of 882 patients who were prescribed antibiotics) to 48.6% (545/1855) (RR 2.35 (2.04 to 2.71)). Hand hygiene compliance also declined from 62.9% (1125/1789) observed moments requiring hand hygiene to 51% (1526/2993) (RR 3.33 (2.99 to 3.70)). Conclusions: Healthcare-associated infections and irrational use of antibiotics remain significant even after the implementation of a multifaceted infection control intervention and antibiotic stewardship program. There is a need for continuous input, ongoing surveillance and long-term monitoring of these interventions to sustain compliance and effectiveness and address problems as they emerge. [ABSTRACT FROM AUTHOR]

Introduction: The expression of proto-oncogene c-fos in brain is very dependent upon physiologic processes and experimental manipulation. Studies have suggested that after thermal stress, animals exhibit cardiovascular and neuronal changes. In addition, stress and pain induced expression of Fos. However, information of Fos expression in the spinal cord after exposure to stress in rats is still lacking. This study investigates the changes in gene expression in the spinal cord after acute thermal shock applied in both hind limbs. Methodology: Twelve adult male Sprague dawley rats were used. Anaesthesia was induced with pentobarbital at dose 50 mg/kg i.p. Heat was given at 42°C for 15 min. Six male rats were used in each group: thermal and control groups. At 2 h after heat stimulation, animals were deeply anesthetized, perfused and fixed with 4% paraformaldehyde. L4-L5 segments of spinal cord were removed, post-fixed in the same fixative for 2-3 h and cryoprotected with sucrose at 4°C overnight. Fos expression in the spinal cord was evaluated by immunohistochemical study. Data were expressed as mean ± SD. The difference of Fos among control and heated rats were determined by T-test. Effects were considered to be statistically significant if P < 0.05. Result: The amounts of Fos were significantly increased (P < 0.001) in the heated group than control group. There were huge numbers of Fos in the medial part of laminae I and II of the L4-L5 segments of spinal cord. Little or no Fos was observed in the other laminae of spinal cord. The numbers of Fos positive neurons were not equal in both sides of the spinal cord. Conclusion: This study showed that thermal stress leads to the expression of Fos in the superficial layer (laminae I and II) of the dorsal horn of spinal cord. There is a possibility that each hind limb has different power and mechanism to combat the heat stress. [ABSTRACT FROM AUTHOR]

Introduction: High level of cholesterol is one risk factor for the development of cardiovascular diseases including atherosclerosis, myocardial infarction and heart attack. The influence of Tinospora crispa on atherosclerotic plaque formation was investigated in rabbits fed with high fat diet (HFD) Methodology: The duration of this study was 10 weeks. Male New Zealand White rabbits were divided into 6 groups. Group NC and PC was used as a negative and positive (0.5% cholesterol) control. Group SC was given HFD with 5mg/kg simvastatin. Group 150CTC, 300CTC and 450CTC act as treatment groups receiving HFD with supplementation of 150, 300 and 450mg/kg of T.crispa extract respectively. Blood was collected from ear vein at weeks 0, 5 , 10 and the serum used for biochemical analysis. The aortas were excised and examined microscopically by H&E staining for foam cell-rich lesion assessment. Results: Comparison within groups showed that PC, 300CTC and 450CTC have significantly increased (p<0.05) total cholesterol level from week 0 to 10. Meanwhile, in week 10, groups 150CTC, 300CTC and 450CTC showed significantly lower (p<0.05) LDL-C level at 74%, 59% and 49% respectively against PC group. In this study, all treatments groups showed significant increase (p<0.05) in HDL-cholesterol level through 10 weeks of experimental period. A significant increase (p<0.05) of total antioxidant status activity was observed in all treatment groups compared to the positive group. At week 10, group 450CTC has significantly higher (p<0.05) glutathione peroxidase and superoxide dismutase level compared to PC group. The atheromatous plaque formation in group given with HFD is significantly higher than treatment groups. In group 450CTC, which is the highest dose, as well as negative group and group given with simvastatin, no atheromatous plaque formation was found. Conclusion: This study suggested that supplementation of Tinospora crispa extract would be able to reduce or retard the progression of atherosclerotic plaque development induced by dietary cholesterol. The enhanced serum HDL cholesterol and the increased antioxidant status may be the possible underlying the mechanisms antiatherogenic effect of Tinospora crispa. [ABSTRACT FROM AUTHOR]