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Ariel Melloul,1,2 Ophir Freund,1,2 Boaz Tiran,1,2 Tal Moshe Perluk,1,2 Netanel Golan,1,2 Eyal Kleinhendler,1,2 Evgeni Gershman,1,2 Avraham Unterman,1,2 Avishay Elis,2,3 Amir Bar-Shai1,2 1The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel; 2Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; 3Internal Medicine C, Rabin Medical Center, Petach Tikva, IsraelCorrespondence: Ophir Freund, The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, Tel +972-545-305648, Email ophir068@gmail.comPurpose: Exacerbations of COPD (ECOPD) significantly impact disease progression and mortality. Visiting a respiratory specialist (RS) in proximity to the exacerbation may lead to prompt treatment and improved outcomes. We aimed to evaluate the association between an RS visit 30-days before admission and exacerbation outcomes.Patients and methods: The prospective study included subjects that were hospitalized with ECOPD between 2017 and 2019 in 13 medical centers. Pre-admission, in-hospital, and 30-day outcomes were assessed and compared between patients with and without a 30-day RS visit, using propensity score matching. A sub-group analysis was performed based on the reason for the RS visit (emergent vs regular follow-up).Results: Three hundred and forty-four subjects were included, and 105 (31%) had pre-admission RS visit (RS group). Before matching, indicators of severe COPD were prevalent in the RS group, while after matching there were no differences. RS visits were associated with pre-hospital initiation of short acting bronchodilators (50% vs 36%), antibiotics (30% vs 17%), and systemic steroids (38% vs 22%). The RS group had longer duration between first symptoms to hospital arrival (median 5 vs 3 days, p < 0.01) and shorter hospital length-of-stay (median 4 vs 5 days, p = 0.04). In-hospital and 30-days outcomes were similar between the groups. However, a non-emergent pre-hospital RS visit was associated with improved in-hospital and 30-day outcomes.Conclusion: Routine RS visits could lead to correct and early treatment for ECOPD with a potential for improved outcomes. These findings highlight the need for available specialists and higher awareness.Keywords: clinic, pulmonologist, bronchodilators, admission, diagnosis

Objective: This review synthesized evidence on the use of body weight exercises through high-intensity interval training (HIIT-BW). Methods: The research was performed in the Science Direct, Embase, MEDLINE, PEDro, SciELO, CINAHL, and LILACS databases from 2013 to 2023. Descriptors such as: high-intensity whole-body, high-intensity functional training, whole-body, whole-body training, whole-body calisthenics, high-intensity calisthenic training, and HIIT bodywork were used. In addition, original articles in English and Portuguese that addressed body weight HIIT were included. The final analysis consisted of 12 articles. Results: HIIT-BW protocols presented varied methodological characteristics: number of series ranged from 4 to 20; stimulus time ranged from 5 to 30 seconds with all-out intensity; and the passive interval ranged from 10 to 35 seconds between the series in 11 studies. The acute responses resulted in psychophysiological changes, increased lactate, Rated Perceived Exertion (RPE), heart rate (HR), fatigue, sweating rate, body size perception, training load, maximum oxygen volume (VO2max), caloric expenditure, perception of recovery, feeling of anger, mood disorder, intention of physical activity and reduction in the perception of pleasure, variability in HR, number of movements in complex exercises, and vigor. When compared with moderate continuous exercise and other high-intensity interval training protocols, HIIT-BW presented similar responses, however the use of preferred songs in the session provided an increase in the number of movements and perception of pleasure when compared with sessions that used non-preferred music and without music. Conclusion: In conclusion, based on data from studies found in the literature, HIIT-BW sessions promote increased feelings of fatigue, anger, mood disorder, RPE, HR, lactate, sweating rate, body size perception, caloric expenditure, and VO2. The results found helped to project indicators of long-term physical fitness and to plan sessions aimed at improving the lifestyle of its practitioners.

The prediction of manoeuvring performance for safe navigation and effective design of ships increasingly depends on artificial intelligence (AI), mainly digital twin technology. This technology requires a digital model of the physical ship. The hydrodynamic coefficients and parameters of these models are commonly obtained through two experimental methods: the planar motion mechanism (PMM) and the circular motion test (CMT). These methods are time-consuming and expensive, which may not be feasible during the early stages of the design process. This study investigates a cost-effective alternative approach to these methods by implementing a grey box method on ships. For the first of these implementations, a full-scale tanker ship was applied with artificial training data of zigzag manoeuvres. A validation study was carried out by comparing the simulation and free-running model test results of the tanker. For the second of these implementations, a scale model of a car carrier was selected, and several numerical search methods were combined to obtain a more accurate digital model. The 3-degree-of-freedom (DOF) Manoeuvring Modelling Group (MMG) models identified through this combination were validated with simulations and compared with the free-running model test results for various manoeuvres. The contribution of this study lies in the accurate capture of the manoeuvring characteristics of the physical model, which is achieved through the use of the adjustment interval and the combination of various numerical search method of the grey box method. Consequently, the developed model can be used in future studies as a faster decision-making tool for determining the straight-line stability or instability of a ship in the ship design and in predicting the manoeuvring performance of the ship.

ABSTRACT A crucial phase in the life cycle of tick-borne pathogens is the time spent colonizing and persisting within the arthropod. Tick immunity is emerging as a key force shaping how transmissible pathogens interact with the vector. How pathogens remain in the tick despite immunological pressure remains unknown. In persistently infected Ixodes scapularis, we found that Borrelia burgdorferi (causative agent of Lyme disease) and Anaplasma phagocytophilum (causative agent of granulocytic anaplasmosis) activate a cellular stress pathway mediated by the endoplasmic reticulum receptor PKR-like ER kinase (PERK) and the central regulatory molecule eIF2α. Disabling the PERK pathway through pharmacological inhibition and RNA interference (RNAi) significantly decreased microbial numbers. In vivo RNAi of the PERK pathway not only reduced the number of A. phagocytophilum and B. burgdorferi colonizing larvae after a bloodmeal but also significantly reduced the number of bacteria that survive the molt. An investigation into PERK pathway-regulated targets revealed that A. phagocytophilum and B. burgdorferi induce activity of the antioxidant response regulator, nuclear factor erythroid 2-related factor 2 (Nrf2). Tick cells deficient for nrf2 expression or PERK signaling showed accumulation of reactive oxygen and nitrogen species in addition to reduced microbial survival. Supplementation with antioxidants rescued the microbicidal phenotype caused by blocking the PERK pathway. Altogether, our study demonstrates that the Ixodes PERK pathway is activated by transmissible microbes and facilitates persistence in the arthropod by potentiating an Nrf2-regulated antioxidant environment. IMPORTANCE Recent advances demonstrate that the tick immune system recognizes and limits the pathogens they transmit. Innate immune mediators such as antimicrobial peptides and reactive oxygen/nitrogen species are produced and restrict microbial survival. It is currently unclear how pathogens remain in the tick, despite this immune assault. We found that an antioxidant response controlled by the PERK branch of the unfolded protein response is activated in ticks that are persistently infected with Borrelia burgdorferi (Lyme disease) or Anaplasma phagocytophilum (granulocytic anaplasmosis). The PERK pathway induces the antioxidant response transcription factor, Nrf2, which coordinates a gene network that ultimately neutralizes reactive oxygen and nitrogen species. Interfering with this signaling cascade in ticks causes a significant decline in pathogen numbers. Given that innate immune products can cause collateral damage to host tissues, we speculate that this is an arthropod-driven response aimed at minimizing damage to “self” that also inadvertently benefits the pathogen. Collectively, our findings shed light on the mechanistic push and pull between tick immunity and pathogen persistence within the arthropod vector.

IntroductionClinical studies have shown that low levels of endogenous testosterone are associated with cardiovascular diseases. Considering the intimate connection between oxidative metabolism and myocardial contractility, we determined the effects of testosterone deficiency on the two spatially distinct subpopulations of cardiac mitochondria, subsarcolemmal (SSM) and interfibrillar (IFM).MethodsWe assessed cardiac function and cardiac mitochondria structure of SSM and IFM after 12 weeks of testosterone deficiency in male Wistar rats. Results and DiscussionResults show that low testosterone reduced myocardial contractility. Orchidectomy increased total left ventricular mitochondrial protein in the SSM, but not in IFM. The membrane potential, size and internal complexity in the IFM after orchidectomy were higher compared to the SHAM group. However, the rate of oxidative phosphorylation with all substrates in the IFM after orchidectomy was lower compared to the SHAM group. Testosterone replacement restored these changes. In the testosterone-deficient SSM group, oxidative phosphorylation was decreased with palmitoyl-L-carnitine as substrate; however, the mitochondrial calcium retention capacity in IFM was increased. There was no difference in swelling of the mitochondria in either group. These changes in IFM were followed by a reduction in phosphorylated form of AMP-activated protein kinase (p‐AMPK‐α), peroxisome proliferator‐activated receptor gamma coactivator 1‐alpha (PGC‐1α) translocation to mitochondria and decreased mitochondrial transcription factor A (TFAM). Testosterone deficiency increased NADPH oxidase (NOX), angiotensin converting enzyme (ACE) protein expression and reduced mitochondrial antioxidant proteins such as manganese superoxide dismutase (Mn-SOD) and catalase in the IFM. Treatment with apocynin (1.5 mM in drinking water) normalized myocardial contractility and interfibrillar mitochondrial function in the testosterone depleted animals. In conclusion, our findings demonstrate that testosterone deficiency leads to reduced myocardial contractility and impaired cardiac interfibrillar mitochondrial function. Our data suggest the involvement of reactive oxygen species, with a possibility of NOX as an enzymatic source.

Adult tissue stem cells contribute to tissue homeostasis and repair but the long-lived neurons in the human adult cerebral cortex are not replaced, despite evidence for a limited regenerative response. However, the adult cortex contains a population of proliferating oligodendrocyte progenitor cells (OPCs). We examined the capacity of rat cortical OPCs to be re-specified to a neuronal lineage both in vitro and in vivo. Expressing the developmental transcription factor Neurogenin2 (Ngn2) in OPCs isolated from adult rat cortex resulted in their expression of early neuronal lineage markers and genes while downregulating expression of OPC markers and genes. Ngn2 induced progression through a neuronal lineage to express mature neuronal markers and functional activity as glutamatergic neurons. In vivo retroviral gene delivery of Ngn2 to naive adult rat cortex ensured restricted targeting to proliferating OPCs. Ngn2 expression in OPCs resulted in their lineage re-specification and transition through an immature neuronal morphology into mature pyramidal cortical neurons with spiny dendrites, axons, synaptic contacts, and subtype specification matching local cytoarchitecture. Lineage re-specification of rat cortical OPCs occurred without prior injury, demonstrating these glial progenitor cells need not be put into a reactive state to achieve lineage reprogramming. These results show it may be feasible to precisely engineer additional neurons directly in adult cerebral cortex for experimental study or potentially for therapeutic use to modify dysfunctional or damaged circuitry.

Hemodialysis is an exceptionally huge general clinical issue, notwithstanding the extremely significant expense of treatment and treatment. Moderate muscle unwinding is a non-pharmacological treatment that depends on the standard that the activity of muscles on the physiological unsettling influences of the human body diminishes messes. Muscle cramps are disappointment experienced by the gathering without torment, in cirrhotic patients and those going through hemodialysis. The motivation behind this study was to decide the effect of moderate muscle unwinding on lessening muscle cramps in hemodialysis patients. This sort of exploration utilizes quantitative strategies with a semi-trial plan through a one gathering pre-test post-test configuration approach. The populace in this study was 35 patients who experienced cramps. The strategy utilized for testing is soaked inspecting, with the goal that the necessary example is 30 individuals. The aftereffects of the review got added up to 58-63 years, with the male sex. The consequences of the information acquired before the mediation were most of the extreme spasms. After the intercession of gentle squeezing. In light of the reduction in muscle cramps in hemodialysis patients, the worth of sig (2-followed) was 0.00, and that intends that there were contrasts in muscle cramps when the technique.

Tujuan penelitian ini adalah untuk mendesain dan mengimplementasikan media pembelajaran interaktif berbantuan Swishmax-4 materi garis lurus. Jenis penelitian yang digunakan dalam penelitian ini adalah Research and Development, dengan menggunakan model penelitian ADDIE. Teknik pengumpulan adalah Wawancara, Angket dan Tes. Data penelitian berupa hasil pretest dan posttest dianalisis menggunakan rumus effect size. Hasil penelitian menunjukkan bahwa media pembelajaran yang dikembangkan sangat valid, ahli materi memperoleh skor rata-rata 3,73 dan ahli media skor rata-rata 3,27. Respon mahasiswa memperoleh hasil skor rata-rata 3,49 pada uji skala kecil dan 3,42 pada uji skala besar dengan criteria keduanya sangat menarik. Keefektifan media pembelajaran diuji mengunakan effect size yaitu dengan perolehan skor efektifitas 0,78 dengan kategori efektivitas sedang.

Chronic disease (CKD) a clinical condition because of conclusive changes in kidney capacity and construction. Psychological status is a direct risk factor for hypertension. This study aims to determine the effect of foot massage on reducing in blood pressure and psychological stress in families of chronic kidney failure at Rasyida Special Renal Hospital Medan. The study design was a quantitative method with a quasi-experimental design through a one-group pre-test post-test. The population in this study was 35 patients' families. The sampling technique was Saturated Sampling and a sample of 35 people. Methods using questionnaires Perceived Stress Scale (PSS) and observation sheets. The bivariate analysis using of the Wilcoxon test. The results of the study before giving foot massage therapy to the patient's family failed to win the attention of 19 people (54.3%) and experiencing stress as many as 25 people (71.4%), and after giving therapy of foot massage a large number of people's blood (74.3%) ) there was a decrease in stress levels to mild as many as 26 people (74.3%), obtained p-value 0.000, it can say that there is an effect of foot massage on reducing blood pressure and psychological stress in chronic kidney failure families.

Se señala por primera vez la presencia de Panstrongylus geniculatus, naturalmente infectado con Trypanosoma cruzi, en el intra y peri-domicilio de viviendas de la población de El Portachuelo, a 1650 msnm (Ejido, Estado Mérida, Venezuela). Se plantea la importancia ecológica del presente hallazgo tras los recientes reportes de brotes de la enfermedad de Chagas en el estado Mérida. Se discuten los factores antrópicos locales y climáticos globales que podrían estar correlacionados con la infestación de triatominos en escenarios epidemiológicos emergentes en localidades rurales en proceso de urbanización.

Reading is regarded as one of the basic learning processes that provides multiple skills and abilities for daily life. The study reported on here arose from evidence of reading comprehension difficulties of middle school students in Colombia, and from reflection on the didactic strategies used for the promotion and teaching of reading. The purpose of this research was to strengthen students' reading comprehension by taking advantage of the benefits of Easy-to-Read in the context of a methodology applied in Universal Design for Learning. The methodology was centred on the critical social paradigm, and the type of research was mixed with a design based on action research. The instruments used included non-participant observation, online questionnaire, standardised testing and a survey. The pedagogical proposal "Easy Reading" was designed and implemented to show progress in the students' reading comprehension skills, meeting the objectives set.

ABSTRACT The insect immune deficiency (IMD) pathway is a defense mechanism that senses and responds to Gram-negative bacteria. Ticks lack genes encoding upstream components that initiate the IMD pathway. Despite this deficiency, core signaling molecules are present and functionally restrict tick-borne pathogens. The molecular events preceding activation remain undefined. Here, we show that the unfolded-protein response (UPR) initiates the IMD network. The endoplasmic reticulum (ER) stress receptor IRE1α is phosphorylated in response to tick-borne bacteria but does not splice the mRNA encoding XBP1. Instead, through protein modeling and reciprocal pulldowns, we show that Ixodes IRE1α complexes with TRAF2. Disrupting IRE1α-TRAF2 signaling blocks IMD pathway activation and diminishes the production of reactive oxygen species. Through in vitro, in vivo, and ex vivo techniques, we demonstrate that the UPR-IMD pathway circuitry limits the Lyme disease-causing spirochete Borrelia burgdorferi and the rickettsial agents Anaplasma phagocytophilum and A. marginale (anaplasmosis). Altogether, our study uncovers a novel linkage between the UPR and the IMD pathway in arthropods. IMPORTANCE The ability of an arthropod to harbor and transmit pathogens is termed “vector competency.” Many factors influence vector competency, including how arthropod immune processes respond to the microbe. Divergences in innate immunity between arthropods are increasingly being reported. For instance, although ticks lack genes encoding key upstream molecules of the immune deficiency (IMD) pathway, it is still functional and restricts causative agents of Lyme disease (Borrelia burgdorferi) and anaplasmosis (Anaplasma phagocytophilum). How the IMD pathway is activated in ticks without classically defined pathway initiators is not known. Here, we found that a cellular stress response network, the unfolded-protein response (UPR), functions upstream to induce the IMD pathway and restrict transmissible pathogens. Collectively, this explains how the IMD pathway can be activated in the absence of canonical pathway initiators. Given that the UPR is highly conserved, UPR-initiated immunity may be a fundamental principle impacting vector competency across arthropods.

ABSTRACT: The chemical composition of Santa Inês sheep colostrum was evaluated, as well as chilled milk (zero to 240 hours) and frozen milk for up to 70 days. Results of chemical composition (fat, protein, casein, lactose, total and degreased dry extract) and colostrum somatic cell count (SCC) were presented descriptively. The results of chemical composition and SCC and total bacterial count (TBC) of chilled and frozen milk were evaluated in a completely randomized design, the repetition of milk collection days and the treatments of the times when the milk was chilled and frozen. The comparison of the quality averages of chilled and frozen milk was performed by Tukey test, with a probability of 5.0 %. Santa Inês sheep colostrum showed high protein and fat content, demonstrating a high source of nutrients for lamb nutrition. Santa Inês sheep’s milk can be stored for up to 240 hours without changes in chemical quality. Frozen milk from Santa Inês ewes for up to 70 days minus fat content; however, this form of milk preservation is viable. Refrigeration and freezing are alternatives that add value to the milk of Santa Inês ewes, but studies with previous preservation methods are necessary for greater quality assurance.

Objectives: The objective of this study is to depict the Pharmaceutical Supply Centers (PSCs) of municipalities in Rio Grande do Sul, regarding the structure, the processes carried out and the results obtained. Methods: The sample consists of a total of 29 municipalities. Data collection took place through visits to the PSC of these municipalities and on-site interviews, document analysis, direct observation, and the use of a questionnaire developed with questions drawn from the literature review. Results: The results showed that the daily control of temperature and humidity is recorded in 84.6% and 76.9% of the PSCs, respectively, and all those that have a refrigerator for thermolabile, control these parameters. Most centers that store controlled drugs (Portaria 344/98) use a separate room with a key (75.0%). Upon receipt of the medicines, an inspection is carried out regarding the validity and necessary documentation (invoice, for example) in 92.3% of the places. All PSCs used a computerized system for stock control, in six (23.1%) there was an accumulation of stock resulting from overestimated demand, resources used from the previous year, excess purchases or seasonality and 88.5% carry inventory. For them to function legally, some documentation is needed, such as a health permit, which only 26.9% of the PSCs claimed to have. Conclusion: In the evaluation of the quality of the storage stage of the AF, through the components: structure, processes, and results, partially positive results were observed about the technical and administrative recommendations for the PSCs, requiring improvements in some aspects.

Eratyrus mucronatus Stål, 1859 y Eratyrus cuspidatus Stål, 1859 pertenecen a la subfamilia Triatominae, cuyas especies son todas potenciales transmisoras del agente etiológico de la enfermedad de Chagas (Trypanosoma cruzi Chagas, 1909). En el presente trabajo se analizan los caracteres morfológicos diagnósticos de machos y hembras de E. cuspidatus provenientes de Talaigua Nuevo, Bolívar (Colombia) y E. mucronatus provenientes de Ejido, Mérida (Venezuela). Se analizaron 7 hembras y 7 machos de E. mucronatus y 4 machos y 4 hembras de E. cuspidatus. Se redescriben y sustentan los caracteres: color del cuerpo, morfología de la vesica o proceso mediano distal, dentículos del fémur, y se aportan nuevos caracteres de interés taxonómico como: escutelo, vellosidad corporal, genital externo de la hembra, hemiélitros y urotergito I. Se sugiere que cada especie está a cada lado de la cordillera de los Andes en un devenir ortogénico restringido por una conformación triangulada por: la forma (como Hemiptera, Reduviidae, Triatominae), el tiempo (especiación reciente, emergente) y el espacio (este y oeste de la cordillera andina).

Diabetes mellitus (DM) is a group of metabolic diseases characterized by high levels of glucose in the blood (hyperglycemia) that occurs due to impaired insulin secretion, decreased insulin action, or a result of both. Self-acceptance is the ability and desire of individuals to live with all the characteristics themselves against diabetes mellitus. This study aims to determine the effectiveness of diabetic ulcer treatment on self-acceptance of Type II Diabetes Mellitus patients at Asri Wound Care Center Medan. This study uses quantitative research methods with a quasi-experimental design through the one-group pretest-posttest design approach. The population in the study as many as 20 people, with sampling techniques using saturated sampling, the research sample amounted to 20 people. This study uses a nonparametric statistical test that is paired t-test. The results of research on self-acceptance of patients with type II diabetes mellitus before treatment of diabetic ulcers showed that the majority of self-acceptance was not good, and the self-acceptance of patients after treatment of diabetic ulcers obtained the majority of good self-acceptance. The effectiveness of diabetic ulcer treatment on self-acceptance of type II diabetes mellitus patients obtained significance value p-value = 0.00 (p-value

This study aimed to explore the cognition of taxpayers related to their experience in reporting income tax and understand what the influencing factors on the willingness to pay taxes. Interpretative phenomenology design was applied through semi-structured interviews to four taxpayers as participants. Data was analyzed by developing of textures and structural descriptions. The results showed that psychological factors that considered by participant in their tax behavior including knowledge about the system and tax regulation as well as information on the use of tax returns; perceived service and trust in tax authority. Further research is needed to understand the dynamics of psychological variables in influencing tax behavior with cooperative perspective instead of compliance to avoid punishment.

The purpose of this study was to look at conjunctions in a descriptive text from a Senior High School textbook for the tenth grade. The English Textbook for Tenth Grade was employed as the research sample, and we chose SMA N 20 Medan English Textbook. This study employed two instruments: the first was a search for all the conjunction meanings, functions, and types, and the second was an analysis of the conjunctions used in the English textbook for Senior High School's Tenth Grade. The results of this study revealed that the most common types of conjunctions in English textbooks. The table shows that the Coordinating Conjunction is the most common type of conjunction in a descriptive text used in the English Textbook. The results revealed that the Coordinating Conjunctions are most prominent in the English Textbook for Senior High School's tenth grade. Which, the word “and” is most shown on the descriptive text of the English Textbook used in the tenth grade of senior high school.

This study aimed to explore how the Islamic Sundanese adolescents experience and express their anger. A total of 697 students from two high school in Bandung and Tasikmalaya participated in the survey. Data was qualitatively collected using a questionnaire that recorded the causes and expressions of the participants’ anger. The obtained data was analyzed using content analysis. The findings suggest three emerging themes regarding the causes of anger among the Sundanese adolescents: 1) related to disturbing situations, 2) related to people (attitudes, behaviors and personal characteristics), and 3) related to other things (mood, feelings of depression, and physiological conditions). Participants mostly expressed their anger through passive and non-verbal expressions. Their reactions towards anger appeared to be associated with their Islamic religious values (which most participants were affiliated with), such as taking wudhu, istigfhar, pray, be patient and sincere, as well as perform sholat.

Este artigo tem o objetivo de discutir a experiência de implementação da formação continuada de professores no IFFar-FW. A pesquisa foi de tipo bibliográfica e documental, com abordagem qualitativa o uso de questionário. A investigação confirmou que a construção da proposta de formação continuada deve associar o trabalho e a experiência do professor, estimulando novas práticas e reflexões, revelando conflitos, superando preconceitos, expondo o potencial das práticas pedagógicas desenvolvidas pelos professores e sua sistematização deve ser estimulada. Portanto, a trajetória profissional dos docentes pode acrescentar qualidade às formações e consolidar uma prática pedagógica mais consistente, que não dispensa a aceitação de que somos seres inconclusos para estar receptivos às novas aprendizagens.

Post partum blues ini dialami 80% wanita setelah bersalin yaitu merupakan semacam perasaan sedih atau uring-uringan yang melanda ibu dan timbul dalam jangka waktu dua hari sampai dua minggu pasca persalinan. Post partum blues ini sendiri biasanya muncul pada hari ke 2 sampai 2 minggu setelah bersalin dan lebih sering terjadi pada wanita muda yang melahirkan dan merasa kesulitan untuk menyusui. Ada kalanya ibu mengalami perasaan sedih yang berkaitan dengan bayinya. Keadaan ini disebut baby blues. Mengabaikan masalah hingga akhirnya tidak mendapatkan penanganan yang tepat akan menimbulkan tekanan yang sangat mengganggu dan mengancam kesehatan fisik dan mental.Menurunnya tingkat kekebalan tubuh, susah tidur,pikiran kacau,mudah marah,dan afeksi negatif lainnya hanyalah contoh kecil efek samping dari masalah yang dihadapi ibu postpartum blues. Untuk itulah, konseling sangat dibutuhkan sebagai media perantara yang dapat membantu mengatasi berbagai macam permasalahan ibu post partum blues.Tujuan jangka panjang yang ingin dicapai dalam penelitian yaitu mengidentifikasi dan menganalisis Efektifitas konseling terhadap post partum blues pada ibu primipara. Target khusus yang ingin dicapai agar setiap tenaga kesehatan (Dokter,Perawat, Bidan) yang bekerja di fasilitas kesehatan menerapkan konseling pada ibu yang mengalami post partum blues.Penelitian yang akan dilakukan menggunakan desain Quasy Eksperiment (eksperimen semu), dengan sasaran ibu primipara yang mengalami postpartum blues diberikan konseling. Metode pengumpulan data dengan kuesioner,wawancara dan observasi. Metode analisis data menggunakan uji-t dependen. Dimana pada kelompok berpasangan, subjek yang sama diperiksa sebelum dan setelah intervensi (desain before dan after). Hasil penelitian diperoleh rata-rata hasil kuesioner EPDS postpartum blues ibu primipara sebelum diberikan konseling adalah 16,78 dengan standar deviasi 3,270. Rata-rata hasil kuesioner sesudah diberikan konseling 10,25 dengan standar deviasi 2,627. Beda mean 6,531 diperoleh P-value 0,000. Maka dapat disimpulkan bahwa ada Efektivitas Konseling terhadap Postpartum Blues pada ibu primiparaKata kunci : Konseling, Post partum Blues, Ibu Primipara

Supervision is an important part of the overall management and leadership responsibilities. So as to manage the nursing care, manager's ability to supervise nursing is urgently required. This study aims to find out relationship between supervision and the implementation of nursing care in the inpatient floor 10 at Royal Prima General Hospital Medan in 2017. This study is descriptive correlative. The population are 40 people and sampling techniques used was saturated sampling, then 40 people were drawn to be samples. Data collection was performed by using observation sheets and questionnaires. Based on the research finding, it is found that there is a relationship between the supervision and implementation of nursing care in the inpatient floor 10 of Royal Prima Hospital Medan in which it is obtained that the data of respondents who supervised well consists of 31 people (77.5%), medium was 7 people (17.5%), and less by 2 people (5%). Respondents who did the implementation of nursing care were 38 people (95%) and those who did not perform 2 people (5%). Spearman test results showed that value of significance of (2 - tailed) was 0.401 or probability (p) above 0.05 (0.401 that there is not any relationship between supervision and implementation of nursing care in the inpatient floor 10 of Royal Prima Hospital Medan. It is suggested that further studies should be conducted about supervision in the implementation of nursing care which refers to the standard operating procedures. Keywords: Relationship, Supervision, Implementation, Nursing Care, Hospitalization

The aim of this article is to report an experience lived during the PET health survillance extension program, developed between 2010 and 2012, at the Federal University of Santa Catarina. There were planned weekly meetings to debate on health subject at the beggining of the process, together with practical activities to be performed outside of the university. At the university, the activities consisted of groups of dynamics, debates and presentations, and the field activity was comprised by means of following the work processess in the “Laboratório Central and the Diretoria de Vigilância Epidemiológica de Santa Catarina”. The transdisciplinarity and the knowledge sharing amongst the students from the university health center with the accompained services were evident. This experience provided an opportunity to exchange savvies beyond the classroom in relation to health concepts and to the work process on the health survillance scope.

Jawa Barat is one of the provinces with strong cultural identity. Nowadays, several districts in West Java seek to strengthen their cultural identity in various ways. This study explores the characteristics and factors that shape the identity of Sundanese. The study was conducted in one of the districts in West Java that are intense in maintaining and developing Sundanese culture. Respondents consisted of 639 students in seventeen schools. Data were collected using questionnaires and interviews. The results show that the ethnic identity of the respondents was above average. Most respondents have reached the “achieved” stage, which is marked by strong exploration and commitment. Factors influencing the ethnic identity of respondents include gender, parent education, and the use of Sundanese as the native language. Sundanese ethnic characteristics are mentioned by many respondents, among others, polite and polite, friendly or “someah,” solider and like mutual help, compassionate, sociable, and religious.

This intervention program aims to increase trust of the members of Al Bahar community towards the well water. This is done by increasing active participation of the adolescents Al Bahar in looking after the environmental hygiene surrounding the wells. Community participation and empowerment techniques were applied to encourage adolescents to perform as change agents in the community. This program has been executed for approximately 2 (two) months with the active involvement of 15 (fifteen) adolescents. Experiential learning and participatory approaches such as games, role plays, and discussions, and other fun activities were used to stimulate adolescence’s participation. The program evaluation of this intervention has showed some significant indications for changes among the adolescents. The changes are among others: the establishment of an informal organization of adolescence to maintain their activities; awareness and willingness to take care of the environmental hygiene in the area; coming up with ideas to solve some contextual environmental problems. By listening and respect the voices of this adolescence they become more confident. By letting them to participate actively in the programs they felt a sense of belonging towards the program achievement and the environment as well.

This action research aimed to increase trust of the members of Al Bahar community towards the well water so it could reduce the community’s dependences toward clean water supplies from outside. This program has been executed by using participation techniques and empowerment for approximately 2 (two) months with the active involvement of 15 (fifteen) adolescents by increasing their active participation in investigating the problem as well as looking after the environmental sanitation surrounding the wells. The program evaluation of this intervention has showed some significant indications for changes among the members namely awareness of their responsibilities as the user of the wells, reveal their willingness willingness to take care of the environmental sanitation in the area; coming up with ideas to solve some contextual environmental problems.

O objetivo desta pesquisa foi analisar, a partir de dados do satélite Landsat - 5, o padrão multitemporal e espacial das anomalias térmicas na cidade de Iporá - Goiás. Para tanto, foram utilizadas imagens multiespectrais (banda termal do satélite Landsat 5), dos anos de 1984 a 2011. Para o processamento das imagens foram desenvolvidos modelos matemáticos por meio da ferramenta Model Maker do software Erdas Imagine 11. Os resultados evidenciaram que: 1 - com a utilização das anomalias térmicas, os mapas ficaram homogêneos, o que possibilitou comparação temporal; 2 - Anomalias térmicas máximas de superfície ocorreram em áreas de pouca urbanização, com solo exposto; 3 - O maior número de anomalias positivas ocorreu nas áreas de baixa urbanização, com solos expostos. Enquanto que nas áreas mais urbanizadas com presença de vegetação e próximas a superfície de água, ocorreu a maior quantidade de anomalias negativas; 4 - Nos pontos B, E, F e H foram observadas tendências estatisticamente significativas.

Academic guidance to reduce the cheating behavior of Madrasah Tsanawiyah students. This research is motivated by the cheating problem experienced by some of the students when facing test or repetition, if the behavior of cheating is left protracted, then the behavior will become a habit to form a dishonest person. The purpose of this study to obtain a general description of the behavior of students who cheat as a foundation in the preparation of academic guidance programs to reduce the cheating behavior of learners. This research uses a quantitative approach with descriptive research method with total population of 155 students in class VIII MTs. Rijalul Hikam Jatinagara academic year 2014/2015 using saturated samples. (2) The validation result according to BK that the academic guidance program service is feasible to be used to reduce cheating behavior. The recommendation of this research is an academic guidance program to reduce cheating behavior of learners can be used as an alternative of guidance and counseling services in overcoming the problems of learning, especially to reduce the cheating behavior of learners.

ABSTRACT Coping mechanism is a way performed by individuals to adapt with stress. It is important to be performed to solve problems. The effective coping can assist individuals to get free from a long term stress. The objective of the study is to find out relationship between coping mechanism and patient quality of life of terminal patients of cervical cancer at Vina Estetika General Hospital Medan. This is a correlational study with cross-sectional design. The populations were 23 persons drawn by saturated sampling technique that 23 persons were determined to be the samples. The result of this study showed that 15 persons made a negative coping (65.2%) and 8 persons (34.8%) had a positive coping mechanism. Persons having a good quality of life were 6 persons (26.1%) and those having less quality of life were 17 persons (73.9%). Based on Spearman Correlation test with 2 tailed level of significance 0.00 (α < 0,05) with correlation coefficient of 0.760, it was found that there is a relationship between coping mechanism and patients quality of life of cervix cancer patients. The sufferers should be able to control their condition by positive coping strategy by having more focus on problems they face instead of emotions to reach better quality of life. Keywords: Coping Mechanism, Quality of Life, Cervix Cancer Patients

ABSTRACT Breast cancer is a tumor (cancer) that is originated from the malignant breast cells. The psychological impact inflicted such losses and changes in sense of comfort resulting from the symptoms of the disease or its treatment. This study aims to determine the relationship between psychology and personal hygiene of breast cancer patients at the Hospital of Dr. Pirngadi Medan in 2016. This research used descriptive correlative with cross sectional design. The population of this study were 48 people, drawn by purposive sampling technique. The samples obtained were 43 people.The results of the psychological research on breast cancer patients showed that psychological occured on 35 people (81.40%) and severe psychological were 8 people (18.60%). Results of research on breast cancer patients and personal hygiene were 25 people (58.14%), lack of personal hygiene on 18 people (41.86%). Based on Spearman Rank correlation test on the relationship between psychology and personal hygiene on breast cancer patients with a significance level (α In conclusion, there is a psychological relationship between personal hygiene on breast cancer patients at the Hospital of Dr. Pirngadi Medan in 2016. It is expected that the hospital can improve the quality of health services, nurses pay more attention to aspects of bio, psycho, socio, and spiritual, assistance and provide motivation in the fulfillment of basic needs and maintain personal hygiene breast cancer patients. Keywords: Psychological, Personal Hygiene, Breast Cancer Patients

In this study, mangaba residue (seeds) was used as a substrate for Aspergillus niger lipase production by solid-state fermentation. The partially purified enzyme was efficiently immobilized in a sol-gel matrix by covalent bonding with an immobilization yield of 91.2%. The immobilized biocatalyst and free lipase had an optimum pH of 2.0 and 5.0, respectively. However, greater stability was obtained at pH 4.0 and 7.0, respectively. The biocatalysts showed stability at the optimum temperature of 55°C, where the residual activity was above 87% after 240 min., of incubation. The lower deactivation constant (kd) and higher half-life of the immobilized biocatalyst indicated greater thermal stability than those obtained with the free enzyme. The Michaelis Constant (Km) (77 and 115 mM for free and immobilized lipase, respectively) and maximum reaction rate (Vmax) (1250 and 714 U mg-1 for free and immobilized lipase, respectively) indicated that the immobilization process reduced enzyme-substrate affinity. Regarding the operational stability, the biocatalyst showed relative activity above 50% until seven cycles of reuse in olive oil hydrolysis. This novel biocatalyst obtained from a tropical fruit residue showed biochemical characteristics that support its application in future biocatalysis studies.

Studies have been directed towards the production of new titanium alloys, aiming for the replacement of Ti-6 Aluminium-4 Vanadium (TiAlV) alloy in the future. Many mechanisms related to biocompatibility and chemical characteristics have been studied in the field of implantology, but enzymatic defenses against oxidative stress remain underexplored. Bone marrow stromal cells have been explored as source of cells, which have the potential to differentiate into osteoblasts and therefore could be used as cells-based therapy. The objective of this study was to evaluate the activity of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) in porous scaffolds of Ti-6 Aluminium-4 Vanadium (TiAlV), Ti-35 Niobium (TiNb), and Ti-35 Niobium-7 Zirconium-5 Tantalum (TiNbZrTa) on mouse bone marrow stromal cells. Porous titanium alloy scaffolds were prepared by powder metallurgy. After 24 hours, cells plated on the scaffolds were analyzed by scanning electron microscopy (SEM). The antioxidant enzyme activity was measured 72 hours after cell plating. Quantitative real time PCR (qRT-PCR) was performed after 3, 7, and 14 days, and Runx2 (Runt-related transcription factor2) expression was evaluated. The SEM images showed the presence of interconnected pores and growth, adhesion, and cell spreading in the 3 scaffolds. Although differences were noted for SOD and CAT activity for all scaffolds analyzed, no statistical differences were observed (p>0.05). The osteogenic gene Runx2 presented high expression levels for TiNbZrTa at day 7, compared to the control group (TiAlV day 3). At day 14, all scaffolds had more than 2-fold induction for Runx2 mRNA levels, with statistically significant differences compared to the control group. Even though we were not able to confirm statistically significant differences to justify the replacement of TiAlV regarding antioxidant enzymes, TiNbZrTa was able to induce faster bone formation at early time points, making it a good choice for biomedical and tissue bioengineering applications.

Arthur Schopenhauer (1788-1860) was deeply influenced by Plato and conceived each species as an Idea, whose shape is essentially and permanently predetermined. He rejected Lamarck’s proposal of organ’s use/disuse as a source of evolution, but he was close to the orthogenetic movement that developed after his death. The philosopher did not conceive biological individual variability as a source for evolution, mathematical population analysis, and gradual evolution; he even imagined an ultra-rapid saltatory model in “higher forms.” Moreover, he conceived a metaphysically based coupling among all phenomena which resembles the contemporary model of natural drift of evolution. Hence, Schopenhauer did not strictly anticipate Darwin’s model of natural selection. However, he expressed in his own words competition and struggle for life. The philosopher thus anticipated more the orthogenesis and natural drift and less the Darwinian’s mechanisms of evolution than what is generally alleged. His work is a valuable philosophical source in the contemporary search for a new synthesis in evolutionary thought.