Search results for: Rahayu Setyawati Arifin

Authors: Oktia Woro Kasmini Handayani, Sri Ratna Rahayu, Efa Nugroho, Bertakalswa Hermawati

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The double burden of nutrition problem must be faced by Indonesia as developing country. The implemented program did not improve the nutritional status, therefore need to consider to utilize local potential. The objective of this research was to find out the effectivity of magnification model of early detect through local potential utilization in urban region, Semarang, Central Java, Indonesia. The research used an experimental design with the quantitative-qualitative approach. The population was all toddlers under five within the research region, sample determination by purposive sampling, as many as 216 toddlers. Quantitative data analysis used effectively criteria by Sugiono. Qualitative data was analyzed using NVivo. The optimization of local potential in the effort of nutrition status improvement shows number of nutrition case found was increased 225% (very effective), number of cases treated was increased 175% (very effective), number of cases counselled was increased 200% (effective), and number of cases that have improvement increase 75% (effective). The local potential need to be utilized in the effort of nutrition program improvement one of it is through the community empowerment, particularly health care and health high education institution as partner.

Keywords: early detection, nutrition status, local potential, health cadre

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Authors: Rahayu Azkiya

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Career guidance is an integral part of education that aims to help students understand their interests, talents, and potential and provide direction in choosing an appropriate career path. Approximately 76 million people are working out of 17 million people with disabilities in 2022, and this number has become a focal point as career guidance is crucial among people with special needs. Therefore, this study explores how the career guidance program is implemented and what challenges are faced by teachers. This study employs a qualitative case study in one of the senior high schools for special needs (SMLB) in Depok, Indonesia. Meanwhile, the data analysis was done through thematic analysis. Data has been obtained through the interviews of two teachers who focused on the physically impaired and deaf. The results of this study show that (1) the school has implemented career guidance well, the students were selected in the first year to look for their talents and interests, and for the second and third years, students are trained to master their abilities. (2) There are still many challenges teachers face in implementing career guidance programs, such as a need for more human resources for both students and teachers, high curriculum demands, and simple facilities that hinder student progress. Therefore, this research shows that every child is unique, so schools must meet the standards of student needs and re-evaluate the various challenges that teachers and students still face. This research is expected to serve as an analysis material for the government's policy towards special needs schools in Indonesia.

Keywords: Students with Special Needs, Career Guidance Program, Implementation, Challenges

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Authors: Evy Latifah, Eko Widaryanto, M. Dawam Maghfoer, Arifin

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Tomato (Lycopersicon esculentum Mill.) is potential vegetables to develop, because it has high economic value and has the potential to be exported. There is a decrease in tomato productivity due to unfavorable growth conditions such as bacterial wilt, fusarium wilt, high humidity, high temperature and inappropriate production technology. Grafting technology is one alternative technology. In addition to being able to control the disease in the soil, grafting is also able to increase the growth and yield of production. Besides, it is also necessary to know the economic benefits if using grafting technology. A promising eggplant rootstock for tomato grafting is Solanum torvum. S. torvum is selected as a rootstock with high compatibility. The purpose of this research is to know the effect of grafting several varieties of tomatoes with Solanum torvum as a rootstock. The experiment was conducted in Agricultural Extension Center Pare. Experimental Garden of Pare Kediri sub-district from July to early December 2016. The materials used were tomato Cervo varieties, Karina, Timoty, and Solanum torvum. Economic analysis, growth, and yield including plant height, number of leaves, percentage of disease and tomato production were used as performance measures. The study showed that grafting tomato Timoty scion with Solanum torvum as rootstock had higher production. Financially, grafting tomato Timoty and Cervo scion had higher profit about. 28,6% and 16,3% compared to Timoty and Cervo variety treatment without grafting.

Keywords: grafting technology, economic analysis, growth, yield of tomato, Solanum torvum

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Authors: Mohammad Saeri, Zainal Arifin

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The purpose of this study is to obtain information on technical and social-economic feasibility of sugarcane-soybean. To achieve these objectives, soybeans intercropping study was conducted in sugar cane crops. This assessment was conducted in two locations with different agroecosystem,ie lowland of low plain in Mojokerto, East Java, with altitude of 50m above sea level and upland of medium plain in Malang, East Javawithaltitude of 500 m above the sea level. The design used was Split plot, with the main plots, is the soybean varieties, consisting of: (a) Anjasmoro, (b) Argomulyo, and (c) Dena-1, while the subplot is bio-fertilizer, consisting of : (1) Agrimeth, (2) Agrisoy, and (3) Biovarm. The variables observed were growth, yield and yield components and economic analysis. The yield of soybean in lowland reached 0.74 t/ha of seeds with farm profit of Indonesian Rupiah 359.200. This result is relatively low due to the delay of soybean cultivation from sugar cane soup time so that sugar cane cover soybean cultivation, while in upland obtained 0.92t/ha seeds with farm profit of Indonesian Rupiah 2,015,000. Therefore, it is suggested that soybeans are planted immediately after ratoon cane so that soybean growth can be optimal before the growth of sugarcane cover the soil surface. The yield of sugar cane in the lowland reached 124.5 tons with a profit of Indonesian Rupiah. 21,200,000,- while in upland obtained by sugarcane yield equal to 78,5 ton with profit equal to Indonesian Rupiah 8,900,000,-.

Keywords: intercropping, sugar cane, soybean, profit, farming

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Authors: Mazifah Simis, Azahan Awang, Kadir Arifin

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The brownfield regeneration is being implemented in developped countries. However, as a group 1 developing country in the South East Asia, the rapid development and increasing number of urban population in Malaysia have urged the needs to incorporate the brownfield regeneration into its physical planning development. The increasing number of urban ex-landfills is seen as a new resource that could overcome the issues of inadequate urban green space provisions. With regards to the new development approach in urban planning, this perception study aims to identify the sustainable planning approach based on what the stakeholders have in mind. Respondents consist of 375 local communities within four urban ex-landfill areas and 61 landscape architect and town planner officers in the Malaysian Local Authorities. Three main objectives are set to be achieved, which are (i) to identify ex-landfill issues that need to be overcome prior to the ex-landfill redevelopment (ii) to identify the most suitable types of ex-landfill redevelopment, and (iii) to identify the priority function for ex-landfill redevelopment as the public parks. From the data gathered through the survey method, the order of priorities based on stakeholders' perception was produced. The results show different perception among the stakeholders, but they agreed to the development of the public park as the main development. Hence, this study attempts to produce an integrated approach as a model for sustainable ex-landfill redevelopment that could be accepted by the stakeholders as a beneficial future development that could change the image of 296 ex-landfills in Malaysia into the urban public parks by the year 2020.

Keywords: brownfield regeneration, ex-landfill redevelopment, integrated approach, stakeholders' perception

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Authors: R. Sutjiati, Rubianto, I. B. Narmada, I. K. Sudiana, R. P. Rahayu

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The prevalence of post-treatment relapse in orthodontics in the community is high enough; therefore, relapses in orthodontic treatment must be prevented well. The aim of this study is to experimentally test the inhibition of relapse of orthodontics tooth movement in NaF of expression TGF-β1, Runx2, alkaline phosphatase (ALP) and microscopic of woven bone. The research method used was experimental laboratory research involving 30 rats, which were divided into three groups. Group A: rats were not given orthodontic tooth movement and without NaF. Group B: rats were given orthodontic tooth movement and without 11.5 ppm by topical application. Group C: rats were given orthodontic tooth movement and 11.75 ppm by topical application. Orthodontic tooth movement was conducted by applying ligature wires of 0.02 mm in diameter on the molar-1 (M-1) of left permanent maxilla and left insisivus of maxilla. Immunohistochemical examination was conducted to calculate the number of osteoblast to determine TGF β1, Runx2, ALP and haematoxylin to determine woven bone on day 7 and day 14. Results: It was shown that administrations of Natrium Fluoride topical application proved effective to increase the expression of TGF-β1, Runx2, ALP and to increase woven bone in the tension area greater than administration without natrium fluoride topical application (p < 0.05), except the expression of ALP on day 7 and day 14 which was significant. The results of the study show that NaF significantly increases the expressions of TGF-β1, Runx2, ALP and woven bone. The expression of the variables enhanced on day 7 compared on that on day 14, except ALP. Thus, it can be said that the acceleration of woven bone occurs on day 7.

Keywords: TGF-β1, Runx2, ALP, woven bone, natrium fluoride

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Authors: Oktia Woro Kasmini Handayani, Sri Ratna Rahayu, Efa Nugroho, Bertakalswa Hermawati

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In Indonesia, from 2007 until 2013, the prevalence of overnutrition in children under five years and school age tends to increase. Clean and Health Life Behavior of school children supporting nutrition status still below the determined target. On the other side, school institution is an ideal place to educate and form health behavior, that should be initiated as early as possible (Early Age Education/PAUD level). The objective of this research was to find out the effectivity of education model through partnership with school institution in urban region, city of Semarang, Central Java Province, Indonesia. The research used quantitative approach supported with qualitative data. The population consist of all mother having school children of ages 3-5 years within the research region; sampling technique was purposive sampling, as many as 237 mothers. Research instrument was Clean and Health Life Behavior evaluation questionaire, and video as education media. The research used experimental design. Data analysis used effectivity criteria from Sugiyono and 2 paired sampel t test. Education model optimalization in the effort to improve nutrition status indicates t test result with signification < 0.05 (there was significant effect before and after model intervention), with effectivity test result of 79% (effective), but still below expected target which is 80%. Education model need to be utilized and optimallized the implementation so that expected target reached.

Keywords: nutrition status, early age education, clean dan health life behavior, education model

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Authors: Sri Rahayu, Supriyatin, Yuli Rahma Dini

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One of the consequences of excess physical activity is the oxidative stress which resulted in damage to blood cells. Oxidative stress condition can be reduced by an exogenous antioxidant. The natural exogenous antioxidant can be extracted from Manggong bamboo (Gigantochloa manggong). This research was aim to evaluate the effect of physical exercise and Manggong bamboo (Gigantochloa manggong) leaf extract on blood profile of rats. This research was conducted in July 2013 to May 2014 using experimental method with completely randomized design (CRD) with two factors, physical exercise and Manggong bamboo leaf extract. The rats blood profile to be measured were the level of erythrocyte cells, leucocyte cells and hemoglobin. Data were analyzed with parametric statistical 2-way ANOVA test (α = 0.05). Manggong bamboo leaf extract was non toxic and contained flavonoid, triterpenoid, saponin and alkaloid. There was an effect of physical exercise and manggong bamboo leaf extract on blood profile of rats. Data obtained on physical activity, giving erythrocyte cells (2.5 million/µl) and hemoglobin (12,42g/dL) declined compared to the number of leucocyte cells increases (6,500cells/L). Extract treatment was increased the erythrocytes (5,13 million/µl) and hemoglobin level (14,72 g/dL.) while the leukocytes level were decreased (1.591,67 cells/L). The extract and physical activity treatment showed an increase in erythrocytes (2,96 million/µl) and hemoglobin (14,3 g/dL) but decrease the number of leukocytes (1.291,67 cells/L). The conclusion was that physical activity and Manggong bamboo leafs extract gaves effect on the blood profile of white rat.

Keywords: antioxidant, blood profile of rats, Manggong bamboo leaf extract, leukocytes

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Authors: Ni Wayan Sinthia Widiastuti, Komang Rahayu Indrawati

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The increasing number of tourists coming to Bali, causing accommodation facilities, such as hotels have increased. The existence of hotel needs will be the source of labor and cost efficiency, so that hotel management employs employees with different working status. The hospitality industry is one of the sectors that require organizational citizenship behavior because, the main goal of every hotel, in general, was to provide the best service and quality to tourists. The purpose of this study was to determine the differences in organizational citizenship behavior based on work status of employees at the Hotel in Bali in terms of quality of work life. Research sample was chosen randomly through two-stage cluster sampling which succeeds to obtain 126 samples from 11 hotels in Denpasar, Bali. The subjects consisted of 64 employees with Employment Agreement of Uncertain Time or who is often called a permanent employee and 62 employees with Employment Agreement of Certain Time or better known as contract employees, outsourcing, and daily workers. Instruments in this study were the scale of organizational citizenship behavior and the scale of quality of work life. The results of ANCOVA analysis showed there were differences in organizational citizenship behavior based on employee work status in terms of quality of work life. Differences in organizational citizenship behavior and quality of work life based on work status of employees using comparative test was analysis by independent sample t-test shows there were differences in organizational citizenship behavior and quality of work life between employees with different working status in hotels in Bali. The result of the regression analysis showed the functional relationship between quality of work life and organizational citizenship behavior.

Keywords: hotel in Bali, organizational citizenship behavior, quality of work life, work status of employees

Procedia PDF Downloads 257

Authors: V. K. Rajaletchumy, S. L. Chia, M. I. Setyawati, M. S. Muthu, S. S. Feng, D. T. Leong

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Triple negative breast cancers (TNBC) can be classified as one of the most aggressive with a high rate of local recurrences and systematic metastases. TNBCs are insensitive to existing hormonal therapy or targeted therapies such as the use of monoclonal antibodies, due to the lack of oestrogen receptor (ER) and progesterone receptor (PR) and the absence of overexpression of human epidermal growth factor receptor 2 (HER2) compared with other types of breast cancers. The absence of targeted therapies for selective delivery of therapeutic agents into tumours, led to the search for druggable targets in TNBC. In this study, we developed a targeted micellar system of cetuximab-conjugated micelles of D-α-tocopheryl polyethylene glycol succinate (vitamin E TPGS) for targeted delivery of docetaxel as a model anticancer drug for the treatment of TNBCs. We examined the efficacy of our micellar system in xenograft models of triple negative breast cancers and explored the effect of the micelles on post-treatment tumours in order to elucidate the mechanism underlying the nanomedicine treatment in oncology. The targeting micelles were found preferentially accumulated in tumours immediately after the administration of the micelles compare to normal tissue. The fluorescence signal gradually increased up to 12 h at the tumour site and sustained for up to 24 h, reflecting the increases in targeted micelles (TPFC) micelles in MDA-MB-231/Luc cells. In comparison, for the non-targeting micelles (TPF), the fluorescence signal was evenly distributed all over the body of the mice. Only a slight increase in fluorescence at the chest area was observed after 24 h post-injection, reflecting the moderate uptake of micelles by the tumour. The successful delivery of docetaxel into tumour by the targeted micelles (TPDC) exhibited a greater degree of tumour growth inhibition than Taxotere® after 15 days of treatment. The ex vivo study has demonstrated that tumours treated with targeting micelles exhibit enhanced cell cycle arrest and attenuated proliferation compared with the control and with those treated non-targeting micelles. Furthermore, the ex vivo investigation revealed that both the targeting and non-targeting micellar formulations shows significant inhibition of cell migration with migration indices reduced by 0.098- and 0.28-fold, respectively, relative to the control. Overall, both the in vivo and ex vivo data increased the confidence that our micellar formulations effectively targeted and inhibited EGF-overexpressing MDA-MB-231 tumours.

Keywords: biodegradable polymers, cancer nanotechnology, drug targeting, molecular biomaterials, nanomedicine

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Authors: Dwi Arisandi Wijaya, Ernawati Arifin Giri-Rachman, Neni Nurainy

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Typhoid fever disease can be prevented by using a polysaccharide-based vaccine Vi which is a virulence factor of S.typhi. To produce high yield Vi polysaccharide from bacteria, it is important to know the biosynthesis of Vi polysaccharide and the regulators involved. In the In vivo condition, S. typhi faces different osmolarity, and the bacterial two-component system OmpR-EnvZ, regulate by up and down Capsular Vi polysaccharide biosynthesis. A high yielded Vi Polysaccharide strain, S. typhi strain C6524 used to study the effect of media osmolarity on Vi polysaccharide biosynthesis and the osmoregulation pattern of S. typhi strain C6524. The methods were performed by grown S. typhi strain C6524 grown on medium with 50 mM, 100 mM, and 150 mM osmolarity with the batch system. Vi polysaccharide concentration was measured by ELISA method. For further investigation of the osmoregulation pattern of strain C6524, the osmoregulator gene, OmpR, has been isolated and sequenced using the specific primer of the OmpR gene. Nucleotide sequence analysis is done with BLAST and Lallign. Amino Acid sequence analysis is done with Prosite and Multiple Sequence Alignment. The results of cultivation showed the average content of polysaccharide Vi for 50 mM, 100 mM, and 150 mM osmolarities 11.49 μg/mL, 12.06 μg/mL, and 14.53 μg/mL respectively. Analysis using Anova stated that the osmolarity treatment of 150 mM significantly affects Vi content. Analysis of nucleotide sequences shows 100% identity between S. typhi strain C6524 and Ty2. Analysis of amino acid sequences shows that the OmpR response regulator protein of the C6524 strain also has a α4-β5-α5 motif which is important for the regulatory activation system when phosphorylation occurs by domain kinase. This indicates that the regulator osmolarity response of S. typhi strain C6524 has no difference with the response regulator owned by S. typhi strain Ty2. A high Vi response rate in the 150 mM osmolarity treatment requires further research for RcsB-RcsC, another two-component system involved in Vi Biosynthesis.

Keywords: osmoregulator, OmpR, Salmonella, Vi polysaccharide

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Authors: Titis Indah Adi Rahayu

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Angiogenesis is the process of generating new capillary from pre-existing blood vessels. VEGFA is a major regulator in angiogenesis that binds and activates two tyrosine kinase receptors, VEGFR1 (Flt-1) and VEGFR2 (Flk-1/KDR) which regulate pathological and physiological angiogenesis. Disruption of VEGFA and VEGFR2 regulation lead to many diseases. The study of α-Mangostin (derivate of xanthone) as anti-oxidant and anti inflammation has been explored recently and both of them have relation to vasculature however the effect of α-Mangostin in blood vessel formation in healthy tissue in vivo has not been studied. Zebrafish is a powerful model in studying angiogenesis and shared many advantages that is a viable whole animal model for screening small molecules that affect blood vessel formation. Therefore the aim of this study is to evaluate angiogenic activity of α-Mangostin in healthy tissue in vivo in zebrafish embryo in relation of patterning blood vessel. Blood vessel patterning is highly characteristic in the developing of zebrafish embryo and the subintestinal vessel (SIV) can be stained and visualized microscopically as a primary screen for α-Mangostin that effect angiogenesis. The zebrafish embryos are divided into 2 groups. Group one consists of the zebrafish embryos at 1 dpf for 4 days which are tested to α-Mangostin in several concentration 2 µM, 4 µM, 6 µM, 8 µM and 10 µM whereas in group two the zebrafish larva at 4 dpf are exposed to α-Mangostin 1,75 µM, 2,3 µM, 2,9 µM, 3,8 µM dan 5 µM for 2 days. DMSO is served as a control for each group. The level expression of vegfa and vegfr2 are observed quantitatively using real time q-PCR and patterning of SIV are then analized via alkaline phospatase staining. Result shows that the level expression of vegfa and vegfr2 is repressed quantitatively as shown in real time q-PCR in the group of 1-4 days of α-Mangostin exposure where it is increased in the group of 4-6 days of α-Mangostin exposure. The result is then compared to alkaline phospatase staining of SIV using stereo microscope. It indicates that α-Mangostin does not disturb the patterning of SIV formation in zebrafish.

Keywords: angiogenesis, Danio rerio, α-Mangostin, SIV, vegfa, vegfr2

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Authors: Abdul Murad Zainal Abidin, Azahar Mohd, Nor Idayu Arifin, Siti Nor Azila Khalid, Mohd Julzaha Zahari Mohamad Yusof

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A thermoelectric cooler (TEC) is an electronic component that uses ‘peltier’ effect to create a temperature difference by transferring heat between two electrical junctions of two different types of materials. TEC can also be used for heating by reversing the electric current flow and even power generation. A heat flow meter (HFM) is an equipment for measuring thermal conductivity of building materials. During the test, water is used as heat transfer medium to cool the HFM. The existing re-circulating cooler in the market is very costly, and the alternative is to use piped tap water to extract heat from HFM. However, the tap water temperature is insufficiently low to enable heat transfer to take place. The operating temperature for isothermal plates in the HFM is 40°C with the range of ±0.02°C. When the temperature exceeds the operating range, the HFM stops working, and the test cannot be conducted. The aim of the research is to develop a low-cost but energy-efficient TEC prototype that enables heat transfer without compromising the function of the HFM. The objectives of the research are a) to identify potential of TEC as a cooling device by evaluating its cooling rate and b) to determine the amount of water savings using TEC compared to normal tap water. Four (4) peltier sets were used, with two (2) sets used as pre-cooler. The cooling water is re-circulated from the reservoir into HFM using a water pump. The thermal conductivity readings, the water flow rate, and the power consumption were measured while the HFM was operating. The measured data has shown decrease in average cooling temperature difference (ΔTave) of 2.42°C and average cooling rate of 0.031°C/min. The water savings accrued from using the TEC is projected to be 8,332.8 litres/year with the application of water re-circulation. The results suggest the prototype has achieved required objectives. Further research will include comparing the cooling rate of TEC prototype against conventional tap water and to optimize its design and performance in terms of size and portability. The possible application of the prototype could also be expanded to portable storage for medicine and beverages.

Keywords: energy efficiency, thermoelectric cooling, pre-cooling device, heat flow meter, sustainable technology, thermal conductivity

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Authors: Dyah Larasati, Karishma Alize Huda, Sri Kusumastuti Rahayu, Martin Daniel Siyaranamual

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Indonesia continues to reform its social protection system to provide the needed protection for its citizen. Indonesia Social Protection consisted of social assistance programs (non-contributory/tax-financed) specifically targeted for the poor and at-risk and social security/insurance program (contributory system). The social assistance programs have mostly been implemented since 1998. The national health insurance has been implemented since 2014 and the employment social insurance since 2015. One major reform implemented has been improving the targeting performance of its major social assistance portfolios including (1) Food Assistance for the poor families (Rastra and BPNT/noncash foods assistance); (2) Education Assistance for poor children; (3) Conditional Cash Transfer for poor families (PKH); and (4) Subsidized beneficiaries of National Health Insurance (JKN-PBI) for the poor and at-risk individuals. For the Social Insurance (through BPJS Employment program), several initiatives have been implemented to expand the program contributing members, although it mostly benefits the formal sector workers. However, major gaps still exist especially for the emerging middle-income groups who typically work at the informal sectors. They have yet to get the protection needed to sustain their social and economic growth. Since 2017, TNP2K (the National Team for Poverty Reduction) under the Vice President office has led the social protection discourse as the government understands the need to address vulnerabilities across the lifecycle and prioritize support to the most at-risk population particularly the elderly, young children and people with disabilities. Discussion and advocacy to recommend for more investment is continuing in order for the government to establish a comprehensive social protection system in the near future (2020-2024) that protects children through an inclusive child benefit program; build a system to benefit more working-age adults (including individuals with disabilities) and a three-tier elderly protection as they reach 65 years.

Keywords: poverty reduction, social assistance, social insurance, social protection

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Authors: Santony Santony, Teguh Rahayu Sartono, Iin Noor Chozin

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Introduction: Pneumonia is acute inflammation on lung parenchyma which is caused by bacteria, virus, fungi, or parasite. In Indonesia, Pneumonia is among the ten inpatient cases. Length of stay is related to the increased morbidity rate, nosocomial infection, and costs. The aim of this study is to assess the effect of pulmonary rehabilitation on the difference in length of stay and the level of Interleukin 6 (IL-6) as an inflammation biomarker for community-acquired pneumonia (CAP) patients in non-intensive rooms. Therefore, pulmonary rehabilitation as adjunctive therapy can be routinely exercised in order to shorten the length of stay, along with the decrease in IL-6 level. Methods: This study was conducted from May to October 2019 at Saiful Anwar General Hospital, Malang. 40 community-acquired pneumonia patients in non-intensive rooms were divided into two groups. 20 patients in the treatment group and 20 patients in the control group, all of them were selected through both inclusion and exclusion criteria. This study used simple consecutive random sampling. In the treatment group, pulmonary rehabilitation performed was composed of breathing exercise, effective coughing technique, clapping (percussion), postural drainage, as well as respiratory muscle training using incentive spirometry device. Pulmonary rehabilitation was conducted twice over five days with a minimum duration of 15 minutes. Blood samples were taken both on the first and the fifth day of the treatment to measure IL-6 level as an inflammation biomarker. Result: For the treatment group, the length of stay was 5.35 days whereas the control group 7.6 days. It can be seen that the treatment group had a shorter length of stay by 2.25 days (P<0,001). The IL-6 level on the first day for the treatment group was 36.27 pg/ml, whereas on the fifth day was 34.36 pg/ml. There was a decrease in IL-6 level on the fifth day of treatment even though it was not statistically significant (P=0.628). IL-6 level on the control group for the first day was 67.76 pg/ml, and after the fifth day, the level decreased to 54.43 pg/ml. There seemed to be a decrease in the IL-6, but it was not statistically significant (P=0.502). On the fifth day, the treatment group showed an average IL-6 level of 34.36 pg/ml. This value was lower than that of the control group which did not receive pulmonary rehabilitation having an IL-6 level of 54.43 pg/ml, even though it was not statistically significant (p=0.221). Conclusion: This study concluded that pulmonary rehabilitation as an adjunctive therapy shortened length of stay by 2.25 days for community-acquired pneumonia patients in a non-intensive room. Both groups experienced a decrease in IL-6 level on the fifth day in comparison with the first day even though it was not statistically significant P>0,05. IL-6 level as an inflammation biomarker decreased on the fifth day of treatment which was in accordance with improvement on pneumonia patients.

Keywords: community-acquired pneumonia, interleukin-6, length of stay, pulmonary rehabilitation

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Authors: Devi Eka Septiyani Arifin, Jrjeng Ruan

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As an approach to manipulate the performance of polymer thin film, epitaxy crystallization within polymer blends of poly(vinylidene fluoride) (PVDF) and its copolymer poly(vinylidene fluoride-trifluoroethylene) P(VDF-TrFE) was studied in this research, which involves the competition between phase separation and crystal growth of constitutive semicrystalline polymers. The unique piezoelectric feature of poly(vinylidene fluoride) crystalline phase is derived from the packing of molecular chains in all-trans conformation, which spatially arranges all the substituted fluorene atoms on one side of the molecular chain and hydrogen atoms on the other side. Therefore, the net dipole moment is induced across the lateral packing of molecular chains. Nevertheless, due to the mutual repulsion among fluorene atoms, this all-trans molecular conformation is not stable, and ready to change above curie temperature, where thermal energy is sufficient to cause segmental rotation. This research attempts to explore whether the epitaxial interactions between piezoelectric crystals and crystal lattice of hexamethylbenzene (HMB) crystalline platelet is able to stabilize this metastable all-trans molecular conformation or not. As an aromatic crystalline compound, the melt of HMB was surprisingly found able to dissolve the poly(vinylidene fluoride), resulting in homogeneous eutectic solution. Thus, after quenching this binary eutectic mixture to room temperature, subsequent heating or annealing processes were designed to explore the involve phase separation and crystallization behavior. The phase transition behaviors were observed in-situ by X-ray diffraction and differential scanning calorimetry (DSC). The molecular packing was observed via transmission electron microscope (TEM) and the principles of electron diffraction were brought to study the internal crystal structure epitaxially developed within thin films. Obtained results clearly indicated the occurrence of heteroepitaxy of PVDF/PVDF-TrFE on HMB crystalline platelet. Both the concentration of poly(vinylidene fluoride) and the mixing ratios of these two constitutive polymers have been adopted as the influential factors for studying the competition between the epitaxial crystallization of PVDF and P(VDF-TrFE) on HMB crystalline. Furthermore, the involved epitaxial relationship is to be deciphered and studied as a potential factor capable of guiding the wide spread of piezoelectric crystalline form.

Keywords: epitaxy, crystallization, crystalline platelet, thin film and mixing ratio

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Authors: Li Jiuen Ong, Magdalin Cheong, Sri Rahayu, Lek Alexander, Pei Ting Tan

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Background: Previous programme evaluations from the diabetes training programme conducted in Changi General Hospital revealed that healthcare professionals (HCPs) are keen to receive advance diabetes training and education, specifically in medical, nutritional therapy. HCPs also expressed a preference for interactive activities over didactic teaching methods to enhance their learning. Since the War on Diabetes was initiated by MOH in 2016, HCPs are challenged to be actively involved in continuous education to be better equipped to reduce the growing burden of diabetes. Hence, streamlining training to incorporate an element of fun is of utmost importance. Aim: The nutrition programme incorporates game play using an interactive board game that aims to provide a more conducive and less stressful environment for learning. The board game could be adapted for training of community HCPs, health ambassadors or caregivers to cope with the increasing demand of diabetes care in the hospital and community setting. Methodology: Stages for game’s conception (Jaffe, 2001) were adopted in the development of the interactive board game ‘Sweet Score™ ’ Nutrition concepts and topics in diabetes self-management are embedded into the game elements of varying levels of difficulty (‘Easy,’ ‘Medium,’ ‘Hard’) including activities such as a) Drawing/ sculpting (Pictionary-like) b)Facts/ Knowledge (MCQs/ True or False) Word definition) c) Performing/ Charades To study the effects of game play on knowledge acquisition and perceived experiences, participants were randomised into two groups, i.e., lecture group (control) and game group (intervention), to test the difference. Results: Participants in both groups (control group, n= 14; intervention group, n= 13) attempted a pre and post workshop quiz to assess the effectiveness of knowledge acquisition. The scores were analysed using paired T-test. There was an improvement of quiz scores after attending the game play (mean difference: 4.3, SD: 2.0, P<0.001) and the lecture (mean difference: 3.4, SD: 2.1, P<0.001). However, there was no significance difference in the improvement of quiz scores between gameplay and lecture (mean difference: 0.9, 95%CI: -0.8 to 2.5, P=0.280). This suggests that gameplay may be as effective as a lecture in terms of knowledge transfer. All the13 HCPs who participated in the game rated 4 out of 5 on the likert scale for the favourable learning experience and relevance of learning to their job, whereas only 8 out of 14 HCPs in the lecture reported a high rating in both aspects. 16. Conclusion: There is no known board game currently designed for diabetes training for HCPs.Evaluative data from future training can provide insights and direction to improve the game format and cover other aspects of diabetes management such as self-care, exercise, medications and insulin management. Further testing of the board game to ensure learning objectives are met is important and can assist in the development of awell-designed digital game as an alternative training approach during the COVID-19 pandemic. Learning through gameplay increases opportunities for HCPs to bond, interact and learn through games in a relaxed social setting and potentially brings more joy to the workplace.

Keywords: active learning, game, diabetes, nutrition

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Authors: Nurkhairul Bariyah Baharun, Afzan Adam, Reena Rahayu Md Zin

Abstract:

Tumor microenvironment (TME) in breast cancer is mainly composed of cancer cells, immune cells, and stromal cells. The interaction between cancer cells and their microenvironment plays an important role in tumor development, progression, and treatment response. The TME in breast cancer includes tumor-infiltrating lymphocytes (TILs) that are implicated in killing tumor cells. TILs can be found in tumor stroma (sTILs) and within the tumor (iTILs). TILs in triple negative breast cancer (TNBC) have been demonstrated to have prognostic and potentially predictive value. The international Immune-Oncology Biomarker Working Group (TIL-WG) had developed a guideline focus on the assessment of sTILs using hematoxylin and eosin (H&E)-stained slides. According to the guideline, the pathologists use “eye balling” method on the H&E stained- slide for sTILs assessment. This method has low precision, poor interobserver reproducibility, and is time-consuming for a comprehensive evaluation, besides only counted sTILs in their assessment. The TIL-WG has therefore recommended that any algorithm for computational assessment of TILs utilizing the guidelines provided to overcome the limitations of manual assessment, thus providing highly accurate and reliable TILs detection and classification for reproducible and quantitative measurement. This study is carried out to develop a TNBC digital whole slide image (WSI) dataset from H&E-stained slides and IHC (CD4+ and CD8+) stained slides. TNBC cases were retrieved from the database of the Department of Pathology, Hospital Canselor Tuanku Muhriz (HCTM). TNBC cases diagnosed between the year 2010 and 2021 with no history of other cancer and available block tissue were included in the study (n=58). Tissue blocks were sectioned approximately 4 µm for H&E and IHC stain. The H&E staining was performed according to a well-established protocol. Indirect IHC stain was also performed on the tissue sections using protocol from Diagnostic BioSystems PolyVue™ Plus Kit, USA. The slides were stained with rabbit monoclonal, CD8 antibody (SP16) and Rabbit monoclonal, CD4 antibody (EP204). The selected and quality-checked slides were then scanned using a high-resolution whole slide scanner (Pannoramic DESK II DW- slide scanner) to digitalize the tissue image with a pixel resolution of 20x magnification. A manual TILs (sTILs and iTILs) assessment was then carried out by the appointed pathologist (2 pathologists) for manual TILs scoring from the digital WSIs following the guideline developed by TIL-WG 2014, and the result displayed as the percentage of sTILs and iTILs per mm² stromal and tumour area on the tissue. Following this, we aimed to develop an automated digital image scoring framework that incorporates key elements of manual guidelines (including both sTILs and iTILs) using manually annotated data for robust and objective quantification of TILs in TNBC. From the study, we have developed a digital dataset of TNBC H&E and IHC (CD4+ and CD8+) stained slides. We hope that an automated based scoring method can provide quantitative and interpretable TILs scoring, which correlates with the manual pathologist-derived sTILs and iTILs scoring and thus has potential prognostic implications.

Keywords: automated quantification, digital pathology, triple negative breast cancer, tumour infiltrating lymphocytes

Procedia PDF Downloads 80

Authors: Siti Rahayu, Khairulniza Mohd Puat, Kesavan R., Mohammad Harris A., Jalila, Kunalan G., Fazir Mohamad

Abstract:

The greatest challenge has been in establishing and maintaining the dedicated nursing team. Continuity is served when nurses are assigned exclusively for managing wound, where they can continue to build expertise and skills. In addition, there is a growing incidence of chronic wounds and recognition of the complexity involved in caring for these patients. We would like to share 4 cases with different techniques of wound management. 1st case, 39 years old gentleman with underlying rheumatoid arthritis with chronic periprosthetic joint infection of right total knee replacement presented with persistent drainage over right knee. Patient was consulted for two stage revision total knee replacement. However, patient only agreed for debridement and retention of implant. After debridement, large medial and lateral wound was treated with Instillation Negative Pressure Wound Therapy Dressings. After several cycle, the wound size reduced, and conventional dressing was applied. 2nd case, 58 years old gentleman with underlying diabetes presented with right foot necrotizing fasciitis with gangrene of 5th toe. He underwent extensive debridement of foot with rays’ amputation of 5th toe. Post debridement patient was started on Instillation Negative Pressure Wound Therapy Dressings. After several cycle of VAC, the wound bed was prepared, and he underwent split skin graft over right foot. 3 rd case, 60 years old gentleman with underlying diabetes mellitus presented with right foot necrotizing soft tissue infection. He underwent rays’ amputation and extensive wound debridement. Upon stabilization of general condition, patient was discharge with regular wound dressing by same nurse and doctor during each visit to clinic follow up. After 6 months of follow up, the wound healed well. 4th case, 38-year-old gentleman had alleged motor vehicle accident and sustained closed fracture right tibial plateau. Open reduction and proximal tibial locking plate were done. At 2 weeks post-surgery, the patient presented with warm, erythematous leg and pus discharge from the surgical site. Empirical antibiotic was started, and wound debridement was done. Intraoperatively, 50cc pus was evacuated, unhealthy muscle and tissue debrided. No loosening of the implant. Patient underwent multiple wound debridement. At 2 weeks post debridement wound healed well, but the proximal aspect was unable to close immediately. This left the proximal part of the implant to be exposed. Patient was then put on VAC dressing for 3 weeks until healthy granulation tissue closes the implant. Meanwhile, antibiotic was change according to culture and sensitivity. At 6 weeks post the first debridement, the wound was completely close, and patient was discharge home well. At 3 months post operatively, patient wound and fracture healed uneventfully and able to ambulate independently. Complex wounds are too serious to be dealt with. Team managing complex wound need continuous support through the provision of educational tools to support their professional development, engagement with local and international expert, as well as highquality products that increase efficiencies in services

Keywords: VAC (Vacuum Assisted Closure), empirical- initial antibiotics, NPWT- negative pressure wound therapy, NF- necrotizing fasciitis, gangrene- blackish discoloration due to poor blood supply

Procedia PDF Downloads 81