The Effect of Steamed Tempeh on Hemoglobin Levels and Body Weight in Pregnant Women at the Kalar - Kalar Health Center, Aru Islands District

Background: Nutrition of pregnant women is very influential on fetal growth, one of which is iron deficiency anemia. Iron deficiency increases in pregnant women with increasing age in pregnancy. Significantly low intake of nutrients will make pregnant women experience Chronic Energy Deficiency. The nutritional content of tempeh can be used to meet the nutritional needs of pregnant women. Objective: The aim of this study was to analyze the effect of giving steamed tempeh to the increase in hemoglobin and Body Weight levels in pregnant women at the Kalar-kalar Health Center, Aru Islands Regency. Method: This type of research is a quasi-experimental with a pre-posttest control group design. The intervention was given to the respondents as many as 24 people with 12 people in the control group and 12 people in the treatment group. Sampling purposive sampling. Subjects were taken from two villages in the working area of ​​the Kalar-Kalar Public Health Center which have relatively the same geography and socioeconomic status and only pregnant women with Hb <11 G/dL were selected. The form of treatment was giving 100 G of steamed tempeh 2 times a week for 30 days while the control group was given biscuits for pregnant women 2 times per week 100 G. Data analysis used univariate and bivariate analysis with paired T test and Mann Whitney. Results: Mann Whitney test results of the effect of steamed tempeh on weight gain in the treatment group obtained a p-value of 0.050 (p=0.05). Differences in hemoglobin levels in anemic pregnant women with a p-value of 0.018 (<0.05) with a mean difference of 0.42 G/dL in the pre-posttest treatment group and the control group with a p-value of 0.217 (<0.05) with a mean difference of 0.21 G/d dL. Conclusion: There is an effect of giving steamed tempeh to increase hemoglobin and body weight in pregnant women. Keywords: Anemia, Pregnant women, Hemoglobin, Body Weight, Tempeh.

Teenage childbearing and school dropout in a sample of 18,791 single mothers in Cameroon

Background Adolescent childbearing increases the risk of adverse health and social consequences including school dropout (SDO). However, it remains unclear why some teenage mothers drop out of school and others do not, especially in sub-Saharan Africa settings. We aimed to investigate the background and behavioral characteristics of single mothers, associated with school dropout in a sample of 18,791 Cameroonian girls, who had their first child during adolescence. Methods We used data from a national registry of single mothers, collected during the years 2005–2008 and 2010–2011. Both bivariate analysis and logistic binary regression models were used to explore the relationship between adolescence motherhood and SDO controlling for a range of socio-economic, family, sexual and health seeking behavior characteristics. Results Among the 18,791 single mothers, 41.6% had dropped out of school because of pregnancy. The multivariable regression model showed that SDO was more common in those who were evicted from their parental home (aOR: 1.85; 95% CI: 1.69–2.04), those who declared having other single mothers in their family (aOR: 1.16; 95% CI 1.08–1.25) and in mothers who had their first child before 15. Using modern contraceptive methods, having declared no sexual partner during the last year and having less than 2 children were associated with a reduced likelihood of school dropout. Conclusions Strong social support is essential to ensure school continuity in this vulnerable population. Dropping out of school may put the teenage mother more at risk of unsafe health behaviour and new pregnancies.

Clinical Predictors of Survival for Patients with Atypical Teratoid/Rhabdoid Tumors

Purpose: Atypical teratoid/rhabdoid tumors (AT/RT) are malignant central nervous system (CNS) neoplasms of the young. Our study analyzed a large AT/RT cohort from the National Cancer Database (NCDB) to elucidate predictors of short-term mortality and overall survival (OS). Methods: Information was collected on patients with histologically-confirmed AT/RT using the NCDB (2004-2016). Kaplan-Meier analysis indicated OS. Prognostic factors for 30-day mortality, 90-day mortality, and OS were determined via multivariate Cox proportional-hazards (CPH) and logistic regression models. Results: Our cohort of 189 patients had a median age of 1 year (IQR [1, 4]) and tumor size of 4.7±2.0 cm at diagnosis. Seventy-two percent were under 3 years old; 55.6% were male and 71.0% were Caucasian. Fifty (27.2%) patients received only surgery (S) (OS=5.91 months), 51 (27.7%) received surgery and chemotherapy (S+CT) (OS=11.2 months), and 9 (4.89%) received surgery and radiotherapy (S+RT) (OS=10.3 months). Forty-five (24.5%) received S+CT+RT combination therapy (OS=45.4 months), 13 (17.1%) received S+CT+BMT/SCT (bone marrow or stem cell transplant) (OS=55.5 months), and 16 (8.70%) received S+CT+RT+BMT/SCT (OS=68.4 months). Bivariate analysis of dichotomized age (HR=0.550, 95% CI[0.357, 0.847], p=0.0067) demonstrated significantly increased patient survival if diagnosed at or above 1 year old. On multivariate analysis, administration of S+CT+RT, S+CT+BMT/SCT, or S+CT+RT+BMT/SCT combination therapy predicted significantly (p<0.05) increased OS compared to surgery alone. Conclusion: AT/RTs are CNS tumors where those diagnosed under 1 year old have a significantly worse prognosis. Our study demonstrates that while traditional CT, RT, and BMT/SCT combination regimens prolong life, overall survival in this population is still low.

Kepemilikan Fasilitas Sanitasi Dasar Rumah Tangga Di Desa Air Selumar Kecamatan Sijuk Kabupaten Belitung

Ownership of basic sanitation facilities of the house is one of the conditions of a healthy home. Health problems in the home environment can not be separated from the level of knowledge, attitude, income of the head of the family and the number of dependents of the head of the family. It is seen that there are still people who do not have thoughts about the importance of basic sanitation for their lives and there are still many people who do not have basic sanitation facilities. The purpose of this study is to find out the factors related to the ownership of basic household sanitation facilities in Selumar Water Village, Sijuk Subdistrict, Belitung Regency.This study uses observational analytics method with cross sectional approach. The samples in this study numbered 101 samples, using proportional random sampling method. Research instruments are questionnaires and checklists. Data analysis is performed using Chi square test. Bivariate analysis results show there is a relationship between the level of knowledge and the ownership of basic household sanitation facilities p value=0.000, there is a relationship between attitude with the ownership of basic household sanitation facilities p value=0.005, there is a relationship between the level of income and the ownership of basic household sanitation facilities p value=0.000, there is a relationship between the number of family members and the ownership of basic household sanitation facilities p value=0.016. The level of knowledge, attitude, income level and number of family members relates to the ownership of basic household sanitation facilities in Selumar Water Village, Sijuk Subdistrict, Belitung Regency

Clinical Trial Quality Assessment in Adult Spinal Surgery: What Do Publication Status, Funding Source, and Result Reporting Tell Us?

Study Design Narrative Review Objectives The objective of this study was to compare publication status of clinical trials in adult spine surgery registered on ClinicalTrials.gov by funding source as well as to identify other trends in clinical trials in adult spine surgery. Methods All prospective, comparative, therapeutic (intervention-based) trials of adult spinal disease that were registered on ClinicalTrials.gov with a start date of January 1, 2000 and completion date before December 17, 2018 were included. Primary outcome was publication status of published or unpublished. A bivariate analysis was used to compare publication status to funding source of industry vs non-industry. Results Our search identified 107 clinical trials. The most common source of funding was industry (62 trials, 57.9% of total), followed by University funding (26 trials, 24.3%). The results of 76 trials (71.0%) were published, with industry-funded trials less likely to be published compared to non–industry-funded trials (62.9% compared to 82.2%, P = .03). Of the 31 unpublished studies, 13 did not report any results on ClinicalTrials.gov , and of those with reported results, none was a positive trial. Conclusions Clinician researchers in adult spine surgery should be aware that industry-funded trials are less likely to go on to publication compared to non–industry-funded trials, and that negative trials are frequently not published. Future opportunities include improvement in result reporting and in publishing negative studies.

Analisis faktor keikutsertaan screening hepatitis “B” pada ibu hamil

Background: Nagan Raya Regency is included in the top 5 districts/cities with the fourth highest number of hepatitis in Aceh Province. The hepatitis B screening program has not been implemented properly. The impact of the low coverage of this program affects public ignorance about the spread of hepatitis B from sufferers to other communities.Objective: This study aims to analyze the participation factors for Hepatitis B screening in pregnant women in the working area of the Ujong Patihah Health Center.Method: This research design is cross sectional study, in 2021. Data were collected using a questionnaire with a sample size of 220 pregnant women. Data collection was carried out by direct interviews with respondents, using a questionnaire instrument. Data analysis used the Cgi-square statistical test with a significance level of 95%, and continued with multivariate analysis using the Binary Logistics Regression test.Results: Bivariate analysis showed that there was a relationship between knowledge (p= 0.022), mother's attitude (p= 0.010), husband's role (p = 0.018), role of health workers (p = 0.028) and participation in hepatitis B screening, while education did not affect participation in hepatitis B screening (p= 0.668). Multivariate results showed that the mother's attitude was the dominant factor for participation in hepatitis B screening (OR= 2.24).Conclusion: Positive attitudes had a 2.24 times relationship to the participation of pregnant women in hepatitis B screening than negative attitudes.

Analisis program sanitasi total berbasis masyarakat (STBM) pilar cuci tangan pakai sabun pada anak SD

Background: The problem of washing hands with soap in elementary school students is still high. Elementary schools in Kuala Pesisir Subdistrict, Nagan Raya Regency have not implemented hand washing with soap according to the 6-step principle. Efforts made by the Health Office to make this program successful are by increasing student compliance in hand washing activities through socialization and direct practice.Objective: This study aims to analyze the factors that influence the success of the pilar community-based total sanitation program for washing hands with soap at elementary school levels class V and VI in Kuala Pesisir District, Nagan Raya Regency.Method: Design This research is a cross sectional study. Data were collected using a questionnaire with a sample size of 240 students consisting of grades V and VI. Statistical analysis using Chi-square test and Binary Logistics Regression.Results: The results of bivariate analysis showed that there was a relationship between knowledge (p=0.002), attitude (p=0.007), behavior p=(0.000), hand washing facilities (p=0.000), teacher support (p=0.036), and availability of water (p=0.036). p=0.000) with a total community-based sanitation program pillar washing hands with soap. Based on multivariate analysis, the dominant variables associated with the pillars of hand washing with soap are behavior (OR=0.207; 95%CI: 0.082-0.524), water availability (OR=0.173; 95%CI: 0.050-0.595) and facilities. wash hands (OR=0.153; 95%CI: 0.047-0.501).Conclusion: It was concluded that positive student behavior 0.207 times was associated with the success of the hand washing program with soap compared to negative student behavior.

Association between housing and health of refugees and asylum seekers in Germany: explorative cluster and mixed model analysis

Background Accommodation for asylum seekers and refugees (ASR) in Germany differs in many ways depending on a range of political, structural, social, and environmental factors. These contextual differences present a challenge for assessing health impacts of refugee accommodation. We aimed to devise a broad typology of refugee accommodation that allows to assess associations between housing and health of ASR. Methods We performed a cluster analysis of population-based, cross-sectional secondary data in Germany to identify clusters of refugee accommodation. We then assessed health disparities across clusters by performing bivariate analysis and linear mixed model regression analysis. Results We identified four clusters, three of them reflected different types of private accommodation and one pointed to collective accommodation. The collective accommodation cluster clearly differed from the private accommodation clusters in terms of space, area, level of restrictions, social connections and respondent satisfaction. Across private accommodation clusters we also found differences in space, area, and level of restrictions. In regression analysis, belonging to one of the private accommodation cluster was significantly associated with better mental health compared to belonging to the collective accommodation cluster. Physical health was significantly lower in one private accommodation cluster characterized by poor access to public transport and a higher level of restrictions compared to a private accommodation cluster showing better connections and a lower level of restrictions. Conclusion We demonstrate that unfavourable conditions cluster in collective accommodation with negative outcomes for mental health but not for physical health. We also found health disparities across types of private accommodation. We conclude that housing plays a role in the production of health inequalities in ASR but needs to be assessed in a differentiated, multidimensional way.

Kendall Transformation: A Robust Representation of Continuous Data for Information Theory

Kendall transformation is a conversion of an ordered feature into a vector of pairwise order relations between individual values. This way, it preserves ranking of observations and represents it in a categorical form. Such transformation allows for generalisation of methods requiring strictly categorical input, especially in the limit of small number of observations, when discretisation becomes problematic.In particular, many approaches of information theory can be directly applied to Kendall-transformed continuous data without relying on differential entropy or any additional parameters. Moreover, by filtering information to this contained in ranking, Kendall transformation leads to a better robustness at a reasonable cost of dropping sophisticated interactions which are anyhow unlikely to be correctly estimated. In bivariate analysis, Kendall transformation can be related to popular non-parametric methods, showing the soundness of the approach.The paper also demonstrates its efficiency in multivariate problems, as well as provides an example analysis of a real-world data.

Mutations at Codon 641 of Exon 16 of EZH2 in Circulating Tumor DNA: A Biomarker for Relapse in Patients With Diffuse Large B-cell Lymphoma Treated With the R-CHOP Scheme.

Background: The epigenetic regulator EZH2 is a subunit of the polycomb repressive complex 2 (PRC2), methylates H3K27, resulting in transcriptional silencing. The mutation at Y646 amino acid in the EZH2 gene is mutated in up to 40 % of B-cell lymphomas. Methods: We compared the presence of exon 16 EZH2 mutations in tumor samples and ctDNA in a prospective trial. The mutations were determined by sanger sequencing, and by ddPCR. We also evaluated the impact of these mutations on response, relapse, and survival. Results: One hundred and thirty-eight cases were included. Ninety-eight were germinal center, and twenty had EZH2 mutations. Mean follow-up (IQR 25-75) was 23 (7- 42) months. The tumor samples were considered the standard of reference. Considering the results of the mutation in ctDNA by Sanger sequencing, the sensibility (Se) and specificity (Sp) were 52 % and 99 %, respectively. After adding the ddPCR analysis, the Se and Sp increased to 95 and 100 %, respectively. After bivariate analysis, only the presence of double-hit lymphoma (p=0.04), or EZH2 mutations were associated with relapse. The median PFS (95 % Interval confidence) was 27.7 (95 % IC: 14-40) vs 44.1 (95 % IC: 40-47.6) months for the mutated vs wt patients. Conclusions: The ctDNA is usefull to analyse EZH2 mutations, which have an impact in PFS.