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Introduction. Childhood tuberculosis (TB) is difficult to diagnosed and is based together on clinical and microbiology examinations. Since in children signs and symptoms of TB are not typical and sputum is difficult to be obtained, Mycobacterium tuberculosis (Mtb) antigen detection could be considered as a non invasive method for early detection of childhood TB. ESAT-6 is a low molecular weight specific protein that plays an important role in Mtb virulence. Aim. To determine the diagnostic value of urinary ESAT-6 for the diagnosis of childhood tuberculosis. Methodology.This was a cross-sectional study, with consecutive sampling collection . in children aging between 0-14 years suspected for pulmonary TB based on the clinical presence of :cough lasting more than 2 weeks, fever without clear ethiology, loss of body weight or poor weight gain, fatigue, malaise with positive history of contact with sputum smear from adult TB patients. Diagnosis of pulmonary TB was based on clinical presentation plus tuberculin positive skin test, chest x-ray, AFB staining and/or sputum culture. Subjects who met the inclusion criteria but unconfirmed by clinical and microbiological were considered as control (non-TB group). Urinary ESAT-6 level was analyzed by using ELISA. Cut off value and AUC was determined using ROC Statistical Analysis (SPSS 20.0). Sensitivity and specificity was measured from 2x2 crosstable. Result. Between the 61 studied children with suspected TB, 46/61 (75%) were finally diagnosed with TB, with 34/46 (74%) microbiologically confirmed cases either by sputum microscopy 31/34 (91%) or culture 3/34 (9%), whereas 15/61 (25%) subjects were not-confirmed cases (non-TB group). The mean value of urinary ESAT-6 level was higher in TB than non-TB group, Mean (SD) [4.855(6.714)] ng/mLvs [1.503(0.946)] ng/mL; p=

Di seluruh dunia, sepsis adalah penyebab utama kematian. Insiden sepsis telah berlipat ganda selama beberapa tahun terakhir. Terdapat peradangan sistemik pada sepsis yang menyebabkan disfungsi organ. Dengan demikian, kita membutuhkan biomarker untuk menentukan diagnosis dan prognosis sepsis. Lactate dehydrogenase (LDH) adalah biomarker kerusakan organ terkait sepsis. Tujuan penelitian ini adalah untuk mengevaluasi hubungan antara LDH dan luaran klinis pasien dengan sepsis di RSUD Dr. Saiful Anwar Malang. Studi ini dilakukan menggunakan pendekatan kohort prospektif, sementara desainnya adalah analitik observasional. Pengambilan sampel dilakukan dengan metode konsekutif. Pemeriksaan kadar LDH dilakukan menggunakan Roche Cobas 8000, kemudian mortalitas dan lama perawatan dikumpulkan dari catatan medis. Temuan menunjukkan bahwa tidak ada variasi kadar LDH dalam hubungannya dengan kematian pada pasien sepsis (p = 0,414) dan ada hubungan negatif antara kadar LDH dengan lama perawatan pasien sepsis (r = -0,576, p = 0,031), tidak ada hubungan antara kadar LDH dan kematian pasien sepsis (r = 0,14, p = 0,414). Didapatkan nilai cut-off LDH untuk memprediksi kematian adalah 728 U/I, dengan nilai risiko relatif 1,28. Pengukuran LDH yang hanya satu kali dianggap berdampak pada temuan laporan ini. Studi ini menyimpulkan bahwa pada pasien sepsis, kadar LDH memiliki hubungan yang moderat dengan lama perawatan, tetapi tidak memiliki hubungan pada kematian pasien sepsis.

Recently, two-dimensional (2D) materials have been studied due to its unique properties and potentials for electronic devices. Tin Selenide (SnSe) is a promising material to be developed in many fields by identifying its electronic structure. In this study, we investigate the effect of layer-dependent electronic properties of SnSe using first-principles calculations based on density functional theory (DFT). We firstly optimized layer dependent of the lattice constant and atomic distortion and then calculate the electronic structure-related parameter including band structure and density of electron (DOS). We find that the calculated band gap decreases with increasing the layers of SnSe which is not dependent on fully relativistic calculation by turning spin orbit coupling (SOC). However, we identify substantial spin splitting in the band structure under the presence of the SOC, making this multilayer is promising for spintronics.

The coexistence of ferroelectricity and spin-orbit coupling in noncentrosymmetric systems may allow for a nonvolatile control of spin textures in the momentum space by tuning the ferroelectric polarization. Based on first-principles calculations, supplemented with $\stackrel{P\vec}{k}\ifmmode\cdot\else\textperiodcentered\fi{}\stackrel{P\vec}{p}$ analysis, we report the emergence of the reversible spin textures in the two-dimensional (2D) $\mathrm{Ga}XY$ ($X=\mathrm{Se}$, Te; $Y=\mathrm{Cl}$, Br, I) monolayer compounds, a new class of 2D materials exhibiting in-plane ferroelectricity. We find that due to the large in-plane ferroelectric polarization, unidirectional out-of-plane spin textures are induced in the topmost valence band having giant spin splitting. Importantly, such out-of-plane spin textures, which can host a long-lived helical spin mode known as a persistent spin helix, can be fully reversed by switching the direction of the in-plane ferroelectric polarization. We show that the application of an external in-plane electric field oriented oppositely to the in-plane ferroelectric polarization direction is an effective method to flip the orientation of the out-of-plane spin textures. Thus, our findings can open avenues for interplay between the unidirectional out-of-plane spin textures and the in-plane ferroelectricity in 2D materials, which is useful for efficient and nonvolatile spintronic devices.

Kurangnya pengetahuan masyarakat tentang COVID-19, lupus, reumatik, dan alergi mempengaruhi keberhasilan terapi, penurunan angka kejadian, dan pencegahan kekambuhan. Tujuan pengabdian masyarakat adalah membangun desa-desa binaan tanggap COVID-19, lupus, reumatik, dan alergi di Malang oleh Tim Kelompok Kajian Lupus, Autoimun, Reumatik, dan Alergi (LAURA) Universitas Brawijaya. Warga desa binaan diberikan penyuluhan berupa seminar awam dan pelatihan tentang pertolongan awal pada penyakit COVID-19, lupus, reumatik, dan alergi, kemudian diminta mengisi kuesioner posttest untuk mengukur pemahaman. Desa-desa binaan diberikan thermo-gun dan wastafel untuk menerapkan protokol kesehatan. Satu bulan kemudian dievaluasi adanya kejadian COVID-19, lupus, reumatik, dan alergi di desa binaan. Hasil evaluasi menunjukkan rata-rata warga desa binaan memahami 78,3% materi yang diberikan dan menerapkan protokol kesehatan sesuai yang diajarkan saat penyuluhan. Dilaporkan tidak ada kejadian COVID-19 serta kekambuhan lupus, reumatik, dan alergi dalam satu bulan terakhir kegiatan. Kesimpulan: pembangunan desa-desa binaan di Malang meningkatkan tanggap warga terhadap COVID-19, lupus, reumatik, dan alergi.

Background: Healthcare workers (HCWs) run a high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The HCWs are prone to the SARS-CoV-2 infection in the hospital despite being fully vaccinated. The present study aimed to address the factors associated with the coronavirus disease 2019 (COVID-19) vaccine breakthrough among HCWs. Study Design: A prospective cohort study. Methods: Participants were 184 HCWs receiving two doses of inactivated SARS-CoV-2 vaccine (CoronaVac, Sinovac Life Science). All participants were followed for six months. Confirmed COVID-19 was defined as positive SARS-CoV-2 by reverse transcription-polymerase chain reaction (RT-PCR). Before undergoing RT-PCR, questionnaires were used to obtain information on demographic characteristics, profession, contact with COVID-19 cases, personal protective equipment (PPE), health protocols adherence, exercise, and nutritional habits. Results: A number of 57 (31%) participants were COVID-19 positive. Close contact with COVID-19 cases (adjusted RR 6.82, 95% CI: 1.97, 47.98, P=0.044), being a resident doctor (adjusted RR 4.72, 95% CI: 1.11, 20.11, P=0.036), improper mask-wearing (adjusted RR 2.36, 95% CI: 1.15, 4.85, P=0.019), and lower frequency of eating fruit and vegetables (adjusted RR 2.73, 95% CI: 1.34, 5.57, P=0.006) increased the risk of vaccine breakthrough. Compared to single surgical masks, KN95 and N95 significantly reduced the risk of COVID-19 (adjusted RR 0.27, 95% CI: 0.07, 0.97, P=0.045 and adjusted RR 0.25, 95% CI: 0.07, 0.87, P=0.029), respectively. Conclusion: As evidenced by the obtained results, being a resident doctor, close contact with confirmed COVID-19 cases, health protocol incompliance, as well as the lower frequency of fruit and vegetable consumption were associated with the risk of vaccine breakthrough among HCWs. Appropriate strategies are needed to prevent the risk of SARS-CoV-2 infection among HCWs.

The ability to control the spin textures in semiconductors is a fundamental step toward novel spintronic devices, while seeking desirable materials exhibiting persistent spin texture (PST) remains a key challenge. The PST is the property of materials preserving a unidirectional spin orientation in the momentum space, which has been predicted to support an extraordinarily long spin lifetime of carriers. Herein, by using first-principles density functional theory calculations, we report the emergence of the PST in the two-dimensional (2D) germanium monochalcogenides (GeMC). By considering two stable formations of the 2D GeMC, namely the pure GeX and Janus Ge2XY monolayers (X, Y = S, Se, and Te), we observed the PST around the valence band maximum where the spin orientation is enforced by the lower point group symmetry of the crystal. In the case of the pure GeX monolayers, we found that the PST is characterized by fully out-of-plane spin orientation protected by C2v point group, while the canted PST in the y-z plane is observed in the case of the Janus Ge2XY monolayers due to the lowering symmetry into Cs point group. More importantly, we find large spin-orbit coupling (SOC) parameter in which the PST sustains, which could be effectively tuned by in-plane strain. The large SOC parameter observed in the present systems leads to the small wavelength of the spatially periodic mode of the spin polarization, which is promising for short spin channel in the spin Hall transistor devices., Journal of Physics: Condensed Matter (Accepted)

Background: Sepsis is the most severe manifestation of acute infection which can cause death in 30-50% of cases. Rapid and accurate diagnosis of sepsis is a challenge for clinicians and laboratories. Neutrophil Lymphocyte Count Ratio is a potential index to detect the occurrence of sepsis. This examination is easy, fast and cheap. Procalcitonin is currently widely used as a newer indicator in diagnosing pre-shock but is rarely done because of its cost. This study aims to compare the diagnostic value of Neutrophil Lymphocyte Count Ratio with procalcitonin as a marker in septicpatients.Method: A Case-control analytic research was conducted from March to June 2018. Examination of neutrophils and lymphocytes using Sysmex XN-1000 while procalcitonin examination used Elecsys BRAHMS PCT using ECLIA method. Diagnostic values are analyzed using the ROC curve, and the cut-off value is determined. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy are calculated with 2x2 tables.Result: The subjects of the study were 60 patients who hospitalized and examined for procalcitonin with 30 patients diagnosed based on clinical symptoms and SOFA score ≥ two by clinicians as sepsis patients and also 30 control patients. ROC analysis with procalcitonin cut-off values of 2,24 ng / mL obtained a sensitivity of 93%, specificity of 86,7%, PPV of 86,9%, and NPV of 92,4%.. At the cut-off value of Neutrophil Lymphocyte Count Ratio 5,06, there was a sensitivity of 80%, specificity of 76,7%, PPV of 76,9%, and NPV of 79,1%.Conclusion: Procalcitonin has a better diagnostic value than Neutrophil Lymphocyte Count Ratio in diagnosing sepsis.

Waldenstrom macroglobulinemia is a chronic, indolent, lymphoproliferative disorder, which is characterized by the presence of a high macroglobulin (IgM) level, elevated serum viscosity, and the presence of a lymphoplasmacytic infiltrate in the bone marrow. Clinical manifestations may be found due to the presence of IgM paraprotein and malignant lymphoplasmacytic cell infiltration of the bone marrow and other tissues. We reported a case of male patient with Waldenstrom macroglobulinemia and bilateral maxillary sinusitis. He had received symptomatic and antibiotic treatment for his sinusitis, FFP and PRC transfusion to improve his general condition and chemotherapy with CHOP regimen as definitive treatment.

Hydroxyapatite (Ca10(PO4)6(OH2), HA has similarities with human bone mineral composition and morphology, bioactive, and non-toxic. However, HA has a weakness in the decay of material, so it can inhibit the growth of new bone tissue. The other materials used as biodegradable bone substitute are Tri Calcium Phosphate (TCP). It has the reception of the body is almost as good as HA but it have fast decay time, so that the material has been discharged before the newly formed tissue. This study aimed to developed a Biphasic Calcium Phosphate (BCP) which is a combination of the properties of HA and TCP, it makes the decay time can be in accordance with the growth of new bone tissue. Calcination method was used in this study. Four groups of bovine bone samples were calcined at four different temperatures ranging from 1000oC to 1300oC using the electric furnace. The heating rate during calcination process was 5oC/minute and dwell time of 2 hours. The calcined bioceramics samples are being examined to determine the characterization of materials. XRD testing to determine the chemical compounds, FTIR performed to determine the ionic bonds that exist in materials and SEM to determine the microstructure of the material calcination results. The current investigation confirms the possibility of producing porous BCP bone graft from porous bovine bone cube, without any important impurities as indicated by XRD and FT-IR techniques. The partially decomposition of HA into TCP was started when bovine bone samples were heated at 1200oC.

Recently, ferroelectric materials have attracted much attention in the field of spintronics since they enable to manipulation of spin splitting and spin textures via electric control of electric polarization. Here, two-dimensional ferroelectric SnSe monolayer (ML) comprises a promising candidate for spintronics since it has large and switchable in-plane electric polarization. However, the application of strain strongly modifies the electronic properties of the SnSe ML, which is expected to significantly affect the properties of the spin-splitting bands. By using fully-relativistic density-functional theory calculations, we predict that a strongly anisotropic spin splitting is observed in the energy bands near both the conduction band minimum (CBM) and valence band maximum (VBM), which can be effectively tuned by applying a small uniaxial in-plane strain. We demonstrate that these spin-splitting bands exhibit a unidirectional out-of-plane spin configuration in the momentum space, giving rise to a long-lived persistent spin helix (PSH) state. Importantly, a giant spin splitting (up to 245 meV) is achieved under the uniaxial in-plane tensile strain without losing the nature of the PSH state, thus offering a possibility for realizing efficient spintronic devices enabling operation at room temperature.

Background: Neonatal sepsis remains worldwide one of the leading causes of morbidity and mortality in both term and preterm infants. Lower mortality rates are related to timely diagnostic evaluation and prompt initiation of empiric antibiotic therapy. Blood culture, as gold standard examination for sepsis, has several limitations for early diagnosis, so that sepsis biomarkers could play an important role in this regard. This study was aimed to compare the value of the two biomarkers presepsin and procalcitonin in early diagnosis of neonatal sepsis.Methods: This was a prospective cross-sectional study performed in Saiful Anwar General Hospital Malang, Indonesia, in 51 neonates that fulfill the criteria of systemic inflammatory response syndrome (SIRS) with blood culture as diagnostic gold standard for sepsis.Results: At reviewer operating characteristic (ROC) curve analyses, using a presepsin cutoff of 706.5 pg/mL, the obtained area under the curve (AUCs) were sensitivity = 85.7%, specificity = 68....

Background: WHO-ILAR COPCORD Program is a program that aimed to obtain data on joints pain and musculoskeletal diseases in developing countries, one aspect which has not been studied is the ability of COPCORD questionnaire as a screening tool which standardized for  screening  joint pain and musculoskeletal diseases. Objective of this study is to assess the validity of modified COPCORD questionnaire Indonesian version in screening joint pain and musculoskeletal disease compared to examination by rheumatologists.Methods: The initial phase of the research is determining essential points, translation to Indonesian, and back translation. The second stage is testing questionnaires in communities which 100 respondents involved. Dependent variable is the diagnosis of rheumatic diseases and independent variables are pain in less and more than 7 days, high degree pain in less and more than 7 days, history of NSAIDs/Steroids/DMARDs use, and disabilities. Validation test was assessed by calculating the sensitivity, specificity, PPV, NPV, LR+, and ROC curve. Bivariate analysis using Chi Square analysis, and multivariate analysis using logistic regression.Results: The sensitivity test results is best obtained on the question history of NSAIDs/steroids/DMARDs use (100%) and specificity is best obtained on the question about disability (98%). ROC curve analysis which the results >85% obtained on the question of pain >7 days (90%), high degree pain >7 days (93%), and history of NSAIDs/steroids/DMARDs use (92%).  LR+ to diagnose rheumatic diseases found in all questions. Chi square analysis showed that all questions were significant with p