Sam Ratulangi University

BACKGROUND: For more than three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has provided a framework to quantify health loss due to diseases, injuries, and associated risk factors. This paper presents GBD 2023 findings on disease and injury burden and risk-attributable health loss, offering a global audit of the state of world health to inform public health priorities. This work captures the evolving landscape of health metrics across age groups, sexes, and locations, while reflecting on the remaining post-COVID-19 challenges to achieving our collective global health ambitions. METHODS: The GBD 2023 combined analysis estimated years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 375 diseases and injuries, and risk-attributable burden associated with 88 modifiable risk factors. Of the more than 310 000 total data sources used for all GBD 2023 (about 30% of which were new to this estimation round), more than 120 000 sources were used for estimation of disease and injury burden and 59 000 for risk factor estimation, and included vital registration systems, surveys, disease registries, and published scientific literature. Data were analysed using previously established modelling approaches, such as disease modelling meta-regression version 2.1 (DisMod-MR 2.1) and comparative risk assessment methods. Diseases and injuries were categorised into four levels on the basis of the established GBD cause hierarchy, as were risk factors using the GBD risk hierarchy. Estimates stratified by age, sex, location, and year from 1990 to 2023 were focused on disease-specific time trends over the 2010-23 period and presented as counts (to three significant figures) and age-standardised rates per 100 000 person-years (to one decimal place). For each measure, 95% uncertainty intervals [UIs] were calculated with the 2·5th and 97·5th percentile ordered values from a 250-draw distribution. FINDINGS: Total numbers of global DALYs grew 6·1% (95% UI 4·0-8·1), from 2·64 billion (2·46-2·86) in 2010 to 2·80 billion (2·57-3·08) in 2023, but age-standardised DALY rates, which account for population growth and ageing, decreased by 12·6% (11·0-14·1), revealing large long-term health improvements. Non-communicable diseases (NCDs) contributed 1·45 billion (1·31-1·61) global DALYs in 2010, increasing to 1·80 billion (1·63-2·03) in 2023, alongside a concurrent 4·1% (1·9-6·3) reduction in age-standardised rates. Based on DALY counts, the leading level 3 NCDs in 2023 were ischaemic heart disease (193 million [176-209] DALYs), stroke (157 million [141-172]), and diabetes (90·2 million [75·2-107]), with the largest increases in age-standardised rates since 2010 occurring for anxiety disorders (62·8% [34·0-107·5]), depressive disorders (26·3% [11·6-42·9]), and diabetes (14·9% [7·5-25·6]). Remarkable health gains were made for communicable, maternal, neonatal, and nutritional (CMNN) diseases, with DALYs falling from 874 million (837-917) in 2010 to 681 million (642-736) in 2023, and a 25·8% (22·6-28·7) reduction in age-standardised DALY rates. During the COVID-19 pandemic, DALYs due to CMNN diseases rose but returned to pre-pandemic levels by 2023. From 2010 to 2023, decreases in age-standardised rates for CMNN diseases were led by rate decreases of 49·1% (32·7-61·0) for diarrhoeal diseases, 42·9% (38·0-48·0) for HIV/AIDS, and 42·2% (23·6-56·6) for tuberculosis. Neonatal disorders and lower respiratory infections remained the leading level 3 CMNN causes globally in 2023, although both showed notable rate decreases from 2010, declining by 16·5% (10·6-22·0) and 24·8% (7·4-36·7), respectively. Injury-related age-standardised DALY rates decreased by 15·6% (10·7-19·8) over the same period. Differences in burden due to NCDs, CMNN diseases, and injuries persisted across age, sex, time, and location. Based on our risk analysis, nearly 50% (1·27 billion [1·18-1·38]) of the roughly 2·80 billion total global DALYs in 2023 were attributable to the 88 risk factors analysed in GBD. Globally, the five level 3 risk factors contributing the highest proportion of risk-attributable DALYs were high systolic blood pressure (SBP), particulate matter pollution, high fasting plasma glucose (FPG), smoking, and low birthweight and short gestation-with high SBP accounting for 8·4% (6·9-10·0) of total DALYs. Of the three overarching level 1 GBD risk factor categories-behavioural, metabolic, and environmental and occupational-risk-attributable DALYs rose between 2010 and 2023 only for metabolic risks, increasing by 30·7% (24·8-37·3); however, age-standardised DALY rates attributable to metabolic risks decreased by 6·7% (2·0-11·0) over the same period. For all but three of the 25 leading level 3 risk factors, age-standardised rates dropped between 2010 and 2023-eg, declining by 54·4% (38·7-65·3) for unsafe sanitation, 50·5% (33·3-63·1) for unsafe water source, and 45·2% (25·6-72·0) for no access to handwashing facility, and by 44·9% (37·3-53·5) for child growth failure. The three leading level 3 risk factors for which age-standardised attributable DALY rates rose were high BMI (10·5% [0·1 to 20·9]), drug use (8·4% [2·6 to 15·3]), and high FPG (6·2% [-2·7 to 15·6]; non-significant). INTERPRETATION: Our findings underscore the complex and dynamic nature of global health challenges. Since 2010, there have been large decreases in burden due to CMNN diseases and many environmental and behavioural risk factors, juxtaposed with sizeable increases in DALYs attributable to metabolic risk factors and NCDs in growing and ageing populations. This long-observed consequence of the global epidemiological transition was only temporarily interrupted by the COVID-19 pandemic. The substantially decreasing CMNN disease burden, despite the 2008 global financial crisis and pandemic-related disruptions, is one of the greatest collective public health successes known. However, these achievements are at risk of being reversed due to major cuts to development assistance for health globally, the effects of which will hit low-income countries with high burden the hardest. Without sustained investment in evidence-based interventions and policies, progress could stall or reverse, leading to widespread human costs and geopolitical instability. Moreover, the rising NCD burden necessitates intensified efforts to mitigate exposure to leading risk factors-eg, air pollution, smoking, and metabolic risks, such as high SBP, BMI, and FPG-including policies that promote food security, healthier diets, physical activity, and equitable and expanded access to potential treatments, such as GLP-1 receptor agonists. Decisive, coordinated action is needed to address long-standing yet growing health challenges, including depressive and anxiety disorders. Yet this can be only part of the solution. Our response to the NCD syndemic-the complex interaction of multiple health risks, social determinants, and systemic challenges-will define the future landscape of global health. To ensure human wellbeing, economic stability, and social equity, global action to sustain and advance health gains must prioritise reducing disparities by addressing socioeconomic and demographic determinants, ensuring equitable health-care access, tackling malnutrition, strengthening health systems, and improving vaccination coverage. We live in times of great opportunity. FUNDING: Gates Foundation and Bloomberg Philanthropies.

Since the outbreak of the COVID-19 (coronavirus disease 19) pandemic, researchers have been trying to investigate several active compounds found in plants that have the potential to inhibit the proliferation of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). The present study aimed to evaluate bioactive compounds found in plants using a molecular docking approach to inhibit the main protease (Mpro) and spike (S) glycoprotein of SARS-CoV-2. The evaluation was performed on the docking scores calculated using AutoDock Vina (AV) as a docking engine. A rule of five (Ro5) was calculated to determine whether a compound meets the criteria as an active drug orally in humans. The determination of the docking score was performed by selecting the best conformation of the protein-ligand complex that had the highest affinity (most negative Gibbs’ free energy of binding/ <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mi mathvariant="normal">Δ</a:mi> <a:mi>G</a:mi> </a:math> ). As a comparison, nelfinavir (an antiretroviral drug), chloroquine, and hydroxychloroquine sulfate (antimalarial drugs recommended by the FDA as emergency drugs) were used. The results showed that hesperidin, nabiximols, pectolinarin, epigallocatechin gallate, and rhoifolin had better poses than nelfinavir, chloroquine, and hydroxychloroquine sulfate as spike glycoprotein inhibitors. Hesperidin, rhoifolin, pectolinarin, and nabiximols had about the same pose as nelfinavir but were better than chloroquine and hydroxychloroquine sulfate as Mpro inhibitors. This finding implied that several natural compounds of plants evaluated in this study showed better binding free energy compared to nelfinavir, chloroquine, and hydroxychloroquine sulfate, which so far are recommended in the treatment of COVID-19. From quantum chemical DFT calculations, the ascending order of chemical reactivity of selected compounds was pectolinarin &gt; hesperidin &gt; rhoifolin &gt; morin &gt; epigallocatechin gallate. All isolated compounds’ C=O regions are preferable for an electrophilic attack, and O-H regions are suitable for a nucleophilic attack. Furthermore, Homo-Lumo and global descriptor values indicated a satisfactory remarkable profile for the selected compounds. As judged by the RO5 and previous study by others, the compounds kaempferol, herbacetin, eugenol, and 6-shogaol have good oral bioavailability, so they are also seen as promising candidates for the development of drugs to treat infections caused by SARS-CoV-2. The present study identified plant-based compounds that can be further investigated in vitro and in vivo as lead compounds against SARS-CoV-2.

BACKGROUND: Timely and comprehensive analyses of causes of death stratified by age, sex, and location are essential for shaping effective health policies aimed at reducing global mortality. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 provides cause-specific mortality estimates measured in counts, rates, and years of life lost (YLLs). GBD 2023 aimed to enhance our understanding of the relationship between age and cause of death by quantifying the probability of dying before age 70 years (70q0) and the mean age at death by cause and sex. This study enables comparisons of the impact of causes of death over time, offering a deeper understanding of how these causes affect global populations. METHODS: GBD 2023 produced estimates for 292 causes of death disaggregated by age-sex-location-year in 204 countries and territories and 660 subnational locations for each year from 1990 until 2023. We used a modelling tool developed for GBD, the Cause of Death Ensemble model (CODEm), to estimate cause-specific death rates for most causes. We computed YLLs as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. Probability of death was calculated as the chance of dying from a given cause in a specific age period, for a specific population. Mean age at death was calculated by first assigning the midpoint age of each age group for every death, followed by computing the mean of all midpoint ages across all deaths attributed to a given cause. We used GBD death estimates to calculate the observed mean age at death and to model the expected mean age across causes, sexes, years, and locations. The expected mean age reflects the expected mean age at death for individuals within a population, based on global mortality rates and the population's age structure. Comparatively, the observed mean age represents the actual mean age at death, influenced by all factors unique to a location-specific population, including its age structure. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 250-draw distribution for each metric. Findings are reported as counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2023 include a correction for the misclassification of deaths due to COVID-19, updates to the method used to estimate COVID-19, and updates to the CODEm modelling framework. This analysis used 55 761 data sources, including vital registration and verbal autopsy data as well as data from surveys, censuses, surveillance systems, and cancer registries, among others. For GBD 2023, there were 312 new country-years of vital registration cause-of-death data, 3 country-years of surveillance data, 51 country-years of verbal autopsy data, and 144 country-years of other data types that were added to those used in previous GBD rounds. FINDINGS: The initial years of the COVID-19 pandemic caused shifts in long-standing rankings of the leading causes of global deaths: it ranked as the number one age-standardised cause of death at Level 3 of the GBD cause classification hierarchy in 2021. By 2023, COVID-19 dropped to the 20th place among the leading global causes, returning the rankings of the leading two causes to those typical across the time series (ie, ischaemic heart disease and stroke). While ischaemic heart disease and stroke persist as leading causes of death, there has been progress in reducing their age-standardised mortality rates globally. Four other leading causes have also shown large declines in global age-standardised mortality rates across the study period: diarrhoeal diseases, tuberculosis, stomach cancer, and measles. Other causes of death showed disparate patterns between sexes, notably for deaths from conflict and terrorism in some locations. A large reduction in age-standardised rates of YLLs occurred for neonatal disorders. Despite this, neonatal disorders remained the leading cause of global YLLs over the period studied, except in 2021, when COVID-19 was temporarily the leading cause. Compared to 1990, there has been a considerable reduction in total YLLs in many vaccine-preventable diseases, most notably diphtheria, pertussis, tetanus, and measles. In addition, this study quantified the mean age at death for all-cause mortality and cause-specific mortality and found noticeable variation by sex and location. The global all-cause mean age at death increased from 46·8 years (95% UI 46·6-47·0) in 1990 to 63·4 years (63·1-63·7) in 2023. For males, mean age increased from 45·4 years (45·1-45·7) to 61·2 years (60·7-61·6), and for females it increased from 48·5 years (48·1-48·8) to 65·9 years (65·5-66·3), from 1990 to 2023. The highest all-cause mean age at death in 2023 was found in the high-income super-region, where the mean age for females reached 80·9 years (80·9-81·0) and for males 74·8 years (74·8-74·9). By comparison, the lowest all-cause mean age at death occurred in sub-Saharan Africa, where it was 38·0 years (37·5-38·4) for females and 35·6 years (35·2-35·9) for males in 2023. Lastly, our study found that all-cause 70q0 decreased across each GBD super-region and region from 2000 to 2023, although with large variability between them. For females, we found that 70q0 notably increased from drug use disorders and conflict and terrorism. Leading causes that increased 70q0 for males also included drug use disorders, as well as diabetes. In sub-Saharan Africa, there was an increase in 70q0 for many non-communicable diseases (NCDs). Additionally, the mean age at death from NCDs was lower than the expected mean age at death for this super-region. By comparison, there was an increase in 70q0 for drug use disorders in the high-income super-region, which also had an observed mean age at death lower than the expected value. INTERPRETATION: We examined global mortality patterns over the past three decades, highlighting-with enhanced estimation methods-the impacts of major events such as the COVID-19 pandemic, in addition to broader trends such as increasing NCDs in low-income regions that reflect ongoing shifts in the global epidemiological transition. This study also delves into premature mortality patterns, exploring the interplay between age and causes of death and deepening our understanding of where targeted resources could be applied to further reduce preventable sources of mortality. We provide essential insights into global and regional health disparities, identifying locations in need of targeted interventions to address both communicable and non-communicable diseases. There is an ever-present need for strengthened health-care systems that are resilient to future pandemics and the shifting burden of disease, particularly among ageing populations in regions with high mortality rates. Robust estimates of causes of death are increasingly essential to inform health priorities and guide efforts toward achieving global health equity. The need for global collaboration to reduce preventable mortality is more important than ever, as shifting burdens of disease are affecting all nations, albeit at different paces and scales. FUNDING: Gates Foundation.

In the last two decades, considerable interest has been shown in understanding the development of the gut microbiota and its internal and external effects on the intestine, as well as the risk factors for cardiovascular diseases (CVDs) such as metabolic syndrome. The intestinal microbiota plays a pivotal role in human health and disease. Recent studies revealed that the gut microbiota can affect the host body. CVDs are a leading cause of morbidity and mortality, and patients favor death over chronic kidney disease. For the function of gut microbiota in the host, molecules have to penetrate the intestinal epithelium or the surface cells of the host. Gut microbiota can utilize trimethylamine, N-oxide, short-chain fatty acids, and primary and secondary bile acid pathways. By affecting these living cells, the gut microbiota can cause heart failure, atherosclerosis, hypertension, myocardial fibrosis, myocardial infarction, and coronary artery disease. Previous studies of the gut microbiota and its relation to stroke pathogenesis and its consequences can provide new therapeutic prospects. This review highlights the interplay between the microbiota and its metabolites and addresses related interventions for the treatment of CVDs.

Plant-mediated synthesis of nanomaterials has been increasingly gaining popularity due to its eco-friendly nature and cost-effectiveness. In the present study, we synthesized silver (Ag) nanoparticles using aqueous extracts of fresh leaves of Impatiens balsamina and Lantana camara medicinal plants as bioreducing agents. This method allowed the synthesis of nanoparticles, which was confirmed by ultraviolet-visible (UV-Vis) spectrophotometry and transmission electron microscopy (TEM). UV-Vis spectra and visual observation showed that the color of the fresh leaf extracts of L. camara and I. balsamina turned into grayish brown and brownish yellow, respectively, after treatment with Ag precursors. In addition, TEM analysis confirmed that AgNO 3 solutions for all concentrations produced Ag nanoparticles and their average size was less than 24 nm. Moreover, aqueous leaf extracts of I. balsamina and L. camara were separately tested for their antimicrobial activity against Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli bacteria. The results showed that the bacterial growth was inhibited by the extracts containing Ag nanoparticles. Statistical calculation performed using the Tukey test showed that zones of inhibition for the two bacteria produced by the aqueous leaf extracts of L. camara containing 3 mM and 5 mM Ag precursors were not significantly different from that by ciprofloxacin as positive control. On the contrary, there was significant difference between the zone of inhibition for E. coli by ciprofloxacin and that by the extracts of I. balsamina leaves containing 3 mM and 5 mM Ag precursors. A similar result was observed on the zone of inhibition for S. aureus by the extracts of I. balsamina leaves containing 3 mM Ag precursor. It was shown that the aqueous extracts of fresh L. camara leaves containing Ag nanoparticles were comparable to ciprofloxacin in inhibiting bacterial growth.

Bromelain is an effective chemoresponsive proteolytic enzyme derived from pineapple stems. It contains several thiol endopeptidases and is extracted and purified via several methods. It is most commonly used as an anti-inflammatory agent, though scientists have also discovered its potential as an anticancer and antimicrobial agent. It has been reported as having positive effects on the respiratory, digestive, and circulatory systems, and potentially on the immune system. It is a natural remedy for easing arthritis symptoms, including joint pain and stiffness. This review details bromelain's varied uses in healthcare, its low toxicity, and its relationship to nanoparticles. The door of infinite possibilities will be opened up if further extensive research is carried out on this pineapple-derived enzyme.

Abstract: Systemic Lupus erythematosus (SLE) is a connective tissue disorder that attacks several organs of the body, including the eyes. Ocular manifestation of this disease could be a sign of SLE activity and can cause decreased vision function to blindness. SLE can also affect extraocular tissue, anterior segment, posterior segment, and the optic nerve. The assessment of eye abnormalities that may arise due to SLE should alert the ophthalmologists. Treatment can be either local or systematic. The systematic management includes antimalarial agent, corticosteroids, immunomodulators, and biological agents. Cooperation among divisions and other medical fields is needed in the treatment of SLE. This paper aims to present the ocular manifestations of SLE, and is expected to improve the diagnostic quality, especially in terms of early diagnosis and appropriate treatment.Keywords: systemic lupus erythematosus; ocular manifestation Abstrak: Sistemik lupus eritematosus merupakan kelainan jaringan ikat yang yang menyerang beberapa organ tubuh termasuk mata. Gangguan pada mata ini dapat menjadi tanda keaktifan SLE, dan menyebabkan penurunan fungsi penglihatan hingga kebutaan. SLE dapat memengaruhi jaringan ekstraokular, segmen anterior, segmen posterior, dan saraf optik. Pengkajian kelainan mata yang mungkin timbul akibat SLE ini perlu mendapat perhatian oleh dokter mata. Tatalaksana dapat berupa tatalaksana lokal maupun sistemik. Tatalaksana sistemik berupa obat-obatan anti malaria, kortikosteroid, imunomodulator, dan agen biologis. Kerjasama antar divisi dan bidang kedokteran lainnya diperlukan dalam penanganan SLE. Tulisan ini bertujuan untuk menge-mukakan manfestasi klinis SLE pada mata dan diharapkan dapat meningkatkan kualitas diagnostik terutama dalam hal diagnosis dini dan tatalaksana yang cepat dan tepat.Kata kunci: sistemik lupus eritematosus; manifestasi okular

Ginkgo biloba is an ancient plant species that is thought to provide a variety of health benefits to living organisms and contains plenty of bioactive components, making it a chemically diversified plant. G. biloba has been shown to have a variety of medicinal and pharmacological properties, including anticancer, antidementia, antidiabetic, antiobesity, antilipidemic, antimicrobial, antioxidant, antilipid peroxidation, antiplatelet, anti-inflammatory, hepatoprotective, antidepressant, antiaging, immunomodulatory, antihypertensive, and neuroprotective effects and is frequently used to treat neurological, cardiovascular, and respiratory diseases, such as tardive dyskinesia. Therefore, this review described the therapeutic applications of G. biloba. In addition to describing the therapeutic potential, this review also evaluates the chemical constituents, toxicity, adverse effect, synergistic effect, and the clinical studies of this plant which have been utilized for therapeutic benefits but have demonstrated other consequences. The capacity of G. biloba components to act as free radical scavengers is critical, and combining its extract with other plant extracts has been shown to synergistically boost antioxidant properties. G. biloba used long-term or at high doses that resulted in some adverse effects. Severe drug interactions have also been reported in both animals and humans when combined with other medications. The available data established from both preclinical and clinical studies confirm the potential of G. biloba plant extract in various diseases. Besides, the safety and efficacy of G. biloba continue to require verification through additional experimentation to guide medicinal use.

KONSENTRASI KLOROFIL DAUN SEBAGAI INDIKATOR KEKURANGAN AIR PADA TANAMAN Nio Song Ai1) dan Yunia Banyo1) 1)Program Studi Biologi FMIPA Universitas SamRatulangi Manado, 95115;email: nio_ai@yahoo.com ABSTRAK Kekurangan air mempengaruhi semua aspek pertumbuhan tanaman, yang meliputi proses fisiologi, biokimia, anatomi dan morfologi. Salah satu respons fisiologis tanaman terhadap kekurangan air adalah penurunan konsentrasi klorofil daun yang dapat disebabkan oleh pembentukan klorofil dihambat, penurunan enzim rubisco, dan terhambatnya penyerapan unsur hara, terutama nitrogen dan magnesium yang berperan penting dalam sintesis klorofil. Kandungan klorofil daun dapat dipakai sebagai indikator yang terpercaya untuk mengevaluasi ketidakseimbangan metabolisme antara fotosintesis dan hasil produksi pada saat kekurangan air. Kata kunci: cekaman, fotosintesis, respons fisiologi THE CONCENTRATION OF LEAF CHLOROPHYLL AS WATER-DEFICIT INDICATOR IN PLANTS ABSTRACT Water deficit influences all aspects of plant growth including physiological, biochemical, anatomical and morphological processes. One of plant physiological responses to water deficit is the decrease of leaf-chlorophyll concentration because the chlorophyll synthesis is inhibited, the rubisco enzyme was reduced and the absorption of nutrients, especially nitrogen and magnesium that are required for chlorophyll synthesis, was inhibited. The concentration of leaf chlorophyll is able to be used as reliable indicator for evaluating unbalanced metabolism between photosynthesis and plant production under water deficit. Keywords: stress, photosynthesis, physiological response

A research has been done to analyze the phytochemical of medicine plant used by North Minahasa society. The research done qualitatively to know the present of alkaloid component, flavonoid, triterpenoid, steroid, saponin, and tannin. Analyzes of alkaloid component using Mayer, Dragendorff and Wagner reagents showed presipitate when react with alkaloid. Mayer reagent showed white presipitate, Dragendorff reagent showed red-orange presipitate and Wagner reagen showed brown presipitate. In flavonoid analysis, positive result indicated with red solution. Saponim analysis indicated with a stable foam. Tannins analysis indicated with green and blue-black solution and triterpenoid analysis indicated with red-orange or purple solution. Although the steroida analysis indicated with blue solution. The result show that 46 samples from 46 spesies of medicine plant that had been analyzed are 97,83% positive containing alkaloid component; 13,04% containing triterpenoid; 28,26% containing steroid; 47,83% containing flavonoid; 63,04% containing saponin and 63,44% containing tannin.

BACKGROUND: Chronic kidney disease (CKD) is common and ranks among the leading causes of mortality and morbidity. This analysis aimed to present global CKD estimates using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 to inform evidence-based policies for CKD identification and treatment. METHODS: This analysis focused on adults aged 20 years and older over the period 1990 to 2023, from 204 countries and territories. Data sources used were published literature, vital registration systems, kidney failure treatment registries, and household surveys. Estimates of CKD burden, including deaths, incidence, prevalence, and disability-adjusted life-years (DALYs), were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool. A comparative risk assessment approach estimated the proportion of cardiovascular deaths attributable to impaired kidney function and estimated risk factors for CKD. FINDINGS: Globally, in 2023, 788 million (95% uncertainty interval 743-843) people aged 20 years and older were estimated to have CKD, up from 378 million (354-407) in 1990. The global age-standardised prevalence of CKD in adults was 14·2% (13·4-15·2), a relative rise of 3·5% (2·7-4·1) from 1990. The region with the highest age-standardised prevalence was north Africa and the Middle East (18·0%; 16·9-19·4). Most people had stage 1-3 CKD, with a combined prevalence of 13·9% (13·1-15·0). In 2023, CKD was the ninth leading cause of death globally, accounting for 1·48 million (1·30-1·65) deaths, and the 12th leading cause of DALYs, with an age-standardised DALY rate of 769·2 (691·8-857·4) per 100 000. Impaired kidney function as a risk factor accounted for 11·5% (8·4-14·5) of cardiovascular deaths. High fasting plasma glucose, body-mass index, and systolic blood pressure were all leading risk factors for CKD DALYs. INTERPRETATION: CKD is a major global health issue, with rising prevalence and increasing importance as a cause of death and as a risk factor for cardiovascular death. A better understating of aetiology, appropriate screening, and implementation programmes are needed to translate advances in CKD treatment into improved patient outcomes. FUNDING: Gates Foundation, Wellcome, US National Kidney Foundation, and US National Institute of Diabetes and Digestive and Kidney Diseases.

Abstract: Aerobic exercise is a kind of exercise systematically by increasing the load gradually and continuously using energy derived from the combustion using oxygen, and takes oxygen without causing fatigue. Examples of aerobic exercise is the way, jogging, running, cycling, and swimming. Physical fitness is the body’s ability to function effectively when working or doing other things, and still have enough energy to handle or emergencies that may arise. Before planning to do aerobic exercise, namely: the frequency of exercise three to five times every week, exercise intensity 60 - 80% of maximum heart rate, and duration of exercise 20 – 60 minutes.mConclusion: With regular aerobic exercise, blood flow to be smooth and speed up the disposal of metabolic waste substances, so that recovery takes place rapidly, and the person with not experience fatigue after performing the task, and still be able to perform other activities. Benefits of aerobic exercise training is increased physical fitness.Keywords: aerobic exercise, physical fitness.Abstrak: Latihan olahraga aerobik ialah aktivitas olahraga secara sistematis dengan peningkatan beban secara bertahap dan terus-menerus yang menggunakan energi yang berasal dari pembakaran dengan menggunakan oksigen, dan membutuhkan oksigen tanpa menimbulkan kelelahan.Contoh latihan olahraga aerobic adalah jalan, jogging, lari, bersepeda, dan renang. Kebugaran fisik adalah kemampuan tubuh untuk berfungsi secara efektif ketika bekerja atau melakukan aktivitas lainnya, dan masih memiliki cukup energi untuk menangani atau menghadapi keadaan darurat yang mungkin timbul. Sebelum merencanakan untuk melakukan latihan olahraga aerobik, perlu memperhatikan kriteria-kriteria yang berkaitan dengan takaran latihan, yaitu: frekuensi latihan tiga sampai lima kali setiap minggu, intensitas latihan 60-80% dari denyut jantung maksimal, dan durasi latihan 20 - 60 menit. Simpulan: Dengan pembuangan zat-zat sisa metabolisme, sehingga pemulihan berlangsung dengan cepat, dan seseorang tidak akan mengalami kelelahan setelah melaksanakan tugas, serta masih dapat melakukan aktivitas lainnya. Manfaat latihan olahraga aerobik ialah kebugaran fisik meningkat.Kata kunci: Latihan olahraga aerobik, kebugaran fisik.

Penilaian tingkat keuangan suatu Perusahaan dapat dilakukan dengan menganalisis laporan keuangan Perusahaan. Untuk mengetahui apakah keadaan keuangan Perusahaan dalam kondisi yang baik dapat dilakukan berbagai analisa, salah satunya adalah analisis rasio. Tujuan penelitian ini adalah untuk mengetahui kinerja keuangan pada PT. Hanjaya Mandala Sampoerna Tbk ditinjau dari analisis rasio keuangan. Metode analisis yang digunakan adalah analisis deskriptif menggunakan pengukuran rasio likuiditas, solvabilitas, aktivitas dan profitabilitas. Data dan informasi penelitian diperoleh dari Bursa Efek Indonesia. Berdasarkan rasio likuiditas setiap tahunnya mengalami peningkatan sehingga keadaan Perusahaan dikategorikan dalam keadaan baik (liquid). Dari rasio solvabilitas menunjukkan bahwa modal Perusahaan tidak lagi mencukupi untuk menjamin hutang yang diberikan oleh kreditor sehingga keadaan Perusahaan dikatakan dalam keadaan tidak baik (insolvable). Ditinjau dengan rasio aktivitas menujukkan peningkatan di setiap tahunnya sehingga keadaan Perusahaan dikatakan dalam keadaan baik. Berdasarkan rasio profitabilitas menunjukkan adanya peningkatan dari tahun ke tahun sehingga dapat dikatakan keadaan Perusahaan berada pada posisi yang baik. Kata kunci: analisis, laporan keuangan, kinerja keuangan.

MEPS Marine Ecology Progress Series Contact the journal Facebook Twitter RSS Mailing List Subscribe to our mailing list via Mailchimp HomeLatest VolumeAbout the JournalEditorsTheme Sections MEPS 216:253-264 (2001) - doi:10.3354/meps216253 Recruitment mechanisms of tropical eels Anguilla spp. and implications for the evolution of oceanic migration in the genus Anguilla Takaomi Arai1,*, Daniel Limbong2, Tsuguo Otake3, Katsumi Tsukamoto1 1Ocean Research Institute, The University of Tokyo, Minamidai, Nakano, Tokyo 164-8639, Japan 2Faculty of Fisheries and Marine Science, Sam Ratulangi University, Manado 95115, Indonesia 3Faculty of Bioresources, Mie University, Kamihama, Tsu 514-8507, Japan *Present address: Otsuchi Marine Research Center, Ocean Research Institute, The University of Tokyo, 2-106-1, Akahama, Otsuchi, Iwate 028-1102, Japan. E-mail: arai@wakame.ori.u-tokyo.ac.jp ABSTRACT: Otolith microstructure and microchemistry of the tropical eels Anguilla celebesensis Kaup, A. marmorata Quoy & Gaimard and A. bicolor pacifica Schmidt were examined in glass eels collected at the mouth of the Poigar River, north Sulawesi Island, Indonesia, throughout 1997. Ages at metamorphosis and recruitment, respectively, were 84 to 95 d and 104 to 118 d in A. celebesensis, 114 to 158 d and 144 to 182 d in A. marmorata, and 129 to 171 d and 158 to 201 d in A. bicolor pacifica. No significant differences were found in mean ages among months within any one species, whereas significant differences were found among species. Hatching was estimated to occur throughout almost the entire year in A. celebesensis and A. marmorata compared with intermittently over about 6 mo in A. bicolor pacifica. Based on year-round recruitment of A. bicolor pacifica at the mouth of the Poigar River in an earlier study and age at recruitment being constant throughout the year, the spawning season of this species may also occur throughout the year. In all species examined, positive linear relationships were found between age at metamorphosis and age at recruitment, suggesting that early metamorphosing larvae were recruited to freshwater habitats at an early age. Year-round recruitment of tropical glass eels to the river mouth would necessarily follow year-round spawning and stable recruitment age. Such a recruitment mechanism differs from that of temperate eels, the latter having a limited spawning season followed by a limited period of recruitment. KEY WORDS: Tropical Anguilla spp. · Glass eel · Otolith · Growth increments · Sr:Ca ratios · Metamorphosis · Larval dispersal · Oceanic migration Full text in pdf format PreviousNextExport citation RSS - Facebook - Tweet - linkedIn Cited by Published in MEPS Vol. 216. Online publication date: July 06, 2001 Print ISSN: 0171-8630; Online ISSN: 1616-1599 Copyright © 2001 Inter-Research.

Abstract Aim This study aimed to test monophyly and geographical boundaries in five marine intertidal snail species from the central Indo‐West Pacific. We tested the prediction that phylogenetic breaks between the Indian and Pacific Ocean basins should be more pronounced in continental than oceanic settings, and sought common geographical patterns of interspecific boundaries and intraspecific phylogenetic breaks in the region. Location The tropical seas of the Indo‐West Pacific. Methods We sequenced over 1200 bp of the mitochondrial cytochrome oxidase subunit I gene (COI) from 18–92 individuals sampled from throughout the ranges of each of five species of Echinolittorina (Littorinidae): three members of the Echinolittorina trochoides species complex; Echinolittorina reticulata ; and Echinolittorina vidua , together with sister species, in order to test species boundaries. In addition, 630 bp of the nuclear 28S rRNA gene were sequenced from E. reticulata and its sister Echinolittorina millegrana. Phylogenetic structure was assessed using neighbour‐joining and parsimony analyses. Results COI data confirmed species boundaries and geographical distributions for all species except the pair E. reticulata and E. millegrana , which were nevertheless reciprocally monophyletic for 28S rRNA. The species from ecologically ‘continental’ habitats ( E. trochoides A and E. vidua , but not E. trochoides B) mostly showed strong interoceanic breaks (with age estimates 0.58–4.4 Ma), while the ecologically ‘oceanic’ E. trochoides D and E. reticulata did not. The sister species E. trochoides A and B occupy the shores of the continental shelves of Southeast Asia and Australasia respectively; between them lies the oceanic ‘eastern Indonesian corridor’ occupied by E. trochoides D and E. reticulata . The widespread continental species E. vidua showed a complex pattern of deep division into six haplotype clades with apparently parapatric distributions. Main conclusions Our results show that ecological differences (in this case continental vs. oceanic habitat) influence both intraspecific phylogenetic structure and interspecific boundaries in these snails of intertidal rocky shores. Two of the three species restricted to continental shelves show phylogenetic breaks between the Indian and Pacific Oceans, consistent with vicariant separation during Plio‐Pleistocene low sea levels. The two oceanic species do not show breaks, suggesting that they maintained interoceanic connections through the eastern Indonesian corridor. The geographical location of the interspecific boundary between continental E. trochoides A and oceanic E. trochoides D mirrors intraspecific breaks reported in other species. The sister relationship of E. trochoides A and B in Asia and Australasia, respectively, is an example of a ‘marine Wallace's line’ distribution, and we suggest that it is the result of separation of two continental species by a barrier of unsuitable oceanic habitat.

Carbon dots (CDs) are a new cluster of carbon atoms with particle size less than 10 nm. CDs also exhibit interesting fluorescence (FL) properties. CDs are attractive because of their fascinating characteristics including low toxicity, good water solubility, and tremendous biocompatibility. Recently, CDs have been investigated as biosensors for numerous target analytes. Meanwhile, the utilization of cheap and renewable natural resources not only fulfills the pressing requirement for the large-scale synthesis of CDs but also encourages the establishment of sustainable applications. The preparation of CDs using natural resources, i.e., plants, offers several advantages as it is inexpensive, eco-friendly, and highly available in the surroundings. Plant parts are readily available natural resources as the starting materials to produce CDs with different characteristics and attractive applications. Several review articles are now available covering the synthesis, properties, and applications of CDs. However, there is no specific and focused review literature discussing plant part-derived CDs for biosensing applications. To handle this gap, we provide a review of the progress of CDs derived from various plant parts with their synthesis methods, optical properties, and biosensing applications in the last five years. We highlight the synthesis methods and then give an overview of their optical properties and applications as biosensors for various biomolecules and molecules in biological samples. Finally, we discuss some future perspectives for plant part-derived CDs for better material development and applications.

Polyphenols are natural compounds and the most plentiful with synergistic properties contributing to potential health benefits. This review describes the synergistic interactions of polyphenolic compounds; as yet, no literature review has been undertaken to consider the experimental evidence of synergistic effects of polyphenols. The polyphenolic compounds claimed to have synergistic activities are highly effective against oxidation, peptic ulcers, myocardial infarction, tumors, and a variety of other conditions. In addition, anticancer activity via apoptosis and antibacterial, antifungal, anti-inflammatory, and estrogenic behaviors have also been reported. Apart from the synergistic effects of polyphenols, this review also illustrates their specific health benefits too and bioavailability in humans. The toxicity of some polyphenolic agents, including antinutritional effects, chronic nephrotoxicity, reduction in net protein utilization and antiluteinizing hormone, and tumor development, is also evaluated. Synergistic treatment approaches may be effective in the treatment of many diseases. These findings provide information about the benefits of polyphenol compounds in combination, which could be useful for future studies.

Perkembangan dunia komputer dan teknologi informasi dewasa ini telah mempengaruhi pola kerja dan aktivitas setiap individu. Tidak terkecuali dalam dunia pendidikan. Guru-guru di zaman komputerisasi seperti sekarang ini dituntut untuk bisa melengkapi kemampuan diri dengan keterampilan komputer dan penggunaan teknologi informasi dalam proses pembelajaran dan juga dalam tugas-tugas administrasi. Namun, beberapa kendala termasuk di dalamnya usia yang tidak muda lagi, terkadang menjadi masalah bagi guru-guru untuk memanfaatkan komputer dan teknologi informasi dalam tugas-tugasnya. Di lain pihak, siswa SD zaman sekarang sudah tidak asing lagi dengan dunia komputer dan internet. Namun demikian, penggunaannya seringkali tidak terkontrol dan tidak tepat sasaran akibat kurangnya pemahaman dan kontrol dari lingkungannya, terlebih khusus di sekolah. Untuk menjawab permasalahan ini, tim akan melaksanakan pelatihan dan sosialisasi penggunaan komputer dan teknologi informasi bagi guru-guru dan siswa-siswa di SD GMIM Kinilow dan SD Katolik Kinilow. Kedua sekolah ini dipilih sebagai mitra antara lain karena perkembangan dunia komputer dan teknologi informasi di kedua sekolah ini cukup signifikan. Hal ini antara lain disebabkan lokasi kedua sekolah ini yang memudahkan berbagai akses dengan ibukota provinsi Sulawei Utara.Kata kunci: Komputer, Teknologi Informasi, Uji-T berpasangan

This present study intends to analyze the factors affecting the performance of the local government of North Sulawesi. The population of this study includes the members of the Regional People’s Representative Assembly and the leaders of Regional Apparatus Organizations managing the Regional Revenue and Expenditure Budget (APBD). Those Regional Apparatus Organizations include Education and Culture Office, Health Office, Regional Revenue Service, Tourism Office, Public Works Office, and Auditor Inspectorate of North Sulawesi Province. The sampling technique used is the saturated sampling technique. Data collection techniques employed consist of an interview, documentation study, and questionnaire dissemination. The analysis is conducted using Partial Least Square (PLS). Based on the analysis, we found that public participation has a significant effect on the transparency of financial management; the internal control system has a significant effect on local government performance; the internal control system has a significant effect on public accountability; the internal control system has a significant effect on the quality of financial reports, and public accountability has a significant effect on the performance of local governments. However, public participation has no significant effect on local government performance; public participation has no significant effect on public accountability; public participation has no significant effect on the quality of financial reports; the internal control system has no significant effect on financial management transparency; financial management transparency has no significant effect on local government performance, and the quality of financial reports has no significant effect on local government performance. This study also reveals that public accountability is the mediating variable between the internal control system and local government performance.

Suatu penelitian telah dilakukan untuk melihat sejauh mana pengaruh pemupukan anorganik dan organik terhadap tinggi tanaman, panjang dan lingkar tongkol serta bobot pipilan kering jemur jagung. Penelitian ini dilaksanakan di lahan pertanian milik keluarga M. Manoppo yang dimulai sejak bulan April 2009 sampai dengan Oktober 2009 di Desa Koka Kecamatan Tombulu Kabupaten Minahasa. Jumlah petak yang digunakan dalam penelitian ini sebanyak 20 (dua puluh) petak yang ditempatkan secara acak dengan ukuran 2 x 2 meter dengan jarak tanam 50 cm x 70 cm dan jenis benih jagung yang digunakan adalah jagung hibrida (NUSANTARA 1). Rancangan penelitian yang digunakan adalah Rancangan Acak Kelompok (RAK), terdiri dari 5 kelompok dan 4 perlakuan yang terdiri dari T0 (tanpa pemupukan), T1 (pemupukan anorganik dengan dosis 3,67 kg/petak), T2 (pemupukan organik dengan dosis 1,4 kg/petak) dan T3 (menggabungkan pupuk anorganik dengan dosis 1,83 kg/petak dan pupuk organik dosis 0,7 kg/petak). Variabel yang diukur meliputi tinggi tanaman, panjang dan lingkar tongkol serta bobot pipilan kering jemur. Pengambilan data dilakukan disaat panen sampai dengan selesai penjemuran jagung yang telah dipipil. Data yang diambil kemudian ditabulasi dan diuji menurut analisis keragaman untuk melihat pengaruh perlakuan. Uji lanjut Beda Nyata Jujur (BNJ) dilakukan untuk melihat perbedaan antara masing-masing perlakuan. Hasil analisis keragaman menunjukkan bahwa perlakuan memberi pengaruh yang berbeda nyata (P &gt; 0,05) terhadap panjang dan lingkar tongkol serta bobot pipilan kering jemur. Dari penelitian yang telah dilakukan diambil kesimpulan bahwa pemupukan dengan menggabungkan antara pupuk anorganik dan organik lebih meningkatkan produksi tanaman jagung baik itu panjang tongkol, lingkar tongkol dan bobot pipilan kering jemur.