The glucagon-like Peptide-2

Multiple peptide hormones produced within the gastrointestinal system act also in the central nervous system and aid in the regulation of energy homeostasis and metabolism. The list of these peptides is progressively increasing and includes glucagon-like peptide 2 (GLP-2) as an anorexigenic factor. GLP-2 is released from enteroendocrine L-cells following food intake and its principal target is represented by the gastrointestinal tract. GLP-2 has been shown to be an important intestinotrophic factor that stimulates epithelial cell proliferation and inhibits apoptosis. GLP-2 increases intestinal blood flow and the activity and expression of epithelial brush-border digestive enzymes and nutrient transporters, and consequently increases the intestinal digestive and absorptive capacity. It inhibits gastric and intestinal motility, thus providing another mechanism to increase absorption of nutrients. Current research has focused on determining its physiological actions and its biological mechanisms in the gut, while very little is known on the GLP-2 actions within the brain. This review provides an overview of the state of the art on GLP-2 biology.peer-reviewe

TINGKAT KECEMASAN (ANXIETY) DALAM MENGHADAPI PERTANDINGAN PADA ATLET TIM HOCKEY INDOOR PUTRI JAWA TIMUR

Penelitian ini bertujuan untuk mengetahui seberapa besar tingkat kecemasan (anxiety) dalam menghadapi pertandingan pada atlet hockey putri Jawa Timur. Penelitian ini merupakan jenis penelitian Deskripstif Kuantitatif. Populasi dalam penelitian ini berjumlah 12 atlet putri hockey Jawa Timur. Berdasarkan hasil penelitian menunjukkan bahwa tingkat kecemasan atlet hockey indoor putri Jawa Timur masuk dalam kategori sedang. Frekuensi terbanyak berada pada kategori sedang dengan jumlah 6 orang atau 50%. Hal ini menunjukkan bahwa pemain masih merasa cemas pada saat pertandingan. Faktor kecemasan atlet dibedakan menjadi 2 yaitu faktor instrinsik dan faktor ekstrinsik. Berdasarkan hasil penelitian tingkat kecemasan atlet berdasarkan faktor  instrinsik dalam kategori sedang dengan presentase 58,3%, sedangkan faktor ekstrinsik juga masuk dalam kategori sedang dengan presentase yang sama yaitu 58,3%. Setelah mendapatkan hasil penelitian maka diharapkan dapat menjadi bahan Evaluasi untuk Pelatih maupun Atlet hockey indoor putri Jawa Timur agar dapat mengetahui Faktor-fatktor penyebab kecemasan muncul sehingga ketika akan menghadapi pertandingan selanjutnya tingkat kecemasan atlet hockey indoor putri Jawa Timur dapat masuk dalam kategori rendah. Kata Kunci: Kecemasan, Pertandingan, Atlet Hockey Jawa Timu

TINGKAT KECEMASAN (ANXIETY) DALAM MENGHADAPI PERTANDINGAN PADA ATLET TIM HOCKEY INDOOR PUTRI JAWA TIMUR

Penelitian ini bertujuan untuk mengetahui seberapa besar tingkat kecemasan (anxiety) dalam menghadapi pertandingan pada atlet hockey putri Jawa Timur. Penelitian ini merupakan jenis penelitian Deskripstif Kuantitatif. Populasi dalam penelitian ini berjumlah 12 atlet putri hockey Jawa Timur. Berdasarkan hasil penelitian menunjukkan bahwa tingkat kecemasan atlet hockey indoor putri Jawa Timur masuk dalam kategori sedang. Frekuensi terbanyak berada pada kategori sedang dengan jumlah 6 orang atau 50%. Hal ini menunjukkan bahwa pemain masih merasa cemas pada saat pertandingan. Faktor kecemasan atlet dibedakan menjadi 2 yaitu faktor instrinsik dan faktor ekstrinsik. Berdasarkan hasil penelitian tingkat kecemasan atlet berdasarkan faktor  instrinsik dalam kategori sedang dengan presentase 58,3%, sedangkan faktor ekstrinsik juga masuk dalam kategori sedang dengan presentase yang sama yaitu 58,3%. Setelah mendapatkan hasil penelitian maka diharapkan dapat menjadi bahan Evaluasi untuk Pelatih maupun Atlet hockey indoor putri Jawa Timur agar dapat mengetahui Faktor-fatktor penyebab kecemasan muncul sehingga ketika akan menghadapi pertandingan selanjutnya tingkat kecemasan atlet hockey indoor putri Jawa Timur dapat masuk dalam kategori rendah. Kata Kunci: Kecemasan, Pertandingan, Atlet Hockey Jawa Timu

Survey of Triangle Security in Cloud

Cloud computing remains the world's most demanded development trend. It is one of the most important topic whose application is currently being explored. The distributed storage has been one of the apparent administrations in distributed computing. Instead of providing the engaged worker for conventionally organizated storage, the distributed storage sets various outsider individuals with the knowledge. The customer does not care about any details on various external employees and no one knows exactly where information is spared. The distributed storage supplier asserts that the information can be secured, but no one trusts in it. Security risk is information placed in the plain content configuration over cloud and across the organization. This document offers a method that allows customers to securely store and access data from the distributed storage. It also ensures that neither the distributed storage provider, apart from the verified customer, can get details. This technique ensures the safety and confidentiality of cloud-related information. Another favorite position is that if the cloud provider breaks down, the information of the client remains safe as all information is encoded. Customers must also not stress that cloud providers have illegal access to their data.</jats:p

Knee Muscle Strength After Recent Partial Meniscectomy Does Not Relate to 2-year Change in Knee Adduction Moment

Background Knee muscle weakness and a greater external knee adduction moment are suggested risk factors for medial tibiofemoral knee osteoarthritis. Knee muscle weakness and a greater knee adduction moment may be related to each other, are potentially modifiable, and have been observed after arthroscopic partial meniscectomy. Questions/purposes The aim of this exploratory study was to determine if knee muscle weakness 3 months after arthroscopic partial meniscectomy (baseline) is associated with an increase in external knee adduction parameters during the subsequent 2 years. Methods Eighty-two participants undergoing medial arthroscopic partial meniscectomy were assessed at baseline, and 66 participants who were reassessed 2 years later were included in our study. Isokinetic muscle strength and external adduction moment parameters (peak and impulse) during normal and fast walking were measured at baseline and followup. Multiple linear regression models were used to examine the association between baseline muscle strength and 2-year change in adduction moment parameters. A post hoc power calculation showed we had 80% power to detect a correlation of 0.31 between baseline muscle strength and change in the external knee adduction, with an alpha error of 0.05 and two-sided significance. Results Maximal isokinetic muscle strength 3 months after arthroscopic partial meniscectomy was not associated with change in adduction moment parameters (p value range from 0.12 to 0.96). Conclusions No evidence was found to suggest that improving maximal knee muscle strength after a recent arthroscopic partial meniscectomy would reduce change in knee adduction moment observed during the subsequent 2 years. As muscle function is modifiable, future investigation of other aspects of muscle function that may relate to change in knee adduction moment is warranted. Level of Evidence Level II, prognostic study. See the Instructions for Authors for a complete description of levels of evidence.No Full Tex

Respiratory physiology of COVID-19-induced respiratory failure compared to ARDS of other etiologies

Abstract Background Whether respiratory physiology of COVID-19-induced respiratory failure is different from acute respiratory distress syndrome (ARDS) of other etiologies is unclear. We conducted a single-center study to describe respiratory mechanics and response to positive end-expiratory pressure (PEEP) in COVID-19 ARDS and to compare COVID-19 patients to matched-control subjects with ARDS from other causes. Methods Thirty consecutive COVID-19 patients admitted to an intensive care unit in Rome, Italy, and fulfilling moderate-to-severe ARDS criteria were enrolled within 24 h from endotracheal intubation. Gas exchange, respiratory mechanics, and ventilatory ratio were measured at PEEP of 15 and 5 cmH2O. A single-breath derecruitment maneuver was performed to assess recruitability. After 1:1 matching based on PaO2/FiO2, FiO2, PEEP, and tidal volume, COVID-19 patients were compared to subjects affected by ARDS of other etiologies who underwent the same procedures in a previous study. Results Thirty COVID-19 patients were successfully matched with 30 ARDS from other etiologies. At low PEEP, median [25th–75th percentiles] PaO2/FiO2 in the two groups was 119 mmHg [101–142] and 116 mmHg [87–154]. Average compliance (41 ml/cmH2O [32–52] vs. 36 ml/cmH2O [27–42], p = 0.045) and ventilatory ratio (2.1 [1.7–2.3] vs. 1.6 [1.4–2.1], p = 0.032) were slightly higher in COVID-19 patients. Inter-individual variability (ratio of standard deviation to mean) of compliance was 36% in COVID-19 patients and 31% in other ARDS. In COVID-19 patients, PaO2/FiO2 was linearly correlated with respiratory system compliance (r = 0.52 p = 0.003). High PEEP improved PaO2/FiO2 in both cohorts, but more remarkably in COVID-19 patients (p = 0.005). Recruitability was not different between cohorts (p = 0.39) and was highly inter-individually variable (72% in COVID-19 patients and 64% in ARDS from other causes). In COVID-19 patients, recruitability was independent from oxygenation and respiratory mechanics changes due to PEEP. Conclusions Early after establishment of mechanical ventilation, COVID-19 patients follow ARDS physiology, with compliance reduction related to the degree of hypoxemia, and inter-individually variable respiratory mechanics and recruitability. Physiological differences between ARDS from COVID-19 and other causes appear small. </jats:sec

Respiratory physiology of COVID-19-induced respiratory failure compared to ARDS of other etiologies

Abstract Background Whether respiratory physiology of COVID-19-induced respiratory failure is different from acute respiratory distress syndrome (ARDS) of other etiologies is unclear. We conducted a single-center study to describe respiratory mechanics and response to positive end-expiratory pressure (PEEP) in COVID-19 ARDS and to compare COVID-19 patients to matched-control subjects with ARDS from other causes. Methods Thirty consecutive COVID-19 patients admitted to an intensive care unit in Rome, Italy, and fulfilling moderate-to-severe ARDS criteria were enrolled within 24 h from endotracheal intubation. Gas exchange, respiratory mechanics, and ventilatory ratio were measured at PEEP of 15 and 5 cmH2O. A single-breath derecruitment maneuver was performed to assess recruitability. After 1:1 matching based on PaO2/FiO2, FiO2, PEEP, and tidal volume, COVID-19 patients were compared to subjects affected by ARDS of other etiologies who underwent the same procedures in a previous study. Results Thirty COVID-19 patients were successfully matched with 30 ARDS from other etiologies. At low PEEP, median [25th–75th percentiles] PaO2/FiO2 in the two groups was 119 mmHg [101–142] and 116 mmHg [87–154]. Average compliance (41 ml/cmH2O [32–52] vs. 36 ml/cmH2O [27–42], p = 0.045) and ventilatory ratio (2.1 [1.7–2.3] vs. 1.6 [1.4–2.1], p = 0.032) were slightly higher in COVID-19 patients. Inter-individual variability (ratio of standard deviation to mean) of compliance was 36% in COVID-19 patients and 31% in other ARDS. In COVID-19 patients, PaO2/FiO2 was linearly correlated with respiratory system compliance (r = 0.52 p = 0.003). High PEEP improved PaO2/FiO2 in both cohorts, but more remarkably in COVID-19 patients (p = 0.005). Recruitability was not different between cohorts (p = 0.39) and was highly inter-individually variable (72% in COVID-19 patients and 64% in ARDS from other causes). In COVID-19 patients, recruitability was independent from oxygenation and respiratory mechanics changes due to PEEP. Conclusions Early after establishment of mechanical ventilation, COVID-19 patients follow ARDS physiology, with compliance reduction related to the degree of hypoxemia, and inter-individually variable respiratory mechanics and recruitability. Physiological differences between ARDS from COVID-19 and other causes appear small