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All Journal MEDIA MEDIKA INDONESIANA Journal of Nutrition and Health Rotasi JURNAL GIZI INDONESIA Jurnal Psikologi JURNAL TEKNIK MESIN Jurnal Kedokteran Diponegoro Medical Journal of Indonesia Journal of Biomedicine and Translational Research Global Medical and Health Communication The Indonesian Biomedical Journal Sari Pediatri Paediatrica Indonesiana Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indonesian Journal of Global Health research Diponegoro International Medical Journal (DIMJ) Mechanical Engineering for Society and Industry
Tri Indah Winarni
Center For Biomedical Research (CEBIOR), Faculty Of Medicine, Universitas Diponegoro, Jl. Prof. Sudharto, SH, Tembalang, Semarang
Aerospace Engineering Automotive Engineering Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Control & Systems Engineering Dentistry Education Electrical & Electronics Engineering Energy Engineering Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Languange, Linguistic, Communication & Media Materials Science & Nanotechnology Mechanical Engineering Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Transportation

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REKONSTRUKSI DAN ANALISIS TEGANGAN VON MISES PADA VERTEBRA LUMBALIS 4 HINGGA SACRALIS 1 TERHADAP VARIASI INDEKS MASSA TUBUH Rama, Leonardo Jalusius; Jamari, Jamari; Winarni, Tri Indah
JURNAL TEKNIK MESIN Vol 12, No 3 (2024): VOLUME 12, NOMOR 3, JULI 2024
Publisher : Jurusan Teknik Mesin, Fakultas Teknik, Universitas Diponegoro

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Abstract

Dalam kehidupan sehari-hari tulang lumbar berperan dalam menopang berat badan tubuh dan mendukung gerakan tubuh dalam berkativitas. Tulang lumbar merupakan rangkaian tulang yang sering mengalami keluhan penyakit, salah satu contoh keluhan penyakit yang biasa terjadi adalah low back pain (LBP) atau yang lebih dikenal dengan nyeri punggung bagian bawah tubuh. Kondisi ini bisa terjadi oleh beberapa faktor, antara lain akibat dari melakukan kegiatan fisik secara berlebihan seperti mengangkat beban yang terlalu berat dan dapat diakibatkan oleh kondisi berat badan yang berlebih (obesitas). Simulasi dengan menggunakan metode elemen hingga dilakukan untuk mengetahui pengaruh yang terjadi akibat dari kondisi berat badan yang berlebih terhadap tulang lumbar. Kondisi berat badan dikategorikan dalam 5 kategori indeks massa tubuh (BMI), yaitu underweight, normal, at-risk of obesity, obesitas I, dan obesitas II. Hasil simulasi menunjukkan peningkatan tegangan von Mises seiring dengan kenaikan beban, dengan tegangan tertinggi terjadi pada kategori obesitas II. Temuan ini memberikan wawasan penting terkait risiko penyakit hernia nucleus pulposus (HNP) pada populasi dengan BMI tinggi yang dapat diakibatkan oleh tegangan mekanik pada struktur diskus intervetebralis.
STUDI PENDAHULUAN DALAM OPTIMALISASI REKONSTRUKSI DAN ANALISIS MEKANIKA KONTAK LUMBAR SPINE (L1-L2) Bilal, Muhamad; Jamari, Jamari; Winarni, Tri Indah
JURNAL TEKNIK MESIN Vol 12, No 3 (2024): VOLUME 12, NOMOR 3, JULI 2024
Publisher : Jurusan Teknik Mesin, Fakultas Teknik, Universitas Diponegoro

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Abstract

Tulang belakang merupakan penyusun terpenting dalam rangka tubuh manusia, terdapat beberapa penyusun tulang belakang salah satunya adalah lumbar spine. Tulang belakang lumbar terdiri atas beberapa tingkatan yaitu lumbar 1 sampai dengan lumbar 5. Penelitian yang dilakukan akan terfokus pada lumbar 1 sampai dengan lumbar 2. Penelitian dilakukan untuk menganalisis mekanika kontak yang terjadi pada lumbar. Penelitian sebelumnya telah banyak dilakukan secara in vitro dengan menggunakan mayat manusia atau cadaver. Akan tetapi, Terdapat beberapa permasalahan dari pengujian in vitro dalam proses analisis biomekanika kontak. hal tersebut dikarenakan oleh kendala etik dan biaya yang cukup mahal. Oleh karena itu, Metode elemen hingga menjadi solusi alternatif yang mempermudah riset analisis biomekanika kontak pada manusia. Metode elemen hingga dilakukan dengan computerized system yang mana menggunakan bantuan software dalam merekonstruksi visualisasi tulang dan  menganalisis mekanika kontak dengan aplikasi. Proses rekonstruksi dilakukan menggunakan aplikasi mimics 21.0 dengan pengolahan data dari CT-Scan pasien dengan mengubah 2D menjadi 3D. Hasil rekonstruksi akan diproses menggunakan finite element analysis dengan software ansys 2020 R2. Hasil yang didapat tentunya bisa memberikan referensi treatment pada lumbar spine dengan tinjauan variasi mekanika kontak yang terjadi. Optimalisasi rekonstruski perlu dikembangkan untuk mendapatkan hasis analisis mekanika kontak sesuai dengan referensi yang tertera seperti penambahan cortical, nucleus, dan beberapa ligament.
Development and validation of The Down Syndrome Stigma Scale in a Balinese sample Suardani, Ni Wayan; Ediati, Annastasia; Winarni, Tri Indah
Jurnal Psikologi Vol 23, No 1 (2024): April 2024
Publisher : Faculty of Psychology, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jp.23.1.25-34

Abstract

Background: Individuals with Down Syndrome are often subjected to social stigma due to their physical appearance. In Indonesia, there was a paucity of research on stigma associated with Down syndrome because the instrument is not available. The study aims to develop and validate the Down Syndrome Stigma Scale in the Indonesian language. Method: An expert panel selected 27 relevant items from the Iranian version of the Stigma Scale towards Down Syndrome. After the translation process, the validity and reliability of the items were evaluated in 79 parents of children with Down syndrome. Results: A factor analysis with factor loading greater than 0.40 was performed. Three factors were identified from 23 items (α=0.928), namely social interaction (10 items; α=0.881), acceptance (8 items; α=0.853), and health-related factors (5 items; α=0.821). Conclusionss The psychometric quality of the Indonesian version of the Down Syndrome Stigma Scale is satisfactory and can be utilized in future research. 
Effect of vitamin D3 supplementation on serum 25 (OH)D Levels, hand grip strength, blood sugar levels, and cognitive function in the elderly Probosari, Enny; Subagio, Hertanto Wahyu; Winarni, Tri Indah; Nugroho, Heri; Manikam, Nurul Ratna Mutu
Jurnal Gizi Indonesia (The Indonesian Journal of Nutrition) Vol 13, No 1 (2024): December
Publisher : Department of Nutrition Science, Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jgi.13.1.79-87

Abstract

ABSTRACTBackground: The aging process in the elderly can be caused by a decrease in vitamin D precursors and reduced Vitamin D levels due to impaired absorption of Vitamin D. Vitamin D plays a role in cognitive function, acts as an immunomodulator affecting blood glucose levels, promotes muscle atrophy, and affects the intranuclear VDR concentration and gene expression of VDR.Objectives: To determine the effect of vitamin D3 supplementation on Serum 25(OH)D levels, hand grip strength, blood sugar levels, and cognitive function in the elderly.Materials and Methods: This study used a quasi-experimental pre-posttest control group design with a total of 60 subjects included and divided into two groups. The treatment group received vitamin D3 at a dosage of 1000 IU/day for three months, while the control group was given a placebo. Blood serum levels were used to obtained serum 25(OH)D and blood sugar level. Hand grip strength values were measured by a hand grip dynamometer, and cognitive function was assessed using the Mini-Mental State Examination (MMSE) Questionnaire. The data was analyzed using the Wilcoxon test, and the bivariate analysis was performed using the Mann-Whitney test.Results: Most subjects were between 60 and 92 years old and had a vitamin D deficiency. Significant (P<0,05) differences were observed in serum 25(OH)D levels, blood sugar levels, and cognitive function following the intervention. The differences in serum 25(OH)D levels were 8,50±6,17, blood sugar levels were -21,68±25,88, and cognitive function was 2,23±3,05. Additionally, hand grip strength increased after the intervention (mean=0,42±4,66) but was not statistically significant (P=0,633).Conclusion: There is an improvement in cognitive function and a decrease in blood glucose levels, along with an increase in 25(OH)D levels after three months of vitamin D supplementation. However, hand grip strength did not significantly increase after supplementation.Keywords: Vitamin D3 Supplementation; serum 25(OH)D; hand grip strength; blood sugar level; cognitive function; elderly.
Gender Identity and Phenotypic Variation of Sex Chromosome Disorders: A Study at Center for Disorder of Sex Development in Indonesia Azalia, Putri; Juniarto, Achmad Zulfa; Winarni, Tri Indah
Diponegoro International Medical Journal Vol 5, No 2 (2024): December 2024
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v5i2.24332

Abstract

Background: Sex chromosome DSD (Disorder of Sex Development) can be caused by numerical or structural abnormality in sex chromosome, which will lead to the atypical development in phenotype and also psychosexual. Gender assignment often become the primary problem in management of individual with DSD.Objective: To describe gender identity and phenotype variability based on karyotype classification among sex chromosome DSD cases in Indonesia Methods: This study is a descriptive retrospective study. Analyzing gender identity, karyotype classification and phenotype data from medical record of patients with cytogenetic analysis results classified as sex chromosome DSD in CEBIOR over 18 years period from 2004 to 2022.Results: Data showed the sex chromosome DSD classification with karyotype 45,X and variant  (without Y chromosome), constituted 43.7% (42/96) cases, 100 % (42/42) patients have female gender identity; 19.8% (19/96) cases had karyotype 45,X/46,XY or Turner variant mosaicism with Y chromosome, majority of patients have male gender identity 73.7% (14/19); 18.7% (18/96) cases  had 47,XXY (Klinefelter syndrome) and variant, majority of patients have male gender identity in 88.9 % (16/18) cases; 11.4% (11/96) cases had 46,XX/46,XY karyotype, majority have male gender identity in 81.8 %(9/11) cases ; and 6 cases (6.25%) classified as others, 66.67% (4/6) cases all of which contain Y chromosome, have male gender identity.Conclusion: . This study shows  the presence of Y chromosome in the karyotype support a male gender identity.  Sex chromosome DSD constitute high karyotype diversity and wide phenotypic abnormalities that necessitates careful clinical and cytogenetic evaluation
Down Syndrome Combined with Robertsonian Translocation (13;14) Carrier Lestari, Esa Loyallita; Utari, Agustini; Winarni, Tri Indah; Hendrianingtyas, Meita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 2 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i2.2205

Abstract

Down Syndrome (DS) is a genetic disorder in the form of adding chromosome 21 due to abnormal cell division. This condition causes a distinctive physical appearance and intellectual impairment. The prevalence of DS is between 10-11 out of 10,000 live births worldwide. A 2-week-old baby presented with complaints of jaundice with the clinical picture of DS. There was a mild increase in fT4 levels, and TSH levels were still within the reference value range. Karyotype examination showed Robertsonian translocation of chromosomes 13 and 14 and several abnormalities, namely trisomy 21.
Urinary calcium and matrix Gla protein levels in the kidney stones: a case-control study Ali, Zulfikar; Selanno, Fradelino Esau; Gunawan, I Putu Gde Fredy; Sulchan, Mohammad; Birowo, Ponco; Winarni, Tri Indah
Medical Journal of Indonesia Vol. 34 No. 1 (2025): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257748

Abstract

BACKGROUND Kidney stones are a global issue with varying prevalence. The most common metabolic risk factor is hypercalciuria, a condition where excess calcium in the urine promotes stone formation. Matrix Gla protein (MGP) inhibits stone formation by preventing crystal growth. This study aimed to analyze the correlation between urinary calcium and MGP levels in kidney stone formation. METHODS A case-control study at Kardinah Hospital, Indonesia, included 64 patients with kidney stone and 64 healthy controls. Exclusion criteria included renal failure, stroke, kidney tumor, heart failure, and hemodialysis. Urinary calcium and MGP were measured using the 5’-nitro-5’-methyl-BAPTA method and enzyme-linked immunosorbent assay. Cut-off values were determined via receiver operating characteristic analysis. RESULTS Among 128 participants (mean age: 51.6), the optimal cut-off for urinary MGP was 1,405 ng/l (p = 0.00024) with 62.5% sensitivity and 72% specificity. Urinary calcium cut-off was 72.5 mg/24 hours with 81.3% sensitivity and 62.5% specificity. Higher urinary calcium and MGP levels were linked to kidney stones (OR: 7.22; 95% CI: 3.23–16.18 and OR: 4.26; 95% CI: 2.03–8.96, respectively). A significant association was found between urinary calcium and MGP (OR: 5.11; 95% CI: 2.31–11.29, p = 0.00006) that hypercalciuria and increased MGP levels are predictors of kidney stone formation. CONCLUSIONS Urinary calcium and MGP levels are associated with kidney stones. Elevated urinary calcium (>1,405 ng/l) increases MGP levels more than 5-fold. Depending on their levels, urinary calcium and MGP act as both promoters and inhibitors of stone formation.
Stress distribution on the L1/L2 endplates under multiaxial loads: A finite element study Wicaksono, Hasyid Ahmad; Rafli, Muhammad; Bilal, Muhamad; Lamura, M. Danny Pratama; Maula, Mohamad Izzur; Bayuseno, Athanasius Priharyoto; Winarni, Tri Indah; Jamari, Jamari
Mechanical Engineering for Society and Industry Vol 5 No 1 (2025)
Publisher : Universitas Muhammadiyah Magelang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31603/mesi.12843

Abstract

Understanding stress distribution on lumbar vertebral endplates is essential for predicting mechanical failure and guiding clinical interventions. Therefore, this study aims to investigate the von Mises stress patterns on the L1/L2 endplates under multiaxial loading using a 3-dimensional finite element (FE) model derived from CT imaging of a healthy 55-year-old male. Anatomical structures were reconstructed in Mimics 21.0, and simulations were conducted in ANSYS Workbench 2023 R2. Material properties for cortical bone, cancellous bone, and intervertebral disc were assigned based on validated biomechanical data. A compressive load of 500 N and multiaxial moments ranging from 2.5 to 10 N•m were applied to simulate physiological movements, while the inferior surface of L2 was fully constrained to reflect realistic boundary conditions. The results showed that the superior endplate experienced the highest von Mises stress, particularly during flexion and lateral bending, indicating increased vulnerability to mechanical overload. Extension loading significantly reduced stress on both endplates, with a 60.54% decrease on the superior endplate and 69.17% on the inferior endplate. Stress distribution was asymmetrical and was influenced by anatomical features, such as cortical thickness and trabecular alignment. These results show the superior endplate as a biomechanically critical region prone to degeneration, emphasizing its importance in implant design, preventive strategies, and risk assessment for microfracture in high-risk populations.
Edwards Syndrome and Trisomy 8: a case report of a newborn with multiple congenital anomalies with double aneuploidy Utari, Agustini; Maharani, Nani; Indriyati, Rita; Sihombing, Nydia Rena Benita; Sarosa, Gatot Irawan; Winarni, Tri Indah
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.350-6

Abstract

Chromosomal aneuploidy is the most common genetic cause of multiple congenital anomalies (MCA), contributing to high neonatal mortality and morbidity rates in intensive care units. Prevalence of live birth double trisomy is rarely reported, with previous studies reporting the involvement of autosomal aneuploidy combined with sex chromosomal aneuploidy that is a more tolerable or benign phenotype. Mostly, a live-born baby with a double trisomy is associated with mosaicism.  This report aims to present a rare case of a viable baby with non-mosaic double autosomal trisomy involving chromosomes 8 and 18. A term baby from advanced maternal and paternal age with low birth weight and height was born from spontaneous vaginal delivery from unremarkable pregnancy. The phenotype was suitable with Edward syndrome with congenital heart anomalies confirmed by cytogenetic analysis with additional extra chromosome 8 (48, XX,+8,+18). The baby was on and off the mechanical ventilator due to respiratory failures, and her health condition gradually deteriorated, leading to her death at the age of 2.5 months due to neonatal pneumonia.
Scoping Review of Verbal De-Escalation in Psychiatric Emergency Pragholapati, Andria; Fitrikasari, Alifiati; Handayani, Fitria; Kristina, Tri Nur; Dewi, Nur Setiawati; Winarni, Tri Indah
Indonesian Journal of Global Health Research Vol 6 No 2 (2024): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v6i2.2826

Abstract

This article presents an in-depth literature review on the practices and significance of verbal de-escalation in psychiatric emergency situations. Verbal de-escalation is a communication strategy aimed at reducing tension and conflict in psychiatric patients experiencing crises. The aim of this research is to explore the effectiveness of various training methods in implementing verbal de-escalation techniques in psychiatric emergencies. The research method with scoping review, this article provides an overview of the concept of verbal de-escalation, commonly used techniques, and its positive impact on enhancing safety and intervention effectiveness in psychiatric emergencies. Additionally, the article identifies factors influencing the success of implementing verbal de-escalation and emphasizes the need for training and a holistic approach in managing psychiatric emergencies. The findings of this research can offer insights for practitioners, researchers, and policymakers in improving the quality of psychiatric emergency services through the effective implementation of verbal de-escalation strategies.
Co-Authors A, Mahayu Dewi Achmad Zulfa Juniarto Afif, Ilham Afif, Ilham Yustar Agustini Utari Aisha Balkhar Ali Alifiati Fitrikasari Ammarullah, Muhammad Andria Pragholapati Ani Melani Maskoen Annastasia Ediati Atanasius Priharyoto Bayuseno Azalia, Putri Banundari Rachmawati Bremmy Laksono Budi Mulyono Cinta Cynthia Rudianto Donna Hermawati Edi Dharmana Enny Probosari Farmaditya EP Mundhofir Farmaditya EP Mundhofir Fatinah Shahab Ferdy Kurniawan Cayami Fitria Handayani Gara Samara Brajadenta Gatot Irawan Sarosa, Gatot Irawan Gunawan, I Putu Gde Fredy Hary Tjahjanto Heri Nugroho Hertanto Wahyu Subagio Husaini, Farhan Husaini, Farhan Ali Ignatius Riwanto, Ignatius Indriyati, Rita Inu Mulyantoro J. Jamari Jamari, J Jessica Juan Pramudita Lamura, M Danny Lamura, M. Danny Pratama Lestari, Esa Loyallita Lisyani B.Suromo Lisyani Budipardigdo Suromo Maria Belladonna Rahmawati Maula, Mohammad Meira Erawati Meita Hendrianingtyas Mohamad Izzur Maula Mohammad Sulchan Muhamad Bilal Mursyd, Ariq Imam Nani Maharani Nur Setiawati Dewi Nurul Ratna Mutu Manikam Nydia Rena Benita Sihombing Nyoman Suci Widyastiti Permatasari, Galuh Arum Ponco Birowo Pramudtya, Reza Rafli, Muhammad Rahman Jamal Rama, Leonardo Jalusius Rita Indriyati Selanno, Fradelino Esau Selvia Eva Sabatini Sihombing, Nydia Rena Benita Suardani, Ni Wayan Sue-Mian Then Suhartono, Suhartono Sultana MH Faradz Syarief Taufik Tithasiri Audi Audi Rahardjo Tri Nur Kristina Vynda Ulvyana Wicaksono, Hasyid Ahmad Zulfikar Ali, Zulfikar