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Abstrak :
Latar Belakang: Subyek diabetes melitus (DM) tipe 2 mengalami peningkatan risiko fraktur akibat penurunan kekuatan tulang. Bone mineral density (BMD), sebagai parameter kuantitas tulang, tidak dapat menggambarkan fragilitas tulang pada subyek DM tipe 2 karena menunjukkan hasil yang normal atau meningkat dibandingkan dengan subyek bukan DM, sehingga peningkatan resiko fraktur pada subyek DM tipe 2 lebih disebabkan oleh penurunan kualitas tulang. Salah satu unsur penentu kualitas tulang adalah turnover tulang. Beberapa faktor yang berpengaruh pada turnover tulang, antara lain tumor necrosis factor-α (TNF-α) dan sclerostin. Kajian TNF-α dan sclerostin pada subyek DM perempuan pernah dilaporkan namun melibatkan subyek pascamenopause, sehingga tidak dapat dipisahkan efek TNF-α dan sclerostin terhadap turnover tulang. Tujuan: Penelitian ini bertujuan untuk mendapatkan profil kadar TNF-α dan sclerostin serum pada subyek perempuan pramenopause DM tipe 2 dan bukan DM. Metode: Studi potong lintang dilakukan pada 80 subyek perempuan pramenopause yang terdiri dari ini 40 subyek DM Tipe 2 dan 40 subyek bukan DM. Data yang dikumpulkan antara lain: karakteristik subyek, riwayat penggunaan obat-obatan, HbA1C, SGPT, kreatinin, dan eGFR. Pemeriksaan TNF-α dan sclerostin serum dilakukan dengan metode enzyme-linked immunosorbent assay (ELISA). Hasil: Median (rentang interkuartil) kadar TNF-α serum pada subyek DM tipe 2 [43,0 pg/mL (14,4-101,31)], lebih tinggi dibandingkan subyek bukan DM [23,86 pg/mL (11,98-78,54)] namun perbedaan tersebut tidak bermakna (p=0.900). Rerata (simpang baku) kadar sclerostin serum pada subyek DM tipe 2 [132,05 pg/mL (SB 41,54)], lebih tinggi bermakna (p<0.001) dibandingkan subyek bukan DM [96,03 pg/mL (SB 43,66)]. Tidak didapatkan hubungan antara kadar TNF-α dan sclerostin serum baik pada subyek DM tipe 2 (p=0,630) maupun subyek bukan DM (p=0,560). Kesimpulan: Subyek perempuan pramenopause DM tipe 2 memiliki kadar TNF- α serum lebih tinggi namun tidak bermakna dibandingkan dengan subyek bukan DM. Subyek perempuan pramenopause DM tipe 2 memiliki kadar sclerostin serum lebih tinggi bermakna dibandingkan dengan subyek bukan DM. ......Background: The subject of type 2 diabetes mellitus (T2DM) has an increased risk of fracture due to a decrease in bone strength. Bone mineral density (BMD), as a parameter of bone quantity, cannot describe bone fragility in T2DM subjects because it shows normal or increased results compared to non-DM subjects, so an increased risk of fracture in T2DM subjects is due to a decrease in bone quality. One element that determines bone quality is bone turnover. Some factors that influence bone turnover include tumor necrosis factor-α (TNF-α) and sclerostin. TNF-α and sclerostin studies in female DM subjects have been reported but involve postmenopausal subjects, so that the effects of TNF-α and sclerostin cannot be separated from bone turnover. Objective: This study aims to obtain a profile of serum TNF-α and sclerostin levels in premenopausal women with T2DM and non-DM. Method: A cross-sectional study was carried out on 80 premenopausal female subjects consisting of 40 T2DM subjects and 40 non-DM subjects. Data collected included: subject characteristics, history of drug use, HbA1C, SGPT, creatinine, and eGFR. Serum TNF-α and sclerostin examination was carried out by the enzyme-linked immunosorbent assay (ELISA) method. Results: The median (interquartile range) of serum TNF-α levels in T2DM subjects [43.0 pg/mL (14.4-101.31)], was higher than non-DM subjects [23.86 pg/mL (11.98 -78.54)] but the difference was not significant (p= 0.900). The mean (standard deviation) of serum sclerostin levels in T2DM subjects [132.05 pg/mL (SD 41.54)], was significantly higher (p< 0.001) than non-DM subjects [96.03 pg/mL (SD 43.66)]. There was no association between serum TNF-α and sclerostin levels in both T2DM subjects (p= 0.630) and non-DM subjects (p= 0.560). Conclusions: Subjects of premenopausal women with T2DM had higher serum TNF-α levels but were not significant compared to non-DM subjects. Subjects of premenopausal women with T2DM had significantly higher serum sclerostin levels compared to non-DM subjects.

Abstrak :
Latar Belakang: Pada artritis reumatoid diketahui terjadi kehilangan massa tulang, baik secara lokal maupun sistemik. TNF-a adalah sitokin utama yang berperan pada proses resorpsi tulang, namun perannya pada formasi tulang belum diketahui. Penelitian ini akan menilai korelasi TNF-adengan proses formasi tulang yang dinilai dengan P1NP, terutama berhubungan dengan SFRP-1 yang merupakan inhibitor alami osteoblas. Sampai saat ini belum ada penelitian yang menilai hubungan sitokin proinflamasi TNF-a, SFRP1 terhadap kedua penanda turnover tulang(CTX dan P1NP) secara sistemik pada pasien artritis reumatoid. Tujuan: Penelitian ini bertujuan untuk mendapat gambaran aktivitas turnovertulang pada pasien AR dengan melihat korelasi antara TNF-adengan SFRP-1, CTX dan P1NP, dan korelasi SFRP1 dengan P1NP. Metode: Penelitian ini merupakan studi potong lintang dengan 38 subjek perempuan premenopause dengan AR. Pengambilan sampel dilakukan secara konsekutif di poliklinik reumatologi Rumah Sakit Cipto Mangunkusumo. Pemeriksaan TNF-a, SFRP-1, CTX, dan P1NP dilakukan dengan metode ELISA. Hasil: Pada penelitian ini didapatkan median durasi menderita AR 5 tahun. 60,6% pasien berada dalam kondisi remisi dan aktivitas rendah. Kadar TNF-amedian 10,6 pg/mL, rerata kadar SFRP-1 9,29 ng/mL, rerata kadar CTX 2,74 ng/mL, serta kadar P1NP 34 pg/mL. Kadar SFRP-1 dan CTX dijumpai meningkat sedangkan P1NP relatif lebih rendah bila dibandingkan dengan kadar populasi normal pada penelitian-penelitian terdahulu. Pada penelitian ini dijumpai adanya korelasi positif lemah antara TNF-a dengan P1NP (r=0,363, p=0,026), begitu juga SFRP-1 dengan P1NP (r=0,341; p=0,036), sedangkan variabel lain tidak menunjukkan korelasi yang bermakna. Simpulan: Pada penelitian ini didapatkan korelasi positif lemah antara TNF-adengan P1NP, dan korelasi positif lemah antara SFRP-1 dengan P1NP. Namun dijumpai kadar CTX yang tinggidan kadar P1NP yang rendah, menunjukkan respon resorpsi meningkat namun tidak diimbangi dengan formasi pada pasien AR perempuan premenopause. ......Background: Rheumatoid arthritis is known to have a loss of bone mass, both locally and systemically. TNF-a is the main inflammatory cytokine that can directly increase bone resorption. However, its role in bone formation is still unknown. This study will assess the correlation of TNF-a with the process of bone formation evaluated with P1NP, mainly related to the SFRP-1 pathway which is a natural inhibitor of osteoblasts. However, there are currently no studies that assess the correlation of inflammatory cytokines TNF-a, SFRP-1, with bone turnover marker (CTX and P1NP) in rheumatoid arthritis patients Objective: This study aims to examine bone turnover in RA patients by analyzing the correlation between TNF-a with SFRP-1 and CTX and P1NP, and correlation SFRP-1 with P1NP Methods: This is a cross-sectional study in 38 subjects of premenopausal women with RA. The Subjects were collected with consecutive sampling technique in rheumatology outpatient clinic in Rumah SakitCipto Mangunkusumo, Jakarta. Measurement of serum TNF-a, SFRP-1, CTX, and P1NP levels were done using ELISA technique. Results: In this study, the median duration of RA is 5 years. 60.6% of the patients were in remission and low activity disease. The median value of TNF-a was 10.6 pg/mL, the mean value of SFRP-1 was 9.29 ng/mL, the mean value of CTX was 2.74 ng/mL, and mean value of P1NP was 34 pg/mL. SFRP-1 and CTX levels were increased while P1NP level was relatively lower compared to the normal population value in previous studies. There was a weak positive correlation between TNF-a and P1NP(r=0.363, p=0.026), also SFRP-1 and P1NP(r=0.341; p=0.036),while the other variables showed no significant correlation. Conclusions: This study demonstrated weak positive correlation between TNF-a and P1NP, and weak positive correlation between SFRP-1 and P1NP. However high value of CTX and low value of P1NP showed that a high resorption response cannot be balanced with bone formation activity in patients with rheumatoid arthritis in premenopausal woman.

Abstrak :
This book presents the design of a robust, portable and low-cost PoC sensing system for the early detection of bone loss. The device can measure the level of CTx-I-one of the most sensitive biochemical markers of bone resorption-in serum and transmit the measured value to an IoT-based cloud server. The selectivity of the sensing system to CTx-I has been achieved by coating the sensor with artificial antibodies, prepared by means of molecular imprinting technology. Explaining all aspects of the systems development in detail, the book will be of great interest to all engineers, researchers and scientists whose work involves the development of electrochemical sensors and PoC devices.

Abstrak :
This book presents the theory of electromagnetic (EM) waves for upper undergraduate, graduate and PhD-level students in engineering. It focuses on physics and microwave theory based on Maxwells equations and the boundary conditions important for studying the operation of waveguides and resonators in a wide frequency range, namely, from approx. 10--9 to 10--16 hertz. The author also highlights various current topics in EM field theory, such as plasmonic (comprising a noble metal) waveguides and analyses of attenuations by filled waveguide dielectrics or semiconductors and also by conducting waveguide walls. Featuring a wide variety of illustrations, the book presents the calculated and schematic distributions of EM fields and currents in waveguides and resonators. Further, test questions are presented at the end of each chapter.