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Mohammad A, Elham H, Andreas K. A scoping review of the effect of chronic stretch training on sleep quality in people with sleep disorders. Eur J Appl Physiol 2024:10.1007/s00421-024-05541-z. [PMID: 38918221 DOI: 10.1007/s00421-024-05541-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/14/2024] [Indexed: 06/27/2024]
Abstract
PURPOSE The widespread and health-detrimental sleep disorders have resulted in stretching exercises being investigated as a non-drug solution for enhanced sleep quality. However, a comprehensive understanding of the impact of stretching exercises on individuals with sleep disorders is lacking. METHODS This scoping review systematically maps the existing literature and identifies research gaps on the impact of stretching exercises on sleep quality in individuals with sleep disorders. RESULTS Sixteen eligible studies were included, where the weighted mean changes indicate a positive trend in sleep quality improvement, ranging from trivial to very large magnitudes. However, concerning the individual study results only 5 out of 16 studies reported significant improvements. Notable enhancements include a small 1.22% overall sleep quality improvement, a large 6.51% reduction in insomnia severity, a large 8.88% increase in sleep efficiency, a moderate 4.36% decrease in sleep onset latency, a large 8.27% decrease in wake after sleep onset, and a very large 14.70% improvement in total sleep time. Trivial changes are noted in sleep duration (0.58%), sleep disturbance reduction (0.07%), and daytime dysfunction reduction (0.19%). Likely mechanisms for the improvement of sleep include autonomic nervous system modulation, muscle tension relief, cortisol regulation, enhanced blood circulation, and psychological benefits such as stress reduction and mood enhancement. CONCLUSION There is little evidence that stretching exercises positively impact sleep quality in individuals with sleep disorders. Additionally, further research is vital for designing optimal protocols, understanding of the long-term effects, and clarification of the mechanisms.
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Affiliation(s)
- Alimoradi Mohammad
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, University of Shahid Bahonar Kerman, Kerman, Iran
| | - Hosseini Elham
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, University of Shahid Bahonar Kerman, Kerman, Iran
| | - Konrad Andreas
- Institute of Human Movement Science, Sport and Health, Graz University, Mozartgasse 14, 8010, Graz, Austria.
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Qing Z, Wu C, Gao T. The impact of social participation on Subjective Wellbeing in the older adult: the mediating role of anxiety and the moderating role of education. Front Public Health 2024; 12:1362268. [PMID: 38818440 PMCID: PMC11137287 DOI: 10.3389/fpubh.2024.1362268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 04/29/2024] [Indexed: 06/01/2024] Open
Abstract
Introduction The study aims to examine the mediating role of anxiety in the relationship between social participation and Subjective Wellbeing among Chinese older adults. Additionally, it investigates the moderating ed of education in this relationship. Methods The data came from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) published by peking University, with a sample size of 10,626 individuals aged 60 years and above. SPSS 21.0 was used for the statistical analysis of the data, and Mplus 8.0 was used for the statistical processing of the mediating and moderating effects analysis. Results (1) The social participation significantly and positively predicated Subjective Wellbeing; (2) Anxiety partially mediated the eect between social participation and Subjective Wellbeing. The mediating eect value was 0.103; (3) Education plays a moderating role in the impact of social participation on subjective Wellbeing. Discussion In summary, social participation can reduce the anxiety and enhance their Subjective Wellbeing. Meanwhile, the eet of social participation on Subjective Wellbeing was the greatest for the older adult with high education. The findings suggest that community-led activities can be initiated to improve social participation in the older adult. Furthermore, educational courses could be to support the healthy aging of older adults in China.
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Affiliation(s)
- Zaihua Qing
- Hunan University of Finance and Economics, Changsha, China
| | - Caihong Wu
- Hunan University of Finance and Economics, Changsha, China
| | - Tao Gao
- Guangdong Industry Polytechnic, Guangzhou, China
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Huang D, Wang J, Fang H, Wang X, Zhang Y, Cao S. Global research trends in the subjective well-being of older adults from 2002 to 2021: A bibliometric analysis. Front Psychol 2022; 13:972515. [PMID: 36160594 PMCID: PMC9500504 DOI: 10.3389/fpsyg.2022.972515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose This study aimed to explore current developments and trends in the field of subjective well-being (SWB) of older adults at a macro level and identify research hotspots. Methods We included reviews and articles on the SWB of older adults in the Web of Science Core Collection published from 2002 to 2021. We used CiteSpace to draw a knowledge map of the authors, institutions, countries, references, and keywords for visual analysis and used Microsoft Excel tables to count basic information details. Results A total of 354 papers were included, and the number of papers published over the past two decades showed a pattern of growth. The core force of publications was primarily attributed to studies conducted in Europe, North America, Asia, and Oceania, which have relatively major issues of aging and good economic strength. However, links between states, institutions, and authors were relatively weak. Cluster analysis showed that the research field could be divided into eight topics: the application of social psychology in the study of the SWB of older adults, aging in older adults, health condition of older adults, achieving successful aging, interventions for SWB, age differences in SWB research, an economic perspective of SWB research and social support for older adults. Current research frontiers are socioeconomic status, community, intervention, participation, adjustment, validation, and personality. Conclusion The results of the present study provided a comprehensive picture in the research field of SWB of older adults. It showed that the mechanism, especially the bidirectional effect, between the SWB of older adults and its influencing factors is still worthy of further exploration. More research on evidence-based and intervention strategies should be conducted in the future.
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Affiliation(s)
- Derong Huang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jian Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
- *Correspondence: Jian Wang,
| | - Huiling Fang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xuehan Wang
- School of Public Administration, Central South University, Changsha, Hunan, China
| | - Yujie Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Shuo Cao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
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Majumdar V, Snigdha A, Manjunath NK, Nagarathna R, Mavathur R, Singh A, S R K, H R N. Study protocol for yoga-based lifestyle intervention for healthy ageing phenotype in the older adults (yHAP): a two-armed, waitlist randomised controlled trial with multiple primary outcomes. BMJ Open 2021; 11:e051209. [PMID: 34531216 PMCID: PMC8449966 DOI: 10.1136/bmjopen-2021-051209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The conceptualisation of healthy ageing phenotype (HAP) and the availability of a tentative panel for HAP biomarkers raise the need to test the efficacy of potential interventions to promote health in older adults. This study protocol reports the methodology for a 24-week programme to explore the holistic influence of the yoga-based intervention on the (bio)markers of HAP. METHODS AND ANALYSIS The study is a two-armed, randomised waitlist controlled trial with blinded outcome assessors and multiple primary outcomes. We aim to recruit 250 subjects, aged 60-80 years from the residential communities and old age clubs in Bangalore city, India, who will undergo randomisation into intervention or control arms (1:1). The intervention will include a yoga-based programme tailored for the older adults, 1 hour per day for 6 days a week, spread for 24 weeks. Data would be collected at the baseline and post-intervention, the 24th week. The multiple primary outcomes of the study are the (bio)markers of HAP: glycated haemoglobin, low-density lipoprotein cholesterol (LDL-C), systolic blood pressure, and forced expiratory volume in 1 s for physiological and metabolic health; Digit Symbol Substitution Test, Trail Making Tests A and B for cognition; hand grip strength and gait speed for physical capability; loneliness for social well-being and WHO Quality of Life Instrument-Short Form for quality of life. The secondary outcomes include inflammatory markers, tumour necrosis factor-alpha receptor II, C reactive protein, interleukin 6 and serum Klotho levels. Analyses will be by intention-to-treat and the holistic impact of yoga on HAP will be assessed using global statistical test. ETHICS AND DISSEMINATION The study is approved by the Institutional Ethics Committee of Swami Vivekananda Yoga Anusandhana Samsthana University, Bangalore (ID: RES/IEC-SVYASA/143/2019). Written informed consent will be obtained from each participant prior to inclusion. Results will be available through research articles and conferences. TRIAL REGISTRATION NUMBER CTRI/2021/02/031373.
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Affiliation(s)
- Vijaya Majumdar
- Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Atmakur Snigdha
- Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - N K Manjunath
- Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | | | - Ramesh Mavathur
- Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Amit Singh
- Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Kalpana S R
- Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
| | - Nagendra H R
- Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
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Experience of Elderly People Regarding the Effect of Yoga/Light Exercise on Sedentary Behavior: A Longitudinal Qualitative Study in Madhya Pradesh, India. Geriatrics (Basel) 2020; 5:geriatrics5040103. [PMID: 33322402 PMCID: PMC7768492 DOI: 10.3390/geriatrics5040103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/01/2020] [Accepted: 12/04/2020] [Indexed: 01/01/2023] Open
Abstract
This study is set on the background of a randomized control trial (RCT) in which intervention was carried to observe the effects of yoga/light exercise on the improvement in health and well-being among the elderly population. A longitudinal qualitative study was conducted as part of RCT interventions to explore the experience of the elderly practicing yoga/light exercise in relation to sedentary behavior in the Ujjain district of Madhya Pradesh, India. Participants of the RCT were selected for this study. Eighteen focus group discussions were conducted—six during each phase of RCT interventions (before, during, and after). The findings regarding motivating and demotivating factors in various phases of intervention were presented in three categories: experience and perception of the effects of yoga/light exercise on sedentary behavior (1) before, (2) during, and (3) after intervention. This study explores the positive effect of yoga/light exercise on sedentary behavior and subjective well-being on the elderly population. They were recognized to have undergone changes in their physical and emotional well-being by consistently practicing yoga/light exercise. The main driving factors were periodic health check-ups and the encouragement of qualified trainers without any cost. This study concludes with the notion that these interventions should be encouraged in the community to use physical exercise as a method to better control the physical and social effects of aging.
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Abstract
BACKGROUND Physician burnout is a well-known problem and widespread issue in the field of medicine. Recently, more attention has been given to the significance of burnout among plastic surgeons. The cause of burnout is multifactorial, with emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment all playing a role. The objective of this article is to provide practical measures to help plastic surgeons in identifying the signs of burnout, thereby mitigating its consequences. METHODS A literature review was performed to determine the comprehensive findings of previous research conducted on burnout among plastic surgeons. Particular interest was given to successful tactics used in managing work-related stress. Wellness strategies and resources from both academic and private medical settings were also obtained to further review methods for burnout management. RESULTS There is a wide range of causes and risk factors for burnout among plastic surgeons. The majority of cases correlate with increased workload, loss of physician autonomy, and, in the context of trainees, lack of mentorship. Managing burnout can be supported by identification through survey tools. Establishing a wellness committee is also useful to develop institution-specific interventions. Equally as important, individuals must take steps to manage and minimize their burnout. CONCLUSIONS This article provides practical strategies for institutions to identify and manage burnout among plastic surgeons. It is obvious that causes of burnout vary in different settings such as academic and community hospitals; therefore, it is critical for institutions to individualize their approach to burnout.
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Sharma K, Anand A, Kumar R. The role of Yoga in working from home during the COVID-19 global lockdown. Work 2020; 66:731-737. [PMID: 32925134 DOI: 10.3233/wor-203219] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has become a major cause of stress and anxiety worldwide. Due to the global lockdown, work, employment, businesses and the economic climate have been severely affected. It has generated stress among people from all sections of society, especially to workers who have been assigned to cater to healthcare service or those constrained to secure daily essential items. It is widely perceived that elderly or those affected by diabetes, hypertension and other cardiovascular diseases are prone to COVID-19. As per an ongoing survey, the initial data shows that the above-mentioned anxiety and stress cause insomnia, and has the considerable potential to weaken the immune system, the sole protection against the virus. OBJECTIVE This study focuses on the need of Yoga practice at work places and at home during the global lockdown due to the COVID-19 pandemic. METHODS Literature was searched using PubMed and Google Scholar for COVID-19-related stress and anxiety at work and society due to the worldwide lockdown. The predisposing comorbidities, viral mechanism of action and treatment regimen were also searched. Yoga-based intervention studies and online programs were also searched. RESULTS As the lockdown cannot last forever and workplaces will have to be functional soon, there is an increased possibility of recurrent infection. Therefore, Yoga can provide the necessary tool for risk reduction, amelioration of stress and anxiety and strengthening of the immune function. The online platforms provide a good media for Yoga training at work places and homes. CONCLUSION Due to social distancing norms, the availability of Yoga trainers has become restricted. Yoga practice is actively sought to achieve reduced anxiety and stress so that improved sleep may positively impact immunity. As a consequence, there is a spurt in social media, catering to daily online Yoga sessions which apparently prove useful in providing accessible means to achieve mental as well as physical well-being.
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Affiliation(s)
- Kanupriya Sharma
- Neuroscience Research Lab, Department of Neurology, PGIMER, Chandigarh, India
| | - Akshay Anand
- Neuroscience Research Lab, Department of Neurology, PGIMER, Chandigarh, India
| | - Raj Kumar
- Department of English and Cultural Studies, Panjab University, Chandigarh, India
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Gunawan A, Fajar JK, Tamara F, Mahendra AI, Ilmawan M, Purnamasari Y, Kartini DA, Winoto ES, Saifillah ES, Wulandari DS, Krisna PA, Mayasari ED, Dantara TWI, Wicaksono RS, Soeatmadji DW. Nitride oxide synthase 3 and klotho gene polymorphisms in the pathogenesis of chronic kidney disease and age-related cognitive impairment: a systematic review and meta-analysis. F1000Res 2020; 9:252. [PMID: 34035901 PMCID: PMC8112466 DOI: 10.12688/f1000research.22989.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2021] [Indexed: 12/25/2022] Open
Abstract
Background: While it has been known that the development of chronic kidney disease (CKD) and age-related cognitive impairment involves several mediators, the evidence in clinical practice only reveals nitride oxide synthase (NOS) and klotho. However, the evidence for this topic is conflicted. The aim of this study was to assess the role of NOS and klotho single nucleotide polymorphisms (SNPs) in the pathogenesis of CKD and age-related cognitive impairment. Methods: We performed a meta-analysis during October to December 2019. Paper collection was performed in major scientific websites, and we extracted information of interest from each paper. Data were analyzed using a Z-test with either random or fixed effect model. Results: Our initial assessment identified NOS3 G894T, NOS3 T786C, NOS3 4b/4a, klotho ( KL) G395A, and KL C1818T as the gene candidate for our meta-analysis. Our pooled calculation revealed that NOS3 G894T was associated with the risk of both age-related cognitive impairment and CKD. Increased susceptibility to age-related cognitive impairment was observed in the GG genotype, and increased risk of CKD was found in patients with a single T allele and TT genotype for NOS3 nucleotide 894. For NOS3 4b/4a, increased risk of CKD was only found in 4a4a genotype. For NOS3 T786C, we failed to show the association with both CKD and age-related cognitive impairment. Subsequently, for KL G395A, A allele and GA genotype were found to correlate with increased susceptibility to CKD, while its correlation to age-related cognitive impairment was failed to clarify. For KL C1818T, our analysis failed to find the correlation with the risk of CKD. Conclusions: Our results reveal that the NOS3 G894T gene polymorphism has a crucial role in the pathogenesis of both CKD and age-related cognitive impairment.
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Affiliation(s)
- Atma Gunawan
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Jonny Karunia Fajar
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Fredo Tamara
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Aditya Indra Mahendra
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Muhammad Ilmawan
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Yeni Purnamasari
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | | | - Eden Suryoiman Winoto
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Efriko Septananda Saifillah
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Dewi Sri Wulandari
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Pratista Adi Krisna
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Ema Dianita Mayasari
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Tri Wahyudi Iman Dantara
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Ramadi Satryo Wicaksono
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
- Department of Internal Medicine, Rumah Sakit Umum Daerah Bangil., Pasuruan, East Java, 67153, Indonesia
| | - Djoko Wahono Soeatmadji
- Division of Endocrinology and Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
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Gunawan A, Fajar JK, Tamara F, Mahendra AI, Ilmawan M, Purnamasari Y, Kartini DA, Winoto ES, Saifillah ES, Wulandari DS, Krisna PA, Mayasari ED, Dantara TWI, Wicaksono RS, Soeatmadji DW. Nitride oxide synthase 3 and klotho gene polymorphisms in the pathogenesis of chronic kidney disease and age-related cognitive impairment: a systematic review and meta-analysis. F1000Res 2020; 9:252. [PMID: 34035901 PMCID: PMC8112466 DOI: 10.12688/f1000research.22989.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/02/2020] [Indexed: 04/03/2024] Open
Abstract
Background: While it has been known that the development of chronic kidney disease (CKD) and age-related cognitive impairment involves several mediators, the evidence in clinical practice only reveals nitride oxide synthase (NOS) and klotho. However, the evidence for this topic is conflicted. The aim of this study was to assess the role of NOS and klotho single nucleotide polymorphisms (SNPs) in the pathogenesis of CKD and age-related cognitive impairment. Methods: We performed a meta-analysis during October to December 2019. Paper collection was performed in major scientific websites, and we extracted information of interest from each paper. Data were analyzed using a Z-test with either random or fixed effect model. Results: Our initial assessment identified NOS3 G894T, NOS3 T786C, NOS3 4b/4a, klotho ( KL) G395A, and KL C1818T as the gene candidate for our meta-analysis. Our pooled calculation revealed that NOS3 G894T was associated with the risk of both age-related cognitive impairment and CKD. Increased susceptibility to age-related cognitive impairment was observed in the GG genotype, and increased risk of CKD was found in patients with a single T allele and TT genotype for NOS3 nucleotide 894. For NOS3 4b/4a, increased risk of CKD was only found in 4a4a genotype. For NOS3 T786C, we failed to show the association with both CKD and age-related cognitive impairment. Subsequently, for KL G395A, A allele and GA genotype were found to correlate with increased susceptibility to CKD, while its correlation to age-related cognitive impairment was failed to clarify. For KL C1818T, our analysis failed to find the correlation with the risk of CKD. Conclusions: Our results reveal that the NOS3 G894T gene polymorphism has a crucial role in the pathogenesis of both CKD and age-related cognitive impairment.
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Affiliation(s)
- Atma Gunawan
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Jonny Karunia Fajar
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Fredo Tamara
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Aditya Indra Mahendra
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Muhammad Ilmawan
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Yeni Purnamasari
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | | | - Eden Suryoiman Winoto
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Efriko Septananda Saifillah
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Dewi Sri Wulandari
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Pratista Adi Krisna
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Ema Dianita Mayasari
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Tri Wahyudi Iman Dantara
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Ramadi Satryo Wicaksono
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
- Department of Internal Medicine, Rumah Sakit Umum Daerah Bangil., Pasuruan, East Java, 67153, Indonesia
| | - Djoko Wahono Soeatmadji
- Division of Endocrinology and Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
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