Search

Nutrition status is health relating to the use of eating pattern by body. Belawan Public Health center ranked4 with malnutrition status with the total of 196 (3.1%) below Medan Labuhan, Medan Helvetia, and MedanTuntungan. Malnutrition mostly occured at environment 15 that is, 8 babies suffering from malnutrition outof 2.047 babies, and 2 babies having bad nutrition. The research aims at finding out the relationshipbetween dependent and independent variables at environment 15, families of Pekan Labuhan, PekanLabuhan regency of Medan Labuhan in 2015. The research method is Cross sectional using total samplingtechniqe that 40 familes were taken as samples having babies. The research data were taken byperforming home visits from house to house, visiting to integrated post service (Posyandu) with interviewguide and questionnaires. The result of the study showed that 2 respondents (5%) experiencedmalnutrition, 8 respondents (20%) suffered from less nutrition and 30 respondents (75%) experiencedgood nutrition. Based on bivariate analysis, it was found that there was a dependent variable not having asignificant relationship with baby nutrition status; that is, variable of family income ( ρ-value = 0.108) and 4independent variables have a significant relationship with baby nutrition status; that is, variable of mother’s(ρ-value = 0.000), and the number of family member (ρ-value = 0.027). The research concludes that thereis a significant relationship between mother knowledge, mother attitude, mother education and the numberof family members on the baby nutrition status. Public Health Center is suggested to provide counseling tomothers having babies continually Mothers are suggested to visit Public Health Center routinely to checkup their baby nutrition

The COVID-19 pandemic has necessitated adaptation of cancer patient care. Oncology patients who contract COVID-19 have poor outcomes. Telemedicine clinics (teleclinics) have been introduced for cancer patients to reduce the risk of horizontal transmission at St. Bartholomew’s Hospital and The Royal Free Hospital in London. Teleclinics have become routine in many specialities; however, inclusion in oncology care was not standard prior to the pandemic. A mixed-methods survey was designed and delivered to cancer patients (n = 106) at St. Bartholomew’s Hospital and The Royal Free Hospital who had transitioned to teleclinics in March 2020. The survey explored patients’ perceptions of this format. In total, 96 (90.5%) patients consented to take part, across a range of tumour types. Overall, respondents reacted favourably to the format of the teleclinics, with 90.6% of respondents (87/96) stating they would utilise teleclinics beyond the pandemic. Additionally, a survey was distributed to clinicians delivering these teleclinics (n = 16) to explore previous training in, perceptions of, and lessons learned from the introduction of telemedicine. Results suggest patients are accepting of teleclinic use for most clinical purposes. Teleclinic implementation affords benefits to cancer patient care both during and after COVID-19, but there is an urgent need for telemedicine education in oncology specialty training. Supplementary Information The online version contains supplementary material available at 10.1007/s13187-021-02053-8.

Fragestellung: Aseptische Lockerungen und periprothetische Infektionen gehören zu den häufigsten Komplikationen der Hüft- und Kniegelenk-Endoprothetik. Die differentialdiagnostische Abklärung gestaltet sich insbesondere in der Frühphase häufig schwierig. Das Ziel der hier [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Background Autism is hypothesized to represent a disorder of brain connectivity, yet patterns of atypical functional connectivity show marked heterogeneity across individuals. Methods We used a large multi-site dataset comprised of a heterogeneous population of individuals with autism and typically developing individuals to compare a number of resting-state functional connectivity features of autism. These features were also tested in a single site sample that utilized a high-temporal resolution, long-duration resting-state acquisition technique. Results No one method of analysis provided reproducible results across research sites, combined samples, and the high-resolution dataset. Distinct categories of functional connectivity features that differed in autism such as homotopic, default network, salience network, long-range connections, and corticostriatal connectivity, did not align with differences in clinical and behavioral traits in individuals with autism. One method, lag-based functional connectivity, was not correlated to other methods in describing patterns of resting-state functional connectivity and their relationship to autism traits. Conclusion Overall, functional connectivity features predictive of autism demonstrated limited generalizability across sites, with consistent results only for large samples. Different types of functional connectivity features do not consistently predict different symptoms of autism. Rather, specific features that predict autism symptoms are distributed across feature types. Electronic supplementary material The online version of this article (10.1186/s13229-019-0273-5) contains supplementary material, which is available to authorized users.

PD-1 as an immune checkpoint molecule down-regulates T cell activity during immune responses in order to prevent autoimmune tissue damage. In chronic infections or tumors, lasting antigen-exposure leads to permanent PD-1 expression that can limit immune-mediated clearance of patho-gens or degenerated cells. Blocking PD-1 can enhance T cell function; in cancer treatment PD-1 blockade is already used as a successful therapy. However, the role of PD-1 expression and block-ing in the context of acute and chronic infections is less defined. Building on its success in cancer therapy leads to the hypothesis that blocking PD-1 in infectious diseases is also beneficial in acute or chronic infections. This review will focus on the role of PD-1 expression in acute and chronic infections with virus, bacteria and parasites, with a particular focus on recent studies regarding PD-1 blockade in infectious diseases.

Background: Clavicular shortening often occurs after midclavicular fractures and its impact on functional outcomes has thus far been evaluated solely by radiographic and surgeon-based measures, with divergent findings.

The individuals with Hansen’s disease experience situations of prejudice that, together with stigma and discrimination, culminate in social isolation and restrictions in social relationships. This study aimed to evaluate the perception of stigma in individuals with Hansen’s disease and its social repercussions. It was configured as a qualitative study, by means of semi-structured interviews with 20 users registered to chemotherapy treatment in reference units of Zona da Mata Mineira, in the first half of 2014. The analysis was performed through content analysis and the following categories were defined: Lack of knowledge about the disease; Diagnosis and cure; Discrimination and fear; Concealment of the disease; Social support; and Bond and social participation. Lack of knowledge about the disease interferes with the individual’s ability to cope with it, and coupled with fear of discrimination, it was enough for them to conceal their diagnosis from others. Thus, it was not possible to notice any changes in their social bonds. The different emotional reactions at the moment of diagnosis stood out, in addition to the emphasis on healing given by respondents. In this study, it became clear that the concealment of the disease and the social support acted as protective factors that prevented moments of discrimination and restriction in social participation.

Key Points Question Do individuals with autism show atypical duration of brain functional connections? Findings In this cohort study of 52 individuals with autism and 38 typically developing participants and a replication study of 1402 participants in a brain imaging database, increased durations of functional connections in autism were found in both distributed networks and individual brain regions, which were associated with metrics of disease severity. Meaning Persistence of brain connectivity in autism may limit the ability to rapidly shift from one brain state to another and contribute to the pathophysiology of autism., Importance Despite reports of widespread but heterogeneous atypicality of functional connectivity in individuals with autism, little is known regarding the temporal dynamics of functional brain connections and how they relate to autistic traits. Objective To investigate differences in temporal synchrony between brain regions in individuals with autism and those with typical development. Design, Setting, and Participants This cohort study, conducted at the University of Utah, included 90 adolescent and adult male participants. A larger sample from the multisite Autism Brain Imaging Data Exchange (ABIDE) was also used as a replication sample. The study includes data acquired between December 2016 and April 2018. Aggregate data included in the replication sample were released to the public in August 2012 (ABIDE I) and June 2016 (ABIDE II). Data analysis were conducted between January 2018 and April 2018. Exposures Male individuals diagnosed as having autism (n = 52) and typically developing male individuals (n = 38). Main Outcomes and Measures Long duration (30 minutes/individual) of multiband, multiecho functional magnetic resonance imaging was acquired to estimate functional connectivity between brain regions. Sustained connectivity, a measure of functional connectivity duration, as well as lagged temporal dynamics related to functional connectivity, were compared between groups for 361 gray matter regions of interest and a 17-network parcellation. Lagged findings were replicated in the larger ABIDE sample (n = 1402). Sustained connectivity findings were also associated with behavioral and cognitive variables. Results In 52 males with autism (mean [SD] age, 27.73 [8.66] years) and 38 control males with typical development (mean [SD] age, 27.09 [7.49] years), increases in both sustained and functional connectivity at several lags were found in individuals with autism compared with the control group. Group differences in functional connectivity were replicated in the larger ABIDE data set at a 6-second lag. Measures of symptom severity in individuals with autism were positively associated with sustained connectivity values. In the control group, sustained connectivity was negatively associated with cognitive processing. A replication sample (n = 1402) composed of 579 individuals with autism (80 female and 499 male; mean [SD] age, 15.08 [6.89] years) and 823 in the control group (211 female and 612 male; mean [SD] age, 15.06 [6.79] years) from the ABIDE data set was also analyzed. Conclusions and Relevance Whereas the magnitude of functional connectivity in autism is variable across brain regions, participant samples, and development, prolonged temporal synchrony of functional connections is reproducibly observed in autism, suggesting a potential mechanism for core symptoms., This cohort study investigates the differences in temporal synchrony between brain regions in individuals with autism and those with typical development.

Supplementary Information results. (PDF 8812Â kb)

Antecedentes: La infección con la varicela zoster es mundial. La incidencia varía por grupos de edad, localización geográfica. En Colombia la transmisibilidad el virus se favorece por la multiplicidad de climas, aspectos geográficos y atmosféricos. En el año 2016 se notificaron 112.400 casos, 34.037 en población adulta, 744 fueron población privada de la libertad (PPL). La definición de brote en establecimientos carcelarios se da a partir de un caso. Condiciones de hacinamiento y el contexto social hacen interesante conocer el estudio de brote y las medidas de implementación realizadas.Objetivo: Describir los factores de riesgo, características demográficas y evaluar medidas de control de la varicela en el Centro de Prisiones y Prisiones de Seguridad Moderada(EPMSC) de Cali de 2017 a 2018Métodos: Se realizó un estudio observacional descriptivo de corte transversal entre el 2017 al 2018 en PPL, mediante registros, entrevistas y fichas de notificación se analizaron variables de tiempo, lugar y persona, se realizaron distribuciones de frecuencias, se calcularon medidas de tendencia central, tasas de ataque y proporciones por pabellón.Resultados: Fue un brote de fuente propagada, se registraron 146 casos. La tasa de ataque del brote (2017) fue de 2.2% y en 2018 fue de 0.4%. El pabellon con mayor tasa de ataque (2017) fue el 5 (4.9%) y en 2018 el 1A (2.5%). El hacinamiento en el 2017 fue de 264% y en el 2018 de 192%.Conclusiones: El hacinamiento y las condiciones de salud en los centros penitenciarios dificultan el control oportuno de las epidemias.

The problem of the level of influence of soil carrying capacity is one of the things needed to be considered in a planning and work of a civil construction. This is because the soil serves as a medium that withstands the load or action of the construction built on it. Stabilization using sand materials is one way to meet the necessary power requirements. Weather and temperature changes in the field are factors making the ground unstable. Type of stabilized soil is silt originating from jl.Pancasila Batangkuis Regency Deliserdang. This research was conducted using mixed sand with mixed variations of 25%, 40%, 55% and 65%. Then, DST testing and Index properties were done for each sample. Based on the results of this test the soil obtained classification According to AASHTO criteria that is that this land including silt land or with a general assessment as the soil very well up to very well. This is because the plasticity (PI) of the soil sample is 8.69

Introduction Stoma closure is one of the most frequently performed surgeries. The common complications are surgical site infection (SSI) and poor scar cosmesis. Purse-string sutures are expected to have less incidence of SSI due to the free drainage of secretions from the wound and possibly the early detection of a wound infection. Compared to the conventional linear closure, the purse-string closure technique is expected to have less wound infection, improved scar cosmesis, and good patient satisfaction because of a smaller size scar. Hence, a well-structured study is required to substantiate the advantage of this technique. Methodology This randomized control trial was carried out for two years in a tertiary care centre in Southern India. Patients with various stoma reversals, including colostomy, as well as ileostomy reversal, were included in the study. Patients were divided into Group I - conventional linear skin suturing (n = 40) and Group II - purse-string closure (n = 40). After the closure of rectus muscle, the skin is closed using the purse-string method (subcuticular) in the experimental group. Results Both the groups were comparable with respect to age, gender, body mass index (BMI), the presence of co-morbidities, and indication for surgery. Stomal procedures were done (26.3%) for malignant cases. The difference in mean hospital days for both groups were statistically insignificant (11.95 vs. 9.9; p = 0.927). The incidence of SSI between the groups were statistically significant (17 vs. 3; p = 0.003). The mean Patient and Observer Scar Assessment Scoring (POSAS) scores between the groups (65.30 vs. 83.40; p = 0.012) were statistically significant. This proved significant improvement in scar cosmesis in purse-string skin closure. At one month postoperative, the purse-string group had better patient satisfaction (3.08 vs. 4.48; p = 0.001), which was evidenced by a mean Likert 3 scale score. The mean visual analogue scale (VAS) score did not show any significant difference in pain between the groups. Conclusion Purse-string skin closure for stoma reversal had significantly less incidence of SSI. The duration of antibiotic therapy was also less in purse-string skin closure patients as compared to linear skin closure patients. Purse-string skin closures significantly improved the scar outcome and patient satisfaction.

Progress in gene discovery for Autism Spectrum Disorder (ASD) has been rapid over the past decade, with major successes in validation of risk of predominantly rare, penetrant, de novo and inherited mutations in over 100 genes (de Rubies et al., 2015; Sanders et al., 2015). However, the majority of individuals with ASD diagnoses do not carry a rare, penetrant genetic risk factor. In fact, recent estimates suggest that most of the genetic liability of ASD is due to as yet undiscovered common, less penetrant inherited variation (Gaugler et al., 2014) which is much more difficult to detect. The study of extended, high-risk families adds significant information in our search for these common inherited risk factors. Here, we present results of a new, powerful pedigree analysis method (Shared Genomic Segments—SGS) on three large families from the Utah Autism Research Program. The method improves upon previous methods by allowing for within-family heterogeneity, and identifying exact region boundaries and subsets of cases who share for targeted follow-up analyses. Our SGS analyses identified one genome-wide significant shared segment on chromosome 17 (q21.32, p=1.47x10-8). Additional regions with suggestive evidence were identified on chromosomes 3, 4, 6, 8, 11, 13, 14, 15, and 18. Several of these segments showed evidence of sharing across families. Genes of interest in these regions include ATP8A1, DOCK3, CACNA2D2, ITGB3, AMBRA1, FOLH1, DGKZ, MTHFS, ARNT2, BTN2A2, BTN3A1, BTN3A3, BTN2A1, and BTN1A1. We are exploring multiple other lines of evidence to follow up these implicated regions and genes.

Background: Clavicular shortening often occurs after midclavicular fractures and its impact on functional outcomes has thus far been evaluated solely by radiographic and surgeon-based measures, with divergent findings.

The purpose of this study was to investigate comorbid psychiatric disorders and psychotropic medication use among adults with autism spectrum disorder (ASD) ascertained as children during a 1980's statewide Utah autism prevalence study (n = 129). Seventy-three individuals (56.6 %) met criteria for a current psychiatric disorder; 89 participants (69.0 %) met lifetime criteria for a psychiatric disorder. Caregivers reported a psychiatric diagnosis in 44 participants (34.1 %). Anxiety disorder had the highest current and lifetime prevalence (39.5 and 52.7 %, respectively). Participants with intellectual disability (n = 94, 72.8 %) were significantly less likely to have community-based diagnoses of anxiety (χ(2) = 5.37, p = 0.02) or depression (χ(2) = 13.18, p 0.001) reported by caregivers. Seventy-six participants (58.9 %) were taking ≥1 psychotropic medication. Comorbid psychiatric disorders occur frequently in adults with ASD, though identifying these disorders poses a challenge in community settings. A greater understanding of the presentation of these conditions within this population will increase assessment validity and the potential for efficacious intervention.

Klavikulaschaftfrakturen gehoren mit einer Inzidenz von 64/100.000 zu den haufigen Frakturen. Ende der 1990er Jahre wurde die elastisch-stabile intramedullare Schienung mit Prevot-Nageln beschrieben, die eine minimalinvasive Stabilisierung der Fraktur und damit eine sofortige Ubungsstabilitat und schnelle Belastbarkeit ermoglicht. Heute erfreut sich diese Technik wegen der fur die Patienten geringen Belastung und schneller Rekonvaleszenz groser Beliebtheit. Wurden fruher fast alle Frakturen konservativ therapiert, wird heute eine deutlich grosere Anzahl operativ behandelt. Bei groben Dislokationen und/oder Verkurzungen von uber 1,75 cm sollte bei 2- und 3-Fragment-Frakturen eine intramedullare Schienung erfolgen, da sie funktionell zu besseren Ergebnissen fuhrt, als die konservative Therapie. Wenn eine geschlossene Reposition nicht moglich ist, kann offen reponiert werden. Bei dislozierten mehrfragmentaren Frakturen und bei Pseudarthrosen ist die Plattenosteosynthese die Therapie der ersten Wahl.

Item does not contain fulltext OBJECTIVES: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. DESIGN: Web-based reliability study. SETTING: Independent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey. PARTICIPANTS: One hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns. MAIN OUTCOME MEASUREMENTS: Fleiss kappa (kappa) was used to assess the reliability of agreement between the surgeons. RESULTS: The overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, kappa = 0.54) with a 71% proportion of rater agreement (PA) and for the 9 groups (A1 to C3, kappa = 0.47) with a 57% PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), kappa = 0.79) was substantial and the agreement about a fractured body (Body (B), kappa = 0.57) or process was moderate (Process (P), kappa = 0.53); however, PAs were more than 81%. The agreement on the treatment recommendation was moderate (kappa = 0.57) with a 73% PA. CONCLUSIONS: The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions. 01 maart 2014