Outcome analysis of 71 clinical intestinal transplantations

Objective: The aim of the study was to determine risk factors associated with graft failure and mortality after transplantation of the intestine alone or as pad of an organ complex. Summary Background Data: Even with modern immunosuppressive therapies, clinical intestinal transplantation remains a difficult and unreliable procedure. Causes for this and solutions are needed. Methods: Between May 1990 and February 1995, 71 intestinal transplantations were performed in 66 patients using tacrolimus and low-dose steroids. The first 63 patients, all but one treated 1 to 5 years ago, received either isolated grafts (n = 22), liver and intestinal grafts (n = 30), or multivisceral grafts (n = 11). Three mere recipients of allografts who recently underwent surgery and one undergoing retransplantation were given unaltered donor bone marrow cells perioperatively as a biologic adjuvant. Results: Of the first 63 recipients, 32 are alive: 28 have functioning primary grafts and 4 have resumed total parenteral nutrition after graft enterectomy. Thirty-five primary grafts were lost to technical and management errors (n = 10), rejection (n = 6), and infection (n = 19). Regression analysis revealed that duration of surgery, positive donor cytomegalovirus (CMV) serology, inclusion of graft colon, OKT3 use, steroid recycle, and high tacrolimus blood levels contributed to graft loss. All four intestine and bone marrow recipients are alive for 2-3 months without evidence of graft- versus-host disease. Conclusion: To improve outcome after intestinal transplantation with previous management protocols, it will be necessary to avoid predictably difficult patients, CMV seropositive donors, and inclusion of the graft colon. Bone marrow transplantation may further improve outcome by ameliorating the biologic barriers of rejection and infection and allowing less restrictive selection criteria

Pendapatan dan Kerentanan Petani Kopi Robusta di Sekitar Kawasan Taman Nasional Bukit Barisan Selatan

Kopi robusta merupakan komoditas perkebunan yang memiliki potensi tinggi mengingat trend konsumsi dan produksi yang besar di beberapa provinsi di Indonesia salah satunya Provinsi Lampung, namun peningkatan produksi tersebut berdampak pada penggunaan lahan di kawasan hutan Taman Nasional Bukit Barisan Selatan Nasional (TNBBS) untuk kegiatan pertanian kopi, terlebih lagi pandemi yang melanda dunia membuat tantangan baru dalam bisnis pertanian kopi ini. Tujuan dari penelitian ini adalah menganalisis dan membandingkan tingkat pendapatan usaha tani kopi dan kerentanan keluarga petani kopi disebabkan pandemi Covid-19 di sekitar TNBBS, baik di dalam maupun di luar TNBBS. Analisis data menggunakan analisis pendapatan usaha tani dan analisis indeks kerentanan mata pencaharian (LVI). Hasil penelitian ini menunjukkan bahwa pendapatan petani di kawasan TNBBS lebih kecil yaitu Rp. 9.833.453,57 sedangkan di luar kawasan TNBBS sebesar Rp. 12.571.781,31, rasio R/C juga menunjukkan bahwa bertani di luar daerah adalah yang paling menguntungkan. Perbedaan jarak lahan petani dalam kawasan dan luar kawasan memberikan kontribusi besar terhadap perbedaan jumlah ini. Kerentanan keluarga petani di dalam TNBBS dan di luar TNBBS tergolong rendah hingga sedang baik dalam perhitungan LVI maupun LVI yang mempertimbangkan definisi IPCC. Strategi mata pencaharian dan jaringan sosial yang tidak memadai di beberapa rumah tangga petani berkontribusi pada angka LVI yang dihasilkan dari analisis.Coffee, the prominent plantation commodity in Indonesia, exhibits significant potential due to its substantial consumption and production trends. Alongside tea and spices (HS code 09), coffee accounted for 41.5 percent of Indonesia's total agricultural exports between 2016 and 2020. South Sumatra, Lampung, Aceh, and East Java serve as the primary coffee production regions in the country. However, this burgeoning industry has led to adverse effects on land conversion, particularly in Lampung province, where 60 percent of the forest area in Bukit Barisan Selatan National Park (TNBBS) has been converted for agricultural purposes, with 73 percent being utilized for Robusta coffee fields. Despite the promising outlook, the Covid-19 pandemic introduced new challenges to the coffee farming sector. This study aims to analyze and compare the income levels and vulnerability of coffee farming families inside and outside the TNBBS area during the pandemic. Primary data were collected through direct interviews, utilizing a non-probability sampling quota sampling method. The analysis includes farm income assessment with evaluation of poverty levels among farmer households and livelihood vulnerability index. Results indicate that coffee farmers outside the TNBBS area experience higher income and profits compared to their counterparts within TNBBS. Additionally, the poverty rate is higher for farmers within the TNBBS area. Vulnerability analysis reveals a medium-scale vulnerability level for farming families in both regions, emphasizing the necessity for targeted support to enhance their resilience

Detection and quantification of probiotic bacteria using optimized DNA extraction, traditional and real-time PCR methods in complex microbial communities

The aim of this study is to optimize molecular detection and quantification methods of probiotic bacteria in complex microbial communities that have long been difficult for traditional culture-based methods. Traditional and real-time PCR were optimized to detect and quantify Lactobacillus spp. and Bifidobacterium spp. in complex microbial community. Fish and shrimp sauce were used as a model for complex microbial community. Directly form samples, 4 DNA extraction methods, primers specificity, PCR, and real-time PCR procedures were optimized, tested in comparison with samples, enriched bacteria and related standard bacterial strains, E. coli, Bacteroides, Enterococcus and Salmonella. Results showed that extracted genomic DNA using Wizard® Genomic DNA Purification Kit showed the highest yield, quality and performance. Moreover, the specificity of the primer set specific for Lactobacillus spp. and Bifidobacterium spp. was checked and found highly specific. The sensitivity of real-time PCR was higher than the conventional PCR and its quantifying potential is very precise for the detection and quantification of Lactobacillus spp. but not Bifidobacterium spp. which was absent in the tested samples. In conclusion, PCR and real-time PCR assays could be used very efficiently in quantifying and detecting Lactobacillus spp. that are present in very PCR-suppressive and complex microbial environment

Religious Culture in the Plurality of Nations: Analysis of Values, Practices and Cultural Symbols in Islamic Religious Education

This article discusses something very interesting about religious culture in Islamic religious education. The form of developing religious culture or religious atmosphere in schools is a form of culture, necessitating development efforts at three levels, namely, the level of values adhered to, the level of daily practices and the level of cultural symbols (Koentjaraningrat, 1974). In this research, researchers used a qualitative approach. Using primary sources and secondary sources. Data collection uses documentary techniques, interviews, observation and literature. Analytical techniques using critical analysis and content analysis. The results of the research are religious culture in the plurality of nations which is implemented in schools, an attitude of tolerance, getting used to greetings, respecting each other's local languages, maintaining sportsmanship, not forcing one's will, discipline, justice, getting used to praying, reading the Koran before lessons start, getting used to cults, getting used to dhuha prayer, dhuhur prayer in congregation, dhikr after prayer, holding PHBI, providing assistance to orphans, halal bi halal events

Antibiotic susceptibility of Staphylococcus epidermidis among undergraduate students in Malaysia Public University Health Campus

Staphylococcus epidermidis (S. epidermidis) has become one of the major concerns in the hospital setting due to its ability to cause hospital-acquired infection particularly from medical device contamination. The management of S. epidermidis infections become more challenging with the increase of antimicrobial resistance cases over the past years. Limited reports on S. epidermidis antibiotic resistance among healthy people leave uncertainty about the magnitude of antimicrobial resistance spreads among the community. Therefore, this study aimed to identify the antibiotic susceptibility pattern of S. epidermidis isolated from healthy undergraduate students in one of Malaysia public universities-health campuses. Ninety-six hand palm swab samples were collected and undergo several tests, including microscopic, biochemical identification tests and antibiotic susceptibility test for erythromycin, oxacillin, gentamicin, penicillin and tetracycline following Kirby-Bauer test. A total of 43 samples showed the presence of S. epidermidis (44.8%), where 72.1% of the isolates showed resistance towards at least one type of antibiotic. The highest and lowest resistance was observed for penicillin and gentamycin, respectively. Although there is no significant difference of antibiotic susceptibility pattern was observed between genders, the presence of high antibiotic resistance in S. epidermidis among these healthy communities should warrant further investigation since the spreading of the resistant strain could occur in the wider community population without notice

Infusion of donor leukocytes to induce tolerance in organ allograft recipients

To further enhance chimerism, 229 primary allograft recipients have received perioperative intravenous infusion of a single dose of 3 to 6 x 108 unmodified donor bone marrow (BM) cells/kg body weight. In addition, 42 patients have been accrued in a concurrent protocol involving multiple (up to three) sequential perioperative infusions of 2 x 108 BM cells/kg/day from day 0-2 posttransplantation (PTx). Organ recipients (n = 133) for whom BM was not available were monitored as controls. The infusion of BM was safe and except for 50 (18%), all study patients have optimal graft function. Of the control patients, allografts in 30 (23%) have been lost during the course of follow-up. The cumulative risk of acute cellular rejection (ACR) was statistically lower in the study patients compared with that of controls. It is interesting that, 62% of BM-augmented heart recipients were free of ACR (Grade ≥ 3A) in the first 6 months PTx compared to controls. The incidence of obliterative bronchiolitis was also statistically lower in study lung recipients (3.8%) compared with the contemporaneously acquired controls (31%). The levels of donor cell chimerism were at least a log higher in the peripheral blood of majority of the study patients compared with that of controls. The incidence of donor-specific hyporeactivity, as determined by one-way mixed leukocyte reaction, was also higher in those BM-augmented liver, kidney, and lung recipients that could be evaluated compared to controls