A survey of the treatment and management of patients with severe chronic spontaneous urticaria.

Chronic spontaneous urticaria (CSU) is characterized by the recurrent appearance of weals, angio‐oedema or both, occurring at least twice weekly for longer than 6 weeks.1 It is often managed with antihistamines, but occasionally requires other systemic agents in recalcitrant cases. A cross‐sectional survey was conducted by means of an internet‐based survey tool (Typeform; https://www.typeform.com). Participating consultants with a specialist interest in urticaria were identified through the specialist registers of the British Society of Allergy and Clinical Immunology (BSACI), the Improving Quality in Allergy Services (IQAS) Group and the British Association of Dermatologists (BAD), and invited to take part. The survey content was based on current CSU treatment guidelines from EAACI/GA2LEN/EDF/WAO1 and the British Society for Allergy and Clinical Immunology (BSACI).2 The EAACI/GA2LEN/EDF/WAO guidelines are a joint initiative of the Dermatology Section of the European Academy of Allergy and Clinical Immunology (EAACI), the Global Allergy and Asthma European Network (GA2LEN) (a European Union‐funded network of excellence), the European Dermatology Forum (EDF), and the World Allergy Organization (WAO). To standardize responses, all participants were presented with a case of recalcitrant CSU (failed on maximum dose of nonsedating antihistamines and montelukast), requiring alternative systemic treatment. Questions covered usage of systemic treatments, routine disease severity assessments, adherence to treatment guidelines and perceived barriers to prescribing. Responses (Table 1) were received from 19 UK consultants (26 surveys sent; completion rate 73%), 15 of whom had > 10 years’ experience in the treatment of CSU. The majority were allergy (58%) and dermatology consultants (37%). Of the 19 consultants, 56% provide a dedicated urticaria service, 37% treat both adult and paediatric patients, and the majority (79%) use systemic medications other than antihistamines and montelukast. Omalizumab and ciclosporin were the most commonly used first‐line agents (47% and 27% respectively) (Fig. 1). The majority (84%) of consultants use validated measures to assess disease severity, including the weekly Urticaria Activity Score (UAS‐7, 63%), the Physician Global Assessment (63%), the Patient Global Assessment (44%) and the Dermatology Quality of Life Index (DLQI) (38%). Guidelines are used by 89% to direct their management of CSU, with 50% using the EAACI/GA2LEN/EDF/WAO guideline,1 compared with 31% primarily using the BSACI guideline.2 The main perceived barriers to prescribing systemic medications were potential adverse effects (AEs) (32% strongly agreed), potential long‐term toxicity (26% strongly agreed), cost of treatment (42% strongly agreed), and views expressed by the patient and their family (37% agreed)

ANALISIS STRATEGI PEMASARAN SPARE PART MOTOR PADA BENGKEL SENTRAL JAYA ENDE

The purpose of this research is to find out the marketing strategy of motor spare parts workshop at The Jaya Ende Central Workshop. By analyzing strength, weaknesses, opportunities and threats possessed by the Workshop. The type of research used is qualitative descriptive, analytical techniques data used are SWOT Matrix, SWOT Analysis Diagram, Internal Factor Analysis Strategy, as well as External Factor Analysis Strategy. The population researched is Bengkel Sentral Jaya Ende with a total of 10 employees, and the number of respondents taken as many as 10 people. From the calculation of the IFAS table strength is higher than weakness, as well as from efas table calculations the odds are smaller than the threat so the point is in quadrant IV. The results showed that the marketing strategy of motor spare parts at Bengkel Sentral Jaya Ende is a strategic location that can help marketing at the workshop, as well as the quality of goods and the quality of service make customers comfortable to buy spare part products at Bengkel Sentral Jaya Ende

Effectiveness of adjuvant photoactivated chromophore corneal collagen cross-linking versus standard antimicrobial treatment for infectious keratitis: a systematic review protocol

OBJECTIVE: The objective of this review is to systematically examine the effectiveness of adjuvant photoactivated chromophore for keratitis - corneal collagen cross-linking (PACK-CXL) versus standard antimicrobial treatment alone for corneal healing in patients with infectious keratitis. INTRODUCTION: Infectious keratitis is a major cause for corneal blindness globally. Broad-spectrum antimicrobial therapy is currently the standard treatment, but there is a growing need for alternative or adjuvant antimicrobial treatment, due to the emerging antimicrobial resistance, long treatment duration and cost of treatment. Photoactivated chromophore for keratitis - corneal collagen cross-linking has been increasingly used as an adjuvant treatment for infectious keratitis but high-quality evidence is limited. INCLUSION CRITERIA: This review will consider studies that include patients with infectious keratitis, encompassing bacterial, fungal, acanthamoeba, viral, mixed or culture-negative presumed infectious keratitis cases. Patients who have a previous history of infectious keratitis before the study or those that had less than seven days' follow-up from the start of the treatment will be excluded. METHODS: The electronic databases to be searched will include MEDLINE, Embase and Cochrane Central Register of Controlled Trials. Only English articles will be included. Titles, abstracts and full text of the relevant studies will be assessed by two independent reviewers. The extracted data will include specific details about the study, including authors and study title, year of publication, sample size, populations, and study methods. A meta-analysis will be performed for the included randomized controlled trials when there are sufficient similarities in the reporting of outcome measures. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019131290

Effectiveness and safety of early adjuvant amniotic membrane transplant versus standard antimicrobial treatment for infectious keratitis: a systematic review protocol

OBJECTIVE: The objective of this review is to systematically examine the effectiveness of early adjuvant amniotic membrane transplant versus standard antimicrobial therapy for infectious keratitis. INTRODUCTION: Infectious keratitis is a major cause of corneal blindness worldwide. Broad-spectrum topical antimicrobial therapy is currently the gold standard for treatment. Amniotic membrane transplant has been employed as an adjuvant therapy to promote corneal healing; however, high-quality evidence is limited. INCLUSION CRITERIA: This review will consider studies that include patients of all ages with all types of infectious keratitis, including bacterial, fungal, viral, acanthamoeba, mixed, and culture-negative presumed infectious keratitis. The authors will exclude patients who have undergone other types of primary surgery other than amniotic membrane transplant during the initial management and those who had less than seven days' follow-up from the commencement of the treatment. METHODS: Electronic databases, including MEDLINE, Embase, Cochrane CENTRAL, and relevant registries, will be searched for pertinent studies. Titles, abstract, and full text of the relevant studies will be independently assessed by two reviewers. Extracted data will include authors, year of publication, sample size, types of amniotic membrane transplant techniques, types of causative microorganisms, main outcomes, visual acuity, and adverse events. No restriction will be applied to the date or language. Bibliographies of the included articles will be independently and manually screened by two authors to identify further relevant studies. Eligible studies will be critically appraised by two independent reviewers for methodological quality. A meta-analysis will be performed for the included randomized controlled trials when there are sufficient similarities. SYSTEMATIC REVIEW REGISTRATION NUMBER: This systematic review has been registered with PROSPERO (CRD42020175593)

Amniotic membrane transplantation for infectious keratitis: a systematic review and meta-analysis

Infectious keratitis (IK) is the 5th leading cause of blindness globally. Broad-spectrum topical antimicrobial treatment is the current mainstay of treatment for IK, though adjuvant treatment or surgeries are often required in refractory cases of IK. This systematic review aimed to examine the effectiveness and safety of adjuvant amniotic membrane transplantation (AMT) for treating IK. Electronic databases, including MEDLINE, EMBASE and Cochrane Central, were searched for relevant articles. All clinical studies, including randomized controlled trials (RCTs), non-randomized controlled studies and case series (n > 5), were included. Primary outcome measure was time to complete corneal healing and secondary outcome measures included corrected-distance-visual-acuity (CDVA), uncorrected-distance-visual-acuity (UDVA), corneal vascularization and adverse events. A total of twenty-eight studies (including four RCTs) with 861 eyes were included. When compared to standard antimicrobial treatment alone, adjuvant AMT resulted in shorter mean time to complete corneal healing (- 4.08 days; 95% CI - 6.27 to - 1.88; p < 0.001) and better UDVA (- 0.26 logMAR; - 0.50 to - 0.02; p = 0.04) at 1 month follow-up in moderate-to-severe bacterial and fungal keratitis, with no significant difference in the risk of adverse events (risk ratio 0.80; 0.46-1.38; p = 0.42). One RCT demonstrated that adjuvant AMT resulted in better CDVA and less corneal vascularization at 6 months follow-up (both p < 0.001). None of the RCTs examined the use of adjuvant AMT in herpetic or Acanthamoeba keratitis, though the benefit was supported by a number of case series. In conclusion, AMT serves as a useful adjuvant therapy in improving corneal healing and visual outcome in bacterial and fungal keratitis (low-quality evidence). Further adequately powered, high-quality RCTs are required to ascertain its therapeutic potential, particularly for herpetic and Acanthamoeba keratitis. Future standardization of the core outcome set in IK-related trials would be invaluable

Neural Network Demodulation for an Optical Sensor

Methods and systems of neural network demodulation for an optical sensor. An optical sensor may be coupled to a structure and be capable of reflecting a reflected optical signal. A wavelength of the reflected optical signal may be spread based on a strain being applied to the structure. A replication device may receive the reflected optical signal from the optical sensor and produce a plurality of optical signals. A filter may be coupled to the replication device to receive an optical signal from the plurality of optical signals and filter the received optical signal. A detector may receive the filtered optical signal and provide a voltage output proportional to an amount of the filtered optical signal received. A neural network may receive the voltage output and determine the strain on the structure

Quantifying engineered nanomaterial toxicity: comparison of common cytotoxicity and gene expression measurements

BACKGROUND: When evaluating the toxicity of engineered nanomaterials (ENMS) it is important to use multiple bioassays based on different mechanisms of action. In this regard we evaluated the use of gene expression and common cytotoxicity measurements using as test materials, two selected nanoparticles with known differences in toxicity, 5 nm mercaptoundecanoic acid (MUA)-capped InP and CdSe quantum dots (QDs). We tested the effects of these QDs at concentrations ranging from 0.5 to 160 µg/mL on cultured normal human bronchial epithelial (NHBE) cells using four common cytotoxicity assays: the dichlorofluorescein assay for reactive oxygen species (ROS), the lactate dehydrogenase assay for membrane viability (LDH), the mitochondrial dehydrogenase assay for mitochondrial function, and the Comet assay for DNA strand breaks. RESULTS: The cytotoxicity assays showed similar trends when exposed to nanoparticles for 24 h at 80 µg/mL with a threefold increase in ROS with exposure to CdSe QDs compared to an insignificant change in ROS levels after exposure to InP QDs, a twofold increase in the LDH necrosis assay in NHBE cells with exposure to CdSe QDs compared to a 50% decrease for InP QDs, a 60% decrease in the mitochondrial function assay upon exposure to CdSe QDs compared to a minimal increase in the case of InP and significant DNA strand breaks after exposure to CdSe QDs compared to no significant DNA strand breaks with InP. High-throughput quantitative real-time polymerase chain reaction (qRT-PCR) data for cells exposed for 6 h at a concentration of 80 µg/mL were consistent with the cytotoxicity assays showing major differences in DNA damage, DNA repair and mitochondrial function gene regulatory responses to the CdSe and InP QDs. The BRCA2, CYP1A1, CYP1B1, CDK1, SFN and VEGFA genes were observed to be upregulated specifically from increased CdSe exposure and suggests their possible utility as biomarkers for toxicity. CONCLUSIONS: This study can serve as a model for comparing traditional cytotoxicity assays and gene expression measurements and to determine candidate biomarkers for assessing the biocompatibility of ENMs.1R01GM84702-01 - National Institute of General Medical Science

ANALISIS PENGARUH HUBUNGAN ANTAR MANUSIA,KONDISI FISIK LINGKUNGAN KERJA DAN BEBAN KERJA TERHADAP KINERJA KARYAWAN PADA PT. CHEETHAM GARAM INDONESIA DI KABUPATEN NAGEKEO

This study aims to determine the effect of human relationships, physical conditions of the work environment and workload on employee performance at PT. Indonesian salt cheetham in Nagekeo Regency. Types of causality research. The data analysis technique is multiple linear regression analysis. The research sample was 73 people. The sampling technique is random sampling. The results of the t-statistical test show that the relationship between humans, the physical condition of the work environment has an effect on employee performance, while the workload variable has no effect on employee performance. The results of the F test show that the variables X1, X2, X3 simultaneously affect Y

PENGARUH ORIENTASI KEWIRAUSAHAAN, INOVASI PRODUK, DAN KEUNGGULAN BERSAING TERHADAP KINERJA PEMASARAN PADA USAHA RUMAH MAKAN YANG TERDAFTAR DI DINAS PARIWISATA KOTA ENDE

This study aims to determine the effect of entrepreneurial orientation, product innovation and competitive advantage on marketing performance. Types of quantitative research. Sampling used simple random sampling, namely all restaurants in the city of Ende as many as 32 respondents. The data analysis technique is multiple linear regression analysis. The results of the t-test show that entrepreneurial orientation and product innovation have a positive and significant effect on marketing performance, while competitive advantage has no positive and significant effect on marketing performance. The results of the F test show that it simultaneously has a positive and significant effect on marketing performance. The results of the coordination test of determination showed that 65.4% was influenced by other factors

ANALISIS TINGKAT KESEHATAN BANK DENGAN MENGGUNAKAN METODE CAMEL PADA PT. BANK RAKYAT INDONESIA CABANG BAJAWA

The purpose of this study was to analyze to determine the soundness level of the bank using the CAMEL method at PT. Bajawa People's Bank. This research is quantitative descriptive. This research was conducted at PT. Bank Rakyat Indonesia, Bajawa Branch. The data collection techniques used were interviews and literature study. The data analysis technique is the CAMEL method (capital, assets, management, earnings and liquidity). The results of this study indicate that the level of health at Bank Rakyat Indonesia, Bajawa Branch, is 1) The soundness level of the bank in terms of capital cannot be calculated because the capital structure is presented on a consolidated basis. 2) The soundness level of the bank in the aspect of productive asset quality (KAP) PT. Bank Rakyat Indonesia, Bajawa Branch is included in the very healthy category with an average of 0.9828%. 3) The soundness level of the bank from the management aspect uses the net profit margin ratio at PT. Bank Rakyat Indonesia Bajawa Branch is included in the very healthy category with an average of 112.56%. 4) The soundness level of the bank in terms of profitability, both in the ROA and BOPO ratios, the results of the calculation of the ROA ratio for the last three years have fluctuated, so the ROA ratio is categorized in the healthy group with an average of 5.506%. The results of the calculation of the BOPO ratio are fluctuating from year to year. Then this ratio is categorized in the unhealthy group with an average of 373.64%. 5) The soundness level of the bank from the liquidity aspect of the ratio of the calculation of the loan to deposit ratio for three years, namely from year to year has increased. Then the results of the LDR calculation achieved by PT. Bank Rakyat Indonesia Bajawa Branch is categorized as unhealthy with an average of 132.65%