THE KNOWLEDGE AND ATTITUDES OF THE COMMUNITY IN SIBANGKAJA VILLAGE, BADUNG, REGARDING THE RABIES INCIDENT

Background: The challenges in overcoming the rabies epidemic include the public's lack of knowledge and attitudes regarding the control and first aid in dog bites. Sibangkaja is one of the villages in Badung Regency, which is an endemic area for rabies. Purpose: This study aimed to describe the knowledge, attitudes, and factors influencing the behavior of the residents of Sibangkaja Village, Badung, regarding rabies. Methods: This descriptive observational study was carried out using a cross-sectional design. The samples were 250 residents of Sibangkaja Village, taken by convenience sampling. Data were collected from February to March 2020 through interviews using the digital questionnaire. The variables were knowledge and community attitudes toward rabies vaccination in the village. Results: The results showed that the respondents' knowledge was good, but 34% did not know the symptoms of rabies. It was discovered that attitudes toward rabies prevention and management are significantly more in favor of vaccination than eliminating dogs. Furthermore, there is an association between knowledge and dog ownership on people's attitudes (p-value=0.01). Conclusion: Information and education about the symptoms of rabies is needed for residents to exercise caution and pay more attention to themselves and the surrounding dogs. Results: The results showed that the respondents' knowledge of rabies was good, but 34% of the people of Sibangkaja Village did not know the symptoms of rabies. Attitudes toward rabies prevention and management are largely in favor of vaccination than elimination of dogs. Conclusion: Information and education is needed regarding the symptoms of rabies so that residents are able to be careful and pay more attention to themselves and the dogs around them

A reactive transport model for geochemical mitigation of CO2 leaking into a confined aquifer

Long-term storage of anthropogenic CO2 in the subsurface generally assumes that caprock formations will serve as physical barriers to upward migration of CO2. However, as a precaution and to provide assurances to regulators and the public, monitoring is used detect any unexpected leakage from the storage reservoir. If a leak is found, the ability to rapidly deploy mitigation measures is needed. Here we use the TOUGHREACT code to develop a series of two-dimensional reactive transport simulations of the hydrogeochemical characteristics of a newly formed CO2 leak into an overlying aquifer. Using this model, we consider: (1) geochemical shifts in formation water indicative of a leak; (2) hydrodynamics of pumping wells in the vicinity of a leak; and (3) delivery of a sealant to a leak through an adjacent well bore.Our results demonstrate that characteristic shifts in pH and dissolved inorganic carbon can be detected in the aquifer prior to the breakthrough of supercritical CO2, and could offer a potential means of identifying small and newly formed leaks. Pumping water into the aquifer in the vicinity of the leak provides a hydrodynamic control that can temporarily mitigate the flux rate of CO2 and facilitate delivery of a sealant to the location of the caprock defect. Injection of a fluid-phase sealant through the pumping well is demonstrated by introduction of a silica-bearing alkaline flood, resulting in precipitation of amorphous silica in areas of neutral to acidic pH. Results show that a decrease in permeability of several orders of magnitude can be achieved with a high molar volume sealant, such that CO2 flux rate is decreased. However, individual simulation results are highly contingent upon both the properties of the sealant, the porosity-permeability relationship employed in the model, and the relative flux rates of CO2 and alkaline flood introduced into the aquifer. These conclusions highlight the need for both experimental data and controlled field tests to constrain modelling predictions

Deep sustained response to daratumumab monotherapy associated with T-cell expansion in triple refractory myeloma

Abstract Background Daratumumab, a human CD38 monoclonal antibody that has direct on-tumor and immunomodulatory mechanisms of action, demonstrated clinical benefit as monotherapy or in combination with established regimens in patients with multiple myeloma with one or more prior lines of therapy. Case presentation A male patient, who was 70 years of age at the time of diagnosis of multiple myeloma in 2011, relapsed after five lines of therapy, including autologous stem cell transplantation. The patient’s disease, which was considered high risk with a deletion of chromosome 17p, advanced quickly and was triple refractory 2 years after diagnosis leaving few treatment options. He was treated with daratumumab monotherapy in the SIRIUS clinical trial resulting in a stringent complete response and clearance of minimal residual disease. The duration of the patient’s clinical response is now over 3.5 years without relapse, compared with a median of 7.6 months for similarly treated patients. The patient’s immunophenotype revealed CD8+ T-cell expansion, clonal expansion of the T-cell receptor repertoire, and decreases in regulatory T cells during daratumumab therapy, suggesting a robust adaptive immune response. This immune response was still present 32 months into daratumumab therapy. Conclusions The results from this case report showed that a patient with advanced multiple myeloma, who had exhausted all treatment options with existing regimens, mounted an ongoing, deep, and durable response to daratumumab monotherapy. Further investigation of the immunologic profile provided additional patient-level evidence of an immunomodulatory mechanism of action of daratumumab. Trial registration ClinicalTrials.gov Identifier number NCT01985126. Submitted 22 July 201