Kesiapan Petugas Puskesmas dalam Penanggulangan Infeksi Menular Seksual dan Hiv/aids pada Pelayanan Antenatal

Background: Prevalence HIV/AIDS among housewife has been increasing which was notice by higher cases of HIVpositive babies. An effective intervention effort in the health sector is to accelerate the decreasing of Maternal Mortality Rate (MMR) through integrated approach of reproductive health care and STD HIV/AIDS. One of reproductive health services was to prevention and treatment of STD-HIV/AIDS. When this program was integrated with antenatal care it will prevents transmission of HIV from mother to child. The program called Prevention Mother To Child Transmission or PMTCT. Recently in Indonesia program antenatal care has not yet optimally integrated with STD-HIV/AIDS service. The objectiive of this study was to know how far preparedness of health center personnel in prevention transmission of STD, HIV/AIDS integrated with antenatal care. Methods: This study was exploration research. Respondents of this study were personals of public health center that have task related to antenal care and prevention program of STD, HIV/AIDS. Locations of study were Surabaya Malang Blitar Tulungagung, Semarang, Surakarta, Denpasar and Batam. Dara collection was done by interviewed and Focus Group Discussion. Results: The result of the study revealed the unprepared-ness of PHC personnel in term of knowledge about reproductive health and skill in universal precaution practice in integrated program of prevention STD, HIV/AIDS and antenatal care. Lack of facilities and its supporting system including the laboratory equipment and reagents also make activities of this integrated program being obstacle. Health service program still conducted fragmented because there was no standard operational procedure (SOP) of integrated program of STD, HIV/AIDS prevention and antenatal care. It was suggested to conduct a comprehensive program of reproductive health by increasing health personnel knowledge and skill with training; arrange SOP of integrated program of STD, HIV/AIDS prevention and antenatal care. It also needs to complete the facility with laboratory equipment i.e. rapid test and drugs to support this integrated program

ARCH-COMP22 category report: Artificial intelligence and neural network control systems (AINNCS) for continuous and hybrid systems plants

This report presents the results of a friendly competition for formal verification of continuous and hybrid systems with artificial intelligence (AI) components. Specifically, machine learning (ML) components in cyber-physical systems (CPS), such as feedforward neural networks used as feedback controllers in closed-loop systems are considered, which is a class of systems classically known as intelligent control systems, or in more modern and specific terms, neural network control systems (NNCS). We more broadly refer to this category as AI and NNCS (AINNCS). The friendly competition took place as part of the workshop Applied Verification for Continuous and Hybrid Systems (ARCH) in 2022. In the fourth edition of this AINNCS category at ARCH-COMP, four tools have been applied to solve 10 different benchmark problems. There are two new participants: CORA and POLAR, and two previous participants: JuliaReach and NNV. The goal of this report is to be a snapshot of the current landscape of tools and the types of benchmarks for which these tools are suited. The results of this iteration significantly outperform those of any previous year, demonstrating the continuous advancement of this community in the past decade.</jats:p

Mixed connective tissue disease : state of the art on clinical practice guidelines

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Mixed connective tissue disease (MCTD) is a complex overlap disease with features of different autoimmune connective tissue diseases (CTDs) namely systemic sclerosis, poly/dermatomyositis and systemic lupus erythematous in patients with antibodies targeting the U1 small nuclear ribonucleoprotein particle. In this narrative review, we summarise the results of a systematic literature research which was performed as part of the European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases project, aimed at evaluating existing clinical practice guidelines (CPGs) or recommendations. Since no specific CPGs on MCTD were found, other CPGs developed for other CTDs were taken into consideration in order to discuss what can be applied to MCTD even if designed for other diseases. Three major objectives were proposed for the future development of CPGs: MCTD diagnosis (diagnostic criteria), MCTD initial and follow-up evaluations, MCTD treatment. Early diagnosis, epidemiological data, assessment of burden of disease and QOL aspects are among the unmet needs identified by patients.This publication was funded by the European Union’s Health Programme (2014-2020)info:eu-repo/semantics/publishedVersio

Treatment of active lupus nephritis with the novel immunosuppressant 15-deoxyspergualin: an open-label dose escalation study

Introduction: As the immunosuppressive potency of 15-deoxyspergualin (DSG) has been shown in the therapy of renal transplant rejection and Wegener's granulomatosis, the intention of this study was to evaluate the safety of DSG in the therapy of lupus nephritis (LN). Methods: Patients with histologically proven active LN after prior treatment with at least one immunosuppressant were treated with 0.5 mg/kg normal body weight/day DSG, injected subcutaneously for 14 days, followed by a break of one week. These cycles were repeated to a maximum of 9 times. Doses of oral corticosteroids were gradually reduced to 7.5 mg/day or lower by cycle 4. Response was measured according to a predefined decision pattern. The dose of DSG was adjusted depending on the efficacy and side effects. Results: 21 patients were included in this phase-I/II study. After the first DSG injection, one patient was excluded from the study due to renal failure. 5 patients dropped out due to adverse events or serious adverse events including fever, leukopenia, oral candidiasis, herpes zoster or pneumonia. 11/20 patients achieved partial (4) or complete responses (7), 8 were judged as treatment failures and one patient was not assessable. 12 patients completed all 9 cycles; in those patients, proteinuria decreased from 5.88g/day to 3.37g/day (P = 0.028), Selena-SLEDAI decreased from 17.6 to 11.7. In 13/20 patients, proteinuria decreased by at least 50%; in 7 patients to less than 1g/day. Conclusions: Although the number of patients was small, we could demonstrate that DSG provides a tolerably safe treatment for LN. The improvement in proteinuria encourages larger controlled trials

Technical developments for online bioprocess monitoring in continuously orbitally shaken microtiter plates

Shaken bioreactors are widespread in the field of biotechnology. Especially, microtiter plates are increasingly used as bioreactors in the early stages of process development. Microtiter plates allow for the investigation of numerous parallel experiments within a short period of time. Furthermore, microtiter plates offer economic advantages compared to larger systems due to reduced material consumption. When used as a bioreactor, microtiter plates are mostly used as bioreactor in combination with shakers with an orbital shaking movement. Due to the orbital shaking movement, the centrifugal force acts on the culture broth and leads to the formation of a rotating liquid sickle. In addition to mixing of the culture broth, the motion of the liquid also increases the gas-liquid exchange surface, which increases the supply of oxygen to microorganisms.However, the full potential of small-scale systems is only guaranteed if (online) monitoring for each bioreactor is available. BioLector technology, an optical monitoring system based on fluorescence and scattered light measurements, allows for the online monitoring of various process parameters such as biomass, NADH and flavin levels during cultivation in orbitally shaken microtiter plates. pH value and dissolved oxygen tension (DOT) are also important biotechnological process parameters. Unfortunately, these parameters cannot be determined directly by fluorescence measurements. Sensitive fluorescent dyes are available for both measurements; these dyes change their fluorescence behavior depending on the respective concentrations. In microtiter plates, these sensitive fluorescent dyes are commonly immobilized at the well bottom. These optical sensor spots are also called optodes. However, previous studies have found interferences between biogenic fluorescence and the fluorescent dyes, leading to erroneous results.In the present work, an alternative measurement system for DOT monitoring in orbitally shaken microtiter plates based on a fluorescent dye was established. The fluorescent dye chosen for DOT determination is excited with red light and emits light in the near-infrared region. With this technique, fluorescence lift time is used as a raw signal. The measurement is conducted outside of the biogenic fluorescence region to prevent interference. Another advantage is that the fluorescent dye is immobilized on nanoparticles, which can easily be added to the culture broth. Accordingly, the system can be used with any type of microtiter plate, as there is no dependence on microtiter plates equipped with optodes. Furthermore, it was shown that dispersed oxygen-sensitive nanoparticles do not influence the growth behavior of Gluconobacter oxydans, Hansenula polymorpha or Escherichia coli.In the present thesis, a BioLector device equipped with the above-mentioned alternative DOT measurement system was combined with the so-called µRAMOS technique. µRAMOS allows for the online determination of the oxygen transfer rate (OTR) in each well of a 48-well-microtiter plate. Because both techniques are based on optical measurement signals, a measuring cycle was developed to obtain interference-free measurements. For the first time, with this new device, multiple data can be collected simultaneously by means of a single experiment. In the past, the combination of elaborated parallel shake flask and microtiter plate experiments were required. By combining both techniques, it was also possible to calculate the volumetric oxygen transfer coefficient (kLa) during E. coli culture. The estimated kLa values are in excellent agreement with an empirical correlation found in the literature.Similar to the DOT, other important process parameters cannot be determined directly via fluorescence. For example, glucose and glycerol are often used as carbon sources in culture media. Unfortunately, these compounds are not fluorescent. No sensitive fluorescent dyes for these substances are commercially available so far. However, multi-wavelength (2D) fluorescence spectroscopy can be applied to determine such process parameters non-invasively. In multi-wavelength (2D) fluorescence spectroscopy, multiple excitation and emission spectra are acquired and combined to an excitation vs. emission matrix (multi-wavelength (2D) fluorescence spectrum). To evaluate the acquired multi-wavelength (2D) fluorescence spectra and great amount of associated data, chemometric methods such as the “Partial Least Squares” (PLS) regression must be applied. So far, this approach has been applied to stirred-tank reactors (with a working volume > 1 L) because the acquisition rates of common fluorescence spectrometers are too slow to monitor each well in microtiter plates. This was overcome by the integration of a “Charge Coupled Device” (CCD) detector-based spectrometer with a BioLector device, which allowed for simultaneous acquisition of the entire emission spectrum. To ensure reliable measurements, a resolution-resolved measurement was established. The usefulness of the new device for online monitoring of glucose, glycerol and acetate concentrations as well as the pH value over time was demonstrated in cultures of H. polymorpha and E. coli.In the present work, different monitoring techniques for small-scale culture systems are described. These techniques provide valuable process parameters that were not easily and reliably accessible beforehand. By means of these novel developed techniques, the user gains significant insight into the investigated cultures. Thus, the clear distinction between secondary screening programs and process development has become noticeably blurred