Aetiology and pathogenesis of hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a chronic inflammatory disorder. Patients develop inflamed nodules and abscesses and, at later stages of disease, epithelialized tunnels and scars in skinfolds of axillary, inguinal, gluteal and perianal areas. Quality of life is affected due to severe pain, purulent secretion, restricted mobility and systemic involvement. Genetics and lifestyle factors including smoking and obesity contribute to the development of HS. These factors lead to microbiome alteration, subclinical inflammation around the terminal hair follicles, and infundibular hyperkeratosis, resulting in plugging and rupture of the follicles. Cell-damage-associated molecules and propagating bacteria trigger inflammation and lead to massive immune cell infiltration that clinically manifests as inflamed nodules and abscesses. The immune system plays a key role also in the progression and chronification of skin alterations. Innate proinflammatory cytokines (e.g. interleukin-1 beta and tumour necrosis factor-alpha), mediators of activated T helper (Th)1 and Th17 cells (e.g. interleukin-17 and interferon-gamma), and effector mechanisms of neutrophilic granulocytes, macrophages and plasma cells are involved. Simultaneously, skin lesions contain anti-inflammatory mediators (e.g. interleukin-10) and show limited activity of Th22 and regulatory T cells. The inflammatory vicious circle finally results in pain, purulence, tissue destruction and scarring. Chronic inflammation in patients with HS is also frequently detected in organs other than the skin, as indicated by their comorbidities. All these aspects represent a challenge for the development of therapeutic approaches, which are urgently needed for this debilitating disease. This scholarly review focuses on the causes and pathogenetic mechanisms of HS and the potential therapeutic value of this knowledge

Simulasi Sistem Proteksi Petir Eksternal dengan Metode Pembalik Muatan Menggunakan Matlab

Sistem proteksi petir merupakan suatu sistem yang sangat diperlukan pada saat ini, mengingat peralatan listrik semakin berkembang dengan pesat. Sistem ini melindungi kita serta peralatan listrik kita dari sambaran langsung. Di Indonesia sendiri sebagai kawasan dengan intensitas petir yang tinggi. Secara umum, sistem proteksi petir eksternal terdiri dari dua yaitu sistem proteksi Aktif dan sistem proteksi Pasif. Pada penelitian ini akan membahas tentang simulasi sistem proteksi petir dengan metode pembalik muatan dengan menggunakan prinsip kerja Op-Amp dalam MATLAB dimana dalam pengujiannya akan membandingkan dua buah finial dengan mengukur kuat medan listrik antara keduanya, dimana salah satu finial akan dipasang alat pembalik muatan, dan diberinya spark gap untuk proteksi peralatannya tersebut. Besar pengujian alat proteksi ini menggunakan tegangan impuls sampai 150 KV. Dalam pengujiannya hanya menggunakan parameter tegangan. Setelah diuji akan ada perbandingan dengan hasil perhitungan dan model sebelumnya

The Use Value of Medicinal Plant Species of Dawan (Amanatun) Community in Hoineno Village, South Central Timor District

This research aims to determine the use of plants in traditional medicine. This ethnobotany study is quantitative and descriptive and includes exploratory survey techniques and interviews. The research sample included 30 people who identified as shamans/healers or had expertise in medicinal herbs. In this study, quantitative descriptive analysis was employed to analyze the data. Indonesian names, local names, scientific names, family names, organs used, and their advantages are all recorded. Species Use Value is used to calculate the use value of a plant species (SUV). The Dawan community (Amanatun) used 42 species found in this study to cure 30 ailments divided into 13 disease categories. Based on the species use value (SUV) assessment, Dawan (Amanatun) has a pretty high confidence level in 13 of the 42 medicinal plant species identified. Zingiber officinale Rosc. has the highest use value (SUV of 0.97), whereas Milletia sericea (Vent.) has the lowest value (SUV of 0.03).ABSTRAK: Penelitian ini bertujuan untuk mengetahui pemanfaatan tanaman sebagai obat tradisional. Studi etnobotani dalam penelitian ini merupakan penelitian deskriptif kuantitatif dengan teknik survey ekploratif  dan wawancara. Sampel penelitian sebayak 30 orang yang tergolong dukun/tabib dan masyarakat yang memiliki pengetahuan  tentang tanaman obat. Analisis data yang digunakan dalam penelitian ini adalah analisis deskriptif kuantitatif. Data yang dicatat adalah nama indonesia, nama lokal, nama ilmiah, nama family, organ yang digunakan, dan manfaatnya. Menghitung nilai guna suatu spesies tanaman dengan menggunakan perhitungan Spesies Use Value (SUV). Sebanyak 42 spesies yang teridentifikasi dalam penelitian ini dimanfaatkan oleh masyarakat Dawan (Amanatun) untuk mengobati 30 jenis penyakit yang dikelompokan dalam 13 kategori penyakit. Berdasarkan hasil perhitungan nilai guna spesies (SUV) menunjukan bahwa dari 42 spesies tanaman obat yang teridentifikasi, masyarakat Dawan (Amantun) memiliki tingkat kepercayaan yang cukup tinggi pada 13 spesies. Nilai guna paling tinggi yaitu Zingiber officinale Rosc. (SUV sebesar 0,97), dan terendah yaitu Milletia sericea (Vent.) (SUV sebesar 0,03)

Patient-centred assessment and management of pain for older adults with dementia in care home and acute settings

Evidence suggests that there is a greater prevalence of pain, particularly chronic pain, in the older than in the younger population. This review looks at how dementia affects older people's ability to report pain, and indicates that pain is poorly assessed and managed in people living with dementia, in particular in care and acute settings. The review also reports findings from two recent studies looking at ways of improving the assessment and management of pain in acute settings. Multi-dimensional, patient-centred approaches to assessing and managing pain in those living with dementia are required, and future research should focus on innovative and practical approaches that can be applied in care home and acute settings

Living with a diagnosis of behavioural-variant frontotemporal dementia: The person’s experience.

YesResearch investigating behavioural-variant frontotemporal dementia has concentrated on identifying and quantifying people’s difficulties; yet few studies have considered how people with behavioural-variant frontotemporal dementia make sense of their difficulties. Five participants were interviewed and interpretive phenomenological analysis used to analyse the data. Two superordinate themes emerged: ‘Bewilderment’ and ‘Relationships with others’. ‘Bewilderment’ reflected the feelings of the participants from the start of their dementia, and was divided into two main themes (1) ‘Awareness of change: What’s the problem? and (2) Threats to self: This is not me. The superordinate theme, ‘Relationships with others’, reflected difficulties with social relationships and comprised two main themes (1) ‘Family and friends: Things haven’t changed… but do I say anything wrong?’ and (2) Coping with threats to self: Blame others or just avoid them. The themes were discussed in relation to literature evaluating the difficulties associated with behavioural-variant frontotemporal dementia together with implications for clinical practice

Carers’ responses to shifting identity in dementia in Iris and Away From Her: cultivating stability or embracing change?

An emphasis on supporting and maintaining self-identity in people who have dementia for as long as possible has gone hand in hand with the revitalisation of dementia interventions, services and empowerment. However, recognition of the need for change, adaptation and personal growth is as necessary when living with dementia as at any other time in people's lives. Those who care for people with dementia must constantly navigate this tension between continuity and change within the context of memory loss, knowing when to respond by reinforcing the ‘self’ they have known over time, and when it may be better to respond by acknowledging the changes that have taken place in that ‘self’. The creative arts are avenues for the exploration of the caring relationship under these conditions, conveying the challenges and stimulating audiences to ask how they themselves might choose to respond in a similar situation. This article considers how the scenarios of two noted films, Iris (dir. Richard Eyre, 2001 UK)) and Away From Her (dir. Sarah Polley, 2006 Can), present the dilemmas of identity and caring. In both, a husband cares for a wife experiencing cognitive decline, but responds differently in each to her shifting needs and experience of identity. We argue that the two films reveal complementary and provocative perspectives on this situation. They offer no easy answers, but provide insights into the everyday decisions characteristic of caring for someone who has dementia

Overview of molecular typing methods for outbreak detection and epidemiological surveillance

Typing methods for discriminating different bacterial isolates of the same species are essential epidemiological tools in infection prevention and control. Traditional typing systems based on phenotypes, such as serotype, biotype, phage-type, or antibiogram, have been used for many years. However, more recent methods that examine the relatedness of isolates at a molecular level have revolutionised our ability to differentiate among bacterial types and subtypes. Importantly, the development of molecular methods has provided new tools for enhanced surveillance and outbreak detection. This has resulted in better implementation of rational infection control programmes and efficient allocation of resources across Europe. The emergence of benchtop sequencers using next generation sequencing technology makes bacterial whole genome sequencing (WGS) feasible even in small research and clinical laboratories. WGS has already been used for the characterisation of bacterial isolates in several large outbreaks in Europe and, in the near future, is likely to replace currently used typing methodologies due to its ultimate resolution. However, WGS is still too laborious and time-consuming to obtain useful data in routine surveillance. Also, a largely unresolved question is how genome sequences must be examined for epidemiological characterisation. In the coming years, the lessons learnt from currently used molecular methods will allow us to condense the WGS data into epidemiologically useful information. On this basis, we have reviewed current and new molecular typing methods for outbreak detection and epidemiological surveillance of bacterial pathogens in clinical practice, aiming to give an overview of their specific advantages and disadvantages

Triple Oxygen Isotope Measurements (Δ\u27\u3csup\u3e17\u3c/sup\u3eO) of Body Water Reflect Water Intake, Metabolism, and δ\u3csup\u3e18\u3c/sup\u3eO of Ingested Water in Passerines

Understanding physiological traits and ecological conditions that influence a species reliance on metabolic water is critical to creating accurate physiological models that can assess their ability to adapt to environmental perturbations (e.g., drought) that impact water availability. However, relatively few studies have examined variation in the sources of water animals use to maintain water balance, and even fewer have focused on the role of metabolic water. A key reason is methodological limitations. Here, we applied a new method that measures the triple oxygen isotopic composition of a single blood sample to estimate the contribution of metabolic water to the body water pool of three passerine species. This approach relies on Δ\u2717O, defined as the residual from the tight linear correlation that naturally exists between δ17O and δ18O values. Importantly, Δ\u2717O is relatively insensitive to key fractionation processes, such as Rayleigh distillation in the water cycle that have hindered previous isotope-based assessments of animal water balance. We evaluated the effects of changes in metabolic rate and water intake on Δ\u2717O values of captive rufous-collared sparrows (Zonotrichia capensis) and two invertivorous passerine species in the genus Cinclodes from the field. As predicted, colder acclimation temperatures induced increases in metabolic rate, decreases in water intake, and increases in the contribution of metabolic water to the body water pool of Z. capensis, causing a consistent change in Δ\u2717O. Measurement of Δ\u2717O also provides an estimate of the δ18O composition of ingested pre-formed (drinking/food) water. Estimated δ18O values of drinking/food water for captive Z. capensis were ~ −11‰, which is consistent with that of tap water in Santiago, Chile. In contrast, δ18O values of drinking/food water ingested by wild-caught Cinclodeswere similar to that of seawater, which is consistent with their reliance on marine resources. Our results confirm the utility of this method for quantifying the relative contribution of metabolic versus pre-formed drinking/food water to the body water pool in birds

Rights in mind: Thinking differently about dementia and disability

The aim of this paper is to argue for the utility of a relational model of disability, as a way of conceptualizing dementia. We explore whether dementia should be considered as a disability, and whether people with dementia might consider themselves as disabled people. We review examples of, and issues raised by, the political activism of people with dementia. We consider how language constructs dementia negatively. We discuss how the environment influences the experience of dementia. In conclusion, we show that a relational model of dementia lays the basis for a human rights approach to the condition, based on collaborative partnerships between people with dementia and people from other disability communities