Trauma Rehabilitation of Traumatic Brain Injury: A Physical Therapy Perspective in the Management of Muscular Complications, Heterotopic Ossification, and Skin Breakdown

Traumatic brain injury (TBI) is any combination of focal and/or diffuse central nervous system dysfunction, both immediate and delayed, at the brainstem level and above. The dysfunctions, which, are not developmental or degenerative, are due to the interaction of any external forces and the body, violent movements of the body, infection, toxicity, surgery, and non-age related vascular disorders. In the United States, TBI has reached epidemic proportions and is the leading killer and cause of disability in children and young adults. The TBI survival rate is increasing due to life-saving technology. Survivors will face extensive rehabilitation services, which have been proven more beneficial if begun in the trauma center or Intensive Care Unit (ICU). Physical therapists in newly accredited level I or II trauma centers may be unfamiliar with trauma rehabilitation management of the TBI survivor. The purpose of this study is to review the literature regarding the incorporation of physical therapy into the trauma rehabilitation of patients with TBI to affect the specific secondary complications following injury including: neurologically imposed muscular changes, heterotopic ossification, and skin breakdown. Trauma rehabilitation will be discussed and examples of techniques will be explored. Injury severity and outcome measures will also be briefly discussed. The information resulting from this study will aid physical therapists in the competent, efficient, and effective trauma rehabilitation of patients with TBI

Saint John of Damascus, ‘Dialogue between a Saracen and a Christian’

El presente trabajo ofrece el texto griego del Dialogo de un Sarraceno y un cristiano con una traducción española. En la introducción tratamos de los autores posibles, los contenidos y los principales asuntos en discusión en el seno del Islam, así como generalidades sobre el género literario y el griego del escrito. Por último se ensaya una posible explicación del desorden temporal (que oscila sin aparente sentido entre el aoristo y el presente), partiendo de la moderna teoría lingüística conocida como teoría de la perfectividad.The aim of this paper is to provide the Greek text of the Dialogue of a Saracen and a Christian, with its Spanish translation. In the introduction the most likely authors, the contents of the text and the main issues under discussion with the Islam are analyzed, as well as an overview of the literary genre and the Greek language of the text. Finally, a possible explanation of the timeframe disorder (with no apparent sense between the aorist and present) is attempted from the modern linguistic theory known as theory of perfectivity

Identifying prospective inhibitors against LdtMt5 from Mycobacterium tuberculosis as a potential drug target.

Masters Degree. University of KwaZulu-Natal, Durban.Tuberculosis (TB) caused by the bacterium, Mycobacterium tuberculosis (M.tb) has resulted in an unprecedented number of deaths over centuries. L,D-transpeptidase enzymes are known to play a crucial role in the biosynthesis of the cell wall, which confers resistance to most antibiotics. These enzymes catalyze the 3→3 peptidoglycan cross-links of the M.tb cell wall. Specific β-lactam antibiotics (carbapenems) have been reported to inhibit cell wall polymerization of M.tb and they inactivate L,D-transpeptidases through acylation. L,Dtranspeptidase 5 (LdtMt5) is a unique paralog and a vital protein in maintaining integrity of the cell wall specifically in peptidoglycan metabolism therefore making it an important protein target. Carbapenems inhibit LdtMt2, but do not show reasonable inhibitory activities against LdtMt5. We therefore sought to perform virtual screening in order to acquire potential inhibitors against LdtMt5 and to investigate the affinity and to calculate the binding free energies between LdtMt5 and potential inhibitors. Furthermore, we sought to investigate the nature of the transition state involved in the catalytic reaction mechanism; to determine the activation free energies of the mechanism using ONIOM through the thermodynamics and energetics of the reaction path and lastly to express, purify and perform inhibition studies on LdtMt5. A total of 12766 compounds were computationally screened from the ZINC database to identify potential leads against LdtMt5. Docking was performed using two different software programs. Molecular dynamics (MD) simulations were subsequently performed on compounds obtained through virtual screening. Density functional theory (DFT) calculations were then carried out to understand the catalytic mechanism of LdtMt5 with respect to β-lactam derivatives using a hybrid ONIOM quantum mechanics/molecular mechanics (QM/MM) method. LdtMt5 complexes with six selected β-lactam compounds were evaluated. Finally, a lyophilised pET28a-LdtMt5 was used to transform E. coli strain BL21 (DE3) and SDS-PAGE was used to verify the purity, molecular weight and protein profile determination. Finally, an in vitro binding thermodynamics analysis using isothermal titration calorimetry (ITC) was later on performed on a single compound (the strongest binder) from the final set, in a bid to further validate the calculated binding energy values. A number of compounds from four different antimicrobial classes (n = 98) were obtained from the virtual screening and those with docking scores ranging from -7.2 to -9.9 kcal mol-1 were considered for MD analysis (n = 37). A final set of 10 compounds which exhibited the greatest affinity, from four antibiotic classes was selected and Molecular Mechanics/Generalized Born iii Surface Area (MM-GBSA) binding free energies (ΔGbind) from the set were characterised. The calculated binding free energies ranged from -30.68 to -48.52 kcal mol-1 . The β-lactam class of compounds demonstrated the highest ΔGbind and also the greatest number of potential inhibitors. The DFT activation energies (∆G # ) obtained for the acylation of LdtMt5 by the six selected β-lactams were calculated as 13.67, 20.90, 22.88, 24.29, 27.86 and 28.26 kcal mol-1 . The ∆G# results from the 6-membered ring transition state (TS) revealed that all selected six βlactams were thermodynamically more favourable than previously calculated activation energy values for imipenem and meropenem complexed with LdtMt5. The results are also comparable to those observed for LdtMt2, however for compound 1 the values are considerably lower than those obtained for meropenem and imipenem in complex with LdtMt2, thus suggesting in theory that compound 1 is a more potent inhibitor of LdtMt5. We also report the successful expression and and purification of LdtMt5, however the molecule selected for the in vitro inhibition study gave a poor result. On further review, we concluded that the main cause of this outcome was due to the relatively low insolubility of the compound. The outcome of this study provides insight into the design of potential novel leads for LdtMt5. Our screening obtained ten novel compounds from four different antimicrobial classes. We suggest that further in vitro binding thermodynamics analysis of the novel compounds from the four classes, including the carbapenems be performed to evaluate inhibition of these compounds on LdtMt5. If the experimental observations suggest binding affinity to the protein, catalytic mechanistic studies can be undertaken. These results will also be used to verify or modify our computational model

Tele Oncology for Cancer Care in Rural Australia

Rural cancer patients in Australia and other countries with significant rural populations face difficulties with accessing various sub specialist services mainly because of shortage of health care work force and long travel distances to access these services (Underhill et al, 2009). Partly as a result, their survival is lower than their urban counterparts (Campbell et al, 2001; Australian Institute of Health and Welfare, 2010; Sabesan and Piliouras, 2009). To improve equity of access and quality of life, clinics and treatment centres should be located closer to homes in rural towns. Currently, there are several models of care exist to address some of the issues as follows (Underhill et al, 2009): (1) medical oncologists travel to larger rural towns and chemotherapy is administered there. Frequency of these visits range between weekly to three monthly intervals; (2) patients travel to larger centres for consultation and return to their home towns to receive their chemotherapy; (3) patient’s travel to major towns to see the specialists and to receive chemotherapy. These models are often inadequate, expensive and cause problems for patients, specialists as well as rural doctors who would ultimately care for these patients

Disparity in cancer survival between urban and rural patients--how can clinicians help reduce it?

Many reasons for the disparity in survival of 5-7% between rural and urban cancer patients relate to government policies and funding issues. However rural healthcare workers, particularly medical practitioners, can make an impact on reducing this disparity with attention to factors such as reducing referral processing time, using telemedicine, and ensuring ongoing education of rural patients regarding risk factors and screening programs, among other strategies

Access to Clinical Trials Closer to Home Using Tele-health

The purpose of this chapter is to outline key considerations for increasing access to clinical trials for people with cancer living in rural and remote locations, and outline the contribution of tele-health models to facilitate study activity across rural and remote locations. Regional and rural group of the Clinical Oncology Society of Australia (COSA), the peak multidisciplinary cancer clinician body in Australia, has developed the Australasian Teletrial Model in collaboration with its stakeholders to improve rural access to clinical trials. Benefits of this model are not limited to regional, rural and remote systems. This model has the potential to connect larger centres even within the same city and improve the rate of recruitment of highly specialised clinical trials, including rare cancer trials. This model has been developed in consideration of the requirements for the proper conduct of clinical trials ensuring the protection of the rights and safety of trial participants and quality data for the demonstration of safe and efficacious cancer treatments. Ethical and safe conduct of clinical trials using this model requires that the following aspects are considered and addressed by implementation plans

Efektivitas Penyaluran Dana Zakat Untuk Pendidikan Melalui Program Beasiswa Berkah Pada Lembaga Amil Zakat Dana Peduli umat (LAZ DPU) Kota Samarinda

Penelitian ini bertujuan untuk mengetahui mekanisme penyaluran beasiswa berkah dan Efektivitas penyaluran program beasiswa berkah di LAZ DPU. Penelitian ini menggunakan teknik penelitian kualitatif dengan jenis penelitian deskriptif, teknik pengumpulan data yang digunakan adalah wawancara, dokumentasi dan studi kepustakaan. Hasil penelitian ini menunjukkan bahwa LAZ DPU kota Samarinda telah berhasil dalam menyalurkan dana zakat untuk pendidikan melalui program beasiswa berkah, mekanisme penyaluran dana zakat yang telah berjalan hingga saat ini dapat dikatan baik dengan setiap tahapannya yang terstruktur. Sedangkan efektivitas penyaluran  program beasiswa berkah, untuk indikator efektivitas yaitu sasaran program dan tujuan program cukup efektif karena sasaran dan tujuan program beasiswa berkah telah tercapai, sedangkan untuk indikator sosialisasi program dan pemantauan program kurang efektif karena sosialisasi yang dilaukan hanya secara umum dan pemantaun yang dilaukakan belum fokus kepada perkembangan pendidikan anak tersebu

Impediments to learning the English language in Nigerian education: A philosophical discourse

The English Language plays many important roles in Nigeria in respect of its social, professional, and educational life. It dominates the everyday life of an educated Nigerian. It is the medium of instruction especially from the fourth year of primary education to tertiary education. It is taught and learnt as a second language because of the central position it occupies. Unfortunately, however, learning the language is fraught with impediments which largely include the inherent inconsistencies or irregularities in some aspects of the language, colloquialisms and slang, language transfer, inadequate learning facilities, and unqualified teachers. If appropriate measures are put in place, learners of English can go a long way towards achieving communicative competence, which is the goal of learning English as a second language. Keywords: Second language, impediments, inconsistencies, language transfer

Telemedicine platforms must be leveraged to strengthen rural health systems

[Extract] Telemedicine is a technology that has come of age, now it must be put to use to address inequities in cancer care. The principles and applications of telemedicine have undergone rapid evolution over the last two years globally.1, 2 Prior to the COVID-19 pandemic, the utilisation of telemedicine was largely driven by local champions and lacked systematic uptake despite Government investment and incentives at both state and commonwealth levels. The pandemic and the resulting need for social distancing saw rapid and widespread adoption of telephone and telehealth services aided by Government funding, even for patients in metropolitan areas. Now is the time to leverage this momentum to embed telemedicine in our health systems

ANALISIS BENTUK SOAL LATIHAN BAHASA PRANCIS PADA LAMAN WWW.FRANCAISFACILE.COM TINGKAT A1

This research discusses the form of French practice questions for A1 level on the www.francaisfacile.com page. The purpose of this research are: (1) to discover the forms of exercices questions in the page Www.francaisfacile.com; and (2) to analyze the suitability of the form of French exercices questions in the page with the study material of courses Production Orale I, Production Écrite I, Compréhension Orale I, Compréhension Écrite I, and Grammaire I in the Semester Learning Plans (RPS) French Department of Education. This research used a qualitative approach with descriptive analysis methods. Data collection techniques used in this research are literature study and document analysis by classifying the excercices questions on the page based on their shape according to Tagliante's theory (2005) and the suitability with the objectives of the course in the Semester Learning Plan (RPS) of the Department of French Language Education. The population in this research is a form of practice questions in the page www.francaisfacile.com level A1, and the sample of this study is a form of French practice questions in the page www.francaisfacile.com level A1 in accordance with the RPS of the Department of French Language Education. The results show that there are 35 questions on the page that match the RPS in various forms. The form of questions contained on the page include: (1) multiple choice questions with one correct answer; (2) a matter of equipping; (3) matching questions; and (4) short stuffing questions. There are 14 questions of the form of multiple choice questions with one correct answer dominates. Not all the study materials found in the French Department of Education's RPS are also on the page so that not all A1 level questions on the page are appropriate.;---Penelitian ini membahas bentuk soal latihan bahasa Prancis pada laman www.francaisfacile.com tingkat A1. Penelitian ini bertujuan untuk mendeskripsikan bentuk soal latihan bahasa Prancis pada laman www.francaisfacile.com dan memperoleh data mendeskripsikan kesesuaian bentuk soal latihan bahasa Prancis pada laman www.francaisfacile.com dengan tujuan mata kuliah Production Orale I, Production Écrite I, Compréhension Orale I, Compréhension Écrite I, dan Grammaire I dalam Rencana Pembelajaran Semester (RPS) Departemen Pendidikan Bahasa Prancis. Penelitian ini menggunakan pendekatan kualitatif dengan metode analisis deskriptif. Teknik pengumpulan data dilakukan melalui studi pustaka dan analisis dokumen dengan mengklasifikasikan soal-soal latihan bahasa Prancis pada laman tersebut berdasarkan bentuknya menurut teori Tagliante (2005) dan kesesuaiannya dengan bahan kajian mata kuliah dalam Rencana Pembelajaran Semester (RPS) Departemen Pendidikan Bahasa Prancis. Ada pun populasi dalam penelitian ini yaitu seluruh bentuk soal latihan bahasa Prancis tingkat A1 yang terdapat pada laman www.francaisfacile.com, dan sampel penelitian ini yakni seluruh bentuk soal latihan bahasa Prancis tingkat A1 pada laman www.francaisfacile.com yang sesuai dengan RPS Departemen Pendidikan Bahasa Prancis. Hasil penelitian menunjukkan bahwa terdapat 35 soal pada laman tersebut yang sesuai dengan RPS dalam bentuk yang bervariasi. Bentuk soal yang terdapat pada laman tersebut di antaranya: (1) soal pilihan ganda dengan satu jawaban benar; (2) soal melengkapi; (3) soal menjodohkan dan (4) soal isian singkat. Bentuk soal pilihan ganda dengan satu jawaban benar mendominasi sebanyak 14 soal. Tidak semua bahan kajian yang terdapat pada RPS Departemen Pendidikan Bahasa Prancis terdapat juga pada laman tersebut sehingga tidak semua soal tingkat A1 pada laman tersebut sesuai