Rare Presentation of a Rare Orthopedic Pathology: Erdheim Chester Disease

In 1930, William Chester and pathologist Jakob Erdheim discovered the pathology currently known as Erdheim Chester disease. There are only approximately 249 histologically confirmed patients to have been diagnosed with this disease as noted in the medical literature. We describe a case report of an indolent form of Erdheim Chester Disease (ECD), in a patient in whom the disease has been present for approximately 14 years. Despite widespread sclerosis of long bones in the extremities, the patient has no complaints of peripheral bone pain. Although, the patient does have involvement of the jaw with subsequent loss of multiple teeth secondary to the facial manifestations of the disease. This is also the first patient have the disease incidentally discovered after an ACL injury, and the first ECD patient to receive an ACL reconstruction

An Orthopedic-, Surgical-, and Epidemiological-Based Investigation of Leprosy, in the Tamil Nadu State of India

No other research paper has ever been written about leprosy in this manner. The orthopedic and surgical implications, as well as the functional debility caused by the disease, have not been previously explained by past research as they have in such a comprehensive manner in this paper. The results of this study have regional and global implications as they pertain to disease pathology, risk factor recognition/disease prevention, and treatment. This paper is a unique, in that it also serves as a combination of a review of the current medical literature, as well as an epidemiological survey of the disease in a region of the world which has never been researched in the past. Clinical data points to the possibility of a new strain of the disease. This information is of significance because it effects prevention and improved treatment of the disease, which leads to devastating sequela. This was a cross-sectional study involving subjects diagnosed with leprosy in the Chengalpet region of the Kancheepuram District, of the Tamil Nadu state of India. The study was performed at the Tamil Nadu Medical College Teaching Hospital and Research Center. This study included various physical examinations, observation and survey of lesions, questionnaires in regard the debilitating orthopedic and medical effects of the disease, as well as treatment options

Encapsulation in an alginate–goats’ milk–inulin matrix improves survival of probiotic Bifidobacterium in simulated gastrointestinal conditions and goats’ milk yoghurt

In this work, a new encapsulating matrix, alginate–goats’ milk–inulin, was used to encapsulate Bifidobacterium animalis subsp. lactis BB‐12. The addition of inulin resulted in capsules with a compact structure, and a higher probiotic cell count under simulated gastrointestinal conditions and in probiotic goats’ milk yoghurt during refrigerated storage. Encapsulation of the probiotic bacteria led to slower post‐acidification yoghurts. The results of this study showed that the alginate–goats’ milk–inulin matrix has potential to be used as a new encapsulation material to encapsulate probiotics for use in goats’ milk‐based probiotic fermented dairy products, avoiding the cross‐contamination caused by using capsules based on cows’ milk

A Case Report and Review of the Literature of Adult Gastric Duplication Cyst

Gastrointestinal (GI) duplication cysts are a rare congenital disease. They may involve any level of the alimentary tract, but they most commonly involve the ileum, esophagus, and jejunum. Gastric duplication cysts represent approximately 4–8% of GI duplication cysts, the majority of which present in early childhood. We present a rare case of adult gastric duplication cyst in a 25-year-old female found to have abdominal mass on computed tomography imaging. There are several potential methods to diagnose gastric duplication cyst and treatment of choice is complete surgical resection

ANALISIS KENAKALAN REMAJA TERHADAP PRESTASI BELAJAR SISWA KELAS X SMA N 1 GUNUNG SITOLI

Penelitian ini bertujuan untuk mendeskripsikan kerentanan masa remaja pada hal negatif. Remaja merupakan tahapan dimana individu mencari jati dirinya dan mengidentikkan kepada banyak orang. Sikap ingin dihargai adalah hal yang sangat penting bagi remaja. Dalam tahapan pertumbuhan, remaja berada pada kondisi sangat labil, baik secara fisik maupun psikis. Remaja ingin melakukan banyak hal, baik itu positif maupun negatif. Sebagai perlakuan positif, remaja sering kali menunjukkan eksistensinya melalui organisasi, pertunjukan, dan hal-hal lain yang bisa dicapai. Sedangkan bentuk negatifnya, remaja melakukan hal-hal yang tidak terpuji contoh mabuk-mabukan, berbohong, tidak mau ke sekolah atau bolos saat jam pembelajaran. Oleh karena semua perlakuan remaja ini, maka semua aktivitasnya sangat perlu diperhatikan. Orang dewasa menjadi tiang penyokong bagi mereka supaya tidak terjerumus kepada hal-hal yang negatif yang merusak masa depan mereka

Feasibility and Effectiveness of a Peer Referral Incentive Intervention to Promote Male Circumcision Uptake in Zambia

Medical male circumcision is a promising HIV prevention tool in countries with generalized HIV epidemics, but demand creation interventions are needed to support scale-up. We piloted a peer referral intervention in which circumcision clients were offered incentives for referring their peers for circumcision

Developing a framework for understanding policy decision-making behaviors in the transition of an HIV prevention program towards sustainability: a case study from Zambia’s voluntary medical male circumcision program [version 2; peer review: 1 approved, 2 approved with reservations]

Faced with declining donor funding for HIV, low- and middle-income countries must identify efficient and cost-effective ways to integrate HIV prevention programs into public health systems for long-term sustainability. In Zambia, donor support to the voluntary medical male circumcision (VMMC) program, which previously funded non-governmental organizations as implementing partners, is increasingly being directed through government structures instead. We developed a framework to understand how the behaviors of individual decision-makers within the government could be barriers to this transition. We interviewed key stakeholders from the national, provincial, and district levels of the Ministry of Health, and from donors and partners funding and implementing Zambia’s VMMC program, exploring the decisions required to attain a sustainable VMMC program and the behavioral dynamics involved at personal and institutional levels. Using pattern identification and theme matching to analyze the content of the responses, we derived three core decision-making phases in the transition to a sustainable VMMC program: 1) developing an alternative funding strategy, 2) developing a policy for early-infant (0–2 months) and early-adolescent (15–17 years) male circumcision, which is crucial to sustainable HIV prevention; and 3) identifying integrated and efficient implementation models. We formulated a framework showing how, in each phase, a range of behavioral dynamics can form barriers that hinder effective decision-making among stakeholders at the same level (e.g., national ministries and donors) or across levels (e.g., national, provincial and district). Our research methodology and the resulting framework offer a systematic approach for in-depth investigations into organizational decision-making in public health programs, as well as development programs beyond VMMC and HIV prevention. It provides the insights necessary to map organizational development and policy-making transition plans to sustainability, by explaining tangible factors such as organizational processes and systems, as well as intangibles such as the behaviors of policymakers and institutional actors

ONTOLOGY IN DIALOGUE

In its first section the volume contains contributions dealing with the debate between the German philosopher Markus Gabriel and some scholars in Palermo who discussed the fundaments of his ontology. In the next sections are gathered essays on critical ontology in the modern age, essays on intersubjectivity in social ontology and on ontology of arts and aesthetics