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

Upgrading the field-imaging far-infrared line spectrometer for the Stratospheric Observatory for Infrared Astronomy (SOFIA) with KIDs: enabling large sample (extragalactic) surveys

We present the initial design, performance improvements and science opportunities for an upgrade to the Field-Imaging Far-Infrared Line Spectrometer (FIFI-LS). FIFI-LS efficiently measures fine structure cooling lines, delivering critical constraints of the interstellar medium and starforming environments. SOFIA provides the only FIR observational capability in the world, making FIFI-LS a workhorse for FIR lines, combining optimal spectral resolution and a wide velocity range. Its continuous coverage from 51-203 microns makes FIFI-LS a versatile tool to investigate a multitude of diagnostic lines within our galaxy and in extragalactic environments. The sensitivity and field-of-view (FOV) of FIFI-LS are limited by its 90s-era photoconductor arrays. These limits can be overcome by upgrading the instrument using the latest developments in Kinetic Inductance Detectors (KIDs). KIDs provide sensitivity gains in excess of 1.4 and allow larger arrays, enabling an increase in pixel count by an order of magnitude. This increase allows a wider FOV and instantaneous velocity coverage. The upgrade provides gains in point source observation speed by a factor <2 and in mapping speed by a factor <3.5, enabled by the improved sensitivity and pixel count. This upgrade has been proposed to NASA in response to the 2018 SOFIA Next Generation Instrumentation call

Discrepancy between German S3 Guideline Recommendations and Daily Urologic Practice in the Management of Nonmuscle Invasive Bladder Cancer: Results of a Binational Survey

Introduction: Guideline recommendations are meant to help minimize morbidity and to improve the care of nonmuscle invasive bladder cancer (NMIBC) patients but studies have suggested an underuse of guideline-recommended care. The aim of this study was to evaluate the level of adherence of German and Austrian urologists to German guideline recommendations. Methods: A survey of 27 items evaluating diagnostic and therapeutic recommendations (15 cases of strong consensus and 6 cases of consensus) for NMIBC was administered among 14 urologic training courses. Survey construction and realization followed the checklist for reporting results of internet e-surveys and was approved by an internal review board. Results: Between January 2018 and June 2019, a total of 307 urologists responded to the questionnaire, with a mean response rate of 71%. The data showed a weak role of urine cytology (54%) for initial diagnostics although it is strongly recommended by the guideline. The most frequently used supporting diagnostic tool during transurethral resection of the bladder was hexaminolevulinate (95%). Contrary to the guideline recommendation, 38% of the participants performed a second resection in the case of pTa low-grade NMIBC. Correct monitoring of Bacille Calmette-Guerin (BCG) response with cystoscopy and cytology was performed by only 34% of the urologists. Conclusions: We found a discrepancy between certain guideline recommendations and daily routine practice concerning the use of urine cytology for initial diagnostics, instillation therapy with a low monitoring rate of BCG response, and follow-up care with unnecessary second resection after pTa low-grade NMIBC in particular. Our survey showed a moderate overall adherence rate of 73%. These results demonstrate the need for sharpening awareness of German guideline recommendations by promoting more intense education of urologists to optimize NMIBC care thus decreasing morbidity and mortality rates

SOFIA Observations of Far-IR Fine-structure Lines in Galaxies to Measure Metallicity

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.We present new and archival SOFIA FIFI-LS far-IR spectroscopic observations of the [O iii] 52 μm and/or the [N iii] 57 μm lines of 25 local galaxies. Including 31 other galaxies from Herschel-PACS, we discuss a local sample of 47 galaxies, including the H ii galaxies, luminous IR galaxies, low-metallicity dwarfs, and Seyfert nuclei. Analyzing the mid- to far-IR fine-structure lines of this sample, we assess the metallicity and compare it with the optical spectroscopy estimates. Using the IR, we find an O/H–N/O relation similar to that known in the optical. Conversely, we find systematically lower N/O IR abundances when compared to the optical determinations, especially at high values of N/O ($\mathrm{log}({\rm{N}}/{\rm{O}})\gt$ −0.8). We explore various hypotheses to account for this difference: (i) difference in ionization structure traced by optical (O+, N+ regions) versus IR lines (O2+, N2+ regions), (ii) contamination of diffuse ionized gas affecting the optical lines used to compute the N/O abundance, and (iii) dust obscuration affecting the optical-based determinations. However, we have not found any correlation of${\rm{\Delta }}{({\rm{N}}/{\rm{O}})={({\rm{N}}/{\rm{O}})}_{\mathrm{OPT}}-({\rm{N}}/{\rm{O}})}_{\mathrm{IR}}$ with ionization, or electron density, or optical extinction. We speculatively suggest that the accretion of metal-poor gas from the circumgalactic medium could provide an explanation for this difference because the rapid decrease of total abundances during infall is followed by a N/O ratio decrease due to the primary production of young—possibly embedded—massive stars, which are preferentially traced by the IR diagnostics, while optical diagnostics would better trace the secondary production, when both N/O and O/H abundance ratios increase. © 2022. The Author(s). Published by the American Astronomical Society.This work is based on observations made with the NASA/DLR Stratospheric Observatory for Infrared Astronomy (SOFIA). SOFIA is jointly operated by the Universities Space Research Association, Inc. (USRA), under NASA contract NNA17BF53C, and the Deutsches SOFIA Institut (DSI) under DLR contract 50 OK 0901 to the University of Stuttgart. We thank the anonymous referee, who helped to improve this paper. J.A.F.O. and L.S. acknowledge financial support by the Agenzia Spaziale Italiana (ASI) under research contract 2018-31-HH0. J.A.F.O. acknowledges financial support from the Spanish Ministry of Science and Innovation and the European Union—NextGenerationEU through the Recovery and Resilience Facility project ICTS-MRR-2021-03-CEFCA. M.P.S. acknowledges support from the Comunidad de Madrid through the Atracción de Talento Investigador grant 2018-T1/TIC-11035 and PID2019-105423GA-I00 (MCIU/AEI/FEDER, UE). We acknowledge financial support from the NASA/SOFIA grant USRA 07-0239.With funding from the Spanish government through the Severo Ochoa Centre of Excellence accreditation SEV-2017-0709.Peer reviewe

Dose-Dependent Effects of Endotoxin on Neurobehavioral Functions in Humans

Clinical and experimental evidence document that inflammation and increased peripheral cytokine levels are associated with depression-like symptoms and neuropsychological disturbances in humans. However, it remains unclear whether and to what extent cognitive functions like memory and attention are affected by and related to the dose of the inflammatory stimulus. Thus, in a cross-over, double-blind, experimental approach, healthy male volunteers were administered with either placebo or bacterial lipopolysaccharide (LPS) at doses of 0.4 (n = 18) or 0.8 ng/kg of body weight (n = 16). Pro- and anti-inflammatory cytokines, norephinephrine and cortisol concentrations were analyzed before and 1, 1.75, 3, 4, 6, and 24 h after injection. In addition, changes in mood and anxiety levels were determined together with working memory (n-back task) and long term memory performance (recall of emotional and neutral pictures of the International Affective Picture System). Endotoxin administration caused a profound transient physiological response with dose-related elevations in body temperature and heart rate, increases in plasma interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α and IL-1 receptor antagonist (IL-1ra), salivary and plasma cortisol, and plasma norepinephrine. These changes were accompanied by dose-related decreased mood and increased anxiety levels. LPS administration did not affect accuracy in working memory performance but improved reaction time in the high-dose LPS condition compared to the control conditon. In contrast, long-term memory performance was impaired selectively for emotional stimuli after administration of the lower but not of the higher dose of LPS. These data suggest the existence of at least two counter-acting mechanisms, one promoting and one inhibiting cognitive performance during acute systemic inflammation

Environmental factors in a population-based inception cohort of inflammatory bowel disease patients in Europe--an ECCO-EpiCom study.

To access publisher's full text version of this article click on the hyperlink at the bottom of the pageThe incidence of inflammatory bowel disease (IBD) is increasing in Eastern Europe possibly due to changes in environmental factors towards a more "westernised" standard of living. The aim of this study was to investigate differences in exposure to environmental factors prior to diagnosis in Eastern and Western European IBD patients.The EpiCom cohort is a population-based, prospective inception cohort of 1560 unselected IBD patients from 31 European countries covering a background population of 10.1 million. At the time of diagnosis patients were asked to complete an 87-item questionnaire concerning environmental factors.A total of 1182 patients (76%) answered the questionnaire, 444 (38%) had Crohn's disease (CD), 627 (53%) ulcerative colitis (UC), and 111 (9%) IBD unclassified. No geographic differences regarding smoking status, caffeine intake, use of oral contraceptives, or number of first-degree relatives with IBD were found. Sugar intake was higher in CD and UC patients from Eastern Europe than in Western Europe while fibre intake was lower (p<0.01). Daily consumption of fast food as well as appendectomy before the age of 20 was more frequent in Eastern European than in Western European UC patients (p<0.01). Eastern European CD and UC patients had received more vaccinations and experienced fewer childhood infections than Western European patients (p<0.01).In this European population-based inception cohort of unselected IBD patients, Eastern and Western European patients differed in environmental factors prior to diagnosis. Eastern European patients exhibited higher occurrences of suspected risk factors for IBD included in the Western lifestyle.Danish Colitis Crohn Patients Organisation (CCF) Vibeke Binder and Povl Riis Foundation Scientific Council at Herlev Hospital Sigrid Rignnor Moran Foundation, Aage and Johanne Louis-Hansens Foundation Munkholm Foundation C.C. Klestrup and Henriette Klestrup Foundation Knud and Dagny Gad Andresens Foundation Else and Mogens Wedell-Wedellsborgs Foundation Direktor Jacob Madsen and Olga Madsen's Foundation, Scan Ve

A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic.

The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world

System für die gleichzeitige Messung des Stoffwechsels von Zellkulturen in bis zu 48 Wells in Mikrotiterplatten

For this thesis, a system has been developed to simultaneously determine the metabolism of microorganisms in every single well of a 48-well microtiter plate. For this purpose, a cover has been developed for the microtiter plate incorporating two micro valves for each well providing the wells with a constant air flow and to separate the wells from their environment for a short period of time to take measurements. While the wells were separated from their air flow, the composition of the air changed because oxygen was consumed and carbon dioxide was produced. This change in the composition of the air has been recorded with optical sensors, allowing to observe the activity of the microorganisms. Since the air flow must be the same in every well, a much bigger cross-section was selected for the supply and drain channels compared to the valve inlets. The valves have been milled into cover plates and a pneumatically driven membrane has been fixed between them. In addition, a measurement system to determine the oxygen partial pressure has been integrated into each well. To measure additionally the pH and CO2 values, a holder has been developed to attach the opto-chemical sensors to each well by means of ultrasonic welding.The final outcome is a microfluidic cover containing 96 pneumatically driven micro valves consisting of three structural components and three membranes supported by a few metal parts. This development process not only involved integrating and testing measurement systems (from two different manufacturers) to determine oxygen and carbon dioxide partial pressure and pH value, but also the development of a new way to attach sensor foils in microtiter plates

Reforming International Fisheries Law Can Increase Blue Carbon Sequestration

The oceans are by far the largest carbon sink and are estimated to have absorbed roughly 40 percent of anthropogenic carbon dioxide emissions since the beginning of the industrial era. The climate services performed by the oceans can be described as an interaction between a physical and a biological carbon pump. Whereas the role of the physical carbon pump is well established, the full scale of the climate services provided by the biological carbon pump has only recently been understood. This pump is made up of services provided by different marine species, from microbes to marine mammals. Many of these species are managed under the international law of the sea and subject to the concept of Maximum Sustainable Yield (MSY). Although the MSY concept has developed since its inception, maximum generation of fish for human consumption remains the core objective according to the law of the sea. Under MSY based management, states are not required to consider the climate services represented by different marine organisms, making this regime unable to balance the interest of maximizing fish as a product against the oceansâ\u80\u99 role in carbon sequestration. In order to make optimal use of the carbon sequestering features of marine organisms, this perspective proposes five action points. Foremost, MSY should be complemented with a new management objective: maximum carbon sequestration (MCS). Although many aspects of climate-based fisheries management remain to be explored, it appears clear that this would imply allowing stocks to recover to maintain a larger amount of biomass, increasing conservation measures for species particularly efficient in providing negative emissions, differentiation of fisheries within species as well as a new approach to ecosystem management. Climate reforming international fisheries law could make an important contribution to the operationalization of the Paris Agreement on Climate Change, as well as the UN Sustainable Development Goals. As a first step, international guidelines should be developed on how to integrate the concept of maximum carbon sequestration in fisheries management