82 research outputs found
Perspektif dalam Membangun Sistem Hukum yang Progresif sebagai Salah Satu Ilmu Pengetahuan Hukum
Ilmu dan pengetahuan merupakan sesuatu yang berbeda pemahamannya. Ilmu adalah suatu cara untuk mengetahui, dalam artian bahwa ilmu bukanlah satu - satunya cara bagi manusia untuk mengetahui. Kebutuhan untuk menempatkan Ilmu Hukum sebagai sebenar ilmu pada akan sangat menentukan terciptanya di samping suatu landasan intelektual bagi komunitas keilmuwan, juga memaparkan masalah-masalah yang perlu dibahas, dan langkah-langkah yang perlu ditempuh oleh para pakar ilmu untuk memecahkan berbagai persoalan yang dihadapi oleh Ilmu Hukum.Munculnya sosiologi dalam Ilmu Hukum dikarenakan ingin melihat hakikat hukum yang tidak terbatas pada teks normatif yang abstrak. Tetapi lebih jauh dari itu, hukum ingin dilihat dalam segenap kompleksitasnya dalam interaksinya dengan alam realitas empirik sebagai medan tumbuh-kembangnya hukum tersebut. Apakah bunyi aturan hukum benar-benar berfungsi atau tidak berfungsi dalam realitas empirik
Inflammatory Profile of Awake Function-Controlled Craniotomy and Craniotomy under General Anesthesia
Background. Surgical stress triggers an inflammatory response and releases mediators into human plasma such as interleukins (ILs). Awake craniotomy and craniotomy performed under general anesthesia may be associated with different levels of stress. Our aim was to investigate whether those procedures cause different inflammatory responses.
Methods. Twenty patients undergoing craniotomy under general anesthesia and 20 patients undergoing awake function-controlled craniotomy were included in this prospective, observational, two-armed study. Circulating levels of IL-6, IL-8, and IL-10 were determined pre-, peri-, and postoperatively in both patient groups. VAS scores for pain, anxiety, and stress were taken at four moments pre- and postoperatively to evaluate physical pain and mental duress.
Results. Plasma IL-6 level significantly increased with time similarly in both groups. No significant plasma IL-8 and IL-10 change was observed in both experimental groups. The VAS pain score was significantly lower in the awake group compared to the anesthesia group at 12 hours postoperative. Postoperative anxiety and stress declined similarly in both groups.
Conclusion. This study suggests that awake function-controlled craniotomy does not cause a significantly different inflammatory response than craniotomy performed under general anesthesia. It is also likely that function-controlled craniotomy does not cause a greater emotional challenge than tumor resection under general anesthesia
Liefkenshoektunnel: protection of the tunnel against damage caused by ship anchors by means of asphalt mattresses
Дискретно-континуальные системы: подходы, модели, программно-модельные комплексы
<div><p>Background</p><p>Diaphragm weakness is the main reason for respiratory dysfunction in patients with Pompe disease, a progressive metabolic myopathy affecting respiratory and limb-girdle muscles. Since respiratory failure is the major cause of death among adult patients, early identification of respiratory muscle involvement is necessary to initiate treatment in time and possibly prevent irreversible damage. In this paper we investigate the suitability of dynamic MR imaging in combination with state-of-the-art image analysis methods to assess respiratory muscle weakness.</p><p>Methods</p><p>The proposed methodology relies on image registration and lung surface extraction to quantify lung kinematics during breathing. This allows for the extraction of geometry and motion features of the lung that characterize the independent contribution of the diaphragm and the thoracic muscles to the respiratory cycle.</p><p>Results</p><p>Results in 16 3D+t MRI scans (10 Pompe patients and 6 controls) of a slow expiratory maneuver show that kinematic analysis from dynamic 3D images reveals important additional information about diaphragm mechanics and respiratory muscle involvement when compared to conventional pulmonary function tests. Pompe patients with severely reduced pulmonary function showed severe diaphragm weakness presented by minimal motion of the diaphragm. In patients with moderately reduced pulmonary function, cranial displacement of posterior diaphragm parts was reduced and the diaphragm dome was oriented more horizontally at full inspiration compared to healthy controls.</p><p>Conclusion</p><p>Dynamic 3D MRI provides data for analyzing the contribution of both diaphragm and thoracic muscles independently. The proposed image analysis method has the potential to detect less severe diaphragm weakness and could thus be used to determine the optimal start of treatment in adult patients with Pompe disease in prospect of increased treatment response.</p></div
Physical and mental health comorbidity is common in people with multiple sclerosis: nationally representative cross-sectional population database analysis
<b>Background</b> Comorbidity in Multiple Sclerosis (MS) is associated with worse health and higher mortality. This study aims to describe clinician recorded comorbidities in people with MS. <p></p>
<b>Methods</b> 39 comorbidities in 3826 people with MS aged ≥25 years were compared against 1,268,859 controls. Results were analysed by age, gender, and socioeconomic status, with unadjusted and adjusted Odds Ratios (ORs) calculated using logistic regression. <p></p>
<b>Results</b> People with MS were more likely to have one (OR 2.44; 95% CI 2.26-2.64), two (OR 1.49; 95% CI 1.38-1.62), three (OR 1.86; 95% CI 1.69-2.04), four or more (OR 1.61; 95% CI 1.47-1.77) non-MS chronic conditions than controls, and greater mental health comorbidity (OR 2.94; 95% CI 2.75-3.14), which increased as the number of physical comorbidities rose. Cardiovascular conditions, including atrial fibrillation (OR 0.49; 95% CI 0.36-0.67), chronic kidney disease (OR 0.51; 95% CI 0.40-0.65), heart failure (OR 0.62; 95% CI 0.45-0.85), coronary heart disease (OR 0.64; 95% CI 0.52-0.71), and hypertension (OR 0.65; 95% CI 0.59-0.72) were significantly less common in people with MS. <p></p>
<b>Conclusion</b> People with MS have excess multiple chronic conditions, with associated increased mental health comorbidity. The low recorded cardiovascular comorbidity warrants further investigation
Dynamic recruitment of resting state sub-networks
Resting state networks (RSNs) are of fundamental importance in human systems neuroscience with evidence suggesting that they are integral to healthy brain function and perturbed in pathology. Despite rapid progress in this area, the temporal dynamics governing the functional connectivities that underlie RSN structure remain poorly understood. Here, we present a framework to help further our understanding of RSN dynamics. We describe a methodology which exploits the direct nature and high temporal resolution of magnetoencephalography (MEG). This technique, which builds on previous work, extends from solving fundamental confounds in MEG (source leakage) to multivariate modelling of transient connectivity. The resulting processing pipeline facilitates direct (electrophysiological) measurement of dynamic functional networks. Our results show that, when functional connectivity is assessed in small time windows, the canonical sensorimotor network can be decomposed into a number of transiently synchronising sub-networks, recruitment of which depends on current mental state. These rapidly changing sub-networks are spatially focal with, for example, bilateral primary sensory and motor areas resolved into two separate sub-networks. The likely interpretation is that the larger canonical sensorimotor network most often seen in neuroimaging studies reflects only a temporal aggregate of these transient sub-networks. Our approach opens new frontiers to study RSN dynamics, showing that MEG is capable of revealing the spatial, temporal and spectral signature of the human connectome in health and disease
Patient-provider interaction from the perspectives of type 2 diabetes patients in Muscat, Oman: a qualitative study
<p>Abstract</p> <p>Background</p> <p>Patients' expectations and perceptions of the medical encounter and interactions are important tools in diabetes management. Some problems regarding the interaction during encounters may be related to a lack of communication skills on the part of either the physician or the patient.</p> <p>This study aimed at exploring the perceptions of type 2 diabetes patients regarding the medical encounters and quality of interactions with their primary health-care providers.</p> <p>Methods</p> <p>Four focus group discussions (two women and two men groups) were conducted among 27 purposively selected patients (13 men and 14 women) from six primary health-care centres in Muscat, Oman. Qualitative content analysis was applied.</p> <p>Results</p> <p>The patients identified some weaknesses regarding the patient-provider communication like: unfriendly welcoming; interrupted consultation privacy; poor attention and eye contact; lack of encouraging the patients to ask questions on the providers' side; and inability to participate in medical dialogue or express concerns on the patients' side. Other barriers and difficulties related to issues of patient-centeredness, organization of diabetes clinics, health education and professional competency regarding diabetes care were also identified.</p> <p>Conclusion</p> <p>The diabetes patients' experiences with the primary health-care providers showed dissatisfaction with the services. We suggest appropriate training for health-care providers with regard to diabetes care and developing of communication skills with emphasis on a patient-centred approach. An efficient use of available resources in diabetes clinics and distributing responsibilities between team members in close collaboration with patients and their families seems necessary. Further exploration of the providers' work situation and barriers to good interaction is needed. Our findings can help the policy makers in Oman, and countries with similar health systems, to improve the quality and organizational efficiency of diabetes care services.</p
Sociocultural considerations in aging men's health: implications and recommendations for the clinician
http://dx.doi.org/10.1016/j.jomh.2009.07.00
Dynamics of large-scale electrophysiological networks: a technical review
For several years it has been argued that neural synchronisation is crucial for cognition. The idea that synchronised temporal patterns between different neural groups carries information above and beyond the isolated activity of these groups has inspired a shift in focus in the field of functional neuroimaging. Specifically, investigation into the activation elicited within certain regions by some stimulus or task has, in part, given way to analysis of patterns of co-activation or functional connectivity between distal regions. Recently, the functional connectivity community has been looking beyond the assumptions of stationarity that earlier work was based on, and has introduced methods to incorporate temporal dynamics into the analysis of connectivity. In particular, non-invasive electrophysiological data (magnetoencephalography / electroencephalography (MEG/EEG)), which provides direct measurement of whole-brain activity and rich temporal information, offers an exceptional window into such (potentially fast) brain dynamics. In this review, we discuss challenges, solutions, and a collection of analysis tools that have been developed in recent years to facilitate the investigation of dynamic functional connectivity using these imaging modalities. Further, we discuss the applications of these approaches in the study of cognition and neuropsychiatric disorders. Finally, we review some existing developments that, by using realistic computational models, pursue a deeper understanding of the underlying causes of non-stationary connectivity
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