68 research outputs found
Gait Pathway in Subcortical Vascular Dementia and in Alzheimer’s Disease
No full textGait impairment, worse equilibrium scores and falls are associated with leukoaraiosis, as widely recognised [1-6]. In Binswanger’s disease with a severe leukoaraiosis gait disorders are clearly evident while patients with mild periventricular changes may present subclinical forms of gait disorders, as proposed by some authors (see data in [7]).
Gait disorders in the elderly are particularly relevant, since they can influence the loss of functional independence and death [8]. As anticipated, cerebral small vessel disease (both white matter lesions and lacunar infarcts) correlates with gait parameters: stride length and a lower gait velocity [8]. Most importantly, subcortical vascular lesions seem to increase the possibility of falls, even if clear evidences are still lacking [9-11].
Walking difficulties in Alzheimer’s disease are well described [12]: patients show slow and irregular steps, difficulties in turning and avoiding obstacles [13, 14]. These disturbances have been described also in patients free from extrapyramidal, ataxic, paretic signs, and clinically relevant musculoskeletal impairments [12, 14]. Moreover, Alzheimer’s disease patients have a worse balance [12, 14, 15] and a higher risk of falls compared with matched controls [16, 17]. The prevalence of gait abnormalities varies widely across the studies (from 8.7% [18] to over 90% [19]); this can be explained because of different inclusion criteria and/or assessment procedures.
These observations have been confirmed by studies demonstrating that patients with Alzheimer’s disease walk more slowly compared to healthy controls [12] and these gait problems have been interpreted as manifestations of the extrapyramidal deficits (well-known to affect 12–28% of Alzheimer patients), or as side effects of drug treatment (e.g. neuroleptic agents) [20]. Since a overt walking problems and trunk movement alterations can be seen also in absence of extrapyramidal signs, it has been proposed that some Alzheimer’s disease patients may present “frontal gait disorder”, a syndrome coterminous with gait apraxia [21, 15]. The lack of a standardised instrument to assess gait has been implicated as a possible cause for the low frequency of reports on the topic.
Since the walking assessment cannot discriminate between walking disorders caused by gait apraxia and other neurological causes of walking difficulty, there has been the necessity to exclude alternative causes of walking abnormalities in Alzheimer’s disease (overt extrapyramidal impairments or other concurrent neurological diseases); in order to assess gait capacity, a new test has been proposed and a large proportion of the sample (40%) scored below cut off, even if the percentage of severely impaired was smaller. Although the possibility of right–left confusion, working memory deficits, and problems with verbal comprehension was minimised by demonstrating the items, the complexity of some of them might have contributed to inflating the proportion of patients performing poorly. Even though, the presence of associated vascular pathology in a few patients also cannot account for the outcome. Neuroradiological signs of white matter changes were reported in three of the 24 patients (22.5%) in the Della Sala et al.’s study [12], who scored below cut off in the assessment of walking skills.
Therefore, in a well-defined population suffering from subcortical vascular dementia and Alzheimer’s disease (standing from a neurological, clinical, and radiological criteria), we tried to explore gait, balance and equilibrium alterations, and a behavioral complex symptom, such as apathy, even considering precipitant factors, such as concomitant pathologies and consequent therapies. We now present an extension of the work, with a speculation on what we observed for a two-year follow-up
Rapid identification system of frontal dysfunction in subclinical hepatic encephalopathy
No full textIntroduction & Aim: Liver disease is associated with cognitive dysfunction also at early stages and minimal hepatic encephalopathy, affecting 20-70% of patients, is frequently under-recognised.
The main purpose of this work is to demonstrate that a huge number of patients, enrolled due to acute confusional state, without any clinical diagnosis, presented hepatic encephalopathy. Material & Methods: 410 acute confusional state subjects, not diagnosed before, have been enrolled in this study, due to the further subsequent diagnosis of well compensated liver diseases; among them 237 (57.8%) have hepatic alterations, acute, subacute or chronic. Results: Even in acute minimal hepatic sufferance the psychometric tests applied demonstrated precocious signs of cerebral frontal alteration, which become more evident while they have their clinical pathway, transforming themselves, in minimal hepatic failure or chronic liver disease. Conclusions: In conclusion, these instruments are essential to detect even very precocious and totally subclinical frontal failure and can be a good instrument to follow these patients and to give a valid score for the chronic liver disease, in relation to frontal alterations
STRATEGI PENGEMBANGAN BISNIS DI RUMAH MAKAN BATAGOR BASO CITAMIANG SPESIAL BANDUNG
No full textPenelitian ini bertujuan untuk mengetahui faktor internal dan faktor eksternal yang berpengaruh dalam penyusunan strategi pengembangan bisnis rumah makan Batagor Baso Citamiang Spesial.
Pada penelitian ini menggunakan metode kuantitatif dan deskriptif kualitatif. Data yang diperoleh kemudian dianalisis dengan menggunakan matriks IFAS, matriks EFAS, matriks IE, matriks SWOT dan QSPM. Berdasarkan analisis data menggunakan matriks diagram analisis SWOT, Batagor Baso Spesial Citamiang berada dalam kuadran empat. Posisi tersebut merupakan situasi dimana perusahaan tersebut memiliki peluang dan kekuatan sehingga dapat memanfaatkan peluang yang ada.
Dengan adanya hal tersebut, penulis merekomendasikan alternatif strategi yang memaksimalkan kekuatan Btagor Baso Citamiang Spesial dalam memanfaatkan peluang. Berdasarkan hasil olahan data terdapat 14 alternatif strategi untuk pengembangan usaha Batagor Baso Citamiang Spesial. Melalui pengolahan data menggunakan QSPM, dapat diketahui bahwa alternatif strategi utama dalam pengembangan usaha ini adalah meningkatkan kualitas rasa dan melakukan inovasi baru pada menu dengan mempertahankan kelezatan rasa, harga yang murah dan kualitas yang baik dengan nilai STAS 5,522.;---This study aims to determine the internal and external factors which is influential in the preparation of bussiness development strategies in Batagor Baso Citamiang Spesial.
In this study, the authors used qualitative and descriptive quantitative methods. These factors were then used as a reference to establish alternative strategies in developing Batagor Baso Citamiang Spesial. The data obtained were then analyzed using IFAS matrix, EFAS matrix, IE matrix, SWOT matrix and QSPM. Based on the SWOT analysis diagram matrix, Batagor Baso Citamiang Spesial is in quadrant four. The position is a situation where the company has the opportunity and strength so that it can take advantage of its favorable condition.
With that in mind, the author recommends an alternative strategy that maximizes the strength of Batagor Baso Citamiang Spesial in harnessing its opportunities. Based on the results of data processing there are 14 alternative strategies for the development of Batagor Baso Citamiang Spesial business. Through the processing of data using QSPM, it was inferred that the main alternative strategy in the development of this business is to improve the taste quality and innovate on the menu by maintaining its succulent taste, affordable price and good quality with the value of STAS at 5,522
Pengaruh Kualitas Produk Terhadap Keputusan Pembelian Pada Baso Aci Wak Acan Di Pekanbaru
No full textThe research conducted by the author aims to see the effect of product quality on Baso Aci Wak Acan Pekanbaru. This study also aims to determine the dimensions of product quality that affect purchasing decisions. Sampling using incidental sampling method is a technique based on chance. The data in this study were obtained through a questionnaire sample taken by 50 people. Types and sources of data used are primary data and secondary data. The data analysis technique used the test and the coefficient of determination and the data analysis used the SPSS v.25 application. The results of data analysis showed that the quality of the product partially influenced the purchasing decision of the baso aci wak acan. Based on the results of the coefficient of determination, it shows that product quality on purchasing decisions has an effect of 59.2% and is included in a good category
Lung Volume and Ventilation Distribution After Bariatric Surgery-High-Flow Nasal Cannula Versus CPAP
No full textBackground: Patients with obesity are at increased risk of postoperative pulmonary complications. CPAP has been used successfully to prevent and treat acute respiratory failure, but in many clinical scenarios, high-flow nasal cannula (HFNC) therapy is emerging as a possible alternative. We aimed to compare HFNC and CPAP in a sequential study measuring their effects on gas exchange, lung volumes, and gas distribution within the lungs measured through electrical impedance tomography (EIT). Methods: We enrolled 15 subjects undergoing laparoscopic bariatric surgery. Postoperatively they underwent the following oxygen therapy protocol (10 min/step): baseline air-entrainment mask, HFNC at increasing (40, 60, 80, and 100 L/min) and decreasing flows (80, 60, and 40 L/min), washout air-entrainment mask and CPAP (10 cm H2O). Primary outcome was the change in end-expiratory lung impedance (ΔEELI) measured by EIT data processing. Secondary outcomes were changes of global inhomogeneity (GI) index and tidal impedance variation (TIV) measured by EIT, arterial oxygenation, carbon dioxide content, pH, respiratory frequency, and subject's comfort. Results: Thirteen subjects completed the study. Compared to baseline, ΔEELI was higher during 10 cm H2O CPAP (P = .001) and HFNC 100 L/min (P = .02), as well as during decreasing flows HFNC 80, 60, and 40 L/min (P = .008, .004, and .02, respectively). GI index was lower during HFNC 100 compared to HFNC 60increasing (P = .044), HFNC 60decreasing (P = .02) HFNC 40decreasing (P = .01), and during 10 cm H2O CPAP compared to washout period (P = .01) and HFNC 40decreasing (P = .03). TIV was higher during 10 cm H2O CPAP compared to baseline (P = .008). Compared to baseline, breathing frequency was lower at HFNC 60increasing, HFNC 100, and HFNC 80decreasing (P = .01, .02, and .03, respectively). No differences were detected regarding arterial oxygenation, carbon dioxide content, pH, and subject's comfort. Conclusions: HFNC at a flow of 100 L/min induced postoperative pulmonary recruitment in bariatric subjects, with no significant differences compared to 10 cm H2O CPAP in terms of lung recruitment and ventilation distribution
Phonetic Transcription of Language ‘Baso Palembang Sari-Sari’ in Local Communication
No full textThe problem raised in this study is how to explore the phenomenology of daily Palembang language. This study aims to analyze the phonetic transcription of Palembang language (Baso Palembang Sari-Sari) using the General Linguistic Theory proposed by Chaer. Through an analysis of various everyday expressions in Palembang, such as greetings, expressing gratitude, saying goodbye, apologizing, introducing oneself, and family terms, this research identifies phonetic and phonological differences between Palembang and Standard Indonesian. The Palembang Sari-Sari language was chosen due to its uniqueness as a regional language widely used in daily interactions in Palembang. The research method used is descriptive qualitative. The data sources were obtained from recordings of conversations between the author and native speakers of Palembang, based on foreign language learning syllabi and Palembang language dictionary documents. The data validity check technique used was peer debriefing. From the conversations, 29 Palembang Sari-Sari vocabulary items were obtained. Additionally, 60 Palembang Sari-Sari vocabulary items were found in the document analysis. Some distinctive features of the Palembang language identified include the use of diphthongs, voiced velar fricative [ɣ], open vowels [ɔ] and [ɛ], and the characteristic glottal stop [ʔ]. This phonetic analysis also reflects how these phonological variations relate to the Palembang language's more relaxed and informal structure. The findings of this study provide insights into the phonological practices of regional languages, which are essential to explore further in the context of applied linguistics. This research is expected to serve as a reference for learning regional languages, particularly for foreign speakers interested in exploring the diversity of the Indonesian language
Tradisi Pasambahan pada Masyarakat Minangkabau (Studi Tentang Pelaksanaan Tradisi Pasambahan Manjapuik Marapulai di Dusun Tampuak Cubadak, Jorong Koto Gadang, Nagari Koto Tinggi, Kecamatan Baso, Kabupaten Agam, Sumatera Barat)
No full textTradition pasambahan manjapuik marapulai is one type of Minangkabau oral literature. This tradition is carried on in traditional Minangkabau wedding ceremony. Pasambahan happens in the show is a kind of manjapuik marapulai pasambahan reciprocated. The study took place in the Dusun Tampuak Cubadak, Jorong Koto Gadang, Nagari Koto Tinggi, Baso, Agam, West Sumatra. The purpose of this study is to investigate the implementation of manjapuik marapulai pasambahan tradition is normative and the process of inheritance traditions manjapuik pasambahan marapulai. The method used in this research is descriptive qualitative research methods. Descriptive qualitative research is research that aims to uncover the facts, circumstances, and the various phenomena that occur. Relation to the disclosure of this research is the implementation of a normative tradition and shift implementation at this time. Therefore, the author will develop concepts, collect data and facts that occurred in the study area. Data collection techniques used were in-depth interviews and observation. While descriptive qualitative data analysis techniques through data collection, data reduction, data presentation and conclusion along with suggestions. Based on the implementation of the results of research, implementation pasambahan tradition manjapuik marapulai has happened persegeran of normative rules such as roles, responsibilities, and procedures for implementation. In the process of inheritance is also influenced by the level of interest or motivation, facilities and infrastructures, media information and communication, environmental conditions of society, and the media that are used during the process of inheritance. In the tradition of pasambahan manjapuik marapulai contained values such as the value of humility, value manners, the value of deliberation, the value of accuracy, and the value of adherence to customary rules applicable
Quantitative regional variation in the expression of major histocompatibility class II antigens in enterocytes of the mouse small intestine
No full textThe qualitative and quantitative expression of major histocompatibility class II antigens was investigated in the absorptive epithelium of the duodenum, jejunum, and ileum from mice of C3H/He (H-2k haplotype) and C57BL/6 (H-2b haplotype) strains by peroxidase-antiperoxidase labelling and image analysis. Immunohistochemical labelling revealed that the expression of class II antigens was greatest in the ileum and decreased proximally towards the duodenum. The villus epithelium of the duodenum showed a granular staining pattern in the apices of some cells. In the jejunum, an increased expression was demonstrated in the apical and basal cytoplasm of all cells covering the villus. Cells at the tip of the villus, in addition, showed staining of the lateral surfaces. Ileal enterocytes demonstrated the most intense immunostaining appearing in the cytoplasm and along baso-lateral surface membranes. Quantitative analyses confirmed that a highly significant (p less than 0.0001) difference in expression of class II antigens occurred in the three regions of the small intestine, which corroborated the qualitative findings. This regional variation of class II molecules by the absorptive epithelium may influence regional differences in antigen presenting functions and immune responsiveness to ingested antigens.LR: 20061115; PUBM: Print; JID: 0214745; 0 (Histocompatibility Antigens Class II); ppublishSource type: Electronic(1
Resection margins and local recurrences in breast cancer : Comparison between conventional and oncoplastic breast conserving surgery
No full textBackground: This retrospective cohort study aims to compare surgical margins, reoperations and local recurrences after conventional or oncoplastic breast conservation surgery (BCS). Furthermore, we aim to investigate differences between various oncoplastic techniques. Material and methods: We reviewed 1800 consecutive patients with primary invasive breast cancer (N =1707) or ductal carcinoma in situ (N = 93) who underwent BCS at Helsinki University Hospital between 2010 and 2012. Results: Conventional BCS was performed in 1189 (66.1%) patients, oncoplastic BCS in 611 (33.9%). Various oncoplastic techniques were used. Patients with oncoplastic BCS had more often multifocal (p There was no difference, however, in surgical margins (p = 0.578) or reoperation rates (p = 0.430) between the groups. A total of 152 (8.4%) patients were reoperated because of insufficient margins, 96 (8.1%) in the conventional, 56 (9.2%) in the oncoplastic BCS group. The median follow-up time was 75 (2-94) months. There was no difference in local recurrence-free survival between the conventional and oncoplastic BCS groups (log-rank test, p = 0.172). Conclusions: Oncoplastic BCS was used for larger, multifocal and more aggressive tumours. Nevertheless, no difference in reoperation rate or local recurrences were found. Oncoplastic BCS is as safe as conventional BCS enabling breast conserving for patients who otherwise were candidates for mastectomy. (C) 2019 Elsevier Ltd, BASO - The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.Peer reviewe
Memahami Allah dalam Perspektif Teologis Bencana Banjir dan Implikasinya Bagi Orang Kristen di Desa Patila
No full textAbstract:In this paper, the author describes understanding God in the theological perspective from the flood disaster that occurred in Patila Village. The problem of flooding that occurred there was due to the swampy soil structure and the government's attitude which was slow and did not pay attention to this event. In this paper, the author uses a qualitative method by conducting a literature study on various reliable sources such as journals, books and so on. God wants to show His sovereignty and omnipotence to humans. This indicates that God's wisdom is far beyond human. God wants to show His existence that humans are creatures who cannot live without relying on God's love and care. Christians in Patila Village must always reflect on maintaining the quality of their faith with authentic trust and true obedience. Abstrak:Pada tulisan ini penulis menguraikan tentang memahami Allah dalam perspektif teologi dari bencana banjir yang terjadi di Desa Patila. Masalah banjir yang terjadi disana dikarenakan struktur tanah yang berawa-rawa dan sikap pemerintah yang lamban dan kurang memperhatikan peristiwa ini. Dalam tulisan ini penulis menggunakan metode kualitatif dengan melakukan studi pustaka terhadap berbagai sumber-sumber yang terpercaya seperti jurnal, buku-buku dan sebagainya. Allah hendak menunjukkan kedaulatan dan kemahakuasaanNya pada diri manusia. Ini menandakan bahwa hikmat Allah jauh melampaui manusia. Allah ingin memperlihatkan eksistensiNya bahwa manusia merupakan ciptaan yang tidak bisa hidup tanpa mengandalkan kasih dan pemeliharaan Tuhan. Orang Kristen di Desa Patila harus senantiasa berefleksi dalam menjaga kualitas iman mereka dengan kepercayaan yang otentik dan ketaatan yang sungguh
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