PRODUCT DEVELOPMENT OF A WHEELCHAIR FOR DISABILITIES

Person with disabilities who are referred to as disabled people, are often regarded as unproductive citizens, unable to carry out their duties and responsibilities so that their rights are ignored. About 15 percent of the world's population are people with disabilities - more than one billion people. They are considered the largest minority group in the world. Persons with disabilities are often excluded from education, vocational training and employment opportunities. In reality, there are not many public facilities or special services provided to persons with disabilities. One of them is in the aspect of education. In public facilities, namely education, there are not many education buildings or educational providers that have facilities and infrastructure that can support people with disabilities. As for mobility equipment that can help people with disabilities on both legs, namely crutches, walking sticks, walkers, and wheelchairs that aim to help and facilitate their mobility. But the wheelchair that is available in the market today only has a limited function of moving left, right, and spinning, the function can not be maximized to help the movement of persons with disabilities there are some activities that cannot be done such as reaching higher objects, moving the body from a wheelchair to another seat, through the stairs / steps. Therefore we need a product design that starts from the preparation of product concepts from old products that will be modified into a new product to meet the needs of the market / people with disabilities.

Six-month follow-up of functional status in discharged patients with coronavirus disease 2019

Background The long-term functional outcome of discharged patients with coronavirus disease 2019 (COVID-19) remains unresolved. We aimed to describe a 6-month follow-up of functional status of COVID-19 survivors. Methods We reviewed the data of COVID-19 patients who had been consecutively admitted to the Tumor Center of Union Hospital (Wuhan, China) between 15 February and 14 March 2020. We quantified a 6-month functional outcome reflecting symptoms and disability in COVID-19 survivors using a post-COVID-19 functional status scale ranging from 0 to 4 (PCFS). We examined the risk factors for the incomplete functional status defined as a PCFS > 0 at a 6-month follow-up after discharge. Results We included a total of 95 COVID-19 survivors with a median age of 62 (IQR 53–69) who had a complete functional status (PCFS grade 0) at baseline in this retrospective observational study. At 6-month follow-up, 67 (70.5%) patients had a complete functional outcome (grade 0), 9 (9.5%) had a negligible limited function (grade 1), 12 (12.6%) had a mild limited function (grade 2), 7 (7.4%) had moderate limited function (grade 3). Univariable logistic regression analysis showed a significant association between the onset symptoms of muscle or joint pain and an increased risk of incomplete function (unadjusted OR 4.06, 95% CI 1.33–12.37). This association remained after adjustment for age and admission delay (adjusted OR 3.39, 95% CI 1.06–10.81, p = 0.039). Conclusions A small proportion of discharged COVID-19 patients may have an incomplete functional outcome at a 6-month follow-up; intervention strategies are required.

NrnA is a linear dinucleotide phosphodiesterase with limited function in cyclic dinucleotide metabolism in Listeria monocytogenes

Listeria monocytogenes produces both c-di-AMP and c-di-GMP to mediate many important cellular processes, but the levels of both nucleotides must be regulated. C-di-AMP accumulation attenuates virulence and diminishes stress response, and c-di-GMP accumulation impairs bacterial motility. An important regulatory mechanism to maintain c-di-AMP and c-di-GMP homeostasis is to hydrolyze them to the linear dinucleotides pApA and pGpG, respectively, but the fates of these hydrolytic products have not been examined in L. monocytogenes . We found that NrnA, a stand-alone DHH-DHHA1 phosphodiesterase, has a broad substrate range, but with a strong preference for linear dinucleotides over cyclic dinucleotides. Although NrnA exhibited detectable cyclic dinucleotide hydrolytic activities in vitro, NrnA had negligible effects on their levels in the bacterial cell, even in the absence of the c-di-AMP phosphodiesterases PdeA and PgpH. The Δ nrnA mutant had a mammalian cell infection defect that was fully restored by E. coli Orn. Together, our data indicate that L. monocytogenes NrnA is functionally orthologous to Orn, and its preferred physiological substrates are most likely linear dinucleotides. Furthermore, our findings revealed that, unlike some other c-di-AMP and c-di-GMP-producing bacteria, L. monocytogenes does not employ their hydrolytic products to regulate their phosphodiesterases, at least at the pApA and pGpG levels in the Δ nrnA mutant. Finally, the Δ nrnA infection defect was overcome by constitutive activation of PrfA, the master virulence regulator, suggesting that accumulated linear dinucleotides might inhibit the expression, stability, or function of PrfA-regulated virulence factors. IMPORTANCE Listeria monocytogenes produces both c-di-AMP and c-di-GMP, and encodes specific phosphodiesterases that degrade them into pApA and pGpG, respectively, but the metabolism of these products has not been characterized in this bacterium. We found that L. monocytogenes NrnA degrades a broad range of nucleotides. Among the tested cyclic and linear substrates, it exhibits a strong biochemical and physiological preference the linear dinucleotides pApA, pGpG, and pApG. Unlike in some other bacteria, these oligoribonucleotides do not appear to interfere with cyclic dinucleotide hydrolysis. The absence of NrnA is well tolerated by L. monocytogenes in broth cultures but impairs its ability to infect mammalian cells. These findings indicate a separation of cyclic dinucleotide signaling and oligoribonucleotide metabolism in L. monocytogenes .

Treatment of knee joint osteoarthritis in overweight women in outpatient practice

Objectives: evaluation of the clinical efficacy and safety of the healthy joints maintaining compound Artroflex® in knee osteoarthritis (OA) in postmenopausal overweight women in outpatient clinical practice.Patients and methods. An open, prospective observational single-center post-marketing study included 30 postmenopausal women 50–75 years old (mean age 62.3±6.3 years) with knee OA. Patient body mass index (BMI) was >25 (mean body weight 85.3±15.3 kg). Radiographically confirmed primary gonarthrosis stage II according to Kellgren–Lawrence was detected in 26 (87.0%) patients, stage III – in 4 (13.0%). The duration of knee OA ranged from 1 to 21 years (average 7.8±6.1 years).Artroflex® was prescribed 1 capsule 2 times a day for 3 months. During three visits (baseline, after 1 and 3 months), the need for analgesics or non-steroidal anti-inflammatory drugs (NSAIDs) and the occurrence of adverse reactions (AR) were determined. Health status and pain level were also assessed using a visual analogue scale (VAS), the severity of pain and stiffness, limited function according to the WOMAC questionnaire, fatigue/fatigue according to the FACIT scale, the Charlson comorbidity index, satisfaction of the doctor with the results of treatment using the IMOS scale, and satisfaction of the patient with using the IMPSS scale.Results and discussion. A statistically significant decrease in the pain score according to the VAS, an improvement in health status, and the WOMAC index were found in the overwhelming number of patients, regardless of BMI. 90% of women noted decrease in fatigue/fatigue on the FACIT scale, and 93% of patients reported satisfaction with treatment, regardless of the Charlson comorbidity index. The need for NSAIDs after one month of use of the Artroflex® compound decreased by 7%, after 3 months – by 23%. A negative feedback was found between the baseline indicator of health status and the assessment of the effectiveness of therapy. No serious ARs were identified during the study.Conclusion. Feasibility of using the Artroflex® compound in real clinical practice in patients with knee OA and excessive body mass has been shown.

Behandeling van spasticiteit met enkele overwegingen naar sport toe

Treatment of spasticity with some considerations regarding sport Spasticity is a possible side effect in patients with a central nervous system pathology and it affects more than 12 million people worldwide. Spasticity can have an important impact on the quality of life and sporting activities. Spasticity only needs to be treated if there is spasticity associated pain and/or (expected) limited function. Primarily triggering factors of spasticity must be treated. A multidisciplinary approach containing a combination of medication and physical therapy is recommended in the treatment of spasticity. If this approach remains insufficient, interventional therapies can be taken into consideration, although they should always be combined with rehabilitation to reduce (the) spastic tone/spasticity. Sports and exercising should not be merely seen in the context of therapy and/or rehabilitation but also as a crucial aspect of a healthy lifestyle, in particular for people ‘at risk’ for inactivity. Therefore, it is important to fill the gap between rehabilitation and sustainable sports practice for the rehabilitator.

NrnA is a linear dinucleotide phosphodiesterase with limited function in cyclic dinucleotide metabolism in Listeria monocytogenes

ABSTRACTListeria monocytogenes produces both c-di-AMP and c-di-GMP to mediate many important cellular processes, but the levels of both nucleotides must be regulated. C-di-AMP accumulation attenuates virulence and diminishes stress response, and c-di-GMP accumulation impairs bacterial motility. An important regulatory mechanism to maintain c-di-AMP and c-di-GMP homeostasis is to hydrolyze them to the linear dinucleotides pApA and pGpG, respectively, but the fates of these hydrolytic products have not been examined in L. monocytogenes. We found that NrnA, a stand-alone DHH-DHHA1 phosphodiesterase, has a broad substrate range, but with a strong preference for linear dinucleotides over cyclic dinucleotides. Although NrnA exhibited detectable cyclic dinucleotide hydrolytic activities in vitro, NrnA had negligible effects on their levels in the bacterial cell, even in the absence of the c-di-AMP phosphodiesterases PdeA and PgpH. The ΔnrnA mutant had a mammalian cell infection defect that was fully restored by E. coli Orn. Together, our data indicate that L. monocytogenes NrnA is functionally orthologous to Orn, and its preferred physiological substrates are most likely linear dinucleotides. Furthermore, our findings revealed that, unlike some other c-di-AMP and c-di-GMP-producing bacteria, L. monocytogenes does not employ their hydrolytic products to regulate their phosphodiesterases, at least at the pApA and pGpG levels in the ΔnrnA mutant. Finally, the ΔnrnA infection defect was overcome by constitutive activation of PrfA, the master virulence regulator, suggesting that accumulated linear dinucleotides might inhibit the expression, stability, or function of PrfA-regulated virulence factors.IMPORTANCEListeria monocytogenes produces both c-di-AMP and c-di-GMP, and encodes specific phosphodiesterases that degrade them into pApA and pGpG, respectively, but the metabolism of these products has not been characterized in this bacterium. We found that L. monocytogenes harbors an NrnA homolog that degrades a broad range of nucleotides, but exhibits a strong biochemical and physiological preference for linear dinucleotides, including pApA and pGpG. Unlike in some other bacteria, these oligoribonucleotides do not appear to interfere with cyclic dinucleotide hydrolysis. The absence of NrnA is well tolerated by L. monocytogenes in broth cultures but impairs its ability to infect mammalian cells. These findings indicate a separation of cyclic dinucleotide signaling and oligoribonucleotide metabolism in L. monocytogenes.

KINERJA PENGAWASAN INTERNAL TERHADAP INSTANSI PERANGKAT DAERAH PROVINSI KALIMANTAN TENGAH

This research aims to determine the performance of internal supervision Inspectorate of Central Kalimantan Province. Indicators used in measuring internal supervision performance of the Central Kalimantan Provincial Device Institution namely Input (inputs), Process (process), Output (Output), Outcomes, Benefits, Impacts.This research was conducted by using qualitative descriptive method by interviewing Central Kalimantan provincial inspectorate staff. The data obtained is then processed by reduction steps, presenting the data and drawing conclusions. The informants interviewed in the Inspectorate of Central Kalimantan Province are 4 informants and 3 informants from different SOPD, with the number of informants 7 people.The results of this study explain that the performance of Inspectorate of Central Kalimantan Province in carrying out the function of guidance and supervision has been done well, based on the rules and applicable law. Internal supervision is done so that no abuse in government, coaching and supervision in PP 60 year 2008 is a preventive action. The factors that affect the performance of internal supervision of the regional apparatus of Central Kalimantan Province are: Supporting Factors: a. Ability b. Motivation c. Communication. Inhibiting Factor is the ability of human resources that limited the number of personnel of the supervisory apparatus, limited availability of budget, limited function of supervision activities in terms of performing the task of the absence of search function, seizure if SOPD is not open.Conducting internal control over the local apparatus institutions, the financial management is running well and neatly, reducing the administrative errors of the office, the work environment is orderly and effective, the regional apparatus institutions feel helped by the supervision and guidance by the Inpektorat of Central Kalimantan Province.For that through this thesis the authors provide suggestions that is expected for the Government to be able to overcome obstacles in implementing coaching and supervision, such as human resources limited personnel supervisory personnel, limited availability of budget.

Six-month follow-up of functional status in discharged patients with coronavirus disease 2019

Background The long-term functional outcome of discharged patients with coronavirus disease 2019 (COVID-19) remains unresolved. We aimed to describe a six-month follow-up of functional status of COVID-19 survivors.Methods We reviewed the data of COVID-19 patients who had been consecutively admitted to the Tumor Center of Union Hospital (Wuhan, China) between 15 February and 14 March 2020. We quantified a six-month functional outcome reflecting symptoms and disability in COVID-19 survivors using a post-COVID-19 functional status scale ranging from 0 to 5 (PCFS). We examined the risk factors for the incomplete functional status defined as a PCFS > 0 at a six-month follow-up after discharge.Results We included a total of 95 COVID-19 survivors with a median age of 62 (IQR 53-69) who had a complete functional status (PCFS grade 0) at baseline in this retrospective observational study. At six-month follow-up, 67 (70.5%) patients had a complete functional outcome (grade 0), 9 (9.5%) had a negligible limited function (grade 1), 12 (12.6%) had a mild limited function (grade 2), 7 (7.4%) had moderate limited function (grade 3). Univariable logistic regression analysis showed a significant association between the onset symptoms of muscle or joint pain and an increased risk of incomplete function (unadjusted OR 4.06, 95%CI 1.33 - 12.37). This association remained after adjustment for age and admission delay (adjusted OR 3.39, 95%CI 1.06 - 10.81, p = 0.039).Conclusions A small proportion of discharged COVID-19 patients may have an incomplete functional outcome at a six-month follow-up; intervention strategies are required.

Preoperative and postoperative radiomorphological changes in the bones forming the knee joint of patients with tibial shortening and deformities of different etiology

Introduction. Tibial lengthening is one of highly popular surgical procedures that can be associated with complications of the knee joint related to surgical intervention or baseline changes in the bones forming the knee. Objective. To explore preoperative and postoperative changes in the bones forming the knee joint of patients with tibial shortening of different etiology. Material and methods. Radiography and multislice computed tomography (MSCT) were performed for 48 achondroplasia patients, 15 subjects with subjectively low height, 25 patients with vitamin-D resistant rickets (MRI produced for 20 patients), 56 patients with Blount’s disease (MSCT produced for 10 cases) before and after tibial lengthening or deformity correction. Results. The findings showed that tibial lengthening was accompanied by limited function of the knee even in absence of evident articular changes. Good results could be ensured with adequately performed lengthening technique and proper control of muscle condition and rehabilitation program to be meticulously followed. Patients with baseline problems in the joints were shown to have progressive changes in the knee joints during tibial lengthening, however, they were not critical and could provide a normal function at a long-term follow-up. Conclusion. Tibial lengthening as a complicated biomechanical and morphological process is accompanied by changes in the knee joint and can be successfully accomplished with adequate technique applied and rehabilitation program performed. Chnages in the knee were more evident in patients with baseline disorders in the anatomy and architechtonics of the femoral and tibial condyles, however, improved biomechanical parameters of the limb allowed us to obtain positive outcomes and good function in almost all the cases.

Near-Field Warping Sampling Scheme for Broad-Side Antenna Characterization

In this paper the problem of sampling the field radiated by a planar source observed over a finite planar aperture located in the near-field is addressed. The problem is cast as the determination of the spatial measurement positions which allow us to discretize the radiation problem so that the singular values of the radiation operator are well-approximated. More in detail, thanks to a suitably warping transformation of the observation variables, the kernel function of the relevant operator is approximated by a band-limited function and hence the sampling theorem applied to achieved discretization. It results in the sampling points having to be non-linearity arranged across the measurement aperture and their number can be considerably lowered as compared to more standard sampling approach. It is shown that the proposed sampling scheme works well for measurement apertures that are not too large as compared to the source’s size. As a consequence, the method appears better suited for broad-side large antenna whose radiated field is mainly concentrated in front of the antenna. A numerical analysis is included to check the theoretical findings and to study the trade-off between the field accuracy representation (over the measurement aperture) and the truncation error in the estimated far-field radiation pattern.