COVID-19-associated encephalitis or Creutzfeldt–Jakob disease: a case report

Background: Accurate diagnosis and management of patients with rapidly progressive dementia may be challenging during the COVID-19 pandemic, which has negatively influenced the diagnostic performances, medical resource allocation and routine care for all non-COVID-19 diseases. Case Presentation: We herein present a case of a 57‐year‐old male with rapidly progressive cognitive decline, headache, diplopia, myalgia, unsteady gait, aggression, depression, insomnia, hallucinations and delusions of persecution. COVID-19-associated encephalitis was briefly considered as a differential diagnosis. However, this hypothesis was rejected upon further investigation. A final diagnosis of sporadic Creutzfeldt–Jakob disease was made. Conclusion: A timely and accurate diagnosis of Creutzfeldt–Jakob disease gives patients and their families the chance to receive a good standard of healthcare and avoid extensive evaluations for other conditions.

P-P04 The cost of acute pancreatitis is amylasing!

Background Amylase is the key serum biomarker in the diagnosis of acute pancreatitis, however there is no indication for repeat/serial measurement once the diagnosis is established. It is estimated that £27,000pa is spent unnecessarily on repeat amylase investigations without clinical indication1. Anecdotally, within the department, unnecessary repeats were being routinely performed. Resultantly, we audited in 2019 and 2020 to understand the extent of the issue. Following the first cycle, pre-rotation departmental talks were given to all relevant healthcare staff. Aim(s) Methods Data was collected and analysed retrospectively over 2 audit cycles (C1 & C2) from 79 patient episodes of admissions to the surgical department of a Northern Major Trauma Centre with confirmed diagnoses of acute pancreatitis between 01/05/2019 – 31/07/2019 and 01/08/2020 – 31/12/2020. Resources used included: patient notes, IMPAX and WebICE. Data was collected and analysed by one author in C1 but multiple authors in C2. Results Mean age = 60 years. Male:Female ratio was 8:16 and 24:31, respectively. Initial amylase was diagnostic in > 75% (61/79). 81 unnecessary repeats performed. Most patients underwent imaging (75% and 67%) however, only approximately one-third (30.8% and 32.4%) of scans were performed to confirm the diagnosis. • Despite imaging confirming the diagnosis in 88%, >50% of imaged patients had repeat amylase testing. Conclusions The results demonstrate that our intervention, a pre-rotation departmental talk, has significantly reduced the over-requesting of amylase and current practice is of a good standard. Improvements are still required. Resultantly, we are additionally producing an electronic ‘alert’ into our investigations software that, on requesting a repeat amylase, will prompt clinicians to consider its necessity. Other centres offering acute treatment for similar patients may benefit from performing a similar audit to optimise care while reducing overall clinical costs.

INFLUENCE OF THE POURING DIRECTION ON THE QUALITY OF THE MELT ENTERING THE MOLD AND OBTAINING A GOOD STANDARD CAST IRON SAMPLE

The paper presents the results of computer simulation (on the example of grey cast iron of SCH 20 grade) of the influence of melt pouring direction on the degree of defects of shrinkage origin in the axial zone of the neck of a tensile sample when filling the mold cavity with a standard cast sample for optimal values of melt mass flow rate.

A Field Measurement of Noise Comfort Classroom in Xaverius Pringsewu Senior High School

A school is a place where all learning activities are carried out by students. In learning activities in the classroom, it must meet a good standard of comfort, especially the noise factor. Classroom noise can be caused by external and internal factors. The audial comfort level for classrooms is standard 55 Dba. The purpose of this study was to determine and analyze the comfort level of noise in the classroom at Xaverius Pringsewu High School. The research methods were field measurement using sound level meter. In addition survey was conducted on building users with questionnaire to know about perception of audio comfort.The classrooms studied have a classroom design where the wall vents of the two classes have different heights. With a different ventilation design, it will certainly affect the noise conditions in the classroom. The study resulted that classroom RK 1 was noisier than the classroom RK 2 due to the different class design where the classroom RK 1 had wide ventilation on the wall, while the classroom RK 2 had a closed room with vents on the door and window.

THE ENHANCEMENT OF CULTURAL TOURISM ROUTES IN THE LANNA REGION OF NORTHERN THAILAND

The Lanna region is a former kingdom in the area of modern-day Northern Thailand that also once extended into Myanmar, Laos and China. Currently, Lanna culture is used as a selling point for tourism to Northern Thailand, but there are problems with the way tourism routes are designed and packaged. This paper aims to promote the architectural value of Lanna culture through the development of tourism routes. The qualitative investigation assesses existing Lanna tourist routes in Northern Thailand and develops guidelines for the development of cultural tourism in the region. Initial research led to the identification of 35 sites for in-depth evaluation. Data was gathered by document research, field evaluation and interviews following criteria co-developed by Chulalongkorn University and the Department of Tourism (2007). Findings indicated that destinations in Northern Thailand are of a good standard but should be developed in terms of tourism support and management. The researchers produced guidelines for the development of individual attractions and designed cultural routes according to provincial boundaries and periodic themes.

Building Arabic Paraphrasing Benchmark based on Transformation Rules

Measuring semantic similarity between short texts is an important task in many applications of natural language processing, such as paraphrasing identification. This process requires a benchmark of sentence pairs that are labeled by Arab linguists and considered a standard that can be used by researchers when evaluating their results. This research describes an Arabic paraphrasing benchmark to be a good standard for evaluation algorithms that are developed to measure semantic similarity for Arabic sentences to detect paraphrasing in the same language. The transformed sentences are in accordance with a set of rules for Arabic paraphrasing. These sentences are constructed from the words in the Arabic word semantic similarity dataset and from different Arabic books, educational texts, and lexicons. The proposed benchmark consists of 1,010 sentence pairs wherein each pair is tagged with scores determining semantic similarity and paraphrasing. The quality of the data is assessed using statistical analysis for the distribution of the sentences over the Arabic transformation rules and exploration through hierarchical clustering (HCL). Our exploration using HCL shows that the sentences in the proposed benchmark are grouped into 27 clusters representing different subjects. The inter-annotator agreement measures show a moderate agreement for the annotations of the graduate students and a poor reliability for the annotations of the undergraduate students.

The Process of Emotional Regulation

Emotional regulation is a developmental skill that everyone must learn. It is the ability for you to tune into, make sense of and control your own strong feelings. It affectively influences how well you can adapt to situations and events in your life, as well as how you navigate and adapt to the world. A lack of healthy emotional regulation can lead one to become dysregulated. Two important phenomenon underpin our ability to regulate: emotional complexity and splitting. The more acknowledgment and understanding that we give to our emotions (not just the thoughts in our mind but the feelings in our better), the more control and problem solving skills we can harness to sustain a good standard of personal well-being.

INFLACIÓN QUE PAUPERIZA EL PODER ADQUISITIVO (DERECHO AL SUBSIDIO) INFLATION THAT PAUPERIZES PURCHASING POWER (RIGHT TO SUBSIDY)

Resumen: En esta era globalizada parece ser que la pobreza y la segregación son el signo distintivo de la vida diaria. Podría pensarse que en la era digital y de la información todos los seres humanos del orbe tendríamos acceso a mejores y mayores oportunidades, pero eso no es así debido a que el valor adquisitivo del dinero se ve amenazado por el constante aumento de los precios.La paradoja es que volverse pobre sale caro porque significa tener menos oportunidades para acceder a un mejor nivel de vida. ¿Qué significa el hecho de tener un buen nivel de vida? Simple y llanamente todo aquello que permite satisfacer las necesidades básicas de las personas. ¿Ser pobre se refiere a lo estrictamente monetario? O ¿Hay otras cuestiones que también deben de considerarse como parámetros para medir los niveles de pobreza?¿No acaso nos empobrecen en nuestra salud con la calidad del aire que respiramos actualmente? ¿La comida chatarra –alimento carente de nutrientes- que nos venden en los OXXO’s –y que proliferan como hongos por todas partes- no nos hacen más vulnerables a ser obesos y por ende más pobres en nuestra salud?Es más, podemos hablar de la pobreza que tenemos con relación al tiempo del que disponemos o en relación con la generación de tecnología. Hace veinte años se empezó a utilizar el famoso horario de verano que en nada beneficia a la salud del ser humano además de que disponen de nuestro tiempo. ¿No es el tiempo propiedad de cada ser humano? Y si el tiempo es propiedad de cada ser humano ¿Con qué Derecho nos quitan una hora diaria durante siete meses al año?Muchas son las cuestiones que deben replantearse en torno a los conceptos de la pobreza y no pensar en términos estrictamente monetarios. Por ejemplo, es cierto que ser pobre en salud repercute en tener que utilizar más recursos monetarios en medicinas y médicos para mantener a esta última.Por último, la escasez más peligrosa es aquélla que se traduce en la falta de conocimientos que nos ayuden a generar riqueza para la sociedad y para las personas de manera individual.Abstrac: In this globalized age it seems that poverty and segregation are the distinguishing characteristic of daily life. It could be thought that in the digital and information age all human beings in the world would have access to better and greater opportunities, but that is not the reality because the purchasing power of mammon is threatened by the constant increase in prices.The paradox is that becoming poor is expensive because it means having fewer opportunities to access a better standard of living. What does it mean to have a good standard of living? Simple and plainly everything that allows satisfying the basic needs of the people. Is being poor strictly monetary? O Are there other issues that should also be considered as parameters to measure poverty levels?Are we not being impoverished in our health with the quality of the air we currently breathe? Doesn't the junk food -food lacking in nutrients- that they sell us in the OXXO’s –and that proliferate like mushrooms everywhere- make us more vulnerable to being obese and therefore poorer in our health?Furthermore, we can talk about the poverty we have in relation to the time we have or in relation to the generation of technology. Twenty years ago, the famous summertime began to be used, which does not benefit human health in any way other than that they dispose of our time. Isn't time the property of every human being? And if time is the property of each human being, with what right do they take away an hour a day for seven months a year?There are many questions that must be rethought around the concepts of poverty and not think in strictly monetary terms. For example, it is true that being poor in health has an impact on having to use more monetary resources on medicines and doctors to support the latter.Finally, the most dangerous scarcity is that which translates into a lack of knowledge that helps us generate wealth for society and for people individually.

Multidrug-resistance and mobile colistin resistance (mcr) genes of Salmonella isolates from pork in Thailand during 2014-2017: comparison between two different types of slaughterhouses and retails

Food-producing animals are the major reservoir for Salmonella infections in humans. Salmonella contamination and spread of antimicrobial resistance genes can occur during the production chain of animal products. The aims of this study were to investigate antimicrobial resistance patterns and compare the proportions of multidrug resistance and the presence of mobile colistin resistance (mcr) genes, mcr-1, mcr-2 and mcr-3, among Salmonella isolates which were recovered from pork at two different standard practice slaughterhouses and retails during 2014-2017 in Thailand. Salmonella isolates recovered from good standard practice slaughterhouses (GSH, n=75), below standard practice slaughterhouses (BSH, n=75), good standard practice retails (GRT, n=75) and below standard practice retails (BRT, n=75) were examined for their antimicrobial resistance patterns and the existence of mcr-1 to mcr-3 genes. Salmonella strains of the 4 origins showed similar resistance rates to almost all antimicrobial agents tested. BRT origin (33/75, 44%) had slightly higher proportion of MDR Salmonella than the others group with no statistical difference. Five MDR Salmonella isolates carrying the mcr-3 gene were detected among isolates of all origins, while only 4 isolates (1.33%) displayed colistin resistance phenotype (MIC 4-8 ug/mL). This study revealed that MDR Salmonella isolates have widely spread in both standard and low hygiene practice slaughterhouses and retails. This is the first report of mcr-3 positive MDR Salmonella isolates from pork in Thailand. Effective monitoring program in slaughterhouses and retails should be continually implemented to reduce the contamination of MDR Salmonella carrying the mcr gene to consumers.

Febri dwi laksana, Evaluasi Program Jamianan Kesehatan Indonesia (Studi Kasus Penanganan Covid 19 di Indonesia)

World health organization, WHO, guarantees that every community in the world gets a good standard of health services. Through Universal Health Coverage, it is hoped that countries around the world are able to raise the level of health services that have so far been overlooked. This is done as an effort to guarantee human rights that guarantee rights freedom of life and the right to health services. But the health standard system (UHC) is still lacking in its application in Indonesia. This is seen from several important points that occur in Indonesia. Hospital facilities are still inadequate, especially hospitals in the region. In this paper I will provide information regarding evaluations carried out on the health insurance program in Indonesia with case studies of how to deal with Covid 19 in Indonesia whether it is in accordance with health standards or not.