Search

Kelapa Sawit merupakan sumber utama minyak kelapa sawit yang namanya mengacu pada negara asalnya yaitu Afrika. Minyak kelapa sawit didapat dari hasil pengolahan tandan buah segar (TBS) dipabrik, tujuan utama dari pengolahan kelapa sawit adalah mengurangi fosil dan dapat menghasilkan Crude Palm Oil CPO). Untuk memenuhi permintaan konsumen di bulan Januari-Juni 2021, CPO yang dihasilkan tidak memenuhi standar kualitas perusahaan yang telah disepakati dengan konsumen. Tingginya kadar asam lemak bebas mulai dari 5.02%-6.68%, kadar air mulai dari 0.16%-0.26% dan kadar kotoran mulai dari 0.020%-0.029%, Dengan kondisi tersebut, maka perlu dilakukan kegiatan analisis produksi untuk mengukur kualitas CPO, dengan menggunakan metode Seven Tools dan menerapkan konsep Kaizen. Yang bertujuan untuk meningkatkan kualitas CPO dan perbaikan sistem kerja di PT. Perekebunan Nusantara VI UU Solok Selatan. Berdasarkan hasil dari analisis kualitas CPO dengan menggunakan metode Seven Tools, diketahui bahwa rendahnya kualitas CPO disebabkan oleh 3 faktor yaitu kadar asam lemak bebas, kadar air dan kadar kotoran. Dimana dari hasil perhitungan menggunakan Seven Tools tersebut didapatkan tingkat tertinggi yang mempengaruhi rendahnya kualitas CPO adalah Kadar Asam Lemak Bebas (ALB). Yang terjadi sebanyak 20 kali, kemudian disusul oleh kadar kotoran sebanyak 15 kali dan kadar air sebanyak 11 kali dalam periode waktu Januari-Juni 2021. Usulan perbaikan sistem kerja dengan Konsep Kaizen menggunakan metode 5W+1H dan PDCA yaitu, melakukan pengumpulan buah tepat setelah pasca panen dan melakukan pengolahan buah kelapa sawit secara cepat. Agar tidak menumpuk dalam waktu yang lama, proses penyortiran buah dilakukan dengan teliti agar buah kelapa sawit yang diolah sesuai dengan standarisasi yang telah ditentukan, memberikan pelatihan berdasarkan divisi kerja karyawan agar tidak terjadi permasalahan, karyawan dianjurkan untuk memanfaatkan waktu istirahat dengan baik, agar saat bekerja bisa konsentrasi, melakukan pemeriksaan dan menjaga kebersihan secara keseluruhan

La vejiga neurogénica se relacionada con la disfunción del tracto urinario inferior, comprometiendo la funcionalidad de la vejiga, implicando un involuntario vaciamiento de la vejiga o a su vez un vaciado incompleto quedando residuos urinarios en base a una alteración de manera parcial o total de las vías neurológicas, favoreciendo la mayor predisposición del desarrollar infecciones del tracto urinario (ITU). Una de los procedimientos quirúrgicos más utilizados es el Mitrofanoff, permitiendo vaciar la vejiga, reducir las ITU y mejorando la calidad de vida. El objetivo principal de este estudio es el procedimiento de Mitrofanoff que se enfoca en mejorar la calidad de vida, un control de la vejiga neurogénica y reducir las complicaciones en pacientes pediátricos. Por lo que se realizó una búsqueda exhaustiva en base de datos como: SCOPUS, Pub Med, Taylor and Francis, Scient Direct. Se utilizó criterios de inclusión como: estudios cuantitativos, observacionales, retrospectivos, revisiones sistemáticas y metaanálisis; los criterios de exclusión fueron: estudios incompletos, estudios en animales, tesis, posgrado y publicaciones anteriores al 2018. El procedimiento de Mitrofanoff es una herramienta muy utilizada en pacientes pediátricos que se realizan auto cateterismo, siendo bueno para la protección de las vías urinarias bajas, mejorando el vaciamiento vesical demostrando una tasa de éxito en su totalidad.

IntroductionChildren often present to primary care with functional abdominal pain (FAP) or irritable bowel syndrome (IBS), and around half still have abdominal complaints 1 year later. Hypnotherapy is an evidence-based treatment that is used in specialist care, but it lacks evidence in primary care. This study will investigate the (cost) effectiveness of home-based guided hypnotherapy for children with FAP or IBS in primary care.Methods and analysisWe report the design of a pragmatic randomised controlled trial among children aged 7–17 years, diagnosed with FAP or IBS by their general practitioner (GP), with assessments over 12 months. The control group will receive care as usual (CAU) by their GP (eg, communication, education and reassurance), while the intervention group will receive CAU plus 3 months of home-based guided hypnotherapy via a website. The primary outcome will be the proportion of children with adequate relief from abdominal pain/discomfort at 12 months, analysed on an intention-to-treat basis. Secondary outcomes will include the adequacy of pain relief at 3 and 6 months, pain/discomfort severity, pain frequency and intensity, daily functioning and impact on function, anxiety and depression, pain beliefs, sleep disturbances, school absence, somatisation, and healthcare use and costs. We must include 200 children to determine a 20% difference in those with adequate relief (55% control vs 75% intervention).Ethics and disseminationThe Medical Ethics Review Committee of the University Medical Center Groningen, the Netherlands, approved this study (METc2020/237). The results will be disseminated to patients, GPs and other stakeholders via email, a dedicated website, peer-reviewed publications and presentations at national and international conferences. We plan to collaborate with the Dutch Society of GPs to implement the results in clinical practice.Trial registration numberNCT05636358.

Tropomyosin receptor kinase (TRK) inhibitors have been approved for metastatic solid tumors harboring NTRK fusions, but the detection of NTRK fusions is challenging. International guidelines recommend pan-TRK immunohistochemistry (IHC) screening followed by next generation sequencing (NGS) in tumor types with low prevalence of NTRK fusions, including metastatic colorectal cancer (mCRC). RNA-based NGS is preferred, but is expensive, time-consuming, and extracting good-quality RNA from FFPE tissue is challenging. Alternatives in daily clinical practice are warranted. We assessed the diagnostic performance of RNA-NGS, FFPE-targeted locus capture (FFPE-TLC), fluorescence in situ hybridization (FISH), and the 5′/3′ imbalance quantitative RT-PCR (qRT-PCR) after IHC screening in 268 patients with microsatellite-instability-high mCRC, the subgroup in which NTRK fusions are most prevalent (1–5%). A consensus result was determined after review of all assay results. In 16 IHC positive tumors, 10 NTRK fusions were detected. In 33 IHC negative samples, no additional transcribed NTRK fusions were found, underscoring the high sensitivity of IHC. Sensitivity of RNA-NGS, FFPE-TLC, FISH, and qRT-PCR was 90%, 90%, 78%, and 100%, respectively. Specificity was 100% for all assays. Robustness, defined as the percentage of samples that provided an interpretable result in the first run, was 100% for FFPE-TLC, yet more limited for RNA-NGS (85%), FISH (70%), and qRT-PCR (70%). Overall, we do not recommend FISH for the detection of NTRK fusions in mCRC due to its low sensitivity and limited robustness. We conclude that RNA-NGS, FFPE-TLC, and qRT-PCR are appropriate assays for NTRK fusion detection, after enrichment with pan-TRK IHC, in routine clinical practice.

Glycoprotein VI (GPVI) mediates collagen-induced platelet activation after vascular damage and is an important contributor to the onset of thrombosis, heart attack, and stroke. Animal models of thrombosis have identified GPVI as a promising target for antithrombotic therapy. Although for many years the crystal structure of GPVI has been known, the essential details of its interaction with collagen have remained elusive. Here, we present crystal structures of the GPVI ectodomain bound to triple-helical collagen peptides, which reveal a collagen-binding site across the β-sheet of the D1 domain. Mutagenesis and binding studies confirm the observed binding site and identify Trp76, Arg38, and Glu40 as essential residues for binding to fibrillar collagens and collagen-related peptides (CRPs). GPVI binds a site on collagen comprising two collagen chains with the core formed by the sequence motif OGPOGP. Potent GPVI-binding peptides from Toolkit-III all contain OGPOGP; weaker binding peptides frequently contain a partial motif varying at either terminus. Alanine-scanning of peptide III-30 also identified two AGPOGP motifs that contribute to GPVI binding, but steric hindrance between GPVI molecules restricts the maximum binding capacity. We further show that no cooperative interactions could occur between two GPVI monomers binding to a stretch of (GPO)5 and that binding of ≥2 GPVI molecules to a fibril-embedded helix requires non-overlapping OGPOGP motifs. Our structure confirms the previously suggested similarity in collagen binding between GPVI and leukocyte-associated immunoglobulin-like receptor 1 (LAIR-1) but also indicates significant differences that may be exploited for the development of receptor-specific therapeutics.

Bu kitapçık çocuk yanıkları ile karşılaşan pratisyen hekimler ve diğer sağlık profesyonelleri için güncel tedavi protokollerinin özetlendiği bir kaynak olarak hazırlanmıştır. Kendine has özellikleri nedeniyle yanık yarasının patofizyolojisinin bilinmesi yanık yarasına yaklaşımda neyin neden yapılması gerektiğinin anlaşılmasını sağlayacaktır. Sağlıklı derinin yapısı ile yanık yarasının iyileşme aşamalarının detaylandırıldığı bölümlerde temel anatomik ve histolojik bilgiler özetlenmiştir. Bunun yanı sıra yanık hastasına ve yanık yarasına yaklaşımda çocuk yanıklarını erişkin yanıklarının küçüğü olarak değerlendirme hatasına düşülmemesi için dikkat edilmesi gereken hususlar üzerinde durulmuştur.

The individual differences are widely held in the field of moral decision-making. Yet, there is a scarce evidence about the link between attachment system and moral-decision making processes. One of these few number of investigations claimed that anxious attachment style and utilitarian dispositions mediated by discomfort with caring for others and attachment anxiety predicted utilitarian judgment (Koleva, et al., 2014; Robinson et al., 2015). However, as there is a few number of investigation considering the underlying mechanism of the relationship between moral judgments and attachment styles, there is still a need for further evidence. In this study, we aim to investigate the moral judgments using CNI model (Gawronski, et al., 2017), which enable us to differentiate the varied responses and their determinants (sensitivity to consequences, sensitivity to norms and inaction preferences over action), and the link of these responses with the varied caregiving system activations. Specifically, we predicted that deactivation of the caregiving behavioral system would be positively related to inaction, whereas hyperactivation of the caregiving behavioral system would be positively related to action preferences. Additionally, we predict that deactivation of the caregiving behavioral system would be positively related to sensitivity to norms, while higher hyperactivation of the caregiving behavioral system would be positively related to sensitivity to consequences.

The importance of oxidative stress in the pathogenesis of burn injuries has been shown in various studies. Glutathione (GSH) and thiols have important roles in antioxidant protection and detoxification. The study aimed to investigate the relationship between pediatric burn trauma and GSH and thiol homeostasis. Twenty-nine children with thermal-burn injuries and 29 healthy peers are included in this prospective randomized study. Children with burn wounds of 15–25% of total body surface area (TBSA) were included in the patient group. The control group was created from healthy peers of both sexes. All children were 1–10 years of age. Serum GSH, oxidized glutathione (GSSG), redox ratio (GSH/GSSG), and thiol–disulfide (SS) tests were conducted in both groups, and the changes between admission and day 7 were analyzed in patients with burn injuries. The mean age was 4.09 ± 2.54 years for the patient group and 4.28 ± 2.55 years for the controls (p > 0.05). Total thiol (TT), native thiol (SH), and SS levels were significantly lower in the patient group than in the controls (TT = 291.69 ± 7.93 vs 346.79 ± 18.89 μmol/L, SH = 259.39 ± 7.90 vs 297.64 ± 12.81 μmol/L, SS = 16.15 ± 4.68 vs 24.58 ± 5.76 μmol/L; p < 0.001). SH/TT ratio was higher in the patient group (89.05 ± 3.00 vs 85.93 ± 3.01 μmol/L; p < 0.001). The SS/SH and SS/TT ratios were significantly lower in the patient group, while the SH/TT ratio was significantly higher (p < 0.001). The patients had significantly decreased GSH levels (26.12 ± 2.42 vs 34.80 ± 2.26) and GSH/GSSG ratios (1.69 ± 0.12 vs 3.05 ± 0.29) and increased GSSG levels (16.09 ± 0.34 vs 11.48 ± 1.17, p < 0.001 for all). The GSSG level and GSSG/SH and GSSG/TT ratios were higher in the patient group than in the controls while the SH, TT, and SS levels, and SS/SH and SS/TT ratios were lower in the patient group. Analysis of serum GSSG levels, and ratios with SH and TT homeostasis, might be useful in order to determine burn damage in children.