Introdução: A síndrome de reconstituição imune (SIRI) é uma resposta inflamatória anômala que ocorre em pacientes com HIV após iniciar a terapia antirretroviral (TARV). Manifesta-se através de ...sintomas associados à reativação de doenças prévias. Possui relevância clínica devido ao seu impacto na morbidade e mortalidade dos pacientes. Sua ocorrência está correlacionada a alguns fatores de risco que o nosso paciente apresenta. Descrição: Relatamos o quadro de paciente do sexo masculino, 41 anos, que recebeu diagnóstico de HIV ao investigar quadro pulmonar com evolução de 3 meses, com confirmação por PCR de tuberculose pulmonar. Na primo-internação realizou-se pesquisa exaustiva de demais co-infecções excluídas e documentadas para início seguro da TARV (Tenofovir, Lamivudina e Dolutegravir). Em período inferior a 30 dias apresentou deterioração do padrão respiratório com hipoxemia, piora de imagem pulmonar e exames laboratoriais, bem como aumento brusco de hepatimetria, considerados como manifestação de reconstituição imune intensa, com posterior confirmação de leishmaniose visceral e histoplasmose concomitantes, confirmados com antígeno sérico e urinário, respectivamente, previamente negativos. A SIRI foi confirmada pela queda da carga viral e aumento inabitual de CD4 de 170 para 2688 células no curto período. Comentários: A co-infecção de leishmaniose e histoplasmose durante a SIRI é rara e pode resultar em manifestações clínicas mais exuberantes e graves, exigindo desafios adicionais ao seu manejo no período crítico e nas escolhas terapêuticas devido às múltiplas interações medicamentosas. Esse caso ilustra a complexidade do manejo desses pacientes, susceptíveis à SIRI mesmo após seguir os protocolos para condução segura do tratamento, bem como necessidade de vigilância cautelosa para intervenção em tempo hábil para que o paciente se recupere sem sequelas e mantenha sua independência e qualidade de vida.
•The current study explores how humans interact with an intelligent virtual agent, Siri, and how such interactions impact their comfortable feelings toward Siri as various relational partners.•Higher ...levels of trust in cognitive dimensions were associated with performing functional tasks assisted by Siri.•Stronger faith in Siri was observed when participants’ gender matched with the gender of Siri's voice.•Copresence, a dimension of social presence, and faith and personal attachment, affective dimensions of trust, facilitated comfortable feeling toward Siri as a coworker, supervisor, or friend.
The current study explores how humans interact with an intelligent virtual agent (IVA), Siri, on their mobile phones and how such experiences may impact their trust, social presence, and comfort level toward the IVA as a coworker, supervisor, and friend. A two (male- vs. female-voice of Siri) by two (functional vs. social task) by two (matched vs. ummatched with participants’ gender) between-subjects experiment was performed with 163 participants. Higher levels of trust in cognitive dimensions were associated with functional tasks assisted by Siri, and one interaction between participants’ gender and Siri's gendered voice was observed in an affective dimension of trust, faith. Copresence dimension of social presence was associated with technical competence, understandability, faith, and personal attachment dimension of trust whereas psychological involvement was related with reliability and technical competence. Copresence, alongside faith and personal attachment, both affective dimensions of trust, seemed to facilitate comfortable feelings toward Siri imagined as various relational partners.
Artificial intelligence (AI) has the potential to change consumer behavior. However, despite billions of consumers using mobile smart phones, adoption of (artificial) intelligent voice assistants, ...like Siri, is relatively low. A conceptual model was constructed to determine the influence of consumer trust, interaction, perceived risk, and novelty value on brand loyalty for AI supported devices. Using the MTurk platform, data was collected from a sample of 675 Apple iPhone-using respondents. The findings showed perceived risk seems to have a significantly negative influence on brand loyalty; however, other factors were found to have a significantly positive influence on brand loyalty. The influence of novelty value of using Siri was found to be moderated by brand involvement and consumer innovativeness in such a way the influence is greater for consumers who are less involved with the brand and who are more innovative.
ABSTRAK Status anak dalam hukum keluarga dapat di kategorikan menjadi dua macam yaitu: anak yang sah dan anak yang tidak sah. Anak sah adalah anak yang lahir didalam atau akibat suatu perkawinan ...yang sah sebagaimana dijelaskan dalam Pasal 42 Undang-Undang RI Nomor 1 Tahun 1974 tentang Perkawinan yang berbunyi: “Anak yang sah adalah anak yang dilahirkan dalam atau sebagai akibat perkawinan yang sah”, dan anak yang tidak sah adalah anak yang dilahirkan diluar perkawinan yang sah dan perkaewinannya sering disebut sebagai perkawinan/nikah siri. Disebut dengan perkawinan siri karena perkawinan itu dilaksanakan hanya mengikuti ketentuan agama yang bisa dikatakan sebagai kawin bawah tangan dan tersembunyi (siri), ada faktor yang menyebabkan terjadinya perkawinan siri dan diantaranya karena menutup malu keluarga karena calon mempelai telah hamil dan belum berusia dewasa. Anak yang lahir dari perkawinan siri dikatan anak tidak sah karena terlahir dari perkawinan yang tidak sesuai ketentuan hukum perkawinan, akibatnya anak tersebut tidak memiliki hubungan nasab (baca: akte lahir) dari orang tuanya sebagai bentuk bukti nasab yang merupakan hak bagi setiap anak yang lahir Dalam Islam untuk menentukan nasab anak dapat dilakukan beberapa cara, diantaranya: • Melalui pernikahan yang sah • Dengan cara melalui pengakuan atau gugatan terhadap anak • Melalui pembuktian • Melului perkiraan ( Qiyafah) Kata Kunci: Hukum, Fikih, Perkawinan, Siri, Nasab, Anak
Systemic inflammation response index (SIRI=N×M/L), based on neutrophil (N), monocyte (M), and lymphocyte (L) counts, is used to predict the survival of patients with malignant tumors and can fully ...evaluate the balance between host immune and inflammatory condition. The present study is aimed to evaluate the potential prognostic significance of SIRI in patients with breast cancer undergoing neoadjuvant chemotherapy.
A total of 262 breast cancer patients treated with neoadjuvant chemotherapy were enrolled in this retrospective study. The optimal cutoff value of SIRI by receiver operating characteristic curve stratified patients into low SIRI (<0.85×10
/L) group and high SIRI (≥0.85×10
/L) group. The associations between breast cancer and clinicopathological variables by SIRI were determined by chi-square test or Fisher's exact test. Kaplan-Meier plots and log-rank test were used to evaluate the clinical outcomes of disease-free survival (DFS) and overall survival (OS). Univariate and multivariate Cox proportional hazards regression models were used to analyze the prognostic value of SIRI. The toxicity of neoadjuvant chemotherapy was evaluated by the National Cancer Institute Common Toxicity Criteria (NCICTC).
The results were shown that SIRI had prognostic significance by optimal cutoff value of 0.85×10
/L on DFS and OS in univariate and multivariate Cox regression survival analyses. Compared with patients who had high SIRI, patients with low SIRI had longer DFS and OS (41.27 vs 30.45 months, HR: 1.694, 95% CI: 1.128-2.543, P=0.011; 52.86 vs 45.75 months, HR: 1.288, 95% CI: 0.781-3.124, P=0.002, respectively). The patients with low SIRI had better 3-, 5-, and 10-year rates of DFS and OS than those with high SIRI. The common toxicities after neoadjuvant chemotherapy were hematologic and gastrointestinal reaction, and the SIRI had no significance on toxicities of all enrolled patients, excepted diarrhea. In patients without neural invasion, those with low SIRI had better prognosis and lower recurrence rates than those with high SIRI.
Pretreatment SIRI with the advantage of repeatable, convenient, and non-invasive is a useful prognostic indicator for breast cancer patients who received neoadjuvant chemotherapy and is a promising biomarker for breast cancer on treatment strategy decisions.
A study was undertaken with an objective to assess productive and reproductive performance of Siri cattle in West Bengal. The study was conducted among 80 farmers rearing either Siri-Pure or ...Siri-Graded cattle in the hilly region. Equal numbers of respondents either rearing Siri-Pure or Siri-Graded cattle were randomly selected from Darjeeling and Kalimpong districts for the study. The study on productive performance of Siri-Pure and Siri- Graded cattle shows that mean first lactation milk yield was 469.7 and 497.2 litres, daily milk yield was 3.2 and 3.7 litres, peak milk yield was 3.8 and 4.2 litres, total lactation milk yield was 864.1 and 1035.5 litres, lactation length was 273.4 and 284.8 days and dry period was 189.3 and 167.9 days. The t-test shows highly significant difference between Siri-Pure and Siri-Graded cattle in first lactation milk yield, daily milk yield, total lactation milk yield and lactation length in productive performance whereas age at first services, calving intervals and gestation period in reproductive performance. The reproductive performance of Siri-Pure and Siri-Graded cattle shows that mean age at first services was 38.47 and 31.65 months, gestation period was 285.2 and 279.1 days, heat interval was 27.8 and 28.2 days, number of services per conception was 1.3 and 1.3 times, and calving intervals recorded as 463.7 and 452.7 days respectively. The age at first service was significantly lower in large farmers and significantly higher calving interval in small farmers rearing Siri-Pure cattle. Daily milk yield, peak milk yield and total milk yield was significantly higher in large and medium farmers than small farmer rearing Siri-Pure cattle whereas total milk yield was significantly higher in large farmers than small and medium farmers rearing Siri-Graded cattle.
Tradisi uang panai’ adalah salah satu tradisi suku Makassar yang selalu menarik untuk dikaji. Tradisi ini adalah bagian dari budaya siri’ na pacce dari suku bugis Makassar yang tetap eksis di era ...modern. Meski dalam pelaksanaannya telah terjadi pergeseran nilai, dimana makna uang panai tidak sama dari makna pada awal munculnya tradisi ini tapi hal tersebut tidak menjadikan tradisi uang panai terkikis di masyarakat bugis tapi sebaliknya tradisi ini semakin berkembang. Pada awal munculnya uang panai’ diyakini sebagai bentuk penghargaan dan penghormatan kepada perempuan bangsawan dari seorang laki-laki yang akan meminang perempuan berdarah biru. Dengan kata lain uang panai sebenarnya membeli darah perempuan bangsawan, sedang untuk perempuan yang tidak berketurunan bangsawan tidak mendapatkan uang panai’ dari laki-laki yang akan meminangnya pada saat itu. OLeh karena itu menarik jika pergeseran makna pada uang panai dilihat dari persepektif budaya siri na pacce. Metodologi Penelitian ini menggunakan metode kajian pustaka ( library research). Untuk penelitian selanjutnya diharapkan dapat diteliti nilai-nilai pada tradisi uang panai’ yang juga banyak mengalami pergeseran makna.
Purpose – In the procedural rules of marriage within the Indonesian Islamic society, it is stipulated that marriages must be officially recorded and published in accordance with Marriage Law No. 1 of ...1974. In reality, not all segments of the Indonesian population adhere to the established procedures or rules. This is evidenced by the fact that a portion of the population in the Tualang District of Siak Regency still engages in unregistered marriages that are not officially documented or published, which deviates from the provisions of Law No. 1 of 1974 on Marriage and the Compilation of Islamic Law. This study aimed to identify the factors underlying the occurrence of unregistered marriages in the Tualang District. Methods – To achieve this objective, the researcher employed qualitative research methodology. Data collection was carried out using observation, interview, and documentation methods. The data validity testing technique used was triangulation of sources and methods. Data analysis was conducted using an interactive analysis model consisting of data collection, data reduction, data presentation, and drawing conclusions. Findings – The research findings indicate that the practice of unregistered marriages in the Tualang District is similar to regular marriages, with the key distinction being the lack of official documentation. The factors contributing to unregistered marriages in the Tualang District include: out-of-wedlock pregnancies, economic factors, and the desire for polygamy. Research implications/limitations – The impacts of unregistered marriages on the community include ease of conducting marriages, difficulties in obtaining birth certificates for children, a higher likelihood of divorce, document forgery, and conflicts. Originality/value – The results of this research are expected to be a practical reference for the community and government to overcome the problem of nikah siri. The factors that cause nikah siri described in this research can be an illustration for the government to be able to formulate policies related to the problem of siri marriage.
Objective
To evaluate System Inflammation Response Index (SIRI) and Systemic Immune Inflammation Index (SII), which are the inflammatory indices, for the prediction of gestational diabetes mellitus ...(GDM) in the first trimester.
Methods
This was a prospective observational study conducted in a tertiary center from April 2023 to September 2023. Ninety‐four pregnant women with gestational diabetes and 107 healthy pregnant women were included. The two groups were compared according to first‐trimester SIRI and SII values. A receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut‐off levels of SII and SIRI in predicting GDM.
Results
Significantly higher first‐trimester SII and SIRI values were present in the gestational diabetes group (P < 0.001). Optimal cut‐off values in the prediction of gestational diabetes were found to be 1.58 (area under the curve AUC 0.71, 67% sensitivity, 65% specificity, 95% confidence interval CI 0.64–0.78, P < 0.001) and 875 (AUC 0.70, 66% sensitivity, 65% specificity, 95% CI 0.63–0.77, P < 0.001) for SIRI and SII, respectively. Neutrophil counts, mean platelet volume (MPW), neutrophil to lymphocyte ratio (NLR), and red cell distribution width (RDW) were significantly higher in the GDM group (P < 0.001, P = 0.02, P = 0.01, P < 0.01, respectively).
Conclusion
Novel inflammatory indices SII and SIRI may be useful in the prediction of GDM in the first trimester, but their utility in the prediction of insulin requirement is questionable. They may be used as additional tools in routine clinical practice.
Synopsis
SIRI and SII indices between the 6th and 8th weeks of gestation were significantly higher in the GDM group than in healthy pregnant women.
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