ANALISIS MANAJEMEN LAYANAN TEKNOLOGI INFORMASI DENGAN FRAMEWORK (ITIL) DOMAIN SERVICE STRATEGY

klinik pratama aisyiyah pekanbaru merupakan salah satu klinik yang ada di pekanbaru. tepatnya dijalan KH Ahmad Dahlan. di klinik pratama aisyiyah pekanbaru sudah menggunakan aplikasi dalamkesehariannya, aplikasi tersebut bernama KANZA. aplikasi tersebut berbasis java dan aplikasitersebut sudah mencakup seluruh pengerjaan di klinik mulai dari sistem antrian hingga rekammedis. Namun aplikasi ini terdapat beberapa kekurangan yaitu tampilan ui/ux dari aplikasi yangmembingungkan calon pasien sehingga aplikasi ini kurang efektif jika digunakan secara umum (olehpasien dan staf klinik). dan juga aplikasi ini selama penggunaan sejak tahun 2019 pernah diretasyang artinya aplikasi ini masih rentan terhadap hacker. namun teknisi klinik dengan sigapmemperbaiki firewall dari aplikasi KANZA. Karena hal tersebut penelitian ini sangat perludituntaskan sampai akhir sehingga jurnal ini nantinya dapat digunakan sebagai rujukan bagiinstansi yang mengalami kasus yang mirip atau sama dengan penelitian ini, serta khusus nya diKlinik Pratama Aisyiyah Pekanbaru yang menjadi objek penelitian kami

Reduced microvascular density in omental biopsies of children with chronic kidney disease

Endothelial dysfunction is an early manifestation of cardiovascular disease (CVD) and consistently observed in patients with chronic kidney disease (CKD). We hypothesized that CKD is associated with systemic damage to the microcirculation, preceding macrovascular pathology. To assess the degree of "uremic microangiopathy", we have measured microvascular density in biopsies of the omentum of children with CKD.Omental tissue was collected from 32 healthy children (0-18 years) undergoing elective abdominal surgery and from 23 age-matched cases with stage 5 CKD at the time of catheter insertion for initiation of peritoneal dialysis. Biopsies were analyzed by independent observers using either a manual or an automated imaging system for the assessment of microvascular density. Quantitative immunohistochemistry was performed for markers of autophagy and apoptosis, and for the abundance of the angiogenesis-regulating proteins VEGF-A, VEGF-R2, Angpt1 and Angpt2.Microvascular density was significantly reduced in uremic children compared to healthy controls, both by manual imaging with a digital microscope (median surface area 0.61% vs. 0.95%, p<0.0021 and by automated quantification (total microvascular surface area 0.89% vs. 1.17% p = 0.01). Density measured by manual imaging was significantly associated with age, height, weight and body surface area in CKD patients and healthy controls. In multivariate analysis, age and serum creatinine level were the only independent, significant predictors of microvascular density (r2 = 0.73). There was no immunohistochemical evidence for apoptosis or autophagy. Quantitative staining showed similar expression levels of the angiogenesis regulators VEGF-A, VEGF-receptor 2 and Angpt1 (p = 0.11), but Angpt2 was significantly lower in CKD children (p = 0.01).Microvascular density is profoundly reduced in omental biopsies of children with stage 5 CKD and associated with diminished Angpt2 signaling. Microvascular rarefaction could be an early systemic manifestation of CKD-induced cardiovascular disease

Global Potato Yields Increase Under Climate Change With Adaptation and CO2 Fertilisation

The contribution of potatoes to the global food supply is increasing—consumption more than doubled in developing countries between 1960 and 2005. Understanding climate change impacts on global potato yields is therefore important for future food security. Analyses of climate change impacts on potato compared to other major crops are rare, especially at the global scale. Of two global gridded potato modeling studies published at the time of this analysis, one simulated the impacts of temperature increases on potential potato yields; the other did not simulate the impacts of farmer adaptation to climate change, which may offset negative climate change impacts on yield. These studies may therefore overestimate negative climate change impacts on yields as they do not simultaneously include CO2 fertilisation and adaptation to climate change. Here we simulate the abiotic impacts of climate change on potato to 2050 using the GLAM crop model and the ISI-MIP ensemble of global climate models. Simulations include adaptations to climate change through varying planting windows and varieties and CO2 fertilisation, unlike previous global potato modeling studies. Results show significant skill in reproducing observed national scale yields in Europe. Elsewhere, correlations are generally positive but low, primarily due to poor relationships between national scale observed yields and climate. Future climate simulations including adaptation to climate change through changing planting windows and crop varieties show that yields are expected to increase in most cases as a result of longer growing seasons and CO2 fertilisation. Average global yield increases range from 9 to 20% when including adaptation. The global average yield benefits of adaptation to climate change range from 10 to 17% across climate models. Potato agriculture is associated with lower green house gas emissions relative to other major crops and therefore can be seen as a climate smart option given projected yield increases with adaptation

Expression of the transcription factor, TFII-I, during post-implantation mouse embryonic development

<p>Abstract</p> <p>Background</p> <p>General transcription factor (TFII-I) is a multi-functional transcription factor encoded by the Gtf2i gene, that has been demonstrated to regulate transcription of genes critical for development. Because of the broad range of genes regulated by TFII-I as well as its potential role in a significant neuro-developmental disorder, developing a comprehensive expression profile is critical to the study of this transcription factor. We sought to define the timing and pattern of expression of TFII-I in post-implantation embryos at a time during which many putative TFII-I target genes are expressed.</p> <p>Findings</p> <p>Antibodies to the N-terminus of TFII-I were used to probe embryonic mouse sections. TFII-I protein is widely expressed in the developing embryo. TFII-I is expressed throughout the period from E8-E16. However, within this period there are striking shifts in localization from cytoplasmic predominant to nuclear. TFII-I expression varies in both a spatial and temporal fashion. There is extensive expression in neural precursors at E8. This expression persists at later stages. TFII-I is expressed in developing lung, heart and gut structures. There is no evidence of isoform specific expression. Available data regarding expression patterns at both an RNA and protein level throughout development are also comprehensively reviewed.</p> <p>Conclusions</p> <p>Our immunohistochemical studies of the temporal and spatial expression patterns of TFII-I in mouse embryonic sections are consistent with the hypothesis that hemizygous deletion of <it>GTF2I </it>in individuals with Williams-Beuren Syndrome contributes to the distinct cognitive and physiological symptoms associated with the disorder.</p

Update on hypertrophic cardiomyopathy and a guide to the guidelines

Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disorder, affecting 1 in 500 individuals worldwide. Existing epidemiological studies might have underestimated the prevalence of HCM, however, owing to limited inclusion of individuals with early, incomplete phenotypic expression. Clinical manifestations of HCM include diastolic dysfunction, left ventricular outflow tract obstruction, ischaemia, atrial fibrillation, abnormal vascular responses and, in 5% of patients, progression to a 'burnt-out' phase characterized by systolic impairment. Disease-related mortality is most often attributable to sudden cardiac death, heart failure, and embolic stroke. The majority of individuals with HCM, however, have normal or near-normal life expectancy, owing in part to contemporary management strategies including family screening, risk stratification, thromboembolic prophylaxis, and implantation of cardioverter-defibrillators. The clinical guidelines for HCM issued by the ACC Foundation/AHA and the ESC facilitate evaluation and management of the disease. In this Review, we aim to assist clinicians in navigating the guidelines by highlighting important updates, current gaps in knowledge, differences in the recommendations, and challenges in implementing them, including aids and pitfalls in clinical and pathological evaluation. We also discuss the advances in genetics, imaging, and molecular research that will underpin future developments in diagnosis and therapy for HCM

Analisis Komparasi Rasio Keuangan Sebelum Dan Selama Pandemi Covid-19 Pada Perusahaan Terbuka Yang Terdaftar Pada Indeks Lq45

Penelitian ini bertujuan untuk mengetahui dan menganalisis apakah terdapat perbedaan atau tidak antara rasio keuangan sebelum dan selama adanya pandemi Covid-19 pada perusahaan terbuka yang terdaftar dalam Indeks LQ45 periode Agustus 2020-Januari 2021. Rasio keuangan yang digunakan adalah current ratio, debt to asset ratio, debt to equity ratio, total assets turnover, dan return on equity. Populasi dalam penelitian ini adalah perusahaan terbuka yang terdaftar dalam Indeks LQ45 periode Agustus 2020-Januari 2021. Pengambilan sampel dilakukan dengan metode purposive sampling. Sehingga diperoleh 39 perusahaan sebagai sampel. Metode analisis data yang digunakan yaitu paired sample t-test dan wilcoxon signed rank test, yang sebelumnya dilakukan uji normalitas. Hasil analisis data menunjukkan terdapat perbedaan antara total assets turnover dan return on equity sebelum adanya pandemi dengan selama adanya pandemi. Serta tidak terdapat perbedaan pada variabel current ratio, debt to asset ratio, dan debt to equity ratio antara sebelum adanya pandemi dengan selama adanya pande