PELATIHAN PENGGUNAAN MEDIA PEMBELAJARAN ONLINE YANG TERINTEGRASI GOOGLE SUITE BAGI JEMAAT GPM IMANUEL OSM

Salah satu kebijakan pemerintah dalam memutus mata rantai Covid-19 dalam bidang pendidikan adalah dengan pemindahan proses belajar mengajar yang dilakukan di sekolah menjadi dilakukan di rumah. Kegiatan proses belajar mengajar seperti ini sekarang lebih dikenal dengan metode pembelajaran dengan sistem online. Penerapan metode pembelajaran dengan sistem online ini menuntut pendidik dan peserta didik tak terkecuali orang tua untuk memanfaatkan teknologi yang ada agar proses belajar mengajar di masa pandemi dapat berjalan dengan baik. Salah satunya dengan memanfaatkan platform berbasis website yang terintegrasi dengan Google Suite. Platform yang terintegrasi Google Suite yang sering digunakan sebagai aplikasi pembelajaran online, yaitu Google Classroom, Google Meet dan Google Form. Aplikasi-aplikasi tersebut sering digunakan karena tidak berbayar dan sederhana dalam mengoperasikannya. Peran orang tua dalam mendampingi, bimbing selama proses pembelajaran online bagi peserta didik khususnya tingkat sekolah dasar sangat diperlukan. Namun, kendala terbesar yang dihadapi orang tua yaitu keterbatasan pengetahuan dalam mengakses beberapa aplikasi tersebut. Melalui pelatihan penggunaan platform berbasis website yang terintegrasi Google Suite sebagai media pembelajaran online, diharapkan para orang tua serta peserta didik memiliki kecakapan dan pengetahuan yang lebih baik dalam mengakses beberapa aplikasi guna dapat menunjang terlaksananya metode pembelajan dengan sistem online

Occipital nerve block is effective in craniofacial neuralgias but not in idiopathic persistent facial pain

Occipital nerve block (ONB) has been used in several primary headache syndromes with good results. Information on its effects in facial pain is sparse. In this chart review, the efficacy of ONB using lidocaine and dexamethasone was evaluated in 20 patients with craniofacial pain syndromes comprising 8 patients with trigeminal neuralgia, 6 with trigeminal neuropathic pain, 5 with persistent idiopathic facial pain and 1 with occipital neuralgia. Response was defined as an at least 50% reduction of original pain. Mean response rate was 55% with greatest efficacy in trigeminal (75%) and occipital neuralgia (100%) and less efficacy in trigeminal neuropathic pain (50%) and persistent idiopathic facial pain (20%). The effects lasted for an average of 27 days with sustained benefits for 69, 77 and 107 days in three patients. Side effects were reported in 50%, albeit transient and mild in nature. ONBs are effective in trigeminal pain involving the second and third branch and seem to be most effective in craniofacial neuralgias. They should be considered in facial pain before more invasive approaches, such as thermocoagulation or vascular decompression, are performed, given that side effects are mild and the procedure is minimally invasive

Interaction of hyperalgesia and sensory loss in complex regional pain syndrome type I (CRPS I)

Sensory abnormalities are a key feature of Complex Regional Pain Syndrome (CRPS). In order to characterise these changes in patients suffering from acute or chronic CRPS I, we used Quantitative Sensory Testing (QST) in comparison to an age and gender matched control group

Differential, Positional-Dependent Transcriptional Response of Antigenic Variation (var) Genes to Biological Stress in Plasmodium falciparum

1% of the genes of the human malaria causing agent Plasmodium falciparum belong to the heterogeneous var gene family which encodes P. falciparum erythrocyte membrane protein 1 (PFEMP1). This protein mediates part of the pathogenesis of the disease by causing adherence of infected erythrocytes (IE) to the host endothelium. At any given time, only one copy of the family is expressed on the IE surface. The cues which regulate the allelic exclusion of these genes are not known. We show the existence of a differential expression pattern of these genes upon exposure to biological stress in relation to their positional placement on the chromosome – expression of centrally located var genes is induced while sub-telomeric copies of the family are repressed - this phenomenon orchestrated by the histone deacetylase pfsir2. Moreover, stress was found to cause a switch in the pattern of the expressed var genes thus acting as a regulatory cue. By using pharmacological compounds which putatively affect pfsir2 activity, distinct changes of var gene expression patterns were achieved which may have therapeutic ramifications. As disease severity is partly associated with expression of particular var gene subtypes, manipulation of the IE environment may serve as a mechanism to direct transcription towards less virulent genes

Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p&lt;0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (&lt;1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (&lt;1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Über die Bestimmung von Urankonzentrationsprofilen im Pyrokohlenstoff beschichteter Kernbrennstoffteilchen

Zur quantitativen Bestimmung von Uranspuren in PyC-Schichten beschichteter Kernbrennstoffteilchen im Bereich von 10$^{-6}$ bis 10$^{-9}$ g wurde ein Verfahren entwickelt. Dabei werden zunächst auf mechanischem Wege die Schichten in Schritten von 5-15 $\mu$m abgetragen. Hierzu wurden spezielle Abriebbehälter aus Glas mit Erfolg erprobt, in denen nicht nur der stufenweise Abrieb stattfindet, sondern auch der naßchemische Aufschluß des abgetragenen Pyrokohlenstoffes. Die quantitative Uranbestimmung erfolgt anschließend mit Hilfe einer fluorimetrischen Methode. Die relative Standardabweichung des Verfahrens beträgt für 10$^{-9}$g Uran $\pm$ 34 %, für 10$^{-7}$g + 6 % und für 10$^{-6}$g $\pm$ 4 %. Die Nachweisgrenze liegt bei 10$^{-9}$ g Uran. Die aus den Brennstoffteilchen bzw. von der Aufarbeitung des Pyrokohlenstoffs stammenden Verunreinigungen, wie Thorium, Kieselsäure und H$_{2}$SO$_{4}$ stören in den vorhandenen Konzentrationen die quantitative Uran-Bestimmung nicht. Mit Hilfe dieses Verfahrens ist es möglich, Urankonzentrationsprofile in der Hüllschicht beschichteter Brennstoffteilchen aufzunehmen. Es wurde bei allen untersuchten Teilchen ein mehr oder weniger ausgeprägtes Wannenprofil beobachtet. Die Höhe der Urankonzentration innerhalb der Schicht ist abhängig von der Beschichtungstemperatur. Sie ist bei Teilchen deren Außenschicht bei 2000°C aufgebracht wurde um etwa eine Größenordnung höher als bei solchen, deren Beschichtungstemperatur unterhalb 1600° C lag