Efektivitas Pelayanan dalam Pembuatan Akta Kelahiran di Kecamatan Bukit Batu Kabupaten Bengkalis

Service is one of the things that really need to get the attention of the government, so that the user community services were satisfied with the service provided. In relation to the above Department of Population and Civil Registration Bukit Batu District is one of the agencies authorized to provide services to the community, which of especially in the areas of service. Birth certificate is a certificate issued by the competent authority, which is related to the birth in order to acquire or obtain legal certainty against someone. Deed made based on reports of births conveyed within the time limit no later than 60 (sixty) working days for the citizen and 10 (ten) working days from the date of birth for foreigners baby. The research to aims identify and analyze of Birth Certificate Child Care Arrangements in the District Of Bukit Batu. The writer used qualitative method and the technique of collecting data are interview, observation and documentation. The interview was conducted by the research informants defined through snowball sampling technique.The theory of Bronoos in Sutupo will be used as reference to analyze and Ädefines the overall area is service a birth certificate there are some good service quality criteria which professionalism and skills, attitudes and behaviors, and trustworthy reliability, accessibility and flexibility, improved. Data collection using the techniques of observation and interviews. Data analysis techniques using qualitative descriptive techniques.The result of showed, Effectiveness a obtaining of certificate service has not running well based on the minimum services standart that have been established in regulations. This matter could be seen from the phenomenon and fact of the implementation of certificate service that occured on the real life. The factors that influenced the implementation of Department of Population and Civil Registration Pekanbaru City regency are : Human resources, infrastructure and leadership.Key words: Care, Birth Certificate, Department of Population and Civil Registratio

Levothyroxine effects on depressive symptoms and limbic glucose metabolism in bipolar disorder: a randomized, placebo-controlled positron emission tomography study.

Adding supraphysiologic doses of levothyroxine (L-T4) to standard treatment for bipolar depression shows promise, but the mechanisms underlying clinical improvement are unknown. In a previous pilot study, L-T4 treatment reduced depression scores and activity within the anterior limbic network. Here we extended this work in a randomized, double-blind, placebo-controlled study of patients with bipolar depression. Cerebral glucose metabolism was assessed with positron emission tomography and [F-18]fluorodeoxyglucose before and after 6 weeks of treatment with L-T4 (n=15) or placebo (n=10) in 12 volumes of interest (VOIs): the bilateral thalamus, amygdala, hippocampus, dorsal striatum and ventral striatum, and midline cerebellar vermis and subgenual cingulate cortex. Radioactivity in the VOIs, normalized to whole-brain radioactivity was taken as a surrogate index of glucose metabolism, and markers of thyroid function were assayed. Changes in brain activity and their association with clinical response were assessed using statistical parametric mapping. Adjunctive L-T4 treatment produced a significant decline in depression scores during the 6-week treatment. In patients treated with L-T4, we found a significant decrease in regional activity at P<0.05 after Bonferroni correction in the left thalamus, right amygdala, right hippocampus, left ventral striatum and the right dorsal striatum. Decreases in the left thalamus, left dorsal striatum and the subgenual cingulate were correlated with a reduction in depression scores (P<0.05 after Bonferroni correction). Placebo treatment was associated with a significant decrease in activity only in the right amygdala, and no region had a change in activity that was correlated with change in depression scores. The groups differed significantly in the relationship between the changes in depression scores and in activity in the thalamus bilaterally and the left ventral striatum. The findings provide evidence that administration of supraphysiologic thyroid hormone improves depressive symptoms in patients with bipolar disorder by modulating function in components of the anterior limbic network

Preliminary post findings in BPPV patients presenting with normal vestibulo-ocular reflex (VOR) gain and observable saccades using video head impulse test (vHIT)

Introduction: Benign Paroxysmal Positional Vertigo (BPPV) is a common peripheral hypofunction reported in dizzy clinics and is mostly dependant on positional manoeuvres for diagnosis and intervention. Although video head impulse test (vHIT) is not warranted in BPPV cases however due to the subjectivity of patients’ reports, it is sometimes performed on patients to exclude potential vestibular ocular reflex (VOR) deficits. Objective: Observe differentiation patterns of VOR gain and possible corrective eye movements in patients with BPPV using vHIT. Method: Two male and five female participants with BPPV were tested using vHIT. Three patients out of the seven who were relieved from post Canalith Repositioning Procedure (CRP) were tested again with vHIT. Ten responses for each semicircular canal stimulation were recorded for every participant by making small unpredictable head movements. Results: VOR gain for all canal stimulations were found to be within the normal range. All participants showed consistent pre-treatment corrective saccadic eye movements with gain between 0.12 to 1.35 and latency of onset between 80 to 220 milliseconds after vHIT was initiated. All saccades were recorded in lateral canals only despite patients presenting with anterior or posterior canal BPPV. Post-treatment vHIT findings showed that the saccades have diminished for two participants while a participant showed reduced saccades. Conclusions: Rapid head thrusts could trigger VOR adjustments in patients with dislodged otoconia such in BPPV cases. Further investigation is necessary to validate the potential use of vHIT as a tool to supplement findings via manoeuvres especially to check the effectiveness of CRP

Sawah Baru Landscape Identification for Agroedutourism Agriculture 4.0, A Community-Based Development Project

IPB University has adequate agricultural land facilities and infrastructure for education and research activities. It has the potential to be developed into an agricultural area 4.0 for agrotourism activities, one of which is in the landscape of the Babakan Education Garden or Farm Teaching Sawah Baru located in Babakan Village, Dramaga District, Bogor Regency. This study aims to identify the character of the Sawah Baru landscape for the development of community-based agricultural agrotourism 4.0. The analysis used in this study used direct observation of the field and the literature study method. The identification of several aspects in the field is carried out using drones to obtain aerial photos, which are then processed using software to produce orthophotos and continue to digitize the boundaries of the research location using spatial analyst tools. The stages of identifying new rice field landscapes for the development of community-based agricultural agrotourism 4.0 include several stages, namely the preparation and inventory stages. The results of the identification of several aspects consisting of landscape sustainability, potential tourist attraction and tourism-supporting potential show that in terms of landscape sustainability, the criteria of each existing aspect are excellent and suitable to be developed into tourist destinations. Regarding potential tourist destinations, the study area presents aspects that have the potential to attract visitors. Finally, regarding tourism-supporting potential, Sawah Baru has tourism-supporting aspects that are quite adequate to meet the needs of tourism activities. However, there is still a need to create additional facilities and utilities that can support user activity on the site. Keywords: agriculture 4.0, agroedutourism, community-based, Sawah Baru DOI: 10.7176/CER/15-1-06 Publication date: May 28th 202

Klinischer Behandlungspfad Carotisstenose : Evaluation im Ländervergleich ; Poster

Poster Einleitung Im Rahmen effizienzsteigernder Maßnahmen sind klinische Behandlungspfade unter DRG- Bedingungen und im Rahmen der Qualitätssicherung wichtige Instrumente. Material und Methoden Aus der Analyse zweier erfahrungsbasierter klinischer Behandlungspfade in Frankfurt/D und Newcastle/GB wurde ein halbstandardisierter clinical pathway Carotisstenose entwickelt, der der heterogenen Befundkonstellation bei Aufnahme, den unterschiedlichen klinischen Stadien der Erkrankung und den individuellen Patientenbedürfnissen Rechnung trägt. Es wurden dazu zwei Gruppen mit je 25 konsekutiv in Frankfurt/D ( Gruppe FrankfurtI) und New Castle/GB ( Gruppe New Castle )operierten Patienten retrospektiv analysiert.Aus den retrospektiv erhobenen Daten wurde ein stadienbezogener und der Zuweisersituation gerecht werdender klinischer Behandlungspfad erstellt, der anhand von 20 konsekutiv operierten Patienten, davon 60 % im Stadium IV der Erkrankung, ( Gruppe FrankfurtII ) analysiert wurde. Ergebnisse In Frankfurt 1 wurde 21 mal eine Eversions-TEA und 4 mal eine TEA/ Patchplastik angewendet, 62 % der Patienten befanden sich im Stadium 1 der Erkrankung, ,65 % erhielten präoperativ eine i.a.DSA der supraaortalen Äste ,100% eine Duplexsonografie und eine CCT; postoperativ fielen insgesamt 12 Intensiv- Pflegetage an sowie eine Revision aufgrund einer Nachblutung. In der Gruppe New Castle befanden sich 68% der Patienten in einem klinischen Stadium 2,es wurde 25 mal offen thrombendarteriektomiert, davon 21 mal mit Direktnaht verschlossen und 4 mal mit Patchplastik, alle Patienten erhielten präoperativ eine CT- Angiografie und eine Duplexsonografie; postoperativ fiel 1 Intensivpflegetag an und eine Revision wegen Nachblutung. Die Morbiditäts-/ Mortalitätsrate betrug in beiden Gruppen 0%. Betriebswirtschaftlich wurden bei einer Liegedauer von durchschnittlich 10 Tagen in Frankfurt 1 tatsächliche Kosten von 2768.96€ pro Patient ermittelt, in New Castle,bei einer Liegedauer von durchschnittlich 5 Tagen und einer differenten Kostenstruktur von 2510.56 €. In der Gruppe Frankfurt 2 wurde 11mal eine TEA mit Patchplastik und 9 mal eine Eversions-TEA durchgeführt, alle Patienten erhielten präoperativ eine Duplexsonografie und eine CCT , postoperativ fielen insgesamt 6 Intensivtage an, es wurde nicht revidiert, die Morbiditäts-/Mortalitätsrate lag ebenfalls bei 0%. Durch Einführung eines klinischen Behandlungspfades wurde also die Liegedauer in Frankfurt um 40 % reduziert sowie die tatsächlichen Kosten auf 2384.41€ pro Fall und damit im Mittel um 14 % gemindert. Schlussfolgerung Unter DRG-Bedingungen trägt daher die Anwendung eines klinischen Behandlungspfades in der Carotischirurgie zu einer Verbesserung der Erlössituation ohne Qualitätseinbuße bei

Achievements in CTF3 and Commissioning status

The aim of the latest CLIC test facility CTF3, built at CERN by an international collaboration, is to prove the main feasibility issues of the CLIC two-beam acceleration technology. Several of the main goals have been already achieved in the past years, like the full-loading linac operation mode and the delay loop principle. During 2008 also the combiner ring concept has been experimentally proven and the recombined beam has been used to generate the RF power. In parallel in the fall of the year also the probe beam line commissioning had started

Status of an automatic Beam Steering for the CLIC Test Facility 3

An automatic beam steering application for CTF 3 is being designed in order to automatize operation of the machine, as well as providing a test-bed for advanced steering algorithms for CLIC. Beam-based correction including dispersion free steering have been investigated. An approach based on a PLACET on-line model has been tested. This paper gives an overview of the current status and the achieved results of the CTF3 automatic steering

Novel loss-of-function variants in CDC14A are associated with recessive sensorineural hearing loss in Iranian and Pakistani patients

CDC14A encodes the Cell Division Cycle 14A protein and has been associated with autosomal recessive non-syndromic hearing loss (DFNB32), as well as hearing impairment and infertile male syndrome (HIIMS) since 2016. To date, only nine variants have been associated in patients whose initial symptoms included moderate-to-profound hearing impairment. Exome analysis of Iranian and Pakistani probands who both showed bilateral, sensorineural hearing loss revealed a novel splice site variant (c.1421+2T>C, p.?) that disrupts the splice donor site and a novel frameshift variant (c.1041dup, p.Ser348Glnfs*2) in the gene CDC14A, respectively. To evaluate the pathogenicity of both loss-of-function variants, we analyzed the effects of both variants on the RNA-level. The splice variant was characterized using a minigene assay. Altered expression levels due to the c.1041dup variant were assessed using RT-qPCR. In summary, cDNA analysis confirmed that the c.1421+2T>C variant activates a cryptic splice site, resulting in a truncated transcript (c.1414_1421del, p.Val472Leufs*20) and the c.1041dup variant results in a defective transcript that is likely degraded by nonsense-mediated mRNA decay. The present study functionally characterizes two variants and provides further confirmatory evidence that CDC14A is associated with a rare form of hereditary hearing loss