An In-depth Review of Retinitis Pigmentosa Development and Pathologies Overtime in Patients

Retinitis Pigmentosa is a disease which can cause blindness and affects around 2.5 million people worldwide. It is a disorder that has a multitude of ways of being inherited, such as autosomal dominant, autosomal recessive as well as X-linked and mitochondrial linked disorder. While some versions of RP may be syndromic (20%-30%), a majority of cases are in fact non-syndromic. The majority of non-syndromic cases inherited via autosomal dominant RP having RHO gene mutations, and X-linked means of inheritance having majority of patients with RPGR gene mutations. Ushers Syndrome, a syndromic version of retinitis pigmentosa and autosomal recessive RP having a majority of patients suffering from USH2A gene mutation, is associated with both vision loss as well as hearing impairment as the disease progresses and is found in 20-40% of cases whom have developed the disease via autosomal recessive inheritance (10-20% of cases worldwide). The symptoms of the two diseases are not dependent upon one another; with cases of patients either having complete loss of both visual and auditory function, loss of strictly visual function with no hearing loss, or loss of hearing with no loss of visual function. RP is insidious in nature – in that it begins to slowly degenerate the vision of an individual over a period of time, and thus presents with varying symptoms as the disease progresses. Due to the varying genetic mutations that RP can be linked to, researchers do not know of an exact pathology that can be attributed to all cases found in individuals, which makes the disease all the more difficult to cure. Many researchers have looked to counteract the onset/progression of RP via a plethora of methods such as gene therapy, cell therapy, antioxidant medication and even retinal prostheses based on the many theories of how the genetic mutations lead to a multitude of stressed within the patients eye (metabolic, trophic and oxidative stress)

Are patients admitted to emergency departments with regular supraventricular tachycardia (SVT) treated appropriately?

Regular supraventricular tachycardia (SVT) is frequently encountered in clinical practice. Guidelines are available from the National Service Framework (NSF) for the treatment of patients attending emergency departments (ED) with SVT. These recommend a thyroid-function test (TFT) and arrhythmia electrocardiography (ECG), and referral to a heart-rhythm specialist on discharge. Hospital admission is rarely required. In our multicentre study, we examined the implementation of these guidelines among patients attending the ED with SVT. Only 34% of patients had specialist referrals, with an average wait of 50.3 days (the majority of delays resulted from referral requests from general practitioners). A history of previous SVT, the mode of tachycardia termination, patient age and/or comorbidities were similar for the 27 (23.5%) patients who were admitted overnight. Of these, 15 (13%) of the total 115 patients who attended ED with regular SVT were referred for Holter monitoring despite having ECGs demonstrating arrhythmia. Low referral rates, unnecessary investigations and admissions indicate a need for improvement for better patient care and to minimise healthcare costs. We have formulated a standard operating procedure, which will be available via the College of Emergency Medicine website

The Level of Knowledge of the Community About Heart Health in The Covid-19 Pandemic Era

Background: Cardiovascular disease is still a global health problem. Data obtained from the World Health Organization (WHO) states that the death rate from cardiovascular disease (CVD) is 17.7 million people every year and 31% is the cause of all global deaths. The purpose of this study was to determine the level of public knowledge about heart health in the covid-19 pandemic era.  Method: The sampling technique used consecutive sampling, namely subjects who came and met the inclusion criteria were included in the study until the number of samples was met. This study is expected to provide information to the public about heart health and its relationship to the era of the covid-19 pandemic in the community/employees in the USU Medical Faculty Results: In this study, the number of samples was 100 people, the age group > 30 years (62%), while the age group ≤ 30 years (38%). The majority of the sample works as official governments 40 people (40%), had good score predicate, good level of knowledge is Government Employees 20 peoples (20%), health workers (20%), while the level of education is Strata 1.  Conclusion: The level of knowledge of the community about heart health in the Covid-19 pandemic era is good with education level Strata 1 and most of them are Government Employee

Enhancing Talent Development Using AI-Driven Curriculum-Industry Integration

The specific hiring needs render low-skill-based job-seeking invalid in coping with the nation's economic development. There needs to be more graduate readiness for the industry's needs. This paper explores the transformative potential of Artificial Intelligence (AI) in fostering a symbiotic relationship between academic curricula and industry demands, aimed at building a robust talent pool for the future. A new hiring selection model that matches industry-identified hiring parameters with the knowledge and skills obtained from the university. By aligning educational programs with real-world challenges and market needs, this novel approach seeks to propel the growth of talents

Building Information Modeling (BIM): A New Paradigm for Quality of Life Within Architectural, Engineering and Construction (AEC) Industry

AbstractThe adoption of Building Information Modeling (BIM) constitutes a paradigm shift in the architectural, engineering and construction (AEC) industry. Broader BIM adoption will transform construction processes to achieve greater efficiency to improve the quality of life (QOL) of construction stakeholders. This paper seeks to identify determinant factors and implementation gaps of BIM in the AEC industry. A case study was conducted through a preliminary workshop organised by CIDB among the five potential stakeholders: Public Private Partnership (PPP) Unit (UKAS), JARING, eMOST/UMP, Greenwave Synergy (GWS) and CIDB eConstruct (EC) of the AEC industry in Malaysia. The findings suggest various determining factors and gaps existed at the national and organisational levels. Finally, the workshop suggested an ‘affordable BIM concept’ with ‘pay-per-use or periodical license’ method to be adopted for SMEs contractors

SOCIAL PROTEST MOVEMENT ISLAMIC LAW PERSPECTIVE (Critical Study of the Protest Phenomenon in Indonesia)

This study formulates three problems which include: (1) The principles of the social protest movement from the perspective of Islamic law; (2) Methods and techniques for conducting demonstrations from the perspective of Islamic law; (3) The social impact of demonstrations in Indonesia from the perspective of Islamic law. This study uses a qualitative method (descriptive-analytic). Based on the data source is library research (library research). The approach used is the sociological approach of Islamic law and the siyasah fiqh approach. In the perspective of scientific studies, these two approaches are used to understand the phenomenon of demonstrations in Indonesia based on legal arguments contained in the Qur'an and Hadith, the opinions of fuqaha' and opinions that develop (ijitahad) at a time in life. Muslims. Meanwhile, from a methodological perspective, these two approaches are used to provide an interpretation of the methodology of Islamic law on the concept and practice of demonstrations based on social movement theory and Islamic political theory. The results of this study found that: The principles of the Islamic social protest movement are built on the doctrine of rights and obligations between the people and the rulers in an Islamic state which include: the principle of hisbah; The principle of freedom of expression; The principle of deliberation; and constitutional principles. Based on the method of carrying out the demonstration, there are 2 methods, namely the exclusive method and the inclusive method. Based on the technique of holding demonstrations, there are 3 levels, namely: (1) demonstrations with the ability and strength of the masses; (2) demonstration with verbal ability and strength; (3) protest with the ability of the heart. Through the istislahi approach, that Islamic law strongly condemns all demonstration activities that cause harm to religion, soul, mind, descendants and property. On the other hand, he strongly supports all demonstration activities that uphold the five maintenances (Maqasid al-khamsah). That demonstrations are not at all motivated by passion or personal tendencies, let alone to cause damage to the earth. It is an obligation not just an appeal for those who can afford it. The law is fardu kifayah. Turning away from that obligation is the same as carrying oneself That demonstrations are not at all motivated by passion or personal tendencies, let alone to cause damage to the earth. It is an obligation not just an appeal for those who can afford it. The law is fardu kifayah. Turning away from that obligation is the same as carrying oneself That demonstrations are not at all motivated by passion or personal tendencies, let alone to cause damage to the earth. It is an obligation not just an appeal for those who can afford it. The law is fardu kifayah. Turning away from that obligation is the same as carrying oneself

Seleksi Fitur Dengan Information Gain Untuk Meningkatkan Deteksi Serangan DDoS menggunakan Random Forest

Tantangan deteksi serangan saat ini adalah jumlah trafik yang besar dan beragam serta hadir jenis serangan baru. Sehingga diperlukan teknik baru untuk meningkatkan performa deteksi. Dengan pesatnya perkembangan teknologi layanan komunikasi, menghasilkan trafik dengan informasi yang beragam. Pada dasarnya tidak semua informasi pada trafik jaringan digunakan untuk mendeteksi serangan seperti DDoS. Penelitian ini bertujuan meningkatkan performa Random Forest dalam mendeteksi serangan DDoS dengan seleksi fitur menggunakan teknik Information Gain. Berdasarkan hasil eksperimen diperoleh bahwa teknik yang diusulkan mampu meningkatkan akurasi deteksi DDoS hingga 99.99% dengan tingkat alarm palsu 0.00

Studi Kasus Perancangan Cable Tray di Area Pabrik Semen Berbasis Autocad dan Fungsi Logika

Tugas akhir ini meneliti tentang perancangan dan perhitungan kabel tray pada pabrik PT. Semen Padang. Objek perancangan dan perhitungan kabel tray tersebut dari substation 348 ke Raw Mill. Perhitungan lebar kabel tray dilakukan berdasarkan jenis kabel yang dibutuhkan dan cara pemasangan kabel tersebut. Dalam pemasangan kabel tray dibedakan jadi beberapa tipe antara lain tipe H, tipe W, tipe M, tipe C dan tipe Y. Studi kasus untuk beban lubrication unit for grinding roller dibutuhkan kabel NYY 4x2.5 mm2 tergolong kabel tipe W yang membutuhkan 1 tingkatan kabel tray sebesar 150 HBW. Pada studi kasus kedua perancangan rotor starter dibutuhkan kabel N2XSY 1X300 mm2 tergolong kabel tipe H yang berfungsi sebagai power suplay rotor starter, NYY 4X6 mm2 tergolong kabel tipe W yang berfungsi sebagai suplay daya heater kumparan dari rotor starter, 7X1.5 RE YY-G dan 3X1.5 RE YY-G tergolong kabel tipe M yang berfungsi sebagai kabel instrument. Total tingkatan tray yang dibutuhkan adalah 4 tingkatan kabel tray sebesar 600 HBH + 300 HBH + 150 HBW + 100 JBM

ANALISIS YURIDIS PENYELESAIAN SENGKETA PADA AKAD PEMBIAYAAN MURABAHAH ANTARA NASABAH DENGAN PT. BANK SYARIAH INDONESIA,Tbk KANTOR CABANG MEDAN AHMAD YANI MENURUT UNDANG-UNDANG NOMOR 21 TAHUN 2008 TENTANG PERBANKAN SYARIAH

Perkembangan ekonomi syariah yang kian pesat, dikarenakan dengan meningkatnya beragam produk-produk pembiayaan, memunculkan implikasi hukum akan maraknya sengketa dalam ekonomi syariah. Sengketa dapat muncul akibat salah satu pihak melakukan perbuatan melawan hukum serta membawa kerugian kepada orang lain dan/atau dapat disebabkan oleh salah satu pihak melakukan wanprestasi atau pengingkaran terhadap kesepakatan yang dibuat seperti yang tertuang pada kontrak. Perkembangan perbankan dengan menggunakan prinsip syariah atau lebih dikenal dengan nama bank syariah dilaksanakan dengan memenuhi ketentuan pokok hukum Islam antara lain prinsip keadilan dan keseimbangan ('adl wa tawazun), kemaslahatan (maslahah), dan universalisme (alamiyah) serta tidak mengandung gharar, maysir, riba, dzalim, riswah, dan obyek haram. PT Bank Syariah Indonesia,Tbk. (BSI) merupakan lembaga keuangan yang bergerak dibidang penghimpun dana dan penyaluran dana kepada masyarakat yang menjalankan kegiatan usahanya berdasarkan prinsip syariah. Salah satu produk penyaluran dana yang sering digunakan dalam transaksi pembiayaan pada PT Bank Syariah Indonesia,Tbk. (BSI) yaitu dengan menggunakan akad pembiayaan murabahah.Jenis penelitian yang digunakan dalam penelitian ini adalah yuridis normatif yang merupakan penelitian yang memiliki objek kajian tentang kaidah atau aturan hukum. Kemudian sifat penelitian ini Deskriptif analitik yaitu menggambarkan peraturan perundang-undangan yang berlaku dikaitkan dengan teori-teori hukum dari praktik pelaksanaan hukum positif yang menyangkut permasalahan dalam penelitian.Fokus penelitian yang diteliti adalah bentuk penyelesaian sengketa pada akad pembiyaan murabahah antara nasabah dengan PT Bank Syariah Indonesia Kantor Cabang Medan Ahmad Yani sesuai Undang-Undang Nomor 21 Tentang Perbankan Syariah. Bagaimana pengaturan akad pembiyaan murabahah diimplementasikan sesuai Undang-Undang Nomor 21 Tahun 2008 Tentang Perbankan Syariah dan Fatwa DSN MUI Nomor 04/DSN-MUI/IV/2000 sehingga terciptanya kepastian hukum. Kemudian bagaimana bentuk-bentuk permasalahan yang menjadi penyebab terjadinya sengketa pada akad pembiayaan murabahah dan bagaimana penyelesaian sengketa tersebut baik secara litigasi dan non litigasi agar terwujudnya perlindungan hukum baik kepada nasabah maupun kepada PT Bank Syariah Indonesia Kantor Cabang Ahmad Yani

Predictor of Left Atrial Spontaneous Echocardiographic Contrast in Rheumatic Mitral Stenosis Patients

Background: Previously conducted researches showed that presence of SEC in the left atrium can constitute a risk factor for thrombus formation. Some previous studies have also reported that in addition to atrial fibrillation and blood stasis in the left atrium, the pathophysiology of left atrial thrombus and SEC occurring in patients with rheumatic mitral stenosis exhibits some other mechanisms, such as autoimmunity, inflammation and increased thrombotic activity. Methods: Cross sectional study was conducted between July 2015 to July 2017 in patient who admitted to Haji Adam Malik Hospital due to rheumatic mitral stenosis. They were divided into two groups according to presence of left atrial SEC. Result: From 104 patients, 52 (mean age 40 ± 11 years; 71,2% women) were in the left atrial SEC-negative group and 52 patients (mean age 40 ± 10 years; 73,1% women) were in the left atrial SEC-positive group. There were no significant differences in the leucocyte, 8,06±1,54 were in the left atrial SEC-negative group and 7,37±1,76 were in the left atrial SEC-positive group. In multivariate analysis, atrial fibrillation (OR = 51,311, 95% CI 3,723 – 707,100, p = 0,003) neutrophil/lymphocyte ratio (OR = 21,641, 95% CI 5,174 – 90,528, p < 0,001), mitral valve area (OR = 14,423, 95% CI 1,665 – 124,908, p = 0,015), and RDW (OR = 5,743, 95% CI 1,349 – 24,445, p = 0,018), These study show that neutrophil/lymphocyte ratio with cut off point of >3,2 had sensitivity, spesificity, positive predictive value, and negative predictive value to predict left atrial SEC is the same 81%, respectively. Conclusion: Atrial fibrillation, neutrophil/lymphocyte ratio, RDW and mitral valve area can predict left atrial spontaneous echocardiographic contrast in rheumatic mitral stenosis patients.   Abstrak Latar Belakang: Penelitian sebelumnya menunjukkan adanya SEC di atrium kiri menjadi faktor risiko untuk pembentukan trombus. Pada pasien stenosis mitral rematik, risiko trombosis dan perkembangan SEC di atrium kiri tinggi. Beberapa penelitian sebelumnya melaporkan bahwa patofisiologi trombus dan SEC di atrium kiri selain fibrilasi atrium dan stasis aliran darah di atrium kiri juga adanya beberapa mekanisme lain seperti respon imun, inflamasi dan peningkatan aktifitas trombotik. Metode: Ini adalah penelitian observasional yang bersifat cross sectional, dilakukan dari Juli 2015 sampai Juli 2017 terhadap pasien stenosis mitral rematik yang datang ke rumah sakit Haji Adam Malik. Pasien dibagi 2 kelompok berdasarkan kehadiran SEC di atrium kiri menurut hasil pemeriksaan ekokardiografi. Hasil: Didapatkan 104 pasien, dimana 52 pasien (usia rata-rata 40 ± 11 tahun, 71% wanita) merupakan kelompok tanpa SEC, dan 52 pasien (usia rata-rata 40 ± 10 tahun, 73% wanita) merupakan kelompok dengan SEC. Tidak ada perbedaan bermakna pada lekosit, dimana kelompok tanpa SEC (8,06±1,54) dan kelompok dengan SEC (7,37±1,76). Dari analisis multivariat regresi logistik, didapatkan fibrilasi atrium (OR = 51,311, nilai IK 95% antara 3,723 – 707,100, p = 0,003) rasio netrofil/limfosit (OR = 21,641, nilai IK 95% antara 5,174 – 90,528, nilai p < 0,001), area katup mitral (OR = 14,423, nilai IK 95% antara 1,665 – 124,908, nilai p = 0,015), dan RDW (OR = 5,743, nilai IK 95% antara 1,349 – 24,445, nilai p = 0,018), merupakan prediktor independen untuk terjadinya SEC. Titik potong untuk nilai rasio N/L > 3,2 memiliki angka sensitivitas, sensitifitas, nilai prediktif positif dan nilai prediktif negatif yang sama yaitu masing-masing 81% untuk memprediksi kejadian SEC di atrium kiri pada pasien stenosis mitral rematik. Kesimpulan: Fibrilasi atrium, rasio netrofil/limfosit, RDW dan area katup mitral dapat menjadi prediktor SEC di atrium kiri pada pasien stenosis mitral rematik