Pengaruh Citra Perusahaan Terhadap Loyalitas Nasabah Melalui Kualitas Pelayanan Sebagai Variabel Intervening Pada Pt.bpr Jaya Kerti Mengwi Badung

The purpose of this study was carried out, 1. To determine the influence of corporate image on customer loyalty in PT.BPR Jaya Kerti Mengwi, 2. To determine the effect of service quality on customer loyalty in PT.BPR Jaya Kerti Mengwi, 3. To determine the influence of corporate image on customer loyalty through quality of service at PT. RB Jaya Kerti Mengwi. The analysis includes the validity, reliability and path analysis with the help of software SPSS 17.0 for wimdows. Samples taken as many as 100 respondents. Data were collected by using observation, interview, documentation, literature and questionnaires were filled by the customer. Based on the results of the analysis indicate that 1) the company\u27s image significantly affect Loyalty 2) Quality of care significantly affect customer loyalty, 3) Corporate image through service quality effect on customer loyalty

Evaluating the clinical feasibility of an artificial intelligence–powered, web-based clinical decision support system for the treatment of depression in adults: longitudinal feasibility study

Background:- Approximately two-thirds of patients with major depressive disorder do not achieve remission during their first treatment. There has been increasing interest in the use of digital, artificial intelligence–powered clinical decision support systems (CDSSs) to assist physicians in their treatment selection and management, improving the personalization and use of best practices such as measurement-based care. Previous literature shows that for digital mental health tools to be successful, the tool must be easy for patients and physicians to use and feasible within existing clinical workflows. Objective:- This study aims to examine the feasibility of an artificial intelligence–powered CDSS, which combines the operationalized 2016 Canadian Network for Mood and Anxiety Treatments guidelines with a neural network–based individualized treatment remission prediction. Methods:- Owing to the COVID-19 pandemic, the study was adapted to be completed entirely remotely. A total of 7 physicians recruited outpatients diagnosed with major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Patients completed a minimum of one visit without the CDSS (baseline) and 2 subsequent visits where the CDSS was used by the physician (visits 1 and 2). The primary outcome of interest was change in appointment length after the introduction of the CDSS as a proxy for feasibility. Feasibility and acceptability data were collected through self-report questionnaires and semistructured interviews. Results:- Data were collected between January and November 2020. A total of 17 patients were enrolled in the study; of the 17 patients, 14 (82%) completed the study. There was no significant difference in appointment length between visits (introduction of the tool did not increase appointment length; F2,24=0.805; mean squared error 58.08; P=.46). In total, 92% (12/13) of patients and 71% (5/7) of physicians felt that the tool was easy to use; 62% (8/13) of patients and 71% (5/7) of physicians rated that they trusted the CDSS. Of the 13 patients, 6 (46%) felt that the patient-clinician relationship significantly or somewhat improved, whereas 7 (54%) felt that it did not change. Conclusions:- Our findings confirm that the integration of the tool does not significantly increase appointment length and suggest that the CDSS is easy to use and may have positive effects on the patient-physician relationship for some patients. The CDSS is feasible and ready for effectiveness studies

HUBUNGAN KADAR GLUKOSA DARAH DAN LAMA MENDERITA DIABETES DENGAN DERAJAT RETINOPATI DIABETIKA

Background: Diabetic Retinopathy is an important long-standing complication of diabetes mellitus. It is caused by high incidence and it's worse prognosis i.e actuity visual loss. High blood glucose levels (hyperglicemia) and long time endure of diabetic influence the severity of diabetic retinopathy. A long time hyperglycemia enhances changes the cellular component of basalis membranes of retinal cell, immune system, and platelets, therefore the atherosclerosis at the retinal vessels manifested. The objective of the study is to find the relation blood glucose levels and duration endure of diabetic to the severity of Diabetic Retinopathy at Kariadi Hospital Semarang. Methods: The study was analytical using historical study. The data of diabetic patiets with Diabetic Retinopathy as it's complication which found from medical record Kariadi Hospital Semarang during Jan 1st,2002 to Dec 31st,2004. The data include sex, age, blood glucose levels, duration endure of diabetic, and funduscopic examinations, that analysed using logistic regression test. Results: The statistic result were p=0,368 (p> 0,05) for blood glucose levels and p=0,019 (p<0,05) for duration endure of diabetic with CI 95 % or couldn't conclude that high blood glucose related with the severity of Diabetic Retinopathy, but duration endure of diabetic related with the severity of Diabetic Retinopathy. The patients that suffered longtime endure diabetic may occured Proliferative Diabetic Retinopathy. Conclusion: The test could not conclude that blood glucose levels related with the severity of Diabetic Retinopathy but duration endure of diabetic related with the severity of Diabetic Retinopathy

Large deformation analysis of geomechanics problems by a combined rh-adaptive finite element method

Finite element analysis of large deformation problems is a major challenge in computational geomechanics, due largely to the severe mesh distortion that may occur after updating the spatial configuration of the nodal points using a conventional Updated-Lagrangian approach. There are two alternative and reasonably well-known strategies to tackle this issue of mesh distortion, viz., the r-adaptive and h-adaptive methods. The r-adaptive finite element method has been designed to eliminate possible mesh distortion by changing and optimising the locations of the nodal points without modifying the overall topology of the mesh adopted to solve a given problem. In order to obtain an accurate solution by this method a relatively fine mesh is required right from the beginning of the analysis, which potentially increases the overall analysis time. On the other hand, the h-adaptive finite element method improves the accuracy of the solution by gradually decreasing the size of the elements based on an error assessment method. However, this approach may leave the very small elements in the mesh vulnerable to distortion. To eliminate the individual drawbacks of these adaptive methods, while preserving the accuracy of the solution, a combined rh-adaptive finite element method has been developed and is presented in this paper for the analysis of sophisticated problems of geomechanics that involve large deformations and changing boundary conditions. The proposed method is designed to improve the accuracy of the solution obtained using the h-refinement strategy while successfully avoiding the mesh distortion by the use of r-adaptive refinement. It is shown that this new combination can significantly increase the efficiency of adaptive finite element methods

A comparative study of error assessment techniques for dynamic contact problems of geomechanics

Numerical analysis of dynamic large deformation problems is one of the most challenging and sophisticated tasks in computational geomechanics. The complexity is mainly due to nonlinear soil behaviour, large deformations accompanied by severe mesh distortion, changing boundary conditions due to contact, and time-dependent behaviour. A typical example of such problems is the dynamic penetration of an object into a layer of soil due to its initial kinetic energy. This paper introduces an h-adaptive finite element method to tackle penetration as well as indentation problems of geomechanics in the presence of inertia forces. The h-adaptive finite element procedure automatically changes and optimises the density of the finite element mesh in a region to obtain a more accurate solution as well as to eliminate or reduce possible mesh distortion. A key component of an h-adaptive strategy is the error assessment technique. Although several methods exist for estimating the error in a finite element domain, the advantages as well as the capability of such methods in many geotechnical problems, particularly those involved with dynamic forces and changing boundary conditions, are not clearly understood. This paper describes a comparative study between three alternative error estimation techniques, including those based on the energy norm, the Green-Lagrange strain, and the plastic dissipation. The specific problems investigated involve the static and dynamic analysis of a strip footing on an undrained layer of soil, as well as the penetration of an object into a layer of sand. For these dynamic contact problems of geomechanics, the numerical results clearly show that the error estimator based on the Green-Lagrange strain outperforms the other two methods

Refined h-adaptive finite element procedure for large deformation geotechnical problems

Adaptive finite element procedures automatically refine, coarsen, or relocate elements in a finite element mesh to obtain a solution with a specified accuracy. Although a significant amount of research has been devoted to adaptive finite element analysis, this method has not been widely applied to nonlinear geotechnical problems due to their complexity. In this paper, the h-adaptive finite element technique is employed to solve some complex geotechnical problems involving material nonlinearity and large deformations. The key components of h-adaptivity including robust mesh generation algorithms, error estimators and remapping procedures are discussed. This paper includes a brief literature review as well as formulation and implementation details of the h-adaptive technique. Finally, the method is used to solve some classical geotechnical problems and results are provided to illustrate the performance of the method