Kajian Normatif: Pengelolaan Perbataan dan Kelembagaan Pusat-daerah Berdasarkan Rencana Induk Pengelolaan Perbatasan Negara

Penulis ingin menelaah bagaimana rentang kendali kelembagaan dari pusat ke daerah dalam mengelolawilayah perbatasan berdasarkan rencana induk pengelolaan perbatasan negara. Rencana induk pengelolaanbatas wilayah negara dan kawasan perbatasan atau Rinduk adalah rencana pembangunan nasional jangkamenengah 5 (lima) tahun yang memberikan arah kebijakan, strategi, dan program pengelolaan batas wilayahnegara dan pembangunan kawasan perbatasan yang berpedoman pada Rencana Pembangunan Jangka PanjangNasional atau RPJPN dan Rencana Pembangunan Jangka Menengah Nasional atau RPJMN. Metode penelitianpada paper ini menggunakan metode normatif, dimana secara kualitatif ditelaah berbagai regulasi yang terkaitdengan lembaga dan kelembagaan pengelola perbatasan Negara Kesatuan Republik Indonesia. Regulasimengenai kelembagaan (Badan Nasional Pengelola Perbatasan (BNPP) yang mengatur tata kelola wilayahperbatasan negara sudah ada, namun perlu penguatan kelembagaan yang lebih lagi, pelatihan sumber dayamanusia dan penyediaan dana yang dibutuhkan sesuai dengan prioritas penanganan perbatasan Negara

Pemberian Motivasi Cinta Lingkungan Kepada Siswasiswi SMA

Kerusakan kualitas lingkungan disebabkan juga oleh sistem pendidikan yang tidak memperhatikanpendidikan lingkungan terhadap anak didik sejak dini. Tujuan pengabdian kepada masyarakat ini adalahmemberikan motivasi kepada siswa-siswa SMA dalam memelihara lingkungan sejak dini. Metodologi penulisanlaporan ini adalah dengan metode deskriptif. Metode pelaksanaan diawali dengan rapat perencanaan, persiapanbahan, pelaksanaan dan evaluasi. Kegiatan pelaksanaan dilakukan dengan mengumpulkan siswa-siswi SMA dariPerguruan Advent Bogor dalam suatu kelas, lalu diberikan paparan mengapa mereka perlu mencintailingkungan demi generasi mereka sendiri. Perhatian utama yang menjadi acuan adalah lingkungan sungai,karena semua sampah pada akhirnya akan hanyut ke aliran sungai menuju laut. Pemaparan juga mengenaiSungai Citarum yang menjadi perhatian dunia karena sangat kotor dan sampai saat ini belum dapat dibersihkansecara baik. Para peserta, siswa-siswi dan guru-guru, memperhatikan dengan seksama dan banyak bertanyamengenai siapa yang bertanggung jawab mengenai kelestarian lingkungan apakah pemesrintah atau pihaklainnya. Pihak yang terutama menjaga lingkungan adalah diri sendiri agar lingkungan yang bersih dapatdinikmati secara baik sampai dengan generasi yang akan datang

Multi-omic phenotyping reveals host-microbe responses to bariatric surgery, glycaemic control and obesity

Background Resolution of type 2 diabetes (T2D) is common following bariatric surgery, particularly Roux-en-Y gastric bypass. However, the underlying mechanisms have not been fully elucidated. Methods To address this we compare the integrated serum, urine and faecal metabolic profiles of participants with obesity ± T2D (n = 80, T2D = 42) with participants who underwent Roux-en-Y gastric bypass or sleeve gastrectomy (pre and 3-months post-surgery; n = 27), taking diet into account. We co-model these data with shotgun metagenomic profiles of the gut microbiota to provide a comprehensive atlas of host-gut microbe responses to bariatric surgery, weight-loss and glycaemic control at the systems level. Results Here we show that bariatric surgery reverses several disrupted pathways characteristic of T2D. The differential metabolite set representative of bariatric surgery overlaps with both diabetes (19.3% commonality) and body mass index (18.6% commonality). However, the percentage overlap between diabetes and body mass index is minimal (4.0% commonality), consistent with weight-independent mechanisms of T2D resolution. The gut microbiota is more strongly correlated to body mass index than T2D, although we identify some pathways such as amino acid metabolism that correlate with changes to the gut microbiota and which influence glycaemic control. Conclusion We identify multi-omic signatures associated with responses to surgery, body mass index, and glycaemic control. Improved understanding of gut microbiota - host co-metabolism may lead to novel therapies for weight-loss or diabetes. However, further experiments are required to provide mechanistic insight into the role of the gut microbiota in host metabolism and establish proof of causality

Integrated fecal microbiome–metabolome signatures reflect stress and serotonin metabolism in irritable bowel syndrome

To gain insight into the complex microbiome-gut-brain axis in irritable bowel syndrome (IBS) several modalities of biological and clinical data must be combined. We aimed to identify profiles of faecal microbiota and metabolites associated with IBS and to delineate specific phenotypes of IBS that represent potential pathophysiological mechanisms. Faecal metabolites were measured using proton Nuclear Magnetic Resonance (1H-NMR) spectroscopy and gut microbiome using Shotgun Metagenomic Sequencing (MGS) in a combined dataset of 142 IBS patients and 120 healthy controls (HC) with extensive clinical, biological and phenotype information. Data were analysed using support vector classification and regression and kernel t-SNE. Microbiome and metabolome profiles could distinguish IBS and HC with an area-under-the-receiver-operator-curve (AUC) of 77.3% and 79.5%, respectively, but this could be improved by combining microbiota and metabolites to 83.6%. No significant differences in predictive ability of the microbiome-metabolome data were observed between the three classical, stool pattern-based, IBS subtypes. However, unsupervised clustering showed distinct subsets of IBS patients based on faecal microbiome-metabolome data. These clusters could be related plasma levels of serotonin and its metabolite 5-hydroxyindoleacetate, effects of psychological stress on gastrointestinal symptoms, onset of IBS after stressful events, medical history of previous abdominal surgery, dietary caloric intake and IBS symptom duration. Furthermore, pathways in metabolic reaction networks were integrated with microbiota data, that reflect the host-microbiome interactions in IBS. The identified microbiome-metabolome signatures for IBS, associated with altered serotonin metabolism and unfavourable stress-response related to gastrointestinal symptoms, support the microbiota-gut-brain link in the pathogenesis of IBS

Effectiveness and safety of dabigatran versus acenocoumarol in 'real-world' patients with atrial fibrillation

Aims Randomized trials showed non-inferior or superior results of the non-vitamin-K-antagonist oral anticoagulants (NOACs) compared with warfarin. The aim of this study was to assess the effectiveness and safety of dabigatran (direct thrombin inhibitor) vs. acenocoumarol (vitamin K antagonist) in patients with atrial fibrillation (AF) in daily clinical practice. Methods and results In this observational study, we evaluated all consecutive patients who started anticoagulation because of AF in our outpatient clinic from 2010 to 2013. Data were collected from electronic patient charts. Primary outcomes were stroke or systemic embolism and major bleeding. Propensity score matching was applied to address the non-randomized design. In total, 920 consecutive AF patients were enrolled (442 dabigatran, 478 acenocoumarol), of which 2 x 383 were available for analysis after propensity score matching. Mean follow-up duration was 1.5 +/- 0.56 year. The mean calculated stroke risk according to the CHA(2)DS(2)-VASc score was 3.5%/year in dabigatran vs. 3.7%/year acenocoumarol-treated patients. The actual incidence rate of stroke or systemic embolism was 0.8%/year [95% confidence interval (CI): 0.2-2.1] vs. 1.0%/year (95% CI: 0.4-2.1), respectively. Multivariable analysis confirmed this lower but non-significant risk in dabigatran vs. acenocoumarol after adjustment for the CHA(2)DS(2)-VASc score [hazard ratio (HR)(dabigatran) = 0.72, 95% CI: 0.20-2.63, P = 0.61]. According to the HAS-BLED score, the mean calculated bleeding risk was 1.7%/year in both groups. Actual incidence rate of major bleeding was 2.1%/year (95% CI: 1.0-3.8) in the dabigatran vs. 4.3%/year (95% CI: 2.9-6.2) in acenocoumarol. This over 50% reduction remained significant after adjustment for the HAS-BLED score (HRdabigatran = 0.45, 95% CI: 0.22-0.93, P = 0.031). Conclusion In 'real-world' patients with AF, dabigatran appears to be as effective, but significantly safer than acenocoumarol

Performance of metabonomic serum analysis for diagnostics in paediatric tuberculosis

We applied a metabonomic strategy to identify host biomarkers in serum to diagnose paediatric tuberculosis (TB) disease. 112 symptomatic children with presumptive TB were recruited in The Gambia and classified as bacteriologically-confirmed TB, clinically diagnosed TB, or other diseases. Sera were analysed using 1H nuclear magnetic resonance (NMR) spectroscopy and mass spectrometry (MS). Multivariate data analysis was used to distinguish patients with TB from other diseases. Diagnostic accuracy was evaluated using Receiver Operating Characteristic (ROC) curves. Model performance was tested in a validation cohort of 36 children from the UK. Data acquired using 1H NMR demonstrated a sensitivity, specificity and Area Under the Curve (AUC) of 69% (95% confidence interval [CI], 56–73%), 83% (95% CI, 73–93%), and 0.78 respectively, and correctly classified 20% of the validation cohort from the UK. The most discriminatory MS data showed a sensitivity of 67% (95% CI, 60–71%), specificity of 86% (95% CI, 75–93%) and an AUC of 0.78, correctly classifying 83% of the validation cohort. Amongst children with presumptive TB, metabolic profiling of sera distinguished bacteriologically-confirmed and clinical TB from other diseases. This novel approach yielded a diagnostic performance for paediatric TB comparable to that of Xpert MTB/RIF and interferon gamma release assays

Statistical HOmogeneous Cluster SpectroscopY (SHOCSY): an optimized statistical approach for clustering of ¹H NMR spectral data to reduce interference and enhance robust biomarkers selection.

We propose a novel statistical approach to improve the reliability of (1)H NMR spectral analysis in complex metabolic studies. The Statistical HOmogeneous Cluster SpectroscopY (SHOCSY) algorithm aims to reduce the variation within biological classes by selecting subsets of homogeneous (1)H NMR spectra that contain specific spectroscopic metabolic signatures related to each biological class in a study. In SHOCSY, we used a clustering method to categorize the whole data set into a number of clusters of samples with each cluster showing a similar spectral feature and hence biochemical composition, and we then used an enrichment test to identify the associations between the clusters and the biological classes in the data set. We evaluated the performance of the SHOCSY algorithm using a simulated (1)H NMR data set to emulate renal tubule toxicity and further exemplified this method with a (1)H NMR spectroscopic study of hydrazine-induced liver toxicity study in rats. The SHOCSY algorithm improved the predictive ability of the orthogonal partial least-squares discriminatory analysis (OPLS-DA) model through the use of "truly" representative samples in each biological class (i.e., homogeneous subsets). This method ensures that the analyses are no longer confounded by idiosyncratic responders and thus improves the reliability of biomarker extraction. SHOCSY is a useful tool for removing irrelevant variation that interfere with the interpretation and predictive ability of models and has widespread applicability to other spectroscopic data, as well as other "omics" type of data