Reproductive Issues in Women with Turner Syndrome

Turner syndrome is one of the most common chromosomal abnormalities affecting female infants. The severity of clinical manifestations varies and it affects multiple organ systems. Women with Turner syndrome have a 3-fold increase in mortality, which becomes even more pronounced in pregnancy. Reproductive options include adoption or surrogacy, assisted reproductive techniques, and in rare cases spontaneous pregnancy. Risks for women with Turner syndrome during pregnancy include aortic disorders, hepatic disease, thyroid disease, type 2 diabetes, and cesarean section delivery. Providers must be familiar with the risks and recommendations in caring for women with Turner syndrome of reproductive age

Yolk sac tumor in children and the resulting biopsychosocial and spiritual aspects

Yolk sac tumor is a rare germ cell tumor in children, accounting for only about 3.5% of pediatric cancers. However, the yolk sac tumor is a malignant tumor that requires chemotherapy, but the side effects of chemotherapy can have an impact on the biopsychosocial and spiritual aspects of the child. This case report presents the negative impacts on the biopsychosocial and spiritual aspects of a child diagnosed with a yolk sac tumor. 11-year-old girl experienced symptoms of an enlarged abdomen, feeling bloated, pain, and frequent urination. The pathological examination revealed a yolk sac tumor, and the examination of ascites showed malignant cells. The patient was diagnosed with a yolk sac tumor, Stage 1C3, and was to undergo chemotherapy. She scored 15, indicating that the patient experienced anxiety due to the yolk sac tumor diagnosis and was anxious about the side effects of chemotherapy. Examination of the biological, psychological, social, and spiritual aspects in pediatric patients with a yolk sac tumor can assist in addressing the adverse effects of the diagnosis and the anxiety about chemotherapy in a more comprehensive manner

Collaboration Is Key for Successful Treatment of Youth-Onset Type 2 Diabetes

Type 2 diabetes (T2D) is increasing in U.S. adolescents, particularly those of ethnic and racial minority groups. Risk factors for youth-onset T2D include obesity, family history of T2D, poor diet, lack of exercise, and poverty. The onset of diabetes-related complications is accelerated in adolescents with T2D compared to adults, and knowledge regarding the optimal way to prevent and slow complications is lacking. Existing treatment options are limited, and research into novel pharmacologic treatments is hindered by lack of sufficient patient population for clinical trials. Health care providers and investigators should collaborate both with each other, and with patients and their communities to build networks that will allow comprehensive evaluation of this disease in order to offer optimal, comprehensive care for these adolescents

Mechanism of RNA Translocation by a Viral Packaging Motor

Molecular motors are proteins that convert chemical energy into mechanical work. The viral packaging ATPase P4 is a hexameric molecular motor that translocates RNA into preformed viral capsids. P4 belongs to the ubiquitous class of hexameric helicases. Although its structure is known, the mechanism of RNA translocation remains elusive. Here we present a detailed kinetic study of nucleotide binding, hydrolysis, and product release by P4. We propose a stochastic-sequential cooperative model to describe the coordination of ATP hydrolysis within the hexamer. In this model the apparent cooperativity is a result of hydrolysis stimulation by ATP and RNA binding to neighboring subunits rather than cooperative nucleotide binding. Simultaneous interaction of neighboring subunits with RNA makes the otherwise random hydrolysis sequential and processive. Further, we use hydrogen/deuterium exchange detected by high resolution mass spectrometry to visualize P4 conformational dynamics during the catalytic cycle. Concerted changes of exchange kinetics reveal a cooperative unit that dynamically links ATP binding sites and the central RNA binding channel. The cooperative unit is compatible with the structure-based model in which translocation is effected by conformational changes of a limited protein region. Deuterium labeling also discloses the transition state associated with RNA loading which proceeds via opening of the hexameric ring. Hydrogen/deuterium exchange is further used to delineate the interactions of the P4 hexamer with the viral procapsid. P4 associates with the procapsid via its C-terminal face. The interactions stabilize subunit interfaces within the hexamer. The conformation of the virus-bound hexamer is more stable than the hexamer in solution, which is prone to spontaneous ring openings. We propose that the stabilization within the viral capsid increases the packaging processivity and confers selectivity during RNA loading. Finally, we use single molecule techniques to characterize P4 translocation along RNA. While the P4 hexamer encloses RNA topologically within the central channel, it diffuses randomly along the RNA. In the presence of ATP, unidirectional net movement is discernible in addition to the stochastic motion. The diffusion is hindered by activation energy barriers that depend on the nucleotide binding state. The results suggest that P4 employs an electrostatic clutch instead of cycling through stable, discrete, RNA binding states during translocation. Conformational changes coupled to ATP hydrolysis modify the electrostatic potential inside the central channel, which in turn biases RNA motion in one direction. Implications of the P4 model for other hexameric molecular motors are discussed

APLIKASI PERENCANAAN DAN EVALUASI ANGGARAN PRODUKSI MENGGUNAKAN METODE ACTIVITY BASED BUDGETING (STUDI KASUS : CV TRIWARNA MULYA INDAH, BANDUNG)

Sebagai perusahaan manufaktur yang melakukan produksi, seharusnya menghitung seluruh biaya produksi. Sebelum melakukan produksi, perusahaan membuat perencanaan produksi berupa anggaran produksi. Perusahaan hanya membuat anggaran untuk biaya bahan baku, namun tidak melakukan penganggaran untuk seluruh proses produksi. Biaya produksi untuk tenaga kerja langsung dan overhead pabrik hanya menggunakan perkiraan tanpa memperhatikan detail dari aktivitas selama proses produksi, sehingga perusahaan tidak dapat mengevaluasi penyerapan anggaran produksi. Untuk mengatasi permasalahan tersebut dibangun sebuah aplikasi web yang dapat mengelola perencanaan dan mengevaluasi anggaran produksi berdasarkan aktivitas. Aplikasi berbasis web ini dibangun dengan metode berorientasi objek dan pengembangan model SDLC serta menggunakan bahasa pemrograman PHP dan Framework CodeIgniter. Aplikasi ini memiliki fungsionalitas untuk pembuatan anggaran produksi yang terdiri dari anggaran biaya bahan baku, biaya tenaga kerja langsung, dan biaya overhead pabrik berdasarkan aktivitas, membuat transaksi dalam bentuk jurnal dan buku besar, membuat laporan realisasi anggaran, dan membuat laporan perbandingan anggaran dan realisasi serta evaluasi. Fungsionalitas berjalan 100% setelah diujikan dengan black box testing, perbandingan hitung manual berhasil diimplementasikan sesuai dengan luaran aplikasi, dan telah dilakukan pengujian penerimaan pengguna. Setelah diimplementasikan, aplikasi mampu melakukan pembuatan perencanaan produksi berdasarkan aktivitas dan dapat mengevaluasi kinerja dari perusahaan melalui perbandingan anggaran dan realisasi. Kata Kunci: Perencanaan, Anggaran Produksi, Evaluasi, Framework CodeIgnite

Interactive Board in Teaching

65 s., 18 s. příl. :il., tab. +CD ROMCílem bakalářské práce je vytvoření výukového kurzu, pro pedagogy středních škol, zaměřeného na využití interaktivní tabule jako didaktického prostředku. Výukový kurz je postaven dle moderních trendů vzdělávání, které využívá množství specializovaných firem v oblasti vzdělávání a výuky. Interaktivní tabule je zde pak brána nejen jako didaktická pomůcka, o které je samotný výukový kurz, ale především je to didaktický nástroj, na němž je postavena samotná výuka. Účastníci kurzu tak mají jedinečnou možnost samotné interakce s tímto prostředkem již v době studia

MEDIASI ONLINE SEBAGAI ALTERNATIF PENYELESAIAN SENGKETA PERBANKAN DI INDONESIA

Tesis ini berjudul “Mediasi Online Sebagai Alternatif Penyelesaian Sengketa Perbankan di Indonesia”. Tesis dengan judul tersebut bertujuan mengetahui dan mengkaji konsep dan mekanisme mediasi online sebagai alternatif penyelesaian sengketa perbankan di Indonesia. Penelitian merupakan penelitian normatif dengan pendekatan komparatif dan pendekatan perundang-undangan. Sumber data berupa data sekunder yang terdiri atas bahan hukum primer dan bahan hukum sekunder. Metode pengumpulan data menggunakan studi pustaka dan wawancara dengan narasumber. Bahan hukum primer dan bahan hukum sekunder dianalisis dengan menggunakan dengan metode analisis hukum. Proses berpikir deduktif digunakan untuk menarik kesimpulan. Teori musyawarah mufakat dan teori kemanfaatan digunakan sebagai dasar analisis dalam mengkaji hasil penelitian. Hasil penelitian ini menunjukkan bahwa konsep mekanisme mediasi online sebagai alternatif penyelesaian sengketa perbankan di Indonesia adalah nasabah perbankan telah melakukan pengaduan ke unit pengaduan nasabah terhadap bank terkait terlebih dahulu dengan nilai sengketa yang diajukan maksimal Rp. 500.000.000,- dan sengketa keperdataan yang diajukan tidak sedang dalam proses ataupun belum pernah diputus oleh lembaga alternatif penyelesaian sengketa dan pengadilan. Mekanisme tahapan penyelesaian sengketa perbankan melalui mediasi online dapat diawali dengan tahap permohonan dan penyerahan dokumen, tahap pernyataan pembuka, tahap diskusi, tahap komunikasi terpisah, tahap kesepakatan dan diakhiri dengan tahap penutupan. Keberhasilan penerapan konsep mediasi online sebagai alternatif penyelesaian sengketa perbankan di Indonesia harus dipengaruhi dengan struktur hukum yang baik, substansi hukum yang jelas dan kultur budaya masyarakat. Struktur hukum menyangkut tentang sarana dan prasarana telekomunikasi memadai serta kecakapan mediator, substansi hukum merupakan peraturan perundangundangan yang mendukung penerapan mediasi online dan mengatur pelaksanaan mediasi online di Indonesia dan kultur budaya masyarakat sebagai kekuatan sosial bagaimana penggunaan hukum dengan baik

Sistem Informasi Perencanaan dan Evaluasi Anggaran Biaya Produksi Menggunakan Pendekatan Metode Activity Based Budgeting

As a manufacturing company before production, they should make production planning and calculate the production costs. One of the production cost planning tools are production budget. The company usually budgeting their production cost by prediction total cost, not consider the product, material, labour and mechine, its make company harder to evaluate the absorption of production budgets. Activity based budgeting method (ABB method) was a budgeting tools considering activity. The goal make this information system help company make production planning considering activity and evaluate company performance by evaluate the absosrption of budgeting (comparision between budget and realization). This information system built with the object-oriented method and development model with SDLC, use the programming language PHP and CodeIgniter framework. This system has the functionality to make production budget such as budgetary costs of raw materials, the cost of direct labor, and factory overhead costs based on the activity and also make transactions in accounting journals and ledgers and make realization budget reports and make comparison report between budget and realization and evaluating. The functionality of application has run 100% after tested with black box testing and user acceptance tests have been performed