Kepemimpinan Camat dalam Meningkatkan Prestasi Kerja Aparatur Sipil Negara di Kecamatan Galela Barat

Study is based on initial observations that the leadership of Camat in improving the performance of the State Civil Apparatus within the government of West Galela District has not been running well. This condition is suspected to have something to do with the lack of optimal decision-making, delegation of authority, supervision, and communication has not been well overnight. This research applies qualitative research method with informant that set as many as 6 people. After the data collected the analysis is done by applying data analysis techniques namely, data reduction, data presentation, and data verification or conclusion.The research shows that (1) In leadership of Camat to improve the performance of Civil State Apparatus apparatus is one of indicator that decision making has not run as expected of Civil State Apparatus in District of Galela Barat. This is because the decision making which is often done by the Camat is not involving the participation of the staff, so there are employees who feel the need for involvement in decision making. (2) Leadership indicators Camat in improving job performance Civil Service Apparatus one of them is the delegation of authority. As per the result of research that indicator have not run well. Due to the reality, there is still less Camat's confidence in subordinates / employees, so that in delegation of authority more in submitted to the Secretary of the Camat in comparison with other employees. (3) One indicator of leadership of Camat that needs to be done is supervision on employee performance. According to the results of the research that the supervisory system Camat on employee performance has not gone well, because seen from the fact that there are still employees who are not disciplined in performing duties as a public servant. (4) As the result of research indicate that communication aspect has been running well, be it communication vertically (Up-Down) or horizontally (Interview).Based on the conclusion above, the researcher suggests that the Camat leadership needs to improve in terms of decision making, delegation of authority, supervision and communication. It is expected that the Camat as the leader to involve the participation of the State Civil Apparatus in the subdistrict of Galela Barat, the delegation of the authority of the Subdistrict Head should see the educational background of the officer who will assume the position temporarily, in order to be able to carry out the tasks according to the instruction of the Camat based on the stated objectives. (3) The sub-district head as the representative of the district government in the kecamatan should further improve the supervisory function on ASN performance. Because in Government Regulation No. 46 of 2011 on the assessment of the performance of civil servants, that one indicator of employee performance is seen from the level of self-discipline employees. By that, the Camat is expected to further tighten supervision in terms of employee discipline in performing duties as a public servant. (4) Communication between leaders and employees can be done better, in order to provide information relating to the duties and functions of each employee in West Galela District

Patient organ and effective dose estimation in CT: comparison of four software applications

Background: Radiation dose in computed tomography (CT) has become a topic of high interest due to the increasing numbers of CT examinations performed worldwide. Hence, dose tracking and organ dose calculation software are increasingly used. We evaluated the organ dose variability associated with the use of different software applications or calculation methods. Methods: We tested four commercial software applications on CT protocols actually in use in our hospital: CT-Expo, NCICT, NCICTX, and Virtual Dose. We compared dose coefficients, estimated organ doses and effective doses obtained by the four software applications by varying exposure parameters. Our results were also compared with estimates reported by the software authors. Results: All four software applications showed dependence on tube voltage and volume CT dose index, while only CT-Expo was also dependent on other exposure parameters, in particular scanner model and pitch caused a variability till 50%. We found a disagreement between our results and those reported by the software authors (up to 600%), mainly due to a different extent of examined body regions. The relative range of the comparison of the four software applications was within 35% for most organs inside the scan region, but increased over the 100% for organs partially irradiated and outside the scan region. For effective doses, this variability was less evident (ranging from 9 to 36%). Conclusions: The two main sources of organ dose variability were the software application used and the scan region set. Dose estimate must be related to the process used for its calculation

The 9p21 Rs 1333040 polymorphism is associated with coronary microvascular obstruction in ST-segment elevation myocardial infarction treated by primary angioplasty

Background: Microvascular obstruction (MVO) after primary percutaneous coronary intervention (pPCI) leads to higher incidence of both early and late complications. A number of single nucleotide polymorphisms in 9p21 chromosome have been shown to affect angiogenesis in response to ischaemia. In particular, Rs1333040 with its three genotypic vriants C/C, T/C and T/T might influence the occurrence of MVO after pPCI. Methods: We enrolled ST-elevation myocardial infarction (STEMI) patients undergoing pPCI. The Rs1333040 polymorphism was evaluated by polymerase chain reaction-restriction fragment length polymorphism using restriction endonucleases (Bsml). Two expert operators unaware of the patients' identity performed the angiographic analysis; collaterals were assessed applying Rentrop's classification. Angiographic MVO was defined as a post-pPCI Thrombolysis In Myocardial Infarction (TIMI)<3 or TIMI 3 with myocardial blush grade 0 or 1, whereas electrocardiographic MVO was defined as ST segment resolution Results: Among our 133 STEMI patients (mean age 63 +/- 11 years, men 72%), 35 (26%) and 53 (40%) respectively experienced angiographic or electrocardiographic MVO. Angiographic and electrocardiographic MVO were different among the three variants (p= 0.03 and p=0.02 respectively). In particular, T/T genotype was associated with a higher incidence of both angiographic and electrocardiographic MVO compared with C/C genotype (p=0.04 and p=0.03 respectively). Moreover, Rentrop score <2 detection rate differed among the three genotypes (p=0.03). In particular T/T genotype was associated with a higher incidence of a Rentrop score <2 as compared with C/C genotype (p= 0.02). Conclusion: Rs1333040 polymorphism genetic variants portend different MVO incidence. In particular, T/T genotype is related to angiographic and electrocardiographic MVO and to worse collaterals towards the culprit artery

Lazy Abstraction-Based Controller Synthesis

We present lazy abstraction-based controller synthesis (ABCS) for continuous-time nonlinear dynamical systems against reach-avoid and safety specifications. State-of-the-art multi-layered ABCS pre-computes multiple finite-state abstractions of varying granularity and applies reactive synthesis to the coarsest abstraction whenever feasible, but adaptively considers finer abstractions when necessary. Lazy ABCS improves this technique by constructing abstractions on demand. Our insight is that the abstract transition relation only needs to be locally computed for a small set of frontier states at the precision currently required by the synthesis algorithm. We show that lazy ABCS can significantly outperform previous multi-layered ABCS algorithms: on standard benchmarks, lazy ABCS is more than 4 times faster

Specifying evidence-based behavior change techniques to aid smoking cessation in pregnancy

Introduction: Behavioural support aids smoking cessation in pregnancy. However, it remains unclear which component behaviour change techniques (BCTs) contribute to effectiveness, or the extent to which these are applied in practice. This study aimed to examine: i) which BCTs were included in effective behavioural support interventions for pregnant smokers, and ii) the prevalence of use of these BCTs by the English Stop Smoking Services (SSSs). Methods: From a Cochrane review of smoking cessation behavioural support in pregnancy, seven interventions were identified as effective in that they increased the odds of cessation by at least 50% and differences between intervention and control conditions were statistically significant. BCTs in each intervention were identified using an established taxonomy of BCTs. Thirteen treatment manuals from SSSs were coded for inclusion of BCTs. Results: Thirty-seven BCTs were identified across trials of behavioural support for pregnant smokers, with an average of eight BCTs, and a range of six to 34 BCTs, per intervention. Eleven BCTs were present in at least two effective interventions [e.g. facilitate goal setting (n=6), advise on social support (n=2), action planning (n=5), provide rewards contingent on successfully stopping smoking (n=4)]. Only 15.4% of treatment manuals from SSSs contained all eleven BCTs; 53.8% contained at least six of them. Conclusions: Whilst BCTs associated with effective interventions can be identified from systematically reviewed literature, English SSSs appear to use only a limited proportion of these in practice

Self‐assembled quantum dots of InSb grown on InP by atomic layer molecular beam epitaxy: Morphology and strain relaxation

Self-organized InSb dots grown by atomic layer molecular beam epitaxy on InP substrates have been characterized by atomic force and transmission electron microscopy. Measurement of high-energy electron diffraction during the growth indicates a Stransky–Krastanov growth mode beyond the onset of 1.4 InSb monolayer ~ML! deposition. The dots obtained after a total deposition of 5 and 7 ML of InSb present a truncated pyramidal morphology with rectangular base oriented along the ^110& directions, elongated towards the @110# direction with $111$113%/$114$111%A lateral facets in @11 ¯ 0# views, and ~001! flat top surfaces. The mismatch between the dot and the substrate has been accommodated by a network of 90° misfit dislocation at the interface. A corrugation of the InP substrate surrounding the dot has been also observedThis work has been funded by the Spanish CICYT Project MAT95-0966.Peer reviewe

EP-1364: Proposal of thermal neutron detector stability for peripheral dose estimation in clinac at a novel neutron facility

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Allergy in total knee replacement surgery: Is it a real problem?

Total knee arthroplasty is a common procedure, with extremely good clinical results. Despite this success, it produces 20% unsatisfactory results. Among the causes of these failures is metal hypersensitivity. Metal sensitization is higher in patients with a knee arthroplasty than in the general population and is even higher in patients undergoing revision surgery. However, a clear correlation between metal sensitization and symptomatic knee after surgery has not been ascertained. Surely, patients with a clear history of metal allergy must be carefully examined through dermatological and laboratory testing before surgery. There is no globally accepted diagnostic algorithm or laboratory test to diagnose metal hypersensitivity or metal reactions. The patch test is the most common test to determine metal hypersensitivity, though presenting some limitations. Several laboratory assays have been developed, with a higher sensitivity compared to patch testing, yet their clinical availability is not widespread, due to high costs and technical complexity. Symptoms of a reaction to metal implants present across a wide spectrum, ranging from pain and cutaneous dermatitis to aseptic loosening of the arthroplasty. However, although cutaneous and systemic hypersensitivity reactions to metals have arisen, thereby increasing concern after joint arthroplasties, allergies against implant materials remain quite rare and not a well-known problem. The aim of the following paper is to provide an overview on diagnosis and management of metal hypersensitivity in patients who undergo a total knee arthroplasty in order clarify its real importance