ANALISIS PENGEMBANGAN KAWASAN AGROPOLITAN DI LANGOWAN KABUPATEN MINAHASA

Kesenjangan antara kawasan perkotaan dan perdesaan saat ini sering terjadi.Dimana perkembangan pembangunan diperkotaan yang demikian pesat membuat pertumbuhan ekonomi perkotaan menjulang tinggi dan setiap aspek kehidupan sosial didalamnya juga berkembang dengan sangat baik, disamping itu juga adanya benturan dengan aspek lingkungan terkait pembangunan kawasan perkotaan.Dengan demikian, perlu adanya pengembangan kawasan perdesaan dengan memanfaatkan seluruh potensi sumberdaya yang dimiliki oleh perdesaan.Langowan termasuk didalam wilayah Kawasan Agropolitan Pakakaan yang berada di Kabupaten Minahasa.Kawasan Agropolitan merupakan kawasan yang terdiri atas beberapa pusat kegiatan pada wilayah perdesaan sebagai sistem produksi pertanian dan pengelolaan sumber daya alam tertentu, dengan adanya keterkaitan fungsi dan hirarki keruangan sistem permukiman dan sistem agribisnis.Langowan merupakan wilayah yang sangat potensial untuk pengembangan sektor pertanian.Namun berdasarkan survey lapangan yang ada, saat ini belum adanya perkembangan sektor pertanian yang kompetitif dari hulu hingga hilir.Tujuan dari penelitian ini yaitu mengidentifikasi karakteristik kawasan dan menganalisis struktur ruang Kawasan Agropolitan di Langowan Kabupaten Minahasa.Penelitian ini menggunakan pendekatan metode kuantitatif deskriptif dengan teknik analisis menggunakan metode statistika deskriptif, metode Location Quotient (LQ) dan Shift Share (SS), dan metode skalogram guttman.Bila dilihat dari hasil penelitian maka dapat disimpulkan karakteristik Kawasan Agropolitan di Langowan memiliki kondisi agroklimat yang cocok untuk pertanian.Memiliki fasum, fasos, sarana dan prasarana dasar.Memiliki infrastruktur penunjang pertanian.Memiliki sumberdaya manusia yaitu penduduk tani dan kelompok tani.Memiliki 17 jenis komoditas pertanian dengan 6 potensi unggulan prioritas pengembangan yaitu komoditas ubi jalar, cabe keriting, kelapa, buncis, padi sawah, dan tomat.Struktur ruang Kawasan Agropolitan di Langowan diketahui hirarki I yang diarahkan sebagai pusat pelayanan utama kawasan berada pada Kecamatan Langowan timur, hirarki II yang diarahkan sebagai pusat pertumbuhan I berada pada Kecamatan Langowan barat, dan hirarki III yang diarahkan sebagai pusat pertumbuhan II berada pada Kecamatan Langowan utara dan Langowan selatan.   KATA KUNCI : Pengembangan Kawasan, Agropolitan,  Struktur Ruan

Neo-LVOT and Transcatheter Mitral Valve Replacement: Expert Recommendations

With the advent of transcatheter mitral valve replacement (TMVR), the concept of the neo-left ventricular outflow tract (LVOT) was introduced and remains an essential component of treatment planning. This paper describes the LVOT anatomy and provides a step-by-step computed tomography methodology to segment and measure the neo-LVOT while discussing the current evidence and outstanding challenges. It also discusses the technical and hemodynamic factors that play a major role in assessing the neo-LVOT. A summary of expert-based recommendations about the overall risk of LVOT obstruction in different scenarios is presented along with the currently available methods to reduce the risk of LVOT obstruction and other post-procedural complications

LIDAR-INERTIAL LOCALIZATION WITH GROUND CONSTRAINT IN A POINT CLOUD MAP

Real-time localization is a crucial task in various applications, such as automatic vehicles (AV), robotics, and smart city. This study proposes a framework for map-aided LiDAR-inertial localization, with the objective of accurately estimating the trajectory in a point clouds map. The proposed framework addresses the localization problem through a factor graph optimization (FGO), enabling the fusion of homogenous measurements for sensor fusion and designed absolute and relative constraints. Specifically, the framework estimates the light detection and ranging (LiDAR) odometry by leveraging inertial measurement unit (IMU) and registering corresponding featured points. To eliminate the accumulative error, this paper employs a ground plane distance and a map matching error to constraint the positioning error along the trajectory. Finally, local odometry and constraints are integrated using a FGO, including LiDAR odometry, IMU pre-integration, and ground constraints, map matching constraints, and loop closure. Experimental results were evaluated on an open-source dataset, UrbanNav, with an overall localization accuracy of 2.29 m (root mean square error, RMSE)

Malignant perivascular epithelioid cell tumor of the uterus

Perivascular epithelioid cell tumors (PEComas) are a rare collection of tumors arising in a wide array of anatomic locations and characterized by a myomelanocytic phenotype. PEComas which occur in non-classic anatomic distributions are known as perivascular epithelioid cell tumor-not otherwise specified (PEComa-NOS), and one of the most common primary sites for PEComa-NOS is the uterus. The risk of aggressive behavior of these tumors has been linked to a number of factors evaluable on pathologic review following initial surgical resection. We report a case of PEComa-NOS of the uterus with multiple high-risk features, including frank vascular invasion, with no evidence of recurrent disease 18 months following initial surgical resection

Monitoring quality of care in hepatocellular carcinoma: A modified Delphi consensus

Although there are several established international guidelines on the management of hepatocellular carcinoma (HCC), there is limited information detailing specific indicators of good quality care. The aim of this study was to develop a core set of quality indicators (QIs) to underpin the management of HCC. We undertook a modified, two-round, Delphi consensus study comprising a working group and experts involved in the management of HCC as well as consumer representatives. QIs were derived from an extensive review of the literature. The role of the participants was to identify the most important and measurable QIs for inclusion in an HCC clinical quality registry. From an initial 94 QIs, 40 were proposed to the participants. Of these, 23 QIs ultimately met the inclusion criteria and were included in the final set. This included (a) nine related to the initial diagnosis and staging, including timing to diagnosis, required baseline clinical and laboratory assessments, prior surveillance for HCC, diagnostic imaging and pathology, tumor staging, and multidisciplinary care; (b) thirteen related to treatment and management, including role of antiviral therapy, timing to treatment, localized ablation and locoregional therapy, surgery, transplantation, systemic therapy, method of response assessment, and supportive care; and (c) one outcome assessment related to surgical mortality. Conclusion: We identified a core set of nationally agreed measurable QIs for the diagnosis, staging, and management of HCC. The adherence to these best practice QIs may lead to system-level improvement in quality of care and, ultimately, improvement in patient outcomes, including survival

Symptomatic Acute Hepatitis C in Egypt: Diagnosis, Spontaneous Viral Clearance, and Delayed Treatment with 12 Weeks of Pegylated Interferon Alfa-2a

The aim of this study was to estimate the proportion of spontaneous viral clearance (SVC) after symptomatic acute hepatitis C and to evaluate the efficacy of 12 weeks of pegylated interferon alfa-2a in patients who did not clear the virus spontaneously.Patients with symptomatic acute hepatitis C were recruited from two "fever hospitals" in Cairo, Egypt. Patients still viremic three months after the onset of symptoms were considered for treatment with 12 weeks of pegylated interferon alfa-2a (180 microg/week).Between May 2002 and February 2006, 2243 adult patients with acute hepatitis were enrolled in the study. The SVC rate among 117 patients with acute hepatitis C was 33.8% (95%CI [25.9%-43.2%]) at three months and 41.5% (95%CI [33.0%-51.2%]) at six months. The sustained virological response (SVR) rate among the 17 patients who started treatment 4-6 months after onset of symptoms was 15/17 = 88.2% (95%CI [63.6%-98.5%]).Spontaneous viral clearance was high (41.5% six months after the onset of symptoms) in this population with symptomatic acute hepatitis C. Allowing time for spontaneous clearance should be considered before treatment is initiated for symptomatic acute hepatitis C

The pandemic toll and post-acute sequelae of SARS-CoV-2 in healthcare workers at a Swiss University Hospital.

Healthcare workers have potentially been among the most exposed to SARS-CoV-2 infection as well as the deleterious toll of the pandemic. This study has the objective to differentiate the pandemic toll from post-acute sequelae of SARS-CoV-2 infection in healthcare workers compared to the general population. The study was conducted between April and July 2021 at the Geneva University Hospitals, Switzerland. Eligible participants were all tested staff, and outpatient individuals tested for SARS-CoV-2 at the same hospital. The primary outcome was the prevalence of symptoms in healthcare workers compared to the general population, with measures of COVID-related symptoms and functional impairment, using prevalence estimates and multivariable logistic regression models. Healthcare workers (n=3,083) suffered mostly from fatigue (25.5%), headache (10.0%), difficulty concentrating (7.9%), exhaustion/burnout (7.1%), insomnia (6.2%), myalgia (6.7%) and arthralgia (6.3%). Regardless of SARS-CoV-2 infection, all symptoms were significantly higher in healthcare workers than the general population (n=3,556). SARS-CoV-2 infection in healthcare workers was associated with loss or change in smell, loss or change in taste, palpitations, dyspnea, difficulty concentrating, fatigue, and headache. Functional impairment was more significant in healthcare workers compared to the general population (aOR 2.28; 1.76-2.96), with a positive association with SARS-CoV-2 infection (aOR 3.81; 2.59-5.60). Symptoms and functional impairment in healthcare workers were increased compared to the general population, and potentially related to the pandemic toll as well as post-acute sequelae of SARS-CoV-2 infection. These findings are of concern, considering the essential role of healthcare workers in caring for all patients including and beyond COVID-19

Study Protocol: The Behaviour and Pain in Dementia Study (BePAID)

<p>Abstract</p> <p>Background</p> <p>People with dementia admitted to the acute hospital often receive poor quality care particularly with regards to management of behavioural and psychiatric symptoms of dementia (BPSD) and of pain. There have been no UK studies on the prevalence and type of pain or BPSD in people with dementia in this setting, or on how these may impact on patients, carers, staff and costs of care.</p> <p>Methods/Design</p> <p>We shall recruit older people with dementia who have unplanned acute medical admissions and measure the prevalence of BPSD using the Behave-AD (Behaviour in Alzheimer's Disease) and the CMAI (Cohen Mansfield Agitation Inventory). Pain prevalence and severity will be assessed by the PAINAD (Pain Assessment in Advanced Dementia) and the FACES pain scale. We will then analyse how these impact on a variety of outcomes and test the hypothesis that poor management of pain is associated with worsening of BPSD.</p> <p>Discussion</p> <p>By demonstrating the costs of BPSD to individuals with dementia and the health service this study will provide important evidence to drive improvements in care. We can then develop effective training for acute hospital staff and alternative treatment strategies for BPSD in this setting.</p

Co-morbidity and drug treatment in Alzheimer's disease. A cross sectional study of participants in the Dementia Study in Northern Norway

Inappropriate medical treatment of co-morbidities in Alzheimer’s disease (AD) is an increasing concern in geriatric medicine. The objective of this study was to compare current drug use related to co-morbidity between individuals with a recent diagnosis of AD and a cognitively healthy control group in a population based clinical trial in Northern Norway. Setting: Nine rural municipalities with 70 000 inhabitants in Northern Norway. Participants: Participants with and without AD recruited in general practice and by population based screening. 187 participants with a recent diagnosis of AD were recruited among community dwellers. Of 791 respondents without cognitive symptoms, 500 were randomly selected and invited to further clinical and cognitive testing. The final control group consisted of 200 cognitively healthy individuals from the same municipalities. Demographic characteristics, data on medical history and current medication were included, and a physical and cognitive examination was performed. The statistical analyses were carried out by independent sample t-test, chi-square, ANCOVA and logistic regression. A co-morbidity score was significantly higher in AD participants compared to controls. The mean number of drugs was higher for AD participants compared to controls (5.1 ± 3.6 and 2.9 ± 2.4 respectively, p < 0.001 age and gender adjusted), also when adjusted for co-morbidity. AD participants used significantly more anticholinergic, sedative and antidepressant drugs. For nursing home residents with AD the mean number of drugs was significantly higher compared to AD participants living at home (6.9 ± 3.9 and 4.5 ± 3.3, respectively, p < 0.001). AD participants were treated with a significantly higher number of drugs as compared to cognitively healthy controls, even after adjustment for co-morbidity. An inappropriate use of anticholinergic and sedative drugs was identified, especially among nursing home residents with AD. The drug burden and the increased risk of adverse reactions among individuals suffering from AD need more attention from prescribing doctors