scholarly journals Pengaruh Kepemimpinan Terhadap Kinerja Dosen dan Karyawan STIKES NU Tuban

2019 ◽  
Vol 4 (3) ◽  
pp. 174
Author(s):  
Sugiyono Sugiyono

To achieve a high level of performance, of course depends on various factors that influence it. There are at least six external factors that determine the level of performance of an employee, namely: (a) environment, (b) management behavior, (c) job design, (d) education level, (e) training, (f) motivation and (g) administration payment. The purpose of this study was to analyze the effect of leadership on the performance of Stikes NU lecturers and staff in Tuban. The research method is descriptive research, the population of all lecturers and staff of STIKES NU Tuban is 120 people, the sample is divided into 3 groups (group 1 (17 people), group 2 (27 people), and group 3 (76 people)). Techniques for collecting data through observation and interviews. Data analysis uses Pearson Product moment (PPM). Based on the results of the study indicate that leadership has a significant effect on the performance of lecturers and employees in a positive direction. In addition to supporting the second hypothesis which states that leadership has a significant effect on the performance of lecturers and employees. Leadership applied by STIKES NU Tuban has been felt in accordance with the expectations and desires of lecturers and employees in the long term and caused lecturers and employees to be loyal to STIKES NU Tuban

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
E Belik ◽  
OV Gruzdeva ◽  
YUA Dyleva ◽  
EG Uchasova ◽  
MYU Sinitsky ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Aim to determine the features of adiponectin expression, secretion of adiponectin and its receptors in local fat depots in CVD. Materials and methods The study included 90 patients with СAD (Group 1) and 60 patients with heart defects (Group 2). Adipocytes were isolated from samples of subcutaneous (SAT), epicardial (EAT) and perivascular (PVAT) adipose tissue obtained during CABG or heart valve replacement. The expression of adiponectin was determined by qPCR using TaqManTM Gene Expression Assays (Applied Biosystems, USA) in the ViiA 7 Real-Time PCR System (Applied Biosystems, USA), the levels of expression products was determined using enzyme immunoassay (Bender MedSystems GmbH, Vienna, Austria). The data were analyzed using the statistical software Statistica 9.0. Results EAT adipocytes were characterized by the lowest adiponectin expression relative to adipocytes of other localization both in Group 1 and Group 2. In patients Group 1 adiponectin expression in EAT was reduced relative in SAT and PVAT (by 1.2 and 1.5 times). In Group 2, the adiponectin mRNA in the EAT was lower than in the SAT and PVAT (1.4 and 1.5 times). The expression of adiponectin in EAT in Group 2 exceeded the same indicator in Group 1 by 1.2 times. The maximum expression of adiponectin was observed in the PVAT culture in patients of both groups. For Group 2, this indicator exceeded the values of Group 1 by 1.2 times. The content of adiponectin in the culture EAT was lower than in the SAT, both in Group 1 and Group 2 (by 1.3 and 1.13 times). The level of this indicator in Group 2 was 1.4 times higher than in Group 1. PVAT adipocytes of patients with CAD were characterized by the lowest level of adiponectin secretion in comparison with adipocytes of other localization. The adiponectin level in the PVAT of Group 2 exceeded that of fat stores of other localization and in Group 1 patients by 1.8 times. There were no statistically significant differences in the expression and concentration of adiponectin in the culture of adipocytes of the SAT between the groups of patients. In Group 1, the lowest level of AdipoR1 was found in the adipocyte culture of the PVAT. Noteworthy is the decrease in the level of AdipoR1 in Group 1 compared to the level of Group 2, observed in the SAT and PVAT: 1.3 and 1.5 times. There were no significant differences in the concentration of the AdipoR1 in the EAT, as well as AdipoR2 in all types of AT between the groups of patients. Conclusion: in CVD the EAT is characterized by minimal expression and secretion of adiponectin, regardless of nosology. In CAD despite the high level of expression of adiponectin, the adipocytes of the PVAT were found to have the lowest content in comparison with adipocytes of other localization. Dysregulation of the adiponectin/AdipoR axis is observed in PVAT, which may be due to low expression of adiponectin receptors and long-term processes of its post-translational modification and oligomerization in CAD.


Author(s):  
Tsuyoshi Yamabe ◽  
Yanling Zhao ◽  
Paul A Kurlansky ◽  
Suzuka Nitta ◽  
Saveliy Kelebeyev ◽  
...  

Abstract OBJECTIVES Chronic kidney disease (CKD) is prevalent in patients undergoing cardiovascular surgery, and it negatively impacts procedural outcomes; however, its influence on the outcomes of aortic surgery has not been well studied. This study aims to elucidate the importance of CKD on the outcomes of aortic root replacement (ARR). METHODS Patients who underwent ARR between 2005 and 2019 were retrospectively reviewed (n = 882). Patients were divided into 3 groups based on the Kidney Disease: Improving Global Outcomes criteria: Group 1 [estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m2, n = 421); Group 2 (eGFR = 30–59 ml/min/1.73 m2, n = 424); and Group 3 (eGFR < 30 ml/min/1.73 m2, n = 37). To reduce potential confounding, a propensity score matching was also performed between Group 1 and the combined group of Group 2 and Group 3. The primary end point was 10-year survival. Secondary end points were in-hospital mortality and perioperative morbidity. RESULTS Severe CKD patients presented with more advanced overall chronic and acute illnesses. Kaplan–Meier analysis showed a significant correlation between CKD stage and 10-year survival (log-rank P < 0.001). The number of events for Group 1 was 15, Group 2 was 49 and Group 3 was 11 in 10 years. Group 3 had significantly higher in-hospital mortality (13.5% vs 3.5% in Group 2 vs 0.7% in Group 1, P < 0.001) and stroke (8.1% vs 7.1% vs 1.2%, P < 0.001) as well as introduction to new dialysis (27.0% vs 5.4% vs 1.7%, P < 0.001). eGFR was shown to be an independent predictor of mortality (hazard ratio, 0.98; 95% confidence interval, 0.96–0.99). Comparison between propensity matched groups showed similar postoperative outcomes, and eGFR was still identified as a predictor of mortality (hazard ratio, 0.97; 95% confidence interval, 0.95–0.99). CONCLUSIONS Higher stage in CKD negatively impacts the long-term survival in patients who are undergoing ARR.


2009 ◽  
Vol 3 ◽  
pp. CMC.S2289 ◽  
Author(s):  
Taysir S. Garadah ◽  
Salah Kassab ◽  
Qasim M. Al-Shboul ◽  
Abdulhai Alawadi

Recent studies indicated a high prevalence of hyperglycemia in non-diabetic patients presenting with acute coronary syndrome (ACS). However, the threshold of admission glucose (AG) as a predictor of adverse events in ACS is unclear. Objective The aim of this study was to assess the threshold of admission glucose (AG) as a predictor of adverse events including Major Acute Cardiac Events (MACE) and mortality, during the first week of admitting patients presenting with ACS. Material and Methods The data of 551 patients with ACS were extracted and evaluated. Patients were stratified according to their blood glucose on admission into three groups: group 1: <7 mmol/L (n = 200, 36.3%) and group 2: >7 mmol/L and <15 mmol/L (n = 178, 32.3%) and group 3: ≥15 mmol/L (n = 173, 31.4%). Stress hyperglycemia was arbitrarily defined as AG levels > 7 mmol/L (group 2 and 3). Patients with ACS were sub-divided into two groups: patients with unstable angina (UA, n = 285) and those with ST segment elevation myocardial Infarction (STEMI, n = 266) and data were analyzed separately using multiple regression analysis. Results The mean age of patients was 59.7 ± 14.8 years and 63% were males. The overall mortality in the population was 8.5% (5.4% in STEMI and 3.1% in UA) patients. In STEMI patients, the odds ratio of stress hyperglycemia as predictor of mortality in group 3 compared with group 1 was 3.3 (CI 0.99-10.98, P < 0.05), while in group 2 compared with group 1 was 2.4 (CI: 0.75-8.07, P = 0.065) after adjustment for age and sex. Similarly, in UA patients, the odds ratio of stress hyperglycemia in group 3 compared with group 1 was 2.7 (CI 0.37-18.98, P < 0.05), while in group 2 compared with group 1 was 2.4 (CI: 0.4-15.2, P = 0.344) after adjustment for age and sex. The incidence of more than 2 MACE in both STEMI and UA patients was higher in group 3 compared with the other two groups. Regression analysis showed that history of DM, high level of LDL cholesterol, high level of HbA1c, and anterior infarction were significant predictors of adverse events while other risk factors such as BMI, history of hypertension and smoking were of no significance. Conclusion This study indicates that the stress hyperglycemia on admission is a powerful predictor of increased major adverse events and hospital mortality in patients with acute coronary syndrome.


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Teruhiko Imamura ◽  
Koichiro Kinugawa ◽  
Takeo Fujino ◽  
Toshiro Inaba ◽  
Hisataka Maki ◽  
...  

Introduction: Preserved function of collecting duct is essential for the response to tolvaptan (TLV), and urinary level of aquaporin 2 (U-AQP2) can be a marker for vasopressin-dependent activity of collecting duct. Hypothesis: Higher levels of U-AQP2 in proportion to plasma levels of vasopressin (P-AVP) may be associated with better initial responses to TLV and eventually result in the improved prognosis after long-term treatment of TLV. Methods: Consecutive 60 in-hospital patients with stage D heart failure (HF) who received TLV on a de novo basis were enrolled during 2011-2013. We also selected 60 HF patients by propensity score matching who were hospitalized during the same period but never treated with TLV. Events were defined as death and/or HF re-hospitalization. Results: TLV (3.75-15 mg/day) was continuously administered except death or ventricular assist device implantation occurred. There were 41 patients (group 1) who had increases in UV over the first 24 h after TLV initiation, and all of them had U-AQP2/P-AVP ≥0.5 х103 with higher U-AQP2 levels (5.42 ± 3.54 ng/mL) before TLV treatment. On the other hand, UV rather decreased even after TLV initiation in 19 patients over the first 24 h (group 2). Those in the group 2 universally had U-AQP2/P-AVP <0.5 х103, extremely low U-AQP2 levels (0.76 ± 0.59 ng/mL, p<0.001 vs. group 1), and similar P-AVP with the group 1 at baseline. The 41 and 19 patients without TLV treatment (group 3 and 4) were respectively matched to the group 1 and 2 by propensity scores. Interestingly, every patient in the group 3 had U-AQP2/P-AVP ≥0.5 х103, and vice versa in the group 4. Among the four groups, congestion-related symptoms were only improved in the group 1 after 1 month of enrollment. The patients in the group 1 had significantly better event-free survival over 2-year by TLV treatment compared with the group 3 (76% vs. 43%, p<0.014). In contrast, the patients in the group 2 and 4 had very poor prognoses regardless of TLV treatment (7% vs. 11%, p=0.823). Conclusions: U-AQP2/P-AVP is a novel predictor for the initial response to TLV in HF patients. Patients with higher U-AQP2/P-AVP may enjoy a better prognosis by long-term TLV treatment probably due to efficient resolution of congestion.


2016 ◽  
Vol 174 (4) ◽  
pp. 531-538 ◽  
Author(s):  
Julia Schulz ◽  
Kathrin R Frey ◽  
Mark S Cooper ◽  
Kathrin Zopf ◽  
Manfred Ventz ◽  
...  

ObjectiveIndividuals with primary adrenal insufficiency (PAI) or congenital adrenal hyperplasia (CAH) receive life-long glucocorticoid (GC) replacement therapy. Current daily GC doses are still higher than the reported adrenal cortisol production rate. This GC excess could result in long-term morbidities such as osteoporosis. No prospective trials have investigated the long-term effect of GC dose changes in PAI and CAH patients.MethodsThis is a prospective and longitudinal study including 57 subjects with PAI (42 women) and 33 with CAH (21 women). Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry at baseline and after 2 years. Subjects were divided into three groups (similar baseline characteristics) depending on changes in daily hydrocortisone equivalent dose (group 1: unchanged 25.2±8.2 mg (mean±s.d., n=50); group 2: increased 18.7±10.3 to 25.9±12.0 mg (n=13); group 3: decreased 30.8±8.5 to 21.4±7.2 mg (n=27)).ResultsSubjects in group 1 showed normal lumbar and femoral Z-scores which were unchanged over time. Group 2 subjects showed a significant decrease in femoral neck Z-scores over time (−0.15±1.1 to −0.37±1.0 (P<0.05)), whereas group 3 subjects showed a significant increase in lumbar spine and hip Z-scores (L1–L4: −0.93±1.2 to –0.65±1.5 (P<0.05); total hip: −0.40±1.0 to −0.28±1.0 (P<0.05)). No changes in BMI over time were seen within any group. Reduction in GC dose did not increase the risk of adrenal crisis.ConclusionThis study demonstrates for the first time that cautious reduction in hydrocortisone equivalent doses leads to increases in BMD, whereas dose increments reduced BMD. These data emphasize the need for the lowest possible GC replacement dose in AI patients to maintain health and avoid long-term adverse effects.


2007 ◽  
Vol 19 (1) ◽  
pp. 282
Author(s):  
S.-A. Ock ◽  
D. Kang ◽  
J. Han

Inhibitors of protein synthesis and phosphorylation have been widely used for oocyte activation and have been reported to induce abnormalities in nuclear ploidy due to aberrant DNA synthesis (DNAS). The present experiment was designed to compare the DNAS during the first cell cycle of porcine parthenotes following different activation treatments. Cumulus–oocyte complexes were cultured in TCM-199 supplemented with 0.5 �g mL-1 LH and FSH, 10 ng mL-1 EGF, and 0.1% PVA for 22 h, and additionally cultured in media without LH and FSH for 22 h. MII oocytes were then electrically pulsed twice in 0.28 M mannitol containing 0.05 mM CaCl2 and 0.1 mM MgSO4 at 1.8 kV cm-1 for 30 �s (group 1), followed by 7.5 �g mL-1 cytochalasin B (CCB, group 2), 10 �g mL-1 cycloheximide (CHX, group 3), or 1.9 mM 6-dimethylaminopurine (6-DMAP, group 4) for 3 h. Eggs were incubated with 100 �M 5-bromo-222-deoxyuridine (BrdU) for 1 h at 0, 2, 4, 6, 8, 10, and 12 h after activation to evaluate DNAS (Adenot et al. 1997 Development 124, 4615–4625) by determining the BrdU signal under a fluorescence microscope. Experiments were replicated 4 times; results were expressed as mean � SD and analyzed using one-way ANOVA by SPSS 10.0. The percentage of DNAS was calculated by dividing the number of BrdU-positive eggs by the total number of eggs used. DNAS in groups 1, 3, and 4 initiated at 2–3 h post-activation (hpa) but at 4–5 hpa in group 2. In group 1, DNAS was faint until 3 hpa, gradually increasing thereafter until 11 hpa (20.7 � 19.6, 29.4 � 17.0, 41.3 � 16.7, and 64.4 � 6.2, at 4–5, 6–7, 8–9, and 10–11 hpa, respectively). There was a significant (P &lt; 0.05) increase in DNAS at 10–11 h, but a significant (P &lt; 0.05) decrease (34.3 � 6.4) at 12–13 hpa. In groups 2 and 3, after 4–5 hpa, DNAS gradually increased until 7 h (6.2 � 1.4 and 29.8 � 16.6 at 4–5 hpa, and 21.1 � 13.7 and 40.0 � 18.7 at 6–7 hpa, respectively), but a DNAS peak was observed at 8–9 h (44.6 � 9.0) in group 2 and at 10–11 h (40.5 � 22.1) in group 3. Interestingly, group 4 parthenotes showed a different DNAS pattern compared with other groups, as it started at 2–3 hpa (24.8 � 11.7), reached a significantly (P &lt; 0.05) high level at 4–5 hpa (56.3 � 9.0), and gradually decreased at 6–7 hpa (42.7 � 10.3) until 12–13 hpa (29.5 � 14.9). In conclusion, CCB, CHX, and 6-DMAP used for oocyte activation exhibited different patterns of DNA synthesis during the first cell cycle of porcine parthenotes. Therefore, further experiments are required to evaluate the molecular signaling that regulates DNAS, embryonic developmental velocity, and ploidy of 2-cell parthenotes.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T.K.M Wang ◽  
K Akyuz ◽  
B Xu ◽  
M Gillinov ◽  
G Pettersson ◽  
...  

Abstract Background Isolated tricuspid surgery has markedly higher mortality rates (9–10%) in contemporary national registries compared to other single-valve operations. The optimal timing and indications remain controversial, and earlier surgery before developing ESC guidelines class 1 indications may improve the survival for isolated severe tricuspid regurgitation. Purpose We aimed to compare the characteristics and outcomes of isolated tricuspid regurgitation (TR) surgery by indication. Methods Consecutive patients undergoing isolated tricuspid valve surgery for TR without other concomitant valve surgery at Cleveland Clinic from 2004 to 2019 were studied. Indications were divided into group 1: ESC guidelines class 1 (severe symptomatic TR), group 2: infective endocarditis, and group 3: non-class 1 (asymptomatic severe TR with or without right ventricular dilation and/or dysfunction) and no endocarditis, for comparative analyses of characteristics and outcomes. Results The study included 207 patients (group 1: 115, group 2: 48 and group 3: 44) with mean age 54.1±17.8 years, 116 (56.0% females and 151. Tricuspid repair was performed in 72.9% (73.0%, 66.7% and 79.5% for Groups 1–3, P=0.381). Group 3 patients were younger, had higher prevalence of primary TR, lower prevalence of heart failure, atrial fibrillation, chronic lung disease, cirrhosis, renal impairment, right ventricular and left ventricular dysfunction than Group 1. Overall operative mortality rates were 4.9% ( group 1: 7.0%, group 2: 4.2% and group 3: 0.0%), while mortality during follow-up of 3.3±4.0 years was lower for group 3 than for groups 1 or 2 (Figure 1). Independent predictors of long-term mortality were Group 1 compared to Group 3 and reduced estimated glomerular filtration rate. Conclusion Patients without class I or endocarditis indications had superior unadjusted and adjusted survival compared to those with these indications. The high mortality rate of isolated TR surgery may be reduced by both earlier surgery and being performed at an experienced cardiac surgery center. Figure 1. Kaplan-Meier survival curves Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): National Heart Foundation of New Zealand - Overseas Clinical and Research Fellowship


2020 ◽  
Vol 9 (12) ◽  
pp. 3904
Author(s):  
Ha-Rim So ◽  
Hae Young Lopilly Park ◽  
So-Hyang Chung ◽  
Hyun-Seung Kim ◽  
Yong-Soo Byun

Autologous serum eyedrops (ASE) are effective in treating various ocular surface diseases, including damages induced by long-term use of preserved glaucoma eyedrops. However, there has been no study on whether ASE is effective without stopping the causative eyedrops. This retrospective observational study included 55 patients with ocular-surface diseases caused by long-term use of preserved glaucoma eyedrops: 18 patients who used ASEs for 2 months without discontinuing the use of glaucoma eyedrops (Group 1), 22 patients who used ASEs for 2 months, discontinuing the use of glaucoma eyedrops for the first month (Group 2) and 15 patients who used non-preservative artificial tears for 2 months, discontinuing the use of glaucoma eyedrops for the first month (Group 3). There were no intergroup differences in the baseline values of the Schirmer I test results, tear breakup time (TBUT), ocular surface staining (OSS) score, loss of the meibomian gland, meibum quality and ocular-surface disease index (OSDI). Group 1 showed significant differences in TBUT, OSS score and OSDI at 2 months when compared to the baseline values before treatment, while Group 2 showed significant differences in those values at both 1 and 2 months. There were no differences in any of the parameters at baseline, 1 month or 2 months in Group 3. Our result suggested that ASE is effective for treating ocular surface diseases caused by glaucoma eyedrops containing preservatives and its effects can be expected without interruption of glaucoma eyedrop treatment.


2015 ◽  
Vol 86 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Willian Juarez Granucci Guirro ◽  
Karina Maria Salvatore Freitas ◽  
Guilherme Janson ◽  
Marcos Roberto de Freitas ◽  
Camila Leite Quaglio

ABSTRACT Objective:  To compare the postretention stability of maxillary incisors alignment in subjects with Class I and II malocclusion treated with or without extractions. Materials and Methods:  The sample comprised 103 subjects with initial maxillary anterior irregularity greater than 3 mm and was divided into four groups: group 1 comprised 19 patients with Class I malocclusion treated with nonextraction (mean initial age = 13.06 years); group 2 comprised 19 patients with Class II malocclusion treated with nonextraction (mean initial age = 12.54 years); group 3 comprised 30 patients with Class I malocclusion treated with extractions (mean initial age = 13.16 years); group 4 comprised 35 patients with Class II malocclusion treated with extractions (mean initial age = 12.99 years). Dental casts were obtained at three different stages: pretreatment (T1), posttreatment (T2), and long-term posttreatment (T3). Maxillary incisor irregularity and arch dimensions were evaluated. Intergroup comparisons were performed by one-way analysis of variance followed by Tukey tests. Results:  In the long-term posttreatment period, relapse of maxillary crowding and arch dimensions was similar in all groups. Conclusion:  Changes in maxillary anterior alignment in Class I and Class II malocclusions treated with nonextractions and with extractions were similar in the long-term posttreatment period.


2021 ◽  
pp. 38-42
Author(s):  
N.F. Zakharenko ◽  
S.I. Regeda ◽  
I.P. Manoliak ◽  
V.S. Solskyy

Research aim: to determine the clinical efficacy and safety of bioavailable curcumin Longimin® in the complex anti-relapse therapy of patients with extragenital endometriosis after surgery.Materials and methods. Study involved 45 women with a mean age of 29.3 ± 3.6 years with a diagnosis of extragenital endometriosis. After surgical treatment of this disease all patients were prescribed dienogest 2 mg/day for 6 months with anti-relapse purpose. After that, 22 patients did not receive drug treatment (group 1) and other 23 women started a six-month course of 400 mg bioavailable curcumin (group 2).Results. After 12 months of observation 3 cases (13.6%) of newly formed foci of endometriosis were found among patients of group 1, two of which were multi-endometriomas, and the third was retrocervical heterotopia. There were no signs of recurrence in the group of sequential use of dienogest and bioavailable curcumin. In addition, 6 months after completion of hormonal treatment the number of women with chronic pelvic pain in group 1 was increased and average score on a visual analogue scale (VAS) was increased by 80% (p ≤0.05). It was accompanied by a stable moderately high level of anxiety throughout the observation period. At the same time the number of women who complained of intermenstrual pain in group 2 decreased from 15 to 13, and the average VAS score decreased by 13% (p ≥0.05) during the treatment period. Patients in group 2 noted an improvement in emotional control during treatment, which resulted in the average score decrease on the scale of personal and situational anxiety of the Spielberg-Hanin's questionnaire (25% and 30% respectively, p ≤0.05).Conclusions. The nature of the endometriosis development and progression is multipathogenetic. Blocking only its hormonal link, especially in cases of extragenital forms, may not be sufficient to stop the pathological process and prevent recurrence in the long term. Оbtained results of sequential course of dienogest and bioavailable curcumin Longimin® with anti-relapse purpose showed the wider clinical effectiveness of this therapy, which is probably based on additional inhibition of systemic inflammation, proliferation, stroma and psychogenic component of disease.


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