27 research outputs found
Analisis Pemasaran Sosial dengan Metode SWOT pada Program Keluarga Berencana (KB) di Kantor Badan TASKIN PMPKB Kabupaten Tanah Datar: Indonesia
No full textABSTRACT
The purpose of this study is to analyze internal and external factors that influence the social marketing strategy of the Family Planning (KB) program at the Tanah Datar District TASKIN PMPKB Office and analyze what strategies are appropriate to be applied to the Tanah Datar TASKIN PMPKB Agency Office. In this study, the author uses the SWOT method to analyze internal and external factors and what strategies are appropriate to be applied to the TASKIN PMPKB Office of Tanah Datar Regency. Based on the SWOT analysis, the total score of the strength factor is more dominant or greater than the weakness factor at the Tanah Datar TASKIN PMPKB Office, which is 1.58 compared to 1.49.
While the external factor, the opportunity score is greater than the threat score at the Tanah Datar TASKIN PMPKB Office, which is 1.81 compared to 1.14, so it can be concluded that all existing weaknesses can be covered or overcome with strengths. exist, as well as threats that come from outside can be overcome with the opportunities that exist for the Tanah Datar District TASKIN PMPKB Office
Testosterone Changes in Men With Obesity and Type 2 Diabetes 6 Months After Sleeve Gastrectomy With Transit Bipartition
No full textBackground: Metabolic/bariatric surgery has been shown to increase testosterone in males with obesity. This study investigated the effect of the novel metabolic/bariatric surgery procedure, sleeve gastrectomy with transit bipartition (SG-TB), on serum total testosterone and metabolic variable changes in men with obesity and type 2 diabetes. Methods: In a prospective single-center cohort study, laboratory samples were analyzed preoperatively and at 6 months following SG-TB in patients with a body mass index (BMI) >= 30 kg/m(2). Changes in metabolic parameters and testosterone were evaluated. Results: Between July 2018 and March 2019, 166 patients with a mean baseline BMI of 34.9 +/- 3.8 kg/m(2) (mean age 51.5 +/- 9.3 y), glycosylated hemoglobin 9.5 +/- 1.3%, and testosterone 3.1 +/- 1.3 underwent SG-TB. At 6-month follow-up, mean excess BMI loss was 70.2 +/- 24.3%; glycosylated hemoglobin, 6.6 +/- 1.1% (P<0.001); and testosterone, 4.5 +/- 1.5 (P<0.001). Conclusion: In the early term following SG-TB, more than any other factor assessed, BMI loss was found to be a significant driver of improvement in testosterone levels. Regardless of preoperative obesity classification, patients with initially low testosterone attained significantly increased testosterone levels at 6-month follow-up
Interval Type-2 Trapezoidal Fuzzy AHP and Modified Delphi Method: Evaluation of Railway Transportation for Istanbul, Turkey
No full textOne of the most vital forms of public transportation, particularly in large, populated areas, is rail transit. In order to improve the infrastructure of the railway public transportation systems, integration and adaptation of new technologies are of great importance. Therefore, the technological assessment of the most popular Tram, Subway, and Marmaray alternatives of Istanbul's train transit is covered in this chapter. First, expert interviews are done in the chapter once the criteria are established, and Modified Delphi approach is then used for consolidation. Subsequently, Interval Type-2 Fuzzy AHP is applied for obtaining importance weights of transport technology criteria. A sensitivity analysis is performed to show the applicability and reliability of the proposed methodology. Overall, the results show that the suggested model is reliable and can be used broadly in similar evaluation problems. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023
Bilateral posterior retroperitoneal robotic adrenalectomy for ACTH-independent Cushing syndrome.
No full textEfficacy of laparoscopic radiofrequency ablation for the treatment of patients with small solitary colorectal liver metastasis.
No full textA Critical Analysis of Postoperative Morbidity and Mortality After Laparoscopic Radiofrequency Ablation of Liver Tumors
No full textAlthough the laparoscopic approach provides certain advantages over the percutaneous radiofrequency thermal ablation (RFA), the morbidity needs to be defined. The aim of this study is to analyze the morbidity and underlying risk factors after laparoscopic RFA of liver tumors
Infiltration pattern predicts metastasis and progression better than the T-stage and grade in pancreatic neuroendocrine tumors: a proposal for a novel infiltration-based morphologic grading
No full text© 2021, The Author(s), under exclusive licence to United States & Canadian Academy of Pathology.The advancing edge profile is a powerful determinant of tumor behavior in many organs. In this study, a grading system assessing the tumor-host interface was developed and tested in 181 pancreatic neuroendocrine tumors (PanNETs), 63 of which were <=2 cm. Three tumor slides representative of the spectrum (least, medium, and most) of invasiveness at the advancing edge of the tumor were selected, and then each slide was scored as follows. Well-demarcated/encapsulated, 1 point; Mildly irregular borders and/or minimal infiltration into adjacent tissue, 2 points; Infiltrative edges with several clusters beyond the main tumor but still relatively close, and/or satellite demarcated nodules, 3 points; No demarcation, several cellular clusters away from the tumor, 4 points; Exuberantly infiltrative pattern, scirrhous growth, dissecting the normal parenchymal elements, 5 points. The sum of the rankings on the three slides was obtained. Cases with scores of 3–6 were defined as \"non/minimally infiltrative\" (NI; n = 77), 7–9 as \"moderately infiltrative\" (MI; n = 68), and 10–15 as \"highly infiltrative\" (HI; n = 36). In addition to showing a statistically significant correlation with all the established signs of aggressiveness (grade, size, T-stage), this grading system was found to be the most significant predictor of adverse outcomes (metastasis, progression, and death) on multivariate analysis, more strongly than T-stage, while Ki-67 index did not stand the multivariate test. As importantly, cases <=2 cm were also stratified by this grading system rendering it applicable also to this group that is currently placed in \"watchful waiting\" protocols. In conclusion, the proposed grading system has a strong, independent prognostic value and therefore should be considered for integration into routine pathology practice after being evaluated in validation studies with larger series
A New Technique of Radiofrequency-assisted Ultrasound-guided Needle-localized Laparoscopic Resection of Disappearing Colorectal Liver Metastases
No full textThe management of disappearing colorectal liver metastases in the postadjuvant chemotherapy setting is challenging. We describe a novel technique that facilitates laparoscopic resection of disappearing metastatic liver lesions with great precision. Details of this new technique are described in 2 patients with colorectal cancer synchronously metastatic to the liver. Both patients had small indistinct intraparenchymal liver lesions after adjuvant chemotherapy. A video displays the steps of the procedure. Both patients presented with colorectal cancer with synchronous liver metastasis. They received FOLFOX regimen after resection of their primary. They both responded to adjuvant chemotherapy. On repeat posttreatment imaging, the liver lesions became smaller and indistinct. With laparoscopic ultrasound, subtle parenchymal heterogeneities were identified. The lesions were initially ablated with a wide radiofrequency ablation zone. Then, without removing the needle, the prongs were deployed to the borders of the parenchymal heterogeneity. Using an ultrasonic vessel sealer, the lesions were resected. Final pathology identified 1 viable focus of cancer in each patient. Both patients were discharged home uneventfully on their second postoperative day. There were no complications. We have described a novel technique that could facilitate precise resection of intraparenchymal small indistinct or disappearing liver metastases of colorectal origin. This option should be kept within the armamentarium of the laparoscopic liver surgeon managing patients with malignant liver tumors
How rapidly do neutron stars spin at birth? Constaints from archival X-ray observations of extragalactic supernovae
No full textTraditionally, studies aimed at inferring the distribution of birth periods of neutron stars are based on radio surveys. Here we propose an independent method to constrain the pulsar spin periods at birth based on their X-ray luminosities. In particular, the observed luminosity distribution of supernovae (SNe) poses a constraint on the initial rotational energy of the embedded pulsars, via the correlation found for radio pulsars, and under the assumption that this relation continues to hold beyond the observed range. We have extracted X-ray luminosities (or limits) for a large sample of historical SNe observed with Chandra, XMM and Swift, which have been firmly classified as core-collapse SNe. We have then compared these observational limits with the results of Monte Carlo simulations of the pulsar X-ray luminosity distribution for a range of values of the birth parameters. We find that a pulsar population dominated by millisecond periods at birth is ruled out by the data
