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The effort of the prevention and countermeasures in order to break the chain of transmission of Corona Virus Disease 2019 (Covid-19), it needs to be done in an integrated and comprehensive manner from various aspects of governance, health, socio-cultural and economic aspects. As part of the state of public health emergencies and has beeb designated as a non natural disaster, the regional goverment has the authority to take preventive and countermeasures actions primarily in the enforcement of health protocol during the Covid-19 pandemic in accordance with statutory provinsions. The research objective is to understand the enforcement of health protocols during the Covid-19 pandemic. The research method used is juridical-normative with a statutory approach and a conceptual approach to analyze problems qualitatively. The results and discussion concluded that The formulation of policies and formation of regional legal product that from the basic of legitimacy as well as the basic of legality to act for local goverments in the efoort to optimize the enforcement of prtococols during the Covid-19 pandemic, certaily need to develop specific policy formulation models and becemo a reference for local goverments in policy formulations and formulation reginal legal product in the enforcement of the Covid-19 health protocol. Policy formulation and formation of regional legal product in the enforcement of the Covid-19 health protocol include, and a review of the stages of policy formulation

The solvent influences for dioxygen reactivity with [Cu(PYAN)(MeCN)]B(C(sub 6)F(sub 5))(sub 4) are studied. Results demonstrate that solvent interaction and/or binding can be probed and plays an important role in the dynamic equilibrium between the side-on perexo Cu(super II)(sub 2)-(O2) and bis-mu-oxo Cu(super III)(sub 2)-(O2) isomeric forms.

Background and objectives: Secondary hyperparathyroidism (SHPT) can lead to significant morbidity, mortality, and additional healthcare resource utilization in chronic kidney disease (CKD) stage 5. The objective of this study was to examine healthcare costs and utilization, and the risks of dialysis or mortality, among pre-dialysis CKD patients with and without SHPT. Research design and methods: This retrospective cohort study examined insurance claims from 66 644 adult, pre-dialysis, CKD patients with and without SHPT during a 72-month period. Annualized estimates of healthcare costs and utilization, and disease progression to dialysis or death following index CKD diagnosis were compared. Results: Post-index annualized costs and inpatient healthcare resource utilization was higher in those with SHPT in both unadjusted and adjusted (controlling for gender, age, plan type, payer type, geographic region, physician specialty, pre-index co-morbidities, and pre-index total healthcare costs), and unmatched and matched analyses. Kaplan-Meier analysis demonstrated that the rate of progression to dialysis or death was higher for CKD with SHPT compared to CKD without SHPT, and Cox proportional hazard models suggested that CKD patients with SHPT were more than four to five times as likely to initiate dialysis or die as compared to CKD without SHPT. Conclusion: SHPT in pre-dialysis CKD patients is associated with significantly greater healthcare costs, inpatient hospitalizations, and a faster rate of disease progression compared to pre-dialysis CKD without SHPT. Since observational studies are designed to demonstrate associations rather than causality, further investigation is required to confirm these findings. [ABSTRACT FROM AUTHOR]

Adynamic bone in patients with chronic kidney disease (CKD) is a clinical concern because of its potential increased risk for fracture and cardiovascular disease (CVD). Prevalence rates for adynamic bone are reportedly increased, although the variance for its prevalence and incidence is large. Differences in its prevalence are largely attributed to classification and population differences, the latter of which constitutes divergent groups of elderly patients having diabetes and other comorbidities that are prone to low bone formation. Most patients have vitamin D deficiency and the active form, 1,25-dihydroxyvitamin D, invariably decreases to very low levels during CKD progression. Fortunately, therapy with vitamin D receptor activators (VDRAs) appears to be useful in preventing bone loss, in part, by its effect to stimulate bone formation and in decreasing CVD morbidity, and should be considered as essential therapy regardless of bone turnover status. Future studies will depend on assessing cardiovascular outcomes to determine whether the risk/reward profile for complications related to VDRA and CKD is tolerable.Kidney International (2008) 73, 1345–1354; doi:10.1038/ki.2008.60; published online 12 March 2008 [ABSTRACT FROM AUTHOR]