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Pulmonary vein isolation (PVI) ablation is a standard therapy for paroxysmal atrial fibrillation (PAF). Lesion Index (LSI) is a metric to guide radiofrequency (RF) ablation using the TactiCath Ablation Catheter, Sensor Enabled with the EnSite Cardiac Mapping System (Abbott).This study (NCT-03906461) was designed to capture best practices using LSI-guided catheter ablation to treat PAF subjects in a real-world setting.This prospective single-arm observational study enrolled 143 PAF subjects in the United States, Europe, and Japan undergoing de novo PVI with RF ablation. PVI lesions were assigned to 10 anatomically defined segments. Mean LSIs achieved for all lesions were analyzed. Follow-up was conducted between 3-6 months and 12 months after the procedure.Pulmonary veins were isolated in all subjects. The mean achieved LSI was 4.9, with lower values in Europe (4.4) and Japan (4.5) than the United States (5.5). First-pass success, defined as no gaps requiring touch-up ablation after 20 minutes post isolation, was achieved in 76.2% of subjects. Use of high LSI (≥5) resulted in shorter procedure, RF, and fluoroscopy times and fewer touch-up ablations compared to low LSI (5). At 12 months, 99.3% of subjects were free from procedure- or device-related serious adverse events and 95.7% (112/117) (35.0% on antiarrhythmic drugs) were free from recurrence and/or a repeat ablation procedure for atrial fibrillation / atrial flutter / atrial tachycardia.LSI-guided ablation strategies proved safe and effective despite differences in LSI workflows. Use of high LSI values resulted in shorter procedure, RF, and fluoroscopy times and fewer touch-up ablations compared to low LSI.

Pandemi Covid 19 membawa dampak yang serius terhadap tatanan kehidupan masyarakat di seluruh belahan dunia, hal yang sangat dirasakan dampak dari pandemi tersebut adalah dalam dunia pendidikan. Karena dengan munculnya virus corona tersebut kemendikbud mengeluarkan surat edaran belajar dari rumah, dari kebijakan tersebut maka berdampak pula terhadap peran ibu rumah tangga yaitu berperan sebagai guru di rumah. Tujuan dari penelitian ini adalah untuk menganalisis terjadinya peningkatan peran ibu rumah tangga dalam keluarga, serta untuk mengetahui upaya ibu rumah tangga dalam menghadapi peningkatan peran dalam keluarga. Penelitian ini menggunakan jenis penelitian kualitatif dengan pendekatan studi kasus. Teknik pengumpulan data yang digunakan seperti wawancara, wawancara, dan dukumentasi. Teknik analsis data menggunakan teknik analisis data kualitatif. Hasil penelitian ini menunjukkan bahwa terjadinya peningkatan peran ibu rumah tangga di tengah pandemi covid 19 dikarenakan siswa belajar dari rumah sehingga sangat berdampak pada peran ibu rumah tangga. Adapun upaya yang dilakukan dalam menghadapai peningkatan peran adalah menciptakan suasana belajar yang aman dan nyaman hingga pada diskusi ibu rumah tangga dengan guru kelas melalui grup whatshap sebagai guru paguyuban kelas.

Background Lost to follow-up among pediatric human immune deficiency virus infected patients is a major challenge for the global scale-up of lifesaving antiretroviral therapy (ART). It is considerable obstacle for effectiveness of the program which negatively impacted on immunological benefits of ART and drug adherence. Additionally, it increases drug toxicity, resistance and acquired immune deficiency syndrome related morbidity and mortality. Therefore, it is very crucial to identify the incidence and determinants of loss to follow up among children in study area. Objectives To determine incidence and determinants of lost to follow-up among human immune deficiency virus-infected children on Anti-Retroviral Treatment. Method A retrospective cohort study was conducted among 269 randomly selected children who had been on ART in the health facilities of Shashemene Town from January 1, 2015 to December 30, 2020. Data on patients’ medical records such as patient intake form and the registers were collected using standardized checklist. Data were coded and entered by Epidata version 3.1 and analyzed by Statistical Product and Service Solutions (SPSS) version 25. The Cox proportional hazard assumption was checked using Schoenfeld residual test (global test > 0.05). Finally, adjusted hazard ratio with 95% confidence interval was computed, and variables with P-values

Background Increased physical activity is associated with a reduction in all–cause mortality and may increase life expectancy, an effect strongly linked to a reduction in the risk of cardiovascular (CV) disease. Regular aerobic exercise (EX) results in modest reductions in waist circumference (CIRC) (associated with CV mortality) and visceral adipose tissue. Vigorous intensity EX may offer greater benefits than moderate intensity. Aim of the study: To evaluate whether the continuation of EX after Cardiac Rehabilitation (CR) leads to an improvement in physical capacity and parameters related to CV pathology of patients (PZ) with ischemic heart disease (IC). Methods retrospective observational study on patients referred to the Outpatient CR of the O.C. S.M. del Prato (Feltre) from January 2018 to May 2021. Of the initial population of 270 PZ, 47 did not show up at the f.–up, 22 did not perform 6MWT at the f.–up and 33 had CR indications other than IC. The Outpatient CR consisted of 10 monthly sessions with 3 modalities: • educational (ED) + supervised EX • ED only • online (Covid period). Supervised EX: soft bodyweight gymnastics (30 min) + 30 minutes monitored moderate to vigorous supervised EX on stationary bikes and treadmills ED: frontal lessons (1–2 h) multidisciplinary (doctor, nurse, dietician, psychologist) aimed at improving the patient‘s management of CV disease and risk factors. On–line: soft bodyweight gymnastics (30 min) + ED by videoconference The f.–up was on average 6 months after the CR. Statistical processing with Jamovi 2.3.13 Materials and methods: At admission to CR and at f.–up, weight, height, CIRC, calculated BMI were measured, performed 6–minute walk test (6MWT) with Borg scale detection. At the f.–up a questionnaire was self–administered and adherence to EX, bodyweight exercise, how often, attendance at a gym, use of heart rate monitor (CF), etc. were declared. Conclusions The 6MWT improves in a statistically significant way in all PZs at f.–up except in those who declare not to perform EF. Significant improvements in CIRC, BMI and Borg were observed in PCS performing EX more frequently weekly (2–4 times), using CF and in PCS undergoing complete RC (ED + EX). No predictors of improvement at 6 months of the examined variables were identified.

The existence of bureaucracy is a logical consequence of the main task of the state (government) to organize social welfare. The state is required to be involved in producing goods and services needed by its people (public goods and services), either directly or indirectly. This study aims to determine the effectiveness of the related bureaucracy in public services in the Biak Numfor district government. This study uses the "triangulation" method, which combines qualitative and quantitative methods with data collection techniques by means of interviews, documentation, and questionnaires. This research shows that the local government, in this case the Department of Population and Civil Registry, in the service of making electronic identity cards has been effective. This can be seen from Actors, Interdependency and Frame getting a score of 2.05 (high), Interaction and Complexity getting a score of 1.35 (moderate), Institutional Features getting a score of 1.55 (moderate), and Network Management getting a score of 2.3 (high). Whereas the Regional Revenue Agency in making NPWPD services and tax payments which are divided into two types of services namely offline and online have been very effective where Actors, Interdependency and Frame get a score of 2.1 (high), Interaction and Complexity get a score of 2.3 (high) Institutional Features scored 2.05 (high), and Network Management scored 2.5 (high).

Für ein Neubauprojekt wurde eine möglichst effektive und kostengünstigste Langzeitwärmespeicherung gesucht. Die Bauherren entschieden sich für einen Makadamspeicher. Der Speicher besteht aus einer Mischung aus Granitschotter, Granitsplitten, Sand und Kalk, in die die Wärmezu- und Abführungsleitungen eingebettet werden. Drei Jahre Nutzung zeigen, die Wärmespeicherung mit einem Makadamspeicher hat sich bestens bewährt. Weitere Projekte zeigen das Gleiche. Diese Metadaten wurden zur Verfügung gestellt von der Literaturdatenbank RSWB®plus

The presence of the special autonomy law in Papua has had an impact on institutions. This can be seen with the formation of the Papua People's Assembly (MRP). This study aims to determine the effectiveness of making specific regional regulations in the province of Papua. This study uses a "triangulation" method that combines qualitative and quantitative methods with data collection techniques, namely interviews, documentation, and questionnaires. The results showed that the Papuan People's Assembly (MRP) in making special regional regulations (Perdasus) was already quite effective, which can be seen from the involvement of the MRP which scored 1,35 (moderate), MRP commitment 2,05 (high), the role of MRP 2,0 (high), and the implementation of the MRP mechanism 2,1 (high).