Công ty Cổ phần FPT (FPT) phản hồi thông tin phân phối…

Chi tiết: http://vietf.vn/2013/04/17/chua-chinh-thuc-thong-nhat-viec-hop-tac-giua-fpt-va-apple.html

Chiều nay, ĐHCĐ thường niên…

Chi tiết: http://vietf.vn/2013/04/17/la-phuong-an-phat-hanh-co-phieu-cho-co-dong-chien-luoc-cua-tran-anh.html

CTCP Tập đoàn Đức Long Gia Lai bị nhắc nhở vì chậm công bố thông tin BCTC kiểm toán 2012 như sau:

Theo TTVN/HSX

Chi tiết: http://vietf.vn/2013/04/17/dlg-bi-nhac-nho-vi-cham-cong-bo-thong-tin-bctc-kiem-toan-2012.html

HSX

Chi tiết: http://vietf.vn/2013/04/17/vnh-bi-nhac-nho-viec-thuc-hien-cong-bo-thong-tin-lan-2.html

Công ty Cổ phần Cấp nước…

Chi tiết: http://vietf.vn/2013/04/17/tdw-ke-hoach-lnst-2013-dat-21-5-ty-dong-giu-nguyen-co-tuc-12.html

CTCP Đầu tư Căn Nhà Mơ Ước (DRH) giải trình KQKD lỗ năm 2012 và phương án khắc phục như…

Chi tiết: http://vietf.vn/2013/04/16/drh-nam-2013-se-tich-cuc-thoai-von-dau-tu-dai-han-vao-ctlk-va-du-an.html

Nhờ được hoàn nhập 57 tỷ đồng dự phòng giảm giá…

Chi tiết: http://vietf.vn/2013/04/16/quy-i-thu-nhap-ban-lanh-dao-cii-tang-gan-40-so-voi-cung-ky.html

Công ty Cổ phần Sách Giáo dục tại Tp.Hà…

Chi tiết: http://vietf.vn/2013/04/16/ebs-khong-con-loi-nhuan-khac-lai-quy-1-giam-sau-so-voi-cung-ky.html

Công ty cổ phần Chứng khoán Dầu Khí (PSI) thông báo kết quả
kinh doanh quý 1 năm 2013.
Bất ngờ tăng trưởng mạnh…

Chi tiết: http://vietf.vn/2013/04/16/psi-du-tien-ky-quy-cuoi-quy-1-cua-ndt-tang-100-ty-dong-so-voi-dau-nam.html

Peripheral nerve lacerations are common injuries and often cause long lasting disability (1a) due to pain, paralyzed muscles and loss of adequate sensory feedback from the nerve receptors in the target organs such as skin, joints and muscles (1b).

Nerve injuries are common and typically affect young adults with the majority of injuries occur from trauma or complication of surgery. Traumatic injuries can occur due to stretch, crush, laceration (sharps or bone fragments), and ischemia, and are more frequent in wartime, i.e., blast exposure. Domestic or occupational accidents with glass, knifes of machinery may also occur.

Statistics show that peripheral nervous system (PNS) injuries were 87% from trauma and 12% due to surgery (one-third tumor related, two-thirds non– tumor related). Nerve injuries occurred 81% of the  time in the upper extremities and 11% in the lower extremities, with the balance in other locations (4).

Injury to the PNS can range from severe, leading to major loss of function or intractable neuropathic pain, to mild, with some sensory and/or motor deficits affecting quality of life.

Functional recovery after nerve injury involves a complex series of steps, each of which may delay or impair the regenerative process. In cases involving any degree of nerve injury, it is useful initially to categorize these regenerative steps anatomically on a gross level. The sequence of regeneration may be divided into anatomical zones (4):

1. the neuronal cell body
2. the segment between the cell body and the injury site
3. the injury site itself
4. the distal segment between the injury site and the end organ
5. the end organ itself

A delay in regeneration or unsuccessful regeneration may be attributed to pathological changes that impede normal reparative processes at one or more of these zones.

Repairing nerve defects with large gaps remains one of the most operative challenges for surgeons. Incomplete recovery from peripheral nerve injuries can produce a diversity of negative outcomes, including numbness, impairment of sensory or motor function, possibility of developing chronic pain, and devastating permanent disability.

In the past few years several techniques have been used to try and repair nerve defects and include:

• Coaptation
• Nerve autograph
• Biological or polymeric nerve conduits (hollow nerve guidance conduits)

For example, When a direct repair of the two nerve ends is not possible, synthetic or biological nerve conduits are typically used for small nerve gaps of 1 cm or less. For extensive nerve damage over a few centimeters in length, the nerve autograft is the “gold standard” technique. The biggest challenges, however, are the limited number and length of available donor nerves, the additional surgery associated with donor site morbidity, and the few effective nerve graft alternatives.

Degeneration of the axonal segment in the distal nerve is an inevitable consequence of disconnection, yet the distal nerve support structure as well as the final target must maintain efficacy to guide and facilitate appropriate axonal regeneration. There is currently no clinical practice targeted at maintaining fidelity of the distal pathway/target, and only a small number of researchers are investigating ways to preserve the distal nerve segment, such as the use of electrical stimulation or localized drug delivery. Thus development of tissue-engineered nerve graft may be a better matched alternative (6,7).

The guidance conduit serves several important roles for nerve regeneration such as: a) directing axonal sprouting from the regenerating nerve b) protecting the regenerating nerve by restricting the infiltration of fibrous tissue c) providing a pathway for diffusion of neurotropic and neurotophic factors

Early guidance conduits were primarily made of silicone due to its stability under physiological conditions, biocompatibility, flexibility as well as ease of processing into tubular structures. Although silicone  conduits have proven reasonably successful as conduits for small gap lengths in animal models (<5 mm). The non-biodegradability of silicone conduits has limited its application as a strategy for long-term repair and recovery. Tubes also eventually become encapsulated with fibrous tissue, which leads to nerve compression, requiring additional surgical intervention to remove the tube.Another limiting factor with inert guidance conduits is that they provide little or no nerve regeneration for gap lengths over 10 mm in the PNS unless exogenous growth factors are used (6,7).

In animal studies, biodegradable nerve guidance conduits have provided a feasible alternative, preventing neuroma formation and infiltration of fibrous tissue. Biodegradable conduits have been fabricated from natural or synthetic materials such as collagen, chitosan and poly-L-lactic acid.

Nanostructured Scaffolds for Neural Tissue Engineering: Fabrication and Design

At the micro- and nanoscale, cells of the CNS/PNS reside within functional microenvironments consisting of physical structures including pores, ridges, and fibers that make up the extracellular matrix (ECM) and plasma membrane cell surfaces of closely apposed neighboring cells. Cell-cell and cell-matrix interactions contribute to the formation and function of this architecture, dictating signaling and maintenance roles in the adult tissue, based on a complex synergy between biophysical (e.g. contact-mediated signaling, synapse control), and biochemical factors (e.g. nutrient support and inflammatory protection). Neural tissue engineering scaffolds are aimed toward recapitulating some of the 3D biological signaling that is known to be involved in the maintenance of the PNS and CNS and to facilitate proliferation, migration and potentially differentiation during tissue repair.

Nanotechnology and tissue engineering are based on two main approaches:

• Electrospinning (top-down) – involves the production of a polymer filament using an electrostatic force. Electrospinning is a versatile technique that enables production of polymer fibers with diameters ranging from a few microns to tens of nanometers.
• Molecular self-assembly of peptides (bottom-up) – Molecular self-assembly is mediated by weak, non-covalent bonds, such as van der Waals forces, hydrogen bonds, ionic bonds, and hydrophobic interactions. Although these bonds are relatively weak, collectively they play a major role in the conformation of biological molecules found in nature.

Pfister et al (6) very nicely summarized the various polymeric fibers been used to achieve the goal of nerve regeneration, even in humans. These material include a wide array of polymers from silica to PLGA/PEG and Diblock copolypeptides.

Many of these approaches also enlist many trophic factors that have been investigated in nerve conduits

Currently there are three general biomaterial approaches for local factor delivery:

1. Incorporation of factors into a conduit filler such as a hydrogel
2. Designing a drug release system from the conduit biomaterial such as microspheres
3. Immobilizing factors on the scaffold that are sensed in place or liberated upon matrix degradation.

Maeda et al had a  creative approach to bridge larger gaps by using the combination of nerve grafts and open conduits in an alternating “stepping stone” assembly, which may perform better than an empty conduit alone (8).

Summary

Peripheral nerve repair is a growing field with substantial progress being made in more effective repairs. Nanotechnology and biomedical engineering have made significant contributions; from surgical instrumentation to the development of tissue engineered grafting substitutes.  However, to date the field of neural tissue engineering has not progressed much past the conduit bridging of small gaps and has not come close to matching the autograf. Much more studies are needed to understand the cell behaviour that can promote cell survival, neurite outgrowth, appropriate re-innervation and consequently the functional recovery post PNS/CNS injuries. This is since understanding of the cellular response to the combination of these external cues within 3D architectures is limited at this stage.

Ref:

1a. Jaquet JB, Luijsterburg AJ, Kalmijn S, Kuypers PD, Hofman A, Hovius SE.  Median, ulnar, and combined median-ulnar nerve injuries:functional outcome and return to productivity. J Trauma 2001 51: 687-692. http://www.ncbi.nlm.nih.gov/pubmed/11586160

1b. Lundborg G, Rosen B. Hand function after nerve repair. Acta Physiol (Oxf) 2007 189: 207-217. http://www.ncbi.nlm.nih.gov/pubmed/17250571

1. Chang WC., Kliot M and Stretavan DW. Microtechnology and Nanotechnology in Nerve Repair. Neurological Research 2008; vol 30: 1053-1062. http://vision.ucsf.edu/sretavan/sretavanpdfs/2008b-Chang%20&%20Sretavan.pdf

2. Biazar E., Khorasani MT and Zaeifi D. Nanotechnology for peripheral nerve regeneration. Int. J. Nano. Dim. 2010 1(1): 1-23.  http://www.ijnd.ir/doc/2010-v1-i1/2010-V1-I1-1.pdf

3. Albert Aguayo. Nerve regeneration revisited. Nature Reviews Neuroscience 7, 601 (August 2006).

http://www.nature.com/nrn/journal/v7/n8/full/nrn1974.html

4. Burnett MG and  Zager EL. Pathophysiology of Peripheral Nerve Injury: A Brief Review. Neurosurg Focus. 2004;16(5) .

http://www.medscape.com/viewarticle/480071_5

5. Dag Welin. Neuroprotection and axonal regeneration after peripheral nerve injury. MEDICAL DISSERTATIONS

Welin, D., Novikova, L.N., Wiberg, M., Kellerth, J-O. and Novikov, L.N. Survival and regeneration of cutaneous and muscular afferent neurons after peripheral nerve injury in adult rats. Experimental Brain Research, 186, 315-323, 2008.

http://link.springer.com/article/10.1007%2Fs00221-007-1232-5

6. Pfister BJ., Gordon T., Loverde JR., Kochar AS., Mackinnon SE and Cullen Dk. Biomedical Engineering Strategies for Peripheral Nerve Repair: Surgical Applications, State of the Art, and Future Challenges. Critical Reviews™ in Biomedical Engineering 2011, 39(2):81–124. http://www.med.upenn.edu/cullenlab/user_documents/2011Pfisteretal-PNIReviewArticleCritRevBME.pdf

7. Zhou K, Nisbet D, Thouas G,  Bernard C and Forsythe J. Bio-nanotechnology Approaches to Neural Tissue Engineering. Intechopen. Com. http://cdn.intechopen.com/pdfs/9811/InTech-Bio_nanotechnology_approaches_to_neural_tissue_engineering.pdf

8. Maeda T, Mackinnon SE, Best TJ, Evans PJ, Hunter DA, Midha RT. Regeneration across ’stepping-stone’ nerve grafts. Brain Res. 1993;618(2):196–202. http://www.ncbi.nlm.nih.gov/pubmed/?term=Maeda+T+and+regeneration+across+stepping+stone

On Sun 24th of March – Donnelly Auctions: Large selection of Australian and world coins and banknotes, many in Proof, Decimal and Pre-decimal, Some sets. General antique and Artwork auction.  @ Donnelly’s Showrooms, 328 Walcott St, Mt Lawley Comm: 10:00 am

Wed 26th of March: Perth Numismatic Society’s monthly meeting. This will be one you do NOT want to miss!! Can say no more at present. Venue: The Homestead, 5 Mackie St,  Vic Pk. Time: 7:30 pm. All welcome – bring a camera!

Sat 18th of May: PNS Coin, Medal and Banknote Fair Tables available for sellers. Buyers welcome to browse or chat, Hot refreshments available. South Perth Civic Hall, cnr South Tce and Sandgate S.t S Perth. from 10L00 am.

Central Nervous System (CNS) Supporting Cells:

Neurons account for only ten percent of the cells in the central nervous system. The rest of the cells are called glial cells.

Glial cells help the neurons of the CNS. The surround the body, axon, and dendrites of neurons. They function to provide support structurally and metabolically. Here are some types of CNS glial cells:

Oligodendrocytes: As mentioned in the neuron post, oligodendrocytes form the myelin sheath that covers axons in the CNA. This myelin covering consists of about 20-200 layers of a sort of plasma membrane from the oligodendrocyte. Each oligodendrocyte can branch out to create myelin on as many as 40 axons.

Astrocytes: These cells help to keep the composition of the extracellular fluid in the CNS in balance so the neurons can function at their best. Astrocytes also help to form the barrier between capillaries, which carry blood throughout the circulatory system, and the CNS. This is known as the blood-brain barrier and prevents harmful substances from entering the brain. Astrocytes also provide neurons with metabolic support by getting them glucose and removing toxins like ammonia.

Microglia: These are cells that perform immune system functions throughout the CNS. They act like macrophages, meaning they destroy pathogens or things that may be harmful to the CNS.

Ependymal cells: These cells line the fluid-filled cavities of the brain and spinal cord. They help to maintain the flow and production of cerebrospinal fluid.

Picture depicting supporting cells of the CNS. The yellow cells are neurons. Blue cells are oligodendrocytes branching out to form mylein protective coverings on the axons of the neurons. Green cell are astrocytes that are supporting the neurons and helping form the barrier between capillaries and the CNS. The dark red cells are microglia. Ependymal cells are depicted as the small red cells forming a wall, as they line the cavities of the brain and spinal cord. Source: commons.wikimedia.org

Peripheral Nervous System (PNS) Supporting Cells:

Schwann Cells: These cells are similar to the CNS oligodendrocytes in that they form myelin to protect the axons. However, the difference is each Schwann cell only forms one segment of myelin along the axon. They can form 1-1.5mm-long segments of myelin at regular intervals along some axons.

A neuron with mylein sheaths on its axon. Each sheath is made from an individual Schwann cell. Source: commons.wikimedia.org

Why it Matters

All of these cells work together with the neurons to allow the Nervous System to function properly. These supporting cells are under extensive research because it is believed they may have larger roles in relaying messages to and from the brain than once thought. For example, astrocytes have neuron-like characteristics. They are capable of producing small electrical signals, or messages. Click here for a recent study on mice and the roles astrocytes may play in how messages are transmitted. It is definitely very exciting research that could help solve some of the mysteries of neurological disorders.

Source of some of the information found on this post:

Widmaier, E., Hershel, R., & Strang, K. (2011). Vander’s human physiology. (12th ed.). McGraw-Hill Companies.

The European Union has granted CE mark certification to Medtronic’s Attain Performa portfolio of quadripolar leads.

Available in various shapes including Dual Cant, S-Shape and Straight, the quadripolar leads feature four electrodes with 16 pacing configurations and are designed with shorter spacing between the two centre electrodes to increase phrenic nerve thresholds and reduce phrenic nerve stimulation (PNS).

Pada umumnya (walaupun tidak semuanya), untuk melanjutkan pendidikan ke jenjang yang lebih tinggi dengan biaya sendiri bagi seorang abdi negara merupakan hal yang berat mengingat biaya yang dibutuhkan tidak sedikit sementara gaji (plus tunjangan) sudah dialokasikan terlebih dahulu (baca: habis) untuk memenuhi kebutuhan perut dan rumah tangga (bagi yang masih single dikecualikan dalam kategori ini). Bahkan bagi single sekalipun, untuk melanjutkan pendidikan ke level yang lebih tinggi dengan biaya sendiri terasa sayang mengingat masih banyak hawa nafsu yang antri untuk dipenuhi (misal gadget terbaru atau bahkan sekadar memenuhi kebutuhan hura-hura bersama dengan kolega-kolega). Kesimpulannya adalah untuk melanjutkan pendidikan ke jenjang yang lebih tinggi dengan biaya sendiri perlu dorongan dan niat dari masing-masing individu.

Solusi yang ditawarkan bagi mereka yang mau dan memiliki niat untuk meningkatkan level pendidikan namun terkendala biaya adalah dengan mencoba berbagai macam tawaran beasiswa yang ada. Tawaran tersebut bisa berasal dari dalam negeri ataupun dari luar negeri. Tawaran beasiswa yang berasal dari dalam negeri biasanya (walaupun tidak selalu) berasal dari dana APBN. Pilihan universitas maupun jurusan dibebaskan sepanjang masih sesuai dengan jalur karir dari masing-masing institusi tempat abdi negara tersebut bekerja. Bagi mereka yang sudah berkeluarga, malas mengurus tetek bengek kelengkapan belajar ke luar negeri, cinta produk dalam negeri, atau bahkan tidak pede dengan kemampuan berbahasa asingnya, ini merupakan tawaran yang sangat pas.  Sementara bagi mereka yang merasa tertantang untuk bisa hidup independen di negara orang, memiliki mental petualang,  kemampuan berbahasa asing yang minimal sedikit di atas rata-rata, atau bahkan sekadar mengais dollar bisa mencoba beasiswa yang ditawarkan oleh negara-negara asing.

Sedikit mengulas sistem pendidikan di negara-negara luar negeri, untuk memperoleh gelar master (S2) terdapat dua jalur utama yaitu jalur kuliah (coursework) dan jalur riset. Satu pilihan lagi yaitu hybrid antara coursework dan riset dimana komponen riset tidak seberat pada S2 dengan jalur riset dan masih diberik kesempatan untuk mengambil mata kuliah. Hal ini berbeda dengan sistem pendidikan di dalam negeri dimana untuk jenjang S2 sebagian besar (atau bahkan semuanya) diwajibkan untuk mengambil mata kuliah tesis sebagai persyaratan kelulusan. Tesis ini selanjutnya masih harus diuji melalui sidang yang tentunya makin membuat pucat orang yang tidak memiliki rasa percaya diri yang mumpuni.

Kembali kepada pilihan antara jalur kuliah atau riset, manakah yang paling tepat untuk seorang abdi negara? Untuk menjawab pertanyaan ini kembali lagi kepada deskripsi pekerjaan kita serta aspirasi dan cita-cita kita di masa depan. Dalam hal pekerjaan kita tidak membutuhkan riset yang intens, mengambil jalur coursework adalah pilihan yang tepat. Namun demikian, mengingat visi ke depan aparatur sipil negara akan lebih diarahkan kepada jalur fungsional dan menghapus jabatan-jabatan struktural, mengambil jalur riset atau kombinasi coursework dan riset akan menjadi sebuah kebutuhan yang tidak terhindarkan dikarenakan adanya pengalaman untuk melakukan riset. Hal ini tentunya tidak menutup kemungkinan jalur coursework juga dapat berperan dalam era fungsionalisasi aparatur sipil negara.

Sekali lagi, pertanyaan kembali pada masing-masing abdi negara tersebut. Apakah abdi negara tersebut memiliki rasa ingin tahu yang tinggi serta mampu mempersiapkan jawaban-jawaban yang ilmiah atas setiap permasalahan yang timbul? Mungkin saat ini, memang tidak perlu pendidikan yang tinggi apabila dengan level pendidikan saat ini dirasa masih cukup untuk bisa menjawab pertanyaan-pertanyaan yang ada. Namun demikian, patut diingat bahwa tantangan abdi negara ke depan akan semakin kompleks dan tentunya diperlukan kapasitas dan kompetensi yang lebih tinggi lagi agar seorang abdi negara bisa menyelesaikan masalah-masalah yang timbul. Ketidakmauan abdi negara untuk bisa menyesuaikan terhadap tuntutan jaman dan ekspektasi masyarakat akan menjadi sebuah bumerang bagi perkembangan karir dan kemajuan bangsa ini kedepannya. Apabila hal ini sudah terjadi maka tinggal tunggu waktu saja untuk tersingkir dari medan pertempuran dan angkat kopor lebih dulu.

Dalam berita disebutkan bahwa “Wali Kota Medan Rahudman Harahap melarang pembayaran Tunjangan Tambahan Penghasilan (TTP) kepada pegawai yang tidak mengikuti apel pagi dan sore sebanyak tiga kali“.

Bagi Pemkot Tebing Tinggi, ide pendisiplinan PNS dengan pelarangan pembayaran TPP dapat ditiru dan dikembangkan lebih lanjut:

1. Diterapkan di seluruh SKPD Kota Tebing Tinggi, tidak sebatas lingkup Sekretariat Kota saja.
2. Tidak hanya menilai disiplin PNS dalam apel pagi dan sore, tetapi juga menilai pencapaian sasaran kerja pegawai. Lihat penjelasannya di tulisan “Penilaian Prestasi Kerja Pegawai Negeri Sipil (berdasarkan PP nomor 46 tahun 2011)“

Penggabungan upaya perbaikan perilaku kerja (dalam hal ini berupa pendisiplinan PNS) dengan penilaian pencapaian target sasaran kerja pegawai sangat penting. Mengapa?  Karena bisa saja  “disiplin apel pagi dan sore” ditingkatkan, tetapi tidak memperbaiki kinerja pencapaian sasaran kerja PNS Kota Tebing Tinggi.

Pelajaran berikut yang dapat ditarik adalah mengenai: “peningkatan peran PNS untuk ikut serta dalam mesosialisasikan program-program pembangunan kepada masyarakat“. Ini merupakan ide sederhana tetapi dapat berdampak sistematis. Dengan sosialisasi yang lebih baik, maka di masyarakat akan tumbuh rasa memiliki  dan rasa tanggun jawab,  yang merupakan variabel pendorong peningkatan peran serta aktif masyarakat dalam pembangunan di Kota Tebing Tinggi.

Bayangkan bila di masyarakat Kota Tebing Tinggi tidak ada rasa memiliki dan rasa tanggungjawab, kecuali rasa apatis (tidak peduli) dan anti Pemko Tebing Tinggi? Mungkinkah masyarakat mau secara sukarela berperan aktif dalam pembangunan di Kota Tebing Tinggi?

Masih terkait dengan hal di atas, pelajaran berikut yang dapat diambil oleh Kota Tebing Tinggi adalah pandangan paradigmatis berikut ini: “masalah kebersihan bukan hanya tanggung jawab pemerintah baik itu camat maupun lurah, melainkan tanggung jawab kita semua“

Bagi banyak orang, arahan di atas adalah arahan klise. Padahal arahan di atas adalah arahan yang bersifat paradigmatis; mempengaruhi pilihan program dan kegiatan SKPD. Bila SKPD meyakini pandangan di atas, maka pilihan program SKPD itu akan cenderung bersifat PEMBERDAYAAN MASYARAKAT. Dan bila masyarakat sudah fungsional dan berdaya, maka beberapa permasalahan tingkat RT dapat diselesaikan sendiri oleh masyarakat tersebut, sehingga dana yang terbatas dapat difokuskan untuk hal lain yang lebih strategis.

Demikian beberapa pelajaran yang dapat di tarik dari arahan Walikota Medan dari berita “Tiga Kali Tak Apel, TPP Pegawai Pemkot Medan Tak Dibayar“. Berita selengkapnya adalah sebagai berikut:

PNS Berprestasi !

Apakah saya PNS yang berkinerja? Tergantung Nilai Prestasi Kerja Anda. Semakin tinggi Nilai PK PNS, semakin baik kinerja Anda ! Nilai Prestasi Kerja (PK) PNS ditentukan oleh 2 (dua) variabel, yaitu pencapaian Sasaran Kerja Pegawai dan Perilaku Kerja Pegawai. Nilai PK PNS dihasilkan dari PENILAIAN PRESTASI KERJA PNS, yaitu: Suatu proses penilaian secara sistematis yg dilakukan oleh pejabat penilai, thdp Sasaran Kerja Pegawai dan Perilaku Kerja PNS.

Mari mempelajarinya dari slide di bawah ini