Pengaruh Pelatihan dan Komitmen Organisasi terhadap Kinerja Perawat RSUD Dorak di Kabupaten Kepulauan Meranti

This research was conducted at the Meranti Islands Regency Hospital Dorak Jl.Dorak. This study aims to determine how the Effect of Training and organizational commitment simultaneously or partially on the performance of nurses in hospitals Dorak Meranti Islands Regency. As for the population in this study were all nurses in hospitals Dorak Meranti Islands Regency, amounting to 85 people and the whole population sample were calculated using the formula of Slovin sample as respondents, the method of analysis used is descriptive and quantitative analysis with SPSS Version 20. From the results of simultaneous testing (F test) showed that the independent variables studied (Training and organizational commitment) has a positive and significant effect on the variable (performance of nurses). The results of the testing that has been done, the partial regression test (t test) showed that each of the variables studied bebes (Training And Organizational Commitment) has a positive and significant impact on the dependent variable (performance Nurses).Keywords: Training, Organizational Commitment and Performance Nurs

Pengaruh Pelatihan dan Komitmen Organisasi terhadap Kinerja Perawat RSUD Dorak di Kabupaten Kepulauan Meranti

This research was conducted at the Meranti Islands Regency Hospital Dorak Jl.Dorak. This study aims to determine how the Effect of Training and organizational commitment simultaneously or partially on the performance of nurses in hospitals Dorak Meranti Islands Regency. As for the population in this study were all nurses in hospitals Dorak Meranti Islands Regency, amounting to 85 people and the whole population sample were calculated using the formula of Slovin sample as respondents, the method of analysis used is descriptive and quantitative analysis with SPSS Version 20. From the results of simultaneous testing (F test) showed that the independent variables studied (Training and organizational commitment) has a positive and significant effect on the variable (performance of nurses). The results of the testing that has been done, the partial regression test (t test) showed that each of the variables studied bebes (Training And Organizational Commitment) has a positive and significant impact on the dependent variable (performance Nurses)

Peningkatan Hasil Belajar IPS Menggunakan Media Audio Visual Untuk Membentuk Karakter Belajar

This classroom action research aims to describe the character of the students, student is learning outcomes, and the relationship of the characters with learning outcomes. The method used is a classroom action research conducted by three cycles to improve student learning outcomes and form the character of students. The results in cycle 1, the character of the students reached 75.5% in the category of character, student learning outcomes reached 55.5% that is not in accordance with the criteria and class completeness of 8 new characters indicator reached 4 indicators and 4 indicators has not been achieved. In cycle 2 characters 68.05% of students achieved with character of category, student learning outcomes reached 72.2% that is not in accordance with the criteria and class completeness of 8 new characters indicator reached 6 indicators and 2 indicators has not been achieved in cycle 3, the character of the students achieve 84.7% to the category of character, student learning outcomes was 94.4%.Penelitian tindakan kelas ini bertujuan untuk mendeskripsikan karakter siswa, hasil belajar siswa, dan hubungan karakter dengan hasil belajar. Metode yang digunakan yaitu penelitian tindakan kelas yang dilaksanakan dengan 3 siklus untuk meningkatkan hasil belajar siswa dan membentuk karakter siswa. Hasil penelitian pada siklus 1, karakter siswa mencapai 75,5% dengan kategori berkarakter, hasil belajar siswa mencapai 55,5% sehingga belum sesuai dengan kriteria ketuntasan kelas dan dari 8 indikator karakter baru tercapai 4 indikator dan 4 indikator belum tercapai. Pada siklus 2 karakter siswa mencapai 68,05% dengan kategori berkarakter, hasil belajar siswa mencapai 72,2% sehingga belum sesuai dengan kriteria ketuntasan kelas dan dari 8 indikator karakter baru tercapai 6 indikator dan 2 indikator belum tercapai Pada siklus 3, karakter siswa mencapai 84,7% dengan kategori berkarakter, hasil belajar siswa mencapai 94,4%

Borrelia recurrentis employs a novel multifunctional surface protein with anti-complement, anti-opsonic and invasive potential to escape innate immunity

Borrelia recurrentis, the etiologic agent of louse-borne relapsing fever in humans, has evolved strategies, including antigenic variation, to evade immune defence, thereby causing severe diseases with high mortality rates. Here we identify for the first time a multifunctional surface lipoprotein of B. recurrentis, termed HcpA, and demonstrate that it binds human complement regulators, Factor H, CFHR-1, and simultaneously, the host protease plasminogen. Cell surface bound factor H was found to retain its activity and to confer resistance to complement attack. Moreover, ectopic expression of HcpA in a B. burgdorferi B313 strain, deficient in Factor H binding proteins, protected the transformed spirochetes from complement-mediated killing. Furthermore, HcpA-bound plasminogen/plasmin endows B. recurrentis with the potential to resist opsonization and to degrade extracellular matrix components. Together, the present study underscores the high virulence potential of B. recurrentis. The elucidation of the molecular basis underlying the versatile strategies of B. recurrentis to escape innate immunity and to persist in human tissues, including the brain, may help to understand the pathological processes underlying louse-borne relapsing fever

Microbes Bind Complement Inhibitor Factor H via a Common Site

To cause infections microbes need to evade host defense systems, one of these being the evolutionarily old and important arm of innate immunity, the alternative pathway of complement. It can attack all kinds of targets and is tightly controlled in plasma and on host cells by plasma complement regulator factor H (FH). FH binds simultaneously to host cell surface structures such as heparin or glycosaminoglycans via domain 20 and to the main complement opsonin C3b via domain 19. Many pathogenic microbes protect themselves from complement by recruiting host FH. We analyzed how and why different microbes bind FH via domains 19–20 (FH19-20). We used a selection of FH19-20 point mutants to reveal the binding sites of several microbial proteins and whole microbes (Haemophilus influenzae, Bordetella pertussis, Pseudomonas aeruginosa, Streptococcus pneumonia, Candida albicans, Borrelia burgdorferi, and Borrelia hermsii). We show that all studied microbes use the same binding region located on one side of domain 20. Binding of FH to the microbial proteins was inhibited with heparin showing that the common microbial binding site overlaps with the heparin site needed for efficient binding of FH to host cells. Surprisingly, the microbial proteins enhanced binding of FH19-20 to C3b and down-regulation of complement activation. We show that this is caused by formation of a tripartite complex between the microbial protein, FH, and C3b. In this study we reveal that seven microbes representing different phyla utilize a common binding site on the domain 20 of FH for complement evasion. Binding via this site not only mimics the glycosaminoglycans of the host cells, but also enhances function of FH on the microbial surfaces via the novel mechanism of tripartite complex formation. This is a unique example of convergent evolution resulting in enhanced immune evasion of important pathogens viautilization of a “superevasion site.

Variation in the use of renal replacement therapy in patients with septic shock : a substudy of the prospective multicenter observational FINNAKI study

Peer reviewe

Staphylococcal protein Ecb impairs complement receptor-1 mediated recognition of opsonized bacteria

Staphyloccus aureus is a major human pathogen leading frequently to sepsis and soft tissue infections with abscesses. Multiple virulence factors including several immune modulating molecules contribute to its survival in the host. When S. aureus invades the human body, one of the first line defenses is the complement system, which opsonizes the bacteria with C3b and attract neutrophils by release of chemotactic peptides. Neutrophils express Complement receptor-1 [CR1, CD35) that interacts with the C3b-opsonized particles and thereby plays an important role in pathogen recognition by phagocytic cells. In this study we observed that a fraction of S. aureus culture supernatant prevented binding of C3b to neutrophils. This fraction consisted of S. aureus leukocidins and Efb. The C-terminus of Efb is known to bind C3b and shares significant sequence homology to the extracellular complement binding protein [Ecb). Here we show that S. aureus Ecb displays various mechanisms to block bacterial recognition by neutrophils. The presence of Ecb blocked direct interaction between soluble CR1 and C3b and reduced the cofactor activity of CR1 in proteolytic inactivation of C3b. Furthermore, Ecb could dose-dependently prevent recognition of C3b by cell-bound CR1 that lead to impaired phagocytosis of NHS-opsonized S. aureus. Phagocytosis was furthermore reduced in the presence of soluble CR1 [sCR1). These data indicate that the staphylococcal protein Ecb prevents recognition of C3b opsonized bacteria by neutrophil CR1 leading to impaired killing by phagocytosis and thereby contribute to immune evasion of S. aureus.Peer reviewe

Crystal structure of a tripartite complex between C3dg, C-terminal domains of factor H and OspE of Borrelia burgdorferi

Complement is an important part of innate immunity. The alternative pathway of complement is activated when the main opsonin, C3b coats non-protected surfaces leading to opsonisation, phagocytosis and cell lysis. The alternative pathway is tightly controlled to prevent autoactivation towards host cells. The main regulator of the alternative pathway is factor H (FH), a soluble glycoprotein that terminates complement activation in multiple ways. FH recognizes host cell surfaces via domains 19–20 (FH19-20). All microbes including Borrelia burgdorferi, the causative agent of Lyme borreliosis, must evade complement activation to allow the infectious agent to survive in its host. One major mechanism that Borrelia uses is to recruit FH from host. Several outer surface proteins (Osp) have been described to bind FH via the C-terminus, and OspE is one of them. Here we report the structure of the tripartite complex formed by OspE, FH19-20 and C3dg at 3.18 Å, showing that OspE and C3dg can bind simultaneously to FH19-20. This verifies that FH19-20 interacts via the “common microbial binding site” on domain 20 with OspE and simultaneously and independently via domain 19 with C3dg. The spatial organization of the tripartite complex explains how OspE on the bacterial surface binds FH19-20, leaving FH fully available to protect the bacteria against complement. Additionally, formation of tripartite complex between FH, microbial protein and C3dg might enable enhanced protection, particularly on those regions on the bacteria where previous complement activation led to deposition of C3d. This might be especially important for slow-growing bacteria that cause chronic disease like Borrelia burgdorferi.Peer reviewe