Analisis Aktivitas Radionuklida Alam dan Dosis Paparan Radiasi pada Material Bangunan

Building materials cement, gipsum and sand were analized quantitatively and qualitatively for the natural radionuclides using gamma spectroscopy method with detector high purity germanium (HPGe). The highest value observed in the activity concentration of 226Ra, 232Th and 40K were found in sand that 42,12 Bq kg-1, 27,79 Bq kg-1and 316,20 Bq kg-1. The highest value of radium equivalent (Raeq) 106,21 Bq kg-1 was found in sand are bellow the Internationally accepted values (370 Bq kg-1). The highest value of internal and external hazard indices were found in sand 0,401 dan 0,287 are less than unity (Hin≤1 and Hex≤1). The highest value of absorbed dose rate was found in sand 49,52 nGy h-1 are lower than the world population-weight average of 84 nGy h-1. The highest annual effective dose values was found in sand 0,243 mSv y-1 is lower than the limit of accepted value 1 mSv y-1. The study shows that measured radioactivity for bulding materials cement, gipsum and sand does not pose as significant source radiological hazard and is save for use in construction of building or dwelling

Kajian Radioaktivltas Jatuhan (Fall-out) di Sekitar Fasilitas Nuklir YOGYAKARTA dengan Memperhatikan Aktivitas Gunung Merapi

KAJIAN RADIOAKTIViTAS JATUHAN (FALL-OUT) DI SEKITAR FASILITAS NUKLIR YOGYAKARTA DENGAN MEMPERHATIKAN AKTIVITAS GUNUNG MERAPI. Kajian terhadap fluktuasi radioaktivitas jatuhan di sekitar fasilitas nuklir Pusat Teknologi Akselerator dan Proses Bahan (PTAPB)-BATAN dilakukan dengan mencermati aktivitas gunung Merapi pada kurun waktu dari tahun 1987 sampai tahun 2005. Hal ini penting dilakukan mengingat faslitas nuklir PTAPB berada hanya sekitar 30 km dari gunung Merapi yang merupakan gunung teraktif di Indonesia. Radioaktivitas jatuhan ditentukan dengan metode tak fangsung, yaitu dengan mengukur radioaktivitas jatuhan basah atau kering yang tertampung dalam wadah selama satu bulan. Fluktuasi radioaktivitas gross beta jatuhan di sekitar PTAPB selama periode tahun 1987 sampai 2005 dipengaruhi ofeh aktivitas gunung Merapi. Tercatat 5 kejadian dad aktivitas gunung Merapi memberi kontribusi yang signifikan terhadap kenaikan tingkat radioaktivitas jatuhan

STRATEGI PEMASARAN DIGITAL DI ERA MILENIAL

Strategi pemasaran dengan metode digital dapat dikatakan merupakan aspek terpenting dalam suatu bisnis inovatif, dalam menciptakan produk atau jasa tertentu, kita tidak akan bisa sukses dalam bisnisnya tanpa menerapkan strategi manajemen pemasaran tradisional saja dalam mengelola bisnis kedepannya. Disisi lain, pengelolaan bisnis dengan hanya mengandalkan manajamen produksi maupun keuangan yang baik, tidak pula bisa menjamin keberhasilan sebuah organisasi berbisnis. Pemasaran digital adalah suatu proses sosial manajerial dimana individu dan kelompok mendapatkan kebutuhan dan keinginan mereka dengan menciptakan, menawarkan, dan bertukar sesuatu yang bernilai satu sama lain di media sosial atau secara online lainnya. Masuknya revolusi industri 4.0 menjadi salah satu acuan untuk meningkatkan efisiensi dan efektivitas dalam melakukan kegiatan, termasuk dalam hal bisnis. Berbagai kegiatan saat ini dapat teratasi dengan menggunakan teknologi seperti penggunaan dalam hal internet. Setengah dari populasi dunia saat ini sudah terhubung dalam jaringan internet. Internet seperti sudah menjadi bagian integral dalam keseharian masyarakat. Di Indonesia sendiri, sekitar 57% pengguna internet adalah generasi milenial. Generasi milenial saat ini menjadi generasi yang medominasi usia produktif dan berperan besar pada era bonus demografi. Sebagai generasi dengan populasi terbesar, generasi milenial akan memegang kendali atas roda pembangunan khususnya di bidang ekonomi. Indonesia memiliki potensi besar untuk mengembangkan ekonomi digital. Ini terlihat dari aktivitas digital penduduk Indonesia yang cukup tinggi, terutama dalam hal generasi milenial sebagai target pasar belanja online

Early short course of neuromuscular blocking agents in patients with COVID-19 ARDS: a propensity score analysis

Abstract Background The role of neuromuscular blocking agents (NMBAs) in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) is not fully elucidated. Therefore, we aimed to investigate in COVID-19 patients with moderate-to-severe ARDS the impact of early use of NMBAs on 90-day mortality, through propensity score (PS) matching analysis. Methods We analyzed a convenience sample of patients with COVID-19 and moderate-to-severe ARDS, admitted to 244 intensive care units within the COVID-19 Critical Care Consortium, from February 1, 2020, through October 31, 2021. Patients undergoing at least 2 days and up to 3 consecutive days of NMBAs (NMBA treatment), within 48 h from commencement of IMV were compared with subjects who did not receive NMBAs or only upon commencement of IMV (control). The primary objective in the PS-matched cohort was comparison between groups in 90-day in-hospital mortality, assessed through Cox proportional hazard modeling. Secondary objectives were comparisons in the numbers of ventilator-free days (VFD) between day 1 and day 28 and between day 1 and 90 through competing risk regression. Results Data from 1953 patients were included. After propensity score matching, 210 cases from each group were well matched. In the PS-matched cohort, mean (± SD) age was 60.3 ± 13.2 years and 296 (70.5%) were male and the most common comorbidities were hypertension (56.9%), obesity (41.1%), and diabetes (30.0%). The unadjusted hazard ratio (HR) for death at 90 days in the NMBA treatment vs control group was 1.12 (95% CI 0.79, 1.59, p = 0.534). After adjustment for smoking habit and critical therapeutic covariates, the HR was 1.07 (95% CI 0.72, 1.61, p = 0.729). At 28 days, VFD were 16 (IQR 0–25) and 25 (IQR 7–26) in the NMBA treatment and control groups, respectively (sub-hazard ratio 0.82, 95% CI 0.67, 1.00, p = 0.055). At 90 days, VFD were 77 (IQR 0–87) and 87 (IQR 0–88) (sub-hazard ratio 0.86 (95% CI 0.69, 1.07; p = 0.177). Conclusions In patients with COVID-19 and moderate-to-severe ARDS, short course of NMBA treatment, applied early, did not significantly improve 90-day mortality and VFD. In the absence of definitive data from clinical trials, NMBAs should be indicated cautiously in this setting. </jats:sec

Impact of Hemoglobin Levels on Composite Cardiac Arrest or Stroke Outcome in Patients With Respiratory Failure Due to COVID-19

OBJECTIVES:. Anemia has been associated with an increased risk of both cardiac arrest and stroke, frequent complications of COVID-19. The effect of hemoglobin level at ICU admission on a composite outcome of cardiac arrest or stroke in an international cohort of COVID-19 patients was investigated. DESIGN:. Retrospective analysis of prospectively collected database. SETTING:. A registry of COVID-19 patients admitted to ICUs at over 370 international sites was reviewed for patients diagnosed with cardiac arrest or stroke up to 30 days after ICU admission. Anemia was defined as: normal (hemoglobin ≥ 12.0 g/dL for women, ≥ 13.5 g/dL for men), mild (hemoglobin 10.0–11.9 g/dL for women, 10.0–13.4 g/dL for men), moderate (hemoglobin ≥ 8.0 and < 10.0 g/dL for women and men), and severe (hemoglobin < 8.0 g/dL for women and men). PATIENTS:. Patients older than 18 years with acute COVID-19 infection in the ICU. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Of 6926 patients (median age = 59 yr, male = 65%), 760 patients (11.0%) experienced stroke (2.0%) and/or cardiac arrest (9.4%). Cardiac arrest or stroke was more common in patients with low hemoglobin, occurring in 12.8% of patients with normal hemoglobin, 13.3% of patients with mild anemia, and 16.7% of patients with moderate/severe anemia. Time to stroke or cardiac arrest by anemia status was analyzed using Cox proportional hazards regression with death as a competing risk. Covariates selected through clinical knowledge were age, sex, comorbidities (diabetes, hypertension, obesity, and cardiac or neurologic conditions), pandemic era, country income, mechanical ventilation, and extracorporeal membrane oxygenation. Moderate/severe anemia was associated with a higher risk of cardiac arrest or stroke (hazard ratio, 1.32; 95% CI, 1.05–1.67). CONCLUSIONS:. In an international registry of ICU patients with COVID-19, moderate/severe anemia was associated with increased hazard of cardiac arrest or stroke