Analisis Faktor Yang Mempengaruhi Kemandirian Pada Pasien Cedera Kepala Yang Pernah Dirawat Di Igd RSUD Dr. R. Koesma Tuban

Cedera kepala akibat kecelakaan lalulintas merupakan penyebab utama disabilitas dan mortalitas. Functional Independence Measure (FIM) merupakan salah satu pengukuran kemandirian pasien cedera kepala. Beberapa faktor yang dicurigai adalah usia, mekanisme cedera, skor awal GCS, hipotensi, diameter pupil dan reaksi cahaya, CT scan, konsumsi alkohol, dan lama perawatan. Tujuan penelitian ini adalah mengetahui faktor yang mempengaruhi kemandirian pasien cedera kepala. Penelitian ini bersifat analitik observasional dengan menggunakan rancangan retrospektif terhadap107 sampel rekam medis RSUD dr. R. Koesma Tuban dari periode Januari-April 2016. Teknik sampling yang digunakan adalah teknik cluster random sampling dengan kriteria inklusi dan ekslusi. Instrumen yang digunakan lembar checklist dan lembar FIM. Analisis menggunakan uji koefisien kontingensi dan regresi logistik. Hasil uji regresi logistik menunjukan faktor yang mempengaruhi adalah GCS (p=0,996) dan Pupil (p=0,077). Persamaan yang didapat y = 0,357 + 19,434 (GCS) + 2,041 (Pupil). Hasil uji Hosmer and Lameshow menunjukan kalibrasi yang baik (p=1,000), nilai AUC menunjukan bahwa 93,6% persamaan regresi yang diperoleh mampu membedakan kemandirian pasien cedera kepala berdasarkan variabel GCS dan pupil, sisanya yaitu 6,4% dipengaruhi oleh faktor lain. Skor GCS yangrendah pada awal cedera berhubungan dengan prognosa yang buruk, sedangkan abnormalitas fungsi pupil, gangguan gerakan ekstraokular, pola-pola respons motorik yang abnormal seperti postur fleksor dan postur ekstensor, juga memprediksikan outcome yang buruk setelah cedera kepala.Kesimpulan dari penelitian ini adalah Skor awal GCS dan Pupil menjadi faktor yang dominan berpengaruh terhadap kemandirian. Oleh karena itu, perawat perlu meningkatkan manajemen pasien cedera kepala pada fase emergency dengan tidak mengabaikan pengukuran GCS dan Pupil

Conductometric Gas Sensors based on Nanostructured WO3 Thin Films

Nanostructured WO3 thin films have been prepared bythermal evaporation to detect hydrogen at low temperatures.The influence of heat treatment on the physical, chemical andelectronic properties of these films has been investigated. Thefilms were annealed at 400oC for 2 hours in air. AFM and TEManalysis revealed that the as-deposited WO3 film is highamorphous and made up of cluster of particles. Annealing at400oC for 2 hours in air resulted in very fine grain size of theorder of 5 nm and porous structure. GIXRD and Raman analysisrevealed that annealing improved the crystallinity of WO3 film.Gas sensors based on annealed WO3 films have shown a highresponse towards various concentrations (10-10000 ppm) H2 atan operating temperature of 150oC. The improved sensingperformance at low operating temperature is due to the optimumphysical, chemical and electronic properties achieved in the WO3film through annealing

Clinics in diagnostic imaging (102)

A 19-year-old man presented with cough and haemoptysis of ten days duration. He also had mild right hypochondrial pain. Chest radiograph and computed tomography (CT) showed a rounded soft tissue density opacity with an air crescent sign. CT showed multiple cystic lesions in the liver with a daughter cyst in its lateral wall. Diagnosis of hydatid disease of lung and liver was made. The contents of the liver cyst were aspirated, hypertonic saline instilled, re-aspirated, and absolute alcohol injected. Hydatid disease is endemic in certain parts of the world. Although the lungs and liver are most frequently affected, the disease can arise in any part of the body and should be kept in differential diagnosis whenever a cystic lesion is encountered. Hydatid cysts typically demonstrate characteristic imaging findings, however, the appearances may become complicated due to cyst rupture or secondary infection. Ultrasonography is the imaging modality of choice particularly in hepatic disease. CT best demonstrates cyst wall calcification and cyst infection

A Dual Band Slotted Patch Antenna on Dielectric Material Substrate

A low profile, compact dual band slotted patch antenna has been designed using finite element method-based high frequency full-wave electromagnetic simulator. The proposed antenna fabricated using LPKF printed circuit board (PCB) fabrication machine on fiberglass reinforced epoxy polymer resin material substrate and the performance of the prototype has been measured in a standard far-field anechoic measurement chamber. The measured impedance bandwidths of (reflection coefficient <-10 dB) 12.26% (14.3–16.2 GHZ), 8.24% (17.4–18.9 GHz), and 3.08% (19.2–19.8) have been achieved through the proposed antenna prototype. 5.9 dBi, 3.37 dBi, and 3.32 dBi peak gains have been measured and simulated radiation efficiencies of 80.3%, 81.9%, and 82.5% have been achieved at three resonant frequencies of 15.15 GHz, 18.2 GHz, and 19.5 GHz, respectively. Minimum gain variation, symmetric, and almost steady measured radiation pattern shows that the proposed antenna is suitable for Ku and K band satellite applications

Tunneling of a composite particle: Effects of intrinsic structure

We consider simple models of tunneling of an object with intrinsic degrees of freedom. This important problem was not extensively studied until now, in spite of numerous applications in various areas of physics and astrophysics. We show possibilities of enhancement for the probability of tunneling due to the presence of intrinsic degrees of freedom split by weak external fields or by polarizability of the slow composite object.Comment: 6 pages, 3 figures, version to be published in Journal of Physics

Numerical investigation of heat transfer enhancement of nanofluids in an inclined lid-driven triangular enclosure.

The behavior of nanofluids is investigated numerically in an inclined lid-driven triangular enclosure to gain insight into convective recirculation and flow processes induced by a nanofluid. The present model is developed to examine the behavior of nanofluids taking into account the solid volume fraction δ. Fluid mechanics and conjugate heat transfer, described in terms of continuity, linear momentum and energy equations, were predicted by using the Galerkin finite element method. Comparisons with previously published work on the basis of special cases are performed and found to be in excellent agreement. Numerical results are obtained for a wide range of parameters such as the Richardson number, and solid volume fraction. Copper–water nanofluids are used with Prandtl number, Pr = 6.2 and solid volume fraction δ is varied as 0%, 4%, 8% and 10%. The streamlines, isotherm plots and the variation of the average Nusselt number at the hot surface as well as average fluid temperature in the enclosure are presented and discussed in detailed. It is observed that solid volume fraction strongly influenced the fluid flow and heat transfer in the enclosure at the three convective regimes. Moreover, the variation of the average Nusselt number and average fluid temperature in the cavity is linear with the solid volume fraction

Z7Z_7 Orbifold Models in M-Theory

Among $T^7/\Gamma$ orbifold compactifications of $M$-theory, we examine models containing the particle physics Standard Model in four-dimensional spacetimes, which appear as fixed subspaces of the ten-dimensional spacetimes at each end of the interval, $I^1\simeq S^1/Z_2$, spanning the $11^\text{th}$ dimension. Using the $Z_7$ projection to break the $E_8$ gauge symmetry in each of the four-planes and a limiting relation to corresponding heterotic string compactifications, we discuss the restrictions on the possible resulting gauge field and matter spectra. In particular, some of the states are non-local: they connect two four-dimensional Worlds across the $11^\text{th}$ dimension. We illustrate our programmable calculations of the matter field spectrum, including the anomalous U(1) factor which satisfies a universal Green-Schwarz relation, discuss a Dynkin diagram technique to showcase a model with $SU(3)\times SU(2)\times U(1)^5$ gauge symmetry, and discuss generalizations to higher order orbifolds.Comment: 23 pages, 2 figures, 4 tables; LaTeX 3 time

Staging the neoaortoiliac system: Feasibility and short-term outcomes

BackgroundThe neoaortoiliac system (NAIS) has gained popularity as a durable procedure for treating aortic graft infections. However, one of the disadvantages has been a long operation that can take up to 10 hours. The goal of this study was to assess the feasibility of staging the NAIS procedure with deep vein harvest a day before the aortofemoral bypass and evaluate if staging had any effect on graft patency or morbidity and mortality, or both.MethodsWe reviewed data for all the NAIS procedures performed for aortic graft infections at a tertiary care university hospital. The femoral popliteal veins of patients undergoing the staged NAIS were harvested a day in advance and left in situ. The next day patients underwent the prosthetic graft excision with reconstruction using the femoral popliteal veins. Patients with aortic occlusion on presentation were not candidates for vein harvest in advance and underwent a unilateral bypass with a subsequent femorofemoral bypass as a second stage.ResultsIn the last 8 years, 26 patients (17 men, 9 women; mean age, 62.6 ± 8.3 years) underwent the NAIS procedure for aortic graft infections. Mean follow-up was 15.7 months. Primary assisted graft patency was 100%. There were 11 patients in the staged group and 10 patients in the nonstaged group. All the staged patients underwent vein mobilization a day before excision of aortic prosthesis. Despite undergoing a separate procedure for vein harvesting at a different time, there was no difference in total operative time (12.0 ± 1.8 vs 11.9 ± 2.2 hours), operative blood loss (2.6 ± 1.2 vs 3.4 ± 2.4 L), and requirements for transfusion for blood products (6.7 ± 3.7 vs 6.0 ± 5.4 U) or crystalloid (11.3 ± 3.1 vs 10.9 ± 2.4 L) between the staged group and nonstaged groups. One amputation occurred in each group. The perioperative mortality was 18% for the staged group and 20% for nonstaged group. The 12-month survival was 72% for staged and 70% for nonstaged NAIS. No graft-related complications were observed from the preoperative vein harvest.ConclusionThe NAIS can be staged without compromising the efficacy of the procedure as evident by excellent long-term patency and control of the infection. By reducing the duration of the primary procedure, staging may be beneficial to both the patient and the surgeon