Penyelesaian masalah penugasan dengan menggunakan Pendekatan Optimal Diagonal, Heuristic Method dan Hungarian Method

Penelitian ini membahas tentang masalah penugasan optimal dengan empat kasus yakni: 2 kasus data seimbang dan 2 kasus data tidak seimbang, yang diselesaikan dengan menggunakan metode penugasan Pendekatan Optimal Diagonal, Heuristic Method, dan Hungarian Method. Selanjutnya dilakukan perbandingan solusi optimal tersebut untuk mencari metode penugasan yang menghasilkan solusi optimal terbaik. Berdasarkan hasil penelitian ini diketahui bahwa menyelesaikan kasus dengan menggunakan Pendekatan Optimal Diagonal, dan Hungarian Method menghasilkan nilai solusi optimal yang sama namun dengan iterasi yang berbeda, sedangkan dengan menggunakan Heuristic Method tidak semua kasus menghasilkan nilai solusi optimal yang sama. Pada kasus yang diteliti disimpulkan bahwa Pendekatan Optimal Diagonal lebih baik dari pada Heuristic Method dan Hungarian Method

GARAM SEHAT RENDAH NATRIUM MENGGUNAKAN METODE BASAH

Garam konsumsi (NaCl) merupakan kebutuhan yang sangat penting bagi manusia, diantaranya sebagai bumbu dan pengawet makanan. Selama ini kebanyakan orang mengonsumsi makanan hanya memikirkan selera dan rasanya saja sehingga kurang memperhatikan apa yang dibutuhkan oleh tubuh. Hipertensi adalah salah satu permasalahan dalam tubuh, karena peningkatan tekanan darah sistolik dan diastolik. Sebenarnya, garam konsumsi yang dijual bukanlah penyebab dari meningkatnya tekanan darah. Namun, kandungan natrium di dalam garam itulah yang menyebabkan hipertensi. Garam sehat diharapkan dapat menurunkan tekanan darah bagi penderita hipertensi yang memiliki kadar maksimum natrium sebesar 60% berat dan kadar kalium maksimum sebesar 40% berat. Pada penelitian ini akan dibuat garam rendah Natrium dengan penambahan Kalium Klorida (KCl) sebagai bahan campuran. Kadar Natrium dalam garam konsumsi nantinya akan menurun dengan penambahaan kalium klorida, penambahan dilakukan dengan perbandingan massa NaCl dan KCl 1:3, 1:2, 1:1, 2:1, 3:1 dari total massa bahan yang nantinya setiap bahan akan dilarutkan dan diaduk menjadi satu dengan suhu pengadukan 40°C, 70°C, 100°C. Diaduk hingga terjadi proses rekristalisasi. Perbandingan yang paling baik dalam percobaan ini,  untuk mendekati garam dengan kadar NaCl 60% dan KCl 40%, yaitu pada perbandingan massa NaCl dan KCl 1:1 pada suhu 70°C. Kata kunci : garam konsumsi ; garam sehat ; hipertensi ; kalium klorida ; natrium klorida. DOI : https://doi.org/10.33005/jurnal_tekkim.v14i2.204

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine