PENGURANGAN KUNING TELUR PADA BEBERAPA KONSENTRASI GUM XANTHAN TERHADAP KARAKTERISTIK FISIKOKIMIA DAN ORGANOLEPTIK CAKE BERAS RENDAH LEMAK

Reducing levels of fat content in reduced fat rice cake can be done by reducing the use of egg yolk. Egg yolk reduction causes the changes of characteristics of reduced fat rice cake so that need the addition of an other compounds that can improve the characteristics of reduced fat rice cake. Gum xanthan can be used to improve the characteristics of reduced fat rice cake is. This research objective to determine the effect of egg yolk reduction and gum xanthan concentration and interaction on physicochemical and sensory properties of reduced fat rice cake. Research design was Randomized Block Design with factorial design that consisted of two factors, namely egg yolk reduction and gum xanthan concentration. Reduced egg yolk consisted of two levels, 60% and 80% from the based formula of egg yolk meanwhile gum xanthan concentration consisted of three levels, 0,1%; 0,2% and 0,3% from the weight of rice flour. The research was conducted in four replications. Data were analyzed using Analysis of Variance at α = 5%. If the ANOVA test showed a significant effect, data were analyzed by Duncan’s Multiple Range Test at α = 5% to determine the level of treatments that gave a significant difference. The results showed the interaction between egg yolk reduction and gum xanthan concentration provided significant effect on moisture content, specific volume, hardness, gumminess and color reduced fat rice cake. Egg yolk reduction provided significant effect on texture characteristics, such as springiness, cohesiveness and chewiness while gum xanthan concentration provided significant effect on texture characteristics, such as chewiness reduced fat rice cake. Egg yolk reduction at gum xanthan concentration variation provided significant effect on preference of color, pore uniformity, softness, taste and swallowability (moistness) reduced fat rice cake. Reduced fat rice cake with 60% egg yolk reduction and 0,1% gum xanthan concentration was the most preferred treatment.Keywords: reduced fat rice cake, egg yolk reduction, gum xantha

PIK3CA mutations are common in lobular carcinoma in situ, but are not a biomarker of progression

Sample and data collection were funded by Cancer Research UK. Analysis was funded by Breast Cancer Now, the Rosetrees Trust, Guys & St Thomas’ Charity (CanHelp) and the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy’s and St. Thomas’ NHS Foundation Trust and King’s College London

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Pembuatan Sistem Knowledge Management Berbasis Web pada PT Benua Cakra Petrolindo

Knowledge Management merupakan sebuah proses merencanakan, mengumpulkan dan mengorganisir, memimpin dan mengendalikan data dan informasi yang telah digabung dengan berbagai bentuk pemikiran dan analisa dari macam-macam sumber yang kompeten. Knoweledge Management membantu organisasi dalam memperoleh wawasan dan pengertian dari pengalamannya. Kegiatan Knowledge Management yang spesifik dapat membantu organisasi dalam memperoleh, menyimpan dan mengembangkan knowledge untuk hal-hal seperti pemecahan masalah, pembelajaran dinamis, perencanaan strategis dan pengambilan keputusan. Pada PT Benua Cakra Petrolindo (BECAP), tingkat ketergantungan yang tinggi terhadap staf layanan teknis karena jabatan rangkap seorang service engineer dan sales engineer mengakibatkan beberapa masalah yakni keterlambatan respon perusahaan terhadap permintaan layanan pelanggan. Hal ini berpengaruh pada kemampuan perusahaan dalam menghadapi proses bisnis yang ada dan masalah yang timbul terutama pada kepuasan pelanggan. Kondisi ini tentu sangat tidak menguntungkan bagi sebuah perusahaan yang berperan sebagai perusahaan jasa yang khususnya memberikan pelayanan terbaik kepada pelanggan. Selain itu, tidak adanya suatu mekanisme yang mengatur pengetahuan yang ada di perusahaan membuat kinerja perusahaan menjadi tidak efektif dan tidak efisien

Usage de la procalcitonine pour guider l’utilisation des antibiotiques en cas de sepsis

RésuméObjectif : L’objectif est de discuter de l’intérêt de la procalcitonine comme biomarqueur de l’infection bactérienne dans les situations de sepsis.Sources des données : Les données proviennent d’une recherche effectuée dans la base de données PubMed, sans limites de dates. Les études prospectives à répartition aléatoire contrôlées et les référentiels internationaux publiés entre 2005 et 2015 ont été sélectionnés pour cet article à l’aide des mots anglais antibiotic, procalcitonin, sepsis, septic shock.Sélection des études et extraction des données : Les études comparatives prospectives à répartition aléatoire et les référentiels internationaux ont été sélectionnés pour cet article.Analyse des données : La procalcitonine est un marqueur spécifique et précoce de l’infection bactérienne. Sa supériorité, en matière de sensibilité et de spécificité, face à d’autres marqueurs tels que la protéine C-réactive a été démontrée. Certaines études ont montré que l’utilisation du dosage de la procalcitonine comme facteur décisionnel dans la stratégie thérapeutique pour les patients septiques – en présence ou non de choc – hospitalisés dans une unité de soins intensifs, a entraîné une diminution de la durée de l’antibiothérapie et de l’hospitalisation, sans répercussion délétère sur l’évolution clinique des patients. Une telle utilisation pourrait être associée à des coûts de santé moindres. Cependant, les protocoles et les seuils d’intervention utilisés dans les différentes études sont hétérogènes et le taux de non-adhésion au protocole varie de 16 à 84 %, ce qui pourrait entraîner un biais de résultats.Conclusion : La procalcitonine semble être un marqueur pronostic intéressant pour la prise en charge du sepsis. Cependant, d’autres études s’avèrent nécessaires pour valider cet outil. L’outil s’interprète en concordance avec les autres résultats de laboratoire et l’évaluation clinique du patient reste l’élément prédominant dans la décision thérapeutique.AbstractObjective: The objective is to discuss the value of procalcitonin as a biomarker of bacterial infection in cases of sepsis.Data sources and study selection: The PubMed database was searched without date restrictions. Randomized, prospective, controlled trials and international guidelines published between 2005 and 2015 were selected for this article using the following English words: antibiotic, procalcitonin, sepsis, septic shock.Data analysis: Procalcitonin is an early specific marker of bacterial infection. In terms of sensitivity and specificity, it has been shown to be superior to other markers, such as C-reactive protein. In septic patients—with or without shock—hospitalized in an intensive care unit, the use of procalcitonin as a decision-making factor in the treatment strategy has, in some studies, led to a decrease in the duration of antibiotic therapy and a shorter duration of hospital stay, with no negative impact on the patients’ clinical course. This tool may be associated with lower health-care costs. However, the protocols and intervention thresholds used in the different studies were heterogeneous, and the protocol noncompliance rates varied from 16 to 84%, which adds a potential bias to the results obtained.Conclusion: Procalcitonin seems to be a useful prognostic marker in sepsis management. Nevertheless, further studies are necessary to validate this usage. This tool should be interpreted in the context of other laboratory results, and the clinical evaluation of the patient remains the key component in therapeutic decision-making

Utilisation de la procalcitonine pour le diagnostic et le suivi du traitement des infections respiratoires et du sepsis au Centre hospitalier de l’Université de Montréal

RésuméObjectif : L’objectif est d’évaluer l’utilisation du dosage de la procalcitonine sur le plan des indications, de l’utilisation d’un algorithme décisionnel, de la durée de l’antibiothérapie et du taux de mortalité pour les patients traités au Centre hospitalier de l’Université de Montréal.Méthode : L’étude, descriptive et rétrospective, a analysé 500 dossiers patients pour lesquels au moins un dosage de la procalcitonine a été effectué entre le 20 juillet 2014 et le 12 janvier 2015. Aucun critère d’exclusion n’est retenu.Résultats : L’analyse comprend 722 dosages de procalcitonine. Les patients sont âgés de 67 ± 16 ans, 78,4 % présentent une ou plusieurs comorbidités et 79,4 % d’entre eux sont hospitalisés (32 % sont admis dans le service de chirurgie et 26,7 % dans le service de pneumologie). La grande majorité (77,8 %) des dosages de procalcitonine ont été effectués pour mettre en évidence ou écarter une infection respiratoire basse ou un sepsis. Dans 52,4 % des cas, l’algorithme décisionnel propre à l’établissement a été respecté. L’utilisation du dosage de la procalcitonine semble être associée à une diminution de la durée de l’antibiothérapie (estimée à 5,8 ± 1,4 jours en moyenne; environ 1 036 jours de traitement sauvés), sans répercussions sur le taux de mortalité des patients (9,3 % comparativement à 7,8 %, différence non significative).Conclusion : En cas d’infection respiratoire basse ou de sepsis, le dosage de la procalcitonine et l’utilisation d’un algorithme décisionnel semblent être associés à une réduction de l’utilisation des antibiotiques, sans répercussions sur le taux de mortalité. Une telle approche permettrait de limiter l’apparition de résistances bactériennes et de réduire les coûts de santé.AbstractObjective: The objective was to evaluate the use of procalcitonin assays in terms of indication, use of a decision algorithm, duration of antibiotic therapy, and mortality in patients treated at the Centre Hospitalier de l’Université de Montréal.Method: This is a descriptive, retrospective study based on the review of the charts of 500 patients for whom at least one procalcitonin assay was performed between July 20, 2014, and January 12, 2015. There were no exclusion criteria.Results: The analysis concerned 722 procalcitonin assays. The patients were 67 ± 16 years of age, and 78.4% had one or more comorbidities. In all, 79.4% of the patients were inpatients; 32% had been admitted for surgery and 26.7% for respiratory care. A total of 77.8% of the procalcitonin assays were performed to identify or rule out a lower respiratory tract infection or sepsis. In 52.4% of the cases, the decision algorithm, specific to this institution, was followed. The use of procalcitonin assays seemed to be associated with a decrease in the duration of antibiotic therapy, estimated at 5.8 ± 1.4 days on average, with 1,036 treatment days saved, with no impact on patient mortality rates (9.3% vs. 7.8%, difference nonsignificant).Conclusion: In cases of patients with lower respiratory tract infections or sepsis, procalcitonin assays and the use of a decision algorithm appear to be associated with a decline in antibiotic use, with no impact on mortality. This test can help limit the development of bacterial resistance and reduce healthcare costs