Perhitungan Oee (Overall Equipment Effectiveness) Pada Mesin Komuri 2 Lithrone S40 Dan Heidelberg 4we Dalam Rangka Penerapan Total Productive Maintenance (Tpm)

[OEE (Overall Equipment Effectiveness) Calculations on Komuri 2 Lithrone S40 Engine and Heidelberg 4WE Engine In Order to Total Productive Maintenance (TPM) Aplications] Today in the modern industry, quality be a top priority for almost all companies in the world. PT. Solo Murni is one of the largest printing company in Indonesia that has market share was almost cover the whole world. The success that has been achieved so far would not be separated from good quality control. Based on the problem background, the research do because the productivity of the machine Komuri 2 Lithrone S40 and Heidelberg 4WE felt has begun to decline, so it is necessary to identify and analyze the factors that most dominant and contributed in order to immediately be repaired and as inputs in the implementation of Total Productive Maintenance (TPM ). After the research is done, the averages of OEE calculation for Komuri 2 Lithrone S40 is equal to 49.52% and Heidelberg 4WE is equal to 42.65%. It can be concluded that the effectiveness of the two machines are still far from worldclass standard that is equal to 85%. Six big losses of factors that contribute most to Komuri 2 Lithrone S40 and Heidelberg 4WE is preparation equipment with a percentage of 25.55% and 32.13% and impaired engine and idle at 31.62% and 37.38%

Attitude and knowledge towards concussion among doctors and rugby players in Malaysia

Malaysia is faced with the inadequacy of research studies assessing the attitudes and knowledge towards concussions among doctors and rugby player. This lack of knowledge and unsafe attitudes can lead to short and long term sequelae if a CC is not managed correctly. The poor understanding and misconception regarding concussions could result in a lack of proper reporting and lead to more players and doctors ignoring the injury. This is a cross sectional study among doctors and rugby players in Malaysia to assess knowledge and attitude towards . Self-administered questionnaire, RoCKAS-ST is adopted from previous study. Questionnaire was given to 285 rugby players and 217 doctors with return rate of 63% and 23% respectively. Descriptive analysis and univariate ANOVA was used to analyse the statistical response. Both doctors and rugby players recorded good attitude index compared to other previous study however the knowledge index of rugby players in Malaysia is subpar. There is significant differences in knowledge index among doctors and rugby players in Malaysia More training and education programme regarding should be done in Malaysia to increase the level of knowledge and attitude in both group of rugby players and doctors especially those in emergency medicine, family medicine, sports medicine, neurosurgery, surgery and orthopaedics

In vivo assessment of the mechanical properties of the child cortical bone using quantitative computed tomography

The mechanical properties of the rib cortical bone are extremely rare on children due to difficulties to obtain specimens to perform conventional tests. Some recent studies used cadaveric bones or bone tissues collected during surgery but are limited by the number of samples that could be collected. A non-invasive technique could be extremely valuable to overcome this limitation. It has been shown that a relationship exists between the mechanical properties (apparent Young’s modulus and ultimate strength) and the bone mineral density (assessed using Quantitative Computed Tomography, QCT), for the femur and recently by our group for the adult ribs ex vivo. Thus the aim of this study was to assess the mechanical properties of the child rib cortical bone using both QCT images in vivo and the previous relationship between bone mineral density and mechanical properties of the rib cortical bone. Twenty-eight children were included in this study. Seven age-groups have been considered (1, 1.5, 3, 6, 10, 15, 18 years old). The QCT images were prescribed for various thoracic pathologies at the pediatric hospital in Lyon. A calibration phantom was added to the clinical protocol without any modifications for the patient. The protocol was approved by the ethical committee. A 3D reconstruction of each thorax was performed using the QCT images. A custom software was then used to obtain cross-sections to the rib midline. The mean bone mineral density was then computed by averaging the Hounsfield Units in a specific cross-section and by converting the mean value (Hounsfield Units) in bone mineral density using the calibration phantom. This bone mineral density was assessed for the 6th rib of each subject. Our relationship between the bone mineral density and the mechanical properties of the rib cortical bone was used to derive the mechanical properties of the child ribs in vivo. The results give values for the apparent Young’s modulus and the ultimate strength. The mechanical properties increase along growth. As an example the apparent Young’s modulus in the lateral region ranges from 7 GPa +/-3 at 1 year old up to 13 GPa +/- 2 at 18 years old. These data are in agreement with the few previous values obtained from child tissues. This methodology opens the way to in vivo measurement of the mechanical properties of the child cortical bone based on calibrated QCT images

Posttraumatic ankle arthritis due to a novel Nocardia species

Introduction: Nocardial arthritis in immunocompetent patients is rare, and the optimum duration of antimicrobial therapy is unknown, although several months of antibiotic treatment is often recommended. Case report: We here report the first case of human infection with a novel Nocardia sp., summarise the epidemiology of nocardial arthritis and outline the feasibility of relatively short antibiotic treatments after careful surgical drainag

Impact of service provision platforms on maternal and newborn health in conflict areas and their acceptability in Pakistan: a systematic review

Various models and strategies have been implemented over the years in different parts of the world to improve maternal and newborn health (MNH) in conflict affected areas. These strategies are based on specific needs and acceptability of local communities. This paper has undertaken a systematic review of global and local (Pakistan) information from conflict areas on platforms of health service provision in the last 10 years and information on acceptability from local stakeholders on effective models of service delivery; and drafted key recommendations for improving coverage of health services in conflict affected areas. The literature search revealed ten studies that described MNH service delivery platforms. The results from the systematic review showed that with utilisation of community outreach services, the greatest impacts were observed in skilled birth attendance and antenatal consultation rates. Facility level services, on the other hand, showed that labour room services for an internally displaced population (IDP) improved antenatal care coverage, contraceptive prevalence rate and maternal mortality. Consultative meetings and discussions conducted in Quetta and Peshawar (capitals of conflict affected provinces) with relevant stakeholders revealed that no systematic models of MNH service delivery, especially tailored for conflict areas, are available. During conflict, even previously available services and infrastructure suffered due to various barriers specific to times of conflict and unrest. A number of barriers that hinder MNH services were discussed. Suggestions for improving MNH services in conflict areas were also laid down by participants. The review identified some important steps that can be undertaken to mitigate the effects of conflict on MNH services, which include: improve provision and access to infrastructure and equipment; development and training of healthcare providers; and advocacy at different levels for free access to healthcare services and for the introduction of the programme model in existing healthcare system. The obligation is enormous, however, for a sustainable programme, it is important to work closely with both the IDP and host community, and collaborating with the government and non-government organisations

Design of Cationic Multi-Walled Carbon Nanotubes as Efficient siRNA Vectors for Lung Cancer Xenograft Eradication

Polo-Like Kinase (PLK1) has been identified as a potential target in cancer gene therapy via chemical or genetic inhibitory approaches. The biomedical applications of chemically functionalized carbon nanotubes (f-CNTs) in cancer therapy have been studied due to their ability to efficiently deliver siRNA intracellularly. In this study, we established the capacity of cationic MWNT-NH3+ to deliver the apoptotic siRNA against PLK1 (siPLK1) in Calu6 tumor xenografts by direct intratumoural injections. A direct comparison with cationic liposomes was made. This study validates the PLK1 gene as a potential target in cancer gene therapy including lung cancer, as demonstrated by the therapeutic efficacy of siPLK1:MWNT-NH3+ complexes and their ability to significantly improve animal survival. Biological analysis of the siPLK1:MWNT-NH3+ treated tumors by RT-PCR and Western blot, in addition to TUNEL staining confirmed the biological functionality of the siRNA intratumourally, suggesting that tumor eradication was due to PLK1 knockdown. Furthermore, by using a fluorescently labelled, non-coding siRNA sequence complexed with MWNT-NH3+, we established for the first time that the improved therapeutic efficacy observed in f-CNT-based siRNA delivery is directly proportional to the enhanced siRNA retention in the solid tumor and subsequent uptake by tumor cells after local administration in vivo

A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.

BACKGROUND: Coronary Heart Disease (CHD) is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to reduce CHD events. This paper presents an economic evaluation of population based salt reduction policies in Tunisia, Syria, Palestine and Turkey. METHODS AND FINDINGS: Three policies to reduce dietary salt intake were evaluated: a health promotion campaign, labelling of food packaging and mandatory reformulation of salt content in processed food. These were evaluated separately and in combination. Estimates of the effectiveness of salt reduction on blood pressure were based on a literature review. The reduction in mortality was estimated using the IMPACT CHD model specific to that country. Cumulative population health effects were quantified as life years gained (LYG) over a 10 year time frame. The costs of each policy were estimated using evidence from comparable policies and expert opinion including public sector costs and costs to the food industry. Health care costs associated with CHDs were estimated using standardized unit costs. The total cost of implementing each policy was compared against the current baseline (no policy). All costs were calculated using 2010 PPP exchange rates. In all four countries most policies were cost saving compared with the baseline. The combination of all three policies (reducing salt consumption by 30%) resulted in estimated cost savings of $235,000,000 and 6455 LYG in Tunisia;$39,000,000 and 31674 LYG in Syria; $6,000,000 and 2682 LYG in Palestine and$1,3000,000,000 and 378439 LYG in Turkey. CONCLUSION: Decreasing dietary salt intake will reduce coronary heart disease deaths in the four countries. A comprehensive strategy of health education and food industry actions to label and reduce salt content would save both money and lives

Evaluation of a De-Identification Process for Ocular Imaging

Medical privacy of NASA astronauts requires an organized and comprehensive approach when data are being made available outside NASA systems. A combination of factors, including the uniquely small patient population, the extensive medical testing done on these individuals, and the relative cultural popularity of the astronauts puts them at a far greater risk to potential exposure of personal information than the general public. Therefore, care must be taken to ensure that the astronauts identities are concealed. Magnetic Resonance Imaging (MRI) medical data is a recent source of interest to researchers concerned with the development of Visual Impairment due to Intracranial Pressure (VIIP) in the astronaut population. Each vision MRI scan of an astronaut includes 176 separate sagittal images that are saved as an image series for clinical use. In addition to the medical information these image sets provide, they also inherently contain a substantial amount of non-medical personally identifiable information (PII) such as-name, date of birth, and date of exam. We have shown that an image set of this type can be rendered, using free software, to give an accurate representation of the patients face. This currently restricts NASA from dispensing MRI data to researchers in a de-identified format. Automated software programs, such as the Brain Extraction Tool, are available to researchers who wish to de-identify MRI sagittal brain images by erasing identifying characteristics such as the nose and jaw on the image sets [1]. However, this software is not useful to NASA for vision research because it removes the portion of the images around the eye orbits, which is the main area of interest to researchers studying the VIIP syndrome. The Lifetime Surveillance of Astronaut Health program has resolved this issue by developing a protocol to de-identify MRI sagittal brain images using Showcase Premier, a DICOM (Digital Imaging and Communications in Medicine) software package. The software allows manual Reporting provided by Web Services at Public Affairs | University of Illinois at Urbana-Champaign Page 10 editing of one image from a patients image set to be automatically applied to the entire image series. This new approach would allow a new level of access to untapped medical imaging data relating to VIIP that can be utilized by researchers while protecting the privacy of the astronauts. In the next step toward finalizing this technique, NASA clinical radiology consultants will test the images to verify removal of all metadata and PII. REFERENCES [1] Schimke, N., Kuehler, M., & Hale, J. (2011). Preserving privacy in structural neuroimages. In Data and Applications Security and Privacy XXV (pp. 301-308). Springer Berlin Heidelberg.Ope

Experiences of caregivers of children with inherited metabolic diseases: a qualitative study

Background: We sought to understand the experiences of parents/caregivers of children with inherited metabolic diseases (IMD) in order to inform strategies for supporting patients and their families. We investigated their experiences regarding the management of disease, its impact on child and family life, and interactions with the health care system. Methods: From four Canadian centres, we conducted semi-structured telephone interviews with parents/caregivers of children with an IMD who were born between 2006 and 2015 and who were participating in a larger cohort study. Participants were selected with the aim of achieving a diverse sample with respect to treatment centre, IMD, and age of the child. Interviews emphasized the impacts of the disease and its treatment on the child and family and explicitly queried perceptions of interactions with the health care system. We identified emergent themes from the interview data. Results: We completed interviews with 21 parents/caregivers. The 21 children were aged \u3c1 to 7 years old with IMD that included amino acid disorders, urea cycle disorders, fatty acid oxidation disorders, and organic acid disorders or \u27other\u27 IMD. Most parents reported that they and their families had adapted well to their child\u27s diagnosis. Parents used proactive coping strategies to integrate complex disease management protocols into routine family life. An important source of stress was concern about the social challenges faced by their children. Participants reported positive interactions with their most involved health care providers within the metabolic clinic. However, they reported challenges associated with the health care system outside of disease-specific metabolic care, when encountering systems and providers unfamiliar with the child\u27s disease. Conclusions: The successful use of proactive coping strategies among parents of children with IMD in this study suggests the potential value of promoting positive coping and is an important direction for future study. Parents\u27 social concerns for their children were important stressors that warrant consideration by health care providers positioned to support families. Our results with respect to experiences with care highlight the important role of specialized metabolic clinics and point to a need for better coordination of the care that takes place outside the disease-specific management of IMD

The Utility of Iron Chelators in the Management of Inflammatory Disorders

Since iron can contribute to detrimental radical generating processes through the Fenton and Haber-Weiss reactions, it seems to be a reasonable approach to modulate iron-related pathways in inflammation. In the human organism a counterregulatory reduction in iron availability is observed during inflammatory diseases. Under pathological conditions with reduced or increased baseline iron levels different consequences regarding protection or susceptibility to inflammation have to be considered. Given the role of iron in development of inflammatory diseases, pharmaceutical agents targeting this pathway promise to improve the clinical outcome. The objective of this review is to highlight the mechanisms of iron regulation and iron chelation, and to demonstrate the potential impact of this strategy in the management of several acute and chronic inflammatory diseases, including cancer