Selecting Treatment Modality for Small Hepatocellular Carcinoma: Radiofrequency Ablation, Percutaneous Alcohol and Acetic Acid Injection

Hepatocellular carcinoma (HCC) is the most common primary hepatic Malignancy worldwide and is the leading cause of death in patients with cirrhosis. In early-stage tumors, potential curative therapies have been used including ablative therapies using percutaneous ethanol injection (PEI), percutaneous acetic acid injection (PAI) or radiofrequency ablation (RFA); surgical resection and liver transplantation. RFA is more effective and safer than other local ablative therapy modalities. RFA should be considered as the first-line treatment for patients with small HCC, i.e. sized less than 5 cm; preferably less than or equal to 3 cm since they are not suitable for liver resection or liver transplantation. RFA should also be compared with transarterial embolization, which currently has been considered as the standard HCC therapy in some countries. It has been reported that the combination of RFA and embolization treatment may reduce the early and late recurrence rate

PERANCANGAN PROTOTYPE LANDING GEAR SYSTEM DAN MONITORING PERGERAKAN LANDING GEAR SYSTEM PESAWAT TERBANG MENGGUNAKAN MIKROKONTROLER

Pesawat merupakan salah satu modal transportasi yang sangat sering digunakan oleh sebagian besar masyarakat untuk berpergian jarak jauh. Tentunya faktor keamanan sangat diperlukan untuk menjamin keselamatan para penumpang. Faktor keamanan yang perlu diperhatikan yaitu sistem kerja pesawat itu sendiri. Salah satunya adalah landing gear system. Landing gear system merupakan sistem gerak roda pesawat ketika pendaratan (landing) maupun saat tinggal landas (take off). Tentunya untuk merancang sistem pendaratan pesawat tidak hanya memerlukan engineer dengan keterampilan handal, tetapi juga membutuhkan engineer yang memiliki pengetahuan yang cukup tentang prosedur keamanan dalam sistem pendaratan pesawat. Prototype landing gear system ini dirancang dengan menggunakan mikrokontroler AVR ATmega16 sebagai kontrolernya dan pneumatik sebagai aktuatornya. Prototype dilengkapi indikator berupa nyala lampu sesuai urutan operasi sistem landing gear dan bunyi untuk memenuhi kebutuhan simulasi pendaratan. Selain itu, digunakan juga sensor gyro dan accelerometer (pada penelitian ini digunakan sensor MPU6050) untuk memonitor pergerakan prototype landing gear pesawat terbang menggunakan arduino uno yang ditampilkan pada laptop dengan komunikasi serial. Pengujian pada tugas akhir ini dilakukan dengan menguji sistem kontrol dengan sistem mekanik landing gear . Berdasarkan hasil pengujian, sistem kontrol berjalan dengan baik terhadap kondisi simulasi yang telah ditentukan. Sistem monitoring pun telah berhasil dilakukan. Interface antara arduino, labview dan solidworks sudah dapat terhubung. Keywords: landing gear system, mikrokontroler atmega16, pneumatic, labview, solidwork

KAJI EKSPERIMENTAL PERBANDINGAN EFISIENSI ANTARA REFRIGERANT (R-22) DENGAN MUSICOOL (MC-22) TERHADAP KINERJA ALAT PENGKONDISIAN UDARA (AC)

Abstrak Seiring dengan semakin meluasnya pemakaian mesin AC dengan menggunakan freon (R22)sebagai media pendingin (refrigerant) telah menimbulkan permasalahan terhadaplingkungan yaitu terjadinya kerusakan lapisan ozon pada atmosfir sehingga meningkatnyapanas global dipermukaan bumi. Salah satu cara untuk menangani permasalahan tersebutadalah dengan mencari jenis refrigerant lain yang sesuai sebagai pengganti R-22 yangdapat digunakan secara langsung pada mesin AC yang sebelumnya menggunakan R-22dan kemudian di retrofit menggunakan MC-22 atau R-290, tanpa melakukan perubahanyang besar terhadap spesifikasi dan dimensi dari peralatan mesin AC tersebut. Tujuanutama dari penelitian ini adalah untuk mengetahui kualitas kinerja mesin AC Split TipePanasonic di Balai Latihan kerja Industri (BLKI) Banda Aceh. Metode yang digunakandalam penelitian ini adalah membandingkan performasi berdasarkan data desain denganhasil pengukuran sebenarnya. Dengan mendapatkan data yang kita akan tahu nilaientalphy dari setiap proses pada diagram P-h dan menghitung COP serta efisiensi dariunit. Hasil penelitian menunjukkan bahwa nilai dari R-22 selama menit ke-120didapatkan COP aktual adalah 3,51, EER 11,979 Btu/h.W, dan efisiensi refrigerasi49,78%, nilai ini lebih rendah dari data desain yang menggunakan MC-22 nilai COPaktual adalah 1,73, EER 5,904 Btu/h.W, dan efisiensi refrigerasi 30,03%. Berdasarkanperbandingan meskipun nilainya lebih rendah, tetapi kita dapat mengatakan kinerja alatmasih baik karena nilainya tidak jauh berbeda. Kata kunci : Refrigerant 22, Musicool 22, COP, Media Pendingin

Pengaruh Inovasi Produk, Literasi Keuangan dan Kemampuan Manajerial terhadap Kinerja UKM di Kabupaten Banyumas (Studi Kasus UKM Toko Oleh-Oleh Makanan Khas di Kabupaten Banyumas)

Penelitian ini bertujuan untuk mengetahui pengaruh inovasi produk,literasi keuangan, kemampuan manajerial terhadap kinerja UKM toko oleh-olehmakanan khas. Populasi dalam penelitian ini adalah seluruh pelaku UKM yangbergerak di bidang toko oleh-oleh makanan khas yang berada di KabupatenBanyumas. Teknik pengambilan sampel yang digunakan adalah purposiveconvenience sampling dengan sampel berjumlah 55 responden. Teknikpengumpulan data dalam penelitian ini menggunakan kuesioner. Teknik analisisdata dalam penelitian ini menggunakan analisis regresi berganda dibantu dengansoftware SPSS. Hasil penelitian ini menunjukkan bahwa: (1) inovasi produk, literasi keuangan, dan kemampuan manajerial berpengaruh positif terhadap kinerja UKM(2) inovasi produk negatif signifikan terhadap kinerja UKM, (3) literasi keuanganberpengaruh positif signifikan terhadap kinerja UKM, (4) kemampuan manajerialberpengaruh positif signifikan terhadap kinerja UKM, (5) kemampuan manajerialmemiliki pengaruh yang paling dominan terhadap kinerja UKM. Implikasi dari kesimpulan tersebut adalah sebagai berikut: (1) Upaya untuk meningkatkan kinerja UKM dilakukan dengan cara menerapkan inovasiproduk, menambah pengetahuan dan pemahaman mengenai literasi keuangan, danmeningkatkan kemampuan manajerial agar usaha dapat berjalan optimal, (2)Pelaku UKM melakukan inovasi produk merupakan hal yang mungkin berisiko.Inovasi produk yang dilakukan tidak tepat dapat mengakibatkan kerugian bagiusahanya, sebelum melakukan inovasi perlu adanya analisis mengenai kondisi danfaktor-faktor tertentu agar inovasi yang dilakukan dapat memberikan keuntunganyang positif bagi usahanya, (3) Literasi keuangan merupakan pemahaman konsepatau risiko keuangan yang digunakan untuk menganalisis, mengelola, sertamelakukan keputusan terhadap keuangan dalam bisnisnya. Dengan adanya literasikeuangan yang baik, diharapkan pelaku UKM dapat mengelola sumber dayakeuangan usahanya dengan baik sehingga terjadi peningkatan kinerja. Literasikeuangan dapat ditingkatkan melalui sosialisasi dan seminar, (4) Pelaku UKMharus memiliki kemampuan manajerial yang baik, karena seorang pelaku UKMmerupakan kunci utama suatu usaha untuk meraih kesuksesan. Pelaku UKMdianggap sebagai faktor utama penentu baik atau buruknya perkembangan UKM,(5) Kemampuan manajerial merupakan landasan utama pelaku UKM agar dapatmengelola usahanya. Pelaku UKM harus meningkatkan pengetahuan dankemampuan manajerial mereka sehingga usaha yang dikelola dapat berjalandengan baik agar tujuan usahanya dapat tercapai serta terjadi peningkatan kinerja

Hyperuricemia as a Risk Factors of Major Adverse Cardiac Events in Patients with Acute Coronary Syndrome: a Retrospective Cohort Study

Aim: to investigate the MACE-free survivals difference between hyperuricemic and normouricemic patients and to determine its role as risk factor for MACE occurrence in hospitalized acute coronary syndrome patients. Methods: retrospective cohort study with survival analysis approach was conducted in 251 patients with acute coronary syndrome who were treated in ICCU Cipto Mangunkusumo Hospital during period from January 2009 to December 2011. Clinical data, laboratory results, electrocardiography result, echocardiography result, and coronary angiography were collected. Patients were observed and followed on major adverse cardiac event during 7 days of hospitalization in ICCU. Major adverse Cardiac Event is an event as a complication occur after acute coronary syndrome such as cardiogenic syock, acute heart failure, stoke, reinfarct during early ward treatment, sudden cardiac death, repeat PCI during ward ulang and perform coronary artery bypass graft (CABG) surgery. Difference in survival is shown in Kaplan-meier curve and difference in survival between groups were tested with Log-rank test, and multivariate analysis with Cox proportional hazard regression to calculate adjusted HR on major adverse cardiac event with confounding variables as covariates. Results: there was a significant difference in survival between hyperuricemia group and non-hyperuricemia group (Log-rank test (p<0.001)) with crude HR 2.7 (CI 95% 1.6–4) and adjusted HR 2.67 (CI 95% 1.6-4.3).There was significant difference in survival between hyperuricemia group (mean survival 6.05 days with SE 0.2 (CI 95% 5.6-6.4) and non-hyperuricemia group (mean survival 7.33 days with SE 0.1 (CI 95% 7.0-7.6). Conclusion: survival of patients suffering from ACS with hyperuricemia is worse compared to those without hyperuricemia during ICCU hospitalization.Key words: hyperuricemia, acute coronary syndrome, major adverse cardiac event, surviva

Early Recognition of Alzheimer’s Disease using Brain MRI

Abstract—Alzheimer’s disease (AD) is a brain disease that causes a slow decline in memory, thinking and reasoning skills. It represents a major public health problem.&nbsp; Magnetic Resonance Imaging (MRI) have shown that the brains of people with (AD) shrink significantly as the disease progresses. This shrinkage appears in specific brain regions such as the hippocampus which is a small, curved formation in the brain that plays an important role in the limbic system also involved in the formation of new memories and is also associated with learning and emotions.&nbsp; Medical information on brain MRI is used in detecting the abnormalities in physiological structures. Structural MRI measurements can detect and follow the evolution of brain atrophy which is a marker of the disease progression; therefore, it allows diagnosis and prediction of AD.&nbsp; The research’s main target is the early recognition of Alzheimer’s disease automatically, which will thereby avoid deterioration of the case resulting in complete brain damage stage.&nbsp; Alzheimer’s disease yields visible changes in the brain structures. The aim is to recognize if the patient belongs to Alzheimer’s disease category or a normal healthy person at an early stage. Initially, image pre-processing and features extraction techniques are applied including data reduction using Discrete Cosine Transform (DCT) and Cropping, then traditional classification techniques like Euclidean Distance, Chebyshev Distance, Cosine Distance, City Block Distance, and Black pixel counter, were applied on the resulting vectors for classification. Image pre-processing includes noise reduction, Gray-scale conversion and binary scale conversion were applied for the MRI images. Feature extraction techniques follow including cropping and low spatial frequency components (DCT). This paper aims to automatically recognize and detect Alzheimer’s infected brain using MRI, without the need of clinical expert. This early recognition would be helpful to postpone the disease progression and maintain it at an almost steady stage. It was concluded after collecting a dataset of 50 MRI , 25 for normal MRI and&nbsp; 25 for AD MRI that Chebyshev Distance classifier yielded the highest success rate in the recognition of Alzheimer’s disease with accuracy 94% compared to other classification techniques used where, Euclidean Distance is 91.6%,&nbsp; Cosine Distance is 86.8%, City block Distance is 89.6%, Correlation Distance is 86.4% and Black pixels counter is 90%

Cardiac Tamponade Due to Liver Amebiasis Rupture

Amebiasis is common cases in Asia, Africa, and South Africa. Liver amebiasis has become a serious problem worldwide especially in health and social aspect. The protozoa named Entamoeba histolytica was easily found in area with poor sanitation, low socioeconomic status, and poor nutrition status. The incidence of amebiasis in several hospitals in Indonesia is 5-15% per year. Epidemiological observation showed the comparison of incidence among male and female population and it was approximately 3 : 1 until 22 : 1 with male predominance. The potential age suffered from amebiasis is around 20 - 50 years old. The route of infection spread to oral-fecal and oral-anal-fecal. The most common complication is abscess rupture (5-15.6%). Rupture may be located in pleural cavity, pericardial cavity, lung, bowel, intraperitoneal, and skin. Rupture of liver amebias spread to pleural and pericardial cavity is a rare case and frequently under reported. This case report illustrates a 40-year-old male with cardiac tamponade due to rupture of liver amebiasis. Patient's was admitted with chief complaint of shortness of breath, positive Beck's triad, hepatomegaly, pleural effusion, liver abscess on sonography and swinging of heart on echocardiography. This patient was treated with metronidazole as a drug of choice, and pericardiocentesis for the cardiac tamponade

Tuberculous Peritonitis Presenting Acute Recurrent Pancreatitis

Tuberculosis (TB), one of the oldest diseases known to affect humans, is a major cause of death worldwide. TB is still a major problem in Indonesia. This disease, which is caused by bacteria of the Mycobacterium tuberculosis, usually affects the lungs, although other organs are involved in up to one- third of cases. Approximately 95% cases of TB and 98% death because of TB occur in developing country. Gastrointestinal tuberculosis is uncommon, making up 3.5% of extrapulmonary cases in the United States. This kind of TB may involve gastrointestinal tract, peritoneal, lymph nodes, or solid intraabdominal organs (viscera). A 17 years old male admitted to hospital with TB peritonitis presenting unusual clinical manifestation. At the first admission patients was diagnosed with acute pancreatitis based on elevation of amylase and lipase level up to 285 and 2,046 U/L and after finishing further examination, patients suffered from tuberculous peritonitis which based on literature manifested some gastrointestinal disorders. Diagnostic confirmation was accomplished by conducting serum-ascites albumin gradient (SAAG) of &lt; 1.1 g/dL, peritoneal thickening and the presence of ascites with fine mobile septations on ultrasound, positive polymerase chain reaction (PCR) TB from ascitic fluid. Patients received conventional antitubercular therapy for 12 months of rifampicin, isoniazid, pyrazinamide, and ethambutol. The addition of corticosteroids for the first two or three months of treatment may reduce the incidence of late complications arising from adhesive disease, such as small bowel obstruction

Transition metal-nitrogen-carbon catalysts for oxygen reduction reaction in neutral electrolyte

© 2016 The Authors Platinum group metal-free (PGM-free) catalysts based on M-N-C types of materials with M as Mn, Fe, Co and Ni and aminoantipyrine (AAPyr) as N-C precursors were synthesized using sacrificial support method. Catalysts kinetics of oxygen reduction reaction (ORR) was studied using rotating ring disk electrode (RRDE) in neutral pH. Results showed that performances were distributed among the catalysts as: Fe-AAPyr>Co-AAPyr>Mn-AAPyr>Ni-AAPyr. Fe-AAPyr had the highest onset potential and half-wave potential. All the materials showed similar limiting current. Fe-AAPyr had an electron transfer involving 4e− with peroxide formed lower than 5%. Considering H2O2 produced, it seems that Co-AAPyr, Mn-AAPyr and Ni-AAPyr follow a 2×2e− mechanism with peroxide formed during the intermediate step. Durability test was done on Fe-AAPyr for 10,000cycles. Decrease of activity was observed only after 10,000cycles

Bifunctional non-noble metal oxide nanoparticle electrocatalysts through lithium-induced conversion for overall water splitting

Developing earth-abundant, active and stable electrocatalysts which operate in the same electrolyte for water splitting, including oxygen evolution reaction and hydrogen evolution reaction, is important for many renewable energy conversion processes. Here we demonstrate the improvement of catalytic activity when transition metal oxide (iron, cobalt, nickel oxides and their mixed oxides) nanoparticles (~20&#8201;nm) are electrochemically transformed into ultra-small diameter (2&#8211;5&#8201;nm) nanoparticles through lithium-induced conversion reactions. Different from most traditional chemical syntheses, this method maintains excellent electrical interconnection among nanoparticles and results in large surface areas and many catalytically active sites. We demonstrate that lithium-induced ultra-small NiFeOx nanoparticles are active bifunctional catalysts exhibiting high activity and stability for overall water splitting in base. We achieve 10&#8201;mA&#8201;cm&#8722;2 water-splitting current at only 1.51&#8201;V for over 200&#8201;h without degradation in a two-electrode configuration and 1&#8201;M KOH, better than the combination of iridium and platinum as benchmark catalysts.open10