Meminimalkan Rugi-rugi pada Sistem Distribusi Tegangan Menengah dengan Pemasangan Kapasitor

Sistem distribusi merupakan bagian dari sistem tenaga listrik yang berguna untuk menyalurkan tenaga listrik dari sumber daya yang besar agar sampai ke konsumen. Sebelum tenaga listrik sampai ke konsumen terdapat rugi-rugi daya, susut energi dan drop tegangan pada saluran. Agar rugi-rugi daya, susut energi dan drop tegangan dapat dikurangi salah satunya dengan pemasangan kapasitor pada sistem distribusi. Dengan menggunakan teknik analisa aliran daya radial maka profil tegangan dan rugi-rugi daya dapat diketahui dan dengan menggunakan faktor sensitifitas rugi-rugi maka dapat diketahui dimana letak kapasitor akan dipasang dengan kapasitas dari kapasitor telah ditentukan besarnya

Surfactants, nanomedicines and nanocarriers: a critical evaluation on clinical trials

Advances, perspectives and innovation in drug delivery have increased in recent years; however, there is limited information available regarding the actual presence of surfactants, nanomed-icines and nanocarriers in investigational medicinal products submitted as part of a request for authorization of clinical trials, particularly for those authorized in the European Economic Area. We retrieve, analyze and report data available at the Clinical Trial Office of the Italian Medicines Agency (AIFA), increasing the transparency and availability of relevant information. An analysis of quality documentation submitted along with clinical trials authorized by the AIFA in 2018 was carried out, focusing on the key terms “surfactant”, “nanomedicine” and “nanocarrier”. Results suggest potential indications and inputs for further reflection and actions for regulators to actively and safely drive innovation from a regulatory perspective and to transpose upcoming evolution of clinical trials within a strong regulatory framework

Clinical Evidence: a useful tool for promoting evidence-based practice?

Background: Research has shown that many healthcare professionals have problems with guidelines as they would prefer to be given all relevent information relevent to decision-making rather than being told what they should do. This study assesses doctors' judgement of the validity, relevance, clarity and usability of the Italian translation of Clinical Evidence (CE) after its free distribution launched by the Italian Ministry of Health. Methods: Opinions elicited using a standardised questionnaire delivered either by mail or during educational or professional meetings. Results: Twenty percent (n = 1350) doctors participated the study. Most of them found CE's content valid, useful and relevant for their clinical practice, and said CE can foster communications among clinicians, particularly among GPs and specialists. Hospital doctors (63%) more often than GPs (48%) read the detailed presentation of individual chapters. Twenty-nine percent said CE brought changes in their clinical practice. Doctors appreciated CE's nature of an evidence-based information compendium and would have not preferred a collection of practice guidelines. Conclusions: Overall, the pilot initiative launched by the Italian Ministry of Health seems to have been well received and to support the subsequent decision to make the Italian edition of Clinical Evidence concise available to all doctors practising in the country. Local implementation initiatives should be warranted to favour doctor's use of CE

Laryngectomized patients caregivers' life experience: A phenomenological study

Background: Laryngectomized patients often depend on their caregivers who have a central and difficult role in supporting them dealing with financial, social, and relational issues. In fact, they feel very responsible and committed, especially considering the time devoted to take care of their beloved. Besides, providing care induces caregivers high stress levels, emotional distress, anxiety and the fear of cancer recurrence or progress. Few studies investigated laryngectomized patients caregivers\u2019 life experience during both the whole course of illness and at the end of the treatment. Therefore, the purpose of our study was to explore, through a phenomenological approach, the lived-experience of primary family caregivers of laryngectomized patients undergoing radical surgery. Methods: Qualitative semi-structured and audiotaped interviews were held with 12 laryngectomized patients\u2019 primary family caregivers. Data were analysed using the descriptive phenomenological approach outlined by Colaizzi. Results: Three key themes emerged: the caregivers lived experience of illness; the change of caregivers\u2019 daily life and how they support their sick beloved. The experience of caregivers\u2019 lived relations changes from being a family member to a supportive carer, and the illness of their beloved negatively affects their psychological lived experience. Their perception of time and Quality of Life change as their perception of the future becomes uncertain. Finally, they feel guilty mainly because of the limited amount of time they can devote to their beloved. Conclusions: The study findings allowed to understand in depth how the presence of a laryngectomized person in the family may affect the life of the caregiver, even after the treatment phase. This suggests the need for healthcare professionals to support caregivers throughout the whole care journey and especially in dealing with the perception of time during the diagnosis and care phases. Further research should be conducted on factors contributing to time perception alteration and possible interventions to support caregivers to cope with it

Rare and Insidious Toxicities from New Combination Therapies in Metastatic Renal Cell Cancer: Lessons Learned from Real-Practice

The advent of immune checkpoint inhibitors in combination with multitarget tyrosine kinase inhibitors has become a standard first-line treatment for metastatic renal cell cancer. Along with survival improvement, new toxicities have emerged. Such adverse events are still complex to be managed and some of them are rare and could be insidious or even fatal. Medical oncologists dispose of guidelines about the management of toxicities from immune checkpoint inhibitors but not for combinations. Therefore, it is still difficult to properly attribute and manage additive or overlapping adverse events. We report two clinical cases regarding rare treatment-related endocrine toxicities—hypophysitis and thyroiditis—with particular focus on their management. To this purpose, immune checkpoint-related toxicities guidelines represent the starting point. However, their implementation with additional measures is needed, considering the increasing complexity of current clinical scenarios. The goal is to correctly recognize adverse events and address side effects, so as not to discontinue effective treatments. We, therefore, aim at discussing the points of proper management of toxicities and individuating potential areas of improvement

Using Clinical Evidence in a national continuing medical education program in Italy.

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Massively parallel computing on an organic molecular layer

Current computers operate at enormous speeds of ~10^13 bits/s, but their principle of sequential logic operation has remained unchanged since the 1950s. Though our brain is much slower on a per-neuron base (~10^3 firings/s), it is capable of remarkable decision-making based on the collective operations of millions of neurons at a time in ever-evolving neural circuitry. Here we use molecular switches to build an assembly where each molecule communicates-like neurons-with many neighbors simultaneously. The assembly's ability to reconfigure itself spontaneously for a new problem allows us to realize conventional computing constructs like logic gates and Voronoi decompositions, as well as to reproduce two natural phenomena: heat diffusion and the mutation of normal cells to cancer cells. This is a shift from the current static computing paradigm of serial bit-processing to a regime in which a large number of bits are processed in parallel in dynamically changing hardware.Comment: 25 pages, 6 figure

CO on supported Cu nanoclusters: Coverage and finite size contributions to the formation of carbide via the boudouard process

The interaction of carbon monoxide with an ordered array of copper nanoclusters was investigated under ultrahigh vacuum conditions by means of in situ X-ray photoelectron spectroscopy in combination with density functional theory calculations. The Cu clusters were supported on an alumina template grown on the Ni3Al(111) termination. Adsorption and dissociation of carbon monoxide occur at the copper clusters, yielding accumulation of carbidic carbon at the metal particles through the Boudouard process. The involved mechanisms are investigated at the atomic level, unveiling the effects of cluster finite size, reconstruction, support, and of local CO coverage. It is found that the high coverage of CO at the cluster surface, which considerably exceeds that achievable on single crystal surfaces, facilitates the metal restructuring and the reaction, yielding carbon incorporation into the bulk of the particles

Executive function scale for parents of adolescents: construction, assessment and validation

En el presente trabajo se expone el proceso de construcción, validación y baremación de la Escala de Funciones Ejecutivas para padres de adolescentes, realizado en la Ciudad de Resistencia, Chaco, Argentina. El objetivo fue evaluar el funcionamiento ejecutivo de adolescentes con edades comprendidas entre los 12 y 17 años, desde la perspectiva parental; a tal fin se optó por un diseño no experimental, transversal, de alcance exploratorio. Los resultados indicaron una correlación elevada y estabilidad en las respuestas, por lo tanto este instrumento posee indicios de fiabilidad estadística. La escala final quedó conformada por 28 ítems y 4 sub-escalas, a saber: Fluidez Verbal (FV); Memoria de Trabajo (MT)/Planificación (Pl); Inhibición (I), y Razonamiento (R). Los baremos no reportaron diferencias significativas en función de la edad y el género del grupo etario, lo cual se adjudica a características del tipo de población. Se discute la importancia que posee la creación y adaptación de instrumentos psicométricos, para el progreso de la ciencia y el entendimiento en materia de desarrollo humano; además se alienta a la confección de baremos regionalizados. Finalmente, se concluye que el presente estudio realiza grandes aportes en el área de instrumentos psicométricos que permite disponer de otra herramienta fidedigna para la recolección de datos y arribar así a una primera aproximación del funcionamiento ejecutivo adolescente.O presente trabalho expõe o processo de construção, validação e dimensionamento da Escala de Funções Executivas para pais de adolescentes de 12 a 17 anos, realizado na cidade de Resistencia, Chaco, Argentina. O objetivo desse estudo foi avaliar o funcionamento executivo de adolescentes entre 12 e 17 anos, na perspectiva dos pais. Para isso foi escolhido um delineamento transversal não-experimental, exploratório. Os resultados indicaram alta correlação e estabilidade nas respostas, portanto, esse instrumento apresenta indicações de confiabilidade estatística. A escala final foi composta por 28 itens e com 4 subescalas que são Fluência Verbal (FV); Memória de Trabalho (MT) / Planejamento (Pl); Inibição (I) e Raciocínio (R). As escalas não relataram diferenças significativas na idade e no sexo o que se atribuemas características do tipo de população. Discute-se, ainda, a importância da criação e da adaptação de instrumentos psicométricos para o progresso da ciência e da compreensão no desenvolvimento humano. Além disso, a preparação de escalas regionalizadas é incentivada. Por fim, conclui-se que esse estudo traz grandes contribuições na área de instrumentos psicométricos, o que nos permite ter outras ferramentas confiáveis para a coleta de dados e, assim, chegar a uma primeira aproximação do funcionamento executivo do adolescente.Dans ce travail, le processus de construction, de validation et de mise à l'échelle de l'échelle des fonctions exécutives pour les parents d'adolescents de 12 à 17 ans, mené dans la ville de Resistencia-Chaco, est exposé. L'objectif était d'évaluer le fonctionnement exécutif des adolescents âgés de 12 à 17 ans, du point de vue parental; À cette fin, un plan transversal non expérimental avec une portée exploratoire a été choisi. Les résultats ont indiqué une corrélation et une stabilité élevées dans les réponses, donc cet instrument a des indications de fiabilité statistique. L'échelle finale était composée de 28 éléments et 4 sous-échelles, à savoir: la fluidité verbale (VF); Mémoire de travail (MT) / Planification (Pl); Inhibition (I) et raisonnement (R). Les échelles n'ont pas signalé de différences significatives selon l'âge et le sexe du groupe d'âge, ce qui est attribué aux caractéristiques du type de population. L'importance de la création et de l'adaptation d'instruments psychométriques pour le progrès de la science et de la compréhension du développement humain est discutée. De plus, la préparation d'échelles régionalisées est encouragée. Enfin, nous concluons que la présente étude apporte des contributions dans le domaine des instruments psychométriques qui permettent d'avoir un autre outil de collecte de données et ainsi d'arriver à une première approximation du fonctionnement exécutif des adolescents.In this work we present the process of construction, validation and scaling of the Executive Functions Scale for parents of adolescents from 12 to 17 years old, carried out in the City of Resistencia-Province of Chaco. The objective was to evaluate the executive functioning of adolescents between 12 and 17 years old, from the parental perspective. To this end, a non-experimental transversal design with an exploratory scope was chosen. The results indicated a high correlation and stability in the responses; therefore this scale had adequate reliability. The final scale was made up of 28 items and 4 subscales, namely: Verbal Fluidity (VF); Working Memory (WM) / Planning (Pl); Inhibition (I), and Reasoning (R). The scales did not report significant differences based on age and gender of the age group, which is attributed to characteristics of the type of population. The importance of the creation and adaptation of psychometric instruments for the progress of science and understanding in matters of human development is discussed. Also, regionalized scales are encouraged. Finally, it is concluded that the present study makes great contributions in the area of psychometric instruments that allows us to have another reliable tool for data collection and thus arrive at the first approximation of adolescent executive functioning.Fil: Muchiut, Álvaro Federico. Instituto Superior de Neuropsicología; ArgentinaFil: Dri, Constanza A.. Instituto Superior de Neuropsicología; ArgentinaFil: Vaccaro, Paola. Instituto Superior de Neuropsicología; ArgentinaFil: Pietto, Marcos Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentin