RANCANG BANGUN SISTEM INFORMASI RAWAT INAP

Pada era irformasi sekarang suatu rumah sakit dalam pelayanan rawat inap hendaknya memerlukan kemampuan dan keterampilan mengolah data menjadi suatu informasi siap pakai. Untuk mempermudah pembuatan sistem irformasi rawat inap, dibutuhkan sistem yang terstruktur dan terintegrasi, maka manajemen rumah sakit mengembangkan database menggunakan Data Flow Diagram (DFD) dan Entity Relationship Diagram (ERD). Makalah ini akan membahas mengenai proses pembuatan DFD dan ERD dari sistem informasi rawat inap berdasarkan aturan-aturan yang ada

Vortex-type elastic structured media and dynamic shielding

The paper addresses a novel model of metamaterial structure. A system of spinners has been embedded into a two-dimensional periodic lattice system. The equations of motion of spinners are used to derive the expression for the chiral term in the equations describing the dynamics of the lattice. Dispersion of elastic waves is shown to possess innovative filtering and polarization properties induced by the vortextype nature of the structured media. The related homogenised effective behavior is obtained analytically and it has been implemented to build a shielding cloak around an obstacle. Analytical work is accompanied by numerical illustrations.Comment: 24 pages, 13 figure

BDDC and FETI-DP under Minimalist Assumptions

The FETI-DP, BDDC and P-FETI-DP preconditioners are derived in a particulary simple abstract form. It is shown that their properties can be obtained from only on a very small set of algebraic assumptions. The presentation is purely algebraic and it does not use any particular definition of method components, such as substructures and coarse degrees of freedom. It is then shown that P-FETI-DP and BDDC are in fact the same. The FETI-DP and the BDDC preconditioned operators are of the same algebraic form, and the standard condition number bound carries over to arbitrary abstract operators of this form. The equality of eigenvalues of BDDC and FETI-DP also holds in the minimalist abstract setting. The abstract framework is explained on a standard substructuring example.Comment: 11 pages, 1 figure, also available at http://www-math.cudenver.edu/ccm/reports

Mesh update techniques for free-surface flow solvers using spectral element method

This paper presents a novel mesh-update technique for unsteady free-surface Newtonian flows using spectral element method and relying on the arbitrary Lagrangian--Eulerian kinematic description for moving the grid. Selected results showing compatibility of this mesh-update technique with spectral element method are given

Small Bowel Tumors: Clinical Presentation, Prognosis, and Outcome in 33 Patients in a Tertiary Care Center

Introduction. Small bowel cancers are rare. Accumulation of data regarding their clinical presentation, pathologic features, prognostic factors, treatment modalities, and outcome is difficult. Methods. This is a retrospective study of the medical records of 33 patients with small bowel cancers treated at the American University of Beirut-Medical Center over a 20-year period. Results. The study included 25 males (76%) and 8 females (24%). Median age at presentation was 56 years. Most common symptoms were abdominal pain (66.7%) and weight loss (57.6%). Thirteen patients presented with abdominal emergencies (39.3%). Lymphoma was the most common malignant tumor (36.4%), followed by adenocarcinoma (33.3%), leiomyosarcoma (15.2%), gastrointestinal stromal tumors (12.1%), and neuroendocrine tumors (3.0%). Tumors were located in the duodenum in 30% of patients, jejunum in 33%, and ileum in 36%. Resectability rate was 72.7% and curative R0 resection was achieved in 54.1% (13/24) of patients. 5-year survival of the 33 patients was 24.2%. Conclusion. Small bowel cancers are difficult to diagnose because of the nonspecific symptoms. Most patients present with advanced disease and have poor prognosis. Adenocarcinoma and duodenal location have the worst 5-year survival in contrast to stromal tumors and those with ileal location which have the best survival

An investigation into the use of CALNN capped gold nanoparticles for improving microwave heating

The use of microwaves for both therapeutic and diagnostic applications has become an accepted alternative in the clinics. For diagnostics, gold (Au) nanoparticles have been used for imaging tumour vasculature and also served as potential diagnostic markers for cancer. [1] In high-frequency therapeutic applications, two different treatments exist; hyperthermia and ablation. [2] In hyperthermia, the tumour tissue is heated to supra-physiological temperatures, making it more susceptible to traditional treatment methods such as chemotherapy and radiotherapy. This type of treatment could be administered externally. However, there still remains a challenge to focus the heating to particular areas which need to be treated, while avoiding unwanted hotspots. To date, numerous methods have been used to focus the heat from different antennas. A novel technique which is being investigated is the use of nanoparticles to improve focusing and thus achieve better localised heating effect. A previous study by Cardinal et al. [3] showed that at RF-frequencies, remarkable improvements resulted from using Au nanoparticles. In this work, the use of CALNN peptide capped Au nanoparticles for the focusing of microwaves at 2.45 GHz is investigated. The CALNN capped Au nanoparticles were prepared as described elsewhere. [4] Au nanoparticles were added to tissue mimicking solutions (such as muscle, liver or fat) to compare their dielectric properties with the those of the control (without Au nanoparticles). The frequency range investigated was from 400 MHz to 20 GHz. During this study, various concentrations, particle sizes and shapes of Au nanoparticles were considered. The study also investigated the heating rates of the pseudo-biological tissue samples and how these varied with the addition of the nanoparticles. The outcome of this study will determine the viability of using CALNN capped Au nanoparticles to assist in the focusing of microwave radiation during microwave hyperthermia

The prevalence of silent kidney stones: An ultrasonographic screening study

Objective: Silent and not yet discovered stones of the upper urinary tract are potentially dangerous, since in due course they may cause infection, obstruction and renal damage. The aim of this study was to determine the prevalence of such silent kidney stones in a representative Pakistani population of Karachi. Subjects and Methods: We studied 201 consecutive subjects at our hospital who underwent additional kidney screening whilst undergoing abdominal ultrasound. All these subjects did not have a history or symptoms of urolithiasis. Results: We found silent kidney stones in 3% of subjects. All stone bearers were males. Most stones were in the left kidney. Notably, multiple stones and stones of a considerable size went unnoticed. Conclusion: In addition to the usual figures of incidence and prevalence of stone disease drawn from patient data, there is a prevalence of 3% silent stones that may only be discovered incidentally or by screening. This is true for a “stone country” like Pakistan. Figures for other regions have yet to be determined. Due to socioeconomic reasons, we believe that a general kidney screening for urolithiasis is, however, not indicated, at least in our countr

Cerebral Vasospasm with Ischemia following a Spontaneous Spinal Subarachnoid Hemorrhage

Cerebral vasospasm is a well-known consequence of aneurysmal subarachnoid hemorrhage (SAH) triggered by blood breakdown products. Here, we present the first case of cerebral vasospasm with ischemia following a spontaneous spinal SAH. A 67-year-old woman, who was on Coumadin for atrial fibrillation, presented with chest pain radiating to the back accompanied by headache and leg paresthesias. The international normalized ratio (INR) was 4.5. Ten hours after presentation, she developed loss of movement in both legs and lack of sensation below the umbilicus. Spine MRI showed intradural hemorrhage. Her coagulopathy was reversed, and she underwent T2 to T12 laminectomies. A large subarachnoid hematoma was evacuated. Given her complaint of headache preoperatively and the intraoperative finding of spinal SAH, a head CT was done postoperatively that displayed SAH in peripheral sulci. On postoperative day 5, she became obtunded. Brain MRI demonstrated focal restricted diffusion in the left frontoparietal area. Formal angiography revealed vasospasm in anterior cerebral arteries bilaterally and right middle cerebral artery. Vasospasm was treated, and she returned to baseline within 48 hours. Spontaneous spinal SAH can result in the same sequelae typically associated with aneurysmal SAH, and the clinician must have a degree of suspicion in such patients. The pathophysiological mechanisms underlying cerebral vasospasm may explain this unique case

Diet, Genetics, and Disease: A Focus on the Middle East and North Africa Region

The Middle East and North Africa (MENA) region suffers a drastic change from a traditional diet to an industrialized diet. This has led to an unparalleled increase in the prevalence of chronic diseases. This review discusses the role of nutritional genomics, or the dietary signature, in these dietary and disease changes in the MENA. The diet-genetics-disease relation is discussed in detail. Selected disease categories in the MENA are discussed starting with a review of their epidemiology in the different MENA countries, followed by an examination of the known genetic factors that have been reported in the disease discussed, whether inside or outside the MENA. Several diet-genetics-disease relationships in the MENA may be contributing to the increased prevalence of civilization disorders of metabolism and micronutrient deficiencies. Future research in the field of nutritional genomics in the MENA is needed to better define these relationships

Compton double-to-single ionization ratio of helium at 57 keV

We have measured the Compton double-to-single ionization ratio of helium using an ion time-of-flight spectrometer along with monochromatized synchrotron radiation of 57 keV. This photon energy is high and probes the Compton ionization alone, since the photoionization makes only a negligible contribution to the total cross section. Comparing our result, which is (1.25±0.3)%, with theoretical calculations and measurements at lower energies shows that this energy is most likely still not high enough to confirm the value of the asymptotic high-energy limit experimentally