Pengaruh Kualitas Pelayanan dan Kualitas Produk Kredit Multiguna terhadap Kepuasan Nasabah Kredit pada PT. Bpr Hoki Cabang Denpasar

The purpose of this study was to determine the effect of quality of service and product quality multipurpose loans to credit customer satisfaction at PT. BPR Hoki Region Denpasar. This study used a qualitative research using surveys and questionnaires to 85 respondents customers multipurpose loans PT. BPR Hoki Region Denpasar. The sampling technique uses accidental sampling. Data analysis techniques used in this research is multiple linear regression. It was found that the quality of service and quality of products simultaneously affect the customer satisfaction at PT. BPR Hoki Denpasar. Second, the quality of service and significant positive effect on customer satisfaction at PT BPR Hoki Denpasar. Finally, quality products and a significant positive effect on customer satisfaction at PT BPR Hockey Denpasar

Effect of Work Environment, Quality of System and Work Culture on Satisfaction of Accounting Information System User

The purpose of this study to explain the empirical evidence of the influence of the work environment, the quality of IT systems and work culture on the satisfaction of users of accounting information systems at PT XYZ. Sampling in this study uses nonprobability sampling methods that use criteria that employees who are sampled are employees using IT systems in his work with saturated sampling techniques, data was collected using a survey method with questionnaire techniques with respondents were employees at PT XYZ by analyzing the data using multiple linear regression. 216 questionnaires were distributed but only 124 questionnaires could be processed. The research results show that the work environment influences the satisfaction of cash system users, IT system quality influences the satisfaction of cash system users and work culture influences the satisfaction of cash system users. The results of hypothesis testing provide a synthesis that the better the work environment, the quality of IT systems and work culture, then the satisfaction of cash system users produced by employees at PT XYZ will be better too

Analisis Pengaruh Temperatur Dan Perlakuan Korosi Terhadap Ketahanan Putus Tabung Silinder Asetilin Bermaterial Drum Besi Bekas (Baja AISI 1045)

corrosion rate of cylinder tube materials. The temperature variations determined by the specimen were 200ºC, 250ºC and 300ºC. The specimens were subjected to corrosion treatment with Calcium Carbide (Carbide) corrosion media, then tested. The results showed that the lowest corrosion rate was the treatment specimen, namely 48.57142 mg/cm2 day, while the specimen with the highest rate was the specimen with the provisions of 70.47619 mg/cm2 day. For the tensile test, the highest value of fracture tensile stress (σp) was the untreated specimen of 243.35 MPa, while the lowest value of fracture stress (σp) was the specimen with a temperature of 300oC of 156,786 Mpa, the highest value of fracture tensile strain (ɛp) was the specimen with 300oC of 0.166875%, while the lowest value of fracture tensile strain (ɛp) is the specimen with the provision of 250 °C of 0.12025%, the highest modulus of elasticity is the specimen with the 200oC requirement of 1569.2026 MPa, while the lowest modulus of elasticity is the specimen with 300 °C of 939.5415 MPaPeneletian ini bertujuan menganalisis pengaruh variasi temperatur dan pemberian perlakuan korosi terhadap kekuatan tarik dan laju korosi material tabung silinder asetilin. Variasi temperatur pemanasan spesimen yaitu 200ºC, 250ºC, dan 300ºC. Spesimen diberikan perlakuan korosi dengan media korosi Kalsium Karbida (Karbid), setelah itu dilakukan pengujian tarik. Hasil penelitian menunjukan bahwa spesimen dengan laju korosi terendah adalah spesimen tanpa perlakuan yaitu 48,57142  mg/cm2hari, sedangkan spesimen dengan laju korosi tertinggi adalah spesimen dengan pemanasan 300oC yaitu 70,47619  mg/cm2hari. Untuk pengujian tarik, nilai tegangan tarik patah (σp) tertinggi yaitu spesimen tanpa perlakuan sebesar 243,35 MPa, sedangkan nilai tegangan tarik patah (σp) terendah yaitu spesimen dengan pemanasan pada temperatur 300oC sebesar 156,786 Mpa, nilai regangan tarik patah (ɛp) tertinggi yaitu spesimen dengan pemanasan 300oC sebesar 0,166875 %, sedangkan nilai regangan tarik patah (ɛp) terendah yaitu spesimen dengan pemanasan 250°C sebesar 0,12025 %, nilai modulus elastisitas tertinggi yaitu spesimen dengan pemanasan 200oC sebesar 1569,2026 MPa, sedangkan nilai modulus elastisitas terendah yaitu spesimen dengan pemanasan 300°C sebesar 939,5415 MP

Strategi Pengembangan Rekam Medis Elektronik di Instalasi Rawat Jalan RSUD Gambiran Kota Kediri

Pelayanan kesehatan di Indonesia dihadapkan pada era disrupsi. Kementerian Kesehatan Indonesia dalam upaya menghadapi era disrupsi pada program pembinaan pelayanan kesehatan rujukan diantaranya dengan mentargetkan pada tahun 2024 seluruh rumah sakit di Indonesia telah menerapkan rekam medis elektronik (RME) terintegrasi serta pengembangan pertukaran resume medis online antar rumah sakit. RME merupakan bagian dari aplikasi sistem informasi manajemen rumah sakit (SIMRS) yang terus dikembangkan. RSUD Gambiran telah menggunakan SIMRS untuk RME, namun penggunaannya belum optimal. Tujuan kegiatan pengabdian masyarakat ini adalah menganalisa strategi pengembangan SIMRS untuk RME di instalasi rawat jalan RSUD Gambiran Kota Kediri. Kegiatan dilakukan melalui wawancara mendalam dan observasi langsung, kemudian melakukan analisa fishbone untuk menentukan faktor-faktor penyebab masalah, menentukan prioritas penyelesaian masalah dengan analisa USG (urgency, seriousness, growth) dilanjutkan penyusunan strategi dengan analisa SWOT (strength, weakness, opportunity, threats). Faktor sumber daya manusia dan organisasi menjadi faktor utama yang mendukung keberhasilan penerimaan teknologi di rumah sakit. Manfaat dari kegiatan ini adalah dapat mengidentifikasi strategi pengembangan SIMRS untuk RME di instalasi rawat jalan RSUD Gambiran Kota Kediri. Penyusunan regulasi tatacara dan alur penggunaan SIMRS untuk RME merupakan strategi yang dapat diterapkan pada kegiatan pengabdian masyarakat saat ini

Spatial Proximity and Relative Distribution of Tumor-Infiltrating Lymphocytes and Macrophages Predict Survival in Melanoma

Tumor microenvironment plays a crucial role in primary cutaneous melanoma (CM) progression. Although the role of tumor-infiltrating lymphocyte (TIL) density has been known for a long time, its spatial distribution and impact with or without tumor-associated macrophages (TAMs) remain controversial. Herein, we investigated spatial proximity between tumor cells and immune cells in 113 primary CM and its correlation with disease-free (DFS) and overall survival (OS). The study cohort included clinical stage II (n 1⁄4 79) and stage III (n 1⁄4 34) primary CM with a Breslow thickness of >2 mm (with a median age of 64 years, including 72 men and 41 women). In univariate models, patients with SOX10þ melanoma cells with high proximity to CD8þ TILs in a 20 mm radius showed longer DFS (hazard ratio [HR], 0.58; 95% CI, 0.36e0.93; P 1⁄4 .025) and OS (HR, 0.55; 95% CI, 0.32e0.92; P 1⁄4 .023). Furthermore, at multivariate combined analysis, patients with SOX10þ melanoma cells with high proximity to CD8þ TILs or low proximity to CD163þ TAMs in a 20 mm radius showed an increased OS (aHR, 0.37; 95% CI, 0.14e0.96; P 1⁄4 .04) compared with melanoma patients with low proximity to CD8þ TILs or high proximity to CD163þ TAMs. In a subgroup analysis including 92 patients, a significant negative impact on DFS (aHR, 4.49; 95% CI, 1.73e11.64; P 1⁄4 .002) and OS (aHR, 3.97; 95% CI, 1.37e11.49; P 1⁄4 .01) was observed in sentinel lymph node (SLN)-negative patients with a high proximity of CD163þ TAMs to CD8þ TILs. These findings could help identify high-risk patients in the context of thick melanoma and a negative SLN. Our study suggests the importance of quantifying not only the density of immune cells but also the individual and combined relative spatial distributions of tumor cells and immune cells for clinical outcomes in SLN-negative primary CM patients

Nicotinamide Phosphoribosyltransferase (NAMPT) as a Therapeutic Target in BRAF-Mutated Metastatic Melanoma

Background: One of the effects of oncogenic signaling is metabolic reprogramming of tumor cells to support anabolic growth, opening the way to therapeutic targeting of metabolic pathways. Methods: We studied NAD biosynthesis in BRAF inhibitor (BRAFi)-resistant (BiR) melanoma cell lines. Data in cell lines were confirmed by immunohistochemistry in biopsies from 17 patients with metastatic melanoma (MM) before and after the acquisition of resistance to BRAFi. Therapeutic potential of NAD biosynthesis inhibitors was determined by in vitro monitoring cell growth and death and in mouse xenograft models. Mice (n=6-10 mice/group) were treated with nicotinamide phosphoribosyltranferase inhibitor (NAMPTi), BRAFi, or their combination, and tumor growth and survival were analyzed. All statistical tests were two-sided. Results: BiR cells had higher NAD levels compared with their BRAFi-sensitive counterparts (P < .001 and P = .001 for M14 and A375, respectively) and with normal melanocytes (P<.001), achieved through transcriptional upregulation of the enzyme NAMPT, which became the master regulator of NAD synthesis. Conversely, treatment with BRAFi or MEK inhibitors decreased NAMPT expression and cellular NAD levels. Robust NAMPT upregulation was documented in tissue biopsies from MM patients after development of resistance to BRAFi (P < .001). Treatment of melanoma cells with NAMPTi depleted NAD and ATP, depolarized mitochondrial membrane, and led to reactive oxygen species production, blocking cells in the G2/M phase and inducing apoptosis. Treatment of BiR xenografts with NAMPTi improved mouse survival (median survival of vehicletreated mice was 52 days vs 100 days for NAMPTi-treated ones in M14/BiR, while in A375/BiR median survival of vehicletreated mice was 23.5 days vs 43 days for NAMPTi-treated ones, P < .001). Conclusions: BiR melanoma cells overexpress NAMPT, which acts as a connecting element between BRAF oncogenic signaling and metabolism, becoming an actionable target for this subset of MM patients

Tumor-Infiltrating Lymphocyte Recognition in Primary Melanoma by Deep Learning Convolutional Neural Network

The presence of tumor-infiltrating lymphocytes (TILs) is associated with a favorable prognosis of pri-mary melanoma (PM). Recently, artificial intelligence (AI)-based approach in digital pathology was proposed for the standardized assessment of TILs on hematoxylin and eosin-stained whole slide images (WSIs). Herein, the study applied a new convolution neural network (CNN) analysis of PM WSIs to automatically assess the infiltration of TILs and extract a TIL score. A CNN was trained and validated in a retrospective cohort of 307 PMs including a training set (237 WSIs, 57,758 patches) and an inde-pendent testing set (70 WSIs, 29,533 patches). An AI-based TIL density index (AI-TIL) was identified after the classification of tumor patches by the presence or absence of TILs. The proposed CNN showed high performance in recognizing TILs in PM WSIs, showing 100% specificity and sensitivity on the testing set. The AI-based TIL index correlated with conventional TIL evaluation and clinical outcome. The AI-TIL index was an independent prognostic marker associated directly with a favorable prognosis. A fully automated and standardized AI-TIL appeared to be superior to conventional methods at differentiating the PM clinical outcome. Further studies are required to develop an easy-to-use tool to assist pathologists to assess TILs in the clinical evaluation of solid tumors. (Am J Pathol 2023, 193: 2099-2110; https://doi.org/10.1016/j.ajpath.2023.08.013