Are We Optimizing the Use of Dual Antiplatelet Therapy in Patients Hospitalized with Acute Myocardial Infarction?

Background: Dual antiplatelet therapy (DAPT) is a mainstay treatment for hospital survivors of an acute myocardial infarction (AMI). However, there are extremely limited data on the prescribing patterns of DAPT among patients hospitalized with AMI. Objective: To examine decade-long trends (2001-2011) in the use of DAPT versus antiplatelet monotherapy and patient characteristics associated with DAPT use. Methods: The study population consisted of 2,389 adults hospitalized with an initial AMI at all 11 central Massachusetts medical centers on a biennial basis between 2001 and 2011. DAPT was defined as the discharge use of aspirin plus either clopidogrel or prasugrel. Logistic regression analysis was used to identify patient characteristics associated with DAPT use. Results: The average age of the study population was 65 years, and 69% of them were discharged on DAPT. The use of DAPT at the time of hospital discharge increased from 49% in 2001 to 74% in 2011; this increasing trend was seen across all age groups, both sexes, types of AMI, and in those who underwent a PCI. After multivariable adjustment, older age was the only factor associated with lower odds of receiving DAPT, while being male, receiving additional evidence-based cardioprotective therapy and undergoing cardiac stenting were associated with higher odds of receiving DAPT. Conclusions: Between 2001 and 2011, the use of DAPT increased markedly among patients hospitalized with AMI. However, a significant proportion of patients were not discharged on this therapy. Greater awareness is needed to incorporate DAPT into the management of patients with AMI

Foreign Investment and Firm’s Performance of Sharia Compliance: A Comparative Study of Indonesia and Malaysia

Foreign investment can enhance the global business because it exposes the firm with new markets and marketing channels, access to new technology, products, skills and financing. Foreign investment is important to investors in developed areas who provide funding and expertise to smaller companies in emerging markets to expand and increase international sales. Hence, this article determines the relationship of foreign investment to the performance. Performance is measured by return on assets (ROA), return on equity (ROE), net profit margin (NPM) and Tobin’s Q. The analyses indicate that there is no significant influence between foreign investments and the performance.     Keywords: foreign investment, performanc

Peningkatan Kompetensi Guru Dalam Kegiatan Belajar Mengajar Melalui Model Pembinaan CLCK Dalam Program Penyusunanan RPP Di Madrasah Tsanawiyah Negeri Kota Madiun Semester I Tahun Pelajaran 2018/2019

Peranan pendidikan dalam pembentukan diri seseorang sebagai sumber daya  manusia  tersebut  sebagai tujuan  umum pendidikan  yang meliputi  aspek kognitif, psikomotor dan afektif. Namun kenyataan yang ada terbalik berdasarkan hasil supervisi oleh penulis selaku kepala sekolah di Madrasah Tsanawiyah Negeri Kota Madiun terhadap guru-guru di sekolah tersebut masih dominan menggunakan pengelolaan pembelajaran berdasarkan pola lama dan masih dominan menggunakan pengelolaan pembelajaran yang tidak sesuai karakteristik siswa dan situasi kelas.  Tujuan penelitian tindakan ini adalah untuk meningkatkan kompetensi guru Madrasah Tsanawiyah Negeri Kota Madiundalam program  menyusun RPP dengan penerapan metode CLCK. Jenis penelitian yang akan digunakan tergolong pada penelitian tindakan (Action Research). Subyek dalam penelitian ini adalah Guru kelas dengan jumlahnya  6 orang dengan teknik observasi dan teknik wawancara. Berdasarkan hasil penelitian dari siklus I hingga siklus II terdapat  dipeningkatan kinerja guru yang signifikan dalam kegiatan belajar mengajar. Penerapan model pembinaan CLCK dalam program penyusunan rencana pelaksanaan pembelajaran dapat meningkatkan Kompetensi Guru di Madrasah Tsanawiyah Negeri Kota Madiun, karena guru memperoleh suatu pengalaman baru dalam  penyelenggaraan program penyusunan rencana pelaksanaan pembelajaran sehingga pelaksanaan kegiatan pembelajaran dapat berlangsung secara efektif dan efisien

Analisa Pengaruh Laju Aliran Partikel Padat Terhadap Sudu-sudu Turbin Reaksi Pada Sistem Pembangkit Listrik Tenaga Uap Menggunakan Cfd

A good quality of steam is essentially needed on power plant system. The main function of this steam is to rotate steam turbine and to couple generator for produce electric. The use of the steam bean is very risky because of the relatively high velocity fluid that comes out of the previous step due to the narrowing of the flow. High velocity may cause huge turbulence which affects the rate of erosion in steam turbine blade. The purpose of this study is to determine the effect of effect of mass flow rate of solid particle of the fluid toward the erosion rate in the blade using CFD. Variations of the mass flow rate of solid particle are 1 kg/s, 1,2 kg/s, 1,4 kg/s, 1,6 kg/s, 1,8 kg/s, and 2 kg/s. Simulation results shows that the increased mass flow rate of solid particle affects to the increasing the erosion rate

Investigating The Anisotropy Of Magnetic Susceptibility And Other Rock Magnetic Properties Of The Beaver River Diabase In Northeastern Minnesota

The Beaver River Diabase (BRD) is a series of mafic dikes and sills within the Beaver Bay Complex (BBC) of northern Minnesota, which formed during the development of the ~1.1 Ga Midcontinent Rift (MCR). The BRD is one of the youngest and most extensive intrusive phases of the BBC. The BRD dikes and sills were emplaced into the medial levels of the 6-10 kilometer-thick North Shore Volcanic Group and occur over an arcuate area extending 120 by 20 kilometers. The BRD is composed of fine- to medium-grained ophitic olivine gabbro and does not display obvious foliation or lineation features and rarely displays modal layering. Without obvious magmatic internal structures, it is difficult to determine emplacement properties such as flow direction using standard geologic mapping or petrographic techniques. For this reason, we measured the anisotropy of magnetic susceptibility (AMS), in conjunction with other rock magnetic properties, to better understand the BRD\u27s emplacement and deformation history in the context of the MCR. AMS measures the directional dependence of low-field magnetic susceptibility, and is used to infer a shape-preferred orientation of magnetic minerals within a rock, which can be related to specific emplacement mechanisms (e.g. directional flow or settling). Preliminary analysis of AMS at 20 sites within the southern half of the BRD (with 4-7 samples per site) shows maximum susceptibility values between 4.48 x 10-6 and 2.22 x 10-4 m3/kg (1165 and 65400 μSI). Most specimens display nearly isotropic AMS ellipsoids (Pj \u3c 1.15) with minor degrees of prolateness and oblateness. However, about 20% of specimens have higher anisotropies (Pj between 1.15 and 1.67) and higher degrees of oblateness and prolateness. Variations in AMS properties may reflect differences in concentration and composition of magnetic minerals, as well as emplacement mechanisms. Measurements of susceptibility as a function of temperature yield Curie points between 470 and 570 °C, indicating the presence of low-titanium titanomagnetite. Major hysteresis loops show coercivities between 1 and 25 mT, consistent with titanomagnetite as the dominant remanence carrier

Population Assessment and Appropriate Spraying Technique to Control the Bagworm (Metisa Plana Walker) in North Sumatra and Lampung

Over the last few years, the bagworm Metisa plana Walker (Lepidoptera: Psychidae) has become an important pest of oil palm, especially in North Sumatra. Recent report suggested that the bagworm has also been found in Lampung. The report requires preliminary survey to assess M. plana status and to prepare an effective control measure for the pest. This study was conducted to determine the relative density of M. plana in North Sumatra and Lampung and to compare the effectiveness of the spraying versus fogging application to control M. plana in oil palm fields. The observation confirmed that in 2010 M. plana colonies have developed in Lampung with an average relatively similar to that in North Sumatra during 2005. The finding implies that monitoring should be taken routinely to anticipate further development of the bagworm population in Lampung. Overall results of carbosulfan treatments suggested that the fogging insecticide technique was potentially as effective as spraying technique. This finding could be beneficial for bagworm control program due to the extensive areas of oil palm and the large size of canopy. A more thorough experiment is required to explore the most economical doses and to select effective insecticides to control M. plana

A Comparison of the Origin of Idioms in Mandarin and Indonesian

In language, idioms can function as stand-alone semantic units because they contain whole concepts. These concepts, formed from human thought, can be explored to discover cultural elements which served as the basis for idiom creation. If the origins of an idiom are known or recognized, that idiom\u27s meaning can be understood more easily. Idioms are frequently used by language communities in their day-to-day lives. However, the origins of idioms in the Indonesian language has almost never been discussed or researched. This article compares the origins of idioms in Mandarin and in Indonesian. It finds that the origins of idioms in Mandarin and in Indonesian are diverse, but in general fit one of two main types: they may be adapted from foreign languages (most importantly in idioms related to religion), or be created within the society and reproduced from generation to generation. Idioms can be traced to either the written tradition or the oral tradition. Idioms in Mandarin generally originate from the written tradition, whereas idioms in Indonesian tend to originate from orality. This study uses the theory of meaning formation first proposed by Ogden and Richards (1911). The comparative method of data analysis is used here, as the origins of idioms in Mandarin and Indonesian are compared

Orthotropic Material and Anisotropic Damage Mechanics Approach for Numerically Seismic Assessment of Arch Dam-Reservoir-Foundation System

In contrast with modeling of the contraction joints, the performance and influence of lift joints are usually neglected in numerical analysis of concrete arch dams. In this paper, the seismic nonlinear response of a concrete arch dam– reservoir–foundation system is investigated with considering the effects of lift joints using orthotropic-based material. An anisotropic damage mechanics approach is introduced and modified to take into account the effects of weak horizontal planes between concrete lifts during the construction phase. This model is capable to consider the pre-softening behavior, the softening initiation criterion and anisotropic cracking behavior in mass concrete. The coupled equation of motion in dam–reservoir system is solved by staggered displacement method while the foundation rock is assumed as a mass-less and rigid mediums. The coupled system is excited using three-component ground motion in the maximum credible level. It is found that using orthotropic-based material increases crest displacements and also leads to more damage in the dam body in comparison with the case using the common isotropic-based material.В отличие от моделирования усадочных швов, при численном анализе бетонных арочных плотин работа и влияние строительных швов обычно не учитываются. Исследуется сейсмическая нелинейная реакция системы (бетонная) арочная плотина–резервуар–основание с учетом действия строительных швов на основе ортотропного материала. Представленный анизотропный подход к механике повреждения изменен для учета слабых горизонтальных плоскостей между слоями бетона в процессе строительства. Эта модель допускает учет характеристики предварительного размягчения, критерия возникновения размягчения и характеристики анизотропного растрескивания. С помощью метода ступенчатых перемещений, предполагая, что скальное основание состоит из невесомых жестких тел, решена система связанных уравнений движения в системе плотина–резервуар. Движение грунта по трехкомпонентной технологии возбуждает данную систему на максимально вероятном уровне. Обнаружено, что использование ортотропного материала увеличивает смещение гребня плотины и, как следствие, повреждение тела плотины в большей степени по сравнению с использованием распространенного изотропного материала.На відміну від моделювання усадкових швів, при чисельному аналізі бетонних арочних гребель робота і вплив будівельних швів зазвичай не враховуються. Досліджується сейсмічна нелінійна реакція системи (бетонна) арочна гребля–резервуар–основа з урахуванням дії будівельних швів на основі ортотропного матеріалу. Представлений анізотропний підхід до механіки руйнування змінено для урахування слабких горизонтальних площин між шарами бетону в процесі будівництва. Ця модель допускає урахування характеристики попереднього розм’якшення, критерію виникнення розм’якшення і характеристики анізотропного розтріскування. За допомогою методу східчастих переміщень, припускаючи, що скельову основу складають невагомі жорсткі тіла, розв’язано систему зв’язаних рівнянь руху в системі гребля–резервуар. Рух ґрунту за трикомпонентною технологією збуджує дану систему на максимально імовірному рівні. Установлено, що використання ортотропного матеріалу збільшує зміщення гребеня греблі і, як наслідок, пошкодження тіла греблі в більшій мірі порівняно з використанням розповсюдженого ізотропного матеріалу