Is endoanal, introital or transperineal ultrasound diagnosis of sphincter defects more strongly associated with anal incontinence?

INTRODUCTION AND HYPOTHESIS: Our aim was to explore the association between anal incontinence (AI) and persistent anal sphincter defects diagnosed with 3D endoanal (EAUS), introital (IUS) and transperineal ultrasound (TPUS) in women after obstetric anal sphincter injury (OASI) and study the association between sphincter defects and anal pressure. METHODS: We carried out a cross-sectional study of 250 women with OASI recruited during the period 2013-2015. They were examined 6-12 weeks postpartum or in a subsequent pregnancy with 3D EAUS, IUS and TPUS and measurement of anal pressure. Prevalence of urgency/solid/liquid AI or flatal AI and anal pressure were compared in women with a defect and those with an intact sphincter (diagnosed off-line) using Chi-squared and Mann-Whitney U test. RESULTS: At a mean of 23.6 (SD 30.1) months after OASI, more women with defect than those with intact sphincters on EAUS had AI; urgency/solid/liquid AI vs external defect: 36% vs 13% and flatal AI vs internal defect: 27% vs 13%, p < 0.05. On TPUS, more women with defect sphincters had flatal AI: 32% vs 13%, p = 0.03. No difference was found on IUS. Difference between defect and intact sphincters on EAUS, IUS and TPUS respectively was found for mean [SD] maximum anal resting pressure (48 [13] vs 55 [14] mmHg; 48 [12] vs 56 [13] mmHg; 50 [13] vs 54 [14] mmHg) and squeeze incremental pressure (33 [17] vs 49 [28] mmHg; 37 [23] vs 50 [28] mmHg; 36 [18] vs 50 [30] mmHg; p < 0.01). CONCLUSIONS: Endoanal ultrasound had the strongest association with AI symptoms 2 years after OASI. Sphincter defects detected using all ultrasound methods were associated with lower anal pressure

Aplikasi Fuzzy Type-2 PSS untuk Perbaikan Stabilitas Dinamik Pembangkit Listrik Tenaga Mikro Hidro dan Diesel: Application of Fuzzy Type-2 PSS to Improve Dynamic Stability of Micro Hydro and Diesel Power Plants

Teknologi fuzzy tipe 2 (FT2) berkembang sangat pesat dan memasuki bidang stabilitas sistem tenaga listrik. Pembangkit listrik tenaga mikro hidro (PLTMH) dan diesel (PLTD) riskan terhadap gangguan perubahan beban. Studi stabilitas penting dikerjakan untuk memastikan bahwa operasi PLTMH-PLTD tetap stabil ketika dan setelah beban berubah. Maka power system stabilizer (PSS) berbasis FT2 diusulkan untuk perbaikan stabilitas sistem tersebut. FT2PSS didesain dengan input kecepatan rotor dan derivatifnya. Outputnya adalah sinyal stabilitas yang diumpankan pada sistem eksitasi. Hasilnya, FT2PSS mampu mereduksi overshoot -0,035 deg. Sedangkan overshoot untuk CPSS adalah -0,051 deg. FT2PSS juga dapat mempersingkat settling time dan mempercepat steady state. Stabilitas PLTMH-PLTD yang dilengkapi dengan FT2PSS diperbaiki secara significan

Strategy to reduce transient current of inverter-side on an average value model high voltage direct current using adaptive neuro-fuzzy inference system controller

Growing-up of high voltage direct current (HVDC) penetration into modern power systems (PS) makes difficulty on the PS operation. The HVDC produces high and slow transient current (TC) at start-time, especially for higher up-ramp rate (Urr&gt;20 pu/s). Its condition makes the HVDC cannot be linked and synchronized into the PS rapidly. A strategy to reduce the TC is proposed by an adaptive network based fuzzy inference system (ANFIS) control on inverter HVDC-link to cope up this problem. The ANFIS control is tuned with the help of conventional control in various train-data by using offline mode. Response of ANFIS scheme is improved by suppressing TC at the values of 3.75% for the both phases (A and C), and 3.95% for phase B, for the Urr=30 pu/s. While the conventional control achieved at 9.1% for the both phases (A and B), and 9.2% for the phase C. The ANFIS control gives shorter settling time (0.553 s) than the conventional control (0.584 s) for all phases. The proposed control is more effective than the conventional control at all the scenario

Perbaikan Stabilitas Dinamik Sistem Tenaga Terintegrasi Pembangkit Listrik Tenaga Mikro Hidro dan Diesel Menggunakan PSS Berbasis ANFIS

Power generating units should be built closed to load centers according to electric power company regulation. These units are generally small in capacity, so that makes power transfer among inter- and outer-areas is easier to be done. This study aims to improve dynamic stability of a Micro Hydro Power Plant (MHPP) on perspective of 5% load increased in Diesel Power Plant (DPP). The DPP is equipped by an ANFIS-based Power System Stabilizer (PSS) in this scheme. Two inputs with Gauss2mf membership function (MF) type and 5-number of the each MF are used to implement the ANFIS model. Simulation results show that overshoot of MHPP power angle deviation is reduced to the values of 0.023, 0.0138 and 0.0132°, for the DPP without PSS, conventional and ANFIS PSS, respectively.  Also, reduction in setting time is achieved at times &gt;6, 4.051 and 3.553 s. It is shown that the ANFIS PSS is more effective to enhance the dynamic stability compared to other PS

Makna Slametan Kematian Masyarakat Jawa Sebagai Ide Penciptaan Seni Lukis

Penciptaan karya seni lukis bertema tentang tradisi masyarakat Jawa yang berjudul “Makna Slametan Kematian Masyarakat Jawa Sebagai Ide Penciptaan Seni Lukis” memaknai peristiwa slametan kematian penciptaan yang berfokus pada jalinan kekerabatan, sajian penghormatan dan nilai gotong royong. Karya yang tumbuh dari pengalaman hidup spiritual pencipta ditengah kehidupan global mencoba memvisualisasikan, merefleksikan dan mendeskripsikan bentuk khayalan atau anganan ke dalam bentuk karya seni lukis. Bertujuan sebagai media ekspresi diri meluapkan emosi batin perasaan, juga sebagai media penyampaian pengetahuan ke khalayak umum. Pengalaman pribadi yang di olah sedemikian rupa menjadi sebuah karya seni lukis tidak hanya dinikmati secara visual saja namun juga berfungsi sebagai pengetahuan baru. Karya seni lukis yang merujuk referensi karya beberapa seniman seperti Zico Albaiquni, Saleh Husein dan Daniel Mellor dimana setiap seniman memiliki kenuikan yang menarik seperti teknik, narasi karya hingga pencarian jati diri. Proses penciptaan dilandasi dengan menggunakan metode dari Gustami SP dimulai eksplorasi, perancangan sampai perwujudan. Karya yang dihasilkan sebanyak lima karya seni lukis. Karya pertama berjudul “Harapan Untuk Menjaga Bersama”, Karya kedua “Tergerak Bersama”, karya ketiga “Terjalin Menyatu”, karya keempat “Javanese Waslimah” dan karya kelima “Bersemayam pada keancuran yang nyata”. Karya disajikan seperti lukisan yang menginstal dari display yang dipasang, digantung, dirangkai, hingga disajikan diatas lantai

Televisi dan Dinamika Politik (Opini Pemerhati Talk Show Obrolan Karebosi Pasca Pilkada Serentak 2015 di Sulawesi Selatan)

The mass media have a responsibility in democratization, through the fulfillment of political education to the community. This study aims to determine (1) the opinions of observer of Talk Show Obrolan Karebosi about this tv program Post-Unison Election at 2015 in South Sulawesi (2) how the process of formation of observers opinion on the talk show Obrolan Karebosi. This study uses a qualitative approach with a basic theory research to lead to the discovery or strengthen a theory. The research was conducted in Makassar with several informants who are Celebes TV viewers. The types and sources of data used are primary and secondary data. The primary data or main data in the form of interviews with informants, secondary data or supporting documents such as books, thesis, journals, articles and internet. Informants consisted of five Celebes TV viewers who've joined in Obrolan Karebosi program that discussed about simultaneous elections in 2015 in South Sulawesi and hereinafter referred to as observer of Obrolan Karebosi. Data were collected in the form of interviews with informants. Data were analyzed using several theories. The results showed that (1) observer of Obrolan Karebosi give a positive opinion for the hosts, theme, and the event speakers, while speakers from among politicians and organizers of the elections, observers showed a negative opinion in terms of the balance, suitability, mastery of the material and honesty. (2) Opinion observer of Obrolan Karebosi shaped by their attitude to the program, thir trust as well as their perception that formed on the Obrolan Karebosi. Media massa memiliki tanggungjawab dalam demokratisasi, melalui pemenuhan pendidikan politik ke masyarakat. Penelitian ini bertujuan untuk mengetahui (1) opini pemerhati Talk Show Obrolan Karebosi Pasca Pilkada Serentak 2015 di Sulawesi Selatan (2) bagaimana proses terbentuknya opini pemerhati terhadap talk show Obrolan Karebosi. Penelitian ini menggunakan pendekatan kualitatif dengan jenis penelitian teori dasar untuk mengarahkan pada penemuan atau menguatkan suatu teori. Penelitian ini dilaksanakan di kota Makassar dengan beberapa informan yang merupakan pemirsa Celebes TV. Jenis dan sumber data yang digunakan adalah data primer dan sekunder. Data primer atau data utama berupa hasil wawancara dengan informan, dan data sekunder atau data pendukung berupa buku, tesis, jurnal, artikel dan internet. Informan terdiri atas lima orang pemirsa Celebes TV yang pernah bergabung di program Obrolan Karebosi pada pembahasan Pilkada serentak 2015 di Sulawesi Selatan dan selanjutnya disebut sebagai pemerhati Obrolan Karebosi. Data dikumpulkan berupa hasil wawancara dengan para informan. Data dianalisis dengan menggunakan beberapa teori. Hasil penelitian menunjukkan bahwa (1) pemerhati Obrolan Karebosi memberikan opini positif terhadap host, tema dan narasumber acara tersebut, sedangkan untuk narasumber dari kalangan politisi dan penyelenggara Pilkada, pemerhati menunjukkan opini negatif ditinjau dari keberimbangan, kesesuaian, penguasaan materi dan kejujuran. (2) Opini pemerhati Obrolan Karebosi dibentuk oleh sikap mereka terhadap program, kepercayaan serta persepsi mereka yang terbentuk tentang Obrolan Karebosi