Coinfection of COVID-19 and dengue: a case report

Dengue hemorrhagic fever (DHF) and corona virus disease 2019 (COVID-19) are two viral infectious diseases that can occur simultaneously and have the potential to complicate each other. Therefore, sustained attention to this phenomenon is required. A 9 y.o. boy was diagnosed with dengue and COVID-19 at the Panti Rapih Hospital in Yogyakarta, Indonesia, in the early phase of the COVID-19 pandemic. Both viral infectious diseases have distinctive clinical and laboratory features. Acute fever, vomiting, weakness, thrombocytopenia, and hemoconcentration that improve from day 5 after infection are typical symptoms of DHF in children. Complaints of fever, runny nose, cough, and pain when swallowing that usually occurs in COVID-19 also appeared. Medical investigations with serological tests for DHF and COVID-19 at the beginning of the COVID-19 pandemic can be used to diagnose these two infections because standard diagnostic tools using the PCR swab test cannot yet be performed. Symptomatic therapy for moderate degrees of these two viral infections is appropriate

Kadar enzim creatine-kinase total dalam cairan serebrospinal pada meningitis bakterial akut anak

ABSTRACT Background: Acute bacterial meningitis is one of paediatric emergency cases which results in high morbidity and mortality. Diagnostic procedures using cerebrospinal fluid (CSF) are often unsatisfactory. A simple and rapid procedure is required for early diagnosis and prompt treatment. Objectives: The aims of this study were to assess total cerebrospinal fluid creatine-kinase (CSF-CK) level in childhood acute bacterial meningitis and to assess the diagnostic values of CSF-CK level compare with routine CSF analysis (i.e. cell count, morphology, chemical, C reactive protein and culture) which is accepted as diagnostic gold standard for acute meningitis. Materials and methods: All patients hospitalized in the Pediatric Department Sardjito Hospital for suspected acute bacterial meningitis in July-December 1998, underwent lumbar puncture. The level of CSF-CK and routine analyses were examined for diagnosis acute bacterial meningitis. Results: Forty five children with suspected meningitis were included in this study. CSF-CK 16 U/I had sensitivity 50%, specificity 80%, positive predictive value 42%, negative predictive value 85% and likelihood ratio 2,75. Mean of CSF-CK in childhood acute bacterial meningitis was 82,84 U/I. Conclusion : CSF-CK level was not sensitive, but it is a specific diagnostic test for childhood bacterial meningitis. Key words: acute bacterial meningitis - CK-CSF - diagnostic test Latar belakang: Meningitis bakterial akut merupakan salahsatu kegawatdaruratan medik pada anak yang memberi risiko kecacatan dan kematian yang cukup tinggi. Penegakan diagnosis penyakit ini melalui pemeriksaan cairan serebrospinal belum sepenuhnya dapat diandalkan. Pemeriksaan yang sederhana dan cepat diperlukan untuk menetapkan terapi sedini mungkin. Tujuan: Mengetahui kadar enzim creatin-kinase total dalam cairan serebrospinal (CK-LCS) pada meningitis bakterial akut anak dan menentukan kekuatan CK-LCS sebagai perasat diagnostik. Rancang Bangun: Uji diagnostik. Bahan dan cara: Naracoba yang digunakan adalah semua pasien yang dikelola sebagai meningitis dan dirawat inap di Bangsal Anak RSUP Dr. Sardjito Yogyakarta dalam periode bulan Juli sampai dengan Desember 1998. Dilakukan pemeriksaan CK-LCS dan analisis LCS rutin meliputi pemeriksaan sel radang, kimia klinik, CRP-LCS dan biakan LCS untuk diagnosis meningitis bakterial akut. Hasil: Terdapat 45 anak yang dicurigai menderita meningitis dan digunakan sebagai naracoba. Dari 45 anak tersebut (10 anak menderita meningitis bakterial akut dan 35 anak menderita meningitis bukan bakterial akut) rata-rata kadar CK-LCS pada anak yang menderita meningitis bakterial akut adalah 84,82 U/I, atau hampir 8 kali lipat dibandingkan anak yang menderita meningitis bukan bakterial akut. Kadar CK-LCS U/I sebagai uji ..

Pembangunan Sistem Deteksi Kelainan Sel Darah Merah Menguunakan General Regression Neural Network

ABSTRAKSI: Perkembangan Medical imaging yang cepat karena didukung oleh perkembangan teknologi membuka sebuah kemungkinan untuk mempermudah tugas ahli medis dengan menggunakan mesin cerdas atau jaringan saraf tiruan untuk mendiagnosis suatu penyakit. Salah satu kasus dimana medical imaging yang didukung jaringan saraf tiruan mampu mempermudah tugas ahli medis adalah dalam kasus pendeteksian kelainan sel darah merah pada hapusan sel darah merah. Jenis jaringan saraf tiruan yang mampu digunakan untuk kasus ini adalah General Regression Neural Network (GRNN). GRNN merupakan jaringan saraf tiruan yang diciptakan oleh Donald F Spech pada tahun 1991. GRNN merupakan Multilayer Feed Forward Neural Network dimana informasi berjalan satu arah. Kelainan sel darah merah yang akan dideteksi oleh GRNN adalah kelainan yang berupa kelainan morfologis yaitu krenasi, thalasemia, dan sickle cell. Metode Wavelet Haar dipilih untuk mengekstraksi ciri citra yang telah diubah menjadi biner sebelumnya. Setelah tahapan ekstraksi ciri, GRNN digunakan untuk membedakan citra berdasarkan empat kelas yaitu normal, krenasi, thalasemia, dan sickle cell . Pada penelitian ini GRNN mampu mendeteksi kelainan sel darah merah pada citra dengan akurasi mencapai 85 % saat diuji untuk mendeteksi 40 pada dataset testing dengan menggunakan nilai parameter smooth 0.2 dan 0.3 dan jenis fungsi distance paling baik untuk digunakan pada kasus ini adalah Euclidean distance.Kata Kunci : GRNN, Sel Darah Merah, Thallasemia, Krenasi, Sel Sabit, WaveletABSTRACT: Rapid development of medical imaging that supported by development of thecnology makes a possibility to use it for assiting medic to diagnose a disease. One example case where medical imaging supported by neural network can assists medic is when they have to diagnose red blood cell disorder from blood smear. Neural network that can be used for this case is General Regression Neural Network(GRNN). This type of artificial neural networks are capable of being used for this case is the General Regression Neural Network (GRNN). GRNN is a neural network that was created by Donald F Spech in 1991. GRNN is a Multilayer Feed Forward Neural Network where information goes in one direction. Abnormalities of red blood cells to be detected by the GRNN is an abnormality in the form of morphological abnormality that is krenasi, thalassemia, and sickle cell. Haar wavelet method chosen for extracting image features that have been converted into a binary before. After the feature extraction stage, GRNN is used to distinguish the image based on four classes, namely normal, krenasi, thalassemia, and sickle cell. In this study GRNN is able to detect abnormalities of red blood cells in the image with an accuracy reaching 85% when tested to detect a 40 on a testing dataset using the parameter values 0.2 and 0.3 and the smooth function of distance is the best type to use in this case is the Euclidean distance.Keyword: GRNN,Red Blood Cell , Thallasemia, Crenation, Sickle Cell, Wavele

Active and Passive Structural Vibration Mitigation for High-Speed Machine Tools

This thesis presents novel feedback and feedforward control system design strategies for active to passive vibration mitigation of residual vibrations on high speed machine tools. Residual vibrations on high-speed machine tools are triggered when the machine axes (table) undergo large accelerations, which induce sudden inertial forces and excite the lightly damped structural modes of the machine tool structure. The proposed active vibration mitigation design approach utilizes an accelerometer, and feed the spindle (tool-tip) acceleration and velocity back to the motion controller to dampen them. On the other hand, the passive vibration mitigation approach shapes the frequency spectrum of reference motion trajectories (commands) to avoid triggering residual vibrations of the feed drive transmission system. Design of the proposed active and passive techniques require accurate modeling of the machine tool’s structural dynamics. Hence, time and frequency domain identification methods are presented. In order to facilitate a practical tuning strategy, a convex-optimization based iterative tuning approach is also presented. The proposed active and passive vibration mitigation design method are tested experimentally and show significant improvements in the command tracking and vibration suppression performance

Indonesia's Forest Moratorium: Impacts and Next Steps

The authors identify opportunities for progress with the recently extended Indonesian forest moratorium, a policy aiming to protect an area the size of Japan from development

Framing national REDD+ benefits, monitoring, governance and finance: A comparative analysis of seven countries

This article analyzes how and with what possible consequences REDD+ is framed in the national policy arena in Cameroon, Indonesia, Nepal, Papua New Guinea, Peru, Tanzania, and Vietnam. It analyzes the most prominent views and storylines around key REDD+ design features among policy actors and in policy documents. We focus on storylines related to four questions, namely: (1) What should REDD+ achieve: carbon or also non-carbon objectives? (2) Who should monitor REDD+ outcomes: only technical experts or also local communities? (3) At what level should REDD+ be governed: at national or sub-national level? and (4) How should REDD+ be financed: through market- or fund-based sources? The vast majority of policy actors and policy documents frame REDD+ as a mechanism that should also realize non-carbon benefits, yet non-carbon monitoring receives very little attention. In all but one country, policy documents contain plans to involve local communities in the design and/or execution of measuring, reporting and verifying REDD+ outcomes. With regard to the level at which REDD+ should be governed, while most policy documents contain elements of a nested approach to accounting, almost all countries envision a long-term transition to national accounting and benefit distribution. We found strikingly little discussion among policy actors and in policy documents of how to finance REDD+ and acquire results-based payments. In the conclusion we reflect on possible consequences of the prominence of REDD+ storylines in the seven countries, and argue that carbonization and centralization of forest governance are possible outcomes given the limited attention to non-carbon monitoring and the envisioned centralized approaches to REDD+

Governing the design of national REDD +: an analysis of the power of agency

This paper investigates how three aspects of governance systems, namely the policy context, the influence of key agents and their discursive practices, are affecting national-level processes of policy design aimed at REDD. +, reducing emissions from deforestation and forest degradation in developing countries; and the role of conservation, sustainable management of forests and enhancement of forest carbon stocks in developing countries. We conducted analysis in six REDD. + countries (Brazil, Cameroon, Indonesia, Nepal, Papua New Guinea and Vietnam). The paper combines three methods: policy analysis, media-based discourse analysis and policy network analysis. The paper shows that policies both within and outside the forestry sector that support deforestation and forest degradation create path dependencies and entrenched interests that hamper policy change. In addition, most dominant policy coalitions do not challenge business-as-usual trajectories, reinforcing existing policy and political structures. No minority policy coalitions are directly tackling the root causes of deforestation and forest degradation, that is, the politico-economic conditions driving them. Instead they focus on environmental justice issues, such as calls for increased participation of indigenous people in decision-making. Only in two of the six countries are these transformational change coalitions vocal enough to be heard, yet to exercise their agency effectively and to support more substantial reforms, these coalitions would need the participation of more influential policy actors, particularly state agencies that have the authority to make binding decisions about policy. Furthermore, discourses supporting transformational change would need to be reflected in institutional practices and policy decisions

Integration of adaptation and mitigation in climate change and forest policies in Indonesia and Vietnam

Forests play a major role in both climate change mitigation and adaptation, but few policies, if any, integrate these two aspects. Using Indonesia and Vietnam as case studies, we identify challenges at the national level but opportunities at the local level. Although both countries demonstrate political commitment to integrating adaptation and mitigation in their development plans, guidelines for policy and planning treat the two approaches separately. The main challenges identified are lack of knowledge, lack of political will, lack of financial incentives, and fragmentation of mandates and tasks of different government agencies. In contrast, at the local level, integration of mitigation and adaptation is facilitated by subnational autonomy, where mitigation projects might have adaptation co-benefits, and vice versa. Our results also show that many actors have a dual mandate that could bridge adaptation and mitigation if appropriate political and financial incentives are put in place. Successful integration of mitigation and adaptation policies would not only remove contradictions between policies, but also encourage governments that are designing domestic policies to exploit the potential for positive spillovers and realize the benefits of both approaches