Reposisi dan Penggantian Menara Transmisi 150 KV

Saluran transmisi adalah suatu hal yang sangat mutlak dalam suatu sistem tenaga listrik. Dalam penyaluran tenaga listrik dari pusat-pusat pembangkit ke beban (konsumen), dimana jaraknya cukup jauh maka dilakukan lewat saluran transmisi. Saluran transmisi yang umum digunakan berdasarkan konstruksinya adalah tipe lattice dan steel pole. Saluran transmisi ini memiliki batas aman terhadap obyek lain yang ada di sekitarnya sesuai standar yang ditetapkan. Saluran transmisi udara menggunakan konduktor jenis TACSR (Thermal Aluminium Conductor Steel Reinforced) yang memiliki kemampuan kerja dengan suhu sampai 1500C. Berdasarkan perhitungan pada saat jarak span 212 m dan dengan suhu 1500C andongan maksimumnya bernilai 9,40 m. Pada saat jarak 173 m dan dengan suhu 1500C andongan maksimalnya 7,8m. Pada saat jarak 233 m dengan suhu 1500C andongan maksimumnya adalah 10,58m. Keadaan suhu dan panjang span mempengaruhi nilai andongan, semakin besar suhu dan panjang span maka nilai andongan akan semakin besar

Meningkatkan Aktivitas Belajar Siswa melalui Metode Demonstrasi pada Pembelajaran IPA di Sekolah Dasar

The problem in this study, namely how improving student learning activities through demonstrations on science teaching methods in class IV SDN 07 Tumbang Titi. The purpose of this study, namely (1) Increase students' physical activity by using the method of demonstration in science learning. (2) Improve the mental activity of students using demonstration method in teaching science. (3) Enhance the emotional activity of students in learning by using a method demonstration on science learning. The method used in this method is the descriptive method. The shape of the research in this study was a classroom action research, namely in Vienna Sanjaya According to Hopkins (2010: 53) is a spiral shape PTK research, ie research that starts from the sensed a problem, planning, implementing actions, make observations. The results of this study, namely the machine as follows. (1) Increased physical activity of students is based on the observations that have been made there is an increase of 27.34% and 64.84% from the first cycle to the second cycle to 91.40 with an increase of 26.56%. The overall increase from baseline of 37.5% to 91.40% the second cycle is 53.9% ". (2) Increased mental activity of students overall from the base line to the second cycle, namely 49.22% 86.25% thereby increase emotional activity can be categorized as "pretty". (3) Increased student emotional activity that is 40.62% to 89.84% the second cycle is 49.22%

Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study

Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p<00001), age 70 years or older versus younger than 70 years (230 [165-322], p<00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p<00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Perancangan dan Penataan Penerangan Jalan Umum dengan Aplikasi Dialux Evo 8.2 di Jalan Depok Cilodong

The increase in population, urban development and road construction are the demands of many communities in obtaining public street lighting for road users by providing better services. Public street lighting has become a necessity for many people, which is very important for two-wheeled, four-wheeled, and many-wheeled drivers for safety and comfort in traffic, especially at night. Therefore, the authors conducted a new research design by arranging public street lighting in the area of ​​the Depok Cilodong highway, with the aim of providing the beauty of the road environment by the model of the arrangement and installation of poles, pole height and PJU lamp models to the road body. Its uniqueness is seen from the perspective of the side of social and environmental impacts that are generally not seen by the local government and the level of evenness of road lighting on road materials is still lacking, so that the impact on the road user community is better and more modern. The method used with the Dialux EVO 8.2 Program for short road lengths can choose street lights taken from the IES Lighting data on the 10W Eco Led, 10 VAC Milky Way, which is installed with a height of 8 meters with a distance between poles 15 meters with a large amount of procurement allows for high costs. For the long distance of the road, you can use the 20W Led Bimasakti Eco street light, 10 VAC, which is installed with a height of 8 meters and 20 meters between the poles. So by analyzing the selection criteria, it is capable of producing street lighting with lighting levels in accordance with SNI 7391-2008 and considering the quantity of material procurement as well as the tipping point which has an impact on financing for installation services.     &nbsp

Analisis Simulasi Perbandingan Pencahayaan Malam Hari Terowongan Senen-Atrium Menggunakan LED CAVES 350

Dalam penelitian ini, penulis menggunakan software Dialux evo 4.13 yang didapat dari IES Lighting untuk Lampu LED CAVES 350 dengan daya 80Watt, 110Watt, dan 150Watt. Untuk terowongan Senen sepanjang 585 meter dengan lebar 9 meter dan tinggi terowongan 5 meter. Zona terowongan Senen-Atrium memiliki terowongan satu arah yang terbagi dengan 2 lajur yang berada di bagian sisi terowongan percabangan dari jalan Letjen. Suprapto tembus langsung menuju jalan Senen Raya dan jalan Kwitang. Dari hasil simulasi pencahayaan terowongan Senen-Atrium malam hari daya luminer 80 Watt, 110 Watt, dan 150 Watt adalah 12112 lumen, 14557 lumen, dan 20426 lumen. LED CAVES daya 80 Watt yaitu 13 hingga 69 Lux. Untuk 110 Watt yaitu 14 hingga 81 Lux, dan daya 150 Watt adalah 21 hingga 115 Lux. Pada simulasi  hasil sebaran bidang jalan untuk LED CAVES 350 yang 80 W, 110 W, dan 150 W, yaitu 0,181 ; 0, 177  dan 0,183, dan rasio kemerataan pencahayaan untuk terowongan adalah 4 : 1. Perhitungan jumlah lampu yang dipasang mengacu pada jarak lebih dari 34 meter, sehingga mendapatkan jumlah lampu 18 buah. Batasannya sesuai SNI 7391:2008 mengacu pada aturan kualitas pencahayaan normal E rata-rata, batasan kuat pencahayaan pada terowongan, dan rasio kemerataan pencahayaan. Dari ketiga lampu yang dipilih yang paling ideal, yaitu CAVES 350 80W   &nbsp