38 research outputs found
Analisis Investasi Sistem Penyediaan Air Minum Kota Dumai Berdasarkan Kerjasama Pemerintah dan Swasta
Construction of water supply system has been implemented Dumai City since 2009. But until 2011 the construction should be done despite stalled cost as much as Rp 180 billion. The cost is only partially physical labor can build transmission and distribution networks in 4 districts. Therefore, the city government plans to continue the development dumai the project. In the government's development plan includes an investor to reduce sourced financing from the state budget. In this study, the system will analyze the cooperation undertaken by making 3 schemes. And each of these schemes will be analyzed in the economy that is based on net present value (NPV), internal rate of return (IRR), benefit cost ratio (BCR), and payback period (PBP). Economic analysis is performed on each scheme can be stated that the three schemes is feasible, for each of the parameters such as NPV is positive, BCR greater than 1.0 and internal rate of return and the value of the prevailing commercial interest, but the rates obtained are very expensive so the rates are not feasible. but the rates obtained are very expensive so the rates are not feasible. Thus, in the financing of infrastructure development should be done budget sharing the rates obtained becomes smaller
Perancangan Kapal Wisata Katamaran Dengan Sistem Penggerak Mesin Dan Layar Di Daerah Wisata Bahari Barelang (Batam, Rempang, Galang)
Potensi wisata yang dimiliki kawasan Barelang sangat besar, sehingga dibutuhkan sebuah sarana penunjang berupa kapal wisata yang lebih baik dari kapal kayu. Dengan adanya penelitian, tentang perancangan kapal wisata dengan bentuk lambung katamaran yang menggunakan sistem penggerak layar ini diharapkan dapat membantu pengembangan potensi wisata di Barelang. Dalam melaksanakan penelitian ini dilakukan beberapa tahapan perancangan yaitu perhitungan ukuran utama, membuat rencana garis, Perancangan layar,rencana umum, analisa hidrostatik, analisa stabilitas dan analisis olah gerak kapal. Serta pemilihan perlengkapan kapal dan motor induk berdasarkan hasil perhitungan daya motor dan analisa hambatan yang dialami kapal. Hasil perancangan kapal wisata ini berupa analisa hidrostatik, perencanaan dan analisa layar, gambar rencana umum, analisa stabilitas serta olah gerak kapal. Hasil analisa hidrostatik, letak titik bouyancy terletak dibelakang midship kapal sejauh 0,596 m. Hasil perencanaan dan analisa layar dengan sudut datang angin yang digunakan adalah 350, 450, 500, 600, 750 ,800,900,1000,1800. luasan layar (sail area) sebesar 60,9958 m² yang terdiri dari luasan mainsail sebesar 40,9958 m² dan foresail sebesar 20,00 m², dan tiang layar berada 4 m dari titik terluar haluan kapal. Hasil rencana umum, menunjukkan bahwa kapal wisata ini mampu membawa penumpang dengan kapasitas maksimum 17 orang. Pada tinjauan stabilitas, menunjukkan nilai GZ terbesar 2,84 m pada kondisi sepuluh yaitu saat membawa penumpang di samping kiri kapal dengan berat consumable 100%. Kapal wisata ini mempunyai olah gerak yang baik pada kondisi perairan Slight Water, Moderate Water, dan Rought Water dengan variasi wave heading 0°,90°,135°,180° dengan dan tidak terjadi deck wetnes
Using Movie Script in Teaching Reading Text at the Second Grade of SMP
Penelitian ini bertujuan untuk mendeskripsikan bagaimana movie script digunakan dalam pembelajaran membaca dan untuk mencari masalah yang ditemukan oleh siswa dan guru. Sampel dalam penelitian ini berjumlah 40 siswa yang dianalisis secara kualitatif. Data didapatkan melalui dua instrumen yaitu observasi kelas dan kuesioner. Hasil penelitian memperlihatkan bahwa terdapat beberapa aktifitas yang aktif dan menarik dalam proses pembelajaran namun terdapat beberapa masalah yang dihadapi oleh siswa dan guru dalam proses pembelajaran. Dapat disimpulkan bahwa guru dapat mengajar siswa secara kreatif dan inovatif sedangkan siswa tertarik untuk mempelajari teks membaca secara berbeda dalam penggunakan movie script sebagai media.This research was conducted to describe how movie script was used in reading text class and to find out the students\u27 and teacher\u27s problems in using movie script in reading texts. The subject of the reseach was the second grade students numbering of 40 students which were analyzed qualitatively. The data were collected by using two instruments: classroom observation note and questionnaire for the students. The result showed that there were some active and interesting activities in the teaching reading process. There are some problems faced by the students and the teacher in the process of teaching learning. However, it can be concluded that by using movie script as a media, the teacher can teach the students creatively and inovatively while the students are interested to learn reading text differently
Pengaruh Biaya Promosi Penjualan dan Biaya Periklanan terhadap Nilai Penjualan Produk pada Optik Kalista di Tabanan
In an effort to increase the value of product sales, Kalista Optics carries out various types of promotions consisting of sales promotion costs and advertising costs, which in recent years have experienced ups and downs in sales. The purpose of this study was to determine the effect of simultaneous and partial between sales promotion costs and advertising costs on the value of product sales in Kalista Optics in Tabanan. This research is explanatory research. The objects in this study are sales promotion costs and advertising costs and the value of product sales. Data analysis consisted of multiple linear regression analysis, classic assumption test, F statistical test and statistical test t. The conclusion of the research is that multiple linear regression equations can be said to have a positive effect simultaneously between the cost of sales promotion and the cost of product advertising or in other words increasing the value of product sales is influenced simultaneously by the increase in sales promotion costs and advertising costs.
Dalam upaya meningkatkan nilai penjualan produk, Optik Kalista melaksanakan berbagai jenis promosi yang terdiri dari biaya promosi penjualan dan biaya periklanan yang beberapa tahun terakhir ini mengalami pasang surut penjualan. Tujuan penelitian ini adalah untuk mengetahui pengaruh secara simultan dan parsial antara biaya promosi penjualan dan biaya periklanan terhadap nilai penjualan produk pada Optik Kalista di Tabanan. Penelitian ini merupakan penelitian eksplanatori. Obyek pada penelitian ini adalah biaya promosi penjualan dan biaya periklanan serta nilai penjualan produk. Analisis data terdiri dari Analisis regresi linier berganda, uji asumsi klasik, uji statistik F dan uji statistik t. Simpulan hasil penelitian adalah persamaan regresi linier berganda dapat dikatakan ada pengaruh yang positif secara simultan antara biaya promosi penjualan dan biaya periklanan produk atau dengan kata lain meningkatnya nilai penjualan produk dipengaruhi secara simultan oleh peningkatan biaya promosi penjualan dan biaya periklanan
Safety and efficacy of xenon in routine use as an inhalational anaesthetic
Abstract
40 patients (24 male, 16 female, aged 21-59 years) of American Society of Anesthesiologists class I or II who were undergoing routine surgery took part in a randomised, double-blind comparison of the anaesthetic efficacy and potency of xenon and nitrous oxide and their effects on the circulatory and respiratory systems. During anaesthesia, for each rise in blood pressure of more than 20% of the preanaesthetic (baseline) value, the patient received 0·1 mg fentanyl. The total amount of fentanyl required per patient was used as an index of the anaesthetic potency of the study gases. Patients in the xenon group required on average only 0·05 mg fentanyl, whereas those in the nitrous oxide group required 0·24 mg fentanyl; the duration of anaesthesia was similar in the two groups. Changes in blood pressure were significantly greater throughout the study in the nitrous oxide than in the xenon group. Thorax-lung compliance fell during the study period in the nitrous oxide group but not in the xenon group. Thus, xenon is a potent and effective anaesthetic which can be safely used under routine conditions
Beta-Blocking Agents and Electroconvulsive Therapy
In this review we want to summarize the results of the placebo-controlled randomized clinical trials with betablocking
adrenergic agents during electroconvulsive therapy (ECT), and review the effect on seizure duration and cardiovascular
variables. We sea
Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants
Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks
Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults
Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We
estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from
1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories.
Methods We used data from 3663 population-based studies with 222 million participants that measured height and
weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate
trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children
and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the
individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference)
and obesity (BMI >2 SD above the median).
Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in
11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed
changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and
140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of
underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and
countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior
probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse
was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of
thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a
posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%)
with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and
obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for
both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such
as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged
children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls
in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and
42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents,
the increases in double burden were driven by increases in obesity, and decreases in double burden by declining
underweight or thinness.
Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an
increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy
nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of
underweight while curbing and reversing the increase in obesit
Controversy and consensus on the management of elevated sperm DNA fragmentation in male infertility: A global survey, current guidelines, and expert recommendations
Purpose
Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in infertile men, summarize the relevant professional society recommendations, and provide expert recommendations for managing this condition.
Materials and Methods
An online global survey on clinical practices related to SDF was disseminated to reproductive clinicians, according to the CHERRIES checklist criteria. Management protocols for various conditions associated with SDF were captured and compared to the relevant recommendations in professional society guidelines and the appropriate available evidence. Expert recommendations and consensus on the management of infertile men with elevated SDF were then formulated and adapted using the Delphi method.
Results
A total of 436 experts from 55 different countries submitted responses. As an initial approach, 79.1% of reproductive experts recommend lifestyle modifications for infertile men with elevated SDF, and 76.9% prescribe empiric antioxidants. Regarding antioxidant duration, 39.3% recommend 4–6 months and 38.1% recommend 3 months. For men with unexplained or idiopathic infertility, and couples experiencing recurrent miscarriages associated with elevated SDF, most respondents refer to ART 6 months after failure of conservative and empiric medical management. Infertile men with clinical varicocele, normal conventional semen parameters, and elevated SDF are offered varicocele repair immediately after diagnosis by 31.4%, and after failure of antioxidants and conservative measures by 40.9%. Sperm selection techniques and testicular sperm extraction are also management options for couples undergoing ART. For most questions, heterogenous practices were demonstrated.
Conclusions
This paper presents the results of a large global survey on the management of infertile men with elevated SDF and reveals a lack of consensus among clinicians. Furthermore, it demonstrates the scarcity of professional society guidelines in this regard and attempts to highlight the relevant evidence. Expert recommendations are proposed to help guide clinicians
Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants.
BACKGROUND: Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS: We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. FINDINGS: The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. INTERPRETATION: Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. FUNDING: WHO