PENGELOLAAN SAMPAH BERBASIS 4R DAN TANGGUNG JAWAB MASYARAKAT DALAM MENJAGA LINGKUNGAN DI KOTA LHOKSEUMAWE

The problem of waste as waste that continues to be produced not only by the industrial sector but also the household sector turns out to be a problem that is not only an environmental problem but also a social problem that has a long-term impact. Low public understanding and awareness then make the problem even worse. The habit of people who often litter and accumulate garbage in open areas will cause environmental pollution, especially soil which will then have an impact on the water content in the soil, blockages in waterways which can then cause disasters for the environment. To overcome this, waste management needs to be carried out comprehensively and integrated from upstream to downstream with a circular economy approach by the central government, local governments and the community, so as to provide economic benefits, healthy for the community, and safe for the environment. The application of the 4-R principle (reduce, reuse, recycle and replace) in waste management and encouragement to raise awareness of the dangers of waste must be instilled from an early age, especially in children and adolescents and society in general. The importance of 4R (reduce, reuse, recycle, replace) is very vital for the preservation of a clean and economical environment in Lhokseumawe City

Techies Agronomics Corporation : Portative Cutter / Muhammad Ali Al Muntazar Mohd Suhaimi...[et al.]

Our company, Techies Agronomics Corporations will produce a product called Portative Cutter. This product will give high satisfaction to the customer who want to deal with agriculture and farming. Our product is not just use for farming only, but it can use also for home lawn cleaning process. It is because, our product can use as a grass cutter. So, with our product the customer can save their money from buy two products. It is because our product has two function in one system or body

Agreement between ccNexfin CO-trek cardiac output and intermittent cold-bolus pulmonary thermodilution in a prospective multi-centre study

BACKGROUND: The ccNexfin system uses the CO-trek algorithm to analyse a non-invasively obtained arterial pressure waveform and calculate cardiac output (NEXCO). It remains matter of debate whether NEXCO can replace invasive, pulmonary artery catheter derived, cold-bolus pulmonary thermodilution cardiac output measurement (PACCO). This study aimed at testing NEXCO-PACCO agreement in a large sample size, multi-centre study. We hypothesized that agreement between NEXCO and PACCO would be demonstrated by a mean accuracy (bias) < 0.6 l·min-1 with a percentage error < 30%. METHODS: Patients undergoing cardiac surgery in three academic hospitals clinically requiring pulmonary artery catheterisation were included. Exclusion criteria were aortic, pulmonary and tricuspid (valve) abnormalities, non-sinus rhythm and insufficient perfusion of the digits such as in Raynaud's disease. After induction of anaesthesia, cardiac output was measured with four cold bolus thermodilution measurements and four averaged thirty second ccNexfin measurements randomised through the respiratory cycle to obtain one measurement pair. Mean accuracy and precision of ccNexfin were expressed as bias (mean of all NEXCO-PACCO differences) and limits of agreement (LOA; 1.96 · SD of bias). Percentage error was calculated as [LOA/ (NEXCO-PACCO average)]. RESULTS: Fifty-five patients were enrolled in the study, 51 completed the protocol. Median PACCO was 3.7 (IQR: 3.2 to 4.6) l·min-1 and median NEXCO was 3.8 (IQR: 3.1 to 4.7) l·min-1. NEXCO-PACCO bias was 0.1 (LOA: -1.4 to +1.6) l·min-1 with a 37% percentage error. CONCLUSION: In this study, cardiac output measurement with ccNexfin failed to meet the predefined criteria for agreement with cold-bolus pulmonary artery thermodilution

Agreement between ccNexfin CO-trek cardiac output and intermittent cold-bolus pulmonary thermodilution in a prospective multi-centre study

The ccNexfin system uses the CO-trek algorithm to analyse a non-invasively obtained arterial pressure waveform and calculate cardiac output (NEXCO). It remains matter of debate whether NEXCO can replace invasive, pulmonary artery catheter derived, cold-bolus pulmonary thermodilution cardiac output measurement (PACCO). This study aimed at testing NEXCO-PACCO agreement in a large sample size, multi-centre study. We hypothesized that agreement between NEXCO and PACCO would be demonstrated by a mean accuracy (bias) < 0.6 l·min-1 with a percentage error < 30%. Patients undergoing cardiac surgery in three academic hospitals clinically requiring pulmonary artery catheterisation were included. Exclusion criteria were aortic, pulmonary and tricuspid (valve) abnormalities, non-sinus rhythm and insufficient perfusion of the digits such as in Raynaud's disease. After induction of anaesthesia, cardiac output was measured with four cold bolus thermodilution measurements and four averaged thirty second ccNexfin measurements randomised through the respiratory cycle to obtain one measurement pair. Mean accuracy and precision of ccNexfin were expressed as bias (mean of all NEXCO-PACCO differences) and limits of agreement (LOA; 1.96 · SD of bias). Percentage error was calculated as [LOA/ (NEXCO-PACCO average)]. Fifty-five patients were enrolled in the study, 51 completed the protocol. Median PACCO was 3.7 (IQR: 3.2 to 4.6) l·min-1 and median NEXCO was 3.8 (IQR: 3.1 to 4.7) l·min-1. NEXCO-PACCO bias was 0.1 (LOA: -1.4 to +1.6) l·min-1 with a 37% percentage error. In this study, cardiac output measurement with ccNexfin failed to meet the predefined criteria for agreement with cold-bolus pulmonary artery thermodilutio