Analisis Potensi Ekonomi Sektoral pada Empat Kabupaten di Pulau Madura

The purpose of this research is to determine the pattern of the economy, the advanced sector/subsector on each district, and determining the growth center on the Madura Island. The analysis tools that are used in this research are Typology Klassen, Location Quotient (LQ), and analysis of gravity. The research concluded there are four (4) patterns of economic growth on four districts in the Madura Island. An area that "fast advance and grow" is Bangkalan, “the advanced but depressed" is Sumenep, the "growing fast" is Pamekasan, and the "relatively low" is district Sampan

Pengetahuan Dan Sikap Masyarakat Tentang Upaya Pencegahan Tuberkulosis

Penyakit tuberkulosis paru adalah penyakit menular kronis yang disebabkan oleh bakteri Mycobacterium tuberculosis. World Health Organization (WHO) menyatakan bahwa 1/3 penduduk dunia telah terinfeksi kuman tuberkulosis. Pada tahun 2012 kasus penderita tuberkulosis baru di Kalimantan Selatan dilaporkan 96 per 100.000penduduk. Tujuan penelitian ini adalah mengetahui hubungan antara tingkat pengetahuan dan sikap dengan upaya pencegahan penyakit tuberkulosis di wilayah kerja Puskesmas Bawahan Selan tahun 2015. Metode penelitian ini adalah kuantitatif dengan pendekatan cross sectional study. Populasi penelitian sebanyak 24.410 orang, teknikpengambilan sampel menggunakan metode cluster random sampling, kemudian jumlah sampel ditentukan menggunakan rumus slovin dan didapat sampel sebanyak 100 orang. Instrumen penelitian menggunakan kuesioner. Hasil penelitian menggunakan uji chi square menunjukkan ada hubungan antara pengetahuan (p=0,000) dan sikap (p=0,000), dapat disimpulkan bahwa ada hubungan pengetahuan dan sikap dengan upaya pencegahan tuberkulosis

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

YOLO-UNet Architecture for Detecting and Segmenting the Localized MRI Brain Tumor Image

Brain tumor detection and segmentation are the main issues in biomedical engineering research fields, and it is always challenging due to its heterogeneous shape and location in MRI. The quality of the MR images also plays an important role in providing a clear sight of the shape and boundary of the tumor. The clear shape and boundary of the tumor will increase the probability of safe medical surgery. Analysis of this different scope of image types requires refined computerized quantification and visualization tools. This paper employed deep learning to detect and segment brain tumor MRI images by combining the convolutional neural network (CNN) and fully convolutional network (FCN) methodology in serial. The fundamental finding is to detect and localize the tumor area with YOLO-CNN and segment it with the FCN-UNet architecture. This analysis provided automatic detection and segmentation as well as the location of the tumor. The segmentation using the UNet is run under four scenarios, and the best one is chosen by the minimum loss and maximum accuracy value. In this research, we used 277 images for training, 69 images for validation, and 14 images for testing. The validation is carried out by comparing the segmentation results with the medical ground truth to provide the correct classification ratio (CCR). This study succeeded in the detection of brain tumors and provided a clear area of the brain tumor with a high CCR of about 97%

Amalan Tidak Berintegriti: Remeh Tapi Salah

Kajian ini merupakan sebuah sorotan kajian mengenai integriti. Integriti merangkumi pelbagai nilai murni termasuk kesopanan, ketepatan, kebolehpercayaan, ketekunan, kemuliaan, kesederhanaan, ketinggian peribadi, jujur, ikhlas, amanah, berpegang pada janji, bercakap benar, dan pelbagai sifat positif lain. Akan tetapi, sesuatu organisasi tidak mampu mencapai kecemerlangan jika berlaku masalah dalaman yang berpunca dari integriti atau jika terdapat pengaruh luar yang tidak diselesaikan berikutan kelemahan institusi itu sendiri. Kebanyakan masalah integriti yang dibangkitkan adalah merujuk kepada hal-hal yang remeh yang sering berkait dengan bidang masing-masing, walau bagaimanapun, ia tetap salah dan perlu diperbetulkan. Oleh itu, terdapat keperluan terhadap mengenal pasti punca kelemahan pembudayaan dan penguatkuasaan integriti dalam sesuatu organisasi, khasnya dalam diri masyarakat. Hasil dari permasalahan yang berbangkit ini, dua kemungkinan telah digariskan yang bertujuan membincangkan faktor isu ini sukar menunjukkan yang ianya akan berakhir. Hasil sorotan kajian mendapati, pengetahuan dan pembudayaan tentang isu integriti dilihat menjadi kelemahan ketara dalam kegagalan pengaplikasian integriti dalam pekerjaan. Oleh itu, kefahaman tentang konsep integriti seorang kakitangan adalah perlu bagi memperlihatkan keselarasan antara kata-kata dengan perlakuan, bertindak bersandarkan kepada prinsip moral, etika dan undang-undang, serta mengutamakan kepentingan umum melebihi kehendak diri dan melakukan kerja dengan komprehensif, holistik dan relevan. Selain itu, budaya organisasi berlandaskan piawai etika yang tinggi harus menjadi penggerak dan pengaruh positif kepada amalan tingkah laku beretika dalam kalangan pekerja