Analisis Hubungan Biaya Perawatan Dan Hasil Perawatan Pasien Surgikal Di Ruang Rawat Intensif Icu

Latar belakang Pasien post operasi membutuhkan ruangan intensif yang bertujuan untuk pemantauan kondisi pasien setelah tindakan operasi. Biaya perawatan di ICU yang tinggi banyak dipengaruhi oleh beberapa hal yang akan diteliti hubungannya terhadap hasil perawatan. Oleh karena itu penelitian ini akan melihat hubungan antara biaya perawatan dengan hasil perawatan.Tujuan Mengetahui hubungan antara karakteristik pasien post operasi dengan hasil perawatan,dan mengetahui hubungan antara biaya perawatan dengan hasil perawatan Metode Penelitian ini mengggunakan sampel pasien post operasi di ICU RSUP dr.Kariadi,jumlah sampel sebanyak 43 orang yang diambil dengan teknik consecutive sampling.Variabel data yang diteliti adalah usia, jenis kelamin, durasi penggunaan ventilator,Skor Apache II,Lama rawat, biaya rawat dan hasil perawatan. Untuk mengetahui hubungan antar variabel yang diteliti, menggunakan uji korelasi Spearman\u27s. Hasil penelitian menunjukkan bahwa tidak adanya hubungan antara biaya perawatan dengan hasil perawatan pasien ICU post operasi dengan nilai p = 0,144 dan r = 0,226, (p < 0,05 signifikan) . Untuk uji korelasi karakteristik pasien terhadap output didapatkan bahwa Skor Apache II dan durasi ventilator adalah variable yang memiliki hubungan terhadap hasil perawatanKesimpulan dari analisis data tidak ditemukan adanya hubungan antara biaya perawatan terhadap hasil perawatan Kata kunci ICU, APACHE II skor, post operasi, biaya rawat , hasil rawat

A Mathematical Analysis of the Dynamics of Prion Proliferation

How do the normal prion protein (PrP(C)) and infectious prion protein (PrP(Sc)) populations interact in an infected host? To answer this question, we analyse the behavior of the two populations by studying a system of differential equations. The system is constructed under the assumption that PrP(Sc) proliferates using the mechanism of nucleated polymerization. We prove that with parameter input consistent with experimentally determined values, we obtain the persistence of PrP(Sc). We also prove local stability results for the disease steady state, and a global stability result for the disease free steady state. Finally, we give numerical simulations, which are confirmed by experimental data

Cleaning graphene : a first quantum/classical molecular dynamics approach

Graphene outstanding properties created a huge interest in the condensed matter community and unprecedented fundings at the international scale in the hope of application developments. Recently, there have been several reports of incomplete removal of the polymer resists used to transfer as-grown graphene from one substrate to another, resulting in altered graphene transport properties. Finding a large-scale solution to clean graphene from adsorbed residues is highly desirable and one promising possibility would be to use hydrogen plasmas. In this spirit, we couple here quantum and classical molecular dynamics simulations to explore the kinetic energy ranges required by atomic hydrogen to selectively etch a simple residue, a CH3 group, without irreversibly damaging the graphene. For incident energies in the 2-15 eV range, the CH3 radical can be etched by forming a volatile CH4 compound which leaves the surface, either in the CH4 form or breaking into CH3+H fragments, without further defect formation. At this energy, adsorption of H atoms on graphene is possible and further annealing will be required to recover pristine graphene.Comment: 9 figures, 27 page

Multi-isotopic assessments of spatio-temporal diet variability: the case of two sympatric gulls in the western Mediterranean

In predator populations, changes in foraging behaviour in response to spatio-temporal variability of prey are expected. Prey depletion might cause trophic niche widening in generalist species, but not in specialists, which are expected to increase their foraging effort without diet shifts. In sympatric species feeding on similar resources, reduced food availability can increase interspecific competition and cause trophic niche segregation. To understand these processes, we studied the spatio-temporal variability in diet and niche width in 2 sympatric gull species, the yellow-legged gull Larus michahellis and Audouin’s gull Ichthyaetus audouinii, which have experienced exponential growth in recent decades due to an increase in anthropogenic food subsidies. We sampled feathers from chicks of both species in several colonies along the western Mediterranean from 2009 to 2011 and performed stable isotope analysis of carbon, nitrogen and sulphur on these feathers. Bayesian modelling shows that both species displayed opportunistic behaviour if different types of resources were available, but could also narrow their trophic niche if 1 resource was abundant. We also provide evidence of trophic segregation between the 2 gull species, suggesting the occurrence of interspecific competition for food. Our meta-population approach provides a comprehensive view of the trophic ecology and the competitive interactions of these gull species. We emphasize the usefulness of 3-dimensional isotope analyses to correctly assess spatio-temporal variability in trophic behaviour of predator species, revealing differences that would remain hidden in single population studies or when using only the isotopic ratios of 2 elements.info:eu-repo/semantics/acceptedVersio

Deep silicon maxima in the stratified oligotrophic Mediterranean Sea

The silicon biogeochemical cycle has been studied in the Mediterranean Sea during late summer/early autumn 1999 and summer 2008. The distribution of nutrients, particulate carbon and silicon, fucoxanthin (Fuco), and total chlorophyll-<i>a</i> (TChl-<i>a</i>) were investigated along an eastward gradient of oligotrophy during two cruises (PROSOPE and BOUM) encompassing the entire Mediterranean Sea during the stratified period. At both seasons, surface waters were depleted in nutrients and the nutriclines gradually deepened towards the East, the phosphacline being the deepest in the easternmost Levantine basin. Following the nutriclines, parallel deep maxima of biogenic silica (DSM), fucoxanthin (DFM) and TChl-<i>a</i> (DCM) were evidenced during both seasons with maximal concentrations of 0.45 μmol L<sup>−1</sup> for BSi, 0.26 μg L<sup>−1</sup> for Fuco, and 1.70 μg L<sup>−1</sup> for TChl-<i>a</i>, all measured during summer. Contrary to the DCM which was a persistent feature in the Mediterranean Sea, the DSM and DFMs were observed in discrete areas of the Alboran Sea, the Algero-Provencal basin, the Ionian sea and the Levantine basin, indicating that diatoms were able to grow at depth and dominate the DCM under specific conditions. Diatom assemblages were dominated by <i>Chaetoceros</i> spp., <i>Leptocylindrus</i> spp., <i>Pseudonitzschia</i> spp. and the association between large centric diatoms (<i>Hemiaulus hauckii</i> and <i>Rhizosolenia styliformis</i>) and the cyanobacterium <i>Richelia intracellularis</i> was observed at nearly all sites. The diatom's ability to grow at depth is commonly observed in other oligotrophic regions and could play a major role in ecosystem productivity and carbon export to depth. Contrary to the common view that Si and siliceous phytoplankton are not major components of the Mediterranean biogeochemistry, we suggest here that diatoms, by persisting at depth during the stratified period, could contribute to a large part of the marine primary production as observed in other oligotrophic areas

Inferring phytoplankton carbon and eco-physiological rates from diel cycles of spectral particulate beam-attenuation coefficient

The diurnal fluctuations in solar irradiance impose a fundamental frequency on ocean biogeochemistry. Observations of the ocean carbon cycle at these frequencies are rare, but could be considerably expanded by measuring and interpreting the inherent optical properties. A method is presented to analyze diel cycles in particulate beam-attenuation coefficient (<i>c</i><sub>p</sub>) measured at multiple wavelengths. The method is based on fitting observations with a size-structured population model coupled to an optical model to infer the particle size distribution and physiologically relevant parameters of the cells responsible for the measured diel cycle in <i>c</i><sub>p</sub>. Results show that the information related to size and contained in the spectral data can be exploited to independently estimate growth and loss rates during the day and night. In addition, the model can characterize the population of particles affecting the diel variability in <i>c</i><sub>p</sub>. Application of this method to spectral <i>c</i><sub>p</sub> measured at a station in the oligotrophic Mediterranean Sea suggests that most of the observed variations in <i>c</i><sub>p</sub> can be ascribed to a synchronized population of cells with an equivalent spherical diameter around 4.6±1.5 μm. The inferred carbon biomass of these cells was about 5.2–6.0 mg m<sup>−3</sup> and accounted for approximately 10% of the total particulate organic carbon. If successfully validated, this method may improve our in situ estimates of primary productivity

Los aportes de aerosoles afectan las propiedades ópticas de la materia orgánica disuelta en las aguas costeras del Mediterráneo Noroccidental

10 pages, 6 figures, 1 table[EN] Aeolian inputs of organic and inorganic nutrients to the ocean are important as they can enhance biological production in surface waters, especially in oligotrophic areas like the Mediterranean. The Mediterranean littoral is particularly exposed to both anthropogenic and Saharan aerosol depositions on a more or less regular basis. During the last few decades experimental studies have been devoted to examining the effect of inorganic nutrient inputs from dust on microbial activity. In this study, we performed experiments at two different locations of the NW Mediterranean, where we evaluated the changes in the quality and quantity of dissolved organic matter due to atmospheric inputs of different origin (Saharan and anthropogenic) and its subsequent transformations mediated by microbial activities. In both experiments the humic-like and protein-like substances, and the fluorescence quantum yield increased after addition. In general, these changes in the quality of dissolved organic matter did not significantly affect the prokaryotes. The recalcitrant character of the fluorescent dissolved organic matter (FDOM) associated with aerosols was confirmed, as we found negligible utilization of chromophoric compounds over the experimental period. We framed these experiments within a two-year time series data set of atmospheric deposition and coastal surface water analyses. These observations showed that both Saharan and anthropogenic inputs induced changes in the quality of organic matter, increasing the proportion of FDOM substances. This increase was larger during Saharan dust events than in the absence of Saharan influence[ES] Los aportes atmosféricos de nutrientes orgánicos e inorgánicos al océano son importantes ya que pueden aumentar la producción biológica en aguas superficiales, especialmente en las zonas oligotróficas como el Mediterráneo. El litoral del Mediterráneo está particularmente expuesto a aportes de origen antropogénico y a deposiciones de polvo sahariano de forma más o menos regular. Durante las últimas décadas los estudios experimentales se han dedicado, sobre todo, a examinar el efecto de la entrada de nutrientes inorgánicos atmosféricos sobre la actividad microbiana. En este estudio, se realizaron experimentos con comunidades microbianas procedentes de dos zonas del Mediterráneo noroccidental. Se evaluaron los cambios en la calidad y cantidad de la materia orgánica disuelta debido a aportes atmosféricos de distinto origen y sus posteriores transformaciones mediadas por actividades microbianas. En ambos experimentos las sustancias orgánicas fluorescentes y el rendimiento cuántico de fluorescencia aumentaron después de la adición de material atmosférico. En general, estos cambios en la calidad de la materia orgánica no afectaron significativamente a los organismos procariotas. El carácter recalcitrante de la materia orgánica disuelta fluorescente (FDOM) contenida en los aerosoles se confirmó ya que la utilización de compuestos cromóforos durante el período experimental fue insignificante. Los resultados obtenidos se contextualizan en relación con una serie temporal de dos años de datos adquiridos de deposición atmosférica y análisis de agua superficial costera. La variabilidad temporal de estas dos variables mostró que tanto los aportes saharianos como antropogénicos provocaron cambios en la calidad de la materia orgánica disuelta en aguas superficiales, incrementando la fracción fluorescente. Éste aumento resultó ser mayor durante eventos de polvo sahariano que en ausencia de ellosThis study was supported by the projects 1179-1198. ADEPT (CTM2011-23458), DOREMI (CTM2012-342949) and ANIMA (CTM2015-65720-R MINECO/FEDER, UE). E.D. Sánchez-Pérez would like to thank the Consejo Nacional de Ciencia y Tecnologia (CONACyT) for their financial support through a PhD fellowship. I. Marín thanks the FPI Spanish scholarship programme for its support (BES 2012-052976)Peer Reviewe

Los aportes de aerosoles afectan las propiedades ópticas de la materia orgánica disuelta en las aguas costeras del Mediterráneo Noroccidental

Aeolian inputs of organic and inorganic nutrients to the ocean are important as they can enhance biological production in surface waters, especially in oligotrophic areas like the Mediterranean. The Mediterranean littoral is particularly exposed to both anthropogenic and Saharan aerosol depositions on a more or less regular basis. During the last few decades experimental studies have been devoted to examining the effect of inorganic nutrient inputs from dust on microbial activity. In this study, we performed experiments at two different locations of the NW Mediterranean, where we evaluated the changes in the quality and quantity of dissolved organic matter due to atmospheric inputs of different origin (Saharan and anthropogenic) and its subsequent transformations mediated by microbial activities. In both experiments the humic-like and protein-like substances, and the fluorescence quantum yield increased after addition. In general, these changes in the quality of dissolved organic matter did not significantly affect the prokaryotes. The recalcitrant character of the fluorescent dissolved organic matter (FDOM) associated with aerosols was confirmed, as we found negligible utilization of chromophoric compounds over the experimental period. We framed these experiments within a two-year time series data set of atmospheric deposition and coastal surface water analyses. These observations showed that both Saharan and anthropogenic inputs induced changes in the quality of organic matter, increasing the proportion of FDOM substances. This increase was larger during Saharan dust events than in the absence of Saharan influence.Los aportes atmosféricos de nutrientes orgánicos e inorgánicos al océano son importantes ya que pueden aumentar la producción biológica en aguas superficiales, especialmente en las zonas oligotróficas como el Mediterráneo. El litoral del Mediterráneo está particularmente expuesto a aportes de origen antropogénico y a deposiciones de polvo sahariano de forma más o menos regular. Durante las últimas décadas los estudios experimentales se han dedicado, sobre todo, a examinar el efecto de la entrada de nutrientes inorgánicos atmosféricos sobre la actividad microbiana. En este estudio, se realizaron experimentos con comunidades microbianas procedentes de dos zonas del Mediterráneo noroccidental. Se evaluaron los cambios en la calidad y cantidad de la materia orgánica disuelta debido a aportes atmosféricos de distinto origen y sus posteriores transformaciones mediadas por actividades microbianas. En ambos experimentos las sustancias orgánicas fluorescentes y el rendimiento cuántico de fluorescencia aumentaron después de la adición de material atmosférico. En general, estos cambios en la calidad de la materia orgánica no afectaron significativamente a los organismos procariotas. El carácter recalcitrante de la materia orgánica disuelta fluorescente (FDOM) contenida en los aerosoles se confirmó ya que la utilización de compuestos cromóforos durante el período experimental fue insignificante. Los resultados obtenidos se contextualizan en relación con una serie temporal de dos años de datos adquiridos de deposición atmosférica y análisis de agua superficial costera. La variabilidad temporal de estas dos variables mostró que tanto los aportes saharianos como antropogénicos provocaron cambios en la calidad de la materia orgánica disuelta en aguas superficiales, incrementando la fracción fluorescente. Éste aumento resultó ser mayor durante eventos de polvo sahariano que en ausencia de ellos