Influence of Microwave Incinerated Rice Husk Ash on Hydration of Foamed Concrete

This research explains the results of an investigation carried out to understand the influence of a microwave incinerated rice husk ash (MIRHA) powder on foamed concrete (FC) hydration. The experimental work was designed using the Taguchi approach. This method was selected to have a target for the optimum working conditions of the parameter that affects some physical properties of concrete mixtures. The loss on ignition (LOI) method was used to establish the nonevaporable water (wn) content at all selected ages of hydration. It was observed that the MIRHA powder showed lower nonevaporable water contents than the normal FC, indicating that MIRHA powder facilitated enhancement in FC hydration. The optimum FC properties were achieved at 10% MIRHA composition as proven from the highest compressive strength. This level corresponds to the highest values in change in nonevaporable water and degree of hydration

PEMANFAATAN MEDIA PEMBELAJARAN BERBASIS GAME MENGGUNAKAN KAHOOT!

Abstrak: Tujuan kegiatan pengabdian kepada masyarakat ini adalah melakukan pelatihan kepada guru-guru terkait pemanfaatan media pembelajaran berbasis game menggunkan   Kahoot!. Aplikasi Kahoot! dapat digunakan sebagai media evaluasi yang dapat membantu guru dalam proses evaluasi karena selain memanfaatkan teknologi, hal ini disukai siswa lebih efisien dibandingkan harus menulis lembaran jawaban dalam kertas evaluasi. Metode pelaksanaan program ini terdiri dari sejumlah tahapan yaitu (1) melakukan pendataan peserta yang akan mengikuti pelatihan, (2) menyiapkan modul dan peralatan pelatihan, (3) melakukan pelatihan Pemanfaatan media pembelajaran berbasis game dengan Kahoot! bagi guru-guru di Amuntai, (4) membuat laporan kegiatan, (5) melakukan publikasi kegiatan. Pendataan peserta akan dilaksanakan selama 2 minggu dengan cara penyebaran undangan ke instansi mitra, yaitu Madrasah Aliyah Swasta Al Ukhuwah, Madrasah Ibtidaiyah Integral Al Ukhuwah Amuntai, Madrasah Aliyah Negeri 1 Hulu Sungai Utara dan Madrasah Aliyah Negeri 2 Hulu Sungai Utara. Berdasarkan hasil evaluasi, dapat disimpulkan bahwa peserta pelatihan berupaya aktif memahami konsep dan implementasi penggunaan aplikasi Kahoot! dalam pembelajaran yang menyenangkan berupa kuis sesuai mata pelajaran yang diampu. Hasil análisis menunjukkan bahwa guru-guru memberikan respon positif terhadap kegiatan pelatihan pemanfaatan media pembelajaran berbasis game dengan Kahoot!.Abstract: The purpose of this community service activity was to conduct training for teachers related to the use of game-based learning media using Kahoot!. Kahoot! app could be used as an evaluation medium that can help teachers in the evaluation process because in addition to utilizing technology, this is preferred by students more efficiently than having to write answer sheets on evaluation papers. The method of implementing this program consists of a number of stages, namely (1) collecting data on participants who will take part in the training, (2) preparing training modules and equipment, (3) conducting training in the use of game-based learning media with Kahoot! for teachers in Amuntai, (4) make activity reports, (5) publish activities. Participant data collection would be carried out for 2 weeks by distributing invitations to partner agencies, namely Al Ukhuwah Private Madrasah, Al Ukhuwah Integral Madrasah Al Ukhuwah Amuntai, State Aliyah Madrasah 1 Hulu Sungai Utara and Madrasah Aliyah Negeri 2 Hulu Sungai Utara. Based on the evaluation results, it could be concluded that the trainees are actively trying to understand the concept and implementation of using the Kahoot! in fun learning in the form of quizzes according to the subjects taught. The results of the analysis showed that the teachers gave a positive response to the training activities on the use of game-based learning media with Kahoot!

Implementasi Konsep Lean Manufacturing Untuk Meminimalkan Waktu Keterlambatan Penyelesaian Produk ”a” Sebagai Value Pelanggan (Studi Kasus PT. Tsw (Tuban Steel Work)

PT. TSW (Tuban Steel Work) is a company engaged in manufacturing fabricated (make to order) with the commitment and the goal of providing effective services, convenient and timely delivery. But in fact, the company's commitment to the purpose can not be achieved that delays the project completion time is not in accordance with the order due date. Based on the observations made in the study, this is due to some events that can not add value or called by the waste (non-value added). This study aims to identify waste, analysis of contributing factors and recommendations for improvement as the system improvement efforts in creating customer value. By using the concept of lean manufacturing this study begins by describing the current state map and weighting of the waste system, waste weights were analyzed by matrix VALSAT used to identify waste in the system, to analyze the causes of waste by fishbone diagram to illustrate the root cause of waste and failures mode system analysis using failure mode and effect analysis (FMEA) to determine the value of risk priority number (RPN) of the potential causes and potential effects of waste that occurs. The results showed that the waste that occurs is that there are waiting on purchasing activities (supplier), marking-up cutting and fit-up welding. From the discussion, the company recommended improving information systems internal-external (supplier) as well as improvements in the fabrication process activities

Epidemiology and outcomes of out-of-hospital cardiac arrest in a developing country-a multicenter cohort study.

Background Out-of-hospital cardiac arrest (OHCA) is one of the leading causes of death and disability worldwide. Overall survival after an OHCA has been reported to be poor and limited studies have been conducted in developing countries. We aimed to investigate the rates of survival from OHCA and explore components of the chain of survival in a developing country. Methods We conducted a multicenter prospective cohort study in the emergency departments (ED) of five major public and private sector hospitals of Karachi, Pakistan from January 2013 to April 2013. Twenty-four hour data collection was performed by trained data collectors, using a structured questionnaire. All patients ≥18 years of age, presenting with OHCA of cardiac origin, were included. Patients with do-not-resuscitate status or referred from other hospitals were excluded. Our primary outcome was survival of OHCA patients at the end of ED stay. Results During the three month period, data was obtained from 310 OHCA patients. The overall survival to ED discharge was 1.6 % which decreased to 0 % at 2-months after discharge. More than half (58.3 %) of these OHCA patients were brought to the hospital in a non-EMS (emergency medical service) vehicle i.e. public or private transportation. Patients utilizing non-EMS transportation reached the hospital earlier with a median time of 23 min compared to patients utilizing any type of ambulances which had a delay of 7 min hospital reaching time (median time 30 min). However, patients utilizing ambulances with life-support facilities, as compared to all other types of pre-hospital transportation, had the shortest time to first life-support intervention (15 min). Most of the patients (92.9 %) had a witnessed cardiac arrest out of which only a small percentage (2.3 %) received bystander CPR (cardio pulmonary resuscitation). Median time from arrest to receiving first CPR was 20 min. Only 1 % of patients were found to have a shockable rhythm on first assessment. Conclusion This study showed that the overall survival of OHCA is null in this population. Lack of bystander CPR and weaker emergency medical services (EMS) leading to a delay in receiving life-support interventions were some of the important observations. Poor survival emphasizes the need to standardize EMS systems, initiate public awareness programs and strengthen links in the chain of survival. Electronic supplementary material The online version of this article (doi:10.1186/s12873-016-0093-2) contains supplementary material, which is available to authorized users. Keywords: Out-of-hospital cardiac arrest, Survival, Chain-of-surviva

Global Retinoblastoma Presentation and Analysis by National Income Level

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- A nd middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt