16 research outputs found

    Analysis of the Contribution of TSS, pH, Fe, and Mn Parameters to the Pollution Load Capacity of Coal Mines in the Oal River, South Sumatra

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    The Oal River receives coal wastewater input at several companies. Coal mining in the vicinity of the location adds to the burden of water pollution in the Oal River due to waste water disposal activities. The increase in the concentration of coal waste and the pollution load that enters the Oal River water body will have an impact on the reducing capacity of the pollution load. This study aim to provide information on the condition of the pollution load carrying capacity of the Oal River. Determination of the carrying capacity of water pollution loads at water sources using the mass balance method. The characteristic of the Oal River water with the parameters TSS, pH, Fe and Mn have not yet passed the quality standards for river water and wastewater, both according to PP No. 22 of 2021 and South Sumatra Governor Regulation No. 8 of 2012. The Oal River still has the capacity to accommodate TSS and pH parameters

    Penyuluhan Peningkatan Kesadaran Hukum Masyarakat Terhadap Perilaku Peduli Hukum Dan Lingkungan Melalui Program Kemitraan Masyarakat

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    Peningkatan perilaku peduli hukum dan Penegakan  hukum  memerlukan  ketegasan  aparat  dan  kesadaran  masyarakat.  Penegakan hukum  akan  menjamin  kehidupan  berbangsa  dan  bernegara  yang  aman.  Masyarakat  perlu kesadaran   hukum   yang   tinggi   sehingga   mempunyai   perilaku   hukum   yang   tinggi. Provinsi Sumatera Utara merupakan  salah  satu  provinsi  yang  setiap  tahunnya  mengalami  kebakaran lahan  dan  hutan.  Faktor  kebakaran  lahan  dan  hutan  meliputi  faktor  alam  dan  manusia.  Faktor alam terutama musim kemarau merupakan faktor yang sulit dikendalikan maka salah satu langkah preventifnya   adalah   mengendalikan faktor   manusia.   Pengendalian faktor   manusia   melalui peningkatan peduli hukum dan lingkungan sehingga manusia tidak melakukan pelanggaran hukum terutama   pembakaran   lahan   dan   hutan.   Program   Kemitraan   Masyarakat   Peduli   Hukum merupakan   salah   satu   cara   meningkatkan  perilaku   peduli   hukum   dan  lingkungan.  Metode pelaksanaan  kegiatan  PKM  ini  melalui  sosialisasi  dan  penyuluhan,  demonstrasi  dan  pelatihan, dan  pendampingan  terhadap  mitra  yaitu masyarakat  Desa Singa  Kabupaten Karo meliputi  para  petani, ibu-ibu PKK dan karang taruna. Hasil kegiatan menunjukkan bahwa aparat  Desa Singa Kabupaten Karo dan  masyarakat antusias  mengikuti  kegiatan  ini.  Kegiatan  dilakukan  di  sela-sela  kesibukan bekerja masyarakat Desa Singa Kabupaten Karo. Kegiatan dilakukan dengan pendekatan secara persuasif sehingga   interaksi   dengan   masyarakat   menjadi   nyaman.   Hal   ini   dilakukan   agar   transfer pengetahuan  dan  ketrampilan  berjalan  dengan  baik.  Berdasarkan  hasil  kuisioner  sebelum  dan  sesudah  kegiatan  menunjukkan  bahwa  perilaku  peduli  hukum  dan  lingkungan  masyarakat  Desa Singa Kabupaten Karo meningkat.  Kondisi  ini  sangat  penting  untuk  menciptakan  penegakan  hukum  dan kepedulian lingkungan untuk kehidupan manusia yang nyama

    Global Retinoblastoma Presentation and Analysis by National Income Level.

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    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

    Global Retinoblastoma Presentation and Analysis by National Income Level

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    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

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

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    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

    Global Retinoblastoma Presentation and Analysis by National Income Level

    Get PDF
    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. © 2020 American Medical Association. All rights reserved

    PEMBANGUNAN APLIKASI SISTEM PAKAR ANALISIS PENYAKIT GANGGUAN KEPRIBADIAN MENGGUNAKAN TEOREMA BAYES

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    Gangguan kepribadian merupakan istilah umum untuk suatu jenis penyakit di mana cara berpikir, memahami situasi, dan berhubungan dengan orang lain tidak berfungsi. Dalam beberapa kasus, kemungkinan penderita tidak menyadari bahwa mereka memiliki gangguan kepribadian karena cara berpikir dan berperilaku tampak alami bagi si penderita, dan penderita mungkin menyalahkan orang lain atas keadaannya. Sedangkan orang awam yang ingin mengetahui apakah kepribadian mereka mengalami gangguan, terkadang mengalami kendala bagaimana solusi untuk bisa berkonsultasi tanpa harus menemui seorang psikiater atau psikolog. Salah satu teknik dalam mendiagnosis gangguan kepribadian adalah sistem pakar. Dimana sistem pakar ini dapat mendiagnosis gangguan kepribadian dengan meniru kerja para ahli/pakar. Sistem pakar ini dibangun dengan menggunakan bahasa pemrograman Microsoft Visual C#. Metode yang digunakan adalah metode Fordward Chaining yang dipadukan dengan pengaplikasian Teorema Bayes. Dengan adanya sistem pakar ini pengguna sistem dapat mengetahui jenis gangguan kepribadian yang mungkin diderita serta penanganannya
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