Analisis Faktor Yang Mempengaruhi Kemandirian Pada Pasien Cedera Kepala Yang Pernah Dirawat Di Igd RSUD Dr. R. Koesma Tuban

Cedera kepala akibat kecelakaan lalulintas merupakan penyebab utama disabilitas dan mortalitas. Functional Independence Measure (FIM) merupakan salah satu pengukuran kemandirian pasien cedera kepala. Beberapa faktor yang dicurigai adalah usia, mekanisme cedera, skor awal GCS, hipotensi, diameter pupil dan reaksi cahaya, CT scan, konsumsi alkohol, dan lama perawatan. Tujuan penelitian ini adalah mengetahui faktor yang mempengaruhi kemandirian pasien cedera kepala. Penelitian ini bersifat analitik observasional dengan menggunakan rancangan retrospektif terhadap107 sampel rekam medis RSUD dr. R. Koesma Tuban dari periode Januari-April 2016. Teknik sampling yang digunakan adalah teknik cluster random sampling dengan kriteria inklusi dan ekslusi. Instrumen yang digunakan lembar checklist dan lembar FIM. Analisis menggunakan uji koefisien kontingensi dan regresi logistik. Hasil uji regresi logistik menunjukan faktor yang mempengaruhi adalah GCS (p=0,996) dan Pupil (p=0,077). Persamaan yang didapat y = 0,357 + 19,434 (GCS) + 2,041 (Pupil). Hasil uji Hosmer and Lameshow menunjukan kalibrasi yang baik (p=1,000), nilai AUC menunjukan bahwa 93,6% persamaan regresi yang diperoleh mampu membedakan kemandirian pasien cedera kepala berdasarkan variabel GCS dan pupil, sisanya yaitu 6,4% dipengaruhi oleh faktor lain. Skor GCS yangrendah pada awal cedera berhubungan dengan prognosa yang buruk, sedangkan abnormalitas fungsi pupil, gangguan gerakan ekstraokular, pola-pola respons motorik yang abnormal seperti postur fleksor dan postur ekstensor, juga memprediksikan outcome yang buruk setelah cedera kepala.Kesimpulan dari penelitian ini adalah Skor awal GCS dan Pupil menjadi faktor yang dominan berpengaruh terhadap kemandirian. Oleh karena itu, perawat perlu meningkatkan manajemen pasien cedera kepala pada fase emergency dengan tidak mengabaikan pengukuran GCS dan Pupil

Arthritis of leprosy

An inflammatory polyarthritis has been previously described in leprosy but accounts of the clinical characteristics have varied. All patients with joint symptoms admitted to a leprosy centre over 5 months were examined by a rheumatologist. Of 48 acute admissions, 20 (42%) had a symmetrical polyarthritis affecting the wrists and fingers. This was strikingly similar to RA in appearance. The arthritis occurred exclusively in patients with reactions mainly during anti-mycobacterial treatment. The clinical features of the joint disorder were identical in Type I (associated with alterations in immune status) and Type II (erythema nodosum leprosum) reactions. Synovial tissue from one patient revealed no mycobacteria. Four of five hand X-rays suggested small erosions of the finger joints

Galerkin approximations with embedded boundary conditions for retarded delay differential equations

Finite-dimensional approximations are developed for retarded delay differential equations (DDEs). The DDE system is equivalently posed as an initial-boundary value problem consisting of hyperbolic partial differential equations (PDEs). By exploiting the equivalence of partial derivatives in space and time, we develop a new PDE representation for the DDEs that is devoid of boundary conditions. The resulting boundary condition-free PDEs are discretized using the Galerkin method with Legendre polynomials as the basis functions, whereupon we obtain a system of ordinary differential equations (ODEs) that is a finite-dimensional approximation of the original DDE system. We present several numerical examples comparing the solution obtained using the approximate ODEs to the direct numerical simulation of the original non-linear DDEs. Stability charts developed using our method are compared to existing results for linear DDEs. The presented results clearly demonstrate that the equivalent boundary condition-free PDE formulation accurately captures the dynamic behaviour of the original DDE system and facilitates the application of control theory developed for systems governed by ODEs

Conductometric Gas Sensors based on Nanostructured WO3 Thin Films

Nanostructured WO3 thin films have been prepared bythermal evaporation to detect hydrogen at low temperatures.The influence of heat treatment on the physical, chemical andelectronic properties of these films has been investigated. Thefilms were annealed at 400oC for 2 hours in air. AFM and TEManalysis revealed that the as-deposited WO3 film is highamorphous and made up of cluster of particles. Annealing at400oC for 2 hours in air resulted in very fine grain size of theorder of 5 nm and porous structure. GIXRD and Raman analysisrevealed that annealing improved the crystallinity of WO3 film.Gas sensors based on annealed WO3 films have shown a highresponse towards various concentrations (10-10000 ppm) H2 atan operating temperature of 150oC. The improved sensingperformance at low operating temperature is due to the optimumphysical, chemical and electronic properties achieved in the WO3film through annealing

Adaptive sparse Galerkin methods for vibrating continuous structures

Adaptive reduced-order methods are explored for simulating continuous vibrating structures. The Galerkin method is used to convert the governing partial differential equation (PDE)into a finite-dimensional system of ordinary differential equations (ODEs) whose solution approximates that of the original PDE. Sparse projections of the approximate ODE solution are then found at each integration time step by applying either the least absolute shrinkage and selection operator (lasso) or the optimal subset selection method. We apply the two projection schemes to the simulation of a vibrating Euler–Bernoulli beam subjected to nonlinear unilateral and bilateral spring forces. The subset selection approach is found to be superior for this application, as it generates a solution with similar sparsity but substantially lower error than the lasso

Effect of water and air flow on concentric tubular solar water desalting system.

This work reports an innovative design of tubular solar still with a rectangular basin for water desalination with flowing water and air over the cover. The daily distillate output of the system is increased by lowering the temperature of water flowing over it (top cover cooling arrangement). The fresh water production performance of this new still is observed in Sri Ramakrishna Mission Vidyalaya College of Arts and Science, Coimbatore (11° North, 77° East), India. The water production rate with no cooling flow was 2050ml/day (410ml/trough). However, with cooling air flow, production increased to 3050ml/day, and with cooling water flow, it further increased to 5000ml/day. Despite the increased cost of the water cooling system, the increased output resulted in the cost of distilled water being cut in roughly half. Diurnal variations of a few important parameters are observed during field experiments such as water temperature, cover temperature, air temperature, ambient temperature and distillate output

Tunneling of a composite particle: Effects of intrinsic structure

We consider simple models of tunneling of an object with intrinsic degrees of freedom. This important problem was not extensively studied until now, in spite of numerous applications in various areas of physics and astrophysics. We show possibilities of enhancement for the probability of tunneling due to the presence of intrinsic degrees of freedom split by weak external fields or by polarizability of the slow composite object.Comment: 6 pages, 3 figures, version to be published in Journal of Physics