Pengembangan Parameter Teknologi Terhadap Prediksi Produktivitas Pembangunan Kapal Dengan Pendekatan Splin Kubik

Development ofTechnology Parameter Towards Shipbuilding Productivity Predictor Using Cubic Spline Approach. Ability of production processes associated with state-of-the-art technology, which allows the shipbuilding,is customized with modern equipment. It will give impact to level of productivity and competitiveness. This study proposes a nonparametric regression cubic spline approach with 1 knot, 2 knots, and 3 knots. The application programs Tibco Spotfire S+ showed that a cubic spline with 2 knots (4.25 and 4.50) gave the best result with the value of GCV = 56.21556, and R2 = 94.03%.Estimation result of cubic spline with 2 knots for the PT. Batamec shipyard = 35.61 MH/CGT, PT. Dok & Perkapalan Surabaya = 27.49 MH/CGT, PT. Karimun Sembawang Shipyard = 27.49 MH/CGT, and PT. PAL Indonesia = 19.89 MH/CGT

PENGEMBANGAN PARAMETER TEKNOLOGI TERHADAP PREDIKSI PRODUKTIVITAS PEMBANGUNAN KAPAL DENGAN PENDEKATAN SPLIN KUBIK

Development ofTechnology Parameter Towards Shipbuilding Productivity Predictor Using Cubic Spline Approach. Ability of production processes associated with state-of-the-art technology, which allows the shipbuilding,is customized with modern equipment. It will give impact to level of productivity and competitiveness. This study proposes a nonparametric regression cubic spline approach with 1 knot, 2 knots, and 3 knots. The application programs Tibco Spotfire S+ showed that a cubic spline with 2 knots (4.25 and 4.50) gave the best result with the value of GCV = 56.21556, and R2 = 94.03%.Estimation result of cubic spline with 2 knots for the PT. Batamec shipyard = 35.61 MH/CGT, PT. Dok & Perkapalan Surabaya = 27.49 MH/CGT, PT. Karimun Sembawang Shipyard = 27.49 MH/CGT, and PT. PAL Indonesia = 19.89 MH/CGT.Keywords: technology parameter, shipbuilding productivity, cubic splin

Preparation of anti-vicinal amino alcohols: asymmetric synthesis of D-erythro-Sphinganine, (+)-spisulosine and D-ribo-phytosphingosine

Two variations of the Overman rearrangement have been developed for the highly selective synthesis of anti-vicinal amino alcohol natural products. A MOM-ether directed palladium(II)-catalyzed rearrangement of an allylic trichloroacetimidate was used as the key step for the preparation of the protein kinase C inhibitor D-erythro-sphinganine and the antitumor agent (+)-spisulosine, while the Overman rearrangement of chiral allylic trichloroacetimidates generated by asymmetric reduction of an alpha,beta-unsaturated methyl ketone allowed rapid access to both D-ribo-phytosphingosine and L-arabino-phytosphingosine

Preparation of amino-substituted indenes and 1,4-dihydronaphthalenes using a one-pot multireaction approach: total synthesis of oxybenzo[c]phenanthridine alkaloids

Allylic trichloroacetimidates bearing a 2-vinyl or 2-allylaryl group have been designed as substrates for a one-pot, two-step multi-bond-forming process leading to the general preparation of aminoindenes and amino-substituted 1,4-dihydronaphthalenes. The synthetic utility of the privileged structures formed from this one-pot process was demonstrated with the total synthesis of four oxybenzo[c]phenanthridine alkaloids, oxychelerythrine, oxysanguinarine, oxynitidine, and oxyavicine. An intramolecular biaryl Heck coupling reaction, catalyzed using the Hermann–Beller palladacycle was used to effect the key step during the synthesis of the natural products

Outcomes following small bowel obstruction due to malignancy in the national audit of small bowel obstruction

Introduction Patients with cancer who develop small bowel obstruction are at high risk of malnutrition and morbidity following compromise of gastrointestinal tract continuity. This study aimed to characterise current management and outcomes following malignant small bowel obstruction. Methods A prospective, multicentre cohort study of patients with small bowel obstruction who presented to UK hospitals between 16th January and 13th March 2017. Patients who presented with small bowel obstruction due to primary tumours of the intestine (excluding left-sided colonic tumours) or disseminated intra-abdominal malignancy were included. Outcomes included 30-day mortality and in-hospital complications. Cox-proportional hazards models were used to generate adjusted effects estimates, which are presented as hazard ratios (HR) alongside the corresponding 95% confidence interval (95% CI). The threshold for statistical significance was set at the level of P ≤ 0.05 a-priori. Results 205 patients with malignant small bowel obstruction presented to emergency surgery services during the study period. Of these patients, 50 had obstruction due to right sided colon cancer, 143 due to disseminated intraabdominal malignancy, 10 had primary tumours of the small bowel and 2 patients had gastrointestinal stromal tumours. In total 100 out of 205 patients underwent a surgical intervention for obstruction. 30-day in-hospital mortality rate was 11.3% for those with primary tumours and 19.6% for those with disseminated malignancy. Severe risk of malnutrition was an independent predictor for poor mortality in this cohort (adjusted HR 16.18, 95% CI 1.86 to 140.84, p = 0.012). Patients with right-sided colon cancer had high rates of morbidity. Conclusions Mortality rates were high in patients with disseminated malignancy and in those with right sided colon cancer. Further research should identify optimal management strategy to reduce morbidity for these patient groups

National prospective cohort study of the burden of acute small bowel obstruction

Background Small bowel obstruction is a common surgical emergency, and is associated with high levels of morbidity and mortality across the world. The literature provides little information on the conservatively managed group. The aim of this study was to describe the burden of small bowel obstruction in the UK. Methods This prospective cohort study was conducted in 131 acute hospitals in the UK between January and April 2017, delivered by trainee research collaboratives. Adult patients with a diagnosis of mechanical small bowel obstruction were included. The primary outcome was in‐hospital mortality. Secondary outcomes included complications, unplanned intensive care admission and readmission within 30 days of discharge. Practice measures, including use of radiological investigations, water soluble contrast, operative and nutritional interventions, were collected. Results Of 2341 patients identified, 693 (29·6 per cent) underwent immediate surgery (within 24 h of admission), 500 (21·4 per cent) had delayed surgery after initial conservative management, and 1148 (49·0 per cent) were managed non‐operatively. The mortality rate was 6·6 per cent (6·4 per cent for non‐operative management, 6·8 per cent for immediate surgery, 6·8 per cent for delayed surgery; P = 0·911). The major complication rate was 14·4 per cent overall, affecting 19·0 per cent in the immediate surgery, 23·6 per cent in the delayed surgery and 7·7 per cent in the non‐operative management groups (P < 0·001). Cox regression found hernia or malignant aetiology and malnutrition to be associated with higher rates of death. Malignant aetiology, operative intervention, acute kidney injury and malnutrition were associated with increased risk of major complication. Conclusion Small bowel obstruction represents a significant healthcare burden. Patient‐level factors such as timing of surgery, acute kidney injury and nutritional status are factors that might be modified to improve outcomes

Development of Technology Parameter Towards Shipbuilding Productivity Predictor Using Cubic Spline Approach

Ability of production processes associated with state-of-the-art technology, which allows the shipbuilding,&nbsp;is customized with modern equipment. It will give impact to level of productivity and competitiveness. This study proposes a nonparametric regression cubic spline approach with 1 knot, 2 knots, and 3 knots. The application programs Tibco Spotfire S+ showed that a cubic spline with 2 knots (4.25 and 4.50) gave the best result with the value of GCV = 56.21556, and R2 = 94.03%.Estimation result of cubic spline with 2 knots for the PT. Batamec shipyard = 35.61 MH/CGT, PT. Dok &amp; Perkapalan Surabaya = 27.49 MH/CGT, PT. Karimun Sembawang Shipyard = 27.49 MH/CGT, and PT. PAL Indonesia = 19.89 MH/CGT.</p

Multimodal Management of Metastatic Malignant Meningiomas: The Role of Radiosurgery in Long-Term Local Control

Background: Metastatic meningiomas (MMs) are rare (0.1 of 100 cases). Their treatment requires a multimodal approach, with surgery, radiotherapy, chemotherapy, and radiosurgery, which allows a long-term local control (LC) and an extension of free survival. In this study, the authors performed a review of the literature and reported 2 cases of patients affected by extracranial MMs, with long-term follow-up. Case Description: Case 1: A 48-year-old woman was admitted for resection of an extra-axial falx lesion (meningioma G1). After 2 years, the lesion got a local recurrence, resected with a histologic diagnosis of meningioma G3. During the next 9 years, the patient underwent 5 Gamma Knife radiosurgery (GKRS) procedures for local recurrence. At 56 years, she was readmitted for a surgical local recurrence (histologic definition: anaplastic meningioma G3). At the age of 62, the patient underwent a right lobectomy for a lung mass (histologic diagnosis: anaplastic meningioma G3). After that, multiple lesions at soma L5 and adrenal gland were discovered and then monitored. Case 2: A 48-year-old woman was operated for a lesion involving torcular herophili (meningioma G2). After 3 years, a local recurrence requires GKRS combined with tamoxifen. In the next 7 years, she underwent 5 GKRS procedures for local recurrence. The patient also underwent chemotherapy with octreotide. At the age of 61, she discovered multiple lesions in both lungs, liver, and kidney. A hepatic biopsy showed anaplastic meningioma G3. Also this patient does not suffer from any neurologic or clinical deficits. Conclusions: LC in malignant meningioma is achievable through a multimodal approach; GKRS makes possible LC, but a novel aspect of these lesions is opened to discussion: the metastases. These reports show that multimodal treatment for MMs is an effective approach with good LC and improvement of overall survival. However, a long survival may allow systemic diffusion of the disease, in particular, when sagittal sinus is involved

Comparison between the different types of heterologous materials used in cranioplasty: A systematic review of the literature

INTRODUCTION: The choice of heterologous materials for cranioplasty after decompressive craniectomy is still difficult. The aim of this study is to examine the association between material of choice and related complications to suggest the best treatment option. eViDeNce acQuisiTioN: a systematic review was performed for articles reporting cranioplasty comparing the following heterologous implants: titanium, poli-methyl-methacrylate (PMMa), polyetheretherketone (PeeK) and hydroxyapatite (Ha). extracted data included implant materials and incidence of the most frequent complications. EVIDENCE SYNTHESIS: The final selection resulted in 106 papers but according to our rules only 27 studies were included in the final analysis. among a total of 1688 custom-made prosthesis implanted, 649 were titanium (38.49%), 298 PMMa (17.56%), 233 PeeK (13.82%), and 508 were Ha (30.13%). a total of 348 complications were recorded out of 1688 reported patients (20.64%). in the titanium group, 139 complications were recorded (21.42%); in the PMMa group 57 (19.26%), in the PeeK group 49 (21.03%) and in the Ha group 103 (20.3%). if we examine a summary of the reported complications clearly related to cranioplasty (postoperative infections, fractures and prosthesis displacement) versus type of material in multicentric and prospective studies we can see how Ha group patients have less reported infections and cranioplasty explantation after infections than PMMa, PeeK and titanium. on the contrary Ha patients seem to have a higher number of prosthesis displacement again if compared with the other materials. since these data are not derived from a statistically correct analysis they should be used only to help to differentiate the properties of the various heterologous cranioplasties. CONCLUSIONS: The ideal material for all heterologous cranioplasty has not yet been identified. The choice of material should be based on the clinical data of patients, such as the craniectomy size, presence of seizures, possibility of recovery, good long-term outcome associated with a cost analysis