PERILAKU KEPEMIMPINAN KIAI DALAM PENYELENGGARAAN PENDIDIKAN DI PONDOK PESANTREN ASSALAFIYAH LUWUNGRAGI BREBES JAWA TENGAH

Penelitian ini berjudul “Perilaku Kepemimpinan Kiai dalam Penyelenggaraan Pendidikan di Pondok Pesantren Assalafiyah Luwungragi Brebes Jawa Tengah”. Permasalahan yang akan dikaji penulis dalam penelitian ini adalah : 1) Bagaimana perilaku kepemimpinan kiai yang berorientasi tugas dalam penyelenggaraan pendidikan di Pondok Pesantren Assalafiyah Luwungragi Brebes Jawa Tengah?, 2) Bagaimana perilaku kepemimpinan kiai yang berorientasi hubungan dalam penyelenggaraan pendidikan di Pondok Pesantren Assalafiyah Luwungragi Brebes Jawa Tengah?. Tujuan dari penelitian ini adalah: 1) Untuk memperoleh gambaran yang jelas mengenai perilaku kepemimpinan kiai yang berorientasi tugas dalam penyelenggaraan pendidikan di Pondok Pesantren Assalafiyah Luwungragi Brebes Jawa Tengah, 2) Untuk memperoleh gambaran yang jelas mengenai perilaku kepemimpinan kiai yang berorientasi hubungan dalam penyelenggaraan pendidikan di Pondok Pesantren Assalafiyah Luwungragi Brebes Jawa Tengah. Metode pengumpulan data yang digunakan adalah observasi, wawancara, dan studi dokumentasi. Sedangkan metode analisis data yang digunakan adalah metode deskriptif kualitatif. Menggunakan teknik purpose sampling dan mengunakan analisis data line by line. Kesimpulan penelitian ini bahwa kiai cenderung direktif dengan cara mendefinisikan peran dan memerintahkan tentang apa, bagaimana, kapan, dan di mana Assatidz atau bawahan melaksanakan tugasnya. Komunikasi yang terjadi hanya satu arah yaitu dari kiai yang memberi perintah kepada Assatidz yang menerima perintah. Adapun perilaku kepemimpinan kiai yang berorientasi hubungan cenderung dominan pada perilaku memberi dukungan dan mengembangkan, sedangkan untuk perilaku memberikan pengakuan masih kurang implementasinya. This study is entitled "Kiai’s Leadership Behavior in the Implementation of Education in Assalafiyah Boarding School, Luwungragi, Brebes, Central Java". Problems discussed by the writer in this study are: 1) How does the Kiai’s leadership behavior in implementing task-oriented technique in Assalafiyah Boarding School, Luwungragi, Brebes, Central Java? 2) How does the Kiai’s leadership behavior in implementing relationship-oriented technique in Assalafiyah Boarding School, Luwungragi, Brebes, Central Java? The aim of this study are: 1) To obtain a clear picture of the Kiai’s leadership behavior in implementing task-oriented technique in Assalafiyah Boarding School, Luwungragi, Brebes, Central Java? 2) To obtain a clear picture of Kiai’s leadership behavior in implementing relationship-oriented technique in Assalafiyah Boarding School, Luwungragi, Brebes, Central Java? Data collection methods used are observation, interviews, and documentation. While the method of data analysis used is descriptive qualitative method using purpose sampling techniques and line by line data analysis. The conclusion of this study shows that the Kiai tend to be directive by defining roles and ordering about what, how, when, and where Assatidz or subordinate conduct their duties. Communication occurs only in one direction, it is from the Kiai who give orders to Assatidz who take orders. However, Kiai’s leadership behaviors who implements the relationship-oriented technique tend to dominantly show supports and development, while giving recognition behavior is still lacking of implementation

Effect of acid hydrolysis time on tensile and morphological properties of microcrystalline chitin filled polylactic acid biocomposites

The objective of this study is to investigate the effect of acid hydrolysis time on microcrystalline chitin (MCC) filled polylactic acid (PLA) biocomposites using solution casting method. MCC was produced from commercial chitin using controlled hydrolysis process at four different hydrolysis time; 15, 30, 45 and 60 min. The tensile and morphological properties of PLA/MCC biocomposites were investigated using tensile testing machine and atomic force microscopy (AFM), respectively. Tensile strength and Young’s modulus of PLA/MCC biocomposites increased gradually by increasing hydrolysis time. The biocomposites with longest hydrolysis time (60 min) showed the higher tensile strength, Young’s modulus and elongation at break values. AFM analysis showed homogeneous dispersion of MCC fillers with smaller particles size at longer hydrolysis time, resulted in smother surface morphology compared to biocomposites with shorter hydrolysis time

Cancer detection using an electronic nose: A preliminary study on detection and discrimination of cancerous cells

Lack of effective tools to diagnose lung cancer at an early stage has caused high mortality in cancer patients especially in lung cancer patients. Electronic nose (E-Nose) technology is believed to offer non-invasive, rapid and reliable analytic approach by measuring the odour released from cancer to assist medical diagnosis. In this work, using a commercial E-nose (Cyranose-320), we aimed to detect the volatile organic compounds (VOCs) emitted by different types of cancerous cells. The lung cancer cell (A549) and breast cancer cell (MCF-7) were used for this study. Both cells were cultured using Dulbecco’s Modified Eagle’s Medium (DMEM) with 10% of Fetal Bovine Serum (FBS) and incubated for three days. The static headspace of cell cultures and blank medium were directly sniffed by Cyranose-320. The preliminary results from this study showed that, the E-nose is able to detect and distinguish the presence of VOCs in cancerous cells with accuracy of 100% using LDA. To this end, the VOCs emitted from cancerous cells can potentially used as biomarker

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

In vitro cancer cell line classification using pattern recognition approach based on metabolite profiling

This study aims to evaluate the feasibility of metabolite profiling for the characterisation and discrimination volatile compounds using the pattern recognition from in vitro cancer cell lines, which are lung, breast and colon cancer together with the blank medium as a control group. This study implemented the A549 (lung), MCF7 (breast) and HCT116 (colon). Cells were harvested and maintained until they grow as monolayer adherent and reach confluence 70-90% before sampling. The volatiles profile from the targeted cell line was established using headspace solid phase microextraction coupled to gas chromatography-mass spectrometry (HSSPME/GCMS). Multivariate data analysis employed principal component analysis (PCA) to better visualise the subtle similarities and the differences among these data sets. A total of 116 volatile organic compounds were detected focused on a limited range of retention time from 3rd until 17th minutes, and 33 compounds were recognized as targeted compounds (peak area>1%). According to both results, the score and the loading plot explained 83% of the total variance. The volatiles compound has shown to be significantly distinguished among cancerous and control group based on metabolite profiling using pattern recognition approach