Integrasi Pareto Fitness, Multiple-Population Dan Temporary Population Pada Algoritma Genetika Untuk Pembangkitan Data Tes Pada Pengujian Perangkat Lunak

Pengujian perangkat lunak memerlukan biaya yang mahal dan sering kali lebih dari 50% biaya keseluruhan dalam pengembangan perangkat lunak digunakan dalam tahapan ini. Untuk mengurangi biaya proses pengujian perangkat lunak secara otomatis dapat digunakan. Hal yang sangat penting dalam pengujian perangkat lunak secara otomatis adalah proses menghasilkan data tes. Pengujian secara otomatis yang paling efektif dalam menekan biaya adalah pengujian branch coverage. Salah satu metode yang banyak digunakan dan memiliki kinerja baik adalah algoritma genetika (AG). Salah satu permasalahan AG dalam menghasilkan data tes adalah ketiga target cabang dipilih memungkinkan tidak ada satupun individu yang memenuhi kriteria. Hal ini akan menyebabkan proses pencarian data tes memakan waktu lebih lama. Oleh karena itu di dalam penelitian ini diusulkan integrasi pareto fitness, multiple-population dan temporary population di dalam proses pencarian data tes dengan menggunakan AG (AG-PFMPTP). Multiple-population diusulkan untuk menghindari premature convergence. Kemudian pareto fitness dan temporary population digunakan untuk mencari beberapa data tes sekaligus, kemudian mengevaluasinya dan memasukkan ke dalam archive temporary population. Dari hasil pengujian yang telah dilakukan rata-rata generasi metode AG-PFMPTP secara signifikan lebih sedikit dalam menghasilkan data tes yang dibutuhkan dibandingkan metode AG standar ataupun AG dengan multiple-population (AG-MP) pada semua benchmark program yang digunakan. Hal tersebut menunjukkan metode yang diusulkan lebih cepat dalam mencari data tes yang dibutuhka

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 hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

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

Perancangan Sistem Informasi Geografis Pemetaan Lokasi Pariwisata di Wilayah Kota Bogor Berbasis Web

Kemajuan teknologi di bidang komputer yang begitu pesat telah mendorong perkembangan sebuah informasi. Salah satunya adalah informasi geografis dunia pariwisata. Perkembangan informasi pariwisata di Kota Bogor dari tahun ke tahun meningkat, namun dalam mempromosikan pariwisata, Dinas Pariwisata masih menggunakan manual dan kurang meluas. Wisatawan yang datang ke tempat-tempat wisata atau ke Dinas Pariwisata akan diberi buklet atau buku panduan. Informasi yang dibuat oleh Dinas Pariwisata setempat sangat terbatas, oleh karena itu masyarakat umum tidak bisa mendapatkan informasi tentang pariwisata. Maka hal ini diperlukan sebuah sistem yang dapat mendukung pemilihan lokasi tujuan wisata bagi pengunjung agar memudahkan tercapainya informasi lokasi wisata. Dalam penelitian ini penulis ingin membangun sistem informasi geografis pariwisata dalam bentuk peta digital yang dapat memberikan informasi lengkap kepada wisatawan dengan menggunakan Google Maps sebagai tampilan utama peta. Sistem ini diharapkan bisa memberikan informasi yang akurat dan relevan bagi wisatawan. Penelitian ini menghasilkan sistem informasi geografis di Kota Bogor yang berbasis web dimana ada juga informasi wisata, Fasilitas seperti pencarian lokasi wisata, dan rute perjalanan

Peluang Usaha Budidaya Ikan Lele Sistem Akuaponik Berteknologi Bioflok di Desa Purwoasri, Tegaldlimo, Banyuwangi

Budidaya ikan lele dengan sistem kombinasi akuaponik dan bioflok merupakan sistem terpadu yang dinilai efektif dan efisien. Sistem akuaponik mereduksi amonia dengan menyerap air buangan budidaya atau air limbah dengan menggunakan akar tanaman. Bioflok merupakan sistem budidaya ikan intensif yang memanfaatkan prinsip daur ulang nutrien pakan yang terbuang melalui bakterial. Tujuan dilaksanakannnya pengabdian masyarakat sebagai upaya pengenalan budidaya ikan lele dengan sistem kombinasi akuaponik dan bioflok kepada masyarakat di Desa Purwoasri, Tegaldlimo, Banyuwangi. Kegiatan dilaksanakan pada bulan Juni-Oktober 2019, terdiri dari pengenalan sistem budidaya pada masyarakat melalui sosialisasi dan pelatihan serta pendampingan pelaksanaan budidaya ikan lele dengan sistem kombinasi akuaponik dan bioflok dalam bentuk bangunan/demplot. Selanjutnya dilakukan evaluasi kepada mitra melalui pre-tes dan post-tes dan diakhiri dengan pembentukan kader. Kegiatan pengenalan sistem budidaya dilakukan kepada mitra yang terdiri dari PKK dan anggota karang taruna di desa Purwoasri sebanyak 20 orang. Berdasarkan evaluasi selama kegiatan ini berlangsung diketahui bahwa pengetahuan mitra tentang sistem budidaya meningkat hingga 75% dari evaluasi awal sebesar 40%. Selain itu, ketertarikan mitra terhadap sistem ini juga mengalami peningkatan dari 65% menjadi 89%. Hal ini menunjukkan bahwa kegiatan pengabdian masyarakat memberikan dampak positif bagi mitra

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe