bluuebunny/crossref_metadata_2025 huggingface dataset:
FOTO PREWEDDING DALAM PRESPEKTIF SANTRI PONDOK PESANTREN AL-ISHLAH BANDAR KIDUL MOJOROTO KOTA KEDIRI
Authors: Hermawan Andik , Ropingi Ropingi
Published: April 2019

Fotografi menjadi sebuah ladang bisnis baik bagi fotografer pemula maupun fotografer profesional. Sekarang ini foto prewedding sudah menjadi budaya baru di tengah-tengah masyarakat modern, yakni foto yang dilakukan sebelum pernikahan. Tidak terkecuali umat muslim juga melaksanakan foto prewedding yang mana hukum dari foto prewedding tersebut adalah haram. Penelitian ini bertujuan untuk mengetahui bagaimana pemaknaan santri Pondok Pesantren Al-Ishlah Bandar Kidul Mojoroto Kota Kediri terkait tentang foto prewedding tersebut. Mulai dari tahap eksternalisasi di mana santri beradaptasi dengan budaya baru ini. Kemudian tahap objektivasi, memahami bagaimana dan seperti apa foto pre wedding. Yang terakhir tahap internalisasi, yakni santri memberi pemaknaan atau penafsiran terhadap foto pre wedding.

Dalam penelitian ini penulis menggunakan pendekatan kualitatif dengan menggunakan tiga metode pengumpulan data yaitu observasi, yang mana penulis menjadi observasi partisipan, wawancara mendalam (indept interview), informan dari penelitian ini adalah santri Pondok Pesantren Al-Ishlah yang berjumlah 20 orang, dan selanjutnya dokumentasi. Untuk menganalisis data penulis menggunakan teknik Analisis Interaktif Miles dan Huberman dengan membuat gambaran yang sistematis, faktual dan analisisnya dilakukan melalui tiga jalur reduksi data, penyajian data (data display), dan penarikan kesimpulan.

Penelitian ini mendapatkan hasil bahwa santri Pondok Pesantren Al-Ishlah Bandarkidul, Mojoroto, Kota Kediri memberi penafsiran atau pemaknaan terhadap foto prewedding dengan beberapa tahap seperti yang dikemukakan oleh Peter L. Berger. Pertama tahap eksternalisasi di mana santri membuka diri dan beradaptasi dengan budaya baru yang ada di masyarakat yakni foto pre wedding. Kemudian tahap objektivasi, santri berusaha memahami bagaimana dan seperti apa foto pre wedding tersebut. Yang terakhir tahap internalisasi, yakni santri memberi pemaknaan atau penafsiran terkait foto pre wedding yang menjamur di masyarakat. Bahwa hukum foto pre wedding menurut santri adalah haram, apabila dalam pembuatan dan hasil foto terdapat adegan atau pose yang melanggar syariat. Dan boleh melakukan foto pre wedding, apabila dalam pembuatan dan hasil foto pre wedding tidak menyalahi syariat dan norma agama.

Kata kunci: Konstruksi, Santri, Foto Prewedding.
BRANDING PEMIMPIN NASIONALIS BASUKI TJAHAYA PURNAMA DALAM DEBAT PILKADA DKI JAKARTA 2017 (Menurut Kode-Kode Televisi John Fiske)
Authors: Citra Orwela
Published: April 2019

Basuki Tjahaya Purnamais one of governor candidates for DKI Jakarta 2017. As an incumbent, Ahok (his nickname) has been continued Joko Widodo, which was resigned after won the president election. Ahok had been governor candidate that got highlights in many headline news. This happens because his blunder when he socialized his program in Kepulauan Seribu. He made statement about Al-Qur’an and a part of moslem in Indonesia offended with his statement.One of qonsequences is the destruction of his image as the leader that can embrace the people accros their culture, religion, race and social status. John Fiske Television Codes Model mandated three steps of data analysis on scenes that appear in the Ahok’s debating performance within the last debate in the second season. First, the analysis found a reality construction by Ahok that displaying within speech. Ahok presents himself as populist leader and accepted by the society. A representasion in public debating showed Ahok accepted by ethnic groups and social in Jakarta who positioned to provide a solution to the problem of low and middle class. It displaying within ‘kotak-kotak’. Analysis of the ideology that reached based on reality and representasion by the author shows Ahok foundation of communication in the debate season is to using an emotional approach. This article will analyzeAhok’s perfomancein public debating fo governor election in DKI Jakarta in the second season. The researchers concluded such as accepted social classes, ethnic groups amd nationalism. Of the three ideologies, Ahok focused use nationalist leader as an attempt to construct the brand image of Ahok as a candidate during the Jakarta Governor 2017 in his strategy of political marketing. These results showed that Ahok is a leader who displays himself with nationalist leader.
НАДАННЯ ПІДВИЩЕНОЇ ЗНОСОСТІЙКОСТІ ТКАНИНАМ ДЛЯ ЗАХИСНОГО ОДЯГУ
Authors: Кулікова І. О. , Міщенко Г. В. , Міщенко О. В. , Венгер О. О. , Попович Т. А.
Published: April 2019

The purpose of the work is to increase the wear resistance of textile materials by forming composite polymer films on their surfaces. Methodology. The problem was solved by the use of a mixture of polymers and due to their ability to formulate composite polymer systems that combine the properties of individual polymers and exhibit new ones. One of them was used in the form of aqueous dispersion of the finished polymer of urethane type, and the  second  one  was  synthesized  from  pre-condensates  of  thermosetting  resins  (PTSR)  in  the  process  of finishing, namely, at the stage of heat treatment of the fabric after impregnation and drying, by providing conditions for the course of the condensation reaction.
Sistem Peradilan di Indonesia
Authors: Dr. Patawari SHI.
Published: April 2019

Judul Makalah “Sistem Peradilan Di Indonesia” adalah materi yang disajikan/dipresentasikan di depan peserta Pendidikan Khusus Provesi Advokat (PKPA) DPN PERADI kerjasama Fakultas Hukum Universitas Sawerigading Makassar, pada Sabtu 11 Pebruari 2017
Ride-hailing platforms are shaping the future of mobility, but for whom?
Authors: Young Mischa , Farber Steven
Published: April 2019

Claiming that ride-hailing companies have disrupted the transportation sector is an understatement. The ability and vision of companies, such as Uber and Lyft, to harness smartphones’ built-in GPS technologies, provide real-time information about wait times, and facilitate cashless transactions has enabled them to effectively compete with the taxi industry, and potentially capture a sizeable share of the ridership of other modes as well. RH services are now increasingly being recognized as an accepted transportation service within cities, and have rapidly positioned themselves among the most valuable companies within the transportation sector. Albeit a relatively new field of research, studies on this novel mode of travel have mostly focused on its impacts upon the transportation sector, and on the regulatory and policy frameworks that should be implemented to either encourage or deter its usage. To date, not much work has been done to determine who actually benefits from RH and to understand the equity concerns that it may engender. In this chapter, we explore these largely unaddressed concerns by situating ride-hailing within the well-established transport equity literature that has long focussed on disparities in access and mobility between different social, economic, and demographic groups. This allows us to elaborate on the potentially restrictive nature of RH for many segments of the population. Once unveiled, these equity concerns will shape our discussion and inform our recommendations for an agenda to research equity concerns vis-a-vis ride-hailing.
Analisis Pelaksanaan Tugas dan Wewenang Badan Permusyawaratan Nagari Padang Ganting Kabupaten Solok Selatan
Authors: netrivianti
Published: April 2019

Basis sekian banyak diperoleh hasil penelitian. 1), dalam tugas dan wewenang BAMUS Nagari melakukan Padang Ganting adalah pembuatan regulasi mendalam wilayah Nagari dengan Wali Nagari (undang-undang), aspirasi masyarakat daerah pengawasan daerah, membentuk perguruan tinggi pemilihan Wali Nagari, mengatur disiplin BAMUS Nagari dan keseluruhannya dilakukan dengan setiap pertimbangan . 2), tentang masalah yang sering dihadapi oleh BAMUS Nagari Padang Ganting dalam tugas dan wewenang yang dilakukan itu dikurangi ilmu akan tugas dan fungsinya, banyaknya kesalahpahaman yang terjadi antara Wali nagari dan BAMUS Nagari, kendala dalam pelaksanaan logistik pengawasan. Semua tentang masalah ini mencakup mekanisme BAMUS Nagari dan tradisi penjaga masalah otoritas di nagari. Tentang masalah lain adalah berapa kali terjadi kesalahpahaman antara komandan nagari dan BAMUS Nagari, khususnya dalam hal akuntabilitas keuangan nagari. 3), upaya yang dilakukan untuk menyelesaikan masalah tersebut adalah perlu meningkatkan formulir konstruksi dan aplikasi keterampilan teknis untuk menjadi anggota BAMUS Nagari, mengusahakan kandidat BAMUS Nagari yang dinilai oleh kapabel dan sebanyak mungkin mewakili semua elemen masyarakat dan tidak hanya mewakili mengandalkan orang yang memiliki pengaruh besar.
PENERAPAN MEDIA KOMPUTER (SOFTWARE DERIVE 6.0) DALAM UPAYA MENINGKATKAN HASIL BELAJAR MATEMATIKA PADA MATERI AJAR INTEGRAL SISWA KELAS XII IPA SMA DARUL DA’WAH WAL IRSYAD KENDARI
Authors: La Ode Sabran
Published: April 2019

ABSTRAK LA ODE SABRAN, “Penerapan Media Komputer (Software Derive 6.0) dalam Upaya Meningkatkan Hasil Belajar Matematika pada Materi Ajar Integral Siswa Kelas XII IPA SMA Darul’ Da’wah Wal Irsyad Kendari.” Penelitian ini adalah Penelitian Tindakan Kelas (PTK). Rumusan masalah dalam penelitian ini adalah apakah hasil belajar matematika siswa pada materi ajar integral dapat ditingkatkan dengan menerapkan komputer (software derive 6.0) sebagai media pembelajaran? Tujuannya adalah melalui penerapan komputer (software derive 6.0) sebagai media pembelajaran pada materi ajar integral, hasil belajar matematika siswa, kelas XII IPA SMA Darul Da’wah Wal Irsyad Kendari dapat ditingkatkan. Hipotesis tindakan penelitian ini adalah hasil belajar matematika siswa kelas XII IPA SMA DDI Kendari pada materi ajar integral dapat ditingkatkan dengan menerapkan komputer (Software Derive 6.0) sebagai media pembelajaran. Penelitian ini dilaksanakan pada siswa kelas XII IPA SMA DDI Kendari pada tahun pelajaran 2011/2012 dengan jumlah siswa 21 orang. Instrument yang digunakan adalah tes hasil belajar matematika berupa tes siklus I, tes siklus II dan tes siklus III (setelah pemberian tindakan), lembar observasi guru dan siswa serta rekaman video untuk kondisi pelaksanaan tindakan. Prosedur penelitian ini terdiri dari: (1) perencanaan, (2) pelaksanaan tindakan, (3) observasi dan evaluasi, dan (4) reflekasi. Pembelajaran diberikan dengan menerapkan komputer (software derive 6.0) sebagai media pembelajaran. Hasil penelitian ini menunjukkan bahwa melalui penerapan komputer (software derive 6.0) sebagai media pembelajaran, hasil belajar matematika siswa kelas XII IPA SMA DDI Kendari dapat ditingkatkan. Hal ini terlihat dari tercapainya indikator kinerja baik dari segi proses maupun hasil pada penelitian ini yaitu dari segi pelaksanaan skenario pembelajaran oleh guru yang telah disusun, pada siklus I mencapai 77,27%, siklus II 90,9%, dan pada siklus III mencapai 100%. Begitu pula dengan pelaksanaan pembelajaran yang dilakukan oleh siswa pada siklus I mencapai 85,93%, siklus II 87,5%, dan siklus III mencapai 90,62%. Sedangkan dari segi hasil yang berkaitan dengan hasil belajar siswa menunjukkan bahwa pada siklus I mencapai 80,95% dengan rata-rata 69,42, siklus II 80,95 % dengan nilai rata-rata 71,52 dan pada siklus III meningkat 90, 47% dengan nilai rata-rata 73,52.
Hospitaliti dalam Teknologi Pelayanan Prima Versus Customer Service Officers
Authors: Djumrianti Desloehal
Published: April 2019

ABSTRAK, Memberikan pelayanan yang terbaik kepada setiap customer adalah suatu kewajiban yang harus dilakukan oleh setiap petugas front office, karena pelayanan tersebut akan memberikan kesan terhadap perusahaan, instansi tersebut. Sedangkan customer pun juga mengharapkan untuk mendapatkan pelayanan sesuai dengan keinginan mereka. Apa yang mereka butuhkan pada saat berada di front office terpenuhi dari pelayanan petugas. Sementara itu kemajuan teknologi juga sudah memasuki sektor pelayanan kepada konsumen. Beberapa bagian dari pekerjaan customer service officers bahkan dapat diambil alih oleh teknologi ini. Adanya kekhatiwatiran dari teknologi ini mampu menggantikan petugas customer sevice. Oleh karena itu, paper ini bertujuan untuk mengkaji beberapa literatur secara teoritis termasuk penelitian terdahulu, buku, dan sumber lainnya tentang hospitaliti servis secara konvensional dan penggunaan teknologi pelayanan untuk melihat bagaimana pelayanan prima yang diberikan oleh teknologi berbanding dengan pelayanan prima yang diberikan oleh petugas customer service. Penelitian ini adalah kualitatif dengan mengaplikasi metode Miles and Huberman kedalam analisis penelitian terdahulu dan literatur lainnya. Ada tiga tahap yaitu reduksi data, penyajian data, dan kesimpulan. Penelitan ini merupakan pembanding dan pengembangan dari penelitian sebelumnya. Hasilnya yang bahwa petugas customer service yang professional secara personal masih disenangi oleh customer. Sementara itu kemajuan teknologi dalam pelayanan prima membantu mempercepat dari tugas-tugas yang dilakukan oleh front office. Paper ini diharapkan sebagai referensi bagi perusahaan yang melakukan pelayanan secara konvensional atau dengan teknologi, dan referensi dasar bagi peneliti dan mahasiswa.
Strategi Camat dalam Meningkatkan Penerimaan Pajak Bumi dan Bangunan (PBB) di Kecamatan Pauh Limo
Authors: Musri
Published: April 2019

Basis sekian banyak diperoleh hasil penelitian. Pertama, penerimaan Pajak Bumi dan Bangunan di Kabupaten Pauh Limo Kota Padang pada tahun 2015 meningkat kejadian tahun-tahun sebelumnya. Hal yang paling mungkin terwujud dari berbagai tahapan dan upaya yang harus dilalui yaitu melalui penyuluhan kepada wajib pajak dan juga agen perpajakan (kolektor) dan melakukan koordinasi dengan Pemerintah Daerah Kabupaten Jazzy selatan. Keduanya, menemukan kendala dalam meningkatkan penerimaan PBB di Kabupaten Sangir Jujuan adalah kualitas Sumber Daya Manusia (SDM) yang mengurangi dan membatasi energi operasional, kualitas / kolektor pajak), peningkatan kecerdasan masyarakat, asisten / kolektor secara umum masih baru dan masih banyak wajib pajak yang memperpanjang waktu / menunggu nilai jatuh tempo. Ketiga, upaya yang dilakukan untuk menyelesaikan kendala dalam meningkatkan penerimaan PBB di Kabupaten Sangir Jujuan adalah meningkatkan kesadaran fiskus (petugas pajak), meningkatkan kesadaran yang dapat dinilai, meningkatkan pelayanan dan pengamatan.
PERBANDINGAN SISTEM KESEHATAN DI NEGARA MAJU DAN BERKEMBANG
Authors: LAHAS ULRIKUS JULIANO
Published: April 2019

ULRIKUS JULIANO LAHAS & LIBERIUS BERNADINUS HADON
ADMINISTRASI KURIKULUM
Authors: Rahmafitri
Published: April 2019

Resume 3 Maharani Rahmafitri
Strategi Penegakkan Disiplin Wali Nagari Terhadap Perangkat Nagari
Authors: netrivianti
Published: April 2019

Berdasarkan hasil temuan di lapangan menunjukkan bahwa pelaksanaan disiplin di Kantor Wali Nagari Sawah Laweh Pasar Baru Pesisir Selatan sudah mulai membaik yaitu dengan memberikan wewenang sesuai tugas dan fungsi yang sudah dikelola, memberikan peningkatan kesejahteraan pada pegawai yang aktif, mengatur Rapat magang setiap hari di semua dengan semua perangkat dan membuat beberapa perintah agar disiplin didisiplinkan. Selain itu ada satu kendala yang dihadapi yaitu: pengurangannya adalah kerja keras karyawan karena rendahnya ilmu pengetahuan dan upah kecil periferal nagari. Upaya demikian yang dilakukan yaitu: memberi konstruksi dan pelatihan, memberi teguran adalah pelanggaran dan diberikan langkah peningkatan kesejahteraan. Dengan upaya itu diharapkan semua perangkat dapat bekerja lebih baik dengan bimbingan dan instruksi yang sudah diberikan oleh Sponsor Nagari sehingga terwujud disiplin yang tinggi.
Acute Respiratory Distress and Its Risk Factors among Neonates Admitted in a Tertiary Care Center of Western Nepal
Authors: Adhikari Jyoti , Aryal Sajju , Gupta Veena
Published: April 2019

Background: Neonatal period is defined as a period from birth to under 4 weeks (<28 days) of age. It is a highly vulnerable time for an infant, who is completing many of the physiologic adjustments required for extra uterine existence. The term Respiratory distress (RD) is used to indicate signs & symptoms of abnormal respiratory pattern.

Methods: All neonates admitted in neonatal intensive care unit of Nepalgunj Medical College, Kohalpur with respiratory distress were included. Same number of age and sex matched controls without RD were selected.

Results: The NICU based hospital incidence of RD was 9.1% with  male: female ratio 1.4:1 The Most Common etiology was neonatal sepsis (51.6%), followed by hyaline membrane disease (17.8%), TTN (12.7%), meconium aspiration syndrome (6%), birth asphyxia (5.08%), tracheoesophageal fistula (2%) and pneumothorax (2%). Newborns with poor APGAR score requiring resuscitation were more likely to develop RD (p=0.025). Newborns with birth weight <2.5 kg and >4 kg were 2 times likely to develop RD as compared to control group (p<0.012). There was 7 times higher risk of developing MAS when a baby was born through thick MSL as compared to control group (P<0.022). Inadequate ANC visit significantly increased RD in newborns (p<0.001). Babies born to mother with PROM for more than 18 hours were 5.5 times likely to develop RD (p<0.001) whereas those born to mother who had any source of infection were about 6 times at risk of developing respiratory distress than control group (p=0.007).

Conclusion: Certain measures that could be taken to reduce the number of RD are: 1. discouraging early marriage and teenage pregnancy. 2. Increasing awareness regarding temporary and permanent contraceptive measures. 3. Promoting education of girls. 4. Increasing coverage of ANC visit in rural areas and 5. formulating integrated plan and policies from the Government level.
Effects of Adding Intrathecal Fentanyl as Adjunct to Hyperbaric Bupivacaine in Vaginal Hysterectomy: A Double Blinded Randomized Controlled Trial
Authors: Dhakal Yogesh
Published: April 2019

Introduction: Spinal anesthesia is the preferred means for gynecological surgeries. Adjuvants to local anesthesia for spinal anesthesia may enhance quality and duration of analgesia. Our study aimed to evaluate efficacy and safety of fentanyl added to bupivacaine for spinal anesthesia.

Methods: A prospective, randomized, double blind study was conducted on 60 ASA I or II adult female patients undergoing vaginal hysterectomy under spinal anesthesia. Patients were randomly divided into two groups. Patients in Group B (n=30) were administered 3 mL of 0.5% hyperbaric bupivacaine with 0.4 ml NS and Group F (n=30) were given 3 mL of 0.5% hyperbaric bupivacaine with 0.4 ml (20μg) fentanyl intrathecally. Hemodynamic variables (i.e. heart rate, noninvasive blood pressure, oxygen saturation), onset of motor and sensory block, duration of sensory and motor blockade and any side effects observed were recorded intraoperatively and postoperatively.

Results: The duration of sensory and motor blockade was significantly prolonged (P<0.05) in fentanyl group (268.6±55.4 and 182.8±43.87) compared to control group (235.03±51.97 and 149.47±38.75). Similarly, the onset of sensory and motor block was significantly earlier (P<0.05) in group F (5.2±2.55 and 7.8±2.91) compared to group B (6.63±2.88 and 9.97±3.28). There was no significant statistical difference in the incidence of side effects and changes in hemodynamic variables in both the groups. No adverse events were observed during study.

Conclusion: Addition of fentanyl to hyperbaric bupivacaine for spinal anesthesia offers early onset, better surgical analgesia, prolongs the duration of analgesia without any significant adverse effects.
MAKNA SIMBOLIK SEBUTAN “AANG/AAH” DI KALANGAN UMAT ISLAM KECAMATAN GEKBRONG, CIANJUR (SUATU TELAAH PERSPEKTIF INTERAKSIONISME SIMBOLIK)
Authors: Zein Wiwin
Published: April 2019

Tujuan dari penelitian ini adalah untuk mengetahui makna simbolik sebutan "Aang/Aah" di kalangan umat Islam Kecamatan Gekbrong, Kabupaten Cianjur, Provinsi Jawa Barat.

Hasil penelitian menunjukkan bahwa makna simbolik sebutan "Aang/Aah", bagi umat Islam di kecamatan Gekbrong memiliki makna simbolik yang subyektif, tergantung pada kepada siapa nama itu dilekatkan. Tapi makna simbolik nama "Aang/Aah" memiliki makna yang bersipat umum, yaitu merepresentasikan tokoh atau orang yang memiliki/menguasai ilmu agama yang luas dan mendalam, karismatik (otoritatif), berpengaruh, saleh, dan memiliki posisi tinggi/mulia. Makna simbolik nama "Aang/Aah" yang bersipat umum itu sipatnya permanen, kepada siapapun nama itu dilekatkan, akan memiliki makna yang sama.

Kata Kunci : simbolik, interaksionisme, Gekbrong, Aang, Aah.
â€œTUBUH PEREMPUAN HINDUâ€ DAN BUDAYA DOMINAN DI BALI: ANTARA PERSPEKTIF AGAMA, BUDAYA DAN REALITAS KONTEMPORER
Authors: Segara I Nyoman Yoga
Published: April 2019

Artikel ini adalah ulasan atas hasil penelitian dan literatur yang bertujuan untuk melihat kembali posisi perempuan Hindu di Bali di tengah budaya dominannya. Dengan pendekatan antropologi feminisme, artikel ini tidak akan memasuki wilayah yang sudah umum dilakukan banyak orang jika mendiskusikan perempuan, misalnya tentang jender atau gerakan kesetaraan semata. Antropologi feminisme membawa artikel ini untuk memahami perempuan dari kebertubuhannya, perannya dalam konteks sosial budaya, dan juga agama. Strategi perempuan dalam menampilkan dirinya di ruang pribadi maupun di ruang publik, serta kemampuannya untuk bertahan dalam serangan diskriminasi menjadi penting untuk dijelaskan. Pendekatan seperti ini adalah cara untuk melihat kembali bagaimana tubuh perempuan secara antropologis. Dengan demikian, tema pokok artikel ini menjadi satu kasus untuk memperlihatkan bahwa perempuan Hindu masih dan akan terus menghadapi masalah, serta stigma dan stereotipe yang disematkan kepadanya, padahal secara dogmatis perempuan Hindu telah diakui dan banyak disebut-sebut dalam berbagai kitab suci Veda. Begitu juga peran perempuan di masa lalu yang diyakini sebagai Rsi dan ikut menulis beberapa kitab suci dan susastera Veda lainnya.
MAUDUâ€™ (A WAY OF UNION WITH GOD)
Authors: Dewi Rita Sukma
Published: April 2019

The term â€œSayyidâ€ or â€œArabâ€ has always been associated with Islam in Indonesia. Since Islam originated in the land of Arab, Muslims in Indonesia often believe that religion and Arab race are similar, just as the term â€œCultureâ€ or â€œReligionâ€, although they have different context, many people believe that the term â€œcultureâ€ is similar to â€œreligionâ€. Religious influences are embedded in many aspects of culture but Arabic culture is not an identity about Islam, these two should be separate from one another.
Pengaruh Faktor Eksternal terhadap Piutang Tak Tertagih pada Koperasi Guru Rambate Rata (KGRR) Tinambung Kabupaten Polewali Mandar
Authors: Unsulbar Administrator Jepa , Purwati Wiwi , Dahlia Dahlia
Published: April 2019

Penelitian ini bertujuan untuk mengetahui: pengaruh Faktor Eksternal terhadap Piutang Tak Tertagih pada Koperasi Guru Rambate Rata (KGRR) Tinambung Kabupaten Polewali Mandar. Populasi penelitian ini  adalah 33 orang anggota koperasi yang terindikasi atau yang termasuk mempunyai piutang tak tertagih pada Koperasi Guru Rambate Rata (KGRR) Tinambung Kabupaten Polewali Mandar. Data penelitian di perolah dengan menggunakan instrument kuesioner dan wawancara. Uji hipotesis yang digunakan adalah regresi linier sederhana dan uji t. Hasil penelitian ini menunjukkan bahwa: Faktor Eksternal berpengaruh positif terhadap Piutang Tak Tertagih pada Koperasi Guru Rambate Rata (KGRR) Tinambung Kabupaten Polewali Mandar yang  ditunjukkan  dengan  nilai  koefisien  determinasi  sebesar 0,456, nilai signifikansi lebih kecil dari  level of significant  (0,000 < 0,050) dan persamaan garis regresinya.
Awake craniotomy with transcortical motor evoked potential monitoring for resection of gliomas in the precentral gyrus: utility for predicting motor function
Authors: Saito Taiichi , Muragaki Yoshihiro , Tamura Manabu , Maruyama Takashi , Nitta Masayuki , Tsuzuki Shunsuke , Fukuchi Satoko , Ohashi Mana , Kawamata Takakazu
Published: April 2019

OBJECTIVE

Resection of gliomas in the precentral gyrus carries a risk of severe motor dysfunction. To prevent permanent, severe postoperative motor dysfunction, reliable intraoperative predictors of postoperative function are required. Since 2005, the authors have removed gliomas in the precentral gyrus with combined functional mapping and estimation of intraoperative voluntary movement (IVM) during awake craniotomy and transcortical motor evoked potentials (MEPs). The purpose of the current study was to evaluate whether intraoperative findings of combined monitoring of IVM during awake craniotomy and transcortical MEP monitoring were useful for predicting postoperative motor function of patients with gliomas in the precentral gyrus.

METHODS

The current study included 30 patients who underwent resection of precentral gyrus gliomas during awake craniotomy from April 2000 to January 2018. All tumors were removed with monitoring of IVM during awake craniotomy and transcortical MEPs. Postoperative motor function was classified as stable or declined, with the extent of decline categorized as mild, moderate, or severe. We defined moderate and severe deficits were those that hindered daily life.

RESULTS

In 28 of 30 cases, available waveforms were obtained with transcortical MEPs. The mean extent of resection (EOR) was 93%. Relative to preoperative status, motor function 6 months after surgery was considered stable in 20 patients and was considered to show mild decline in 7, moderate decline in 2, and severe decline in 1. Motor function 6 months after surgery was significantly correlated with IVM (p = 0.0096), changes in transcortical MEPs (decline ≤ or > 50%) (p = 0.0163), EOR, and ischemic lesions on postoperative MRI. Six patients with no change in IVM showed stable motor function 6 months after surgery. Only 2 patients with a decline in IVM and a decline in MEPs ≤ 50% had a decline in motor function 6 months after surgery (18%; 2/11 patients), whereas 11 patients with a decline in IVM and a decline in MEPs > 50% had such a decline in motor function (73%; 8/11 patients) including 2 patients with moderate and 1 with severe deficits. Three patients with moderate or severe motor deficits showed the lowest MEP values (< 100 µV).

CONCLUSIONS

Combined judgment from monitoring of IVM during awake craniotomy and transcortical MEPs is useful for predicting postoperative motor function during removal of gliomas in the precentral gyrus. Maximum resection was achieved with an acceptable morbidity rate. Thus, these tumors should not be considered unresectable.
Comparing two randomized deep brain stimulation trials for Parkinson’s disease
Authors: Deuschl Günther , Follett Kenneth A. , Luo Ping , Rau Joern , Weaver Frances M. , Paschen Steffen , Steigerwald Frank , Tonder Lisa , Stoker Valerie , Reda Domenic J.
Published: April 2019

OBJECTIVE

Several randomized studies have compared the effect of deep brain stimulation (DBS) of the subthalamic nucleus with the best medical treatment in large groups of patients. Important outcome measures differ between studies. Two such major studies, the life-quality study of the German Competence Network for Parkinson’s disease (LQ study) and the US Veterans Affairs/National Institute of Neurological Disorders and Stroke trial (VA/NINDS trial), were compared here in order to understand their differences in outcomes.

METHODS

Unless otherwise noted, analyses were based on those subjects in each study who received a DBS implant (LQ study 76 patients, VA/NINDS trial 140 patients) and who had data for the measurement under consideration (i.e., no imputations for missing data), referred to hereafter as the “as-treated completers” (LQ 69 patients, VA/NINDS 125 patients). Data were prepared and analyzed by biostatisticians at the US Department of Veterans Affairs Cooperative Studies Program Coordinating Center, the Coordinating Center for Clinical Trials Marburg, and Medtronic, under the direction of two authors (G.D. and K.A.F.). Data were extracted from the respective databases into SAS data sets and analyzed using SAS software. Analyses were based on the 6-month follow-up data from both studies because this was the endpoint for the LQ study.

RESULTS

Pre-DBS baseline demographics differed significantly between the studies, including greater levodopa responsiveness (LDR) in the LQ study population than in the VA/NINDS group. After DBS, LQ subjects demonstrated greater improvement in motor function (Unified Parkinson’s Disease Rating Scale, Motor Examination [UPDRS-III]), activities of daily living (ADLs), and complications of therapy. Medication reduction and improvements in life quality other than ADLs were not significantly different between LQ and VA/NINDS subjects. When the two populations were compared according to pre-DBS LDR, the “full responders” to levodopa (≥ 50% improvement on UPDRS-III with medication) in the two studies showed no significant difference in motor improvement with DBS (LQ 18.5 ± 12.0–point improvement on UPDRS-III vs VA/NINDS 17.7 ± 15.6–point improvement, p = 0.755). Among levodopa full responders, ADLs improved slightly more in the LQ group, but scores on other UPDRS subscales and the Parkinson’s Disease Questionnaire-39 were not significantly different between the two studies.

CONCLUSIONS

This comparison suggests that patient selection criteria, especially preoperative LDR, are the most important source of differences in motor outcomes and quality of life between the two studies.
Associations between clinical outcome and tractography based on navigated transcranial magnetic stimulation in patients with language-eloquent brain lesions
Authors: Sollmann Nico , Fratini Alessia , Zhang Haosu , Zimmer Claus , Meyer Bernhard , Krieg Sandro M.
Published: April 2019

OBJECTIVE

Navigated transcranial magnetic stimulation (nTMS) in combination with diffusion tensor imaging fiber tracking (DTI FT) is increasingly used to locate subcortical language-related pathways. The aim of this study was to establish nTMS-based DTI FT for preoperative risk stratification by evaluating associations between lesion-to-tract distances (LTDs) and aphasia and by determining a cut-off LTD value to prevent surgery-related permanent aphasia.

METHODS

Fifty patients with left-hemispheric, language-eloquent brain tumors underwent preoperative nTMS language mapping and nTMS-based DTI FT, followed by tumor resection. nTMS-based DTI FT was performed with a predefined fractional anisotropy (FA) of 0.10, 0.15, 50% of the individual FA threshold (FAT), and 75% FAT (minimum fiber length [FL]: 100 mm). The arcuate fascicle (AF), superior longitudinal fascicle (SLF), inferior longitudinal fascicle (ILF), uncinate fascicle (UC), and frontooccipital fascicle (FoF) were identified in nTMS-based tractography, and minimum LTDs were measured between the lesion and the AF and between the lesion and the closest other subcortical language-related pathway (SLF, ILF, UC, or FoF). LTDs were then associated with the level of aphasia (no/transient or permanent surgery-related aphasia, according to follow-up examinations).

RESULTS

A significant difference in LTDs was observed between patients with no or only surgery-related transient impairment and those who developed surgery-related permanent aphasia with regard to the AF (FA = 0.10, p = 0.0321; FA = 0.15, p = 0.0143; FA = 50% FAT, p = 0.0106) as well as the closest other subcortical language-related pathway (FA = 0.10, p = 0.0182; FA = 0.15, p = 0.0200; FA = 50% FAT, p = 0.0077). Patients with surgery-related permanent aphasia showed the lowest LTDs in relation to these tracts. Thus, LTDs of ≥ 8 mm (AF) and ≥ 11 mm (SLF, ILF, UC, or FoF) were determined as cut-off values for surgery-related permanent aphasia.

CONCLUSIONS

nTMS-based DTI FT of subcortical language-related pathways seems suitable for risk stratification and prediction in patients suffering from language-eloquent brain tumors. Thus, the current role of nTMS-based DTI FT might be expanded, going beyond the level of being a mere tool for surgical planning and resection guidance.
Evaluation of cost and survival in intracranial gliomas using the Value Driven Outcomes database: a retrospective cohort analysis
Authors: Wilde Herschel , Azab Mohammed A. , Abunimer Abdullah M. , Abou-Al-Shaar Hussam , Karsy Michael , Guan Jian , Menacho Sarah T. , Jensen Randy L.
Published: April 2019

OBJECTIVE

Gliomas occur in 3–4 individuals per 100,000 individuals and are one of the most common primary brain tumors. Treatment options are limited for gliomas despite the progressive nature of the disease. The authors used the Value Driven Outcomes (VDO) database to identify cost drivers and subgroups that are involved in the surgical treatment of gliomas.

METHODS

A retrospective cohort of patients with gliomas treated at the authors’ institution from August 2011 to February 2018 was evaluated using medical records and the VDO database.

RESULTS

A total of 263 patients with intracranial gliomas met the authors’ inclusion criteria and were included in the analysis (WHO grade I: 2.0%; grade II: 18.5%; grade III: 18.1%; and grade IV: 61.4%). Facility costs were the major (64.4%) cost driver followed by supplies (16.2%), pharmacy (10.1%), imaging (4.5%), and laboratory (4.7%). Univariate analysis of cost contributors demonstrated that American Society of Anesthesiologists physical status (p = 0.002), tumor recurrence (p = 0.06), Karnofsky Performance Scale score (p = 0.002), length of stay (LOS) (p = 0.0001), and maximal tumor size (p = 0.03) contributed significantly to the total costs. However, on multivariate analysis, only LOS (p = 0.0001) contributed significantly to total costs. More extensive tumor resection in WHO grade III and IV tumors was associated with significant improvement in survival (p = 0.004 and p = 0.02, respectively).

CONCLUSIONS

Understanding care costs is challenging because of the highly complex, fragmented, and variable nature of healthcare delivery. Adopting effective strategies that would reduce facility costs and limit LOS is likely the most important aspect in reducing intracranial glioma treatment costs.
Modulation of saccades in humans by electrical stimulation of the posterior subthalamic area
Authors: Bangash Omar K. , Dissanayake Arosha S. , Knight Shirley , Murray John , Thorburn Megan , Thani Nova , Bala Arul , Stell Rick , Lind Christopher R. P.
Published: April 2019

OBJECTIVE

Posterior subthalamic area (PSA) deep brain stimulation (DBS) targeting the zona incerta (ZI) is an emerging treatment for tremor syndromes, including Parkinson’s disease (PD) and essential tremor (ET). Evidence from animal studies has indicated that the ZI may play a role in saccadic eye movements via pathways between the ZI and superior colliculus (incerto-collicular pathways). PSA DBS permitted testing this hypothesis in humans.

METHODS

Sixteen patients (12 with PD and 4 with ET) underwent DBS using the MRI-directed implantable guide tube technique. Active electrode positions were confirmed at the caudal ZI. Eye movements were tested using direct current electrooculography (EOG) in the medicated state pre- and postoperatively on a horizontal predictive task subtending 30°. Postoperative assessments consisted of stimulation-off, constituting a microlesion (ML) condition, and high-frequency stimulation (HFS; frequency = 130 Hz) up to 3 V.

RESULTS

With PSA HFS, the first saccade amplitude was significantly reduced by 10.4% (95% CI 8.68%–12.2%) and 12.6% (95% CI 10.0%–15.9%) in the PD and ET groups, respectively. With HFS, peak velocity was reduced by 14.7% (95% CI 11.7%–17.6%) in the PD group and 27.7% (95% CI 23.7%–31.7%) in the ET group. HFS led to PD patients performing 21% (95% CI 16%–26%) and ET patients 31% (95% CI 19%–38%) more saccadic steps to reach the target.

CONCLUSIONS

PSA DBS in patients with PD and ET leads to hypometric, slowed saccades with an increase in the number of steps taken to reach the target. These effects contrast with the saccadometric findings observed with subthalamic nucleus DBS. Given the location of the active contacts, incerto-collicular pathways are likely responsible. Whether the acute finding of saccadic impairment persists with chronic PSA stimulation is unknown.
Sublaminar polyester bands as a salvage fixation method in the cervical spine: novel application in two patients
Authors: Smith Luke G. F. , Hoang Nguyen , Shaikhouni Ammar , Viljoen Stephanus
Published: April 2019

Pedicle and lateral mass screws are the most common means of rigid fixation in posterior cervical spine fusions. Various other techniques such as translaminar screw placement, paravertebral foramen screw fixation, sublaminar and spinous process wiring, cement augmentation, and others have been developed for primary fixation or as salvage methods. Use of these techniques can be limited by a prior history of osteotomies, poor bone density, destruction of the bone-screw interface, and unfavorable vascular and osseous anatomy.

Here, the authors report on the novel application of cervical sublaminar polyester bands as an adjunct salvage method or additional fixation point used with traditional methods in the revision of prior constructs. While sublaminar polyester bands have been used for decades in pediatric scoliosis surgery in the thoracolumbar spine, they have yet to be utilized as a method of fixation in the cervical spine. In both cases described here, sublaminar banding proved crucial for fixation points where traditional fixation techniques would have been less than ideal. Further study is required to determine the full application of sublaminar polyester bands in the cervical spine as well as its outcomes.
Machine learning for automated 3-dimensional segmentation of the spine and suggested placement of pedicle screws based on intraoperative cone-beam computer tomography
Authors: Burström Gustav , Buerger Christian , Hoppenbrouwers Jurgen , Nachabe Rami , Lorenz Cristian , Babic Drazenko , Homan Robert , Racadio John M. , Grass Michael , Persson Oscar , Edström Erik , Elmi Terander Adrian
Published: April 2019

OBJECTIVE

The goal of this study was to develop and validate a system for automatic segmentation of the spine, pedicle identification, and screw path suggestion for use with an intraoperative 3D surgical navigation system.

METHODS

Cone-beam CT (CBCT) images of the spines of 21 cadavers were obtained. An automated model-based approach was used for segmentation. Using machine learning methodology, the algorithm was trained and validated on the image data sets. For measuring accuracy, surface area errors of the automatic segmentation were compared to the manually outlined reference surface on CBCT. To further test both technical and clinical accuracy, the algorithm was applied to a set of 20 clinical cases. The authors evaluated the system’s accuracy in pedicle identification by measuring the distance between the user-defined midpoint of each pedicle and the automatically segmented midpoint. Finally, 2 independent surgeons performed a qualitative evaluation of the segmentation to judge whether it was adequate to guide surgical navigation and whether it would have resulted in a clinically acceptable pedicle screw placement.

RESULTS

The clinically relevant pedicle identification and automatic pedicle screw planning accuracy was 86.1%. By excluding patients with severe spinal deformities (i.e., Cobb angle > 75° and severe spinal degeneration) and previous surgeries, a success rate of 95.4% was achieved. The mean time (± SD) for automatic segmentation and screw planning in 5 vertebrae was 11 ± 4 seconds.

CONCLUSIONS

The technology investigated has the potential to aid surgeons in navigational planning and improve surgical navigation workflow while maintaining patient safety.
Клініко-інструментальна характеристика та клінічний прогноз у пацієнтів з хронічною серцевою недостатністю і зниженою фракцією викиду лівого шлуночка залежно від наявності та характеру залізодефіцитного стану
Authors: Gorbachova V. V. , Lyashenko A. V. , Gavrilenko T. I. , Mhitaryan L. S. , Voronkov L. G.
Published: April 2019

The aim – to compare patients with chronic heart failure and reduced left ventricular ejection fraction (LVEF) with absolute and functional iron deficiency (ID) state according to the main clinical, hemodynamic, laboratory parameters and clinical prognosis indicators. Material and methods. In January – February, 2018, 128 stable patients with chronic heart failure (111 of men and 17 of women), 18–75 years old, NYHA class II–IV, with left ventricular ejection fraction < 40 % were screened. Patients were included in a clinical compensation phase. Quality of life was assessed by the Minnesota living with heart failure questionnaire (MLHFQ), physical activity was estimated by the Duke University index, functional status – by assessing the 6-minute walking test and a standardized lower limb extension test.Results. ID was observed in 61 % of patients, 65 % had absolute ID. Patients with both types of ID were in higher functional class, had a poorer quality of life and worse clinical and laboratory indices than patients without ID. Regardless of the difference in the functional and absolute ID formation mechanisms, no significant distinctions in the clinical and functional parameters, quality of life, as well as the parameters of intracardiac hemodynamics were found. Contrary to expectations, elevated levels of hepcidin were not detected in patients with functional ID compared to the absolute ID group. The reliable differences in survival/hospitalization rate between patients without ID and both groups of patients with ID allow us to recommend the screening of iron deficiency in all patients with chronic heart failure and reduced LVEF.Conclusions. ID is found in 61 % patients. Functional ID was found in 27 patients (21 %), absolute ID – in 51 patients (39.6 %). There were no differences between groups of patients with absolute and functional ID by age, functional class, LVEF, percentage of aneamic patients, 6-minute walking distance, thigh quadriceps endurance, quality of life, physical activity index, NT-proBNP, citrulline and hepcidin levels. Compared to patients with absolute ID, patients with functional ID had higher levels of hemoglobin, MCV, MCH, interleukin-6. Presence of both ID types was associated with worse survival and more frequent hospitalization.
Кардіопротекція у хворих зі стабільною стенокар­­дією: аналіз цифрової обробки електрокардіограми
Authors: Tashchuk V. K. , Polianska O. S. , Ivanchuk P. R. , Amelina T. M. , Tashchuk M. V.
Published: April 2019

The aim – to evaluate the cardioprotective effect of metabolic therapy in patients with coronary heart disease (ICD) by digital processing of a standard electrocardiogram using original software.Material and methods. 46 patients with stable angina pectoris of II functional class were examined. In order to determine the cardioprotective effect of metabolic therapy, the results of digital processing of the standard ECG in patients with coronary heart disease were analyzed using original software. with the evaluation of the effect of drugs (tivortin, tivorel, tiotriazoline, corvitine) with antiarrhythmic anticipation, in comparison with the effects of amiodarone and bisoprolol on the main parameters of HRD and dispersion of the QT interval, the angle of inclination of the ST segment and the results of the analysis differentiated T wave. The possibility of an effective quantitative evaluation of the electrocardiogram with its digital processing (digitalization) with the use of its own Smart-ECG software in patients with stable angina pectoris was proven. Results. In the complex analysis of effects from the use of drugs, it was found that tivortin/tivorel reduced the risk of adverse events with stable angina pectoris and activated parasympathetic contour, corvitine and tiotriazoline – reduced the dispersion of the QT interval, tiotriazoline, corvitine and tivortin, accelerated transient depression of the ST segment  – reducing the risk of coronary heart disease and increasing antiarrhythmic effect. Bisoprolol and amiodarone increase the SDNN score and consequently reduce the risk of adverse events with stable angina pectoris, amiodarone stimulates the activation of the parasympathetic contour and less efficiently affects ST slope than bisoprolol, both drugs slightly optimize the ratio of maximum velocities and thus maintain anti-ischemic status.Conclusions. Quantitative evaluation of the electrocardiogram with its digital processing (digitization) can be recommended for increasing the effectiveness of the individual approach in the treatment of patients with acute and chronic ischemic heart disease with the objectification of cardioprotection.
Поєднання субстратів атипової атріовентрикулярної вузлової реципрокної тахікардії та феномена Вольфа – Паркінсона – Уайта
Authors: Stichinskiy O. S. , Yakushev A.V. , Paratsii O. Z. , Malyarchuk R. H. , Kravchuk B. B. , Onischenko V. F.
Published: April 2019

The work is based on an analysis of a clinical case in a patient with paroxysmal tachycardia with narrow QRS complexes, which was diagnosed as WPW phenomenon by electrocardiography. A differential electrophysiological diagnosis was performed. It was proven that tachycardia with narrow complexes was an atypical form of atrioventricular nodal reciprocal tachycardia, and the WPW phenomenon is a concomitant diagnosis. This finding allowed to perform a successful radiofrequency ablation of tachycardia without redundant applications and X-ray exposure. The obtained data allow to clarify the existing knowledge about paroxysmal tachycardia and to improve the results of diagnosis and surgical treatment of this category of patients.
Когнітивна дисфункція у віддалений післяопераційний період при кардіохірургічних втручаннях зі штучним кровообігом
Authors: Sudakevych S. M. , Loskutov O. A. , Druzhyna O. M. , Todurov B. M.
Published: April 2019

The aim – determine the state of cognitive function in the early and late postoperative period in patients with coronary heart disease who underwent on-pump coronary artery bypass grafting.Маterial and methods. In a retrospective observational one-center study, the data obtained from the clinical and instrumental examination of patients who underwent on-pump coronary artery bypass grafting were analyzed. The analysis group included 84 patients (51.5 %) from the total cohort of 163 patients (68 men (80.9 %) and 16 women (19.1 %), mean age 64.4±7.5 years), in which in the early postoperative period cognitive impairments were detected. Neurocognitive testing was performed 3 days prior to surgery, on the 7th day after the intervention, and 3 months after discharge from the hospital using the MMSE Mini Mental State Examination Scale and the Trial Making Test Part A and B.Results. Patients in the surveillance group in the preoperative period at the time of passing the MMSE test scored 26.2±2.3 points. At 7 days after surgery, patients gained 23.6±2.2 points (8.2 % less than before the operation – mild cognitive impairment). 3 months after discharge from the hospital, the patients of the study group gained 24.8±2.2 points (improving the cognitive status, but failed to achieve the upward level of testing). The patients spent 32.0±5.0 seconds test for the Trial Making Test Part A series in the preoperative period and 35.6±6.8 seconds on day 7. After 3 months after the operation, the test results amounted 33.3±5.0 seconds, which didn’t differ compared to preoperative indicators. The second part of the Trial Making Test Part B showed similar results.Conclusion. The results of the cognitive tests for patients undergoing coronary artery bypass grafting demonstrated that cognitive dysfunctions registered in the early postoperative period in 51.5 % of patients (in the form of mild cognitive impairment), significantly decreased to 16.6 % at 3 months after surgery, which is consistent with the results of international studies.