bluuebunny/crossref_metadata_2025 huggingface dataset:
The global and local robustness analysis in geodetic networks
Authors: KÜREÇ NEHBİT Pakize , KONAK Haluk
Published: September 2019

The geodetic networks should be able to detect the possible earth crust movements caused by active tectonic movements in Turkey. Geodetic networks should also be able to determine the crust movements accurately as well as provide precision and reliability requests. The capacity of geodetic networks to determine the crustal movements can be determined by sensitivity analysis. Robustness analysis consists of strengthening internal reliability analysis with strain techniques. Robustness is defined as the deformation strength induced by the maximum undetectable errors with the internal reliability analysis. The robustness of a geodetic network is determined by the global initial condition, which aims at minimizing the total displacement value in the network. In this study, the local initial condition that aims to minimize the total displacement value at the uniform polyhedron, which consists of observations from each station points. The displacement values obtained according to the local and the global initial conditions are compared with threshold values. The results have also been interpreted.
Perfil dos pacientes atendidos na clínica de odontopediatria de uma universidade privada de Curitiba, PR, Brasil
Authors: Barbaresco Bruna Lorena , Franco Gizele , Resende Rafaela Guimarães , Cruz Daniely Baumel da , Koch Luiza Foltran de Azevedo , Pizzatto Eduardo , Gabardo Marilisa Carneiro Leão
Published: September 2019

Introdução: Propôs-se traçar o perfil dos pacientes atendidos na Clínica de Odontopediatria da Universidade Positivo, Curitiba, PR, Brasil. Métodos: Com desenho analítico, observacional e transversal, foram selecionados todos os prontuários (n=1527) dos pacientes atendidos no período de janeiro de 2009 a dezembro de 2017. As informações coletadas foram: ano de atendimento, gênero, cor da pele, motivo da consulta, idade da primeira consulta, hábitos deletérios, escovação e uso do fio dental. Os dados foram tabulados e apresentados em tabelas de frequências por meio do SPSS, versão 21. Resultados: A média da idade foi igual a 8 ± 2,7 anos, com maior frequência de meninas (51,3%) e crianças de cor branca (83,7%). Como motivo da consulta houve predomínio da categoria “rotina” (43,5%) e “tratamento ortodôntico” (20,6%). A maioria das crianças (69,4%) realizou a primeira consulta na clínica com idade superior a quatro anos. Constatou-se que 52,9% das crianças não apresentaram hábitos deletérios. Em relação à escovação dentária, 99,0% da amostra relataram fazê-la, entretanto, o uso do fio dental não foi uma prática adotada por boa parte dos pesquisados (64,6%). Conclusões: O perfil aqui determinado poderá servir de subsídios para o desenvolvimento de estratégias de promoção e de recuperação da saúde ofertadas pelo serviço em questão.
Desarrollo de las habilidades del pensamiento en estudiantes de Tercer Año de Bachillerato de la Unidad Educativa "Amelia Gallegos Díaz" - Riobamba
Authors: Piñas-Morales Maria Belén , Paredes-Peñaherrera Antonio , Casanova-Zamora Tannia Alexandra
Published: September 2019

El examen Ser Bachiller es un instrumento que evalúa el desarrollo de las aptitudes y destrezas que los estudiantes que deben alcanzar al culminar la educación intermedia, y que son necesarias para acceder a los estudios de Educación Superior. El objetivo de la investigación es analizar el impacto de las capacitaciones realizadas a los estudiantes de tercer año de bachillerato de las Unidades Educativas de la provincia de Chimborazo, en el área de Ciencias Naturales,especificamente en el desarrollo de las habilidades del razonamiento numérico, abstracto y verbal. Con relación a los puntajes obtenidos en el examen Ser Bachiller, la investigación es de carácter descriptiva y explicativa, utilizando como instrumento un estudio de campo con la aplicación de una prueba de diagnóstico sin capacitación y una evaluación final después de recibir la capacitación. El resultado principal fue que la gran mayoría de estudiantes posee una alta deficiencia en conocimientos con relación a las áreas de razonamiento numérico, Ciencias naturales, razonamiento verbal y abstracto, mientras que un mínimo porcentaje demuestra un mejor nivel de conocimiento.
Vinculación con la colectividad: una propuesta de gestión
Authors: González Juan Carlos , Yépez-Reyes Verónica , García Elizabeth
Published: September 2019

Las funciones sustantivas de la Educación Superior son la docencia, la investigación y la vinculación con la colectividad. Sin embargo, esta última, y sus nexos con investigación y docencia, suelen ser los grandes ausentes en distintos espacios académicos, en donde se privilegia a las otras dos funciones por sobre la vinculación, pese a que esta constituye la razón de ser de la Educación Superior. Este artículo busca llenar este vacío a través de una propuesta de gestión de la vinculación con la colectividad a partir de un método exploratorio de investigación de los proyectos, propuestas y modelos de vinculación que se manejan en el país y a nivel internacional, respondiendo a la pregunta de cómo articular las funciones sustantivas de la educación para otorgar el peso significativo que tiene la vinculación con la sociedad en el quehacer académico. Los resultados comprenden un diseño de articulación de las tres funciones, un sistema de gestión y una plataforma de encuentro entre Instituciones de Educación Superior (IES) y Organizaciones de la Sociedad Civil (OSC). Esta es solo una propuesta que tendrá que ser repensada, replanteada y re-elaborada por las IES, constituyendo un punto de partida para futuras investigaciones.
Información turística de cuatro comunidades de Pedro Pablo Gómez, Jipijapa, Manabí, Ecuador
Authors: Villamar-González Juan Francisco , Marcillo-Rodríguez Erika Belén , Bravo-Guerrero Olga María , Encalada-Menéndez Melanie Sofía
Published: September 2019

La sistematización de la información permite dar a conocer y entender datos de una manera eficaz. El objetivo del trabajo consistió en recopilar información turística de las comunidades San Jacinto, La Línea, La Cabuya y La Curia de San Jacinto de Pedro Pablo Gómez, Jipijapa. Se identificaron los \textit{stakeholders} y se realizaron encuestas, observación y exploración del sector turístico. Se obtuvo información ecológica, antropológica, y económica de las comunidades. Se determinó la importancia de los \textit{stakeholders}, según la utilidad que representan, y el rol que cumple en el ámbito turístico, y el aporte principal en las comunidades. De esta forma se busca la socialización de la información a los representantes y habitantes de las comunidades, para que pueda ser utilizada en beneficio y permita un buen desarrollo turístico en las comunidades involucradas.
La construcción de valores en la educación: un reto
Authors: Yaguana-Castillo Yohana Maricela , Carrera-Herrera Xiomara Paola , Placencia-Tapia Miury Marieliza
Published: September 2019

La UNESCO considera a la inclusión y el respeto a la diversidad como componentes fundamentales de la convivencia armónica superponiéndose y eliminando la exclusión. Por ello, estamos llamados todos los que formamos parte del sistema educativo a desarrollar mecanismos generadores de confianza en sus miembros. La Universidad Técnica Particular de Loja desarrolla actividades complementarias a lo académico e investigativo como parte de la vinculación con la colectividad. Esto nos permite integrar funciones universitarias con la sociedad convirtiendonos en un centro de apoyo en la consecución de sus objetivos. Dichas actividades se identifican por ser esenciales, multidisciplinarias e integradoras, haciendo que la comunidad participa del acervo científico, tecnológico y humanístico, mediante la realización de un diagnóstico previo de las necesidades colectivas. Es así que surge el proyecto de vinculación denominado ``La escuela en la educación de valores ``el mismo que se desarrolló con la participación de 11 estudiantes y 2 docentes de Ciencias Humanas y Religiosas por medio del componente Practicum 3.2, objetivo es fortalecer estrategias metodologías que motiven el proceso de enseñanza aprendizaje en la formación de valores en los estudiantes, docentes y padres de familia de las instituciones educativas. En este estudio se utilizó una metodología cuantitativa, en él se aplicó una encuesta ``La escuela en la educación de valores'', a 290 adolescentes de 8 establecimientos educativos de las ciudades de Santa Rosa, Guayaquil, Quito Bahía de Caraqués, Cuenca Ibarra y Ambato. Así se logró promover la transferencia e intercambio de aprendizaje entre los miembros de la universidad y la comunidad, permitiendo el acercamiento de los estudiantes a un contexto real a través de talleres dinámicos y creativos que generaron impacto positivo especialmente en grupos vulnerables de la sociedad.
Constitución Española de Cádiz 1812
Authors: Carrión Perez Alejandro
Published: September 2019

Los siguientes siete artículos son el resultado de la celebración de “Las Jornadas de Estudio Conmemorativas del Bicentenario de la Constitución de Cádiz” que se realizaron en la ciudad de Quito en octubre de 2013. El resultado aquí presentado ha profundizado en el estudio de las circunstancias que rodearon la promulgación de la Constitución liberal española de 1812, con todo el significado y consecuencias que tuvo para la América española.

Se ha realizado un estudio exhaustivo de la situación  en la antigua Audiencia de Quito. Se ha analizado los aspectos políticos, sociales, económicos y regionales que se desarrollaron en el primer cuarto del siglo XIX y que tanto influyeron en el desarrollo del Ecuador moderno.
Length-weight relationship and stock assessment of tuna fish (Euthynnus affinis) in East Halmahera waters
Authors: Taher Hamid , Titaheluw Syahnul Sardi , Bafagih Aisyah
Published: September 2019

The study was conducted in December 2016 to February 2017 in East Halmahera waters with the aim to examine the relationship between the length of weight and potential and the level of utilization of tuna. The results showed that the long frequency distribution of tuna was ranging from 10.0-28.2 cm, with a maximum length value of 29.93 cm, a growth coefficient of 0.74 per month and a measure of fish worth catching for spawning. The relationship between the weight of tuna in East Halmahera waters is W=0.0078L3.2982, where the length of tuna is greater than this weight increase due to environmental conditions and oceanographic parameters that affect the growth of tuna. The results of the MSY analysis or the sustainable resource potential of tuna in East Halmahera waters using the Fox method, found that the MSY value or sustainable potential of tuna was 4,176.54, with a maximum effort level of 8,047 Trips. This utilization rate is still low from the value of MSY and continues to decline this is due to the low value of fishing efforts.
Analisis Strategy Pengembangan Bisnis E-Commerce Pertamina Retail dengan Pendekatan Bisnis Model Kanvas
Authors: Latief Prori Vitaliano , Syarief Rizal , Hasbullah Rokhani
Published: September 2019

The competition of oil and gas industri in Indonesia is very tight. To get survive from the competition; the company has to develop their technology. Nowadays, technological advancement have salient roles in improving the company's business. PT Pertaminan Retail is a large oil and gas company in Indonesia. This study analyzed the design of e-commerce business development models from PT Pertamina Retail called MyPertamina. The method of the study is descriptive analysis and using business model canvas (BMC), the Delphi method, SWOT (Strenghts, weakness, opportunities, & threats), and the Blue Ocean Strategy. The datas in this study were secondary dan primary data. The secondary data obtained from the literature study and the primary data was by interviewing six informants. The research period starts from November to December 2018. The results of mapping the initial business model that used BMC, showed several aspects such as: customer segments, value propositions, channels, revenue streams, key resources, key activities, key partners, and costs structure. Environmental analysis used the Delphi method and the result was key trend value was 25.48%, industri strength was 25.19%, market strengths was 24.78%, and macroeconomic strengths was 24.55%. MyPertamina's internal environment influenced by product aspects, infrastructure management, customer interface, and financial aspect. The results of the SWOT analysis of nine BMC unsurts showed that the highest strength was the key partnership and the lowest strength was customer relationship. Meanwhile, the biggest opportunity was value proposition and the lowest opportunity was cost structure. The highest threat was customer segment, and the lowest threat was key partners. The business development model in this research focused on customer segment, key partnership, and value proposition, unsurts developed using the blue ocean strategy method.
Kajian Strategi Pemasaran Ubi Cilembu (Kasus di Desa Cilembu, Kecamatan Pamulihan, Kabupaten Sumedang)
Authors: Ervina Cordelia , Hubeis Musa , Pandjaitan Nora H.
Published: September 2019

One of areas which producing sweet potato is Cilembu Village, located in Pamulihan Subdistrict, Sumedang Regency.  The sweet Potato is famous as ubi Cilembu. The objectives of this research were to identify internal and external factors affecting raw material availability and continuity of marketing system of sweet potato Cilembu and to recommend alternative of effective and efficient marketing strategy of sweet potato Cilembu. This research used purposive sampling and also primary and secondary data. Respondents consisted of 30 people from 107 population of sweet potatoes Cilembu in Cilembu village. Analysis was conducted using IFE and EFE matrix, internal-external (IE) matrix, SWOT and QSPM method. From several strategies by using QSPM method, it had chosen one strategy to boost Cilembu sweet potato marketing by KUCP. The strategy was to encourage efforts in creating processing business medium scale of Cilembu sweet potatoes in order to get competitive processed products.
Strategi Peningkatan Daya Saing Ikan Bandeng Olahan Di Kota Serang Banten
Authors: Ridloudin Ahmad , Raharja Sapta , Suryahadi -
Published: September 2019

Milkfish is a fish belonging to the Chanidae tribe which is spread throughout most parts of Indonesia. The method used in determining respondents is purposive sampling method. Based on the results of the SWOT analysis, there are four strategies were obtained in increasing the competitiveness of processed milkfish include; (a) developing a sustainable milkfish agribusiness system and business, (b) building a business system that is competitive, synergistic, mutually beneficial and technology focused on efficiency, (c) institutional, partnership and integrated development of integrated processed fish SMEs, and (d) government involvement in policies in the form of regulations which favor the improvement of milkfish processed SME s in Serang City.The result QSPM analysis found that the alternative strategy which becomes the main priority to increased competitiveness of processed milkfish in Serang City is building a competitive business system, synergy, mutual benefit and technology focus for eficiency
Strategi Pengembangan Wisata Bahari Desa Namu Guna Mendukung Perekonomian Masyarakat Sadar Wisata
Authors: Palupi Ratna Diyah , Ira - , Risfandi -
Published: September 2019

The consequence of tourist village is the community's psychology and environmental carrying capacity. Good strategy will be able to realize the welfare of the village community. The purpose of this study is to make a tourism development strategy in the Namu Village. Methods of data collection using sampling techniques through interviews and questionnaires with a total samples of 70 respondents. Characteristics of tourism conditions and potential are analyzed by supply-demand. While demand analysis is used to recognize the pattern of visitor demand. Both of these analyzes are used as reference materials for development strategies by strengths, weaknesses, opportunities, and threats SWOT analyzed. Furthermore, based on the Internal Factor Analysis Summary (IFAS), the beauty of Namu and the waterfall become the main attraction for tourist destination. On the other side the disadvantage is the unpreparedness of the Namu village community make them not enough in economically. External Factor Analysis Summary (EFAS), partisanship of the government enable for Namu to be developing in marine tourism. However the threats was come from outside investor which can reduce the role of the community to improve their economy. Based on the analysis of IFAS and EFAS, the Namu Village's tourism development strategy is to improve the quality of tourism objects, increasing the role of the government, looking for investors especially in the transportation sector, improve community capacity. For instance manufacture of fishery products, souvenirs, and culinary. Finally safeguard ecosystems through waste management
FALSAFAH HUMA BETANG DI KALIMANTAN TENGAH: SEBUAH PERGULATAN IDENTITAS KONSELOR DAYAK MUSLIM
Authors: Riswanto Dody
Published: September 2019

The background of this research begins with the existence of Muslim Dayak counselors in schools who get a negative perception of the social environment regarding the existence of tribal counselors based on the religion adopted. This research method uses a qualitative approach where researchers act as key instruments, data collection techniques using interviews, observation, documentation studies and data triangulation, data analysis results from a combination of all data collection techniques that produce qualitative meanings and propositions. The negative perception of the social environment is the main problem of the formation of the identity of Muslim Dayak counselors that is strongly believed by the counselor, for which Muslim Dayak counselors need good communication skills in conveying their identities to the social environment so that the formation of self-identity can be done well. Overall Muslim Dayak counselors are able to introduce self-identity well without any obstacles based on the religion adopted. This happened partly because of the philosophy of Huma Betang which contained values of tolerance and mutual respect among religious believers who could reduce negative perceptions of the social environment about the existence of Muslim Dayak counselors.
IMPLIKASI EGOSENTRIS DAN SPIRITUAL REMAJA DALAM MENCAPAI PERKEMBANGAN IDENTITAS DIRI
Authors: Sejati Sugeng
Published: September 2019

Adolescence is a period of development that is very important in the dynamics oflife because at this time adolescents have a tendency known as Identity VersusIdentity Confusion which is the main task of adolescents in achieving adevelopment of self-identity. In fact, at this time, many adolescents havedifficulties in recognizing their own identities, what their potential is and wherethey are going, where it becomes a very urgent problem for adolescents. Whilefor the spiritual development of adolescents, it cannot be separated from thedevelopment of the personality as a whole, meaning that one's attitude andspiritual beliefs in his life are none other than his personal role models that growand develop from birth especially since in the womb. The focus of this paper isthe egocentric and spiritual implications of adolescents in achieving thedevelopment of self-identity. This paper is carried out through library researchtechniques. The conclusions of this paper normatively produce an Egocentricand Spiritual Implication of Youth in achieving the development of self-identitywhich makes the next person into a unique and principled person with animportant role in life and value in society.
Pelatihan Internet Sehat dan Aman bagi Siswa SMK Masmur Pekanbaru
Authors: Guntoro Guntoro , Lisnawita Lisnawita , Sadar Muhamad
Published: September 2019

TRAINING OF HEALTHY AND SAFE INTERNET FOR STUDENTS OF MASMUR VOCATIONAL SCHOOL, PEKANBARU. Internet technology is a tool that can be used by the younger generation to do creativity and innovation. The internet can be used to find information, pictures, entertainment, music, and lessons. Besides the internet has a positive impact, the internet also has a negative side, including sexual harassment, pornography, online game addiction, and violence. The method of implementing this service is distributing questionnaires before giving material, giving material about the whole internet, demonstrating useful internet applications, distributing questionnaires after giving material, distributing leaflets about healthy internet and evaluating the implementation of service activities. The results of this service activity are (1) the suitable internet training has been carried out by the desired target, and the training participants get motivation, knowledge, and insights about ICT and use of the internet healthily and safely. (2) Knowing information about the impact of internet use both from the positive and negative sides. (3) Students of Pekanbaru Masmur Vocational School can develop self-skills through the internet. (4) With the existence of proper internet training, it is expected to avoid the dangers of the internet from the negative side. (5) Find out tips on how to surf healthily and safely. (6) Based on the evaluation, participants understand the material that has been delivered and agree to the use of healthy and safe internet.
Pemanfaatan Visual Literacy melalui Gambar untuk Memotivasi Siswa Belajar Bahasa Inggris
Authors: Budiharto R Agus , Amalia Laili , Fujiono Fujiono
Published: September 2019

USING VISUAL LITERACY THROUGH IMAGES TO MOTIVATE STUDENTS TO LEARN ENGLISH. Existing in an image-rich world, as school students currently experience, does not mean that they naturally possess right visual literacy aptitudes as when they see an object (such as  a picture), they just see what they see, they do not possess a considerable capability to understand, interpret, discover a meaning from an object or information they see. For that reason, students are supposed to possess visual literacy to perform that. Given the importance of utilizing visual literacy through a picture to motivate students in learning English, the writer of this article has the initiative to carry out community service to first-grade students of MTS Qurrotul Uyun. This community service discusses the utilization of visual literacy through colored pictures as a pedagogical tool, which can provide a precious and motivating resource for the students to learn English. The result of this community service suggests that English learning through colored pictures is potential to make the MTS Qurrotul Uyun first grade students motivated in learning pronunciation, speaking, and grammar. They feel that English learning through colored pictures in the classroom is more appealing and pleasurable as the pictures can both catch their mind attention and facilitate them to learn. Moreover, the colored pictures can make the MTS Qurrotul Uyun first grade students motivated and more involved actively in English learning.
Membangun Ketahanan Berbasis Komunitas dalam Mengurangi Risiko Bencana di Desa Pilomonu Kabupaten Gorontalo
Authors: Koem Syahrizal
Published: September 2019

BUILDING RESILIENCE BASED COMMUNITIES IN DISASTER RISK REDUCTION IN THE PILOMONU VILLAGE GORONTALO REGENCY. This article discusses the concept of community-based disaster risk reduction so that it can realize community resilience to disasters. The implementation of community-based disaster resilience programs uses participatory approaches, observation, interviews, socialization, training, and Forum Group Discussion (FGD). The establishment of the PRB and TSBM forums received a positive response from the community because Pilomonu Village was classified as a disaster-prone village, especially landslides and floods. Analysis of the resilience index conducted by the forum based on indicators and achievements found that Pilomonu Village is included in the category of 'village not yet strong' and the level of preparedness is low. Indicators of community disaster resilience that have been established and adjusted in the document can be the main focus of all parties related to disaster risk management. The PRB and TSBM forum are those who have overall access to improving disaster resilience because forum skills in involving stakeholders are a determinant of the success of disaster resilience to lower-level communities. Integration between the Pilomonu Village government program and disaster risk reduction forums can guarantee the sustainability of forum performance.
Pemberdayaan Anggota Ranting Aisyiyah Grendeng dalam Identifikasi Keamanan Jamu Tradisional Instan
Authors: Wibowo Much Ilham Novalisa Aji
Published: September 2019

EMPOWERMENT OF AISYIYAH BRANCH MEMBERS OF GRENDENG IN THE IDENTIFICATION OF INSTANT TRADITIONAL HERBAL MEDICINE SECURITY. Drug chemicals are still found in some instant powder herbal products even though BPOM has carried out its supervisory duties. The drug chemicals in instant herbal mixtures are selling points for unscrupulous manufacturers of traditional medicines because they offer an instant effect over claims of synthetic chemical drugs. The harmful effects of consuming traditional medicines containing medicinal chemicals are felt after 5 to 10 years later with the emergence of various disease conditions resulting from the addition of medicinal chemicals to herbal medicine. One effort to suppress the circulation of herbal medicine with drug chemical is to increase public knowledge in various ways. The activity is an effort to empower the community in identifying safe and legal Instant Traditional Herbal Medicine. Empowerment activities in this service activity are carried out in 5 stages with three main stages, namely the first lecture, which aims to increase public awareness and alertness about Jamu. The second activity is Group Teaching to add knowledge and information intensively in small groups. The third activity is Self Empowering in order to increase the independence of the community to solve the security problems of Traditional Herbal Medicine through training and peer teaching. The science and technology application program for the community can significantly improve partner knowledge based on the Paired T-test statistical test (P < 0.05). It can be concluded that after IbM activities, partners can choose excellent and right herbs based on the provisions of BPOM RI. Partners can distinguish herbal products, standardized herbal medicines, and phytopharmaca. Partners can find out how to use good and right herbs. Knowledge of partners after this activity increased significantly (P < 0.05) from the knowledge category to less good knowledge.
Analisis Kesehatan Lingkungan Rumah, Penyuluhan dan Pelatihan Pencegahan Tuberkulosis (TB) di Bantul, Yogyakarta
Authors: Mulasari Surahma Asti
Published: September 2019

HOME ENVIRONMENTAL HEALTH ANALYSIS, COUNSELING AND TUBERCULOSIS PREVENTION TRAINING (TB) IN BANTUL, YOGYAKARTA. Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis, this disease can attack various organs, especially the lungs. This disease, if left untreated or incomplete treatment, can cause dangerous complications to death, and potential to spread to other people. In Hamlet "X" RT 09 Bantul Yogyakarta, there were families with Tuberculosis sufferers. The purpose of this activity was to prevent the risk of TB transmission and increase the knowledge of residents around TB patients at the service location. The method used in this activity was to analyze the condition of the home environment associated with TB, provide training in managing the home environment to be healthy. The impact obtained was an increase in the knowledge of residents and families of TB patients, and reduce the risk of transmission of TB in the home and community environment.
OUTCOME JANGKA PENDEK PASIEN PENYAKIT JANTUNG KORONER MULTIVESSEL STABIL KANDIDAT UNTUK OPERASI CORONARY ARTERY BYPASS GRAFTING DENGAN GAMBARAN EKG NORMAL
Authors: Hartanto Edwin , Saleh Khalid , Alkatiri Abdul Hakim , Kabo Peter
Published: September 2019

Pendahuluan: Berbagai studi sebelumnya yang melihat outcome pada pasien PJK multivessel stabil baik yang menjalani CABG, PCI, maupun yang hanya mendapat terapi obat tidak mempertimbangkan gambaran EKG yang mungkin berpengaruh pada outcome. Studi ini bertujuan untuk melihat outcome jangka pendek pasien PJK multivessel stabil kandidat untuk operasi CABG dengan gambaran EKG normal. Metode: Studi Kohort. Outcome primer yang dinilai berupa angina berulang, kejadian SKA, stroke dan kematian karena berbagai sebab dalam 6 bulan. Data dianalisis menggunakan SPPSS versi 16. Data dinyatakan signifikan jika nilai p<0.05. Hasil: Didapatkan 79 pasien (69 pria dan 10 wanita) dikelompokkan pada kelompok yang menjalani CABG(n=13), PCI (n=12), maupun terapi obat (n=54). Kejadian bebas SKA dalam 6 bulan pada kelompok CABG sebanyak 100%, kelompok PCI sebanyak 75%, dan kelompok terapi obat sebanyak 85.1%. Dalam ikutan selama 6 bulan, kejadian bebas angina pada kelompok CABG sebanyak 87.4%, kelompok PCI sebanyak 67% dan kelompk terapi obat sebanyak 42.9% (p=0.015 & OR=7.413). Kesimpulan: Terapi obat untuk PJK multivessel berhubungan dengan kejadian SKA yang lebih rendah dibandingkan PCI dalam 6 bulan. CABG lebih superior dibandingkan terapi obat dalam menghilangkan gejala angina. Ketiga strategi terapi berhubungan dengan tingkat kematian yang rendah dalam 6 bulan.
Resolution of ST-Segment Depression In Reciprocal Leads As Predictor Mayor Adverse Cardiac Event For ST-Segment Elevation Myocardial Infarction With Fibrinolytic Therapy
Authors: Adhitya Aldino Satria , Sitepu Andika , Mukhtar Zulfikri , Hasan Harris
Published: September 2019

Background: ST Elevation Myocardial Infarction (STEMI) may cause Major Cardiovascular Event (MACE). Revascularization needs to be done in all STEMI patients to restore coronary blood flow, hence saving myocardial perfusion. ST Segment Depression (STSD) in reciprocal ECG lead is associated with poor prognosis in STEMI patients receiving fibrinolytic therapy. The main purpose of this study is to evaluate MACE in STEMI patients receiving fibrinolytic therapy using resolution in STSD. Methods: This cohort prospective study with 60 subjects of STEMI patients which are evaluated for MACE (death, heart failure, and rehospitalization) within 30 days after myocardial infarction. Resolution in STSD is defined as resolution ≥ 50% STSD in reciprocal leads within 90 minutes after fibrinolytic therapy.Results: Bivariate analysis showed that Ejection fraction (EF) <40% with OR 8,32 (2,11-32,74), p=0,001; smoking with OR 4,17 (1,05-16,57), p=0,034; Anterior STEMI with OR 3,94 (1,11-13,90), p= 0,027; Creatinine > 1,97 mg/dl with OR 3,69 (1,18-11,55), p= 0,022; complete outpatient medication with OR 5,23 (1,61-17,01), p= 0,004; fragmented QRS with OR 5,23 (1,61-17,01), p= 0,001; resolution in STSD with OR 26,35 (5,16-134, 40), p=<0,001; resolution in ST Segment Elevation with OR 10,5 (2,97-37,24), p=<0,001; are proven to be determining factor for MACE within 30 days. Multivariate analysis showed that among those determining factors for MACE, resolution in STSD on reciprocal leads is evidently the most dominant factor for predicting MACE within 30 days in STEMI patients receiving fibrinolytic therapy [OR 11.47 (1.14-115.10), p=0.038].Conclusion: There is significant difference in MACE within 30 days after myocardial infarction (MI) between patients with and without resolution in STSD. The subjects without resolution in STSD showed higher MACE incidence. Resolution in STSD is evidently an independent predictor for MACE within 30 days after myocardial infarction in STEMI patients.Keywords: Resolution in STSD, MACE, STEMI, Fibrinolytic
Tindakan Ablasi pada Fibrilasi Atrium Berasal dari Vena Kava Superior
Authors: Almazini Prima , Sinaka Gustaf David , Yugo Dony , Raharjo Sunu Budhi , Hanafy Dicky Armein , Yuniadi Yoga
Published: September 2019

Latar Belakang: Fibrilasi atrium (FA) merupakan aritmia yang paling sering ditemukan. Fibrilasi atrium membutuhkan adanya pemicu untuk inisiasi dan substrat untuk mempertahankan aritmia. Fokus tunggal atau multipel sebagai pemicu, paling sering di vena pulmonal tetapi dapat juga berasal dari selain vena pulmonal, seperti di vena kava superior. Patofisiologi aritmia di vena kava superior masih belum dapat dipahami.

Ilustrasi Kasus: Seorang perempuan, 72 tahun, datang ke poliklinik Pusat Jantung Nasional Harapan Kita (PJNHK) dengan keluhan utama sering berdebar-debar. Pasien pertama kali mengeluh berdebar-debar pada tahun 2000, namun baru pada tahun 2007 pasien melakukan pemeriksaan dan terapi dengan obat-obatan serta dilakukan tindakan ablasi FA. Pada tahun 2010, pasien mengeluh berdebar-debar kembali dan dapat dikontrol dengan terapi medikamentosa. Pada tahun 2016, pasien menjalani tindakan ablasi kedua dengan hasil berhasil dilakukan isolasi vena pulmonal dan angiografi koroner memperlihatkan arteri koroner normal. Pasien sempat datang ke UGD PJNHK bulan Mei 2017 dengan keluhan berdebar dan hasil pemeriksaan EKG saat di UGD menunjukkan irama FA. Dilakukan tindakan ablasi ketiga dengan hasil berhasil dilakukan isolasi vena kava superior.

Kesimpulan: Vena kava superior dapat berperan sebagai pemicu atau substrat fibrilasi atrium. Sebagai fokus, selain vena pulmonal, yang paling sering menjadi sumber fibrilasi atrium, vena kava superior menjadi target penting saat tindakan ablasi fibrilasi atrium.
CHA2DS2-VAS-HSF Score as a Predictor for Contrast- Induced Nephropathy in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention
Authors: Parlindungan Herman William , Hasan Refli , Andra Cut Aryla , Akbar Nizam Zikri , Nasution Ali Nafiah , Hasan Harris , Safri Zainal , Lubis Anggia C , Napitupulu Bertha Gabriella
Published: September 2019

Background: Contrast-Induced Nephropathy (CIN) is a serious problem that can be found in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). The development of CIN in hospitalized patients even with coronary revascularization can immediately increase morbidity and mortality both during treatment and long-term outcomes. In a recent study, a CHA2DS2-VASC-HSF score was reported to predict coronary artery severity and major cardiovascular events (MACE) as well as CIN in AMI patients without atrial fibrillation. The purpose of this study was to investigate the CHA2DS2-VASC score as a predictor of CIN in AMI patients undergoing PCI procedures.

Methods: This study was an ambispective cohort study of 53 AMI patients who were treated at cardiac care and underwent PCI procedures. The CHA2DS2-VASC-HSF score was calculated for each patient. From this study found 14 cases (26.4%) with a total CIN prevalence of 16.83%. CIN is defined as an increase in serum creatinine> 0.5 mg / dL or an increase in serum creatinine> 25% from baseline within 24 hours post PCI.

Results: Through the analysis of the ROC curve, we established the CHA2DS2- VASC-HSF score cut point> 5 as a predictor of CIN with a sensitivity of 78.57% and specificity of 66.6 %% (AUC 0.818, 95%: CI 3.018-6.142, p <0.001). By getting the equation from the linear regression assessment we also found the probability of the occurrence of CIN in accordance with the CHA2DS2-VASC-HSF score.

Conclusion: CHA2DS2-VASC score has a positive correlation with CIN. Therefore, this score can be used as a simple scoring system and can predict the incidence of CIN in AMI patients undergoing PCI procedures.
Defisiensi vitamin D pada pasien gagal jantung kronik yang menjalani rawat inap
Authors: Hartanto Yanuar Budi , Sugiri Sugiri , Anggriyani Novi , Herry Yan , Bahrudin Udin
Published: September 2019

Latar Belakang: Gagal jantung merupakansalah satu masalah kesehatan masyarakat global dengan jumlah penderita yang diperkirakan terus mengalami peningkatan. Meskipun terdapat kemajuan dalam tata kelolanya, gagal jantung masih memiliki prognosis yang buruk. Vitamin D merupakan mikronutrien yang berpengaruh terhadap prognosis  pasien gagal jantung kronik. Saat ini belum ada data mengenai kadar vitamin D serum pada pasien gagal jantung kronik yang dirawat pada populasi Indonesia. Tujuan penelitian ini adalah untuk mengetahui kadar vitamin D serum pada pasien gagal jantung kronik yang menjalani rawat inap.Metode: Penelitian observasional pada pasien gagal jantung kronik yang dirawat di RSUP. Dr. Kariadi Semarang mulaibulan November 2017 sampaiJanuar1 2018. Pemeriksaan kadar vitamin D serum [25(OH)D] dilakukan dengan metode chemiluminescence immunoassay (CLIA).Hasil: Sebanyak 102 pasien (median usia 55 (22–65) tahun) yang terlibat, terdapat 69 sampel yang memenuhi kriteria seleksi. Median fraksi ejeksi ventrikel kiri adalah 35 (10-76)%. Median kadar vitamin D serum adalah 47.25 (14.25–143.02) nmol/L.Yang menarik,  88,4% pasien menunjukkan kadar vitamin D lebih rendah dari yang direkomendasikan. Dibandingkan dengan pasien dengan kadar vitamin D normal, pasien dengan kadar rendah tersebut lebih sering disertai denganhipertensi atau diabetes, berjenis kelamin perempuan, dan memiliki riwayat rawat inap ulang yang lebih sering.Kesimpulan: Defisiensi vitamin D serum dialami olehsebagian besar pasien gagal jantung kronik yang dirawat. Data ini menunjukkan perlunya pengukuran kadar vitamin D pada pasien gagal jantung kronik dengan hipertensi, diabetes, jenis kelamin wanita dan rawat inap ulang.Kata Kunci : Gagal jantung, defisiensi vitamin D, rawat inap
The Hypoxic Preconditioning Effect On Senescence Cell Process In Cultured Adipose-Derived Mesenchymal Stem Cells (AMSCs)
Authors: Nuarisa Nadiar Dwi , Suryawan I Gde Rurus , Andrianto Andrianto
Published: September 2019

Introduction : Stem cell therapy for myocardial regeneration is expected to increase cardiomyocyte proliferation and trigger neovascularization to improve cardiomyocytes. Mesenchymal Stem Cells (MSCs) are ideal candidates for regenerative medicine and immunotherapy. But low viability of MSCs is a major challenge in this alternative therapy. Therefore, a cytoprotective strategy is needed, one of them is hypoxic preconditioning which can significantly increase survival stem cells after being transplanted. MSCs are known to have a limited life span, after experiencing several splits MSC will enter the senescence process. It is known that hypoxia can also increase cell proliferation and differentiation potential in vitro and in vivo through the role of Octamer-4 (Oct-4) as a regulator of the pluripotency gene.

Methods : Experimental laboratory studies (in vitro studies) using human-AMSCs which were given hypoxic preconditioning, observed as a immunocytochemistry.

Results : The results showed that hypoxic precondition (1% O2) inhibited the senescence process. It can be seen in the lower expression of senescence in hypoxic conditions at P6, P7, P8, P9, P10 compared to normoxic ((p=0,004, p=0,001, p=0,009, p=0,013, p=0,024. There is a significant difference in the senescence expression of each passage in hypoxic and normoxic conditions with the highest expression at P10. In addition, we also observed AMSCs differentiation through the Oct-4 expression. It is showed that Oct-4 expression were higher in hypoxia compared to normoxia on P7, P8, P9, P10 (p=0,009, p=0,009, p=0,030, p=0,0001).

Conclusions : Hypoxic preconditioning have the effect of inhibiting the senescence process on Adipose-derived MSCs (AMSCs) or prolonging their life span. The longer life span of AMSCs is also seen by higher cell differentiation potential from increased expression of Oct-4. However, the mechanism of inhibiting the senescence process in hypoxia in stem cells is still remain unknown.

Keywords: human-Adipose derived Mesenchymal Stem Cell Cultures (h-AMSCs), Hypoxic Preconditioning, Senescence cell, Oct-4.
Improvement of level MDA and SOD Using of Ganoderma Lucidum as Adjunctive Treatment for Statin Based Therapy in High Risk Patient Based on Framingham Score
Authors: Vitriyaturrida Vitriyaturrida , Rohman M Saifur , Sargowo Djanggan , Hendrawan Dadang
Published: September 2019

It is well known from previous research on the importance of antioxidants to inhibit the progression of coronary heart disease in high-risk patients based on framingham scores. Statins are routinely administered in high-risk patients  based on the Dyslipidemia 2016 ESC guidelines but the effects of adding Ganoderma are known to have antioxidant effects, in patients who have received statins. This study aims to assess the effect of antioxidants through measurement of SOD and MDA in patients given a combination of Ganoderma lucidum with statins.Method: A total of 24 patients with high-risk patients based on the Framingham score > 20% were selected as sample of study. Patients with respondents who had never received statin therapy or ACEi or ARB or CCB or beta blocker, or did not routinely consume the drug for 2 weeks were excluded from this study. The addition of Ganoderma lucidum dose of 3x250 mg was added to statins as the first group and Ganoderma lucidum dose of 3x250 mg was added to the Statin combination of Angiotensin Converting Enzym inhibitors (ACE inhibitors) or Angiotensin Receptor Blockers (ARB) and or Calcium Channel Blockers (CCB) and or Beta blockers as second group for 90 days. SOD and MDA levels were measured before and after the administration of Ganoderma Lucidum with the ELISA method.Result: After the administration of Ganoderma Lucidum with standard therapy, there was a decrease in MDA levels and an increase in SOD levels after 90 days in two groups. Conclusion: The addition of Ganoderma Lucidum to standard therapy can reduce oxidant levels in high-risk patients based on framingham scores.

Keyword: Superoxyde-dismutase, Malondyaldehide, Oxidative Stress, Antioxidant, Ganoderma Lucidum, Statin
PERANAN ACETAMINOPHEN (PARASETAMOL) DALAM PENUTUPAN DUCTUS ARTERIOSUS
Authors: Dimiati Herlina , Fasli Rini
Published: September 2019

Abstrak

Patent ductus arteriosus (PDA)  adalah kelainan kongenital yang ditandai adanya kegagalan penutupan duktus arteriosus (DA) segera setelah lahir. Dampak tidak menutupnya DA akan terjadi  gangguan hemodinamik ,memperberat masalah lain yang menyertai bayi prematur sehingga akan meningkatkan morbiditas dan mortalitas. Parasetamol merupakan obat yang relatif baru digunakan untuk menutup PDA jika dibandingkan dengan indometasin ataupun ibuprofen dengan tinkat keberhasilan yang tinggi.

Kata kunci: Patent ductus arteriosus (PDA), gangguan hemodinamik, parasetamol

Abstract

Patent ductus arteriosus (PDA) is a congenital disorder characterized by a failure to close the ductus arteriosus (DA) immediately after birth. The impact of not closing the DA will occur hemodynamic disturbances, aggravating other problems that accompany premature babies so that it will increase morbidity and mortality. Paracetamol is a relatively new drug used to close PDAs when compared with indomethacin or ibuprofen with the  high success rates.

Keywords: Patent ductus arteriosus (PDA), hemodynamic problem,  paracetamol
Aritmia Ventrikel Pasca Intervensi Koroner Perkutan : Petanda Reperfusi atau Iskemia yang Masih Berlangsung ?
Authors: Putra Meidianaser , Rasyid Hauda El
Published: September 2019

Aritmia ventrikel setelah IKP awalnya diindikasikan sebagai reperfusi yang sukses. Namun, beberapa penelitian menyebutkan bahwa aritmia ini diakibatkan oleh iskemia yang sedang berlangsung. Aritmia yang sering terjadi adalah kontraksi ventrikel premature sustained atau nonsustained takikardi ventrikel, accelerated idioventricular tachycardia, fibrilasi atrium, dan fibrilasi ventrikel. Gangguan irama dihubungkan dengan oklusi koroner didefinisikan sebagai aritmia iskemik, sedangkan aritmia terjadi akibat peningkatan perfusi miokard yang disebut aritmia reperfusi. Accelerated idioventricular tachycardiabisa menjadi penanda dari reperfusi awal dan patensi arteri berkelanjutan.

         Penatalaksanaan aritmia ventrikel pasca intervensi koroner perkutan meliputi penggunaan obat anti aritmia, overdrive pacing, ablasi radiofrekuensi, dan ICD.

Kata kunci: aritmia ventrikel, IKP, obat anti aritmia, overdrive pacing, ablasi radiofrekuensi, dan ICD
CORELATION OF GLOBAL LONGITUDINAL STRAIN (GLS) – LEFT VENTRICLE AND SOLUBLE SUPRESSION OF TUMORGENICITY 2 (sST2) IN ACUTE HEART FAILURE WITH SYSTOLIC DYSFUNCTION
Authors: Yulidia Herlina , Aminuddin Muhammad , Pikir Budi S
Published: September 2019

Background  :  Assessment of  left  ventricular  function  in  patients with   acute heart failure is important for prognostication, determination of treatment plan, for decisions related to  expensive device therapies and for assessing response  to treatment. Echocardiography is the "gold standard" of assessing left ventricular function, and in establishing a diagnosis of heart failure. Left ventricular Global Longitudinal Strain (GLS) assessed through Speckle Tracking Echocardiography (STE) is currently considered sensitive in assessing left ventricular motion, by analyzing multidimensional myocardial deformation

. s ST2 used to be correlated with stretch miocard and inhibid ligand of IL-33 wich also inhibit the cardioprotectve effect.

Objective : To prove the positive correlation between GLS-left ventricle with soluble ST2.

Methods  :  This  is  a  correlational  study  with  cosecutive   sampling   technique. Thirty subjects participate in this reseach and each subject underwent echocardiography and  GLS-left  ventricle  and  soluble ST2 blood examination. The correlation between GLS-left ventricle and soluble ST2  were  evaluated using Spearman correlation test.

Results : There is a strong, significant, positive correlation between the GLS-left ventricle with soluble ST2 (r = 0.99 and p =  0.0001).

Conclusion : There is a  strong,  significant,  positive  correlation  between  the  GLS- left ventricle with soluble ST2.

Keywords :  acute  heart  failure,   systolic   dysfunction,   global  longitudinal  strain, soluble ST2.
VISUALISASI HEWAN PADA RELIEF RAMAYANA
Authors: Hidajat Henny
Published: September 2019

Hewan-hewan yang tergambar pada Relief Ramayana di Candi Prambanan tidak hanya memiliki fungsi sebagai elemen dekoratif tetapi juga memiliki peran sebagai pelengkap alur cerita Ramayana serta memiliki makna simbolis. Artikel ini disusun berdasarkan penelitian untuk mengungkapkan deskripsi visual dari keragaman hewan yang tergambar pada Relief Ramayana di Candi Prambanan, Jawa Tengah untuk meneliti gaya visual, karakteristik, atribut, serta peranan hewan-hewan tersebut dalam mendukung alur cerita Ramayana. Berdasarkan dokumentasi lapangan dari karakter hewan-hewan yang tergambar pada relief candi dan referensi sejarah, literatur Ramayana serta literature lainnya, maka diharapkan bahwa visualisasi dari hewan-hewan tersebut seperti bentuk fisik, gaya, peran serta maknanya dapat dianalisis.
Dengan demikian suatu kesimpulan dapat disimpulkan sebagai suatu referensi visual bagi penelitian selanjutnya maupun proyek desain ataupun seni kreatif lainnya, terutama yang dibangun berdasarkan inspirasi kebudayaan dan tradisi.

Kata Kunci: relief candi, Prambanan, hewan, karakteristik visual