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"Although it is widely recognized that time is of the essence in the management of stroke, there are currently few efficient stroke centers that prospective new centers may emulate. This book offers a concise and practical guide on how to set up and run an acute stroke service tailored to the needs of the individual center as a provider of primary, secondary or tertiary care. All aspects of the subject are tackled. Essential knowledge on current imaging and treatment options is provided and guidance is offered on organizing a site-specific stroke pathway so as to ensure the quickest possible provision of treatment. The authors played an integral part in the development and operation of one of Europe’s most successful early stroke centers and also have experience of the factors that can undermine the creation of world-class stroke units."

"Penelitian ini dilakukan untuk mengetahui pengaruh pemberian nutrisi enteral tinggi protein pada status protein penderita stroke akut. Subjek penelitian dibagi 2 kelompok secara randomisasi blok, yaitu kelompok perlakuan mendapat nutrisi enteral tinggi protein (NETP) dan kelompok kontrol mendapat nutrisi enteral standar rumah sakit (NERS). Tiga puluh enam subjek dari 60 penderita stroke akut berhasil menjalani 7 hari penelitian ini. Hasil penelitian menunjukkan bahwa pemberian NETP dapat meningkatkan kadar prealbumin serum, menurunkan ekskresi kreatinin urin, dan memperkecil penurunan kadar albumin serum dibandingkan kelompok kontrol. (Med J Indones 2004; 14: 37-43)

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The objective of this study was to determine the effect of high protein enteral nutrition on protein status in acute stroke patients. The subjects were divided into two groups using block randomisation, i.e. the intervention group that received high protein enteral nutrition (HPEN), and the control group that received enteral hospital diet. Thirty six out of 60 acute stroke patients had completed 7 days of follow-up. The results showed that HPEN have increased prealbumin level, decreased urinary creatinine excretion, and decreased the decline of albumin serum compared to the control group. (Med J Indones 2004; 14: 37-43)"

"Latar belakang: Dehidrasi sering terjadi pada stroke iskemik akut SIA dan secara teoretik dapat memperburuk luaran pasien dengan menurunkan curah jantung dan meningkatkan viskositas darah sehingga menurunkan aliran darah otak. Tujuan penelitian ini adalah untuk mengetahui apakah dehidrasi dapat memperburuk luaran klinis dan fungsional SIA. Metode: Studi kohort dilakukan antara Oktober 2016-April 2017. Sebanyak 44 subjek ikut penelitian dan dibagi menjadi 2 kelompok berdasarkan rasio ureum/kreatinin darah dan osmolalitas serum. Dehidrasi didefinisikan sebagai rasio ureum kreatinin 332,1 atau osmolalitas darah >310 mOsm/kg pada hari pertama masuk rumah sakit. Luaran diukur dengan 2 skala: 1 perbedaan nilai National Institutes of Health Stroke Scale NIHSS pada hari pertama dan ke-7 pascaawitan; dan 2 nilai modified Rankin scale mRS pada hari ke-30 pascaawitan. Hasil: Sebanyak 44 subjek ikut serta dalam penelitian dehidrasi, n = 21; kontrol, n = 23 . Sebanyak 25 subjek 57 adalah pria; 4 subjek 9 mengalami partial anterior circulation infarct PACI dan 40 subjek 91 mengalami lacunar infarct LACI . Dehidrasi tidak berhubungan dengan perburukan NIHSS nilai p = 0.176 atau nilai mRS-30-hari yang buruk nilai p = 1.00 . Satu-satunya variabel yang berhubungan dengan perburukan NIHSS atau nilai mRS-30-hari yang buruk adalah PACI nilai p masing-masing 0.003 and 0.001. Kesimpulan: Dehidrasi tidak berhubungan dengan perburukan NIHSS atau nilai mRS-30-hari yang buruk. Studi lebih lanjut dibutuhkan dengan kriteria diagnostik dan luaran yang lebih baik.

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Background: Dehydration occurs frequently in patients with acute ischemic stroke AIS and theoretically can worsen patient rsquo s outcome by decreasing cardiac output and increasing blood viscosity resulting in decreased cerebral blood flow. The aim of this study was to determine whether dehydration worsened clinical and functional outcome of AIS.

Method: A cohort study was performed between October 2016 and April 2017. There were 44 subjects with AIS recruited. Subjects were divided into 2 groups on the basis of blood ureum creatinine ratio and serum osmolality. Dehydration is defined as ureum creatinine ratio 332,1 or blood osmolality 310 mOsm kg at admission day. Outcome was measured with 2 scale 1 National Institutes of Health Stroke Scale NIHSS score difference on admission compared to score at day 7 of hospitalization and 2 modified Rankin scale mRS at day 30 after AIS onset.

Result: A total of 44 subjects were enrolled dehydration, n 21 control, n 23. 25 subjects 57 were male 4 subjects 9 had partial anterior circulation infarct PACI and 40 subjects 91 had lacunar infarct LACI . Dehydration was not associated with either NIHSS worsening p value 0.176 or poor 30 day mRS p value 1.00 . The only variable associated with poor NIHSS and mRS outcome was PACI p value 0.003 and 0.001, respectively.

Conclusion: This study found that dehydration in AIS was not associated with poor 7 day NIHSS and 30 day mRS outcome. Further study with better diagnostic and outcome criteria is required. "

"Perkembangan industri global menuntut para pelaku yang berada di dalamnya untuk terus berinovasi. Namun dalam penerapan inovasi yang ada saat ini, metode estimasi masih harus melewati tahap detail desain. Sehingga penerapan inovasi membutuhkan waktu yang lama dan biaya yang besar. Inovasi yang dilakukan tentu akan berpengaruh langsung terhadap tingkat kerumitan dari produk yang dibuat. Hal ini mendorong diperlukannya suatu metode untuk dapat mengestimasi tingkat kerumitan dari suatu produk, sehingga para produsen dapat memperkirakan biaya yang dibutuhkan dalam membuat suatu produk berdasarkan tingkat kerumitan dari produk tersebut. El Maraghy dan Urbanic mengemukakan bahwa suatu produk manufaktur memiliki nilai kompleksitas yang merepresentasikan tingkat kerumitan dari suatu produk. Perhitungan kompleksitas tidak terlepas dari bentuk geometri produk, namun variasi geometri yang tak terbatas dari setiap produk tidak memungkinkan untuk dilakukannya perhitungan nilai kompleksitas. Jong Yun Jung (2002) selanjutnya mengklasifikasikan bentuk dasar dari suatu produk dengan mencakup variasi geometri yang ada menjadi beberapa fitur. Menurut El Maraghy, proses permesinan secara umum terdiri dari tiga proses utama, yaitu set up, operation dan non operation. Masing-masing memiliki nilai kompleksitas yang disebut kompleksitas proses (El Maraghy & Urbanic, 2003). Proses operation dan non-operation dilakukan sesuai dengan jenis mesin yang digunakan. Keduanya semakin dipermudah dengan adanya mesin Computerized Numerical Control (CNC). Namun untuk setiap fitur yang akan dibuat, memerlukan proses set up yang berbeda. Sehingga diperlukan perhitungan kompleksitas set up untuk setiap fitur. Oleh karena itu, diperlukan penelitian khusus mengenai proses set up. Pada penelitian ini akan dihitung nilai kompleksitas masing-masing fitur yang dikemukakan oleh Jong Yun Jung, khususnya prismatic dan slab feature. Kedua fitur tersebut dibentuk melalui proses milling. Perhitungan dilakukan dengan menjumlahkan nilai kompleksitas dari masing-masing subproses yang dilakukan dalam melakukan proses set up.

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The development of global industry demands all of the part of industry to keep innovating. However, the methods that currently exist makes the application of innovation must developed through detail design. It requires a long time analysis and great cost. The innovation will give a direct effect to the level of product complexity that manufactured. That brings out the need for a method to estimate the complexity of a product, so all of manufacturing producer can estimate the cost of manufacturing product based on the complexity of the product itself. El Maraghy and Urbanic explain that every manufacturing product have a value of complexity that represents the level of product complexity. The calculation of complexity cannot be separated from the geometry of a product, however, the variation of product geometry is infinite, it makes the calculation cannot be done. Furthermore, Jong Yun Jung (2002) classifies this geometry into some features that contains the variation of geometry. According to El Maraghy, machining consists of three main process, set up, operation and non operation. All of these process have a complexity value called process complexity (El Maraghy & Urbanic, 2003). Operation and non operation process is depend on the type of the machine. The time for those two process is shorten by the use of CNC machine. However, for every feature that manufactured, needs a different set up process.Therefore, special study about set up is required. In this research, the complexity of features that classified by Jong Yun Jung is calculated, especially prismatic and slab feature. Both features is manufacturd with milling process. The calculation is done by summing the complexity value of the subprocesses in set up process."