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"SBRT adalah salah satu metode dalam radioterapi dengan menggunakan fraksi yang sedikit namun memiliki efek samping berpotensi menghasilkan wilayah hostpsot. Diusulkan volume target baru, yaitu Definie Target Volume (DTV). DTV memiliki probabilitas tinggi dimana jaringan target berada. DTV ditentukan melalui probabilitas okupansi dan kontraksi margin. DTV akan menjadi target prioritas dan PTV-crop diberlakukan seperti PTV pada perencanaan klinis. Optimisasi DTV dilakukan dengan eksplorasi dosis secara maksimum namun dengan membatasi dosis ke bagian OAR. Berdasarkan perencanaan, pada volume DTV kasus HCC, peningkatan 𝐷𝑚𝑎𝑥 tertinggi mencapai 187,3% dengan rata-ratanya 124,98% ± 29,02%. Untuk volume PTV-crop, rata-rata peningkatan 𝐷𝑚𝑒𝑎𝑛 adalah 103,84% ± 4,69%. Peningkatan 𝐷𝑚𝑎𝑥-DTV kasus serviks mencapai 138,49% dan rata-ratanya 116,80% ± 13,19%. Pada PTV-crop, rata-rata peningkatan 𝐷𝑚𝑒𝑎𝑛 serviks 101,89% ± 5,58%. Pemberian dosis yang besar pada target DTV akan berkaitan dengan peningkatan pada OAR. Peningkatan dosis OAR-HCC sebesar 106,93% ± 5,57% dan OAR-serviks sebesar 101,18% ± 1,87%. Hasil penelitian ini didapatkan dosis pada target DTV mengalami peningkatan yang cukup tinggi namun target PTV-crop mempunyai peningkatan dosis yang masih sesuai dalam standar untuk klinis. Selain itu OAR sekitar target meskipun dosis rata-ratanya meningkat, namun tidak terlalu signifikan dan masih dibawah konstrain.

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SBRT is a method in radiotherapy using a small fraction but has side effects that have the potential to produce a host site. A new target volume is proposed, namely the Define Target Volume (DTV). DTV has a high probability of where the target network is. DTV is determined through the probability of occupancy and the contraction margin. DTV will be a priority target and PTV-crop is treated like PTV in clinical planning. Optimization of DTV is carried out by exploring the maximum dose but by limiting the dose to the OAR. Based on the plan, on the DTV volume of HCC cases, the highest 𝐷𝑚𝑎𝑥 reached 187.3% with an average of 124.98% ± 29.02%. For PTV-crop volume, the average 𝐷𝑚𝑒𝑎𝑛 increase to 103.84% ± 4.69%. The dose escalation in 𝐷𝑚𝑎𝑥-DTV for cervical cases reached 138.49% and the average was 116.80% ± 13.19%. In the PTV-crop, the average escalation in cervical 𝐷𝑚𝑒𝑎𝑛 was 101.89% ± 5.58%. Prescription of large doses to target DTV will be associated with an increase in OAR. The increase in the dose of OAR-HCC was 106.93% ± 5.57% and OAR-cervix was 101.18% ± 1.87%. The results of this study obtained that the dose on the DTV target had increased quite high, but the PTV-crop target had an increased dose that was still according to clinical standards. In addition, the OAR is around the target, although the average dose has increased, it is not very significant and is still under constraints."

"Stereotactic body radiation therapy (SBRT) has emerged as an important innovative treatment for various primary and metastatic cancers. This book provides a comprehensive and up-to-date account of the physical/technological, biological, and clinical aspects of SBRT. It will serve as a detailed resource for this rapidly developing treatment modality. The organ sites covered include lung, liver, spine, pancreas, prostate, adrenal, head and neck, and female reproductive tract. Retrospective studies and prospective clinical trials on SBRT for various organ sites from around the world are examined, and toxicities and normal tissue constraints are discussed. This book features unique insights from world-renowned experts in SBRT from North America, Asia, and Europe. It will be necessary reading for radiation oncologists, radiation oncology residents and fellows, medical physicists, medical physics residents, medical oncologists, surgical oncologists, and cancer scientists."

"Multiple output (MIMO) uses multiple transmit antenna and multiple receive antenna which offer better system performance and capacity in multipath fading channel...."

"Planning Target Volume (PTV) merupakan area treatment radioterapi yang diperoleh dengan melakukan penambahan margin pada Clinical Target Volume (CTV). Margin tersebut merupakan kompensasi dari ketidakpastian geometri yang terjadi pada saat treatment. Nilai margin diperoleh dari data online On-Board Imaging (OBI) match result 26 pasien kanker serviks yang mendapatkan penanganan dengan mesin linac Halcyon di RSUPN Dr. Cipto Mangunkusumo. Data OBI dalam arah vertikal (anterior-posterior), longitudinal (cranial-caudal), dan lateral (left-right) digunakan untuk menghitung kesalahan pengaturan, yakni berupa kesalahan sistematik dan acak sebagai variabel dari formulasi Stroom dan Van Herk. Berdasarkan formula Stroom, diperoleh nilai margin sebesar 1 cm untuk arah vertikal dan longitudinal, serta 1,6 cm untuk arah lateral. Sedangkan formula Van Herk, yaitu 1,2 cm untuk arah vertikal, 1,1 cm untuk arah longitudinal, dan 1,9 cm untuk arah lateral. Hasil tersebut menunjukkan nilai yang jauh lebih besar dibandingkan dengan margin yang digunakan pada approved treatment plan yaitu 0,7 cm untuk segala arah. Evaluasi dilakukan dengan cara pengonturan ulang PTV dan planning ulang pada 4 kasus pasien. Hasil penelitian ini menunjukkan bahwa dosis yang diterima target pada approved treatment plan lebih baik dibandingkan target yang menggunakan margin Stroom dan Van Herk. Hal ini dikarenakan nilai margin yang lebih besar berisiko mengenai organ lebih banyak, sehingga optimasi yang dilakukan harus lebih optimal agar organ at risk (OAR) menerima dosis serendah mungkin sesuai dengan constraint guidelines menurut QUANTEC.

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Planning Target Volume (PTV) is a radiotherapy volume concepts that obtained by adding margin to the Clinical Target Volume (CTV). The margin is a compensation for geometric uncertainty that occurs during treatment. PTV margin was obtained from online data on On-Board Imaging (OBI) match results of 26 cervical cancer patients treated with the Halcyon Linac machine in RSUPN. Dr. Cipto Mangunkusumo. OBI data in the vertical (anterior-posterior), longitudinal (cranial-caudal), and lateral (left-right) axis used to count setup errors, namely systematic and random errors, variables from the Stroom and Van Herk formulations. Based on the Stroom formula, the margin values ​​are 1 cm for the vertical and longitudinal axis, and 1.6 cm for the lateral axis. On the other hand, the margin from Van Herk formula was 1.2 cm for the vertical axis, 1.1 cm for the longitudinal axis, and 1.9 cm for the lateral axis. These results are larger than the margin in approved treatment plan, which is 0.7 cm for all axis. We evaluated the dosimetric difference by re-contouring PTV and replanning 4 cases of the treated patients. This study indicate that the dose received by the target in the approved treatment plan is better than the target using Stroom and Van Herk margins. That cause a large margin has a bigger risk of affecting more normal tissue area. Therefore, optimization must be more optimal to reduce organ at risk (OAR) dose as low as possible according to QUANTEC constraint guidelines."

"Laporan magang ini bertujuan untuk melakukan evaluasi atas Rancangan Kerja dan Anggaran Kementerian Negara dan Lembaga (RKA-KL) tahun anggaran 2020 yang merupakan bagian dari laporan keuangan Balai ABC yang berakhir pada 31 Desember 2020. Penganggaran di Balai ABC tahun anggaran 2020 menggunakan Aplikasi SAKTI mulai dari perencanaan, pelaksanaan, hingga pertanggungjawaban anggaran. Evaluasi dilakukan dengan melakukan revisi setiap ada perubahan yang tidak sesuai dengan rencana awal, agar pagu anggaran dapat terserap secara maksimal. Berdasarkan hasil evaluasi, pagu anggaran yang telah terserap di setiap kegiatan berbeda dengan rencana awal. Namun, secara keseluruhan pagu anggaran telah terserap dengan maksimal.

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This report aims to conduct the evaluation of Work and Budget Planning of Ministry/Agency for the 2020 which is part of the financial report of the Balai ABC ending on December 31, 2020. Budgeting at Balai ABC for the 2020 fiscal year using the SAKTI Application from planning, implementation, to budget accountability. Evaluation is carried out by making revisions every time there are changes that are not in accordance with the initial plan, so that the budget can be absorbed optimally. Based on the evaluation results, the budget that has been absorbed in each activity is different from the initial plan. However, overall the budget has been fully absorbed."

"ABSTRAKIbu pasca bedah sesar dapat mengalami postpartum blues karena tidak mampu mengontrol terhadap perubahan fisik maupun psikologis selama masa nifas. Penelitian ini bertujuan untuk mengetahui efektifitas paket pendidikan kesehatan dan teknik relaksasi terhadap kejadian postpartum blues pada ibu pasca bedah sesar. Penelitian ini menggunakan desain quasi eksperimen. Teknik pengambilan sampel menggunakan konsekutif pada 60 responden yang terbagi dalam kelompok kontrol dan intervensi. Instrumen yang digunakan berupa kuesioner postpartum blues.Hasil penelitian menunjukkan ada perbedaan yang signifikan kejadian postpartum blues sebelum dan setelah intervensi pada kelompok intervensi p 0 000 paket efektif 16 kali menurunkan kejadian postpartum blues setelah dikontrol oleh faktor pendidikan OR 16 2 CI 95 3 212 81 698. Paket pendidikan kesehatan dan teknik relaksasi efektif menurunkan kejadian postpartum blues dan direkomendasikan di pelayanan kesehatan untuk meningkatkan kesehatan ibu pasca bedah sesar.

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ABSTRACT

Post caesarean mothers may experience postpartum blues because they are unable to control their physical and psychological changes during postpartum period. This study aimed to measure the effectiveness of the health education package and the relaxation techniques against the incidence of postpartum blues in post caesarean mothers. This study applied a quasi experimental design. The samples were 60 respondents divided into a control and an intervention groups selected by consecutive sampling. The instrument was the postpartum blues questionnaire.

The results showed that there was a significant difference between the incidence of postpartum blues before and after the intervention in the intervention group p 0 000. The intervention package was 16 times more effective to decrease the incidence of postpartum blues after being controlled by the education factor OR 16 2 95 CI 3 212 81 698. The health education package and the relaxation techniques were effectively reduced the incidence of postpartum blues and recommended in health care to improve the health of post caesarean mothers."

"Optimasi dosis radiasi pada perencanaan klinis menggunakan Treatment Planning System (TPS) untuk pasien radioterapi sangat penting untuk mencapai keseimbangan antara efektivitas terapi dan keselamatan pasien. Namun, proses ini memakan waktu dan sangat bergantung pada keahlian fisikawan medis. Pada penelitian ini dilakukan prediksi dosis menggunakan machine learning pada Planning Target Volume (PTV) dan Organ at Risk (OAR) untuk kasus kanker otak dengan teknik perencanaan Volumetric Modulated Arc Therapy (VMAT). Data DICOM perencanaan di ekstraksi menggunakan 3D slicer untuk mendapatkan nilai radiomic dan dosiomic yang akan digunakan pada penelitian ini dengan menggunakan model algoritma random forest. Hasil evaluasi model menunjukkan bahwa peforma model random forest dalam memprediksi dosis memiliki nilai Mean Square Error (MSE) sebesar 0,018. Nilai Homogeneity Index (HI) dan Conformity Index (CI) untuk data klinis adalah 0,136±0,134 dan 0,939±0,131 secara berturut-turut, sementara hasil prediksinya adalah 0,136±0,039 dan 0,949±0,006, dengan nilai p-value untuk fitur PTV dan OAR > 0,05. Dengan demikian, dapat disimpulkan bahwa model random forest efektif dalam memprediksi dosis untuk PTV kanker otak dan OAR, dan dapat digunakan sebagai referensi dalam proses perencanaan.

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Optimizing radiation doses in clinical planning using a Treatment Planning System (TPS) for radiotherapy patients is crucial to achieving a balance between therapeutic effectiveness and patient safety. However, this process is timeconsuming and highly dependent on the expertise of medical physicists. In this study, dose prediction using machine learning for the Planning Target Volume (PTV) and Organ at Risk (OAR) in brain cancer cases was performed using the Volumetric Modulated Arc Therapy (VMAT) planning technique. DICOM planning data was extracted using 3D Slicer to obtain radiomic and dosiomic values, which were then used in this study with a random forest algorithm model. Model evaluation results showed that the random forest model's performance in predicting doses had a Mean Square Error (MSE) of 0.018. The Homogeneity Index (HI) and Conformity Index (CI) values for clinical data were 0.136±0.134 and 0.939±0.131, respectively, while the predicted results were 0.136±0.039 and 0.949±0.006, with p-values for PTV and OAR features > 0.05. Therefore, it can be concluded that the random forest model is effective in predicting doses for brain cancer PTV and OAR and can be used as a reference in the planning process."

"Latar belakang: Separasi sternum atau dehisensi adalah komplikasi sternotomi mediana yang jarang terjadi tetapi memiliki angka morbiditas dan mortalitas yang tinggi. Ketidakstabilan sternum merupakan salah satu faktor timbulnya dehisensi dan teknik aproksimasi sternum adalah komponen penting dalam pencegahannya. Penelitian ini membandingkan dua teknik aproksimasi sternum menggunakan kawat baja tahan karat antara teknik trans-sternal figure-of-eight dan simple interrupted.Metode: Penelitian eksperimental secara in vivo pada 24 sternum kambing. Setelah sternotomi, 12 sternum di aproksimasi menggunakan kawat baja tahan karat dengan teknik trans-sternal figure-of-eight dan 12 sternum yang lain dengan teknik simple interrupted. Uji biomekanik yang terdiri dari regangan transversal, longitudinal dan tarikan lateral dilakukan dengan pembebanan 100- 400 N pada setiap kelompok 4 sternum . Separasi sternum diukur pada setiap pembebanan. Analisis dilakukan dengan uji T-test independent.Hasil: Pada uji biomekanik regangan transversal dan longitudinal, aproksimasi sternum menggunakan kawat baja tahan karat dengan teknik trans-sternal figure-of-eight memiliki perbedaan bermakna secara statistic dibandingkan teknik simple interrupted p 0,05.Kesimpulan: Aproksimasi sternum menggunakan kawat baja tahan karat dengan teknik trans-sternal figure-of-eight lebih stabil dibandingkan simple interrupted secara biomekanik. Kestabilan ini diharapkan dapat memberikan penyembuhan yang lebih baik pada sternum.

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Backgrounds Sternal separation or dehiscence is a rare complication of median sternotomy with high morbidity and mortality. Instability after sternotomy is one factor for the development of the dehiscence and sternal approximation technique is a key component in prevention of that. This study compares two sternal approximation technique using stainless steel between trans sternal figure of eight and simple interrupted.Methods Experimental in vivo studies using 24 goat rsquo s sternum. Sternotomy is performed. 12 sternum fixed with trans sternal figure of eight sutures using a stainless steel wire and 12 others fixed with trans sternal simple interrupted sutures. Biomechanical test consists of testing of transverse shear, longitudinal shear, and lateral distraction performed on each group 4 sternum each type of the test with a load ranging from 100 Newtons to 400 Newtons. Sternal separation was measured for each level of loading. Independent T test was performed to analize the data.Results Biomechanical test of transverse and longitudinal shear, sternal approximation using trans sternal figure of eight technique is better than simple interrupted and the difference was statistically significant p 0.05.Conclusions Sternal approximation using stainless steel wire, trans sternal figure of eight technique provides better stability rather than simple interrupted based on biomechanical analysis. This stability is expected to affect the rate of healing of the sternum better. "

"ABSTRAK Penelitian ini bertujuan untuk menguji signifikansi antara teknik manajemen danpraktik akuntansi manajemen dalam meningkatkan kinerja perusahaan dengan tigastrategi yang berbeda, yaitu differentiation, low cost, dan combination. Teknikmanajemen mencakup improving existing processes, quality systems,manufacturing systems innovation, integrating systems, team-based structures,dan human resource management policies. Sedangkan, praktik akuntansimencakup traditional techniques, activity-based techniques, balance performanemeasures, employee-based measures, benchmarking, dan strategic planning.Penelitian menggunakan sampel orang yang memiliki pengalaman kerja diperusahaan manufaktur dan menggunakan model persamaan struktural. Hasilnyaterdapat perbedaan kombinasi dari komponen teknik manajemen dan praktikakuntansi manajemen dari ketiga strategi yang berpengaruh terhadap kinerja.

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ABSTRACT This research aims to test whether significance of management techniques andmanagement accounting practices can improve the performance of the company inthree different strategies, which are differentiation, low cost, and combination.Management techniques include improving existing processes, quality systems,manufacturing systems by innovation, integrating systems, team-based structures,and human resource management policies. While, management accountingpractices include traditional techniques, activity-based techniques, balancesperformane measures, employee-based measures, benchmarking, and strategicplanning. Samples are people who have working experience in manufacturingcompanies, and use structural equation modelling. Results concluded that thereare differences combination of management techniques and managementaccounting practices components for the strategies which have an effect on to theperformance."