Evaluasi Dan Analisa Jadwal Pada Pelaksanaan Pekerjaan Struktur Proyek Konstruksi (Studi Kasus Proyek ‘X\u27)

Jadwal pelaksanaan proyek konstruksi merupakan salah satu unsur penting dalam pengendalian proyek demi tercapainya waktu pelaksanaan yang ditargetkan.Berdasarkansiklus Plan – Do – Check – Action, pengendalian dilakukan di tahap Check secara berkesinambungan tiap lantainya. Evaluasi dan analisa studi kasus dibuat selama pelaksanaan pekerjaan struktur 10 lantai pada proyek hotel 15 lantai, dimana tiap lantainya memiliki bobot pekerjaan tipikal sekitar Rp 868.000.000,00 dan durasi pekerjaan yang mirip sekitar 7 hari untuk pekerjaan balok dan plat, sekitar 6 hari untuk pekerjaan kolom, dan 5 hari untuk pekerjaan tangga. Evaluasi yang dilakukan dengan Earned ValueAnalysis untuk mengukur kemajuan proyek menunjukkan dari durasi rencana 106 hari, pekerjaan aktual struktur lantai 7 dimulai dengan keterlambatan 2 hari, lantai 18 diselesaikan dengan keterlambatan 33 hari, dan durasi aktual lantai 7 sampai dengan 18 adalah 137 hari, dengan 18 hari libur Lebaran, 1 hari libur Idul Adha, dan 6 hari Tower Crane tidak berfungsi.Bila dilihat dari durasi pekerjaan, maka kinerja proyek yang terbaik ada pada Lantai 8. Penyebab keterlambatan yang perlu diperhatikan adalah tidak tersedianya bahan sesuai kebutuhan, banyaknya pekerjaan yang dilakukan secara bersamaan, libur Lebaran, belum selesainya pekerjaan lantai sebelumnya, tower crane tidak dapat dioperasikan, pergantian pekerja pada subkontraktor

Pengembangan indeks biaya konstruksi rumah sejahtera murah di beberapa daerah di Indonesia

Abstra

KBG syndrome presenting with brachydactyly type E

We report the case of a young woman who presented at age 10 years with height on the tenth centile, brachydactyly type E and mild developmental delay. Biochemistry and hormonal profiles were normal. Differential diagnoses considered included Albright hereditary osteodystrophy without hormone resistance (a.k.a pseudopseudohypoparathyroidism), 2q37 microdeletion syndrome and acrodysostosis. She had a normal karyotype and normal FISH of 2q37. Whole genome sequencing (WGS) identified a mutation in the ANKRD11 gene associated with KBG syndrome. We review the clinical features of the genetic syndromes considered, and suggest KBG syndrome be considered in patients presenting with syndromic brachydactyly type E, especially if short stature and developmental delay are also present

Risky business: a single-centre cross-sectional analysis of calculated cardiovascular risk in patients with primary aldosteronism and essential hypertension

Objectives Primary aldosteronism (PA), the most common endocrine cause of hypertension, is associated with a higher risk of cardiovascular disease (CVD) than blood pressure (BP)-matched essential hypertension (EH). We aimed to compare the calculated risks of CVD in patients who had hypertension with PA or EH using CVD risk calculators, hypothesising that they will fail to recognise the increased CVD risk in PA. Design Cross-sectional analysis. Setting An endocrine hypertension service in Victoria, Australia. Participants Patients who had hypertension without CVD referred for the investigation of hypertension. Outcome measures Calculated 5-year or 10-year CVD risk as predicted by the National Vascular Disease Prevention Alliance (NVDPA) algorithm, Framingham Risk Score, Pooled Cohort Equations and QRISK3. Results Those with PA (n=128) and EH (n=133), did not differ significantly in their calculated CVD risks with the NVDPA algorithm (moderate-to- high 5-year risk 36/100 vs 45/99, p=0.17); the Framingham Risk Score (median 10-year risk 7.72% (4.43%–12.95%) vs 6.84% (3.85%– 10.50%), p=0.14); the Pooled Cohort Equations (median 10-year risk 9.45% (4.36%–15.37%) vs 7.90% (2.09%– 14.73%), p=0.07); and QRISK3 (median 10-year risk 11.31% (7.22%–20.29%) vs 12.47% (5.10%–19.93%), p=0.51). Similarities persisted on regression analyses accounting for systolic BP. Conclusions CVD risk algorithms do not reflect the increased risk of CVD in patients with PA, and likely underestimate the true risk of CVD among those with PA. Screening for PA, in addition to using the CVD risk algorithm in patients who had hypertension, may facilitate the targeted treatment of PA and minimisation of cardiovascular risk in affected individuals.Pravik Solanki, Stella May Gwini, Renata Libianto, Genevieve Gabb, Jimmy Shen, Morag J Young, Peter J Fuller, Jun Yan

Relationship between urinary sodium excretion and serum aldosterone in patients with diabetes in the presence and absence of modifiers of the renin-angiotensin-aldosterone system

Abstract Although low dietary salt intake has beneficial effects on BP (blood pressure), low 24hUNa (24 h urinary sodium excretion), the most accurate estimate of dietary salt intake, is associated with increased mortality in people with diabetes. In the non-diabetic population, low salt intake is associated with increased RAAS (renin-angiotensin-aldosterone system) activity. In this cross-sectional study, we examined the relationship between 24hUNa, PRA (plasma renin activity), serum aldosterone and BNP (brain natriuretic peptide) in patients with diabetes. Clinical characteristics, 24hUNa, PRA, serum aldosterone and BNP were recorded in 222 consecutive patients (77 % with Type 2 diabetes) attending a diabetes clinic at a tertiary hospital. The relationship between 24hUNa, serum aldosterone, PRA, BNP , urinary potassium excretion, serum potassium, serum sodium, eGFR (estimated glomerular filtration rate), urinary albumin excretion and HbA 1c (glycated haemoglobin) was examined by a multivariable regression model. Levels of 24hUNa significantly predicted serum aldosterone in a linear fashion (R 2 = 0.20, P = 0.002). In the subgroup of patients (n = 46) not taking RAAS-modifying agents, this relationship was also observed (R 2 = 0.10, P = 0.03), and the effect of 24hUNa on serum aldosterone was found to be more pronounced than in the whole cohort (coefficient = − 0.0014, compared with − 0.0008). There was no demonstrable relationship between 24hUNa and PRA or BNP . Low 24hUNa is associated with increased serum aldosterone in people with diabetes, in the presence and absence of RAAS-modifying agents. This raises the possibility that stimulation of the RAAS may be a mechanism that contributes to adverse outcomes observed in patients with low 24hUNa

Complement C5a induces renal injury in diabetic kidney disease by disrupting mitochondrial metabolic agility

The sequelae of diabetes include microvascular complications such as diabetic kidney disease (DKD), which involves glucose-mediated renal injury associated with a disruption in mitochondrial metabolic agility, inflammation, and fibrosis. We explored the role of the innate immune complement component C5a, a potent mediator of inflammation, in the pathogenesis of DKD in clinical and experimental diabetes. Marked systemic elevation in C5a activity was demonstrated in patients with diabetes; conventional renoprotective agents did not therapeutically target this elevation. C5a and its receptor (C5aR1) were upregulated early in the disease process and prior to manifest kidney injury in several diverse rodent models of diabetes. Genetic deletion of C5aR1 in mice conferred protection against diabetes-induced renal injury. Transcriptomic profiling of kidney revealed diabetes-induced downregulation of pathways involved in mitochondrial fatty acid metabolism. Interrogation of the lipidomics signature revealed abnormal cardiolipin remodeling in diabetic kidneys, a cardinal sign of disrupted mitochondrial architecture and bioenergetics. In vivo delivery of an orally active inhibitor of C5aR1 (PMX53) reversed the phenotypic changes and normalized the renal mitochondrial fatty acid profile, cardiolipin remodeling, and citric acid cycle intermediates. In vitro exposure of human renal proximal tubular epithelial cells to C5a led to altered mitochondrial respiratory function and reactive oxygen species generation. These experiments provide evidence for a pivotal role of the C5a/C5aR1 axis in propagating renal injury in the development of DKD by disrupting mitochondrial agility, thereby establishing a new immunometabolic signaling pathway in DKD

Pemilihan Alternatif Pemasok Daging Ayam di Restoran SAte Taichan "Goreng" menggunakan Metode Promethee

Pandemi merupakan tantangan besar bagi banyak perusahaan terutama bagi perusahaan yang bergerak dalam makanan dan minuman. Perusahaan mengalami banyak kerugian akibat dari pandemi COVID-19, dalam menghadapinya banyak cara yang dilakukan untuk mengurangi pengeluaran perusahaan. Perusahaan Sate Taichan “Goreng” memiliki permasalahan dalam pemasok mereka terutama pemasok daging ayam, didukung dengan adanya dampak dari pandemi COVID-19 maka perusahaan memutuskan untuk mengganti pemasok daging ayam mereka. Perushaan Sate Taichan “Goreng” dalam menentukan alternatif pemasok, memiliki 5 kriteria yang diinginkan yaitu : ketepatan waktu pengiriman, harga, kualitas daging, metode pembayaran, dan sistem order. Alternatif pemasok yang ada yaitu 4 alternatif. Tujuan dari penelitian ini yaitu untuk menentukan peringkat dari alternatif, pembuatan program sistem pendukung keputusan, dan menentukan alternatif terbaik dari hasil pemeringkatan tersebut. Penelitian ini dilakukan di perusahaan cabang Surabaya dengan menggunakan pendekatan Multi Criteria Decision Making (MCDM). Metode yang digunakan dalam penelitian ini adalah metode PROMETHEE. Metode ini bertujuan untuk memberi peringkat pada alternatif yang ada. Pengumpulan data dilakukan dengan cara wawancara atau interview kepada manajer perusahaan. Dalam pengolahan data, untuk memudahkan penulis, hasil penelitian diolah menggunakan software Microsoft Excel. Perancangan sistem pengambil keputusan dilakukan dengan software Microsoft excel. Metode pengembangan sistem menggunakan prinsip PROMETHEE. Perancangan worksheet sistem dimulai dari penginputan alternatif dan kriteria, lalu penilaian bobot kriteria, perhitungan selisih bobot, penentuan nilai preferensi, perhitungan nilai index preferensi, perhitungan nilai leaving flow, entering flow, dan net flow, serta penentuan ranking alternatif. Dari hasil pengaplikasian sistem dapat dipastikan sistem pendukung keputusan berjalan dengan baik. Hasil pengolahan data dengan sistem pendukung keputusan dengan metode PROMETHEE menggunakan software Microsoft excel didapatkan nilai Net Flow alternatif 1 sebesar 0, alternatif 2 sebesar 0,27, alternatif 3 sebesar 0,13, alternatif 4 sebesar- 0,40. Dari nilai net flow ditentukan alternatif dengan peringkat pertama yaitu alternatif 2

Primary Aldosteronism: Prevalence, Clinical Features and Biomarkers

Hypertension affects over 6 million Australians and is a leading risk factor for heart attack and stroke. Most people with hypertension have "essential hypertension" (i.e. they have no reversible cause), but a proportion have a treatable secondary cause of which the most common is primary aldosteronism (PA) caused by excessive production of aldosterone hormone. We found that 14% of patients with early-stage hypertension who present to their General Practitioners have PA. Unfortunately, there are no clinical markers that can reliably distinguish PA from essential hypertension, but we found genetic signatures which could help diagnose PA. Thus, our study showed that PA is much more common than currently thought and further work is needed to improve its detection rate and enable timely treatment of this potentially curable form of hypertension

Prediksi Jumlah Kunjungan Wisatawan Mancanegara Pada Negara Singapura Menggunakan Algoritme Extreme Learning Machine

Pariwisata merupakan salah satu aspek penting penyumbang pemasukan bagi negara, khususnya negara Singapura. Singapura merupakan negara berperingkat ke-2 pada benua asia dan menduduki peringkat ke-13 di dunia pada sektor kepariwisatanya. Pendapatan negeri Singapura salah satunya dihasilkan pada sektor pariwiswatanya yaitu sebesar 14,8%. Lebih dari 16 juta wisatawan mancanegara datang ke Singapura setiap tahunnya. Namun, Jumlah kunjungan wisatawan tersebut mengalami kenaikan dan penurunan setiap bulannya. Perubahan nilai yang fluktuatif tersebut, dapat menyebabkan kurang maksimalnya industri pariwisata yang ada di Singapura, khususnya sektor infrastruktur. Hal tersebut dikarenakan akomodasi yang terbatas dalam menampung banyaknya jumlah wisatawan yang datang. Maka dari itu, diperlukan sebuah prediksi jumlah kunjungan wisatawan pada negara Singapura sehingga menjadi sebuah bahan pertimbangan dalam mempersiapkan akomodasi yang lebih baik. Salah satu algoritme prediksi yang dapat digunakan adalah Extreme Learning Machine (ELM). Dari hasil penelitian yang telah dilakukan, parameter algoritme (ELM) yang optimal adalah jumlah fitur data: 5, ratio data training dan data testing: 80%:20%, dan hidden neuron: 10 dengan data jumlah kunjungan wisatawan pada bulan januari hingga desember pada tahun 2010 sampai dengan 2016, diperoleh nilai error dengan menggunakan MAPE sebesar 7,41%