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Abstrak :
[ABSTRAK
Latar belakang. Angka kejadian akut kardiovaskular diperkirakan akan semakin meningkat. Pasien dengan Angina APS dapat berkembang menjadi Sindroma Koroner Akut (SKA). Konsep proses inflamasi dan stress oksidatif berperan terhadap patogenesis atherosklerosis. Radikal bebas seperti reactive oxygen atau nitrogen species, dan HOCL (hypochlorous acid) dapat mengakibatkan kerapuhan plak. HOCL merupakan Reactive Oxygen Species (ROS) kuat yang menyebabkan ketidakstabilan plak sehingga mudah ruptur. Plak yang mudah ruptur disebut plak vulnerable. HOCL adalah substrat yang dihasilkan oleh myeloperoxidase (MPO). Studi histopatologi plak vulnerablemenilai ukuran pusat nekrotik adalah prediktor kuat terjadinya ruptur plak (OR 0.35; P <0.05), dan (OR 2.0; P <0.02).CT angiografi koroner adalah suatu modalitas pencitraan non invasif yang mampu memvisualisasi morfologi plak vulnerable salah satunya dengan mengidentifikasi adanya Napkin Ring Sign (NRS). NRS sangat spesifik untuk menilai pusat nekrotik. Studi ini bertujuan melihat hubungan MPO dengan plak vulnerableyang dinilai dengan Napkin Ring Sign pada pasien angina pektoris stabil. Metode. Penelitian ini adalah studi potong lintang yang dilakukan di Pusat Jantung Nasional Harapan Kita dari periode Juni ? November 2014. Studi dilakukan pada 41 subyek, pada pasien dengan angina pektoris stabil, jumlah laki ? laki sebanyak 32 orang ( 78%) dan perempuan 9 orang (22%), Pengambilan sampel secara konsekutif. Pengukuran kadar MPO dilakukan dengan menggunakan colorimetri assay. Pemeriksaan CT angiografi koroner dilakukan untuk mengidentifikasi NRS.Analisa statistik untuk mencari hubungan antara kadar MPO dengan plak vulnerable yang ditandai dengan NRSpada pemeriksaan CT angiografi koroner. Hasil.Kadar MPO (nmol) pada pasien dengan positif NRS lebih tinggi dibandingkan yang negatif 124,371 + 15,324 vs 105,206 + 18,335, aktivitas MPO (milliunit/mL) 829,136 + 102,157 vs701,371 + 122,235. Analisa bivariat erdapat hubungan yang bermakna antara kadar MPO dengan NRS p 0,002, IK 95%2.3,0 - 39,9. Dari multivariat regresi logistik didapatkan kadar MPO > 117,2 (median), memiliki OR 9,6 (IK 95% 2,3 -39) dengan p 0,002. Setelah dilakukan penyesuaian dengan faktor resiko, pada analisa multivariat regresi logistik, didapatkan OR 20,3 (IK 95% 3,1-31,7) dengan p 0,002. Kesimpulan. Kadar MPO memiliki hubungan yang bermakna dengan plak vulnerable yang ditandai dengan temuan NRS pada CT angiografi koroner pada pasien dengan APS. Kata kunci : atherosklerosis, plak vulnerable, myeloperoxidase, napkin ring sign.

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ABSTRACT
Background.Coronary Heart Disease ( CHD) is still the major health problem in worldwide. Atherosclerosis is a chronic inflammatory process where oxidative damage play a role in atherosclerosis. Overexpression of Reactive Oxygen Species ( ROS) could be detrimental and weaken the plaque. This type of plaque is often referred to as vulnerable plaque. Reactive oxygen or nitrogen species, and HOCL (hypochlorous acid) responsible for plaque vulnerability leading to Acute Coronary Syndrome. HOCL is a substrat of Myeloperoxidase (MPO). MPO is a member of the heme peroxidase superfamily, generates reactive oxidants contributes to plaque vulnerability. Coronary Computed Tomography Angiography (CCTA) is a non invasive modality which able to identify morphology of vulnerable plaque. Napkin- Ring Sign (NRS) has been associated with high-risk plaques in several studies. Methods. A cross sectional study in 41 patients stable angina pectoris was done.The subjects was taken blood sample and underwent CCTA to evaluate NRS in National Cardiovascular Center Harapan Kita from June to November 2014. Statistical analysis is done to explore the association between MPO and vulnerable plaque marked with NRS in stable angina pectoris. Results. There was association between MPO level with vulnerable plaque marked with Napkin Ring Sign, p value 0,002 , CI 95%2.3,0 - 39.9. Level of MPO is higher in positif NRS vs non NRS (nmol) 124,371 + 15,324 vs 105,206 + 18,335, activity of MPO (milliunit/mL) 829,136 + 102,157 vs701,371 + 122,235. Logistic regression analysis showed level of MPO ≥ 117,2 nmol (median), OR 9,6 (CI95% 2,3 -39) p value0,002. After adjustment with confounding factor MPO level ≥ 117,2 nmol (median), OR 20,3 (IK 95% 3,1-31,7) , p value 0,002. Conclusion.There was association between Myeloperoxidase level with vulnerable plaque marked with Napkin Ring Sign;Background.Coronary Heart Disease ( CHD) is still the major health problem in worldwide. Atherosclerosis is a chronic inflammatory process where oxidative damage play a role in atherosclerosis. Overexpression of Reactive Oxygen Species ( ROS) could be detrimental and weaken the plaque. This type of plaque is often referred to as vulnerable plaque. Reactive oxygen or nitrogen species, and HOCL (hypochlorous acid) responsible for plaque vulnerability leading to Acute Coronary Syndrome. HOCL is a substrat of Myeloperoxidase (MPO). MPO is a member of the heme peroxidase superfamily, generates reactive oxidants contributes to plaque vulnerability. Coronary Computed Tomography Angiography (CCTA) is a non invasive modality which able to identify morphology of vulnerable plaque. Napkin- Ring Sign (NRS) has been associated with high-risk plaques in several studies. Methods. A cross sectional study in 41 patients stable angina pectoris was done.The subjects was taken blood sample and underwent CCTA to evaluate NRS in National Cardiovascular Center Harapan Kita from June to November 2014. Statistical analysis is done to explore the association between MPO and vulnerable plaque marked with NRS in stable angina pectoris. Results. There was association between MPO level with vulnerable plaque marked with Napkin Ring Sign, p value 0,002 , CI 95%2.3,0 - 39.9. Level of MPO is higher in positif NRS vs non NRS (nmol) 124,371 + 15,324 vs 105,206 + 18,335, activity of MPO (milliunit/mL) 829,136 + 102,157 vs701,371 + 122,235. Logistic regression analysis showed level of MPO ≥ 117,2 nmol (median), OR 9,6 (CI95% 2,3 -39) p value0,002. After adjustment with confounding factor MPO level ≥ 117,2 nmol (median), OR 20,3 (IK 95% 3,1-31,7) , p value 0,002. Conclusion.There was association between Myeloperoxidase level with vulnerable plaque marked with Napkin Ring Sign, Background.Coronary Heart Disease ( CHD) is still the major health problem in worldwide. Atherosclerosis is a chronic inflammatory process where oxidative damage play a role in atherosclerosis. Overexpression of Reactive Oxygen Species ( ROS) could be detrimental and weaken the plaque. This type of plaque is often referred to as vulnerable plaque. Reactive oxygen or nitrogen species, and HOCL (hypochlorous acid) responsible for plaque vulnerability leading to Acute Coronary Syndrome. HOCL is a substrat of Myeloperoxidase (MPO). MPO is a member of the heme peroxidase superfamily, generates reactive oxidants contributes to plaque vulnerability. Coronary Computed Tomography Angiography (CCTA) is a non invasive modality which able to identify morphology of vulnerable plaque. Napkin- Ring Sign (NRS) has been associated with high-risk plaques in several studies. Methods. A cross sectional study in 41 patients stable angina pectoris was done.The subjects was taken blood sample and underwent CCTA to evaluate NRS in National Cardiovascular Center Harapan Kita from June to November 2014. Statistical analysis is done to explore the association between MPO and vulnerable plaque marked with NRS in stable angina pectoris. Results. There was association between MPO level with vulnerable plaque marked with Napkin Ring Sign, p value 0,002 , CI 95%2.3,0 - 39.9. Level of MPO is higher in positif NRS vs non NRS (nmol) 124,371 + 15,324 vs 105,206 + 18,335, activity of MPO (milliunit/mL) 829,136 + 102,157 vs701,371 + 122,235. Logistic regression analysis showed level of MPO ≥ 117,2 nmol (median), OR 9,6 (CI95% 2,3 -39) p value0,002. After adjustment with confounding factor MPO level ≥ 117,2 nmol (median), OR 20,3 (IK 95% 3,1-31,7) , p value 0,002. Conclusion.There was association between Myeloperoxidase level with vulnerable plaque marked with Napkin Ring Sign]

Abstrak :
Pada era digitalisasi, infrastruktur teknologi berperan penting dalam pengembangan literasi digital di berbagai sektor yang dimana hal ini dapat memberikan informasi penting bagi masyarakat secara luas. Pemanfaatan teknologi informasi dan komunikasi (TIK) di Indonesia dalam lima tahun terakhir menunjukkan perkembangan indikator TIK yang sangat masif. Penduduk yang menggunakan internet juga mengalami peningkatan selama periode 2016–2020, yang ditunjukkan dengan meningkatnya persentase penduduk yang mengakses internet pada tahun 2016 dari sekitar 25,37 persen menjadi 53,73 persen pada tahun 2020. Penelitian ini bertujuan untuk mereview kembali kerentanan TIK di wilayah Indonesia timur melalui pendekatan analisis klaster yang berbasis pembelajaran mesin machine learning. Data yang dikumpulkan dalam penelitian ini berasal dari Badan Pusat Statistik (BPS) melalui SUSENAS untuk memperoleh gambaran tingkat kesejahteraan sosial ekonomi dan SAKERNAS untuk mendapat sudut pandang dari sisi lapangan kerja. Penelitian ini menggunakan 15 variabel berdasarkan aspek kerentanan yang meliputi 174 kabupaten/kota. Analisis klaster menggunakan Fuzzy C Means (FCM) digunakan untuk mendapatkan profil kerentanan TIK di wilayah Indonesia bagian timur dengan pemilihan model terbaik. Model terbaik diperoleh dengan mempertimbangkan nilai validasi seperti Silhouette Index, Partition Entropy, Partition Coefficient, dan Modified Partition Coefficient. Untuk beberapa daerah dengan tingkat kerentanan yang sangat tinggi, diperlukan perhatian khusus dari pemerintah pusat atau daerah untuk mendukung peningkatan teknologi informasi melalui perencanaan yang baik. Aspek sosial ekonomi dan lapangan kerja sudah tercermin dalam analisis klaster ini, dan dampak peningkatan TIK akan memberikan nilai positif bagi peningkatan kualitas hidup masyarakat. Dari hasil pemodelan, model klaster terbaik adalah dua cluster, yang dikategorikan dalam kerentanan tinggi dan kerentanan rendah. Anggota klaster yang memiliki kesamaan atau kedekatan satu sama lain, akan berada dalam satu anggota klaster. ......In the present digital era, technology infrastructure plays an important role in the development of digital literacy in various sectors that can provide various important information on a large scale. The use of information and communication technology (ICT) in Indonesia in the last five years has shown a massive development of ICT indicators. The population using the internet also experienced an increase during the period 2016–2020, as indicated by the increasing percentage of the population accessing the internet in 2016 from around 25.37 percent to 53.73 percent in 2020. This study led to a review of the level of ICT vulnerability in eastern Indonesia through a machine learning-based cluster analysis approach. Data were collected in this study from Badan Pusat Statistik (BPS) through SUSENAS to obtain an overview of the socioeconomic level and SAKERNAS to capture the employment side. This study uses 15 variables based on aspects of business vulnerability covering 174 districts/cities. Cluster analysis using Fuzzy C Means (FCM) was used to obtain a profile of ICT level vulnerability in eastern Indonesia by selecting the best model. The best model is obtained by selecting the validation value such as Silhouette Index, Partition Entropy, Partition Coefficient, and Modified Partition Coefficient. For some areas with a very high level of vulnerability, special attention is needed for the central or local government to support the improvement of information technology through careful planning. Socio-economic and occupational aspects have been reflected in this very vulnerable cluster, and the impact of the increase in ICT will provide a positive value for community development. From the modelling results, the best cluster model is two clusters, which are categorized as high vulnerability and low vulnerability. For each cluster member who has a similarity or proximity to each other, there will be one cluster member.

Abstrak :
Kejadian sindrom koroner akut (SKA) pada pasien risiko atau suspek penyakit jantung koroner (PJK) terkait dengan tipe plaque-nya. Coronary Computed Tomography Angiography (CCTA) merupakan modalitas pilihan untuk melihat adanya soft plaque, mixed plaque dan calcified plaque pada arteri koronaria. Mengetahui hubungan antara vulnerable plaque dengan kejadian SKA pada pasien yang telah diperiksa CCTA menjadi informasi tambahan dalam evaluasi dan penatalaksanaan pasien. Metode.: Penelitian retrospektif dengan comparative cross sectional pasien risiko atau suspek PJK yang menjalani pemeriksaan CCTA yang terdapat soft plaque dan mixed plaque yang termasuk vulnerable plaque serta calcified plaque. Dilakukan penilaian rerata Hounsfield Unit dan perhitungan remodeling indeks (RI) untuk melihat komponen positif remodeling (PR). Hasil : Terdapat hubungan yang bermakna pada vulnerable plaque yang mengalami SKA dengan nilai p < 0,001 dan OR : 6.55. Selain itu didapatkan juga hubungan yang bemakna antara soft plaque dan mixed plaque dengan positif remodeling dibandingkan tanpa positif remodeling dengan nilai p : 0,039 dan OR : 2,92. Kesimpulan : Terdapat hubungan yang bermakna antara vulnerable plaque pada pasien risiko atau suspek PJK dengan kejadian SKA Background and Objective : Acute coronary syndrome (ACS) event in risk or suspect of coronary artery disesase depent on their plaque type. Coronary Computed Tomography Angiography (CCTA) is modality of choice to recognise soft plaque, mixed plaque and calcified plaque in coronary artery disease (CAD). Correlation between vulnerable plaque with ACS event in risk or suspek CAD that already examined by CCTA have additional information for evaluation and treatment patient.Methods : Comparative cross sectional retrospective study patient with risk or CAD that already examined by CCTA that contain soft plaque and mixed plaque that categorized as vulnerable plaque and calcified plaque, also assessment average value of Hounsfield Unit and quantification of remodeling index (RI) to see the positive remodeling (PR). Results :There is correlation in vulnerable plaque related to ACS with p < 0,001 and OR : 6,55. Besides that there also correlation between soft plaque and mixed plaque with posistif remodeling compare without positive remodeling with value p 0,039 and OR : 2,92. Conclusions : There is correlation between ACS event and vulnerable plaque in patient with risk or suspect CAD

Abstrak :
Tulisan ini merupakan refleksi pengalaman saya dalam mengikuti Program Desa Cemara yang diadakan oleh Kementerian PPN/Bappenas. Pembahasan dalam tulisan ini akan berfokus pada upaya kepesertaan Jaminan Kesehatan Nasional (JKN) BPJS PBI untuk kelompok masyarakat rentan, dan mekanisme pendataan Sepakat Desa dan Regsosek. Mekanisme penargetan berbasis data memungkinkan hilangnya subjektivitas dalam program perlindungan sosial. Basis data Sepakat Desa dan Regsosek yang digunakan merupakan inskripsi yang dihasilkan melalui serangkaian prosedural yang telah diatur sebagai inscriptional device. Pengambilan data didasarkan pada pengalaman saya dalam implementasi program perlindungan sosial di Desa Pasanggrahan. Hal ini dilakukan dengan metode kuantitatif berdasarkan data Sepakat Desa dan Regsosek, serta observasi dan wawancara untuk memperkuat data yang ada. Program perlindungan sosial dalam bentuk kepesertaan Jaminan Kesehatan Nasional merupakan hal yang penting bagi kelompok rentan, seperti disabilitas, penyakit kronis berkepanjangan, dan lansia. Masih diperlukan sinkronisasi data Sepakat Desa dan Regsosek dengan data DTKS dalam mengimplementasikan program perlindungan sosial. Selain itu, diperlukan pula pemutakhiran secara berkala untuk menjaga kualitas data kependudukan yang digunakan sebagai acuan program perlindungan sosial. ......This paper is a reflection of my experience in participating in the Desa Cemara Program held by the Ministry of National Development Planning/Bappenas. The discussion in this paper will focus on the BPJS PBI National Health Insurance (JKN) membership efforts for vulnerable groups, and the data collection mechanisms of Sepakat Desa and Regsosek. Data-driven targeting mechanisms enable the elimination of subjectivity in social protection programs. The Sepakat Desa and Regsosek databases used are inscriptions produced through a series of procedural arrangements as inscriptional devices. Data collection is based on my experience in implementing social protection programs in Desa Pasanggrahan. This was conducted using quantitative methods based on data from the Sepakat Desa and Regsosek, as well as observations and interviews to strengthen existing data. Social protection programs in the form of National Health Insurance membership are important for vulnerable groups, such as those with disabilities, prolonged chronic illnesses, and the elderly. There is still a need to synchronize data from Sepakat Desa and Regsosek with DTKS data in implementing social protection programs. In addition, regular updates are also needed to maintain the quality of population data used as a reference for social protection programs.

Abstrak :
A legal identity document is the right of every citizen because it is a prerequisite in accessing public services. This study aims to assess the implementation of Presidential Regulation Number 62 of 2019 on the National Strategy of Strengthening Civil Registration and Vital Statistics (Stranas Percepatan AKPSH), which focuses on regulatory synchronization and services at a local level. A qualitative analysis approach was used, consisting of a literature study and in-depth interview methods. The research sample includes ministries/agencies at the central level, also several local governments, i.e., Palu City, Bantul Regency, Muaro Jambi Regency, East Sumba Regency, DKI Jakarta Province, and Surabaya City. The study shows that the central government has made policies to facilitate vulnerable groups in CRVS access. Local governments have policies that make it easier for vulnerable groups to get CRVS access; innovate administrative services; carry out socialization, advocacy, and education efforts involving third parties; and increase cooperation between regional government organizations (OPD) in implementing integrated civil registration services. However, there are still vulnerable groups that are not accommodated. Implementation at the regional level still has infrastructure readiness, human resources, and required special data collection team availability. Therefore, the determination of the vulnerability category becomes essential. This study recommends that it is necessary to create an additional classification of vulnerable groups in CRVS. In addition, it is essential to strengthening outreach to vulnerable groups in CRVS, especially at the regional level.

Abstrak :
Sejak program Peningkatan Peranan Wanita Menuju Keluarga Sejahtera (P2WKSS) diimplementasikan oleh Dinas Pemberdayaan Perempuan, Perlindungan Anak, Pengendalian Penduduk, dan Keluarga Berencana, Dinas Sosial Kabupaten Bogor turut berpartisipasi dalam menyelenggarakan pemberdayaan ekonomi perempuan melalui program WRSE yang menyasar perempuan pencari nafkah utama dan/atau pembantu pencari nafkah dalam rumah tangga miskin. Namun, Indeks Pemberdayaan Gender (IDG) Kabupaten Bogor di tahun 2019 berada di posisi terendah kedua di Provinsi Jawa Barat, yang salah satunya menunjukan masih terdapat ketimpangan distribusi pendapatan antara perempuan dan laki-laki. Oleh sebab itu, penelitian ini bertujuan untuk menganalisis hasil pelaksanaan program WRSE di Desa Bangunjaya, Kecamatan Cigudeg, Kabupaten Bogor dengan model evaluasi CIPP (Context, Input, Process, Product). Penelitian ini menggunakan pendekatan post-positivist dengan teknik pengumpulan data gabungan atau mixed methods. Data yang digunakan dalam penelitian ini bersumber dari wawancara mendalam, studi kepustakaan, dan survei. Hasil penelitian menunjukkan bahwa program belum mampu menyelesaikan permasalahan kemiskinan perempuan di Kabupaten Bogor karena tidak memenuhi kebutuhan strategis gender. Faktor lainnya ialah pada saat pelaksanaan program tidak menyediakan Tempat Penitipan Anak (TPA), keterbatasan pemberian modal awal untuk usaha, jangka waktu pelatihan keterampilan terlalu pendek, dan tidak dilakukan monitoring lanjutan. ......Ever since the Bogor Regency Department of Women Empowerment, Child Protection, Human Population Control, and Family Planning (DP3AP2KB) implement the Increasing Role of Women Towards a Prosperous Family (P2WKSS) program, the Bogor Regency Department of Social Service has participated in organizing women's economic empowerment through the Socio-Economic Vulnerable Women (WRSE) program. The program targets women who classified as the primary breadwinners and assistant breadwinners in poor households. However, Bogor Regency's Gender Empowerment Index (IDG) in 2019 was at the second-lowest in West Java Province, showing inequality in income distribution between women and men. Therefore, this study analyzes the implementation results of the Socio-Economic Vulnerable Women (WRSE) program in the Bangunjaya Village, Cigudeg District, Bogor Regency using the Context, Input, Process, Product (CIPP) evaluation model. This research conducted post-positivist approach which combined qualitative and quantitative data collection techniques. This research collects data through semi-structured in-depth interviews, document studies, and surveys. The result shows that the program has not reduced women's poverty in Bogor Regency because the program design does not meet gender strategic need. Also, during the program implementation, it did not provide a Child Care Center (TPA), has limited initial capital for businesses, the period of skills training was too short, and further monitoring was not carried out.

Abstrak :

ABSTRACT
This paper assesses the performance of method targeting and implementation error of social transfer programs in Indonesia, which consists of Raskin, in-kind transfer; Program Keluarga Harapan (PKH), a conditional cash transfer; Program Indonesia Pintar (PIP), scholarship program; and Program Indonesia Sehat (PIS), free health insurance for the poor and vulnerable. The logit model of exclusion and inclusion errors shows the drivers of probability error in targeting these four kinds of social transfer programs. The finding shows error in the implementation that relies heavily on urban-rural differences and legal identity ownership rather than the role of government employees. Measuring the performance of miss-targeting is needed to improve the effectiveness of social transfer programs on achieving their goals. The analysis of targeting performance suggests caution in employing a mechanism of the delivery program to improve the implementation of the targeting program to promote more social safety net rather than in-kind transfer and cash transfer as well as to re-evaluate the identification requirement for receiving social benefits to reach the beneficiaries from the extreme poor.