1,614 research outputs found

    Abstract 1122‐000190: Persistent DWI Signal for 18 Months in Ischemic Stroke Patient with Carotid Web

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    Introduction: Diagnostic tools for acute ischemic infarcts include the use of DWI sequence on MRI to identify acute infarcts is especially useful since lesions can become hyperintense on this sequence very rapidly (Albers 1998). Over the next 15 days, DWI hyperintensity slowly decreases back to isointense. In some patients, however, there is persistent DWI hyperintensity past 1 month. There are theories that these persistent areas exhibit delayed onset infarct, prolonged ischemia, or perhaps different repair processes (Rivers, et al 2006). To this day, all DWI signals have been known to resolve within a few months even for persistent hyperintensities (Rivers, et al 2006). Carotid webs are a rare form of fibromuscular dysplasia that protrudes from the intimal tissues of carotid arteries. They are shelf‐like projections that grow into the lumen and disrupt normal blood flow (Zhang, et al 2018). These outgrowths are theorized to lead to ischemic strokes due to flow stasis and subsequent embolization of clots that form (Zhang, et al 2018). There is no consensus on the best management of carotid webs, and secondary prevention of recurrent strokes range from medical management to carotid stenting. Methods: This is a case report, and information for the patient was gathered through review of medical records on the EMR. Results: We present a case of ischemic stroke in the right basal ganglia/corona radiata, who presented with left sided weakness. The patient was found to have prediabetes, HTN, and HLD. However, she had recurrence of her symptoms over the next 18 months (figure 1). Repeat MRIs showed persistent DWI hyperintensity that slowly decreased in size and signal intensity over this period but in the same area as the initial infarct. The rest of the work up was only significant for a carotid web in the right internal carotid artery identified on conventional angiography. Ultimately she was managed with medical therapy including aspirin, statin, and antihypertensives. Conclusions: It is unclear whether the carotid web is associated with persistent DWI for such an extended time frame. There is very little research that explores the pathophysiology of ischemic strokes from carotid webs. In addition, there is even less information about the physiology of an evolving infarct that shows persistent DWI signals for such an extended time frame. Further studies that look into carotid webs may help us understand the best long term management in such patients. Future studies that explore the physiology of ischemic strokes that show such persistent DWI signals may elucidate and perhaps expand upon current management options and possibly identify new areas for intervention

    Strike Three Yer Out!? : Examining the Constitutional Limits on the Use of Prior Uncounseled DWI Convictions to Impose Mandatory Prison Sentences on Repeat DWI Offenders

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    This Comment examines the constitutional implications of using prior uncounseled DWI convictions to incarcerate repeat DWI offenders. The Comment reviews the Supreme Court decisions that established the right to court-appointed counsel for the indigent accused and examines the federal constitutional limitations on the collateral use of prior uncounseled DWI convictions. It also critically evaluates state court decisions involving the collateral use of prior uncounseled DWI convictions. The author concludes that, because an uncounseled conviction is inherently unreliable, it should not be used to mandatorily incarcerate a DWI repeat offender

    KAJIAN NEW HISTORISME DALAM NOVEL HATI SINDEN KARYA DWI RAHYUNINGSIH: A Study Of New Historicism In The Novel Of Hati Sinden By Dwi Rahyuningsih

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    Abstrak: Penelitian ini menggunakan perspektif new historisme dengan tujuan untuk mengidentifikasi sejarah dan budaya Indonesia dalam novel Hati Sinden karya Dwi Rahyuningsih. Data dalam penelitian berupa teks, baik berupa kata, kalimat, atau wacana yang sesuai dengan rumusan masalah. Adapun sumber data dalam penelitian ini yaitu novel Hati Sinden karya Dwi Rahyuningsih yang diterbitkan oleh Diva Press pada tahun 2011. Instrumen dalam penelitian ini yaitu penulis yang berorientasi pada penelitian tentang sejarah dan budaya Indonesia dalam novel Hati Sinden karya Dwi Rahyuningsih. Teknik pengumpulan data dalam penelitian ini dilakukan melalui dua tahapan yaitu baca dan catat. Teknik analisis data dilakukan melalui tiga tahapan yaitu kategorisasi, deskripsi, dan penyajian data. Hasil penelitian menunjukkan bahwa pertama, dalam novel Hati Sinden karya Dwi Rahyuningsih terdapat representasi sejarah Indonesia yaitu tentang Partai Komunis Indonesia. Kedua, representasi unsur budaya dalam novel Hati Sinden karya Dwi Rahyuningsih yang terdiri dari unsur budaya pada sistem kesenian, sistem mata pencaharian hidup, dan sistem kepercayaan. Abstract: This research used new historicism perspective with the aim of identifying Indonesian history and culture in the novel of Hati Sinden by Dwi Rahyuningsih. The data in this research is the form of text, either the form of words, sentences, or discourse in accordance with the formulation of problem. The data source in this research is novel of Hati Sinden by Dwi Rahyuningsih, published by Diva Press in 2011. The instrument in this research is the author who oriented towards research on Indonesian history and culture in the novel of Hati Sinden by Dwi Rahyuningsih. The data collection technique in this research was carried out in two stages, namely reading and taking notes. The data analysis technique was carried out in three stages, namely categorization, description, and presentation of the data. The results show that first, in the novel of Hati Sinden by Dwi Rahyuningsih, there is a representation of Indonesian history, namely the Indonesian Communist Party. Second, the representation of cultural elements in the novel of Hati Sinden by Dwi Rahyuningsih, which consists of cultural elements in the art system, livelihood system, and belief system.Penelitian ini menggunakan perspektif new historisme dengan tujuan untuk mengidentifikasi sejarah dan budaya Indonesia dalam novel Hati Sinden karya Dwi Rahyuningsih.  Data dalam penelitian yaitu berupa teks, baik berupa kata, kalimat, atau wacana yang sesuai dengan rumusan masalah. Adapun sumber data dalam penelitian ini yaitu novel Hati Sinden karya Dwi Rahyuningsih yang diterbitkan oleh Diva Press pada tahun 2011. Instrumen dalam penelitian ini yaitu penulis yang berorientasi pada penelitian tentang sejarah dan budaya Indonesia dalam novel Hati Sinden karya Dwi Rahyuningsih. Teknik pengumpulan data dalam penelitian ini dilakukan melalui dua tahapan yaitu baca dan catat. Teknik analisis data dilakukan melalui tiga tahapan yaitu kategorisasi, deskripsi, dan penyajian data. Hasil penelitian menunjukkan bahwa pertama, dalam novel Hati Sinden karya Dwi Rahyuningsih terdapat representasi sejarah Indonesia yaitu tentang Partai Komunis Indonesia. Kedua, representasi unsur budaya dalam novel Hati Sinden karya Dwi Rahyuningsih yang terdiri dari unsur budaya pada sistem kesenian, sistem mata pencaharian hidup, dan sistem kepercayaan

    AUTOMOTIVE VOCATIONAL TEACHER CANDIDATES: PROBLEMS AND SOLUTIONS NEEDED

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    This research was conducted to study the problems faced by automotive vocational teacher candidates especially in automotive electrical subject. The subject in this research was limited in automotive ignition system controlled by electronic control unit which generally become the main problem. This research was an expose facto research to reveal the real handicaps met by vocational teacher candidates. The population was the automotive student of teacher training in Yogyakarta and Semarang consisting of 145 students who had passed automotive electrical system subject. All of the population members were to be the sample of this research. The result showed that 70% student got difficulties in mastering computer controlled ignition system. The most difficult matter (56%) was in understanding the operation of the ignition system. Learning the matter through reading books was not effective for 62% respondent stated difficult. Although there were learning media, they did not helped yet. Based on the result, it is concluded that automotive vocational teacher candidates suffer from difficulties in understanding the operation of computer controlled ignition system. The available reading material and learning media were not effective yet. That’s why computer based multimedia being able to facilitate the basic principle and operation of computer controlled ignition system is urgently needed

    Use of TiO2 Powder and Activated Carbon as Catalytic Ceramic Filling Material to Reduce Hazardous Pollutants on Gasoline Engine

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    The purpose of this study was, 1) to examine the effect of the mixture composition between ceramics, TiO2, and activated carbon on catalytic converters on vehicle exhaust emissions, 2) test the composition of the mixture between ceramic, TiO2, and activated carbon in catalytic converters that produce the most exhaust emissions low. This study uses an experimental method with descriptive statistics. The independent variable is catalytic converter with a variety of ceramic material composition with a mixture of TiO2 and activated carbon. Control variables are the composition of the mixture, catalytic converter porosity control, standard exhaust without catalytic converter, engine speed used at stationary speed, and duration of testing time. Dependent variables are vehicle exhaust emissions CO and HC. The results of this study are, 1) The use of ceramic materials mixed with TiO2 and activated carbon in catalytic converters can reduce CO and HC content in gasoline-powered vehicles. 2) The best reduction is in the composition of 50% ceramic material, 25% TiO2, and 25% activated carbon, which is able to reduce CO content from 4.19% to 1.44% and HC gas. Suggestions from this study are, gasoline-powered vehicles can use catalytic converters made from Ceramic with a mixture of TiO2, and activated carbon with a composition of 50% ceramic material, 25% TiO2, and 25% activated carbon
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