Search results for: Ariane Utomo
16 Understanding Chances and Challenges of Family Planning: Qualitative Study in Indonesia's Banyumas District
Authors: Utsamani Cintyamena, Sandra Frans Olivia, Shita Lisyadewi, Ariane Utomo
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Family planning is one of fundamental aspects in preventing maternal morbidity and mortality. However, the prevalence rate of Indonesia’s married women in choosing contraception is low. This study purpose to assess opportunities and challenges in family planning. Methodology: We conducted a qualitative study in Banyumas District which has huge reduction of maternal mortality rate from 2013 to 2015. Four focus group discussions and four small group discussions were conducted to assess knowledge and attitude of women in using contraceptive and their method of choice, as well as in-depth interview to four health workers and two family planning field officers as triangulation. Thematic content analysis was done manually. Results: Key themes emerge across interviews including (1) first choice of contraception is the one that they previously had, provided that they did not encountered problems with it, (2) rumor and fear of side effect affected their method of choice, (3) selection of contraceptive method was influenced by approval of husband, believes, and role model in community. Conclusion: Collaboration of health worker, family planning field officers, community, as well as support from stakeholder, must be increased to socializing family planning.Keywords: attitude, challenge, chance, family planning, knowledge
Procedia PDF Downloads 14915 Food Package Design To Preserve The Food Temperature
Authors: Sugiono, Wuwus Ardiatna, Himma Firdaus, Nanang Kusnandar, Bayu Utomo, Jimmy Abdel Kadar
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This study was aimed to explore the best design of single-used hot food packaging through various package designs. It examined how designed packages keep some local hot food reasonably longer than standard packages. The food packages were realized to consist of the outer and the inner layers of food-grade materials. The packages were evaluated to keep the hot food decreased to the minimum temperature of safe food. This study revealed a significant finding that the transparent plastic box with thin film aluminum foil is the best package.Keywords: hot food, local food, one used, packaging, aluminum foil
Procedia PDF Downloads 14914 The Labor Participation–Fertility Trade-off: The Case of the Philippines
Authors: Daphne Ashley Sze, Kenneth Santos, Ariane Gabrielle Lim
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As women are now given more freedom and choice to pursue employment, the world’s over-all fertility has been decreasing mainly due to the shift in time allocation between working and child rearing. As such, we study the case of the Philippines, where there exists a decreasing fertility rate and increasing openness for women labor participation. We focused on the distinction between fertility and fecundity, the former being the manifestation of the latter and aim to trace and compare the effects of both fecundity and fertility to women’s employment status through the estimation of the reproduction function and multinomial logistic function. Findings suggest that the perception of women regarding employment opportunities in the Philippines links the negative relationship observed between fertility, fecundity and women’s employment status. Today, there has been a convergence in the traditional family roles of men and women, as both genders now have identical employment opportunities that continue to shape their preferences.Keywords: multinomial logistic function, tobit, fertility, women employment status, fecundity
Procedia PDF Downloads 61113 The Labor Participation-Fertility Trade-Off: Exploring Fecundity and Its Consequences to Women's Employment in the Philippines
Authors: Ariane C. Lim, Daphne Ashley L. Sze, Kenneth S. Santos
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As women are now given more freedom and choice to pursue employment, the world’s over-all fertility has been decreasing mainly due to the shift in time allocation between working and child-rearing. As such, we study the case of the Philippines, where there exists a decreasing fertility rate and increasing openness for women labor participation. We focused on the distinction between fertility and fecundity, the former being the manifestation of the latter and aim to trace and compare the effects of both fecundity and fertility to women’s employment status through the estimation of the reproduction function and multinomial logistic function. Findings suggest that the perception of women regarding employment opportunities in the Philippines links the negative relationship observed between fertility, fecundity and women’s employment status. Today, there has been a convergence in the traditional family roles of men and women, as both genders now have identical employment opportunities that continue to shape their preferences.Keywords: multinomial logistic function, tobit, fertility, women employment status, fecundity
Procedia PDF Downloads 63412 Effect of Atmospheric Pressure on the Flow at the Outlet of a Propellant Nozzle
Authors: R. Haoui
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The purpose of this work is to simulate the flow at the exit of Vulcan 1 engine of European launcher Ariane 5. The geometry of the propellant nozzle is already determined using the characteristics method. The pressure in the outlet section of the nozzle is less than atmospheric pressure on the ground, causing the existence of oblique and normal shock waves at the exit. During the rise of the launcher, the atmospheric pressure decreases and the shock wave disappears. The code allows the capture of shock wave at exit of nozzle. The numerical technique uses the Flux Vector Splitting method of Van Leer to ensure convergence and avoid the calculation instabilities. The Courant, Friedrichs and Lewy coefficient (CFL) and mesh size level are selected to ensure the numerical convergence. The nonlinear partial derivative equations system which governs this flow is solved by an explicit unsteady numerical scheme by the finite volume method. The accuracy of the solution depends on the size of the mesh and also the step of time used in the discretized equations. We have chosen in this study the mesh that gives us a stationary solution with good accuracy.Keywords: finite volume, lunchers, nozzles, shock wave
Procedia PDF Downloads 28911 Paradox of Business Strategic toward Sustainable Business: A Case Study of Hijab Fashion in Bandung
Authors: Lisandy Arinta Suryana, Santi Novani, Utomo Sarjono
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Paradox of business strategic is associated with the contradictory practice. It becomes one of the critical way to survive and win in the dynamic competitive landscape – high level of uncertainty and rapid change in the business environment. Those characteristics are similar with the environment of hijab fashion business, especially in Indonesia. This paper aims to describe the success of paradoxical strategic based on historical data of hijab fashion business which have been validated by qualitative approach. This paper discusses two main aspects of paradoxical strategic such as paradox in human resource management, and logistic center management. Then, the detail effects from each practice are described in term of causal loop diagram. Moreover, the practice of paradoxical strategic depends on leadership that can make a brave and dynamic decision by capturing the main problems and opportunities in their business, and also build commitment to achieve a specific goal.Keywords: paradox of business strategic, paradoxical strategic, causal loop diagram, sustainable business, hijab fashion business, business strategic
Procedia PDF Downloads 39110 Application of Two Stages Adaptive Neuro-Fuzzy Inference System to Improve Dissolved Gas Analysis Interpretation Techniques
Authors: Kharisma Utomo Mulyodinoto, Suwarno, A. Abu-Siada
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Dissolved Gas Analysis is one of impressive technique to detect and predict internal fault of transformers by using gas generated by transformer oil sample. A number of methods are used to interpret the dissolved gas from transformer oil sample: Doernenberg Ratio Method, IEC (International Electrotechnical Commission) Ratio Method, and Duval Triangle Method. While the assessment of dissolved gas within transformer oil samples has been standardized over the past two decades, analysis of the results is not always straight forward as it depends on personnel expertise more than mathematical formulas. To get over this limitation, this paper is aimed at improving the interpretation of Doernenberg Ratio Method, IEC Ratio Method, and Duval Triangle Method using Two Stages Adaptive Neuro-Fuzzy Inference System (ANFIS). Dissolved gas analysis data from 520 faulty transformers was analyzed to establish the proposed ANFIS model. Results show that the developed ANFIS model is accurate and can standardize the dissolved gas interpretation process with accuracy higher than 90%.Keywords: ANFIS, dissolved gas analysis, Doernenberg ratio method, Duval triangular method, IEC ratio method, transformer
Procedia PDF Downloads 1509 Development of Water-Based Thermal Insulation Paints Using Silica Aerogel
Authors: Lu Yanru, Handojo Djati Utomo, Yin Xi Jiang, Li Xiaodong
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Insulation plays a key role in the sustainable building due to the contribution of energy consumption reduction. Without sufficient insulation, a great amount of the energy used to heat or cool a building will be lost to the outdoors. In this study, we developed a highly efficient thermal insulation paint with the incorporation of silica aerogel. Silica aerogel, with a low thermal conductivity of 0.01 W/mK, has been successfully prepared from the solid waste from the incineration plants. It has been added into water-based paints to increase its thermal insulation properties. To investigate the thermal insulation performance of silica aerogel additive, the paint samples were mixed with silica aerogel at different sizes and with various portions. The thermal conductivity, water resistance, thermal stability and adhesion strength of the samples were tested and evaluated. The thermal diffusivity measurements proved that adding silica aerogel additive could improve the thermal insulation properties of the paint significantly. Up to 5 ˚C reductions were observed after applying paints with silica aerogel additive compare to the one without it. The results showed that the developed thermal insulation paints have great potential for an application in green and sustainable building.Keywords: silica aerogel, thermal insulation, water-based paints, water resistant
Procedia PDF Downloads 1908 Use of Quasi-3D Inversion of VES Data Based on Lateral Constraints to Characterize the Aquifer and Mining Sites of an Area Located in the North-East of Figuil, North Cameroon
Authors: Fofie Kokea Ariane Darolle, Gouet Daniel Hervé, Koumetio Fidèle, Yemele David
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The electrical resistivity method is successfully used in this paper in order to have a clearer picture of the subsurface of the North-East ofFiguil in northern Cameroon. It is worth noting that this method is most often used when the objective of the study is to image the shallow subsoils by considering them as a set of stratified ground layers. The problem to be solved is very often environmental, and in this case, it is necessary to perform an inversion of the data in order to have a complete and accurate picture of the parameters of the said layers. In the case of this work, thirty-three (33) Schlumberger VES have been carried out on an irregular grid to investigate the subsurface of the study area. The 1D inversion applied as a preliminary modeling tool and in correlation with the mechanical drillings results indicates a complex subsurface lithology distribution mainly consisting of marbles and schists. Moreover, the quasi-3D inversion with lateral constraint shows that the misfit between the observed field data and the model response is quite good and acceptable with a value low than 10%. The method also reveals existence of two water bearing in the considered area. The first is the schist or weathering aquifer (unsuitable), and the other is the marble or the fracturing aquifer (suitable). The final quasi 3D inversion results and geological models indicate proper sites for groundwaters prospecting and for mining exploitation, thus allowing the economic development of the study area.Keywords: electrical resistivity method, 1D inversion, quasi 3D inversion, groundwaters, mining
Procedia PDF Downloads 1577 Gender Based of Sustainable Food Self-Resilience for Village Using Dynamic System Model
Authors: Kholil, Laksanto Utomo
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The food needs of the Indonesian people will continue increase year to year due to the increase of population growth. For ensuring food securityand and resilience, the government has developed a program food self-resilience village since 2006. Food resilience is a complex system, consisting of subsystem availability, distribution and consumption of the sufficiency of food consumed both in quantity and quality. Low access, and limited assets to food sources is the dominant factor vulnerable of food. Women have a major role in supporting the productive activities of the family to meet food sufficiency and resilience. The purpose of this paper is to discuss the model of food self-resilience village wich gender responsive by using a dynamic system model. Model will be developed into 3 level: family, vilage, and regency in accordance with the concept of village food resilience model wich has been developed by ministry of agriculture. Model development based on the results of experts discussion and field study. By some scenarios and simulation models we will able to develop appropriate policy strategies for family food resilience. The result of study show that food resilience was influenced by many factors: goverment policies, technology, human resource, and in the same time it will be a feed back for goverment policies and number of poor family.Keywords: food availability, food sufficiency, gender, model dynamic, law enfrocement
Procedia PDF Downloads 5346 Fuzzy Logic-Based Approach to Predict Fault in Transformer Oil Based on Health Index Using Dissolved Gas Analysis
Authors: Kharisma Utomo Mulyodinoto, Suwarno, Ahmed Abu-Siada
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Transformer insulating oil is a key component that can be utilized to detect incipient faults within operating transformers without taking them out of service. Dissolved gas-in-oil analysis has been widely accepted as a powerful technique to detect such incipient faults. While the measurement of dissolved gases within transformer oil samples has been standardized over the past two decades, analysis of the results is not always straightforward as it depends on personnel expertise more than mathematical formulas. In analyzing such data, the generation rate of each dissolved gas is of more concern than the absolute value of the gas. As such, history of dissolved gases within a particular transformer should be archived for future comparison. Lack of such history may lead to misinterpretation of the obtained results. IEEE C57.104-2008 standards have classified the health condition of the transformer based on the absolute value of individual dissolved gases along with the total dissolved combustible gas (TDCG) within transformer oil into 4 conditions. While the technique is easy to implement, it is considered as a very conservative technique and is not widely accepted as a reliable interpretation tool. Moreover, measured gases for the same oil sample can be within various conditions limits and hence, misinterpretation of the data is expected. To overcome this limitation, this paper introduces a fuzzy logic approach to predict the health condition of the transformer oil based on IEEE C57.104-2008 standards along with Roger ratio and IEC ratio-based methods. DGA results of 31 chosen oil samples from 469 transformer oil samples of normal transformers and pre-known fault-type transformers that were collected from Indonesia Electrical Utility Company, PT. PLN (Persero), from different voltage rating: 500/150 kV, 150/20 kV, and 70/20 kV; different capacity: 500 MVA, 60 MVA, 50 MVA, 30 MVA, 20 MVA, 15 MVA, and 10 MVA; and different lifespan, are used to test and establish the fuzzy logic model. Results show that the proposed approach is of good accuracy and can be considered as a platform toward the standardization of the dissolved gas interpretation process.Keywords: dissolved gas analysis, fuzzy logic, health index, IEEE C57.104-2008, IEC ratio method, Roger ratio method
Procedia PDF Downloads 1605 Predictive Value Modified Sick Neonatal Score (MSNS) On Critically Ill Neonates Outcome Treated in Neonatal Intensive Care Unit (NICU)
Authors: Oktavian Prasetia Wardana, Martono Tri Utomo, Risa Etika, Kartika Darma Handayani, Dina Angelika, Wurry Ayuningtyas
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Background: Critically ill neonates are newborn babies with high-risk factors that potentially cause disability and/or death. Scoring systems for determining the severity of the disease have been widely developed as well as some designs for use in neonates. The SNAPPE-II method, which has been used as a mortality predictor scoring system in several referral centers, was found to be slow in assessing the outcome of critically ill neonates in the Neonatal Intensive Care Unit (NICU). Objective: To analyze the predictive value of MSNS on the outcome of critically ill neonates at the time of arrival up to 24 hours after being admitted to the NICU. Methods: A longitudinal observational analytic study based on medical record data was conducted from January to August 2022. Each sample was recorded from medical record data, including data on gestational age, mode of delivery, APGAR score at birth, resuscitation measures at birth, duration of resuscitation, post-resuscitation ventilation, physical examination at birth (including vital signs and any congenital abnormalities), the results of routine laboratory examinations, as well as the neonatal outcomes. Results: This study involved 105 critically ill neonates who were admitted to the NICU. The outcome of critically ill neonates was 50 (47.6%) neonates died, and 55 (52.4%) neonates lived. There were more males than females (61% vs. 39%). The mean gestational age of the subjects in this study was 33.8 ± 4.28 weeks, with the mean birth weight of the subjects being 1820.31 ± 33.18 g. The mean MSNS score of neonates with a deadly outcome was lower than that of the lived outcome. ROC curve with a cut point MSNS score <10.5 obtained an AUC of 93.5% (95% CI: 88.3-98.6) with a sensitivity value of 84% (95% CI: 80.5-94.9), specificity 80 % (CI 95%: 88.3-98.6), Positive Predictive Value (PPV) 79.2%, Negative Predictive Value (NPV) 84.6%, Risk Ratio (RR) 5.14 with Hosmer & Lemeshow test results p>0.05. Conclusion: The MSNS score has a good predictive value and good calibration of the outcomes of critically ill neonates admitted to the NICU.Keywords: critically ill neonate, outcome, MSNS, NICU, predictive value
Procedia PDF Downloads 714 Profile of Programmed Death Ligand-1 (PD-L1) Expression and PD-L1 Gene Amplification in Indonesian Colorectal Cancer Patients
Authors: Akterono Budiyati, Gita Kusumo, Teguh Putra, Fritzie Rexana, Antonius Kurniawan, Aru Sudoyo, Ahmad Utomo, Andi Utama
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The presence of the programmed death ligand-1 (PD-L1) has been used in multiple clinical trials and approved as biomarker for selecting patients more likely to respond to immune checkpoint inhibitors. However, the expression of PD-L1 is regulated in different ways, which leads to a different significance of its presence. Positive PD-L1 within tumors may result from two mechanisms, induced PD-L1 expression by T-cell presence or genetic mechanism that lead to constitutive PD-L1 expression. Amplification of PD-L1 genes was found as one of genetic mechanism which causes an increase in PD-L1 expression. In case of colorectal cancer (CRC), targeting immune checkpoint inhibitor has been recommended for patients with microsatellite instable (MSI). Although the correlation between PD-L1 expression and MSI status has been widely studied, so far the precise mechanism of PD-L1 gene activation in CRC patients, particularly in MSI population have yet to be clarified. In this present study we have profiled 61 archived formalin fixed paraffin embedded CRC specimens of patients from Medistra Hospital, Jakarta admitted in 2010 - 2016. Immunohistochemistry was performed to measure expression of PD-L1 in tumor cells as well as MSI status using antibodies against PD-L1 and MMR (MLH1, MSH2, PMS2 and MSH6), respectively. PD-L1 expression was measured on tumor cells with cut off of 1% whereas loss of nuclear MMR protein expressions in tumor cells but not in normal or stromal cells indicated presence of MSI. Subset of PD-L1 positive patients was then assessed for copy number variations (CNVs) using single Tube TaqMan Copy Number Assays Gene CD247PD-L1. We also observed KRAS mutation to profile possible genetic mechanism leading to the presence or absence of PD-L1 expression. Analysis of 61 CRC patients revealed 15 patients (24%) expressed PD-L1 on their tumor cell membranes. The prevalence of surface membrane PD-L1 was significantly higher in patients with MSI (87%; 7/8) compared to patients with microsatellite stable (MSS) (15%; 8/53) (P=0.001). Although amplification of PD-L1 gene was not found among PD-L1 positive patients, low-level amplification of PD-L1 gene was commonly observed in MSS patients (75%; 6/8) than in MSI patients (43%; 3/7). Additionally, we found 26% of CRC patients harbored KRAS mutations (16/61), so far the distribution of KRAS status did not correlate with PD-L1 expression. Our data suggest genetic mechanism through amplification of PD-L1 seems not to be the mechanism underlying upregulation of PD-L1 expression in CRC patients. However, further studies are warranted to confirm the results.Keywords: colorectal cancer, gene amplification, microsatellite instable, programmed death ligand-1
Procedia PDF Downloads 2233 Usability Evaluation of Four Big e-Commerce Websites in Indonesia
Authors: Harry B. Santoso, Lia Sadita, Firlia Sandyta, Musa Alfatih, Nove Spalo, Nu'man Naufal, Nuryahya P. Utomo, Putu A. Paramatha, Rezka Aufar Leonandya, Tommy Anugrah, Aulia Chairunisa, M. Fadly Uzzaki, Riandy D. Banimahendra
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The numbers of Internet active users in Indonesia reach out over 88.1 million, where 48% of them are daily active users. Seeing these numbers, it is the best opportunity for IT companies to grow their business, especially e-Commerce. In fact, the growth of e-Commerce companies in Indonesia is proportional with internet daily active users. This phenomenon shows that competition happening among the e-Commerce companies is raising high. It triggers many e-Commerce companies to improve their services. The authors hypothesized that one of the best ways to improve the services is by improving their usability. So, the authors had done a study to evaluate and find out ways to improve usability of those e-Commerce websites. The authors chose four e-Commerce websites which each of them has different business focus and profiles. Each company is labeled as A, B, C, and D. Company A is a fashion-based e-Commerce services with two-million desktop visits Indonesia. Company B is an international online shopping mall for everyday appliances with 48,3-million desktop visits in Indonesia. Company C is a localized online shopping mall with 3,2-million desktop visits in Indonesia. Company D is an online shopping mall with one-million desktop visits in Indonesia. Writers used popular web traffic analytics platform to gain the numbers. There are some approaches to evaluate the usability of e-Commerce websites. In this study, the authors used usability testing method supported by the User Experience Questionnaire. This method involved the user in interacting directly with the services provided by the e-Commerce company. This study was conducted within two months including preparation, data collection, data analysis, and reporting. We used a pair of computers, a screen-capture video application named Smartboard, and User Experience Questionnaire. A team was built to conduct this study. They consisted of one supervisor, two assistants, four facilitators and four observers. For each e-Commerce, three users aged 17-25 years old were invited to do five task scenarios. Data collected in this study included demographic information of the users, usability testing results, and users’ responses to the questionnaire. Some findings were revealed from the usability testing and the questionnaire. Compared to the other three companies, Company D had the least score for the experiences. One of the most painful issues figured out by the authors from the evaluation was most users claimed feeling confused by user interfaces in these e-Commerce websites. We believe that this study will help e-Commerce companies to improve their services and business in the future.Keywords: e-commerce, evaluation, usability testing, user experience
Procedia PDF Downloads 3192 User-Centered Design in the Development of Patient Decision Aids
Authors: Ariane Plaisance, Holly O. Witteman, Patrick Michel Archambault
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Upon admission to an intensive care unit (ICU), all patients should discuss their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. We employed user-centered design to adapt an existing decision aid (DA) about CPR to create a novel wiki-based DA adapted to the context of a single ICU and tailored to individual patient’s risk factors. During Phase 1, we conducted three weeks of ethnography of the decision-making context in our ICU to identify clinician and patient needs for a decision aid. During this time, we observed five dyads of intensivists and patients discussing their wishes concerning life-sustaining interventions. We also conducted semi-structured interviews with the attending intensivists in this ICU. During Phase 2, we conducted three rounds of rapid prototyping involving 15 patients and 11 other allied health professionals. We recorded discussions between intensivists and patients and used a standardized observation grid to collect patients’ comments and sociodemographic data. We applied content analysis to field notes, verbatim transcripts and the completed observation grids. Each round of observations and rapid prototyping iteratively informed the design of the next prototype. We also used the programming architecture of a wiki platform to embed the GO-FAR prediction rule programming code that we linked to a risk graphics software to better illustrate outcome risks calculated. During Phase I, we identified the need to add a section in our DA concerning invasive mechanical ventilation in addition to CPR because both life-sustaining interventions were often discussed together by physicians. During Phase II, we produced a context-adapted decision aid about CPR and mechanical ventilation that includes a values clarification section, questions about the patient’s functional autonomy prior to admission to the ICU and the functional decline that they would judge acceptable upon hospital discharge, risks and benefits of CPR and invasive mechanical ventilation, population-level statistics about CPR, a synthesis section to help patients come to a final decision and an online calculator based on the GO-FAR prediction rule. Even though the three rounds of rapid prototyping led to simplifying the information in our DA, 60% (n= 3/5) of the patients involved in the last cycle still did not understand the purpose of the DA. We also identified gaps in the discussion and documentation of patients’ preferences concerning life-sustaining interventions (e.g.,. CPR, invasive mechanical ventilation). The final version of our DA and our online wiki-based GO-FAR risk calculator using the IconArray.com risk graphics software are available online at www.wikidecision.org and are ready to be adapted to other contexts. Our results inform producers of decision aids on the use of wikis and user-centered design to develop DAs that are better adapted to users’ needs. Further work is needed on the creation of a video version of our DA. Physicians will also need the training to use our DA and to develop shared decision-making skills about goals of care.Keywords: ethnography, intensive care units, life-sustaining therapies, user-centered design
Procedia PDF Downloads 3551 Muscle and Cerebral Regional Oxygenation in Preterm Infants with Shock Using Near-Infrared Spectroscopy
Authors: Virany Diana, Martono Tri Utomo, Risa Etika
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Background: Shock is one severe condition that can be a major cause of morbidity and mortality in the Neonatal Intensive Care Unit. Preterm infants are very susceptible to shock caused by many complications such as asphyxia, patent ductus arteriosus, intra ventricle haemorrhage, necrotizing enterocolitis, persistent pulmonal hypertension of the newborn, and septicaemia. Limited hemodynamic monitoring for early detection of shock causes delayed intervention and comprises the outcomes. Clinical parameters still used in neonatal shock detection, such as Capillary Refill Time, heart rate, cold extremity, and urine production. Blood pressure is most frequently used to evaluate preterm's circulation, but hypotension indicates uncompensated shock. Near-infrared spectroscopy (NIRS) is known as a noninvasive tool for monitoring and detecting the state of inadequate tissue perfusion. Muscle oxygen saturation shows decreased cardiac output earlier than systemic parameters of tissue oxygenation when cerebral regional oxygen saturation is still stabilized by autoregulation. However, to our best knowledge, until now, no study has analyzed the decrease of muscle oxygen regional saturation (mRSO₂) and the ratio of muscle and cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Purpose: The purpose of this study is to analyze the decrease of mRSO₂ and ratio of muscle to cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Patients and Methods: This cross-sectional study was conducted on preterm infants with 28-34 weeks gestational age, admitted to the NICU of Dr. Soetomo Hospital from November to January 2022. Patients were classified into two groups: shock and non-shock. The diagnosis of shock is based on clinical criteria (tachycardia, prolonged CRT, cold extremity, decreased urine production, and MAP Blood Pressure less than GA in weeks). Measurement of mRSO₂ and cRSO₂ by NIRS was performed by the doctor in charge when the patient came to NICU. Results: We enrolled 40 preterm infants. The initial conventional hemodynamic parameter as the basic diagnosis of shock showed significant differences in all variables. Preterm with shock had higher mean HR (186.45±1.5), lower MAP (29.8±2.1), and lower SBP (45.1±4.28) than non-shock children, and most had a prolonged CRT. The patients’ outcome was not a significant difference between shock and non-shock patients. The mean mRSO₂ in the shock and non-shock groups were 33,65 ± 11,32 vs. 69,15 ± 3,96 (p=0.001), and the mean ratio mRSO₂/cRSO₂ 0,45 ± 0,12 vs. 0,84 ± 0,43 (p=0,001), were significantly different. The mean cRSO₂ in the shock and non-shock groups were 71,60 ± 4,90 vs. 81,85 ± 7,85 (p 0.082), not significantly different. Conclusion: The decrease of mRSO₂ and ratio of mRSO₂/cRSO₂ can differentiate between shock and non-shock in the preterm infant when cRSO₂ is still normal.Keywords: preterm infant, regional muscle oxygen saturation, regional cerebral oxygen saturation, NIRS, shock
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