bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-lasting response with lapatinib treatment: a case report
Authors: Milani Andrea , Nuzzolese Imperia , Chilà Giovanna
Published: December 2018

Lapatinib is a small molecule and a reversible inhibitor of HER2, which has shown to be effective on brain lesions in patients with HER2-positive breast cancer relapsed at the central nervous system (CNS). We report the clinical case of a young woman, treated with the combination of lapatinib and capecitabine from September 2009 to today for a metastatic recurrence of HER2-positive breast carcinoma at CNS level and who has achieved a complete response of the encephalic lesion and has not shown disease progression at systemic or CNS level, with excellent tolerance profile (Oncology).
Lapatinib and chronic renal insufficiency
Authors: Moscetti Luca
Published: December 2018

Lapatinib is an intracellular tyrosine-kinase inhibitor of both EGFR (ErbB1) and HER2 (ErbB2) receptors, which is indicated in the treatment of metastatic disease pretreated with anti-HER2 therapies. We report the clinical case of a woman with chronic renal failure in dialysis affected by HER2-positive metastatic breast neoplasia and treated with lapatinib and letrozole (Oncology).
Good control of diffuse brain metastasis with lapatinib plus capecitabine in a patient with HER2-positive breast cancer
Authors: Faggioni Giovanni
Published: December 2018

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We present the case of a patient affected by HER2-positive breast carcinoma, relapsed at supraclavicular and mediastinal lymph nodes level, after three and eight years from initial diagnosis. These relapses were successfully treated by local radiotherapy, hormone therapy and trastuzumab. After 10 years from onset, the patient developed cerebral progression with a number of seizable lesions, overt clinical symptoms. To avoid the short- and long-term side effects of whole brain radiotherapy, the patient is initially treated with lapatinib and capecitabine in light of the favorable data on the efficacy of this combination on brain metastases from HER2-positive breast carcinoma. This therapy results in a considerable lesions reduction, allowing to postpone the panencephalic radiotherapy to a later time with a lower tumor burden. The response to radiotherapy is significant and sustanined for a progression-free interval of about 10 months. This case suggests that lapatinib may represent the treatment of choice in cases of indolent disease, characterized by long progression free intervals with minor symptoms with the aim to postpone the use of more invasive treatments (Oncology).
Efficacy of lapatinib-capecitabine combination in a patient with multiple metastasis from HER2-positive breast cancer
Authors: Moritti Maria , Maiello Evaristo
Published: December 2018

HER2 overexpression occurs in about 15-20% of breast cancer cases and is associated with rapid tumor growth. The introduction in clinical practice of several drugs inhibiting the biological activity of HER2, such as trastuzumab, pertuzumab, trastuzumab emtansine (T-DM1) and lapatinib, has clearly modified the prognosis for these patients. The combination of the two inhibitors of HER2, trastuzumab and pertuzumab, with a taxane (paclitaxel or docetaxel), is currently considered the first choice treatment for patients affected by HER2-positive metastatic breast cancer, whereas T-DM1 is considered the preferred treatment after the failure of first line therapy. We present the case of a 50-year-old woman affected by HER2-positive breast cancer with bone, hepatic, pulmonary and encephalic metastases, resistant both to trastuzumab-pertuzumab double-block treatment and to T-DM1, but sensitive to third line therapy to the combination lapatinib-capecitabine with a clinical response both for visceral and cerebral metastases (Oncology).
Toxicity management and efficacy of lapatinib-capecitabine in elderly patient with lymph node metastasis from HER2-positive occult mammary carcinoma
Authors: Quarta Giuseppe , Zizzari Giovanni
Published: December 2018

The overexpression of the HER2 oncoprotein, which corresponds to the genotype-amplification of the HER2/neu oncogene, is reported in 20% of breast tumors. The development of anti-HER2 drugs has improved the prognosis of these particularly aggressive tumors and the positivity to HER2, detected with immunohistochemistry or with FISH (fluorescent in situ hybridization) method in metastatic cells, allows today a therapeutic approach and a better outcome for the patient. We report a peculiar clinical case of a patient whose diagnosis of HER2-positive asymptomatic breast tumor was based on the identification of a metastatic lymph node and who responded very well to 6-years therapy with anti-HER2 drugs, with good compliance to the treatment and with management of its toxicity (Oncology).
Efficacy of second-line treatment with capecitabine and lapatinib in HER2-positive mammary neoplasia, with encephalic metastasis, after first-line therapy with dual anti-HER2 block
Authors: Zeppola Tea
Published: December 2018

Lapatinib is a small molecule that reversibly inhibits the tyrosine kinase activity of EGFR and HER2. It is indicated in the treatment of breast carcinoma overexpressing HER2 (ErB2), in combination with capecitabine, in patients with advanced or metastatic disease, progressing after treatment with anthracyclines, taxanes and trastuzumab. We report the case of a 53-year-old patient with hepatic and local disease at diagnosis, treated as first line with trastuzumab, pertuzumab and docetaxel. After 9 months, encephalic progression was documented. The patient was treated with radiotherapy, trastuzumab and pertuzumab. After recurrence of the encephalic disease, the patient started therapy with lapatinib and capecitabine, leading to stable disease at local, hepatic and cerebral level, with an excellent tolerability profile (Oncology).
Complicated plantar ulcer in diabetic patient with multiple comorbidities
Authors: Monge Luca
Published: December 2018

Diabetic foot syndrome is characterized by an intrinsic patient fragility and involves complex medical and surgical therapeutic approach. Lesions, often chronic, have a high risk of recurrence and amputation. The patient with diabetic foot is more frequently affected by comorbidities, not only for micro-angiopathic complications of diabetes mellitus but also for the frequent presence of cardiovascular disease. We report the case of a 63-year-old diabetic patient with multiple comorbidities. Treatment with linagliptin allowed to simplify the therapy for glycemic control, switching from a injective therapy four times daily to a therapy with only basal insulin and linagliptin. This therapy has proven to be safe and suitable to maintain good glycemic control even in a fragile patient with diabetic foot and middle-severe renal insufficiency of diabetic origin (Diabetology).
Patient not adequately controlled with insulin therapy and hospitalized for congestive heart failure
Authors: Frison Vera , Filippi Alessio , Simioni Natalino
Published: December 2018

The data provided by cardiovascular safety studies of type 2 sodium-glucose transporter inhibitors have aroused great interest among diabetologists and other specialists. They demonstrated that these drugs reduce significantly, compared to placebo, the risk of major cardiovascular events, all cause and cardiovascular mortality, and hospitalization for heart failure in patients with type 2 diabetes at high cardiovascular risk. We report the case of a cardiovascular diabetic patient not adequately controlled by high-dose multi-injective insulin therapy and hospitalized for congestive heart failure, treated with empagliflozin in association with high doses of loop diuretic (furosemide) and sacubitril/valsartan (Diabetology).
A new challenge for linagliptin: diabetes, organ transplantation and chronic renal insufficiency in the same patient
Authors: Bonora Benedetta M.
Published: December 2018

The association between liver cirrhosis and type 2 diabetes mellitus (DMT2) has been known for many years. It is estimated that changes in glucose metabolism are present in at least two thirds of cirrhosis patients. Diabetes can be both a consequence of liver disease and a pre-existing condition. In the first case, liver transplantation would be the solution but post-transplant diabetes remains a common condition. For patients with liver cirrhosis the therapeutic approach for the treatment of DMT2 is extremely limited and the studies available on this type of population are very few. The pharmacokinetic characteristics of linagliptin are well suited for patients with DMT2 and chronic liver disease; in fact, no dose adjustment is required in patients regardless of the degree of hepatic impairment. With regard to the treatment of diabetes in post-transplantation, data on the efficacy and safety of oral hypoglycemic drugs are scarce; however, the available studies suggest that dipeptidyl peptidase 4 (DPP4i) inhibitors are safe and effective in these patients. In describing this clinical case, we discuss how the use of a DPP4i, and in particular of linagliptin, may represent a valid therapeutic strategy in the management of diabetic, cirrhotic patients who undergo liver transplantation (Diabetology).
Dual therapy in a patient with atrial fibrillation at high risk of bleeding
Authors: Rolandi Andrea
Published: December 2018

In patients with atrial fibrillation (AF) undergoing coronary angioplasty (PCI) the guidelines recommend the use of triple therapy (oral anticoagulant therapy in addition to dual antiplatelet therapy) for varying periods depending on the individual patient's risk profile, limiting the possibility of starting immediately with dual antithrombotic therapy to patients with relevant haemorrhagic risk. Triple therapy is associated with a high frequency of major bleeding; in recent years there have been several studies investigating new therapeutic strategies attempting to reduce the risk of bleeding without increasing the thrombotic risk. We report the case of an elderly patient suffering from hypertension, a previous acute coronary syndrome with anterior descending stenting and permanent AF treated with dabigatran 110 mg bid for 2 years. The patient is admitted to hospital for syncope with facio-brachio-crural hemiparesis associated with myocardial infarction; she is treated with idarucizumab and coronary angiography shows trivessel disease with acute occlusion of the right proximal coronary arteru. This case is an example of how in a patient with AF, in which the risk of bleeding increases 4-fold, the adoption of the dual therapy rather than the triple therapy immediately after the acute event (according to data from the RE-DUAL PCI) or after 1 month (according to the guidelines), can prove effective over the long term, ensuring adequate protection both from hemorrhagic events and from the risk of stent thrombosis (Cardiology).
Systemic control and encephalic response with lapatinib plus capecitabine as second-line therapy in HER2-positive, metastatic breast cancer
Authors: Ardito Raffaele , Marino Fiorella Restaino
Published: December 2018

Overexpression of the human epidermal growth factor receptor (HER2) oncoprotein in breast cancer patients, is one of the biological characteristics of the disease that determines the choice of appropriate systemic treatment. We report the case of a 41-year-old woman, with relapsing HER2-positive breast cancer in cerebral and pulmonary cells. The patient underwent multimodal first Iine treatment including pertuzumab, trastuzumab and docetaxel and panencephalic radiotherapy with good response and progression-free survival for approximately 16 months. Subsequently, further to a encephalic progression of the disease, the patient was treated in second line with the combination lapatinib + capecitabine which induced further encephalic response and disease control for additional 20 months (Oncology).
The patient with atrial fibrillation undergoing percutaneous angioplasty: triple therapy or new therapeutic strategies?
Authors: Campo Gianluca , Bugani Giulia
Published: December 2018

The management of antithrombotic therapy in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) is a challenge cardiologists face daily. The main difficulty is represented by finding the right balance between the prevention of thrombotic risk and the inevitable increase in bleeding. Most guidelines recommend the use of both oral anticoagulants and dual antiplatelet therapy in combination (triple therapy) in patients with FA undergoing PCI, suggesting however immediate use of dual antithrombotic therapy in patients with prevalent bleeding risk. Many studies show that triple therapy is associated with high frequency of major bleeding, thus stimulating the research for new therapeutic strategies. We report the case of a patient suffering from hypertension, dyslipidemia and epistaxis, hospitalized for the onset of angina associated with moderate efforts. Despite scientific evidence to support the use of dual therapy with dabigatran, the patient's detailed clinical history shows that this type of approach has not yet entered into current clinical practice, although the final therapeutic choice is in line with the results of the RE-DUAL PC study (Cardiology).
Diabetes onset before age 40: more and more often it is type 2 diabetes
Authors: Sanga Viola
Published: December 2018

An increase in the appearance of diabetes mellitus at young age is observed, and not necessarily type 1 diabetes is involced. We report the case of a 35-year-old patient, with a family history of diabetes, with type 2 diabetes at onset (Diabetology).
Linagliptin in the frail elderly diabetic patient
Authors: Palmieri Eva
Published: December 2018

The elderly patient with diabetes represents the paradigmatic example of a "patient-centered approach" in the therapeutic strategy of diabetic disease. Treatment of the elderly with diabetes is complicated by significant clinical and functional heterogeneity: in these patients, comorbidities and polytherapies are extremely common and the risk of interactions and/or adverse effects becomes relevant. In this particular population it is therefore important to identify a less restrictive glycemic target, although it is not acceptable to consider hyperglycemia in the elderly as a physiological condition. Due to their efficacy, high tolerability, ease of use and cardiovascular safety profile, dipeptidyl peptidase IV (DPP-4) inhibitors are a preferred treatment option rather than sulfonylureas and glinides in elderly patients that are not adequately controlled with metformin alone or are intolerant or have contraindications to metformin. We describe the case of an 82-year-old patient with type 2 diabetes mellitus for about 25 years, with a sedentary lifestyle due to a partial motor difficulty linked to instability. For over 15 years it has also suffered from chronic ischemic heart disease, arterial hypertension and chronic renal failure. The use of linagliptin in this patient therapy confirms the known tolerability ease of use and safety profile of the drug. The data obtained support how it is possible to safely and independently manage the therapy with linagliptin in combination with insulin, which is therefore a valid therapeutic option in elderly patients with high cardiovascular risk undergoing multiple treatments (Diabetology).
Atrial fibrillation ablation
Authors: Sgarito Giuseppe
Published: December 2018

Transcatheter ablation can be used in case of atrial fibrillation (AF) not controlled by medical therapy due to lack of efficacy or poor tolerability.The procedure is however associated with the risk of periprocedural events and therefore requires particular attention to systemic anticoagulant therapy. In this clinical setting dabigatran may represent a valid therapeutic option to ensure adequate patient protection during the ablation procedure, as demonstrated by the results of the RE-CIRCUIT study. Here we describe an elderly patient, treated for hypertension, with a slightly impaired renal function, a long history of highly symptomatic paroxysmal AF resistant to antiarrhythmic drugs. It describes the common clinical practice prior to the publication of the RE-CIRCUIT study results, which support performing the AF ablation procedure without interrupting the anticoagulant therapy in place with dabigatran. It also highlights the potential efficacy of dabigatran in the treatment of endoauricular thrombus in patients with FA, for whom the currently recommended treatment is bridging with LMWH and the initiation of oral anticoagulant therapy with VKA, which however may be ineffective, as in this case (Diabetology).
Treatment of atrial fibrillation in complex patients: a case report beyond the obvious
Authors: Fazio Giovanni
Published: December 2018

Many cardiovascular diseases and comorbidities increase the risk of atrial fibrillation (AF) and further complications. Identifying and managing these conditions is critical for the prevention and control of AF, contributing to optimal patient management. We describe the case of a 74-year-old patient suffering from arterial hypertension and diabetes mellitus, with HCV related liver disease evolved into liver cirrhosis. The patient received aorto-coronary bypass for ischemic heart disease and PTCA for unstable angina. After six months paroxysmal episodes of AF developed and therapy with sotalol and edoxaban was started. Following an increase in the severity of paroxysmal AF, with the occurrence of an episode requiring cardiovertion, we opted to control the frequency with a pharmacological strategy. Due to the marked deterioration of liver function, severe anemia, thrombocytopenia and Grade I esophageal varices, edoxaban was discontinued and therapy with fondaparinux was initiated. After treatment with corticosteroids and antibiotics, the patient was discharged and reintroduction of NOAC therpy was evaluated. After consulting with a liver disease specialist, it was decided to start therapy with dabigatran. Since then the patient is asymptomatic and in stable clinical conditions. The management of AF in complex patients requires an integrated approach that takes into account individual diseases as well as the overall risk profile. In this context, NOACs in general and dabigatran in particular represent a therapeutic option that allows to ensure adequate prevention of thromboembolic risk and to limit the risk of bleeding (Cardiology)
Dabigatran in the ischemic patient undergoing atrial fibrillation ablation
Authors: Spoladore Roberto
Published: December 2018

Trans-catheter ablation of atrial fibrillation (AF) is a common treatment for symptomatic AF. Among the major complications of AF ablation are stroke, transient ischemic attacks and peri-procedural cardiac tamponade. Various clinical trials have shown that uninterrupted treatment with vitamin K antagonists (VKA) is associated with a lower incidence of embolic events compared to discontinuation of therapy; until recently, in the absence of equally solid evidence, this practice was not extended to the new oral anticoagulants (NOAC) not VKA due to the fear of hemorrhagic complications potentially associated with the use of an "irreversible" anticoagulant. The case of a patient suffering from numerous comorbidities is reported here. In light of the poor response to anti-arrhythmics, a TC-RF ablation was performed, with suspension of dabigatran administration only on the day of the procedure (for a total period <24 hours). Although the fear of the risk of bleeding potentially associated with the trans-catheter ablation procedure may still induce clinicians to stop anticoagulant therapy, even the decision to discontinue anticoagulant therapy with dabigatran on the day of surgery alone is challenged by recent evidence in the literature supporting the efficacy of dabigatran in reducing the incidence of hemorrhagic events during and after ablation, including the results of the RE-CIRCUIT study (Cardiology)
Lapatinib as second-line treatment after the double block pertuzumab-trastuzumab: a case report
Authors: Magri Valentina , Scagnoli Simone , Piesco Gabriele , Pomati Giulia
Published: December 2018

We report the case of a young, 36-year-old patient diagnosed with multifocal breast carcinoma, undergoing neoadjuvant chemotherapy, surgery and adjuvant treatment. The patient presented an early recovery of liver disease after only 7 months of free interval. Histological reevaluation after liver biopsy revealed a HER2-positive disease, for which it was treated with first line chemotherapy including double anti-HER2 block. After 3 cycles the disease progressed at liver and encephalic level. It was therefore decided to treat brain localizations with whole-brain radiotherapy and to start a second line with capecitabine associated with lapatinib. This chemo-radiotherapy approach allowed to control the disease for 8 months. Following further progression (lymph node and bone), a third line was chosen with trastuzumab emtansine (TDM1). The encephalic disease remained stable for another 8 months, when due to visceral progression and worsening of clinical picture, TDM1 was interrupted and supportive therapies were started (Oncology).

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Anticoagulant therapy in a patient with a history of cerebral hemorrhage
Authors: Crisci Mario
Published: December 2018

Several guidelines recommend the preferential use of NOAC compared to warfarin in patients with atrial fibrillation, based on evidence to support a efficacy similar to warfarin, but with a lower incidence of intracranial hemorrhage. The case described is a typical example of non-optimal use of NOACs in clinical practice: although the final choice of dabigatran 110 mg bid is in line with the recommendations of the guidelines and with the literature, the previous choice of administering enoxaparin is inadequate due to the presence of atrial fibrillation which makes the use of the drug off-label due to the lack of clinical data in this type of patient. Nevertheless, use of enoxaparin waiting to optimize anticoagulant therapy is very common in clinical practice. Non-inferiority in reagards to thromboembolic events and a superior safety profile in comparison to warfarin in the RE-LY study, make dabigatran 110 mg bid a suitable choice in clinical practice for patients at high risk of both thrombotic and hemorrhagic stroke (Cardiology).
Interaction between chemotherapeutics and anticoagulants
Authors: Guerra Federico
Published: December 2018

Patients with metastatic renal cell carcinoma are at increased risk of bleeding, which must be taken into account if the thromboembolic risk profile requires anticoagulant therapy. Patients treated with sunitinib, especially if with a history of hypertension or coronary artery disease, have a higher risk of cardiovascular events, therefore they should be monitored closely for evidence of worsening arterial hypertension or signs of left ventricular dysfunction. The development of some complications associated with sunitinib increases the thromboembolic risk of patients, who often have to resort to anticoagulant therapy. In the absence of specific guidelines for the management of thromboembolic risk in cancer patients, the therapeutic choice must be guided by the evidence available in the literature to support the individual pharmacological classes. We describe her the case of a patient treated with sunitinib for clear cell renal cell carcinoma, with different comorbidities. The case provides interesting clues for optimal prophylaxis of cardioembolism in cancer patient with atrial fibrillation (Cardiology).
ANALISIS NILAI TAMBAH DAN STRATEGI PENGEMBANGAN HOME INDUSTRY KUPANG KERING DI DESA BALONGDOWO KECAMATAN CANDI KABUPATEN SIDOARJO
Authors: Diarsa Ari Wahyu , Januar Jani , Suwandari Anik
Published: December 2018

Shellfish is the raw material for making dried shellfish. Home industry located in Balongdowo village, Sidoarjo regency has long been cultivated, but until now most of the craftsmen have not showed significant development. This study was aimed to determine value added of shellfish based product dried, cost efficiency of dried shellfish processed product, and development strategy at dried shellfish home industry in Balongdowo Village, Sidoarjo Regency. Analyzer used include analysis of value added, analysis efficiency cost, and SWOT analysis. The result of the analysis shows that: (1) Wet shellfish added value in shellfish dried home industries medium, (2) Home industry shellfish dried in the use of production cost has been efficient, (3) The appropriate development strategy to be applied was using the W-O strategy that was by dried shellfish industry should use labour maximization, good packaging process, labelling, and try to get healt-assesment certification to expand the marketing process.
ANALISIS DINAMIKA KELOMPOK SENTRA PENYULUHAN KEHUTANAN DAN PEDESAAN MANGGA DELIMA TAMAN NASIONAL KARIMUNJAWA
Authors: Yani Diarsi Eka , Faridha Idha
Published: December 2018

Comprehensive development is a management process combined with the socio-economic aspects of the community, especially in the buffer zone of the National Park area. The community can play a role in extension activities through Forestry and Rural Extension Center (SPKP) in order to encourage productivity’s enhancement and community’s autonomy through various productive activities undertaken. The research objectives are (1) identify individual characteristics, and (2) analyze the dynamics of SPKP Mangga Delima Karimunjawa National Park group. The research used census method in SPKP Mangga Delima, Kemujan village, Karimunjawa distrcts. The research used census method in SPKP Mangga Delima, Kemujan village, Karimunjawa districts. There were 16 respondents that are members of the group. Data analysis used frequency distribution and description. The findings of individual characteristic are mostly (56,25%) middle adult age (36-50 years old), formal education less than 9 years (62,50%), less good cosmopolitan (56,25%) participate in decision making (87,50%), and join member less than 5 years (62,50%). The findings for the dynamics of the group are most respondents consider the group objectives are good enough (50%) and good (50%), the group structure is good enough (56.25%), the group task function is good (81.25%), the coaching and group development is  good enough (81.25%), the group cohesiveness is good (62.5%), the group atmosphere is good (56.25%), the group tension is good enough (50%) and good (50%), the group effectiveness is good enough (50%).
STRATEGI PENGEMBANGAN PENGELOLAAN HASIL HUTAN NON KAYU (HHBK) BUAH DURIAN DI ZONA TRADISIONAL, TAMAN NASIONAL MERU BETIRI, KABUPATEN BANYUWANGI
Authors: Guntoro Dodit Ari , Purwantono Purwantono , Kholiq Nur , Ananda Alif Aulia
Published: December 2018

Traditional zone of Meru Betiri National Park (TNMB) has been enacted as a traditional used-area by community who had high dependency on natural resources for generations. Utilization of Non-Timber Forest Products (NTFP) in TNMB in the form of durian was conducted on the area of 25ha spread over 12 blocks with the total number of at least 925 trees (ϕ of >150 cm). Several problems occurred in NTFP management such as: (a) conflict of interest between durian user group and local people, (b) no legacy of NTFP utilization group in TNMB, (3). Low price of durians and no processing durian products. The objectives of this study were to evaluate the internal and external key factors influenced the management of NTFP and to determine the effective strategies to strengthen the sustainable management. Analysis was performed using SWOT with matrix of internal and external factors. The results of this study showed that there were seven (7) factors of each factors of Strength, Weakness, Opportunity and Treat influenced the NTFP management. In general, the conditions of NTFP management in traditional used- area in TNMB was in the position of internally strong and could be improved by developing potential opportunities and reducing the negative effects of potential threads.
ANALISIS EFISIENSI PEMASARAN BAGLOG DAN JAMUR TIRAM PUTIH PADA UD AROMA JAMUR DI KABUPATEN LUMAJANG
Authors: Kusuma Dadang Adi , Hani Evita Sholiha , Rijal Julian Adam
Published: December 2018

Demand for white oyster mushroom continues to increase because it has a good nutritional content. The increasing mushroom demand positively affects the needs of baglog and white oyster mushroom, causing many producers who work baglog and white oyster mushroom one of them is UD Aroma Jamur. Research conducted at UD Aroma Jamur aims to know: (1) marketing channel of baglog and white oyster mushroom; (2) marketing function of each marketing agency of baglog and white oyster mushroom; (3) the efficiency and marketing margin of baglog and white oyster mushroom. Location of research in UD Aroma Jamur is determined intentionally (Purposive Method). Sampling used is purposive sampling and snowball sampling. The data used are primary and secondary data analyzed by using margin analysis and marketing efficiency. The results of the study showed that: (1) The marketing channel of baglog consist of zero-level channel, one-level, two-level. The white oyster mushroom marketing channel consists of a zero-level, a two-level, three-level, and four-level: (2) marketing functions undertaken by marketing agencies of baglog and white oyster mushroom, is a function of purchasing, sales function, transport function, storage function, market information function, risk function, packaging function, and sorting function: (3) an efficient marketing channel  of baglog is a one level channel with marketing margin of Rp. 1,000 / baglog and profit share equal to 87,5% and efficiency value equal to 12,5%. The most efficient white oyster mushroom marketing channel is a two-tier channel with a marketing margin of Rp. 5.250 / kg and a profit share of 94.77% and an efficiency rating of 4.54%.
Teknologi Pemanfaatan Limbah Padat Pengolahan Keripik Singkong Menjadi Pakan Pellet Ayam Pedaging di Desa Baratan Kabupaten Jember
Authors: Pratiwi Nurul
Published: December 2018

Desa Baratan, Kecamatan Patrang, Kabupaten Jember memiliki potensi tinggi dalam usaha produksi keripik singkong yang dikelola oleh Industri Rumah Tangga (IRT). Limbah padat berupa kulit singkong yang dihasilkan dari pengolahan singkong menjadi kripik singkong belum termanfaatkan dengan baik. Kulit singkong dapat digunakan sebagai bahan baku pakan ternak. Tujuan dari program ini adalah pemberdayaan masyarakat IRT Desa Baratan dalam pengolahan kulit singkong menjadi pakan pelet ayam pedaging sehingga menambah nilai guna dari limbah tersebut dan mampu meningkatkan ekonomi para pelaku IRT keripik singkong di Desa Baratan. Kulit singkong memiliki kekurangan karena kandungan antrinutrisi (Asam Sianida) yang berbahaya apabia dikonsumsi. Metode yang digunakan dalam program ini yaitu penyuluhan dan percontohan pemotongan singkong dengan alat chipping, penyuluhan dan pelatihan pemanfaatan limbah kulit singkong, penyuluhan dan pelatihan formulasi pakan ayam pedaging, pembuatan pelet, pendampingan, monitoring dan evaluasi. Hasil dari program pengabdian kepada masyarakat ini adalah kelompok IRT Desa Baratan Kabupaten Jember mampu mengolah limbah padat pengolahan keripik singkong menjadi pakan pelet ayam pedaging. Buku panduan dapat digunakan oleh masyarakat dengan baik sehingga IRT dapat mengolah limbah menjadi pakan secara mandiri. IRT keripik singkong selaku mitra program pengabdian ini dapat melaksanakan dan menerapkan teknologi yang telah diberikan dan berusaha untuk selalu kontinu dalam pembuatan pakan serta pengembangan produk pelet sebagai upaya meningkatkan kesejahteraan dan keberlanjutan program.

 Kata kunci: limbah kulit singkong, pakan, Desa Baratan
Peningkatan Performa Budidaya Lele Dumbo (Clarias garipenus, Burch) Di Desa Serut Kecamatan Panti Kabupaten Jember Provinsi Jawa Timur
Authors: Wathon Syubbanul -
Published: December 2018

Lele dumbo merupakan jenis ikan lele yang memiliki beberapa keistimewaan dan banyak diminati masyarakat. Hal ini karena pada dasarnya budidaya lele dumbo tidak memerlukan lahan khusus, modal yang tidak terlalu besar, tidak memerlukan air dalam jumlah banyak, mudah dipelihara dan pertumbuhannya cepat. Rasa daging yang lezat dan gurih membuat bisnis budidaya lele dumbo menjadi peluang usaha yang cukup menjanjikan keuntungan. Budidaya lele dumbo sudah dikenal dan dijadikan lahan bisnis di berbagai daerah, termasuk di desa Serut kecamatan Panti kabupaten Jember. Namun seiring berjalannya waktu, beberapa kendala dihadapi oleh kelompok tani lele dumbo tersebut, diantaranya adalah penggunaan pakan yang terlalu boros, harga pakan yang mahal, adanya serangan penyakit serta pembesaran lele yang tidak merata. Kendala-kendala ini perlu diselesaikan dengan pengetahuan dan penerapan teknologi sederhana untuk meningkatkan performa budidaya. Adanya pendekatan dengan kelompok karang taruna dan kelompok ternak melalui metode komunikasi, diskusi dan bekerja secara sinergi, tim dapat merealisasikan hasil dan luaran, antara lain: pembuatan kolam dan kelengkapannya, workshop dan pelatihan, pembuatan pakan alternatif beserta cara pemberian pakan, serta wacana pengembangan budidaya lele pada program pengabdian, kemitraan atau program lain yang berkaitan, dan simulasi capaian jangka panjang untuk budidaya lele di desa Serut kecamatan Panti, kabupaten Jember. Melalui program ini, performa lele meningkat sehingga dapat meningkatkan penghasilan petani lele sekaligus dapat meningkatkan skala budidaya serta dapat membuka peluang usaha mandiri penduduk sekitar. Tidak hanya itu, keberhasilan peningkatan performa budidaya lele dumbo di Desa Serut dapat menjadi desa model percontohan bagi kawasan lainnya untuk mengembangkan usaha budidaya lele dumbo dengan cara yang tepat.

Kata Kunci: Budidaya, Lele Dumbo, Mitra, Performa.
TOE-Modell der Quaternionen (III)
Authors: Kuch  , Kuch Sven
Published: December 2018

Zentrales Element des TOE-Modells. Visualisierung der hyperkomplexen Zahlensysteme und damit wohl eines der zentralen Elemente einer Neuen Physik. Hier wird der Nullraum/ Ausgleichsraum im Existenzraum "-1" visualisiert.
TOE-Modell, Entstehung der Formenvielfalt
Authors: Kuch  , Kuch Sven
Published: December 2018

Eine einfache Übersicht, in der die Entstehung der Formenvielfalt in ihren jeweiligen Ausdehnungsgebieten verdeutlicht wird.
Ausprägungen der chemischen Elemente
Authors: Kuch  , Kuch Sven
Published: December 2018

Die Struktur der Elemente. Dargestellt werden die Zahlenverhältnisse, aus denen sich die Struktur der 81 stabilen Elemente ergibt. Eine Weiterentwicklung der Ausführungen von Peter Plichta.
Drehungen und Dimensionen der Neuen Physik
Authors: Kuch  , Kuch Sven
Published: December 2018

Die Zuordnung der Drehrichtungen und Dimensionen zu den Ausdehnungsgebieten. Diese Darstellung erwies sich als eine der wichtigsten Darstellungen zur Entwicklung des TOE-Modells. So werden die Anzahl der verinnerlichten Dimensionen endlich allgemein verständlich.
Dunkle Energie und Dunkle Materie
Authors: Kuch  , Kuch Sven
Published: December 2018

Darstellung der Entstehungsbereiche von dunkler Energie und dunkler Materie. Entstehungsbereiche im Kleinen, Wirkungsbereiche im Grossen. Ersteres wird hier dargestellt.
Pengaruh Radikal Bebas Terhadap Proses Inflamasi pada Penyakit Paru Obstruktif Kronis (PPOK)
Authors: Suryadinata Rivan Virlando
Published: December 2018

Background: Chronic Obstructive Pulmonary Disease is diseases caused by exposure to cigarette smoke. Cigarette smoke carries free radicals into the airways which can lead to acute exacerbations in patients.Objectives: explanation of inflammatory processes in the airways in patients with PPOK due to an increase in free radicals.Discusion: In the human body, free radicals are metabolic products from normal cells and function as one of the body's defense systems. Free radicals can be Reactive Oxygen Species (ROS) and Reactive Nitrogen Species (RNS), both of which can be obtained from the inside (endogenous) or from outside the body (exogenous). In the pathological, exposure to cigarette smoke causes an imbalance between the amount of free radicals produced in the body so that it can lead to oxidative stress.Conclusion: An increase in the number of free radicals will directly affect inflammatory mediators in the body. Increased free radicals will trigger the inflammatory process locally in the airways and systemically, so increasing the rate of exacerbations in COPD patients.ABSTRAKLatar Belakang : Penyakit PPOK ditimbulkan akibat paparan asap rokok yang terus menerus. Radikal bebas yang dibawa oleh asap rokok terhirup masuk kedalam saluran napas dapat menimbulkan eksaserbasi.Tujuan : Menjelaskan proses eksaserbasi yang dipengaruhi oleh proses inflamasi pada penderita PPOK akibat peningkatan radikal bebas.Ulasan : Pada tubuh manusia, radikal bebas merupakan produk hasil metabolisme dari sel normal. Pada keadaan normal, Radikal bebas berfungsi sebagai salah satu sistem pertahanan tubuh. Radikal bebas dapat berupa Reactive Oxygen Spesies (ROS) dan Reactive Nitrogen Spesies (RNS), keduanya dapat diperoleh melalui dari dalam  (endogen) maupun dari luar tubuh (eksogen). Pada keadaan patologis akibat paparan asap rokok menimbulkan ketidakseimbangan antara jumlah radikal bebas yang dihasilkan dalam tubuh sehingga dapat mengakibatkan terjadinya stress oksidatif.Kesimpulan:Peningkatan jumlah radikal bebas secara langsung akan berpengaruh pada mediator inflamasi pada tubuh. Peningkatan radikal bebas akan memicu proses inflamasi secara lokal pada saluran napas dan sistemik sehingga meningkatkan angka kejadian eksaserbasi pada penderita PPOK.
Pengaruh Usia, Pendidikan, dan Pengetahuan Terhadap Konsumsi Tablet Tambah Darah pada Ibu Hamil di Puskesmas Maron, Kabupaten Probolinggo
Authors: Shofiana Fauziah Itsnaini , Widari Denok , Sumarmi Sri
Published: December 2018

Background: Anemia is a major nutritional problem in Indonesian, one of the occurs in pregnant women. Therefore the government issued prevention and control program of iron deficiency anemia through consecutive iron supplementation for at least 90 days during pregnancy.Objectives: This study aimed to analyze the influence of age, education and knowledge of consumption of iron tablets.Methods: This research was conducted in Maron Public Health Center, District of Probolinggo using a cross sectional design. A sample of 40 pregnant women in their last trimester who have received 90 iron tablets was recruited with a simple random sampling technique. The influence of age, education, and knowledge was analyzed using logistic regression test with significance value < 0,05.Results: The results showed that the knowledge of pregnant women affected of consumption of iron tablets (p=0.026), but age (p=0.914), education (p=0.419) did not affected of consumption of iron tablets. Conclusion: The conclusion of this research is that consumption of iron tablets in pregnant women is influenced by knowledge of pregnant women. The lack knowledge of the mother, the lower the level consumption of iron tablets. ABSTRAKLatar Belakang: Anemia merupakan masalah gizi utama di Indonesia, salah satunya terjadi pada ibu hamil. Oleh karena itu pemerintah mengeluarkan program pencegahan dan pengendalian anemia defisiensi besi melalui suplementasi besi berturut-turut selama setidaknya 90 hari selama kehamilan.Tujuan: Tujuan penelitian ini untuk menganalisis pengaruh usia, pendidikan, dan pengetahuan terhadap konsumsi tablet tambah darah.Metode: Penelitian ini dilakukan di Puskesmas Maron, Kabupaten Probolinggo menggunakan desain cross sectional, sampel sebanyak 40 ibu hamil TM III yang mendapatkan 90 tablet besi dengan teknik simple random sampling. Pengaruh usia, pendidikan, dan pengetahuan dianalisis menggunakan uji regresi logistik dengan nilai signifikansi <0,05.Hasil: Hasil penelitian menunjukkan bahwa pengetahuan ibu hamil berpengaruh terhadap konsumsi tablet besi (p = 0.026) , tapi usia (p = 0.914), pendidikan (p = 0.419) tidak berpengaruh terhadap konsumsi tablet besi.Kesimpulan: Konsumsi tablet besi pada ibu hamil dipengaruhi oleh pengetahuan ibu hamil. Rendahnya pengetahuan ibu, maka akan tingkat konsumsi tablet tambah darah semakin rendah.
Hygiene, Sanitation and Bacteriological Quality of Cow's Milk in Krajan Design, Gendro Village, Tutur Regency of Pasuruan District
Authors: Permatasari Ririn Indah
Published: December 2018

Cattle waste contains high enough Escherichia coli microbes that can contaminate dairy products. Contamination can come from various sources of cow udder, cow body, dust in the air, dirty equipment and humans who do milking. Hygiene and sanitation efforts are one of the most important environmental health efforts to prevent dairy contamination. This study aims to analyzed the relationship of hygiene breeders, sanitation cage and bacteriological quality of cow milk (Escherichia coli) in Krajan Hamlet, Gendro Village, Tutur District, Pasuruan Regency. This research was conducted with cross sectional design. The sample size used was the total population of 26 farmers registered to be members of the group of Agung II breeders in Krajan Hamlet. Breeder hygiene and cage sanitation were analyzed descriptively quantitatively on bacteriological quality of cow's milk (Escherichia coli). Breeder hygiene includes 3 components: the use of PPE when working (boots, masks, gloves), hand-washing habits and work clothing conditions. Cage sanitation includes 5 components namely the technical requirements of the cage building, the location of the cage, the direction of the cage, the handling of livestock waste, the cleanliness of the cage. Bacteriological qualities of cow's milk (Escherichia coli) were examined in the laboratory using isolation and identification techniques. As many as 73% of respondents included in the category of poor farmer's hygiene and 65% of respondents included in the category of poor cage sanitation. While the examination of milk samples as much as 65% is known to be contaminat Escherichia coli. Increas use of PPE (Personal Protective Equipment) and cage sanitation management needs to be done by farmers to prevent contamination of Escherichia coli in dairy products.
The Physical And Microbiological Quality Of Clean Water In Nanas Sub Village Kediri District Post Natural Phenomena Sinking Wells
Authors: Putra Clairine Maretha Martin
Published: December 2018

Indonesia prones to natural disasters because it is located at the meeting of three world’s major tectonic plates that move and collide each other. The natural phenomena of sinking well that occurs in 2017 damaging 79 wells in the Nanas sub village, Puncu sub-district, Kediri district. The sinking well is natural phenomena which causes wells to down or to sink underground. The highest percentage of sinking well is in Nanas sub-village, There are 40 (50.6%) of wells are damaged. The research purpose was to know the physical quality and microbiology of well water in Nanas sub-village. This research type was observational. Samples were taken by purposive sampling. The water samples were obtained from 10 wells which were not damaged, 10 wells which were once muddy, and 10 wells which were sunk in 2017. The water check results were compared to regulation of the Minister of Health no. 32 in 2017 about Environmental Health Quality Standards and Water Requirements for Hygiene Sanitation, Swimming Pool, SPA and Public Bath. This research result was 30 (100%) water source fulfilled the physical quality requirement, and 28 (93,3%) qualified microbiology quality, while the remaining 2 (6,7%) did not fulfill the microbiological quality requirements for the need of hygiene and sanitation. The physical and microbiological quality of well water, after the natural phenomena of sinking wells, is qualified. The society is expected to maintain clean water sources.
Cages Sanitation and Health Complaints Among Dairy Farmers in Murukan Village, Jombang
Authors: Zuroida Rizqi
Published: December 2018

Dairy farmers have risk to get bad effect from dairy cows waste that is not managed properly, because dairy farmers use to make a contact with dairy cows waste everyday. Dairy cows waste contains various microorganism, gases and other organic materials that can be an agent of disesase in humans. Objectives of this study were to analyze the correlation between cages sanitation that include location of the cages, cage’s construction building, cleanliness of the cage and density of flies with dairy farmer’s health complaints during work in the cages. This was an observational study with cross-sectional approach. Sampling was done by using simple random sampling method. The sample size used in this study was 58 dairy farmers that interviewed about their health complaints during work in the cages and observed the cages. The cages sanitation was sufficient (70,7%), while the density of flies around the cages was medium category (48,3%). Result of this study showed that there was no correlation between cages sanitation with dairy farmer’s health complaints during work in the cages (p=0,710). Dairy farmers should pay more attention and improve their cages sanitation especially in maintaining cleanliness of the cages, so that health complaints can be minimized.
Observation of chloride permeability between normal aggregates concrete and recycled aggregates concrete Containing fly ash and clay
Authors: Islam Md. Shafiqul , Baul Pronab Kanti , Haque Oarda
Published: December 2018

Recycling of concrete is needed based on environmental preservation and effective utilization of resources point of view. Chloride attack has become a major concern in modern construction. Chloride ion is very dangerous for concrete structures because it leads to corrosion of the reinforcements in concrete. Many researchers have carried out numerous investigations on the chloride permeability of normal aggregates concrete. The purpose of this paper is to compare the chloride permeability between normal aggregates concrete and recycled aggregates concrete containing fly ash and clay. Water absorption in recycled aggregates concrete is also shown. The cylindrical concrete specimens made with recycled aggregates were subjected to high chloride permeability. Clay and ash were mixed in separate specimens in different proportions to reduce the porosity of concrete and hence to decrease the chloride permeability. The objective of this paper is to show the decrease chloride permeability in recycled aggregates concrete which is almost same for normal aggregates concrete and to make a relationship between water absorption and chloride permeability.
Unmanned Aerial Vehicle Classification, Applications and Challenges: A Review
Authors: Singhal Gaurav , Bansod Babankumar , Mathew Lini
Published: December 2018

In past few years, unmanned aerial vehicles (UAV) or drones has been a hot topic encompassing technology, security issues, rules and regulations globally due to its remarkable advancements and uses in remote sensing and photogrammetry applications. This review paper highlights the evolution and development of UAV, classification and comparison of UAVs along with Hardware and software design challenges with diverse capabilities in civil and military applications. Further, safety and security issues with drones, existing regulations and guidelines to fly the drone, limitations and possible solutions have also been discussed.
Development a System for Modeling and Assessing the Hazard of the Works in Medical and Biological Facilities
Authors: Yezhov I. N. , Yashechkin Yu. I. , Lyapin M. N. , Drozdov I. G.
Published: December 2018

Within the frames of an analytical review, modern approaches are described whose development is considered to be very important in order to rationally operate secure working procedures at the facilities of medical and biological profile. Peculiarities of formulating the methods to assess biological hazards are analyzed together with the ways of their objectivization. The place and the role of biological safety as a scientific trend are discussed in relation with the problem of availability of practical application of the "risk theory" elements with the aim of making governing decisions based on complex, well established estimations. The architecture of the system of modeling and estimation of potential danger associated with handling pathogenic biological agents is enunciated.