bluuebunny/crossref_metadata_2025 huggingface dataset:
Maximal Androgen Blockade for the Treatment of Metastatic Prostate Cancer—A Systematic Review
Authors: Lukka H. , Waldron T. , Klotz L. , Winquist E. , Trachtenberg J. ,   on behalf of the Genitourinary Cancer Disease Site Group of the Cancer Care Ontario Program in Evidence-Based Care
Published: February 2021

Introduction: Maximal androgen blockade (mab) versus castration alone in patients with metastatic prostate cancer has been extensively evaluated in randomized trials. The inconsistent results have led to the publication of multiple meta-analyses. The present review examines the evidence from meta-analytic reports to determine whether mab using agents such as flutamide, nilutamide, and cyproterone acetate (cpa) is associated with a survival advantage. Methods: We conducted a systematic review of the literature (medline, embase, and the Cochrane Library through July 2004; cancerlit through October 2002) for meta-analyses that compared mab with castration alone in previously untreated men with metastatic prostate cancer (D1 or D2, N+/M0 or M1). Two reviewers selected papers for eligibility; disagreement was resolved by all the authors through consensus. Results: The literature search identified six meta-analyses that met the eligibility criteria of the review. Two of those reports were based on individual patient data (ipd), and four were based on data from the published literature. All six meta-analyses pooled data on overall survival. The best evidence came from the largest meta-analysis, conducted by the Prostate Cancer Trialists Collaborative Group and based on ipd (8725 patients) from 27 trials. That analysis detected no difference in overall survival between mab and castration alone at 2 or 5 years. However, a subgroup analysis showed that mab with nonsteroidal anti-androgens (nsaas) was associated with a statistically significant improvement in 5-year survival over castration alone (27.6% vs. 24.7%; p = 0.005). The combination of mab with cpa, a steroidal anti-androgen, was associated with a statistically significant increased risk of death (15.4% vs. 18.1%; p = 0.04). Compared with castration alone, mab was associated with more side effects (that is, gastrointestinal, endocrine function) and reduced quality of life in domains related to treatment symptoms and emotional functioning. Conclusions: The small survival benefit conferred by mab with nsaa is of questionable clinical significance given the added toxicity and concomitant decline in quality of life observed in patients treated with mab. Therefore, combined treatment with flutamide or nilutamide should not be routinely offered to patients with meta-static prostate cancer beyond the purpose of blocking testosterone flare. Monotherapy, consisting of orchiectomy or the administration of a luteinizing hormone–releasing hormone agonist is recommended as standard treatment.
Recent Advances in Adjuvant Systemic Treatment for Breast Cancer: All Systems Go!
Authors: Fishman P.N. , Verma S.
Published: February 2021

Breast cancer is the most common life-threatening malignancy in Western women [...]
Prueba 8
Authors: Martí Ronda
Published: February 2021

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Liberalization Of Ideological Threats In Europe In The Late Twentieth And Early Twenty-First Centuries
Authors:   Uzbekistan Republic Internal Affairs Ministry Boarding-School English Language Teacher Uzbekistan, Muksumkhodjaevich Muminkhujaev Abrorkhuja
Published: February 2021

The article discusses the history of liberalism and the reasons why is it playing a key role in the politics of European countries. The article also analyzes the practical and vital role of liberalism in the political and social life of European countries. In particular, the positive results of the liberal approach to threats that contradict European culture, mentality, ideology (Nazism, nationalism, LGBT movement, local separatism) are illustrated with examples. Through the article the author tries to proove liberalism is the most apt way to solve political and social problems for the time being.
A forced regressive shelf-margin wedge formed by transition-slope progradation: lowermost Cretaceous Rauk Plateau Member, Jameson Land, East Greenland
Authors: Surlyk F.
Published: February 2021

The Middle Jurassic – lowermost Cretaceous succession of Jameson Land, East Greenland records a marine, overall regressive–transgressive–regressive cycle with regressive maxima in the Late Bajocian and Late Volgian separated by a transgressive maximum in the Kimmeridgian. Smaller-scale regressive interludes took place in the Late Callovian and Mid Oxfordian. A shelf-slope-basin physiography started to develop in the Late Callovian due to increasing rifting and a relief of several hundred metres was attained during maximum end-Jurassic regression and deposition of the Volgian Raukelv Formation. The formation consists of a forestepping stack of laterally extensive shelf-edge wedges, each several tens of metres thick, composed of coarse-grained sandstone, showing highangle clinoform bedding and containing marine body and trace fossils. These clinoform beds are superimposed on the large-scale clinoforms of the shelf–slope–basin. The wedges onlap older shelf deposits in a landward direction and are overlain by thin transgressive sandstones or mudstones, or directly by the next coarse-grained wedge. The top wedge, comprising the Rauk Plateau Member, is of Late Volgian (i.e. earliest Cretaceous) age and is characterized by steep clinoforms truncated by internal erosional downlap surfaces. The clinoforms are simple avalanche beds, a few tens of centimetres thick, or they may be several metres thick and contain large-scale cross-bedded intrasets of probable tidal origin. The erosional events were associated with downshift of the succeeding clinoforms, recording minor sea-level fall and forced regression. The top surface of the Rauk Plateau wedge is incised by a system of minor channels leading to a large canyon-like valley. The wedge was deposited by transition-slope progradation below wave base during a period of sea-level stillstand punctuated by minor, stepwise falls. It provides an excellently exposed example of a laterally derived, coarse-grained shelf-margin wedge, showing high-angle clinoform bedding and representing an ancient counterpart to Holocene and Late Pleistocene prograding infralittoral wedges seen on seismic profiles across Mediterranean shelf edges.
PERANCANGAN MUROTTAL OTOMATIS MENGGUNAKAN MIKROKONTROLLER ARDUINO MEGA 2560
Authors: Arifin Jauhari , Zulita Leni Natalia , Hermawansyah Hermawansyah
Published: February 2021

The research Scheme of Automatic Murottal Use Microkontroller Arduino Mega 2560 designed to facilitate work of custodian of mosque when seedang not residing in place so that when time of sholat have almost arrive hence appliance of ni can turn around holy sentence bouncing movement Al Qu'An automatically. Research Laboratory of Hardware Study Program Computer Engineering Faculty Computer Science University of Dehasen Bengkulu, In July - September 2015. Data method which used in this research Method Documentation, Observation, and Study Book.Result of from this research obtained Conclusion that is automatic murottal can use Application Ianguage of Program Visual Basic 6.0 can be by 2 the way of that is: Automatically and Manual, Automatically by chosening letter to turning around and lead the time twiddling before adzan fill the air, while manually will be controlled to Application appearance with clicking one of the button exist in application of interface computer.Keyword: Real Time Clock (RTC), Microkontroller Arduino Mega 2560, Ianguage of Visual Basic 6.0 program
Analisa Performansi Protokol TCP, UDP dan SCTP Pada Lalu Lintas Multimedia
Authors: Mardiana Yesi , Sahputra Julidian
Published: February 2021

This study aims to analyze Performance of TCP, UDP and SCTP Protocol on Multimedia Traffic. The TCP (Transmission Control Protocol) protocol, UDP (User Datagram Protocol) and SCTP (Stream Control Transmission Protocol) reside on the same layer in the OSI-Layer at the Transport layer that controls the flow of data, data packets and so on. This research uses windows operating system and Softperfect Network Protocol Analyzer software. Where network analysis software has a complete feature such as can filter almost all the protocol on the OSI-Layer, has a report of easy to read results and so forth. From the test results conducted for three days by analyzing the online and offline way obtained SCTP protocol results both for Multimedia activities but can not be used simultaneously with other activities (such as video conversations). for everyday activities should use TCP and UDP protocol because it tends to be stable.Keyword : TCP, UDP, SCTP
Media Pembelajaran Berbasis Android Pada Mata Pelajaran Sistem Operasi Jaringan Kelas XI
Authors: Kuswanto Joko , Radiansah Ferri
Published: February 2021

Penggunaan media pembelajaran merupakan bagian yang tidak bisa dipisahkan dan sudah merupakan suatu integrasi terhadap metode belajar yang dipakai. Salah satu contoh media pembelajaran yang bisa dikongkritkan dengan memanfaatkan perkembangan teknologi di bidang pendidikan adalah media pembelajaran berbasis android. Penelitian ini bertujuan untuk mengembangkan media pembelajaran berbasis android pada mata pelajaran Sistem Operasi Jaringan kelas XI. Metode penelitian yang digunakan adalah penelitian pengembangan dengan tahapan perancangan, produksi, evaluasi, dan menganalisis data dengan persentase. Hasil penelitian ini menunjukkan bahwa media pembelajaran berbasis android yang dikembangkan pada mata pelajaran Sistem Operasi Jaringan kelas XI sudah layak untuk digunakan dalam pembelajaran oleh guru dan siswa. Berdasarkan beberapa tahapan uji coba, media pembelajaran dikategorikan valid dengan tingkat kelayakan sebesar 82% dengan kriteria baik. Penelitian ini diharapkan dapat menjadi media pembelajaran pada mata pelajaran Sistem Operasi Jaringan Kelas XI dan dapat bermanfaat bagi guru, siswa, dan peneliti lanjutan.

 Kata Kunci:           Andorid, Media Pembelajaran, Pengembangan, Sistem Operasi Jaringan
Pengembangan Modul Interaktif Pada Mata Pelajaran IPA Terpadu Kelas VIII
Authors: Kuswanto Joko
Published: February 2021

Salah satu bentuk bahan ajar interaktif adalah modul interaktif. Modul interaktif merupakan jenis kesatuan kegiatan belajar yang terencana, dirancang untuk membantu para siswa secara individual dalam mencapai tujuan belajarnya. Penelitian ini bertujuan untuk mengembangkan modul interaktif pada mata pelajaran IPA Terpadu kelas VIII. Metode penelitian yang digunakan adalah penelitian pengembangan dengan tahapan perancangan, produksi, evaluasi, dan menganalisis data dengan persentase. Hasil penelitian ini menunjukkan bahwa media pembelajaran berupa modul interaktif yang dikembangkan pada mata pelajaran IPA Terpadu Kelas VIII sudah layak untuk digunakan dalam pembelajaran oleh guru dan siswa. Berdasarkan beberapa tahapan uji coba, modul interaktif dikategorikan valid dengan tingkat kelayakan sebesar 82% dengan kriteria baik. Penelitian ini diharapkan dapat menjadi media pembelajaran pada mata pelajaran IPA Terpadu Kelas VIII dan dapat bermanfaat bagi guru, siswa, dan peneliti lanjutan.

Kata Kunci: Modul Interaktif, Media Pembelajaran, Pengembangan, IPA
Sistem Informasi Buku Piket Rumah Dinas Gubernur Provinsi Bengkulu
Authors: Zulfiandry Ricky , Siswanto Siswanto
Published: February 2021

Sistem informasi yang berbasis komputer mempunyai peranan yang sangat penting dalam menyediakan sistem informasi bagi setiap organisasi atau instansi pemerintah. seperti halnya pada Rumah Dinas Gubernur Provinsi Bengkulu. Dimana saat ini buku piket masih bersifat manual atau proses pengolahan data ditulis satu persatu pada kertas dan buku besar. Ini tentunya sangat membutuhkan suatu sistem yang terorganisir dan kompleks. Dan apabila hanya didukung oleh sistem manual, maka efesiensi dan efektifitas dalam penyajian informasi tersebut tidak akan tercapai.  Sistem Informasi Buku Piket Rumah Dinas Gubernur Provinsi Bengkulu merupakan satu aplikasi yang dapat membantu petugas piket dalam melakukan pengolahan data buku piket yang meliputi mendata aset, kegiatan, dan tamu. Selain itu aplikasi ini memungkinkan untuk pembuatan output laporan yang akan dilaporkan berdasarkan hari, bulan, dan tahun. Sistem Informasi Buku Piket Rumah Dinas Gubernur Provinsi Bengkulu dibuat menggunakan bahasa pemrograman Visual Basic .Net. Berdasarkan hasil pengujian yang dilakukan, Sistem Informasi Buku Piket Rumah Dinas Gubernur Provinsi Bengkulu dapat membantu petugas dalam mengelola data kegiatan, aset, dan tamu, dimana selama ini masih dilakukan secara konvensional. Dan Jika petugas/admin yang tidak memiliki password, maka tidak bisa mengakses Sistem Informasi Buku Piket Rumah Dinas Gubernur Provinsi Bengkulu.

Kata Kunci : Sistem Informasi, Buku Piket, Rumah Dinas Gubernur, Provinsi Bengkulu
Pembuatan Animasi Pendaftaran Siswa Baru Pada SMAN 5 Kepahiang Berbasis Multimedia Linier
Authors: Hidayah Agung Kharisma , Sarwanto Legi , Handayani Sri
Published: February 2021

SMAN 5 Kepahiang merupakan salah satu sekolah di Kabupaten Kepahiang. Oleh sebab itu Sekolah SMAN 5 Kepahiang merupakan pilihan yang cocok bagi para orang tua yang ingin menyekolahkan anaknya ditingkat SMA khususnya di lingkungan Bermani Ilir, Kepahiang kurang maksimalnya pelayanan dalam pemberian informasi dikarenakan banyak calon siswa yang ingin mendapatkan informasi dan tata cara pendaftaran untuk menjadi siswa baru di SMAN 5 Kepahiang, Informasi pendaftaran yang ada tidak sepenuhnya dipahami oleh calon siswa baru. Untuk alasan ini, penulis membuat pendaftaran calon siswa baru yang didasarkan pada multimedia linear sebagai media tambahan dan dukungan untuk penerbitan informasi tentang tutorial pendaftaran untuk semua calonsiswa. Pembuatan animasi ini menggunakan perangkat lunak Blender dan aplikasi perangkat lunak Adobe Premiere Pro. format file yang dihasilkan dari proses pembuatan animasi ini adalah format MP4. jenis konten yang ditampilkan dalam pembuatan animasi ini adalah video, suara, dan teks yang menjelaskan tutorial pendaftaran siswa baru di SMAN

5 Kepahiang. Pengujian Vidio animasi menggunakan Angket yang telah didaptakan rata-rata jawaban 82.8%.

Kata Kunci: Multimedia, Vidio Animasi Pendaftaran,

Software Blender
Pengamanan Data Teks Dengan Menggunakan Algoritma Zero-Knowledge Proof
Authors: Toyib Rozali , Darnita Yulia
Published: February 2021

Keamanan data sangat penting dilakukan dalam menjaga kerahasiaan informasi itu sendiri, terutama bila informasi tersebut hanya boleh diketahui pihak yang tertentu saja. Pengiriman data atau informasi tanpa dilakukan pengamanan akan beresiko terhadap penyadapan. Sehingga informasi yang ada di dalamnya dapat mudah diketahui oleh pihak-pihak yang tidak berhak, dan hal seperti itu sangat merugikan.Hingga saat ini, kriptografi merupakan salah satu solusi untuk menjamin keamanan dari suatu informasi. Zero Knowledge Proof (ZKP) merupakan protokol kriptografi yang dapat digunakan seseorang untuk membuktikan kepemilikan seseorang (prover) akan suatu informasi rahasia kepada orang lain (verifier), tanpa perlu mengungkapkan informasi tersebut atau memberikan cara bagi orang lain untuk mengetahui rahasia tersebut. Hasil pengujian adalah Zero Knowledge Proof membagi satu aliran data menjadi blok-blok kecil Masing-masing blok ini dienkripsi secara terpisah. Dalam implementasi tanpa bukti pengetahuan, kunci untuk mengenkripsi hanya akan berada pada pengguna, dan dengan itu, ia akan dapat mengenkripsi dan mendekripsi informas, Algoritma zero knowledge proof adalah metode yang unik dimana pengguna dapat membuktikan kepada pengguna lain bahwa dia tahu informasi tambahan.

Kata Kunci: Keamanan ,data,penyadapan ,Zero-Knowledge proof
A Aplikasi Sarana Prasarana Pendidikan Pada SMKN 4 Kota Bengkulu Menggunakan Pemrograman Visual Basic
Authors: Yulianti Liza , Prahasti Prahasti , Sari Venny Novita
Published: February 2021

Pengelolaan sarana dan prasarana pendidikan yang kurang baik dapat menimbulkan berbagai permasalahan terutama dalam pendokumentasian dan pengelolaan aset yang ada di sekolah. Sarana prasarana pendidikan merupakan aset sekolah yang harus ditata dan dikelola dengan baik untuk mendukung terjaminnya kualitas pendidikan yang ada disekolah. Pemanfaatan teknologi informasi melalui bahasa pemrograman dapat menciptakan berbagai aplikasi yang dibutuhkan sesuai kebutuhan pengguna. Penelitian ini bertujuan untuk membuat sarana dan prasana pendidikan dengan menggunakan bahasa pemrograman visual basic dan database mySQL . Metode Pengembangan Sistem Yang digunakan Adalah Sistem Pengembangan Lif Cycle (SDLC) ATAU pendekatan udara terjun ( waterfall). Tahapan penelitian dimulai dari perancangan sistem, analisis sistem, desain sistem, program pengkodean, uji coba program, pelaksanaan sistem dan pemeliharaan sistem. Hasil penelitian adalah adanya aplikasi sarana prasarana pendidikan dengan laporan-laporan data ruang, laporan sarpras perjenis, laporan sarpras perruang dan rekapitulasi sarpras pendidikan. Aplikasi yang diharapkan diharapkan dapat meningkatkan pelayanan bagi pihak sekolah akan informasi sarana prasana pendidikan sehingga dapat menjamin mutu pendidikan di SMKN 4 Kota Bengkulu.

Kata Kunci: Sarana Prasarana Pendidikan, Bahasa Pemrograman, MySQL , Visual Basic .
A METODE PEMBELAJARAN BAHASA JEPANG TINGKAT DASAR BERBASIS MULTIMEDIA MENGGUNAKAN MACROMEDIA FLASH MX
Authors: Sapri Sapri , Kanedi Indra
Published: February 2021

Metode Pembelajaran Bahasa Jepang Tingkat Dasar Berbasis Multimedia Menggunakan Macromedia Flash MX (2010). Penelitian ini bertujuan untuk membuat metode pembelajaran bahasa jepang tingkat dasar pada LP2M El Rahma Bengkulu dengan menggunakan Macromedia Flash MX, agar mempermudah pengajar, siswa dan mahasiswa dalam mempelajari bahasa jepang tingkat dasar sehingga menambah minat dan daya tarik dalam belajar bahasa jepang.

Penelitian dilaksanakan di LP2M El Rahma Bengkulu, yang beralamatkan di Jalan Kemang Manis No.10 Sawah Lebar Bengkulu Telp.(0736) 22123 Bengkulu. Penelitian dilaksanakan dari bulan Maret sampai Juli 2010. Permasalahan dalam Penelitian ini adalah bagaimana membuat metode pembelajaran bahasa jepang tingkat dasar menggunakan Macromedia Flash MX. Sehingga dapat bermanfaat bagi El Rahma Bengkulu dan siswa dan mahasiswa tentunya.

Berdasarkan hasil dan pembahasan serta hasil dari pengujian sistem, dapat ditarik kesimpulan bahwa dalam membuat metode pembelajaran bahasa jepang ini pada LP2M El Rahma Bengkulu terlebih dahulu membuat perancangan sistem, Software ini di buat dengan menggunakan Macromedia Flash MX. Sehingga memiliki tampilan yang menarik dan mendapatkan hasil yang baik.

Kata Kunci : Metode Pembelajaran Bahasa Jepang Tingkat Dasar.
KOLABORASI WHATSAPP GROUP, ZOOM CLOUD MEETING, DAN GOOGLE DRIVE SEBAGAI FORMULA DALAM PELAKSANAAN KEGIATAN PERKULIAHAN ONLINE DI MASA PANDEMI COVID-19
Authors: Kurniawansyah Arius Satoni , Siswanto Siswanto
Published: February 2021

Dunia Pendidikan menghadapi tantangan besar dengan adanya Pandemi Covid-19 ini. Semua kegiatan Perkuliahan yang biasanya dengan tatap muka, sekarang dilarang dan harus melaksanakan kegiatan secara daring atau online. Banyak Aplikasi yang ditawarkan dalam melaksanakan Perkuliahan secara online, seperti Zoom, Google Meeting, Whatsapp Group, dan Google Drive dan lain-lain. Dosen dan mahasiswa harus mampu dan melek Teknologi, kalau salah satu ada yang tidak bisa memanfaatkan Teknologi, maka akan sulit untuk terlaksana kegiatan Perkuliahan onlinenya. Dampak pandemi COVID-19 salah satunya adalah perubahan sistem pembelajaran sekolah menjadi via daring. Bagi kebanyakan sekolah pembelajaran ini masih harus menyesuaikan banyak hal, termasuk bagaimana melatih siswa menjawab soal-soal tanpa mereka harus menyontek dengan membuka internet. Salah satu media pembelajaran berbasis teknologi yang dapat dijadikan sebagai penunjang pada media yang sudah ada adalah dalam bentuk e-learning (pembelajaran elektronik). E-learning merupakan aplikasi internet yang dapat menghubungkan peserta didik dan pendidik dalam sebuah ruang belajar online. E-learning didesain untuk mengatasi keterbatasan antara pendidik dan pesrta didik, terutama dalam hal waktu, ruang kondisi, dan keadaan. Ringkasnya, e-learning dapat menciptakan sebuah ruang digital pembelajaran, dimana peserta didik dapat mengakses materi dari berbagai sumber tanpa dibatasi ruang dan waktu. Dalam masa pandemi Covid-19 sangat efektif melaksanakan Perkuliahan daring dengan memanfaatkan Aplikasi Zoom, Whatsapp Group, dan Google Drive.

Kata Kunci: Whatsapp Group, Zoom, Google Drive, Pandemi Covid-19
Підвищення ресурсу зернопосівних машин
Authors: Дудніков А. , Дудник В. , Біловод О. , Канівець О. , Бурлака О.
Published: February 2021

Одним з основних видів зношування робочих органів ґрунтообробних та посівних машин є абразивне зношування. Таке зношування призводить до втрати працездатності леза робочих органів, зокрема зернопосівних машин.Під час виконання механізованих технологічних операцій посіву зернових культур дискові сошники сівалок знижують (втрачають) свою працездатність в разі, коли відстань між їх кромками в місці, де вони сходяться, перевищує 5 мм. Останнє обумовлено зменшенням зовнішнього діаметра дисків і є підґрунтям для заміни дисків.Економічно обґрунтовано здійснення відновлення зношених дисків. Тому у статті розглянуто існуючі методи відновлення робочих органів зернопосівних машин. Запропоновано метод відновлення зазначених деталей з використанням механічних вібраційних коливань обробного інструменту.Основні параметри відновлених дисків, з використанням механічних вібраційних коливань обробного інструменту, порівняно з параметрами відновлених дисків методом наплавлення зношеного шару металу.Експериментально підтверджено, що спосіб відновлення посівних дисків впливає не величину їхнього остаточного ресурсу. Перевагу надано вібраційному відновленню.Проведені дослідження процесу вібраційного зміцнення матеріалу деталей, які сприяють підвищенню якості відновлення дисків сошників зернопосівних машин, що забезпечує їх підвищену зносостійкість і, відповідно, підвищення ресурсу.Встановлено основні параметри обробки при вібраційному зміцненні (амплітуда, частота коливань обробного інструменту, час обробки).Проведеними дослідженнями встановлено характер інтенсивності зношування діаметра дисків сошників і товщини їх леза.Встановлено, що зносостійкість, а отже, і ресурс дисків сошників залежать як від їх параметрів, так і від способу відновлення.Отримані дані стендових випробувань дозволяють розробити і впровадити у виробництво технологію відновлення дисків сошників методом вібраційного деформування.
Dual Solutions in Mixed Convection Stagnation-Point Flow Over a Vertical Stretching Sheet with External Magnetic Field and Radiation Effect
Authors: Md Ali Fadzilah , Khamat Amira Natasya Azizan , Junoh Mohamad Mustaqim
Published: February 2021

The purpose of this research is to study the problem of mixed convection stagnation-point flow on a vertical stretching sheet with external magnetic field, with the effect of radiation is taken into account. The partial differential equations are reduced to ordinary differential equations using similarity transformation. The transformed boundary layer equations are then solved numerically via bvp4c in MATLAB software. The effects of different values of radiation parameter and Hartmann number on the skin friction coefficient and local Nusselt number, velocity and temperature profiles are presented and discussed. The effect of radiation parameter and Hartmann number are also considered for both assisting and opposing flows. Dual solutions are found to exist in the opposing flow only, while for assisting flow, unique solution exists. It is also found that the radiation parameter enhances the boundary layer separation, and the Hartmann number delays the boundary layer separation.
Strategies of Sanatorium-Resort Technologies in Patients with Arterial Hypertension
Authors: Nikiforova T. I.
Published: February 2021

Недостаточный контроль артериального давления (АД) при артериальной гипертензии (АГ) ассоциируется с вероятностью роста таких сердечно-сосудистых осложнений (ССО), как инсульт, инфаркт миокарда (ИМ), хроническая сердечная недостаточность, определяющих высокую смертность и инвалидизацию населения. Внедрение немедикаментозных, в том числе санаторно-курортных, технологий в реабилитацию, лечение и вторичную профилактику у пациентов с сердечно-сосудистыми заболеваниями повышает эффективность лечебных мероприятий, снижает риск дальнейшего прогрессирования заболевания и развития грозных осложнений. В работе установлено более значимое снижение повышенного клинического, среднесуточного, среднедневного и средненочного САД и ДАД и их вариабельности у больных с АГ высокого и очень высокого риска развития сердечно-сосудистых осложнений (ССО) и смертности с сопутствующей ИБС под влиянием технологии с включением «сухих» углекислых ванн, электрофореза анаприлина синусоидальными модулированными токами и низкочастотного переменного магнитного поля на область проекции почек по сравнению с группой больных, получивших технологию с включением электросна, общих хлоридных натриевых ванн и надвенной лазерной терапии, что свидетельствует о достоверно большем снижении риска развития ССЗ и осложнений: ИБС и инсульта, в том числе с летальным исходом у большего количества больных соответственно.
Influence du leadership dans le processus de légitimation du cadre de santé hors filière débutant
Authors: Friry Dominique
Published: February 2021

Les missions du cadre de santé ont opéré un virage managérial depuis les directives de la loi HPST. Dans les hôpitaux, à présent, des cadres hors filière soignante peuvent encadrer dans des secteurs de soins. Un cadre de santé débutant doit faire l’apprentissage de ses nouvelles missions et s’approprier son nouveau rôle. Cela est d’autant plus compliqué quand il est d’une filière différente. Dans un environnement ou l’expertise métier est importante pour être reconnu professionnellement, comment le cadre hors filière fait-il pour être légitime à son poste ? Notre travail de recherche étudie le processus de construction de la légitimité des cadres de santé de filière et hors filière. L’objectif est de comparer l’utilisation de l’expertise et du leadership en tant que source de légitimité par les deux catégories de cadres, d’identifier les stratégies mises en place et caractériser les natures de légitimité obtenues.
Les investissements idéologiques par le champ du pouvoir, du politique et du religieux de la crise sanitaire COVID-19 en Turquie
Authors: Balcı Bayram , Kaya Sümbül
Published: February 2021

Cet article vise à analyser les différents investissements idéologiques dans les champs du pouvoir, du politique et du religieux auxquels la pandémie donne lieu en Turquie. Dans un pays où politique et religieux sont intimement liés, dans une expérience turque originale qui a peu d’équivalent dans le monde musulman, notre interrogation sera double : comment évaluer l’impact, toujours en cours, du COVID-19 sur le champ politique en Turquie et, dans un deuxième temps, quelle a été la réponse du secteur religieux pour épauler le politique dans sa réponse à la crise. Nous chercherons notamment à comprendre les effets de la crise sanitaire sur le pouvoir en place, sur les orientations de la politique nationale et internationale en contexte de crise sanitaire. Enfin, il conviendra de se demander comment le religieux joue un rôle dans la gestion de la crise.
Authoritarianism and the Pandemic: Activities of Rights-based organisations in Turkey
Authors: Keleşoğlu Ekin İlke
Published: February 2021

In this article, the examination of authoritarianism and the effects of COVID-19 in the times of the pandemic on rights-based organisations in Turkey were studied. In parallel with critical political scientists such as Loic Blondiaux, Chantal Mouffe and Giorgio Agamben, this article supports the view that the limited instruments that modern democracy provides create a need for more effective political participation forms, which we deal with the concept of ‘unconventional political participation’ in this study. Accordingly, we approach COVID-19 as an unprecedented challenge for the rights demands of social opposition groups in addition to the existing problems in Turkey. The field research which was held in scope of this study reveals that COVID-19 has undoubtedly affected the activities of rights-based organisations to a certain extent, while their activities are being oriented to the ‘new normal’ in terms of the growing use of online tools, written statements and reports for policy-influencing as forms of unconventional political participation.
Usage of Oldenlandia diffusa for skin diseases and skin-care
Authors: Law Siukan , Leung Albert Wingnang , Xu Chuanshan
Published: February 2021

Dear Editor,

Oldenlandia diffusa (Bai Hua She She Cao) is a common herb in traditional Chinese medicine. (...)
Macrophage supernatant infected with Leishmania major mediates the cytology of fibroblast cells in skin wounds
Authors: Ghomashlooyan Mohsen , Namdar Fatemeh , Fesharaki Mehrafarin , Hosseini Shervin Ghaffari , Narimani Manizheh , Sebghatollahi Zahra , Basirpour Bahareh , Hejazi Seyed Hossein
Published: February 2021

Objective: Healing of Cutaneous Leishmaniasis relies on the effective and modulates protective immune responses. Although the immune system is necessary to eliminate the parasite, it could be considered as the main cause of ulcers. Therefore, main aim of this study was to explore the possible regulatory functions of macrophage supernatant infected with Leishmania major on the fibroblast cells.

Materials and Methods: In this experimental study, different concentrations of infected macrophage supernatant extract (50, 100, 150, 200, and 250μg/mL) were tested at different times (6, 24, 48, and 72h) and the effect of the leishmanicidal extract on fibroblast cells was determined by MTS assay. Also, the flow-cytometry technique was used for the investigation of apoptosis induction percentage.

Results: MTS assay showed that the leishmanicidal effect of infected macrophage supernatant extract was dependent on the concentration and the time of treatment. So, the best efficacy was observed in 200 μg/mL with 72 hours exposure time. Flow cytometry analysis showed that the infected macrophage supernatant extract could induce apoptosis in cultured fibroblasts.

Conclusions: We have demonstrated that reduction of survival rate and induction of apoptosis in fibroblasts displayed a similar manner to keratinocytes when exposed to infected macrophages with L. major. Our data suggest that such a phenomenon can be the underlying cause of lesions with scarring, and future, the mechanism remains to be elucidated.
Biomechanical Response to External Biofeedback During Functional Tasks in Individuals With Chronic Ankle Instability
Authors: Torp Danielle M. , Thomas Abbey C. , Hubbard-Turner Tricia , Donovan Luke
Published: February 2021

Context

Altered biomechanics displayed by individuals with chronic ankle instability (CAI) is a possible cause of recurring injuries and posttraumatic osteoarthritis. Current interventions are unable to modify aberrant biomechanics, leading to research efforts to determine if real-time external biofeedback can result in changes.

Objective

To determine the real-time effects of visual and auditory biofeedback on functional-task biomechanics in individuals with CAI.

Design

Crossover study.

Setting

Laboratory.

Patients or Other Participants

Nineteen physically active adults with CAI (7 men, 12 women; age = 23.95 ± 5.52 years, height = 168.87 ± 6.94 cm, mass = 74.74 ± 15.41 kg).

Intervention(s)

Participants randomly performed single-limb static balance, step downs, lateral hops, and forward lunges during a baseline and 2 biofeedback conditions. Visual biofeedback was given through a crossline laser secured to the dorsum of the foot. Auditory biofeedback was given through a pressure sensor placed under the lateral foot and connected to a buzzer that elicited a noise when pressure exceeded the set threshold. Cues provided during the biofeedback conditions were used to promote proper biomechanics during each task.

Main Outcome Measure(s)

We measured the location of center-of-pressure (COP) data points during balance with eyes open and eyes closed for each condition. Plantar pressure in the lateral column of the foot during functional tasks was extracted. Secondary outcomes of interest were COP area and velocity, time to boundary during static balance, and additional plantar-pressure measures.

Results

Both biofeedback conditions reduced COP in the anterolateral quadrant while increasing COP in the posteromedial quadrant of the foot during eyes-open balance. Visual biofeedback increased lateral heel pressure and the lateral heel and midfoot pressure-time integral during hops. The auditory condition produced similar changes during the eyes-closed trials. Auditory biofeedback increased heel pressure during step downs and decreased the lateral forefoot pressure-time integral during lunges.

Conclusions

Real-time improvements in balance strategies were observed during both external biofeedback conditions. Visual and auditory biofeedback appeared to effectively moderate different functional-task biomechanics.
Fertility Preservation in Cancer Patients
Authors: Jing Yuan-Xue , Zhang Li-Li , Li Hong-Xing , Yue Feng , Wang Nai Hui , Xue Shi-Long , Wang Yi-Qing , Zhang Xue-Hong
Published: February 2021

Abstract

Traditional radiotherapy and chemotherapy often cause irreversible damage to the fertility and endocrine function of cancer patients. The current methods of fertility preservation include freezing the sperms of adult and adolescent males after puberty; freezing the embryos, oocytes, and ovarian tissue of females; and drug intervention and fertility preservation surgery. This article reviews fertility preservation in cancer patients with respect to current methods, indications, and some more recently developed methods that remain under investigation.
Effects of Copper-Containing Intrauterine Devices on the Endometrium
Authors: Che Jia-Hui , Yao Xiao-Ying
Published: February 2021

Abstract

The use of copper-containing intrauterine devices (Cu-IUDs) is a safe, effective, and long-term contraceptive method. Here, we review the effects of Cu-IUDs on subsequent pregnancy and the morphology, local coagulation function, sensitivity to estrogen and progesterone, cell proliferation, and immune response of the endometrium. Studies on the morphology of endometrium indicate that the use of Cu-IUDs can affect the number and binding capacity of estrogen and progesterone receptors in the endometrium and reduce the response of the endometrium to estrogen and progesterone. The use of Cu-IUDs can also affect the proliferation of endometrial cells, suggesting that the aseptic inflammation caused by Cu-IUDs may differ from chronic infectious or noninfectious inflammation; this highlights that the use of Cu-IUDs provides protection against endometrial proliferative diseases. The use of Cu-IUDs increases local endometrial angiogenesis, bleeding tendency, and fibrinolytic activity, which can result in prolonged menstruation or abnormal uterine bleeding. Additionally, the use of Cu-IUDs can cause the infiltration of numerous lymphocytes, monocytes, macrophages, and other inflammatory cells around the endometrial gland and changes in endometrial immune function, immune cell function, and the number and type of immune molecules. Cu-IUD-induced decidual injury significantly increases the invasiveness of trophoblasts, further affecting the aberrant expression of their growth-, angiogenesis-, and invasion-related factors and improving the formation of the placenta. Moreover, the endometrial damage caused by Cu-IUD placement before embryo transfer can improve both clinical pregnancy and live birth rates; however, specific changes in the immune system after Cu-IUD use as well as its effects on future pregnancies require further investigation.
Knife Cut Fissures
Authors: Ranjitha ML , Shilpa Kanathur , Leelavathy Budamakuntla , Lakshmi DV
Published: February 2021

Crohn's disease is an inflammatory bowel disorder with various extraintestinal manifestations. Vulva is rarely involved in Crohn's disease and occasionally may constitute the only sign of the disease. It is often unrecognized and can be confused with various disorders involving the vulva. Vulval Crohn's disease is often refractory to treatment. We describe a case of 30-year-old female presented with labial swelling, discharging sinuses and knife cut fissures and diagnosed as a case of vulval Crohn's without intestinal involvement, that was managed with oral steroids, sulfasalazine, and metronidazole.
Involvement of Palms in Leprosy
Authors: Divyalakshmi C , Kansal Naveen Kumar , Joshi Prashant Pranesh , Singh Divya
Published: February 2021

Leprosy (Hansen's disease), a chronic granulomatous infection caused by Mycobacterium leprae, frequently affects the areas of skin, which have a relatively low temperature and/or are prone to trauma. Several zones of skin, for example, scalp, palms and soles, groins, genitalia, axillae, eyelids, and perineum, have usually been described as “immune” to lesions of leprosy. However, clinical, bacteriological, and pathologic evidence of involvement of these so-called “immune zones” has rarely been documented. Therefore, now many workers have proposed that these “immune zones” should be called “relatively immune,” rather than “absolute immune.” Hereby, we report a rare case of leprosy with palmar involvement.
Clinical, Dermoscopic, and Mycological Association in Onychomycosis in a Tertiary Care Hospital
Authors: Vasava Daksha , Mehta Hita , Patel Twinkle , Jhavar Milan , Lakhotia Rahul
Published: February 2021

Background:

Onychomycosis (OM) refers to fungal infection of the nail unit. It is one of the most common nail disorders, accounting for 50% of all nail disorders and about 30% of all cutaneous fungal infections. OM is mostly diagnosed clinically, but Dermoscopic (DS) examination aids in diagnosis.

Objectives:

The purpose of the study is to study the association between clinical, dermoscopic, and mycological patterns of OM.

Materials and Methods:

A total of 200 patients with clinical suspicion of OM were included in the study. All patients underwent clinical examination, dermoscopic examination with a handheld dermoscope Dermlite II pro (3 Gen, San Juan, Capistrano, CA, USA) with a ×10 magnification, KOH assessment, and culture analysis. The most frequent dermoscopic patterns were identified and their associations with the clinical subtype of OM were analyzed.

Results:

Out of the 200 cases, 65 cases were male and 135 cases were female. The most common findings seen on clinical examination of nails were discoloration of nail plates (178) and onycholysis (109). Distal irregular termination (91) was the most common dermoscopic finding seen followed by spike pattern (76). A significant association was seen between dermoscopic patterns such as superficial transverse striation, spike pattern, and different types of OM (P < 0.05). Eighty-two cases were positive for fungal elements by direct microscopy, 68 were positive by culture, and 18 patients showed positive result for both. The most common causative organism found on culture examination was Candida albicans (24).

Conclusion:

Dermoscopy is an easy-to-perform, noninvasive, and cost-effective method which aids in early diagnosis of OM.
Bullous Pemphigoid
Authors: Janagond Ajit B , Lingaiah Anusha , Inamadar Arun C
Published: February 2021

Bullous pemphigoid (BP) is an autoimmune blistering disorder with subepidermal split, which predominantly affects the elderly. Here, we report a case of BP with hypertension and bronchial asthma managed during coronavirus disease-2019 national lockdown. A known case of BP in remission for 10 months came with recurrence. The patient was managed with dapsone and topical corticosteroids. Social media application was utilized further to prescribe and monitor the patient due to inconvenience faced during the current pandemic.
Investigation of Oxidative Stress in Relapse and Remission Periods of Patients with relapsing-Remitting Multiple Sclerosis
Authors: Öncel Samet , Öztürk Musa , Gözübatik-Çelik Rabia Gökçen , Soysal Aysun , Baybaş Sevim
Published: February 2021

Introduction:

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. The role of oxidative stress has gained importance in the pathogenesis of free radicals in cells such as protein, lipid, and nucleic acids by showing myelin loss and axonal degeneration. In this study, serum total oxidant level total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and paraoxonase (PON) in patients with relapsing-remitting-MS (RRMS) were examined. The hypothesis was that antioxidants might indicate the attack phase or the progression phase.

Methods:

Twenty-four patients with RRMS known to have undergone new attacks and 24 healthy controls whose demographic data were appropriate were included. PON and TAS/TOS measurements were performed once in the healthy group and twice in the serum samples of patients during relapse and remission periods. The Number Cruncher Statistical System 2007 and Power Analysis and Sample Size 2008 Statistical Software (Utah, USA) program was used for statistical analysis.

Results:

TAS, TOS, and PON levels were similar in the patient and control groups during the attack. In remission, only a positive, statistically significant relationship between the duration of the disease and TAS measurements was noted (r = 0.435; P = 0.034). No significant relationship was found between sociodemographic characteristics, illness duration, laboratory/imaging findings, and antioxidant parameters in blood.

Conclusion:

In this study, TOS, TAS, OSI, and PON serum levels had no role in determining attack and remission periods in RRMS. There were only significant differences between disease duration and TAS results during the remission period. Following TAS results may help in monitoring progression in patients with early MS.
Pan-cancer Analysis of Tumor Mutational Burden and Homologous Recombination DNA Damage Repair Using Targeted Next-Generation Sequencing
Authors: Wang Hai-Yun , Deng Ling , Li Ying-Qing , Zhang Xiao , Long Ya-Kang , Zhang Xu , Feng Yan-Fen , He Yuan , Tang Tao , Yang Xin-Hua , Wang Fang
Published: February 2021

Purpose Current variability in methods for tumor mutational burden (TMB) estimation and reporting demonstrates the urgent need for a homogeneous TMB assessment approach. Here, we compared TMB distributions in different cancer types using two customized targeted panels commonly used in clinical practice. Materials and Methods TMB spectra of 295- and 1021-gene panels in multiple cancer types were compared using targeted next-generation sequencing (NGS). The TMB distributions across a diverse cohort of 2,332 cancer cases were then investigated for their associations with clinical features. Treatment response data were collected for 222 patients who received immune-checkpoint inhibitors (ICIs) and their homologous recombination DNA damage repair (HR-DDR) and programmed death-ligand 1 (PD-L1) expression were additionally assessed and compared with the TMB and response rate. Results The median TMB between gene panels was similar despite a wide range in TMB values. The highest TMB was 8 and 10 in patients with squamous cell carcinoma and esophageal carcinoma according to the classification of histopathology and cancer types, respectively. Twenty-three out of 103 patients (22.3%) were HR-DDR‒positive and could benefit from ICI therapy; out of those 23 patients, seven patients had high TMB (p=0.004). Additionally, PD-L1 expression was not associated with TMB or treatment response among patients receiving ICIs. Conclusion Targeted NGS assays demonstrated the ability to evaluate TMB in pan-cancer samples as a tool to predict response to ICIs. In addition, TMB integrated with HR-DDR‒positive status could be a significant biomarker for predicting ICI response in patients.
Clinical Characteristics and Mortality Profile of COVID-19 Patients Aged less than 20 years Old in Pernambuco – Brazil
Authors: Sena Gabrielle R. , Lima Tiago P. F. , Vidal Suely A. , Duarte Maria do Carmo M. B. , Bezerra Patrícia G. M. , Fonseca Lima Eduardo J. , Braga Cynthia , Andrade Lívia B. de , Lins Mecneide M. , Torres Leuridan C. , Lima Jurema T. O. , Mello Maria Julia G.
Published: February 2021

COVID-19 in children and adolescents has low frequency, severity, and fatality rate all over the world. A cross-sectional study was conducted to assess the epidemiological and clinical aspects of COVID-19 in patients younger than 20 years in Pernambuco (Brazil), with cases confirmed by reverse-transcriptase–PCR SARS-CoV-2 between 13 February and June 19, 2020, reported on information systems. Data regarding age (< 30 days, 1–11 months, 1–4 years, 5–9 years, 10–14 years, and 15–19 years), gender, color/race, symptoms, pregnancy or puerperium, comorbidities, hospitalization, and death were investigated. Fatality rate and mortality coefficient were calculated, and a multiple logistic regression analysis was performed to determine if gender, age, and comorbidities were factors associated with death. Of 682 pediatric cases, 52.8% were female, with a mean age of 9 ± 7.2 years. The most frequent symptoms were fever (64.4%), cough (52.4%), and respiratory distress (32.4%). Hospitalization was reported in 46.2% of cases, mainly among neonates (80.3%) and infants (73.8%). Thirty-eight deaths were notified, and a fatality rate of 5.6% (95% CI: 3.9–7.3) was found, with higher fatality rates among neonates 11.5% (7 of 61) and 9.5% (8 of 84) infants. The mortality coefficient was 10.9 per 100,000 inhabitants < 1 year of age, whereas comorbidities (Odds ratio [OR] = 14.13, 95% CI: 6.35–31.44), age < 30 days (OR = 5.17, 95% CI: 1.81–14.77), and age 1–11 months (OR = 3.28, 95% CI: 1.21–8.91) were independent factors associated with death. The results demonstrate the vulnerability of neonates and infants with severe conditions, need hospitalization, and high fatality rate, indicating the necessity to adapt public health policies for these age-groups.
Plica neuropathica – unraveling the mystery of Plica polonica
Authors: Fałczyńska Aleksandra , Grabarczyk Maksymilian , Głownia Agnieszka , Bachoń Emilia , Balak Aleksandra , Grzeszczak Roksana , Rotte Katarzyna , Pękacka-Falkowska Katarzyna
Published: February 2021

Background: Plica as a disease entity appeared fi rst in the 13th century. Its aetiology is still unknown and not fully understood. Being, in fact, an irreversible condition of tangling and felting the hair, its origin was interpreted in various ways, from religious ones, through lack of hygiene to mental illness. Although p. polonica originates from Eastern and Central Europe, and p. neuropathica, typical of Indian people, was fi rst described in England, many characteristics connect these two conditions. Aim and Objectives: The study aimed to review the plica species over the centuries and to compare p. neuropathica and p. polonica. Materials and Methods: PubMed and Google Scholar databases were searched for medical articles, books and case studies on plica published up 1884 to 2020. We conducted a systematic and critical review of the literature to compare p. polonica and p. neuropathica. Results: Plica polonica and Plica neuropathica are the same disease entity. Conclusion: The variety of names and interpretations of the disease has made plica a condition still to be fully explained.