bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corticotroph hyperplasia and Cushing disease: diagnostic features and surgical management
Authors: Catalino Michael P. , Meredith David M. , De Girolami Umberto , Tavakol Sherwin , Min Le , Laws Edward R. 
Published: September 2020

OBJECTIVE
This study was done to compare corticotroph hyperplasia and histopathologically proven adenomas in patients with Cushing disease by analyzing diagnostic features, surgical management, and clinical outcomes.

METHODS
Patients with suspected pituitary Cushing disease were included in a retrospective cohort study and were excluded if results of pathological analysis of the surgical specimen were nondiagnostic or normal. Cases were reviewed by two experienced neuropathologists. Total lesion removal was used as a dichotomized surgical variable; it was defined as an extracapsular resection (including a rim of normal gland) in patients with an adenoma, and for hyperplasia patients it was defined as removal of the presumed lesion plus a rim of surrounding normal gland. Bivariate and multivariate analyses were performed. Recurrence-free survival was compared between the two groups.

RESULTS
The final cohort consisted of 63 patients (15 with hyperplasia and 48 with adenoma). Normal pituitary acinar architecture was highly variable. Corticotroph hyperplasia was diagnosed based on the presence of expanded acini showing retained reticulin architecture and predominant staining for adrenocorticotropic hormone. Crooke’s hyaline change was seen in 46.7% of specimens, and its frequency was equal in nonlesional tissue of both groups. The two groups differed only by MRI findings (equivocal/diffuse lesion in 46% of hyperplasia and 17% of adenoma; p = 0.03). Diagnostic uncertainty in the hyperplasia group resulted in additional confirmatory testing by 24-hour urinary free cortisol. Total lesion removal was infrequent in patients with hyperplasia compared to those with adenoma (33% vs 65%; p = 0.03). Initial biochemical remission was similar (67% in hyperplasia and 85% in adenoma; p = 0.11). There was no difference in hypothalamic-pituitary-adrenal axis recovery or disease recurrence. The median follow-up was 1.9 years (IQR 0.7–7.6 years) for the hyperplasia group and 1.2 years (IQR 0.4–2.4 years) for the adenoma group. Lack of a discrete lesion and diagnostic uncertainty were the only significant predictors of hyperplasia (sensitivity 53.3%, specificity 97.7%, positive predictive value 88.9%, negative predictive value 85.7%). An adjusted Cox proportional hazards model showed similar recurrence-free survival in the two groups.

CONCLUSIONS
This study suggests an association between biochemically proven Cushing disease and histopathologically proven corticotroph hyperplasia. Imaging and operative findings can be ambiguous, and, compared to typical adenomas with a pseudocapsule, the surgical approach is more nuanced. Nevertheless, if treated appropriately, biochemical outcomes may be similar.
Predictors of the development of takotsubo cardiomyopathy in aneurysmal subarachnoid hemorrhage and outcomes in patients with intra-aortic balloon pumps
Authors: Catapano Joshua S. , Ducruet Andrew F. , Frisoli Fabio A. , Nguyen Candice L. , Louie Christopher E. , Labib Mohamed A. , Baranoski Jacob F. , Cole Tyler S. , Whiting Alexander C. , Albuquerque Felipe C. , Lawton Michael T. 
Published: September 2020

OBJECTIVE
Takotsubo cardiomyopathy (TC) in patients with aneurysmal subarachnoid hemorrhage (aSAH) is associated with high morbidity and mortality. Previous studies have shown that female patients presenting with a poor clinical grade are at the greatest risk for developing TC. Intra-aortic balloon pumps (IABPs) are known to support cardiac function in severe cases of TC, and they may aid in the treatment of vasospasm in these patients. In this study, the authors investigated risk factors for developing TC in the setting of aSAH and outcomes among patients requiring IABPs.

METHODS
The authors retrospectively reviewed the records of 1096 patients who had presented to their institution with aSAH. Four hundred five of these patients were originally enrolled in the Barrow Ruptured Aneurysm Trial, and an additional 691 patients from a subsequent prospectively maintained aSAH database were analyzed. Medical records were reviewed for the presence of TC according to the modified Mayo Clinic criteria. Outcomes were determined at the last follow-up, with a poor outcome defined as a modified Rankin Scale (mRS) score > 2.

RESULTS
TC was identified in 26 patients with aSAH. Stepwise multivariate logistic regression analysis identified female sex (OR 8.2, p = 0.005), Hunt and Hess grade > III (OR 7.6, p < 0.001), aneurysm size > 7 mm (OR 3, p = 0.011), and clinical vasospasm (OR 2.9, p = 0.037) as risk factors for developing TC in the setting of aSAH. TC patients, even with IABP placement, had higher rates of poor outcomes (77% vs 47% with an mRS score > 2, p = 0.004) and mortality at the last follow-up (27% vs 11%, p = 0.018) than the non-TC patients. However, aggressive intra-arterial endovascular treatment for vasospasm was associated with good outcomes in the TC patients versus nonaggressive treatment (100% with mRS ≤ 2 at last follow-up vs 53% with mRS > 2, p = 0.040).

CONCLUSIONS
TC after aSAH tends to occur in female patients with large aneurysms, poor clinical grades, and clinical vasospasm. These patients have significantly higher rates of poor neurological outcomes, even with the placement of an IABP. However, aggressive intra-arterial endovascular therapy in select patients with vasospasm may improve outcome.
Auswirkungen des Trockensommers 2018 auf Flächen der Interkantonalen Walddauerbeobachtung
Authors: Braun Sabine , de Witte Lucienne C. , Hopf Sven E. 
Published: September 2020

Auswirkungen des Trockensommers 2018 auf Flächen der Interkantonalen Walddauerbeobachtung
Die Interkantonale Walddauerbeobachtung untersucht seit 1984 die Waldgesundheit an Buchen, Fichten und Eichen in heute 185 Beobachtungsflächen in der Schweiz. Sie ist ein geeignetes Instrument, um schleichende Veränderungen dieser Wälder zu dokumentieren. Aktuell hilft sie, die Reaktionen der Bäume auf den Trockensommer 2018 zu beobachten und Unterschiede zwischen Baumarten und zwischen Regionen festzustellen. Trockenheitsindikatoren wie die minimale Standortwasserbilanz zeigen, dass das Jahr 2018 im Vergleich zu 2003 nicht trockener war. Jedoch folgte das Jahr 2018 auf eine Reihe trockener Jahre. Die Folgeschäden, die 2019 zutage traten, überstiegen alle bisherigen Beobachtungen auf dem Messnetz. Der Anteil von Buchen mit einer Kronenverlichtung von über 60% war sechsmal höher als im Mittel der gesamten Beobachtungszeit. In einigen Flächen waren bis zu 41% der Buchen zu mehr als 60% verlichtet. Die Buchenmortalität war 2018 und 2019 um das Vierbis Fünffache erhöht. Auf Flächen mit mangelhafter Phosphorversorgung war die Erhöhung deutlich stärker. Bei den Fichten stieg die Mortalität durch Buchdruckerbefall bis zum Herbst 2019 auf einen Rekordwert von 4.9% und lag damit um ein Vielfaches höher als nach dem Hitzesommer 2003. Stiel-, Trauben-und Flaumeiche zeigten keine Vitalitätseinbussen, die über die bisherigen Erfahrungen hinausgingen. Die Flaumeiche war jedoch im Vergleich zur Traubeneiche stärker verlichtet. Färbungsversuche der Leitgefässe und Messungen des Wassergehalts an Buchen- und Eichenästen zeigten, dass bei der Buche Trockenheit im Vorjahr die Aktivität der Leitgefässe vermindert und den Wassergehalt negativ beeinflusst, bei den Eichen jedoch nicht. Das ist ein wichtiger Hinweis darauf, dass die Schäden 2019 nicht allein die Folge der extremen Trockenheit 2018, sondern vielmehr das Ergebnis mehrerer vorangegangener Trockenjahre waren.
Nilai Moralitas dalam Pembentukan Peraturan Perundang-Undangan
Authors: Suryani Suryani 
Published: September 2020

<p><em>The legislators should make the value of Pancasila a fundamental value or as the source of all sources of law, bringing consequences for the legislators to become a guide and guide in carrying out legislative functions. Ironically, the reality is that the legislators show that there are paradigmatic problems and a crisis of ethical awareness in the formation and enforcement of laws in Indonesia. What emerges is law development and law enforcement that is stagnant, centralized, corrupt and very far from divine and humanist values, and far from achieving social justice. The actualization of Divine Values as the fundamental value of Pancasila should be accommodated and become the basis for legislators in carrying out their functions and duties in the formation of laws or laws and transformed into laws that they form, so that they will give birth to laws that are effective and have divine dimensions. humanity, unity and social justice.</em></p><p><strong><em>Keywords: </em></strong><em>Morality; Legislation; Regulation.</em></p>
Public Engagement in the Implementation of the Policy on Waste Banking
Authors: Jaelani Abdul Kadir , Indrastuti Lusia 
Published: September 2020

<p><em>Kalisoro urban village is one of the tourist areas facing the issue of rising pile of garbage and the lack of knowledge of the waste. Especially in waste management this problem really needs more attention. Society involvement support is required in this waste management. Kalisoro Village waste management is an independent waste management village which involves the community. In this management, using the Reuse, Minimize, and Recycle 3R process. This study aims to explain the participation of independent waste village management by identifying the phases of participation society, the level of participation society and the factors affecting participation in the group. This study is presented in qualitative descriptive form, using in-depth interview technique in data collection and also using interactive data analysis technique for data triangulation. In this study, the culture represented by the Non-Governmental Organisations manages the consequence of involvement society in the management of the autonomous waste villages. Society ways of engagement are to contribute ideas, resources, funds, and engage in waste collection. But not all Kalisoro Village groups participated directly. In Kalisoro Village the level of participation society involves Citizen Power.</em></p><p><strong><em>Keywords: </em></strong>Participation; Society; Kalioso</p>
Relación entre el grado de instrucción académica y la negligencia al cuidado dental en adultos de 45 a 65 años de edad.
Authors: Pereira Gabriela 
Published: September 2020

OBJETIVO: Determinar la relación entre el grado de instrucción académica y la negligencia al cuidado de la salud dental en adultos de 45 a 65 años de edad, de la Parroquia Bellavista de la ciudad de Cuenca en el año 2017. MATERIALES Y MÉTODOS: Estudio de diseño caso control, tipo de investigación de campo y con una técnica comunicacional transversal actual. Para la toma de datos se utilizó la encuesta Dental Neglect Scale (DNS) en la parroquia Bellavista, cada uno se encuentra bajo consentimiento informado, indica su grado de instrucción académica y datos personales. RESULTADOS: Se evaluó el Odds Ratio (OR) del factor asociado entre la exposición y el comportamiento distorsionado, además se pudo determinar el nivel de negligencia según el sexo y la edad. CONCLUSIÓN: Se determinó que las personas con bajo nivel de instrucción académica tienen un mayor grado de negligencia al cuidado dental, así como las personas menores a 50 años presentan un índice mayor a comparación de los adultos mayores.
Microglia Demonstrate Local Mixed Inflammation and a Defined Morphological Shift in an APP/PS1 Mouse Model
Authors: Holloway Olivia G. , King Anna E. , Ziebell Jenna M. 
Published: September 2020

Background: Microglia are traditionally described as the immune cells of the brain and have an inflammatory role in Alzheimer’s disease (AD). Microglial morphological and phenotypic shifts in AD have not been fully characterized; however, microglia are often described as either pro- or anti-inflammatory. Objective: To determine microglial if microglial morphology and phenotype changes with disease status. Methods: This study observed morphology through Iba1 immunohistochemistry on tissue sections encompassing the primary motor cortex and somatosensory barrel fields. Immunohistochemistry for pro-inflammatory markers: CD14 and CD40; and anti-inflammatory markers: CD16 and TREM2, was performed at 3, 6, and 12 months of age which correlated with pre-plaque, onset, and significant plaque load in APP/PS1 brains (n = 6) and compared to age-matched littermate controls (n = 6). Results: Microglia demonstrated a defined morphological shift with time. Deramified morphologies increased in the APP/PS1, at both 6 months (p < 0.0001) and 12 months (p < 0.0001). At 12 months, there were significantly lower numbers of ramified microglia (p < 0.001). Results indicated that microglia have a heterogenic marker immunoreactivity as CD16, TREM2, and CD40 were associated with an activated morphology at the same time points. All inflammatory markers were significantly upregulated at 12 months in the APP/PS1 mice (TREM2 (F (2,30)  = 10.75, p = 0.0003), CD40 (F (2,30)  = 15.86, p < 0.0001), CD14 (F (2,30)  = 6.84, p = 0.0036), and CD16 (F (2,30)  = 3.026, p = 0.0635)). Conclusion: Our data indicate that pro- and anti-inflammatory factors of microglia occur in APP/PS1 mice.
In-pipe crack detection for multiple diameters using TE11 mode microwaves
Authors: Chen Guanren , Katagiri Takuya , Yusa Noritaka , Hashizume Hidetoshi 
Published: September 2020

This study evaluated the effect of pipe diameter on the applicability of a technique using TE11 mode microwaves for in-pipe crack detection. Three TE11 mode converters of different inner diameters were designed based on theoretical calculations and verified via numerical simulations. The working bandwidths of these mode converters were 7.0, 4.0, and 1.9 GHz. Experimental verification was carried out using brass pipes with the corresponding three inner diameters, and with pipe lengths up to 21–25.5 m. An axial and a circumferential slit were introduced to simulate cracks and deployed at multiple positions along the pipes under test. The results showed that both axial and circumferential slits could be detected and located for an inner pipe diameter up to 39 mm and at a distance of 15 m–24 m.
PEMANFAATAN WEBSITE MADRASAH SEBAGAI MEDIA PEMBELAJARAN E-LEARNING DI TENGAH PANDEMI COVID-19 DI MTs KEDUNGJAMBE SINGGAHAN TUBAN
Authors: Fathoni Mochamad , Zainiyati Husniyatus Salamah 
Published: September 2020

AbstractÂ The world is shocked by a global pandemic, known as covid-19 (Corona Virus Diseases-19). Almost all affected countries, including Indonesia. It affects all aspects of life, including education in Indonesia.Pemerintah enforce policies to work from home(WorkFromHome),worship at home, and learn at home. So that Teaching and Learning Activities (KBM) are replaced using online systems .Â The application oflearning electronic(E-Learning) makes educators think seriously about the learning media that will be used. Various methods are used by Madrasas to facilitate these needs. One of them is making Madrasah Website as a learning tool that can be accessed by students from home.Keywords: Learning Media, E-Learning, Madrasa Website, Covid-19Â Â Â
Comparison of Different Clinical and Metabolic Parameters Among Type 2 Diabetic Patients With and Without Retinopathy in Primary Health Clinics in Medan City, North Sumatera, Indonesia
Authors: Rusdiana - , Widjaja Sry Suryani , Daulay Mila Hayati , Ginting Almaycano 
Published: September 2020

Background: The global prevalence of type 2 diabetes mellitus is increasing steadily and diabeticretinopathy is one of the microvascular complications of diabetes mellitus. This research aims tocompare different clinical and metabolic parameters among type 2 diabetic patients with and withoutdiabetic retinopathy.
Methods: This cross-sectional study was done at various primary health care centers in Medan cityand the surrounding areas in North Sumatera from May to July 2020. Collected medical data includedblood pressure, body mass index, duration of disease, family history and medical treatment. Laboratorydata included blood glucose, glycated hemoglobin (HbA1c) and lipid profile. Diabetic retinopathy wasdetected by funduscopic examination by an ophthalmologist.
Results: Total patients were 88 and 26 had retinopathy. There was significant difference betweenthe average blood pressure, blood glucose and HbA1C values among patients with type 2 diabetesmellitus with and without retinopathy (p<0.005). But, there was no significant difference between theaverage body mass index (BMI), abdominal circumference and lipid profile.
Conclusion: Study showed that type 2 diabetic patients with retinopathy had increased blood glucoselevels and HbA1c than patients without retinopathy.
Bangladesh J Medicine July 2020; 31(2) :64-68
İlkokul Öğrencilerinin Sözel Problem Çözme Performansı Üzerinde Anlamsal Tutarlılık Etkisi
Authors: Yıldız Hicran Nurse , Can Derya 
Published: September 2020

Sözel problemlerde karmaşıklık yaratan durumlardan birisi problemlerdeki anahtar sözcüklerin problemin çözümü için gerekli işlemle tutarlı olup olmadığıdır. Bu araştırmada, ilkokul öğrencilerinin işlemle tutarlı ve tutarsız anahtar sözcükler içeren sözel problemlerdeki performanslarının Türkçe ve matematik dersi akademik başarılarına göre nasıl değiştiğinin ve problem çözme performansı üzerinde anahtar sözcüklerin rolünün incelenmesi amaçlanmıştır. Araştırmanın nicel aşamasına, uygun örnekleme yöntemiyle belirlenen ve ilkokul 3. ve 4. sınıfta öğrenim görmekte olan 100 öğrenci katılmıştır. Araştırmanın nitel aşamasında yarı yapılandırılmış görüşmeler yapılmış olup katılımcılar maksimum çeşitlilik örneklemesi yoluyla belirlenmiştir. Araştırma sonucunda, işlemle tutarlı anahtar sözcükler içeren problemlerde öğrenciler daha yüksek performans gösterirken, işlemle tutarsız anahtar sözcükler içeren sözel problemlerde daha düşük performans göstermiştir. Öğrencilere işlem seçimlerinin gerekçeleri sorulduğunda, büyük bir çoğunluğu işlemle tutarlı ve tutarsız anahtar sözcüklere vurgu yapmıştır. İşlemle tutarsız anahtar sözcüklerin yer aldığı problemler, genellikle düşük ve orta başarı grubundaki öğrencilerin hatalı işlem tercihinde bulunmasına neden olmuştur. Özellikle ilkokul döneminde öğrencilerin okuduğunu anlama becerilerinin geliştirilmesi ve sözel problemlerin anlamsal-dilsel özellikleri ile nasıl başa çıkılacağının öğretilmesi öğrencilerin ilerleyen yaşlardaki performanslarının olumlu yönde gelişmesini destekleyebilir.
Çocukların Okula Hazırbulunuşluk Düzeyleri ile Problem Çözme Becerileri Arasındaki İlişkinin İncelenmesi
Authors: Toran Şahika , Alabay Erhan 
Published: September 2020

Bu araştırmada çocukların okula hazırbulunuşluk düzeyleri ile problem çözme becerileri arasındaki ilişkinin incelenmesi amaçlanmıştır. Araştırmada yöntem olarak nicel araştırma yöntemlerinden ilişkisel deseni kullanılarak tasarlanmıştır. Çalışma grubunu 5 yaşında toplam 174 çocuk oluşturmaktadır. Araştırmada Demografik Bilgi Formu, Bracken Temel Kavram Ölçeği Gözden Geçirilmiş Formunun Okula Hazırbulunuşluk Alt Ölçeği ve Çocuklar için Problem Çözme Becerisi Ölçeği veri toplama aracı olarak kullanılmıştır. Normallik testi sonucunda normal dağılım gösteren veriler Basit Doğrusal Regresyon analizi kullanılarak analiz edilmiştir. Yapılan analizler sonucunda çocukların okula hazırbulunuşluk düzeylerinin çocukların problem çözme becerilerini açıklama gücünün yüksek olduğu, okula hazırbulunuşluk düzeyi arttıkça problem çözme becerilerinde de artışın olduğu bulunmuştur.
What Do Teachers As Adult Learners Think About MOOCs? A Case Study
Authors: Vezne Rabia 
Published: September 2020

The aim of this research was to understand and interpret the opinions of teachers as adult learners on MOOCs regarding the effect of MOOC on their personal and professional development, and their motivation to attend more MOOC. The research is a qualitative study with a holistic single case study design. Data were collected by semi-structured questions via the Google Form. At the end of the research, conclusions emerged under three themes. The first one was that the effects of MOOC on teachers’ personal development are learning new things and gaining self-confidence. The second one was that the effects of MOOC on teachers’ professional development are improving teaching and communication skills, and having a different perspective. Finally, the reasons of teachers’ motivation to attend more MOOCs are that MOOCs are easy to reach, suitable for personal learning speed, and economic.
Model Pembelajaran Pendidikan Agama Islam Berlandaskan Multikultural (Telaah Implikasi Model Cooperative Learning di Perguruan Tinggi)
Authors: Rahmat Rahmat 
Published: September 2020

AbstractThe learning model of Islamic Education (PAI) in tertiary institutions has recently been highlighted by many observers of education. This situation is reasonable considering that from year to year, racism acts mainly occur in universities. A nation of caliber in Indonesia with large heterogeneity is indeed very possible for friction between students, considering all the possibilities, this paper tries to analyze the PAI learning model based on multiculturalism in tertiary institutions. This research uses the library research method by analyzing the results of the study of books and scientific journals. This research produces a multicultural PAI based learning model through which students can absorb and practice multicultural PAI based learning in tertiary institutions so that it has implications for attitudes of respect, acceptance and appreciation of differences between students. Keyword: Learning Model, PAI, Multicultural, Higher Education AbstrakModel pembelajaran Pendidikan Agama Islam (PAI) di perguruan tinggi akhir-akhir ini disoroti banyak pemerhati pendidikan. Keadaan ini merupakan hal wajar mengingat dari tahun ketahun terus terjadi perbuatan rasisme terutama di perguruan tingginya. Bangsa sekaliber Indonesia dengan heterogenitas besar memang sangat memungkinkan terjadinya gesekan antar mahasiswa, memperhatikan segala kemungkinan tersebut tulisan ini mencoba menganalisis model pembelajaran PAI berlandaskan multikultural di perguruan tinggi. Penelitian ini menggunakan metode library research dengan menganalisis hasil kajian buku dan jurnal ilmiah. Penelitian ini menghasilkan model pembelajaran PAI berlandaskan multikultural yang dengannya mahasiswa dapat menyerap dan mengamalkan pembelajaran PAI berlandaskan multikultural di perguruan tinggi sehingga berimplikasi pada sikap penghormatan, penerimaan dan penghargaan terhadap perbedaan antar mahasiswa. Kata Kunci: Model Pembelajaran, PAI, Multikultural, Perguruan Tinggi
Seguridad Ciudadana en un Municipio Limeño: Análisis de los Resultados del Plan Local, 2017-2018
Authors: Gonzales Figueroa Iris Katherine , Bardales Cárdenas Miguel 
Published: September 2020

El artículo tuvo como objetivo general comprobar los resultados alcanzados en la ejecución del plan local de seguridad ciudadana, en un municipio limeño, 2017-2018. El tipo de investigación fue participativa, enfoque cualitativo y un diseño de estudio de casos. Se recogieron las entrevistas de un comisario policial de distrito, de un experto en temas de asuntos policiales, de un empresario víctima de hechos delictivos y de un ex miembro dirigencial del Comité de Seguridad ciudadana del Distrito. Los principales hallazgos encontrados fueron: falta de compromiso y responsabilidad de los representantes del Comité Local de Seguridad Ciudadana, alto índice de inseguridad en la zona, robos y asaltos que afectan los negocios, falta de efectivos policiales y serenos, alta rotación de comisarios, demora en la capacidad de respuesta de la policía ante la denuncia de un hecho delictivo e inmigración descontrolada. Las principales conclusiones fueron: nivel de eficacia de los planes de seguridad ciudadana solo alcanzaron un nivel valorativo medio de (58.34%), inadecuado sistema de control del plan local de seguridad ciudadana e incumplimiento de las categorías apriorísticas contrastadas.