bluuebunny/crossref_metadata_2025_split huggingface dataset:
Private Genomes and Public SNPs: Homomorphic Encryption of Genotypes and Phenotypes for Shared Quantitative Genetics
Authors: Mott Richard , Fischer Christian , Prins Pjotr , Davies Robert William 
Published: April 2020

Abstract
Mott et al. show that association between a quantitative trait and genotype can be performed using data that has been transformed by first rotating it in a high-dimensional space. The resulting...
Sharing human genotype and phenotype data is essential to discover otherwise inaccessible genetic associations, but is a challenge because of privacy concerns. Here, we present a method of homomorphic encryption that obscures individuals’ genotypes and phenotypes, and is suited to quantitative genetic association analysis. Encrypted ciphertext and unencrypted plaintext are analytically interchangeable. The encryption uses a high-dimensional random linear orthogonal transformation key that leaves the likelihood of quantitative trait data unchanged under a linear model with normally distributed errors. It also preserves linkage disequilibrium between genetic variants and associations between variants and phenotypes. It scrambles relationships between individuals: encrypted genotype dosages closely resemble Gaussian deviates, and can be replaced by quantiles from a Gaussian with negligible effects on accuracy. Likelihood-based inferences are unaffected by orthogonal encryption. These include linear mixed models to control for unequal relatedness between individuals, heritability estimation, and including covariates when testing association. Orthogonal transformations can be applied in a modular fashion for multiparty federated mega-analyses where the parties first agree to share a common set of genotype sites and covariates prior to encryption. Each then privately encrypts and shares their own ciphertext, and analyses all parties’ ciphertexts. In the absence of private variants, or knowledge of the key, we show that it is infeasible to decrypt ciphertext using existing brute-force or noise-reduction attacks. We present the method as a challenge to the community to determine its security.
Pre and post-extended thymectomy plasmapheresis accelerates mechanical ventilation extubation in Myasthenia Gravis patients with Thymoma
Authors: Widyantara I Wayan , Mulyantari Kadek , Sinardja Ketut 
Published: April 2020

Background: Myastenia gravis (MG) is a neuromuscular junction disorder that causes significant disability in the patient. Plasmaparesis and thymectomy are some therapeutic modalities in MG patients. Patients with MG of 10-15% had thymoma and 60% occurred thymic hyperplasia. Thymectomy may improve MG outcomes in 54-94% of patients (thymoma cases) or 21-42% of patients (cases of thymic hyperplasia). Plasmaparesis perioperatif still controversial. Case report: The 60-year-old man comes with a complaint both eyelids often close and both hands and feet experience fluctuating weakness, improved at rest. Patients with a history of DM and pulmonary TB. On the physical examination obtained eyelid twitch response and improved ptosis on ice test. Laboratory shows hyperglycemia and thrombocytopenia. Electrophysiological examination supports neuromuscular junction lesions. In thoracic and thoracic rectal images the mediastinal mass was obtained. Patients were diagnosed with myastenia gravis with suspected thyroid mediastinal mass. Treatment given mestinon 60 mg every 8 hours peroral, thymectomy plan, platelet transfusion, and plasmaparesis. Obtained a tumor with a large 10x8x7 cm with adhesions around the organ. Microscopic features support a thymoma A. Patients receive perioperative plasmaparesis 1 series (5x administration) divided, 2 preoperative and 3 postoperative times. The patient used mechanical ventilation for less than 24 hours and no residual symptoms. Conclusion: Myastenia gravis grade IIa (Osserman) with thymoma A performed extended thymectomy. Plasmaparesis given pre and post surgery showed clinical improvement and duration of short ventilator use. Good prognosis associated with mild MG degree, no myastenia crisis.Â Keywords: myastenia gravis, thymectomy, plasmaparesis
Usia dan obesitas berhubungan terhadap penyakit batu saluran kemih di RSUP Sanglah Denpasar periode Januari 2014 sampai Desember 2014
Authors: Nurfitriani Nurfitriani , Oka Anak Agung Gde 
Published: April 2020

Introduction: Urinary Stone Disease is the process of forming stones caused by the deposition of a substance with excess amounts of urinary or due to other factors that affect the solvency of substance. Urinary Stone Disease is frequently Â Â found on adults between 15-59 years old. Total patient who diagnosed by Urinary Stone Disease in Indonesia is too high. Many things associated against the onset of this disease, such as age and obesity. Therefore the research to examine which factors cause the occurrence of Urinary Stone Disease is necessary in order to raise the early prevention.Method: Research design is descriptive analytic. Using consecutive sampling method. Data will be analyzed in univariate and bivariate using statistical test of chi-square with a level of significance of Î± < 0.05. Place of research in Sanglah Denpasar Bali Subject of research are men and women above 15 years old, diagnosed with Urinary Stone Disease. Subject research are urology unit visiting patient also patient being hospitalized at Sanglah General Hospital.Result: The research results showed that the age has become risk factors which closely related with Urinary Stone Disease, value of p = 0.002. Obesity does not have significant relations against the occurrence of Urinary Stone Disease with value of p = 0,564.Concluison: Age has close relation with the occurrence of Urinary Stone Disease, while obesity has no relation towards the occurrence of Urinary Stone Disease diseases.
Pengaruh kepatuhan pendokumentasian asuhan medis terhadap kelengkapan dokumen pengajuan klaim JKN di Instalasi Rawat Inap RSUD Badung tahun 2018
Authors: Suryadhi Raditya Putra Pratama , Duarsa Dyah Pradnyaparamita , Sari Komang Ayu Kartika 
Published: April 2020

Background: BPJS as a health insurance institution runs the National Health Insurance (JKN) program. JKN implements a prospective financing system whereby payments made after the provision of services are in accordance with the agreement at the beginning in the form of packages. As regard with the fee, the hospital should take an effort to submit the proof document as the condition for the filing of the claim.Aim: This study aims to determine the effect of medical documenting compliance with the completeness of the JKN claim filing documents at the inpatient installation of Badung Hospital.Method: This study is a cross-sectional analytic study with the sample used is 120 documents of in-patient medical treatment that has been repatriated at the in-patient installation of Badung General Hospital in February 2018. Â Results: This research get result that the price rs = 0.861 and p-value = 0,003.Conclusion: There is an effect of compliance with documenting medical care on the completeness of claim filing documents in the in-patient installation of Badung General Hospital.
Analisis hubungan Rasio Trombosit Limfosit (RTL) dengan derajat keparahan stenosis pada pasien Coronary Artery Disease (CAD)
Authors: Kasim Zahra Inayah , Wibawa Sulina Yanti , Rauf Darmawaty E. 
Published: April 2020

Background: Atherosclerosis in CAD is marked by formation of plaque inside the arterial lumen. Platelet plays a role on formation and development of atherosclerosis. Adhesion of platelets to the endothelial cells followed by releasing platelet granules caused inflammation of endothel. Lymphocytes also play a role in atherosclerosis and atherotrombosis. T lymphocyte was the first to be recruited inside atheromas and gathered along inside an unstable plaque. The severity of stenosis can be calculated using Gensini score. The Aim of this study is to analyze the correlation between PLR and degree of stenosis in CAD.Methods. This study is a retrospective study by collected 110 patients with CAD that had undergone coronary Angiography. Platelets and lymphocyte count were measured by automatic haematologycal analyzer. PLR was measured by dividing trombocyte count with absolute lymphocyte. Angiography findings were calculated using Gensini score and later devided into 3 groups according to degree of severity.Results. 110 patients retrospectively assesed, 80% were male and 20% female. The most age found was 50-59 years (35.5%). Using Anova test there is a significant differences onÂ PLR between 3 groups of lesions (p<0.05). Continued with Posthoc test, the only significant finding was PLR between moderate and severe lesion. By Spearmanâ€™s Correlation test, there is a positif colleration between PLR and severity of stenosis (p<0.048), with R value 0.189 (3.6%).Conclusions. There was a poor correlation between PLR and degree of stenosis severity in CAD. A prospective study needed to assess PLR as predictor of mortality and morbidity in CAD.
Efektivitas ekstrak metanol akar pandan wangi (Pandanus amaryllifolius Roxb.) Sebagai antimalaria terhadap jumlah limfosit dalam darah mencit (Mus musculus) yang diinfeksi Plasmodium berghei
Authors: Mustofa Danang , Kahtan Muhammad Ibnu , Natalia Diana , Zakiah Mistika , Widiyantoro Ari 
Published: April 2020

Malaria is a infectious disease cause by protozoa with genus Plasmodium that is transmitted by female Anopheles mosquito. Our immune system which is role by lymphocyte works specifically when body infected by Plasmodium. The secondary metabolites of Pandan Wangi roots (Pandanus amaryllifolius Roxb.) Â possess as antimalaria. The purpose of this research to know the activity of methanol exctract from roots of Pandan Wangi (Pandanus amaryllifolius Roxb.) as antimalaria on white male mice (Mus muscullus) lymphocyte count infected by Plasmodium berghei. This is a true experimental in vivo with completely randomized design. Antimalaria effect test used methanol extract from roots of Pandan Wangi with concentration 6.5%, 13% and 26%. Positive control group was given 3.74 mg/mL DHP (Dihydroartremisinin-Piperaquin), normal control group was not given any intervention, negative control group was given aquadest. Results of this research show extract with concentration 6.5%, 13% and 26% have the antimalaria effect show by the decrease of parasitemia percentage. In addition, concentration of 26% extract can increase the number of lymphocytes significantly. Extract of Pandan Wangi Roots have antimalaria effect and can increase the number of lymphocytes with the best concentration of 26%. The decreasing number of parasitemia level is not directly related to the increasing of lymphocyte
A-41 years old male with alcoholic cardiomyopathy at Tabanan General Hospital, Bali-Indonesia: a case report
Authors: Wikananda Gede , Ariawan Eka , Priadnyana Ary 
Published: April 2020

Background: Alcoholic cardiomyopathy is a form of toxic cardiomyopathy which develops as a result of long-standing chronic ingestion of alcohol. Its clinical findings share similar features to other forms of dilated cardiomyopathy. Diagnosis can be made based on the history of long term alcohol abuse, clinical findings, and supporting diagnostic studies. This case report aims to overview alcoholic cardiomyopathy; from establishing the initial diagnosis to the treatment given for the condition.Case Description: A 41 years old male came to the emergency department unit with shortness of breath since last few days. Shortness of breath was said to be getting worse over time and progressed to breathlessness at rest. Other complaints were palpitations, fatigue, and long-standing cough. The patient was found to have a history of drinking alcohol in large quantities since 27 years ago. The blood pressure was 110/70â€…mmâ€…Hg, pulse rate 105â€…beats/min, and respiratory rate was 20 breaths/min. Slight edemas on both legs were also found.Â From auscultation examination, bibasilar crepitation on both lungs was found. Cardiac examination showed systolic murmur of mitral regurgitation (MR) and tricuspid regurgitation (TR).Â On supporting investigation, a chest x-ray showed cardiomegaly (cardiothoracic ratio; 57%). ECG examination showed sinus tachycardia and left atrial (LA) and left ventricular (LV) enlargement. Trans-thoracal echocardiographic (TTE) examination revealed; RWMA: global hypokinetic-akinetic, multi-chamber dilated and severe LV systolic dysfunction (EF 29%) and diastolic function (Grade IV (E/A Ratio>4)). Valve examination showed moderate-severe MR and moderate TR (TVG 40 mmHg).Conclusion: Alcohol cardiomyopathy is one of the most common causes of heart failure in young age and carries a poor prognosis if not treated properly. Treatment of alcoholic cardiomyopathy mainly includes total alcohol abstinence along with drugs used to treat systolic heart failure to reverse the condition and correct any nutritional deficiencies.
Three-Port Laparoscopic Sleeve Gastrectomy: Serial Cases Report
Authors: Antara Gede Eka Rusdi , Yustina Maria 
Published: April 2020

Background: Laparoscopic sleeve gastrectomy is the procedure of choice for bariatric surgery. It is a minimally invasive procedure that giving good outcome and less complication compared to other procedures. The multiport sleeve gastrectomy technique is usually described by using 4 to 6 ports and an additional port for a liver retractor. Single-incision laparoscopic sleeve gastrectomy was reported, but not widely adopted. Â Objective: To describe a convenient and applicable modified technique of three ports laparoscopy for sleeve gastrectomy that may give better outcome and cosmetic.Cases: Four patients were diagnosed with obese class II and III. Upper GI study was performed before surgery. We performed three ports laparoscopic sleeve gastrectomy. The 15 mm port was placed in the umbilical, for the camera. The second 12 mm port was placed in the right side of the umbilical for the stapler, and the third port, 5 mm was placed in the right hypochondrium midclavicular line. During the surgery, we used endoscope as guidance during gastric stapling and also for evaluation the stapler line and the size of the stomach. The postoperative condition was uneventful, the patients have less scar and less length of stay.Conclusion: Three ports laparoscopic sleeve gastrectomy is easy to perform, convenient and applicable, consume less time and also give excellent results for the patient's recovery.Â
Skin flap pattern in skin cancer at Sanglah General Hospital Denpasar, Bali-Indonesia
Authors: Wardhana Made , Darmaputra IGN , Wirawan I Gde Nengah Adhilaksman Sunyamurti , Pramita Nyoman Yoga Maya , Maharis Rikcy Fernando , Puspawati Ni Made Dwi , Karmila IGAA Dwi , Praharsini IGAA 
Published: April 2020

Background: The prevalence of skin cancer is consistently increasing recently, an hence a more comprehensive management is necessary for patientsâ€™ satisfaction. Generally, skin cancer is categorized into several histological types, including melanoma, basalioma, squamous cell carcinoma (SCC), and several other less common types such as keratoacanthoma, pyogenic granuloma, and Bechet disease. In dermatology, the intervention is limited which only consists of infiltrative anesthesia, no involvement of other organs, and no attachment to the underlying tissue. Therefore, random skin flap frequently becomes the preferred option that involves advancement, rotation, transposition, and interpolation flap. This study aims to investigate the profile of skin cancer and flap pattern among patients undergoing skin flaps procedure at Dermatology and Venereology Department of Sanglah General Hospital, Denpasar.Â Method: This study included all skin cancer patients who underwent skin flap surgery. Samples collection was performed retrospectively using patientsâ€™ medical records from January 2015 - December 2018.Â Results: Over the study period, there were a total of 41 skin cancer patients who underwent skin flap surgery of whom 10 (54.6%) patients were diagnosed with melanoma, 16 patients with basalioma, 9 patients with SCC and the remaining included 3 cases of acanthoma and 1 Bechet disease. Regarding the flap types, simple advancement and its variances were performed in 6 melanoma, 11 basaliomas, 5 SCC and 4 keratoacanthoma cases. Transposition flap was performed in 2 melanoma, 3 basalioma, and 3 SCC cases; whereas rotation flap was performed in 2 melanoma and 2 basaliomas and SCC cases.Conclusion: From 41 skin cancer patients discovered, basalioma was the most frequent cases and advancement techniques were the most frequently performed flap surgery. Only 1 post-surgical infection was found after rotational flap procedure.Â Â Â
Primary Cardiovascular Disease Prevention: Risk Factors Control vs. Imaging Subclinical Atherosclerosis
Authors: Vancheri Federico , Faggiano Pompilio , Henein Michael Y 
Published: April 2020

The burden of cardiovascular disease in developed countries has shown dramatic improvements over the last 50 years, largely due the identification and control of major risk factors including, smoking hypertension and high cholesterol. However, due to the significant increase in obesity and diabetes CVD incidence rates will not reduce as far over over the next years. Risk prediction in asymptomatic individuals remains a major challenge. Primary preventive treatment is currently based on the assessment of individual’s global risk mainly through screening of conventional risk factors and their treatment with lifestyle intervention and pharmacotherapy, often based on multivariate risk equations, and yet a large proportion of CVD still occurs in individuals who are classified as carrying low- or intermediate-risk according to the risk scores. Atherosclerosis is the most common pathophysiologic process underlying CVD, often after a prolonged asymptomatic phase during which it may be possible to modify the course of the disease. Unlike conventional probabilistic risk scores, non-invasive imaging techniques such as carotid intima-media thickness (CIMT) along with plaque assessment (Figure 2), measured by B-mode ultrasound, and coronary calcium scoring (CAC) detected by CT scan have the advantage of direct visualization of the consequences of atherosclerosis on the arterial system. We consider the proposal that imaging of subclinical atherosclerosis is superior to risk equations as it directly identifies the disease and can effectively predict the risk of future CV events in low- and intermediate-risk individuals. In addition, imaging can improve the adherence to guidelines based treatment in patients and their physicians.
A prospective study on clinico-epidemiological profile and outcome in management of poisonous snake bite
Authors: Chaudhary Mukesh Kumar , Gupta Laxmi K. , Chand Lokendra B. , Chaudhary Ramesh , Ranpal Sabin 
Published: April 2020

Background: Snake bite is a major health problem in Nepal. According to WHO, annual morbidity due to snake bite is 162 out of 100,000 people in Nepal. Aim of the study is to observe epidemiology, clinical features, and analysis of possible relationship between time delay in administration of anti-snake venom (ASV) and mortality. Methods: This prospective observational study analyses the data of 81 patients admitted to the Lumbini zonal hospital, Butwal, Rupandehi, Nepal with history of snake bite between April to September, 2017.Results: In this study 56% patients were female. Patients of age group (15-30) years were maximum (38.27%). The study showed that 50.61% of snake bites were occurred outside home. Most of patients (84%) were from the Terai region. Average no. of vials used per case was (28±10) vials. Most of victims of snake bite were from rural areas. In most of cases we found that prothrombin time was prolonged. It was found that most of patients 57% reach hospital before 4 hours of snake bite. The mean days of hospital stay was 6±2.86. Most of case of snake bite was unknown (62%). The mortality rate in this study was 6.17%.Conclusions: There is a great need to improve in existing health care conditions for effective management of snake bite; it requires training of the personnel engaged in the emergency health care management, development of national guidelines based on the clinical trials, improving the distribution and easy availability of antivenom.
A case of nimesulide induced toxic epidermal necrolysis
Authors: Xaviar Suja , Ravichandran Mirunalini 
Published: April 2020

Toxic epidermal necrolysis (TEN) is a rare life-threatening drug-induced mucocutaneous skin disease with a mortality rate of approximately 30%. Nimesulide is a preferential cyclo-oxygenase (COX-2) inhibitor which is frequently used for its antipyretic, anti-inflammatory and analgesic activity. Here, we report a case of nimesulide induced toxic epidermal necrolysis in a 57 years old male patient. This patient was admitted in the hospital with symptoms of epidermal sloughing and fluid filled blisters all over the body following over the counter intake of nimesulide for fever. The drug was promptly stopped, and patient was managed with steroids, antibiotics and other adequate supportive measures. The patient showed significant recovery following stoppage of drug and adequate management. This case highlights the importance of nimesulide and other NSAIDs as possible cause of TEN.
Clinical profile of patients with forearm and hand injuries
Authors: Bisht Bhaskar , Rajan Manu , Dvivedi Sanjay , A. V. Rawat Kinnari , Konda Sireesha 
Published: April 2020

Background: Hand injuries are among the most frequent injuries, constituting between 6.6% and 28.6% of all injuries. Hand and forearm injuries, however small or large they may be do have a significant impact on the society in terms of cost of treatment, hospital stay and costs of lost production and hence the importance of this study.Methods: The study was conducted in the Department of Surgery, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, over the period of 12 months. Subjects were recruited from patients presenting in emergency/surgery OPD, HIMS, Dehradun with a primary diagnosis of soft tissue injuries in the forearm and the hand. A total of 114 patients were included in the study.Results: Overall mean age of the subjects in our study was 28.21±15.71. The highest incidence was in the age group of (20-40) years i.e. 62 (54.30%). Male to female ratio in our study was 6.6:1. Maximum injuries occurred as workplace and industrial injuries. This contributed to 34.2% (39 subjects) of overall injuries. 50% patients had crush injuries while lacerations, burn and avulsion were other form of injuries. 43 patients had bone and joint involvement,16 patients had neurovascular injuries and 20 patients had tendon injuries. Conclusions: Hand and forearm injuries are more common in males and in the age group of 20 to 40 years leading to loss of productive working days causing a significant financial burden on the society.