bluuebunny/crossref_metadata_2025_split huggingface dataset:
Myasthenia Gravis Is Not an Independent Prognostic Factor of Thymoma: Results of a Propensity Score Matching Trial of 470 Patients
Authors: Zhai Yirui , Wei Yong , Hui Zhouguang , Gao Yushun , Luo Yang , Zhou Zongmei , Feng Qinfu , Li Yuemin 
Published: November 2020

ObjectiveThe association between the prognosis of thymoma and MG remains controversial. Differences in clinical characteristics and treatments between patients with and without MG may affect the findings of those studies. We designed this propensity score matching trial to investigate whether MG is an independent prognostic predictor in thymoma.MethodsPatients with pathologically diagnosed thymoma and MG were enrolled in the MG group. Moreover, the propensity score matching method was used to select patients who were diagnosed with thymoma without MG from the database of two participating centers. Matched factors included sex, age, Masaoka stage, pathological subtypes, and treatments. Matched patients were enrolled in the non-MG group. Chi-squared test was used to compare the characteristics of the two groups. Overall survival, local-regional relapse-free survival, distant metastasis-free survival, progression-free survival, and cancer-specific survival were calculated from the diagnosis of thymoma using the Kaplan–Meier method.ResultsBetween April 1992 and October 2018, 235 patients each were enrolled in the MG and non-MG groups (1:1 ratio). The median ages of patients in the MG and non-MG groups were 46 years old. The World Health Organization pathological subtypes were well balanced between the two groups (B2 + B3: MG vs. non-MG group, 63.0 vs. 63.4%, p = 0.924). Most patients in both groups had Masaoka stages I–III (MG vs. non-MG group, 90.2 vs. 91.5%, p = 0.631). R0 resections were performed in 86.8 and 90.2% of the MG and non-MG groups, respectively (p = 0.247). The median follow-up time of the two groups was 70.00 months (MG vs. non-MG group, 73.63 months vs. 68.00 months). Five-year overall survivals were 92.5 and 90.3%, 8-year overall survivals were 84.2 and 84.2%, and 10-year overall survivals were 80.2 and 81.4% (p = 0.632) in the MG and non-MG groups, respectively. No differences were found in the progression-free survival, distant metastasis-free survival, and local-regional relapse-free survival between the two groups.ConclusionMG is not an independent or direct prognostic factor of thymoma, although it might be helpful in diagnosis thymoma at an early stage, leading indirectly to better prognosis.
Safety and Efficacy of Immune Checkpoint Inhibitors for Patients With Metastatic Urothelial Carcinoma and End-Stage Renal Disease: Experiences From Real-World Practice
Authors: Kuo Ming-Chun , Su Po-Jung , Huang Chun-Chieh , Luo Hao-Lun , Chiu Tai-Jan , Li Shau-Hsuan , Wu Chia-Che , Liu Ting-Ting , Cheng Yuan-Tso , Kang Chih-Hsiung , Su Yu-Li 
Published: November 2020

BackgroundImmune checkpoint inhibitors (ICIs) are used widely for treating metastatic urothelial carcinoma (mUC). In practical settings, evidence is lacking on the efficacy of ICIs in some difficult-to-treat patients, such as those with end-stage renal disease (ESRD). Herein, we evaluate the safety and efficacy of ICIs for patients with mUC and ESRD.MethodsFor this retrospective study, patients with mUC who were given ICIs at Kaohsiung Chang Gang Memorial Hospital and Linkou Chang Gung Memorial Hospital between April 2016 and November 2019 were consecutively enrolled. All clinicopathologic data, treatment responses, and adverse events were recorded. The immune-related adverse events (AEs), objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were compared between ESRD and non-ESRD groups.ResultsIn total, 129 patients with mUC were enrolled, with 11 patients categorized as the ESRD group. Among these patients with ESRD receiving ICIs, 7 of 11 (63.6%) had high-grade (grade ≥3) AEs, chiefly hematologic toxicity. Some rarely encountered AEs were noted, including toxic epidermal necrolysis, tuberculosis reactivation, ascites, and cytokine release syndrome. Patients in the ESRD group had numerically higher ORR (54.5% vs. 28.8%, p = 0.09), PFS (7.1 vs. 3.5 months, p = 0.42), and OS (not reached vs. 15.4 months) than the non-ESRD group. A multivariate Cox regression model demonstrated that leukocytosis (hazard ratio [HR]: 2.63; 95% confidence interval [CI]: 1.23–5.63; p = 0.01) and neutrophil-to-lymphocyte ratio (HR 2.91; 95% CI: 1.30–6.53; p = 0.01) were independent prognostic factors.ConclusionAdministration of ICIs in patients with mUC and ESRD demonstrated a modest antitumor activity, and should be used with caution for increasing risk of hematologic toxicity.
To Become or Not to Become Tumorigenic: Subventricular Zone Versus Hippocampal Neural Stem Cells
Authors: Fontán-Lozano Ángela , Morcuende Sara , Davis-López de Carrizosa Mª América , Benítez-Temiño Beatriz , Mejías Rebeca , Matarredona Esperanza R. 
Published: November 2020

Neural stem cells (NSCs) persist in the adult mammalian brain in two neurogenic regions: the subventricular zone lining the lateral ventricles and the dentate gyrus of the hippocampus. Compelling evidence suggests that NSCs of the subventricular zone could be the cell type of origin of glioblastoma, the most devastating brain tumor. Studies in glioblastoma patients revealed that NSCs of the tumor-free subventricular zone, harbor cancer-driver mutations that were found in the tumor cells but were not present in normal cortical tissue. Endogenous mutagenesis can also take place in hippocampal NSCs. However, to date, no conclusive studies have linked hippocampal mutations with glioblastoma development. In addition, glioblastoma cells often invade or are closely located to the subventricular zone, whereas they do not tend to infiltrate into the hippocampus. In this review we will analyze possible causes by which subventricular zone NSCs might be more susceptible to malignant transformation than their hippocampal counterparts. Cellular and molecular differences between the two neurogenic niches, as well as genotypic and phenotypic characteristics of their respective NSCs will be discussed regarding why the cell type originating glioblastoma brain tumors has been linked mainly to subventricular zone, but not to hippocampal NSCs.
Opioids in Post-stroke Pain: A Systematic Review and Meta-Analysis
Authors: Scuteri Damiana , Mantovani Elisa , Tamburin Stefano , Sandrini Giorgio , Corasaniti Maria Tiziana , Bagetta Giacinto , Tonin Paolo 
Published: November 2020

Background: Post-stroke pain is one of the most common sequelae of stroke, which stands among the leading causes of death and adult-acquired disability worldwide. The role and clinical efficacy of opioids in post-stroke pain syndromes is still debated.Objectives: Due to the important gap in knowledge on the management of post-stroke pain, this systematic review aimed at assessing the efficacy of opioids in post-stroke pain syndromes.Methods: A literature search was conducted on databases relevant for medical scientific literature, i.e. PubMed/MEDLINE, Scopus, Web of Science and Cochrane Library databases from databases inception until August 31st, 2020 for clinical trials assessing the effects of opioids and opioid antagonists on pain reduction and pain related symptoms in patients with post-stroke pain syndromes. Studies assessing the effects of other medications (e.g., tricyclic antidepressant, pregabalin) or non - pharmacological management strategies (e.g., neurostimulation techniques) were excluded. The selected studies have been subjected to examination of the risk of bias.Results: The literature search retrieved 83,435 results. After duplicates removal, 34,285 articles were title and abstract screened. 25 full texts were assessed and 8 articles were identified to be eligible for inclusion in the qualitative summary and narrative analysis, of which three were placebo-controlled and two were dose-response. Among placebo-controlled studies, two evaluated the analgesic effect of morphine and one assessed the effects of the opioid antagonist naloxone on patients with central post-stroke pain. With regard to dose-response studies, both were on patients with central post-stroke pain, one assessing the efficacy of levorphanol, and the other on naloxone. Seven out of eight included studies showed an overall slight analgesic effect of opioids, with less consistent effects on other pain-related symptoms (e.g., mood, quality of life). The randomized controlled trials were subjected to meta-analysis and rating of the quality of evidence for the two outcomes considered according to GRADE (Grading of Recommendations, Assessment, Development and Evaluations) system. The overall results are inconclusive because of the small number of studies and of patients.Conclusions: The limited number of the included studies and their heterogeneity in terms of study design do not support the efficacy of opioids in post-stroke pain and in pain-related outcomes. Large double-blind randomized clinical trials with objective assessment of pain and related symptoms are needed to further investigate this topic.
Association of Hyperuricemia With Immune Disorders and Intestinal Barrier Dysfunction
Authors: Lv Qiulan , Xu Daxing , Zhang Xuezhi , Yang Xiaomin , Zhao Peng , Cui Xuena , Liu Xiu , Yang Wan , Yang Guanpin , Xing Shichao 
Published: November 2020

BackgroundMore than 30–40% of uric acid is excreted via the intestine, and the dysfunction of intestinal epithelium disrupts uric acid excretion. The involvement of gut microbiota in hyperuricemia has been reported in previous studies, but the changes and mechanisms of intestinal immunity in hyperuricemia are still unknown.MethodsThis study developed a urate oxidase (Uox)-knockout (Uox–/–) mouse model for hyperuricemia using CRISPR/Cas9 technology. The lipometabolism was assessed by measuring changes in biochemical indicators. Furthermore, 4-kDa fluorescein isothiocyanate–labeled dextran was used to assess gut barrier function. Also, 16S rRNA sequencing was performed to examine the changes in gut microbiota in mouse feces. RNA sequencing, Western blot, Q-PCR, ELISA, and immunohistochemical analysis were used for measuring gene transcription, the number of immune cells, and the levels of cytokines in intestinal tissues, serum, kidney, liver, pancreas, and vascellum.ResultsThis study showed that the abundance of inflammation-related microbiota increased in hyperuricemic mice. The microbial pattern recognition–associated Toll-like receptor pathway and inflammation-associated TNF and NF-kappa B signaling pathways were significantly enriched. The increased abundance of inflammation-related microbiota resulted in immune disorders and intestinal barrier dysfunction by upregulating TLR2/4/5 and promoting the release of IL-1β and TNF-α. The levels of epithelial tight junction proteins occludin and claudin-1 decreased. The expression of the pro-apoptotic gene Bax increased. The levels of LPS and TNF-α in systemic circulation increased in hyperuricemic mice. A positive correlation was observed between the increase in intestinal permeability and serum levels of uric acid.ConclusionHyperuricemia was characterized by dysregulated intestinal immunity, compromised intestinal barrier, and systemic inflammation. These findings might serve as a basis for future novel therapeutic interventions for hyperuricemia.
The Adolescent Resilience Questionnaire: Validation of a Shortened Version in U.S. Youths
Authors: Anderson Jacqueline R. , Killian Michael , Hughes Jennifer L. , Rush A. John , Trivedi Madhukar H. 
Published: November 2020

IntroductionResilience is a factor in how youth respond to adversity. The 88-item Adolescent Resilience Questionnaire is a comprehensive, multi-dimensional self-report measure of resilience developed with Australian youth.MethodsUsing a cross-sectional adolescent population (n = 3,222), confirmatory factor analysis was conducted to replicate the original factor structure. Over half of the adolescents were non-white and 9th graders with a mean age of 15.5.ResultsOur exploratory factor analysis shortened the measure for which we conducted the psychometric analyses. The original factor structure was not replicated. The exploratory factor analysis provided a 49-item measure. Internal consistency reliability for all 12 factors ranged from acceptable (α&gt; 0.70–0.80). The revised factor total scores were highly and significantly correlated with item–total correlation coefficients (r &gt; 0.63, p &lt; 0.001).ConclusionThis revised shorter 49-item version of the Adolescent Resilience Questionnaire could be deployed and has acceptable psychometric properties.
3D Bioprinting and the Future of Surgery
Authors: Jovic Thomas H. , Combellack Emman J. , Jessop Zita M. , Whitaker Iain S. 
Published: November 2020

Introduction: The disciplines of 3D bioprinting and surgery have witnessed incremental transformations over the last century. 3D bioprinting is a convergence of biology and engineering technologies, mirroring the clinical need to produce viable biological tissue through advancements in printing, regenerative medicine and materials science. To outline the current and future challenges of 3D bioprinting technology in surgery.Methods: A comprehensive literature search was undertaken using the MEDLINE, EMBASE and Google Scholar databases between 2000 and 2019. A narrative synthesis of the resulting literature was produced to discuss 3D bioprinting, current and future challenges, the role in personalized medicine and transplantation surgery and the global 3D bioprinting market.Results: The next 20 years will see the advent of bioprinted implants for surgical use, however the path to clinical incorporation will be fraught with an array of ethical, regulatory and technical challenges of which each must be surmounted. Previous clinical cases where regulatory processes have been bypassed have led to poor outcomes and controversy. Speculated roles of 3D bioprinting in surgery include the production of de novo organs for transplantation and use of autologous cellular material for personalized medicine. The promise of these technologies has sparked an industrial revolution, leading to an exponential growth of the 3D bioprinting market worth billions of dollars.Conclusion: Effective translation requires the input of scientists, engineers, clinicians, and regulatory bodies: there is a need for a collaborative effort to translate this impactful technology into a real-world healthcare setting and potentially transform the future of surgery.
Individual Human Life Morality of Vethathiri Maharishi
Authors: D Sivanantham 
Published: November 2020

From the beginning of the Human race to the present day there has been need to guide the lives of huaman beings. The main reason for this is that man suffers from material attraction and perceptual giddiness. So in every age Scholars, Sages, and Saints have appeared and guided human life to be better and happier. Vethathiri Maharishi, the great philosopher who emerged in the twentieth century in that way and led man to move in the state of knowledge and to live in peace and pleasure. Vethathri Maharishi has given lot of books to the Tamil literature world based on the lofty idea that world peace created through individual human peace. Among them the Gnanak kalanjiyam is a notable book which Published in two volumes, the book contains 1854 songs. This article examines the virtues mentioned by vethathiri maharishi under the rhetoric of virtue in his book as the main virtues that every individual man should follow in his life as the development Gnanak kalanjiyam of the individual who is the foundation of the society as the cause of social and national development.
Gambaran audiogram pada anak dengan penyakit ginjal kronis yang menjalani hemodialisis
Authors: Muyassaroh Muyassaroh , Muryawan Heru , Cahyani Nastiti Dwi 
Published: November 2020

Latar belakang: Penyakit ginjal kronis (PGK) adalah kerusakan ginjal atau penurunan laju filtrasi glomerulus (GFR) kurang dari 60 mL / min / 1,73 m2 paling sedikit 3 bulan. Pasien PGK memiliki resiko kejadian kurang pendengaran yang tinggi. Tujuan: Mengetahui gambaran audiogram anak dengan PGK yang menjalani hemodialisis. Metode : Diskriptif retrospektif 7 kasus PGK ada anak yang menjalani hemodialisis di RSUP Dr.Kariadi Semarang Juli 2017. Hasil : didapatkan 5 kasus(71,4%) kurang pendengaran sensorineural, 1 kasus (14,3%) kurang pendengaran campuran (MHL) dan 1 kasus (14,3%) normal. Derajat kurang pendengaran bervariasi dari derajat ringan sampai sangat berat. Kesimpulan: Kurang pendengaran sensorineural sebagian besar terjadi pada anak dengan PGK yang menjalani hemodialisis.
Kata kunci : Audiogram, SNHL, PGK

Background: Chronic kidney disease (CKD) is kidney damage or a decrease in glomerular filtration rate (GFR) of less than 60 mL / min / 1.73 m2 for at least 3 months. Patients with CKD have a high risk of hearing loss. Objective: The aim of illustrate the audiogram on children with chronic kidney disease undergoing hemodialysis. Methode : Descriptif retrospective to seven cases of children with chronic kidney disease who undergoing hemodialysis in Karyadi hospital juli 2017. Result : Five cases (71,4%) with sensorineural hearing loss. One case(14,3%) showed severe mix hearing loss, one cases(14,3%) with normal audiogram. The degree of hearing loss from mild to profound Conclusion: Sensorineural hearing loss may occur in the majority of children with CKD on hemodialysis
Keywords : Audiogram, SNHL, PGK
Kasus Dua Orang Wanita Umur 36 Tahun Dan 60 Tahun Dengan Akromegali
Authors: Ismayanti Fajri , Sukmaningtyas Hermina 
Published: November 2020

Kasus Akromegali di RSUP dr. Kariadi sangat jarang terdeteksi pada fase awal karena minimnya gejala yang ditimbulkan. Pasien ditemukan tanpa sengaja biasanya datang dengan keluhan penyerta yang lain. Pemeriksaan Radiologi membantu menegakkan diagnosis Akromegali.
Dilaporkan 2 kasus wanita usia 36 tahun dan 60 tahun dengan Akromegali. Kasus pertama Ny. D usia 36 tahun dengan keluhan benjolan di leher dan sulit menelan datang ke poliklinik Penyakit Dalam RSUP dr. Kariadi. Pada pemeriksaan USG colli didapatkan pembesaran kelenjar tiroid, penebalan isthmus, nodul solid dengan jaringan nekrotik (ukuran terbesar ± 3.64 x 2.16 cm). Kasus kedua, Ny. N usia 60 tahun dengan keluhan nyeri diseluruh sendi. Tulang membesar, mentruasi berhenti pada usia 35 tahun. Pada pemeriksaan radiologi X Foto vertebra lumbosacral tampak gambaran Ankylosing Spondilosis. Pada pemeriksan MRI kepala kedua pasien diatas ditemukan makroadenoma. Kedua pasien berperawakan pendek dengan pembesaran tangan, kaki dan tulang wajah (prognatism)
Akromegali adalah suatu penyakit akibat dari peningkatan sekresi hormon pertumbuhan (somatotropin) oleh sel eosinofilik dari lobus anterior kelenjar pituitari, yang disebabkan oleh hiperplasia kelenjar atau tumor yang menyebabkan pertumbuhan tulang yang meningkat. Akromegali umum ditandai dengan pembesaran tangan, kaki dan tulang wajah.
Akromegali menyebabkan perubahan bertahap pada bentuk wajah, seperti rahang bawah dan alis yang menonjol, hidung membesar, bibir menebal dan gigi jarang. Akromegali cenderung berkembang perlahan. Pemeriksaan foto cranium, tangan dan kaki menunjukkan kelainan pada tulang.
Dilaporkan kasus diatas untuk membantu klinisi menegakkan diagnosa Akromegali dengan menggunakan multi modalitas radiografi, sehingga dapat ditegakkan lebih awal untuk membantu tatalaksana pasien.
KATA KUNCI : Akromegali, Prognatism, Makroadenoma
ASIMILASI NARAPIDANA Vs KERESAHAN MASYARAKAT PASCA PELEPASAN NARAPIDANA SAAT COVID 19
Authors: Utami Wiwik 
Published: November 2020

Tulisan yang didasarkan penelitian ini bertujuan untuk mengetahui persepsi masyarakat terhadap kebijakan pemerintah dalam pelepasan narapidan dengan assmilasi saat covid 19. Peneltian ini hukum sosiologis (socio legal research) dengan menggunakan data sekunder,didukung data primer yang diperoleh dengan cara studi literasi dari berbagai sumber online, wawancara dengan beberapa informan, baik dari kepolisian Polresta Malang, kalangan kampus maupun masyarakat umumnya yang merasakan keadaan dengan assimilasi Narapidana saat Covid 19. Daerah penelitian pada wilayah kerja Polresta Malang, hal ini didasarkan bahwa Kota Malang sangat padat penduduknya, ada 3 rumah tahanan (Lapas Lowokwaru, Lapas Wanita Sukun dan rumah tahanan polresta), dan terdapat lebih dari 50 kampus, baik Perguruan Tinggi Negeri maupun Swasta, dimana kondisi ini rawan tindak kejahatan berupa pencurian (curanmor) maupun tindakan kekerasan lainnya, disamping cukup potensial untuk merebahnya virus corona (covid 19) melalui proses interaksi sosial di antara anggota masyarakat. Teknik atau metode analisis dan pengolahan bahan hukum yang digunakan adalah analisis kualitatif yang bersifat deskriptif. Hasil penelitian menunjukkan masyarakat merasakan keresahan dan ketakutan berlapis, baik dengan penyebaran covid 19 maupun terhadap Narapidana assimilasi yang idbebaskan. Kebijakan ini terkesan kurang terdukung oleh kajian akademis yang memadahi.

Kata kunci: Assimilasi Narapidana, keresahan masyarakat ,Covid 19
Dichromothrips corbetti (Priesner, 1936) (Thysanoptera: Thripidae): uma nova praga quarentenária em orquídeas no Brasil
Authors: Cavalleri Adriano , Alves Rogério M. de O. , Fabrício B. Lima Élison 
Published: November 2020

Dichromothrips corbetti (Priesner, 1936) (Thysanoptera: Thripidae): a new quarantine pest in orchids in Brazil
Dichromothrips corbetti (Priesner, 1936), listed as quarantine pest by the Brazilian Ministry of Agriculture, is recorded for the first time in Brazil. Specimens were first detected in the state of Bahia causing chlorosis and deformation on leaves, flowers and flower buds of Vanda and Mokara and Aranda orchids. This thrips species is native to Southeast Asia, but widely reported in countries of Europe and Oceania. This is the first record of D. corbetti in South America.
LEARNING BY DOING MEDIA BELAJAR JAM DINDING DALAM PEMBELAJARAN MATEMATIKA DI KELAS 2 MIN 3 BANYUMAS
Authors: Faujatun Nahdiyah  
Published: November 2020

The research was carried out the lock of student’s abilities in understanding time unit. Time unit is abstract, so it’is needed real object as a model to make the student understand easily.in other hand, the student should be given real activity that can be recreved easily. In order to make them understand the concept of time unit.The success of a teaching and learning process is one of the reasons due to the use of media or participation in the teaching and learning process. Because in the teaching and learning process media has an important meaning.This research used a qualitative method, and used wall clock that made by paper carton. With a wall clock made of cardboard, it is easy for students to use the clock by rotating the direction of the needle on the cardboard between the long needle and the short needle must match.