bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pheochromocytoma crisis with cyclic fluctuation in blood pressure mimics acute coronary syndrome
Authors: Kometani Mitsuhiro , Yoneda Takashi , Maeda Yuji , Oe Masashi , Takeda Yoshimichi , Higashitani Takuya , Aono Daisuke , Yoshino Asuka , Karashima Shigehiro , Takeda Yoshiyu 
Published: September 2020

Summary
Pheochromocytoma crisis results from the sudden release of large quantities of catecholamines and leads to progressive multiple organ dysfunction. Here we report a case of pheochromocytoma crisis with symptoms associated with acute coronary syndrome (ACS) and severe fluctuations in blood pressure (BP). A 43-year-old Japanese man with hypertension (240/120 mmHg) visited a general hospital for chest pain. Echocardiogram showed ST segment depression and blood test demonstrated elevated troponin T. However, emergent coronary angiography revealed normal findings. CT showed a large adrenal mass on the left side, which was suspected as the cause of chest pain and BP elevation. After the patient was transported to our hospital, his BP was found to oscillate between 70 and 240 mmHg, and level of consciousness was decreased. After hospitalization, he had a further decrease in consciousness, a rise in body temperature, and a gradual increase in the interval between the upper and lower systolic BP. His systolic BP varied between 30 mmHg and 300 mmHg at the intervals of 20-30 min. After a multimodality therapy, including α-blocker and high dose fluid replacement, the fluctuation in his BP was gradually decreased and got stabilized after approximately 24 h. Approximately 3 weeks later, he underwent left adrenalectomy. This case showed that pheochromocytoma with internal necrosis might be misdiagnosed as ACS. Furthermore, in cases with a large adrenal tumor and severe elevation or fluctuations of BP, pheochromocytoma should be suspected and treated with α-blockers and fluid replacements as soon as possible prior to surgery.

Learning points:

High catecholamine levels due to pheochromocytoma crisis might cause symptoms associated with acute coronary syndrome.

Adrenal tumor with internal necrosis and the elevation or fluctuations of blood pressure should be suspected to be pheochromocytoma.

If pheochromocytoma crisis is suspected, the specialist, such as an endocrinologist or a urologist, should intervene, and an α-blocker treatment with adequate fluid replacement therapy should be initiated as soon as possible.

Pheochromocytoma multisystem crisis (PMC) is a fatal condition characterized by multiple organ failure, severe blood pressure variability, high fever, and encephalopathy. This is an extremely rare subtype of a very rare disease such as pheochromocytoma. However, because the fatality rate of PMC is high, clinicians should be aware of the symptoms that mark its onset.
Aldosterone- and cortisol-cosecreting adrenal adenoma, ovarian hyperthecosis and breast cancer
Authors: J Orrego John , A Chorny Joseph 
Published: September 2020

Summary
We describe a 56-year-old postmenopausal woman with hypertension, hypokalemia and severe alopecia who was found to have a 4.5-cm lipid-poor left adrenal mass on CT scan performed to evaluate her chronic right-sided abdominal pain. Hormonal studies revealed unequivocal evidence of primary aldosteronism and subclinical hypercortisolemia of adrenal origin. Although a laparoscopic left adrenalectomy rendered her normotensive, normokalemic and adrenal insufficient for 2.5 years, her alopecia did not improve and she later presented with facial hyperpigmentation acne, worsening hirsutism, clitoromegaly, and an estrogen receptor-positive breast cancer. Further testing demonstrated markedly elevated serum androstenedione and total and free testosterone and persistently undetectable DHEAS levels. As biochemical and radiologic studies ruled out primary adrenal malignancy and obvious ovarian neoplasms, a bilateral salpingo-oophorectomy was undertaken, which revealed bilateral ovarian hyperthecosis. This case highlights how the clinical manifestations associated with hyperaldosteronism and hypercortisolemia masqueraded the hyperandrogenic findings. It was only when her severe alopecia failed to improve after the resolution of hypercortisolism, hyperandrogenic manifestations worsened despite adrenal insufficiency and an estrogen receptor-positive breast cancer was found, did it becomes apparent that her symptoms were due to ovarian hyperthecosis.

Learning points:

As cortisol cosecretion appears to be highly prevalent in patients with primary aldosteronism, the term ‘Connshing’ syndrome has been suggested.

The associated subclinical hypercortisolemia could be the driver for the increased metabolic alterations seen in patients with Conn syndrome.

The identification of these dual secretors before adrenal venous sampling could alert the clinician about possible equivocal test results.

The identification of these dual secretors before unilateral adrenalectomy could avoid unexpected postoperative adrenal crises.

Hyperfunctioning adrenal and ovarian lesions can coexist, and the clinical manifestations associated with hypercortisolemia can masquerade the hyperandrogenic findings.
Strategi Kelompok Bimbingan Ibadah haji (KBIH) Maqdis Dalam Meningkatkan Pelayanan Prima Terhadap Calon Jamaah Haji Tahun 2017
Authors: Oktaviaini Nuning Oktaviaini , Rahman Arif , Herman Herman 
Published: September 2020

Tujuan dari penelitian ini untuk mengetahui strategi KBIH dalam meningkatkan pelayanan prima berupa kebutuhan pelanggan atau jamaah secara praktis maupun kebutuhan para pelanggan atau jamaah secara emosional dan proses dari pemberian pelayanan yang ada di KBIH Maqdis dalam hal meningkatkan pelayanan prima terhadap calon jamaah. Metode yang digunakan pada penelitian ini adalah metode deskriptif dengan menggunakan pendekatan kualitatif. Adapun langkah-langkah penelitian ditempuh dengan: penentuan lokasi penelitian, pengumpulan data dengan menggunakan tehnik observasi, wawancara, studi kepustakaan, dan dokumentasi selanjutnya analisis data dengan cara reduksi data kemudian klasifikasi data dan penarikan kesimpulan. Dari hasil penelitian dapat disimpulkan bahwa strategi KBIH Maqdis dalam Meningkatkan pelayanan prima cukup baik karena hal ini dapat dilihat dari kebutuhan secara praktis yang diberikan KBIH Maqdis kepada calon jamaah haji. Pihak KBIH Maqdis memberikan pelayanan yang baik dari segi pelayanannya pembimbing, pengurus maupun ketuanya. Karena dengan upaya memberikan pelayanan yang baik diharapkan jamaah haji merasa puas sehingga dapat memberitahu kepada orang lain tentang kualitas pelayanan yang diberikan pihak KBIH Maqdis terhadap jamaah. Proses pelaksanaan pemberian pelayanan pun dapat terlihat baik yakni dilihat dari pemberian pelayanan prima yang ada di KBIH Maqdis Kota Bandung.
The purpose of this study is to determine the KBIH strategy in improving prime service in the form of customer needs or practical pilgrims as well as the needs of customers or pilgrims emotionally and the process of providing services in KBIH Maqdis in terms of improving excellent service for prospective pilgrims. The method used in this study is descriptive method using a qualitative approach. The research steps are taken by: determining the location of research, collecting data using observation techniques, interviews, literature studies, and documentation then analyzing data by means of data reduction then data classification and drawing conclusions. From the results of the study it can be concluded that the KBIH Maqdis strategy in improving excellent service is quite good because this can be seen from the practical needs given by KBIH Maqdis to prospective pilgrims. The KBIH Maqdis party provides good service in terms of its service, supervisor, management and chairman. Because the effort to provide good service is expected that pilgrims feel satisfied so that they can tell others about the quality of services provided by KBIH Maqdis to worshipers. The process of implementing service delivery can also look good, that is seen from the provision of excellent service in KBIH Maqdis, Bandung.
The Effects of an Educational Drama Program on the Social Interaction of Students with Intellectual Disabilities
Authors: Kim Jinho ,   The Korean Society of Special Education, Jeong Hoyeon 
Published: September 2020

Educational drama usually means the educational activities and methods that use drama for the purpose of education. This study investigated the effects of an educational drama program on the social interactions of elementary students with intellectual disabilities in special education classes. The participants in this study were 16 elementary school students in special education classes in three elementary schools located in Chungbuck Province. The study consisted of intervention settings and general settings and used a multiple-baseline experimental design across the three groups of participants. The experimental phases were set up as baseline,
intervention, and maintenance; in each stage generalization observations were also conducted.
The intervention through the educational drama program included a total of 14 sessions. Data
was measured through recorded videos of the social interactions and presented in a graph that was used to analyze the changes in social interaction. The results were as follows: First, throughout the study, social initiation occurred and positive effects were seen during treatment sessions as well as maintenance sessions. Second, after conducting the educational drama program, social reaction was observed to occur among the subjects and positive effects were also seen during treatment and maintenance sessions. Third, there was a positive effect of the educational drama program to improve social interactions of the participants. Based on the results, this study suggests that educational drama programs may be meaningful and effective educational activities to increase social interaction skills of elementary students with intellectual disabilities in special education sites.
OCT-Angiography in Early Choroidal Melanoma and Choroidal Nevi
Authors: Saakyan S. V. , Myakoshina E. B. , Khlgatyan M. R. , Sklyarova N. V. 
Published: September 2020

Purpose: To study the features of small choroidal melanoma and choroidal nevi angioarchitectonics using the optical coherence tomography angiography (OCTA).Patients and methods. We examined 128 patients with small choroidal neoplasms: 41 — with small choroidal melanoma (group 1), 42 — with suspicious nevi (group 2) and 45 — with benign nevi (group 3). All patients underwent general ophthalmic examinations and special instrumental diagnostic methods (ultrasound examination (US), fluorescence angiography (FA), spectral optical coherence tomography (SOCT), OCTA).Results. OCTA in all patients with small choroidal melanoma showed neovascular network under retinal pigment epithelium. We found a looped, cranked-twisted, heterogeneous vascular network with uneven clearance and with numerous bends and weaves, located under the vessels of retina. The limiting avascular zone corresponding to the tumor slope was determined in 19 (46.3 %) of 41 cases. There was a rim of dilated hyperreflective choriocapillaries on the periphery of the tumor. We identified hyperreflective homogeneous enlarged choriocapillaries in the focus area with a brighter glow than the surrounding choriocapillaries in 39 (92.9 %) of 42 patients with suspicious choroidal nevus. We detected an avascular zone with surrounding extended hyperreflective choriocapillaries in the center of the nevus in 3 (7.1 %) of 42 cases. We diagnosed homogeneous isoreflective choriocapillaries similar in brightness to the surrounding vessels in all 45 patients with benign nevi.Conclusions. Thus, the complex of clinical and instrumental methods, including OCTA, makes it possible to establish the diagnosis of malignant tumor of the choroid in early stages. At the same time, OCTA: 1) allows to visualize of the tumor vessels in the choroidal layer in 100 % of cases of in small choroidal melanoma; 2) makes it possible to distinguish the newly formed tumor vessels from the choriocapillaries in case of small choroidal melanoma; 3) provides an opportunity to establish the correct diagnosis and provide timely assistance to patients with benign and malignant choroidal tumors.
Clinicopathological profile of sinonasal masses-a tertiary care centre study in rural India
Authors: Rokade Vidya , Shinde Kiran J. , More Girishkumar R. 
Published: September 2020

<p><strong>Background:</strong> A variety of mass lesions occur within the paranasal sinus (PNS) and nasal cavity and thus it becomes mandatory for otorhinolaryngologist to elicit detailed history and thorough examination before reaching a final diagnosis. This is retrospective study of all sinonasal masses who were undergone surgical management in the institute of rural India and so in the environment.</p><p><strong>Methods:</strong> This is a retrospective observational study of 70 patients with sinonasal masses treated at a rural tertiary care hospital in rural western Maharashtra from period of Jan 2016 to May 2018. History, clinical assessment and histopathological examination (HPE) was done in all cases as per hospital record supplemented by radiological investigation as per requirement. The patients were grouped as per their histopathological diagnosis as non-neoplastic/inflammatory and neoplastic.</p><p><strong>Results:</strong> A total of 70 patients were analysed age ranging (11-70 years). Majority of the patients were in the age groups 21-40 years (47%). There were 43 (61%) male and 27 (39%) female with M:F ratio 1.6:1. On HPE, 50 (71%) cases were non neoplastic/inflammatory and 20 (29%) cases were neoplastic lesions. HPE revealed that 50 (71%) cases were non neoplastic and 20 (29%) cases were neoplastic lesions.</p><p><strong>Conclusions:</strong> Sinonasal masses have various differential diagnoses. They are fairly common with male predominance. Benign conditions show a peak during 2<sup>nd</sup> to 4<sup>th</sup> decade of life while malignancy increasing with the age after 4th decade. In non-neoplastic lesion, Allergic nasal polyp is the commonest histological pattern seen while in malignant lesions squamous cell carcinoma is noted with 100% male predominance.</p><p> </p>
Actividad antifúngica de extractos metanólicos y alcaloides de Jatropha platyphylla contra Aspergillus parasiticus
Authors: Leyva AcuÑa Mario Alejandro , Quintana Obregón Eber Addí , Soto Landeros Federico , Baez Parra Karla Marina , Montes Avila Julio , Angulo Escalante Miguel Angel 
Published: September 2020

Los metabolitos secundarios presentes en plantas han demostrado ejercer diversas propiedades biológicas, principalmente el grupo de alcaloides, los cuales han sido investigados por su actividad fungicida, capaz de reemplazar a los productos sintéticos. Las especies del género Jatropha han sido estudiadas por su amplia variedad de metabolitos secundarios con potencial antimicrobiano, logrando ser relevantes en la búsqueda de nuevas alternativas al control de hongos de importancia clínica y alimentaria como Aspergillus parasiticus, considerado como una de las principales especies de hongos productores de aflatoxinas.
En el presente trabajo se identificó por primera vez por cromatografía en capa fina de alta resolución (HPTLC) la presencia de alcaloides en Jatropha platyphylla y se evaluó la actividad inhibitoria de los extractos metanólicos y fracción enriquecida de alcaloides, a concentraciones de 0.01, 0.1, 0.5, 1 y 2 mg/mL, sobre el crecimiento radial de A. parasiticus. Además se determinó su germinación a partir de la CI50 de los tratamientos. Se observó una mayor actividad de los alcaloides a 2 mg/mL, con el 80 % de inhibición a las 48 h (P< 0,05), con una CI50 de 2.7 mg/mL. Estos resultados evidencian a los alcaloides de J. platyphylla como posibles tratamientos alternativos al control de A. parasiticus.
Authors: Pertiwi Dini Rizki , Dwiati Murni , Susanto Agus Hery 
Published: September 2020

Nepenthes gymnamphora merupakan spesies kantung semar endemik di Pulau Jawa dan salah satu koleksi tumbuhan di Kebun Raya Baturraden. N. gymnamphora merupakan tumbuhan dioecious dan jenis kelaminnya tidak dapat dibedakan pada masa vegetatif. Apabila jenis kelamin tanaman tersebut dapat diketahui secara dini, maka upaya konservasi dapat dilakukan dengan lebih efisien karena pengembangan jenis kelamin tertentu dapat dilakukan secara dini. Salah satu pendekatan yang dapat dilakukan dalam identifikasi jenis kelamin N. gymnamphora adalah penggunaan marka Random Amplified Polymorphic DNA (RAPD). Penelitian ini bertujuan untuk mengetahui ada tidaknya perbedaan pola RAPD antara N. gymnamphora jantan dan betina, serta mengetahui bagaimana perbedaan pola RAPD tesebut. Penelitian dilakukan secara eksploratif dengan melibatkan lima individu N. gymnamphora koleksi Kebun Raya Baturraden dari jenis kelamin yang berbeda sebagai sampel. DNA genomik diekstraksi dari daun ke dua pada kelima sampel tersebut (dua jantan, dua betina, dan satu sampel yang belum diketahui jenis kelaminnya). Selanjutnya, DNA genomik ini digunakan sebagai templat untuk amplifikasi marka RAPD. Sebanyak lima macam primer acak digunakan untuk amplifikasi marka tersebut, yaitu OPK-16, OPP-15, OPA-15, OPP-08, dan OPD-20. Hasil penelitian menunjukkan bahwa dua primer, yaitu OPP-08 (5’-ACATCGCCCA-3’) dan OPD-20 (5’-ACTTCGCCAC-3’), menghasilkan pita RAPD berukuran kurang lebih 300 pb, yang spesifik terdapat pada individu jantan dan individu yang belum diketahui jenis kelaminnya. Pada individu betina tidak dihasilkan pita tersebut sehingga dapat diduga bahwa pita RAPD tersebut berkaitan dengan gen-gen penentu jenis kelamin pada N. gymnamphora. Primer OPP-08 juga menghasilkan pita RAPD berukuran kurang lebih 250 pb, yang spesifik terdapat pada individu betina. Pita tersebut tidak terlihat pada individu jantan, sehingga dapat diduga pita tersebut terkait dengan gen-gen penentu jenis kelamin pada N. gymnamphora.
Keanekaragaman Tumbuhan Paku Terestrial di Cagar Alam Pemalang Jawa Tengah
Authors: Laely Sulistiani Nur , Widyastuti Ani , Widodo Pudji 
Published: September 2020

Tumbuhan paku adalah tumbuhan perintis yang dapat ditemukan di setiap tipe kawasan hutan dan memegang peranan penting dalam menyusun ekosistem hutan. Kawasan hutan dapat mengalami perubahan fungsi yang antara lain diakibatkan oleh perbedaan kondisi di tepi hutan dengan di dalam hutan. Dampak dari bertemunya dua kondisi lingkungan yang berbeda tersebut terhadap tumbuhan dan hewan dapat disebut efek tepi (edge effect). Penelitian dilakukan di Cagar Alam Bantarbolang Pemalang, Jawa Tengah. Tujuan dari penelitian ini untuk mengetahui keanekaragaman dan faktor lingkungan tumbuhan paku terestrial di Cagar Alam Bantarbolang. Data yang diperoleh dianalisis menggunakan Indeks Nilai Penting (INP), Indeks Keanekaragamaan (H’) Shannon-Wiener, Indeks Kemerataan Spesies (e), dan Indeks Kesamaan Komunitas (IS).
Hasil penelitian di Cagar Alam Bantarbolang diperoleh tumbuhan paku terestrial sebanyak 10 spesies yang terdiri dari 400 individu termasuk dalam 6 familia. Spesies yang paling banyak ditemukan yaitu Stenochlaena palustris dengan 205 individu. Cagar Alam Bantarbolang dipengaruhi oleh efek tepi, karena semakin ke dalam hutan jumlah spesies tumbuhan paku terestrial semakin sedikit. Faktor lingkungan yang berpengaruh terhadap jumlah spesies tumbuhan paku terestrial yaitu suhu, intensitas cahaya dan pH tanah.
Utilization of Biogas Liquid Waste For Starter In The Fermentation of Rice Husk As A Potential Feed For Poultry
Authors: Sjofjan Osfar , Nur Adli Danung , Djunaidi Irfan , Kuncoro Kuncoro 
Published: September 2020

The research was aimed to evaluate the effect of biogas liquid waste as a fermentation starter of rice husk to the nutrient content, gross energy and bulk density. The method used laboratory experiment using a completely randomized design (CRD) on factorial pattern (6 x 5) with the level of biogas waste liquid : P0-treatment (0% negative control), P0+ (Cellulomonas sp as positive control), P1 (5%), P2 (10%), P3 (15%), P4 (20%) ml/g, and the incubation time : T0 (0 day control ), T1(7 days), T2 (14 days), T3 (21 days) and T4 (28 days). The variables measured was the content of ash, crude protein, crude fiber, crude fat, gross energy and bulk density. Data were analyzed by analysis of variance (anova) CRD Factorial pattern and if there is a significant difference was followed by Duncan's Multiple Range Test. The results of research was the level of biogas liquid waste and the incubation time provides a significant influence (P<0.01) on the nutrient content, gross energy and bulk density of rice husk. The interaction level liquid waste provision of biogas and incubation time was highly significant (P<0.01) on the nutrient content, gross energy and bulk density. It can be concluded that the addition of biogas liquid waste 15% (ml/g) with a time of incubation for 21 days have best rice husk quality content based on improvement of crude protein, crude fat, and gross energy with lowest crude fiber.
Improving the Quality of Reproduction and Quail Production (Coturnix coturnix japonica) with Liquid Probiotics
Authors: Susanti Emmy , Tugiyanti Elly 
Published: September 2020

This study aims to determine the effect of the use of various liquid probiotics in drinking water on the quality of the reproductive tract and quail production. The study uses a Completely Randomized Design with directional pattern with four treatments, namely: quail gets drinking water without liquid probiotics (P0), quail gets drinking water with commercial probiotics A (P1), quail gets drinking water with commercial probiotics B (P2), and quail gets drinking drinking water with commercial probiotics C (P3), 5 replications and 5 quails in each study unit. Drinking water is given ad libitum with a liquid probiotic concentration of 2ml / liter. Quail feed contains 22.2% PK and 3032.5 kcal energy. The treatment affected the weight of the reproductive tract + eggs, egg weight and length of the reproductive tract, weight before slaughtered, weight after slaughtered, weight after hair removal, heart weight, gastrointestinal weight, (P <0.01) but had no effect on carcass weight, liver weight, follicular weight, gizard weight, digestive tract length and caeca length. The treatment of liquid probiotics in drinking water increases several indicators of quail reproduction and production.
KAJIAN PEMODELAN DERET WAKTU: METODE VARIASI KALENDER YANG DIPENGARUHI OLEH EFEK VARIASI LIBURAN
Authors: Triyani Winda , Reorita Rina 
Published: September 2020

Calendar variation method is a technique that combines ARIMA modeling and regression modeling. Calendar variation is a cyclical pattern with varying periods due to the different calendar date position for each year. There are two types of calendar variation, trading day variation and holiday variation. In this research, modeling of time series with holiday variation was studied and modification of the modeling was developed for the case of holiday effect due to Eid’s day occur. The case study was conducted to the data of train passenger number at DAOP V Purwokerto. It was found that the last model for the underlying data was the regression model with the residual following seasonal ARIMA (1,1,1)(0,0,1)12 without constant parameter.