bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel Prognostic Nomogram for Recurrence-Free Survival of Patients With Primary Gastrointestinal Stromal Tumors After Surgical Resection: Combination of Prognostic Nutritional Index and Basic Variables
Authors: Li Shuliang , Chen Daming , Li Shilong , Zhao Zongxian , Yang Huaxiang , Wang DaoHan , Zhang Zhaoxiong , Fu Weihua 
Published: January 2021

BackgroundGastrointestinal stromal tumor (GIST) is the most common type of mesenchymal tumors in the digestive tract, often recrudescing even after R0 resection. Adjuvant tyrosine kinase inhibitor therapy prolonged recurrence-free survival (RFS). This study aimed to develop a novel nomogram for predicting the RFS of patients following surgical resection of GISTs.MethodsClinicopathologic data of patients with GISTs at Tianjin Medical University General Hospital (Tianjin, China) from January 2000 to October 2019 were retrospectively reviewed. Univariate and multivariate Cox regression analyses were used to select the suitable variables from the training cohort to construct a nomogram for 2- and 5-year RFS. The 1,000 bootstrap samples and calibration curves were used to validate the discrimination of the nomogram. The receiver operating characteristic analysis(ROC) was used to compare the predictive ability of the nomogram and present four commonly used risk stratification systems: National Institutes of Health (NIH)–Fletcher staging system; NIH–Miettinen criteria; Modified NIH criteria; and Air Forces Institute of Pathology risk criteria (AFIP).ResultsUnivariate and multivariate analyses showed that the tumor site, tumor size, mitotic index, tumor rupture, and prognostic nutritional index were significant factors associated with RFS. These variables were selected to create the nomogram for 2- and 5-year RFS (all P&lt;0.05). The 2- and 5-year the ROC of the nomogram were 0.821 (95% confidence interval [CI]: 0.740–0.903) and 0.798 (95% CI: 0.739–0.903); NIH–Fletcher criteria were 0.757 (95% CI: 0.667–0.846) and 0.683 (95% CI: 0.613–0.753); NIH–Miettinen criteria were 0.762 (95% CI: 0.678–0.845) and 0.718 (95% CI: 0.653–0.783); Modified NIH criteria were 0.750 (95% CI: 0.661–0.838) and 0.689 (95% CI: 0.619–0.760); and AFIP were 0.777 (95% CI: 0.685–0.869) and 0.708 (95% CI: 0.636–0.780). Hence, the predictive probabilities of our nomogram are better than those of other GIST risk stratification systems.ConclusionThis nomogram, combining tumor site, tumor size, mitotic index, tumor rupture, and prognostic nutritional index, may assist physicians in providing individualized treatment and surveillance protocols for patients with GISTs following surgical resection.
Association of Axillary Lymph Node Evaluation With Survival in Women Aged 70 Years or Older With Breast Cancer
Authors: Luo Shi-Ping , Zhang Jie , Wu Qi-Sen , Lin Yu-Xiang , Song Chuan-Gui 
Published: January 2021

BackgroundSurvival in elderly patients undergoing sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND) has not been specifically analyzed. This study aimed to explore the association between different types of axillary lymph node (ALN) evaluations and survival of elderly breast cancer patients.MethodsA retrospective cohort study was conducted of invasive ductal breast cancer patients 70 years and older in the Surveillance, Epidemiology, and End Results database (2004–2016). Analyses were performed to compare the characteristics and survival outcomes of patients who received surgical lymph node dissection and those who did not. Breast cancer specific survival (BCSS) and overall survival were compared by using Cox proportional hazards regression analysis and propensity score matching (PSM) methods to account for selection bias from covariate imbalance.ResultsOf the 75,950 patients analyzed, patients without ALN evaluation had a significantly worse prognosis, while there was no significant difference for BCSS between using a sentinel lymph node biopsy (SLNB) and an axillary lymph node dissection (ALND) after adjustment for known covariates [adjusted hazard ratio (HR) = 0.991, 95% confidence interval (CI) = 0.925–1.062, p = 0.800]. In the stratification analyses after PSM, the ALND did not show a significant BCSS advantage compared with SLNB in any subgroups except for the pN1 stage or above. Furthermore, after PSM of the pN1 stage patients, SLNB was associated with a significantly worse BCSS in hormone receptor negative (HR−) patients (HR = 1.536, 95%CI = 1.213–1.946, p &lt; 0.001), but not in the hormone receptor positive (HR+) group (HR = 1.150, 95%CI = 0.986–1.340, p = 0.075).ConclusionIn our study, ALND does not yield superior survival compared with SLNB for elderly patients with pN1 stage HR+ breast cancer. Although our findings are limited by the bias associated with retrospective study design, we believe that in the absence of results from randomized clinical trials, our findings should be considered when recommending the omission of ALND for elderly breast cancer patients.
Voltage/Calcium Uncoupling Underlies Sustained Torsade de Pointes Ventricular Tachyarrhythmia in an Experimental Model of Long QT Syndrome
Authors: Himel Herman D. , Cupelli Michael , Boutjdir Mohamed , El-Sherif Nabil 
Published: January 2021

BackgroundClinical experience showed that the majority of Torsade de Pointes (TdP) ventricular tachyarrhythmia (VT) in patients with long QT syndrome (LQTS) are self-terminating (ST), but the few that are non-self-terminating (NST) are potentially fatal. A paramount issue in clinical arrhythmology is to understand the electrophysiological mechanism of ST vs. NST TdP VT.MethodsWe investigated the electrophysiological mechanism of ST vs. NST TdP VT in the guinea pig Anthopleurin-A experimental model of LQTS, a close surrogate model of congenital LQT3. We utilized simultaneous optical recordings of membrane voltage (Vm) and intracellular calcium (Cai) and a robust analytical method based on spatiotemporal entropy difference (Ed) to investigate the hypothesis that early Vm/Caiuncoupling during TdP VT can play a primary role in perpetuation of VT episodes.ResultsWe analyzed a total of 35 episodes of TdP VT from 14 guinea pig surrogate models of LQTS, including 23 ST and 12 NST VTs. Edvalues for NST VT were significantly higher than Edvalues for ST VT. Analysis of wave front topology during the early phase of ST VT showed the Caiwave front following closely Vmwave front consistent with a lower degree of Ed. In contrast, NST VT was associated with uncoupling of Vm/Caiwave fronts during the first 2 or 3 cycles of VT associated with early wave break propagation pattern.ConclusionsUtilizing a robust analytical method we showed that, in comparison to ST TdP VT, NST VT was consistently predated by early uncoupling of Vm/Caithat destabilized wave front propagation and can explain a sustained complex reentrant excitation pattern.
The Influence of Career Development, Competence, Work Motivation, Job Satisfaction, Against the Performance of Health Service Employees in Bintan Regency
Authors: Husni Faisal , Kurniadi Didi , Kawangung Verlina Y , Rahmawati Putri 
Published: January 2021

This study uses a causal model survey method using path analysis techniques. This study aims to confirm the theoretical model with empirical data, the study population is employees in Investment and Integrated Service Office Bintan Regency, with sample of 39 employees. Data collecting technical using variable measurements by a questionnaire instrument, this instrument was developed based on theoretical studies. Data analysis uses descriptive statistics and statistical analysis. Statistical tests are used to test the significance of path coefficients using Partial Least Square (PLS) which is a Multivariate Analysis in the second generation using structural equation modeling (SEM). PLS can be used for a small number of samples and does not require the assumption that data distribution must be normal or not. The results of the analysis found that the relationships between variables formulated in the formulation of the problem as many as 6 pieces obtained significant results.
Respon Pertumbuhan Bibit Kopi Robusta Terhadap Pemberian Pupuk Organik Cair Limbah Industri Tahu
Authors: Jatsiyah Venti , Rosmalinda Rosmalinda , Sopiana Sopiana , Nurhayati Nurhayati 
Published: January 2021

Penelitian berjudul Respon Pertumbuhan Bibit Kopi Robusta (Coffea robusta L) Terhadap Pemberian Pupuk Organik Cair Limbah Industri dilaksanakan di Kebun Percobaan, Politeknik Negeri Ketapang, Kabupaten Ketapang, Kalimantan Barat pada Juli sampai September 2020. Penelitian ini bertujuan untuk mengetahui manfaat pemberian konsentrasi yang berbeda dari POC limbah industri tahu terhadap pertumbuhan bibit kopi robusta. Menggunakan jenis penelitian Rancangan Acak Lengkap (RAL) yang terdiri dari 5 perlakuan dan 4 ulangan, yaitu : K0 = 0%, K1 = 25%, K2 = 50%, K3 = 75%, dan K4 = 100%. Data yang diperoleh dianalisis menggunakan ANOVA, jika berpengaruh nyata maka dilanjutkan dengan uji DMRT pada taraf α = 0,05. Hasil penelitian menunjukkan bahwa pemberian POC limbah industri tahu berpengaruh nyata pada parameter tinggi bibit, jumlah daun, panjang akar, berat basah dan berat kering, namun tidak berbeda nyata pada pertambahan diameter batang. Konsentrasi terbaik untuk pertumbuhan bibit kopi robusta adalah 75%.
Sifat Fisik Buah Kakao (Theobroma cacao .L) Terhadap Pengaplikasian Teknik Sambung Samping
Authors: Kusmiah Nurhaya , Fitrianti Fitrianti , Yamin Muh. Arman 
Published: January 2021

Kakao merupakan komoditas pertanian yang berperan dalam peningkatan pendapatan Negara, namun permasalahan yang saat ini dihadapi yaitu rendahnya kualitas fisik dari buah kakao, hal ini dipicu dari banyaknya tanaman kakao yang saat ini tidak lagi produktif, sehingga diperlukan pengaplikasian teknik sambung samping dalam hal meregenerasikan kembali tanaman kakao Indonesia Khususnya Polewali Mandar. Penelitian ini bertujuan untuk mengatahui sejauh mana pengaplikasian teknik sambung samping pada tanaman kakao dapat meningkatkan kualitas tanaman kakao, dilihat dari ukuran panjang, berat dan diameter buah kakao. Metode yang digunakan dalam penelitian ini yaitu Rancangan Acak Kelompok, dengan 3 perlakuan penggunaan entris yang berbeda, diantaranya, entris S1 (Sulawesi 1), entris S2 (Sulawesi 2), dan entris MCC (45), serta Lokal (Tanpa Pengaplikasian Teknik Sambung Samping) sebagai sampel kontrol dengan parameter yang diuji yaitu Berat buah, panjang buah dan diameter buah Kakao. Analisis data dilakukan dengan menggunakan SPSS ver. 21 menggunakan analisis Anova. Hasil Penelitian menunjukkan bahwa berat buah kakao dengan teknik sambung samping menggunakan entries MCC paling tinggi dengan nilai rata-rata 745 gr, sedangkan berat paling rendah yaitu S1 dengan nilai 488 gr. Untuk pengujian panjang buah, hasil menunjukkan bahwa entries MCC paling tinggi dengan nilai 21,2 cm, dan terendah yaitu entries S1 dengan nilai 20 cm, sedangkan parameter diameter buah diperoleh hasil tertinggi pada MCC dengan nilai 9,2 cm dan terendah yaitu S1 dengan nilai 8 cm. Dari perbandingan parameter uji dengan perlakuan dan sampel kontrol, dapat ditarik kesimpulan bahwa Pengaplikasian Teknik Sambung Samping pada Tanaman Kakao dengan menggunan entris yang berbeda, berpengaruh nyata terhadap Berat, Panjang dan Diameter Buah Kakao.
Penerapan Model Pembelajaran Kooperatif Tipe Jigsaw Disertai Penerapan Tugas Baca untuk Meningkatkan Hasil Belajar Siswa
Authors: Syarifuddin Syarifuddin 
Published: January 2021

ABSTRAK
Tujuan penelitian adalah untuk menemukan upaya peningkatan aktifitas dan prestasi belajar peserta didik melalui model pembelajaran kooperatif tipe Jigsaw yang disertai dengan penerapan tugas baca. Penelitian ini dilaksanakan dalam 2 siklus, setiap siklus terdiri atas tahap perencanaan, tindakan, observasi dan refleksi. Subyek penelitian adalah siswa kelas XII.IPA.1 SMA Negeri 5 Sidrap Tahun Pelajaran 2017/2018, dengan jumlah siswa 29 orang, terdiri dari 12 orang laki-laki dan 17 orang perempuan. Analisis data dilakukan dengan analisis deskriptif. Hasil penelitian menunjukkan, rata-rata hasil belajar siswa pada siklus I 74,38 dengan ketuntasan klasikal 75,38%, pada siklus II rata-rata hasil belajar siswa 77,62 dengan ketuntasan klasikal 89,66%. Dan setelah diadakan ulangan harian untuk materi siklus I dan II diperoleh rata-rata hasil belajar 78,14 dengan ketuntasan klasikal 93,10%. Kondisi ini menunjukkan adanya peningkatan hasil belajar siswa serta peningkatan ketercapaian ketuntasan belajar secara klasikal.
Kata kunci: Hasil belajar, kooperatif tipe Jigsaw, tugas baca

ABSTRACT
The research objective was to find efforts to increase the activity and learning achievement of students through the Jigsaw cooperative learning model which was accompanied by the application of reading assignments. This research was conducted in 2 cycles, each cycle consisting of planning, action, observation and reflection stages. The research subjects were students of class XII.IPA.1 SMA Negeri 5 Sidrap in the academic year 2017/2018, with 29 students, consisting of 12 boys and 17 girls. Data analysis was carried out by descriptive analysis. The results showed, the average student learning outcomes in the first cycle 74.38 with 75.38% classical completeness, in the second cycle the average student learning outcomes 77.62 with 89.66% classical completeness. And after the formative tests were held for the material of the first and second cycles, the average learning outcome was 78.14 with 93.10% classical completeness. This condition indicates an increase in student learning outcomes and an increase in the achievement of classical learning completeness.
Keywords: Learning outcomes, Jigsaw cooperative, reading assignment
Neumotórax espontáneo bilateral metastásico. Inusual manifestación de metástasis pulmonar.
Authors: Lavanderos Fernandez Jorge , Jans Báez Jaime , Devaud Jaureguiberry Marcelo , Konrad Fuschlocher Hellmar 
Published: January 2021

Objetivo: Comunicar el caso de una paciente de 77 años tratada de un angiosarcoma de cuero cabelludo, que evoluciona con neumotórax bilateral, cuyo estudio histopatológico informa enfermedad metastásica. Material y método: Revisión de ficha clínica electrónica, registro informático de imagenología e informes de biopsias. Seguimiento ambulatorio en policlínico de cirugía. Resultados: Se realiza manejo por videotoracoscopía bilateral, con bulectomía más pleurodesis. Discusión: El neumotórax secundario por enfermedad metastásica es poco frecuente, aproximadamente 1 a 2% de los casos. De los tumores que más frecuentemente metastizan al pulmón se encuentran los sarcomas. Conclusión: El neumotórax metastásico es poco frecuente y requiere un alto índice de sospecha. Su manejo va a depender del pronóstico y de las condiciones generales del paciente.
EFECTOS DE LA PANDEMIA EN LOS PROGRAMAS DE FORMACIÓN EN CIRUGÍA. PROBLEMAS Y SOLUCIONES
Authors: Uribe Mario , Martinez Salinas Guillermo Andres , Sepúlveda Rolando , Lanzarini Enrique , García Carlos , Cárcamo Carlos , Abba Julio 
Published: January 2021

La pandemia por el Virus SARS 2 ha tenido un efecto deletéreo en las actividades médicas. Los programas de Educación quirúrgica se han visto afectados. El Capítulo Chileno del ACS realizó un un webinar para evaluar y discutir los efectos de la pandemia en la educación quirúrgica, en Chile. En este evento participaron destacados docentes del área quirúrgica. La conclusión más importante fue que el COVID – 19 ha afectado fuertemente los programas de educación quirúrgica. Un 25% de los residentes se contagiaron, pero la mayoría no precisó cuidados especiales. Las intervenciones quirúrgicas disminuyeron hasta un 90% en algunos programas. Los residentes debieron asumir el cuidado de pacientes COVID -19. La situación actual ha derivado en cambios en la educación quirúrgica, implementando sistemas de educación virtual. La evaluación del conocimiento se ha basado en valorar el cumplimiento de tareas asignadas, la mayoría teóricas, vía web. Las sociedades científicas han tenido un importante rol en estas actividades. Las actividades en línea y la simulación adquirirán mayor relevancia en los años venideros. Es posible superar esta crisis como lo han hecho los países desarrollados. Comparados con ellos, carecemos de un plan nacional de emergencia en salud, en el que los estudiantes de medicina, los residentes, médicos y profesionales de salud tengan un rol claramente definido en áreas específicas y con metas claramente definidas. El retorno a la “Nueva Normalidad” estará lleno de desafíos.
Síndrome de resección anterior baja en pacientes con cáncer de recto medio e inferior ¿Qué más podemos hacer?
Authors: Abarca Campos Carmen Paz , Fernández Albornoz Macarena Paz 
Published: January 2021

Durante las últimas décadas los avances en técnicas quirúrgicas, radioterapia y quimioterapia han logrado de forma significativa aumentar la sobrevida y disminuir la recidiva local en el cáncer de recto evitando una colostomía definitiva; sin embargo, este trascendental progreso médico no ha ido acompañado de una mejoría en los resultados funcionales de los pacientes sometidos a una cirugía conservadora de esfínter, siendo el conjunto de síntomas defecatorios posterior a la resección rectal, conocido como síndrome de resección anterior baja (LARS), una secuela prácticamente inevitable, que generalmente se asocia a disfunción sexual, urinaria, dolor crónico, altos costos en rehabilitación y control sintomático, además de una alteración importante en la calidad de vida. En este artículo presentamos una revisión completa y actualizada de las características clínicas y alternativas de tratamiento del LARS, finalizando con una propuesta de manejo integral multidisciplinario que destaca la importancia de la pre-habilitación, evaluación objetiva de los síntomas, educación e información adecuada del paciente y su familia, además del trabajo en equipo en unidades especializadas de rehabilitación de piso pélvico, requisito fundamental a la hora de manejar adecuadamente esta patología.
IMPLEMENTASI METODE PEMBELAJARAN PENDIDIKAN KARAKTER ANAK USIA DINI DI PAUD PONDOK PESANTREN AL BAROKAH AJUNG JEMBER
Authors: Mahrus Mahrus 
Published: January 2021

The problems will be examined in this study are: (1) How understanding the basic concept of the character of early childhood education in boarding school PAUD Al-Barokah, Ajung ? (2) How is implementation of learning methods of early childhood character education in PAUD Al Barokah Boarding School? (3) How to faced constraints in the process of implementation of character education in PAUD Al Barokah boarding school, Ajung.? This Research to know (1) Understanding the basic concept of the character of early childhood education in boarding school PAUD Al-Barokah, Ajung (2) Implementation of learning methods of early childhood character education in PAUD Al Barokah Boarding School (3) Faced constraints in the process of implementation of character education in PAUD Al Barokah boarding school, Ajung. This research was exploratory, qualitative method using the method of data collection by using the observation method, interview and documentation. And analyzed using the descriptive method, preparation of requirement and the validity of the data. Based in the presentation and analysis of data in general it can be concluded that (1) understanding of the basic concepts of early childhood character education in PAUD Al Barokah boarding school are quite diverse, (2) Implementation of learning methods of early childhood character education by using several methods, such as using Conditioning methods, Example, story, field trip and demonstration, (3) As for the barriers are is the language, the number of teachers, APE and textbooks.
Permasalahan yang akan dikaji dalam penelitian ini adalah : (1)Bagaimana pemahaman konsep dasar pendidikan karakter anak usia dini di PAUD Pondok Pesantren Al Barokah Kecamatan Ajung, (2) Bagaimana inplementasi metode pembelajaran pendidikan karakter anak usia dini di PAUD Pondok Pesantren Al Barokah Kecamatan Ajung, (3) Bagaimana kendala-kendala yang dihadapi dalam menginplementasi metode pembelajaran pendidikan karakter di PAUD Pondok Pesantren Al Barokah Kecamatan Ajung. Adapun penelitian ini menggunakan metode kualitatif eksploratif, metode pengumpulan data dengan menggunakan metode abservasi, interview, dan dokumentasi. Dan dianalisis dengan menggunakan metode diskriptif, penyususnan katagori dan validitas data. Berdasarkan penyajian dan analisis data secara umum dapat disimpulkan bahwa (1) Pemahaman Konsep Dasar Pendidikan Karakter Anak Usia Dini di PAUD Pondok Pesantren Al Barokah Kecamatan Ajung cukup beragam,(2) Implementasi Metode Pembelajaran Pendidikan Karakter Anak Usia Dini dengan menggunakan beberapa metode, diantaranya adalah dengan menggunakan Metode Pembiasaan, Keteladanan, Kisah, Karyawisata dan demontrasi, (3) Adapun kendalanya adalah bahasa, jumlah tenaga pengajar, APE dan buku pelajaran.
MODEL PENDIDIKAN KARAKTER DALAM KELUARGA
Authors: Kartini Ade , Maulana Asep 
Published: January 2021

Cultivating character in children is highly recommended to be formed from an early age. Because early childhood is a critical period that will determine children's attitudes and behavior in the future. Parents need to instill moral values as the basis of religious norms and social norms adhered to by the family. Parents' upbringing for their children determines and influences the child's personality and behavior. Children will be good or not all depending on the parenting style of the parents in the family. Thus, a comprehensive character education model in the family is very necessary and important to understand and actualize. This library research is conducted through documentation study and qualitative data analysis. The findings of the research state that character education that has high values must be designed in an educational model. Goal setting is the first thing to do. These goals will guide where this program is directed. To fulfill this, a character education development model in the family is made through several relevant approaches, methods and strategies.and women so that they can change according to different times. gender that has been outlined by nature.
Penanaman karakter pada anak sangat dianjurkan untuk dibentuk sejak dini. Karena usia dini merupakan masa kritis yang akan menentukan sikap dan perilaku anak di masa yang akan datang. Orang tua perlu menanamkan nilai-nilai moral sebagai dasar dari norma agama dan norma sosial yang dianut oleh keluarga. Pola asuh orang tua terhadap anak-anaknya sangat menentukan dan memengaruhi kepribadian serta perilaku anak. Anak akan menjadi baik atau tidak semua tergantung dari pola asuh orang tua dalam keluarga. Dengan demikian model pendidikan karakter dalam keluarga yang komprehensif sangat diperlukan dan penting untuk dipahami dan dapat diaktualisasikan. Penelitian kepustakaan ini dilakukan melalui studi dokumentasi dan analisis data kualitatif. Temuan hasil penelitian menyatakan bahwa pendidikan karakter yang mempunyai nilai yang luhur haruslah dirancang dalam sebuah model pendidikan. Penetapan tujuan adalah hal pertama yang harus dilakukan. Tujuan ini akan menuntun program ke arah yang diinginkan. Untuk memenuhi hal tersebut dibuatlah sebuah model pengembangan pendidikan karakter dalam keluarga melalui beberapa pendekatan, metode, dan strategi yang relevan.