bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgery for advanced oropharyngeal cancer
Authors: Karpenko A. V. , Sibgatullin R. R. , Boyko A. A. , Chumanikhina N. S. , Lomteva E. Yu. , Lavrova M. V. , Kostova M. G. , Nikolayeva O. M. 
Published: November 2018

The study objectiveis to assess the results of this approach and identifications of factors that may influence the effectiveness of such an approach.Materials and methods. Since 2009 through 2016 72 patients with stage III and IV aged between 42 and 77 years underwent upfront surgery.Anatomical sites included 34 (46 %) tonsil, 24 (33 %) base of tongue and 14 (21 %) soft palate cases. Transcervical sparing the mandible,mandibulectomy and transoral approaches were used in 42 (58 %), 11 (15 %) and 7 (10 %) patient, respectively. Total glossectomy was performed in 4 (5.5 %) cases. Tumor extension necessitated extended laryngectomy in 8 patients (11.5 %). Primary closure of the pharyngeal wound was possible in 30 patients (42 %). Reconstruction with distant flaps was performed in the remaining 42 patients. Both free (anterolateral thigh – 19, radial forearm flap – 10) and flaps with axial blood supply (pectoralis major – 9, supraclavicular flap – 4) were used. There were 6 T1, 12 T2, 28 T3 and 20 T4 tumors; 62 patients were N-positive: N1 – 10 cases, N2 – 51, N3 – 1. Positive surgical margins were diagnosed in 13 cases (18 %) including 3 cases of R2 resection. Adjuvant radiation therapy with or without chemotherapy was completed in 45 patients (63.4 %). Survival was calculated according to Kaplan–Mayer method.Results.There was 1 death in early postoperative period. Mean follow-up for the remaining patients (n = 71) was 27 months (1–94). Median survival was 27 months (95 % CI 11.5–42.5); 3-year overall survival was 44 %; 33 out of 34 still alive patients are capable to take food orally. Only 1 (2.9 %) patient is gastrostomy tube dependent. Univariate analysis revealed that positive margins (p <0.0001) and completeness of combined treatment (p <0.01) are the main factors that have statistically significan impact on prognosis.Conclusion.Combined approach with upfront surgery is one of the main treatment modalities for advanced oropharyngeal cancer. Modern reconstructive options and strict adherence to a proper surgical technique give a high chance for a valuable rehabilitation for the vast majority of patients. Scrupulous planning of the resection of the primary tumor based on modern imaging techniques and encouraging patients to complete all prescribed treatments are the main physician-related factors that influence survival outcome.
PREDICTORS OF RE-EXPLORATION FOR BLEEDING AFTER CORONARY ARTERY BYPASS GRAFT AND VALVE SURGERY
Authors: Mohammad Amanj 
Published: November 2018

Background
A significant number of patients undergoing cardiac surgery require re-exploration for postoperative bleeding.
Objectives
The aim of this study is to find out the predictors of re-exploration for such bleeding.
Patients and Methods
Over a 5-year period (January 2010-December 2014) 1,565 patients underwent open-heart surgery in Slemani Cardiac Hospital, Sulaimaniyah, Iraq. Fifty seven patients (3.6%) were identified as having a significant bleeding after coronary artery bypass graft (CABG) and/or valve operations requiring urgent exploration within few hours. The medical records of these patients were retrospectively reviewed.
Results
There were 36 males and 21 females. The mean age was 61.8±7.5 years. The majority of patients had CABG (n=41, 71.9%) while the remainder 16 patients (28.1%) had valve operations. The mean time interval between the primary cardiac operation and re-exploration was 3.17 ± 1.5 hours. Twenty nine patients (50.9%) had a drop in hemoglobin level. Thirteen patients (22.8%) had a fall in arterial blood pressure (ABP) ± raised central venous pressure (CVP). CVP was elevated in 9 patients (15.8%). The mediastinum was widened on chest radiograph in 4 occasions (10.5%). More than half of the patients (n=32, 56.1%) had arterial hemorrhage. The earliest re-exploration was required for arterial bleeding while bleeding of unknown origin was the latest to be re-explored. Decreased ABP and massive blood drainage were associated with early re-exploration, while radiological evidence of widened mediastinum and decreased Hb level were linked to late re-exploration.
Conclusion
A drop in ABP and massive blood drainage seem to be good predictors for exploration.
EVALUATION OF THYROID FUNCTION TESTS IN POSTMENOPAUSAL OSTEOPOROTIC PATIENTS IN SULAIMANI GENERAL TEACHING HOSPITAL
Authors: Mahwi Taha , Sahib Barham 
Published: November 2018

Background
Osteoporosis is a common disorder in the elderly and postmenopausal women due to loss of estrogen that increases the risk of fracture and disability. Hyperthyroidism can cause osteoporosis either due to the effect of thyroid hormones or suppressive effect of Thyroid-stimulating hormone on the bone.
Objectives
The aim of this study was to examine the association between serum thyroid-stimulating hormone levels and osteoporosis in Postmenopausal women in Sulaimani General Teaching hospital.
Patients and Methods
The study was done prospectively, we enrolled one hundred and sixty-two postmenopausal women who underwent Dual-energy X-ray absorptiometry scan in Sulaimani bone Densitometry department for routine health surveillance, thyroid function test was done for them after applying exclusion criteria.
Results
The mean thyroid stimulating hormone level (1.9 ± 1.7) vs (2.7 ± 2.30), body mass index and incidence of diabetes mellitus of the osteoporotic group is lower in comparison to those with normal bone mineral density.
Conclusion
In this study results suggest that low normal serum thyroid stimulating hormone level might be a potential risk factor for the osteoporosis in non-obese elderly women, however further prospective, large-scale, randomized controlled studies are warranted to fully establish these results.
ALLRED SCORE DIRECTLY ASSOCIATED TO BODY MASS INDEX IN KURDISH PREMENOPAUSAL WOMEN WITH BREAST CANCER
Authors: Ameen Hazha 
Published: November 2018

Background
Obesity has been documented as an important prognostic factor and increased mortality with each successive increase in body mass index (BMI). It is unclear whether these associations differ among breast cancer subtypes.
Objectives
To know the association of the Allred score which has both predictive and prognostic value, with the body mass index in Kurdish Premenopausal women with breast cancer.
Patients and Methods
This study carried out at Hiwa hematology/oncology hospital of Sulaimani between June 2007 to December of 2015. Age, menopausal status, hormone receptor, Her-2 neu status height, weight, and body mass index were studied. Allred score by immunohistochemistry of all breast cancer patients was retrospectively analyzed.
Results
We conducted a population-based case-case study consisting of 519 women diagnosed with invasive breast cancer. Mean age of the studied group was 47.3±9.2 years. Mean menopausal age was 51±3 years; almost two-thirds of whom were premenopausal. Mean BMI of breast cancer patients was 30.1±5.6 kg/m2; 47% were obese. There was a strong association between high BMI and breast cancer in the age period of 40 to 49 years (p=0.03). The obese patient had a high tumor grade, ki67 and stage III disease. Strong expression of both Estrogen and progesterone receptors were observed in obese premenopausal patients.
Conclusion
Obese women usually presented with an increased risk of breast cancer in premenopausal women, advanced stage, and the majority of them had positive hormonal receptor status (ER/PR) Estrogen Receptor /Progesterone Receptor. Fortunately, obese linked to high Allred score with good response to hormonal therapy and better survival.
SUBCLINICAL LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN HYPERTENSIVE PATIENTS IN SLEMANI CITY USING 2D ECHOCARDIOGRAPHY
Authors: Hamakarem Omed , Hassan Kamaran , Saeed Dana 
Published: November 2018

Background
Diastolic dysfunction refers to when the diastole part is abnormal. The ventricles do not properly relax and become stiff meaning they cannot fill with blood properly. This causes blood to “dam up” in other parts of the body. The pressure in the ventricles then increases as blood from the next heartbeat tries to enter. Diastolic dysfunction is a common problem, with many people aged older than 70 years having the condition
Objectives
To detect subclinical left ventricular diastolic dysfunction in hypertensive patients with preserved ejection fraction using 2D echocardiography.
Methods
This is a cross-sectional study that was carried on 80 hypertensive patients referred to slemani cardiac hospital and medical emergency outpatient clinic for evaluation and treatment of hypertension and 80 age and sex-matched healthy volunteers as a control group. All subjects underwent conventional echocardiographic examination and assessment of diastolic dysfunction by 2D echocardiography according to updated Europian guidelines for diastolic dysfunction
Results
A total of one hundred sixty (160) individuals were included in the final analysis. Mean age was 55.03±7.67SD years. Males accounted for 51.9% (n=83) of the studied sample and 48.1% (n=77) were females. Fifty percent (n=80) were hypertensive (cases) and the other 50% (n=80) were non-hypertensive (controls).hypertensive patients have significantly higher rates of diastolic dysfunction (22 cases vs 12) and LVH (19 vs 5) than non-hypertensives, they also have higher mean lateral annulus velocity (8.83±2.41vs10.21±2.62 ) and TR velocity(2.28±0.37vs2.11±0.11) but smaller mean LA volume.
Conclusion
Impairment of diastolic function detected by 2D echocardiography was significantly higher in hypertensive patients (with and without LVH) compared to nonhypertensive patients. Early detection of diastolic dysfunction in hypertensive patients is necessary to prevent diastolic heart failure which is the major type of heart failure in hypertensive patients.
Effects of the First Phase of Cardiac Rehabilitation Training on Self-Efficacy among Patients Undergoing Coronary Artery Bypass Graft Surgery
Authors: Borzou Seyed Reza , Amiri Sasan , Salavati Mohsen , Soltanian Ali Reza , Safarpoor Gholamreza 
Published: November 2018

Background: Heart surgery is vital for patients with coronary artery diseases that do not respond to drug treatments. We aimed to determine the effects of the implementation of the first phase of a cardiac rehabilitation program on self-efficacy in patients after coronary artery bypass graft surgery (CABG).
Methods: This clinical trial study was conducted on 60 post-CABG patients by convenience sampling method in 2016. Those selected were randomly assigned to intervention (n=30) and control group (n=30). Overall, 72 hours after CABG, the first phase of the cardiac rehabilitation program both in theory and in practice (face-to-face and group methods) was conducted. Data were collected using a self-efficacy questionnaire completed by the patients in 3 stages: before the intervention, at discharge, and at 1 month after discharge. Data was analyzed by using analysis of covariance and repeated measures.
Results: The mean of age in the intervention and control groups was 61.60±11.72 and 57.97±13. 4 years, respectively. There were 16 (53.3%) male patients in each group. The mean score of self-efficacy was not significantly different between the 2 groups before the intervention (P=0.076), whereas it had a meaningful statistical difference between the 2 groups at discharge and 1 month afterward (P<0.001).
Conclusion: The implementation of the first phase of the cardiac rehabilitation program not only augmented self-efficacy in regard to independent daily activities but also lessened the need for the second phase of the program among our post-CABG patients.
A Genetic Algorithm Based Feature Selection for Handwritten Digit Recognition
Authors: Ahlawat Savita , Rishi Rahul 
Published: November 2018

Background:
The data proliferation has been resulted in large-scale, high dimensional data
and brings new challenges for feature selection in handwriting recognition problems. The practical
challenges like the large variability and ambiguities present in the individual’s handwriting style
demand an optimal feature selection algorithm that would be capable to enhance the recognition accuracy
of handwriting recognition system with reduced training efforts and computational cost.

Objective:
This paper gives emphasis on the feature selection process and proposed a genetic algorithm
based feature selection technique for handwritten digit recognition.

Methods:
A hybrid feature set of statistical and geometrical features is developed in order to get the
effective feature set consist of local and global characteristics of sample digits. The method utilizes a
genetic algorithm based feature selection for selecting best distinguishable features and k-nearest
neighbour for evaluating the fitness of features of handwritten digit dataset.

Results:
The experiments are carried out on standard The Chars74K handwritten digit dataset and
reported a 66% reduction in the original feature set without sacrificing the recognition accuracy.

Conclusion:
The experiment results show the effectiveness of the proposed approach.
Role of Nanomedicine in Treatment of Brain Cancer
Authors: Verma Shivani , Utreja Puneet , Kumar Lalit 
Published: November 2018

Background:
Drug delivery to cancerous brain is a challenging task as it is
surrounded by an efficient protective barrier. The main hurdles for delivery of bioactive
molecules to cancerous brain are blood brain barrier (BBB), the invasive nature of gliomas,
drug resistance, and difficult brain interstitium transportation. Therefore, treatment
of brain cancer with the available drug regimen is difficult and has shown little improvement
in recent years.

Methods:
We searched about recent advancements in the use of nanomedicine for effective
treatment of the brain cancer. We focused on the use of liposomes, nanoparticles,
polymeric micelles, and dendrimers to improve brain cancer therapy.

Results:
Nanomedicines are well suited for the treatment of brain cancer owing to their
highly acceptable biological, chemical, and physical properties. Smaller size of nanomedicines
also enhances their anticancer potential and penetration into blood brain barrier
(BBB).

Conclusion:
Recently, nanomedicine based approaches have been developed and investigated
for effective treatment of brain cancer. Some of these have been translated into
clinical practice, in order to attain therapeutic needs of gliomas. Future advancements in
nanomedicines will likely produce significant changes in methods and practice of brain
cancer therapy.
ANALISIS KARAKTERISTIK ENDAPAN BERDASARKAN LITOFASIES DAN PROSES GEOMORFIK PADA ALUR SUNGAI GENDOL PASCA ERUPSI MERAPI TAHUN 2010
Authors: Wacano Dhandun , Puspitasari Reineta 
Published: November 2018

AbstrakMerapi adalah gunungapi paling aktif yang ada di Indonesia. Merapi meletus dahsyat dengan skala 4 VEI pada tahun 2010 yang lalu. Letusan tersebut mengeluarkan lava dan material piroklastik dengan total kurang lebih 140 juta meter kubik. Material endapan tersebut tersebar pada seluruh wilayah disekitar gunungapi. Endapan hasil letusan Merapi memiliki karakteristik masing-masing sesuai dengan lokasi pengendapan. Informasi karakteristik setiap endapan sangat penting untuk berbagai aplikasi terkait pengelolaan dan pemanfaatan endapan hasil letusan. Lokasi penelitian berada pada Alur Sungai Gendol. Alur Sungai ini menjadi salah satu jalur aliran lava dan material piroklastik terbanyak dan terjauh. Material hasil letusan Merapi akan mengalami proses pengendapan menjadi lapisan batuan volkaniklastik dengan ciri dan karakteristik yang berbeda-beda. Perbedaan karakteristik endapan tersebut di sebabkan faktor proses geomorfik-dinamik yang ada di alur sungai. Tujuan dari penelitian ini adalah untuk (a) mengidentifikasi litofasies dan proses geomorfik pada Alur Sungai Gendol dan (b) menganalisis karakteristik endapan hasil letusan Merapi tahun 2010 pada Alur Sungai Gendol. Metode yang digunakan dalam penelitian ini adalah metode survei lapangan dan analisis laboratorium. Hasil penelitian menunjukkan bahwa Alur Sungai Gendol terbagi dalam 3 fasies, yaitu fasies sentral-proksimal dengan karakterisik endapan berupa piroklastik luncuran dan piroklastik surge, fasies medial dengan dominasi endapan lahar, fasies, dan fasies distal awal dengan dominasi endapan aliran berkonsentrasi tinggi. Kata kunci: Karakteristik endapan, litofasies, proses geomorfik, alur Sungai Gendol
UPAYA KONSERVASI LAHAN POTENSIAL KRITIS DI SUB DAERAH ALIRAN SUNGAI JENES KABUPATEN KULONPROGO
Authors: Kuswantoko Hermawan , Purwantara Suhadi 
Published: November 2018

AbstrakPenelitian ini bertujuan mengetahui: (1) Kemampuan lahan di Sub DAS Jenes; (2) Upaya konservasi untuk mencegah timbulnya lahan kritis berdasarkan kelas kemampuan lahan. Populasi dalam penelitian ini adalah seluruh satuan lahan di Sub DAS Jenes dengan pengambilan sampel menggunakan teknik purposive sampling. Pengumpulan data melalui observasi, dokumentasi dan uji laboratorium. Analisis data menggunakan analisis SIG dengan cara overlay dan analisis pencocokan (matching) menggunakan software LCLP. Hasil penelitian: (1) Terdapat 3 kelas kemampuan lahan, dengan sub kelas kemampuan lahan III–e, III–s, III–e,s, IV–s, dan V–s; (2) Konservasi pada Kelas III–e, III–s dan III–e,s untuk pertanian ekstensif dengan tingkat konservasi sedang berupa penanaman menurut strip, pergiliran tanaman dan pembuatan teras tangga dengan tanaman berseling, Kelas IV–s untuk pertanian marginal dengan tingkat konservasi berat berupa agroforestry, teras bangku, teras tangga dan sistem drainase, Kelas V–s tidak dapat diolah dan membutuhkan konservasi berat berupa terasering dan penanaman vegetasi penahan tanah. Kata kunci: konservasi, kemampuan lahan, Sub DAS Jenes
PENGARUH VEGETASI TERHADAP DINAMIKA PERKEMBANGAN GUMUK PASIR DI PESISIR PARANGKUSUMO
Authors: Nuraini Fahad , Sunarto Sunarto , Santosa Langgeng Wahyu 
Published: November 2018

AbstrakPenelitian ini dilakukan di kawasan gumuk pasir aktif pada lorong angin alami Pesisir Parangkusumo dengan tujuan mengetahui pengaruh tutupan lahan vegetasi pada bentuklahan gumuk pasir di Pesisir Parangkusumo, sedangkan perkembangan normal gumuk pasir terjadi tanpa tutupan. Penelitian ini merupakan penelitian eksploratif-survey dengan maksud mengungkapkan pengaruh vegetasi terhadap perkembangan bentuklahan, dengan fokus peran vegetasi sebagai ecological engineering. Penelitian dilakukan dengan mengidentifikasi pengaruh vegetasi dalam perkembangan gumuk pasir dilihat dari faktor pembentuk yaitu proses deflasi dan juga identifikasi morfologi. Hasil penelitian menunjukkan pada area gumuk pasir terdapat beberapa tipe vegetasi penutup yaitu vegetasi insitu dan eksitu. Vegetasi insitu merupakan vegetasi alami gumuk pasir yaitu pandan, rumput teki, dan siwalan; sedangkan vegetasi eksitu berupa penghutanan dengan vegetasi cemara dan akasia. Kedua tipe vegetasi tersebut berdampak terhadap dinamika perkembangan gumuk pasir yang terjadi secara perlahan dalam kurun waktu tertentu seiring dengan pertumbuhan vegetasi. Efek dari vegetasi menghasilkan gangguan gelembur permukaan sampai dengan perkembangan lubang deflasi sebagai indikator kerusakan gumuk pasir. Kata kunci: Gumuk Pasir, Vegetasi, Parangkusumo
Evaluasi Program Pengentasan Kemiskinan di Kota Yogyakarta
Authors: Gunardo Gunardo 
Published: November 2018

AbstrakKajian evaluasi program pengentasan kemiskinan menunjukkan bahwa program-program pengentasan kemiskinan yang telah dilaksanakan meliputi : program Padat Karya dan Program Pengentasan Kemiskinan Perkotaan (P2KP) dari Dinas Permukiman dan Prasarana Wilayah, Kartu Sehat dari Dinas Kesehatan, Beras Miskin dari Pemerintah Kota,Pelatihan Ketrampilan dan Bantuan Modal Usaha dari Dinas Kesejahteraan Sosial , Kuliah Kerja Nyata dari berbagai perguruan tinggi, dan Beasiswa untuk anak-anak miskin dari Dinas PendidikanProgram-program pengentasan kemiskinan itu tidak semuanya berhasil, yang dianggap berhasil oleh warga miskin yaitu program padat karya, P2KP ,Kartu Sehat dan Beras Miskin.Adapun program-program pelatihan dianggap gagal. Keluarga miskin di sesungguhnya mempunyai motivasi yang cukup kuat untuk melepaskan diri dari predikat kemiskinannya. .Aspirasi yang mereka sampaikan adalah agar melibatkan keluarga miskin dalam program-program pengentasan kemiskinan, terbentuknya paguyuban yang dapat menampung berbagai berbagai aspirasi,usul, saran dan kritikan. Diharapkan ada tindak lanjut pelatihan diikuti penampungan tenaga kerja atau pemasaran hasil produknya.Perlu penanganan kaum ulama sehingga motivasi warga miskin tidak mudah patah menghadapi tantangan yang berat ini dan memperbaiki moral dan mental warga miskin.
Partisipasi dan Orientasi Pemilih Pemula Memilih Calon Anggota Legislatif
Authors: Endah Januarti Nur 
Published: November 2018

Penelitian bertujuan mengetahui partisipasi pemilih pemula dan orientasi pemilih memilih sosok calon anggota legislatif setelah diselenggarakannya Pemilu Legislatif 2014. Penelitian dilakukan di Yogyakarta dengan metode kualitatif melalui observasi, wawancara dan dokumentasi. Informan adalah pemilih pemula. Data dianalisis dengan reduksi data, penyajian, dan penarikan kesimpulan. Hasil penelitian menunjukkan bahwa partisipasi pemilih pemula dipengaruhi oleh sosialisasi berdasarkan kebiasaan, aktivitas sosial, lingkungan sosial, relasi sosial dan media sosial. Metode sosialisasi yang digunakan melalui kampanye langsung dan media sosial. Dasar pertimbangan pemilih pemula dalam menentukan pilihan berdasarkan sosok caleg disebabkan oleh ideologi, prestasi, track record atau latar belakang caleg, metode sosialisasi. Alasan pemilih lebih memilih sosok calon anggota legislatif daripada partai politik menempatkan rasionalitas pemilih pemula yang lebih melihat pada track record calon pemimpin dan melemahnya kepercayaan terhadap partai politik, dan tidak disepakatinya sistem money politic.Kata kunci : pemilu legislatif, pemilih pemula, calon anggota legislatif AbstractThe study aims to determine the participation of voters and orientations of voters chose the figure of legislative candidates after the holding of legislative elections in 2014. The study was conducted in Yogyakarta with qualitative methods through observation, interviews and documentation. Informants are voters. Data were analyzed using data reduction, presentation, and drawing conclusions. The results showed that the participation of voters are influenced by socialization based on customs, social activities, social environment, social relations and social media. Socialization methods used by the direct campaign and social media. The basic consideration for voters in determining the choice of candidates is based on the figure due to ideology, achievements, track record or background of the candidates, the method of socialization. The reason voters preferring figure legislative candidates rather than political parties put the rationality of voters who rather look at the track record of aspiring leaders and weakening confidence in the political parties, and no agreement on the system of money politics.Keywords: participation, voters, legislative candidates