bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regorafenib in Patients with Antiangiogenic-Naïve and Chemotherapy-Refractory Advanced Colorectal Cancer: Results from a Phase IIb Trial
Authors: Riechelmann Rachel P. , Leite Luiz S. , Bariani Giovanni M. , Glasberg Joao , Rivelli Thomas G. , da Fonseca Leonardo Gomes , Nebuloni Daniela R. , Braghiroli Maria I. , Queiroz Marcelo A. , Isejima Alice M. , Kappeler Christian , Kikuchi Luciana , Hoff Paulo M. 
Published: June 2019

Abstract

Background
Regorafenib is a multikinase inhibitor with antiangiogenic effects that improves overall survival (OS) in metastatic colorectal cancer (mCRC) after failure of standard therapies. We investigated the efficacy and safety of regorafenib in antiangiogenic therapy-naïve chemotherapy-refractory advanced colorectal cancer.

Patients and Methods
This single-center, single-arm, phase IIb study (NCT02465502) enrolled adults with mCRC whose disease had progressed on, or who were intolerant to, standard therapy, but who were antiangiogenic therapy-naïve. Patients received regorafenib 160 mg once daily for 3 weeks per 4-week cycle. The primary endpoint was progression-free survival (PFS) rate at week 8.

Results
Of 59 treated patients, almost half had received at least four prior lines of therapy. Patients received a median of 86% of the planned dose. The week 8 PFS rate was 53% (95% confidence interval [CI], 39.1–64.3); median PFS was 3.5 months (95% CI, 1.8–3.6). Median OS was 7.4 months (95% CI, 5.3–8.9). Tumor response (RECIST version 1.1) was 2%, and metabolic response rate (criteria from the European Organisation for Research and Treatment of Cancer) was 41%. The most frequently reported regorafenib-related grade ≥3 adverse events were hypertension (36%), hand–foot skin reaction (HFSR, 25%), and hypophosphatemia (24%). There were no regorafenib-related deaths. An exploratory analysis showed that patients with grade ≥2 HFSR had longer OS (10.2 months) with regorafenib treatment versus those with grades 0–1 (5.4 months).

Conclusion
These findings support the antitumor activity of regorafenib in antiangiogenic-naïve patients with chemotherapy-refractory mCRC.

Implications for Practice
The multikinase inhibitor regorafenib improved overall survival in the phase III CORRECT and CONCUR trials in heavily pretreated patients with treatment-refractory metastatic colorectal cancer (mCRC). Exploratory subgroup analysis from CONCUR suggested that regorafenib treatment prior to targeted therapy (including bevacizumab) may improve outcomes. In this single-center, single-arm phase IIb study, regorafenib demonstrated antitumor activity in 59 antiangiogenic-naïve patients with chemotherapy-refractory mCRC. Further studies should assess the efficacy of regorafenib in this patient population, as well as explore the reasons behind improved outcomes among patients who had a metabolic response and those who developed hand–foot skin reaction.
Licencias de marca: la estrategia ganadora
Authors: Magariño Peñalba Víctor 
Published: June 2019

Cuando una compañía no goza del privilegio de estar en posesión de una marca conocida se le presentan básicamente tres opciones:a. Generar notoriedad de marca.b. Comprar una marca conocida.c. Tomar prestada una marca conocida.El artículo analiza cada una de las opciones y señala que estamos asistiendo a un auge en el sector de la licencia.
A Survey of Field Experiences With Formate Drilling Fluid
Authors: Gao Chang Hong 
Published: June 2019

Summary
High temperatures and wellbore-integrity issues are often encountered when drilling onshore and offshore wells. Formate drilling fluid was initially developed in the 1990s to battle high temperature. Field applications of formate mud have increased since the 2000s. This paper presents worldwide implementations of formate drilling fluid, including field cases in Canada, the North Sea, Germany, the Middle East, and Russia. Experiences with formate mud in Chinese fields that were previously unknown because of the language barrier are also reported. Most field cases reported high rate of penetration (ROP), excellent wellbore stability, good thermal stability, and high production rates upon completion. Reclamation and reuse of formate have significantly improved the cost–effectiveness of formate mud. In the current drilling industry, formate fluid has become one of the best choices for battling high–temperature and wellbore–stability issues.
Entre moradas, ruas e estórias: Ensaio etnográfico sobre ruptura, memória do trabalho e itinerários urbanos em uma vila operária na cidade de Porto Alegre
Authors: Lopo Rafael Martins 
Published: June 2019

Este artigo relata o início de uma pesquisa realizada em um bairro operário na cidade de Porto Alegre. Tendo como universo principal uma Vila operária moldada nas bases das cidades-jardins inglesas, procuro refletir como a relação dos moradores com o bairro, suas memórias e sua particularidade é agenciada em suas narrativas. Em um primeiro momento, discuto as noções de bairro e de unidade através da história e projeto do bairro, para posteriormente me inserir neste espaço através de relatos retirados dos diários de campo e narrativas dos moradores, para compreender melhor como as práticas cotidianas destes sujeitos falam sobre as feições do local e sobre uma memória do trabalho na cidade de Porto Alegre. Palavras chave: Memória. Trabalho. Narrativa. Between addresses, streets and stories: a ethnographic essay about rupture, memory labor and urban itineraries in a workers' village in the city of Porto Alegre, RS, Brasil Abstract This article reports de beggining of a research made in a working-class neighborhood in the city of Porto Alegre. With the main universe a workers' village shaped in the bases of the english garden-cities, I try to reflect how the relationship of dwellers, their memories and their peculiarities are agencied in their narratives. In a first moment, I discuss the notions of neighborhood and unit trough the history and the project of the village to, ulterior, insert myself in this space by reports of filed diaries and narratives from the residents, to better understand how the daily practices from this subject talk about the features of the site and about a working memory in the city of Porto Alegre. Keywords: Memory. Work. Narrative.
ERA DISRUPSI DAN IMPLIKASINYA BAGI REPOSISI MAKNA DAN PRAKTEK PENDIDIKAN (KAJI PETIK DALAM PERSPEKTIF ELEKTIK SOSIAL ANALISIS)
Authors: Lasmawan I Wayan 
Published: June 2019

Tujuan dari tulisan ini adalah membedah secara grounded simpulisasi era disrupsi dan implikasinya terhadap makna dan praktek pendidikan dalam perspektif elective social analysis untuk “menciptakan’ dan “mendorong” lahirnya stigma baru tentang pendidikan yang dibutuhkan di era disrupsi. Kaji petik ini lebih merupakan autokritik dan kesadaran diri atas betapa penting dan strategisnya pendidikan dalam “memainkan peran” dan “mengatur lakon” kehidupan masyarakat dunia agar bersesuaian dengan tagihan jaman.

Berdasarkan kaji petik yang dilakukan, diperoleh simpulan bahwa: (1) disrupsi merupakan istilah yang dipopulerkan oleh Clayton Christensen sebagai kelanjutan dari tradisi berpikir “for you to win, you’ve got to make somebody lose”. Hal ini menstimuli lahirnya teori disruptive innovationyang menjelaskan fenomena dimana sebuah inovasi mengubah pasar atau sektor yang ada dengan memperkenalkan kesederhanaan, kenyamanan, aksesibilitas, dan keterjangkauan (simplicity, convenience, accessibility, and affordability) di mana komplikasi (keruwetan) dan biaya tinggi di posisi status quo, (2) era disrupsi terjadi karena perkembangan teknologi komunikasi, munculnya generasi millenials, kebutuhan pola pikir eksponensial, corporate mindset, model bisnis disruptif, dan era internet of things, (3) aspek-aspek dari disrupsi tersebut secara umum meliputi: aspek sosio-demografis atau mobilitas social, aspek struktur organisasi sosial atau lembaga-lembaga kemasyarakatan, sosio-politik, dan aspek psikokultural, (4) dampak disrupsi secara global terutama meliputi hal-hal yang bertalian dengan: menyerang hampir semua incumbent (pelaku lama, para pemimpin pasar), menciptakan pasar baru yang selama ini diabaikan incumbent, menimbulkan dampak deflasi (penurunan harga) karena biaya mencari (searching cost) dan biaya transaksi (transaction cost) praktis menjadi nol rupiah, dan (5) implikasi disrupsi terhadap makna dan praktek pendidikan lebih terarah pada dibutuhkannya perubahan mindset pendidik, inovasi ruang kelas, revolusi model pembelajaran, dan pengubahan secara massif dan terstruktur kebijakan pembangunan pendidikan agar mampu melahirkan pendidik yang lebih literate terhadap teknologi digital serta memiliki teaching metacognition skill, yakni mengajarkan peserta didik bagaimana cara belajar yang benar agar dapat menjadi pembelajar mandiri bagi diri dan lingkungannya
PENERAPAN MODEL CONTEXTUAL TEACHING AND LEARNING SEBAGAI UPAYA MENINGKATKAN AKTIVITAS DAN PRESTASI BELAJAR PKN SISWA KELAS VIII 5 SMP NEGERI 2 SINGARAJA
Authors: Wiriawan Made 
Published: June 2019

Tujuan utama penelitian ini adalah untuk memformulasi efektivitas model pembelajaran contextual teaching and learningdalam meningkatkan aktivitas belajar siswa dan prestasi belajar siswa kelas VIII 5 SMP Negeri 2 Singaraja. Secara metodologis penelitian ini menggunakan penelitian tindakan kelas (PTK) yang dilalui dengan tahapan perencanaan, pelaksanaan, observasi dan refleksi. Penelitian ini hanya menggunakan satu kelas. Adapun instrumen yang digunakan dalam penelitian ini adalah peneliti (human instrumen)dengan alat bantu pengumpul data berupa pedoman wawancara, pedoman observasi, tes prestasi belajar dan lembar observasi. Teknik analisis data yang digunakan dalam penelitian ini adalah deskriptif kualitatif.
Hasil penelitian menujukkan model pembelajaran contextual teaching and learningmampu meningkatkan prestasi belajar siswa. Pada siklus I, dari 41 orang siswa hanya 16 orang siswa mendapat nilai di bawah kriteria ketuntasan minimal (KKM) dengan nilai terendah 55, dan mengalami peningkatan pada siklus II, dimana hanya 5 orang siswa yang mendapat nilai di bawah KKM dengan nilai terendah 60. Nilai rata-rata siswa sebelum dilakukan tindakan adalah sebesar 70,85 dan mengalami kenaikan menjadi 74,42 pada kegiatan siklus I. Pada siklus II penerapan model pembelajaran contextual teaching and learningmampu meningkatkan prestasi belajar siswa menjadi 78,14. Model pembelajaran contextual teaching and learningjuga mampu meningkatkan aktivitas belajar siswa, dimana 25 ada pada kategori tuntas pada siklus I dan meningkat menjadi 38 orang pada siklus II. Hal ini disebabkan karena model pembelajaran mampu meingkatkan rasa ingin tahu siswa dan membangun semangat kerjasama siswa.
Tuberculosis Mamaria
Authors: Cruz Castillo Yessenia Magaly , Moreira Granda Edison Javier , Saavedra Verduga David Josué , Obando Navas Jose Luis 
Published: June 2019

Introducción: Sir Astley Cooper en 1829 reportó por primera vez un caso de tuberculosis (TB) mamaria, con el nombre de “Inflamación escrofulosa del seno”. Hoy la incidencia de TB mamaria es baja, representando menos del 0,1% de la patología mamaria y 3 % de lesiones benignas tratables.
Objetivo: Describir un caso clínico de Tuberculosis mamaria.
Material y métodos: Se realizó un estudio descriptivo, retrospectivo, presentación de caso clínico sobre Tuberculosis mamaria.
Resultados: Se describe el caso de una paciente femenina de 30 años, atendida en el Hospital Regional Ambato, con antecedentes de tuberculosis mamaria izquierda, que presenta masa mamaria derecha con secreción purulenta por la aerola ipsilateral. Se le realiza Ecografía de mamas que demostró proceso inflamatorio tipo mastitis granulomatosa. Se continuó su estudio realizando PBAF y en la tinción de Ziehl Neelsen de la muestra se observaron Bacilos de Koch, que confirmaron el diagnóstico de Tuberculosis mamaria.
Conclusiones: La Tuberculosis mamaria es una patología poco frecuente en nuestro medio. Las manifestaciones clínicas con las que se presenta el paciente no son específicas y puede ser fácilmente confundida con otras enfermedades. La tinción de Ziehl Neelsen y el PCR son las pruebas recomendadas para el diagnóstico, aunque no son específicas, pudiendo ocasionar falsos negativos. El médico debe tener alta sospecha de tuberculosis mamaria en pacientes con lesiones crónicas resistentes al tratamiento y que han sido descartadas para enfermedades neoplásicas
Capacidad pulmonar y patrones respiratorios en adultos mayores de la población de Apatug y Atahualpa Tungurahua - Ecuador
Authors: Pastor Victoria , Pilco Daniela , Ortiz Villalba Paola , Zavala Calahorrano Alicia Marifernanda 
Published: June 2019

Introducción: Los adultos mayores que residen en los Andes están expuestos a los efectos de la adaptación a gran altura y a los cambios fisiológicos provocados por el envejecimiento.
Objetivo: Evaluar la capacidad pulmonar y los patrones respiratorios en los adultos mayores que residen a gran altura.
Metodología: Estudio explicativo de corte experimental. Se seleccionaron dos comunidades de los Andes ecuatorianos de diferente altitud (Apatug y Atahualpa). Participaron 50 adultos mayores con edad promedio entre 75,44 ± 6,23 (Apatug) y 75± 8,25 (Atahualpa) Los criterios de inclusión fueron personas nativas mayores a 65 años. Los criterios de exclusión fueron la incapacidad de entender el procedimiento de las pruebas y contraindicaciones patológicas para realizar la prueba espirométrica. La espirometría se realizó de acuerdo con los criterios de la American Thoracic Society (ATS).
Resultados: Los resultados de la capacidad pulmonar de la población geriátrica de Apatug es de 3,7 litros ± 0,6 y de Atahualpa 5,4 litros ± 0,4. Los adultos mayores de Apatug obtuvieron patrones restrictivos (n=20) y obstructivos (n=3). En la parroquia de Atahualpa se encontró 12 participantes con patrón restrictivo. Existe disminución de la saturación en Apatug, (85,16 ± 4,4) y presión arterial (107/30 mmHg). Mientras que los niveles de saturación y presión arterial fueron normales en Atahualpa (91,6 ± 2,9 y 120/89 mmHg, respectivamente).
Conclusiones: La población geriátrica de Apatug presenta niveles bajos de capacidad pulmonar y saturación en la sangre. Sin embargo, la presión arterial es normal. En la población de Atahualpa existen niveles normales de capacidad pulmonar, saturación y presión arterial.
Faktor-Faktor yang Mempengaruhi Disiplin Kerja Karyawan Penunjang Medis dan Non Medis
Authors: Amin Muhammad , Sari Septi Puspita , Rachman Abdul 
Published: June 2019

This study aims to determine the factors related to the work discipline of medical and non-medical support employees of the Soeprapto Mental Hospital, Bengkulu Province in 2017. This type of research is a quantitative study with a cross sectional research design. The results of statistical tests show that the relationship between exemplary leadership and work discipline p-value 0.016, the relationship between remuneration for work discipline p-value 0,000, the relationship between penalties for work discipline with a p-value of 0.009 while job objectives p-value of 0.390 and ability employees with a p-value of 0.375. In conclusion, there is a significant relationship between exemplary leaders, remuneration and penalties for work discipline. There is no significant relationship between job goals and employee abilities with the work discipline of medical and non-medical support employees at Soeprapto Mental Hospital, Bengkulu Province.

Keywords: Remuneration, Work Discipline, Exemplary Leaders, Punishment Sanctions
Major complications from radiotherapy following treatment for atypical meningiomas
Authors: Dawley Troy , Rana Zaker , Abou-Al-Shaar Hussam , Goenka Anuj , Schulder Michael 
Published: June 2019

OBJECTIVEComplications from radiotherapy (RT), in a primary or adjuvant setting, have overall been described as uncommon, with few detailed descriptions of major complications. The authors present two cases involving significant complications and their management in their review of patients undergoing RT for treatment of atypical meningioma.METHODSThe authors conducted a retrospective review of all patients with pathologically confirmed atypical meningioma (WHO grade II) treated with primary or adjuvant RT from February 2011 through February 2019. They identified two patients with long-term, grade 3 toxicity. The cases of these patients are described in detail.RESULTSTwo patients had major complications associated with postoperative RT. Patients 1 and 2 both were treated with postoperative RT for pathologically confirmed atypical meningioma. Patient 1 experienced worsening behavioral changes, cognitive decline, and hydrocephalus following treatment. This required cerebrospinal fluid diversion. Patient 2 developed radiation necrosis with mass effect and cognitive decline. Neither patient returned to his/her initial post-RT status after steroid therapy, and each remained in need of supportive care. Both patients remained free of tumor progression at 52 and 38 months following treatment.CONCLUSIONSThe postoperative management of patients with atypical meningioma continues to be defined, with questions remaining regarding timing of RT, dose, target delineation, and fractionation. Both of the patients in this study received fractionated RT, which included a greater volume of normal brain than more focal treatment options such as would be required by stereotactic radiosurgery (SRS). Further research is needed to compare SRS and fractionated RT for the management of patients with grade II meningiomas. The more focused nature of SRS may make this a preferred option in certain cases of focal recurrence.
Trends in the utilization of radiotherapy for spinal meningiomas: insights from the 2004–2015 National Cancer Database
Authors: Yolcu Yagiz Ugur , Goyal Anshit , Alvi Mohammed Ali , Moinuddin FM , Bydon Mohamad 
Published: June 2019

OBJECTIVERecent studies have reported on the utility of radiosurgery for local control and symptom relief in spinal meningioma. The authors sought to evaluate national utilization trends in radiotherapy (including radiosurgery), investigate possible factors associated with its use in patients with spinal meningioma, and its impact on survival for atypical tumors.METHODSUsing the ICD-O-3 topographical codes C70.1, C72.0, and C72.1 and histological codes 9530–9535 and 9537–9539, the authors queried the National Cancer Database for patients in whom spinal meningioma had been diagnosed between 2004 and 2015. Patients who had undergone radiation in addition to surgery and those who had received radiation as the only treatment were analyzed for factors associated with each treatment.RESULTSFrom among 10,458 patients with spinal meningioma in the database, the authors found a total of 268 patients who had received any type of radiation. The patients were divided into two main groups for the analysis of radiation alone (137 [51.1%]) and radiation plus surgery (131 [48.9%]). An age > 69 years (p < 0.001), male sex (p = 0.03), and tumor size 5 to < 6 cm (p < 0.001) were found to be associated with significantly higher odds of receiving radiation alone, whereas a Charlson-Deyo Comorbidity Index ≥ 2 (p = 0.01) was associated with significantly lower odds of receiving radiation alone. Moreover, a larger tumor size (2 to < 3 cm, p = 0.01; 3 to < 4 cm, p < 0.001; 4 to < 5 cm, p < 0.001; 5 to < 6 cm, p < 0.001; and ≥ 6 cm, p < 0.001; reference = 1 to < 2 cm), as well as borderline (p < 0.001) and malignant (p < 0.001) tumors were found to be associated with increased odds of undergoing radiation in addition to surgery. Receiving adjuvant radiation conferred a significant reduction in overall mortality among patients with borderline or malignant spinal meningiomas (HR 2.12, 95% CI 1.02–4.1, p = 0.02).CONCLUSIONSThe current analysis of cases from a national cancer database revealed a small increase in the use of radiation for the management of spinal meningioma without a significant increase in overall survival. Larger tumor size and borderline or malignant behavior were found to be associated with increased radiation use. Data in the present analysis failed to show an overall survival benefit in utilizing adjuvant radiation for atypical tumors.
Stereotactic radiosurgery versus stereotactic radiotherapy in the management of intracranial meningiomas: a systematic review and meta-analysis
Authors: Fatima Nida , Meola Antonio , Pollom Erqi L. , Soltys Scott G. , Chang Steven D. 
Published: June 2019

OBJECTIVEStereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) have been used as a primary treatment or adjuvant to resection in the management of intracranial meningiomas (ICMs). The aim of this analysis is to compare the safety and long-term efficacy of SRS and SRT in patients with primary or recurrent ICMs.METHODSA systematic review of the literature comparing SRT and SRS in the same study was conducted using PubMed, the Cochrane Library, Google Scholar, and EMBASE from January 1980 to December 2018. Randomized controlled trials, case-control studies, and cohort studies (prospective and retrospective) analyzing SRS versus SRT for the treatment of ICMs in adult patients (age > 16 years) were included. Pooled and subgroup analyses were based on the fixed-effect model.RESULTSA total of 1736 patients from 12 retrospective studies were included. The treatment modality used was: 1) SRS (n = 306), including Gamma Knife surgery (n = 36), linear accelerator (n = 261), and CyberKnife (n = 9); or 2) SRT (n = 1430), including hypofractionated SRT (hFSRT, n = 268) and full-fractionated SRT (FSRT, n = 1162). The median age of patients at the time of treatment was 59 years. The median follow-up duration after treatment was 35.5 months. The median tumor volumes at the time of treatment with SRS, hFSRT, and FSRT were 2.84 cm3, 5.45 cm3, and 12.75 cm3, respectively. The radiographic tumor control at last follow-up was significantly worse in patients who underwent SRS than SRT (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.27–0.82, p = 0.007) with 7% less volume of tumor shrinkage (OR 0.93, 95% CI 0.61–1.40, p = 0.72). Compared to SRS, the radiographic tumor control was better achieved by FSRT (OR 0.46, 95% CI 0.26–0.80, p = 0.006) than by hFSRT (OR 0.81, 95% CI 0.21–3.17, p = 0.76). Moreover, SRS leads to a significantly higher risk of clinical neurological worsening during follow-up (OR 2.07, 95% CI 1.06–4.06, p = 0.03) and of immediate symptomatic edema (OR 4.58, 95% CI 1.67–12.56, p = 0.003) with respect to SRT. SRT could produce a better progression-free survival at 4–10 years compared to SRS, but this was not statistically significant (p = 0.29).CONCLUSIONSSRS and SRT are both safe options in the management of ICMs. However, SRT carries a better radiographic tumor control rate and a lower incidence of posttreatment symptomatic worsening and symptomatic edema, with respect to SRS. However, further prospective studies are still needed to validate these results.