Neoadjuvant chemotherapy with capecitabine and temozolomide for unresectable pancreatic neuroendocrine tumor.

Pancreatic neuroendocrine tumors (PNETs) are relatively rare tumors that arise in the endocrine cells of the pancreas. Historically, somatostatin analogues have been used in this disease primarily for symptom control and, to a limited extent, disease stability. More recently, sunitinib and everolimus have been approved for advanced stage PNETs based on a survival benefit. However, both agents have a <10% actual response rate and cause nontrivial side effect profiles that limit duration of therapy. In locally advanced disease, there is a paucity of data to support an optimal neoadjuvant approach with the expectation of down-staging to allow for curative resection. We describe in this case a young woman who was successfully down-staged using a chemotherapy regimen of capecitabine and temozolomide with minimal toxicity

Indicators for Minimizing Energy Consumption and GHG Emissions at Wastewater Treatment Facilities

Wastewater treatment facilities around the world use significant amount of energy which contributes to large quantities of greenhouse gas (GHG) emissions. According to the U.S.EPA, nearly 3% of the USA\u27s energy is used to treat wastewater. This consumption is increasing at faster rates with increase in population and regulations. Wastewater facilities use large number of pumps in their transfer stations, treatment plants, and effluent pump stations. All these pumps consume considerable amounts of energy. This study presents a preliminary energy inspection of two facilities from Louisiana. This audit provides an inventory of the energy consumed for various activities like pumping, treatment, and discharge. This analysis helps the operators to identify the potential power consuming areas and optimize by adopting several energy conservation measures (ECMs). This study also involves the quantification of GHG emissions based on the energy consumption. The benefits of the study include minimizing energy and GHG emission

Perancangan action dan dialog untuk Menampilkan inferioritas karakter dalam Skenario film panjang “judi”

This thesis is a report of feature-length screenwriting of the movie called "Judi". The thesis is entitled "Designing Action and Dialogue to Show Inferiority of Character In Feature Length Scenario "Judi" discusses the influence of action and dialogue written in a long scenario to show the inferiority side of the character This creation thesis report explains how a small action and dialog can display the inferior side that is hard to see. Good action design and dialogue can also help writers to show the characters they want to show in a scenario. The movie "Judi" tells the story of an unemployed person who wants to marry at his own expense but is trapped by a job he does not want

An Innovative Approach for Predicting Software Defects by Handling Class Imbalance Problem

From last decade unbalanced data has gained attention as a major challenge for enhancing software quality and reliability. Due to evolution in advanced software development tools and processes, today’s developed software product is much larger and complicated in nature. The software business faces a major issue in maintaining software performance and efficiency as well as cost of handling software issues after deployment of software product. The effectiveness of defect prediction model has been hampered by unbalanced data in terms of data analysis, biased result, model accuracy and decision making. Predicting defects before they affect your software product is one way to cut costs required to maintain software quality. In this study we are proposing model using two level approach for class imbalance problem which will enhance accuracy of prediction model. In the first level, model will balance predictive class at data level by applying sampling method. Second level we will use Random Forest machine learning approach which will create strong classifier for software defect. Hence, we can enhance software defect prediction model accuracy by handling class imbalance issue at data and algorithm level

COMPARATIVE STUDY OF BALADI GHRITA NASYA WITH GOGHRITA NASYA IN THE MANAGEMENT OF NASAPRATINAHA

Aim: To compare the effect of Baladi Ghrita Nasya with Goghrita Nasya in the management of Nasapratinaha.Objective: 1. To evaluate the effect of Baladi Ghrita (trail drug) Nasya in management of Nasapratinaha.2. To evaluate the effect of Nasya with Goghrita (control drug) in management of Nasapratinaha.Method: Patients were divided into 2 groups. i.e., Group A and Group B.Group A - Baladi Ghrita Nasya was administered for seven days, once daily in the morning.Group B- Nasya with Goghrita for seven days was administered, once daily in the morning.Types of study: Comparative Clinical Study.Period of Study: After seven days of treatment, both the groups were followed at regular intervals of 15 days for a period of two months.Follow Up: Both the groups were followed at regular intervals of 15 days.Results: By comparing both the groups, Group A patients those who were administered Baladi Ghrita Nasya showed a significant improvement / relief in the management of Nasapratinaha. Statistical Analysis: The Statistical Analysis reveals that In Nasapratinaha the efficacy of treatment with Baladi Ghrita Nasya has an effective role in treating Nasapratinaha than Nasya with plain Goghrita.Conclusion: In Nasapratinaha the efficacy of treatment with Baladi Ghrita Nasya has an effective role in treating Nasapratinaha than Nasya with plain Goghrita

Challenges and opportunities for checkpoint blockade in T-cell lymphoproliferative disorders

Abstract The T-cell lymphoproliferative disorders are a heterogeneous group of non-Hodgkin’s lymphomas (NHL) for which current therapeutic strategies are inadequate, as most patients afflicted with these NHL will succumb to disease progression within 2 years of diagnosis. Appreciation of the genetic and immunologic landscape of these aggressive NHL, including PD-L1 (B7-H1, CD274) expression by malignant T cells and within the tumor microenvironment, provides a strong rationale for therapeutic targeting this immune checkpoint. While further studies are needed, the available data suggests that responses with PD-1 checkpoint blockade alone will unlikely approach those achieved in other lymphoproliferative disorders. Herein, we review the unique challenges posed by the T-cell lymphoproliferative disorders and discuss potential strategies to optimize checkpoint blockade in these T-cell derived malignancies.http://deepblue.lib.umich.edu/bitstream/2027.42/134748/1/40425_2016_Article_201.pd

PENGGUNAAN BAHASA ASING DALAM AKTA NOTARIS

Ketentuan Pasal 43 ayat (3) Undang-Undang Nomor 2 Tahun 2014 tentang Perubahan Atas Undang-Undang Nomor 30 Tahun 2004 tentang Jabatan Notaris, dirasa secara substansi sangat berbeda dan secara normatif tidak sejalan dengan ketentuan dan peraturan lainnya tentang penggunaan bahasa akta autentik. Ini menimbulkan ketidakpastian hukum terhadap penggunaan bahasa pada akta notaris yang bersifat autentik mengenai perbuatan, perjanjian, penetapan, dan peristiwa hukum. Berdasarkan hal tersebut, terdapat dua permasalahan yang penulis kaji yaitu yang pertama mengenai penggunaan bahasa dalam akta yang dibuat dihadapan notaris ditinjau dari Undang-Undang Nomor 24 Tahun 2009 tentang Bendera, Bahasa, Lambang Negara, Serta Lagu Kebangsaan dan Undang-Undang Nomor 2 Tahun 2014 tentang Perubahan Atas Undang-Undang Nomor 30 Tahun 2004 tentang Jabatan Notaris dan permasalahan yang kedua mengenai akibat hukum jika akta yang dibuat di hadapan notaris menggunakan bahasa asing.Tujuan yang ingin penulis capai yaitu untuk mengetahui apakah akta notaris dapat dibuat dengan bahasa asing dan bagaimana akibat hukumnya. Untuk mencapai tujuan dari penulisan karya ilmiah ini, penulis melakukan penelitian kepustakaan atau penelitian normatif. Metode pendekatan yang penulis pergunakan yaitu pendekatan perundang-undangan dan pendekatan konsep hukum. Penelitian normatif ini ditunjang dengan sumber bahan hukum untuk memperkuat landasan teori guna pembahasan. Bahan hukum yang terkumpul diklasifikasikan sedemikian rupa kemudian diambil yang ada hubungan dengan permasalahan yang akan dibahas. Akhirnya diperoleh data yang dapat menjawab rumusan masalah dalam tulisan ini, dan hasil penelitian ini dapat dipertanggungjawabkan. Hasil penelitian yang penulis dapatkan berdasarkan analisa kualitatif yaitu akta yang dibuat dihadapan notaris wajib dibuat menggunakan bahasa indonesia guna memenuhi syarat formil akta autentik. Jika akta notaris tidak dibuat menggunakan bahasa Indonesia maka akta tersebut terdegradasi menjadi akta dibawah tangan. Dengan begitu dapat menjadi alasan bagi para pihak yang merasa dirugikan atas terdegradasinya akta untuk melakukan penuntutan penggantian biaya, ganti rugi dan bunga kepada Notaris. Kata Kunci : Akta Notaris, Akta Autentik, Bahas

TO EVALUATE THE EFFECT OF YASHTI-MADHU-GHRITA APPLICATION IN POST-OPERATIVE MANAGEMENT OF AGNIDAGDHA VRANA IN ARSHAS

Aim: To evaluate the effect of Yashti-Madhu-Ghrita application in post-operative management of Agnidagdha Vrana in Arsha.Objective: The effect of Yashti-Madhu-Ghrita in the post operative management of Agnidagdha Vrana in Arsha with regards to see its effect in pain, burning sensation & wound healing.Method: It is an observational study of selected 20 patients with pre test and post- test design Types of study: Clinical StudyAssessment criteria: criteria were used to assess the Vedana, Daha,Vrana Varna, Vrana Srava, and Vrana Akruti.Follow Up: is done on post – operative 1st day, 2nd, 3rd day, 7th day, 14th day, 21st day, 28th day, 60th day and 90th day to assess the pain (both the pathological and procedure induced), wound healing, relief from the associated complaint, complications of Agnikarma This was noted with the help of the self- gradation of the assessment criteria in the proforma of case sheet of Arsha designed for the study.Results: Yashti-Madhu-Ghrita application in post-operative management of Agnidagdha Vrana in Arsha showed a significant result.Statistical Analysis: The Statistical Analysis reveals that Yashti-Madhu-Ghrita application is effective in post-operative management of Agnidagdha Vrana in Arsha.Conclusion: Yashti-Madhu-Ghrita application is effective in post-operative management of Agnidagdha Vrana in Arsha

TO EVALUATE THE EFFECT OF APAMARGA PANIYA KSHARA IN THE MANAGEMENT OF UDARASHULA WITH SPECIAL REFERENCE TO BILIARY COLIC

Aim: To evaluate the effect of Apamarga paniya kshara in the management of Udarashula with special reference to Biliary Colic.Objective: 1) To find the effect of Apamarga Kshara in the management of Udarashula with special reference to biliary colic.2) To review literature regarding Udarashula and biliary colic.3) To establish concept of acute abdomen in Ayurveda and management of it with Ayurvedic principle.Method: 1) Patients were registered with the help of proforma prepared for the study. 2) 20 patients were assigned in a single group for observational study.Types of study: Clinical StudyAssessment criteria: Effect of therapy was assessed by the signs and symptoms before and after treatment. It was assessed on the basis of self-formulated scoring scale for Pain, Tenderness, Murphy’s sign and Visual analogue scale.Period of Study: All patients were treated with Apamarga Paneeya kshara 1 gram twice daily with water for seven daysFollow Up: on 15th, 30th, 60th, 90th day after completion of treatment.Results: By using Apamarga paniya kshara in the management of Udarashula with special reference to Biliary Colic showed a significant result.Statistical Analysis: The Statistical Analysis reveals that in the management of Udarashula with special reference to Biliary Colic the efficacy of Apamarga paniya kshara is effective.Conclusion: Apamarga paniya kshara in the management of Udarashula with special reference to Biliary Colic showed a positive result

CLINICAL STUDY OF INDIGENOUS DRUGS - PATHADI KWATHA IN THE MANAGEMENT OF ARSHA (HEMORRHOIDS)

One of the fast developing branch of Surgery, gained momentum among the various branches of surgery because of manifold increase in incidence of ano-rectal diseases in population as compared to other diseases. As per Ayurveda today's dietary habits are totally controversial, that is, it is totally against the 'Ahar - vidhi visheshayatane'. The ultimate result of this is altered bowel habits which finally results in constipation which may lead to Arsha i.e. Hemorrhoids.Acharya Charka recognizes "Mandagni" as causative factor and further elaborated and emphasized this point saying that Arsha (Haemorrhoids), Atisara (Diarrhoea) and Grahani (Spure) are sometimes causative to each other resulting from Mandagni i.e. weak digestive fire.As per Sushruta the causes leading to variation of Dosha including excessive and erroneous dietetic indulgence, posture which create pressure on the anal region, sexual indulgence and suppression of normal urge of micturation, defecation etc. leads to developing "Arsha".The results of this clinical study, itself are sufficient to comment that 'Pathadi Kwatha' has definite effective role in the management of all types of Arsha in early stage. The Statistical Analysis reveals that In management of all types of Arsha in early stage the Pathadi Kwatha is effective. The conclusion of this clinical study 'Pathadi Kwatha' has definite effective role in the management of all types of Arsha in early stage