Design Management Program Application for Internet Access in STMIK Jakarta Pusyanet

A medium used for the general course requires management to continuity ofoperations, not much different from the means of Internet access that is intended forstudents STMIK Jakarta. By using application programs created with Visual Basiclanguage, management of user identities, the use and timing of each user requests alist of all of them are stored in the database using Microsoft Access

Additional file 13: Figure S4. of Cardiovascular risk factors are major determinants of thrombotic risk in patients with the lupus anticoagulant

Calibration bar graph of the proposed empirical risk stratification rule. (DOCX 22 kb

Dynamic assessment of venous thromboembolism risk in patients with cancer by longitudinal D-Dimer analysis: A prospective study.

BACKGROUND:Venous thromboembolism (VTE) is a frequent complication of cancer. Elevated D-Dimer is associated with an increased risk of cancer-associated VTE. Whether changes in D-Dimer over time harbor additional prognostic information that may be exploited clinically for dynamic prediction of VTE is unclear. OBJECTIVES:To explore the potential role of longitudinal D-Dimer trajectories for personalized prediction of cancer-associated VTE. PATIENTS/METHODS:167 patients with active malignancy were prospectively enrolled (gastrointestinal: n=59 (35%), lung: n=56 (34%), brain: n=50 (30%), others: n=2 (1%); metastatic disease: n=74 (44%)). D-Dimer (median=0.8µg/mL [25th -75th percentile: 0.4-2.0]) was measured at baseline and during 602 monthly follow-up visits. Joint models of longitudinal and time-to-event data were implemented to quantify the association between D-Dimer trajectories and prospective risk of VTE. RESULTS:VTE occurred in 20 patients (250-day VTE risk=12.1%, 95%CI: 7.8-18.5). D-Dimer increased by 34%/month (0.47µg/mL/month, 95%CI: 0.22-0.72, p<0.0001) in patients who developed VTE, but remained constant in patients who did not develop VTE (change/month=-0.06µg/mL/month, 95%CI: -0.15-0.02, p=0.121). In joint modeling, a doubling of the D-Dimer trajectory was associated with a 2.8-fold increase in the risk of VTE (Hazard ratio=2.78, 95%CI: 1.69-4.58, p<0.0001). This finding was independent of established VTE risk factors. Highly personalized, dynamic predictions of VTE conditional on individual patients' D-Dimer trajectories could be obtained. CONCLUSIONS:D-Dimer increases before the onset of cancer-associated VTE, but remains constant over time in patients without VTE. This study represents proof-of-concept that longitudinal trajectories of D-Dimer may advance the personalized assessment of VTE risk in the oncologic setting

Blood-Based Biomarkers Are Associated with Disease Recurrence and Survival in Gastrointestinal Stroma Tumor Patients after Surgical Resection

<div><p>Background</p><p>Inflammatory blood count biomarkers may improve recurrence risk stratification and inform long-term prognosis of cancer patients. Here, we quantify the prognostic impact of blood-based biomarkers on recurrence risk and long-term survival in a large cohort of gastrointestinal stroma tumor (GIST) patients after curative surgery.</p><p>Methods</p><p>One-hundred-forty-nine consecutive GIST patients were followed-up for a median period of 4.8 years. Local recurrence, distant metastasis, and death occurred in 9, 21, and 31 patients, respectively. Time-to-event and competing risk analysis were applied to study the association between haemoglobin (Hb) level, white blood cell count (WBC), neutrophil/lymphocyte ratio (NLR), derived NLR (dNLR), lymphocyte/monocyte ratio (LMR), and platelet/lymphocyte ratio (PLR) with risk of local or distant recurrence (RR), recurrence free survival (RFS), and overall survival (OS).</p><p>Results</p><p>A low Hb (p = 0.029), and elevations in the parameters WBC (p = 0.004), NLR (p = 0.015) and dNLR (p = 0.037) were associated with a poor OS in GIST patients in multivariate analysis. Moreover, a low Hb (p = 0.049) and an elevated WBC (p = 0.001), NLR (p = 0.007), dNLR (p = 0.043) and PLR (p = 0.024) were independently associated with decreased RFS after adjusting for Miettinen score. However, only an increase of dNLR/NLR showed a significant association to higher RR (p = 0.048). Inclusion of NLR or PLR to Miettinen risk score did not reasonably improve the clinical risk prediction of 2-year RFS.</p><p>Conclusion</p><p>Low Hb, elevated WBC, elevated dNLR, and elevated PLR are independent prognostic factors for a worse clinical outcome in GIST patients after curative resection.</p></div

Risk of all-cause mortality according to neutrophil lymphocyte ratio (NLR) at baseline.

<p>Patients with an elevated NLR at baseline had a significantly worse overall survival experience. The risk of death was estimated using the inverse Kaplan-Meier estimator, and the boxed p-value using a log-rank test. The NLR was dichotomized into a binary variable at its 75^th percentile (i.e. Q3, cut-off: 4.9 units).</p

Risk of recurrence according to the derived neutrophil lymphocyte ratio (dNLR) at baseline.

<p>Patients with an elevated dNLR at baseline had a significantly higher risk of developing recurrence. The risk of recurrence (defined as a composite of local recurrence and/or distant metastasis, whatever came first) was estimated using competing risk cumulative incidence estimators with death-from-any-cause as the competing event of interest. The boxed p-value was estimated using Gray’s test. The dNLR was dichotomized into a binary variable at its 75^th percentile (i.e. Q3, cut-off: 2.7 units).</p

Risk of all-cause mortality according to second primary malignancy status (SPM) at baseline.

<p>The presence of a second primary malignancy (SPM) or a history of a SPM at baseline was a significant contributor towards an increased risk of death-from-any-cause. The risk of death was estimated using the inverse Kaplan-Meier estimator, and the boxed p-value using a log-rank test.</p

Baseline Predictors of Oncologic Outcomes in GIST–Univariable Analysis.

<p>The endpoints overall survival and recurrence-free survival were analyzed with Cox proportional hazards models, whereas the endpoints local recurrence, distant metastasis, and recurrence were analyzed using Fine & Gray models. Abbreviations: HR–hazard ratio, SHR–subdistribution hazard ratio, 95%CI– 95% confidence interval, p–p-value, HPF–high power field, g/dL–grams per deciliter, G/L–giga per liter, NLR–neutrophil lymphocyte ratio, dNLR–derived NLR, LMR–lymphocyte monocyte ratio, PLR–platelet lymphocyte ratio.</p

Red blood cell parameters and risk of mortality in the total study cohort (n = 1840). Significant results are highlighted in bold.

<p>Red blood cell parameters and risk of mortality in the total study cohort (n = 1840). Significant results are highlighted in bold.</p

Red blood cell parameters and risk of VTE in patients with solid tumors (n = 1286). Significant results are highlighted in bold.

<p>Red blood cell parameters and risk of VTE in patients with solid tumors (n = 1286). Significant results are highlighted in bold.</p