Metastatic tumors to the stomach: clinical and endoscopic features.

AIM: To evaluate the clinical and endoscopic patterns in a large series of patients with metastatic tumors in the stomach. METHODS: A total of 64 patients with gastric metastases from solid malignant tumors were retrospectively examined between 1990 and 2005. The clinicopathological findings were reviewed along with tumor characteristics such as endoscopic pattern, location, size and origin of the primary sites. RESULTS: Common indications for endoscopy were anemia, bleeding and epigastric pain. Metastases presented as solitary (62.5%) or multiple (37.5%) tumors were mainly located in the middle or upper third of stomach. The main primary metastatic tumors were from breast and lung cancer and malignant melanoma. CONCLUSION: As the prognosis of cancer patients has been improving gradually, gastrointestinal (GI) metastases will be encountered more often. Endoscopic examinations should be conducted carefully in patients with malignancies, and endoscopic biopsies and information on the patient's clinical history are useful for correct diagnosis of gastric metastases

Two-to-one resonant multi-modal dynamics of horizontal/inclined cables. Part I : theoretical formulation and model validation

This paper is first of the two papers dealingwith analytical investigation of resonant multimodal dynamics due to 2:1 internal resonances in the finite-amplitude free vibrations of horizontal/inclined cables. Part I deals with theoretical formulation and validation of the general cable model. Approximate nonlinear partial differential equations of 3-D coupled motion of small sagged cables - which account for both spatio-temporal variation of nonlinear dynamic tension and system asymmetry due to inclined sagged configurations - are presented. A multidimensional Galerkin expansion of the solution ofnonplanar/planar motion is performed, yielding a complete set of system quadratic/cubic coefficients. With the aim of parametrically studying the behavior of horizontal/inclined cables in Part II [25], a second-order asymptotic analysis under planar 2:1 resonance is accomplished by the method of multiple scales. On accounting for higher-order effectsof quadratic/cubic nonlinearities, approximate closed form solutions of nonlinear amplitudes, frequencies and dynamic configurations of resonant nonlinear normal modes reveal the dependence of cable response on resonant/nonresonant modal contributions. Depending on simplifying kinematic modeling and assigned system parameters, approximate horizontal/inclined cable models are thoroughly validated by numerically evaluating statics and non-planar/planar linear/non-linear dynamics against those of the exact model. Moreover, the modal coupling role and contribution of system longitudinal dynamics are discussed for horizontal cables, showing some meaningful effects due to kinematic condensation

Optimasi Site Layout Menggunakan Multi-objectives Function Pada Proyek Pembangunan Gedung Kuliah Terpadu Tahap III Politeknik Negeri Malang

Setiap proyek konstruksi harus ada fasilitas proyek (site facilities) untuk menunjang kinerja pekerja konstruksi. Tata letak fasilitas proyek harus menyesuaikan kebutuhan maupun keadaan/medan di lapangan.Fasilitas proyek (site facilities) pada proyek konstruksi berskala besar harus diimbangi dengan fasilitas kerja yang memadai dan efisien sehingga aktifitas pembangunan dapat berjalan lancar, nyaman serta mendukung program keselamatan dan kesehatan kerja (K3). Sistem manajemen keselamatan kerja sangat penting dalam proyek berskala besar, tingginya intensitas kegiatan yang ada di dalam proyek tersebut mengharuskan penempatan site facilities yang efisien, aman dan nyaman untuk pekerja konstruksi. Pada penelitian ini dilakukan pegoptimasian site layoutproyek dengan menggunakan analisis multi-objectives function yaitu analisis Traveling Distance (jarak tempuh) dan analisisSafety Index (tingkat keamanan dan keselamatan). Semakin kecil nilai traveling distance yang dihasilkan maka semakin dekat perjalanan pekerja untuk berpindah ke fasilitas proyek ke lain dan semakin kecil nilai safety index maka tingkat kecelakaan yang dialami pekerja yang melalui zona bahaya juga akan semakin kecil. Site layout yang paling optimal diketahui dari beberapa skenario pemindahan fasilitas proyek untuk mendapatkan site layout yang efisien. Dari identifikasi dari 4 skenario yang di analisa maka didapat nilai traveling distance paling minimum pada skenario 2 dengan nilai sebesar 59579,271 meter atau mengalami penurunan nilai traveling distance sebesar 0,96% dari kondisi eksisting. Untuk perhitungan nilai safety index diketahui bahwa nilai safety index minimum pada skenario 4 dengan nilai sebesar 809,606 atau mengalami penurunan nilai safety index sebesar 0,95% dari kondisi eksisting. Analisa site layout optimum dan memenuhi kriteria antara persentase 30% untuk nilai traveling distance dan 70% untuk nilai safety index adalah site layout pada skenario 4 dengan nilai total sebesar 1,041273

The mRNA expression of SETD2 in human breast cancer: Correlation with clinico-athological parameters

BACKGROUND: SET domain containing protein 2 (SETD2) is a histone methyltransferase that is involved in transcriptional elongation. There is evidence that SETD2 interacts with p53 and selectively regulates its downstream genes. Therefore, it could be implicated in the process of carcinogenesis. Furthermore, this gene is located on the short arm of chromosome 3p and we previously demonstrated that the 3p21.31 region of chromosome 3 was associated with permanent growth arrest of breast cancer cells. This region includes closely related genes namely: MYL3, CCDC12, KIF9, KLHL18 and SETD2. Based on the biological function of these genes, SETD2 is the most likely gene to play a tumour suppressor role and explain our previous findings. Our objective was to determine, using quantitative PCR, whether the mRNA expression levels of SETD2 were consistent with a tumour suppressive function in breast cancer. This is the first study in the literature to examine the direct relationship between SETD2 and breast cancer. METHODS: A total of 153 samples were analysed. The levels of transcription of SETD2 were determined using quantitative PCR and normalized against (CK19). Transcript levels within breast cancer specimens were compared to normal background tissues and analyzed against conventional pathological parameters and clinical outcome over a 10 year follow-up period. RESULTS: The levels of SETD2 mRNA were significantly lower in malignant samples (p = 0.0345) and decreased with increasing tumour stage. SETD2 expression levels were significantly lower in samples from patients who developed metastasis, local recurrence, or died of breast cancer when compared to those who were disease free for > 10 years (p = 0.041). CONCLUSION: This study demonstrates a compelling trend for SETD2 transcription levels to be lower in cancerous tissues and in patients who developed progressive disease. These findings are consistent with a possible tumour suppressor function of this gene in breast cancer

Polypoid vascular malformation of the small intestine.

A 56-year-old man underwent capsule endoscopy because of obscure GI bleeding. Capsule endoscopy showed a pink and somewhat nodular polypoid lesion of the small bowel partially obstructing the intestinal lumen (A). The patient underwent an ileal resection and the operative specimen showed loss of mucosal folds and the presence of an erythematous area with a polypoid formation of 3.5 × 3 cm (B). Histologic examination revealed the presence of numerous ectatic thin-walled blood vessels and a small number of thick-walled vessels in the submucosa (C and D, arrows; H&E, orig. mag. ×4), surrounded by hypertrophic muscularis mucosae and a chronic inflammatory infiltrate that infiltrated the muscularis propria; the diagnosis of polypoid angiodysplasia was suggested. There has been no recurrence of GI bleeding 14 months after the ileal resection

Gender Communication of Batik Air Flight Attendants in Improving Customer Service

Gender perception in Indonesia is influenced by sociological and cultural processes that focus on the relationship between gender and work in society. Meanwhile, people often associate gender with a certain gender. In economic challenges, such as gender inequalities in education, physical quality, labor, and migration, exacerbate gender imbalances. Cultural norms and values contribute to a more diverse workforce. Based on these problems, this study aims to provide an overview of how the gender communication strategy carried out by flight attendants in improving service during their time as employees at Batik Air airline. The method used in this study uses a descriptive qualitative approach. Primary data was obtained from a semi-structured interview process with three informants who work as Batik Air flight attendants with the criteria of having at least 5 years of experience in Batik airlines. Meanwhile, secondary data is obtained through the process of collecting literature data such as articles and other sources, both from books and national and international journals. The interview focused on service during being a Batik Air flight attendant, as well as the experience of dealing with customers, especially those who are in contact with gender. The viewpoint used in analyzing the data is gender communication. The results of the research findings revealed that: 1). Flight attendants are the brand image of the airline, representing the company's commitment to safety and professional service, 2) flight attendants serve as a representation of the airline's professional service and image, ensuring effective communication and understanding of passenger situations and conditions. In achieving success in terms of professional services, communication strategies are seen from the analysis of the situation, who the target is, what message is to be conveyed, the media used, and the results obtained.   Keywords: Batik Air, Communication, Airlines, Flight Attendants, Strategy &nbsp

The representation of voluntourism in search engines: The case of South Africa

© 2015, © 2015 Government Technical Advisory Centre (GTAC). This paper responds to the paucity of research on the linkages between voluntourism and digital technology and seeks to understand the online representation of the phenomenon in a developing context. In particular, the researchers investigate the so-called ‘online domain’ of voluntourism in South Africa. The researchers collected a series of web results from search engines and analysed the presence of traditional and social media websites, the most relevant presented topics, and the type of argumentation found. Results identify the context and representation of voluntourism as it transpires virtually. This will contribute to the understanding of the interplay between voluntourism and digital technology, with specific emphasis on web presence. Ultimately, results will shed light on how digitally accessible voluntourism is in South Africa and will set the basis for future investigations

“Secure-Preserve-Fight” or “Run-Hide- Fight”: Expectations of an Emergency Department Patient Population During an Active Assailant Event

Objective: We sought to assess the opinions of a general emergency department (ED) patient-family population regarding healthcare providers\u27 life-saving responsibilities during an active assailant event (the traditional “Run-Hide-Fight” paradigm [providercentric] vs the novel “Secure-Preserve-Fight” [vulnerable patient-centric]) paradigm. Design and Method: This institutional review board-approved study presented a scenario-based questionnaire to a convenience sample of ED patients and their retinues. Demographic information included prior military service, formal active-shooter training, and prior violent victimization. The randomly selected subjects evaluated four typical patient scenarios of varying severity within which an emergency physician/nurse was in immediate proximity. They were provided four responses addressing their expectations regarding the healthcare provider\u27s actions: provider-centric (namely, Run-Hide-Fight), or patient-centric (that is, Secure-Preserve-Fight). The frequency of each response was the primary outcome. We employed a non-parametric binomial test as well as SPSS (IBM, Chicago, IL) Conclusion: For this particular ED population, a significant majority supported the patient-centric “Secure-Preserve-Fight” paradigm over the more provider-centric “Run-Hide-Fight” option. This lay public perspective should spur healthcare staff and administration to reconsider their current active shooter plans and possibly modify them to be consistent with “Secure-Preserve-Fight,” especially when dealing with the vulnerable patient

Implementasi Convolutional Neural Network untuk Sistem Prediksi Pigmen Fotosintesis pada Tanaman Secara Real Time

It is common that evaluation on plant health is done by conducting measurement on photosynthetic pigments. Analysis of the presence or absence of some particular pigments could reveal any information about plant responses to the environment or climate changes. This is due to the fact that relative pigment concentrations are influenced by environmental factors such as light and nutrient availability. In this research, a non-destructive and rapid method was developed to identify the existence of photosynthetic pigments in plant leaf i.e. chlorophyll, carotenoid, and anthocyanin. The method used leaf’s RGB digital image as the color representation of the pigments contained in the plant being evaluated. The intelligence agent which is responsible to learn the data and provide information about the pigments was developed based on convolutional neural network (CNN) model. This model was chosen due to its capability to receive a digital image and automatically search for the best feature to learn it. Therefore, plant evaluation could run in real time. The result of the experiment reveals that CNN model could learn the color-pigment relationship very well. The best architecture is ShallowNet using Adam optimizer, batch size 30 and trained with 15 epoch. The MSE of the pigments prediction reaches 0.0055 (actual data range -0.2 up to 2.2) for training and 0.029 for testing.&nbsp