Penggunaan Media Gambar Dalam Meningkatkan Kemampuan Membaca Permulaan Siswa Kelas I SDN Uwedaka Kecamatan Pagimana Kabupaten Banggai

Pokok permasalahan dalam penelitian ini adalah rendahnya tingkat kemampuan membaca permulaan siswa kelas I SDN Uwedaka dalam pembelajaran Bahasa Indonesia. Tujuan Penelitian adalah untuk meningkatkan kemampuan membaca permulaan siswa kelas I SDN Uwedaka Kecamatan Pagimana Kabupaten Banggai. Berdasarkan hasil observasi yang didapatkan masih terdapat beberapa siswa yang sama sekali belum bisa membaca. Pembelajaran membaca permulaan di SDN Uwedaka selama ini hanya menggunakan media pembelajaran yang konvensional yaitu dengan menggunakan papan tulis, pembelajaran yang hanya berpusat pada guru, penggunaan media dalam pembelajaran sebagai alat bantu masih sangat terbatas, hal ini menyebabkan kemampuan membaca permulaan yang masih rendah dan terlihat hampir 65% siswa masih mengalami kesulitan membaca dalam proses belajar mengajar. Metode yang digunakan adalah metode deskriptif kualitatif dan kuantitatif. Data kualitatif didapatkan dari hasil tes dan observasi siswa dan guru. data kuantitatif didapatkan dari hasil tes belajar. Desain penelitian ini mengacu pada desain oleh Kemmis dan Mc Taggart yang terdiri dari empat tahapan, yaitu perencanaan, pelaksanaan tindakan, observasi dan refleksi. Data dikumpulkan melalui penilaian proses dan penilaian hasil setiap akhir tindakan. Penelitian ini dilakukan dalam dua siklus. Pada siklus I diperoleh nilai rata-rata siswa yaitu sebesar 67 dengan ketuntasan belajar klasikal sebesar 40% serta daya serap 66,6%. Pada siklus II, nilai rata-rata meningkat menjadi 83 dengan ketuntasan klasikal sebesar 100% serta daya serap klasikal sebesar 83,3%. Bersarkan hasil penelitian maka dapat disimpulkan bahwa penggunaan media gambar dapat meningkatkan kemampuan membaca permulaan terhadap siswa kelas I SDN Uwedaka Kecamatan Pagimana Kabupaten Banggai

Impact of age, intrinsic subtype and local treatment on long-term local-regional recurrence and breast cancer mortality among low-risk breast cancer patients

<p><b>Aim:</b> To evaluate the long-term prognostic impact of age, local treatment and intrinsic subtypes on the risk of local-regional recurrence (LRR) and breast cancer mortality among low-risk patients.</p> <p><b>Material and methods:</b> Cohort study with prospectively collected data, balanced five-year age groups, including 514 Danish lymph node negative breast cancer patients diagnosed between 1989 and 1998, treated with mastectomy (N = 320) or breast-conserving therapy (BCT) (N = 194) and without systemic treatment. Intrinsic subtype approximation was performed by combining information on estrogen-, progesterone-, HER2 receptor and Ki67.</p> <p><b>Results:</b> The majority of the tumors had a luminal subtype: 70% Luminal-A (LumA), 16% Luminal-B (LumB), and 10% Luminal-HER2 + (Lum-HER2+). The distribution of intrinsic subtypes between younger (≤45 years) and older (>45 years) patients was similar. Intrinsic subtypes had no prognostic impact on the 20-year LRR risk, regardless of age. A distinct 20-year mortality pattern was observed among the younger patients: 11% of patients with LumB tumor died of breast cancer within the first five years after primary surgery, 23% of patients with Lum-HER2+ tumor died within a 5–10-year period, whereas patients with LumA tumor died with a constant low rate throughout the 20-year period. After 20 years of follow-up, patients with LumA tumor had breast cancer mortality comparable to that of patients with LumB tumor (20%) and lower than Lum-HER2+ tumor (39%). Among the older patients, no distinct mortality pattern was observed, and the 20-year breast cancer mortality was not associated with intrinsic subtypes.</p> <p><b>Conclusion:</b> Among low-risk patients, 96% of the tumors were Luminal and the distribution of intrinsic subtypes between younger (≤45 years) and older (>45 years) patients was similar. The observed higher frequency of LRR among younger low-risk BCT patients was not associated intrinsic subtype. The 20-year breast cancer mortality was non-significant for LumA tumors among the older patients, whereas among the younger patients, LumA tumors had a comparable mortality with LumB, but lower than for Lum-HER2 + tumors.</p

Uni- and multivariate analyses.

<p>Uni- and multivariate analyses.</p

Kaplan-Meier estimates of (A) overall survival and (B) disease-specific survival of the combined prediction score of cisplatin, epirubicine, capecitabine for patients who had undergone surgical resection.

<p>Prediction scores are dichotomized by the median score.</p

Standardized assessment of tumor-infiltrating lymphocytes in breast cancer: an evaluation of inter-observer agreement between pathologists

<p><b>Introduction:</b> In breast cancer, there is a growing body of evidence that tumor-infiltrating lymphocytes (TILs) may have clinical utility and may be able to direct clinical decisions for subgroups of patients. Clinical utility is, however, not sufficient for warranting the implementation of a new biomarker in the routine practice, and evaluation of the analytical validity is needed, including testing the reproducibility of decentralized assessment of TILs. The aim of this study was to evaluate the inter-observer agreement of TILs assessment using a standardized method, as proposed by the International TILs Working Group 2014, applied to a cohort of breast cancers reflecting an average breast cancer population.</p> <p><b>Material and methods:</b> Stromal TILs were assessed using full slide sections from 124 breast cancers with varying histology, malignancy grade and ER- and HER2 status. TILs were estimated by nine dedicated breast pathologists using scanned hematoxylin–eosin stainings. TILs results were categorized using various cutoffs, and the inter-observer agreement was evaluated using the intraclass coefficient (ICC), Kappa statistics as well as individual overall agreements with the median value of TILs.</p> <p><b>Results:</b> Evaluation of TILs led to an ICC of 0.71 (95% CI: 0.65–0.77) corresponding to an acceptable agreement. Kappa values were in the range of 0.38–0.46 corresponding to a fair to moderate agreement. The individual agreements increased, when using only two categories (‘high’ vs. ‘low’ TILs) and a cutoff of 50–60%.</p> <p><b>Discussion:</b> The results of the present study are in accordance with previous studies, and shows that the proposed methodology for standardized evaluation of TILs renders an acceptable inter-observer agreement. The findings, however, indicate that assessment of TILs needs further refinement, and is in support of the latest St. Gallen Consensus, that routine reporting of TILs for early breast cancer is not ready for implementation in a clinical setting.</p

Intrinsic subtypes and benefit from postmastectomy radiotherapy in node-positive premenopausal breast cancer patients who received adjuvant chemotherapy – results from two independent randomized trials

<p><b>Background:</b> The study of the intrinsic molecular subtypes of breast cancer has revealed differences among them in terms of prognosis and response to chemotherapy and endocrine therapy. However, the ability of intrinsic subtypes to predict benefit from adjuvant radiotherapy has only been examined in few studies.</p> <p><b>Methods:</b> Gene expression-based intrinsic subtyping was performed in 228 breast tumors collected from two independent post-mastectomy clinical trials (British Columbia and the Danish Breast Cancer Cooperative Group 82b trials), where pre-menopausal patients with node-positive disease were randomized to adjuvant radiotherapy or not. All patients received adjuvant chemotherapy and a subgroup of patients underwent ovarian ablation. Tumors were classified into intrinsic subtypes: Luminal A, Luminal B, HER2-enriched, Basal-like and Normal-like using the research-based PAM50 classifier.</p> <p><b>Results:</b> In the British Columbia study, patients treated with radiation had an overall significant lower incidence of locoregional recurrence compared to the controls. For Luminal A tumors the risk of loco-regional recurrence was low and was further lowered by adjuvant radiation. These findings were validated in the DBCG 82b study. The individual data from the two cohorts were merged, the hazard ratio (HR) for loco-regional recurrence associated with giving radiation was 0.34 (0.19 to 0.61) overall and 0.12 (0.03 to 0.52) for Luminal A tumors.</p> <p><b>Conclusions:</b> In both postmastectomy trials, patients with Luminal A tumors turned out to have a significant lower incidence of loco-regional recurrence when randomized to adjuvant radiotherapy, leaving no indication to omit postmastectomy adjuvant radiation in pre-menopausal high-risk patients with Luminal A tumors. It was not possible to evaluate the effect of radiotherapy among the other subtypes because of limited sample sizes.</p

Additional file 1 of Dynamic whole-body [18F]FES PET/CT increases lesion visibility in patients with metastatic breast cancer

Additional file 1. Supplemental material

Additional file 10: of Integrative clustering reveals a novel split in the luminal A subtype of breast cancer with impact on outcome

Six proteins differentially expressed between luminal A samples in COCA cluster 1 versus COCA cluster 4. (PDF 771 kb

Additional file 2: of Integrative clustering reveals a novel split in the luminal A subtype of breast cancer with impact on outcome

a Supplementary methods. b Summary of clinicopathological properties of the 425 primary breast tumors in the Oslo2 cohort. (PDF 137 kb