Der Resektionskantenstatus invasiver Mammakarzinome und seine Einflussfaktoren

Fragestellung: In zahlreichen Studien wurden Prognosefaktoren für das Auftreten von Lokalrezidiven untersucht und identifiziert. Einer der wichtigsten ist der Resektionskantenstatus. Weitaus seltener untersucht sind patientenbezogene und tumorbiologische Faktoren die das Risiko einer insuffizienten chirurgischen Primärtherapie erhöhen. Die vorliegende Arbeit hat sich ausschließlich der Untersuchung dieser Einflussfaktoren gewidmet. Patientinnen und Methoden: Das Patientenkollektiv in der vorliegenden Arbeit setzt sich zusammen aus 227 Patientinnen, die im Jahr 2006, aufgrund eines invasiv duktalen (IDC) oder invasiv lobulären Mammakarzinoms (ILC) im Universitätsklinikum Marburg operiert wurden. Im Rahmen einer retrospektiven Kohortenstudie wurden 26 patientenbezogene oder tumorbiologische Parameter mithilfe univariater und multivariater Testungen untersucht. Ergebnisse: Von den 227 Frauen des Studienkollektivs mussten 19,4% aufgrund von positiven Resektionskanten mindesten ein zweites Mal operiert werden. Mehr als ein Drittel (36,4%) dieser Patientinnen wiesen dabei kein invasives, sondern ausschließlich ein in situ Karzinom in den Schnittkanten auf. Faktoren die sich in der vorliegenden Studie in der abschließend multivariaten Testung als unabhängig einflussnehmend auf den Resektionskantenstatus herausstellten waren die Tumorgröße (p = 0,003), die Länge des Exzidats (p = 0,045), das Vorliegen eines DCIS (p = 0,001) und die primäre Operationstechnik (p = 0,001). Schlussfolgerung: Insgesamt bestätigen die Ergebnisse dieser Arbeit die Datenlage internationaler Studien. Bei Vorliegen eines DCIS-Anteils des Tumors und bei Tumoren die einen Durchmesser von 5 cm überschreiten sollte die Exzision des pathologischen Gewebes im Vorhinein großzügiger geplant werden. Da die Raten insuffizienter Primäroperationen bei Mastektomien signifikant niedriger waren, sollte immer eine besonders präzise Abschätzung des Risiko-Nutzen Werts einer brusterhaltenden Therapie erfolgen. Die Annahme dass invasiv lobuläre Karzinome, aufgrund ihres häufig dissoziierten Wachstums, häufiger primär unzureichend reseziert werden, konnte nicht bestätigt werden. Eine Erklärung hierfür könnte die gute präoperative Diagnostik mit entsprechender chirurgischer Therapieplanung sein

The incidence of cytological abnormality 12-24 months after a normal smear in a setting with a high prevalence of cervical abnormalities

Introduction: A screening program has been implemented in SA with intervals of 10 years after a normal cytological result. There are no studies which evaluate repeat screening at a shorter interval in SA. Aim: This study aims to find the incidence of cytological abnormalities on a repeat test after a report of normal cytology or an inadequate pap smear. The factors associated with an abnormal cytology on repeat testing will also be explored. Methods: This is a secondary data analysis of the information obtained in a trial investigating the use of the diaphragm in the prevention of HIV infection between 2004 and 2006. Women were offered a Papanicolaou (Pap) smear at the enrolment visit and again at the end of the trial. The incidence of abnormal cytology after a normal or inadequate cytology was obtained. Demographic factors, history, clinical findings and tests for STI were compared amongst women with a normal and abnormal Pap smear on repeat testing after a normal Pap smear. Results: The incidence of cytological abnormalities was 6.48 % per annum in women with a previously normal Pap and 11.71% per annum in women with an inadequate smear result. (Log rank test for difference significant (p=0.03)). The incidence of cytological abnormalities in women with either an inadequate Pap smear or a normal Pap smear was 7.33%. However, the incidence of a high grade lesion was less than 0.5%. Factors associated with abnormal cytology in the multivariate analysis were a history of ectopic pregnancy [OR=9.25 (CI-1.78-48.03), p=0.01], number of male partners [0R=1.12 (CI-1.03-1.22),p=0.01], number of times a women was treated for an STI [OR=6.59 (1.54-28.19), p=0.01], history of vaginal discharge [OR=13.95 (1.18-164.47), p=0.00], and HIV infection [OR=6.58 (1.14-38.16),p=0.04]. Conclusion: The incidence of significant cervical lesions is low, but it would be prudent to continue to repeat those Pap smears that are found to be inadequate with the present interval of 10 years. In women with a normal Pap smear, a repeat Pap smear after 1-2 years should only be performed if clinically indicated

Corak Tingkah Laku Pembangunan Potensi Diri Belia dalam Program Anugerah Remaja Perdana Rakan Muda di Malaysia

Pada peringkat umur belia, mereka secara psikologi mempunyai kekuatan diri masing-masing yang mana kekuatan tersebut akan terserlah pada akhirnya dan digarap sebagai komponen yang menyumbang kepada potensi diri. Program Anugerah Remaja Perdana Rakan Muda (ARP) merupakan program pembangunan diri yang menyediakan diri belia menghadapi cabaran ke arah mencapai potensi diri alam remaja dan dewasa. Oleh itu, kajian ini bertujuan untuk menilai konstruk psikologi sosial iaitu sikap sebagai elemen pembangunan potensi diri belia Program Anugerah Remaja Perdana Rakan Muda (ARP) berdasarkan Teori Tingkah Laku Berencana sebagai model kajian.Seterusnya, mengadaptasi keperluan psikologi sosial yang berlandaskan kepada teori dan model pembangunan potensi belia sejajar dengan keperluan belia sekarang. Kajian-kajian lepas yang telah dijalankan telah menyokong dapatan kajian ini. Teori Tingkah Laku Berencana (TPB) telah digunakan secara meluas di dalam pelbagai kajian bagi meramalkan tingkah laku (Connere, Jones & Berg, 2010) dalam populasi termasuk di kalangan belia (Baker & White, 2010). Anteseden tingkah laku berencana kajian ini memfokuskan kepada pembentuan sikap dalam tingkah laku belia. Kajian ini mempunyai implikasi yang penting kepada teoritikal, praktikal dan dasar ke arah program pembangunan potensi diri belia. &nbsp

Changes in Some Soil Chemical Properties of Ultisol Applied by Mulch from Empty Fruit Bunches in an Oil Palm Plantation

Changes in Some Soil Chemical Properties of Ultisol Applied by Mulch from Empty Fruit Bunches in an Oil Palm Plantation (D Budianta, AYA Wiralaga, and W Lestari):  Objective of this research was to study the effect of empty fruit bunches (EFB) applied as mulching on some soil chemical properties of Ultisol in an Oil Palm Plantation. This field experiment was conducted in PT. Sampoerna Agro Tbk Plantation Mesuji, Ogan Komering Ilir of South Sumatra Province at blocks of 22/A, 23/B, 27/C, 33/, 12/A, 12/B, 24/D, 12/C, 00/C, 24/A, 24/B, 10/B, 02/C, 02/D, 11/C, 11/D, 10/A, 10/C, 11/A, and 24/C. The treatment was EFB dosage which are without EFB (control), 40 Mg ha-1 of  EFB applied only once for a year, 80 Mg ha-1 of EFB applied twice for 2 years, 120 Mg EFB/ha applied three times for 3 years, and 160 Mg ha-1 of EFB applied four times for 4 years. The rate of EFB application was 40 Mg ha-1 per year. Every treatment was replicated 4 times, thus total of experiment was 20 units. Soil samples were taken in two differences of deepness which were 0-20 cm and 20-40 cm, respectively. Soil variables observed were soil pH, organic C, cation exchange capacity (CEC), total N, P availability, exchangeable K and Mg, Al and Fe. The results showed that application of EFB had significantly effect on some soil chemical properties such as soil pH and Mg exchangeable Mg for 0-20 cm and total N for 20-40 cm deepness. Meanwhile application of EFB did not have siginificant effects on total organic C, CEC, P-Bray I, exchangeable K, exchangeabile Al and Fe.  It was also shown that some soil chemical properties were generally higher in top soil layer than sub soil layer, except for CEC, P and  exchangeable Al

Incidence of cytological abnormalities within 24 months of a normal cervical smear in Soweto, South Africa

BACKGROUND: A screening programme for cervical cancer has been implemented in South Africa (SA) with intervals of 10 years after a normal cytological result. There are no studies that evaluate repeat screening at a shorter interval in SA. OBJECTIVES: (i) To find the incidence of cytological abnormalities on a repeat test after a report of normal cytology or an inadequate Pap smear; and (ii) to explore the factors associated with an abnormal cytology on repeat testing. METHODS: This was a secondary data analysis of a randomised controlled trial of diaphragm, lubricant gel and condoms v. condoms in the prevention of HIV infection. HIV-negative women were recruited between November 2003 and December 2005, with a normal Pap smear at entry. Observation time was from the first Pap smear to the date of the repeat Pap smear. Explanatory variables used were baseline, excepting any new HIV infection. RESULTS: The incidence of cytological abnormalities was 6.48% yearly in women with a previously normal Pap smear and 11.71% yearly in women with an inadequate smear result (p=0.03). The incidence of high-grade squamous intra-epithelial lesions (HSILs) was <0.5%. Factors associated with abnormal cytology were a history of ectopic pregnancy (odds ratio (OR) 9.25; confidence interval (CI) 1.78 - 48.02; p=0.01), number of male partners (OR 1.12; CI 1.03 - 1.22; p=0.01), history of vaginal discharge (OR 13.95; CI 1.18 - 164.47; p=0.04), and incident HIV infection (OR 6.56; CI 1.14 - 38.16; p=0.04). CONCLUSION: The incidence of HSILs is low in the first 2 years after a normal or inadequate Pap smear, even in a setting with a high prevalence of cytological abnormalities

Technological innovation at PC sector during Covid-crisis

PURPOSE: The article's primary goal is to assess the current impact of the coronavirus pandemic on the innovative activity of computer hardware manufacturers. It is imperative to assess whether the impact of a pandemic is negative.DESIGN/APPROACH/METHODOLOGY: For the set goals, the authors analyzed the literature on innovation. The analysis of the case study referred to the segment of graphics card manufacturers. Graphics cards were assessed based on selected criteria. These criteria are the technological process of producing graphics processors (photolithography), and the second element in the evaluation of graphics cards were the results of selected card models in a representative program for computer graphics performance tests.FINDINGS: Thanks to this approach, it was possible to identify trends in graphics card performance in the pre-pandemic and pandemic period. The increase in graphics card performance is the result of the implementation of technological innovations. So far, the coronavirus pandemic has not significantly affected the development of the graphics card segment.PRACTICAL IMPLICATIONS: The presented approach and results of analyses may constitute the basis for creating an advanced methodology for determining trends in the development of graphics processor performance.ORIGINALITY/VALUE: Research results confirmed the adopted assumptions that so far, the pandemic has not a negative impact on innovation in the computer hardware industry.peer-reviewe

Extraction of Jatropha Curcas Non – Edible Oil

In this work studies were carried out to produce biodiesel from crude Jatropha Curcas oil has high free fatty acid content. Due to its high free fatty acid content, the crude Jatropha Curcas oil was processed in two steps. During the first step the free fatty acid content of Crude Jatropha Oil was reduced to less than 2% in one hour at 60°C using methanol to oil molar ratio and 2%w/w of oil of H2SO4 After the reaction, the mixture was allowed to settle for two hours and the top layer of methanol-water mixture was removed. The second step was alkali catalyzed Transesterification using methanol to oil molar ratio of 1:5 and the catalyst to oil ratio of 0.55% w/w to produce biodiesel from the product of the first step at 60°C.The maximum yield of biodiesel was 93% v/v of Crude Jatropha Oil which was more than the biodiesel yield (53%) from the one step catalytic Transesterification

Kesepaduan sosial melalui program Anugerah Remaja Perdana Rakan Muda

Artikel ini bertujuan untuk menilai aplikasi kesepaduan sosial belia dalam program Pembangunan Belia di Malaysia. Matlamat utama kajian adalah untuk mengenal pasti indikator utama pembangunan potensi diri belia untuk mencapai kesepaduan sosial di Malaysia. Integrasi sosial dilihat melalui perkongsian praktis terbaik program Anugerah Remaja Perdana Rakan Muda (ARP). Strategi pengumpulan data dalam kajian dirujuk berdasarkan kajian literatur yang berkaitan. Kaedah persampelan bertujuan digunakan untuk memilih responden yang terdiri daripada belia yang telah ditauliahkan Tahap Emas Anugerah Remaja Perdana Rakan Muda dari seluruh Negeri di Malaysia, pemimpin dan mentor yang bertindak sebagai perancang, pelaksana dan penilai program ARP. Kajian rintis dijalankan bertujuan untuk membangunkan instrumen, pengesahan dan kajian kes penyelidikan. Instrumen kajian dibahagikan kepada dua bahagian, Bahagian A: latar belakang responden, pembangunan potensi diri belia dan Bahagian B: kesepaduan sosial belia, soalan terbuka untuk Focus Group Discussion (FGD) dan Nominal Group Technique (NGT). Dapatan kajian ini menekankan kepada aspek kesepaduan dalam pembangunan belia melalui penyertaan atau penglibatan belia dalam program di peringkat komuniti, pengiktirafan dan juga inklusi sosial. Semakin banyak aktiviti dalam komponen ARP dilaksanakan, semakin tinggi kesepaduan sosial belia. Walaupun berbeza etnik, belia di Malaysia masih mengekalkan keharmonian melalui penglibatan dalam aktiviti komuniti. Secara keseluruhan, kajian ini membincangkan penilaian sistematik menerusi perspektif psikologi terutamanya niat bagi pemboleh ubah potensi diri dan pembentukan stereotaip perpaduan sosial dalam pembangunan belia. Kajian lanjut adalah dicadangkan untuk memasukkan lebih banyak pengukuran konstruk kesepaduan sosial dan perancangan program dalam program ARP