Pembuatan dan Karakterisasi Elektroda Karbon Aktif dengan Karbonisasi dan Aktivasi Bertingkat Menggunakan Gas Co2 dan Uap Air

Has been conducted a research to produce cell supercapacitor electrodes of activated carbon (AC) which were prepared using rubber wood sawdust (SGKK). KA electrode is made via carbonization and activation method integrated using CO2 and water vapor for 4 hours. N2 flow is maintained from room temperature to a temperature of 600 0C, followed by CO2 to a temperature of 900 0C for 2 hours, water vapor flow continued for 2 hours at a temperature of 900 0C. Crystallite structure is reviewed samples using X-Ray Diffraction (XRD). Methods Scanning Electron Microscopy (SEM) was used to analyze the surface morphology. While the composition of the content chemical elements the samples were analyzed using Energy Dispersive X-ray (EDX). Electrochemical properties of samples were tested using the method Cyclic Voltammetry (CV). Overall characterization of physical properties indicates that the sample is a carbon material with a carbon content of 90%. Electrochemical test proved that the integrated activation method can produce a electrode with excellent performance with a specific capacitance value of 72 F/g

Pembuatan dan Karakterisasi Sel Superkapasitor Menggunakan Karbon Aktif Monolit dari Kayu Karet Berdasarkan Variasi Konsentrasi Hno 3

Synthesis of carbon electrode from rubber wood was started by carbonizing process by adding N 2 gas at a temperature of 600 °C and continued by utilizing physical activation of CO 2 gas at 850 °C for 2 hours, and followed by a combination process of chemical activation using potassium hydroxide activator and nitric acid (HNO 3 ) with its concentration of 5%, 15% and 25%. Density of resulted electrodes was 0.407 g/cm3, 0.359 g /cm3 and 0.349 g/cm3 for each sample. X-ray diffraction analysis showed amorphous carbon electrodes in the presence of ramps at 2θ of 25.25 o and 44.21 o . The results of cyclic voltametry obtained specific capacitance of 10.444 F/g, 70.1969 F/g and 81.8234 F/g, respectively for each HNO 3 concentration. It was concluted that the addition of HNO3 to the activation proces can improve the performance of supercapacitors cell. The highest specific capacitance obtained 81.823 F/g for the 25% HNO3

Pembuatan dan Karakterisasi Karbon Aktif Monolit dari Kayu Karet dengan Variasi Konsentrasi Koh untuk Aplikasi Superkapasitor

Development of monolithic carbon electrodes with a combination of physical and chemical activation process can improve performance of cell supercapacitor. Monolithic carbon electrodes were made from rubber wood cross-section of the printed form of pellets, then were carbonized at temperature of 600ºC in N2 gas atmosphere and followed by physical activation process at 900ºC for 2 hours in a CO2 gas atmosphere. KOH of 1 and 5 M and HNO3 of 25% solutions were used as of the chemical activation in order to activate functional groups. Characterization of electrochemical supercapacitor cell utilized two-electrode of cyclic voltammetry with 1 M H2SO4 solution was used as electrolyte. Scanning electron microscope and X-ray diffraction were carried out to study the structure of surface morphology and crystalline properties of monolithic carbon electrodes. Specific capacitance for electrodes 1 M KOH and 5 M KOH was obtained as high as 71.08 and 115.38 F/g respectively. These results indicate that increasing the concentration of KOH can improve the performance of the electrode supercapacitor cells

Completion Dissection or Observation for Sentinel-Node Metastasis in Melanoma.

Sentinel-lymph-node biopsy is associated with increased melanoma-specific survival (i.e., survival until death from melanoma) among patients with node-positive intermediate-thickness melanomas (1.2 to 3.5 mm). The value of completion lymph-node dissection for patients with sentinel-node metastases is not clear. In an international trial, we randomly assigned patients with sentinel-node metastases detected by means of standard pathological assessment or a multimarker molecular assay to immediate completion lymph-node dissection (dissection group) or nodal observation with ultrasonography (observation group). The primary end point was melanoma-specific survival. Secondary end points included disease-free survival and the cumulative rate of nonsentinel-node metastasis. Immediate completion lymph-node dissection was not associated with increased melanoma-specific survival among 1934 patients with data that could be evaluated in an intention-to-treat analysis or among 1755 patients in the per-protocol analysis. In the per-protocol analysis, the mean (±SE) 3-year rate of melanoma-specific survival was similar in the dissection group and the observation group (86±1.3% and 86±1.2%, respectively; P=0.42 by the log-rank test) at a median follow-up of 43 months. The rate of disease-free survival was slightly higher in the dissection group than in the observation group (68±1.7% and 63±1.7%, respectively; P=0.05 by the log-rank test) at 3 years, based on an increased rate of disease control in the regional nodes at 3 years (92±1.0% vs. 77±1.5%; P<0.001 by the log-rank test); these results must be interpreted with caution. Nonsentinel-node metastases, identified in 11.5% of the patients in the dissection group, were a strong, independent prognostic factor for recurrence (hazard ratio, 1.78; P=0.005). Lymphedema was observed in 24.1% of the patients in the dissection group and in 6.3% of those in the observation group. Immediate completion lymph-node dissection increased the rate of regional disease control and provided prognostic information but did not increase melanoma-specific survival among patients with melanoma and sentinel-node metastases. (Funded by the National Cancer Institute and others; MSLT-II ClinicalTrials.gov number, NCT00297895 .)

Grading of Recommendations Assessment, Development, and Evaluation and Confidence in Network Meta-Analysis showed moderate to substantial concordance in the evaluation of certainty of the evidence

Objectives: Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and Confidence in Network Meta-Analysis (CINeMA) are available to assess the confidence in network meta-analysis (NMA) results. They share common aspects, but their operationalization differs. We evaluated interrater reliability (IRR) among assessors, the approaches' concordance, and application time. Methods: Two dichotomous (“seizure response”, “ischemic stroke”) and two continuous (“change in attention deficit hyperactivity disorder (ADHD)”, “weight loss”) outcomes with networks of different sizes, structures and complexities were chosen from four NMAs. Thirteen assessors were randomly assigned to four groups to apply both GRADE and CINeMA on one continuous and one dichotomous outcome. We measured IRR and concordance using Gwet's AC on the overall evaluation and each tool's domain. We calculated time spent evaluating each network and tool, including time to consult the guidance papers. Results: IRR ranged from 0.49 (“seizure response”) to 0.70 (“ischemic stroke”) with GRADE, from 0.02 (“ischemic stroke”) to 0.73 (“change in ADHD symptoms”) with CINeMA. Overall concordance was 1, 0.90, 0.68, and 0.42 for “seizure response”, “ADHD symptoms”, “weight loss”, and “ischemic stroke”, respectively. The median time spent to assess each network ranged from 160 to 481 minutes with GRADE, from 150 to 330 minutes with CINeMA. Conclusion: IRR was moderate to substantial with both approaches, except for CINeMA when applied to the largest and most complex network (“ischemic stroke”). Concordance was good for small networks with no or few indirect comparisons (“seizure response”) and decreased as the number of comparisons and indirect evidence increased. Application time was long with both approaches, particularly with GRADE for large networks

Safety and Feasibility of Minimally Invasive Inguinal Lymph Node Dissection in Patients With Melanoma (SAFE-MILND): Report of a Prospective Multi-institutional Trial.

BACKGROUND: Minimally invasive inguinal lymph node dissection (MILND) is a novel approach to inguinal lymphadenectomy. SAFE-MILND (NCT01500304) is a multicenter, phase I/II clinical trial evaluating the safety and feasibility of MILND for patients with melanoma in a group of surgeons newly adopting the procedure. METHODS: Twelve melanoma surgeons from 10 institutions without any previous MILND experience, enrolled patients into a prospective study after completing specialized training including didactic lectures, participating in a hands-on cadaveric laboratory, and being provided an instructional DVD of the procedure. Complications and adverse postoperative events were graded using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events Version 4.0. RESULTS: Eighty-seven patients underwent a MILND. Seventy-seven cases (88.5%) were completed via a minimally invasive approach. The median total inguinal lymph nodes pathologically examined (SLN + MILND) was 12.0 (interquartile range 8.0, 14.0). Overall, 71% of patients suffered an adverse event (AE); the majority of these were grades 1 and 2, with 26% of patients experiencing a grade 3 AE. No grade 4 or 5 AEs were observed. CONCLUSIONS: After a structured training program, high-volume melanoma surgeons adopted a novel surgical technique with a lymph node retrieval rate that met or exceeded current oncologic guidelines and published benchmarks, and a favorable morbidity profile

Clinical Science A better prognosis for Merkel cell carcinoma of unknown primary origin

Abstract BACKGROUND: There is limited evidence that Merkel cell carcinoma (MCC) arising from a nodal basin without evidence of a primary cutaneous (PC) site has better prognosis. We present our experience at 2 tertiary care referral centers with stage III MCC with and without a PC site. METHODS: Fifty stage III MCC patients were identified between 1996 and 2011. Clinical data were analyzed, with primary endpoints being disease-free survival and overall survival. RESULTS: Of stage III patients, 34 patients presented with a PC site and 16 patients with an unknown primary (UP) site. Treatment strategies varied; of patients with UP vs PC sites, 25% vs 44% underwent combined regional lymphadenectomy and radiation, with an additional 25% vs 15% receiving chemotherapy. The median disease-free survival for a UP site was not reached vs 15 months for a PC site (hazards ratio 5 .48, P 5 .18). The median overall survival for a UP site was not reached vs 21 months for a PC site (hazards ratio 5 .34, P 5 .03). Multivariate analysis showed that UP status was a significant factor in overall survival (P 5 .002). CONCLUSIONS: Stage III MCC with a UP site portends a better prognosis than MCC with a PC site

Surveillance of Sentinel Node-Positive Melanoma Patients with Reasons for Exclusion from MSLT-II:Multi-Institutional Propensity Score Matched Analysis

BACKGROUND: In sentinel lymph node (SLN)-positive melanoma, two randomized trials demonstrated equivalent melanoma-specific survival with nodal surveillance vs completion lymph node dissection (CLND). Patients with microsatellites, extranodal extension (ENE) in the SLN, or >3 positive SLNs constitute a high-risk group largely excluded from the randomized trials, for whom appropriate management remains unknown. STUDY DESIGN: SLN-positive patients with any of the three high-risk features were identified from an international cohort. CLND patients were matched 1:1 with surveillance patients using propensity scores. Risk of any-site recurrence, SLN-basin-only recurrence, and melanoma-specific mortality were compared. RESULTS: Among 1,154 SLN-positive patients, 166 had ENE, microsatellites, and/or >3 positive SLN. At 18.5 months median follow-up, 49% had recurrence (vs 26% in patients without high-risk features, p 3 positive SLN constitute a high-risk group with a 2-fold greater recurrence risk. For those managed with nodal surveillance, SLN-basin recurrences were more frequent, but all-site recurrence and melanoma-specific mortality were comparable to patients treated with CLND. Most recurrences were outside the SLN-basin, supporting use of nodal surveillance for SLN-positive patients with microsatellites, ENE, and/ or >3 positive SLN

Active surveillance of patients who have sentinel node positive melanoma:An international, multi-institution evaluation of adoption and early outcomes after the Multicenter Selective Lymphadenectomy trial II (MSLT-2)

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/168248/1/cncr33483.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/168248/2/cncr33483_am.pd