bluuebunny/crossref_metadata_2025 huggingface dataset:
The Correlation Between the Type of Occupation Toward Blood Pressure and Cholesterol Levels in Individuals with Hypertension
Authors: Abror Jeem Yaltafit , Pratama Yanasta Yudo , Adnan Muhammad Luthfi , Nirwingsyah Nadia Rachma
Published: November 2022

Daily activities and occupation can significantly influence health conditions, so a health assessment related to occupational factors is essential to reduce the risk of the disease. One of the leading causes of mortality from cardiovascular disease worldwide is hypertension. This study aims to determine the correlation between the type of occupation toward blood pressure and cholesterol levels in individuals with hypertension. This paper was an analytical observational study with a cross-sectional approach. The population was individuals with hypertension at Depok 2 Public Health Centre, Sleman Regency, Special Region of Yogyakarta. In addition, the sample was 121 respondents with consecutive sampling. The independent variable was the type of occupation, and the dependent variables were blood pressure and cholesterol levels. Instruments were a questionnaire to evaluate the characteristics of respondents and the type of occupation, a digital sphygmomanometer to examine blood pressure, and cholesterol test kits to assess cholesterol levels. The data analysis used the Chi-Square test with α=0.05. Most respondents were female (59.5%) and aged 60-69 years old (47.1%). They worked in the informal sector (81.2%). In addition, they had grade 1 hypertension (52.1%). There was no significant correlation between the type of occupation and blood pressure in individuals with hypertension (p=0.248). In addition, most respondents had high cholesterol levels (50.4%). Furthermore, there was no significant association between the type of occupation and cholesterol levels in individuals with hypertension (p=0.128). In conclusion, the type of occupation is not a risk factor for increased blood pressure and cholesterol levels in individuals with hypertension.
Fabella Syndrome of Bilateral Knee with Common Peroneal Nerve Compression Neuropathy
Authors: Shiraaj Zainul Abiddin  , Mohd Hisham Mohd Isa
Published: November 2022

Fabella syndrome is a rare, often underdiagnosed cause of recurrent posterolateral knee pain. It can disrupt the common peroneal nerve because of its anatomical location at the lateral head of the gastrocnemius at the lateral femoral condyle, where the nerve typically passes. Far East Asians have been shown to have a higher prevalence of fabella syndrome attributed to their genetic predisposition combined with mechanical causes. Failure to adequately identify a common peroneal nerve neuropathy associated with fabella syndrome can lead to recurrent visits, unnecessary examinations, and surgical procedures. Here, we present a case of a patient presenting with recurrent posterolateral knee pain and a slapping gait. Therefore, a high index of suspicion for fabella syndrome is warranted by a physician to diagnose this condition for the best outcome for the patient.
Surgical Intervention on Drug-Influenced Gingival Enlargement using Diode Laser Therapy
Authors: Sabarudin Muhammad Annurdin , Beh Yew Hin , Hassan Akram , Ab Ghani Zuryati , Taib Haslina
Published: November 2022

This is a clinical case describing a hypertensive female patient with a drug-influenced gingival enlargement (DIGE) on the labial and lingual gingivae of the lower anterior dentition. DIGE is attributed to the prolonged use of medications in a susceptible individual. She had undergone non-surgical periodontal therapy prior to surgical intervention for the removal of gingival enlargement (GE) using diode laser therapy. A diode laser is a type of laser widely used in dentistry. This laser therapy is a less invasive technique for the removal of GE. After 6 months of follow-up, no recurrence of GE was observed, and regular supportive periodontal therapy was adopted to sustain the gingival health. The utilization of the diode laser showed excellent predictability and clinical outcomes.
Allah Versus God! Influences of News Reporting on Contents
Authors: Ahmad Sabri Safiyyah
Published: November 2022

Reporting on sensitive or controversial issues, particularly race and religion, has always been challenging for media practitioners. With a plural society background like Malaysia has, the media practitioners have to put more concern in the contents of their news reports. The consideration includes journalists as individuals, media routines, organisation, extra media forces to the ideological, sociocultural forces as presented in the Hierarchy of Influence model by Shoemaker & Reese (2014). The paper aims to study how the Malaysian mainstream media report on controversial issues in the newspapers from the hierarchy of influence perspective. Through a qualitative method, in-depth interviews were conducted among editors and journalists from The Star and Utusan Malaysia to obtain their experience in reporting such issues. Their responses were then analysed using Nvivo through the categorization of themes from the hierarchy of influences. The results show that there are connections between all levels that contributed to the shaping of news contents particularly on controversial issues like the translation of the word ‘God’ to ‘Allah’ case. This shows that Malaysia is unique and different when reporting on such issues as these influences will help to keep and maintain the peace and harmony in the plural society.
"Hello, Selamat Datang!" A preliminary proposed model of Tourism interpersonal communication from an Islamic perspective amongst frontliners
Authors: Abu Hasan Nurul Nadirah , Mohd Sofian Muhammad Raqib , Mior Kamarulbaid Afiqah , Md. Ithnan Izwan Harith
Published: November 2022

These articles explore interpersonal communication in the tourism industry. As the industry faced changes post-pandemic, there is a great reason for the industry to refine people inside the industry, especially the frontliners. Since the frontliners are the first people met and greeted by the tourist, the responsibilities of these groups of industrial players are indeed higher than others. Pieces of the literature suggest that tourism service providers must have expressive communication skills to give a superior product and create a pleasant experience for tourists. Hence, tourism frontliners are expected to be able to express effective interpersonal communication skills both internal and external communication. Interpersonal communication skills in dealing with people are one of the major demands in the industry nowadays.  This has created a skills gap in the hospitality industry, which must be addressed if businesses are to remain competitive. It is suggested that the staff in tourism and hospitality should be carefully recruited and should undergo continual training because their communication skills are a significant indicator of their ability to foster favorable interactions with clients. Therefore, this conceptual paper aims to suggest an Islamic approach to improve current tourism frontliners interpersonal communications through Islamic-based communications. The need for interpersonal communication skills in the tourism industry is also highlighted in this article. An integrated model of tourism interpersonal communication with Islamic-based communication was proposed at the end of the article. It is hoped that this conceptual paper will be a stepping stone for research in tourism communication from an Islamic view.
Parameter Bagi Pembelian Emas Dalam Talian Secara Kaedah Kunci Harga (Lock Price) : Satu Analisis
Authors: Saiman Muhamad Zuhaili
Published: November 2022

Pembelian emas menerusi kaedah kunci harga (lock price) merupakan kaedah yang popular urusniaga emas kontemporari. Kelebihan kaedah kunci harga (lock price) ini memberikan kelebihan kepada pembeli untuk mendapatkan harga yang lebih murah dari berlakunya perubahan harga sekiranya nilai emas melonjak naik. Dengan kunci harga (lock price), pembeli akan mendapat harga emas sewaktu kunci harga dilakukan dan ia tidak akan berubah atau terjejas dengan perubahan nilai emas. Menjadi persoalan kajian ialah bagaimana kaedah kunci harga (lock price) diaplikasikan agar tidak wujud unsur bertangguh yang membawa kepada isu riba memandangkan urusniaga emas yang merupakan item ribawi mestilah berlaku secara tunai dan wujudnya taqabud dari kedua-dua pihak dalam satu majlis. Tumpuan kajian ini ialah mengkaji kaedah kunci harga (lock price) dalam urusniaga emas yang berlaku bagi mengalisis kepatuhan syariah berdasarkan garis panduan urusniaga emas menurut perspektif kewangan Islam. Metodologi yang digunakan ialah reka bentuk kajian kualitatif iaitu menerusi pendekatan kajian kepustakaan berdasarkan analisis kandungan dan dokumen yang berkaitan. Dapatan hasil kajian ialah pembentukan satu parameter yang khusus dalam kaedah kunci harga (lock price) dihasilkan bagi memastikan urusniaga emas dilakukan dengan jelas tanpa wujud unsur bertangguh dan berlakunya taqabud dalam satu majlis. Selain itu, dengan parameter yang dihasilkan ini akan membezakan kaedah kunci harga (lock price) yang merupakan hanya perjanjian dan belum lagi terbentuk akad jual beli emas.
Could Esg and Halal Practices Be Converged? Preliminary Evidence Based on Integrated Reporting And Sustainability Reporting Of A Halal-Certified Company
Authors: Ramli Nathasa Mazna , Shahrul Kamil Aimi Nurshahirah Binti , Jamil Nurul Nazlia , Haron Hasnah
Published: November 2022

One of communication mechanism that used by corporations to state their focus, concerns and activities is corporate reports, such as annual report and stand-alone sustainability report. On top of mandatory reporting of financial statements, corporations use corporate reports to convey their philosophy, construct visibility and image. Integrated Reporting (IR) and Sustainability Reporting are two recent reporting frameworks that have been adopted by corporations.  The corporations’ value creation process is the main focus of IR, which is based on six capitals of corporations. Sustainability Reporting is a way for a corporation to become more sustainable and focuses on economic, environmental and social aspects. The main objective of this study is to compare the two-reporting frameworks. Particularly, the suitability of the reporting frameworks for halal industry players to communicate their halal commitment and activities.  This study also examine whether ESG and Halal practices can be converged based on the reporting framework. This study provides an analysis of corporate reports of a leading halal food manufacturer that is listed in Bursa Malaysia. Based on content analysis, this study highlights halal-related information in the company’s IR and Sustainability Reporting.  Results from the study might provide evidence on non-financial reporting that may acts as a communication tool to the stakeholders. Utilizing IR and Sustainability reporting could build trust of capital market and society, thus ensure the sustainability of halal industry.
Optimization of the Biodiesel Production via Transesterification Reaction of Palm Oil using Response Surface Methodology (RSM): A Review
Authors: Nur Aishah Rajali  , Salina Mat Radzi  , Maryam Mohamed Rehan  , Nur Amalina Mohd Amin
Published: November 2022

The optimization method is vital in chemical synthesis and has been applied in many fields nowadays. Response surface methodology (RSM) is an example of an optimization method that is useful in examining the effects of multiple independent variables. RSM was applied in many studies to optimize the transesterification of biodiesel production from palm oil in the presence of a catalyst. This paper aims to provide an overview of recent catalyzed transesterification trends, as well as the benefits and drawbacks of heterogeneous, homogeneous, and enzyme catalysts in biodiesel production. RSM was used to design the process and statistically analyze the interaction effects of the independent reaction variables. The reaction variables, such as reaction time, reaction temperature, catalyst amount, and the molar ratio of the substrate, were optimized during the process. A statistical model and response surface plots were visualized graphically in the contour plots and three-dimensional figures to explain the interactive effects of variables on a response. In sum, this paper discussed the relationships between the reaction parameters and the production of biodiesel and the optimum conditions for biodiesel production using RSM.
Cancer statistics forAmericanIndian andAlaskaNative individuals, 2022: Including increasing disparities in early onset colorectal cancer
Authors: Kratzer Tyler B. , Jemal Ahmedin , Miller Kimberly D. , Nash Sarah , Wiggins Charles , Redwood Diana , Smith Robert , Siegel Rebecca L.
Published: November 2022

American Indian and Alaska Native (AIAN) individuals are diverse culturally and geographically but share a high prevalence of chronic illness, largely because of obstacles to high‐quality health care. The authors comprehensively examined cancer incidence and mortality among non‐Hispanic AIAN individuals, compared with non‐Hispanic White individuals for context, using population‐based data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries. Overall cancer rates among AIAN individuals were 2% higher than among White individuals for incidence (2014 through 2018, confined to Purchased/Referred Care Delivery Area counties to reduce racial misclassification) but 18% higher for mortality (2015 through 2019). However, disparities varied widely by cancer type and geographic region. For example, breast and prostate cancer mortality rates are 8% and 31% higher, respectively, in AIAN individuals than in White individuals despite lower incidence and the availability of early detection tests for these cancers. The burden among AIAN individuals is highest for infection‐related cancers (liver, stomach, and cervix), for kidney cancer, and for colorectal cancer among indigenous Alaskans (91.3 vs. 35.5 cases per 100,000 for White Alaskans), who have the highest rates in the world. Steep increases for early onset colorectal cancer, from 18.8 cases per 100,000 Native Alaskans aged 20–49 years during 1998 through 2002 to 34.8 cases per 100,000 during 2014 through 2018, exacerbated this disparity. Death rates for infection‐related cancers (liver, stomach, and cervix), as well as kidney cancer, were approximately two‐fold higher among AIAN individuals compared with White individuals. These findings highlight the need for more effective strategies to reduce the prevalence of chronic oncogenic infections and improve access to high‐quality cancer screening and treatment for AIAN individuals. Mitigating the disparate burden will require expanded financial support of tribal health care as well as increased collaboration and engagement with this marginalized population.
Poverty Reduction in Awka Metropolis: The Role of Entrepreneurship Productivity
Authors: Meshack Aggreh , Marcus Garvey Orji  , Nworie Gilbert Ogechukwu
Published: November 2022

The study examined the contribution of entrepreneurship productivity towards poverty reduction using trading SMEs in Awka South as cases of reference. Specifically, the study determined the extent to which entrepreneurial education, entrepreneurial skill acquisition and entrepreneurial innovation affect poverty reduction. Descriptive survey research design was deployed in the study. Primary data were collected using a structured questionnaire administered on a sample size of ninety-nine (99). The reliability of the questionnaire was established using Cronbach alpha statistic. Hypotheses testing was conducted with the aid of Spearman Ranked Order Correlation Coefficient at 5% level of significance. The results of the analysis revealed that: entrepreneurial education significantly contributes to poverty reduction among selected SMEs in Awka South (rho = 0.589, p-value = 0.000); entrepreneurial skill acquisition significantly influences poverty reduction among selected SMEs in Awka South (rho = 0.733, p-value = 0.000); and entrepreneurial innovation significantly helps in poverty reduction in Awka South (rho = 0.591, p-value = 0.000). Among others, it was recommended that the Anambra state government should invest more in massive entrepreneurial skill acquisition in order to help the citizens to learn various aptitudes that will enable them to be self-reliant.
COVID Heart: Fact or Friction
Authors: Ahmed Chowdhury Meshkat , Sultan Md Ashraf Uddin
Published: November 2022

Abstract not available

University Heart Journal 2022; 18(2): 71
Long term Cardiovascular Manifestations of COVID - 19
Authors: Ahmed Khurshed , Sah Sudhir Prasad , Khaled Md Fakhrul Islam , Anwar AFM Azim , Hoque Md Harisul
Published: November 2022

Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is well known for causing an acute respiratory disease, a number of patients after they get recovered from acute infection, subsequently experience a constellation of symptoms and events that lasts for more than 3 months. Adequate clinical data are now accumulating on the subacute and long-term effects of Covid-19 and can involve multiple organ systems. This spectrum of symptoms and late manifestations are thought to have a possible link with the covid-19 and this condition is named LONG COVID or POST-COVID. Some of the patients may show the ongoing evidence of cardiovascular damage on long term without having symptoms which may be picked up by different imaging modalities like CMR. There has been an increase in the number of COVID-19 patients in an exponential fashion so as to cause a collapse in the healthcare system in many countries across the world, with an effect not only on public health, but also on social and economic activities.

University Heart Journal 2022; 18(2): 118-124
Pengembangan Media Maze Kotaku untuk Menstimulasi Kemampuan Memecahkan Masalah pada Anak Usia 4-5 Tahun
Authors: Lestariningrum Anik , Niken Ayu Saptiwi
Published: November 2022

Tahapan berpikir pra-operasional merupakan saat anak-anak membutuhkan sebuah media pembelajaran yang dapat menggabungkan pola pikir sederhana terutama dalam kemampuan mencari solusi dari masalah yang dihadapi. Anak terbiasa dengan bimbingan dan pendampingan yang sangat ketat dari orang dewasa disekitarnya membuat tidak memiliki kebebasan menentukan pilihan sendiri. Permasalahan ini dihadapi oleh anak di lembaga PAUD Darussalam Jabon dari 13 anak capaian kognitif terkait kemampuan memecahkan masalah hanya 4 anak yang memperoleh BSH sedangkan 2 anak dalam kategori MB dan 7 anak BB. Analisis kebutuhan dilakukan ditemukan kebutuhan media pembelajaran yang perlu diinovasi sehingga dapat menumbuhkan minat anak mencapai kemampuan memecahkan masalah sederhana. Desain penelitian adalah R & D dengan mengadopsi Borg & Gall yang digunakan hanya sampai 4 tahapan  dengan keterbatasan penelitian dimiliki yaitu potensi masalah, pengumpulan data, desain produk dan validasi desain.  Hasil penelitian yang diharapkan adalah prototype terkait desain dan panduan media pembelajaran maze kotaku yang akan digunakan dalam pengembangan kemampuan kognitif anak fokus pemecahan masalah. Diharapkan desain hasil produk yang divalidasi nantinya dapat digunakan dalam tahapan selanjutnya.

Kata Kunci: memecahkan masalah, maze kotaku, anak usia 4-5 tahun.
Meningkatkan Kualitas Pendidikan Anak Usia Dini melalui Pembelajaran Kontekstual dengan Pendekatan Merdeka Belajar
Authors: Nisna Nursarofah
Published: November 2022

Kualitas pendidikan di Indonesia masih perlu ditingkatkan, salah satunya pada lembaga pendidikan anak usia dini. Adanya problematika yang terjadi pada pendidikan di Indonesia yaitu dalam pelaksanaan proses pembelajaran yang hanya berorientasi pada guru yang menyebabkan anak kurang mandiri dalam menyelesaikan suatu permasalahan dan anak menjadi kurang kreatif. Kemudian guru yang menyampaikan pembelajaran hanya dengan teori tanpa adanya media pembelajaran sehingga anak kurang memahami makna dari apa yang disampaikan. Penulis menggunakan metode penelitian studi literatur, dan mengambil data dari buku, artikel, internet, dan sumber informasi lain yang relevan. Hasil dari kajian literatur mengenai peningkatan kualitas pendidikan anak usia dini melalui pembelajaran kontekstual dengan pendekatan MERDEKA BELAJAR yaitu diharapkan dapat menjadi salah satu cara untuk meningkatkan kualitas pendidikan di Indonesia. Inti dari pembelajaran kontekstual dengan pendekatan merdeka belajar yaitu pembelajaran yang menghubungkan antara teori dengan kehidupan nyata sehingga memberikan pembelajaran lebih konkrit dan bermakna, dan juga memberikan kebebasan kepada anak untuk mencari dan memecahkan suatu permasalahan dalam proses pembelajaran baik secara kelompok maupun individu sehingga dapat meningkatkan kemandirian dan kreativitas anak.
Implementasi Sistem Informasi Manajemen dalam Mendukung Proses Pembelajaran Daring pada Pendidikan Anak Usia Dini
Authors: Harahap Rani Astria Silvera , Rahyana Hasibuan
Published: November 2022

In order to achieve the educational goals that are expected, teaching and learning activities in school institutions will be better if a school institution has an information system that can manage these learning activities. Management information system is a that can help a leader in the form of information in making decisions. Thus, the school institution can provide information with a variety of according to what is needed. Look at the current pandemic and development of information technology especially by educational institutions in early childhood education programs (PAUD), learning activities can take place remotely (online) via the internet assisted by parents. That way the learning that is done is more effective and efficient.
PENINGKATAN AKTIVITAS BELAJAR MATEMATIKA MENGGUNAKAN APLIKASI GOOGLE CLASSROOM DALAM MATERI PERSAMAAN GARIS LURUS PADA KELAS VIII.1 DI SMP NEGERI 18 KOTA BENGKULU
Authors: Hasdelyati Hasdelyati
Published: November 2022

Penelitian ini bertujuan untuk meningkatkan hasil belajar matematika dengan menggunakan aplikasi Google Classroom pada siswa kelas VIII.1 di SMP Negeri 18 Kota Bengkulu yang berjumlah 30 siswa yang terdiri dari 19 siswa laki-laki dan 11 siswa perempuan. Teknik pengumpulan data menggunakan observasi, tes, dan dokumentasi. Teknik analisis data dilakukan melalui model dengan urutan: reduksi data, penyajian data, dan penarikan kesimpulan. Hasil penelitian ini adalah peningkatan hasil belajar siswa pada pembelajaran matematika. Hal ini terlihat dari peningkatan persentase hasil belajar siswa dari pra siklus, siklus I ke siklus II. Pada pra siklus jumlah siswa yang mencapai KKM sebanyak 47% atau 14 siswa, meningkat 20% pada siklus I menjadi 67% atau 20 siswa. Pada siklus II jumlah siswa yang mencapai KKM meningkat 20% menjadi 87% atau 26 siswa. Dengan demikian dapat disimpulkan bahwa penggunaan aplikasi Google Classroom dapat meningkatkan hasil belajar matematika siswa kelas VIII.1 SMP Negeri 18 Bengkulu tahun 2020/2021.
PENINGKATAN HASIL BELAJAR MATEMATIKA PESERTA DIDIK SMP DENGAN MODEL KOOPERATIF TIPE GROUP INVESTIGATION
Authors: Tama Rizky Dwi , Rusdi Rusdi , Maizora Syafdi
Published: November 2022

Tujuan penelitian ini adalah untuk mendeskripsikan peningkatkan aktivitas dan hasil belajar peserta didik dalam pembelajaran matematika pada pokok bahasan segiempat dan segitiga. Jenis penelitian ini yaitu penelitian tindakan kelas. Subjek penelitian yaitu peserta didik Kelas VII B SMPN 9 Kota Bengkulu semester genap tahun ajaran 2019/2020. Instrumen yang digunakan yaitu lembar observasi aktivitas peserta didik dan tes hasil belajar peserta didik. Hasil penelitian menunjukkan bahwa (1) aktivitas belajar peserta meningkat dengan cara: pembagian kelompok heterogen, pembimbingan kelompok pada kegiatan investigasi, memberikan kesempatan kepada peserta didik untuk menanggapi dan bertanya serta memberikan apresiasi berupa pujian, tepuk tangan dan tambahan nilai. Peningkatan aktivitas belajar dapat dilihat dari rata-rata skor pada lembar observasi aktivitas peserta didik siklus I yaitu 24,125 (kriteria cukup). (2) Hasil belajar peserta didik meningkat dengan cara: menyusun LKPD dengan langkah-langkah model pembelajaran kooperatif tipe group investigation, mengingatkan peserta didik mengenai materi prasyarat, dan memberikan soal latihan. Peningkatan hasil belajar peserta didik dapat dilihat dari nilai rata-rata tes hasil belajar peserta didik pra siklus sampai siklus I yaitu 33,5 dan 58,7 persentase ketuntasan belajar klasikal dari pra siklus sampai siklus I yaitu 0% dan 25,8%.Kata kunci : Aktivitas Belajar, Group Investigation, Hasil Belajar.
PENGEMBANGAN LKPD BERBASIS RME PADA MATERI LINGKARAN DI KELAS VIII SMPN 1 KOTA BENGKULU
Authors: Rum Ahbi Mahdianing , Susanta Agus , Rusdi Rusdi
Published: November 2022

Tujuan dari penelitian ini adalah menghasilkan LKPD berbasis RME pada materi lingkaran di SMPN 1 Kota Bengkulu yang memenuhi efektif. Penelitian ini adalah penelitian pengembangan dengan menerapkan 3 tahapan dari model pengembangan 4D, yaitu pendefinisian, perancangan, dan pengembangan. Instrumen penelitian yaitu lembar efektivitas yang meliputi lembar pengamatan aktivitas pendidik, lembar pengamatan aktivitas peserta didik, lembar respon peserta didik, dan tes hasil belajar. Dari hasil penelitian didapatkan bahwa LKPD berbasis RME pada materi lingkaran di Kelas VIII SMPN 1 Kota Bengkulu memuat langkah-langkah sesuai dengan sintaks RME yang membimbing peserta didik untuk menemukan dan memahami konsep-konsep lingkaran, peserta didik dapat menyelesaikan THB dan memperoleh hasil belajar yang tinggi dengan persentase ketuntasan 93,75%. LKPD berbasis RME dapat memaksimalkan aktivitas peserta didik, memotivasi peserta didik dalam belajar, membantu peserta didik memahami materi, serta aktif dalam pembelajaran. Sehingga LKPD berbasis Realistic Mathematics Education yang telah dikembangkan termasuk dalam kategori sangat efektif dengan skor efektivitas 4,56 berdasarkan aktivitas, respon peserta didik, dan hasil belajar peserta didik.
PENERAPAN PROBLEM BASED LEARNING DALAM MENINGKATKAN KEMAMPUAN BERPIKIR KRITIS SISWA MA NEGERI 1 KOTA BENGKULU
Authors: Malinda Guspita
Published: November 2022

dengan dua siklus. Setiap siklus teridi dari empat tahapan, yaitu: (1) perencanaan, (2) pelaksanaan, (3) pengamatan, dan (4) refleksi. Subjek penelitian adalah siswa kelas XI IPS 2 MA Negeri 1 Kota Bengkulu tahun ajaran 2018/2019 dengan jumlah sebanyak 24 orang siswa. Teknik pengumpulan data dilakukan dengan tes. Instrumen penelitian terdiri dari lembar tes berpikir kritis dan lembar obeservasi. Hasil peneltian diperoleh kesmpulan bahwa penerapan model problem based learning dapat meningkatkan kemampuan berpikir kritis siswa. Hal ini ditunjukkan adanya peningkatan pada setiap siklus.  Pada siklus I dengan nilai rata-rata 60,05 dan  ketuntasan belajar 62,50% dan meningkat pada siklus II dengan nilai rata-rata 74,50 dan ketuntasan belajar 79,16%. Peningkatan dengan melakukan beberapa tindakan: (a) menyiapkan masalah  nyata pada awal pembelajaran, (b) menyiapkan bahan ajar berupa LKS, (c) membentuk kelompok kecil dalam pembelajaran.
‘Fix Crash Corner’ – A Roundabout Story
Authors: Royce Bruno
Published: November 2022

In 2020, a new roundabout was constructed at the intersection of Church and Victoria Streets, Auckland, New Zealand. It replaced a ‘Stop’ controlled cross-roads junction with adverse crash history, nicknamed ‘crash corner’ by locals, having 54 crashes reported over five years. The constructed roundabout was the first ‘Safe System – Vision Zero’ design of its kind in New Zealand, being a fully raised roundabout with four pedestrian crossings. Independent crash analysis determined that the new roundabout had reduced reported crashes at the junction to zero. The ‘lifetime’ crash cost savings of the new roundabout were estimated at a Present Value of over $NZ 10 million. The roundabout also improved pedestrian amenity, upgraded access to public transport and local shops, encouraged modal shift, improved social well-being, and helped reduce carbon emissions. The project progressed from scheme design to successful construction within six months, and was selected as a finalist in the IPWEA NZ ‘Asset Management Excellence Awards’ (2022).
Who Audits Who Using Resection Margins: The Surgeon, or the Pathologist?
Authors: Salmo Emil , Haboubi Najib
Published: November 2022

Clear or involved resection margins have significant bearings on the outcome of colorectal cancer cases. There are two aspects of resection margins: longitudinal and circumferential. Pathological staging for rectal and colonic tumour specimens is a useful tool for providing continuous feedback to surgeons and may serve to improve the quality of surgery and pathology reporting. It is expected that a good pathology report will evaluate and audit the quality of other services such as radiology, surgery, and oncology. The aim of this paper is to outline how this parameter can be audited by surgeons and pathologists to improve both communication and standards.
Defining the Future of Inflammatory Bowel Disease Care: The Pivotal Role of Personalised Treatment
Authors: Webster Samantha
Published: November 2022

At the 14th Annual Congress of European Crohn’s and Colitis Organisation (ECCO), a symposium was convened to discuss the present and future of personalised care for patients with inflammatory bowel disease (IBD). IBD is not one disease: the clinical presentation, disease course, and treatment response differ in every patient. As such, personalised care is considered the best approach for effective management.

Importantly, it is acknowledged that IBD is not confined to the gut. Although the predominant symptoms manifest in the organ, the inflammation is likely to be systemic. The importance of learning from and collaborating with specialists who treat associated conditions, such as spondyloarthritis (SpA), will become the key to managing IBD at the individual level.

IBD is known to be influenced by genetic as well as environmental factors; however, some are yet to be identified. Advances in understanding ‘omes’ (e.g., genome, transcriptome, microbiome, etc.) and how they impact a person’s IBD journey are rapidly occurring. At the congress, experts provided their insights into recent developments in personalised care and how to optimise current tools at their disposal, as well as evolving methodologies that are anticipated to offer increased efficiency in the future, e.g., the introduction of systems biology.
Key Considerations in the Management of Inflammatory Bowel Disease: Interviews with Key Opinion Leaders
Authors: Coker James
Published: November 2022

Treatment advances in inflammatory bowel disease (IBD), as well as the development of new biomarkers and technologies to enhance monitoring of the disease and response to treatment, are providing new possibilities in the management of ulcerative colitis (UC) and Crohn’s disease (CD). Awareness of the impact of IBD on patients beyond clinical endpoints is also increasing, including the prevalence and extent of extra-intestinal manifestations, psychological issues, and nutritional deficiencies. This means that the role of physicians in IBD is more important than ever, with continuous investigation required for every patient and a wealth of considerations to take into account when deciding on the most suitable treatment approach to undertake.

For this article, the European Medical Journal conducted a series of interviews with five key opinion leaders from across Europe, each with a wealth of experience and expertise in managing IBD, to gain their perspectives on a range of topics in this area. From the UK, we spoke to Dr Ian Arnott, Consultant Gastroenterologist, Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK; from Spain, Dr Manuel Barreiro-de Acosta, Gastroenterology Department, Inflammatory Bowel Disease Unit, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain; from Germany, Prof Eduard Stange, Internal Medicine I – Gastroenterology, Hepatology and Infectious diseases, University of Tübingen, Tübingen, Germany; from Italy, Prof Antonio Tursi, Gastroenterology Service, Azienda Sanitaria Locale Barletta Andria Trani, Andria, Italy; and from France, Prof Frank Ruemmele, Professor of Paediatrics, Medical Faculty of the Université Sorbonne, Hôpital Necker Enfants Malades, Assistance Publique – Hôpitaux de Paris, Paris, France.

The article begins by discussing monitoring of treatment response and detection of extra-intestinal manifestations, followed by considerations in making treatment decisions before outlining novel therapy options in both UC and CD. Optimal use of anti-TNF therapy, the impact and challenge of psychological issues in IBD, and nutrition and diet in this disease are also explored.
PEMBERDAYAAN KELOMPOK NELAYAN MELALUI PROGRAM SENTRA KELAUTAN DAN PERIKANAN TERPADU (SKPT) DI KABUPATEN MALUKU BARAT DAYA
Authors: Dewi Mutiar Fitri , Dadiara Frans Simon
Published: November 2022

Indonesia's fisheries potential has an essential and strategic role for the national development since it influences economic, security, ecological and social aspects. With this important role, it is assumed that the living standard of Indonesia’s fishermen improved. However, based on the data from the Ministry of Maritime Affairs (2018), most Indonesia’s fishermen still live within the poverty line. This current study aims at describing the implementation of fishermen group empowerment through integrated marine and fisheries center program in Maluku Barat Daya District. The data of this study are gathered through direct observation, in-depth interview and documentation study. Then they are analyzed based on Empowerment theory by Mardikanto and Soebiato (2017). The study’s result show that the empowerment emerged in three aspects namely human, business, and institutional development. It is also found that the empowerment process is still not optimal due to several obstacles namely lack of awareness of fishermen group, characteristics of the archipelago, and inadequate communication network. To overcome these, the Fishery Department has made efforts such as giving training, distributing fishing gears, and establishing certain fishermen groups. Suggestions given by the authors are giving self-awareness and work ethics socialization, cooperating with the heads of village, and issuing local government regulation regarding fishery.

 

Keywords: Empowerment, Fishermen Group, Integrated Marine and Fisheries Center Program
Kounis Syndrome That Recurs in A Short Time Period: A Case Report
Authors: Akbaş İlker , Kocak Abdullah Osman , Doğruyol Sinem
Published: November 2022

This case report is unique for the occurrence of a quickly recurring Kounis Syndrome (KS) due to re-exposure to the same agent. A 40-year-old male was brought to our ED with a diagnosis of non-ST-segment elevation myocardial infarction. He stated that he had taken one dose of amoxicillin-clavulanate 1,000 mg at 03.00 AM. After taking the drug, chest pain and vomiting began. ECG which was taken at the the rural hospital, revealed a normal sinus rhythm with no ischemic changes. The value of cardiac troponin I 0.34 ng/ml in the rural hospital. The patient was consultated to the cardiology clinic with a pre-diagnosis of KS. Percutaneous coronary intervention showed that coronary arteries were normal and no plaque formation was found. The patient, who was diagnosed with type I KS, left the hospital at his own request at 14:12 PM. The patient presented to our ED again at 22:30 PM with chest pain and shortness of breath after accidentally using the same allergenic drug ~eight hours after leaving our hospital. ECG showed > 0.5 cm ST-segment elevation in leads DII, DIII, and aVF. Quickly recurring KS was due to accidental reuse of the same agent may be more severe than the first occurrence.
Spatial, environmental, and individual associations with Anopheles albimanus salivary antigen IgG in Haitian children
Authors: Jaramillo-Underwood Alicia , Herman Camelia , Impoinvil Daniel , Sutcliff Alice , Knipes Alaine , Worrell Caitlin M. , Fox LeAnne M. , Desir Luccene , Fayette Carl , Javel Alain , Monestime Franck , Mace Kimberly E. , Chang Michelle A. , Lemoine Jean F. , Won Kimberly , Udhayakumar Venkatachalam , Rogier Eric
Published: November 2022

IgG serology can be utilized to estimate exposure to Anopheline malaria vectors and the Plasmodium species they transmit. A multiplex bead-based assay simultaneously detected IgG to Anopheles albimanus salivary gland extract (SGE) and four Plasmodium falciparum antigens (CSP, LSA-1, PfAMA1, and PfMSP1) in 11,541 children enrolled at 350 schools across Haiti in 2016. Logistic regression estimated odds of an above-median anti-SGE IgG response adjusting for individual- and environmental-level covariates. Spatial analysis detected statistically significant clusters of schools with students having high anti-SGE IgG levels, and spatial interpolation estimated anti-SGE IgG levels in unsampled locations. Boys had 11% (95% CI: 0.81, 0.98) lower odds of high anti-SGE IgG compared to girls, and children seropositive for PfMSP1 had 53% (95% CI: 1.17, 2.00) higher odds compared to PfMSP1 seronegatives. Compared to the lowest elevation, quartiles 2-4 of higher elevation were associated with successively lower odds (0.81, 0.43, and 0.34, respectively) of high anti-SGE IgG. Seven significant clusters of schools were detected in Haiti, while spatially interpolated results provided a comprehensive picture of anti-SGE IgG levels in the study area. Exposure to malaria vectors by IgG serology with SGE is a proxy to approximate vector biting in children and identify risk factors for vector exposure.
Adhesin related genes as potential markers for the enteroaggregative Escherichia coli category
Authors: Freire Claudia A. , Rodrigues Beatriz O. , Elias Waldir P. , Abe Cecilia M.
Published: November 2022

Enteroaggregative Escherichia coli (EAEC) is an important cause of diarrhea in children and adults worldwide. This pathotype is phenotypically characterized by the aggregative-adherence (AA) pattern in HEp-2 cells and genetically associated to the presence of the aatA gene. EAEC pathogenesis relies in different virulence factors. At least, three types of adhesins have been specifically associated with EAEC strains: the five variants of the aggregative adherence fimbriae (AAF), the aggregative forming pilus (AFP) and more recently, a fibrilar adhesin named CS22. Our study aimed to evaluate the presence of AAF, AFP and CS22-related genes among 110 EAEC strains collected from feces of children with diarrhea. The presence of aggR (EAEC virulence regulator) and genes related to AAFs (aggA, aafA, agg3A, agg4A, agg5A and agg3/4C), AFP (afpA1 and afpR) and CS22 (cseA) was detected by PCR, and the adherence patterns were evaluated on HeLa cells. aggR-positive strains comprised 83.6% of the collection; among them, 80.4% carried at least one AAF-related gene and presented the AA pattern. aggA was the most frequent AAF-related gene (28.4% of aggR+ strains). cseA was detected among aggR+ (16.3%) and aggR- strains (22.2%); non-adherent strains or strains presenting AA pattern were observed in both groups. afpR and afpA1 were exclusively detected among aggR- strains (77.8%), most of which (71.4%) also presented AA pattern. Our results indicate that AAF- and AFP-related genes may contribute to identify EAEC strains, while the presence of cseA and its importance as an EAEC virulence factor and genotypic marker needs to be further evaluated.
Mixed-UNet: Refined class activation mapping for weakly-supervised semantic segmentation with multi-scale inference
Authors: Liu Yang , Lian Lijin , Zhang Ersi , Xu Lulu , Xiao Chufan , Zhong Xiaoyun , Li Fang , Jiang Bin , Dong Yuhan , Ma Lan , Huang Qiming , Xu Ming , Zhang Yongbing , Yu Dongmei , Yan Chenggang , Qin Peiwu
Published: November 2022

Deep learning techniques have shown great potential in medical image processing, particularly through accurate and reliable image segmentation on magnetic resonance imaging (MRI) scans or computed tomography (CT) scans, which allow the localization and diagnosis of lesions. However, training these segmentation models requires a large number of manually annotated pixel-level labels, which are time-consuming and labor-intensive, in contrast to image-level labels that are easier to obtain. It is imperative to resolve this problem through weakly-supervised semantic segmentation models using image-level labels as supervision since it can significantly reduce human annotation efforts. Most of the advanced solutions exploit class activation mapping (CAM). However, the original CAMs rarely capture the precise boundaries of lesions. In this study, we propose the strategy of multi-scale inference to refine CAMs by reducing the detail loss in single-scale reasoning. For segmentation, we develop a novel model named Mixed-UNet, which has two parallel branches in the decoding phase. The results can be obtained after fusing the extracted features from two branches. We evaluate the designed Mixed-UNet against several prevalent deep learning-based segmentation approaches on our dataset collected from the local hospital and public datasets. The validation results demonstrate that our model surpasses available methods under the same supervision level in the segmentation of various lesions from brain imaging.
Initial experience with pulsed field ablation for atrial fibrillation
Authors: Magni Federico T. , Mulder Bart A. , Groenveld Hessel F. , Wiesfeld Ans C. P. , Tieleman Robert G. , Cox Moniek G. , Van Gelder Isabelle C. , Smilde Tom , Tan Eng S. , Rienstra Michiel , Blaauw Yuri
Published: November 2022

Introduction

Pulsed field ablation (PFA) was recently introduced for the treatment of symptomatic atrial fibrillation (AF) with the claim of selectively ablating the myocardium while sparing surrounding tissues. We present our initial experience with a PFA catheter for pulmonary vein isolation (PVI) and describe procedural findings and peri-procedural safety of the first 100 patients.

Materials and methods

We investigated 100 patients treated for symptomatic AF using the FARAWAVE PFA catheter (Farapulse, Menlo Park, CA, USA) between July 2021 and March 2022. Procedure workflow and electrophysiological findings at the time of ablation, peri-procedural complications, and operator learning curves are described.

Results

The mean age of patients was 62.9 ± 9.4 years, 62% were male subjects and 80% had paroxysmal AF. The median CHA2DS2-VASc score was 1.5 (IQR: 1.0–2.0) and the mean left atrial volume index was 35.7 ± 9.6 ml/m2. In 88 (88%) patients, PVI alone was performed and in 12 (12%) patients additional ablation of the posterior wall was performed. 3D-electroanatomic mapping was performed in 18 (18%) patients. Procedures without mapping lasted for 52.3 ± 16.6 min. The mean number of applications per pulmonary vein (PV) was 8.1 ± 0.6. In all patients (100%), all PVs were confirmed to be isolated. The learning curves of the two operators who performed > 20 procedures showed a negligible variation of performance over time and practice did not significantly predict procedure time [Operator 1 (senior): R2 = 0.034, p = 0.35; Operator 2 (junior): R2 = 0.004, p = 0.73]. There was no difference between the procedure times between senior and junior operators (Operator 1: 46.9 ± 9.7 min vs. Operator 2: 45.9 ± 9.9 min; p = 0.73). The only complications observed were two cases of bleeding at the site of percutaneous access.

Conclusion

Our initial experience shows that use of the PFA catheter for pulmonary vein isolation (PVI) is safe, fast, and easy to learn.
Real-world intravascular ultrasound (IVUS) use in percutaneous intervention-naïve patients is determined predominantly by operator, patient, and lesion characteristics
Authors: Tindale Alexander , Panoulas Vasileios
Published: November 2022

Background

Intravascular Ultrasound (IVUS) has been shown to improve clinical outcomes in patients undergoing percutaneous intervention (PCI) in numerous trials. However, it is still underutilized outside of trial settings, and most trials include a significant proportion of patients with prior PCI. The aim of this study is to look at real-world use and outcomes in PCI-naïve patients who undergo IVUS-guided intervention.

Methods and results

Prospectively collected data from 10,574 consecutive patients undergoing their index PCI was retrospectively analyzed. 455 (4.3%) patients underwent IVUS, with a median follow-up of 4.6 years. Patients undergoing IVUS had higher levels of comorbidities including diabetes (27.5% vs. 19.7%, p < 0.001), hypertension (58.0% vs. 47.9%, p < 0.001), hypercholesterolemia (51.6% vs. 39.2%, p < 0.001) and were generally older (65.9 ± 14.5 vs. 64.5 ± 13.4 years, p = 0.031) with higher mean baseline creatinine levels (95.4 ± 63.3 vs. 87.8 ± 46.1 μmol/L). The strongest predictor of IVUS use was the operating consultant graduating from medical school after the year 2000 [OR 14.5 (3.5–59.8), p < 0.001] and the presence of calcific lesions [OR 5.2 (3.4–8.0) p < 0.001]. There was no significant difference in MACE nor 1-year mortality between patients undergoing IVUS-guided or angiography-only PCI on unadjusted analysis [OR 1.04 (0.73—1.5), p = 0.81, OR 1.055 (0.65–1.71) p = 0.828] nor mortality throughout the study period (HR 0.93 (0.69—1.26), p = 0.638). This held true for stents longer than 28 mm. Propensity matched analysis of patients similarly showed no mortality difference between arms for all patients and those with longer stents (p = 0.564 and p = 0.919).

Conclusion

The strongest predictors of IVUS use in PCI-naïve patients are the operator’s year of graduation from medical school and proxy measures of calcific lesions. On both matched and adjusted analysis there was no evidence of improved mortality nor reduced MACE in this specific retrospective cohort, although this may well be explained by significant selection bias.