bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pengaruh Pendekatan MEAs terhadap Kemampuan Pemecahan Masalah, Komunikasi Matematis, dan Kepercayaan Diri Siswa
Authors: Wijayanti Palupi Sri 
Published: March 2024

Penelitian ini bertujuan untuk mendeskripsikan pengaruh: (1) peringkat sekolah terhadap kemampuan pemecahan masalah siswa, komunikasi matematis, dan kepercayaan diri siswa; (2) pendekatan pembelajaran terhadap kemampuan pemecahan masalah siswa, komunikasi matematis, dan kepercayaan diri siswa; (3) interaksi peringkat sekolah dan pendekatan pembelajaran terhadap kemampuan pemecahan masalah siswa, komunikasi matematis, dan kepercayaan diri siswa. Hasil penelitian menunjukkan bahwa sebagai berikut. (1) Peringkat sekolah tidak mempengaruhi kemampuan pemecahan masalah, komunikasi matematis, dan kepercayaan diri siswa. (2) Pendekatan pembelajaran berpengaruh terhadap kemampuan pemecahan masalah, komunikasi matematis, dan kepercayaan diri siswa. (3) Interaksi peringkat sekolah dan pendekatan Pembelajaran tidak berpengaruh terhadap kemampuan pemecahan masalah, komunikasi matematis, dan kepercayaan diri siswa. (4) Pendekatan pembelajaran dengan MEAs lebih unggul dibandingkan dengan pendekatan tradisional ditinjau dari kemampuan pemecahan masalah siswa.Kata Kunci: Model-eliciting Activities, MEAs, pemecahan masalah, kepercayaan diri The Effects of the Instructional Approach of MEAs on the Students’ Problem Solving Skill, Mathematics Communication, and Self-Confidence AbstractThe study aims at describing the effects of: 1) school rank on the students’ problem solving skill, mathematics communication, and self-confidence. 2) instructional approach on the students’ problem solving skill, mathematics communication, and self-confidence. 3)interaction of school rank and instructional approach on the students’ problem solving skill, mathematics communication, and self-confidence. The result of the study shows the following. 1) The School rank not affects the problem solving skill, mathematics communication, and self-confidence of the students. 2) The instructional approach affects the problem solving skill, mathematics communication, and self-confidence of the students. 3) The interaction of the school rank and the instructional approach not affects the problem solving skill, mathematics communication, and self-confidence of the students. 4) The instructional approach of MEAs more excellent than the instructional approach of taditional on the students’ problem solving skill.Keywords: Model-eliciting Activities, MEAs, problem solving, self-confidence.
Pengembangan Multimedia Macromedia Flash dengan Pendekatan Kontekstual dan Keefektifannya terhadap Sikap Siswa pada Matematika
Authors: Fahmi Syariful , Marsigit Marsigit 
Published: March 2024

Penelitian ini bertujuan untuk menghasilkan multimedia interaktif pada pembelajaran matematika menggunakan Macromedia Flash 8 Professional di standar kompetensi memahami sifat-sifat tabung, kerucut, dan bola, pada siswa kelas IX SMP. Isi multimedia interaktif meliputi standar kompetensi dan kompetensi dasar, petunjuk penggunaan, materi, evaluasi, dan e-book. Model pengembangan yang digunakan adalah model pengembangan Borg and Gall. Penelitian ini telah berhasil mengembangkan multimedia interaktif pada pembelajaran matematika yang mempunyai kualitas BAIK (B) menurut penilaian ahli materi dan pembelajaran, ahli media, dan 42 siswa kelas IX, dengan skor rata-rata 209,48 dari skor maksimal 260. Sedangkan untuk keefektifannya terhadap sikap siswa pada matematika dan ICT, ada perubahan sikap pada aspek rasa cemas siswa, rasa percaya diri siswa, dan rasa suka terhadap matematika dan ICT.Kata Kunci: multimedia interaktif, Macromedia Flash 8 Professional, sikap siswa pada matematika dan ICT. Developing Multimedia Macromedia Flash with Contextual Approach and Its Effect on Students’ Attitude toward Mathematics AbstractThis research aims to develop interactive multimedia in mathematics teaching using Macromedia Flash 8 Professional on a competence standard of solid geometry of tubes, cones, and balls, in class IX of SMP. The content of the interactive multimedia is: competency standards and basic competencies, instructions for use, content, evaluation, and e-book. The development model used was the development model of Borg and Gall. This research has successfully developed interactive multimedia in mathematics teaching which are in a good category (B) according to media and teaching experts and 42 students of class IX with a mean score of 209.48 of the maximum score of 260. As for their effectiveness on the students’ attitudes toward mathematics and ICT, there is a change in students’ attitude toward anxiety, self-confidence, and interest in mathematics and ICT.Keywords: interactive multimedia, Macromedia Flash 8 Professional, student attitudes on mathematics and ICT.
Academic Detailing as a Health Information Technology Implementation Method: Supporting the Design and Implementation of an Emergency Department–Based Clinical Decision Support Tool to Prevent Future Falls
Authors: Barton Hanna J , Maru Apoorva , Leaf Margaret A , Hekman Daniel J , Wiegmann Douglas A , Shah Manish N , Patterson Brian W 
Published: March 2024

Background
Clinical decision support (CDS) tools that incorporate machine learning–derived content have the potential to transform clinical care by augmenting clinicians’ expertise. To realize this potential, such tools must be designed to fit the dynamic work systems of the clinicians who use them. We propose the use of academic detailing—personal visits to clinicians by an expert in a specific health IT tool—as a method for both ensuring the correct understanding of that tool and its evidence base and identifying factors influencing the tool’s implementation.

Objective
This study aimed to assess academic detailing as a method for simultaneously ensuring the correct understanding of an emergency department–based CDS tool to prevent future falls and identifying factors impacting clinicians’ use of the tool through an analysis of the resultant qualitative data.

Methods
Previously, our team designed a CDS tool to identify patients aged 65 years and older who are at the highest risk of future falls and prompt an interruptive alert to clinicians, suggesting the patient be referred to a mobility and falls clinic for an evidence-based preventative intervention. We conducted 10-minute academic detailing interviews (n=16) with resident emergency medicine physicians and advanced practice providers who had encountered our CDS tool in practice. We conducted an inductive, team-based content analysis to identify factors that influenced clinicians’ use of the CDS tool.

Results
The following categories of factors that impacted clinicians’ use of the CDS were identified: (1) aspects of the CDS tool’s design (2) clinicians’ understanding (or misunderstanding) of the CDS or referral process, (3) the busy nature of the emergency department environment, (4) clinicians’ perceptions of the patient and their associated fall risk, and (5) the opacity of the referral process. Additionally, clinician education was done to address any misconceptions about the CDS tool or referral process, for example, demonstrating how simple it is to place a referral via the CDS and clarifying which clinic the referral goes to.

Conclusions
Our study demonstrates the use of academic detailing for supporting the implementation of health information technologies, allowing us to identify factors that impacted clinicians’ use of the CDS while concurrently educating clinicians to ensure the correct understanding of the CDS tool and intervention. Thus, academic detailing can inform both real-time adjustments of a tool’s implementation, for example, refinement of the language used to introduce the tool, and larger scale redesign of the CDS tool to better fit the dynamic work environment of clinicians.
Clinical Decision Support Requirements for Ventricular Tachycardia Diagnosis Within the Frameworks of Knowledge and Practice: Survey Study
Authors: Hu Zhao , Wang Min , Zheng Si , Xu Xiaowei , Zhang Zhuxin , Ge Qiaoyue , Li Jiao , Yao Yan 
Published: March 2024

Background
Ventricular tachycardia (VT) diagnosis is challenging due to the similarity between VT and some forms of supraventricular tachycardia, complexity of clinical manifestations, heterogeneity of underlying diseases, and potential for life-threatening hemodynamic instability. Clinical decision support systems (CDSSs) have emerged as promising tools to augment the diagnostic capabilities of cardiologists. However, a requirements analysis is acknowledged to be vital for the success of a CDSS, especially for complex clinical tasks such as VT diagnosis.

Objective
The aims of this study were to analyze the requirements for a VT diagnosis CDSS within the frameworks of knowledge and practice and to determine the clinical decision support (CDS) needs.

Methods
Our multidisciplinary team first conducted semistructured interviews with seven cardiologists related to the clinical challenges of VT and expected decision support. A questionnaire was designed by the multidisciplinary team based on the results of interviews. The questionnaire was divided into four sections: demographic information, knowledge assessment, practice assessment, and CDS needs. The practice section consisted of two simulated cases for a total score of 10 marks. Online questionnaires were disseminated to registered cardiologists across China from December 2022 to February 2023. The scores for the practice section were summarized as continuous variables, using the mean, median, and range. The knowledge and CDS needs sections were assessed using a 4-point Likert scale without a neutral option. Kruskal-Wallis tests were performed to investigate the relationship between scores and practice years or specialty.

Results
Of the 687 cardiologists who completed the questionnaire, 567 responses were eligible for further analysis. The results of the knowledge assessment showed that 383 cardiologists (68%) lacked knowledge in diagnostic evaluation. The overall average score of the practice assessment was 6.11 (SD 0.55); the etiological diagnosis section had the highest overall scores (mean 6.74, SD 1.75), whereas the diagnostic evaluation section had the lowest scores (mean 5.78, SD 1.19). A majority of cardiologists (344/567, 60.7%) reported the need for a CDSS. There was a significant difference in practice competency scores between general cardiologists and arrhythmia specialists (P=.02).

Conclusions
There was a notable deficiency in the knowledge and practice of VT among Chinese cardiologists. Specific knowledge and practice support requirements were identified, which provide a foundation for further development and optimization of a CDSS. Moreover, it is important to consider clinicians’ specialization levels and years of practice for effective and personalized support.
Correction of endothelial dysfunction in patients with type 2 diabetes mellitus, diabetic kidney disease and non-alcoholic steatohepatitis
Authors: Kotsiubiichuk Z.Ya. , Antoniv A.A. , Kanovska L.V. , Mandryk O.Ye. 
Published: March 2024

Background. Non-alcoholic fatty liver disease and chronic kidney disease are public health concerns worldwide due to their increasing prevalence, adverse prognosis, and health care burden. The purpose of the study was to determine the probable effect of a combination of metformin, rosuvastatin, essential phospholipids and quercetin on the blood lipids, endothelial function, fibrinolysis system and platelet hemostasis, which are factors for the progression of nonalcoholic steatohepatitis. Materials and methods. Studies were performed on the dynamics of treatment in 60 patients with non-alcoholic fatty liver disease, type 2 diabetes mellitus and diabetic kidney disease (stage I–III). Depending on the prescribed treatment at random, the examined patients were divided into 2 groups. Twenty-eight persons of the first group received a low-calorie diet with dietary restrictions, essential phospholipids, metformin hydrochloride, rosuvastatin. Thirty-two patients from the second group received quercetin in addition to similar dietary recommendations, essential phospholipids, hypoglycemic and hypolipidemic therapy. The mean age of patients was 53.80 ± 3.52 years. The comparison group consisted of 30 healthy individuals of the corresponding age. Results. To evaluate the degree of endothelial-protective effect of quercetin on the background of the recommended protocol therapy, markers of endothelial dysfunction, fibrinolysis and platelet hemostasis were studied. NO content significantly reduced (1.7 times) in patients of group 2 before treatment, increased by 1.5 times (p < 0.05). This can be explained by the effect of quercetin, as well as the use of metformin, which reduces the degree of insulin resistance and the level of hyperlipidemia. Conclusions. The effectiveness of a combination therapy for non-alcoholic steatohepatitis and type 2 diabetes mellitus with diabetic kidney disease using essential phospholi­pids, statins and metformin with the addition of quercetin is higher than that of traditional therapy, as it significantly restores the functional state of the endothelium, eliminates the phenomena of hypercoagulation syndrome without the additional prescription of antiplatelet agents.
Radioiodine ablation after thyroidectomy could be safely abandoned or postponed in selected stage I papillary thyroid carcinoma patients of low-risk group: an observational prospective study
Authors: Cherenko S.M. , Glagolieva A.Yu. , Makhmudov D.E. 
Published: March 2024

Background. The European Thyroid Association consensus for the management of differentiated thyroid cancer (2006) suggested to avoid radioactive iodine (RAI) after thyroidectomy in patients with unifocal microcarcinoma (≤ 1 cm) with no extension beyond the thyroid capsule and without lymph node metastases. As the new data was collected and the risk stratification was revised, in 2022 the same recommendation was expanded to the patients with microcarcinoma and central neck lymph node involvement. The American Thyroid Association guidelines (2015) advocated no RAI ablation after hemi- or total thyroidectomy for thyroid cancer less than 1 cm with 5 and less micrometastases up to 2 mm in central neck lymph nodes as this strategy has no negative impact on the disease prognosis. In low-risk patients, no sufficient evidence of the obligatory postsurgical radioiodine ablation has been yet demonstrated. The aim of our study was to reveal whether RAI after thyroidectomy can be abandoned or postponed until the disease progression is confirmed in low-risk patients. Materials and methods. Two groups of patients (30 per group, 60 in total) with papillary microcarcinoma Т1N1a (5 and less level VI micrometastases up to 2 mm) were observed during a 5-year follow-up. In the first group, patients received 100 mCi (3.75 GBq) I131 shortly after total thyroidectomy while in the second group, postponed RAI was applied when progression signs were observed (elevated serum thyroglobulin level and US/CT suspected findings) after thyroid surgery. Results. After 5 years, no significant difference between groups was observed regarding post-RAI local recurrences (one in the first group and two in the second group) and/or distant metastases (t-test, p = 0.58). All cases of neck recurrences were treated with subsequent surgical excision, with no new data of progression within the specified follow-up. Conclusions. RAI adjuvant therapy for papillary thyroid carcinoma Т1N1a may not be necessary for patients with small number of level VI micrometastases. Local and distant metastases revealed during the careful follow-up by thyroglobulin level elevation and when using visualization techniques can be effectively treated with postponed RAI therapy and/or surgery.
Features of type 2 diabetes combined with metabolic dysfunction-associated fatty liver disease under conditions of chronic stress
Authors: Tkach S.M. , Pankiv V.I. , Krushinska Z.H. 
Published: March 2024

Background. Metabolic-associated fatty liver disease (MAFLD) is the most common chronic liver disease in which the main pathogenic processes originate from metabolic dysfunction. In recent years, MAFLD has acquired the nature of an epidemic, which is closely related to the epidemic of obesity, type diabetes mellitus (T2DM) and a significant increase in the risk of cardiovascular diseases. Along with the known pathogenetic factors outlined in the “multiple parallel hits” hypothesis, in the context of the COVID-19 pandemic and the russian military aggression in Ukraine, an additional powerful pathogenetic factor that can affect the course of many diseases, including MAFLD, is chronic stress. The aim of the study is to identify the clinical and biochemical features of MAFLD against the background of T2DM under the conditions of military stress in Ukraine. Materials and methods. We conducted a comparative study on the features of the course of MAFLD in 64 participants with T2DM: the first group — 44 individuals who were constantly under martial law in Ukraine, and controls — 20 patients who returned to Ukraine after a long (over 12 months) stay abroad. Results. The research shows that patients with MAFLD, who were affected by the negative consequences of military actions, had a statistically significant increase in the level of fasting glucose and markers of insulin resistance, an increase in the activity of liver transaminases and the level of markers of systemic inflammation compared to the pre-war period. The negative impact of wartime stress factors causes diabetic distress and a more severe course of MAFLD, which can subsequently lead to rapid progression of the disease. Most patients of the first group reported significant changes in the psycho-emotional state. The most common were low mood (81.8 %), feeling of anxiety/fear (79.5 %), sleep disturbances (81.8 %), general weakness and quick fatigue (63.3 %), which occurred much more often and were more pronounced than in the control group. Conclusions. During active military operations, epigenetic factors such as changes in the regime and quality of nutrition, psycho-emotional disorders in the form of astheno-neurotic and anxiety-depressive disorders, post-traumatic stress disorders, war-related unemployment and other negative factors become of great importance. Therefore, in these patients, control of optimal levels of glycemia, indicators of liver tests and lipid spectrum, as well as the state of mental health, are very significant.
Post-COVID syndrome: status of carbohydrate metabolism in patients with hypertension and stable ischemic heart disease
Authors: Kuryata O.V. , Mytrokhina O.S. , Kushnir Yu.S. , Stadnyk O.I. 
Published: March 2024

Background. Post-COVID syndrome is associated with a wide range of chronic symptoms or conditions. Coronavirus di­sease 2019 (COVID-19) causes metabolic disorders such as hyperglycemia, insulin resistance. Insulin-like growth factor 1 (IGF-1) is associated with an impaired glucose tolerance and a higher risk of developing type 2 diabetes. Currently, the study of molecules regulating carbohydrate metabolism as potential biomarkers of post-COVID syndrome and targets for therapeutic influence is relevant. The purpose of the study was to assess the level of IGF-1 and its relationship with regulation of carbohydrate metabolism, as well as the dynamics of the evaluated indicators under the influence of drug treatment in patients with hypertension and stable coronary heart disease who suffered from COVID-19. Materials and methods. Fifty-five patients who had a mild and moderate COVID-19 were included in the study; their average age was 55.87 [40; 75] years. The results of routine laboratory tests were registered and analyzed. The content of insulin and IGF-1 was assessed by enzyme immunoassay. The HOMA-IR was calculated. Results. In patients with a mode­rate COVID-19 compared to those with a mild one, a significant decrease in the level of IGF-1 (р = 0.008) was found against the background of increased reference values of glucose, insulin, and HOMA-IR (р < 0.01). The influence of the degree of hypertension on the IGF-1 level was revealed (р = 0.004). An inverse relationship between IGF-1 and glucose level was noted (r = –0.28, p = 0.034). The use of meldonium contributed to a significant decrease in glucose and insulin content (p < 0.001), and an increase in IGF-1. Against the background of taking meldonium, the dynamics of the shift towards a decrease in the HOMA-IR was more significant. Conclusions. An inverse relationship was found between IGF-1 and blood glucose, regardless of the level of insulin and HOMA-IR, in patients with hypertension and stable ischemic heart disease in the post-COVID period. Meldonium has been shown to improve carbohydrate metabolism by normalizing insulin levels and redu­cing the phenomena of insulin resistance as a potential drug target. Meldonium improved the clinical course of ischemic heart disease and demonstrated good tolerability and safety.
Growth indices and vitamin D content in children with idiopathic short stature depending on the variants of the Taql polymorphism genotype of the VDR gene
Authors: Ryznychuk M.O. , Bolshova O.V. 
Published: March 2024

Background. The vitamin D receptor (VDR) gene is a key regulator of biological processes, including tissue and cell growth and differentiation, bone metabolism, and modulation of immune responses. Several studies have shown that 1,25(OH)2D increases circulating insulin-like growth factor-1 (IGF-1) levels in vivo and in bone cell cultures. It also increases the expression of IGF-1 receptors in growth plate chondrocytes and several IGF-binding proteins in osteoblasts and bone marrow stromal cell cultures. A vitamin D receptor gene polymorphism is associated with adult height and may affect the growth indicators in children with idiopathic short stature. The purpose was to study the growth indicators and vitamin D levels in children with idiopathic short stature depending on the variants of the Taql polymorphism genotype of the VDR gene. Materials and methods. Determination of the Taql polymorphism of the VDR gene (rs731236) was performed using polymerase chain reaction followed by an analysis of the length of the restriction fragments when detected by agarose gel electrophoresis in 35 children with idiopathic short stature. Results. Most children (68.57 %) were heterozygotes, 17.14 % were homozygotes for T/T alleles, and 14.29 % were homozygotes for C/C alleles. The highest growth retardation has been observed in homozygous T/T carriers. Children carrying homozygotes for C/C alleles had the least growth retardation. Growth hormone levels after clonidine stimulation test and IGF-1 levels in blood were within normal limits in all patients. Vitamin D deficiency was found in T/T homozygotes and vitamin D insufficiency in C/T heterozygotes and C/C homozygotes. Conclusions. Among children with idiopathic short stature, the prevalence of the T/C genotype was 68.57 %. The greatest growth retardation occurred in patients with homozygous T/T alleles (SDS = –2.61 ± 0.31). A decrease in serum vitamin D levels was detected in all children. Vitamin D deficiency (43.83 ± 6.47 nmol/l) was found in children homozygous for the T/T allele, and vitamin D insufficiency — in T/C heterozygotes (58.97 ± 11.78 nmol/l) and C/C homozygotes (56.93 ± 19.54 nmol/l).