Weight-For-Height Z-Score Gain During Inpatient And Subsequent Linear Growth During Outpatient Treatment Of Young Children With Severe Acute Malnutrition, A Prospective Study From Uganda

Background Linear catch-up growth after treatment of severe acute malnutrition (SAM) is low, and little is known about the association between ponderal and subsequent linear growth. Objective The study assessed the association of weight-for-height z-score (WHZ) gain with subsequent linear growth during SAM treatment and examined its modifiers. Methods This was a prospective study, nested in a trial (ISRCTN16454889), among 6–59-mo-old children treated for SAM in Uganda. Weight, total length (TL) and knee-heel length (KHL) were measured at admission, weekly during inpatient-therapeutic-care (ITC), at discharge and fortnightly during outpatient-therapeutic-care (OTC) for 8 weeks. Linear regression was used to assess the association between WHZ gain during ITC and linear growth during OTC. Results Of 400 children, 327 were discharged to OTC and 290 followed-up for 8 weeks. Mean WHZ gains were 0.45 in ITC and 1.24 in OTC, whereas mean height-for-age z-score (HAZ) declined 0.41 during ITC and increased 0.14 during OTC. WHZ gain during ITC was positively associated with HAZ, TL and KHL gains during OTC (regression coefficients (b) [95% CI]: (0.12 [0.09; 0.15] z-score; 3.1 [2.4; 3.8] mm; 0.5 [0.1; 0.7] mm). The regression coefficients were highest for the middle tertile of WHZ gain with respect to HAZ and TL. Admission diarrhea and low plasma citrulline reduced the association between WHZ gain during ITC and HAZ and TL gain during OTC (P < 0.001). In contrast, pneumonia (P = 0.051) and elevated plasma CRP (P < 0.001) increased the association with TL gain, but reduced the association with KHL gain (P < 0.001). Conclusion Among children admitted with SAM, considerable WHZ gain during ITC was followed by very modest linear catch-up growth during OTC, with no indication of a WHZ gain threshold, above which linear growth was higher. To optimize linear growth in these children, early treatment of infections and conditions affecting the gut may be necessary.

Large-for-Gestational-Age, Leptin, and Adiponectin in Infancy

Context Fetal overgrowth “programs” an elevated risk of obesity and type 2 diabetes in adulthood. Plausibly, adipokines may be involved in programming metabolic health. Objective This work aimed to evaluate whether large-for-gestational-age (LGA), an indicator of fetal overgrowth, is associated with altered circulating leptin and adiponectin levels in infancy, and assess the determinants. Methods In the Canadian 3D birth cohort, we studied 70 LGA (birth weight > 90th percentile) and 140 optimal-for-gestational-age (OGA, 25th-75th percentiles) infants matched by maternal ethnicity, smoking, and gestational age at delivery. The primary outcomes were fasting leptin, and total and high-molecular-weight (HMW) adiponectin concentrations at age 2 years. Results LGA infants had higher body mass index (BMI) than OGA infants. However, there were no significant differences in leptin, and total and HMW adiponectin concentrations. Leptin concentrations were positively associated with female sex, weight (z score) gain 0 to 24 months, current BMI, and the sum of triceps and subscapular skinfold thickness, and negatively associated with maternal age and White ethnicity. Female sex was associated with lower total and HMW adiponectin concentrations. Weight (z score) gain 0 to 24 months and current BMI were positively correlated with total and HMW adiponectin concentrations in LGA infants only. Conclusion This study is the first to demonstrate that LGA does not matter for circulating leptin and adiponectin concentrations in infancy, and there may be LGA-specific positive associations between weight gain or current BMI and adiponectin concentrations in infancy, suggesting dysfunction in establishing the adiposity-adiponectin negative feedback loop in LGA individuals.

DEVELOPING PHYSICS GRAPH LEARNING MEDIA IN THE CONCEPT OF KINEMATICS AND ITS ASSESSMENT USING TUG-K (TEST OF UNDERSTANDING GRAPHS IN KINEMATICS)

Background: Assessment to determine the ability to master GLB and GLBB charts, namely the Test of Understanding Graphs in Kinematics (TUG-K). Through TUG-K which is adjusted to basic competencies, teachers can formulate indicators of competency achievement. Aim : This study aimed to develop Physics Graph learning media (GraFIS) on the kinematics concept describe the effectiveness of learning after using GraFIS media and describe students' perceptions of learning using GraFIS media and assessing using TUG-K. Methods: This research is an R and D research. The developed applications used HTML5 technology that can be published on the web app. and mobile app. The application was applied to 143 respondents in grade X MIPA of SMA Negeri 3 Purworejo. Data collection was conducted by giving validation sheets to material experts, media experts, students' questionnaire responses, to provide input on the products developed. Result and Discussion: The results of the research were in the form of graFIS application as a suitable medium for use. The results of implementation in teaching and learning activities through lesson plans that had been prepared showed that the effectiveness of learning using the GraFIS application was still in the low category with a normalized score gain of 0.03, which meant that it still needed revision and improvement. The analysis results of differences in pretest and posttest scores using Shapiro-Wilk obtained data that were not normally distributed, with Sig. 0.015 <0.05. Therefore, testing continued using the Wilcoxon Signed Rank Test. It was obtained the values of Asymp. Sig. (2-tailed) <0.05, which interpreted that there was a significant difference between the results of the pretest and posttest. Conclusions: The conclusion is improvements and revisions are still needed. Based on students' perceptions, the GraFIS application met usability and mobile quality standards.

The Influence of LMS-Based Blended Learning Models on Learning Motivation and Learning Outcomes in Network Infrastructure Administration.

<p>This study aims to find out how much increased learning motivation and student learning outcomes in using the blended learning model. The study involved class XI TKJ students at SMK Sakti Gemolong as participants, who were selected using cluster random sampling techniques. The treatment given to the experimental class is in the form of a blended learning model, while the control class is with conventional learning. The research method used is quantitative. Data were collected by questionnaire method and learning achievement test. Analysis of the questionnaire is used to get data on student motivation. Then to analyze the test of learning outcomes is get to obtain data on student learning outcomes. The study found 1) there is a significant influence of student learning motivation by .209 which means greater than the level of error (0.05). 2) there is a significant influence of learning outcomes of .698 which means it is greater than the level of error (0.05). 3) there is effectiveness in increasing students' learning motivation by using blended learning models with a total score gain of 0.2028. Compared to using conventional learning with a total score gain of 0.0735. 4) there is an effectiveness in increasing student learning outcomes by using a blended learning model with a total score gain of 0.4810. Compared to using conventional learning with a total score gain of 0.2176.</p>

The Influence Of Blended Learning Face To Face Driver Model Type Learning On Learning Interests And Learning Outcomes In Simulation Digital

<p>The purpose of this research is to find out how the influence of the use of blended learning model face to face driver model on student interest and learning outcomes. And to find out how effective the improvement in learning outcomes and learning interests of students uses blended learning type face to face driver model. The research method used in this study is an experimental method with true experimental design research design. The study involved class X TKJ students at SMK Sakti Gemolong as participants, who were selected using cluster random sampling techniques. The treatment given to the experimental class is in the form of a blended learning model face to face driver model, while the control class is done with conventional learning. The research method used is quantitative. Data were collected by questionnaire method and learning achievement test. Analysis of the questionnaire is used to obtain data on student interest in learning, then to the analysis of the learning outcomes test is used to obtain student learning outcomes data on the blended learning model face to face driver model. The results of this study are 1) there is an influence of the use of blended learning models face to face driver model on student learning outcomes with a significant level .836. 2) there is an influence of the use of blended learning type face to face driver model of learning interest of students with a significant level. 3) there is an effectiveness in increasing student learning outcomes by using blended learning models face to face driver model with a total score gain of 0.5142 compared to 0.4274 (control class). 4) there is effectiveness in increasing students' interest in learning by using a blended learning model face to face driver model with a total score gain of 0.2131 compared to 0.0740 (control class).</p>

Neck complaints before and after uncomplicated thyroidectomy: prevalence, postoperative outcome and relationships with thyroid weight and reflux like symptoms

Purpose The surgical thyroid disease includes upper aerodigestive complaints with not homogenous prevalence and specific features. The purpose was to analyze before and after total thyroidectomy (TT) the prevalence and severity of voice, swallowing, respiratory, and reflux airway symptoms in relation with thyroid weight. Methods A total of 98 consenting patients undergoing TT were enrolled. Preoperatively, 1 and 3 months after TT, patients underwent videolaryngoscopy, subjective evaluation of voice (VIS), swallowing (SIS and EAT-10), respiratory (mMRC), and reflux symptoms (RSI, Gerd-Q). The scores were analyzed based on thyroid weight (<25 gr, 26–50 gr, 51–75 gr, >75 gr) and post-operative score gain was calculated from the score before TT and the follow-up examination. Results In total, 40/98 selected cases of uncomplicated TT completed the postoperative evaluation. Endoscopic signs suggestive of reflux disease were observed in 1/40 (2.5%) and 0/19 cases before and after TT respectively. The prevalence of cases with abnormal reflux symptom index decreased significantly after surgery (8/40 vs 1/40) (p < 0.05), similarly occurred for the Gerd-Q (4/40 vs 1/40) (p < 0.05). Three months after TT the voice, swallowing and respiratory scores were significantly lower than the preoperative ones (p < 0.05). The SIS correlated positively with EAT-10 and RSI. After 3 months the postoperative score gain of voice, swallowing, respiratory, and reflux symptoms (Gerd-Q) was statistically higher (p < 0.05) in the cases with heaviest gland. Conclusions The surgical thyroid disease is associated to mild aerodigestive preoperative compressive symptoms, that include respiratory abnormalities and reflux like symptoms, regardless of the gland weight. In absence of endoscopic signs of airway reflux the presence of reflux symptoms suggests an overlapping with thyroid neck complaints. The patients undergoing uncomplicated TT had improvement in compressive symptoms and the greatest improvement is seen in larger goiters.

Efektivitas Penggunaan Game Analisis Training terhadap Peningkatan Kemampuan Berpikir Induktif Remaja

Inductive-reasoning is a step to draw general conclusions from individual matters. IR can be measured using the Intelligent Structure (IST) sub-ZR using a number pattern and using an Inductive Reasoning Test (IRT), which is an image pattern. One of the learning methods that are interesting and fun and student-cantered learning is Educational Game media. This study aims to see the effectiveness of games in learning to improve the students' inductive thinking skills at SMP YKPP Sungai Pakning. This study used a pre-experimental method with one group pretest-posttest conducted on 30 students of class IX B as the experimental subject. The data collection technique was implemented using a test instrument in 20 essay questions for IST and 30 objective questions for IRT. The material used in this game has also passed the validation stage carried out by a psychologist in Pekanbaru. Data were analyzed using the T-Test and score gain. Based on the study results, this game is believed to be 95% effective in improving adolescent inductive thinking skills, with an average increase of 26.6 points in the IST form and 17.8 points in the IRT form. Learning media with games are effectively applied to inductive-learning and can be used as an alternative to learning inductive-thinking at SMP YKPP Sungai Pakning.

Blood Alcohol Concentration Is Associated With Improved AIS Motor Score After Spinal Cord Injury

Objective: To investigate the relationship between blood alcohol concentration (BAC) and neurologic recovery after traumatic spinal cord injury (TSCI) using standardized outcome measures from the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) examination. Method: This is a retrospective review of merged, prospectively collected, multicenter data from the Spinal Cord Injury Model Systems Database and institutional trauma databases from five academic medical centers across the United States. Patients with SCI and a documented BAC were analyzed for American Spinal Injury Association Impairment Scale (AIS) motor score, FIM, sensory light touch score, and sensory proprioception score upon admission and discharge from rehabilitation. Linear regression was used for the analysis. Results: The study identified 210 patients. Mean age at injury was 47 ± 20.5 years, 73% were male, 31% had an AIS grade A injury, 56% had ≥1 comorbidity, mean BAC was 0.42 ± 0.9 g/dL, and the mean Glasgow Coma Score upon arrival was 13.27 ± 4.0. ISNCSCI motor score gain positively correlated with higher BAC (4.80; confidence interval [CI], 2.39–7.22; p &lt; .0001). FIM motor gain showed a trend toward correlation with higher BAC, although it did not reach statistical significance (3.27; CI, −0.07 to 6.61; p = .055). ISNCSCI sensory light touch score gain and sensory proprioception score gain showed no correlation with BAC (p = .44, p = .09, respectively). Conclusion: The study showed a positive association between higher BAC and neurologic recovery in patients with SCI as measured by ISNCSCI motor score gain during rehabilitation. This finding has not been previously reported in the literature and warrants further study to better understand possible protective physiological mechanisms underlying the relationship between BAC and SCI.

The analysis of cognitive restructuring techniques effectiveness to reduce the online game addiction

In schools there are still many students who experience academic disorders such as lazy learning, often neglecting assignments, often skipping school, this is because one of them is because students are addicted to playing online games. This study aims to analyze the effectiveness of cognitive behavioral therapy (CBT) counseling with cognitive restructuring techniques to reduce online game addiction behavior of students. This research is a quantitative study with a quasi-experimental method. The population in this study were students who were addicted to online games. Sampling using a purposive sampling technique, so that the subjects in the experimental group were 8 students and the control group was 8 students. Data collection was done using online game addiction scale that has been tested for validity and reliability. Data analysis using score gain testing. The results showed that CBT cognitive restructuring techniques were effective in reducing online game addiction on students. The CBT cognitive restructuring techniques are effective in reducing online game addiction on students.