Avacopan, a Selective C5a Receptor Antagonist, for Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis

Avacopan, an orally administered C5a receptor (C5aR) antagonist, has been approved for the treatment of microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) in Japan and the United States. In ADVOCATE Phase III clinical trial, patients with active MPA or GPA received either 30 mg avacopan twice daily or prednisone on a tapering schedule in combination with rituximab or cyclophosphamide (followed by azathioprine). The trial met its two primary endpoints: avacopan showed non-inferiority to prednisone for achieving remission at week 26 (avacopan, 72.3%; prednisone, 70.1%; p < 0.001 for non-inferiority and p = 0.24 for superiority) and superiority for maintaining remission at week 52 (65.7% for avacopan, 54.9% prednisone, p < 0.001 for non-inferiority and p = 0.007 for superiority). Of several key secondary endpoints tested, the glucocorticoid toxicity index (GTI)-cumulative worsening score and GTI-aggregate improvement score were significantly lower in the avacopan group than in the prednisone group at both weeks 26 and 52. Serious adverse events related and unrelated to the worsening vasculitis were reported at 10.2% and 37.3% in the avacopan group and at 14.0% and 39.0% in the prednisone group, respectively. Avacopan has set the stage for the semi-glucocorticoid-free or glucocorticoid-free treatment of MPA and GPA.

IMPROVING ENGLISH VOCABULARIES THROUGH DERIVATIONAL MORPHEME

This research aims to improve students' vocabulary acquisition through the strategy of deriving suffixes. The populations of this study are students from Politeknik Ganesha Medan in second semester. This research was conducted through Applied Classroom Action Research (CAR), born in two cycles (cycle 1 and cycle 2), and each process consisted of four meetings. The vocabulary test results showed that the average improvement score of the pre-test was 34.66, the post-test of period 1 was 93.46, and the post-test of period 2 was 97.33. In the first cycle, the nominal comparison rate was 88.83%, the verb nature was 77.46%, the adjective nature was 40.74%, and the adverbial heart was 84.14%. In cycle 2, the nominal comparison rate was 100%, the verb nature was 95.45%, the adjective nature was 65.84%, and the adverbial nature was 94.91%. The proportion of students who passed Minimal Criterion Mastery in each cycle was 100%, cycle 1 increased by 169.64%, and cycle 2 increased by 180.81%. These indicate that there is a significant improvement of the students’ vocabulary mastery through derivational morpheme strategy of the students of Politeknik Ganesha Medan.

The Cartilage Rhinoplasty with Goldman Technique for Correcting the Broad Nasal Tip

In this paper, A retrospective review was performed for all the patients who underwent surgery with the Goldman technique by the senior author from 2004 to 2009 for correction of the broad nasal tip. The clinical and pathologic findings of these patients were reviewed, and an independent observer evaluated the pre- and postoperative photos of the patients using five parameters: projection, rotation, symmetry, shape, and distance of the tip-defining points. The evaluation was performed using a scale of -1 to +1 for each of the five parameters. Of the 205 patients who underwent the technique, 115 (56%) were patients with broad tips, and 90 (44%) were patients with broad (boxy) tips. A total of 189 cases (92.2%) involved primary rhinoplasties, and 16 cases (7.8%) involved revision. During this period, complications were observed in five patients (2.4%), who underwent revision rhinoplasty with a successful result. The average score for the five parameters already mentioned for primary rhinoplasties according to the scale of -5 to +5 showed a significant postoperative improvement (score, +4.3). It implied that the cartilage rhinoplasty with Goldman technique is safe when performed by experienced surgeons and according to specific indications. This conclusion is indicated by the low rate of complications in the large series of patients in this study.

IMPROVING STUDENTS’ WRITING SKILLS IN DESCRIPTIVE TEXT USING PICTURE WORD INDUCTIVE MODEL (PWIM) STRATEGY

The objective of the study is to provide the students treatment and make the students easy in learning process of writing descriptive text, therefore to improve the students writing skills in English by using PWIM strategy. The participants are the 7th grade students of Junior High School at Cimahi in academic year 2019/2020 which consist of 32 students. The study using CAR with two cycles to observe the activities and responses of students in classroom. Result of the study could be seen from the improvement score from pretest to posttest 2 with a minimum score of 75 and maximum score of 85 in posttest 2. Keywords: Writing, Descriptive Text, PWIM Strategy, CAR

The Effectiveness and Students’ Perceptions on Learning Tenses Through Mind Mapping Technique on Elementary Level at an Education and Training Institute in Indonesia

Numerous studies had conducted the use of mind mapping as a technique in teaching and learning English, but relatively few of these studies focused on the effectiveness and students’ perceptions of mind mapping technique in learning tenses on elementary level in a non-formal education institution. This study aimed to investigate the effectiveness of mind mapping technique in learning present tenses and students’ perceptions toward this technique on elementary level students of the English program. 30 students of the English program on elementary level at Aliah Education and Training Institute Makassar took part in the study. Data were collected through pre-test, post-test, observation, questionnaire, and interview and thus used to analyze the results quantitatively and qualitatively using preliminary studies, general mean scores, and percentages of students‘ improvement score. Results of the study showed that the students were really enthusiastic to learn with this technique and the atmosphere of the classroom was more enjoyable. In addition, the students’ ability in using tenses was improved after implementing this technique. In the pre-test, the general mean score of the students was 42.33 and classified as Very Poor. While, the general mean score of the students was 78.92 and classified as Good in the post-test. The students‘ improvement score was increased up to 86.44%. It revealed that mind mapping technique is effective in learning tenses. However, it is suggested that further studies can be conducted with larger data to make it more accurate and applicable.

Characteristics of patients who were able to switch from benzodiazepine hypnotics to lemborexant

Objectives: There is little evidence of insomnia treatment, especially exit strategies for hypnotics. We examined on the characteristics of patients who were able to switch from benzodiazepine hypnotics to lemborexant. Methods: Insomnia was assessed using the Athens Insomnia Scale. Efficacy outcome assessment was the Clinical Global Impressions-Improvement scale. Results: Eighty patients switched from benzodiazepine hypnotic monotherapy to lemborexant and 57 patients who continued the use of benzodiazepine hypnotics. The switched group had a significantly lower benzodiazepine hypnotic diazepam equivalent and a significantly shorter dosing period than the continued group ( p < 0.001 for all). The mean Athens Insomnia Scale total score of the switched group was a significant improved (5.8 ± 3.3 to 4.0 ± 3.3; p < 0.05). The mean Clinical Global Impressions-Improvement score of the switched group was 3.3 ± 0.7. Conclusion: Our findings suggest that when administering benzodiazepine hypnotics, shortening the administration period, as much as possible, allows a smooth switch to safe long-term maintenance therapy using lemborexant, without exacerbating insomnia.

Can the Hypnoteaching Method Increase Students’ Speaking Ability?

The objective of this research was to invest the effect of implementation of hypnoteaching toward eleventh grade to increase students’ speaking ability. The research was facused to know the significant effect of implementation hypnoteaching method at MA YASMI DURI. The population are 42 persons of eleventh grade that consists of two classes and the sample are 16 persons of IPA 1 Class. The research design was pre-experiment with pre-test and post-test design. The are two variables, they are hypnoteaching method and speaking ability, and then to analyze the data obtained,the research used Paired sample T-test. Based on the data analysis and its result, the writer knows that mean score of students in pre – test was 50.5 and mean score of students in post-test was 67.25 and the result of paired sample T-test was Tvalue = 6,898, by df is 15. Based on the table of Tvalue, for df 15, Ttable significant 5% is 2,13 and Ttable significant 1% is 2,95. the writer can make a conclusion that implementation of hypnoteaching method toward speaking ability is categorized in “Ha” level based on the experiment classroom, and there is significant effect of implementation of hypnoteaching method toward eleventh grade student speaking ability at IPA 1 class. the result indicate that there is significant effect difference on implementation hypnoteaching method, where post-test improvement score than the pre-test score.

The patient-reported outcome of age-related cataract using Catquest-8SF questionnaire

AIM: To assess the patient-reported outcome of phacoemulsification with posterior chamber single focus foldable intraocular lens (SIOL) using the Chinese version of Catquest-8SF questionnaire (Catquest-8SF-CN), evaluate the applicability of Catquest-8SF scale in northern Chinese and its sensitivity to cataract surgery. METHODS: Prospective clinical case follow-up study. The patients were recruited from the Central Hospital of Tai’an and completed the Catquest-8SF questionnaire by face-to-face interviews before and 3mo after surgery at the hospital. RESULTS: A total of 120 cataract patients with median age 67.6y and 52.5% female completed the Catquest-8SF. The Cronbach’s α coefficient of the total scale, daily-activity sub-table and comprehensive-evaluation sub-table were 0.861, 0.853 and 0.748 respectively. There was a high level of consistency between two investigators. The cumulative contribution rate was 66.64% by using the principal component analysis and the maximum variance orthogonal rotation method. The preoperative score of the Catquest-8SF-CN had a significant negative correlation with preoperative binocular mean weighted visual acuity and age (P<0.05), while a significant positive correlation with education level (F=6.094, P<0.001). The patients without systemic comorbidities got higher score than those who with (P<0.05). Three months after surgery, 102 (85%) patients came for follow-up and completed the questionnaire. Significant improvement of visual acuity was observed in both binocular and monocular surgery groups (t=10.404, P<0.001). There was higher improvement in binocular weighted visual acuity of binocular surgery group than in monocular surgery group (t=-20.77, P<0.001). The postoperative score was significantly higher in both groups than before (P<0.001). There was a significant improvement in the total score after cataract surgery. The 94 patients (92.2%) were very satisfied or satisfied with the operation; 92 patients (90.2%) thought the surgery achieved their expectations, and they all felt satisfactory. The degree of satisfaction was significantly correlated with the improvement score of the scale and it was also correlated with their expectation of the surgery. CONCLUSION: The Chinese version of Catquest-8SF questionnaire is suitable for the age-related cataract population in northern China. It is highly responsive to cataract surgery and brief, so it may have the potential to become part of a routine clinical assessment for cataract surgery in China. The patient’s overall satisfaction is high, which illustrates that the medical service we provide matches the patient’s needs. The degree of satisfaction was significantly correlated with the improvement score of the scale and it was also correlated with their expectation of the surgery.

IMPROVING STUDENTS’ READING COMPREHENSION BY USING INQUIRY CHART STRATEGY TO THE NINTH GRADE STUDENTS OF SMP SWASTA KATOLIK BUDI MURNI 2 MEDAN

The aim of this study is to find that Inquiry Chart Strategy works effectively on improving students’ reading comprehension and to know the students’ responses after being taught by using Inquiry Chart Strategy. In order to achieve the objectives of the study, a classroom action research was designed and carried out in this study. The participants of this study are 25 students of class IX-4 of SMP Swasta Budi Murni 2 Medan in the academic year 2018/2019. Test, observation sheet and field notes were used as the instruments for collecting data. The result of the study showed significant improvement of the students’ skill in reading. It is proven by the students’ mean score of each test: pre test is 50 with 12%, formative test is 73,92 with 72%, and post test is 87,6 with 92%. And then the percentage of the students’ improvement score from pre-test to post-test was 75.2%. And the total percentage of strongly agree was 55.2%. In addition, the analysis result of the observation sheet and field notes showed that Inquiry Chart Strategy changed the students’ learning behaviour became better than before. They were more enthusiastic during the learning teaching process in each cycle. Based on the result of those study instruments, it can be concluded that using Inquiry Chart Strategy gives the improvement to the students’ reading comprehension. This strategy is suggested to English teacher to apply it in teaching learning reading in order to improve students’ reading comprehension. The writer also suggests to other writers to explore other studies on Inquiry Chart Strategy to improve the students’ reading comprehension and try to apply this technique in different language skills.

139 Early Response with Valbenazine and Long-Term Symptom Reduction in Patients with Tardive Dyskinesia: Post Hoc Analysis of the KINECT 3 Study

Study Objective:Tardive dyskinesia (TD) is a persistent and potentially disabling movement disorder associated with prolonged exposure to antipsychotics and other dopamine receptor blocking agents. Valbenazine is a highly selective vesicular monoamine transporter 2 (VMAT2) inhibitor approved for the treatment of TD in adults. Using data from a long-term study (KINECT 3; NCT02274558), the effects of once-daily valbenazine (40 mg, 80 mg) on TD were assessed using the Abnormal Involuntary Movement Scale (AIMS) in participants who were early responders based on subjective measures, including patient self-report (Patient Global Impression of Change [PGIC]) or clinician judgment (Clinical Impression of Change-Tardive Dyskinesia [CGI-TD]).Methods:Data from KINECT 3 (6-week double-blind, placebo-controlled [DBPC] period; 42-week double-blind extension) were analyzed post hoc. Long-term outcomes included mean change from baseline to Week 48 in AIMS total score (sum of items 1-7) and AIMS response (≥50% total score improvement from baseline) at Week 48. These AIMS outcomes were assessed in participants who achieved early improvement, defined as a PGIC or CGI-TD score of ≤3 (“minimally improved” or better) at Week 2 (first post-baseline visit of the DBPC period). Participants who initially received placebo were not included in the analyses.Results:In participants who received only valbenazine (40 or 80 mg) during KINECT 3 and had available Week 2 assessment, 50% (72/143) had early PGIC improvement (score ≤3) and 43% (61/142) had early CGI-TD improvement (score ≤3). Baseline characteristics were generally similar between participants who achieved early PGIC or CGI-TD improvement and those who did not. Based on available assessments at Week 48, mean AIMS total score change from baseline in participants with early PGIC improvement was similar to those who did not reach the early PGIC improvement threshold (-4.1 [n=35] vs -3.5 [n=41]). Mean AIMS total score change from baseline in participants with early CGI-TD improvement was similar to those who did not achieve early CGI-TD improvement (-4.2 [n=31] vs -3.5 [n=45]). AIMS response at Week 48 was also similar in those who achieved early PGIC and CGI-TD improvement (40% and 42%, respectively) compared to those who did not achieve early PGIC and CGI-TD improvement (39% and 38%, respectively).Conclusions:Results from this long-term valbenazine trial indicate that many participants achieved at least minimal patient- and clinician-reported improvement at Week 2. AIMS outcomes at Week 48 demonstrated long-term reductions in TD severity regardless of early response. More research is needed to understand the association between early improvement and long-term treatment effects, but early non-improvement based on subjective measures may not be predictive of long-term treatment failure.Presented:International Congress of Parkinson’s Disease and Movement Disorders; September 22-26, 2019; Nice, France.Funding Acknowledgements:This study was sponsored by Neurocrine Biosciences, Inc.