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Background and Aim: Dental malformations caused by surgical excision of oral cancerous tissues cause physical, functional and aesthetic problems. Congenital disorders or acquired factors are regarded as the major causes for maxillofacial defects. The purpose of the current investigation was to determine the effect of maxillofacial prosthesis on oral hygiene and oral health related life quality of life of patients in a population of Pakistan. Materials and Methods: This prospective study was conducted on 28 maxillofacial defects’ bearing patients investigated in the Department of Dentistry at a Tertiary Care Hospital in Lahore, Pakistan from January 2021 to December 2022. Hearing as well as visually impaired and edentulous patients were excluded from the study. Oral Health Impact Profile (OHIP) was used for the assessment of Oral Health related Quality of Life (OHR QoL). The OHR-QoL was assessed by a self-administered questionnaire. “Functional limitation (9 items)”, “Physical pain (9 items)”, “Psychological discomfort (5 items)”, “Physical disability (9 items)”, “Psychological disability (6 items)”, “Social disability (5 items)”, and “Handicap (6 items)” were 7 subscales of OHR-QoL recorded in each questionnaire and a greater OHR-QoL impairment was an indicative of a higher overall OHIP score.

Alat yang dirancang khusus untuk membantu pembelajaran sangat penting untuk membina lingkungan yang kondusif untuk belajar. Hal inilah yang mendasari kajian pembuatan alat alat peraga matematika seperti Rencana Pelaksanaan Pembelajaran Berbasis Masalah dan LKPD. Siswa kelas VIII SMP N 1 Huristak berpartisipasi dalam penelitian ini. Tujuan penelitian ini adalah untuk menghasilkan perangkat pembelajaran berbasis Problem Based Learning untuk materi matematika semester 2 kelas VIII SMP yang valid, praktis dan efektif dan dapat meningkatkan kemampuan pemecahan masalah peserta didik. Jenis penelitian ini adalah penelitian pengembangan dengan menggunakan model Plomp. Hasil penelitian menunjukkan bahwa skor validasi RPP sebesar 3,46, yang dianggap valid. Rata-rata skor validasi LKPD adalah 3,47. Berdasarkan skor rata-rata pelaksanaan penilaian pembelajaran, perangkat pembelajaran telah memenuhi kriteria kepraktisan antara lain termasuk dalam kategori baik dan mendapat balasan dari siswa dengan persentase 90,24%. Keefisienan alat belajar 83,45%. Maka, dapat disimpulkan bahwa perangkat pembelajaran berbasis problem based learning dinyatakan valid, praktis dan efektif dalam dapat meningkatkan kemampuan pemecahan masalah peserta didik SMP kelas VIII.

Mathematics is one of the subjects that students find difficult, especially for the mastery of realistic questions or in the form of story problems. These questions are included in CTL-based or contextual questions. Contextual problem is a question that links the material with real-world situations and encourages students to make connections between the material they teach and its application in their daily lives. Mathematics teacher at SMA Adabiah has difficulty designing CTL-based math problems. In addition, during this pandemic, teachers had difficulty giving questions online because face-to-face was not possible. For this reason, teachers are required to have creativity so that learning can be understood by students. Mathematics teachers are given training that supports this. The training that will be provided is in the form of making questions using an online learning application. Teachers who take part in the training are expected to be able to motivate and evaluate students' ability to work on contextual questions even though they are carried out online.

Background GLP‐1 (glucagon‐like peptide‐1) receptor agonists exert beneficial long‐term effects on cardiovascular and renal outcomes. In humans, the natriuretic effect of GLP‐1 depends on GLP‐1 receptor interaction, is accompanied by suppression of angiotensin II, and is independent of changes in renal plasma flow. In rodents, angiotensin II constricts vasa recta and lowers medullary perfusion. The current randomized, controlled, crossover study was designed to test the hypothesis that GLP‐1 increases renal medullary perfusion in healthy humans. Methods and Results Healthy male participants (n=10, aged 27±4 years) ingested a fixed sodium intake for 4 days and were examined twice during a 1‐hour infusion of either GLP‐1 (1.5 pmol/kg per minute) or placebo together with infusion of 0.9% NaCl (750 mL/h). Interleaved measurements of renal arterial blood flow, oxygenation (R 2 *), and perfusion were acquired in the renal cortex and medulla during infusions, using magnetic resonance imaging. GLP‐1 infusion increased medullary perfusion (32±7%, P P P =0.007), whereas cortical perfusion remained unchanged. R 2 * values increased by 3±2% ( P =0.025) in the medulla and 4±1% ( P =0.008) in the cortex during placebo, indicative of decreased oxygenation, but remained unchanged during GLP‐1. Blood flow in the renal artery was not altered significantly by either intervention. Conclusions GLP‐1 increases predominantly medullary but also cortical perfusion in the healthy human kidney and maintains renal oxygenation during NaCl loading. In perspective, suppression of angiotensin II by GLP‐1 may account for the increase in regional perfusion. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04337268.

Purpose: GLP-1 receptor agonism has shown beneficial cardiovascular effects which could include the kidneys. In the human kidney, the high GLP-1 extraction and its natriuretic effect depend on the GLP-1 receptor and is accompanied by suppression of angiotensin II, independent of changes in renal plasma flow. Preclinical data showed that angiotensin II constricts the vasa recta and lowers medullary perfusion. The current randomized, controlled study was designed to test the hypothesis that GLP-1 increases renal medullary perfusion in healthy humans. Methods: Healthy male participants (n=10, 27 ± 4 years) ingested a fixed sodium intake for 4 days and were examined twice during a 1-hour infusion of either GLP-1 (1.5 pmol/kg/min) or placebo together with infusion of 0.9% NaCl (750 mL/h) . Interleaved measurements of renal artery flow, oxygenation (R2*) , and perfusion were acquired in the renal cortex and medulla during infusions, using magnetic resonance imaging. Results: GLP-1 infusion increased medullary perfusion (32 ± 7%, p Conclusions: GLP-1 increases predominantly medullary but also cortical perfusion in healthy human kidneys and maintains oxygenation during NaCl-loading. In perspective, GLP-1 may exert protective effects against renal hypoperfusion and ischemia. Disclosure B. Haddock: n/a. B. L. Jensen: None. A. Asmar: None.

Mathematics has been a part of human cuIture for a very Iong time. Many assume that mathe matics is finaI, permanent, absoIute and unreIated to cuIture. Ethnomatematic is present to bridge be tween cuIture and education, especiaIIy in mathematics Iearning. One of the ethnomatematic objects is an artifact. Each area certainIy has its own cuIture, incIuding artifacts in the form of historicaI buiId ings that are characteristic of the area. Muaro Takus TempIe is one of the historicaI buiIdings in Kec. XIII Koto Kampar Riau. Muara Takus temple is an ancient religious artifact whose construction is still a mystery has the potential as a source of mathematical learning, but this must go through the exploration process. The purpose of this expIorative research with ethnographic approach is to ex pIore and expIore what mathematicaI concepts exist in Muaro Takus tempIe that can be used as a source of mathematics Iearning as weII as an effort to deveIop ethnomatematics as the basis of mathe matics Iearning. Through expIoration, interviews, documentation, Iiterature studies and observations in the muaro takus tempIe environment, it can be concIuded that there is a concept of square fIat buid (square, rectanguIar, paraIIeI trapezoidaI and irreguIar, rectangIe) and triangIe (right triangIe), circIe, refIection & diIatation, as weII as Iines and angIes on the structure of Muara Takus tempIe buiId ing. Iearning mathematics using ethnomatematic objects can enrich the mathematicaI appIications around students and can faciIitate students to understand abstract mathematics by using concrete ethnomatematic objects.

The world of education is currently experiencing a very extraordinary event. The Covid-19 pandemic has a very broad impact on participants and educational institutions. Our education system must be ready to take the leap to transform online learning for all students and by all teachers. We are entering a new era to build creativity, hone student skills, and improve our quality with changes in systems, perspectives and patterns of our interactions with technology. Every individual who is in an educational environment must be able to use technology that can help the learning process, especially in schools. Likewise, with the implementation of teaching and learning at SMAN 3 Padang, the process of implementing learning in these schools currently cannot be carried out face-to-face in class as usual. Students take lessons from home. To find out the ability of teacher students, they must evaluate the learning that has been given. One of them is by giving the teacher online quizzes because face to face is no longer possible during the Covid 19 pandemic. Mathematics is one of the subjects considered difficult by students, especially for mastery of Olympic questions. For this reason, teachers are required to have creativity so that learning can be understood by students. Mathematics teachers are given training that supports this. The training that will be provided is in the form of making questions for quizzes which are carried out online. The students will solve these questions in accordance with the specified time. Teachers who take part in the training are expected to be able to motivate and evaluate students' ability to work on Olympic questions even though they are carried out online.

The mathematics learning outcomes of MAS students in Tanah Datar Regency are still relatively low. This is because students who enter private schools are students who do not pass the selection in public schools, besides learning is still centered on the teacher and the lack of critical thinking skills of students is one of the obstacles that affect the low student learning outcomes. One of the efforts is made to overcome this problem is to apply the PCL approach to learning. This study aims to determine the effect of the PCL approach on students' critical thinking skills, especially in line and series material. The study was conducted on two classes which were used as the experimental class and the control class. In the experimental class the treatment of learning was given by applying the PCL approach while the control class was given treatment with conventional learning. The research data was obtained from the results of the initial ability test (pre-test) given before the sequences and series subject matter was started and the final test (post-test) was given after the PCL treatment was carried out, while the data analysis was performed using non-parametric tests because the data was not normally distributed and has a non-homogeneous variance. The results of data analysis showed that there was the influence of the PCL approach to critical thinking skills of students class XI of MAS Salimpaung. The critical thinking of students with PCL approach was better than the critical thinking of students taught with conventional learning in class XI MAS Salimpaung.

Context Glucagon-like-peptide-1 receptor agonists (GLP-1 RAs) exert cardiovascular benefits by reducing plasma glucose, body weight, and blood pressure. The blood pressure–lowering effect may be mediated by angiotensin II (ANG II) suppression and consecutive natriuresis. However, the role of ANG II and other vasoactive hormones on GLP-1 RA treatment has not been clearly defined. Objective This work aimed to investigate the effect of a 3-week treatment with the GLP-1 RA dulaglutide on vasoactive hormones, that is, renin, ANG II, aldosterone, mid-regional proatrial natriuretic peptide (MP-proANP), and natriuresis in euvolemic participants. Methods Randomized, double-blinded, placebo-controlled, crossover trials were conducted at University Hospital Basel, Switzerland. A total of 54 euvolemic participants, including 20 healthy individuals and 34 patients with primary polydipsia, received a subcutaneous injection of dulaglutide (Trulicity) 1.5 mg and placebo (0.9% sodium chloride) once weekly over a 3-week treatment phase. Results After a 3-week treatment phase, dulaglutide showed no effect on plasma renin, plasma ANG II, or plasma aldosterone levels in comparison to placebo. Natriuresis remained unchanged or decreased on dulaglutide depending on the measured parameter. Dulaglutide significantly decreased plasma MR-proANP levels (treatment effect: 10.60 pmol/L; 95% CI, –14.70 to –7.90; P Conclusion In euvolemic participants, a 3-week treatment of dulaglutide reduced systolic blood pressure independently of plasma renin, ANG II, or aldosterone levels and urinary sodium excretion. The reduction in MR-proANP might be secondary to reduced arterial pulse pressure.

The purpose of this research is to find out how the influence of student independence and learning motivation on the problem-solving abilities of Padang State University students in Space Geometry Courses through the Problem Based Learning (PBL) model. The research method used is a survey with correlation and regression analysis. The population in this study was UNP students, with a sample of 23 students with purposive sampling techniques. Data on student independence and learning motivation is obtained through questionnaires. In contrast, the data of problem-solving capabilities are obtained through tests. The results of the data analysis found that the influence of independence and learning motivation on problem-solving ability was shown by a correlation coefficient of 0.642 and a coefficient of determination R2 of 37.8%, and regression line equation Y = 42.271 + 0.334 X1 + 0.404 X2. The testing analysis obtained that the confident correlation and regression coefficient is significant. This research proves that there is an influence of independence and student learning motivation together on students' problem-solving abilities.

Purpose We have previously demonstrated that glucagon-like peptide-1 (GLP-1) does not affect renal hemodynamics or function under baseline conditions in healthy participants and in patients with type 2 diabetes mellitus. However, it is possible that GLP-1 promotes natriuresis under conditions with addition of salt and water to the extracellular fluid. The current study was designed to investigate a possible GLP-1-renal axis, inducing natriuresis in healthy, volume-loaded participants. Methods Under fixed sodium intake, eight healthy men were examined twice in random order during a 3-hour infusion of either GLP-1 (1.5 pmol/kg/min) or vehicle together with an intravenous infusion of 0.9% NaCl. Timed urine collections were conducted throughout the experiments. Renal plasma flow (RPF), glomerular filtration rate (GFR), and uptake and release of hormones and ions were measured via Fick's principle. Results During GLP-1 infusion, urinary sodium and osmolar excretions increased significantly compared with vehicle. Plasma renin levels decreased similarly on both days, whereas angiotensin II (ANG II) levels decreased significantly only during GLP-1 infusion. RPF and GFR remained unchanged on both days. Conclusions In volume-loaded participants, GLP-1 induces natriuresis, probably brought about via a tubular mechanism secondary to suppression of ANG II, independent of renal hemodynamics, supporting the existence of a GLP-1-renal axis.

Tujuan penelitian ini adalah untuk mempelajari peningkatan kemampuan pemecahan masalah siswa SD yang termasuk dalam kategori lambat belajar yang menerapkan pembelajaran dengan menggunakan model pembelajaran konstruktivisme dan konvensional. Peneliti mengolah data menggunakan program SPSS 16 for Windows dan Microsoft Office Excel 2007 untuk mencapai tujuan tersebut. Subjek dalam penelitian ini adalah siswa slow learner kelas V SDN Adabiah Padang. Teknik pengumpulan data dengan observasi dan wawancara dengan pedoman observasi dan wawancara. Hasil penelitian menunjukkan bahwa melalui pre-test dan post-test keterampilan pemecahan masalah pada akhir pembelajaran menggunakan Model Pembelajaran Konstruktivisme dan pembelajaran konvensional. Data tes keterampilan pemecahan masalah diperoleh dari 16 siswa, 8 siswa kelas eksperimen yang menerapkan Model Pembelajaran Konstruktivisme, dan 8 siswa kelas kontrol yang menerapkan pembelajaran konvensional. Data tes keterampilan pemecahan masalah diperoleh dari 16 siswa, 8 siswa kelas eksperimen yang menerapkan Model Pembelajaran Konstruktivisme, dan 8 siswa kelas kontrol yang menerapkan pembelajaran konvensional. Penerapan model pembelajaran ini terjadi peningkatan keterampilan pemecahan masalah, termasuk pemahaman perencanaan masalah untuk pemecahan masalah berupa pemecahan masalah dari penerapan beberapa konsep pembelajaran matematika. Bukti dari data skor gain yang dinormalisasi (N-gain) antara kedua kelas dapat dilihat.The purpose of this study is to study the improvement of problem-solving skills of elementary students who fall into the category of slow learners who apply to learn using constructivism and conventional learning models. Researchers processed data using the SPSS 16 for Windows and Microsoft Office Excel 2007 programs to achieve these goals. The subjects in this study were students of slow learner class V Adabiah Padang Elementary School. Data collection techniques with observations and interviews with observation and interview guidelines. The results showed that through pre-test and post-test problem-solving skills at the end of learning using the Constructivism Learning Model and conventional learning. The problem-solving skills test data were obtained from 16 students, 8 experimental class students applying the Constructivism Learning Model, and 8 control class students who applied conventional learning. The problem-solving skills test data were obtained from 16 students, 8 experimental class students applying the Constructivism Learning Model, and 8 control class students who applied conventional learning. The application of this learning model occurs an increase in problem-solving skills, including understanding problem planning for problem-solving in the form of problem-solving from the application of several mathematical learning concepts. The evidence from data on normalized gain scores (N-gain) between the two classes may be seen.

Human studies have demonstrated that physiologically relevant changes in circulating glucagon‐like peptide‐1 (GLP‐1) elicit a rapid increase in renal sodium excretion when combined with expansion of the extracellular fluid volume. Other studies support the involvement of various gastrointestinal hormones, e.g., gastrin and cholecystokinin (CCK) in a gut‐kidney axis, responsible for a rapid‐acting feed‐forward natriuretic mechanism. This study was designed to investigate the hypothesis that the postprandial GLP‐1 plasma concentration is sensitive to the sodium content in the meal. Under fixed sodium intake for 4 days prior to each experimental day, 10 lean healthy male participants were examined twice in random order after a 12‐hr fasting period. Arterial blood samples were collected at 10–20‐min intervals for 140 min after 75 grams of oral glucose + 6 grams of oral sodium chloride (NaCl) load versus 75 grams of glucose alone. Twenty‐four‐hour baseline urinary sodium excretions were similar between study days. Arterial GLP‐1 levels increased during both oral glucose loads and were significantly higher at the 40–80 min period during glucose + NaCl compared to glucose alone. The postprandial arterial responses of CCK, gastrin, and glucose‐dependent insulinotropic polypeptide as well as glucose, insulin, and C‐peptide did not differ between the two study days. Arterial renin, aldosterone, and natriuretic peptides levels did not change within subjects or between study days. Angiotensin II levels were significantly lower at the time GLP‐1 was higher (60–80 min) during glucose + NaCl. Sodium intake in addition to a glucose load selectively amplifies the postprandial GLP‐1 plasma concentration. Thus, GLP‐1 may be part of an acute feed‐forward mechanism for natriuresis., This study demonstrates that postprandial glucose‐driven glucagon‐like peptide‐1 (GLP‐1) secretion is sensitive to dietary sodium chloride intake and that this is associated with significantly lower angiotensin II (ANG II) but not aldosterone concentrations. In perspective, this feed‐forward Na+‐driven GLP‐1/ANGII response could have an impact on renal Na+‐handling.

We have recently demonstrated that renal extraction of GLP-1 is ∼45% and that extracellular fluid volume expansion in healthy participants uncovered a natriuretic action of GLP-1 probably via a tubular mechanism secondary to suppression of angiotensin II (ANG II) and independent of changes in renal hemodynamics. It is not known whether the high extraction is due to receptor binding. The present study was designed to test the hypotheses that the renal extraction and natriuretic effect of GLP-1 are mediated via GLP-1 receptor. Under fixed sodium intake for 4 days before each study day, 6 healthy male participants were recruited from our recent study1 and examined during a 3-h infusion of GLP-1 (1.5 pmol/kg/min) together with a 3.5-h infusion of the GLP-1 receptor antagonist, exendin 9-39 (Ex 9-39) (900 pmol/kg/min), initiated 30 minutes before start of GLP-1 infusion. Timed urine collections were conducted throughout the experiments. Renal plasma flow (RPF), glomerular filtration rate (GFR), and renal extraction of GLP-1 were measured via Fick’s principle after catheterization of a renal vein. Renal extraction of GLP-1 was ∼45% during infusion of GLP-1 alone and decreased significantly to ∼25% during co-infusion of GLP-1 and Ex 9-39. Urinary sodium and osmolar excretions remained at baseline levels during co-infusion of GLP-1 and Ex 9-39 compared to a mean 2-fold natriuretic effect during GLP-1 infusion alone. Arterial plasma ANG II levels were unaffected during the co-infusions, whereas ANG II decreased significantly during GLP-1 alone. Arterial plasma renin levels decreased similarly on the two study days, and arterial aldosterone levels remained unchanged on both days. RPF and GFR remained unchanged on both days. In conclusion, renal extraction of GLP-1 is partially and natriuresis is fully dependent on GLP-1 receptor activation, probably via GLP-1-mediated ANG II suppression. 1Asmar A et al. J Clin Endocrinol Metab. 2019 Jul 1;104(7):2509-2519. Disclosure A. Asmar: None. P.K. Cramon: None. M. Asmar: None. L. Simonsen: None. S. Madsbad: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi-Aventis. Research Support; Self; Boehringer Ingelheim International GmbH, Novo Nordisk A/S. Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Novo Nordisk A/S. C.M. Sorensen: None. B. Hartmann: None. J.J. Holst: Advisory Panel; Self; AstraZeneca, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Zealand Pharma A/S. Other Relationship; Spouse/Partner; Antag Therapeutics. P. Hovind: None. B.L. Jensen: None. J. Bülow: None.

Purpose The natriuretic effect of glucagon-like peptide-1 (GLP-1) in humans is independent of changes in renal plasma flow (RPF) and glomerular filtration rate (GFR) but may involve suppression of angiotensin II (ANG II) and a significant (~45%) renal extraction of GLP-1. The current study was designed to investigate the consequences for the renal extraction and the natriuretic effect of blocking GLP-1 receptors with the specific GLP-1 receptor antagonist, Exendin 9–39 (Ex 9–39). Methods Under fixed sodium intake for 4 days before each study day, 6 healthy male participants were recruited from our recent study where GLP-1 or vehicle was infused (1). In the present new experiments, participants were examined during a 3-hour infusion of GLP-1 (1.5 pmol/kg/min) together with a 3.5-hour infusion of Ex 9–39 (900 pmol/kg/min). Timed urine collections were conducted throughout the experiments. Renal extraction of GLP-1 as well as RPF and GFR were measured via Fick’s principle after catheterization of a renal vein. Arterial plasma renin, ANG II, and aldosterone concentrations were measured. Results Co-infusion of Ex 9–39 significantly reduced renal extraction of GLP-1 to ~25% compared with GLP-1 infusion alone (~45%). Urinary sodium excretions remained at baseline levels during co-infusion of Ex 9–39 as well as vehicle. By contrast, GLP-1 infusion alone resulted in a 2-fold increase in natriuresis. Ex 9–39 abolished the GLP-1-induced decrease in arterial ANG II concentrations. RPF and GFR remained unchanged during all experiments. Conclusions Renal extraction of GLP-1 and its effect on natriuresis are both dependent on GLP-1 receptor activation in healthy humans.

Background: Efficacy of protein absorption and subsequent amino acid utilization may be reduced in the elderly. Higher protein intakes have been suggested to counteract this.Objectives: We aimed to elucidate how habituated amounts of protein intake affect the fasted state of, and the stimulatory effect of a protein-rich meal on, protein absorption, whole-body protein turnover, and splanchnic amino acid metabolism.Methods: Twelve men (65-70 y) were included in a double-blinded crossover intervention study, consisting of a 20-d habituation period to a protein intake at the RDA or a high amount [1.1 g . kg lean body mass (LBM)(-)(1) . d(-1) or >2.1 g . kg LBM-1 . d(-1), respectively], each followed by an experimental trial with a primed, constant infusion of D-8-phenylalanine and D-2-tyrosine. Arterial and hepatic venous blood samples were obtained after an overnight fast and repeatedly 4 h after a standardized meal including intrinsically labeled whey protein concentrate and calcium-caseinate proteins. Blood was analyzed for amino acid concentrations and phenylalanine and tyrosine tracer enrichments from which whole-body and splanchnic amino acid and protein kinetics were calculated.Results: High (compared with the recommended amount of) protein intake resulted in a higher fasting whole-body protein turnover with a resultant mean +/- SEM 0.03 +/- 0.01 mu mol . kg LBM-1 . min(-1) lower net balance (P Conclusions: Three weeks of habituation to high protein intake (>2.1 g protein . kg LBM-1 . d(-1)) led to a significantly higher net protein loss in the fasted state. This was not compensated for in the 4-h postprandial period after intake of a meal high in protein.

The purpose of this study is to determine the creativity of teachers in designing ethnomathematical-based student worksheets through LMS - Edmodo at MGMP SMP Payakumbuh. Ethnomathematics based student activity sheet (LKS) is based on the local culture of Payakumbuh. This Ethnomathematics-based LKS is expected to be the initial foundation for teacher creativity to design and develop Ethnomathematics-based LKS in accordance with Payakumbuh City. The method used in the service is in the form of online and offline workshops. The target audience for this community service is the mathematics teacher in the Payakumbuh Mathematics Junior High School Subject Teacher Consultation. This training stage begins online with a zoom meeting, giving questionnaires, carrying out tests, then followed by making Ethnomathematics-based LKS with the Edmodo platform. The results of the implementation show that the creativity of teachers in designing Ethnomathematics-based worksheets using the Edmodo platform is good, with the percentage of achievement of 79% and the creative achievement of teachers in participating in this activity is 78%.

Learning results found in several schools are still low. This happens because students do not understand the real life math problems that surround students, so students are lack of creative thingking. This is because the learning methods used by teachers have not been implemented optimally. One of effort that can be made to overcome these problems is to use learning media based on interactive multimedia in the mathematic learning for 7th grade of junior high school student who valid, practical and effective. This type of research is the development by using Plomp research design. During the initial survey phase, doing necessity analysis, curriculum analysis and conceptual analysis focused on issues related to learning mathematics. In the development phase or prototyping, the design of mathematics media learning based on a scientific approach to improve students' mathematical communication skills, then self-evaluation, one to one evaluation and small group evaluation. The assessment phase carried out a practicality test and a limited effectiveness test. Practicality data were obtained from teacher practicality questionnaires, student practicality questionnaires. Effectiveness data obtained from student result learning after implementing learning with learning devices. The research results showed that the mathematics learning media with macromedia flash based on scientific was valid and practical. Valid because it has qualify the valid criteria in terms of content and construct. Practical because they are easy to use and understand, the allocated allocations are very efficient, attractive, and contribute to learning. Effective in terms of its potential impact on students' mathematical communication skills

We investigated the short-term effect of adding liraglutide 1.8 mg once daily to insulin treatment on cardiovascular risk factors in patients with type 1 diabetes. In total, 100 overweight (BMI ≥25 kg/m(2) ) adult patients (age ≥18 years) with type 1 diabetes and HbA1c ≥ 8% (64 mmol/mol) were randomized to liraglutide 1.8 mg or placebo added to insulin treatment in a 24-week double-blinded, placebo-controlled trial. At baseline and after 24 weeks of treatment, 24-hour blood pressure and heart rate, pulse pressure, pulse wave velocity and carotid intima-media thickness were evaluated. Compared with placebo, liraglutide increased 24-hour heart rate by 4.6 beats per minute (BPM); P = .0015, daytime heart rate by 3.7; P = .0240 and night-time heart rate by 7.5 BPM; P

Glucose-dependent insulinotropic polypeptide (GIP) in combination with hyperinsulinemia increase blood flow and triglyceride clearance in subcutaneous abdominal adipose tissue in lean humans. The present experiments were performed to determine whether the increase involves capillary recruitment. Eight lean healthy volunteers were studied before and after 1 h infusion of GIP or saline during a hyperglycemic–hyperinsulinemic clamp, raising plasma glucose and insulin to postprandial levels. Subcutaneous abdominal adipose tissue blood flow (ATBF) was measured by the 133Xenon clearance technique, and microvascular blood volume was determined by contrast-enhanced ultrasound imaging. During infusion of saline and the clamp, both ATBF (2.7 ± 0.5 mL/min 100 g/tissue) and microvascular blood volume remained unchanged throughout the experiments. During GIP infusion and the clamp, ATBF increased ~fourfold to 11.4 ± 1.9 mL/min 100 g/tissue, P P = 0.003), but not in the control experiments. In conclusion, the increase in ATBF during GIP infusion involves recruitment of capillaries in healthy lean subjects, which probably increases the interaction of circulating lipoproteins with lipoprotein lipase, thus promoting adipose tissue lipid uptake.

The aim of this study was to investigate the effect of glucose-dependent insulinotropic polypeptide (GIP) per se and in combination with hyperglycemia and hyperinsulinemia on splanchnic blood flow and further to investigate the role of GIP in splanchnic lipid metabolism in humans. Eight healthy lean males were examined in a randomized order on four different occasions. Splanchnic blood flow and lipid metabolism were measured by Fick’s Principle using indocyanine green as indicator during GIP (1.5 pmol/kg/min) or saline infused intravenously alone or in combination with a hyperglycemia and hyperinsulinemia (Hygluc-Hyinsu) clamp. During all four experiments, splanchnic blood flow increased similarly. Splanchnic triglyceride output decreased similarly during the Hygluc-Hyinsu clamp with and without GIP (8.6 ± 1.8 and 10.3 ± 2.6 µmol/min, respectively, P=NS). Likewise, during the clamp alone and with GIP, free fatty acids uptake decreased similarly (3.5 ± 3.8 and 6.7 ± 4.6 µmol/min, respectively, P=NS). GIP does not seem to play a key role in the acute regulation of splanchnic blood flow or lipid metabolism under these particular conditions in vivo. Disclosure A. Asmar: None. J.J. Holst: Advisory Panel; Self; Novo Nordisk A/S. M. Asmar: None.

This study aims to describe the metacognitive awareness of students who learn with the RME approach and those who learn with conventional approach; and describes the effect of metacognitive awareness on students' problem solving abilities in implementing RME approach. The subjects of this study were seventh grade students of SMP Negeri Kecamatan Luak Kabupaten Lima Puluh Kota. The research data were obtained by using a Metacognitive Awareness Inventory Junior questionnaire (Jr-MAI) and a final test designed based on indicators of problem solving abilities. Data were analyzed inferentially by using covariant and simple linear regression analysis with SPSS program. The results showed that metacognitive awareness of students who learn with the RME approach is better than those who learn with conventional approach; and there is a positive effect between metacognitive awareness on students' problem solving abilities and the application of RME approach

The learning media used in schools, such as worksheet, are not optimal yet to help students build their understanding. For this reason, it is necessary to develop learning media so that they can provide opportunities for students to find their own concepts and can be remembered for a long time. This study developed a PISA-oriented problem-based learning (PBL) media. This research was a development research (R&D). This research used the Plomp model which consisted of three stages, namely the preliminary research stage, the prototyping phase, and the assessment phase. At the preliminary research stage, needs analysis, curriculum analysis, concept analysis, student analysis was applied. In the prototype-making phase, a prototype development was applied which had been validated and tested. Whereas in the assessment phase, the developed prototype was tested and assessed for practicality and effectiveness, which was assessed by observation, questionnaires, and student learning outcomes. The validation of learning tools is viewed from the content validity and construct validity. The average value of the PISA-oriented PBL-based student worksheet validation was 3.57 with a very valid category. Based on the student response questionnaire, it was found that the learning media was practical with a percentage of 86.83%. Problem solving problems were given to test the effectiveness of the learning media being developed, and the results were these devices are effective for use. After all stages of development, it was concluded that the media being developed were valid, practical, and effective.

As it was found in many schools, the learning media have not helped educators in facilitating students in supporting an effective learning process. Learning tools which consist of a syllabus, lesson plans, teaching materials and learning outcomes tests that were used do not involve students actively. One effort that can be used is through discovery learning methods that are valid, practical and effective. Where this method was implemented by connecting the concept of learning with problems in everyday life and aimed to improve students' problem-solving abilities and teaching them how to solve problems until new knowledge was discovered by students. The aimed of this development was to produce a learning media based on discovery learning by using GeoGebra on valid and practical for second semester topic. This type of research was a development research using the Plomp development model which consists of three phases where the initial investigation, the development phase and the assessment phase. The research subjects were students of class grade 11 in Senior High School Number 2 Pulau Punjung. The results of the validity of the data analysis indicated the ddiscovery learning were in valid criteria in terms of content and validity of lesson plan with a percentage of 86.78% and the validity of worksheet was 82.24%. Practicality of learning media, attractiveness, comfort and time efficiency were 95% based on teacher questionnaire responses and 85.30% questionnaire responses for student learning media with discovery leaning method and the affectivity of discovery learning in term of completeness was 83. 87%.

Concept comprehension abilities is a very important aspect in learning mathematics. The low of concept comprehension abilities will affect the quality of student learning, which in turn has an impact on the low achievement of students in school. This also happened at the Vocational public School in Sijunjung regency. One effort that can be done in reacting to it is through the selection of learning models that can create a learning environment that makes students active. Mind Mapping technique is an alternative to increase student activity in learning. This type of research was quasi-experimental. The instrument used in this study was a test consisting of an initial ability test to see students 'initial abilities consisting of high and low initial abilities, a final test to see students' mathematical concept comprehension abilities. Data was analyzed by using the Mann Whitney U test and two-way ANOVA. Based on the results of data analysis, several conclusions were obtained, namely: (1) The Concept comprehension abilities of students who learn with Mind Mapping Techniques was higher than students who learn with conventional learning; (2) Concept comprehension abilities of high, moderate, and low prior knowledge who learn with Mind Mapping techniques was higher than students who study with conventional learning; (3) there is no interaction between model of learning and prior knowledge.

Penelitian ini bertujuan untuk mengetahui tentang hubungan antara kemandirian belajar dengan kemampuan berpikir kritis mahasiswa melalui penggunaan software Geogebra . Penelitian ini merupakan penelitian eksperimen. Jumlah sampel pada penelitian ini adalah 40 orang mahasiswa Program Studi Pendidikan Matematika Universitas Negeri Padang. Instrumen yang digunakan adalah tes dan angket. Tes yang digunakan berbentuk essay dan memuat indikator kemampuan berpikir kritis, sedangkan angket kemandirian terdiri atas 28 butir pernyataan. Metode penelitian yang digunakan ialah metode korelasi dengan pendekatan kuantitatif. Teknik analisis data menggunakan uji korelasi untuk mengetahui hubungan antara berpikir kritis dengan kemandirian belajar mahasiswa. Hasil penelitian ini menunjukkan bahwa ada hubungan antara kemandirian belajar terhadap kemampuan berpikir kritis mahasiswa melalui penggunaan software Geogebra pada pokok bahasan Geometri khususnya pada materi jarak bidang ke bidang. Hasil tersebut dilihat bahwa nilai korelasi Pearson sebesar 0,412 menunjukkan kekuatan hubungan antara kemandirian belajar terhadap kemampuan berpikir kritis mahasiswa. Di samping itu, diperoleh nilai Sig. sebesar 0,014 lebih kecil dari 0,05. Sehingga dapat disimpulkan bahwa kekuatan hubungan antara kemandirian belajar terhadap kemampuan berpikir kritis mahasiswa signifikan.

The use of classical learning models that have long been known among mathematics educators. The purpose of this study is to describe students’ perceptions of mathematics education on the use of classical learning models with power points in the learning process in class. This research is a qualitative research that reveals students’ perceptions of mathematics education study programs on the effectiveness aspects of classical learning models, student aspects, material aspects, and aspects of learning strategies through questionnaires and interviews to students consisting of two classes with a total of 66 students. Research subjects were involved in implementing Classical Learning models. The results of this study indicate that 77.27% of respondents agree that the use of classical learning models helps students understand mathematical concepts. As many as 65.15% of students agreed that all students, both low and high concept skills, needed learning using classical learning models. As many as 75.76% disagree that all mathematical material needs to be taught using classical learning models and as many as 63.64% of students think agree that special strategies are needed in teaching mathematics using classical learning models. The student’s perception will continue to be developed in studying mathematics learning strategy courses.

Recent randomized and controlled trials of drugs derived from the gut hormone glucagon-like peptide-1 (GLP-1) show that the most frequent adverse symptoms are gastrointestinal, including gallbladder-related side effects such as cholithiasis and cholecystitis. Since the gut hormone cholecystokinin (CCK) stimulates bile secretion and regulates gallbladder motility and emptying, we examined the effect of GLP-1 on the secretion of CCK in normal subjects and patients with type 1 diabetes mellitus.Plasma was sampled from 10 healthy subjects and 10 patients with diabetes. With plasma glucose concentrations clamped between 6 and 9 nmol/l, GLP-1 or saline was infused for 240 min during and after a meal. The plasma concentrations of CCK were measured with a highly specific radioimmunoassay.Basal plasma concentrations of CCK were similar in the normal subjects and in the diabetes patients. During the meal, the CCK concentrations rose significantly during saline infusion, whereas the GLP-1 infusion suppressed the secretion of CCK significantly in both normal subjects and in the diabetes patients.The results show that GLP-1 suppresses the secretion of CCK after a meal in normal and diabetic subjects. The suppression attenuates the gallbladder contractility. Our data, therefore, offer an explanation for the increased risk of adverse gallbladder events during treatment with GLP-1-derived drugs.

We have previously demonstrated that the gut hormone glucagon-like peptide-1 (GLP-1) does not affect renal hemodynamics or function at baseline conditions in healthy individuals and in patients with type 2 diabetes mellitus. However, it is possible that GLP-1 promotes renal NaCl excretion under conditions with addition of salt and water to the extracellular fluid (mimicking a mixed meal/daily NaCl load). The present study was designed to investigate whether GLP-1 induces natriuresis in healthy, volume overloaded individuals. Under fixed sodium intake, 8 healthy men were examined twice in random order during a 3-hour infusion of either GLP-1(1.5 pmol kg-1 min-1) or vehicle together with an intravenous infusion of 0.9% NaCl (750 ml/hour) given throughout both experiments. Timed urine collections were conducted throughout the experiments at voluntary voiding, and subjects remained supine during the experiments. Renal plasma flow (RPF), glomerular filtration rate (GFR), and uptake/release of hormones and ions were measured using Fick’s Principle after catheterization of a renal vein and an artery. During GLP-1 infusion, urinary sodium excretion increased compared to vehicle infusion (193 ± 40 mmol/180 min vs. 89 00B110 mmol/180 min, p Disclosure A. Asmar: None. P.K. Cramon: Employee; Spouse/Partner; Novo Nordisk A/S. L. Simonsen: None. M. Asmar: None. C.M. Sorensen: None. S. Madsbad: Advisory Panel; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Speaker's Bureau; Self; Eli Lilly and Company, Eli Lilly and Company. Advisory Panel; Self; Merck Sharp & Dohme Corp., Sanofi-Aventis, Novo Nordisk A/S. Speaker's Bureau; Self; Novo Nordisk A/S. Research Support; Self; Novo Nordisk A/S. C. Moro: None. B. Hartmann: None. J.J. Holst: Advisory Panel; Self; Novo Nordisk A/S. Board Member; Self; Zealand Pharma A/S. Speaker's Bureau; Self; Merck Sharp & Dohme Corp., AstraZeneca. Research Support; Self; Danish Diabetes Academy, Novo Nordisk Foundation. Other Relationship; Self; Antag Therapeutics. Other Relationship; Spouse/Partner; Antag Therapeutics. B.L. Jensen: None. J. Bülow: None.

The aim of study to analyze the needs the development of mathematics learning device on 21st century skills-based Senior High School in Padang City. The population of the study is high school student’s grade XI and Mathematics teacher in Padang city in 2018/2019. The sampling technique used purposive sampling method. The instrument was collected by observation and questioner and Analyzed descriptively. Conclusions of this research are: (1) learning material of high school mathematics class can be developed with 21st century skills-based mathematics learning; (2) Students have sufficient ability to follow 21st century mathematics-based learning; (3) teachers have the ability to use 21st century skills-based mathematics learning tools

To investigate how fluid shifts, blood pressure and systemic vascular resistance adapt to long duration (3-6 months) spaceflight.