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ABSTRAK Penelitian ini bertujuan untuk mendeskripsikan respon siswa terhadap penggunaan model pembelajaran POE (Predict, Observe, Explain) dalam pembelajaran IPA di SD. Penelitian ini dilaksanakan di MIS Ushuluddin Singkawang dan Subjek dalam penelitian ini adalah siswa kelas V sebanyak 28 siswa. Instrumen untuk pengumpulan data dalam penelitian ini adalah angket respon siswa. Teknik analisis data menggunakan metode deskriptif kuantitatif dengan persentase, untuk mengetahui respon positif siswa terhadap model pembelajaran POE dalam pembelajaran IPA. Hasil penelitian menunjukkan bahwa: Terdapat Respon siswa positif terhadap model pembelajaran POE diperoleh dari hasil persentase tiap indikator respon siswa, Untuk indikator relevansi terdapat persentase 81% dengan kriteria sangat baik, indikator perhatian terdapat 85% dengan kriteria sangat baik, indikator kepuasan terdapat persentase 87% dengan kriteria sangat baik, dan indikator percaya diri terdapat persentase 86% dengan kriteria sangat baik. Kata kunci: Respon siswa; model pembelajaran Predict; Observe; Explain; pembelajaran IPA. ABSTRACT This study aims to describe student responses to the use of the POE (Predict, Observe, Explain) learning model in science learning in elementary schools. This research was conducted at MIS Ushuluddin Singkawang and the subjects in this study were 28 students of class V. The instrument for collecting data in this study was a student response questionnaire. The data analysis technique used quantitative descriptive methods with percentages, to determine the positive response of students to the POE learning model in science learning. The results showed that: There was a positive student response to the POE learning model obtained from the results of the percentage of each student response indicator, for relevance indicators there was a percentage of 81% with very good criteria, 85% attention indicators with very good criteria, satisfaction indicators with a percentage of 87% with very good criteria, and the confidence indicator there is a percentage of 86% with very good criteria. Keywords: Student responses; Predict; Observe; Explain learning models; science learning.

Most biological diversity on Earth is contained within microbial communities. In the ocean, these communities dominate processes related to carbon fixation and nutrient recycling. Yet, specific factors that determine community composition and metabolic activity are difficult to resolve in complex microbial populations, complicating predictions of microbial processes in a changing ocean. Microbial metabolism generates small organic molecules that reflect both the biochemical and physiological diversity as well as the taxonomic specificity of these biological processes. These small molecules serve as the conduit for taxon-specific signaling and exchange. Here, we use liquid chromatography-mass spectrometry (LC-MS)-based metabolomics to taxonomically categorize 111 metabolites that include small molecules in central and secondary metabolism across 42 taxa representing numerically dominant and metabolically important lineages of microbial autotrophs and heterotrophs. Patterns in metabolite presence-absence broadly reflected taxonomic lineages. A subset of metabolites that includes osmolytes, sulfur-containing metabolites, sugars, and amino acid derivatives provided chemotaxonomic information among phytoplankton taxa. A variety of phytohormones and signaling molecules were predominantly found in the heterotrophic bacteria and archaea, expanding knowledge of metabolites implicated in modulating interactions between microbes. This chemotaxonomic inventory of marine microbial metabolites is a key step in deciphering metabolic networks that influence ocean biogeochemical cycles.

Community-acquired pneumonia (CAP) is characterized by elevated markers of inflammation and oxidative stress and depleted circulating concentrations of the antioxidant nutrient vitamin C. A feasibility trial of intravenous and oral vitamin C supplementation, matched to the timing of intravenous and oral antibiotic formulations, was carried out and changes in vitamin C status were monitored to determine whether saturating status could be achieved throughout the administration period. Patients with moderate and severe CAP (CURB-65 ≥ 2; n = 75) who were receiving intravenous antimicrobial therapy were randomized to placebo (n = 39) or intravenous vitamin C (2.5 g per 8 h; n = 36) before moving to oral vitamin C (1 g three times daily) when prescribed oral antimicrobials. Blood samples were collected at baseline and then daily whilst in the hospital. Vitamin C concentrations were determined by high-performance liquid chromatography. The inflammatory and infection biomarkers C-reactive protein and procalcitonin were elevated at baseline (158 (61, 277) mg/L and 414 (155, 1708) ng/L, respectively), and vitamin C concentrations were depleted (15 (7, 25) µmol/L). There was an inverse association between vitamin C and C-reactive protein concentrations (r = −0.312, p = 0.01). Within one day of intervention initiation, plasma vitamin C concentrations in the vitamin C group reached median concentrations of 227 (109, 422) µmol/L, and circulating concentrations remained at ≥150 µmol/L for the duration of the intervention, whilst median vitamin C concentrations in the placebo group remained low (≤35 µmol/L). There was a trend toward decreased duration of hospital stay (p = 0.07) and time to clinical stability (p = 0.08) in the vitamin C group. In conclusion, patients with moderate to severe CAP have inadequate plasma vitamin C concentrations for the duration of their hospital stay. The administration of intravenous or oral vitamin C, titrated to match the antimicrobial formulation, provided saturating plasma vitamin C concentrations whilst in the hospital. There were trends toward shorter duration of hospital stay and time to clinical stability. Thus, larger trials assessing the impact of intravenous and oral vitamin C intervention on CAP clinical outcomes are indicated.

ImportanceChemotherapy-induced alopecia is a common and distressing adverse effect. In previous studies of scalp cooling to prevent chemotherapy-induced alopecia, conclusions have been limited.ObjectivesTo evaluate whether use of a scalp cooling system is associated with a lower amount of hair loss among women receiving specific chemotherapy regimens for early-stage breast cancer and to assess related changes in quality of life.Design, setting, and participantsA prospective cohort study conducted at 5 US medical centers of women with stage I or II breast cancer receiving adjuvant or neoadjuvant chemotherapy regimens excluding sequential or combination anthracycline and taxane (106 patients in the scalp cooling group and 16 in the control group; 14 matched by both age and chemotherapy regimen). The study was conducted between August 2013 and October 2014 with ongoing annual follow-up for 5 years.ExposuresUse of a scalp cooling system. Scalp cooling was initiated 30 minutes prior to each chemotherapy cycle, with scalp temperature maintained at 3°C (37°F) throughout chemotherapy and for 90 minutes to 120 minutes afterward.Main outcomes and measuresSelf-estimated hair loss using the Dean scale was assessed 4 weeks after the last dose of chemotherapy by unblinded patient review of 5 photographs. A Dean scale score of 0 to 2 (≤50% hair loss) was defined as treatment success. A positive association between scalp cooling and reduced risk of hair loss would be demonstrated if 50% or more of patients in the scalp cooling group achieved treatment success, with the lower bound of the 95% CI greater than 40% of the success proportion. Quality of life was assessed at baseline, at the start of the last chemotherapy cycle, and 1 month later. Median follow-up was 29.5 months.ResultsAmong the 122 patients in the study, the mean age was 53 years (range, 28-77 years); 77.0% were white, 9.0% were black, and 10.7% were Asian; and the mean duration of chemotherapy was 2.3 months (median, 2.1 months). No participants in the scalp cooling group received anthracyclines. Hair loss of 50% or less (Dean score of 0-2) was seen in 67 of 101 patients (66.3%; 95% CI, 56.2%-75.4%) evaluable for alopecia in the scalp cooling group vs 0 of 16 patients (0%) in the control group (P

Background: At the start of the COVID-19 pandemic, the DC Department of Health (DC Health) mandated new case reporting for early outbreak detection: (1) weekly healthcare personnel (HCP) absenteeism line lists indicating staff absent for confirmed or suspected SARS-CoV-2, (2) daily line lists of all SARS-CoV-2–positive inpatients, and (3) hospital contact tracing. Between March 27, 2020, and December 31, 2020, DC Health detected 36 confirmed and 14 suspected hospital outbreaks, of which only 18% (8 confirmed and 1 suspect) were known to the affected hospital. DC Health learned which outbreaks warranted early or aggressive intervention by tracking outbreak characteristics across its jurisdiction. This allowed prioritization of during surges when it was difficult for DC Health and hospital staff to investigate every outbreak. Methods: Potential outbreaks in short-stay and inpatient rehabilitation hospitals were flagged after identifying SARS-CoV-2 hospital-onset (HO) inpatients or staff clusters on line lists. Variables of interest in line lists included specimen collection and hospital admission dates, units or departments, and patient contact. Facility contact tracing by infection preventionists further verified epidemiological links among cases. Outbreak details were systematically tracked in a locally developed REDCap database and were analyzed if they had an initial case, outbreak start date, or an investigation start date in 2020. Frequency procedures, SQL statements, and date calculations were computed using SAS Enterprise Guide version 8.3 software. Results: Confirmed outbreaks had an average of 6.92 (range, 0–32) HCP and 2.58 (range, 0–22) patient cases, with 69% being confirmed-HO cases and 31% probable HO. Moreover, 53% of confirmed outbreaks occurred in the following departments: cardiac, behavioral health, intensive care, and environmental services (EVS)/facilities. All of these departments had recurrent outbreaks. Behavioral health, medical and cardiac units had the highest number of patient cases. On average, confirmed outbreak investigations lasted 24.6 days, with outbreaks prolonged in the ICU (40.25 days) and the medical unit (37.67 days). Top triggers for investigations ultimately classified as confirmed outbreaks were (1) positive symptomatic HCP, (2) confirmed-HO cases, and (3) exposures from positive HCP. Conclusions: The dynamic nature of COVID-19 created challenges in detecting and responding to hospital outbreaks. Developing a low-resource outbreak tracking system helped identify outbreak types and triggers that warranted early or aggressive interventions. Understanding the characteristics of hospital outbreaks was critical for maximizing infection control resources during surges of infectious disease outbreaks, such as COVID-19. Hospitals or local health departments could adapt this system to meet their needs.

ABSTRAK Penelitian ini bertujuan untuk mengetahui pengaruh penggunaan model pembelajaran POE (Predict, Observe, Explain) terhadap kemampuan pemahaman konsep IPA siswa pada materi panas dan perpindahannya. Penelitian ini dilaksanakan di MIS Ushuluddin Singkawang. Jenis penelitian yang digunakan yaitu penelitian kuantitatif dengan metode quasi experimental design, dengan bentuk desain post-test only control design. Populasi dalam penelitian ini adalah seluruh siswa kelas V MIS Ushuluddin Singkawang. Sampel diambil menggunakan teknik purposive sampling. Setelah pengambilan sampel, yang terpilih menjadi kelas eksperimen adalah kelas VA dengan menggunakan model pembelajaran POE dan VB sebagai kelas kontrol yang menggunakan model pembelajaran langsung. Hasil penelitian menunjukkan bahwa: (1) Terdapat pengaruh kemampuan pemahaman konsep IPA siswa antara kelas yang diberikan model pembelajaran POE dengan kelas yang diberikan pembelajaran langsung pada materi panas dan perpindahannya di kelas V MIS Ushuluddin Singkawang; (2) Terdapat perbedaan kemampuan pemahaman konsep IPA siswa antara kelas yang diberikan model pembelajaran POE dengan kelas yang di berikan model pembelajaran langsung pada materi panas dan perpindahannya di kelas V MIS Ushuluddin Singkawang. Kata kunci: model pembelajaran POE; kemampuan pemahaman konsep. ABSTRACT This study is aimed at learning the influence of the use of the POE learning model (Predict, Observe, Explain) on a student's ability to understand science concepts on hot matter and transmigration. The study is carried out at MIS Ushuluddin Singkawang. The kind of research used was quantitative research with experimental quasi design. With a design post-test only design control. The population in the study are all the students in the V MIS Ushuluddin Singkawang class. The sample was taken using an additive sampling, after taking the selected sample into a VA class experiment which was an experimental class using the POE and VB control class that use a direct learning model. Research concluded that: (1) there is an influence on a student's ability to understand natural science between a class given by the POE learning model and a class given direct learning on hot matter and transfer to V MIS Ushuluddin Singkawang class; (2) there is a difference in the ability to understand a student science concept between the class given by the POE learning model and the class provided the direct learning model for hot matter and transfer to V MIS Ushuluddin Singkawang class. Keywords: POE learning models; the ability to understand concepts.

Elevated inflammation has been associated with adverse mood states, such as depression and anxiety, and antioxidant nutrients, such as vitamin C, have been associated with decreased inflammation and improved mood. In the current study comprising a cohort of pregnant women with depression and anxiety, we hypothesised that elevated inflammation would be associated with adverse mood states and inversely associated with vitamin C status and that multinutrient supplementation would optimise vitamin concentrations and attenuate inflammation. Sixty-one participants from the NUTRIMUM trial had blood samples collected between 12 and 24 weeks gestation (baseline) and following 12 weeks of daily supplementation with a multinutrient formula containing 600 mg of vitamin C or active placebo. The samples were analysed for inflammatory biomarkers (C-reactive protein (CRP) and cytokines) and vitamin C content and were related to scales of depression and anxiety. Positive correlations were observed between interleukin-6 (IL-6) and all of the mood scales administered (p < 0.05), including the Edinburgh Postnatal Depression Scale, the Clinical Global Impressions—Severity Scale, the Montgomery and Åsberg Depression Rating Scale, the Depression Anxiety Stress Scale 21, and the Generalized Anxiety Disorder-7 (GAD-7). CRP correlated weakly with GAD-7 (p = 0.05). There was an inverse correlation between CRP and the vitamin C status of the cohort (p = 0.045), although there was no association of the latter with the mood scales (p > 0.05). Supplementation with the multinutrient formula resulted in a significant increase in the vitamin C status of the cohort (p = 0.007) but did not affect the inflammatory biomarker concentrations (p > 0.05). In conclusion, greater systemic inflammation was associated with worse mood states; however, 12-week multinutrient supplementation did not alter inflammatory biomarker concentrations. Nevertheless, the vitamin C status of the cohort was improved with supplementation, which may aid pregnancy and infant outcomes.

Vitamin C status is known to be associated with several demographic and lifestyle factors. These include gender, age, ethnicity, pregnancy/lactation, body weight, smoking status and dietary habits. In the present study, our aim was to investigate the National Health and Nutrition Examination Survey (NHANES) 2017–2018 datasets to assess the impact of these factors on vitamin C dose-concentration relationships to establish if there are higher requirements for vitamin C in certain subpopulations, and the possible extent of these additional requirements. The final cohort comprised 2828 non-supplementing adult males and females (aged 18–80+ years) with both vitamin C serum concentrations and dietary intake data available. The data were subsequently stratified by gender, age tertiles (≤36, 37–58, ≥59 years), ethnicity (non-Hispanic white, non-Hispanic black, and total Hispanic), socioeconomic tertiles (poverty income ratios: ≤1.35, 1.36–3.0, >3.0), weight tertiles (91 kg), BMI tertiles (32 kg/m2) and smoking status. Sigmoidal (four parameter logistic) curves with asymmetrical 95% confidence intervals were fitted to the dose-concentration data. We found that males required vitamin C intakes ~1.2-fold higher than females to reach ‘adequate’ serum vitamin C concentrations of 50 µmol/L. Males had both higher body weight and a higher prevalence of smoking than females. Smokers required vitamin C intakes ~2.0-fold higher than non-smokers to reach adequate vitamin C concentrations. Relative to adults in the lighter weight tertile, adults in the heavier weight tertile required ~2.0-fold higher dietary intakes of vitamin C to reach adequate serum concentrations. We did not observe any impact of ethnicity or socioeconomic status on the vitamin C dose-concentration relationship, and although no significant difference between younger and older adults was observed at vitamin C intakes > 75 mg/day, at intakes < 75 mg/day, older adults had an attenuated serum response to vitamin C intake. In conclusion, certain demographic and lifestyle factors, specifically gender, smoking and body weight, have a significant impact on vitamin C requirements. Overall, the data indicate that the general population should consume ~110 mg/day of vitamin C to attain adequate serum concentrations, smokers require ~165 mg/day relative to non-smokers, and heavier people (100+ kg) require ~155 mg/day to reach comparable vitamin C concentrations. These findings have important implications for global vitamin C dietary recommendations.

The role of food constituents as pharmacological agents is an important consideration in health and obesity. Vitamin C acts as a small molecule antioxidant but is also a co-factor for numerous transition metal-dependent enzymes involved in healthy weight and energy metabolism. Vitamin C cannot be manufactured by humans and is mainly obtained from the dietary intake of fresh fruit and vegetables. There is great variability between different nutritional guidelines in the recommended daily allowance of vitamin C. Vitamin C deficiency results from an inadequate intake of vitamin C-containing foods and also increased utilization by oxidative and carbonyl stress. Risk factors for vitamin C deficiency include cigarette smoking, malnutrition, obesity, type 2 diabetes mellitus, age, race, sex, social isolation, major surgery, and Western-type diets. Despite the common belief that vitamin C deficiency is rare in affluent countries, surveys of large populations and specific patient groups suggest otherwise. Patients with obesity typically consume highly processed, energy-dense foods which contain inadequate micronutrients. As obesity increases, larger amounts of oral vitamin C are required to achieve adequate plasma and tissue concentrations, as compared to persons with a healthy weight. This is important in the control of oxidative stress and the maintenance of homeostasis and organ function. In this narrative review, the dosage, absorption, distribution, excretion, and catabolism of vitamin C are reviewed, together with the latest findings on vitamin C pharmacology in patients with obesity. [ABSTRACT FROM AUTHOR]

We report a case of COVID-19 in an adult single-ventricle patient post-Fontan—to our knowledge, the first report in this population documenting the use of the latest management recommendations for this novel disease. Additionally, this patient had significant pre-existing ventricular dysfunction, valvular disease, and comorbidities including HIV. (Level of Difficulty: Advanced.)

Background: Baylor College of Medicine provides a classroom-based implicit bias workshop to all third-year medical students to increase students’ awareness of their unconscious bias and develop strategies for reducing health care disparities. The workshop meets our immediate goals and objectives. However, we are unsure if the benefit would be long-term or diminish over time. Methods: To examine the concept retention from the implicit bias classroom workshop, we administered a self-developed seven-item seven-point Likert-scale survey to our medical students at pre-, post-, and one-year post-workshop attendance. Results: The data set was comprised of survey results from two cohorts of our third and fourth-year medical students from 2018 to 2020 and included 289 completed records at three measurement points. The data included: Student Identifiers, Sex, Race/Ethnicity, Student Enrollment Type, Cohort, and three repeated measures results for each of the seven items, which were documented in wide format. The data may be of interest to those who wish to examine how factors including elapsed time, race, and sex may associate with attitudes and understandings of implicit bias following related training, and those interested in analytical methods on longitudinal research in general.

Conventional flood control has emphasized structural measures such as levees, reservoirs, and engineered channels—measures that typically simplify river channels and cut them off from their floodplain, both with adverse environmental consequences. Structural measures tend to be rigid and not easily adapted to increased flooding regimes resulting from environmental change. Such actions also limit the natural hydrologic benefits of floodplains such as storing floodwaters, improving water quality, providing habitat for invertebrates and fish during periods of inundation, and supporting a multitude of cultural services. As these benefits are more widely recognized, policies are being adopted to encourage projects that reduce flood risks and restore floodplain ecosystems, while acknowledging the social-ecological context. The number of such projects, however, remains small. We assessed four multi-benefit floodplain projects (two in California, United States, and two in Germany) and characterized their drivers, history, and measures implemented. In both United States cases, the dominant driver behind the project was flood risk reduction, and ecosystem restoration followed, in one case inadvertently, in the other as a requirement to receive a subsidy for a flood risk reduction project. One German case was motivated by ecosystem restoration, but it was more widely accepted because it also offered flood management benefits. The fourth case was conceived in terms of balanced goals of flood risk reduction, ecosystem restoration, and recreation. We conclude that projects that both reduce flood risk and restore ecosystems are clearly possible and often cost-effective, and that they could be more widely implemented. The principal barriers are often institutional and regulatory, rather than technical.