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This study aimed to determine the influence of the outdoor education learning models and mental toughness on cardiorespiratory fitness (CRF) levels. A quasi-experimental method was used, employing a 2x2 factorial design. The 2x2 factorial design in this study involved two learning models: the TGT (Team Games Tournament) and STAD (Student Teams Achievement Division), along with two levels of mental toughness: high and low. The sample consisted of 80 students from Jakarta State University, enrolled in recreational sports courses. The subjects in this study were given the TGT and STAD learning models over a period of 9 weeks. The tests administered during the pretest measured cardiorespiratory fitness using the Bleep Test and mental toughness using a questionnaire. The results showed that both the TGT and STAD outdoor education models have a statistically significant impact on students' CRF levels (p

Penelitian ini dilatar belakangi oleh kurangnya kemampuan passing bawah bola voli sebagai gerakan permulaan untuk siswa Sekolah Dasar dalam pengenalan olahraga bola voli. Untuk itu, penelitian ini bertujuan untuk dapat meningkatkan kemampuan passing bawah bola voli dengan menerapkan latihan memantulkan bola ke dinding. Metode penelitian yang digunakan adalah metode penelitian kuantitatif eksperimen dengan desain penelitian one group pretest-postest. Populasi dalam penelitian ini dalah seluruh siswa Sekolah Dasar di Kecamatan Rangkasbitung dan sampel pada penelitian ini adalah siswa yang mengikuti ekstrakurikuler bola voli. Instrumen yang digunakan adalah instrumen test dilakukan dalam 16 kali pertemuan sebanyak dua kali untuk pretets dan postest. Teknik analisis data dengan menggunakan uji validitas instrumen, uji prasyarat analisis dan uji hipotesis. Hasil penelitian menunjukkan bahwa uji hipotesis menggunakan uji-t, didapatkan hasil thitung sebesar 15,3 sedangkan nilai ttabel dengan taraf signifikansi 0,05 sebesar 2,26. Dari hasil pengujian hipotesis tersebut diketahui bahwa thitung>ttabel (15,3>2,26), sehingga dapat disimpulkan bahwa H0 ditolak dan H1 diterima. Hal itu menunjukkan bahwa penerapan latihan memantulkan bola ke dinding memberikan pengaruh positif terhadap kemampuan passing bawah permainan bolavoli pada siswa ekstrakulikuler. Berdasarkan hasil penelitian, hasil posttest latihan memantulkan bola ke dinding lebih tinggi dari pretest. Hal tersebut sebanding dengan skor kemampuan kemampuan passing bawah, hasil tersebut menunjukkan bahwa hasil belajar yang merupakan kemampuan psikomotorik sangat berperan dalam kemampuan passing bawah.

Propolis, a natural product of Honeybees was evaluated as wood preservative. The need for this study arises as a result of the toxicity of conventional preservatives. Propolis Extract (PE) was obtained through ethanol extraction. The extract, diluted with absolute ethanol was prepared into four concentration levels using volume to volume method. Test blocks of Triplochiton scleroxylon measuring 5.0 x 2.5 x 1.5 cm were oven-dried at 103oC for 18h and treated by dipping in the four concentrations for 4 minutes. The treated and untreated test blocks were incubated in culture jars containing active growth of Coriolopsis polyzona and Coniophora puteana grown on Potato dextrose agar for 16 weeks. The efficacy of PE, in inhibiting fungal growth, was evaluated using Weight Loss (WL). Data obtained were analyzed using Descriptive Statistics, 2 - way Analysis of Variance and LSD test for mean separation. Results were significant at p<0.01. The PE was observed to inhibit the test fungi at higher concentrations after incubation. Post mortem analysis revealed the Killing Point Concentration (KPC) of PE against C. polyzona at 50% and Coniophora puteana at 75%. [ABSTRACT FROM AUTHOR]

Early detection of pregnancy is vital for appropriate reproductive management programmes to facilitate the rapid re-insemination of non-pregnant females and reduce the calving interval.

Pengaruh Keseimbangan, Kelincahan dan Motivasi Berolahraga Terhadap Keterampilan Passing Atas Bola Voli. Tujuan penelitian untuk mengetahui dan membuktikan pengaruh langsung dan tidak langsung antara keseimbangan (X1), kelincahan (X2), dan motivasi berolahraga (X3) terhadap keterampilan passing atas pada siswa SMA Negeri I Panggarangan (X4). Penelitian ini dilaksanakan di SMA Negeri I Panggarangan Kabupaten Lebak. Pelaksanaan penelitian berlangsung dari bulan Maret sampai dengan Mei 2015. Metode penelitian yang digunakan dalam penelitian ini adalah metode survei dengan teknik non tes, sedangkan teknik analisis menggunakan pendekatan analisis jalur (path analysis). Populasi dalam penelitian ini adalah 32 siswa SMA Negeri I Panggarangan. Teknik pengambilan sampel dilakukan dengan menggunakan teknik total sampling dengan jumlah sampel 32 siswa. Hasil penelitian menyimpulkan bahwa: (1). Keseimbangan berpengaruh langsung terhadap keterampilan passing atas Siswa SMA Negeri I Panggarangan sebesar 9,30%. (2). Keseimbangan berpengaruh langsung terhadap motivasi berolahraga Siswa SMA Negeri I Panggarangan sebesar 26,11%. (3). Kelincahan berpengaruh langsung terhadap keterampilan passing atas Siswa SMA Negeri I Panggarangan sebesar 12,89%. (4). Kelincahan berpengaruh langsung terhadap motivasi berolahraga Siswa SMA Negeri I Panggarangan sebesar 12,82%. (5). Motivasi berolahraga berpengaruh langsung terhadap keterampilan passing atas Siswa SMA Negeri I Panggarangan sebesar 10,56%. Kata kunci: Keseimbangan, Kelincahan, Motivasi Berolahraga, Passing atas

Penelitian ini bertujuan untuk menganalisa karakteristik getaran pada material komposit seratbambu dengan variasi penempatan posisi penggetar dan arah serat. Metode yang digunakandalam penelitian ini yaitu metode lamina, serat disusun tiga lapis dengan variasi arah 00/00/00,00/300/00 dan 300/00/300, sedangkan untuk metode analisa data adalah metode Euler-Bernoulli, data karakteristik getaran ditentukkan pada posisi penggetar 10 cm, 20 cm, 30 cm,40 cm, dan 50 cm. Hasil penelitian menunjukkan bahwa Kekakuan specimen akibat perubahanpenempatan posisi penggetar pada setiap specimen dengan arah serat yang berbeda adalah13.571 N/m dan 1099.227 N/m untuk arah serat 00/00/00, 44.208 N/m dan 3580.842 N/m untukarah serat 00/300/00 serta 38.387 N/m dan 3109.334 N/m untuk arah serat 300/00/300.Amplitudo maksimum yang terjadi diperoleh pada serat dengan arah 00/00/00 yaitu 0.000670 mdan minimumnya -0.000487 m pada sepesimen dengan arah serat 300/00/300. Nilai frekwensinatural (?n) material komposit serat bambu dipengaruhi oleh arah serat dan modulus elastisitasbahan, dimana untuk serat dengan arah 00/00/00 nilai frekwensi natural (?n) maksimumnya49.534 rad/s dan minimum 5.504 rad/s, dan serat dengan arah 00/300/00 nilai frekwensi natural(?n) maksimumnya 97.849 rad/s dan minimum 10.872 rad/s serta serat dengan arah300/00/300 nilai frekwensi natural (?n) maksimumnya 53.573 rad/s.Kata kunci: Serat bambu, posisi penggetar, karakteristik getaran, metode Euler-Bernoulli. This study aimed to analyze the vibration characteristics of the bamboo fiber composite materialwith a variation of positioning of the vibrator and the direction of the fiber. The method used inthis research is the method of lamina, fiber composed of three layers with variations of thedirection of 0o/0o/0o, 0o/30o/00 and 30o/0o/30o,whereas for data analysis method is the method ofEuler-Bernoulli. The characteristic of data vibration was determined in the positions vibrator of10 cm, 20 cm, 30 cm, 40 cm, and 50 cm. The results showed that the specimens rigidity due tochanges in the positioning of the vibrator on each specimen with different fiber direction is 13571 N / m and 1099,227 N / m for the direction of the fiber 0o/0o/0o, 44 208 N / m and 3580,842N / m for the fiber direction 0o/30o/0o and 38 387 N / m and 3109,334 N / m for fiber direction30o/0o/30o. The maximum amplitude occurs with the direction of fibers obtained on 0o/0o/0o thatthe minimum -0.000487 0.000670 m and m on specimen with 30o/0o/30o fiber direction. Thevalue of natural frequency (?n) bamboo fiber composite material is influenced by the directionof the fiber and the modulus of elasticity of the material, where the fiber with the direction of0o/0o/0o the value of natural frequency (?n) maximum 49 534 rad / s and a minimum of 5504rad / s, and fiber with directions 00/300/00 value of natural frequency (?n) maximum 97 849 rad/ s and a minimum of 10 872 rad / s as well as fiber to the direction 300/00/300 value of naturalfrequency (?n) maximum 53 573 rad / s.Keywords: Bamboo fiber, position vibrator, vibration characteristics, Euler-Bernoulli method.

Objective: Service evaluation of an urban 'Hospital at Home' service which provides care in patients' homes that would traditionally be delivered in the hospital setting., Design: Retrospective longitudinal review of routinely collected data recorded contemporaneously for clinical use, analysed to elicit utilisation patterns and service impact., Setting: A paediatric 'Hospital at Home' service delivered across two large acute hospitals, treating a total of 4427 patients across both primary and secondary care in South London from January 2018 to June 2022., Patients: Children managed by the Hospital at Home service, aged 0-16 years MAIN OUTCOME MEASURES: We describe patient outcomes and service performance including data on demographics, diagnoses, referral sources, hospital reattendances and bed day savings., Results: Over the evaluation period, 11 092 bed days were saved as a direct result of this service at a cost of 1.09-1.25 nursing contacts required per bed day. Reattendance to hospital was 11.1% over the study period, however, parent/carer-initiated reattendance resulting in hospital admission was only 2.7%., Conclusion: Hospital at Home services are a policy priority for the English National Health Service because of their potential to reduce admissions to and enable early discharge from hospital. This evaluation provides insight into an urban population of children managed under Hospital at Home care and demonstrates its feasibility and effectiveness. Our novel approach to the analysis of hospital reattendance data may have the potential as a template for future performance analysis of similar services., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

There is growing awareness of the unique etiology, biology, and clinical presentation of invasive lobular breast cancer (ILC), but additional research is needed to ensure translation of findings into management and treatment guidelines. We conducted a survey with input from breast cancer physicians, laboratory-based researchers, and patients to analyze the current understanding of ILC, and identify consensus research questions. 1774 participants from 66 countries respondents self-identified as clinicians (N = 413), researchers (N = 376), and breast cancer patients and advocates (N = 1120), with some belonging to more than one category. The majority of physicians reported being very/extremely (41%) to moderately (42%) confident in describing the differences between ILC and invasive breast cancer of no special type (NST). Knowledge of histology was seen as important (73%) and as affecting treatment decisions (51%), and most agreed that refining treatment guidelines would be valuable (76%). 85% of clinicians have never powered a clinical trial to allow subset analysis for histological subtypes, but the majority would consider it, and would participate in an ILC clinical trials consortium. The majority of laboratory researchers, reported being and very/extremely (48%) to moderately (29%) confident in describing differences between ILC and NST. They reported that ILCs are inadequately presented in large genomic data sets, and that ILC models are insufficient. The majority have adequate access to tissue or blood from patients with ILC. The majority of patients and advocates (52%) thought that their health care providers did not sufficiently explain the unique features of ILC. They identified improvement of ILC screening/early detection, and identification of better imaging tools as top research priorities. In contrast, both researchers and clinicians identified understanding of endocrine resistance and identifying novel drugs that can be tested in clinical trials as top research priority. In summary, we have gathered information from an international community of physicians, researchers, and patients/advocates that we expect will lay the foundation for a community-informed collaborative research agenda, with the goal of improving management and personalizing treatment for patients with ILC., (© 2024. The Author(s).)

Objective: Approximately 13% of people living with diabetes develop one or more ulcers during the course of the disease, and diabetic foot ulcer (DFU) is responsible for >60% of lower limb amputations worldwide. This case series aimed to demonstrate the effectiveness of medical-grade maggots on DFUs in promoting wound healing and reducing related hospital stays in northern Nigeria., Method: Maggot debridement therapy (MDT) was applied to the DFUs of patients who consented to this treatment between January-August 2021 at the Orthopaedic Unit of the Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Sterile first instar larvae of Lucilia sericata were obtained indigenously and applied using the confinement (free-range) method under aseptic procedure., Results: A total of 15 patients with DFUs of Wagner classification grades III (33.3%) and IV (66.7%), were seen and documented. The patients included 10 (66.7%) females and five (33.3%) males, giving a female:male ratio of 2:1. The mean age (±standard deviation) of the respondents was 51.6±10.8 years. The surface area of the wounds ranged from 24-140cm 2 , with a median value of 75cm 2 . Among the patients, 60% had two cycles of MDT, with a median duration of five days. Most of the wounds (53.3%) were debrided within five days; 13.3% (two wounds) took seven days to be fully debrided. A paired sample t-test showed a statistically significant association between wound surface area and therapy duration (t=8.0; p=0.000) and between wound surface area and cycles of therapy (t=8.3; p=0.000). Before maggot application, 14 (93.3%) DFUs were completely (100%) covered with slough and only one (6.7%) was 95% covered with slough. After maggot application, 10 (66.7%) wounds were completely debrided while five (33.3%) wounds required bedside surgical debridement to achieve complete debridement. A paired sample t-test showed statistically significant difference between the pre- and post-MDT slough covering the wounds (t=45.1; p=0.000)., Conclusion: In this case series, MDT was successfully used in the debridement of DFUs, which facilitated the healing process with an encouraging clinical outcome.

Background: Nipple-sparing mastectomy (NSM) outcomes in the elderly have not been well characterized. The goal of this study was to evaluate NSM outcomes in patients over age 60., Patients and Methods: A single-institution retrospective cohort study was performed for NSM patients over the age of 60 from January 2004 to January 2022. Demographic, intraoperative, and postoperative variables were collected., Results: We identified 136 women who underwent a total of 200 NSMs at a mean age 65.2 years and with mean body mass index of 25. Most (56%) had invasive breast cancer, requiring neoadjuvant chemotherapy in 15%, and 17.5% had radiation prior to NSM. A total of 91% had immediate tissue expander placement. The infection rate was 19%, with 11.5% requiring expander explantation in the follow-up period. In binomial logistic regression analysis, prior radiation increased the odds of any complication by 2.9 (OR 2.93, CI 1.30-6.58, p = 0.009) and increased the odds of infection by 5.7 (OR 5.70, CI 1.95-16.66, p = 0.001), but no associations were seen for other covariates including age, comorbidities, prior chemotherapy, or presence of invasive disease. Diabetes increased the odds of wound breakdown specifically by 9.0 (OR 8.97, CI 2.01-39.92, p = 0.004). Local recurrence was 3% in mean 3.4-year follow-up., Conclusions: Our data support NSM in patients over the age of 60 years with acceptable outcomes within the standard of care. Locoregional recurrence was within the cited range of 0-5%, and only diabetes and prior radiation were associated with reconstructive complications. NSM should thus be offered when appropriate regardless of increased age to achieve oncologic and reconstructive goals., (© 2023. Society of Surgical Oncology.)