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Abstract Background Coronary artery bypass grafting (CABG) surgery is a common procedure for managing multi-vessel coronary artery disease to revascularize the myocardium. Among the various conduits used, the left internal mammary artery (LIMA) is preferred due to its better long-term patency rate. However, CABG procedures involving LIMA may result in rare but serious complications, such as avulsion of the LIMA post-CABG, which leads to disruption of blood flow to the myocardium and the development of fatal cardiac tamponade. Case presentation We hereby present a unique case of spontaneous avulsion of a LIMA graft to the left anterior descending artery (LAD) away from the site of anastomosis, twenty-four hours following CABG surgery in a 67-year-old male patient. Emergency re-exploration and repair of the LIMA with interposition vein graft were performed and resulted in successful stabilization of the patient’s critical condition. However, this was followed by a complicated recovery period involving atrial fibrillation, acute kidney injury, and wound infection. Conclusion Avulsion of LIMA graft following CABG is rare, yet a fatal complication that requires high clinical suspicion and prompt management. Avulsion has been reported a few times in literature following both minimal invasive and conventional CABG. Understanding the etiology, clinical presentation, and management of this complication is crucial to avoid catastrophic outcomes.

The range of abstract concepts encountered when learning chemistry and the inability of students to make connections between the macroscopic, sub-microscopic, and symbolic representations, used in chemistry teaching, are believed to be the main reasons for students' difficulty when learning chemistry. Prediction and determination of molecular geometry using the theory of valence shell electron pair repulsion (VSEPR) is a sample of the abstract concept that is hard to understand by students who learn chemistry. Students may comprehend these ideas better if the learning process is supplemented with cutting-edge, interactive learning aids. To address the conceptual difficulties that students encounter when learning how to predict the shapes of molecules, a card game (MGCards) has been developed which is supported by simple molecular model building (MMB). The card game allows students to work through the steps required to predict the shape of a molecule in an engaging format. The student learning process is supported by feedback at all stages (if students make a mistake, they receive hints that will help them in the next step of the game). Action research with qualitative methods has been used to design, develop, and evaluate the MGCards. The MGCards and MMB were piloted at the University of Leicester with year one Natural Sciences students and modified based on the feedback received. Both MGCards and MMB were then used as part of the first-year chemistry education programme at Tanjungpura University in Indonesia. The findings of students' answer analysis (pre- and post-test) in both cycles showed that students had a better understanding after learning with MGCards and MMB. The positive feedback for MGCards and MMB confirmed that these resources were effective in delivering an engaging learning experience. The results suggest that MGCards and MMB play a significant role in enhancing students' understanding while also keeping them engaged.

Tujuan kegiatan ini adalah memberikan pelatihan dan pendampingan kepada beberapa UMKM di Kota Padang agar mereka dapat memanfaatkan Aplikasi SIAPIK dalam bisnis mereka. Aplikasi SIAPIK adalah aplikasi dari Bank Indonesia untuk pencatatan akuntansi berbasis web yang dirancang untuk memudahkan UMKM dalam melakukan pencatatan keuangan. Metode yang digunakan dalam kegiatan ini meliputi sesi sosialisasi, pelatihan langsung, dan pendampingan secara berkala. Kegiatan dimulai dengan sosialisasi dan pelatihan selama dua hari di Gedung Bank Indonesia Sumatera Barat pada tanggal 15-16 September 2023, diikuti dengan pendampingan intensif selama tiga bulan hingga akhir Desember 2023. Sosialisasi dilakukan untuk memperkenalkan Aplikasi SIAPIK dan manfaatnya, sementara pelatihan langsung memberikan UMKM pemahaman praktis tentang cara penggunaan aplikasi tersebut. Pendampingan selama tiga bulan dilakukan untuk memastikan UMKM dapat mengimplementasikan pencatatan akuntansi secara mandiri. Hasil dari kegiatan ini menunjukkan bahwa seluruh peserta telah mahir dalam menggunakan Aplikasi SIAPIK. Namun, meskipun telah diberikan pelatihan dan pendampingan, tidak semua UMKM melakukan pencatatan keuangan secara rutin dan komprehensif. Hal ini menunjukkan adanya hambatan internal di kalangan UMKM yang perlu diatasi. Kesimpulan dari kegiatan ini adalah pelatihan dan pendampingan intensif sangat efektif dalam meningkatkan kemampuan UMKM dalam menggunakan Aplikasi SIAPIK. Namun, untuk mencapai pencatatan keuangan yang konsisten, diperlukan upaya tambahan seperti pemberian insentif atau dukungan berkelanjutan. Rekomendasi kegiatan selanjutnya adalah mengadakan sesi follow-up secara periodik untuk memantau perkembangan dan memberikan motivasi kepada UMKM agar terus melakukan pencatatan keuangan dengan disiplin menggunakan Aplikasi SIAPIK.

Certain features such as typefaces can be associated with a preference for e-books or print books and vice versa. The purpose of this study is to determine the optimal typeface for reading electronic books. This research uses quantitative methods. This study utilized a Quasi Experiment design , which will be presented below. Through the use of Pretest and Posttest and questionnaires. DIMP Class A and DIMP Class B were the research subjects. Roboto typefaces were used in this study. Homogeneity Test, Independent Sample T Test, Wilcoxon test, and Mann-Whitney test, as the final data analysis in this study. Serif and Sans-Serif Typefaces cannot be differentiated in terms of reading experience, according to the homogeneously distributed samples based on the t-test. As a consequence of the data not being homogeneously distributed or not normally distributed, the Pretest and Posttest data were not normally distributed. The Postets data, after the Mann-Whitney test, showed no difference in the reading experience when using these two fonts; whereas, the pre- and post-test data in the classes using the Wilcoxon test showed a difference, illustrating that the two fonts have different effects on the reading experience. Abstrak Fitur tertentu seperti Typefaces dapat dikaitkan dengan kesukaan terhadap buku elekronik atau buku cetak dan sebaliknya. Tujuan dari penelitian ini adalah untuk menentukan jenis huruf yang optimal untuk membaca buku elektronik. Penelitian ini menggunakan metode kuantitatif. Penelitian ini menggunakan desain Quasi Experiment, yang akan dipaparkan di bawah ini. Melalui penggunaan Pretest dan Posttest dan kuesioner. Kelas DIMP A dan Kelas DIMP B adalah subjek penelitian. Typefaces Roboto digunakan dalam penelitian ini. Uji Homogenitas, Independent Sample T Test, uji Wilcoxon, dan uji Mann-Whitney, sebagai analisis data akhir pada penelitian ini. Jenis Typefaces Serif dan Sans-Serif tidak dapat dibedakan dalam hal pengalaman membacanya, menurut sampel yang terdistribusi secara homogen berdasarkan uji-t. Sebagai konsekuensi dari data yang tidak terdistribusi secara homogen atau tidak berdistribusi normal, maka data Pretest dan Posttest tidak terdistribusi secara normal. Data Postets, setelah uji Mann-Whitney, tidak menunjukkan adanya perbedaan dalam pengalaman membaca ketika menggunakan kedua jenis huruf ini; sedangkan, data sebelum dan sesudah tes di kelas-kelas yang menggunakan uji Wilcoxon menunjukkan adanya perbedaan, yang mengilustrasikan bahwa kedua jenis huruf tersebut memberikan efek yang berbeda terhadap pengalaman membaca.

This quantitative research with an experimental approach aims to determine the effectiveness of group counseling using a client-centered approach to increase the self-confidence of students who are victims of body shaming at MTs 2 Medan. The study population consisted of 150 students, and the sample was taken using purposive sampling. Data was collected by performing pre-tests and post-tests before and after the group counseling sessions using the client-centered approach. The data were analyzed using the Wilcoxon Signed Rank Test with SPSS. The results showed that after the group counseling sessions, there was an increase in self-confidence among the students: 5 students experienced an increase in self-confidence to the high category, and three other students experienced an increase to the very high category. The data analysis using the Wilcoxon Signed Rank Test revealed that the sig (2-tailed) value was less than 0.05, specifically 0.011, indicating that group counseling using the client-centered technique effectively enhances the self-confidence of students who experience body shaming.

The word slander is often spoken in society in everyday life, namely defamation. But in this study, the word slander in question is a trial for women and men. It is said in a hadith of the Prophet Muhammad. "I have not left behind a slander for humans which is more dangerous for men than (its slander) for women." Regarding this hadith, many people still understand it textually without looking at the content of the related hadith. Perceptions like this fall are accompanied by attitudes of blaming and defaming women. Therefore, the understanding of women's hadith as slander cannot be understood in general but must be understood by looking at the asbab al-wurud or fiqh al-hadith of the hadith. Because if you understand it just by looking at the hadith, women are indeed a dangerous source of slander for men, where a woman can be said to be slanderous if she cannot protect herself from things that are prohibited in Islam. This hadith is also considered valid. In this research, the author will discuss the analysis of the targeted hadith and what the scholars think about this hadith, which aims to increase knowledge, understanding, and insight for writers and readers in understanding hadiths, especially women, as slanderers. The method used by the author refers to the tahlili (analytical)/qualitative method in the form of library research.

This research aims to reveal how the concept of employee development management implemented by BPMP DI Yogyakarta optimizes work performance during the COVID-19 pandemic. The pandemic has necessitated that all activities be conducted online, which has created some impediments to employee development, such as instability of the internet network, passive participants, and distractions in the participant environment. This qualitative study uses purposive sampling to select subjects who are knowledgeable, experienced, and understanding of the research theme. Employee development programs at BPMP DI Yogyakarta include institutional development, career development, and education and training. The program has been implemented properly and accurately through the implementation of management functions, including planning, organizing, actuating, controlling, and evaluating. The role of employee development management is illustrated by the increase in the achievement of the SAKIP value of BPMP DI Yogyakarta by 7.9 points in the 2019-2021 period. Additionally, BPMP DI Yogyakarta achieved the ZI-WBK predicate in 2020. These two achievements demonstrate that the employee development management carried out by BPMP Yogyakarta is effective and has successfully optimized employee and institutional performance during the COVID-19 pandemic.

The Takalar Regency Spatial Plan designates the Sanrobone sub-district as an area for the cultivation of food crops, horticultural crops, and plantations. Agriculture in Sanrobone plays a crucial role in fulfilling food needs and driving economic growth in rural areas. The research aims to identify superior commodities, determine the agropolitan activity center, and develop strategies for the agropolitan area in the Sanrobone sub-district. The study was conducted from June to November 2022, covering six villages in the Sanrobone sub-district. The analytical techniques employed include LQ analysis, Shift share analysis, Klassen typology, qualitative descriptive analysis, and SWOT analysis. The research findings reveal that the superior commodity of Sanrobone is Chili Pepper, while prospective commodities are Corn and Paddy, and the lagging commodity is Seagrass. The agropolitan activity center is the main farming town in Banyuanyara, with production centers in the village of Tonasa, and farmer collection towns in Paddinging, Ujung Baji, Lagaruda, and Sanrobone. The recommended strategy is a progressive approach, where empowering farmer groups can enhance the economy, especially in the agricultural sector. Encouraging farmer groups in each village to actively participate in established joint farming groups can boost the potential of food crop agriculture in each village and contribute to the development of the agropolitan area.

The purpose of this community devotion program is as follows: 1) improve the ability to read the Qur'an and memorize Surah Al-Kahfi verses 1-7, 2) teach theory and practice in the implementation of prayer, as well as 3) provide the theories and introductions about mahram to pupils at the middle school level. The method used in community service at the An-Najah Foundation is Community-Based Research (CBR), a collaboration between the community and higher education institutions, with an action-oriented approach and application of service learning to support social movements to create social justice. The results of this activity in the first cycle show that most students still have difficulties understanding and following the activities carried out because the materials taught are still new to them. However, after the second cycle, the results show that: 1) average students can read the Quran and memorize Surah Al-Kahfi paragraphs 1-7, 2) average students understand the theory and practice of prayer, and 3) average students have an understanding of the theories and knowledge of Mahram.

Bahaya dan risiko kesehatan keselamatan kerja (K3) pada pekerja mebel kayu banyak berasal dari debu kayu dan bahan kimia seperti berbagai jenis cat, pelarut organik, dan lem kayu. Budaya kerja sehat selamat yang kurang serta tidak adanya proses komunikasi bahaya pada sektor informal ini, berpeluang munculnya penyakit akibat kerja (PAK) pada pekerja. Dari hasil wawancara bersama 4 orang mantan karyawan pekerja mebel, diketahui alasan berhenti bekerja karena mulai adanya gangguan pernapasan seperti muntah darah, batuk lama, berat badan menurun, dan napas sering tersengal atau sesak. Sehingga, mereka tidak sanggup lagi kembali bekerja di pabrik mebel setelah sembuh karena gejala dan penyakit dapat timbul kembali apabila terpapar debu dan bahan kimia yang ada di pabrik. Untuk itu, dilakukanlah kegiatan komunikasi dan edukasi untuk mengetahui jenis bahaya dan risiko keselamatan dan kesehatan pada pekerja disini dan cara pencegahannya. Kegiatan dilakukan tiga tahapan, dimulai dengan survei awal untuk identifikasi. Tahap kedua, pemberian komunikasi berbentuk edukasi pengenalan bahaya dan risiko di tempat kerjanya, cara membaca lembar data keselamatan bahan (LDKB), penggunaan alat pelindung diri (APD), dsb. Dari hasil komunikasi ini diketahui adanya peningkatan pengetahuan pekerja sebesar 22,25 poin (28%) yang dilihat dari nilai rata-rata pre-test 57 dan post-test 79,25. Tahap akhir, evaluasi implementasi setelah dua bulan kegiatan. Dari hasil pementauan diketahui bahwa masih sedikit pekerja yang mau menerapkan hasil edukasi terutama dalam penggunaan APD selama bekerja. Untuk itu, disarankan agar pemilik pabrik mebel menganggarkan dana untuk pembelian alat keselamatan yang nyaman serta mewajibkan pekerja menggunakannya selama bekerja.

Shrimp cultivation is a very profitable business in Gresik. However, shrimp farmers in Mojopuro Gede Village, Gresik admitted that they did not optimize their cultivation process. The farmer did not realize that water quality is essential to be considered in aquaculture. Based on these problems, the team held a community service in Mojopuro Gede Village, Gresik by introducing the water quality meter module and giving it to several shrimp farmers in the area. This activity was carried out so that the farmers can improve their cultivation process which has not been optimal and also introduce them to technological developments. Technology use in cultivation is expected to increase the quality of the farmers' crops. The implementation methods used in this activity are socialization and training. In this community service program, education has been given to the farmers so that they understand and care about the condition of their ponds in the cultivation process. The purpose of this program is for introducing the importance of technology in the cultivation process, even though it is actually not easy to provide education to shrimp farmers, especially traditional farmers. Therefore, related parties (NU Gresik Maritime Institute and Maritime Affairs and Fisheries Office of East Java Province) are expected to be more active in providing understanding to the farmers regarding the importance of applying technology in the cultivation process.

The purpose of this research was to investigate the performance of photovoltaic modules when used in different heating temperatures. The heating temperature variants used were room T, TA = 50 °C, TB = 60 °C, and TC = 70 °C. The lamp capacity used was 5 watts with a bulb-type lamp. In addition, the circuit used was a series circuit. This research done on the effect of different temperatures of the heater placed under the photovoltaics showed that when there was an increase in the photovoltaic temperature, the voltage, current, power, and efficiency decreased. Therefore, it is necessary to limit the temperature used for photovoltaics.

The problem that will be raised in this community service program is thatthe spread of garbage into the river has become a habit of residents, both on the side of the river and not on the side of the river. Many residents throw garbage in the river for reasons that are more practical, easy, and unpaid. The Community Service Program is carried out in Rawa Makmur Village with the Observation method also carried out as a source of finding information about geographical conditions, potentials, and existing problems. Observations were carried out by sampling methods by interviewing community leaders and conducting surveys of locations and infrastructure in Tani Bhakti village and approaches to the community. The steps taken in solving this problem are the first step to reactivate the compost house facility, the second step is the socialization of CTPS sanimas (Washing Hands with Soap), and the third step is the socialization of waste processing into compost and the processing of waste into ecobricks. It is hoped that this community service work program can benefit the party and the community of Margahayu Village. Permasalahan yang akan diangkat dalam program pengabdian kepada masyarakat ini adalah membuang sampah ke sungai sudah menjadi kebiasaan warga, baik dipinggir sungai maupun bukan dipinggir sungai. Banyak warga yang membuang sampah di sungai karena alasan lebih praktis, mudah dan tidak berbayar. Program Pengabdian kepada Masyarakat dilaksanakan di Desa Rawa Makmur dengan metode Observasi juga dilaksanakan sebagai sumber pencarian informasi mengenai keadaan geografis, potensi dan permasalahan-permasalahan yang ada. Observasi dilakukan dengan metode pengambilan sampel dengan wawancara kepada tokoh-tokoh masyarakat serta melakukan survei-survei lokasi dan prasarana yang ada di desa Tani Bhakti dan pendekatan terhadap masyarakat. Langkah-langkah yang dilakukan dalam penyelesaian masalah ini yaitu Langkah pertama mengaktifkan kembali fasilitas rumah kompos, Langkah kedua adalah sosialisasi sanimas CTPS (Cuci Tangan Pakai Sabun), dan Langkah ketiga yaitu sosialisasi pengolahan sampah menjadi kompos dan pengolahan sampah menjadi ecobrick. Diharapkan program kerja pengabdian kepada masyarakat ini dapat bermanfaat bagi pihak dan masyarakat Desa Margahayu.

In the learning process, the teacher talk is critical because it can help the success of the learning process, especially in mastering English as a foreign language (EFL) at various levels of education. This narrative review aims to determine the form of teacher talk and its importance to EFL learners at different educational levels. This study uses secondary data from 13 journal articles, which are research results on English teacher talk from various levels of education and settings and published between 2010-2020. The articles were accessed through several databases available to the researchers. All data were synthesized based on two research questions. The results of this study were the discovery of 4 categories of teacher talk forms based on (1) speech modification to facilitate learners, (2) the teacher's role as a facilitator, (3) responses to learners, and (4) their attitude in the classroom. Teacher talk is important because it can provide correct language input to learners. This narrative review can provide new insights to EFL teachers at all levels of education regarding the forms of teacher talk that they can use and how the talks can help the learning process and outcomes. HIGHLIGHTS: • Teacher talk can be disseminated in the forms of speech modification to facilitate learners, teachers’ role as a facilitator, responses to learners, and teachers’ attitude in the classroom. • Teacher talk is important because it can provide correct language input to learners and help them develop and improve their ability to speak English.

Penelitian ini bertujuan untuk mengetahui pengaruh literasi keuangan dan kemudahan digital payment secara parsial dan simultan terhadap kinerja UMKM di kota Makassar. Penelitian ini dikategorikan sebagai penelitian deskriftif kuantitatif dengan populasi usaha percetakan, perdagangan, dan kuliner di kota Makassar dan sampel 32 respoenden yang memiliki usaha mikro, kecil, dan menengah di kota Makassar. Data yang diperoleh melalui pembagian kuesioner dengan skala likert. Teknik analisis yang digunakan adalah analisis statistic deskrptif dan analisis statistic inferesial. Hasil penelitian ini menunjukkan bahwa secara parsial dan simultan variabel literasi keuagan dan kemudahan digital payment berpengaruh secara positif dan signifikan terhadap kinerja UMKM di kota Makassar.

Euclidean geometry is a form of structural geometry grounded in a set of axioms from which all theorems are derived. This branch of mathematics encompasses two fundamental measurement types: angles and distances. It is widely recognized that the Euclidean axioms for measuring distances taught to students during primary, middle, and high school mathematics curricula establish the foundational concepts and structures of geometry they learn. The purpose of this article is to propose an educational resource that is designed for exceptional or gifted students in secondary school. This resource introduces alternative methods for measuring distances that differ from the Euclidean method. The objective of this educational material is to encourage students to think beyond the conventional Euclidean framework and explore alternative worlds of geometric structures. By broadening their horizons, students can recognize that geometric structures are not absolute but relative to the axioms and logical definitions that are agreed upon beforehand. [ABSTRACT FROM AUTHOR]

One of the factors that influence shrimp cultivation is the presence of algae. Precise knowing algae content in the pond is essential for effective management. Most research in the field of algae species carried out by researchers were observing Chlorella Sp. more than the other algae species, with a particular emphasis on substance concentrations. This study proposed non-invasive techniques for quantifying algae abundance, utilizing optical density (OD) and image processing (IP) methods. Three different algae species are frequently found in Indonesia i.e., Chlorella Sp., Thalassiosira Sp., and Skeletonema Sp. are used as sample. Those samples are cultured and prepared in a certain volume with a certain quantity. For experimental and observation purposes, those samples are then diluted into water based on percentage value. The experimental results provided RGB values, which were then used to establish polynomial equations. To verify these equations, two approaches were employed: synthetic image analysis and evaluation using additional data. The mean average error (MAE) was found to be 3.467 for IP method and 3.513 for OD method. It shows that IP method give better result compared to OD method in this study. However, it is very possible that the two methods will complement each other. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates the influence of gantry and collimator angles on the dosimetric leaf gap (DLG) and leaf transmission factor (LTF) in a Varian LINAC equipped with rounded‐end multi‐leaf collimators (MLCs). While Varian guidelines recommend DLG measurements at zero degrees for both gantry and collimator, this research aims to address the knowledge gap by assessing DLG and LTF variations at different gantry and collimator angles. Methods: Measurements were conducted using a Varian TrueBeam LINAC with a Millennium 120‐leaf MLC and Eclipse TPS version 16.1. The beams utilized in this study had energies of 6 MV, 10 MV, 6 FFF, and 10 FFF. LTF and DLG were determined using ionization chambers in solid water phantoms at various gantry angles (0°, 45°, 90°, 135°, 180°, 225°, 270°, and 315°). For each gantry angle, measurements were also taken at various collimator angles (0°, 45°, 90°, and 315°). Dosimetric impacts were evaluated through VMAT Picket Fence tests and patient‐specific verification using portal dosimetry for 10 clinical VMAT plans. Results: LTF values showed no significant variation across gantry and collimator angles. However, DLG values exhibited notable differences depending on the gantry angle and were independent of the collimator angle. The highest DLG value was observed at a gantry angle of 270 degrees, while the lowest was at 90 degrees. The AXB DLGAverage (averaging seven measurements of DLGs at different gantry angles) model demonstrated the best agreement between measured and calculated dose distributions, indicating the importance of considering averaged DLG values across multiple gantry angles for accurate dose calculations. Conclusion: Our study highlights the variability of DLG with gantry angle alterations, contrary to Varian guidelines recommending DLG measurements at zero gantry angle only. We advocate for utilizing an averaged DLG value from measurements across multiple gantry angles, as outlined in our methodology. [ABSTRACT FROM AUTHOR]

Along with developments in the maritime sector, especially on ships, the need for electric power on board will be very diverse. The use of diesel engines as power plants requires fuel to drive a diesel while the use of fuel in ships produced from petroleum processing is limited. Efforts to reduce the use of fuel is by implementing new renewable energy as independent electricity on ship. In EBT inverter technology plays an important role in converting DC voltage to AC voltage. In the inverter, the use of microcontrollers as drivers to generate PWM signals continues to develop. One of the developments of the microcontroller is ESP32. The problem that often occurs in inverters is that the output voltage is unstable. In addition to maximizing the performance of the inverter, it is necessary to add a protection system to reduce the risk of damage to the inverter or the load. Therefore, an inverter was made using the ESP32 microcontroller driver with the addition of protection and the fuzzy method as a voltage stabilizer. This inverter will change the 12 Vdc to 220 vac. In the Matlab simulation, the inverter can change the 12 vdc to 12 vpeak with a carrier signal of 20 khz and a reference signal of 50 hz. From the results of the inverter output will be changed to 220 vac using a step up transformer. The research overlay is being able to make a pure sine wave SPWM inverter using an ESP32 driver with a stable voltage.

Some of the objectives of this study were: 1) To analyze the segmentation of iodized crystal coconut palm sugar. 2) To recognize the targeting of iodized crystal coconut pal sugar. 3) To Identify the positioning of Gendis iodized crystal coconut palm sugar products. Data collection was carried out online and offline in Purwokerto, where online questionnaires were distributed in several areas in Central Java and West Java. for four months, namely the period December 2020 - March 2021. The population in this study were consumers of iodized crystal coconut palm sugar and its potential consumers. The sampling method in this study used a non-probability sampling method with purposive sampling and snowball sampling techniques. Based on characteristics of the respondents, there are 3 market segments of iodized crystal coconut palm sugar were created. The target market chosen is cluster 2 with the characteristics of respondents aged 41 - 50 years, diploma educational background, housewife profession, and monthly expenses range of Rp.1.500.000 - Rp.3.000.000. Based on the biplot analysis, the results of the perception mapping by respondents that the most attached to the iodized crystal coconut palm sugar were taste, color, and texture.

Earlier, prior to the development of effective systemic therapy, monotherapy with whole-brain radiotherapy (WBRT) was widely used to treat primary central nervous system lymphoma (PCNSL). Recently, chemotherapy, especially with high dose methotrexate (HDMTX), has largely replaced WBRT as upfront treatment, and the most accepted standard of care is induction with a combination drug therapy followed by consolidation therapy with either autologous stem-cell transplantation (ASCT) or radiation. Whilst WBRT is an effective component of treatment, it is occasionally associated with risk of permanent, irreversible neurotoxicity when doses of more than 30 Gy are used. Hence, there has been a strong focus on the optimization of radiotherapy (RT) which includes dose reduction in the consolidation phase. In this comprehensive review, we have summarized the progress on clinical results and evidence considering the role and use of radiation including combined treatment modalities, low-dose radiotherapy, and neurotoxicity. Finally, we present a practical approach to low-dose WBRT and boosting higher doses to the gross tumor that can be integrated into clinical practice.

Acetaminophen is widely used as a fever and pain reliever drug. However, acetaminophen intoxication was common and responsible for thousands of acetaminophen-induced liver injury (AILI) cases worldwide. It was understood that glutathione (GSH) depletion causes a deposit of acetaminophen metabolites which are toxic to liver cells. N-acetylcysteine (NAC), used as acetaminophen intoxication therapy, has been reported to cause side effects such as nausea, vomiting, and anaphylactic reaction. This narrative review aimed to discuss other potential candidates in AILI management. The biomolecular approach was used to investigate onion skin in-depth and holistic discussion. According to the results, onion peel extract is rich in flavonoids (quercetin and kaempferol) and potentially be a candidate in the management of AILI through proposed mechanisms such as restoration of reduced glutathione (GSH), inhibition of cytochrome P450 (CYP) enzymes, upregulation of uridine 5'-diphospho-glucuronosyltransferase (UGT) enzyme, and inhibition of TLR4 activity.

Sustainable economic growth is followed by an improvement in environmental quality. The purpose of this study is to identify the correlation between economic growth and population density on the environmental quality index (EQI) in Indonesia. In addition, it also aims to determine the impact of economic growth and population density on the environmental quality Index. This study uses a quantitative method with secondary data from 33 provinces in Indonesia from 2010 to 2016. Data were analyzed using Pearson correlation and panel data regression. The result showed that the correlation between economic growth and population density on the quality of the environment was moderate. It has a significant negative impact on environmental quality.

Abstract Background Postoperative pulmonary complications (PPCs) often occur after cardiac operations and are a leading cause of morbidity, inhibit oxygenation, and increase hospital length of stay and mortality. Although clinical evidence for PPCs prevention is often unclear and crucial, measures occur to reduce PPCs. One device usually used for this reason is incentive spirometry (IS). The aim of the study is to evaluate the effect of preoperative incentive spirometry to prevent postoperative pulmonary complications, improve postoperative oxygenation, and decrease hospital stay following coronary artery bypass graft (CABG) surgery patients. Methods This was a clinical randomized prospective study. A total of 80 patients were selected as candidates for CABG at An-Najah National University Hospital, Nablus-Palestine. Patients had been randomly assigned into two groups: incentive spirometry group (IS), SI performed before surgery (study group) and control group, preoperative spirometry was not performed. The 40 patients in each group received the same protocol of anesthesia and ventilation in the operating room. Result The study findings showed a significant difference between the IS and control groups in the incidence of postoperative atelectasis. There were 8 patients (20.0%) in IS group and 17 patients (42.5%) in the control group (p = 0.03). Mechanical ventilation duration was significantly less in IS group. The median was four hours versus six hours in the control group (p

Summary. Polydactyly is defined as an extra finger or toe that is present at birth. It is a congenital anomaly that can manifest as a single disorder or as a component of a syndrome. Treatment can be conservative or operative depending on the anticipated function of the extra digit. In this report, we describe a case of a bifid 5th digit on the right hand. The aim of this report was to report a new variant of type IIIB described by Duran (2015). This will possibly lead to the modification of the current classifications, which will improve the diagnosis and treatment of patients.

Background: Family Planning aims to regulate childbirth and pregnancy interval by using various contraception methods. Eventhough there is many choice among contraception methods, intramuscular injection is still the most used method. This phenomena happened in Indonesia, nationally and locally in Pekanbaru. The behavior of female users in choosing contraception methods is based on their knowledge and attitude about contraception methods. Objective: This study purpose is to describe female conctraception users behavior in the selection of contraception methods in Pekanbaru city. Methods: Research conducted with descriptive observational study design. Sample size is 400, sample was taken by stratified random sampling technique at 12 primary health centers in the city of Pekanbaru. Results: Results: Results show majority respondents had improper contraception methods selection behavior . Majority respondent is in 30- 39 years age group, with educational attainment high school, and most of them is housewives. Conclusions: Majority female contraception users in Pekanbaru had improper contraception methods selection behavior

Pendidikan merupakan kebutuhan yang tidak dapat dipisahkan dari kehidupan manusia. Meningkatkan kualitas pembelajaran merupakan salah satu hal penting yang harus diperhatikan dalam suatu proses belajar mengajar untuk meningkatkan mutu pendidikan. Media pembelajaran dapat berfungsi sebagai stimulus terhadap pikiran, perasaan, perhatian dan motivasi juga minat dalam memperjelas materi pelajaran. Kemajuan dan perkembangan teknologi sudah demikian menonjol sehingga penggunaan alat-alat bantu mengajar seperti alat-alat audio, visual dan audio visual serta perlengkapan sekolah disesuaikan dengan perkembangan jaman tersebut. Beberapa mata pelajaran harus ditempuh siswa pada tingkat sekolah dasar salah satunya adalah mata pelajaran Ilmu Pengetahuan Alam (IPA). Dalam hal ini peneliti menggunakan video sebagai alat bantu media pembelajaran, sehingga dengan menggunakan media ini diharapkan dapat merangsang motivasi dan minat agar dapat meningkatkan hasil belajar. Pada peneliti ini dilakukan posstest untuk teknik pengumpulan data. Penelitian ini menggunakan metode perhitungan cohen’s d dan didapatkan nilai 0,4 sehingga dapat dikategorikan tingkat sedang. Berdasarkan analisa yang didapat menunjukan ada pengaruh sedang pada penggunaan media video animasi terhadap hasil belajar mata pelajaran IPA kelas V di SDIT Al-Hikmah Bekasi.

Although the field of classroom learning environments has undergone remarkable expansion and internationalisation, no study in Afghanistan in any subject area or at any educational level has ever adopted a learning environment framework or involved the assessment and investigation of classroom environments. Our study in Afghanistan included seven learning environment scales from the widely-used What Is Happening In this Class? (WIHIC) questionnaire, together with two scales assessing the student attitudes of Enjoyment and Self-regulation. After minor modifications to suit the Afghani context, scales were translated into Dari (one of the two dominant languages in Afghanistan) and then independently back-translated to check the accuracy of the original translation. Analyses of data from 1619 grade 10-12 science students supported the validity and reliability of the Dari-language scales. Past research in other countries was replicated in Afghanistan in that positive and statistically-significant associations were found between the learning environment and student attitudes. Some consistent patterns of gender differences and school-location differences (urban/rural) were identified.

Diabetes Mellitus is some metabolic diseases marked by hyperglycemia, which is caused by either insufficient insulin production, impaired insulin function, or both. This study aims to investigate the difference in platelet counts between patients with controlled and uncontrolled type II diabetes mellitus at Panembahan Senopati Bantul Regional Hospital. This study employed a quantitative approach, utilizing an observational method to collect secondary data. The study population comprised 100 samples. According to the conducted research, it has been found that patients diagnosed with type II diabetes mellitus predominantly experience elevated HbA1c levels that are difficult to manage. Additionally, the majority of these patients are female and have been dealing with the condition for more than five years. The data analysis utilizing the Mann-Whitney test concluded that there was no statistically significant difference in platelet levels between patients with controlled and uncontrolled type II diabetes mellitus. The study's findings demonstrate that the p-value = 0.084 (< 0.05). [ABSTRACT FROM AUTHOR]

Background: Coronary artery bypass grafting (CABG) surgery is a common procedure for managing multi-vessel coronary artery disease to revascularize the myocardium. Among the various conduits used, the left internal mammary artery (LIMA) is preferred due to its better long-term patency rate. However, CABG procedures involving LIMA may result in rare but serious complications, such as avulsion of the LIMA post-CABG, which leads to disruption of blood flow to the myocardium and the development of fatal cardiac tamponade. Case presentation: We hereby present a unique case of spontaneous avulsion of a LIMA graft to the left anterior descending artery (LAD) away from the site of anastomosis, twenty-four hours following CABG surgery in a 67-year-old male patient. Emergency re-exploration and repair of the LIMA with interposition vein graft were performed and resulted in successful stabilization of the patient's critical condition. However, this was followed by a complicated recovery period involving atrial fibrillation, acute kidney injury, and wound infection. Conclusion: Avulsion of LIMA graft following CABG is rare, yet a fatal complication that requires high clinical suspicion and prompt management. Avulsion has been reported a few times in literature following both minimal invasive and conventional CABG. Understanding the etiology, clinical presentation, and management of this complication is crucial to avoid catastrophic outcomes. [ABSTRACT FROM AUTHOR]