Gray matter structural correlates of fatigue in multiple sclerosis

We aimed to assess whether frontal cortex-striatum-thalamus (FCST) pathway or other grey matter (GM) structures are associated with longitudinal patterns of fatigue, namely reversible (RF) versus sustained fatigue (SF). MS patients enrolled in our prospective cohort were grouped based on their longitudinal Modified Fatigue Impact Scale (MFIS) scores: 1. SF: MFIS≥38 at the two most recent yearly assessments; 2. RF: MFIS<38 at last assessment, but presence of at least one previous MFIS≥38; 3. Never Fatigued (NF): at least five MFIS<38. Accordingly, we selected 98 patients (30 SF, 31 RF, 37 NF; age-range:29-66, female/male:76/22, Extended Disability Status Scale (EDSS)6; 13 patients with secondary progressive (SP) MS and 85 with relapsing remitting (RR) MS in remission). Disability and depression were assessed using the EDSS and CES-D, respectively. 3T T1-weighted MRI was used for voxel based morphometry (VBM) to survey for GM atrophy associated with fatigue, controlling for age, sex and EDSS. Group-wise volumetric comparison was performed on deep GM structures identified by VBM, controlling for age, sex, EDSS and CES-D score. VBM showed significant inverse relation between the MFIS cognitive subscale score and areas within the bilateral fronto-medial and fronto-orbital cortices, anterior striata, thalami, temporal poles, insulae and left lateral occipital cortex (peak FWE-p value of 0.021), and between the MFIS physical subscale and areas within the bilateral frontal poles, and frontal medial cortices (peak FWE-p value of 0.043). Volumetric analysis showed significant atrophy in the putamen (RF<NF p<0.0004; SF<NF p<0.0085) and thalamus (RF<NF p<0.00048)

TECHNICAL DRAWING SKILL IMPROVEMENT WITH MEDIA PEMBELAJARAN MODUL GAMBAR TEKNIK FOR TECHNICAL DRAWING COURSE IN ENGINEERING DEPARTEMENT OF AUDIO VIDEO SMK NEGERI 2 YOGYAKARTA

The purpose of this research is to find out the design of Modul Gambar Teknik, describing the learning process of technical drawing through Media Pembelajaran Modul Gambar Teknik in exertion to improve the technical drawing skill. In addition the purpose of this research is to find out the outcomes of learning the technical drawing course using Media Pembelajaran Modul Gambar Teknik at the students of class 1TAV1 in SMK Negeri 2 Yogyakarta TA 2010/2011. This research method is using the Classroom Action Research (CAR) with the cycle model that implemented as collaborative and passive participative. Implementation of learning through Media Pembelajaran Modul Gambar Teknik in action is interpolated to the cycles of actions. The research was originally planned for 1 cycle, but in the realization it takes three cycles with the whole students of the class 1TAV1 from Audio Video Departement in SMK Negeri 2 Yogyakarta as the research subject with a population 36 students consisting of 26 male and 9 female. Meanwhile the technique of data collection is done through observation, field notes, questionnaires and document of the learning outcomes. These data were analyzed using analysis of Miles-Huberman, which is started from data collection, data reduction, data presentation until the conclusion of the research is obtained. The learning outcomes of technical drawing using Media Pembelajaran Modul Gambar Teknik based on the criteria of class’s average score 80,00 and KKM score 80,00, with students percentage above the KKM is 80,00% or approximately 29 students. In the first cycle, there are 11 (30,56%) students that get the score above the KKM (80,00) and 25 (69,44%) students that get the score below the target of KKM, with the treatment that given by the teacher is only the explanation of the module. Then in the 2nd cycle its become 15 (41,67%) students that get the score above the KKM (80,00) while the other students who still get their score below the KKM is 21 (58,33%), with the treatment of module explanation along with the distribution of the drawing samples in the finished form, and in the 3rd cycle there are 30 (83,33%) students that get the score above the KKM (80,00) while the other student who still get the score below the target of KKM is 6 (16,67%) students, with the treatment given by the teacher is module explanation, providing PCB samples in the finished form along with the video tutorial of job sheet 3. Meanwhile the completeness criteria of finishing the job (6x45 minutes) in the cycle 1, 2 and 3 all of the students completed in completing job sheet. There are improvements of the class’s average score from cycle 1 (75,92) become 77,89 in the cycle 2 or increased ↑1,96 (7,39%), while from cycle 2 to cycle 3 become 79,97 or increased ↑2,09 point (13,95%). From the score of the drawing that shows the improvement from cycle 1 to cycle 3, it can be concluded that the using of Modul Gambar Teknik to improve the drawing skill are reasonable to be used as a learning media

USING A GENRE-BASED APPROACH TO IMPROVE THE ENGLISH WRITING COMPETENCE OF VIIIA STUDENTS OF SMPN 3 METRO LAMPUNG IN THE ACADEMIC YEAR 2011/2012

This research is a collaborative classroom action research, and the subject is VIIIA students of SMPN 3 Metro–Lampung in the academic year 2011/2012 and English teacher who teaches the eight grade of SMPN 3 Metro Lampung. The method of Kemmis & McTaggart was used in this research, consisting four steps: (1) planning, which prepared components of the cycle in genre-based approach including building knowledge of the field, modeling of text, joint construction of text, and independent construction of text; (2) action, which was the implementation of each cycle in the genre-based approach; (3) observation, observing which implemented the genre-based approach; and (4) reflection, which was a discussion between the researcher and collaborator about the findings in the observation and action phases. The research instruments were students observation guide, field note guide, and writing assessment guide. The data were qualitative and quantitative. The qualitative data were obtained from the results of classroom observation and field notes, and the quantitative data were the students’ pretest scores, scores in the independent construction of text in each cycle, and posttest scores. The reliability of the data was obtained by using the triangulation technique which combined the result of the observation, field note, and the result of the students’ writing. The result of the research shows that the improvement was achieved in every cycle. At the building knowledge of the field phase, the students competence in expressing vocabulary improved, at modeling of text phase, the students were able to understand the teachers’ explanation about genre, at the joint construction of text phase, the students were able to interact with their peers, and at the independent construction of text phase, the students were able to compose a text without the teacher’s guide and friends’ help. The result of the improvement can be seen from the comparation of the pretest result, each cycle result, and posttest result. The mean score of the students pretest result is 55.05, the result of the first cycle is 70.08, and the second cycle is 74.63, while the posttest result is 76.1. From those results, it can be concluded that the genre-based approach can improve the students’ writing competence. Keywords: genre-based approach, writing, cycl

Optimal management of seizures associated with tuberous sclerosis complex: current and emerging options.

Seizures are clinically significant manifestations associated with 79%-90% of patients with tuberous sclerosis complex. Often occurring within the first year of life in the form of infantile spasms, seizures interfere with neuropsychiatric, social, and cognitive development and carry significant individual and societal consequences. Prompt identification and treatment of seizures is an important focus in the overall management of tuberous sclerosis complex patients. Medical management, either after seizure onset or prophylactically in infants with electroencephalographic abnormalities, is considered first-line therapy. Vigabatrin and adrenocorticotropic hormone have emerged over the past few decades as mainstay pharmacologic modalities. Furthermore, emerging research on mammalian target of rapamycin inhibitors demonstrated promise for the management of seizures and subependymal giant cell astrocytoma. For appropriate surgical candidates with an epileptogenic zone associated with one or more glioneuronal hamartomas, ideally in noneloquent cortex, resective surgery can be considered, which provides a cure in 56% of patients. For medically refractory patients who do not meet criteria for curative surgery, palliative surgical approaches focused on reducing seizure burden, in the form of corpus callosotomy and vagus nerve stimulation, are alternative management options. Lastly, the ketogenic diet, a reemerging therapy based on the anticonvulsant effects of ketone bodies, can be utilized independently or in conjunction with other treatment modalities for the management of difficult-to-treat seizures