PENERAPAN MODEL PEMBELAJARAN KOOPERATIF TEKNIK CHANGE OF PAIRSUNTUK MENGATASI KESALAHAN SISWA MENYELESAIKAN SOAL-SOAL SUB POKOK BAHASAN LUAS TRAPESIUM KELAS VII A SMP NEGERI 7 JEMBER TAHUN AJARAN 2012/2013

Abstract.Cooperative learning by using change of pairs technique is a learning model which gives chancefor thestudentstoask andstrengthentheir answerfor the exercises.This research implementscooperative learning by using change of pairs technique to reduce student’s errorin solving problems of area of trapezoid. The subject of the research is grade VII A students of SMP Negeri 7 Jember. The type of this research is a Classroom Action Research (CAR). The data collection methods used in this research are observation, documentation, interview, and test. The result shows that the errors are decreasing; misused data decrease from 50% to 0%; distorted theorem or definition decrease from 59,38% to 12,5%; technical errors decrease from 61,25% to 9,34%; and other error decrease from 27,5% to 1,25%. The result also shows that the activity of the students and the teacher in teaching and learning process are increasing. KeyWords:changeofpairs technique, student's error, area of trapezoi

Neuropsychiatric symptoms in 921 elderly subjects with dementia: a comparison between vascular and neurodegenerative types.

Objective:  i) to describe the neuropsychiatric profile of elderly subjects with dementia by comparing vascular (VaD) and degenerative dementias, i.e. dementia with Lewy bodies (DLB) and Alzheimer’s disease (AD); ii) to assess whether the severity and type of dementia are associated with clinically relevant neuropsychiatric symptoms (CR‐NPS). Method:  One hundred and thirty‐one out‐patients with VaD, 100 with DLB and 690 with AD were studied. NPS were evaluated by the neuropsychiatric inventory (NPI). Results:  Vascular dementia had lower total and domain‐specific NPI scores and a lower frequency of CR‐NPS than AD and DLB, for which frequency of CR‐NPS increased significantly with disease severity, particularly in AD. Logistic regression analysis showed that a higher CDR score and a diagnosis of degenerative dementia were independently associated with CR‐NPS. Conclusion:  Vascular dementia is associated less with CR‐NPS than AD and DLB. Frequency of CR‐NPS increases with disease severity in AD and, to a lesser extent, in DLB

Penggunaan Gelatin Pada Reduced-Fat Mayonnaise Ditinjau Dari Keasaman, Protein, Lemak, Dan Asam Lemak Bebas

Mayonnaise merupakan salah satu produk olahan berbahan dasar minyak, sehingga mayonnaise full fat yang beredar di pasaran memiliki kandungan lemak yang tinggi. Kesadaran masyarakat tentang kesehatan yang semakin meningkat, menyebabkan mayonnaise dikonsumsi dalam jumlah yang terbatas. Salah satu upaya untuk memenuhi kebutuhan dan meningkatkan konsumsi mayonnaise, yaitu membuat reduced-fat mayonnaise dengan penambahan gelatin sebagai stabilizer. Gelatin merupakan campuran peptida dan protein yang dihasilkan oleh hidrolisis parsial kolagen yang diekstraksi dari kulit, tulang, dan jaringan ikat ternak sapi. Gelatin diklasifikasikan sebagai jenis hidrokoloid, dengan sifat fungsional yang dapat digunakan sebagai bahan penstabil. Tujuan penelitian ini adalah untuk mengetahui persentase terbaik penambahan gelatin dalam pembuatan reduced-fat mayonnaise ditinjau dari keasaman, protein, lemak, dan asam lemak bebas. Hasil penelitian diharapkan dapat digunakan sebagai informasi dan memberikan ilmu pengetahuan bagi masyarakat umum dalam pembuatan reduced-fat mayonnaise dengan penambahan gelatin. Materi yang digunakan dalam penelitian ini antara lain reduced-fat mayonnaise yang dibuat menggunakan minyak biji bunga matahari, kuning telur, gelatin, dan bahan tambahan pangan seperti garam, gula, mustard, dan lada. Metode yang digunakan dalam penelitian ini adalah metode percobaan laboratorium dengan menggunakan Rancangan Acak Lengkap (RAL), dengan 4 perlakuan dan 4 ulangan. Perlakuan yang diberikan berupa penggunaan gelatin sebagai stabilizer, di mana P0 tanpa penambahan gelatin (sebagai kontrol), P1 dengan penambahan 1% gelatin, P2 dengan penambahan 2% gelatin, dan P3 dengan penambahan 3% gelatin. Parameter atau variabel yang diuji meliputi keasaman, protein, lemak, dan asam lemak bebas. Data yang diperoleh di analisis statistika dengan menggunakan analisis ragam atau Analysis of Variance (ANOVA), dan jika terdapat perbedaan yang nyata maupun sangat nyata, maka akan dilanjutkan dengan Uji Jarak Berganda Duncan (UJBD). Hasil penelitian menunjukkan bahwa penambahan gelatin memberikan pengaruh sangat nyata (P<0,01) terhadap keasaman, protein, lemak, dan asam lemak bebas. Rataan nilai kadar keasaman pada P0, P1, P2, dan P3 berturut-turut 0,59%, 0,63%, 0,64%, dan 0,65%. Rataan nilai kadar protein berturut-turut adalah 1,49%, 1,80%, 1,90%, 2,10%. Rataan nilai hasil kadar lemak berturut-turut adalah 70,99%, 53,86%, 52,74%, 51,51%. Rataan nilai kadar asam lemak bebas berturut-turut adalah 0,071%, 0,067%, 0,063%, 0,060%. Berdasarkan penelitian dapat disimpulkan bahwa penambahan gelatin sebesar 3% menghasilkan reduced-fat mayonnaise terbaik dengan kadar keasaman sebesar 0,65%, kadar protein 2,10%, x kadar lemak 51,51%, dan kadar asam lemak bebas 0,060%. Saran dari penelitian ini, perlu dilakukan penelitian lebih lanjut mengenai daya simpan mayonnaise dengan penambahan gelatin sebesar 3%

Edoxaban: an update on the new oral direct factor Xa inhibitor.

Edoxaban is a once-daily oral anticoagulant that rapidly and selectively inhibits factor Xa in a concentration-dependent manner. This review describes the extensive clinical development program of edoxaban, including phase III studies in patients with non-valvular atrial fibrillation (NVAF) and symptomatic venous thromboembolism (VTE). The ENGAGE AF-TIMI 48 study (N = 21,105; mean CHADS2 score 2.8) compared edoxaban 60 mg once daily (high-dose regimen) and edoxaban 30 mg once daily (low-dose regimen) with dose-adjusted warfarin [international normalized ratio (INR) 2.0-3.0] and found that both regimens were non-inferior to warfarin in the prevention of stroke and systemic embolism in patients with NVAF. Both edoxaban regimens also provided significant reductions in the risk of hemorrhagic stroke, cardiovascular mortality, major bleeding and intracranial bleeding. The Hokusai-VTE study (N = 8,292) in patients with symptomatic VTE had a flexible treatment duration of 3-12 months and found that following initial heparin, edoxaban 60 mg once daily was non-inferior to dose-adjusted warfarin (INR 2.0-3.0) for the prevention of recurrent VTE, and also had a significantly lower risk of bleeding events. Both studies randomized patients at moderate-to-high risk of thromboembolic events and were further designed to simulate routine clinical practice as much as possible, with edoxaban dose reduction (halving dose) at randomisation or during the study if required, a frequently monitored and well-controlled warfarin group, a well-monitored transition period at study end and a flexible treatment duration in Hokusai-VTE. Given the phase III results obtained, once-daily edoxaban may soon be a key addition to the range of antithrombotic treatment options

Surface Feature-Guided Mapping of Cerebral Metabolic Changes in Cognitively Normal and Mildly Impaired Elderly

Purpose: The aim of this study was to investigate the longitudinal positron emission tomography (PET) metabolic changes in the elderly. Procedures: Nineteen nondemented subjects (mean Mini-Mental Status Examination 29.4±0.7 SD) underwent two detailed neuropsychological evaluations and resting 2-deoxy-2-[F-18]fluoro-D-glucose (FDG)-PET scan (interval 21.7±3.7 months), baseline structural 3T magnetic resonance (MR) imaging, and apolipoprotein E4 genotyping. Cortical PET metabolic changes were analyzed in 3-D using the cortical pattern matching technique. Results: Baseline vs. follow-up whole-group comparison revealed significant metabolic decline bilaterally in the posterior temporal, parietal, and occipital lobes and the left lateral frontal cortex. The declining group demonstrated 10–15 % decline in bilateral posterior cingulate/precuneus, posterior temporal, parietal, and occipital cortices. The cognitively stable group showed 2.5–5% similarly distributed decline. ApoE4-positive individuals underwent 5–15 % metabolic decline in the posterior association cortices. Conclusions: Using 3-D surface-based MR-guided FDG-PET mapping, significant metaboli

P2Y12 platelet inhibition in clinical practice

Platelet adhesion, activation and aggregation play a pivotal role in atherothrombosis. Intracoronary atherothrombosis is the most common cause of the development of acute coronary syndrome (ACS), and plays a central role in complications occurring around percutaneous coronary intervention (PCI) including recurrent ACS, procedure-related myocardial infarction or stent thrombosis. Inhibition of platelet aggregation by medical treatment impairs formation and progression of thrombotic processes and is therefore of great importance in the prevention of complications after an ACS or around PCI. An essential part in the platelet activation process is the interaction of adenosine diphosphate (ADP) with the platelet P2Y12 receptor. The P2Y12 receptor is the predominant receptor involved in the ADP-stimulated activation of the glycoprotein IIb/IIIa receptor. Activation of the glycoprotein IIb/IIIa receptor results in enhanced platelet degranulation and thromboxane production, and prolonged platelet aggregation. The objectives of this review are to discuss the pharmacological limitations of the P2Y12 inhibitor clopidogrel, and describe the novel alternative P2Y12 inhibitors prasugrel and ticagrelor and the clinical implications of the introduction of these new medicines

Cognitive neuroscience of delusions in aging

Assessments and clinical understanding of late-onset delusions in the elderly are inconsistent and often incomplete. In this review, we consider the prevalence, neurobehavioral features, and neuroanatomic correlations of delusions in elderly persons – those with documented cognitive decline and those with no evidence of cognitive decline. Both groups exhibit a common phenotype: delusions are either of persecution or of misidentification. Late-onset delusions show a nearly complete absence of the grandiose, mystical, or erotomanic content typical of early onset psychoses. Absent also from both elderly populations are formal thought disorders, thought insertions, and delusions of external control. Neuroimaging and behavioral studies suggest a frontotemporal localization of delusions in the elderly, with right hemispheric lateralization in delusional misidentification and left lateralization in delusions of persecution. We propose that delusions in the elderly reflect a common neuroanatomic and functional phenotype, and we discuss applications of our proposal to diagnosis and treatment

Hypofibrinolysis in diabetes: a therapeutic target for the reduction of cardiovascular risk

An enhanced thrombotic environment and premature atherosclerosis are key factors for the increased cardiovascular risk in diabetes. The occlusive vascular thrombus, formed secondary to interactions between platelets and coagulation proteins, is composed of a skeleton of fibrin fibres with cellular elements embedded in this network. Diabetes is characterised by quantitative and qualitative changes in coagulation proteins, which collectively increase resistance to fibrinolysis, consequently augmenting thrombosis risk. Current long-term therapies to prevent arterial occlusion in diabetes are focussed on anti-platelet agents, a strategy that fails to address the contribution of coagulation proteins to the enhanced thrombotic milieu. Moreover, antiplatelet treatment is associated with bleeding complications, particularly with newer agents and more aggressive combination therapies, questioning the safety of this approach. Therefore, to safely control thrombosis risk in diabetes, an alternative approach is required with the fibrin network representing a credible therapeutic target. In the current review, we address diabetes-specific mechanistic pathways responsible for hypofibrinolysis including the role of clot structure, defects in the fibrinolytic system and increased incorporation of anti-fibrinolytic proteins into the clot. Future anti-thrombotic therapeutic options are discussed with special emphasis on the potential advantages of modulating incorporation of the anti-fibrinolytic proteins into fibrin networks. This latter approach carries theoretical advantages, including specificity for diabetes, ability to target a particular protein with a possible favourable risk of bleeding. The development of alternative treatment strategies to better control residual thrombosis risk in diabetes will help to reduce vascular events, which remain the main cause of mortality in this condition