PELATIHAN GURU SEKOLAH MENENGAH DALAM IMPLEMENTASI METODE PEMBELAJARAN INOVATIF: KONTRIBUSI PERGURUAN TINGGI

Penerapan metode pembelajaran inovatif telah menjadi fokus utama dalam upaya meningkatkan efektivitas pendidikan. Metode-metode seperti flipped classroom, pembelajaran berbasis proyek, pembelajaran kooperatif, dan pembelajaran berbasis permainan menawarkan pendekatan yang berbeda dalam mengaktifkan siswa dalam proses belajar-mengajar. Dalam tulisan ini, kami mengeksplorasi pentingnya penerapan metode pembelajaran inovatif dalam konteks kelas. Kami menyoroti manfaat dari setiap metode dan menekankan perlunya integrasi mereka dalam praktik pengajaran guru. Kami menyimpulkan bahwa penerapan metode pembelajaran inovatif tidak hanya meningkatkan kualitas pembelajaran, tetapi juga mempersiapkan siswa untuk menghadapi tantangan masa depan sebagai pembelajar mandiri, kritis, dan kreatif

Behavioral Intention to Adopt FinTech Services: A Comparative Study Between Digital Immigrants and Digital Natives in Pakistan

This study aims to investigate the key factors influencing the adoption of financial technology among digital immigrants and natives by extending the diffusion of innovation theory. A convenience sampling technique was employed to collect data from 160 digital immigrants and 193 digital natives, resulting in a total of 353 responses. A structural equation modelling approach was employed to conduct a multigroup analysis comparing the responses of digital immigrants and digital natives using SmartPLS software. This study reveals significant relationships between relative advantage, complexity, compatibility, trust, data security, and intention to adopt FinTech services. Moreover, this study emphasizes the importance of addressing data security concerns and ensuring compatibility with existing financial systems to foster trust and facilitate the adoption of FinTech. Notably, the present research holds important implications for stakeholders, including academia, the financial industry, and policymakers, informing modern strategies to promote financial inclusion by targeting all age groups of users in this digital financial landscape

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Elliptic curve cryptography based light weight technique for information security

Recent breakthroughs in cryptographic technology are being thoroughly scrutinized due to their emphasis on innovative approaches to design, implementation, and attacks. Lightweight cryptography (LWC) is a technological advancement that utilizes a cryptographic algorithm capable of being adjusted to function effectively in various constrained environments. This study provides an in-depth analysis of elliptic curve cryptography (ECC), which is a type of asymmetric cryptographic method known as LWC. This cryptographic approach operates over elliptic curves and has two applications: key exchange and digital signature authentication. Next, we will implement asymmetric cryptographic algorithms and evaluate their efficiency. Elliptic curve elgamal algorithms are implemented for encryption and decryption of data. Elliptic curve Diffie-Hellman key exchange is used for sharing keys. Experimental results have shown that ECC needs small size keys to provide similar security. ECC takes less time in key generation, encryption and decryption of plain text. Time taken by ECC to generate a 2,048 bit long key is 1,653 milliseconds in comparison to 4,258 millisecond taken by Rivest-Shamir-Adleman (RSA) technique

Radial artery pseudoaneurysm (RAP) following transradial intervention — an extremely rare complication successfully managed by surgery: case report

The transradial access for diagnostic and therapeutic purpose is becoming increasingly popular, mainly because of its lack of complications. Radial artery pseudoaneurysm (RAP) is an extremely rare complication, so many of its clinical features are unknown and treatment is not systematic. Therapeutic options are conservative management, ultrasound-guided compression, thrombin injection and surgical intervention. Here, we report a 43-year old female who underwent transradial percutaneous angioplasty of left anterior descending artery. During cannulation of her radial artery, multiple puncture attempts were done. Upon removal of the transra¬dial compression band (TR Band), forearm ecchymosis and small hematoma were noted with mild pain. Tight compression bandage was applied but on the following day, she had complaints of increasing right forearm pain and tenderness. Physical evaluation revealed increased swelling of the right forearm and an ultrasound of the right forearm demonstrated a RAP of the right radial artery measuring up to 3.9x1.9 cm with 3.4 mm neck. Tight compression bandage was further prolonged following ultrasound compression with vascular probe which failed to alleviate her complaints. Following failure of conservative therapy and in lieu of her symptoms, surgical exploration, clot removal and successful repair was done

5\u27-nucleotidase, oxidative stress and antioxidant status in alcohol consumers and cirrhotic patients

Uvod: Cilj istraživanja bio je izmjeriti aktivnost enzima 5\u27-nukleotidaza kod bolesnika s cirozom jetre i osoba koje uzimaju alkohol. U istraživanju se ispitivao i oksidacijski stres, antioksidansi te njihova povezanost s 5\u27-nukleotidazom. Materijali i metode: Istraživanje je provedeno u tri skupine po 25 ispitanika jednake dobi i spola: I. skupina (kontrolni ispitanici), II. skupina (osobe koje uzimaju alkohol, tj. konzumenti alkohola) i III. skupina (bolesnici s cirozom jetre). Uzorci krvi prikupljeni od ispitanika centrifugirani su kako bi se odvojila plazma za analizu 5\u27-nukleotidaze. Odvojene stanice su tri puta isprane 0,9-postotnom hladnom fiziološkom otopinom i upotrebljene za analizu glutationa, malondialdehida i superoksid-dismutaze. Rezultati: Aktivnost 5\u27-nukleotidaze u serumu bila je statistički značajno povišena kod skupine bolesnika s cirozom i skupine konzumenata alkohola. Koncentracije malondialdehida bile su također statistički značajno povišene kod bolesnika s cirozom jetre i konzumenata alkohola. Koncentracije glutationa i superoksid-dismutaze bile su statistički značajno snižene u obje skupine. Zaključak: Iz ovih rezultata može se zaključiti da je aktivnost 5\u27-nukleotidaze u serumu dosljedno viša kod bolesnika s cirozom jetre i osoba koje uzimaju alkohol. Zapažena razlika mogla bi ukazivati na opseg oštećenja jetre, oštećenja hepatobilijarnog sustava i opstrukcije jetre.Background: The present study was undertaken to determine the 5\u27-nucleotidase enzyme activity in liver cirrhotic patients and alcohol consumers. Oxidative stress, antioxidants and their association with 5\u27-nucleotidase were also investigated. Methods: The study included three groups of 25 age and sex matched subjects: group I (control), group II (alcohol consumers) and group III (cirrhotic patients). Blood samples were collected and centrifuged for separation of plasma for analysis of 5\u27-nucleotidase. Separated cells were washed thrice with 0.9% w/v cold normal saline and used for the analysis of glutathione, malondialdehyde and superoxide dismutase. Results: The activity of serum 5\u27-nucleotidase was significantly increased in both cirrhotic patients and alcohol consumers. The levels of malondialdehyde were also significantly increased in both cirrhotic patients and alcohol consumers. The levels of glutathione and superoxide dismutase were significantly decreased in both cirrhotic patients and alcohol consumers. Conclusions: Study results indicated the activity of serum 5\u27-nucleotidase to be consistently higher in cirrhotic patients and alcohol consumers. The difference recorded might be pointing to the extent of liver damage, hepatobiliary damage, and biliary stasis

Porównanie stymulacji koniuszkowej i przegrodowej prawej komory: wpływ na wskaźniki echokardiograficzne, czynność lewej komory i efekty kliniczne w obserwacji krótko- i średniookresowej

Introduction. Right ventricular apical pacing (RVAP) has a greater ‘desynchronizing effect’ than pacing from the interventricular septum (RVSP) and may translate into worse outcomes in the long run. The aim of the present study was to examine the short- and intermediate-term effects of RVAP versus RVSP on echocardiographic features, left ventricular function, and clinical outcome. Materials and methods. 467 patients between August 2014 and March 2018 without structural heart disease were prospectively randomised to RVAP (N = 226) or RVSP (N = 241) and were studied at baseline, six months, and 12 months by echocardiography, biochemically [N-terminal pro-B-type natriuretic peptide (NT-proBNP)], and clinically [six-minute walk test (6MWT)]. Left ventricular 2D strain and tissue velocity images were analysed to measure 18-segment time-to-peak longitudinal systolic strain and 12-segment time-to-peak systolic tissue velocity. Intraventricular dyssynchrony was calculated using tissue Doppler velocity data by comparing the time to systolic peak velocity between segments in multiple apical views by their respective standard deviations. Interventricular dyssynchrony was measured as the temporal difference of left ventricular pre-ejection period and right ventricular pre-ejection period by pulse-wave Doppler images. All the analysis was carried out using statistical package for social service version 17.0 (SPSS Inc., Chicago, IL, USA). A p-value < 0.05 was considered statistically significant. Results. The commonest indication for pacemaker implantation was atrioventricular block (N = 311, 66.6%), followed by sinus node dysfunction (N = 138, 29.5%) and chronic bifascicular and trifascicular block (N = 18, 3.9%), with all patients receiving a single chamber pacemaker (VVI: n = 107, 22.9% and VVIR: n = 360,77.1%). There were significant differences in NT-proBNP level (410 ± 254 pg/mL vs. 370 ± 168 pg/mL, p = 0.02), 6MWT (442 ± 19 m vs. 482 ± 21 m, p = 0.01), mean QRS duration (164 ± 8.3 ms vs. 148 ± 10.6 ms, p = 0.02), intraventricular dyssynchrony (septal to lateral wall delay: 88.6 ± 24.2 ms vs. 43.7 ± 11.2 ms, p = 0.04), interventricular dyssynchrony (31.2 ± 22.8 vs. 19.4 ± 11.2, 0 = 0.03), end diastolic volume (78.4 ± 15.6 mL vs. 72.8 ± 14.2 mL, p = 0.04), and end-systolic volume (30.2 ± 13.1 mL vs. 25.6 ± 11.7 mL, p = 0.05) at the end of 12 months between RVAP and RVSP respectively, though not significantly different at six months, favouring the RVS-paced group. However, no significant difference in ejection fraction (59 ± 5% vs. 61.5 ± 3.2%, p = 0.39) and New York Heart Association class (1.29 ± 0.3 vs. 1.28 ± 0.4, p = 0.3) at six and 12 months follow up were noted. Conclusion. Right ventricular septal pacing was associated with a better outcome in terms of echocardiographic indices, left ventricular function, and clinical outcome compared to patients with apical pacing over an intermediate-term follow up.Wstęp. Stymulacja koniuszkowa prawej komory ma większy „wpływ desynchronizacyjny” niż stymulacja przegrodowa prawej komory (RVSP) i w dłuższej perspektywie może prowadzić do poważniejszych skutków. Przedstawione badanie przeprowadzono w celu porównania krótko- i długookresowego wpływu RVAP i RVSP na parametry echokardiograficzne, czynność lewej komory i efekty kliniczne. Materiał i metody. Prospektywne badanie prowadzono od sierpnia 2014 roku do marca 2018 roku. Uczestniczyło w nim 467 chorych bez choroby strukturalnej serca, których przydzielono losowo do RVAP (N = 226) lub RVSP (N = 241). W czasie pierwszej wizyty wszystkich uczestników poddano badaniu echokardiograficznemu, badaniu biochemicznemu [stężenie N-końcowego fragmentu propeptydu natriuretycznego typu B (NT-proBNP)] i ocenie stanu klinicznego [test 6-minutowego marszu (6MWT)]. Badania te powtórzono po 6 i 12 miesiącach. Przeanalizowano lewokomorowe obrazy 2D z badania odkształcenia (strain) i prędkości ruchu miokardium (tissue velocity), aby zmierzyć czas do maksymalnego skurczowego odkształcenie podłużnego w 18 segmentach i czas do maksymalnej skurczowej prędkości ruchu miokardium w 12 segmentach. Dyssynchronię śródkomorową obliczano na podstawie danych uzyskanych w badaniu doplera tkankowego, porównując czas do maksymalnej prędkości skurczowej między segmentami w wielu projekcjach koniuszkowych na podstawie ich odchyleń standardowych. Dyssynchronię międzykomorową mierzono jako różnicę w czasie okresu przedwyrzutowego lewej i prawej komory w badaniu doplera fali pulsacyjnej. Wszystkie analizy statystyczne wykonano za pomocą pakietu oprogramowania SPSS, wersja 17.0 (SPSS Inc., Chicago, IL, USA). Wartości p wynoszące poniżej 0,05 uznano za statystycznie istotne. Wyniki. Najczęstszym wskazaniem do wszczepienia stymulatora był blok przedsionkowo-komorowy (n = 311; 66,6%), a w następnej kolejności dysfunkcja węzła zatokowego (n = 138; 29,5%) i przewlekły blok dwu- lub trójwiązkowy (n = 18; 3,9%). Wszystkim chorym wszczepiono stymulator jednokomorowy (VVI: n = 107; 22,9% lub VVIR: n = 360;77,1%). Stwierdzono istotne różnice między RVAP i RVSP na korzyść stymulacji RVS w wartościach NT-proBNP (odpowiednio 410 ± 254 pg/ml vs. 370 ± 168 pg/ml; p = 0,02), dystansu 6MWT (442 ± 19 m vs. 482 ± 21 m; p = 0,01), średniego czasu trwania zespołu QRS (164 ± 8,3 ms vs. 148 ± 10,6 ms; p = 0,02), dyssynchronii śródkomorowej (opóźnienie między przegrodą międzykomorową a ścianą boczną: 88,6 ± 24,2 ms vs. 43,7 ± 11,2 ms; p = 0,04), dyssynchronii międzykomorowej (31,2 ± 22,8 vs. 19,4 ± 11,2; 0 = 0,03) oraz objętości końcoworozkurczowej (78,4 ± 15,6 ml vs. 72,8 ± 14,2 ml; p = 0,04) i końcowoskurczowej (30,2 ± 13,1 ml vs. 25,6 ± 11,7 ml; p = 0,05) po 12 miesiącach, jednak różnice zaobserwowane po 6 miesiącach. W badaniach przeprowadzonych po 6 i 12 miesiącach nie stwierdzono natomiast istotnych różnic pod względem frakcji wyrzutowej (59 ± 5% vs. 61.5 ± 3.2%, p = 0.39) ani klasy według New York Heart Association (1,29 ± 0,3 vs. 1,28 ± 0,4; p = 0,3). Wnioski. W obserwacji średnioterminowej stymulacja przegrody prawej komory wiązała się z lepszymi efektami w odniesieniu do wskaźników echokardiograficznych, czynności lewej komory i efektu klinicznego niż stymulacja koniuszkowa

Fall seven times, stand up eight: linking project management innovation, project governance, and high-performance work practices to project success

Project managers seem to be puzzled in resolving the global dilemma of project failures across industries. Hence, the present study introduces project management innovation (PMI) as a determinant of project success (PS) and explores whether project governance (PG) and high-performance work practices (HPWPs), strengthen this relationship. To confirm these propositions, study data using adapted scales were collected from project professionals representing software development companies in the emerging IT industry in Pakistan. Structural equation modeling (SEM) was employed to examine the hypothesized relationships and encourage PMI-guided solutions for project failures. SEM results statistically validated that project success is positively influenced by PMI, whereas this relationship is significantly strengthened through the moderating influence of PG and HPWPs, respectively. Theoretically, the present research is the first of its kind to introduce and empirically examine these untested relationships between PMI, PG, HPWPs, and PS in a single framework. These novel findings hold strategic value for both project managers and organizational leaders who oversee a range of project portfolios. Long-lasting advantages and superior achievements can be reinvigorated through PMI, after departure from traditional approaches and answering calls for new solutions to new problems in managing projects. Moreover, project governance and HPWPs should be reconfigured to oversee, as well as meet the special needs of each unique project.Versión publicada - versión final del edito

Joga i rehabilitacja kardiologiczna (Yoga-CaRe) u osób po przebyciu ostrego epizodu wieńcowego

Cardiovascular diseases are a leading cause of death and disability in Asian Indians with huge psychological and economic impact as it affects population in thirty- and forty-year-olds, previously healthy adults and most productive social group. Successful transcatheter therapeutics has opened a new vista for its management; however, it cannot prevent its recurrence. Therefore, secondary prevention is cornerstone of management. Yoga-based Cardiac Rehabilitation (Yoga-CaRe) is a multifaceted approach targeting patient’s physical, psychological, social and occupational status, preventing or delaying the progression of underlying disease and reducing the risk of recurrent rehospitalization and death as well as enabling the patients to live a comfortable and active life. Yoga is an ancient Indian system of philosophy; a mind-body discipline encompassing an array of philosophical precepts, mental attitudes and physical practice. Of seven major branches of yoga, Hatha yoga, which itself includes many different styles (e.g. Iyenger, Ashtanga, etc.), is probably the most commonly recognized, and incorporates elements of physical poses, breath control and meditation, and self-restraint (including that of diet, smoking, alcohol intake and sleep patterns). A Cochrane review reported a 27% reduction in total mortality and 19% reduction in total mortality and non-fatal cardiac events with cardiac rehabilitation (CR), comparing favorably to effective pharmacological treatments (e.g. antiplatelets, angiotensin-converting enzyme inhibitors, statins and beta-blockers). Yoga, therefore, could provide a useful frame work on which to develop an economical CR program, with additional advantages of being culturally appropriate to Indians and potentially be appealing to global population.Choroby układu sercowo-naczyniowego są główną przyczyną zgonów i niepełnosprawności mieszkańców Indii, a ponadto mają ogromny wpływ psychologiczny i ekonomiczny, ponieważ często dotykają 30- i 40-latków, wcześniej niechorujących, którzy stanowią najbardziej produktywną grupę społeczną. Skuteczne techniki przezcewnikowe otworzyły nowe perspektywy w leczeniu tych chorób, jednak nie mogą zapobiec ich nawrotom. Z tego względu podstawowe znaczenie ma prewencja wtórna. Rehabilitacja kardiologiczna oparta na jodze (Yoga-CaRe) to wielopłaszczyznowe podejście oddziałujące na sferę fizyczną, psychiczną, społeczną i zawodową, którego celem jest zapobieganie lub spowalnianie progresji choroby podstawowej i obniżenie ryzyka ponownej hospitalizacji lub zgonu, a także poprawa komfortu życia i zachowanie pełnej aktywności. Joga to starożytny hinduski system filozoficzny, którego istotą jest dyscyplina ciała i umysłu i który obejmuje szereg reguł filozoficznych oraz ćwiczeń mentalnych i fizycznych. Spośród siedmiu głównych odmian jogi najbardziej znaną jest Hatha yoga, która również obejmuje wiele różnych rodzajów (tj. Iyenger, Ashtanga etc.) i łączy element ćwiczeń fizycznych, kontroli oddechu i medytacji z samoograniczeniami (dotyczącymi diety, palenia tytoniu, spożywania alkoholu i snu). W przeglądzie danych dostępnych w bazie Cochrane wykazano, że rehabilitacja kardiologiczna (CR) powoduje zmniejszenie o 27% śmiertelności całkowitej oraz o 19% śmiertelności całkowitej i zdarzeń sercowych niezakończonych zgonem, a więc pozwala uzyskać korzystniejsze efekty niż skuteczna farmakoterapia (tj. leki przeciwpłytkowe, inhibitory konwertazy angiotensyny, statyny i antagoniści receptorów beta-adrenergicznych). Joga może być użyteczna jako podstawa do opracowania ekonomicznego program CR, a jej dodatkowym atutem jest zgodność z kulturą Indii i popularność na całym świecie