Pengaruh Permainan Huruf Punggung Berantai terhadap Motivasi Belajar Anak dalam Menulis Huruf Usia 5-6 Tahun di Ra Al-amin Duri

Based on the results of preliminary observations in RA Amin Al-Duri, in learning magazines media always use early childhood. This instructional media used by teachers almost every day and causing her special children's learning motivation in writing the letter to be low as the lack of enthusiastic children in the activities of writing letters, the child looks bored in the activities of writing letters, and many children do not finish writing letters activities given by the teacher . So that the results obtained from the learning becomes less than optimal. To increase motivation to learn her special child in writing letters, researchers used a game. The purpose of this study was to determine whether there was an effect chain backs letter game against the child's learning motivation in writing the letter aged 5-6 years in RA Al-Amin Duri. The population in this study was the son of RA Al-Amin aged 5-6 years in B2 class of 20 children were held in April 2014. Data collection methods used in this study is the observation of pre-test and post-test. Data analysis was performed using t-test statistics with SPSS for windows release.17. From the results obtained, there are significant differences between children's learning motivation in writing the letters before and after treatment. It can be seen from the price of t -24 314 crashed at the reception Ha when the price t table = 1.734 and using test two parties with 5% error level. Based on the results of observational data processing motivation to learn to write letters pre-test and post-test, the pre-test phase obtained a percentage of 48.54%. After being given a treatment in the form of the game back a chain letter, the post-test phase obtained a percentage of 82.91%. This suggests that the motivation to learn to write letters rose by 34.37%

Automated radiofrequency-based US measurement of common carotid intima-media thickness in RA patients treated with synthetic vs synthetic and biologic DMARDs

Objective. To compare the carotid intima-media thickness (IMT) assessed with automated radiofrequency-based US in RA patients treated with synthetic vs synthetic and biologic DMARDs and controls. Methods. Ninety-four RA patients and 94 sex-and age-matched controls were prospectively recruited at seven centres. Cardiovascular (CV) risk factors and co-morbidities, RA characteristics and therapy were recorded. Common carotid artery (CCA)-IMT was assessed in RA patients and controls with automated radiofrequency-based US by the same investigator at each centre. Results. Forty-five (47.9%) RA patients had been treated with synthetic DMARDs and 49 (52.1%) with synthetic and biologic DMARDs. There were no significant differences between the RA patients and controls in demographics, CV co-morbidities and CV disease. There were significantly more smokers among RA patients treated with synthetic and biologic DMARDs (P = 0.036). Disease duration and duration of CS and synthetic DMARD therapy was significantly longer in RA patients treated with synthetic and biologic DMARDs (P<0.0005). The mean CCA-IMT was significantly greater in RA patients treated only with synthetic DMARDs than in controls [591.4 (98.6) vs 562.1 (85.8); P = 0.035] and in RA patients treated with synthetic and biologic DMARDs [591.4 (98.6) vs 558.8 (95.3); P = 0.040). There was no significant difference between the mean CCA-IMT in RA patients treated with synthetic and biologic DMARDs and controls (P = 0.997). Conclusion. Our results suggest that radiofrequency-based measurement of CCA-IMT can discriminate between RA patients treated with synthetic DMARDs vs RA patients treated with synthetic and biologic DMARDs

Management of rheumatoid arthritis: consensus recommendations from the Hong Kong Society of Rheumatology

Given the recent availability of novel biologic agents for the treatment of rheumatoid arthritis (RA), the Hong Kong Society of Rheumatology has developed consensus recommendations on the management of RA, which aim at providing guidance to local physicians on appropriate, literature-based management of this condition, specifically on the indications and monitoring of the biologic disease-modifying anti-rheumatic drugs (DMARDs). The recommendations were developed using the European League Against Rheumatism (EULAR) recommendations for the management of early arthritis as a guide, along with local expert opinion. As significant joint damage occurs early in the course of RA, initiating therapy early is key to minimizing further damage and disability. Patients with serious disease or poor prognosis should receive early, aggressive therapy. Because of its good efficacy and safety profile, methotrexate is considered the standard first-line DMARD for most treatment-naïve RA patients. Patients with a suboptimal response to methotrexate monotherapy should receive step-up (combination) therapy with either the synthetic or biologic DMARDs. In recent years, combinations of methotrexate with tocilizumab, abatacept, or rituximab have emerged as effective therapies in patients who are unresponsive to traditional DMARDs or the anti-tumor necrosis factor (TNF)-α agents. As biologic agents can increase the risk of infections such as tuberculosis and reactivation of viral hepatitis, screening for the presence of latent tuberculosis and chronic viral hepatitis carrier state is recommended before initiating therapy

XML data clustering: An overview

In the last few years we have observed a proliferation of approaches for clustering XML docu- ments and schemas based on their structure and content. The presence of such a huge amount of approaches is due to the different applications requiring the XML data to be clustered. These applications need data in the form of similar contents, tags, paths, structures and semantics. In this paper, we first outline the application contexts in which clustering is useful, then we survey approaches so far proposed relying on the abstract representation of data (instances or schema), on the identified similarity measure, and on the clustering algorithm. This presentation leads to draw a taxonomy in which the current approaches can be classified and compared. We aim at introducing an integrated view that is useful when comparing XML data clustering approaches, when developing a new clustering algorithm, and when implementing an XML clustering compo- nent. Finally, the paper moves into the description of future trends and research issues that still need to be faced