Penghambatan Pertumbuhan Aspergillus Flavus Dan Fusarium Moniliforme Oleh Ekstrak Seruni (Wedelia Biflora) Dan Kembang Bulan (Tithonia Diversifolia)

The growth inhibition of Aspergillus flavus and Fusarium moniliforme by extract of seruni (Wedelia biflora) and Kembang bulan (Tithonia diversifolia) has studied. Kirby-Bauer disc diffusion were used in this experiment. The leaf methanolic extracts prepared were 0, 5, 10, 15, 30, 40, 50, 60 and 70% with dimethyl sulfoxide as the solvent. The results showed that extract of seruni and kembang bulan has a different activity in inhibiting the growth of both fungus. Seruni extract showed lower activity in inhibiting A. flavus and F. moniliforme than kembang bulan. In 40% seruni inhibits the growth both of the fungus. While kembang bulan showed activity in inhibiting A. flavus and F. moniliforme in 5%

Penghambatan Pertumbuhan Aspergillus Flavus dan Fusarium Moniliforme oleh Ekstrak Salam (Eugenia Polyantha) dan Kunyit (Curcuma Domestica)

Growth inhibition of Aspergillus flavus and Fusarium moniliforme by leaf extract of salam (Eugenia polyantha) and turmeric (Curcuma domestica) was studied. Kirby-Bauer disc diffusion method was used in this experiment. The plant extracts used were 0, 5, 10, 15, 30, 40, 50, 60 and 70% and dimethyl sulfoxide (DMSO) as a solvent. The result showed that the E. polyantha and C. domestica have a different activity in inhibiting the growth of A. flavus. The leaf extract of turmeric showed lower activity inhibiting A. flavus and F. moniliforme than that of E.polyantha. In 5% E. polyantha inhibits the growth both of the fungus. While C. domestica showed activity inhibiting A. flavus in 5 % and F. moniliforme in 40 %

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Analisa Kemampuan Mengajar Guru Matematika dalam Beradaptasi dengan Kurikulum Baru untuk Meningkatkan Performa Belajar Siswa

One major concern in mathematics education in Indonesia is poor performance of student. This low achievement appears both in the National Assessment (UN) and International comparative study such as PISA and TIMSS. Many reasons have been advanced to explain these phenomena. Among the serious reasons are teacher instructions approach which much rely on traditional method, lack of mathematics activity doing by students in the classroom, lack of learning resources, and low motivation of teacher to face new change in 21th century education. Therefore, the aim of this study is to analyze teachers' teaching practice in mathematics classroom to find the actual their problems so that the solution can be suggest. The study also discuss how rich mathematical tasks could be a potential solution for the problem. 10 mathematics teachers and 302 students from 6 junior high schools in Banda Aceh were involved in the survey. The study fond that the majority of teachers start using problem solving approach in teaching mathematics (74%), but the teaching process stil lacks to promote some subtansial aspects of peoblem based learning that such as mathematical connection, reasoning, and reflective thinking. The study also found that teachers mainly use text book provided by the ministry of education (87%) and their ability to desain students activities stil low. This indicates that the teacher face the real problem in conducting learning activities as mandated by new curriculum. The study suggests the rich tasks as a new approach to improve teachers' teaching practice as well as to enhance students' mathematics performance. AbstrackSalah satu desain task yang dapat dikembangkan guru adalah rich task. Beberapa penelitian menujukkan bahwa rich task mampu meningkatkan prestasi belajar siswa. Akan tetapi pendekatan ini jarang digunakan dalam pembelajaran matematika dengan berbagai alasan, sala satunya adalah kurangnya pemahaman guru mengenai pendekatan rich task. Oleh karena itu guru perlu dibekali dengan pendekatan ini agar prestasi belajar siswa dapat ditingkatkan. Penelitian ini untuk melakukan analisis awal mengenai berbagai kondisi objektif pembelajaran serta keadaan guru secara menyeluruh sehingga proses kolaborasi dalam mendesain kegiatan pembelajaran rich task selanjutnya akan dapat berjalan lancar. Hasil penelitian menunjukkan bahwa Guru matematika SMP di Kota Banda Aceh telah memiliki pengetahuan yang cukup untuk menjalankan profesinya sebagai pendidik matematika. Akan tetapi karena factor usia serta rendahnya tingkat kemanfaatan dari pelatihan yang dikuti dalam pembelajaran matematika sehari-hari menyebabkan proses pembelajaran matematika masih kurang melibatkan siswa untuk mengembangkan kemampuan berpikir tingkat tingginya. Aktivitas pembelajaran yang berorientasi pada kemampuan-kemampuan matematis seperti kemampuan koneksi dan berpikir reflektif jarang sekali dimunculkan

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease