Peningkatan Keterampilan Membaca Pemahaman dengan Strategi Membaca Know-want-learn (K-w-l) Bagi Siswa Kelas IV Sdn Made 4 Lamongan

Tujuan penelitian ini untuk mendeskripsikan pelaksanaan pembelajaran keterampilan membaca pemahaman dengan menerapkan strategi KWL pada siswa kelas IV SDN Made 4 Lamongan. hasil belajar siswa tentang keterampilan membaca pemahaman, serta kendala-kendala yang terjadi dalam pelaksanaan pembelajaran membaca dan cara mengatasinya. Penelitian ini menggunakan rancangan Penelitian Tindakan Kelas (PTK), yang dilakukan dengan dua siklus. Teknik pengumpulan data dalam penelitian ini adalah menggunakan lembar observasi, lembar tes untuk siswa, dan lembar catatan lapangan. Teknik analisis data diperoleh berupa data kualitatif dan data kuantitatif. Hasil penelitian menunjukkan bahwa pelaksanaan pembelajaran membaca pemahaman dengan menerapkan strategi membaca KWL pada siswa kelas IV SDN Made 4 Lamongan meningkat. Persentase keterlaksanaan pembelajaran pada siklus I mencapa 100% dan pada siklus II mencapai 100%. Sementara itu, nilai ketercapaian pada siklus I adalah 68,11 dan pada siklus II mencapai 85,72. Adapun ketuntasan klasikal pada siklus I adalah 54,6% dan pada siklus II 84,8%. Kendala-kendala yang muncul selama penelitian antara lain: Guru tidak dapat mengkondisikan siswa dengan baik, pada saat mengerjakan LKS hanya siswa yang pintar yang dominan dalam mengerjakan soal, dan media pembelajaran yang kurang memadai sehingga siswa yang duduk di bangku belakan tidak dapat melihat gambar dengan jelas. Jadi, dapat disimpulkan bahwa penerapan strategi membaca pemahaman menggunakan strategi KWL dapat meningkatkan keterampilan memahami bacaan serta dapat meningkatkan keterampilan siswa untuk menuliskan kembali isi bacaan menggunakan kata-katanya sendiri. Untuk itu, disarankan kepada guru kelas IV SDN Made 4 Lamongan pada pelaksanaan pembelajaran memahami isi bacaan dengan menggunakan strategi KWL

Low-temperature specific heat of real crystals: Possibility of leading contribution of optical and short-wavelength acoustical vibrations

We point out that the repeatedly reported glass-like properties of crystalline materials are not necessarily associated with localized (or quasilocalized) excitations. In real crystals, optical and short-wavelength acoustical vibrations remain damped due to defects down to zero temperature. If such a damping is frequency-independent, e.g. due to planar defects or charged defects, these optical and short-wavelength acoustical vibrations yield a linear-in-$T$ contribution to the low-temperature specific heat of the crystal lattices. At low enough temperatures such a contribution will prevail over that of the long-wavelength acoustical vibrations (Debye contribution). The crossover between the linear and the Debye regime takes place at $T^* \propto \sqrt N$, where $N$ is the concentration of the defects responsible for the damping. Estimates show that this crossover could be observable.Comment: 5 pages. v4: Error in Appendix corrected, which does not change the main results of the pape

Reaction ⁶Li(p, Δ⁺⁺)⁶He At 1.04 GeV And The Δ−N Interaction

The reaction ⁶Li(p, Δ⁺⁺)⁶He has been studied at 1.04 GeV for transferred momenta ranging from 0.11 to 0.35 (GeV/c)2. An exponential decrease of the cross section is observed. A Glauber-type calculation is presented. The possibility of extracting information on σ(ΔN) and α(ΔN) is discussed

Toxic Epidermal Necrolysis after Pemetrexed and Cisplatin for Non-Small Cell Lung Cancer in a Patient with Sharp Syndrome

Background: Pemetrexed is an antifolate drug approved for maintenance and second-line therapy, and, in combination with cisplatin, for first-line treatment of advanced nonsquamous non-small cell lung cancer. The side-effect profile includes fatigue, hematological and gastrointestinal toxicity, an increase in hepatic enzymes, sensory neuropathy, and pulmonary and cutaneous toxicity in various degrees. Case Report: We present the case of a 58-year-old woman with history of Sharp's syndrome and adenocarcinoma of the lung, who developed toxic epidermal necrolysis after the first cycle of pemetrexed, including erythema, bullae, extensive skin denudation, subsequent systemic inflammation and severe deterioration in general condition. The generalized skin lesions occurred primarily in the previous radiation field and responded to immunosuppressive treatment with prednisone. Conclusion: Although skin toxicity is a well-known side effect of pemetrexed, severe skin reactions after pemetrexed administration are rare. Caution should be applied in cases in which pemetrexed is given subsequent to radiation therapy, especially in patients with pre-existing skin diseases

Predictors and Implications of Early Clinical Stability in Patients Hospitalized for Moderately Severe Community-Acquired Pneumonia.

Assessment of early response to treatment is crucial for the management of community-acquired pneumonia (CAP). To describe the predictors and the outcomes of early clinical stability. We did a secondary analysis of a multicentre randomized controlled trial on CAP treatment in which 580 patients hospitalized for moderately severe CAP were included. The association between demographic, clinical and biological variables available at inclusion and early clinical stability (stabilization of vital signs within 72 hours with predetermined cut-offs) was assessed by multivariate logistic regression. The association between early clinical stability and mortality, severe adverse events, and length of stay was also tested. Younger age (OR 0.98, 95% CI 0.96-0.99), lower platelet count (OR per 10 G/L increment 0.96, 95% CI 0.94-0.98), lower respiratory rate (OR 0.94, 95% CI 0.90-0.97), absence of hypoxemia (OR 0.58, 95% CI 0.40-0.85), lower numbers of co-morbid conditions (OR 0.82, 95% CI 0.69-0.98) and signs or symptoms (OR 0.78, 95% CI 0.68-0.90) were significantly associated with early clinical stability. Patients with early clinical stability had lower 90-days mortality (3.4% vs. 11.9%, p<0.001), fewer admissions to the intensive care unit (2.7% vs. 8.0%, p = 0.005) and a shorter length of stay (6.0 days, IQR 4.0-10.0 vs. 10.0 days, IQR 7.0-15.0, p<0.001). Patients with younger age, less co-morbidity, fewer signs or symptoms, less respiratory compromise, and a lower platelet count are more likely to reach early clinical stability. Patients without early clinical stability have a worse prognosis and warrant close scrutiny

Participatory analysis for adaptation to climate change in Mediterranean agricultural systems: possible choices in process design (versão Pre Print)

There is an increasing call for local measures to adapt to climate change, based on foresight analyses in collaboration with actors. However, such analyses involve many challenges, particularly because the actors concerned may not consider climate change to be an urgent concern. This paper examines the methodological choices made by three research teams in the design and implementation of participatory foresight analyses to explore agricultural and water management options for adaptation to climate change. Case studies were conducted in coastal areas of France, Morocco, and Portugal where the groundwater is intensively used for irrigation, the aquifers are at risk or are currently overexploited, and a serious agricultural crisis is underway. When designing the participatory processes, the researchers had to address four main issues: whether to avoid or prepare dialogue between actors whose relations may be limited or tense; how to select participants and get them involved; how to facilitate discussion of issues that the actors may not initially consider to be of great concern; and finally, how to design and use scenarios. In each case, most of the invited actors responded and met to discuss and evaluate a series of scenarios. Strategies were discussed at different levels, from farming practices to aquifer management. It was shown that such participatory analyses can be implemented in situations which may initially appear to be unfavourable. This was made possible by the flexibility in the methodological choices, in particular the possibility of framing the climate change issue in a broader agenda for discussion with the actors

β-Lactam Monotherapy vs β-Lactam-Macrolide Combination Treatment in Moderately Severe Community-Acquired Pneumonia: A Randomized Noninferiority Trial.

IMPORTANCE: The clinical benefit of adding a macrolide to a β-lactam for empirical treatment of moderately severe community-acquired pneumonia remains controversial. OBJECTIVE: To test noninferiority of a β-lactam alone compared with a β-lactam and macrolide combination in moderately severe community-acquired pneumonia. DESIGN, SETTING, AND PARTICIPANTS: Open-label, multicenter, noninferiority, randomized trial conducted from January 13, 2009, through January 31, 2013, in 580 immunocompetent adult patients hospitalized in 6 acute care hospitals in Switzerland for moderately severe community-acquired pneumonia. Follow-up extended to 90 days. Outcome assessors were masked to treatment allocation. INTERVENTIONS: Patients were treated with a β-lactam and a macrolide (combination arm) or with a β-lactam alone (monotherapy arm). Legionella pneumophila infection was systematically searched and treated by addition of a macrolide to the monotherapy arm. MAIN OUTCOMES AND MEASURES: Proportion of patients not reaching clinical stability (heart rate <100/min, systolic blood pressure >90 mm Hg, temperature <38.0°C, respiratory rate <24/min, and oxygen saturation >90% on room air) at day 7. RESULTS: After 7 days of treatment, 120 of 291 patients (41.2%) in the monotherapy arm vs 97 of 289 (33.6%) in the combination arm had not reached clinical stability (7.6% difference, P = .07). The upper limit of the 1-sided 90% CI was 13.0%, exceeding the predefined noninferiority boundary of 8%. Patients infected with atypical pathogens (hazard ratio [HR], 0.33; 95% CI, 0.13-0.85) or with Pneumonia Severity Index (PSI) category IV pneumonia (HR, 0.81; 95% CI, 0.59-1.10) were less likely to reach clinical stability with monotherapy, whereas patients not infected with atypical pathogens (HR, 0.99; 95% CI, 0.80-1.22) or with PSI category I to III pneumonia (HR, 1.06; 95% CI, 0.82-1.36) had equivalent outcomes in the 2 arms. There were more 30-day readmissions in the monotherapy arm (7.9% vs 3.1%, P = .01). Mortality, intensive care unit admission, complications, length of stay, and recurrence of pneumonia within 90 days did not differ between the 2 arms. CONCLUSIONS AND RELEVANCE: We did not find noninferiority of β-lactam monotherapy in patients hospitalized for moderately severe community-acquired pneumonia. Patients infected with atypical pathogens or with PSI category IV pneumonia had delayed clinical stability with monotherapy. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00818610

Modeling Ecosystems Using P Systems: The Bearded Vulture, a Case Study

The Bearded Vulture (Gypaetus barbatus) is an endangered species in Europe that feeds almost exclusively on bone remains of wild and domestic ungulates. In this paper, we present a model of an ecosystem related to the Bearded Vulture in the Pyrenees (NE Spain), by using P systems. The evolution of six species is studied: the Bearded Vulture and five subfamilies of domestic and wild ungulates upon which the vulture feeds. P systems provide a high level computational modeling framework which integrates the structural and dynamic aspects of ecosystems in a comprehensive and relevant way. P systems explicitly represent the discrete character of the components of an ecosystem by using rewriting rules on multisets of objects which represent individuals of the population and bones. The inherent stochasticity and uncertainty in ecosystems is captured by using probabilistic strategies. In order to experimentally validate the P system designed, we have constructed a simulator that allows us to analyze the evolution of the ecosystem under different initial conditions.Ministerio de Educación y Ciencia TIN2006-13425Junta de Andalucía TIC-58

Production of Medical Radioisotopes with High Specific Activity in Photonuclear Reactions with γ\gamma Beams of High Intensity and Large Brilliance

We study the production of radioisotopes for nuclear medicine in $(\gamma,x{\rm n}+y{\rm p})$ photonuclear reactions or ($\gamma,\gamma'$) photoexcitation reactions with high flux [($10^{13}-10^{15}$)$\gamma$/s], small diameter $\sim (100 \, \mu$m$)^2$ and small band width ($\Delta E/E \approx 10^{-3}-10^{-4}$) $\gamma$ beams produced by Compton back-scattering of laser light from relativistic brilliant electron beams. We compare them to (ion,$x$n$+ y$p) reactions with (ion=p,d,$\alpha$) from particle accelerators like cyclotrons and (n,$\gamma$) or (n,f) reactions from nuclear reactors. For photonuclear reactions with a narrow $\gamma$ beam the energy deposition in the target can be managed by using a stack of thin target foils or wires, hence avoiding direct stopping of the Compton and pair electrons (positrons). $(\gamma,\gamma')$ isomer production via specially selected $\gamma$ cascades allows to produce high specific activity in multiple excitations, where no back-pumping of the isomer to the ground state occurs. We discuss in detail many specific radioisotopes for diagnostics and therapy applications. Photonuclear reactions with $\gamma$ beams allow to produce certain radioisotopes, e.g. $^{47}$Sc, $^{44}$Ti, $^{67}$Cu, $^{103}$Pd, $^{117m}$Sn, $^{169}$Er, $^{195m}$Pt or $^{225}$Ac, with higher specific activity and/or more economically than with classical methods. This will open the way for completely new clinical applications of radioisotopes. For example $^{195m}$Pt could be used to verify the patient's response to chemotherapy with platinum compounds before a complete treatment is performed. Also innovative isotopes like $^{47}$Sc, $^{67}$Cu and $^{225}$Ac could be produced for the first time in sufficient quantities for large-scale application in targeted radionuclide therapy.Comment: submitted to Appl. Phys.

Synthesis of bis(ethylenedithio)tetrathiafulvalene (BEDT-TTF) derivatives functionalised with two, four or eight hydroxyl groups

Short synthetic routes to a range of BEDT-TTF derivatives functionalised with two, four or eight hydroxyl groups are reported, of interest because of their potential for introducing hydrogen bonding between donor and anion into their radical cation salts. The cycloaddition of 1,3-dithiole-2,4,5-trithione with alkenes to construct 5,6-dihydro-1,3-dithiolo[4,5-b]1,4-dithiin-2-thiones is a key step, with homo- or hetero-coupling procedures and O-deprotection completing the syntheses. The first synthesis of a single diastereomer of tetrakis(hydroxymethyl)BEDT-TTF, the cis, trans product, was achieved by careful choice of O-protecting groups to facilitate separation of homo- and hetero-coupled products. Cyclisation of the trithione with enantiopure 1R,2R,5R,6R-bis(O,O-isopropylidene)hex-3-ene-1,2,5,6-tetrol (from D-mannitol) gave two separable diastereomeric thiones, which can be transformed to enantiomeric BEDT-TTF derivatives with four or eight hydroxyl groups