Warner University

This research was motivated by students’ low level of, proven by the fact that students rarely visit the school library and they prefer holding cellphones rather than books every day. They access the internet and watch videos on social media than reading and analyzing news or information related to their needs. This research uses qualitative research with in-depth descriptive analysis and is supported by the results of survey data filled in by students from two inclusive schools (SMKN 3 Probolinggo and SMKN 2 Malang, East Java). The research results show that the application of the project can be a solution to the civic literacy problem of students. The project citizen learning model is able to strengthen civic literacy by focuses on students’ understanding of good and correct information, public policies and governmental processes, and their rights and obligations as local citizens and citizens of the world.

Abstract As the severity of extreme precipitation events increases with global climate change, so will episodic pulses of contamination into lotic systems. Periphytic algae represent bioindicator species in most freshwater systems due to their rapid accumulation of toxicants, therefore, it is vital to understand how accumulation differs across temporally variable exposure regimes. This ability to rapidly accrue contaminants additionally has implications for the trophic transfer of metals to primary consumers. While dietary toxicity has been studied in algivorous consumers, techniques used to prepare contaminated periphytic algae for consumption have not been compared. This study used a modified subcellular fractionation method to compare the partitioning of Zinc (Zn) in periphyton cultures exposed for variable durations (cultured in the presence of Zn and 15 min, 24 hr, and 48 hr exposures). Three exposure groups were additionally depurated over a period of 24 hr in order to compare retention of Zn; an important aspect of preparing diets used in dietary toxicity studies. Results not only provide evidence for increased retention by periphytic algae cultured in the presence of Zn but reveal relationships among treatments and subcellular partitioning that suggest time-dependent accumulation and detoxification. These relationships ultimately suggest that episodic exposure of periphytic algae to contaminants may pose a greater risk than that of chronic regimes. Based on these results, we additionally advocate for the culturing of periphytic algae in the presence of contamination in order to produce a more reliable diet for dietary exposure testing in algivorous organisms.

Introduction: Due to conduction disease and dyssynchrony in transthyretin amyloid cardiomyopathy (ATTR-CM), cardiac resynchronization therapy (CRT) may be beneficial. We aimed to determine the impact of CRT on clinical outcomes in ATTR-CM. Methods: We studied 116 consecutive ATTR-CM patients, 23 of whom underwent CRT (70% CRT + defibrillator, median 10 months (IQR 4-20) from ATTR-CM diagnosis). Outcome was a composite of 1 st cardiovascular hospitalization or all-cause mortality. CRT was treated as a time dependent co-variate and entered into multivariate Cox proportional hazards model. Results: Both groups were similar at diagnosis except for a higher proportion with atrial fibrillation (AF) and lower ejection fraction among those who underwent CRT ( Table 1) . CRT indication in 80% was progressive LV dysfunction with wide QRS [mean 152 ± 36 msec] and the remaining at time of AV node ablation for AF. Half of CRT group were ≥ NYHA class III at device implantation. Older age, higher National Amyloidosis Cohort (NAC) ATTR stage, and not taking tafamidis were significantly associated with the outcome. On multivariate analysis, CRT was associated with a HR of 0.6 (95% CI: 0.32 - 1.16) for all-cause mortality or cardiovascular hospitalization after adjusting for age at diagnosis, NAC ATTR stage, and tafamidis use ( Figure 1). Conclusion: CRT implantation maybe associated with improved outcomes in ATTR-CM. Larger prospective randomized, sham-controlled trials are warranted to confirm these findings.

A review of Sudin, S. (2016). Anchor in the storm. Grand Rapids, MI: Revell. 393 pp. $14.99. ISBN 9780800723439

BackgroundA 1.5‐day interactive forum was convened to discuss critical issues in the acquisition, analysis, and sharing of data in the field of cardiovascular and stroke science. The discussion will serve as the foundation for the American Heart Association's (AHA's) near‐term and future strategies in the Big Data area. The concepts evolving from this forum may also inform other fields of medicine and science.Methods and ResultsA total of 47 participants representing stakeholders from 7 domains (patients, basic scientists, clinical investigators, population researchers, clinicians and healthcare system administrators, industry, and regulatory authorities) participated in the conference. Presentation topics included updates on data as viewed from conventional medical and nonmedical sources, building and using Big Data repositories, articulation of the goals of data sharing, and principles of responsible data sharing. Facilitated breakout sessions were conducted to examine what each of the 7 stakeholder domains wants from Big Data under ideal circumstances and the possible roles that the AHA might play in meeting their needs. Important areas that are high priorities for further study regarding Big Data include a description of the methodology of how to acquire and analyze findings, validation of the veracity of discoveries from such research, and integration into investigative and clinical care aspects of future cardiovascular and stroke medicine. Potential roles that the AHA might consider include facilitating a standards discussion (eg, tools, methodology, and appropriate data use), providing education (eg, healthcare providers, patients, investigators), and helping build an interoperable digital ecosystem in cardiovascular and stroke science.ConclusionThere was a consensus across stakeholder domains that Big Data holds great promise for revolutionizing the way cardiovascular and stroke research is conducted and clinical care is delivered; however, there is a clear need for the creation of a vision of how to use it to achieve the desired goals. Potential roles for the AHA center around facilitating a discussion of standards, providing education, and helping establish a cardiovascular digital ecosystem. This ecosystem should be interoperable and needs to interface with the rapidly growing digital object environment of the modern‐day healthcare system.

To present a case of ultrasonic diagnosis and nonoperative management of a complete proximal rectus femoris avulsion in a National Collegiate Athletic Association Division 1 soccer goalkeeper. While delivering a goal kick, a previously uninjured 24-year-old collegiate soccer goalkeeper had the sudden onset of right anterior thigh pain. He underwent rehabilitation with rapid resolution of his presenting pain but frequent intermittent recurrence of anterior thigh pain. After he was provided a definitive diagnosis with musculoskeletal ultrasound, he underwent an extended period of rehabilitation and eventually experienced complete recovery without recurrence. Rectus femoris avulsion, rectus femoris strain or partial tear, inguinal hernia, or acetabular labral tear. Operative and nonoperative options were discussed. In view of the player's recovery, nonoperative options were pursued with a good result. Complete proximal rectus femoris avulsions are rare. Our case contributes to the debate on whether elite-level kicking and running athletes can return to full on-field performance without surgery. Complete proximal rectus femoris avulsions can be treated effectively using nonoperative measures with good preservation of function even in the elite-level athlete. In addition, musculoskeletal ultrasound is an excellent tool for on-site evaluation and may help guide prognosis and management.