Working Group Research Articles

Effectiveness of a Multifaceted Intervention (TEMP) for Prevention of Occupational Heat-Related Illness among Outdoor Workers in the Power Grid Industry: A Cluster Randomized Controlled Trial.

Occupational heat-related illness (OHI) is a health threat to workers that can be fatal in severe cases. Effective and feasible measures are urgently needed to prevent OHI. We evaluated the effectiveness of a multifaceted intervention, TEMP, in reducing the OHI risk among outdoor workers in the power grid industry. A cluster randomized controlled trial was conducted with power grid outdoor workers in Southern China from 4 July 2022 to 28 August 2022. Work groups were randomly allocated (1:1) to the intervention or control groups. The multifaceted intervention TEMP comprised mobile application (app)-based education training (T), personal protective equipment [PPE (E)], OHI risk monitoring (M), and educational posters (P). Four follow-ups were conducted every 2 wk after the trial began. The primary outcome was the OHI incidence, and the secondary outcome was PPE usage. The app usage was considered as the compliance of intervention in the intervention group. The primary analysis used was intention-to-treat analysis. Multilevel analyses using random effects logistic regression models were performed to compare the odds of OHI between the two groups, adjusted for individual-level (education and work position) and work-related (including water intake when feeling thirsty, cooling measures, and poor sleep before work) covariates. Of 528 participants, 422 (79.92%) were males, and the age was y. The primary outcome, OHI incidence, was 1.80% in the intervention group and 4.82% in the control group at the end of the whole follow-up. OHI mainly occurred between 1100 and 1500 hours, with nausea, significantly increased heart rate, and oliguria being the top three reported OHI symptoms. Compared with the control group, the adjusted odds ratios between the intervention group and control group were 0.73 [95% confidence interval (CI): 0.30, 1.76] in the first follow-up wave, with 0.38 (95% CI: 0.15, 0.97), 0.29 (95% CI: 0.08, 1.05), and 0.39 (95% CI: 0.13, 1.19) in the following three follow-up waves, respectively. The intervention also significantly improved PPE usage in the intervention group. This multifaceted intervention reduced the OHI risk among outdoor workers in the power grid industry. However, further research is needed to design a more flexible intervention strategy and evaluate its effectiveness in a larger population. https://doi.org/10.1289/EHP14172.

Appropriate Use Criteria for Neoplastic Compression Fractures.

Clinical outcomes are directly related to patient selection and treatment indications for improved quality of life. With emphasis on quality and value, it is essential that treatment recommendations are optimized. The purpose of the North American Spine Society (NASS) Appropriate Use Criteria (AUC) is to determine the appropriate (ie, reasonable) multidisciplinary treatment recommendations for patients with metastatic neoplastic vertebral fractures across a spectrum of more common clinical scenarios. A Modified Delphi process. Systematic Review OUTCOME MEASURES: Final rating for cervical fusion recommendation as either "Appropriate", "Uncertain", or "Rarely Appropriate" based on the median final rating among the raters. The methodology was based on the AUC development process established by the Research AND Development (RAND) Corporation. The topic of neoplastic vertebral fracture was selected by NASS for its Clinical Practice Guideline development (CPG). In conjunction, the AUC work group determined key modifiers and adopted the standard definitions developed by CPG, with minimal modifications. A literature search and evidence analysis performed by the CPG were reviewed by the AUC work group. A separate multidisciplinary rating group was assembled. Based on the literature, provider experience, and group discussion, each scenario was scored on a nine-point scale on two separate occasions, once without discussion and then a second time following discussion based on the initial responses. The median rating for each scenario was then used to determine if indications were rarely appropriate (1 - 3), uncertain / maybe appropriate (4-6), or appropriate (7-9). Consensus was not mandatory. Medical management was essentially always appropriate. Radiation therapy was appropriate 50% of the time and uncertain otherwise, and directly related to radiosensitivity of the tumor. Ablation was never rated appropriate with agreement, and about 50% of the time was rated as uncertain. For cement augmentation, the scenarios without stenosis or neurological changes, stable fractures with less than 80% height loss and intact posterior wall, and higher VAS pain scores accounted for 88% probability of an appropriate rating. Otherwise, cement augmentation was uncertain 68% of the time. Surgery was rated as appropriate with agreement in 35%, and uncertain or appropriate with disagreement in 59% of scenarios. The most important variables determining final rating for surgery (in order) were stability, spinal stenosis, and prognosis. Multidisciplinary appropriate treatment criteria were generated based on the RAND methodology. Recommendations were made for medical treatment, ablation, radiation, cement augmentation, and surgery based on 432 practical clinical scenarios. This document provides comprehensive evidence-based recommendations for evaluation and treatment of metastatic neoplastic vertebral fractures. The document in its entirety will be found on the NASS website (https://www.spine.org/Research-Clinical-Care/Quality-Improvement/Appropriate-Use-Criteria).

Insect Allergy: Barriers in Training and Practice: A Work Group Report of the AAAAI Anaphylaxis Committee

Insect Allergy: Barriers in Training and Practice: A Work Group Report of the AAAAI Anaphylaxis Committee

Transparency, Accountability, and Influence in the International Investment Law System

This article offers the first interdisciplinary critique of transparency in international investment law (“IIL”) that draws on transparency-skeptical and accountability scholarship in political science and public administration. Not only has the expansive IIL literature overlooked these disciplines, but much of it fails to define the core concept of transparency. Building on contributions from the fields of administrative law, international relations, and system theory in classic political science, we provide a novel functionalist account of transparency that traces a line from transparency to accountability to influence in the IIL system. We make three arguments. First, transparency involves access to data that must be interpreted by an enabled target audience. Second, transparency is not a good in itself but rather a means of advancing accountability, which in turn is designed to promote influence in the system; that is, transparency and accountability are both secondary rather than primary values. Third, transparency is best understood at a system level; a system framework highlights the multiplicity of actors making divergent demands for the creation or application of IIL rules and illuminates the distribution of influence and how that distribution may be shifted by systemic reforms. We apply the lessons from our conceptual discussion to explain the limited utility of recent transparency reforms in investor-state dispute settlement (“ISDS”) by key IIL institutions such as the United Nations Commission on International Trade Law (“UNCITRAL”), insofar as they rely on the public as the primary actor and agent of change in the IIL system. Beyond transparency-specific reforms, we also consider how our theory bears on broader ISDS reforms currently under review by UNCITRAL Working Group III, which has embarked on a historic mission to reform ISDS from the ground up.

The Issue of Attribution of Acts Committed in the Information Space

INTRODUCTION. Due to the recent trend related to the use of information and communication technologies by certain states with the aim to assert their geopolitical superiority, study of the issue of attribution of responsibility for acts committed in the information space as well as possible of responses to such attacks becomes even more relevant. Therefore, in the article the problems related to international responsibility, particularities of attacks in information space and ways to attribute such attacks, as well as effectiveness of international law are analyzed.MATERIALS AND METHODS. The research examines treaties, international customs, general widely recognized principles of international law, as well as resolutions, materials and documents of specialized working groups, and doctrine. General scientific and specific scientific methods of enquiry (methods of analysis and synthesis, deduction, induction, dialectical and formal legal methods) were used in the preparation of the study.RESEARCH RESULTS. The result of the conducted research is the conclusion that it is impossible to effectively regulate issues arising from the issue of attribution of acts committed in the information space exclusively with the current international law. Therefore, there is a need to develop a relevant international treaty taking into account the provisions of the concept of the UN Convention on International Information Security. At the same time, in order to effectively attribute an act, it is important to take into account the political, technical and legal elements of attribution of responsibility.DISCUSSION AND CONCLUSIONS. The article considers approaches to the issue of attribution of attacks in the information space as well as of possible ways of responding to such attacks within the framework of current international law. The problem of possible application of international humanitarian law, especially issue of interpretation of “attack” for the purposes of attacks in information space was also examined. In addition, the author analyzes the provisions of the concept of the UN Convention on International Information Security.The author concludes that current international law is not sufficient for effective attribution of an act committed in the information space. Elaboration of additional international legal regulation that would take into account the particularities of the information space is required. It is also crucial to develop international cooperation in this area, including through the creation of a global register of contact points.

Deep learning can detect elbow disease in dogs screened for elbow dysplasia.

Medical image analysis based on deep learning is a rapidly advancing field in veterinary diagnostics. The aim of this retrospective diagnostic accuracy study was to develop and assess a convolutional neural network (CNN, EfficientNet) to evaluate elbow radiographs from dogs screened for elbow dysplasia. An auto-cropping tool based on the deep learning model RetinaNet was developed for radiograph preprocessing to crop the radiographs to the region of interest around the elbow joint. A total of 7229 radiographs with corresponding International Elbow Working Group scoring were included for training (n=4000), validation (n=1000), and testing (n=2229) of CNN models for elbow diagnostics. The radiographs were classified in a binary manner as normal (negative class) or abnormal (positive class), where abnormal radiographs had various severities of osteoarthrosis and/or visible primary elbow dysplasia lesions. Explainable artificial intelligence analysis were performed on both correctly and incorrectly classified radiographs using VarGrad heatmaps to visualize regions of importance for the CNN model's predictions. The highest-performing CNN model showed excellent test accuracy, sensitivity, and specificity, all achieving a value of 0.98. Explainability analysis showed frequent highlighting along the margins of the anconeal process of both correctly and incorrectly classified radiographs. Uncertainty estimation using entropy to characterize the uncertainty of the model predictions showed that radiographs with ambiguous predictions could be flagged for human evaluation. Our study demonstrates robust performance of CNNs for detecting abnormal elbow joints in dogs screened for elbow dysplasia.

Conversion Therapy for Stage IV Gastric Cancer: Report From the Expert Consensus Meeting at KINGCA WEEK 2024.

Conversion therapy is a treatment strategy that shifts from palliative systemic therapy to curative surgical treatment for primary and/or metastatic stage IV gastric cancer (GC). To address its clinical statements, the Korean Gastric Cancer Association aims to present a consensus on conversion therapy among experts attending KINGCA WEEK 2024. The KINGCA Scientific Committee and Development Working Group for Korean Practice Guidelines prepared preformulated topics and 9 clinical statements for conversion therapy. The Delphi method was applied to a panel of 17 experts for consensus and opinions. The final comments were announced after the statement presentation and discussed during the consensus meeting session of KINGCA WEEK 2024. Most experts agreed that conversion therapy provides a survival benefit for selected patients who respond to systemic therapy and undergo R0 resection (88.3%). Patients with limited metastases were considered good candidates (94.2%). The optimal timing was based on the response to systemic therapy (70.6%). The regimen was recommended to be individualized (100%) and the duration to be at least 6 months (88.3%). A minimally invasive approach (82.3%) and D2 lymph node dissection (82.4%) were considered for surgery. However, resection for metastases with a complete clinical response after systemic therapy was not advocated (41.2%). All experts agreed on the need for large-scale randomized-controlled trials for further evidence (100%). Recent advancements in treatment may facilitate radical surgery for patients with stage IV GC. Further evidence is warranted to establish the safety and efficacy of conversion therapy.

Effects of aquatic exercise compared with land-based exercise on the body composition and function of older adults with sarcopenia: protocol for a randomised controlled trial

IntroductionSarcopenia is a condition that occurs more frequently in older adults. Although many types of exercise have been used in the treatment of sarcopenia, few studies have been conducted on...

Embracing anti-racism: Co-creating recommendations with Black people for how addiction treatment needs to change

In the United States, Black people face harsher health and social consequences of addiction compared to people who are not Black. These differential consequences are largely attributable to systemic racism. While addiction treatment may mitigate health disparities related to substance use, Black people also experience structural barriers and direct interpersonal racism which contribute to inequitable access and treatment outcomes. Improvements in addiction treatment for Black people are urgently needed, but there is little guidance or consensus on how to achieve this. Our interdisciplinary work group is comprised of 16 researchers and clinicians from one urban safety-net hospital in the Northeast US, and 9 community members with lived experience of substance use disorder (SUD) who came together from 2022 to 2024 for a community-engaged initiative to identify how to make addiction treatment more appealing, effective, and equitable for Black people. This paper's objective is two-fold. First, we provide a broad overview of the project, which included 6 scoping literature reviews, 7 focus groups, and 4 day-long convenings which included an additional 30 experts on addiction treatment for Black patients, drawn primarily from the Northeast U.S. Altogether, we engaged more than 70 people with expertise in substance use and treatment, the majority of whom identify as Black. Second, we present major findings from the convenings, where we identified actions that can be taken now to improve the care of Black people and challenge the racist features of our addiction treatment system. Making addiction treatment more appealing, effective, and equitable will help to achieve health equity for Black people who use substances.

Qualitative Assessment of Undergraduate Nursing Students' Perceptions of Combined Virtual Reality and Group Discussion Learning Interventions: A Focus Group Study

Context: The coronavirus disease 2019 (COVID-19) pandemic has forced major changes in the learning environment. The author’s institution created virtual reality (VR) learning content to enhance readiness for on-the-job training students by allowing them to enter situations and circumstances beyond traditional learning, experience simulations of target individuals, and think about the nursing assistance needed. The education combined VR and 360-degree video content with group discussions to increase learning depth. A qualitative analysis of the evaluations from the participating students’ perception was performed to obtain suggestions for future educational methods. Aim: This study aimed to elucidate how undergraduate nursing students perceive the effectiveness of education that combines VR learning content with group discussions. Methods: This qualitative descriptive study summarizes the educational effectiveness from data obtained through focus group interviews (FGI). In the data collection process, two focus group interviews were conducted with five nursing students at a nursing university in the Tokyo metropolitan area in March 2023, using an interview guide that was independently created. The study subjects participated in the nursing practical training and exercises that combined VR learning content with group discussions. Results: Based on the FGI of five participants, two main themes were identified, "educational effectiveness" and "challenges." Educational effectiveness" contains the following four subthemes as effects of the combination of VR learning content and group discussions: Opportunities to think about the experiences of patients receiving care and the ethical behavior of nurses, promotion of understanding of clinical situations that are normally inaccessible, opportunities for reflection through recollection of previous experiences, and expanding and deepening learning in group discussions. Moreover, "challenges" contains two subthemes: Introducing mechanisms and devices to enhance learning effectiveness and VR sickness while viewing the VR learning content. Conclusion: The introduction of VR learning interventions allows for the simulated experience of three-dimensional reconstructed scenes of places and situations that are normally inaccessible and is provided for learners to be useful as a learning opportunity intended to reconstruct knowledge and understanding. Additionally, the emotional experience of VR learning content based on learners' different perspectives and sensitivities can be combined with group discussions to deepen learning through multifaceted opinions and realizations. An effective educational method for fostering critical thinking skills is to incorporate group work into VR-based educational programs.

Association of stromal tumor-infiltrating lymphocytes with clinicopathological parameters in endometrial cancer.

Endometrial cancer (EC) ranks as one of the most prevalent gynecological malignancies globally. The presence and role of stromal tumor-infiltrating lymphocytes (TILs) in the tumor microenvironment have garnered interest due to their prognostic and therapeutic potential. This study aimed to evaluate the association between stromal TILs and various clinicopathological parameters in EC. A prospective study was conducted which included 30 histologically confirmed cases of endometrial carcinoma. Specimens collected from January 2023 to June 2024 were processed for routine histopathological examination and immunohistochemistry for CD3 and CD20 markers. TILs were quantified as per the International Immuno-Oncology Biomarker Working Group guidelines and categorized into low (<20%) and high (≥20%) TILs. The study comprised 30 female patients, predominantly aged 51 to 60 years. Most tumors were of the endometrioid subtype (93.3%). High TILs were significantly associated with early tumor stage, lower grade, lesser myometrial invasion, and absence of nodal involvement on univariate analysis and with lower tumor stage and grade on multivariate analysis. No significant association was found between TILs and age, lymphovascular, or perineural invasion. The findings suggest that high TIL infiltration correlates with favorable tumor characteristics, potentially serving as a prognostic marker for early and less aggressive EC. High TILs were associated with better tumor stage, grade, and reduced nodal involvement, indicating their protective role in tumor progression. However, the lack of association with certain parameters calls for further investigation into the functional state of TILs and their interactions within the tumor microenvironment.

Farmer Group Management Development Model in Rice Farming

Farmer group management is a process of planning, activating and evaluating farmer group work programs. This research aims to analyze the internal factors that can formulate a development model for farmer group management, and analyze how much influence these internal factors have on improving farmer group management. The variables of this study consist of X variables, namely: Characteristics (X1), social psychology of farmers (X2), and the role of stakeholders (X3), and Y variables, namely; farmer group management. This research is designed as explanatory research. Data were collected from a sample selected by proportional sampling from 37 members of a purposively selected farmer group in farmer groups in three districts in Gorontalo City. The data obtained in this research were analyzed using the Structural Equation Model (SEM). The results showed that the variable characteristics, social psychology of farmers, and the role of stakeholders influenced the management of farmer groups with the following coefficients: 0.61, 0.85, and 0.45 significant at α = 0.05. Cumulatively (R2) the influence of characteristics, social psychology of farmers, and the role of stakeholders on farmer group management is 87%, the remaining 13% is the influence of other variables outside of this Research.

МОБІЛЬНІ ДОДАТКИ ЯК ІНСТРУМЕНТ ДЛЯ ПОКРАЩЕННЯ ГРАМАТИЧНИХ НАВИЧОК УЧНІВ

The article examines the importance of mobile applications in improving students' grammar skills while learning English. It is noted that mobile applications are an effective tool due to their accessibility, interactivity and the ability to adapt to individual needs. The importance of using mobile applications for learning English grammar lies in their accessibility, interactivity and ability to meet individual learning needs. These apps offer students every opportunity to practice and improve their grammar skills at their own pace. Various types of applications that promote grammar development are described, including games, adaptive applications, simulators, and tests. In particular, simulators like Duolingo provide users with exercises to practice grammar structures, helping to consolidate theoretical knowledge in an engaging way. Testers such as English Grammar Test or Test Your English are focused on checking grammar and providing feedback, helping users identify their weak points. Interactive textbooks, such as LearnEnglish Grammar from the British Council, offer not only theoretical material, but also interactive tasks that allow you to learn the material better. The advantages of mobile applications compared to traditional teaching methods are highlighted and possible technical challenges and issues of self-discipline are discussed. Methodological recommendations for the integration of these applications into the educational process are presented. Teachers are recommended applications that meet the educational goals and needs of students, are interactive and adapted to their level of knowledge. It is also important to consider the technical capabilities of students and ensure they have access to the necessary equipment. The structure of lessons should include both individual and group work, allowing to combine autonomous and joint learning.

ФОРМУВАННЯ ТА РОЗВИТОК КОМУНІКАТИВНИХ ЗДІБНОСТЕЙ НА УРОКАХ НІМЕЦЬКОЇ МОВИ

The article examines the process of formation and development of students' communicative skills in German lessons. Special attention is paid to the creation of a personally oriented learning model that promotes the development of students through active communication and the implementation of interactive methods. Various methods and approaches are presented that contribute to the stimulation of speech activity, among them: the use of interactive techniques (pair and group work, role-playing games), dialogic speech as the main component of communicative competence, problem-solving tasks for the development of communication skills, creation of a favorable emotional atmosphere for lowering the barrier to speaking a foreign language. The article also emphasizes the importance of a communicative approach in learning, which allows students to learn the material through interest and active interaction.

New History of the Gdańsk/Danzig Organ Tablature

The article presents new findings concerning the so-called Gdańsk/Danzig Organ Tablature from the late sixteenth century. They include a codicological description of the manuscript in which it was recorded (Gdańsk, State Archive, shelf mark 300,R/Vv,123) and recognition of the manuscript’s contents; distinguishing the scribes; identification of the owner of the book and the scribe of the music; a history of the music section of the manuscript; an analysis of groups of works, their function and features of their notation. In the last part, working hypotheses are proposed concerning i.a. the authorship of the compositions, intended to outline the perspectives for future research.

ВИКОРИСТАННЯ МОБІЛЬНОГО ЗАСТОСУНКУ ACTIONTRACK У ПІДГОТОВЦІ МАЙБУТНІХ ФАХІВЦІВ З МУЗЕЄЗНАВСТВА ТА ПАМ’ЯТКОЗНАВСТВА

Modern trends are aimed at the integration of information and communication technologies into the educational process, in particular, thanks to the active use of mobile devices and relevant applications. Teachers can quickly disseminate information among students, provide them with access to various materials, as well as receive feedback from them, etc. The involvement of information and communication technologies forms practical skills and consolidates theoretical knowledge during the training of specialists, and for the specialty 027 “Museum studies, monument studies” at Lesya Ukrainka Volyn National University, which became the subject of the research. The article confirms the positive experience of using the ActionTrack, because the students created an excursion-tourist product using information and communication technologies and participated in its implementation. This testified that it allows students not only to improve digital competencies, but also to work in small groups (quest designers and excursionists) and build internal communication, improve spatial orientation skills, consolidate theoretical knowledge related to interpretation and actualization cultural heritage. The research analyzed the stages of development and implementation of a quest-excursion in the ActionTrack mobile app: obtaining access to the software; displaying the points of the excursion route on the online map and developing tasks for them in the application; making corrections regarding locations directly near cultural heritage objects; monitoring the performance of tasks and movement of participants during the quest. It was established that through the use of ActionTrack, the excursionists of the quest consolidate knowledge about the cultural environment, improve digital skills, and develop interest in the excursion using information and communication technologies. It has been proven that the use of the ActionTrack mobile application in the educational process is a successful form of work with students, which contributes to the improvement of their professional competencies, in particular, аbility to conduct innovative activities in museum affairs and monument preservation activities.

Social emotional learning at global islamic school 3 yogyakarta: challenges and solutions

Background: Social Emotional Learning (SEL) has become an important part that needs to be accomplished from an early age. However, the issue of implementing learning in kindergarten has not been widely researched, especially when viewed from the challenges and solutions for teachers. Social emotional learning is an important agenda at GIS 3 Yogyakarta to lay a solid foundation for children's personality and behavior.Aim: This research aims to examine the challenges and solutions for SEL at Global Islamic School 3 Yogyakarta.Method: This study employed qualitative methods with semi-structured interviews of five teachers. Data analysis includes the process of data collection, data condensation, data presentation, and drawing conclusions/verification. The validity of the data was tested through source triangulation and technical triangulation.Results: The results of the research show that the challenges faced by teachers are the exclusive environment for children, parental care, and lack of control over the use of gadgets. Next, the teacher determines a solution, namely implementing various activities such as morning sharing, class agreements, taking turns appearing in front of the class, new and exciting games, giving reward stars, group work, circle time, market day, show and tell, cooperative games, reading stories or fairy tales, projects with parents, school habituation programs, as well as parenting and collaborating with parents regarding children's use of gadgets. Creative teachers are prudent. They have good personal and professional well-being. Conclution: Collaboration with parents needs to be improved so that social-emotional abilities increase.

Evaluating SARC-F, SARC-CalF, and calf circumference as diagnostic tools for sarcopenia in Thai older adults: results from a nationwide study

BackgroundWith the increasing number of older adults, musculoskeletal disorders such as sarcopenia have become increasingly important to research because of their strong association with falls and fractures. Sarcopenia, which is characterized by reduced muscle mass, is common among older adults and significantly increases the risk of falls. This study aimed to assess the effectiveness of the SARC-F and SARC-CalF questionnaires, along with calf circumference measurements, for sarcopenia screening among Thai community-dwelling older adults, following the 2019 criteria of the Asian Working Group for Sarcopenia.MethodsThis analysis drew on data from the Thai Musculoskeletal Diseases Nationwide Study, which included 2543 participants aged 60 years or older. The SARC-F, SARC-CalF, and calf circumference data were evaluated against the 2019 Asian Working Group for Sarcopenia criteria. We calculated the sensitivity, specificity, and area under the curve to determine the diagnostic performance of each tool.ResultsOf the 2455 participants analyzed, 18.1% were diagnosed with sarcopenia. The SARC-F and SARC-CalF questionnaires showed limited effectiveness in diagnosing sarcopenia, with area under the curve values of 0.508 and 0.729, respectively. In contrast, calf circumference demonstrated greater diagnostic accuracy, with area under the curve values of 0.897 in males and 0.878 in females. Adjusting the cutoff points to < 33 cm for males and < 31 cm for females improved the overall diagnostic accuracy from 66.4 to 82%.ConclusionsSarcopenia is relatively prevalent in Thailand. The SARC-F and SARC-CalF questionnaires are inadequate for diagnosing sarcopenia, while calf circumference alone is the most effective screening tool. Adding more parameters to the SARC-F questionnaire could enhance its diagnostic accuracy.Trial registrationThis study was registered at ClinicalTrials.gov (NCT06558617). Registration Date 16 August 2024.

Geriatric Nutrition Risk Index is closely associated with sarcopenia and quality of life in gastric cancer patients: a cross-sectional study

Impaired nutritional status is closely related to the development of sarcopenia and poor quality of life (QoL) in cancer patients. This study aimed to investigate the association of Geriatric Nutritional Risk Index (GNRI) with sarcopenia and QoL in patients with gastric cancer (GC). Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia 2019 criteria. This cross-sectional study included a total of 311 patients with GC. Among them, 57 (18.3%) patients were diagnosed with sarcopenia. GNRI showed significant correlations with sarcopenia-related indicators including skeletal muscle index, handgrip strength, gait speed, and 5-time chair stand time (p < 0.001). A significant association was observed between GNRI and sarcopenia [odds ratio (OR) = 0.815, 95% confidence interval (CI): 0.760–0.874, p < 0.001] in the multivariate analysis. The optimal cutoff value of GNRI for predicting sarcopenia was 94.98, with a sensitivity of 75.4% and specificity of 73.2%. Patients with low GNRI exhibited significantly lower scores in terms of global health status and most functional scales. Furthermore, the majority of symptoms exhibited greater severity in patients with low GNRI. In conclusion, the present study revealed that GNRI was closely associated with sarcopenia and QoL, and could effectively predict sarcopenia in patients with GC.

Penggunaan Model Pembelajaran Cooperatif Integrated Reading Compotition (CIRC) Dalam Pembelajaran Mahārah Qirā’ah di Kelas X MA Tarbiyatul Islam Soko Tuban Tahun 2023/2024

Arabic language lessons are mandatory lessons at MA Tarbiyatul Islam Soko. Based on the results of interviews and observations, one of the causes of students' difficulties in Arabic language lessons is their previous school background, this is what underlies teachers using the Cooperative Integrated Reading and Composition (CIRC) learning model so that learning can be achieved. includes all students who have different Mahārah Qirā'ah abilities. This research aims to observe and explain how the application, advantages and disadvantages of the Cooperative Integrated Reading and Composition (CIRC) model in Arabic language lessons, and how students' abilities in mahārah qirā'ah skills are, after the teacher applies the Cooperative Integrated Reading and Composition (CIRC) model. The research method used is qualitative research with the data collection process using interviews with school principal respondents, Arabic teachers and class x students. Observation during learning, and Documentation. Data analysis uses data reduction from interviews, observations and documentation, data display by presenting research data, and verification by analyzing data according to the problem formulation. Checking the validity of the data uses the credibility test, transferability test, debendability test, confirmability test. From the research that has been carried out, the following results were obtained; The Cooperative Integrated Reading and Composition learning model is used in Arabic language learning. The steps in its use are the teacher reading the material, dividing students into groups consisting of 4-5 students, students discussing with the group, students presenting the results of group work, teacher and students making conclusions. This learning model also has advantages and disadvantages. Students' Mahārah qirā'ah abilities obtained after learning are oral reading well and correctly, reading comprehension, and developing reading into writing