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Background: Elderly patients undergoing general anesthesia are vulnerable to delayed cognitive recovery and postoperative delirium, partly because age-related physiological changes may increase sensitivity to excessive anesthetic depth. Objective: To compare BIS-guided anesthesia with standard anesthesia management for early postoperative cognitive recovery, delirium incidence, anesthetic consumption, and immediate recovery outcomes in elderly patients undergoing elective non-cardiac surgery. Methods: This parallel-group randomized controlled trial was conducted at a tertiary care teaching hospital in Central Punjab, Pakistan, from August 2025 to January 2026. Eighty patients aged 65–80 years undergoing elective non-cardiac surgery under general anesthesia were randomized to BIS-guided anesthesia or standard anesthesia management. In the BIS-guided group, anesthetic depth was maintained within a BIS range of 40–60. Cognitive recovery was assessed using MMSE and MoCA at baseline, 24 hours, and 72 hours postoperatively, while delirium was assessed using the Confusion Assessment Method. Final complete-case analysis included 73 participants. Results: At 72 hours, the BIS-guided group had higher MMSE scores than the standard anesthesia group (27.1 ± 1.5 vs 25.4 ± 1.9; mean difference, 1.7; 95% CI, 0.90–2.50) and higher MoCA scores (25.0 ± 1.8 vs 22.9 ± 2.1; mean difference, 2.1; 95% CI, 1.19–3.01). BIS-guided anesthesia also reduced sevoflurane consumption, extubation time, and recovery-room stay. Delirium occurred in 8.1% and 25.0% of participants, respectively, with exact testing indicating a clinically relevant but statistically non-definitive difference. Conclusion: BIS-guided anesthesia was associated with better early postoperative cognitive recovery and improved immediate recovery efficiency in elderly surgical patients.
Penelitian ini bertujuan untuk menganalisis kemampuan berhitung siswa kelas 1 sekolah dasar dalam menyelesaikan operasi hitung dasar, khususnya penjumlahan dan pengurangan bilangan 1–20. Pendekatan penelitian yang digunakan adalah kualitatif deskriptif dengan teknik pengumpulan data berupa tes keterampilan berhitung, observasi kelas, dan wawancara terhadap guru. Subjek penelitian terdiri atas 20 siswa kelas 1 di salah satu SD negeri. Hasil penelitian menunjukkan bahwa kemampuan berhitung siswa bervariasi, dengan kategori tinggi (35%), sedang (40%), dan rendah (25%). Faktor-faktor yang memengaruhi kemampuan berhitung mencakup metode pembelajaran yang digunakan guru, keterlibatan orang tua, dan penggunaan media konkret dalam pembelajaran. Siswa dengan dukungan belajar yang memadai cenderung memiliki kemampuan berhitung yang lebih baik. Kendala yang dihadapi antara lain perbedaan tingkat pemahaman siswa, keterbatasan waktu observasi, dan kurangnya peran serta orang tua. Penelitian ini menyimpulkan bahwa kemampuan berhitung siswa kelas awal sangat ditentukan oleh sinergi antara pendekatan pembelajaran yang sesuai, lingkungan belajar yang mendukung, serta keterlibatan aktif orang tua. Temuan ini diharapkan dapat menjadi rujukan bagi guru dan pemangku kebijakan dalam merancang strategi peningkatan numerasi dasar di sekolah dasar.
Abstrak: Pembentukan karakter merupakan salah satu tujuan utama pembelajaran Pendidikan Kewarganegaraan di sekolah dasar. Salah satu pendekatan yang dapat digunakan untuk mengatasi permasalahan tersebut adalah pendekatan pembelajaran mendalam (deep learning) yang menekankan pembelajaran berkesadaran (mindful learning), bermakna (meaningful learning), dan menyenangkan (joyful learning). Penelitian ini bertujuan untuk mendeskripsikan implementasi pendekatan pembelajaran mendalam dalam pembelajaran Pendidikan Kewarganegaraan di kelas rendah, mengidentifikasi nilai-nilai karakter yang terbentuk, serta menganalisis faktor-faktor yang mendukung implementasinya. Penelitian ini menggunakan metode kualitatif deskriptif. Penelitian dilaksanakan di MI Matholi'ul Huda Troso Jepara dengan subjek penelitian satu orang guru kelas 1D dan 30 peserta didik kelas 1D. Informan dipilih menggunakan teknik purposive sampling. Data dikumpulkan melalui observasi, wawancara, dan dokumentasi, kemudian dianalisis melalui tahapan reduksi data, penyajian data, penarikan kesimpulan. Hasil penelitian menunjukkan bahwa pendekatan pembelajaran mendalam telah diimplementasikan melalui tiga dimensi utama, yaitu mindful learning, meaningful learning, dan joyful learning Penerapan ketiga dimensi tersebut berkontribusi terhadap pembentukan karakter disiplin, tanggung jawab, sopan santun, saling menghargai, dan kerja sama. Keberhasilan implementasi didukung oleh kemampuan guru dalam merancang pembelajaran yang kontekstual, penggunaan media pembelajaran yang sesuai dengan karakteristik peserta didik, pemberian penguatan positif, serta terciptanya suasana belajar yang aktif dan menyenangkan. Abstract: Character building is the primary goal of Civics Education in elementary schools. One approach to achieving this is "deep learning," which emphasizes mindful, meaningful, and enjoyable learning experiences. This study aims to describe the implementation of the deep learning approach in Civics Education for lower-grade classes, identify the character values fostered, and analyze the factors supporting its implementation. A descriptive qualitative method was employed. The study was conducted at MI Matholi'ul Huda Troso, Jepara, involving a Grade 1D teacher and 30 Grade 1D students as research subjects. Informants were selected using purposive sampling. Data were collected through observation, interviews, and documentation, and subsequently analyzed through data reduction, data presentation, conclusion drawing. The results indicate that the deep learning approach is implemented through three main dimensions: mindful learning, meaningful learning, and enjoyable learning. The implementation of these dimensions contributes to fostering character traits such as discipline, responsibility, politeness, mutual respect, and cooperation. The successful implementation of this approach is supported by the teacher's ability to design contextual learning, the use of instructional media suited to student characteristics, the provision of positive reinforcement, and the creation of an active and enjoyable learning atmosphere.
Background: Having heart surgery with a heart-lung machine causes a reaction in the body that can affect how quickly someone gets better after the operation. Objective: To see how using medicines for anesthesia compares to using medicines that go into the veins for anesthesia. The comparison is about how each affects the bodys response to inflammation the way the heart and blood pressure work and how quickly people get better after the surgery. The surgery in question is when a patient has an artery bypass graft with a heart-lung machine. Methods: This study had 80 people aged between 45 and 70 years. They were assigned to one of two groups in a 1 to 1 ratio. One group had a mix of medicines and some other drugs. The other group had medicines that go into the vein. The study looked at two substances in the blood called IL-6 and TNF-alpha before the surgery after the heart-lung machine was stopped and 24 hours later. Other things looked at were blood pressure, heart rate how long it took for the patient to breathe on their own after the operation. How long they stayed in the intensive care unit. The final results had 76 people with 38 in each group. Results: After the heart-lung machine was stopped the group with medicines had less IL-6 in their blood than the group with medicines in the veins (142.5±22.4 vs 168.3±26.1 pg/mL; average difference −25.8 95% CI −36.8 to −14.8; p<0.001) as well as less TNF-alpha (32.4±5.1 vs 38.9±6.3 pg/mL; average difference −6.5, 95% CI −9.1 to −3.9; p<0.001). There was a difference in how the two groups responded over time for IL-6 and TNF-alpha. The group with medicines had shorter time to breathing on their own (5.8±1.2 vs 7.4±1.6 hours; p<0.001) and spent less time in the intensive care unit (2.1±0.4 vs 2.6±0.6 days; p<0.001). The highest level of IL-6 after the operation was linked to how the patient needed a breathing machine (r=0.64; p<0.001). In this study using medicines for anesthesia was linked with lower levels of IL-6 and TNF-alpha after the operation and shorter time to get better than using medicines in the veins. These results suggest that using medicines might help with how the body deals with inflammation and how quickly someone gets better after the surgery. However the small number of people, in the study and the ones who were not included after randomization need to be considered
Pembelajaran lagu daerah di sekolah dasar kerap terbatas pada aktivitas menyanyikan lagu tanpa pengkajian makna dan nilai budaya yang terkandung di dalamnya. Penelitian ini bertujuan untuk mendeskripsikan implementasi pembelajaran lagu daerah dengan pendekatan deep learning, mengetahui nilai pendidikan yang terkandung dalam lagu daerah yang diimplementasikan, serta mengidentifikasi faktor pendukung dan penghambat dalam proses pembelajaran. Penelitian menggunakan pendekatan kualitatif deskriptif dengan teknik pengumpulan data berupa observasi, wawancara, dan dokumentasi. Subjek penelitain ini adalah guru dan siswa kelas III SDN Sukoreno 03 Kabupaten Jember. Hasil penelitian menunjukkan bahwa implementasi terlaksana melalui tiga tahap: perencanaan, pelaksanaan, dan evaluasi, dengan ketiga prinsip deep learning joyful learning, mindful learning, dan meaningful learning terwujud nyata dalam setiap kegiatan. Lagu Ampar-Ampar Pisang dan Cublak-Cublak Suweng terbukti mengandung nilai pendidikan meliputi kerja keras, kebersamaan, kejujuran, cinta budaya daerah, dan pelestarian tradisi. Faktor pendukung meliputi antusiasme siswa yang tinggi dan pendekatan guru yang komunikatif, sedangkan faktor penghambatnya adalah perbedaan kemampuan siswa dan belum tersedianya rubrik penilaian yang terstruktur. Secara keseluruhan, temuan penelitian menunjukkan bahwa pendekatan deep learning menjadikan pembelajaran lagu daerah lebih bermakna, menarik, dan mampu memperkaya pemahaman budaya siswa sekolah dasar.
