Background: Oral factor XIa (FXIa) inhibitors may modulate coagulation to prevent thromboembolic events without significantly increasing bleeding. We explored the pharmacodynamics, safety, and efficacy of the oral FXIa inhibitor asundexian for secondary prevention after acute myocardial infarction (MI). Methods: We randomized 1601 patients with recent acute MI to oral asundexian 10, 20, or 50 mg or placebo once daily for 6–2 months in a double-blind, placebo-controlled, phase 2, dose-ranging trial. Patients were randomized within 5 days of their qualifying MI and received dual antiplatelet therapy with aspirin plus a P2Y12 inhibitor. The effect of asundexian on factor XIa inhibition was assessed at 4 weeks. The prespecified main safety outcome was Bleeding Academic Research Consortium type 2, 3, or 5 bleeding comparing all pooled asundexian doses with placebo. The prespecified efficacy outcome was a composite of cardiovascular death, MI, stroke, or stent thrombosis comparing pooled asundexian 20 and 50 mg doses with placebo. Results: The median age was 68 years, 23% were women, 51% had ST-elevation MI, 80% were treated with aspirin plus ticagrelor or prasugrel, and 99% underwent percutaneous coronary intervention before randomization. Asundexian caused dose-related inhibition of FXIa activity with 50 mg resulting in >90% inhibition. Over a median follow-up of 368 days, the main safety outcome occurred in 30 (7.6%), 32 (8.1%), 42 (10.5%), and 36 (9.0%) patients receiving asundexian 10, 20, 50 mg, and placebo (pooled asundexian vs. placebo: HR 0.98, 90% CI 0.71–1.35). The efficacy outcome occurred in 27 (6.8%), 24 (6.0%), 22 (5.5%), and 22 (5.5%) patients assigned asundexian 10, 20, 50 mg, and placebo (pooled asundexian 20 and 50 mg vs. placebo: HR 1.05, 90% CI 0.69–1.61). Conclusions: : In patients with recent acute MI, 3 doses of asundexian, when added to aspirin plus a P2Y12 inhibitor, resulted in dose-dependent, near-complete inhibition of FXIa activity without a significant increase in bleeding and a low rate of ischemic events. These data support the investigation of asundexian at a dose of 50 mg daily in an adequately powered clinical trial of patients following acute MI.
Islamic education in Indonesia and Malaysia stemmed from the very same origin, pondok pesantren. However, they went different ways due to several drives. As madrasah transformed some forms of pondok pesantren, colonial and political context has shaped Islamic education in Indonesia and Malaysia. In Indonesia, education is administered in a separate ministry and finally formed a curriculum that enable graduates to endeavor not only in religious fields but also in all walks of life. Whereas Ministry of Malaysian Education regulate both national education and religious education all students in Indonesia and Malaysia, though, regardless of their schools, must study religion with different gradation. While Islamic instruction in Indonesian schools is supplied only to shape religious character, Malaysian schools strive to create an integration between Islamic and non-Islamic sciences. Pondok pesantrens too, have developed to a degree that differing features do occur, although they share several resemblances. Their private natures enable pondok pesantrens to improvise their education with different outcome and shape, but remain a deeply rooted in Islamic education in both countries.
Studi ini bertujuan untuk meneliti gagasan-gagasan seorang tokoh terkemuka Nahdlatul Ulama (NU), pimpinan Pondok Pesantren Sabilurrosyad Malang yaitu KH Marzuki Mustamar tentang upaya menangkal tumbuhnya paham radikalisme pada pondok pesantren. Melalui analisa hasil wawancara, penelitian ini menemukan bahwa yang terpenting dalam upaya menangkal tumbuhnya paham radikalisme di pesantren adalah kemampuan para kyai atau pengasuh pesantren dalam mengontekstualisasikan nilai-nilai ajaran Islam dengan konteks kehidupan yang ada dalam proses pembelajarannya. Melalui kemampuan ini, para santri akan menjadi tahu dan memahami bahwa ajaran Islam benar-benar relevan dengan kehidupan dan mampu membawa kemaslahatan bagi seluruh umat manusia. Dalam hal ini, para kyai atau para pengasuh pesantren bisa melakukannya melalui beberapa cara: pertama, memilih materi-materi atau kitab-kitab yang berpandangan moderat yaitu yang berpaham ahlussunnah, dan menafsirkan ulang terhadap materi-materi atau kitab-kitab yang tidak sesuai dengan konteks keindonesiaan. Kedua menanamkan kepada para santri nilai-nilai ketauhidan dan nilai-nilai kemanusiaan secara seimbang, ketiga, memberikan keteladanan dalam berperilaku toleran di masyarakat. Keempat membiasakan para santri berperilaku toleran melalui praktek langsung berbaur dengan masyarakat.
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