Search results for: grade 7 math
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1245

Search results for: grade 7 math

975 Heavy Sulphide Material Characterization of Grasberg Block Cave Mine, Mimika, Papua: Implication for Tunnel Development and Mill Issue

Authors: Cahya Wimar Wicaksono, Reynara Davin Chen, Alvian Kristianto Santoso

Abstract:

Grasberg Cu-Au ore deposit as one of the biggest porphyry deposits located in Papua Province, Indonesia produced by several intrusion that restricted by Heavy Sulphide Zone (HSZ) in peripheral. HSZ is the rock that becomes the contact between Grassberg Igneous Complex (GIC) with sedimentary and igneous rock outside, which is rich in sulphide minerals such as pyrite ± pyrrhotite. This research is to obtain the characteristic of HSZ based on geotechnical, geochemical and mineralogy aspect and those implication for daily mining operational activities. Method used in this research are geological and alteration mapping, core logging, FAA (Fire Assay Analysis), AAS (Atomic absorption spectroscopy), RQD (Rock Quality Designation) and rock water content. Data generated from methods among RQD data, mineral composition and grade, lithological and structural geology distribution in research area. The mapping data show that HSZ material characteristics divided into three type based on rocks association, there are near igneous rocks, sedimentary rocks and on HSZ area. And also divided based on its location, north and south part of research area. HSZ material characteristic consist of rock which rich of pyrite ± pyrrhotite, and RQD range valued about 25%-100%. Pyrite ± pyrrhotite which outcropped will react with H₂O and O₂ resulting acid that generates corrosive effect on steel wire and rockbolt. Whereas, pyrite precipitation proses in HSZ forming combustible H₂S gas which is harmful during blasting activities. Furthermore, the impact of H₂S gas in blasting activities is forming poison gas SO₂. Although HSZ high grade Cu-Au, however those high grade Cu-Au rich in sulphide components which is affected in flotation milling process. Pyrite ± pyrrhotite in HSZ will chemically react with Cu-Au that will settle in milling process instead of floating.

Keywords: combustible, corrosive, heavy sulphide zone, pyrite ± pyrrhotite

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974 Application of Adaptive Neuro Fuzzy Inference Systems Technique for Modeling of Postweld Heat Treatment Process of Pressure Vessel Steel AASTM A516 Grade 70

Authors: Omar Al Denali, Abdelaziz Badi

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The ASTM A516 Grade 70 steel is a suitable material used for the fabrication of boiler pressure vessels working in moderate and lower temperature services, and it has good weldability and excellent notch toughness. The post-weld heat treatment (PWHT) or stress-relieving heat treatment has significant effects on avoiding the martensite transformation and resulting in high hardness, which can lead to cracking in the heat-affected zone (HAZ). An adaptive neuro-fuzzy inference system (ANFIS) was implemented to predict the material tensile strength of post-weld heat treatment (PWHT) experiments. The ANFIS models presented excellent predictions, and the comparison was carried out based on the mean absolute percentage error between the predicted values and the experimental values. The ANFIS model gave a Mean Absolute Percentage Error of 0.556 %, which confirms the high accuracy of the model.

Keywords: prediction, post-weld heat treatment, adaptive neuro-fuzzy inference system, mean absolute percentage error

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973 Exploring Faculty Attitudes about Grades and Alternative Approaches to Grading: Pilot Study

Authors: Scott Snyder

Abstract:

Grading approaches in higher education have not changed meaningfully in over 100 years. While there is variation in the types of grades assigned across countries, most use approaches based on simple ordinal scales (e.g, letter grades). While grades are generally viewed as an indication of a student's performance, challenges arise regarding the clarity, validity, and reliability of letter grades. Research about grading in higher education has primarily focused on grade inflation, student attitudes toward grading, impacts of grades, and benefits of plus-minus letter grade systems. Little research is available about alternative approaches to grading, varying approaches used by faculty within and across colleges, and faculty attitudes toward grades and alternative approaches to grading. To begin to address these gaps, a survey was conducted of faculty in a sample of departments at three diverse colleges in a southeastern state in the US. The survey focused on faculty experiences with and attitudes toward grading, the degree to which faculty innovate in teaching and grading practices, and faculty interest in alternatives to the point system approach to grading. Responses were received from 104 instructors (21% response rate). The majority reported that teaching accounted for 50% or more of their academic duties. Almost all (92%) of respondents reported using point and percentage systems for their grading. While all respondents agreed that grades should reflect the degree to which objectives were mastered, half indicated that grades should also reflect effort or improvement. Over 60% felt that grades should be predictive of success in subsequent courses or real life applications. Most respondents disagreed that grades should compare students to other students. About 42% worried about their own grade inflation and grade inflation in their college. Only 17% disagreed that grades mean different things based on the instructor while 75% thought it would be good if there was agreement. Less than 50% of respondents felt that grades were directly useful for identifying students who should/should not continue, identify strengths/weaknesses, predict which students will be most successful, or contribute to program monitoring of student progress. Instructors were less willing to modify assessment than they were to modify instruction and curriculum. Most respondents (76%) were interested in learning about alternative approaches to grading (e.g., specifications grading). The factors that were most associated with willingness to adopt a new grading approach were clarity to students and simplicity of adoption of the approach. Follow-up studies are underway to investigate implementations of alternative grading approaches, expand the study to universities and departments not involved in the initial study, examine student attitudes about alternative approaches, and refine the measure of attitude toward adoption of alternative grading practices within the survey. Workshops about challenges of using percentage and point systems for determining grades and workshops regarding alternative approaches to grading are being offered.

Keywords: alternative approaches to grading, grades, higher education, letter grades

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972 Predictive Value of ¹⁸F-Fdg Accumulation in Visceral Fat Activity to Detect Colorectal Cancer Metastases

Authors: Amil Suleimanov, Aigul Saduakassova, Denis Vinnikov

Abstract:

Objective: To assess functional visceral fat (VAT) activity evaluated by ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) as a predictor of metastases in colorectal cancer (CRC). Materials and methods: We assessed 60 patients with histologically confirmed CRC who underwent 18F-FDG PET/CT after a surgical treatment and courses of chemotherapy. Age, histology, stage, and tumor grade were recorded. Functional VAT activity was measured by maximum standardized uptake value (SUVmax) using ¹⁸F-FDG PET/CT and tested as a predictor of later metastases in eight abdominal locations (RE – Epigastric Region, RLH – Left Hypochondriac Region, RRL – Right Lumbar Region, RU – Umbilical Region, RLL – Left Lumbar Region, RRI – Right Inguinal Region, RP – Hypogastric (Pubic) Region, RLI – Left Inguinal Region) and pelvic cavity (P) in the adjusted regression models. We also report the best areas under the curve (AUC) for SUVmax with the corresponding sensitivity (Se) and specificity (Sp). Results: In both adjusted for age regression models and ROC analysis, 18F-FDG accumulation in RLH (cutoff SUVmax 0.74; Se 75%; Sp 61%; AUC 0.668; p = 0.049), RU (cutoff SUVmax 0.78; Se 69%; Sp 61%; AUC 0.679; p = 0.035), RRL (cutoff SUVmax 1.05; Se 69%; Sp 77%; AUC 0.682; p = 0.032) and RRI (cutoff SUVmax 0.85; Se 63%; Sp 61%; AUC 0.672; p = 0.043) could predict later metastases in CRC patients, as opposed to age, sex, primary tumor location, tumor grade and histology. Conclusions: VAT SUVmax is significantly associated with later metastases in CRC patients and can be used as their predictor.

Keywords: ¹⁸F-FDG, PET/CT, colorectal cancer, predictive value

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971 Enhancing the Flotation of Fine and Ultrafine Pyrite Particles Using Electrolytically Generated Bubbles

Authors: Bogale Tadesse, Krutik Parikh, Ndagha Mkandawire, Boris Albijanic, Nimal Subasinghe

Abstract:

It is well established that the floatability and selectivity of mineral particles are highly dependent on the particle size. Generally, a particle size of 10 micron is considered as the critical size below which both flotation selectivity and recovery decline sharply. It is widely accepted that the majority of ultrafine particles, including highly liberated valuable minerals, will be lost in tailings during a conventional flotation process. This is highly undesirable particularly in the processing of finely disseminated complex and refractory ores where there is a requirement for fine grinding in order to liberate the valuable minerals. In addition, the continuing decline in ore grade worldwide necessitates intensive processing of low grade mineral deposits. Recent advances in comminution allow the economic grinding of particles down to 10 micron sizes to enhance the probability of liberating locked minerals from low grade ores. Thus, it is timely that the flotation of fine and ultrafine particles is improved in order to reduce the amount of valuable minerals lost as slimes. It is believed that the use of fine bubbles in flotation increases the bubble-particle collision efficiency and hence the flotation performance. Electroflotation, where bubbles are generated by the electrolytic breakdown of water to produce oxygen and hydrogen gases, leads to the formation of extremely finely dispersed gas bubbles with dimensions varying from 5 to 95 micron. The sizes of bubbles generated by this method are significantly smaller than those found in conventional flotation (> 600 micron). In this study, microbubbles generated by electrolysis of water were injected into a bench top flotation cell to assess the performance electroflotation in enhancing the flotation of fine and ultrafine pyrite particles of sizes ranging from 5 to 53 micron. The design of the cell and the results from optimization of the process variables such as current density, pH, percent solid and particle size will be presented at this conference.

Keywords: electroflotation, fine bubbles, pyrite, ultrafine particles

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970 Effect of Enzymatic Modification on the Crystallinity of Cellulose Pulps

Authors: J. Janicki, M. Rom, C. Slusarczyk, J. Fabia, M. Siika-aho, K. Marjamaa, K. Kruus, K. Langfelder, C. Steel, M. Paloheimo, T. Puranen, S. Mäkinen, D. Wawro

Abstract:

The cellulose is one of the most abundant polymers in the world, however, its application in the high-end value products such as films or fibres, it triggered by the cellulose properties. The noticeable presence of hydrogen bonding reflected with partially crystalline structure makes the cellulose insoluble in common solvents and not meltable. The existing technologies, such as viscose process, suffer from environmental and economical problems, because of the risk of harmful chemicals liberation during the spinning process. The enzymatic modification of cellulose with endoglucanase makes it directly alkali soluble in NaOH solution, giving the opportunities for film and fibers formation. As the effect of enzymatic treatment, there are observed changes in crystalline structure and accompanying changes of the affinity of cellulose to water, demonstrated by water retention value. The objective of the project ELMO - Novel carbohydrate modifying enzymes for fibre modification is is to develop new enzyme products for modification of dissolving grade pulps. The aim is to increase the reactivity of dissolving grade pulps and remove residual hemicellulose. The scientific aim of this paper is to present the effect of enzymatic treatment on the crystallinity and affinity to water of cellulose pulps modified with enzymes.

Keywords: cellulose, crystallinity, WAXS, enzyme

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969 An Investigation into the Potential of Industrial Low Grade Heat in Membrane Distillation for Freshwater Production

Authors: Yehia Manawi, Ahmad Kayvanifard

Abstract:

Membrane distillation is an emerging technology which has been used to produce freshwater and purify different types of aqueous mixtures. Qatar is an arid country where almost 100% of its freshwater demand is supplied through the energy-intensive thermal desalination process. The country’s need for water has reached an all-time high which stipulates finding an alternative way to augment freshwater without adding any drastic affect to the environment. The objective of this paper was to investigate the potential of using the industrial low grade waste heat to produce freshwater using membrane distillation. The main part of this work was conducting a heat audit on selected Qatari chemical industries to estimate the amounts of freshwater produced if such industrial waste heat were to be recovered. By the end of this work, the main objective was met and the heat audit conducted on the Qatari chemical industries enabled us to estimate both the amounts of waste heat which can be potentially recovered in addition to the amounts of freshwater which can be produced if such waste heat were to be recovered. By the end, the heat audit showed that around 605 Mega Watts of waste heat can be recovered from the studied Qatari chemical industries which resulted in a total daily production of 5078.7 cubic meter of freshwater. This water can be used in a wide variety of applications such as human consumption or industry. The amount of produced freshwater may look small when compared to that produced through thermal desalination plants; however, one must bear in mind that this water comes from waste and can be used to supply water for small cities or remote areas which are not connected to the water grid. The idea of producing freshwater from the two widely-available wastes (thermal rejected brine and waste heat) seems promising as less environmental and economic impacts will be associated with freshwater production which may in the near future augment the conventional way of producing freshwater currently being thermal desalination. This work has shown that low grade waste heat in the chemical industries in Qatar and perhaps the rest of the world can contribute to additional production of freshwater using membrane distillation without significantly adding to the environmental impact.

Keywords: membrane distillation, desalination, heat recovery, environment

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968 Characterization of Martensitic Stainless Steel Japanese Grade AISI 420A

Authors: T. Z. Butt, T. A. Tabish, K. Anjum, H. Hafeez

Abstract:

A study of martensitic stainless steel surgical grade AISI 420A produced in Japan was carried out in this research work. The sample was already annealed at about 898˚C. The sample were subjected to chemical analysis, hardness, tensile and metallographic tests. These tests were performed on as received annealed and heat treated samples. In the annealed condition the sample showed 0HRC. However, on tensile testing, in annealed condition the sample showed maximum elongation. The heat treatment is carried out in vacuum furnace within temperature range 980-1035°C. The quenching of samples was carried out using liquid nitrogen. After hardening, the samples were subjected to tempering, which was carried out in vacuum tempering furnace at a temperature of 220˚C. The hardened samples were subjected to hardness and tensile testing. In hardness testing, the samples showed maximum hardness values. In tensile testing the sample showed minimum elongation. The sample in annealed state showed coarse plates of martensite structure. Therefore, the studied steels can be used as biomaterials.

Keywords: biomaterials, martensitic steel, microsrtucture, tensile testing, hardening, tempering, bioinstrumentation

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967 Utilization of the Compendium on Contextualized Story Word Problems in Mathematics

Authors: Rex C. Apillanes, Ana Rubi L. Sereño, Ellen Joy L. Palangan

Abstract:

The main objective of this action research is to know the effectiveness of the compendium on Contextualized Story Word Problem in Mathematics used as an intervention material to enhance the comprehension and problem-solving skills of Grade 4 pupils. This also addresses the competencies outlined in the curriculum guide while, at the same time, providing instructional material which the pupils can work on and practice solving word problems. The twelve randomly selected grade four pupils of Mantuyom Elementary School have been chosen as respondents for this action research in consideration of their consent and approval. A Pre-Test and a Post-test have been given to the pupils to determine their baseline proficiency level in four fundamental operations. The data has been statistically treated using a T-test to determine their difference. At a mean score of 13.42 and 16.83 for pre and post-tests, respectively, the p-value of 0.000620816 reflects a highly significant difference for the pre-test and post-test. This is lesser than the 0.05 level of significance (p≤0.05). Therefore, it is found that the compendium of contextualized story word problems is an efficient instructional material for Mathematics 4, yet; it is recommended that a Parents’ User Guide shall be developed to assist the parents in the conduct of the Remediation, Reinforcement and Enhancement (RRE).

Keywords: action research, compendium, contextualized, story, word problem, research, intervention

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966 Predictive Value of ¹⁸F-Fluorodeoxyglucose Accumulation in Visceral Fat Activity to Detect Epithelial Ovarian Cancer Metastases

Authors: A. F. Suleimanov, A. B. Saduakassova, V. S. Pokrovsky, D. V. Vinnikov

Abstract:

Relevance: Epithelial ovarian cancer (EOC) is the most lethal gynecological malignancy, with relapse occurring in about 70% of advanced cases with poor prognoses. The aim of the study was to evaluate functional visceral fat activity (VAT) evaluated by ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) as a predictor of metastases in epithelial ovarian cancer (EOC). Materials and methods: We assessed 53 patients with histologically confirmed EOC who underwent ¹⁸F-FDG PET/CT after a surgical treatment and courses of chemotherapy. Age, histology, stage, and tumor grade were recorded. Functional VAT activity was measured by maximum standardized uptake value (SUVₘₐₓ) using ¹⁸F-FDG PET/CT and tested as a predictor of later metastases in eight abdominal locations (RE – Epigastric Region, RLH – Left Hypochondriac Region, RRL – Right Lumbar Region, RU – Umbilical Region, RLL – Left Lumbar Region, RRI – Right Inguinal Region, RP – Hypogastric (Pubic) Region, RLI – Left Inguinal Region) and pelvic cavity (P) in the adjusted regression models. We also identified the best areas under the curve (AUC) for SUVₘₐₓ with the corresponding sensitivity (Se) and specificity (Sp). Results: In both adjusted-for regression models and ROC analysis, ¹⁸F-FDG accumulation in RE (cut-off SUVₘₐₓ 1.18; Se 64%; Sp 64%; AUC 0.669; p = 0.035) could predict later metastases in EOC patients, as opposed to age, sex, primary tumor location, tumor grade, and histology. Conclusions: VAT SUVₘₐₓ is significantly associated with later metastases in EOC patients and can be used as their predictor.

Keywords: ¹⁸F-FDG, PET/CT, EOC, predictive value

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965 The Predictors of Student Engagement: Instructional Support vs Emotional Support

Authors: Tahani Salman Alangari

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Student success can be impacted by internal factors such as their emotional well-being and external factors such as organizational support and instructional support in the classroom. This study is to identify at least one factor that forecasts student engagement. It is a cross-sectional, conducted on 6206 teachers and encompassed three years of data collection and observations of math instruction in approximately 50 schools and 300 classrooms. A multiple linear regression revealed that a model predicting student engagement from emotional support, classroom organization, and instructional support was significant. Four linear regression models were tested using hierarchical regression to examine the effects of independent variables: emotional support was the highest predictor of student engagement while instructional support was the lowest.

Keywords: student engagement, emotional support, organizational support, instructional support, well-being

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964 Reciprocity and Empathy in Motivating Altruism among Sixth Grade Students

Authors: Rylle Evan Gabriel Zamora, Micah Dennise Malia, Abygail Deniese Villabona

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The primary motivators of altruism are usually viewed as mutually exclusive. In this study, we wanted to know if the two primary motivators, reciprocity and empathy, can work together in motivating altruism. Therefore, we wanted to find out if there is a significant interaction of effects between reciprocity and empathy. To show how this may occur, we devised the combined altruism model, which is based on Batson’s empathy altruism hypothesis. A sample of 120, 6th-grade students were randomly selected and then randomly assigned to four treatment groups. A 2x2 between subjects’ design was used, which had empathy and reciprocity as independent variables, and altruism as the dependent variable. The study made use of materials that were effort based, where subjects were required to complete a task or a puzzle to help a person in a given scenario, two videos, one to prime empathy were also used. This along with Witt & Boleman’s adapted Self-Reported Altruism Scale was used to determine an individual’s altruism. It was found that both variables were significant in motivating altruism, with empathy being the greater of the two. However, there was no significant interaction of effects between the two variables. To explain why this occurred, we turned to the combined altruism model, where it was found that when empathically primed, we tend to not think of ourselves when helping others. Future studies could focus on other variables, especially age which is said to be one of the greatest factors that influenced the results of the experiment.

Keywords: reciprocity, empathy, altruism, experimental psychology, social psychology

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963 Challenges for Competency-Based Learning Design in Primary School Mathematics in Mozambique

Authors: Satoshi Kusaka

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The term ‘competency’ is attracting considerable scholarly attention worldwide with the advance of globalization in the 21st century and with the arrival of a knowledge-based society. In the current world environment, familiarity with varied disciplines is regarded to be vital for personal success. The idea of a competency-based educational system was mooted by the ‘Definition and Selection of Competencies (DeSeCo)’ project that was conducted by the Organization for Economic Cooperation and Development (OECD). Further, attention to this topic is not limited to developed countries; it can also be observed in developing countries. For instance, the importance of a competency-based curriculum was mentioned in the ‘2013 Harmonized Curriculum Framework for the East African Community’, which recommends key competencies that should be developed in primary schools. The introduction of such curricula and the reviews of programs are actively being executed, primarily in the East African Community but also in neighboring nations. Taking Mozambique as a case in point, the present paper examines the conception of ‘competency’ as a target of frontline education in developing countries. It also aims to discover the manner in which the syllabus, textbooks and lessons, among other things, in primary-level math education are developed and to determine the challenges faced in the process. This study employs the perspective of competency-based education design to analyze how the term ‘competency’ is defined in the primary-level math syllabus, how it is reflected in the textbooks, and how the lessons are actually developed. ‘Practical competency’ is mentioned in the syllabus, and the description of the term lays emphasis on learners' ability to interactively apply socio-cultural and technical tools, which is one of the key competencies that are advocated in OECD's ‘Definition and Selection of Competencies’ project. However, most of the content of the textbooks pertains to ‘basic academic ability’, and in actual classroom practice, teachers often impart lessons straight from the textbooks. It is clear that the aptitude of teachers and their classroom routines are greatly dependent on the cultivation of their own ‘practical competency’ as it is defined in the syllabus. In other words, there is great divergence between the ‘syllabus’, which is the intended curriculum, and the content of the ‘textbooks’. In fact, the material in the textbooks should serve as the bridge between the syllabus, which forms the guideline, and the lessons, which represent the ‘implemented curriculum’. Moreover, the results obtained from this investigation reveal that the problem can only be resolved through the cultivation of ‘practical competency’ in teachers, which is currently not sufficient.

Keywords: competency, curriculum, mathematics education, Mozambique

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962 Production of Pre-Reduction of Iron Ore Nuggets with Lesser Sulphur Intake by Devolatisation of Boiler Grade Coal

Authors: Chanchal Biswas, Anrin Bhattacharyya, Gopes Chandra Das, Mahua Ghosh Chaudhuri, Rajib Dey

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Boiler coals with low fixed carbon and higher ash content have always challenged the metallurgists to develop a suitable method for their utilization. In the present study, an attempt is made to establish an energy effective method for the reduction of iron ore fines in the form of nuggets by using ‘Syngas’. By devolatisation (expulsion of volatile matter by applying heat) of boiler coal, gaseous product (enriched with reducing agents like CO, CO2, H2, and CH4 gases) is generated. Iron ore nuggets are reduced by this syngas. For that reason, there is no direct contact between iron ore nuggets and coal ash. It helps to control the minimization of the sulphur intake of the reduced nuggets. A laboratory scale devolatisation furnace designed with reduction facility is evaluated after in-depth studies and exhaustive experimentations including thermo-gravimetric (TG-DTA) analysis to find out the volatile fraction present in boiler grade coal, gas chromatography (GC) to find out syngas composition in different temperature and furnace temperature gradient measurements to minimize the furnace cost by applying one heating coil. The nuggets are reduced in the devolatisation furnace at three different temperatures and three different times. The pre-reduced nuggets are subjected to analytical weight loss calculations to evaluate the extent of reduction. The phase and surface morphology analysis of pre-reduced samples are characterized using X-ray diffractometry (XRD), energy dispersive x-ray spectrometry (EDX), scanning electron microscopy (SEM), carbon sulphur analyzer and chemical analysis method. Degree of metallization of the reduced nuggets is 78.9% by using boiler grade coal. The pre-reduced nuggets with lesser sulphur content could be used in the blast furnace as raw materials or coolant which would reduce the high quality of coke rate of the furnace due to its pre-reduced character. These can be used in Basic Oxygen Furnace (BOF) as coolant also.

Keywords: alternative ironmaking, coal gasification, extent of reduction, nugget making, syngas based DRI, solid state reduction

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961 Causes and Implications of Obesity in Urban School Going Children

Authors: Mohammad Amjad, Muhammad Iqbal Zafar, Ashfaq Ahmed Maan, Muhammad Tayyab Kashif

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Obesity is an abnormal physical condition where an increased and undesirable fat accumulates in the human body. Obesity is an international phenomenon. In the present study, 12 schools were randomly selected from each district considering the areas i.e. Elite Private Schools in the private sector, Government schools in urban areas and Government schools in rural areas. Interviews were conducted with male students studying in grade 5 to grade 9 in each school. The sample size was 600 students; 300 from Faisalabad district and 300 from Rawalpindi district in Pakistan. A well-structured and pre-tested questionnaire was used for data collection. The calibrated scales were used to attain the heights and weights of the respondents. Obesity of school-going children depends on family types, family size, family history, junk food consumption, mother’s education, weekly time spent in walking, and sports facility at school levels. Academic performance, physical health and psychological health of school going children are affected with obesity. Concrete steps and policies could minimize the incidence of obesity in children in Pakistan.

Keywords: body mass index, cardiovascular disease, fast food, morbidity, overweight

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960 The Effect of Voice Recognition Dictation Software on Writing Quality in Third Grade Students: An Action Research Study

Authors: Timothy J. Grebec

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This study investigated whether using a voice dictation software program (i.e., Google Voice Typing) has an impact on student writing quality. The research took place in a third-grade general education classroom in a suburban school setting. Because the study involved minors, all data was encrypted and deidentified before analysis. The students completed a series of writings prior to the beginning of the intervention to determine their thoughts and skill level with writing. During the intervention phase, the students were introduced to the voice dictation software, given an opportunity to practice using it, and then assigned writing prompts to be completed using the software. The prompts written by nineteen student participants and surveys of student opinions on writing established a baseline for the study. The data showed that using the dictation software resulted in a 34% increase in the response quality (compared to the Pennsylvania State Standardized Assessment [PSSA] writing guidelines). Of particular interest was the increase in students' proficiency in demonstrating mastery of the English language and conventions and elaborating on the content. Although this type of research is relatively no, it has the potential to reshape the strategies educators have at their disposal when instructing students on written language.

Keywords: educational technology, accommodations, students with disabilities, writing instruction, 21st century education

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959 Cultural Aspect Representation: An Analysis of EFL Textbook Grade 10 Years 2017 in Indonesia

Authors: Soni Ariawan

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The discourse of language and culture relation is an interesting issue to be researched. The debate is not about what comes first, language or culture, but it strongly argues that learning foreign language also means learning the culture of the language. The more interesting issue found once constructing an EFL textbook dealing with proportional representation among source culture, target culture and international culture. This study investigates cultural content representation in EFL textbook grade 10 year 2017 in Indonesia. Cortazzi and Jin’s theoretical framework is employed to analyse the reading texts, conversations, and images. The finding shows that national character as the main agenda of Indonesian government is revealed in this textbook since the textbook more frequently highlights the source culture (Indonesian culture) compared to target and international culture. This is aligned with the aim of Indonesian government to strengthen the national identity and promoting local culture awareness through education. To conclude, the study is expected to be significant in providing the idea for government to consider cultural balances representation in constructing textbook. Furthermore, teachers and students should be aware of cultural content revealed in the EFL textbook and be able to enhance intercultural communication not only in the classroom but also in a wider society.

Keywords: EFL textbook, intercultural communication, local culture, target culture, international culture

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958 The Effect of Group Counseling Program on 9th Grade Students' Assertiveness Levels

Authors: Ismail Seçer, Kerime Meryem Dereli̇oğlu

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This study is conducted to determine the effects of group counseling program on secondary school 9th grade students’ assertiveness skills. The study group was formed of 100 students who have received education in Erzurum Kültür Elementary School in 2015-2016 education years. RAE-Rathus Assertiveness Schedule developed by Voltan Acar was applied on this group to gather data. 40 students who got lower grades from the inventory were divided randomly into experimental and control groups. Each group is formed of 20 students. Group counseling program was carried out on the experimental group to improve the students’ assertiveness skills for 8 weeks. Single-way and two-way analysis of covariance (ANCOVA) were used in the analysis of the data. The data was analyzed by using the SPSS 19.00. The results of the study show that assertiveness skills of the students who participate in the group counseling program increased meaningfully compared to the control group and pre-experiment. Besides, it was determined that the change observed in the experimental group occurred separately from the age and socio-economic level variables, and it was determined with the monitoring test applied after four months that this affect was continued. According to this result, it can be said that the applied group counseling program is an effective means to improve the assertiveness skills of secondary school students.

Keywords: high school, assertiveness, assertiveness inventory, assertiveness education

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957 CO₂ Recovery from Biogas and Successful Upgrading to Food-Grade Quality: A Case Study

Authors: Elisa Esposito, Johannes C. Jansen, Loredana Dellamuzia, Ugo Moretti, Lidietta Giorno

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The reduction of CO₂ emission into the atmosphere as a result of human activity is one of the most important environmental challenges to face in the next decennia. Emission of CO₂, related to the use of fossil fuels, is believed to be one of the main causes of global warming and climate change. In this scenario, the production of biomethane from organic waste, as a renewable energy source, is one of the most promising strategies to reduce fossil fuel consumption and greenhouse gas emission. Unfortunately, biogas upgrading still produces the greenhouse gas CO₂ as a waste product. Therefore, this work presents a case study on biogas upgrading, aimed at the simultaneous purification of methane and CO₂ via different steps, including CO₂/methane separation by polymeric membranes. The original objective of the project was the biogas upgrading to distribution grid quality methane, but the innovative aspect of this case study is the further purification of the captured CO₂, transforming it from a useless by-product to a pure gas with food-grade quality, suitable for commercial application in the food and beverage industry. The study was performed on a pilot plant constructed by Tecno Project Industriale Srl (TPI) Italy. This is a model of one of the largest biogas production and purification plants. The full-scale anaerobic digestion plant (Montello Spa, North Italy), has a digestive capacity of 400.000 ton of biomass/year and can treat 6.250 m3/hour of biogas from FORSU (organic fraction of solid urban waste). The entire upgrading process consists of a number of purifications steps: 1. Dehydration of the raw biogas by condensation. 2. Removal of trace impurities such as H₂S via absorption. 3.Separation of CO₂ and methane via a membrane separation process. 4. Removal of trace impurities from CO₂. The gas separation with polymeric membranes guarantees complete simultaneous removal of microorganisms. The chemical purity of the different process streams was analysed by a certified laboratory and was compared with the guidelines of the European Industrial Gases Association and the International Society of Beverage Technologists (EIGA/ISBT) for CO₂ used in the food industry. The microbiological purity was compared with the limit values defined in the European Collaborative Action. With a purity of 96-99 vol%, the purified methane respects the legal requirements for the household network. At the same time, the CO₂ reaches a purity of > 98.1% before, and 99.9% after the final distillation process. According to the EIGA/ISBT guidelines, the CO₂ proves to be chemically and microbiologically sufficiently pure to be suitable for food-grade applications.

Keywords: biogas, CO₂ separation, CO2 utilization, CO₂ food grade

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956 Contextualization and Localization: Acceptability of the Developed Activity Sheets in Science 5 Integrating Climate Change Adaptation

Authors: Kim Alvin De Lara

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The research aimed to assess the level of acceptability of the developed activity sheets in Science 5 integrating climate change adaptation of grade 5 science teachers in the District of Pililla school year 2016-2017. In this research, participants were able to recognize and understand the importance of environmental education in improving basic education and integrating them in lessons through localization and contextualization. The researcher conducted the study to develop a material to use by Science teachers in Grade 5. It served also as a self-learning resource for students. The respondents of the study were the thirteen Grade 5 teachers teaching Science 5 in the District of Pililla. Respondents were selected purposively and identified by the researcher. A descriptive method of research was utilized in the research. The main instrument was a checklist which includes items on the objectives, content, tasks, contextualization and localization of the developed activity sheets. The researcher developed a 2-week lesson in Science 5 for 4th Quarter based on the curriculum guide with integration of climate change adaptation. The findings revealed that majority of respondents are female, 31 years old and above, 10 years above in teaching science and have units in master’s degree. With regards to the level of acceptability, the study revealed developed activity sheets in science 5 is very much acceptable. In view of the findings, lessons in science 5 must be contextualized and localized to improve to make the curriculum responds, conforms, reflects, and be flexible to the needs of the learners, especially the 21st century learners who need to be holistically and skillfully developed. As revealed by the findings, it is more acceptable to localized and contextualized the learning materials for pupils. Policy formation and re-organization of the lessons and competencies in Science must be reviewed and re-evaluated. Lessons in science must also be integrated with climate change adaptation since nowadays, people are experiencing change in climate due to global warming and other factors. Through developed activity sheets, researcher strongly supports environmental education and believes this to serve as a way to instill environmental literacy to students.

Keywords: activity sheets, climate change adaptation, contextualization, localization

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955 Algorithmic Skills Transferred from Secondary CSI Studies into Tertiary Education

Authors: Piroska Biró, Mária Csernoch, János Máth, Kálmán Abari

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Testing the first year students of Informatics at the University of Debrecen revealed that students start their tertiary studies in programming with a low level of programming knowledge and algorithmic skills. The possible reasons which lead the students to this very unfortunate result were examined. The results of the test were compared to the students’ results in the school leaving exams and to their self-assessment values. It was found that there is only a slight connection between the students’ results in the test and in the school leaving exams, especially at intermediate level. Beyond this, the school leaving exams do not seem to enable students to evaluate their own abilities.

Keywords: deep and surface approaches, metacognitive abilities, programming and algorithmic skills, school leaving exams, tracking code

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954 PTOP Expression Correlates with Telomerase Activity and Grades of Malignancy in Human Glioma Tissues

Authors: F. Polito, M. Cucinotta, A. Conti, C. Lo Giudice, C. Tomasello, F. Angileri, D. La Torre, M. Aguennouz

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Glioblastoma multiforme (GBM) is the most aggressive form of brain tumors, with an extremely poor prognosis. Telomeres lenght is associated with tumor progression in several type of human cancers and telomere elongation is a common molecular feature of advanced malignancies. Among the telomeric shelterin proteins PTOP is required for telomeric protein complex assembly, telomerase recruitment and activity, and telomere length regulation through a PTOP-telomerase interaction. Previous studies suggest that PTOP upregulation is involved in radioresistance and telomere lengthening in colorectal cancer cells. Moreover, in human osteosarcoma cells PTOP deletion led to telomere shortening, increased apoptosis and radiation sensitivity enhancement. However, to date, little is known about the role of PTOP in progression of glioma cancers. In light of this background aim of the study is to investigate the expression of PTOP in different grades of human glioma and its correlation with the pathological grade of gliomas, grades of malignancy, proliferative activity and apoptosis. Fifteen Low Grade Astrocytomas (LGA), 18 Anaplastic Astrocytomas (AA) and 26 Glioblastoma Multiforme (GBM) samples were analyzed. Three samples of normal brain tissue (NBT) were used as controls. The expression levels of PTOP, h-TERT, BIRC1 and cyclin D1 were determined by real time PCR and/or western blot. Results obtained shows that PTOP expression in glioma tissues is tightly correlated with clinical grade ( p < 0.01 ). No correlation was found between PTOP expression and other clinicopathologic parameters. The expression of PTOP was positively correlated with the expression of hTERT and TERF1. Furthermore PTOP positively correlates with cyclin D1 and negatively correlates with the expression of BIRC1. Our findings indicate that PTOP might play key role in the progression of glioma regulating telomerase activity and likely through regulation of cell cycle and apoptosis. In conclusion results obtained prompted us to speculate that PTOP might represents a potential molecular bio marker and a therapeutic target for the treatment of glioblastoma tumors.

Keywords: glioblastoma, PTOP, telomere, brain tumors

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953 Development of Elementary Literacy in the Czech Republic

Authors: Iva Košek Bartošová

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There is great attention being paid in the field of development of first reading, thus early literacy skills in the Czech Republic. Yet inconclusive results of PISA and PIRLS force us to think over the teacher´s work, his/her roles in the education process and methods and forms used in lessons. There is also a significant importance to monitor the family environment and the pupil, themselves. The aim of the publishing output is to focus on one side dealing with methods of practicing reading technique and their results in the process of comprehension. In the first part of the contribution there are the goals of development of reading literacy and the methods used in reading practice in some EU countries and a follow-up comparison of research implemented by the help of modern technology of an eye tracker device in the year 2015 and a research conducted at the Institute of Education and Psychological Counselling of the Czech Republic in the year 2011/12. These are the results of a diagnostic test of reading in first classes of primary schools, taught by the genetic method and analytic-synthetic method. The results show that in the first stage of practice there are no statistically significant differences between any researched subjects taught by different methods of reading practice (with the use of several diagnostic texts focused on reading technique and its comprehension). Different results are shown at the end of Grade One and during Grade Two of primary school.

Keywords: elementary literacy, eye tracker device, diagnostic reading tests, reading teaching method

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952 A Comparison between the McGrath Video Laryngoscope and the Macintosh Laryngoscopy in Children with Expected Normal Airway

Authors: Jong Yeop Kim, Ji Eun Kim, Hyun Jeong Kwak, Sook Young Lee

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Background: This prospective, randomized, controlled study was performed to evaluate the usefulness of the McGrath VL compared to Macintosh laryngoscopy in children with expected normal airway during endotracheal intubation, by comparing the time to intubation and ease of intubation. Methods: Eighty-four patients, aged 1-10 years undergoing endotracheal intubation for elective surgery were randomly assigned to McGrath group (n = 42) or Macintosh group (n = 42). Anesthesia was induced with propofol 2.5-3.0 mg/kg and sevoflurane 5-8 vol%. Orotracheal intubation was performed 2 minutes after injection of rocuronium 0.6 mg/kg with McGrath VL or Macintosh laryngoscope. The primary outcome was time to intubation. The Cormack and Lehane glottic grade, intubation difficulty score (IDS), and success rate of intubation were assessed. Hemodynamic changes also were recorded. Results: Median time to intubation [interquartile range] was not different between the McGrath group and the Macintosh group (25.0 [22.8-28.3] s vs. 26.0 [24.0-29.0] s, p = 0.301). The incidence of grade I glottic view was significantly higher in theMcGrath group than in the Macintosh group (95% vs. 74%, p = 0.013). Median IDS was lower in the McGrath group than in the Macintosh group (0 [0-0] vs. 0 [0-1], p = 0.018). There were no significant differences in success rate on intubation or hemodynamics between the two groups. Conclusions: McGrath VL provides better laryngeal views and lower IDS, but similar intubation times and success rates compared to the Macintosh laryngoscope in children with the normal airway.

Keywords: intubation, Macintosh laryngoscopy, Mcgrath videolaryngoscopy, pediatrics

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951 PD-L1 Expression in Papillary Thyroid Carcinoma Arising Denovo or on Top of Autoimmune Thyroiditis

Authors: Dalia M. Abouelfadl, Noha N. Yassen, Marwa E. Shabana

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Background: The evolution of immune therapy motivated many to study the relation between immune response and progression of cancer. Little is known about expression of PD-L1 (a newly evolving immunotherapeutic drug) in papillary thyroid carcinoma (PTC) arising de-novo and PTC arising on top of autoimmune thyroiditis (Hashimoto's (HT) and lymphocytic thyroiditis (LT)). The aim of this work is to study the alteration of expression of PD-L1 in PTCs arising from de-novo or on top of HT OR LT using immunohistochemistry and image analyser system. Method: 100 paraffin blocks for PTC cases were collected retrospectively for staining using PD-L1 rabbit monoclonal antibody (BIOCARE-ACI 3171 A, C). The antibody expression is measured digitally using Image Analyzer Leica Qwin 3000, and the membranous and cytoplasmic expression of PD-L1 in tumor cells was considered positive. The results were correlated with tumor grade, size, and LN status. Results: The study samples consisted of 41 cases of PTC arising De novo, 36 cases on top of HT, and 23 on top of LT. Expression of PD-L1 was highest among the PTC-HL group (25 case-69%) followed by PTC-TL group (14 case-60.8%) then de-novo PTC (19 case-46%) with P Value < 0.05. PD-L1 expression correlated with nodal metastasis and was not relevant to tumor size or grade. Conclusion: The severity of the immune response in tumor microenvironment directly influences PTC prognosis. The anti PD-L1 Ab can be a very successful therapeutic agent for PTC arising on top of HT.

Keywords: carcinoma, Hashimoto's, lymphocytic, papillary, PD-L1, thyroiditis

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950 Different Approaches to Teaching a Database Course to Undergraduate and Graduate Students

Authors: Samah Senbel

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Database Design is a fundamental part of the Computer Science and Information technology curricula in any school, as well as in the study of management, business administration, and data analytics. In this study, we compare the performance of two groups of students studying the same database design and implementation course at Sacred Heart University in the fall of 2018. Both courses used the same textbook and were taught by the same professor, one for seven graduate students and one for 26 undergraduate students (juniors). The undergraduate students were aged around 20 years old with little work experience, while the graduate students averaged 35 years old and all were employed in computer-related or management-related jobs. The textbook used was 'Database Systems, Design, Implementation, and Management' by Coronel and Morris, and the course was designed to follow the textbook roughly a chapter per week. The first 6 weeks covered the design aspect of a database, followed by a paper exam. The next 6 weeks covered the implementation aspect of the database using SQL followed by a lab exam. Since the undergraduate students are on a 16 week semester, we spend the last three weeks of the course covering NoSQL. This part of the course was not included in this study. After the course was over, we analyze the results of the two groups of students. An interesting discrepancy was observed: In the database design part of the course, the average grade of the graduate students was 92%, while that of the undergraduate students was 77% for the same exam. In the implementation part of the course, we observe the opposite: the average grade of the graduate students was 65% while that of the undergraduate students was 73%. The overall grades were quite similar: the graduate average was 78% and that of the undergraduates was 75%. Based on these results, we concluded that having both classes follow the same time schedule was not beneficial, and an adjustment is needed. The graduates could spend less time on design and the undergraduates would benefit from more design time. In the fall of 2019, 30 students registered for the undergraduate course and 15 students registered for the graduate course. To test our conclusion, the undergraduates spend about 67% of time (eight classes) on the design part of the course and 33% (four classes) on the implementation part, using the exact exams as the previous year. This resulted in an improvement in their average grades on the design part from 77% to 83% and also their implementation average grade from 73% to 79%. In conclusion, we recommend using two separate schedules for teaching the database design course. For undergraduate students, it is important to spend more time on the design part rather than the implementation part of the course. While for the older graduate students, we recommend spending more time on the implementation part, as it seems that is the part they struggle with, even though they have a higher understanding of the design component of databases.

Keywords: computer science education, database design, graduate and undergraduate students, pedagogy

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949 Effect of Science Learning Module in Filipino on Content Mastery and Conceptual Understanding of Grade 9 Students

Authors: Roly B. Bayo-Ang

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This research investigated the effect of science intervention modules in Filipino and in English on mastery of content (MOC) and conceptual understanding of Grade 9 students in Chemistry. Analysis of content mastery scores revealed a significant difference in the mean scores of the control and experimental group, t (46) = -2.14, p < 0.05. The experimental group achieved an MPS of > 75% in three of the five lessons while none in the control group. Analysis of the pretest and posttest scores of the control group in the test for conceptual understanding (TCU) showed no significant difference, t (18), =1.44, p > 0.05, while pretest and posttest scores of experimental group revealed significant difference, t (29) = -5.08, p < 0.05. Comparison of posttest scores of control and experimental group revealed no significant difference t (42) =1.67, p > 0.05. Performance in TCU and MOC of the control group are not significantly correlated, r (17) =.307, p > 0.05; but significantly correlated, r (27) =.571, p < 0.05, for the experimental group. The intervention module in Filipino promotes conceptual understanding and mastery of content than the module in English.

Keywords: action research, conceptual understanding, mastery of content, Filipino module

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948 Case Report of a Secretory Carcinoma of the Salivary Gland: Clinical Management Following High-Grade Transformation

Authors: Wissam Saliba, Mandy Nicholson

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Secretory carcinoma (SC) is a rare type of salivary gland cancer. It was first realized as a distinct type of malignancy in 2010and wasinitially termed “mammary analogue secretory carcinoma” because of similarities with secretory breast cancer. The name was later changed to SC. Most SCs originate in parotid glands, and most harbour a rare gene mutation: ETV6-NTRK3. This mutation is rare in common cancers and common in rare cancers; it is present in most secretory carcinomas. Disease outcomes for SC are usually described as favourable as many cases of SC are lowgrade (LG), and cancer growth is slow. In early stages, localized therapy is usually indicated (surgery and/or radiation). Despitea favourable prognosis, a sub-set of casescan be much more aggressive.These cases tend to be of high-grade(HG).HG casesare associated with a poorer prognosis.Management of such cases can be challenging due to limited evidence for effective systemic therapy options. This case report describes the clinical management of a 46-year-oldmale patient with a unique case of SC. He was initially diagnosed with a low/intermediate grade carcinoma of the left parotid gland in 2009; he was treated with surgery and adjuvant radiation. Surgical pathology favoured primary salivary adenocarcinoma, and 2 lymph nodes were positive for malignancy. SC was not yet realized as a distinct type of cancerat the time of diagnosis, and the pathology reportvalidated this gap by stating that the specimen lacked features of the defined types of salivary carcinoma.Slow-growing pulmonary nodules were identified in 2017. In 2020, approximately 11 years after the initial diagnosis, the patient presented with malignant pleural effusion. Pathology from a pleural biopsy was consistent with metastatic poorly differentiated cancer of likely parotid origin, likely mammary analogue secretory carcinoma. The specimen was sent for Next Generation Sequencing (NGS); ETV6-NTRK3 gene fusion was confirmed, and systemic therapy was initiated.One cycle ofcarboplatin/paclitaxel was given in June 2020. He was switched to Larotrectinib (NTRK inhibitor (NTRKi)) later that month. Larotrectinib continued for approximately 9 months, with discontinuation in March 2021 due to disease progression. A second-generation NTRKi (Selitrectinib) was accessed and prescribedthrough a single patient study. Selitrectinib was well tolerated. The patient experienced a complete radiological response within~4 months. Disease progression occurred once again in October 2021. Progression was slow, and Selitrectinib continuedwhile the medical team performed a thorough search for additional treatment options. In January 2022, a liver lesion biopsy was performed, and NGS showed an NTRKG623R solvent-front resistance mutation. Various treatment pathways were considered. The patient pursuedanother investigational NTRKi through a clinical trial, and Selitrectinib was discontinued in July 2022. Excellent performance status was maintained throughout the entire course of treatment.It can be concluded that NTRK inhibitors provided satisfactory treatment efficacy and tolerance for this patient with high-grade transformation and NTRK gene fusion cancer. In the future, more clinical research is needed on systemic treatment options for high-grade transformations in NTRK gene fusion SCs.

Keywords: secretory carcinoma, high-grade transformations, NTRK gene fusion, NTRK inhibitor

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947 Extracting Therapeutic Grade Essential Oils from the Lamiaceae Plant Family in the United Arab Emirates (UAE): Highlights on Great Possibilities and Sever Difficulties

Authors: Suzan M. Shahin, Mohammed A. Salem

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Essential oils are expensive phytochemicals produced and extracted from specific species belonging to particular families in the plant kingdom. In the United Arab Emirates country (UAE), which is located in the arid region of the world, nine species, from the Lamiaceae family, having the capability to produce therapeutic grade essential oils. These species include; Mentha spicata, Ocimum forskolei, Salvia macrosiphon, Salvia aegyptiaca, Salvia macilenta, Salvia spinosa, Teucrium polium, Teucrium stocksianum, and Zataria multiflora. Although, such potential species are indigenous to the UAE, however, there are almost no studies available to investigate the chemical composition and the quality of the extracted essential oils under the UAE climatological conditions. Therefore, great attention has to be given to such valuable natural resources, through conducting highly supported research projects, tailored to the UAE conditions, and investigating different extraction techniques, including the application of the latest available technologies, such as superficial fluid CO2. This is crucially needed; in order to accomplish the greatest possibilities in the medicinal field, specifically in the discovery of new therapeutic chemotypes, as well as, to achieve the sustainability of this natural resource in the country.

Keywords: essential oils, extraction techniques, Lamiaceae, traditional medicine, United Arab Emirates (UAE)

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946 Multi-Institutional Report on Toxicities of Concurrent Nivolumab and Radiation Therapy

Authors: Neha P. Amin, Maliha Zainib, Sean Parker, Malcolm Mattes

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Purpose/Objectives: Combination immunotherapy (IT) and radiation therapy (RT) is an actively growing field of clinical investigation due to promising findings of synergistic effects from immune-mediated mechanisms observed in preclinical studies and clinical data from case reports of abscopal effects. While there are many ongoing trials of combined IT-RT, there are still limited data on toxicity and outcome optimization regarding RT dose, fractionation, and sequencing of RT with IT. Nivolumab (NIVO), an anti-PD-1 monoclonal antibody, has been rapidly adopted in the clinic over the past 2 years, resulting in more patients being considered for concurrent RT-NIVO. Knowledge about the toxicity profile of combined RT-NIVO is important for both the patient and physician when making educated treatment decisions. The acute toxicity profile of concurrent RT-NIVO was analyzed in this study. Materials/Methods: A retrospective review of all consecutive patients who received NIVO from 1/2015 to 5/2017 at 4 separate centers within two separate institutions was performed. Those patients who completed a course of RT from 1 day prior to initial NIVO infusion through 1 month after last NIVO infusion were considered to have received concurrent therapy and included in the subsequent analysis. Descriptive statistics are reported for patient/tumor/treatment characteristics and observed acute toxicities within 3 months of RT completion. Results: Among 261 patients who received NIVO, 46 (17.6%) received concurrent RT to 67 different sites. The median f/u was 3.3 (.1-19.8) months, and 11/46 (24%) were still alive at last analysis. The most common histology, RT prescription, and treatment site included non-small cell lung cancer (23/46, 50%), 30 Gy in 10 fractions (16/67, 24%), and central thorax/abdomen (26/67, 39%), respectively. 79% (53/67) of irradiated sites were treated with 3D-conformal technique and palliative dose-fractionation. Grade 3, 4, and 5 toxicities were experienced by 11, 1, and 2 patients, respectively. However all grade 4 and 5 toxicities were outside of the irradiated area and attributed to the NIVO alone, and only 4/11 (36%) of the grade 3 toxicities were attributed to the RT-NIVO. The irradiated site in these cases included the brain [2/10 (20%)] and central thorax/abdomen [2/19 (10.5%)], including one unexpected grade 3 pancreatitides following stereotactic body RT to the left adrenal gland. Conclusions: Concurrent RT-NIVO is generally well tolerated, though with potentially increased rates of severe toxicity when irradiating the lung, abdomen, or brain. Pending more definitive data, we recommend counseling patients on the potentially increased rates of side effects from combined immunotherapy and radiotherapy to these locations. Future prospective trials assessing fractionation and sequencing of RT with IT will help inform combined therapy recommendations.

Keywords: combined immunotherapy and radiation, immunotherapy, Nivolumab, toxicity of concurrent immunotherapy and radiation

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