Search results for: clinical skills

Authors: Meredith Jones, Susan Catapano, Carol McNulty

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Study abroad experiences create unique learning opportunities for preservice teachers to strengthen their reflective thinking practices through applied learning experiences. Not only do study abroad experiences provide opportunities for students to expand their cultural sensitivity, but incorporating applied learning experiences in study abroad trips creates unique opportunities for preservice teachers to engage in critical reflection on their teaching skills. Applied learning experiences are designed to nurture learning and growth through a reflective, experiential process outside the traditional classroom setting. As students participate in applied learning experiences, they engage in critical reflection independently, with their peers, and with university faculty. Critical reflection within applied learning contexts generates, deepens, and documents learning but must be intentionally designed to be effective. Grounded in Dewey’s model of reflection, this qualitative study examines longitudinal data from various study abroad cohorts from a particular university. Reflective data was collected during the study abroad trip, and follow up data on critical reflection of teaching practices were collected six months and a year after the trip. Dewey’s model of reflection requires preservice teachers to make sense of their experiences by reflecting on theoretical knowledge, experiences, and pedagogical knowledge. Guided reflection provides preservice teachers with a framework to respond to questions and ideas critical to the applied learning outcomes. Prompts are used to engage preservice teachers in reflecting on situations they have experienced and how they can be transferred to their teaching. Findings from this study noted that students with previous field experiences, or work in the field, engaged in more critical reflection on pedagogical knowledge throughout their applied learning experience. Preservice teachers with limited experiences in the field benefited from engaging in critical reflection prompted by university faculty during the applied learning experience. However, they were able to independently engage in critical reflection once they began work in the field through university field placements, internships, or student teaching. Finally, students who participated in study abroad applied learning experiences reported their critical reflection on their teaching practices, and cultural sensitivity enhanced their teaching and relationships with children once they formally entered the teaching profession.

Keywords: applied learning experiences, critical reflection, cultural sensitivity, preservice teachers, teacher education

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Authors: Ekaterina Sánchez Romero, Emily Gabriela Aguirre Herrera, Sandra Luz Espinoza Esquerra, Jorge García Campos

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Female, 7 months old, daughter of a mother with anemia during pregnancy, with no history of atopy in the family, since birth she presents with recurrent dermatological and gastrointestinal infections, chronically treated for recurrent diaper dermatitis. At 6 months of age, she begins with generalized pallor, hyperpigmentation in hands and feet, smooth tongue, psychomotor retardation with lack of head support, sedation, and hypoactivity. She was referred to our hospital for a fever of 38°C, severe diaper rash, and pancytopenia with HB 9.3, platelets 38000, neutrophils 0.39 MCV: 86.80 high for her age. The approach was initiated to rule out myeloproliferative syndrome, with negative immunohistochemical results of bone marrow aspirate; during her stay, she presented neurological regression, lack of sucking, and focal seizures. CT scan showed cortical atrophy. The patient was diagnosed with primary immunodeficiency due to history; gamma globulin was administered without improvement with normal results of immunoglobulins and metabolic screening. When dermatological and neurological diagnoses were ruled out as the primary cause, a nutritional factor was evaluated, and a therapeutic trial was started with the administration of vitamin B12 and zinc, presenting clinical neurological improvement and resolution of pancytopenia in 2 months. It was decided to continue outpatient management. Discussion: We present a patient with neurological, dermatological involvement, and pancytopenia, so the most common differential diagnoses in this population were ruled out. Vitamin B12 deficiency is an uncommon entity. Due to maternal and clinical history, a therapeutic trial was started resulting in an improvement. Conclusion: VitaminB12 deficiency should be considered one of the differential diagnoses in the approach to pancytopenia with megaloblastic anemia associated with dermatologic and neurologic manifestations. Early treatment can reduce irreversible damage in these patients.

Keywords: vitamin B12 deficiency, pediatrics, pancytopenia, diaper dermatitis

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Authors: Maja Ruzic-Baf, Mirjana Radetic-Paic

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The use of computers by children has many positive aspects, including the development of memory, learning methods, problem-solving skills and the feeling of one’s own competence and self-confidence. Playing on line video games can encourage hanging out with peers having similar interests as well as communication; it develops coordination, spatial relations and presentation. On the other hand, the Internet enables quick access to different information and the exchange of experiences. How kids use computers and what the negative effects of this can be depends on various factors. ICT has improved and become easy to get for everyone. In the past 12 years so many video games has been made even to that level that some of them are free to play. Young people, even some adults, had simply start to forget about the real outside world because in that other, digital world, they have found something that makes them feal more worthy as a man. This article present the use of ICT, forms of behavior and addictions to on line video games. The use of computers by children has many positive aspects, including the development of memory, learning methods, problem-solving skills and the feeling of one’s own competence and self-confidence. Playing on line video games can encourage hanging out with peers having similar interests as well as communication; it develops coordination, spatial relations and presentation. On the other hand, the Internet enables quick access to different information and the exchange of experiences. How kids use computers and what the negative effects of this can be depends on various factors. ICT has improved and become easy to get for everyone. In the past 12 years so many video games has been made even to that level that some of them are free to play. Young people, even some adults, had simply start to forget about the real outside world because in that other, digital world, they have found something that makes them feal more worthy as a man. This article present the use of ICT, forms of behavior and addictions to on line video games.

Keywords: addiction to video games, behaviour, ICT, young people

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Authors: Oyuntsetseg Sandag, Lkhagvadorj Khosbayar, Naidansuren Tsendeekhuu, Densenbal Dansran, Bandi Solongo

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Introduction: Obstructive sleep apnea (OSA) is a common disorder affecting at least 2% to 4% of the adult population. It is estimated that nearly 80% of men and 93% of women with moderate to severe sleep apnea are undiagnosed. A number of screening questionnaires and clinical screening models have been developed to help identify patients with OSA, also it’s indeed to clinical practice. Purpose of study: Determine dependence of obstructive sleep apnea between for severe risk and risk factor. Material and Methods: A cross-sectional study included 114 patients presenting from theCentral state 3th hospital and Central state 1th hospital. Patients who had obstructive sleep apnea (OSA)selected in this study. Standard StopBang questionnaire was obtained from all patients.According to the patients’ response to the StopBang questionnaire was divided into low risk, intermediate risk, and high risk.Descriptive statistics were presented mean ± standard deviation (SD). Each questionnaire was compared on the likelihood ratio for a positive result, the likelihood ratio for a negative test result of regression. Statistical analyses were performed utilizing SPSS 16. Results: 114 patients were obtained (mean age 48 ± 16, male 57)that divided to low risk 54 (47.4%), intermediate risk 33 (28.9%), high risk 27 (23.7%). Result of risk factor showed significantly increasing that mean age (38 ± 13vs. 54 ± 14 vs. 59 ± 10, p<0.05), blood pressure (115 ± 18vs. 133 ± 19vs. 142 ± 21, p<0.05), BMI(24 IQR 22; 26 vs. 24 IQR 22; 29 vs. 28 IQR 25; 34, p<0.001), neck circumference (35 ± 3.4 vs. 38 ± 4.7 vs. 41 ± 4.4, p<0.05)were increased. Results from multiple logistic regressions showed that age is significantly independently factor for OSA (odds ratio 1.07, 95% CI 1.02-1.23, p<0.01). Predictive value of age was significantly higher factor for OSA (AUC=0.833, 95% CI 0.758-0.909, p<0.001). Our study showing that risk of OSA is beginning 47 years old (sensitivity 78.3%, specifity74.1%). Conclusions: According to most of all patients’ response had intermediate risk and high risk. Also, age, blood pressure, neck circumference and BMI were increased such as risk factor was increased for OSA. Especially age is independently factor and highest significance for OSA. Patients’ age one year is increased likelihood risk factor 1.1 times is increased.

Keywords: obstructive sleep apnea, Stop-Bang, BMI (Body Mass Index), blood pressure

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Authors: Joseph Udofia, Isaac Olufadewa

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Everyday, the size of Electronic Health Records data keeps increasing as new patients visit health practitioner and returning patients fulfil their appointments. As these data grow, so is their susceptibility to cyber-attacks from criminals waiting to exploit this data. In the US, the damages for cyberattacks were estimated at $8 billion (2018), $11.5 billion (2019) and $20 billion (2021). These attacks usually involve the exposure of PII. Health data is considered PII, and its exposure carry significant impact. To this end, an enhancement of Health Policy and Standards in relation to data security, especially among patients and their clinical providers, is critical to ensure ethical practices, confidentiality, and trust in the healthcare system. As Clinical accelerators and applications that contain user data are used, it is expedient to have a review and revamp of policies like the Payment Card Industry Data Security Standard (PCI DSS), the Health Insurance Portability and Accountability Act (HIPAA), the Fast Healthcare Interoperability Resources (FHIR), all aimed to ensure data protection and security in healthcare. FHIR caters for healthcare data interoperability, FHIR caters to healthcare data interoperability, as data is being shared across different systems from customers to health insurance and care providers. The astronomical cost of implementation has deterred players in the space from ensuring compliance, leading to susceptibility to data exfiltration and data loss on the security accuracy of protected health information (PHI). Though HIPAA hones in on the security accuracy of protected health information (PHI) and PCI DSS on the security of payment card data, they intersect with the shared goal of protecting sensitive information in line with industry standards. With advancements in tech and the emergence of new technology, it is necessary to revamp these policies to address the complexity and ambiguity, cost barrier, and ever-increasing threats in cyberspace. Healthcare data in the wrong hands is a recipe for disaster, and we must enhance its protection and security to protect the mental health of the current and future generations.

Keywords: cloud security, healthcare, cybersecurity, policy and standard

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Authors: David Onen

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Staff exchanges amongst different work organizations are a growing international phenomenon. In higher education in particular, it is not only the staff participating on international exchange programs, but their students as well. The practice of exchanging staff is premised on the belief that participating members of staff would not only get the chance to network with colleagues from partner institutions but also gain the opportunity for knowledge sharing and skills development. As a result, it would not only benefit the participating individual staff but their institutions too. However, in practice, staff exchange programs everywhere are not all ‘a bed of roses’. In fact, some of the programs seem to be laden with unapparent source of trouble or danger for the participating staff. This paper is a report on an on-going study investigating the experiences of members of academic staff of Makerere University in Uganda who have ever participated on international staff exchange programs. The study is aimed at documenting individual experiences in order to stimulate, not only a debate, but practical ways of enriching the experiences of staff who engage on well-meant international staff exchange programs. The study has employed an exploratory survey research design in which self-administered questionnaire and interview guide are being used to collect data from university academic staff respondents selected through snow-ball and purposive sampling techniques. Data have been analysed with the use of appropriate descriptive and inferential statistics as well as content analysis techniques. Preliminary study findings reveal that the majority of the respondents (95.5%) were, to a large extent, fully satisfied with their participation on the staff exchange programs. Many attested to gaining new experience (97%), networking (75%), gaining new knowledge (94%), acquiring new skills (88%), and therefore bringing to their institutions something ‘new’ and ‘beneficial’. However, a reasonably large percentage (57%) of the participants too expressed dissatisfaction in the institutional support that Makerere University gave them during their participation on the exchange programs. Some respondents reported about the ‘unfriendly welcome’ they received upon returning ‘home’ because colleagues detested how they were chosen to participate on such programs. The researcher thus concluded that international staff exchange programs are truly beneficial to both the participating staff and their institutions though with pitfalls. The researcher thus recommended for mutual and preferably equal engagement of the participating institutions on staff exchange programs if such programs are to benefit both the participating staff and institutions. Besides, exchange programs require clear terms of cooperation including on how staff are selected, facilitated and what are expected of the sending and host institutions as well as the concerned staff.

Keywords: gains, exchange programs, higher education, pitfalls

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Authors: Ntloyalefu Justinah, Fumane Khanare

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English learning has been found as one of the prevalent areas of difficulty for Deaf learners. However, studies conducted indicated that this challenge experienced by Deaf learners is an upsetting concern globally as is blamed and hampered by various reasons such as the way English is taught at schools, lack of teachers ' skills and knowledge, therefore, impact negatively on their academic performance. Despite any difficulty in English learning, this language is considered nowadays as the key tool to an educational and occupational career especially in Lesotho. This paper, therefore, intends to contribute to the existing literature by providing the views of Lesotho English teachers, which focuses on how effectively Universal design for learning can be implemented to enhance the academic performance of Deaf learners in context of the English language classroom. The purpose of this study sought to explore the use of universal design for learning (UDL) to support Deaf learners in Lesotho Secondary schools. The present study is informed by interpretative paradigm and situated within a qualitative research approach. Ten participating English teachers from two inclusive schools were purposefully selected and telephonically interviewed to generate data for this study. The data were thematically analysed. The findings indicated that even though UDL is identified as highly proficient and promotes flexibility in teaching methods teachers reflect limited knowledge of the UDL approach. The findings further showed that UDL ensures education for all learners, including marginalised groups, such as learners with disabilities through different teaching strategies. This means that the findings signify the effective use of UDL for the better performance of the English language by Deaf learners (DLs). This aligns with literature that shows mobilizing English teachers as assets help DLs to be engaged and have control in their communities by defining and solving problems using their resources and connections to other networks for asset and exchange. The study, therefore, concludes that teachers acknowledge that even though they assume to be knowledgeable about the definition of UDL, they have a limited practice of the approach, thus they need to be equipped with some techniques and skills to apply for supporting the performance of DLs by using UDL approach in their English teaching. The researchers recommend the awareness of UDL principles by the ministry of Education and Training and teachers training Universities, as well as teachers training colleges, for them to include it in their curricula so that teachers could be properly trained on how to apply it in their teaching effectively

Keywords: deaf learners, Lesotho, support learning, universal design for learning

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Authors: Camellia Al-Ibrahim, Jenny Yiend, Sukhwinder S. Shergill

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Background: Attention bias to threat play a role in the development, maintenance, and exacerbation of delusional beliefs in schizophrenia in which patients emphasize the threatening characteristics of stimuli and prioritise them for processing. Cognitive control deficits arise when task-irrelevant emotional information elicits attentional bias and obstruct optimal performance. This study is investigating neural correlates of interference effect of linguistic threat and whether these effects are independent of delusional severity. Methods: Using an event-related functional magnetic resonance imaging (fMRI), neural correlates of interference effect of linguistic threat during the emotional Stroop task were investigated and compared patients with schizophrenia with high (N=17) and low (N=16) paranoid symptoms and healthy controls (N=20). Participants were instructed to identify the font colour of each word presented on the screen as quickly and accurately as possible. Stimuli types vary between threat-relevant, positive and neutral words. Results: Group differences in whole brain effects indicate decreased amygdala activity in patients with high paranoid symptoms compared with low paranoid patients and healthy controls. Regions of interest analysis (ROI) validated our results within the amygdala and investigated changes within the striatum showing a pattern of reduced activation within the clinical group compared to healthy controls. Delusional severity was associated with significant decreased neural activity in the striatum within the clinical group. Conclusion: Our findings suggest that the emotional interference mediated by the amygdala and striatum may reduce responsiveness to threat-related stimuli in schizophrenia and that attenuation of fMRI Blood-oxygen-level dependent (BOLD) signal within these areas might be influenced by the severity of delusional symptoms.

Keywords: attention bias, fMRI, Schizophrenia, Stroop

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Authors: Moiseenko F. V., Volkov N. M., Zhabina A. S., Stepanova E. O., Kirillov A. V., Myslik A. V., Artemieva E. V., Agranov I. R., Oganesyan A. P., Egorenkov V. V., Abduloeva N. H., Aleksakhina S. Yu., Ivantsov A. O., Kuligina E. S., Imyanitov E. N., Moiseyenko V. M.

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Analysis of ctDNA in patients with NSCLC is an emerging biomarker. Multiple research efforts of quantitative or at least qualitative analysis before and during the first periods of treatment with TKI showed the prognostic value of ctDNA clearance. Still, these important results are not incorporated in clinical standards. We evaluated the role of ctDNA in EGFR-mutated NSCLC receiving first-line TKI. Firstly, we analyzed sequential plasma samples from 30 patients that were collected before intake of the first tablet (at baseline) and at 6, 12, 24, 36, and 48 hours after the “starting point.” EGFR-M+ allele was measured by ddPCR. Afterward, we included sequential qualitative analysis of ctDNA with cobas® EGFR Mutation Test v2 from 99 NSCLC patients before the first dose, after 2 and 4 months of treatment, and on progression. Early response analysis showed the decline of EGFR-M+ level in plasma within the first 48 hours of treatment in 11 subjects. All these patients showed objective tumor response. 10 patients showed either elevation of EGFR-M+ plasma concentration (n = 5) or stable content of circulating EGFR-M+ after the start of the therapy (n = 5); only 3 of these patients achieved an objective response (p = 0.026) when compared to the former group). The rapid decline of plasma EGFR-M+ DNA concentration also predicted for longer PFS (13.7 vs. 11.4 months, p = 0.030). Long-term ctDNA monitoring showed clinically significant heterogeneity of EGFR-mutated NSCLC treated with 1st line TKIs in terms of progression-free and overall survival. Patients without detectable ctDNA at baseline (N = 32) possess the best prognosis on the duration of treatment (PFS: 24.07 [16.8-31.3] and OS: 56.2 [21.8-90.7] months). Those who achieve clearance after two months of TKI (N = 42) have indistinguishably good PFS (19.0 [13.7 – 24.2]). Individuals who retain ctDNA after 2 months (N = 25) have the worst prognosis (PFS: 10.3 [7.0 – 13.5], p = 0.000). 9/25 patients did not develop ctDNA clearance at 4 months with no statistical difference in PFS from those without clearance at 2 months. Prognostic heterogeneity of EGFR-mutated NSCLC should be taken into consideration in planning further clinical trials and optimizing the outcomes of patients.

Keywords: NSCLC, EGFR, targeted therapy, ctDNA, prognosis

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Authors: Manas Kotepui, Kwuntida Uthaisar, Phiman Thirarattanasunthon, Bhukdee PhunPhuech, Nuoil Phiwklam

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Introduction: Malaria due to Plasmodium vivax has placed huge burdens on the health, longevity, and general prosperity of large sections of the human population. This study aimed at prospectively collecting information on the clinical profile of Plasmodium vivax from subjects acutely infected with P. vivax residing in some of the highest malaria transmission regions in Thailand. Methods: A retrospective study of malaria cases, hospitalized between 2013 and 2015 was performed. Clinical characteristics, diagnosis, and parasitological results on admission, age, and gender were mined from medical records at Phop Phra Hospital located in endemic areas of Tak Province, Thailand. Venous blood samples were collected at the time of admission to the hospital to determine the present of parasite and also parasite count by thick and thin film examination, and also Complete blood count (CBC) parameters. Results: Results showed that patients infected with Plasmodium vivax (276 cases) had a high monocyte count (mean=390 cells/µL) during initial stage of infection and continuously lower during later stage (any stage with gametocyte, mean=230 cells/µL) of infection (P value=0.021) whereas, patients infected with Plasmodium vivax had a low basophil count (mean=20 cells/µL) during initial stage of infection and continuously higher during later stage of infection (mean at stage with gametocyte=70 cells/µL) (P value=0.033). In addition, patients with more than one stage infection tend to have lower lymphocyte count (mean=1180 cells/µL) than patients with only one stage infection (mean=1350 cells/µL)(P value=0.011) whereas, patients with more than one stage infection tend to have lower basophil count (mean=60 cells/µL) than patients with only one stage infection (mean=80 cells/µL) (P value=0.01). Conclusion: This study indicated that patients infected with Plasmodium vivax had high monocyte count and low basophil count during initial stage of infection which was continuously lower during later stage of infection. Patients with more than one stage infection tend to have lower lymphocyte count than patients with only one stage infection whereas, patients with more than one stage infection tend to have lower basophil count than patients with only one stage infection. This information contributes to better understanding of pathological characteristic of Plasmodium vivax infection.

Keywords: plasmodium vivax, Thailand, asexual erythrocytic stages, hematological parameters

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Authors: Lam Pham, Peter Hubber, Russell Tytler

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Students’ conceptual understandings of chemistry concepts/phenomena involve capability to coordinate across the three levels of Johnston’s triangle model. This triplet model is based on reasoning about chemical phenomena across macro, sub-micro and symbolic levels. In chemistry education, there is a need for further examining inquiry-based approaches that enhance students’ conceptual learning and problem solving skills. This research adopted a directed inquiry pedagogy based on students constructing and coordinating representations, to investigate senior school students’ capabilities to flexibly move across Johnston’ levels when learning dilution and molar concentration concepts. The participants comprise 50 grade 11 and 20 grade 10 students and 4 chemistry teachers who were selected from 4 secondary schools located in metropolitan Melbourne, Victoria. This research into classroom practices used ethnographic methodology, involved teachers working collaboratively with the research team to develop representational activities and lesson sequences in the instruction of a unit on solution chemistry. The representational activities included challenges (Representational Challenges-RCs) that used ‘representational tools’ to assist students to move across Johnson’s three levels for dilution phenomena. In this report, the ‘representational tool’ called ‘cross and portion’ model was developed and used in teaching and learning the molar concentration concept. Students’ conceptual understanding and problem solving skills when learning with this model are analysed through group case studies of year 10 and 11 chemistry students. In learning dilution concepts, students in both group case studies actively conducted a practical experiment, used their own language and visualisation skills to represent dilution phenomena at macroscopic level (RC1). At the sub-microscopic level, students generated and negotiated representations of the chemical interactions between solute and solvent underpinning the dilution process. At the symbolic level, students demonstrated their understandings about dilution concepts by drawing chemical structures and performing mathematical calculations. When learning molar concentration with a ‘cross and portion’ model (RC2), students coordinated across visual and symbolic representational forms and Johnson’s levels to construct representations. The analysis showed that in RC1, Year 10 students needed more ‘scaffolding’ in inducing to representations to explicit the form and function of sub-microscopic representations. In RC2, Year 11 students showed clarity in using visual representations (drawings) to link to mathematics to solve representational challenges about molar concentration. In contrast, year 10 students struggled to get match up the two systems, symbolic system of mole per litre (‘cross and portion’) and visual representation (drawing). These conceptual problems do not lie in the students’ mathematical calculation capability but rather in students’ capability to align visual representations with the symbolic mathematical formulations. This research also found that students in both group case studies were able to coordinate representations when probed about the use of ‘cross and portion’ model (in RC2) to demonstrate molar concentration of diluted solutions (in RC1). Students mostly succeeded in constructing ‘cross and portion’ models to represent the reduction of molar concentration of the concentration gradients. In conclusion, this research demonstrated how the strategic introduction and coordination of chemical representations across modes and across the macro, sub-micro and symbolic levels, supported student reasoning and problem solving in chemistry.

Keywords: cross and portion, dilution, Johnston's triangle, molar concentration, representations

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Authors: Esther Pearl Palmer

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Driven by the increased pressure on Higher Education Institutions (HEIs) to produce work-ready graduates for the modern world of work, this study reflects on triad teaching and learning practices to increase student engagement and employability. In the South African higher education context, the employability of graduates is imperative in strengthening the country’s economy and in increasing competitiveness. Within this context, the field of Human Resource Management (HRM) calls for innovative methods and approaches to teaching and learning and assessing the skills and competencies of graduates to render them employable. Digital competency in Human Resource Information Systems (HRIS) is an important component and prerequisite for employment in HRM. The purpose of this research is to reflect on the subject HRIS developed by lecturers at the Central University of Technology, Free State (CUT), with the intention to actively engage students in real-world learning activities and increase their employability. The Enrichment Triad Model (ETM) was used as theoretical framework to develop the subject as it supports a triad teaching and learning approach to education. It is, furthermore, an inter-structured model that supports collaboration between industry, academics and students. The study follows a mixed-method approach to reflect on the learning experiences of the industry, academics and students in the subject field over the past three years. This paper is a work in progress and seeks to broaden the scope of extant studies about student engagement in work-related learning to increase employability. Based on the ETM as theoretical framework and pedagogical practice, this paper proposes that following a triad teaching and learning approach will increase work-related skills of students. Findings from the study show that students, academics and industry alike regard educational opportunities that incorporate active learning experiences with the world of work enhances student engagement in learning and renders them more employable.

Keywords: digital competence, enriched triad model, human resource information systems, student engagement, triad pedagogy.

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Authors: Kari Bjorn

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Team learning has been studied and modeled as double loop model and its variations. Also, metacognition has been suggested as a concept to describe the nature of team learning to be more than a simple sum of individual learning of the team members. Team learning has a positive correlation with both individual motivation of its members, as well as the collective factors within the team. Team learning of previously very independent members of two teaching teams is analyzed. Applied Science Universities are training future professionals with ever more diversified and multidisciplinary skills. The size of the units of teaching and learning are increasingly larger for several reasons. First, multi-disciplinary skill development requires more active learning and richer learning environments and learning experiences. This occurs on students teams. Secondly, teaching of multidisciplinary skills requires a multidisciplinary and team-based teaching from the teachers as well. Team formation phases have been identifies and widely accepted. Team role stress has been analyzed in project teams. Projects typically have a well-defined goal and organization. This paper explores team stress of two teacher teams in a parallel running two course units in engineering education. The first is an Industrial Automation Technology and the second is Development of Medical Devices. The courses have a separate student group, and they are in different campuses. Both are run in parallel within 8 week time. Both of them are taught by a group of four teachers with several years of teaching experience, but individually. The team role stress scale items - the survey is done to both teaching groups at the beginning of the course and at the end of the course. The inventory of questions covers the factors of ambiguity, conflict, quantitative role overload and qualitative role overload. Some comparison to the study on project teams can be drawn. Team development stage of the two teaching groups is different. Relating the team role stress factors to the development stage of the group can reveal the potential of management actions to promote team building and to understand the maturity of functional and well-established teams. Mature teams indicate higher job satisfaction and deliver higher performance. Especially, teaching teams who deliver highly intangible results of learning outcome are sensitive to issues in the job satisfaction and team conflicts. Because team teaching is increasing, the paper provides a review of the relevant theories and initial comparative and longitudinal results of the team role stress factors applied to teaching teams.

Keywords: engineering education, stress, team role, team teaching

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Authors: Axel Mancebo, Ana M. Bada, Angel Casacó, Bárbara González, Avelina León, María E. Arteaga, Consuelo González, Belinda Sánchez, Adriana Carr, Nuris Ledón, Arianna Iglesias

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Despite the many preventive and therapeutic modalities aimed at curing cancer, it remains as a serious world health problem. Promising recent developments suggest that cancer immunotherapy may be the next great hope for cancer treatment. EGFRs are receptor tyrosine kinases and it is considered an important therapeutic target related with tumor progression, and several types of molecular therapies, including monoclonal antibodies, small molecules, and vaccines, have been developed to target the HER family of receptors. On the other hand, gangliosides are membrane glycosphingolipids that contain two variants of sialic acid, the N-acetylated (NeuAc) and the N-glycolylated (NeuGc) variant. The high expression of this antigen-specific molecule has been associated with malignant tumor progression and immunosuppressive mechanisms, so ganglioside could be considered as the target for cancer immunotherapy. We have been working for several years in the safety evaluation of cancer vaccines targeting these two systems, the EGF receptor and ganglioside. We presented in this work results of repeated dose toxicity studies performed in Sprague Dawley rats and Cynomolgus monkeys, including clinical observations, body weight and rectal temperature measuring, clinical pathology analysis, gross necropsy and histological examination in rodent studies, and immunological evaluation. Immunizations were capable of inducing mainly inflammatory effects at the injection site, with findings largely attributable to the adjuvants used and probably enhanced by the immunological properties of the antigens. In general, these vaccines were shown to be well tolerated, and these studies in relevant species allow treating cancer patients with tumors during long periods with relative weight safety margin.

Keywords: cancer vaccines, safety, toxicology, rats, non human primates

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Authors: Sathvika Reddy, Devi Revathi

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Background: In India, deliberate self-harm (DSH) with poisoning agents carries a significant impact on morbidity and mortality. Changes in the patterns of poisoning vary across various geographical locations. It is important to know the patterns in a given region in order to facilitate rapid clinical diagnosis, appropriate treatment to reduce associated morbidity and mortality. Aim and Objective: To study the patterns, treatment outcomes of acute poisoning in patients admitted to emergency wards in a tertiary care hospital and to provide poison information services. Materials and Methods: This study was conducted at M.S Ramaiah Memorial and Teaching Hospital from November 2016 to March 2017. The patient’s data was obtained from patient case sheet, interaction with health care professionals, interviewing patients and their caretakers (if possible), and were documented in a suitably designed form. Results: The study involved 131 patients with a mean age of 27.76 ± 15.5 years. Majority of the patients were in the age group 21-30 years, literates (n=53) dwelling in urban (n=113) areas belonging to upper middle class (n=50). Analgesics and antipyretics were commonly utilized in intentional drug overdosage (n=49). Envenomation constituted n=21(16.03%). Furthermore, a significant relationship was observed between marital status and self-poisoning (n=64) (P < 0.001) which commonly occurred through oral ingestion. The outcomes were correlated with the GCS and PSS system and n=85 recovered, n=17 were discharged against medical advice, and n=4 died, and n=4 were lost to follow up respectively. The poison information queries include drug overdose (n=29) and management related queries (n=22) provided majorly by residents (n=45) to update knowledge (n=11) and for better patient care (n=40). Conclusion: The trend in poisoning is dynamic. Medications were identified as the main cause of poisoning in urban areas of India. Educational programs with more emphasis on preventive measures are necessary to create awareness among the general public.

Keywords: poisoning, suicides, clinical pharmacist, envenomation, poison information services

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Authors: Doua AlSaad, Ahmed Awaisu, Samah Elsalem, Palli Valapila Abdulrouf, Binny Thomas, Moza AlHail

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Background: It has been suggested that pyridoxine has an anti-lactogenic effect. Studies of the efficacy of pyridoxine in suppressing lactation have reported conflicting results. The aim of this review is to evaluate the effectiveness and safety of high-dose pyridoxine in postpartum lactation inhibition. Methods: This systematic review included published trials that compared the efficacy and/or safety of pyridoxine to placebo or to other pharmacological agents for the inhibition of postpartum lactation. We searched PubMed, Embase, ScienceDirect, CINAHL, AMED, the Cochrane library, and the clinical trials registry to identify relevant literature. No limit was imposed on the year of publication of the studies, and the review included studies published until 15 January 2016. Two reviewers independently extracted data and assessed the risk of bias. Results: Seven studies were included, with a total of 1155 women, of which 471 women received pyridoxine. Three studies were randomized controlled trials, while the remaining four studies were non-randomized controlled trials. All of the included studies were relatively small (n = 18 – 482). The studies compared pyridoxine with placebo, bromocriptine, and/or stilboestrol. Pyridoxine was given orally, with a total daily dose of 450 – 600 mg for 5 to 7 days. Two trials (n = 349 participants) indicated that pyridoxine was effective in inhibiting lactation in approximately 95% of the enrolled patients. All other studies failed to demonstrate pyridoxine efficacy through either clinical assessment or prolactin level measurements. Pyridoxine safety was assessed by two trials in which no serious untoward side-effects were reported. Overall, the risk of bias for most of the studies was low to moderate. Conclusion: Current evidence supporting the effectiveness of high dose pyridoxine in the inhibition of postpartum lactation is inconsistent and insufficient. Larger randomized trials are needed to confirm the efficacy of pyridoxine in postpartum lactation inhibition. Acknowledgment: This review received a grant from the Medical Research Center of Hamad Medical Corporation in Qatar (grant number: 15100/15).

Keywords: pyridoxine, safety, effectiveness, lactation inhibition

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Authors: Bruna Azzari Puga, Richard Roe, Andre Pagani de Souza

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abstract outlines a proposed study to examine how and to what extent interactive, experiential, learner centered methodology develops learning of basic civic and democratic competencies among young children. It stems from the Literacy and Law course taught at Georgetown University Law Center in Washington, DC, since 1998. Law students, trained in best literacy practices and legal cases affecting literacy development, read “law related” children’s books and engage in interactive and extension activities with emerging readers. The law students write a monthly journal describing their experiences and a final paper: a conventional paper or a children’s book illuminating some aspect of literacy and law. This proposal is based on the recent adaptation of Literacy and Law to Brazil at Mackenzie Presbyterian University in São Paulo in three forms: first, a course similar to the US model, often conducted jointly online with Brazilian and US law students; second, a similar course that combines readings of children’s literature with activity based learning, with law students from a satellite Mackenzie campus, for young children from a vulnerable community near the city; and third, a course taught by law students at the main Mackenzie campus for 4th grade students at the Mackenzie elementary school, that is wholly activity and discourse based. The workings and outcomes of these courses are well documented by photographs, reports, lesson plans, and law student journals. The authors, faculty who teach the above courses at Mackenzie and Georgetown, observe that literacy, broadly defined as cognitive and expressive development through reading and discourse-based activities, can be influential in developing democratic civic skills, identifiable by explicit civic competencies. For example, children experience justice in the classroom through cooperation, creativity, diversity, fairness, systemic thinking, and appreciation for rules and their purposes. Moreover, the learning of civic skills as well as the literacy skills is enhanced through interactive, learner centered practices in which the learners experience literacy and civic development. This study will develop rubrics for individual and classroom teaching and supervision by examining 1) the children’s books and students diaries of participating law students and 2) the collection of photos and videos of classroom activities, and 3) faculty and supervisor observations and reports. These rubrics, and the lesson plans and activities which are employed to advance the higher levels of performance outcomes, will be useful in training and supervision and in further replication and promotion of this form of teaching and learning. Examples of outcomes include helping, cooperating and participating; appreciation of viewpoint diversity; knowledge and utilization of democratic processes, including due process, advocacy, individual and shared decision making, consensus building, and voting; establishing and valuing appropriate rules and a reasoned approach to conflict resolution. In conclusion, further development and replication of the learner centered literacy and law practices outlined here can lead to improved qualities of democratic teaching and learning supporting mutual respect, positivity, deep learning, and the common good – foundation qualities of a sustainable world.

Keywords: democracy, law, learner-centered, literacy

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Authors: Juha Kettunen

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The purpose of this study is to develop a framework for the assessment of research and development projects. The assessment map is developed in this study based on the strategy map of the balanced scorecard approach. The assessment map is applied in a project that aims to reduce the inequality and risk of exclusion of young people from disadvantaged social groups. The assessment map denotes that not only funding but also necessary skills and qualifications should be carefully assessed in the implementation of the project plans so as to achieve the objectives of projects and the desired impact. The results of this study are useful for those who want to develop the implementation of the Erasmus+ Programme and the project teams of research and development projects.

Keywords: non-formal learning, youth work, social inclusion, innovation

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Authors: Amatulraheem Al-Abassi, K. Khanafer, Ibrahim Deiab

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The coronary artery stent is a promising technology that can treat various coronary diseases. Materials used for manufacturing medical stents should have high biocompatible properties. Stent alloys, in particular, are remarkably promising good clinical outcomes, however, there is threaten of restenosis (reoccurring of artery narrowing due to fatty plaque), stent recoiling, or in long-term the occurrence of stent fracture. However, stents that are made of Nickel-titanium (Nitinol) can bare extensive plastic deformation and resist restenosis. This shape memory alloy has outstanding mechanical properties. Nitinol is a unique shape memory alloy as it has unique mechanical properties such as; biocompatibility, super-elasticity, and recovery to original shape under certain loads. Stent failure may cause complications in vascular diseases and possibly blockage of blood flow. Thus, studying the behaviors of the stent under different medical conditions will help the doctors and cardiologists to predict when it is necessary to change the stent in order to prevent any severe morbidity outcomes. To the best of our knowledge, there are limited published papers that analyze the stent behavior with regards to the contact surfaces of plaque layer and blood vessel. Thus, stent material properties will be discussed in this investigation to highlight the mechanical and clinical differences between various stents. This research analyzes the performance of Nitinol stent in well-known stent design to determine its bearing with stress and its dislocation in blood vessels, in comparison to stents made of different biocompatible materials. In addition, a study of its performance will be represented in the system. Finite Element Analysis is the core of this study. Thus, a physical representative model will be discussed to show the distribution of stress and strain along the interaction surface between the stent and the artery. The reaction of vascular tissue to the stent will be evaluated to predict the possibility of restenosis within the treated area.

Keywords: shape memory alloy, stent, coronary artery, finite element analysis

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Authors: Syed Dawood Md. Taimur, Md. Hasanur Rahman, Syeda Fahmida Afrin, Farzana Islam

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The concept of myocardial injury, although first recognized from animal studies, is now recognized as a clinical phenomenon that may result in microvascular damage, no-reflow phenomenon, myocardial stunning, myocardial hibernation and ischemic preconditioning. The final consequence of this event is left ventricular (LV) systolic dysfunction leading to increased morbidity and mortality. The typical clinical case of reperfusion injury occurs in acute myocardial infarction (MI) with ST segment elevation in which an occlusion of a major epicardial coronary artery is followed by recanalization of the artery. This may occur either spontaneously or by means of thrombolysis and/or by primary percutaneous coronary intervention (PCI) with efficient platelet inhibition by aspirin (acetylsalicylic acid), clopidogrel and glycoprotein IIb/IIIa inhibitors. In recent years, percutaneous coronary intervention (PCI) has become a well-established technique for the treatment of coronary artery disease. PCI improves symptoms in patients with coronary artery disease and it has been increasing the safety of procedures. However, peri- and post-procedural myocardial injury, including angiographical slow coronary flow, microvascular embolization, and elevated levels of cardiac enzyme, such as creatine kinase and troponin-T and -I, has also been reported even in elective cases. Furthermore, myocardial reperfusion injury at the beginning of myocardial reperfusion, which causes tissue damage and cardiac dysfunction, may occur in cases of the acute coronary syndrome. Because patients with myocardial injury is related to larger myocardial infarction and have a worse long-term prognosis than those without myocardial injury, it is important to prevent myocardial injury during and/or after PCI in patients with coronary artery disease. To date, many studies have demonstrated that adjunctive pharmacological treatment suppresses myocardial injury and increases coronary blood flow during PCI procedures. In this review, we highlight the usefulness of pharmacological treatment in combination with PCI in attenuating myocardial injury in patients with coronary artery disease.

Keywords: coronary artery disease, percutaneous coronary intervention, myocardial injury, pharmacology

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Authors: Yen Yen Tan, Lynn Lam, Cynthia Lam, Angela Koh, Edwin Seng

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Entrepreneurial education plays a crucial role in nurturing future innovators and change-makers. Over time, significant progress has been made in refining instructional approaches to develop the necessary skills among learners effectively. Two highly valuable frameworks, Kearney's "4 Principles of Entrepreneurial Pedagogy" and Bloom's "Three Domains of Learning," serve as guiding principles in entrepreneurial education. Kearney's principles align with experiential and student-centric learning, which are crucial for cultivating an entrepreneurial mindset. The potential synergies between these frameworks hold great promise for enhancing entrepreneurial acumen among students. However, despite this potential, their integration remains largely unexplored. This study aims to bridge this gap by building upon the Business Essentials through Action (BETA) module and investigating its contributions to nurturing the entrepreneurial mindset. This study employs a quasi-experimental mixed-methods approach, combining quantitative and qualitative elements to ensure comprehensive and insightful data. A cohort of 235 students participated, with 118 enrolled in the BETA module and 117 in a traditional curriculum. Their Personal Entrepreneurial Competencies (PECs) were assessed before admission (pre-Y1) and one year into the course (post-Y1) using a comprehensive 55-item PEC questionnaire, enabling measurement of critical traits such as opportunity-seeking, persistence, and risk-taking. Rigorous computations of individual entrepreneurial competencies and overall PEC scores were performed, including a correction factor to mitigate potential self-assessment bias. The orchestration of Kearney's principles and Bloom's domains within the BETA module necessitates a granular examination. Here, qualitative revelations surface, courtesy of structured interviews aligned with contemporary research methodologies. These interviews act as a portal, ushering us into the transformative journey undertaken by students. Meanwhile, the study pivots to explore the BETA module's influence on students' entrepreneurial competencies from the vantage point of faculty members. A symphony of insights emanates from intimate focus group discussions featuring six dedicated lecturers, who share their perceptions, experiences, and reflective narratives, illuminating the profound impact of pedagogical practices embedded within the BETA module. Preliminary findings from ongoing data analysis indicate promising results, showcasing a substantial improvement in entrepreneurial skills among students participating in the BETA module. This study promises not only to elevate students' entrepreneurial competencies but also to illuminate the broader canvas of applicability for Kearney's principles and Bloom's domains. The dynamic interplay of quantitative analyses, proffering precise competency metrics, and qualitative revelations, delving into the nuanced narratives of transformative journeys, engenders a holistic understanding of this educational endeavour. Through a rigorous quasi-experimental mixed-methods approach, this research aims to establish the BETA module's effectiveness in fostering entrepreneurial acumen among students at Singapore Polytechnic, thereby contributing valuable insights to the broader discourse on educational methodologies.

Keywords: entrepreneurial education, experiential learning, pedagogical frameworks, innovative competencies

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Authors: Ali Al Orf, Khawaja Bilal Waheed

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Background and objective: Joubert syndrome (JS) is a rare, autosomal-recessive condition. Early recognition is important for management and counseling. Magnetic resonance imaging (MRI) can help in diagnosis. Therefore, we sought to evaluate clinical presentation and MRI findings in Joubert syndrome and related disorders. Method: A retrospective review of genetically proven cases of Joubert syndromes and related disorders was reviewed for their clinical presentation, demographic information, and magnetic resonance imaging findings in a period of the last 10 years. Two radiologists documented magnetic resonance imaging (MRI) findings. The presence of hypoplasia of the cerebellar vermis with hypoplasia of the superior cerebellar peduncle resembling the “Molar Tooth Sign” in the mid-brain was documented. Genetic testing results were collected to label genes linked to the diagnoses. Results: Out of 12 genetically proven JS cases, most were females (9/12), and nearly all presented with hypotonia, ataxia, developmental delay, intellectual impairment, and speech disorders. 5/12 children presented at age of 1 or below. The molar tooth sign was seen in 10/12 cases. Two cases were associated with other brain findings. Most of the cases were found associated with consanguineous marriage Conclusion and discussion: The molar tooth sign is a frequent and reliable sign of JS and related disorders. Genes related to defective cilia result in malfunctioning in the retina, renal tubule, and neural cell migration, thus producing heterogeneous syndrome complexes known as “ciliopathies.” Other ciliopathies like Senior-Loken syndrome, Bardet Biedl syndrome, and isolated nephronophthisis must be considered as the differential diagnosis of JS. The main imaging findings are the partial or complete absence of the cerebellar vermis, hypoplastic cerebellar peduncles (giving MTS), and (bat-wing appearance) fourth ventricular deformity. LimitationsSingle-center, small sample size, and retrospective nature of the study were a few of the study limitations.

Keywords: Joubart syndrome, magnetic resonance imaging, molar tooth sign, hypotonia

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Authors: Reham Khalaf-Nazzal, Imad Dweikat, Paula Gimenez, Iker Oyenarte, Alfonso Martinez-Cruz, Domonik Muller

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Metal cation transport mediator (CNNM) gene family comprises 4 isoforms that are expressed in various human tissues. Structurally, CNNMs are complex proteins that contain an extracellular N-terminal domain preceding a DUF21 transmembrane domain, a ‘Bateman module’ and a C-terminal cNMP-binding domain. Mutations in CNNM2 cause familial dominant hypomagnesaemia. Growing evidence highlights the role of CNNM2 in neurodevelopment. Mutations in CNNM2 have been implicated in epilepsy, intellectual disability, schizophrenia, and others. In the present study, we aim to elucidate the function of CNNM2 in the developing brain. Thus, we present the genetic origin of symptoms in two family cohorts. In the first family, three siblings of a consanguineous Palestinian family in which parents are first cousins, and consanguinity ran over several generations, presented a varying degree of intellectual disability, cone-rod dystrophy, and autism spectrum disorder. Exome sequencing and segregation analysis revealed the presence of homozygous pathogenic mutation in the CNNM2 gene, the parents were heterozygous for that gene mutation. Magnesium blood levels were normal in the three children and their parents in several measurements. They had no symptoms of hypomagnesemia. The CNNM2 mutation in this family was found to locate in the CBS1 domain of the CNNM2 protein. The crystal structure of the mutated CNNM2 protein was not significantly different from the wild-type protein, and the binding of AMP or MgATP was not dramatically affected. This suggests that the CBS1 domain could be involved in pure neurodevelopmental functions independent of its magnesium-handling role, and this mutation could have affected a protein partner binding or other functions in this protein. In the second family, another autosomal dominant CNNM2 mutation was found to run in a large family with multiple individuals over three generations. All affected family members had hypomagnesemia and hypermagnesuria. Oral supplementation of magnesium did not increase the levels of magnesium in serum significantly. Some affected members of this family have defects in fine motor skills such as dyslexia and dyslalia. The detected mutation is located in the N-terminal part, which contains a signal peptide thought to be involved in the sorting and routing of the protein. In this project, we describe heterogenous clinical phenotypes related to CNNM2 mutations and protein functions. In the first family, and up to the authors’ knowledge, we report for the first time the involvement of CNNM2 in retinal photoreceptor development and function. In addition, we report the presence of a neurophenotype independent of magnesium status related to the CNNM2 protein mutation. Taking into account the different modes of inheritance and the different positions of the mutations within CNNM2 and its different structural and functional domains, it is likely that CNNM2 might be involved in a wide spectrum of neuropsychiatric comorbidities with considerable varying phenotypes.

Keywords: magnesium transport, autosomal recessive, autism, neurodevelopment, CBS domain

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Authors: Silvia Alaimo

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This lecture brings to our attention the theme of spirituality within Gestalt therapy’s theoretical and clinical perspectives and which is closely connected to the fertile emptiness and creative indifference’ experiences. First of all, the premise that must be done is the overcoming traditional western culture’s philosophical and religious misunderstandings, such as the dicotomy between spirituality and pratical/material daily life, as well as the widespread secular perspective of classic psychology. Even fullness and emptiness have traditionally been associated with the concepts of being and not being. "There is only one way through which we can contact the deepest layers of our existence, rejuvenate our thinking and reach intuition (the harmony of thought and being): inner silence" (Perls) *. Therefore, "fertile void" doesn't mean empty in itself, but rather an useful condition of every creative and responsible act, making room for a deeper dimension close to spirituality. Spirituality concerns questions about the meaning of existence, which lays beyond the concrete and literal dimension, looking for the essence of things, and looking at the value of personal experience. Looking at fundamentals of Gestalt epistemology, phenomenology, aesthetics, and the relationship, we can reach the heart of a therapeutic work that takes spiritual contours and which are based on an embodied (incarnate size), through the relational aesthetic knowledge (Spagnuolo Lobb ), the deep contact with each other, the role of compassion and responsibility, as the patient's recognition criteria (Orange, 2013) rooted in the body. The aesthetic dimension, like the spiritual dimension to which it is often associated, is a subtle dimension: it is the dimension of the essence of things, of their "soul." In clinical practice, it implies that the relationship between therapist and patient is "in the absence of judgment," also called "zero point of creative indifference," expressed by ‘therapeutic mentality’. It consists in following with interest and authentic curiosity where the patient wants to go and support him in his intentionality of contact. It’s a condition of pure and simple awareness, of the full acceptance of "what is," a moment of detachment from one's own life in which one does not take oneself too seriously, a starting point for finding a center of balance and integration that brings to the creative act, to growth, and, as Perls would say, to the excitement and adventure of living.

Keywords: spirituality, bodily, embodied aesthetics, phenomenology, relationship

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Authors: Orly Yona Drori, Shirley Ben Shlomo

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Objectives: The participants will be able to recognize the predictors of binge eating addiction among women who suffer from psychological abuse in their relationships and will recognize the role of woman's defense mechanisms in moderating the association between psychological abuse and binge eating addiction. Methods: A convenience sample of 380 Israeli women in relationships were located via the Internet, and after consenting to participate in the study, they completed a series of structured questionnaires (The Yale Food Addiction Scale; The Defense Style Questionnaire; psychological maltreatment of women by their male partners; level of differentiation of self; sociodemographic questionnaire). Results: The higher the level of differentiation and mature defense mechanisms, the less addictive a woman is. However, the level of addiction among women who experience psychological abuse within their intimate relations is higher than women who do not experience psychological abuse in their relationship. Among women who experienced psychological abuse in their relations, the defense mechanisms moderate the association between psychological abuse within intimate relations and the extent of the addiction to binge eating. Conclusions: The study contributes to the therapy of women with binge eating addictions, as it raises awareness of therapeutic-related content that could strengthen women and help them to cope with situations in their lives without the need to binge. One of the significant variables for therapeutic work is the level of differentiation of the self. In addition, identifying the types of defense mechanisms might help to match treatment to the woman's emotional needs. The current study found also that it is important to identify the environmental systems by which the addict is surrounded, such as whether woman is in an abusive relationship. Finally the study leads to the recognition that binge eating, which is usually treated with an emphasis on nutritional behavior change, is an addiction, and as such, it requires a combination of mental, nutritional and behavioral therapy. In view of this approach, it is recommended that treating a woman who is addicted to binge eating should involve a multi-disciplinary team comprised of physicians, clinical dietitians, and clinical psychotherapists.

Keywords: binge eating, defence mechanism, food addiction, psychological abuse

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Authors: Nicole Ramlachan, Samuel Mark West

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Lung cancer is the leading cause of cancer-associated deaths in North America, with the vast majority being non-small cell lung cancer (NSCLC), with a five-year survival rate of only 24%. Non-invasive discovery of biomarkers associated with early-diagnosis of NSCLC can enable precision oncology efforts using liquid biopsy-based multiomics profiling of plasma. Although tissue biopsies are currently the gold standard for tumor profiling, this method presents many limitations since these are invasive, risky, and sometimes hard to obtain as well as only giving a limited tumor profile. Blood-based tests provides a less-invasive, more robust approach to interrogate both tumor- and non-tumor-derived signals. We intend to examine 30 stage III-IV NSCLC patients pre-surgery and collect plasma samples.Cell-free DNA (cfDNA) will be extracted from plasma, and next-generation sequencing (NGS) performed. Through the analysis of tumor-specific alterations, including single nucleotide variants (SNVs), insertions, deletions, copy number variations (CNVs), and methylation alterations, we intend to identify tumor-derived DNA—ctDNA among the total pool of cfDNA. This would generate data to be used as an accurate form of cancer genotyping for diagnostic purposes. Using liquid biopsies offer opportunities to improve the surveillance of cancer patients during treatment and would supplement current diagnosis and tumor profiling strategies previously not readily available in Trinidad and Tobago. It would be useful and advantageous to use this in diagnosis and tumour profiling as well as to monitor cancer patients, providing early information regarding disease evolution and treatment efficacy, and reorient treatment strategies in, timethereby improving clinical oncology outcomes.

Keywords: genomics, multiomics, clinical genetics, genotyping, oncology, diagnostics

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Authors: Iman Jabbar

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Within the scope of professionalism and in order to compete with the modern world, teachers, are expected to develop their teaching skills and activities in addition to their professional knowledge. At the college level, the teacher should be able to face classroom challenges through his engagement with the learning situation to understand the students and their needs. In our field of TESOL, the role of the English teacher is no longer restricted to teaching English texts, but rather he should endeavor to enhance the students’ skills such as communication and critical analysis. Within the literature of professionalism, there are certain strategies and tools that an English teacher should adopt to develop his competence and performance. Reflective practice, which is an exploratory process, is one of these strategies. Another strategy contributing to classroom development is motivation. It is crucial in students’ learning as it affects the quality of learning English in the classroom in addition to determining success or failure as well as language achievement. This is a qualitative study grounded on interpretive perspectives of teachers and students regarding the process of professional development. This study aims at (a) understanding how teachers at the college level conceptualize reflective practice and motivation inside EFL classroom, and (b) exploring the methods and strategies that they implement to practice reflection and motivation. This study and is based on two questions: 1. How do EFL teachers perceive and view reflection and motivation in relation to their teaching and professional development? 2. How can reflective practice and motivation be developed into practical strategies and actions in EFL teachers’ professional context? The study is organized into two parts, theoretical and practical. The theoretical part reviews the literature on the concept of reflective practice and motivation in relation to professional development through providing certain definitions, theoretical models, and strategies. The practical part draws on the theoretical one, however; it is the core of the study since it deals with two issues. It involves the research design, methodology, and methods of data collection, sampling, and data analysis. It ends up with an overall discussion of findings and the researcher's reflections on the investigated topic. In terms of significance, the study is intended to contribute to the field of TESOL at the academic level through the selection of the topic and investigating it from theoretical and practical perspectives. Professional development is the path that leads to enhancing the quality of teaching English as a foreign or second language in a way that suits the modern trends of globalization and advanced technology.

Keywords: professional development, motivation, reflection, learning

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Authors: Alec Chabwinja, Cannan Tawonezvi, Jerneja Vidmar, Constance Chingwaru, Walter Chingwaru

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Objective: To evaluate the potential of commercial fermented / probiotic products available in Zimbabwe or internationally, and strains of Lactobacillus plantarum (L. plantarum) as prophylaxis and therapy against diarrhoeal and sexually transmitted infections. Methods: The antimicrobial potential of cultures of lactobacilli enriched from 4 Zimbabwean commercial food/beverage products, namely Dairibord Lacto sour milk (DLSM), Probrand sour milk (PSM), Kefalos Vuka cheese (KVC) and Chibuku opaque beer (COB); three probiotic products obtainable in Europe and internationally; and four strains of L. plantarum obtained from Balkan traditional cheeses and Zimbabwean foods against clinical strains of Escherichia coli (E. coli) and non-clinical strains of Candida albicans and Rhodotorula spp. was assayed using the well diffusion method. Three commercial Agar diffusion assay and a competitive exclusion assay were carried out on Mueller-Hinton agar. Results: Crude cultures of putative lactobacillus strains obtained from Zimbabwean dairy products (Probrand sour milk, Kefalos Vuka vuka cheese and Chibuku opaque beer) exhibited significantly greater antimicrobial activities against clinical strains of E. coli than strains of L. plantarum isolated from Balkan cheeses (CLP1, CLP2 or CLP3) or crude microbial cultures from commercial paediatric probiotic products (BG, PJ and PL) of a culture of Lactobacillus rhamnosus LGG (p < 0.05). Furthermore, the following has high antifungal activities against the two yeasts: supernatant-free microbial pellet (SFMP) from an extract of M. azedarach leaves (27mm ± 2.5) > cell-free culture supernatants (CFCS) from Maaz Dairy sour milk and Mnandi sour milk (approximately 26mm ± 1.8) > CFCS and SFMP from Amansi hodzeko (25mm ± 1.5) > CFCS from Parinari curatellifolia fruit (24mm ± 1.5), SFMP from P. curatellifolia fruit (24mm ± 1.4) and SFMP from mahewu (20mm ± 1.5). These cultures also showed high tolerance to acidic conditions (~pH4). Conclusions: The putative lactobacilli from four commercial Zimbabwean dairy products (Probrand sour milk, Kefalos Vuka vuka cheese and Chibuku opaque beer), and three strains of L. plantarum from Balkan cheeses (CLP1, CLP2 or CLP3) exhibited high antibacterial activities, while Maaz Dairy sour-, Mnandi sour- and Amansi hodzeko milk products had high antifungal activities. Our selection of Zimbabwean probiotic products has potential for further development into probiotic products for use in the control diarrhea caused by pathogenic strains of E. coli or yeast infections. Studies to characterise the probiotic potential of the live cultures in the products are underway.

Keywords: lactic acid bacteria, Staphylococcus aureus, Streptococcus spp, yeast, inhibition, acid tolerance

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Authors: Shohreh Ghasemi

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Introduction: Managing oral and maxillofacial trauma is a multifaceted challenge, as it can have life-threatening consequences and significant functional and aesthetic impact. Navigation techniques have been introduced to improve surgical precision to meet this challenge. A machine learning algorithm was also developed to support clinical decision-making regarding treating oral and maxillofacial trauma. Given these advances, this systematic meta-analysis aims to assess the efficacy of navigational techniques in treating oral and maxillofacial trauma and explore the impact of machine learning on their management. Methods: A detailed and comprehensive analysis of studies published between January 2010 and September 2021 was conducted through a systematic meta-analysis. This included performing a thorough search of Web of Science, Embase, and PubMed databases to identify studies evaluating the efficacy of navigational techniques and the impact of machine learning in managing oral and maxillofacial trauma. Studies that did not meet established entry criteria were excluded. In addition, the overall quality of studies included was evaluated using Cochrane risk of bias tool and the Newcastle-Ottawa scale. Results: Total of 12 studies, including 869 patients with oral and maxillofacial trauma, met the inclusion criteria. An analysis of studies revealed that navigation techniques effectively improve surgical accuracy and minimize the risk of complications. Additionally, machine learning algorithms have proven effective in predicting treatment outcomes and identifying patients at high risk for complications. Conclusion: The introduction of navigational technology has great potential to improve surgical precision in oral and maxillofacial trauma treatment. Furthermore, developing machine learning algorithms offers opportunities to improve clinical decision-making and patient outcomes. Still, further studies are necessary to corroborate these results and establish the optimal use of these technologies in managing oral and maxillofacial trauma

Keywords: trauma, machine learning, navigation, maxillofacial, management

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Authors: Sandra Cardoso, Gaspar Pais, Judite Neves, Sandra Cavaca, Fernando Araújo

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In 2021, Portugal has 63 emergency department (ED) visits per 100 people annually, the highest numbers in Europe. While EDs provide a critical service, high use is indicative of inappropriate and inefficient healthcare. In Portugal, all ED have the Manchester Triage System (MTS), a clinical risk management tool to enable that patients are seen in order of clinical priority. In 2023, more than 40% of the ED visits were of non-urgent conditions (blue and green), that could be better managed in primary health care (PHC), meaning wrong use of resources and lack of health literacy. From 2017, the country has a phone line, SNS24 (Contact Centre of the National Health Service), for triage, counseling, and referral service, 24 hours/7 days a week. The pilot project ‘Call before, save lives’ was implemented in the municipalities of Póvoa de Varzim and Vila do Conde (around 150.000 residents), in May 2023, by the executive board of the Portuguese Health Service, with the support of the Shared Services of the Ministry of Health, and local authorities. This geographical area has short travel times, 99% of the population a family doctor and the region is organized in a health local unit (HLU), integrating PHC and the local hospital. The purposes of this project included to increase awareness to contact SNS 24, before going to an ED, and non-urgent conditions oriented to a family doctor, reducing ED visits. The implementation of the project involved two phases, beginning with: i) development of campaigns using local influencers (fishmonger, model, fireman) through local institutions and media; ii) provision of telephone installed on site to contact SNS24; iii) establishment of open consultation in PHC; iv) promotion of the use of SNS24; v) creation of acute consultations at the hospital for complex chronic patients; and vi) direct referral for home hospitalization by PHC. The results of this project showed an excellent level of access to SNS24, an increase in the number of users referred to ED, with great satisfaction of users and professionals. The second phase, initiated in January 2024, for access to the ED, the need for prior referral was established as an admission rule, except for certain situations, as trauma patients. If the patient refuses, their registration in the ED and subsequent screening in accordance with the MTS must be ensured. When the patient is non-urgent, shall not be observed in the ED, provided that, according to his clinical condition, is guaranteed to be referred to PHC or to consultation/day hospital, through effective scheduling of an appointment for the same or the following day. In terms of results, 8 weeks after beginning of phase 2, we assist of a decrease in self-reported patients to ED from 59% to 15%, and a reduction of around 7% of ED visits. The key for this success was an effective public campaign that increases the knowledge of the right use of the health system, and capable of changing behaviors.

Keywords: contact centre of the national health service, emergency department visits, public campaign, health literacy, SNS24

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