Search results for: grade negotiation

Authors: Robbi Beyer, Tiffanye Vargas, Margaret Flores

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Within the United States, youths with hidden disabilities (specific learning disabilities, attention deficit hyperactivity disorder, emotional behavioral disorders, mild intellectual disabilities and speech/language disorders) can often be part of the kindergarten through twelfth grade school population. Because individuals with hidden disabilities have no apparent physical disability, learning difficulties may be overlooked and these youths may be mistakenly labeled as unmotivated, or defiant because they don't understand and follow directions, or maintain enough attention to remember and perform. These behaviors are considered especially challenging for youth sport coaches to manage and they often find it difficult to successfully select and deliver effective accommodations for the athletes. These deficits can be remediated and compensated through the use of research-validated strategies and instructional methods. However, while these techniques are commonly included in teacher preparation, they rarely, if ever, are included in coaching preparation. Therefore, the purpose of this presentation is to summarize consecutive research studies that examined coaching education within the United States for youth athletes with hidden disabilities. Each study utilized a questionnaire format to collect data from coaches on attitudes, efficacy and solutions for addressing challenging behaviors. Results indicated that although the majority of coaches’ attitudes were positive and they perceived themselves confident in working with athletes who have hidden disabilities, there were significant differences in the understanding of appropriate teaching strategies and techniques for this population. For example, when asked to describe a videotaped situation of why an athlete is not performing correctly, coaches often found the athlete to be at fault, as opposed to considering the possibility of faulty directions, or the need for accommodations in teaching/coaching style. When considering coaches’ preparation, 83% of participants declared they were inadequately prepared to coach athletes with hidden disabilities and 92% strongly supported improved preparation for coaches. The comprehensive examination of coaches’ perceptions and efficacy in working with youth athletes with hidden disabilities has provided valuable insight and highlights the need for continued research in this area.

Keywords: health, hidden disabilties, physical activity, youth recreational sports

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Authors: C. G. Mendez-Garcia, E. T. Romero-Guzman, H. Hernandez-Mendoza, C. Solis, E. Chavez-Lomeli, E. Chamizo, R. Garcia-Tenorio

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Plutonium is present in different concentrations in the environment and biological samples related to nuclear weapons testing, nuclear waste recycling and accidental discharges of nuclear plants. This radioisotope is considered the most radiotoxic substance, particularly when it enters the human body through inhalation of powders insoluble or aerosols. This is the main reason of the determination of the concentration of this radioisotope in the atmosphere. Besides that, the isotopic ratio of ²⁴⁰Pu/²³⁹Pu provides information about the origin of the source. PM₂.₅ sampling was carried out in the Metropolitan Zone of the Valley of Mexico (MZVM) from February 18th to March 17th in 2015 on quartz filter. There have been significant developments recently due to the establishment of new methods for sample preparation and accurate measurement to detect ultra trace levels as the plutonium is found in the environment. The accelerator mass spectrometry (AMS) is a technique that allows measuring levels of detection around of femtograms (10-15 g). The AMS determinations include the chemical isolation of Pu. The Pu separation involved an acidic digestion and a radiochemical purification using an anion exchange resin. Finally, the source is prepared, when Pu is pressed in the corresponding cathodes. According to the author's knowledge on these aerosols showed variations on the ²³⁵U/²³⁸U ratio of the natural value, suggesting that could be an anthropogenic source altering it. The determination of the concentration of the isotopes of Pu can be a useful tool in order the clarify this presence in the atmosphere. The first results showed a mean value of activity concentration of ²³⁹Pu of 280 nBq m⁻³ thus the ²⁴⁰Pu/²³⁹Pu was 0.025 corresponding to the weapon production source; these results corroborate that there is an anthropogenic influence that is increasing the concentration of radioactive material in PM₂.₅. According to the author's knowledge in Total Suspended Particles (TSP) have been reported activity concentrations of ²³⁹⁺²⁴⁰Pu around few tens of nBq m⁻³ and 0.17 of ²⁴⁰Pu/²³⁹Pu ratios. The preliminary results in MZVM show high activity concentrations of isotopes of Pu (40 and 700 nBq m⁻³) and low ²⁴⁰Pu/²³⁹Pu ratio than reported. These results are in the order of the activity concentrations of Pu in weapons-grade of high purity.

Keywords: aerosols, fallout, mass spectrometry, radiochemistry, tracer, ²⁴⁰Pu/²³⁹Pu ratio

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Authors: Sameer A. Pathan, Biswadev Mitra, Salman Mirza, Umais Momin, Zahoor Ahmed, Lubna G. Andraous, Dharmesh Shukla, Mohammed Y. Shariff, Magid M. Makki, Tinsy T. George, Saad S. Khan, Stephen H. Thomas, Peter A. Cameron

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Study objective: Emergency physician’s (EP) ability to identify hydronephrosis on point-of-care ultrasound (POCUS) has been assessed in the past using CT scan as the reference standard. We aimed to assess EP interpretation of POCUS to identify and grade the hydronephrosis in a direct comparison with the consensus-interpretation of POCUS by radiologists, and also to compare the EP and radiologist performance using CT scan as the criterion standard. Methods: Using data from a POCUS databank, a prospective interpretation study was conducted at an urban academic emergency department. All POCUS exams were performed on patients presenting with renal colic to the ED. Institutional approval was obtained for conducting this study. All the analyses were performed using Stata MP 14.0 (Stata Corp, College Station, Texas). Results: A total of 651 patients were included, with paired sets of renal POCUS video clips and the CT scan performed at the same ED visit. Hydronephrosis was reported in 69.6% of POCUS exams by radiologists and 72.7% of CT scans (p=0.22). The κ for consensus interpretation of POCUS between the radiologists to detect hydronephrosis was 0.77 (0.72 to 0.82) and weighted κ for grading the hydronephrosis was 0.82 (0.72 to 0.90), interpreted as good to very good. Using CT scan findings as the criterion standard, Eps had an overall sensitivity of 81.1% (95% CI: 79.6% to 82.5%), specificity of 59.4% (95% CI: 56.4% to 62.5%), PPV of 84.3% (95% CI: 82.9% to 85.7%), and NPV of 53.8% (95% CI: 50.8% to 56.7%); compared to radiologist sensitivity of 85.0% (95% CI: 82.5% to 87.2%), specificity of 79.7% (95% CI: 75.1% to 83.7%), PPV of 91.8% (95% CI: 89.8% to 93.5%), and NPV of 66.5% (95% CI: 61.8% to 71.0%). Testing for a report of moderate or high degree of hydronephrosis, specificity of EP was 94.6% (95% CI: 93.7% to 95.4%) and to 99.2% (95% CI: 98.9% to 99.5%) for identifying severe hydronephrosis alone. Conclusion: EP POCUS interpretations were comparable to the radiologists for identifying moderate to severe hydronephrosis using CT scan results as the criterion standard. Among patients with moderate or high pre-test probability of ureteric calculi, as calculated by the STONE-score, the presence of moderate to severe (+LR 6.3 and –LR 0.69) or severe hydronephrosis (+LR 54.4 and –LR 0.57) was highly diagnostic of the stone disease. Low dose CT is indicated in such patients for evaluation of stone size and location.

Keywords: renal colic, point-of-care, ultrasound, bedside, emergency physician

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Authors: Vaibhav Rathi, Soumen Maity, Achu R. Sekhar, Abhijit Banerjee

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Construction sector in India is extremely resource and carbon intensive. It contributes to significantly to national greenhouse emissions. At the resource end the industry consumes significant portions of the output from mining. Resources such as sand and soil are most exploited and their rampant extraction is becoming constant source of impact on environment and society. Cement is another resource that is used in abundance in building and construction and has a direct impact on limestone resources. Though India is rich in cement grade limestone resource, efforts have to be made for sustainable consumption of this resource to ensure future availability. Use of these resources in high volumes in India is a result of rapid urbanization. More cities have grown to a population of million plus in the last decade and million plus cities are growing further. To cater to needs of growing urban population of construction activities are inevitable in the coming future thereby increasing material consumption. Increased construction will also lead to substantial increase in end of life waste generation from Construction and Demolition (C&D). Therefore proper management of C&D waste has the potential to reduce environmental pollution as well as contribute to the resource efficiency in the construction sector. The present study deals with estimation, characterisation and documenting current management practices of C&D waste in 10 Indian cities of different geographies and classes. Based on primary data the study draws conclusions on the potential of C&D waste to be used as an alternative to primary raw materials. The estimation results show that India generates 716 million tons of C&D waste annually, placing the country as second largest C&D waste generator in the world after China. The study also aimed at utilization of C&D waste in to building materials. The waste samples collected from various cities have been used to replace 100% stone aggregates in paver blocks without any decrease in strength. However, management practices of C&D waste in cities still remains poor instead of notification of rules and regulations notified for C&D waste management. Only a few cities have managed to install processing plant and set up management systems for C&D waste. Therefore there is immense opportunity for management and reuse of C&D waste in Indian cities.

Keywords: building materials, construction and demolition waste, cities, environmental pollution, resource efficiency

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Authors: Gordana Ćetković, Vesna Tumbas Šaponjac, Jasna Čanadanović-Brunet, Sonja Đilas, Slađana Stajčić, Jelena Vulić, Mirjana Jakišić

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Despite the recommended amount of daily intake of fruits, the consumption in modern age remains very low. Therefore there is a need for delivering valuable phytochemicals into the human body through different foods by developing functional food products fortified with natural bioactive compounds from plant sources. Recently, a growing interest rises in exploiting the fruit and vegetable by-products as sources of phytochemicals such as polyphenols, carotenoids, vitamins etc. Cherry contain high amounts of polyphenols, which are known to display a wide range of biological activities like antioxidant, anti-inflammatory, antimicrobial or anti-carcinogenic activities, improvement of vision, induction of apoptosis and neuroprotective effects. Also, cherry pomace, a by-product in juice processing, can also be promising source of phenolic compounds. However, the application of polyphenols as food additives is limited because after extraction these compounds are susceptible to degradation. Microencapsulation is one of the alternative approaches to protect bioactive compounds from degradation during processing and storage. Freeze-drying is one of the most used microencapsulation methods for the protection of thermosensitive and unstable molecules. In this study sour cherry pomace was extracted with food-grade solvent (50% ethanol) to be suitable for application in products for human use. Extracted polyphenols have been concentrated and stabilized on whey (WP) and soy (SP) proteins. Encapsulation efficiency in SP was higher (94.90%), however not significantly (p<0.05) from the one in WP (90.10%). Storage properties of WP and SP encapsulate in terms of total polyphenols, anthocyanins and antioxidant activity was tested for 6 weeks. It was found that the retention of polyphenols after 6 weeks in WP and SP (67.33 and 69.30%, respectively) was similar. The content of anthocyanins has increased in WP (for 47.97%), while their content in SP has very slightly decreased (for 1.45%) after 6-week storage period. In accordance with anthocyanins the decrease in antioxidant activity in WP (87.78%) was higher than in SP (43.02%). According to the results obtained in this study, the technique reported herewith can be used for obtaining quality encapsulates for their further use as functional food additives, and, on the other hand, for fruit waste valorization.

Keywords: cherry pomace, microencapsulation, polyphenols, storage

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Authors: Juariah Salam Suryadi

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North coast (Pantura) line is known as a high-risk area related to reproductive health. This is because along the line, there are many food stalls and entertainment industries that at night the function changed to be sexual transaction areas. This business line also facilitate circulation and transaction of drug and substance abuse. The environment conditions can influence adolescents who live in this area. It is because of adolescence characteristics that has high curiosity and looking for their identities. Therefore, purposes of this study were to explore reproductive health behaviour of early adolescents who lived in Pantura line and to suggest intervention based on the adolescents reproductive health conditions. This study was conducted in November 2016 among the seventh-grade students of Pusakajaya Junior High School 1 and 2, Subang District. Number of respondents were 269 students (Male=135, Female=134). The students were interviewed using a semi-structured questionnaire. Some teachers also interviewed to complement the data. The quantitative data was analyzed with univariate analysis, while content analysis was used for the qualitative data. Findings of this study showed that 85,2% of male students were smoker. Most of them started smoking at elementary school. Male students who often drunk alcohol were about 25,2% and all of them initiated to drink at elementary school. There were about 21,5% of male students ever used drug and substance abuse. There were 54,6% of the students that confessed having a lover. Most of them were female students. Sexual behaviour that ever done with their lovers were: holding hands (37,4%), kissing (4%) and embracing (6,8%). Although all of the students claimed to have never had sexual intercourse, but 5,9% of them said that they had friends who have had sexual intercourse. Most of the students also had friends with negative characteristics. Their friends were smoker (82,2%), drinker (53,2%) and drug abuse (42%). Most of the students recognized that they took the risks behaviour to get pleasure with their peers. Information from the teachers indicated that most problem of male students were smoking and drug and substance abuse; while sexuality including unwanted pregnancies were reproductive problems of many female students. Therefore, It is recommended to enhance understanding of the adolescents about risks of unhealthy behaviour through continuing reproductive health education, both in school and out of school. Policy support to create positive social environment and adolescents friendly is also suggested.

Keywords: reproductive health, behaviour, early adolescents, pantura line

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Authors: P. R. Chauhan, S. K. Tyagi

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Adsorption refrigeration technology offers a sustainable and energy-efficient cooling alternative over traditional refrigeration technologies for meeting the fast-growing cooling demands. With its ability to utilize natural refrigerants, low-grade heat sources, and modular configurations, it has the potential to revolutionize the cooling industry. Despite these benefits, the commercial viability of this technology is hampered by several fundamental limiting constraints, including its large size, low uptake capacity, and poor performance as a result of deficient heat and mass transfer characteristics. The primary cause of adequate heat and mass transfer characteristics and magnitude of exergy loss in various real processes of adsorption cooling system can be assessed by the entropy generation rate analysis, i. e. Second law of Thermodynamics. Therefore, this article presents the second law of thermodynamic-based investigation in terms of entropy generation rate (EGR) to identify the energy losses in various processes of the HPCC-based adsorption system using MATLAB R2021b software. The adsorption technology-based cooling system consists of two beds made up of silica gel and arranged in a single stage, while the water is employed as a refrigerant, coolant, and hot fluid. The variation in process-wise EGR is examined corresponding to cycle time, and a comparative analysis is also presented. Moreover, the EGR is also evaluated in the external units, such as the heat source and heat sink unit used for regeneration and heat dump, respectively. The research findings revealed that the combination of adsorber and desorber, which operates across heat reservoirs with a higher temperature gradient, shares more than half of the total amount of EGR. Moreover, the EGR caused by the heat transfer process is determined to be the highest, followed by a heat sink, heat source, and mass transfer, respectively. in case of heat transfer process, the operation of the valve is determined to be responsible for more than half (54.9%) of the overall EGR during the heat transfer. However, the combined contribution of the external units, such as the source (18.03%) and sink (21.55%), to the total EGR, is 35.59%. The analysis and findings of the present research are expected to pinpoint the source of the energy waste in HPCC based adsorption cooling systems.

Keywords: adsorption cooling cycle, heat transfer, mass transfer, entropy generation, silica gel-water

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Authors: Johanna Gamboa-Kroesen

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School connectedness, or the sense of belonging at school, is a critical factor in adolescent health, academic achievement, and socioemotional well-being. In educational research, the construct of the psychological sense of school membership is often referred to as school engagement, school bonding, or school attachment. While current research recognizes school connectedness as integral to a child’s mental health and academic success, many schools have yet to develop adequate interventions to promote a child’s overall sense of belonging at school. However, prior researches in music education indicates that, among other benefits, music classrooms may provide an environment where students feel they belong. While studies indicates that music learning environments, specifically performing ensemble learning environments, instill a sense of school connectedness and, more broadly, contribute to a student’s socio-emotional development, there has been inadequate research on how the actions of music teachers contribute to this phenomenon. The purpose of this study was to examine the relationship between school connectedness and music learning environments with middle school music students enrolled in a school-based music ensemble. In addition, the study aimed to provide a descriptive analysis of the instructional practices that music teachers use to promote an inclusive environment in their classrooms and an overall sense of belonging in their students. Using 191 student surveys of school membership, student reflective writings, 5 teacher interviews, and 10 classroom observations, this study examined the relationship between 7th and 8th-grade student-reported levels of connectedness within their school-based music ensemble and teacher instructional practice. The study found that students reported high levels of positive school membership within their music classes. Students who participate in school-based orchestra ensembles reported a positive change in emotional state during music instruction. In addition, evidence in this study found that music teachers use instructional practices to build connectedness through de-emphasizing competition and strengthening a student’s sense of relational value within their music learning experience. The findings offer implications for future music teacher instruction to create environments of inclusion, strengthen student-teacher relationships, and promote strategies that enhance student connection to school.

Keywords: music education, belonging, instructional practice, school connectedness

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Authors: M. Ali Mandegari, S. Farzad, J. F. Görgens

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Sugar is one of the main agricultural industries in South Africa and approximately livelihoods of one million South Africans are indirectly dependent on sugar industry which is economically struggling with some problems and should re-invent in order to ensure a long-term sustainability. Second generation bio-refinery is defined as a process to use waste fibrous for the production of bio-fuel, chemicals animal food, and electricity. Bio-ethanol is by far the most widely used bio-fuel for transportation worldwide and many challenges in front of bio-ethanol production were solved. Bio-refinery annexed to the existing sugar mill for production of bio-ethanol and electricity is proposed to sugar industry and is addressed in this study. Since flow-sheet development is the key element of the bio-ethanol process, in this work, a bio-refinery (bio-ethanol and electricity production) annexed to a typical South African sugar mill considering 65ton/h dry sugarcane bagasse and tops/trash as feedstock was simulated. Aspen PlusTM V8.6 was applied as simulator and realistic simulation development approach was followed to reflect the practical behavior of the plant. Latest results of other researches considering pretreatment, hydrolysis, fermentation, enzyme production, bio-ethanol production and other supplementary units such as evaporation, water treatment, boiler, and steam/electricity generation units were adopted to establish a comprehensive bio-refinery simulation. Steam explosion with SO2 was selected for pretreatment due to minimum inhibitor production and simultaneous saccharification and fermentation (SSF) configuration was adopted for enzymatic hydrolysis and fermentation of cellulose and hydrolyze. Bio-ethanol purification was simulated by two distillation columns with side stream and fuel grade bio-ethanol (99.5%) was achieved using molecular sieve in order to minimize the capital and operating costs. Also boiler and steam/power generation were completed using industrial design data. Results indicates 256.6 kg bio ethanol per ton of feedstock and 31 MW surplus power were attained from bio-refinery while the process consumes 3.5, 3.38, and 0.164 (GJ/ton per ton of feedstock) hot utility, cold utility and electricity respectively. Developed simulation is a threshold of variety analyses and developments for further studies.

Keywords: bio-refinery, bagasse, tops, trash, bio-ethanol, electricity

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Authors: Areej Isam Barham

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The implementation of Japanese lesson study approach in the mathematics classroom has been grown worldwide as a model of professional development for teachers. In Qatar, the implementation of IMPULS-QU lesson study program aimed to establish a robust organizational improvement model of professional development for mathematics teachers in Qatar schools. This study describes the implementation of a lesson study model at Al-Markhyia Independent Primary School through different stages; and discusses how the planning process, the research lesson, and the post discussion participates in providing teachers and researchers with a successful research lesson for teacher professional development. The research followed a case study approach in one mathematics classroom. Two teachers and one professional development specialist participated the planning process. One teacher conducted the research lesson study by introducing a problem solving related to the concept of the ‘Mean’ in a mathematics class, 21 students in grade 6 participated in solving the mathematic problem, 11 teachers, 4 professional development specialists, and 4 mathematics professors observed the research lesson. All previous participants except the students participated in a pre and post-lesson discussion within this research. This study followed a qualitative research approach by analyzing the collected data through different stages in the research lesson study. Observation, field notes, and semi-structured interviews conducted to collect data to achieve the research aims. One feature of this lesson study research is that this research describes the implementation for a lesson study as a new experience for one mathematics teacher and 21 students after 3 years of conducting IMPULS-QU project in Al-Markhyia school. The research describes various stages through the implementation of this lesson study model starting from the planning process and ending by the post discussion process. Findings of the study also address the impact of lesson study approach in teaching mathematics for the development of teachers from their point views. Results of the study show the benefits of using lesson study from the point views of participated teachers, theory perceptions about the essential features of lesson study, and their needs for future development. The discussion of the study addresses different features and issues related to the implementation of IMPULS-QU lesson study model in the mathematics classroom. In the light of the study, the research presents recommendations and suggestions for future professional development.

Keywords: lesson study, mathematics education, mathematics teaching experience, teacher professional development

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Authors: Georgios A. Fragkiadakis, Antonia Psaroudaki, Theodora Mouratidou, Eirini Sfakianaki

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Research: The nutritional benefits of eating carob are many and important for the human organism, as it is a food rich in carbohydrates and low in fat and contains multiple nutrients, making it a "superfood". Within the framework of the project "Actions for the optimal utilization of the potential of carob in the Region of Crete" which is financed-supervised by the Region of Crete, a second-grade local self-government authority, with the collaboration of the University of Crete and of the Hellenic Mediterranean University, an online survey was carried out with the aim of evaluating dietary habits and views related to the consumption of carob and its products in a sample of local residents. Results and Conclusions: Of the 351 participants, 259 (73.8%) stated that they consume carob products, and 26.2% stated that they do not. Difficult access and limited availability of carob-food products (33.7%), high price (20.7%), and difficulties of use and preparation (15.2%) were cited as the main reasons for non-consumption. Other reasons, to a lesser extent, concern the taste, especially the sweet aftertaste of some products. Concerning the behavior and eating habits related to the consumption of carob products (n=259), 57.9% of the sample report that they buy carob products "sometimes"; 21.2% report "often"; 19.7% report "rarely", and a very small percentage of 1.2% report "constantly". With reference to the reasons for choosing carob products, the participants mention the main reason for their high nutritional value (51.7%), followed by 32.4% of nutritional claims and health claims, and the organoleptic characteristics (10.8%). Other positive factors are the final price of the product, the ease of use, and the respect for the local environment and producers. Some bakery products show the highest percentage of consumption among carob-food consumers, mainly in the form of rusks (86.1%) and breadsticks (70.3%). They are followed, in descending order, by bread (63.3%), toast (52.1%), and flour (50.6%). More specifically: 40.5% consume carob rusks less than once a month; 22% consume less than once a week; up to twice a week 12.4%; 6.6%, consume rusks 3 to 4 times a week, and daily 3.9%. It is worth mentioning that a high percentage of consumers of carob products recommend the consumption to their family and friends. Only a small percentage, in the range of 5%, does not recommend the consumption of carob products in their close family/social circle. The main motivating factors for the consumption of carob products are the expected effects they may have on health (74.1%) and the organoleptic characteristics with a percentage of 21.6%.

Keywords: food, consumer, preferences, carob, Crete, Greece

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Authors: Gurjeet Khurana, Surender Singh, Poonam Arora, Praveendra K. Sachan

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Introduction: Post-operative quality of recovery is the key outcome in the perspective of anesthesiologist. It is directly related to patient satisfaction. This is unsurprising, considering most aspects of a poor quality recovery after surgery will impair satisfaction with care. This study was thus undertaken to evaluate effects of Dexamethasone and Lignocaine on Quality of Recovery using QoR- 40 questionnaire and compare their effects. Material and methods: After obtaining the ethical committee approval and written informed consent, 67 patients of 18-60 years, ASA grade I and II scheduled for elective laparoscopic cholecystectomy were randomly allocated into two groups. Group I of 34 patients received 2mg/kg lignocaine diluted to 10ml with normal saline. Group 2 of 33 patients received 0.1 mg/kg I/V Dexamethasone diluted to 10ml with normal saline. QoR-40 was assessed on pre-operative day, and again QoR-40 was assessed at 24 hr post-operative day-1. Postoperative pain scores, nausea and vomiting and shoulder pain were secondary outcomes. Results: The Global QoR-40 was more than 180 at 24 hr in both the groups. The Dexamethasone group had higher Global QoR-40 than lignocaine group 187.94 v/s 182.85. Amongst dimensions of QoR-40 Dexamethasone had statistically better physical comfort, physical independence, and pain relief as compared to Lignocaine. Positive items had excellent responses in Dexamethasone group. Headache, backache and sore throat were also less severe in Dexamethasone group as compared to Lignocaine group. Dexamethasone group had lower VAS compared to lignocaine group. Similarly, there was less fentanyl consumption in dexamethasone group (364.08 ± 127.31) in postoperative period when compared to the lignocaine group (412.31 ± 147.8). Group receiving dexamethasone had 36% increase in appetite compared to lignocaine group (17.6%), which facilitated early oral feeding. Frequency of PONV was less in group-2 at different time interval as compared to group 1. Total episode of PONV were 18 in group 1 and 7 in group 2. Statistically significant difference was seen among two groups (p value= 0.007). Use of antiemetic was more in group 1 as compared to group 2 at all the times, though it was not statistically significant at different time intervals. Antiemetics were administered to 18 patients in group 1 as compared to 5 patients in group 2 postoperatively. Statistically significant difference (p value= 0.011) was seen in total antiemetic consumption. Conclusion: Our study demonstrated that pre-operative administration of a single dose of dexamethasone enhanced the quality of recovery after laparoscopic cholecystectomy as compared to Lignocaine bolus dose.

Keywords: dexamethasone, lignocaine, QoR-40 questionnaire, quality of recovery

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Authors: Saima Ali, Liaqat Ali, Nasir Orakzai

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Background: Hydronephrosis is the most common abnormal finding in the urinary tract on prenatal screening with Ultrasonography. The prenatal hydronephrosis is a diagnostic dilemma in differentiating between obstructive variant versus physiologic hydronephrosis. The assessment and prompt diagnosis of prenatal hydronephrosis is important because of the fact that untreated obstructive hydronephrosis usually leads to recurrent UTI, Urosepsis, deterioration of renal functions, non-functioning kidneys, and even end-stage renal disease. Objectives: To determine the etiology and outcome of postnatal treatment of children with prenatal hydronephrosis in two teaching hospitals of Khyber Pakhtunkhwa (KPK) Methods: It is a multicentric descriptive study that was conducted in department of Paediatrics in Kuwait teaching hospital Peshawar and Department of Urology in Institute of Kidney Diseases Hayatabad Medical Complex Peshawar from January 2008 till December 2010. Total numbers of 64 neonates were included in the study with the mean follow-up of 14.5 months. All the diagnostic data in prenatal, postnatal data, and operative and non-operative data were collected on structured Proforma and was analyzed on SPSS version 17. Results: Out of 64 patients, 39 (60.9 %) were male while 25 were female. 52 patients had unilateral while 12 patients had bilateral hydronephrosis. Based upon prenatal USG in term of AP diameter, 37 (57 %) patients had mild hydronephrosis (5-10 mm AP diameter), 14 patients had moderate hydronephrosis (10-15 mm AP diameter) while 13 patients had gross hydronephrosis (More than 15mm). Regarding etiology, 44(76 %) patients were labeled as physiologic hydronephrosis, 11 patients (9.3%) with PUJ obstruction, 5 patients with Vesicoureteric reflux (VUR) and 4 patients with posterior urethral valves. Surgery was performed in total of 15 (23.4%) patients that included open Pyeloplasty in 11 patients, Vesicostomy followed by posterior valve fulguration in 4 patients. All the patients of VUR treated medically. The severity in the grade of prenatal hydronephrosis is significantly associated with the need for definitive urological surgery p < 0.005. Ancillary procedures like percutaneous nephrostomy (PCN) were inserted 7 patients. Conclusions: Prenatal hydronephrosis is a common ailment associated with significant morbidity. Physiological Hydronephrosis and VUR can be successfully treated with medical treatment. However obstructive PUJ obstructions and posterior urethral valves require surgical correction with a good success rate.

Keywords: prenatal hydronephrosis, Pelviureteric Junction (PUJ) Obstruction, vesicoureteric reflux, posterior urethral valve, renography

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Authors: Faiz N. K. Yusufi, Aquil Ahmed, Jamal Ahmad

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Predicting the risk of diabetic retinopathy (DR) in Indian type 2 diabetes patients is immensely necessary. India, being the second largest country after China in terms of a number of diabetic patients, to the best of our knowledge not a single risk score for complications has ever been investigated. Diabetic retinopathy is a serious complication and is the topmost reason for visual impairment across countries. Any type or form of DR has been taken as the event of interest, be it mild, back, grade I, II, III, and IV DR. A sample was determined and randomly collected from the Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N.M.C., A.M.U., Aligarh, India. Collected variables include patients data such as sex, age, height, weight, body mass index (BMI), blood sugar fasting (BSF), post prandial sugar (PP), glycosylated haemoglobin (HbA1c), diastolic blood pressure (DBP), systolic blood pressure (SBP), smoking, alcohol habits, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), physical activity, duration of diabetes, diet control, history of antihypertensive drug treatment, family history of diabetes, waist circumference, hip circumference, medications, central obesity and history of DR. Cox proportional hazard regression is used to design risk scores for the prediction of retinopathy. Model calibration and discrimination are assessed from Hosmer Lemeshow and area under receiver operating characteristic curve (ROC). Overfitting and underfitting of the model are checked by applying regularization techniques and best method is selected between ridge, lasso and elastic net regression. Optimal cut off point is chosen by Youden’s index. Five-year probability of DR is predicted by both survival function, and Markov chain two state model and the better technique is concluded. The risk scores developed can be applied by doctors and patients themselves for self evaluation. Furthermore, the five-year probabilities can be applied as well to forecast and maintain the condition of patients. This provides immense benefit in real application of DR prediction in T2DM.

Keywords: Cox proportional hazard regression, diabetic retinopathy, ROC curve, type 2 diabetes mellitus

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Authors: Sumit Kanwar, Manisha Chand, Gregory Gilot

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Background: Septic arthritis of the shoulder has infrequently been discussed. Focus on infection of the untouched shoulder has not heretofore been described. We present four patients with glenohumeral septic arthritis. Methods: Case 1: A 59 year old male with left shoulder pain in the anterior, posterior and superior aspects. Case 2: A 60 year old male with fever, chills, and generalized muscle aches. Case 3: A 70 year old male with right shoulder pain about the anterior and posterior aspects. Case 4: A 55 year old male with global right shoulder pain, swelling, and limited ROM. Results: In case 1, the left shoulder was affected. Physical examination, swelling was notable, there was global tenderness with a painful range of motion (ROM). The lab values indicated an erythrocyte sedimentation rate (ESR) of 96, and a C-reactive protein (CRP) of 304.30. Imaging studies were performed and MRI indicated a high suspicion for an abscess with osteomyelitis of the humeral head. Our second case’s left arm was affected. He had swelling, global tenderness and painful ROM. His ESR was 38, CRP was 14.9. X-ray showed severe arthritis. Case 3 differed with the right arm being affected. Again, global tenderness and painful ROM was observed. His ESR was 94, and CRP was 10.6. X-ray displayed an eroded glenoid space. Our fourth case’s right shoulder was affected. He had global tenderness and painful, limited ROM. ESR was 108 and CRP was 2.4. X-ray was non-significant. Discussion: Monoarticular septic arthritis of the virgin glenohumeral joint is seldom diagnosed in clinical practice. Common denominators include elevated ESR, painful, limited ROM, and involvement of the dominant arm. The male population is more frequently affected with an average age of 57. Septic arthritis is managed with incision and drainage or needle aspiration of synovial fluid supplemented with 3-6 weeks of intravenous antibiotics. Due to better irrigation and joint visualization, arthroscopy is preferred. Open surgical drainage may be indicated if the above methods fail. Conclusion: If a middle-aged male presents with vague anterior or posterior shoulder pain, elevated inflammatory markers and a low grade fever, an x-ray should be performed. If this displays degenerative joint disease, the complete further workup with advanced imaging, such as an MRI, CT scan, or an ultrasound. If these imaging modalities display anterior space joint effusion with soft tissue involvement, we can suspect septic arthritis of the untouched glenohumeral joint and surgery is indicated.

Keywords: glenohumeral joint, identification, infection, septic arthritis, shoulder

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Authors: Siddharth Jain, Abhenil Mittal, Surendra Kumar Sharma

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Background: With its recent emergence and re-emergence, dengue has become a major international public health concern, imposing significant financial burden especially in developing countries. Despite aggressive control measures in place, India experienced one of its largest outbreaks in 2015 with Delhi being most severely affected. There is a lack of reliable predictors of disease severity and mortality in dengue. The present study was carried out to identify these predictors during the 2015 outbreak. Methods: This prospective observational study conducted at an apex tertiary care center in Delhi, India included confirmed adult dengue patients admitted between August-November 2015. Patient demographics, clinical details, and laboratory findings were recorded in a predesigned proforma. Appropriate statistical tests were used to summarize and compare the clinical and laboratory characteristics and derive predictors of mortality and severe disease, while developing a clinical risk score for mortality. Serotype analysis was also done for 75 representative samples to identify the dominant serotypes. Results: Data of 369 patients were analyzed (mean age 30.9 years; 67% males). Of these, 198 (54%) patients had dengue fever, 125 (34%) had dengue hemorrhagic fever (DHF Grade 1,2)and 46 (12%) developed dengue shock syndrome (DSS). Twenty two (6%) patients died. Late presentation to the hospital (≥5 days after onset) and dyspnoea at rest were identified as independent predictors of severe disease. Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. A clinical risk score was developed (12*age + 14*sensorium + 10*dyspnoea) which, if ≥ 22, predicted mortality with a high sensitivity (81.8%) and specificity (79.2%). The predominant serotypes in Delhi (2015) were DENV-2 and DENV-4. Conclusion: Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. Platelet counts did not determine the outcome in dengue patients. Timely referral/access to health care is important. Development and use of validated predictors of disease severity and simple clinical risk scores, which can be applied in all healthcare settings, can help minimize mortality and morbidity, especially in resource limited settings.

Keywords: dengue, mortality, predictors, severity

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Authors: Vishwajit Ghatge, David Looper

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Over the last few decades, oilfield service rolling equipment has significantly increased in weight, primarily because of emissions regulations, which require larger/heavier engines, larger cooling systems, and emissions after-treatment systems, in some cases, etc. Larger engines cause more vibration and shock loads, leading to failure of electronics and control systems. If the vibrating frequency of the engine matches the system frequency, high resonance is observed on structural parts and mounts. One such existing automated control equipment system comprising wire rope mounts used for mounting computers was designed approximately 12 years ago. This includes the use of an industrial- grade computer to control the system operation. The original computer had a smaller, lighter enclosure. After a few years, a newer computer version was introduced, which was 10 lbm heavier. Some failures of internal computer parts have been documented for cases in which the old mounts were used. Because of the added weight, there is a possibility of having the two brackets impact each other under off-road conditions, which causes a high shock input to the computer parts. This added failure mode requires validating the existing mount design to suit the new heavy-weight computer. This paper discusses the modal finite element method (FEM) analysis and experimental modal analysis conducted to study the effects of vibration on the wire rope mounts and the computer. The existing mount was modelled in ANSYS software, and resultant mode shapes and frequencies were obtained. The experimental modal analysis was conducted, and actual frequency responses were observed and recorded. Results clearly revealed that at resonance frequency, the brackets were colliding and potentially causing damage to computer parts. To solve this issue, spring mounts of different stiffness were modeled in ANSYS software, and the resonant frequency was determined. Increasing the stiffness of the system increased the resonant frequency zone away from the frequency window at which the engine showed heavy vibrations or resonance. After multiple iterations in ANSYS software, the stiffness of the spring mount was finalized, which was again experimentally validated.

Keywords: experimental modal analysis, FEM Modal Analysis, frequency, modal analysis, resonance, vibration

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Authors: Muhandiram Rallage Ruvini Nisansala Yatigammana, Anuruddhika Kumudu Kumari Rajakaruna Jayathilaka

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Sports injuries are common among teenagers and children engaged in organized sports. While most sports injuries are typical, some rare occurrences involve conditions such as eye, dental, cervical, and rare internal organ injuries, such as pancreatic injuries. These injuries, especially traumatic pancreatitis, require prompt attention due to their potential for severe and sometimes fatal complications. This case revolves around a real accident involving a 12-year-old girl, Piyumi, who suffered a face-to-face collision during netball practice, resulting in severe abdominal pain. After a medical examination, she was diagnosed with a rare pancreatic injury, uncommon in children compared to adults. In Piyumi’s case, she had a grade 3 pancreatic injury and underwent non-surgical management, successfully healing her wound without surgery. The study attempts to fill empirical and population gaps, addressing a rarely discussed injury experienced by a 12-year-old female netball player. The paper will also provide an in-depth understanding of pancreatic injury, which is a rare sports injury. The study’s main objective was to investigate the incidence and characteristics of pancreatic injury, particularly focusing on pancreatic trauma, among children and adolescents engaged in high-impact sports, such as netball. This research adopted a case study strategy, employing interviews as the primary data collection method. Interviews were conducted with Piyumi, her parents, and the two specialist doctors directly involved in her treatment, providing firsthand accounts and insights. By examining the case, the paper arrives at three main conclusions. Firstly, pancreatic damage is uncommon, especially in the sports world, and proper diagnosis is essential to avoiding health concerns, particularly for minors. Secondly, CT (Computed Tomography) was useful in locating the injury, as injuries can be diagnosed very well with Computed Tomography (CT) images. Finally, and most importantly, pancreatic injuries are infrequent, but trauma can still occur, particularly in high-impact sports or accidents involving extreme force or falls. These injuries should be accurately diagnosed and treated promptly.

Keywords: child athlete, pancreatic injury, rare sports injuries, sportswoman

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Authors: Atara Shriki, Ilana Lavy

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Teaching for the first time an online course dealing with the history of mathematics, we were struggling with questions related to the design of a proper learning environment (LE). Thirteen high school mathematics teachers, M.Ed. students, attended the course. The teachers were engaged in independent reading of mathematical texts, a task that is recognized as complex due to the unique characteristics of such texts. In order to support the learning processes and develop skills that are essential for succeeding in learning online (e.g. self-regulated learning skills, meta-cognitive skills, reflective ability, and self-assessment skills), the LE comprised of three components aimed at “scaffolding” the learning: (1) An online "self-feedback" questionnaires that included drill-and-practice questions. Subsequent to responding the questions the online system provided a grade and the teachers were entitled to correct their answers; (2) Open-ended questions aimed at stimulating critical thinking about the mathematical contents; (3) Reflective questionnaires designed to assist the teachers in steering their learning. Using a mixed-method methodology, an inquiry study examined the learning processes, the learners' difficulties in reading the mathematical texts and on the unique contribution of each component of the LE to the ability of teachers to comprehend the mathematical contents, and support the development of their learning skills. The results indicate that the teachers found the online feedback as most helpful in developing self-regulated learning skills and ability to reflect on deficiencies in knowledge. Lacking previous experience in expressing opinion on mathematical ideas, the teachers had troubles in responding open-ended questions; however, they perceived this assignment as nurturing cognitive and meta-cognitive skills. The teachers also attested that the reflective questionnaires were useful for steering the learning. Although in general the teachers found the LE as supportive, most of them indicated the need to strengthen instructor-learners and learners-learners interactions. They suggested to generate an online forum to enable them receive direct feedback from the instructor, share ideas with other learners, and consult with them about solutions. Apparently, within online LE, supporting learning merely with respect to cognitive aspects is not sufficient. Leaners also need an emotional support and sense a social presence.

Keywords: cognitive and meta-cognitive skills, independent reading of mathematical texts, online learning environment, self-regulated learning skills

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Authors: Eun-Soo Lim, Young-Min Kang

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M-type Sr-hexaferrite (SrFe₁₂O₁₉) have been studied during the past decades because it is the most utilized materials in permanent magnets due to their low price, outstanding chemical stability, and appropriate hard magnetic properties. Many attempts have been made to improve the intrinsic magnetic properties of M-type Sr-hexaferrites (SrM), such as by improving the saturation magnetization (MS) and crystalline anisotropy by cation substitution. It is well proved that the Ca-La-Co substitutions are one of the most successful approaches, which lead to a significant enhancement in the crystalline anisotropy without reducing MS, and thus the Ca-La-Co-doped SrM have been commercialized in high-grade magnet products. In this research, the effect of respective doping of Ca and La into the SrM lattices were studied with assumptions that these elements could substitute both of Fe and Sr sites. The hexaferrite samples of stoichiometric SrFe₁₂O₁₉ (SrM) and the Ca substituted SrM with formulae of Sr₁₋ₓCaₓFe₁₂Oₐ (x = 0.1, 0.2, 0.3, 0.4) and SrFe₁₂₋ₓCaₓOₐ (x = 0.1, 0.2, 0.3, 0.4), and also La substituted SrM of Sr₁₋ₓLaₓFe₁₂Oₐ (x = 0.1, 0.2, 0.3, 0.4) and SrFe₁₂₋ₓLaₓOₐ (x = 0.1, 0.2, 0.3, 0.4) were prepared by conventional solid state reaction processes. X-ray diffraction (XRD) with a Cu Kα radiation source (λ=0.154056 nm) was used for phase analysis. Microstructural observation was conducted with a field emission scanning electron microscopy (FE-SEM). M-H measurements were performed using a vibrating sample magnetometer (VSM) at 300 K. Almost pure M-type phase could be obtained in the all series of hexaferrites calcined at > 1250 ºC. Small amount of Fe₂O₃ phases were detected in the XRD patterns of Sr₁₋ₓCaₓFe₁₂Oₐ (x = 0.2, 0.3, 0.4) and Sr₁₋ₓLaₓFe₁₂Oₐ (x = 0.1, 0.2, 0.3, 0.4) samples. Also, small amount of unidentified secondary phases without the Fe₂O₃ phase were found in the samples of SrFe₁₂₋ₓCaₓOₐ (x = 0.4) and SrFe₁₂₋ₓLaₓOₐ (x = 0.3, 0.4). Although the Ca substitution (x) into SrM structure did not exhibit a clear tendency in the cell parameter change in both series of samples, Sr₁₋ₓCaₓFe₁₂Oₐ and SrFe₁₂₋ₓCaₓOₐ , the cell volume slightly decreased with doping of Ca in the Sr₁₋ₓCaₓFe₁₂Oₐ samples and increased in the SrFe₁₂₋ₓCaₓOₐ samples. Considering relative ion sizes between Sr²⁺ (0.113 nm), Ca²⁺ (0.099 nm), Fe³⁺ (0.064 nm), these results imply that the Ca substitutes both of Sr and Fe in the SrM. A clear tendency of cell parameter change was observed in case of La substitution into Sr site of SrM ( Sr₁₋ₓLaₓFe₁₂Oₐ); the cell volume decreased with increase of x. It is owing to the similar but smaller ion size of La³⁺ (0.106 nm) than that of Sr²⁺. In case of SrFe₁₂₋ₓLaₓOₐ, the cell volume first decreased at x = 0.1 and then remained almost constant with increase of x from 0.2 to 0.4. These results mean that La only substitutes Sr site in the SrM structure. Besides, the microstructure and magnetic properties of these samples, and correlation between them will be revealed.

Keywords: M-type hexaferrite, substitution, cell parameter, magnetic properties

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Authors: Margherita Cardellini

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To our knowledge, dark skinned children are often victims of discrimination from adults and society, but few studies specifically focus on skin color discrimination on children coming from the same children. Even today, the 'color blind children' ideology is widespread among adults, teachers, and educators and maybe also among scholars, which seem really careful about study expressions of racism in childhood. This social and cultural belief let people think that all the children, because of their age and their brief experience in the world, are disinterested in skin color. Sometimes adults think that children are even incapable of perceiving skin colors and that it could be dangerous to talk about melaninic differences with them because they finally could notice this difference, producing prejudices and racism. Psychology and neurology research projects are showing for many years that even the newborns are already capable of perceiving skin color and ethnic differences by the age of 3 months. Starting from this theoretical framework we conducted a research project to understand if and how primary school children talk about skin colors, picking up any stereotypes or prejudices. Choosing to use the focus group as a methodology to stimulate the group dimension and interaction, several stories about skin color discrimination's episodes within their classroom or school have emerged. Using the photo elicitation technique we chose to stimulate talk about the research object, which is the skin color, asking the children what was ‘the first two things that come into your mind’ when they look the photographs presented during the focus group, which represented dark and light skinned women and men. So, this paper will present some of these stories about episodes of discrimination with an escalation grade of proximity related to the discriminatory act. It will be presented a story of discrimination happened within the school, in an after-school daycare, in the classroom and even episode of discrimination that children tell during the focus groups in the presence of the discriminated child. If it is true that the Declaration of the Right of the Child state that every child should be discrimination free, it’s also true that every adult should protect children from every form of discrimination. How, as adults, can we defend children against discrimination if we cannot admit that even children are potential discrimination’s actors? Without awareness, we risk to devalue these episodes, implicitly confident that the only way to fight against discrimination is to keep her quiet. The right not to be discriminated goes through the right to talk about its own experiences of discrimination and the right to perceive the unfairness of the constant depreciation about skin color or any element of physical diversity. Intercultural education could act as spokesperson for this mission in the belief that difference and plurality could really become elements of potential enrichment for humanity, starting from children.

Keywords: colorism, experiences of discrimination, primary school children, skin color discrimination

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Authors: Christos Karolemeas, Avgi Vassi, Georgia Christodoulopoulou

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Although the past decades, planning a cycle network became an inseparable part of all transportation plans, there is still a lot of room for improvement in the way planning is made, in order to create safe and direct cycling networks that gather the parameters that positively influence one's decision to cycle. The aim of this article is to study, evaluate and visualize the bikeability of cities. This term is often used as the 'the ability of a person to bike' but this study, however, adopts the term in the sense of bikeability as 'the ability of the urban landscape to be biked'. The methodology used included assessing cities' accessibility by cycling, based on international literature and corresponding walkability methods and the creation of a 'bikeability index'. Initially, a literature review was made to identify the factors that positively affect the use of bicycle infrastructure. Those factors were used in order to create the spatial index and quantitatively compare the city network. Finally, the bikeability index was applied in two case studies: two Greek municipalities that, although, they have similarities in terms of land uses, population density and traffic congestion, they are totally different in terms of geomorphology. The factors suggested by international literature were (a) safety, (b) directness, (c) comfort and (d) the quality of the urban environment. Those factors were quantified through the following parameters: slope, junction density, traffic density, traffic speed, natural environment, built environment, activities coverage, centrality and accessibility to public transport stations. Each road section was graded for the above-mentioned parameters, and the overall grade shows the level of bicycle accessibility (low, medium, high). Each parameter, as well as the overall accessibility levels, were analyzed and visualized through Geographic Information Systems. This paper presents the bikeability index, its' results, the problems that have arisen and the conclusions from its' implementation through Strengths-Weaknesses-Opportunities-Threats analysis. The purpose of this index is to make it easy for researchers, practitioners, politicians, and stakeholders to quantify, visualize and understand which parts of the urban fabric are suitable for cycling.

Keywords: accessibility, cycling, green spaces, spatial data, urban environment

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Authors: Mustafa M. Donma, Orkide Donma

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A growing list of cancers might be influenced by obesity. Obesity is associated with an increased risk for the occurrence and development of some cancers. Inflammation can lead to cancer. It is one of the characteristic features of cancer and plays a critical role in cancer development. C-reactive protein (CRP) is under evaluation related to the new and simple prognostic factors in patients with metastatic renal cell cancer. Obesity can predict and promote systemic inflammation in healthy adults. BMI is correlated with hs-CRP. In this study, SII index and CRP values were evaluated in children with normal BMI and those within the range of different obesity grades to detect the tendency towards cancer in pediatric obesity. A total of one hundred and ninety-four children; thirty-five children with normal BMI, twenty overweight (OW), forty-seven obese (OB) and ninety-two morbid obese (MO) participated in the study. Age- and sex-matched groups were constituted using BMI-for age percentiles. Informed consent was obtained. Ethical Committee approval was taken. Weight, height, waist circumference (C), hip C, head C and neck C of the children were measured. The complete blood count test was performed. C-reactive protein analysis was performed. Statistical analyses were performed using SPSS. The degree for statistical significance was p≤0.05. SII index values were progressively increasing starting from normal weight (NW) to MO children. There is a statistically significant difference between NW and OB as well as MO children. No significant difference was observed between NW and OW children, however, a correlation was observed between NW and OW children. MO constitutes the only group, which exhibited a statistically significant correlation between SII index and CRP. Obesity-related bladder, kidney, cervical, liver, colorectal, endometrial cancers are still being investigated. Obesity, characterized as a chronic low-grade inflammation, is a crucial risk factor for colon cancer. Elevated childhood BMI values may be indicative of processes leading to cancer, initiated early in life. Prevention of childhood adiposity may decrease the cancer incidence in adults. To authors’ best knowledge, this study is the first to introduce SII index values during obesity of varying degrees of severity. It is suggested that this index seems to affect all stages of obesity with an increasing tendency and may point out the concomitant status of obesity and cancer starting from very early periods of life.

Keywords: children, C-reactive protein, systemic immune-inflammation index, obesity

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Authors: Farzaneh Badinlou, Reza Kormi-Nouri, Monika Knopf, Kamal Kharrazi

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When we teach, we have two critical elements at our disposal to help students: learning styles as well as testing styles. There are many different ways in which educators can effectively teach their students; verbal learning and experience-based learning. Lecture as a form of verbal learning style is a traditional arrangement in which teachers are more active and share information verbally with students. In experienced-based learning as the process of through, students learn actively through hands-on learning materials and observing teachers or others. Meanwhile, standard testing or assessment is the way to determine progress toward proficiency. Teachers and instructors mainly use essay (requires written responses), multiple choice questions (includes the correct answer and several incorrect answers as distractors), or open-ended questions (respondents answers it with own words). The current study focused on exploring an effective teaching style and testing methods as the function of age over school ages. In the present study, totally 410 participants were selected randomly from four grades (2ⁿᵈ, 4ᵗʰ, 6ᵗʰ, and 8ᵗʰ). Each subject was tested individually in one session lasting around 50 minutes. In learning tasks, the participants were presented three different instructions for learning materials (learning by doing, learning by observing, and learning by listening). Then, they were tested via different standard assessments as free recall, cued recall, and recognition tasks. The results revealed that generally students remember more of what they do and what they observe than what they hear. The age effect was more pronounced in learning by doing than in learning by observing, and learning by listening, becoming progressively stronger in the free-recall, cued-recall, and recognition tasks. The findings of this study indicated that learning by doing and free recall task is more age sensitive, suggesting that both of them are more strategic and more affected by developmental differences. Pedagogically, these results denoted that learning by modeling and engagement in program activities have the special role for learning. Moreover, the findings indicated that the multiple-choice questions can produce the best performance for school-aged children but is less age-sensitive. By contrast, the essay as essay can produce the lowest performance but is more age-sensitive. It will be very helpful for educators to know that what types of learning styles and test methods are most effective for students in each school grade.

Keywords: experience-based learning, learning style, school-aged children, testing methods, verbal learning

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Authors: Jonathon Bailey, Neil Bressloff, Nick Curzen

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Transcatheter Aortic Valve Implantation (TAVI) devices are stent-like frames with prosthetic leaflets on the inside, which are percutaneously implanted. The device in a crimped state is fed through the arteries to the aortic root, where the device frame is opened through either self-expansion or balloon expansion, which reveals the prosthetic valve within. The frequency at which TAVI is being used to treat aortic stenosis is rapidly increasing. In time, TAVI is likely to become the favoured treatment over Surgical Valve Replacement (SVR). Mortality after TAVI has been associated with severe Paravalvular Aortic Regurgitation (PAR). PAR occurs when the frame of the TAVI device does not make an effective seal against the internal surface of the aortic root, allowing blood to flow backwards about the valve. PAR is common in patients and has been reported to some degree in as much as 76% of cases. Severe PAR (grade 3 or 4) has been reported in approximately 17% of TAVI patients resulting in post-procedural mortality increases from 6.7% to 16.5%. TAVI devices, like SVR devices, are circular in cross-section as the aortic root is often considered to be approximately circular in shape. In reality, however, the aortic root is often non-circular. The ascending aorta, aortic sino tubular junction, aortic annulus and left ventricular outflow tract have an average ellipticity ratio of 1.07, 1.09, 1.29, and 1.49 respectively. An elliptical aortic root does not severely affect SVR, as the leaflets are completely removed during the surgical procedure. However, an elliptical aortic root can inhibit the ability of the circular Balloon-Expandable (BE) TAVI devices to conform to the interior of the aortic root wall, which increases the risk of PAR. Self-Expanding (SE) TAVI devices are considered better at conforming to elliptical aortic roots, however the valve leaflets were not designed for elliptical function, furthermore the incidence of PAR is greater in SE devices than BE devices (19.8% vs. 12.2% respectively). If a patient’s aortic root is too severely elliptical, they will not be suitable for TAVI, narrowing the treatment options to SVR. It therefore follows that in order to increase the population who can undergo TAVI, and reduce the risk associated with TAVI, non-circular devices should be developed. Computational simulations were employed to further advance our understanding of non-circular TAVI devices. Radial stiffness of the TAVI devices in multiple directions, frame bending stiffness and resistance to balloon induced expansion are all computationally simulated. Finally, a simulation has been developed that demonstrates the expansion of TAVI devices into a non-circular patient specific aortic root model in order to assess the alterations in deployment dynamics, PAR and the stresses induced in the aortic root.

Keywords: tavi, tavr, fea, par, fem

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Authors: B. Nair, S. Singh

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Oral health behaviors such as dietary preferences and tooth brushing are acquired during a child’s primary socialization period yet many oral health promotion interventions are implemented without taking into account the role and impact of parental influence in supporting healthy oral health behaviors. The aim and objective of this study was to determine the relationship between parental income and level of education with knowledge, attitudes and perceptions of oral health care practices. Methods: The study design was cross-sectional and exploratory, and data collection occurred in two phases. Phase 1 comprised of a self-administered questionnaire. The sample consisted of parents of 313 Grade 1 learners aged between 5-6 years old attending one of twelve selected public primary schools in the Chatsworth Circuit, Durban, South Africa. Phase 2 comprised of focus group discussions held at 5 purposively selected schools. Data collection comprised of a semi-structured face-to-face group interview with the objective of obtaining a deeper understanding of parental knowledge, attitudes and perceptions of dental caries. Results and Discussion: Almost 56% of participants earned a monthly income of less than R6000 (600 US dollars). Nearly three quarters (77.5%) of participants indicated that they did not have medical aid/insurance scheme. More than three-quarters of the participants (76.6%) identified diet as being the primary cause of decayed teeth. More than half of the study sample (56.1%) indicated that milk teeth were important and that rotten teeth (74.6%) could affect the child’s health. Almost half (49.8%) of participants reported that “bad teeth” were inherited. With more than two-thirds of the participants (77.7%), having at most a high school education, there was a correlation between the level of the caregiver’s education and the oral health care of the child. The analysis of the correlation between a child having decayed teeth and income (p=.007); and the manner in which the income is received (p=.003) was statistically significant. The results indicate that more effort needs to be placed in understanding parental knowledge, perceptions and attitudes towards dental caries. Parental level of education, income and oral health literacy is shown to be related to attitudes, and perceptions towards dental caries and its subsequent preventive measures. These findings have important implications for oral health planning at community and facility-based levels.

Keywords: oral health prevention, parental education, dental caries, attitudes and perceptions

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Authors: Mark Anthony Casimiro, Ivan Culaba, Cornelia Soto

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Misconceptions are the wrong concepts understood by the students which may come up based on what they experience and observe around their environment. This seemed to hinder students’ learning. In this study, six different misconceptions were determined by the researcher from the previous researches. Teachers play a vital role in the classroom. The use of appropriate strategies can contribute a lot in the success of teaching and learning Physics. The current study aimed to compare two strategies- Interactive Lecture Demonstration (ILD) and Inquiry-Based Instruction (IBI) in addressing students’ misconceptions in electric circuits. These two strategies are both interactive learning activities and student-centered. In ILD, the teacher demonstrates the activity and the students have their predictions while in IBI, students perform the experiments. The study used the mixed method in which quantitative and qualitative researches were combined. The main data of this study were the test scores of the students from the pretest and posttest. Likewise, an interview with the teacher, observer and students was done before, during and after the execution of the activities. Determining and Interpreting Resistive Electric Circuits Test version 2 (DIRECT v.2) was the instrument used in the study. Two sections of Grade 9 students from Kalumpang National High School were the respondents of the study. The two strategies were executed to each section; one class was assigned as the ILD group and the other class was the IBI group. The Physics teacher of the said school was the one who taught and executed the activities. The researcher taught the teacher the steps in doing the two strategies. The Department of Education level of proficiency in the Philippines was adopted in scoring and interpretation. The students’ level of proficiency was used in assessing students’ knowledge on electric circuits. The pretest result of the two groups had a p-value of 0.493 which was greater than the level of significance 0.05 (p >0.05) and it implied that the students’ level of understanding in the topic was the same before the execution of the strategies. The posttest results showed that the p-value (0.228) obtained was greater than the level of significance which is 0.05 (p> 0.05). This implied that the students from the ILD and IBI groups had the same level of understanding after the execution of the two strategies. This could be inferred that either of the two strategies- Interactive Lecture Demonstration and Inquiry-Based Instruction could be used in addressing students’ misconception in electric circuit as both had similar effect on the students’ level of understanding in the topic. The result of this study may greatly help teachers, administration, school heads think of appropriate strategies that can address misconceptions depending on the availability of their materials of their school.

Keywords: inquiry- based instruction, interactive lecture demonstration, misconceptions, mixed method

Procedia PDF Downloads 198

Authors: Christian Skowronski, Andrew Shanholtzer, Brent Yelton, Muayad Almahariq, Daniel J. Krauss

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Prostate cancer has the third highest incidence rate and is the second leading cause of cancer death for men in the United States. Of the diagnostic tools available for intermediate-risk prostate cancer, magnetic resonance imaging (MRI) provides superior soft tissue delineation serving as a valuable tool for both diagnosis and treatment planning. Currently, there is minimal data regarding the practical utility of MRI for evaluation of intermediate-risk prostate cancer. As such, the National Comprehensive Cancer Network’s guidelines indicate MRI as optional in intermediate-risk prostate cancer evaluation. This project aims to elucidate whether MRI affects radiation treatment decisions for intermediate-risk prostate cancer. This was a retrospective study evaluating 210 patients with intermediate-risk prostate cancer, treated with definitive radiotherapy at our institution between 2019-2020. NCCN risk stratification criteria were used to define intermediate-risk prostate cancer. Patients were divided into two groups: those with pretreatment prostate MRI, and those without pretreatment prostate MRI. We compared the use of external beam radiotherapy, brachytherapy alone, brachytherapy boost, and androgen depravation therapy between the two groups. Inverse probability of treatment weighting was used to match the two groups for age, comorbidity index, American Urologic Association symptoms index, pretreatment PSA, grade group, and percent core involvement on prostate biopsy. Wilcoxon Rank Sum and Chi-squared tests were used to compare continuous and categorical variables. Of the patients who met the study’s eligibility criteria, 133 had a prostate MRI and 77 did not. Following propensity matching, there were no differences between baseline characteristics between the two groups. There were no statistically significant differences in treatments pursued between the two groups: 42% vs 47% were treated with brachytherapy alone, 40% vs 42% were treated with external beam radiotherapy alone, 18% vs 12% were treated with external beam radiotherapy with a brachytherapy boost, and 24% vs 17% received androgen deprivation therapy in the non-MRI and MRI groups, respectively. This analysis suggests that pretreatment MRI does not significantly impact radiation therapy or androgen deprivation therapy decisions in patients with intermediate-risk prostate cancer. Obtaining a pretreatment prostate MRI should be used judiciously and pursued only to answer a specific question, for which the answer is likely to impact treatment decision. Further follow up is needed to correlate MRI findings with their impacts on specific oncologic outcomes.

Keywords: magnetic resonance imaging, prostate cancer, definitive radiotherapy, gleason score 7

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Authors: Soiduate Ogoye-Atanga

Abstract:

During funeral ceremonies, it has become common for attendees to jostle for burial programs in some southern Nigerian towns. Beginning from ordinary typewritten text only sheets of paper in the 1980s to their current digitally formatted multicolor magazine style, burial programs continue to be collected and kept in homes where they remain as archival documents of family photo histories and as a veritable form of leveraging family status and visibility in a social economy through the inclusion of lots of choreographically arranged photographs and text. The biographical texts speak of idealized and often lofty and aestheticized accomplishments of deceased peoples, which are often corroborated by an accompanying section of tributes from first the immediate family members, and then from affiliations as well as organizations deceased people belonged, in the form of scanned letterheaded corporate tributes. Others speak of modest biographical texts when the deceased accomplished little. Usually, in majority of the cases, the display of photographs and text in these programs follow a trajectory of historical compartmentalization of the deceased, beginning from parentage to the period of youth, occupation, retirement, and old age as the case may be, which usually drives from black and white historical photographs to the color photography of today. This compartmentalization follows varied models but is designed to show the deceased in varying activities during his lifetime. The production of these programs ranges from the extremely expensive and luscious full colors of near fifty-eighty pages to bland and very simplified low-quality few-page editions in a single color and no photographs, except on the cover. Cost and quality, therefore, become determinants of varying family status and social visibility. By a critical selection of photographs and text, family members construct an idealized image of deceased people and themselves, concentrating on mutuality based on appropriate sartorial selections, socioeconomic grade, and social temperaments that are framed to corroborate the public’s perception of them. Burial magazines, therefore, serve purposes beyond their primary use; they symbolize an orchestrated social site for image-making and the validation of the social status of families, shaped by prior family histories.

Keywords: biographical texts, burial programs, compartmentalization, magazine, multicolor, photo-histories, social status

Procedia PDF Downloads 166

Authors: Hyeuk Ju Ko, Eui Ju Lee

Abstract:

Many electronic devices are powered by various rechargeable batteries such as lithium-ion today, but occasionally the batteries undergo thermal runaway and cause fire, explosion, and other hazards. If a battery fire should occur in an electronic device of vehicle and aircraft cabin, it is important to quickly extinguish the fire and cool the batteries to minimize safety risks. Attempts to minimize these risks have been carried out by many researchers but the number of study on the successful extinguishment is limited. Because most rechargeable batteries are operated on the ion state with electron during charge and discharge of electricity, and the reaction of this electrolyte has a big difference with normal combustion. Here, we focused on the effect of ions on reaction stability and pollutant emissions during combustion process. The other importance for understanding ionized fuel combustion could be found in high efficient and environment-friendly combustion technologies, which are used to be operated an extreme condition and hence results in unintended flame instability such as extinction and oscillation. The use of electromagnetic energy and non-equilibrium plasma is one of the way to solve the problems, but the application has been still limited because of lack of excited ion effects in the combustion process. Therefore, the understanding of ion role during combustion might be promised to the energy safety society including the battery safety. In this study, the effects of an ionized fuel on the flame stability and pollutant emissions were experimentally investigated in the hydrocarbon jet diffusion flames. The burner used in this experiment consisted of 7.5 mm diameter tube for fuel and the gaseous fuels were ionized with the ionizer (SUNJE, SPN-11). Methane (99.9% purity) and propane (commercial grade) were used as a fuel and open ambient air was used as an oxidizer. As the performance of ionizer used in the experiment was evaluated at first, ion densities of both propane and methane increased linearly with volume flow rate but the ion density of propane is slightly higher than that of methane. The results show that the overall flame stability and shape such as flame length has no significant difference even in the higher ion concentration. However, the fuel ionization affects to the pollutant emissions such as NOx and soot. NOx and CO emissions measured in post flame region decreased with increasing fuel ionization, especially at high fuel velocity, i.e. high ion density. TGA analysis and morphology of soot by TEM indicates that the fuel ionization makes soot to be matured.

Keywords: battery fires, ionization, jet flames, stability, NOx and soot

Procedia PDF Downloads 160