bluuebunny/crossref_metadata_2025 huggingface dataset:
Neglected сlubfoot treated by Ilizarov and Ponseti methods
Authors:   Centre for Ilizarov Techniques, Chaudhary Hospital, AKOLA, India, Chaudhary M.M. , Chaudhary I.M. ,   Centre for Ilizarov Techniques, Chaudhary Hospital, AKOLA, India
Published: June 2021

The Ponseti method has revolutionized clubfoot treatment. Though completely neglected clubfeet are now rare, partially or incompletely and improperly treated feet are not uncommon. Relapses after successful correction may occur due to non-compliance with bracing. In scarred soft tissues due to previous surgery, soft tissue distraction using external fixation helps achieve correction. The Ilizarov fixator permits us to follow the Ponseti protocol, using correction methods that may either be constrained or unconstrained by hinges. Applying force vectors perpendicular to the moment arm allows us to correct the еquinus without damaging the ankle joint. All of the above is possible when the talus is round. Full correction of the deformity is possible. However, longterm follow-up of these patients has revealed stiffness of the ankle setting and frequently with tibio-talar osteophytes anteriorly. They are probably a reaction to excessive pressure developed in the joint due to the tight soft tissues. Hence the author has now added a mild shortening of the tibia and fibula to reduce soft tissue tension, rather than resorting to further soft tissue releases through scarred tissues. This allows faster correction with the Ponseti-Ilizarov protocol and allows good ankle range of motion to persist.
The discovery and clinical significance of the “Twin Open Skylight and Summon Effects” of the Ilizarov tibial transverse transport technique
Authors:   Research Centre for Regenerative Medicine, International Joint Laboratory on Regeneration of Bone and Soft Tissues, Guangxi Medical University, Nanning, China, Chen W. , Hua Q. ,   Research Centre for Regenerative Medicine, International Joint Laboratory on Regeneration of Bone and Soft Tissues, Guangxi Medical University, Nanning, China,   The First Affiliated Hospital of Guangxi Medical University, Nanning, China, Zhao J. ,   Research Centre for Regenerative Medicine, International Joint Laboratory on Regeneration of Bone and Soft Tissues, Guangxi Medical University, Nanning, China,   2The First Affiliated Hospital of Guangxi Medical University, Nanning, China, Qu L. ,   731th Hospital of Chinese Aerospace Science and Industry Corporation, Beijing, China
Published: June 2021

Ilizarov’s tibial transverse transport (TTT) technique can promote vascular regeneration. It has been used in the treatment of a variety of lower limb ischemic diseases, such as thromboangiitis obliterans, diabetic foot ulcers, etc. Recently, several novel therapeutic effects have been discovered based on TTT treatment. For instance, in the treatment of thromboangiitis obliterans, an “Open Skylight Effect” was well defined in which the symptom of resting pain disappeared following tibial cortex osteotomy (Long Qu, 2001). During the treatment of bilateral diabetic foot gangrene, patients that received TTT treatment on the one side of the lower limb were observed to have a simultaneous healing of ulcers on both sides, which was termed as the “Summon Effect” (Qikai Hua, 2017). In 2019, we characterized the above discoveries as the “Twin Open Skylight and Summon Effects”. These findings will inspire more potential clinical applications of TTT technique.
Aprendamos todos a leer: Guía del estudiante: Segundo grado, primer semestre: Unidades 1, 2 y 3
Authors: Márquez de Arboleda Ángela , Osuna Arciniegas Mariana , Jiménez Cardona Martha Liliana , Pérez Niño Lina , Cárdenas Poveda Elizabeth , González Camacho Camilo Andrés , Irigoyen Juan Carlos
Published: June 2021

“Aprendamos todos a leer” es un programa para la enseñanza del lenguaje en la básica primaria. En preescolar y primer grado, la enseñanza explícita de la lectura y la escritura se enfoca en el desarrollo y consolidación de las habilidades precursoras en la etapa inicial, como son: la conciencia fonológica, el principio alfabético, la adquisición de vocabulario nuevo, la comprensión oral y de lectura y la escritura de letras, palabras y oraciones. En segundo grado los materiales, recursos y tareas de aula están encaminadas a la consolidación de las habilidades precursoras y al trabajo enmarcado en los DBA (Derechos Básicos del Aprendizaje) y las tipologías textuales. Las actividades en equipo, en pares, de manera individual y con el docente le permiten al estudiante ejercitar las habilidades que aseguran aprendizajes perdurables. Esta guía hace parte del material diseñado para el uso por parte de los estudiantes durante el primer semestre escolar (unidades 1,2,3).
Impoliteness Addressed to Different Genders and their Responses in The Kitchen Nightmares, a TV Reality Show
Authors: Milal A. Dzo'ul , Pramono Angga Cahya
Published: June 2021

This paper reveals the impoliteness strategies addressed to different genders and their corresponding responses. The data source is the video transcript of a TV reality show, The Kitchen Nightmares season 6 episode 2 for substantial and technical considerations. As it contains impolite expressions, abundant data can be gained to clarify the focal points. The subjects are the host and male and female participants in that show. This study uses a descriptive qualitative approach. In collecting the data, the researcher identifies the utterances containing impoliteness and their responses in the transcript. Then, they are classified and compared to discover the impoliteness strategies and their responses related to gender differences. It is discovered that, in this show, the types of impoliteness strategies addressed to male addressees are not different from those of female participants. Regarding responses, it is found out that male participants respond to the impoliteness differently from the females. It can be concluded from the show that gender difference is not effective as recipients of impoliteness, but it is operative as producers of the response towards impoliteness. Keywords: entertainment, gender, impoliteness, responses to impoliteness
Analysis of a Capacitor Modelled with Conformable Fractional Derivative Under DC and Sinusoidal Signals
Authors: PALAZ Utku , MUTLU Reşat
Published: June 2021

Fractional order circuit elements are successfully used to model circuits and systems in the last few decades. There are different types of fractional derivatives. Recently, another one named “the conformable fractional derivative” (CFD) has been introduced and shown to give good results for modeling supercapacitors. It is imperative to know how circuit elements behave for different current and voltage waveforms in circuit theory so that they can be exploited at their full potential. A CFD capacitor is not a well-known element and its usage and circuit solutions are rarely addressed in literature. In this study, it is examined how a CFD capacitor would behave under DC and AC excitations when it is fed by not only a current source but also a voltage source.
Deep Feature Extraction for Detection of Tomato Plant Diseases and Pests based on Leaf Images
Authors: ALTUNTAŞ Yahya , KOCAMAZ Fatih
Published: June 2021

Plant diseases and pests cause yield and quality losses. It has great importance to detect plant diseases and pests quickly and with high accuracy in terms of preventing yield and quality losses. Plant disease and pest detection performed by plant protection experts through visual observation is a labor-intensive process with a high error rate. Developing effective, fast and highly successful computer-aided disease detection systems has become a necessity in terms of precision agriculture applications. In this study, well-known pre-trained convolutional neural network (CNN) models AlexNet, GoogLeNet and ResNet-50 are used as feature extractors. In addition, a deep learning model that concatenate deep features extracted from 3 CNN models has been proposed. The deep features were used to train the support vector machine classifier. The proposed model was used to classify leaf images of tomato plant diseases and pests, which is a subset of open-access PlantVillage dataset consisting of a total of 18835 images belonging to 10 classes including a healthy one. Accuracy, precision, sensitivity and f-score performance metrics were used with the hold-out validation method in determining model performances. Experimental results show that the detection of tomato plant diseases and pests is possible using concatenated deep features with an overall accuracy rate of 96.99%.
A student participation assessment scheme for effective teaching and learning
Authors: Abuid Bader Ahmed
Published: June 2021

In this paper a systematic and well-defined student participation assessment scheme for college courses is proposed. The scheme supports the involvement of students in a variety of areas of participation within and outside the classroom with the aim of improving their learning. The scheme addresses mostly the challenges related to the practicality of the structure and design of the assessment. It also addresses the subjectivity of grading student participations. Areas of participation are widened to allow the faculty more accurate information about the conduct of each individual student towards more objective assessment. In addition, it provides the faculty with the flexibility to select areas that best fit the learning outcomes, nature of the course, availability of time and resources, and class atmosphere. The proposed scheme is initiated and developed using feedback from the teaching staff of Nizwa College of Technology, (NCT) through a survey and open discussion. The results indicate that over two thirds of the surveyed staff show agreement with the concept of assessing participation and find the scheme design clear and systematic, while 82% of them perceive the scheme as effective in improving the motivation and learning of students.
Challenges associated with teaching mathematics for social justice: Middle Eastern perspectives
Authors: Tanko Mohammed Goma
Published: June 2021

This study involved a group of Middle Eastern Muslim women (ages ranging from 16-36) learning mathematics through social justice pedagogy. One of the important lessons from this experience is that, despite some of the unique challenges associated with teaching for social justice, in this context this method of teaching is doable and beneficial. However, in the current atmosphere throughout the Middle East it is a very challenging task: it needs courage and commitment on the part of the teacher/researcher, as well as support and even protection by the head of the college or policymakers to ensure that it leads to positive learning outcomes.
iPads in the classroom: teachers’ perspectives post-implementation
Authors: Miles Rob
Published: June 2021

This small-scale qualitative case study aimed to investigate English language teachers’ perceptions of the impact of iPads in classrooms in ideal, actual and realistic terms. The study took place at the end of a five-year initiative that saw iPads introduced to English Language classrooms in a UAE Federal Institution. The investigation was carried out from a constructivist epistemology perspective using observations and interviews, analysed through the lens of the SAMR Model (Puentedura, 2010). While curriculum constraints limited the impact in this initiative, the device has the potential to engage students in collaborative tasks and assist in classroom management. A potential two-dimensional SAMR model is proposed, as are opportunities for further research.

ﺗﮭ د ف د را ﺳﺔ اﻟ ﺣﺎﻟ ﺔ اﻟﻧ وﻋﯾ ﺔ اﻟ ﻣ ﺻ ﻐرة ھذه إﻟ ﻰ اﻟﺑ ﺣ ث ﻓ ﻲ ﺗ ﺻ ورا ت ﻣﻌﻠ ﻣ ﻲ اﻟﻠ ﻐﺔ ا ﻹﻧ ﺟﻠﯾ زﯾ ﺔ ﺣول ﺗﺄﺛﯾ ر ا ﻷﺟﮭزة اﻟﻠ وﺣﯾ ﺔ ﻓ ﻲ اﻟﻔ ﺻ ول اﻟد ر ا ﺳ ﯾ ﺔ ﺑ ﺻ و ر ة ﻣﺛﺎﻟﯾ ﺔ و و اﻗ ﻌﯾ ﺔ و ﺣ ﻘﯾﻘﯾ ﺔ. و ﻗد ﺑﻧﯾ ت ھ ذه اﻟد ر ا ﺳ ﺔ ﻋ ﻠ ﻰ ﻣﻧ ظ و ر ﻧ ظ ر ﯾ ﺔ اﻟﻣﻌر ﻓﺔ اﻟ ﺑﻧﺎﺋﯾ ﺔ ﺑﺎ ﺳ ﺗ ﺧ دا م اﻟﻣ ﻼ ﺣ ظ ﺎ ت و اﻟﻣﻘﺎﺑ ﻼ ت ، وا ﻟﺗ ﻲ ﺗم ﺗ ﺣﻠﯾﻠ ﮭﺎ ﻣ ن ﺧﻼل ﻋد ﺳﺔ ﻧ ﻣوذ ج SAMR .(Puentedura, 2010) ( ﻓﺑﺎﻟ رﻏم ﻣ ن أ ن ﻗﯾ ود اﻟ ﻣﻧﺎ ھﺞ ﺣد ت ﻣ ن ﺗﺄﺛﯾ ر ا ﻷﺟﮭزة اﻟﻠ و ﺣ ﯾ ﺔ إ ﻻ أ ن ﻟ دﯾ ﮭﺎ اﻟ ﻘد ر ة ﻋ ﻠ ﻰ إ ﺷ ر ا ك اﻟط ﻼ ب ﻓ ﻲ اﻟﻣﮭﺎم اﻟ ﺗ ﻌﺎ و ﻧﯾ ﺔ و اﻟﻣ ﺳ ﺎ ﻋ دة ﻓ ﻲ إ دا ر ة اﻟ ﻔ ﺻ و ل اﻟد ر ا ﺳ ﯾ ﺔ. ﺗﻘﺗ ر ح ھ ذه اﻟد ر ا ﺳ ﺔ ﻧ ﻣو ذ ج SAMR ذو أﺑ ﻌﺎد ﺛﻧﺎﺋﯾﺔ، ﺑﺎ ﻹ ﺿ ﺎﻓﺔ إﻟ ﻰ ﻓ ر ص ﻹﺟرا ء ﻣزﯾد ﻣ ن اﻟﺑ ﺣو ث.
Virtual Teaching And Learning Challenges- An online learning experience with UAE students
Authors: Rahman Mawdudur
Published: June 2021

In this paper we provide evidence of successful online learning experience with UAE students at Zayed University in the UAE. First we describe the processes and technologies used in delivering the online course "Virtual Business Challenges". Based on survey results we discuss students’ evaluations and experience and the technologies used. Overall, students had a positive learning experience in the course.
An Information Technology Based Instructional Model for Effective Learning
Authors: Higgi Ali Hussain
Published: June 2021

This paper presents an information technology based instructional model for effective learning in management information systems programs and modules for students in undergraduate education. This model is primarily centered on the traditional in-class learning model. Information technology is used in a unique and novel way in order to create a learning environment which not only engages students in the learning process but also enhances their problems solving skills, analysis and decision making abilities. The model embeds information technology in projects in order to hide complexities but without compromising achievement of learning objectives. It also uses information technology in a simulation mode in order to demonstrate key concepts or learning themes, to simulate main themes presented in case studies and to simulate problems behaviors. The model employs other creative techniques in order to deliver its overall goals.
Active learning of eutectic phase diagram in engineering courses
Authors: Hehnes Erika Figueiredo , Souza Paula Carolina de , Dutra Júlio César
Published: June 2021

The present article shows a new strategy used to cover phase diagrams for undergraduate mechanical engineering students. It is based on active learning in which students are required to investigate experimentally three different eutectic alloys by using X-ray diffraction and metallography. The first technique allows students to use Rietveld analysis to obtain the mass fraction of the present phases and they must compare their results with those obtained theoretically whilst the second one is used to characterize those phases and measured their area fractions. From these results, they can also compare them with those obtained theoretically, but considering the density of different phases. The results have shown that students understood more clearly concepts such as the lever rule, and the very interpretation of phase diagram: the liquidus and solidus curve and finally the eutectic point.
A “infodemia” e a conquista do Estado brasileiro: da Ditadura empresarial-militar ao consenso neoliberal
Authors: Rihan Bianca , Sette José Raphael
Published: June 2021

Os recentes debates sobre a epidemia da desinformação, que acomete a cena política brasileira nos últimos anos, levam-nos a reflexões sobre o desenvolvimento das tecnologias de informação e comunicação (TICS) durante o processo de reconfiguração do Estado brasileiro. Sob sucessivas rodadas de “modernização conservadora” e tendência monopolística, abordaremos a apropriação informacional nos esteios de nossa última ditadura (1964-1985) e na posterior inserção nacional no propalado processo de neoliberalização, sob um sistema financeiro internacional desregulado.
Inversor Quasi-Z-Source Fotovoltaico Conectado à Rede com Filtro LCL Utilizando Uma Estrutura MRAC-SM Cascata com Modelo Reduzido para Aplicações em Redes Fracas
Authors: Hollweg Guilherme V. , Evald Paulo J. D. O. , Tambara Rodrigo V. , Azzolin Rodrigo Z. , Grundling Hilton A. , Martins Mário L. S.
Published: June 2021

Este trabalho propõe a utilização de uma estrutura cascata de controladores adaptativos do tipo entrada-saída por modelo de referência (MRAC) utilizando modelos de ordem reduzida para um inversor quasi-Z-Source, conectado à rede por meio de um filtro LCL. A implementação da estrutura adaptativa por meio de modelos de referência reduzidos possibilita um sistema de controle adaptativo mais simples de ser implementado, com equacionamento matemático reduzido e menor esforço computacional. Para a redução da ordem dos modelos de referência, dinâmicas presentes em frequências mais elevadas da planta não são consideradas para projeto do controlador, possibilitando a implementação de uma estrutura simplificada que não comprometa a estabilidade e o desempenho do sistema. Resultados online em Hardware-In-the-Loop implementados em um DSP TMS320F28335 são apresentados, comparando a estrutura proposta com um controlador MRAC-SM por realimentação de estados sem simplificação de modelos. É mostrado que a estrutura adaptativa desenvolvida se comporta de forma robusta em relação às incertezas, apresenta baixo erro de rastreamento e carga computacional reduzida quando comparada com a estrutura adaptativa sem redução do modelo de referência.
Diving deep into the bottom of the soul. Two journeys into the worlds of NLP and PCP
Authors: Suciu Gabriel R.
Published: June 2021

I’m not the first one who point to the fact that the increasing numbers of therapies and therapists have generated the increasing numbers of diseases and patients/ clients. So, I imagine a world of health and wisdom, a world built on the building blocks of NLP and PCP. For each of these fields I offered a) a map, b) a story and c) some models of mind. Also, I use the metaphor of “diving into the deep” to explore these views, leaving open new possibilities of explorations and discoveries.
Pedagogical Approaches To Intercultural Competence Development
Authors: Cojocariu Venera-Mihaela
Published: June 2021

The volume generously provided by Cambridge Scholars Publishing in 2020 and edited by Christine E. Poteau entitled Pedagogical Approaches to Intercultural Competence Development is organized into seven chapters. Beyond the generic theme of interest under which they come together (Pedagogical Approaches to Intercultural Competence Development) and which gives unity to the volume, each chapter is a small universe in itself, unique, interesting, topical, and attractive as a perspective of approach, design, arguments, contents, applications, implications, bibliography. Therefore, the volume can be covered in full, as a holistic approach to the phenomenon, or by chapters, depending on the interest of the reader and his area of ​​expertise. In full agreement with the theme (and, as it were, to increase the diversity of perspectives), it is proposed as a volume that brings together contributions from different geographical and socio-cultural areas (Brazil, Hawaii, Israel, Japan, USA, Ukraine), to researchers and educators with backgrounds in various fields, concerned with the same major problem (enhancing pedagogical approaches and expanding intercultural competence skill development) and finding solutions that, beyond their immediate focus can allow the emergence of suggestions with a higher degree of applicability or generation of explanatory models. That is why, although the analyses are focused on different specific aspects of the problem (in each chapter), the perspective of approach/solution is one that rises towards the global, in which the answers and proposals of the authors are related to the interdisciplinary approach (e.g.: the need to globalize curricula and identify diverse pedagogical challenges in the development of intercultural competence). One of the effects aimed at following this journalistic approach refers precisely to the development of initiatives across fields of experiential learning and the initiation of cooperation programs for a stronger global community.
Estudio transversal: pérdida auditiva causada por ruido en el personal de la aviación militar ecuatoriana
Authors: Ortíz Rodríguez Álvaro Guillermo
Published: June 2021

La hipoacusia como condición de salud crónica ocupa uno de los primeros lugares en países de Norteamérica, superando a la diabetes y el cáncer, motivo por el cual, desde hace décadas sus Fuerzas Armadas iniciaron estudios pormenorizados con el fin de implementar medidas preventivas adecuadas; no obstante, la aviación militar tiene sus particularidades debido a que las principales fuentes de ruido son sus propias aeronaves. Dicho lo anterior, el objetivo de esta investigación es correlacionar la pérdida auditiva con los factores: edad, actividad o rango, analizando las audiometrías de 73 miembros de la aviación ecuatoriana y verificar su estado actual de acuerdo a los umbrales de audición de frecuencias. Los resultados indican que la mayor cantidad de afectados se presentan en el personal de tropa de sexo masculino de 30 a 44 años de edad. Sin embargo, la variabilidad de los niveles de hipoacusia no evidenció la existencia de una relación directa entre pérdida auditiva y el incremento en la edad, tiempo de servicio, actividad inherente al tipo de aeronave, o rango del individuo, por lo que no se puede aseverar que para el caso de la institución la hipoacusia sea producida exclusivamente por las condiciones laborales y, más bien, puede ser producto de antecedentes clínicos de la persona. En consecuencia, se evidencia un eficaz programa preventivo y medidas de mitigación adecuadas, referentes a la seguridad y salud ocupacional. Aunque es imprescindible realizar estudios más detallados, siendo más enfáticos en las bases aéreas donde se despliegan aeronaves de combate y de ala rotatoria.
Diseño de aeronave de combate no tripulada de quinta generación para el apoyo aéreo cercano
Authors: Morales Aguirre Esteban , Duarte García Mateo , Paniagua García Esteban , Aldana Lopera Daniel Enrique , Sabogal Jaramillo Javier Mauricio , Montoya Vélez Jorge Elias , Alvarado Perilla Juan Pablo
Published: June 2021

La evolución en el diseño de aeronaves de combate se ha visto modificada por la inclusión de nuevos parámetros de alta exigencia, dentro de los cuales se incluyen las áreas de investigación relacionadas con la aerodinámica, la furtividad y la optimización en los procesos de operación. El presente artículo contempla el diseño de un Vehículo de Combate Aéreo no Tripulado (UCAV) para la ejecución de misiones de Apoyo Aéreo Cercano (CAS por sus siglas en inglés) en las próximas décadas. Los resultados obtenidos demuestran las habilidades de los UCAV como aeronaves de quinta generación para el reemplazo de flotas reconocidas a nivel mundial (A-10 Thunderbolt II y Sukhoi Su-25) y, además, garantiza su utilidad y viabilidad en los futuros entornos de combate. Así mismo, la investigación se enfoca en una de las variables de mayor discusión respecto a la supervivencia en el combate aéreo, se trata de la furtividad por fenómenos electromagnéticos, con la cual se obtuvieron valores de Sección Equivalente de Radar (RCS) iguales a -24,18 dBsm o representables en un área de detectabilidad de 0,0038 m2 en configuración limpia, de modo que este valor es inferior al de aeronaves furtivas como lo es el Northrop Grumman B-2 Spirit.  Finalmente, el diseño permite la operación con un máximo peso de despegue de 61,900 lb y una carga paga de 11,240 lb que se acondicionan a una configuración alar y de estabilizadores para rangos transónicos.
Creating research spaces for underserved communities: Expanding and extending intersectionality in contemporary educational contexts
Authors: Jackson Oron , Witenstein Matthew A
Published: June 2021

Methods: Intersectionality has extended beyond the tenets of race, gender and class to include queer communities, religious issues, literacy concerns, pedagogical styles, etc. in South Africa, the European Union and beyond. Intersectionality is no longer solely relegated to the needs of African American women germane to the United States.
Aim(s): This paper is also aimed at engaging researchers and practitioners in an intellectual dialog that may contribute to the ever-expanding research on intersectionality to include the United States, European Union, South Africa and other global communities.
Background: Educators are cognisant of the dense demographic shifts and inequities in primary and secondary schools. The call for guidance, resources and policy is critically needed; the disproportionalities consistent in schools have manifested themselves in school disciplinary practices and student achievement. The manuscript encourages discourse and provides a roadmap to examine intersectionality’s expansion critically and how that expansion can aid in improving the lives of K-12 public education students on an international scale. Additionally, the manuscript addresses whether intersectionality or its expansion served as a pivotal voice for marginalised communities and structures domestically and abroad.
Post-school youths' schooling experiences and aspirations
Authors: Naidoo Devika
Published: June 2021

While three million youth in South Africa are not in education, employment or training (NEETS), not much is known about their schooling experiences nor their aspirations for the future. Eighty-seven post-school youth (PSY) were enrolled at a youth development and organisation (IYDO) centre in a Black township to the south-east of Johannesburg. This paper analyses the perspectives of these post-school youths of their formal schooling experiences and their aspirations for the future. The paper is framed by Willis’s (2000) theory of the basic educational paradigm at the heart of the teaching relationship and intentional resistance from working class boys. Analysis of data showed the failure of the schools attended by the participants in providing a reasonable standard and quality of education as the main cause of dropping out of school. In spite of challenging structural constraints both historical and current, these post-school youth are not disaffected nor disengaged from quality education. Contrary to the literature, they aspire for a better life and for educational opportunities that would enable them to access professional and managerial jobs and upward social mobility. Appadurai’s (2004) theory of culture of aspiration enabled making sense of participants’ aspirations. The issue of post school youth requires not only alternative post school programmes but also attention to schooling practices within formal secondary school education.
Exploring the school-university mathematics skills gap for Economic Sciences
Authors: Basson Ilsa , Jankowitz Mardi
Published: June 2021

The training of highly skilled persons for the areas of Economics and Commerce requires that degree students upon entry need certain knowledge and skills in mathematics including aspects of statistics. The context is distance education and entry students seem unable to cope with the requirements of the mathematics-based topics that they need to study at the first year of tertiary education. It resulted in university staff speculating about a gap in pre-knowledge and skills. This study aims to investigate this phenomenon, starting with content and Revised Bloom’s Taxonomy analyses of final year school examination papers in mathematics, comparing it with similar analyses of first-year mathematics-based module examinations in the Economic sciences. Students that passed mathematics at school are supposed to have had adequate preparation for the first level Bachelor of Commerce. Coping with routine procedures mainly upon exit from secondary education does not signal well for the subsequent training of economists and commerce students. The situation seemingly does not improve at tertiary level where there is a further emphasis on routine procedures compared to higher order thinking skills.
COVID-19 enfeksiyonu ilişkili pandemi döneminde Ege Üniversitesi Tıp Fakültesi Hastanesi Acil Servisi’ne başvuran hastane dışı kardiyak arrest vakalarının retrospektif değerlendirilmesi
Authors: YALÇINLI Sercan , ERSEL Murat , KIYAN Güçlü Selahattin , KARBEK AKARCA Funda , ALTUNC Yusuf Ali I , UZ İlhan , ÖZÇETE Enver , SONGÜR KODİK Meltem , CAN Özge
Published: June 2021

Amaç: Covid 19 pandemisi direkt ve indirekt olarak sosyal hayatta önemli değişiklikler oluşturdu. Bu çalışmada acil sağlık hizmetleri açısından önemli bir yer tutan hastane dışı kardiyak arrest (HDKA) vakaları değerlendirildi. Pandemi öncesi dönem ile; demografik, etiyolojik ve acil sağlık hizmetlerinin sunumu açısından herhangi bir farklılık olup olmadığının araştırılması amaçlandı.

Gereç ve Yöntem: Acil Servis’e HDKA nedeni ile 2017, 2018, 2019 ve 2020 yıllarının 11 Mart – 01 Haziran tarihleri arasında başvuran hastalar retrospektif olarak değerlendirildi. Pandemi dönemi ve pandemi öncesi dönem olarak iki grup oluşturuldu. Demografik ve klinik özellikler karşılaştırıldı.

Bulgular: Çalışma popülasyonunu 263 hasta oluşturdu. Hastaların %22,4’ünün (n: 59) 2020, %25,5’inin (n:67) 2019, %27,0’inin (n:71) 2018, %25,1’inin (n:66) 2017 yılında başvuruda bulunduğu belirlendi. Altmış beş yaş altı HDKA sıklığının 2020 yılında (%57,6) diğer yıllara göre (%33,3) daha fazla olduğu gözlendi (p:0.003). Eşlik eden komorbidite durumu gruplar arasında benzer bulundu. Pandemi döneminde olay yerinde temel yaşam desteği (TYD) uygulama sıklığının diğer dönemlere göre daha fazla olduğu belirlendi (p:0.033). Pandemi döneminde hastaların acil servise daha sık 112 ile getirildiği saptandı (p:0.048). Spontan dolaşımın geri dönüşü (SDGD)’nin pandemi döneminde daha az olduğu gözlendi (%22- %37,3, p:0.030). Sağlık çalışanı ile hastaların ilk temas süresinin pandemi döneminde daha kısa olduğu belirlendi (p:0.034).

Sonuç: HDKA vakalarının sıklığında pandemi ve pandemi öncesi arasında değişiklik gözlenmedi. Acil tıbbi hizmet iki grup arasında benzerdi. Pandemi döneminde HDKA hastalarının yaş ortalamasındaki düşüş iyi tasarlanmış çalışmalarla araştırılmalıdır.
Chronic urticaria in the real-life clinical practice setting in Portugal: 2-years results from the non-interventional multicenter AWARE study
Authors: Costa Célia , Rosmaninho Isabel , Portuguese Study Investigational Group On behalf of the AWARE
Published: June 2021

Introduction: Information regarding chronic urticaria patients in the real-world setting is scarce. This analysis reports the two-year results of Portuguese patients included in the AWARE study.Material and Methods: Non-interventional cohort study. Adult patients with a diagnosis of chronic urticaria with symptoms for at least two months, refractory to H1-antihistamines, consulting one of the 10 participating urticaria centers throughout Portugal, from the 31st October 2014 to 31st July 2015, have been included in the study. Clinical parameters, medicines taken for urticaria symptom relief, weekly urticaria activity score, and dermatology quality of life index have been collected throughout the two years of the study.Results: Seventy-six patients were enrolled in the study. Results showed that the proportion of patients with omalizumab therapy almost duplicated after two years of the AWARE study, which was accompanied by the decrease of medical resources use and absenteeism. Moreover, urticaria severity and impact on quality of life both decreased after one year and continued to decrease at two years, although decreased severity was significant at both time points and quality of life was only significant at two years. At the end of two years, 79.0% of patients had their disease controlled compared to 29.3% at baseline (p < 0.001).Discussion: At the end of the AWARE study a significant proportion of patients had their disease controlled allowing for decreased use of medical resources.Conclusion: Chronic urticaria still has a significant impact on quality of life and therefore there is opportunity for further therapy optimization.
Reimagining Numeracies: Empowered, Game-Informed Meaning Making in and beyond the Pandemic Era
Authors: Abrams Sandra Schamroth
Published: June 2021

This article focuses on how a game-informed culture in public school math classes sustained interaction, cooperation, and empowered meaning making when COVID-19 mandates closed school buildings and education went fully online. More specifically, the game-informed learning environment supported the students’ development and discussion of their multimodal numeracies, and the highlighted activity reveals how the generation of math memes can foster students’ engagement in creative and empowered practices. Underscored throughout this article is the importance to embrace the expansiveness of numeracies in order to recognize, value, and support students’ meaning making.
Relación entre el nivel de conocimiento y la capacidad de autocuidado en salud sexual de los adolescentes de una Institución Educativa Pública.
Authors: Vivanco Sime Aida Milagros , Giraldo Giraldo Aurora Marlene , Francia Espinoza Keylla Fernanda , Mescua Peñaloza Catherine Helen
Published: June 2021

Objetivo: Determinar la relación entre el nivel de conocimiento y la capacidad de autocuidado en salud sexual de los adolescentes de una Institución Educativa Pública. Material y Método: Estudio no experimental, correlacional de corte transversal. La población de estudio estuvo conformada por 262 adolescentes. Se usaron dos instrumentos que fueron adaptados y validados mediante juicio de expertos y prueba piloto en una población similar al estudio. Resultados: Predominaron los adolescentes con 16 años en 40,5 %. Respeto a las variables, predominó el nivel de conocimiento bajo en salud sexual según la dimensión social con 48,1 %; en la dimensión biológica el 42,7% presentó nivel de conocimiento bajo y en la dimensión psicológica el 41,2% nivel medio. Para la capacidad de autocuidado en salud sexual en su dimensión interacción social y actividad y reposo el 35,5% presentó capacidad de autocuidado alta y en igual porcentaje a nivel medio; sobre promoción del funcionamiento 39,7% presentaron capacidad de autocuidado alta y en bienestar personal 38,2 % capacidad de autocuidado media. Se halló relación directa y positiva entre las variables con Rho de Spearman de 0,336 (p≤0,01). Conclusiones: Existe relación entre el nivel de conocimiento y la capacidad de autocuidado en salud sexual.
SigmoReLU: An Improvement Activation Function by Combining Sigmoid and ReLU
Authors: Mastromichalakis Stamatis
Published: June 2021

Two of the most common activation functions (AF) in deep neural networks (DNN) training are Sigmoid and ReLU. Sigmoid was tend to be more popular the previous decades, but it was suffering with the common vanishing gradient problems. ReLU has resolved these problems by using zero gradient and not tiny values for negative weights and the value “1” for all positives. Although it significant resolves the vanishing of the gradients, it poses new issues with dying neurons of the zero values. Recent approaches for improvements are in a similar direction by just proposing variations of the AF, such as Leaky ReLU (LReLU), while maintaining the solution within the same unresolved gradient problems. In this paper, the combining of the Sigmoid and ReLU in one single function is proposed, as a way to take the advantages of the two. The experimental results demonstrate that by using the ReLU’s gradient solution on positive weights, and Sigmoid’s gradient solution on negatives, has a significant improvement on performance of training Neural Networks on image classification of diseases such as COVID-19, text and tabular data classification tasks on five different datasets.
Discharge Plan to Promote Patient Safety and Shared Decision by a Multidisciplinary Team of Healthcare Professionals in a Respiratory Unit
Authors: Nnate Daniel A. , Barber David , Abaraogu Ukachukwu O.
Published: June 2021

Patients with chronic obstructive pulmonary disease (COPD) may require frequent hospitalization due to worsening symptoms. Preventing prolonged hospital stay and readmission becomes a challenge for healthcare professionals treating patients with COPD. Although the integration of health and social care supports greater collaboration and enhanced patient care, organisational structure and poor leadership may hinder the implementation of patient-oriented goals. This paper presents a case of a 64-years-old chronic smoker with severe COPD who was to be discharged on long-term oxygen therapy (LTOT). It further highlights the healthcare decisions made to ensure the patient’s safety at home, and further provide a long-lasting solution to the existing medical and social needs. The goal was accomplished through a discharge plan that reflects multidisciplinary working, efficient leadership and change management using Havelock’s theory. While COPD is characterized by frequent exacerbation and hospital readmission, it was emphasized that most failed discharge could be attributed to bureaucratic organizational workflow which might not be in the patient’s best interest. It was further demonstrated that healthcare professionals are likely to miss the window of opportunity to apply innovative and long-lasting solutions to the patient’s health condition in an attempt to remedy the immediate symptoms of COPD.
Living Documents: A Textual Analysis Review
Authors: Deitz Charlie
Published: June 2021

The 19th and early 20th centuries were, for English-speaking Western nations, marked by calamitous change. Among those changes was the way in which Western society handled and treated people who suffered from mental illness, the “mad” as it were. The insane asylum, a peculiar outcropping of culture that combined Christian saviorism with the nascent field of psychiatry, became the go-to vehicle for the care and maintenance of suffering patients. The institution gained such a foothold in society that every American state had at least one asylum, and many had several. After just a few decades, the insane asylum was one of the most powerful institutions in the West. The speed at which the insane asylum embedded itself in culture at such a profound depth was astounding. Scholars have recently been exploring this institution to deconstruct and explain the meteoric rise and fall of such a behemoth. This review will distill and evaluate one such crucial piece of literature to be added to the index of scholarship on the topic.
The Method and the Madness
Authors: Popa Eugen Octav
Published: June 2021

I highly recommend Hanganu-Bresch and Berkenkotter’s work to anyone who is interested in the vicissitudes of early psychiatric diagnosis, confinement and treatment. The book is well written and well documented. The reader benefits form the authors’ admirable knowledge on the evolution of psychiatry in the 19th century, the social co-creation of the institution of asylum and the many genres of discourse (from admission reports to science fiction) that have shaped these developments. While the book offers but a snapshot of a more extended historical process, I believe there is a lot to learn from such a snapshot.
Response to reviews of 'Diagnosing Madness'
Authors: Hanganu-Bresch Cristina
Published: June 2021

I want to thank the reviewers profusely for engaging so deeply and thoughtfully with our book, and for offering both generous assessments and thorough, well informed critiques. It has been two years since the book was published and four since my mentor and co-author passed away; it is, perhaps, a good time to reflect on it and respond to those who in good faith have parsed its ideas and placed them in proper historical and theoretical context.
Stigma, Structural Vulnerability, and “What Matters Most” Among Women Living With HIV in Botswana, 2017
Authors: Yang Lawrence H. , Poku Ohemaa B. , Misra Supriya , Mehta Haitisha T. , Rampa Shathani , Eisenberg Marlene M. , Yang Lyla S. , Dai Cao Thi Xuan , Blank Lilo I. , Becker Timothy D. , Link Bruce G. , Entaile Patlo , Opondo Philip R. , Arscott-Mills Tonya , Ho-Foster Ari R. , Blank Michael B.
Published: June 2021

Objectives. To explore whether beneficial health care policies, when implemented in the context of gender inequality, yield unintended structural consequences that stigmatize and ostracize women with HIV from “what matters most” in local culture.

Methods. We conducted 46 in-depth interviews and 5 focus groups (38 individuals) with men and women living with and without HIV in Gaborone, Botswana, in 2017.

Results. Cultural imperatives to bear children bring pregnant women into contact with free antenatal services including routine HIV testing, where their HIV status is discovered before their male partners’. National HIV policies have therefore unintentionally reinforced disadvantage among women with HIV, whereby men delay or avoid testing by using their partner’s status as a proxy for their own, thus facilitating blame toward women diagnosed with HIV. Gossip then defines these women as “promiscuous” and as violating the essence of womanhood. We identified cultural and structural ways to resist stigma for these women.

Conclusions. Necessary HIV testing during antenatal care has inadvertently perpetuated a structural vulnerability that propagates stigma toward women. Individual- and structural-level interventions can address stigma unintentionally reinforced by health care policies.
Chronic Pelvic Diastasis 22 Years After Twin Natural Delivery
Authors: Pascarella Raffaele , Sangiovanni Pasquale , Fantasia Rossana , Cerbasi Simone
Published: June 2021

Case:

We present here a case of chronic pelvic separation 22 years after twin natural delivery in a 49-year-old woman surgically treated with anterior and posterior stabilization. The functional and radiological recovery after a 4-year follow-up was extremely good.

Conclusion:

Postpartum pubic symphysis diastasis is a rare but dreaded complication of natural delivery. Nonoperative treatment is still considered the gold standard. However, when pain persists despite nonoperative treatment and when a pelvic radiograph reveals a pubic diastasis greater than 2 cm, surgery is recommended. In the case of low back pain because of sacroiliac joint lesions, posterior fixation is indicated.
Surgical Treatment of Unstable Pelvic Ring Injury in a Young Child
Authors: Margalit Adam , Suresh Krishna V. , Hayashi Brooke , Sponseller Paul D.
Published: June 2021

Case:

We describe an anterior and posterior pelvic ring construct, with emphasis on the posterior construct, to treat a vertical displacement fracture in a 2-year-old girl who was struck by a motor vehicle. Eighteen months after her injury, radiographs showed intact sacroiliac joints and symmetrical pubic symphysis.

Conclusion:

Although commonly performed in adults, pelvic fixation is challenging in children because of the small size of the child’s pelvis and osseous fixation pathways. However, this approach enabled successful vertical stabilization of the pelvis, complete resolution of symphyseal diastasis, and recovery of function and mobility.
Being “Other” in Berlin
Authors: Kim Helen
Published: June 2021

Germany is considered a relatively recent country where multiraciality has become a recognised phenomenon. Yet, Germany still considers itself a monoracial state, one where whiteness is conflated with “Germanness”. Based on interviews with seven people who are multiracial (mostly Korean–German) in Berlin, this article explores how the participants construct their multiracial identities. My findings show that participants strategically locate their identity as diasporic to circumvent racial “othering”. They utilise diasporic resources or the “raw materials” of diasporic consciousness in order to construct their multiracial identities and challenge racism and the expectations of racial and ethnic authenticity. I explored how multiracial experiences offer a different way of thinking about the actual doing and performing of diaspora.
The Paradox of Citizenship in American Politics
Authors: Peter Kivisto
Published: June 2021

The Paradox of Citizenship in American Politics: Ideals and Reality, by Mehnaaz Momen, London and New York: Palgrave Macmillan, 2018. 265 pp. $130.63 hardback. ISBN: 978-3-319-61529-5

Reviewed by Peter Kivisto, Augustana College and St. Petersburg State University.
Australian postgraduate student experiences and anticipated employability: A national study from the students’ perspective
Authors: Cook Elizabeth J. , Crane Linda , Kinash Shelley , Bannatyne Amy , Crawford Joseph , Hamlin Gary , Judd Madelaine-Marie , Kelder Jo-Anne , Partridge Helen , Richardson Sarah
Published: June 2021

Postgraduate students are navigating a rapidly evolving landscape for their future careers. In this context, higher education providers are responsible for supporting and monitoring postgraduate (masters and doctoral) students’ development for both education and employability contexts. This empirical research provides a rich analysis of feedback breakfasts, focus groups and interviews with 319 postgraduate student participants from 26 universities. Emergent themes highlight widespread lack of confidence in university-mediated student experiences, particularly in the context of employability, and pessimism regarding career outcomes. Students expressed a view that higher education providers need to direct further attention and relevant supports toward postgraduate education. Future career despondency was particularly prevalent among students with academic aspirations. The findings are discussed using the theoretical framework of eudemonia and flourishing as an approach to revitalising and improving both the process and outcomes of postgraduate education. The paper concludes with practical recommendations for universities to improve the postgraduate student experience in the context of employability.
Allosteric activation of preformed EGF receptor dimers by a single ligand binding event
Authors: Purba Endang R. , Saita Ei-ichiro , Akhouri Reetesh R. , Öfverstedt Lars-Göran , Wilken Gunnar , Skoglund Ulf , Maruyama Ichiro N.
Published: June 2021

Aberrant activation of the epidermal growth factor receptor (EGFR) by mutations has been implicated in a variety of human cancers. Elucidation of the structure of the full-length receptor is essential to understand the molecular mechanisms underlying its activation. Unlike previously anticipated, here, we report that purified full-length EGFR adopts a homodimeric form in vitro before and after ligand binding. Cryo-electron tomography analysis of the purified receptor also showed that the extracellular domains of the receptor dimer, which are conformationally flexible before activation, are stabilized by ligand binding. This conformational flexibility stabilization most likely accompanies rotation of the entire extracellular domain and the transmembrane a-helix, resulting in dissociation of the intracellular kinase dimer and, thus, rearranging it into an active form. Consistently, mutations of amino acid residues at the interface of the inactive, symmetric kinase dimer spontaneously activate the receptor in vivo. Optical single-molecule observation also demonstrated that binding of only one ligand activates the receptor dimer on the cell surface. Based on these results, we propose an allosteric model for the activation of EGFR dimers by ligand binding. Our results demonstrate how oncogenic mutations spontaneously activate the receptor and shed light on the development of novel cancer therapies.