End Of Course Research Articles

Fostering technical skills and creativity in the digital fabrication spaces: an open-ended prototyping approach

AbstractThis paper explores the impact of a digital fabrication course on the development of digital fabrication skills and creativity. The course focused on open-ended prototyping and aimed to investigate its effects on students’ motivation, enjoyment, and confidence. Students’ creativity levels were measured using a creativity test at the beginning and end of a seven-week course. Additionally, the students shared their subjective feedback on their skills and experiences in designing and fabricating prototypes using digital fabrication tools. The results showed that prototyping activities significantly improved students’ overall creativity and perceived proficiency in 2D and 3D modeling, prototyping, embedded programming, and operating fabrication machines. Students’ confidence increased across most skills, although some of their motivation and enjoyment for certain skills decreased by the end of the course. It was also revealed that collaborative learning was perceived as enjoyable and not always suitable for developing certain personal skills, such as 2D modelling and programming. Future research could investigate pedagogical approaches tailored to individual needs and collaborative configurations for optimal skill development.

A simplified and robust risk stratification model for stem cell transplantation in pediatric acute myeloid leukemia

The efficacy of stem cell transplantation (SCT) in pediatric acute myeloid leukemia (pAML) remains unsatisfactory due to the limitations of existing prognostic models in predicting efficacy and selecting suitable candidates. This study aims to develop a cytomolecular risk stratification-independent prognostic model for SCT in pAML patients at CR1 stage. The pAML SCT model, based on age, KMT2A rearrangement (KMT2A-r), and minimal residual disease at end of course 1 (MRD1), effectively classifies patients into low-, intermediate-, and high-risk groups. We validate the effectiveness in an internal validation cohort and in four external validation cohorts, consisting of different graft sources and donors. Moreover, by incorporating the FMS-like tyrosine kinase 3/internal tandem duplication (FLT3/ITD) allelic ratio, the pAML SCT model is refined, enhancing its ability to effectively select suitable candidates. We develop a simple and robust risk stratification model for pAML patients undergoing SCT, to aid in risk stratification and inform pretransplant decision-making at CR1 stage.

EXPERIENCE OF APPLYING NEUROSCIENCE IN TEACHING KAZAKH AS A SECOND LANGUAGE

Teaching and learning the Kazakh language as a second language are one of the main state issues in Kazakhstan. In the modern realities we need very efficient and sufficient approaches and methods of teaching the Kazakh language to non-natives living in Kazakhstan. Teachers and educators are looking for different ways to teach Kazakhas a second language. Nowadays there are not many researches related to the application of the advanced methods of teaching it. This article aims to establish the connection between neuroscience and the teaching of Kazakh as a second language. The articlepresents the theoretical basis of neuroscience and its basic concepts. This article represents results of conducting an experiment of teaching Kazakh as a second language to adults. Based on these neuroscientific concepts and strategies for teaching Kazakh as a second language, we designed and applied a Kazakh language course as a second language for adults. At the end of the course adult learners passed a final test according to the Kaztest system. During and at the end of the experiment course there was not any special preparation for the final test. The results of the experiment showed that implementation of the neuroscientific concepts and strategies was efficient. According to the results of the experiment course we state that we can effectively construct the Kazakh language teaching course by having a thorough understanding of the brain function that neuroscience studies. Using the results of this experiment, educators and teachers of the Kazakh language can improve their methodology and contribute to the effective learning of the language by learners.

Situating the Self Through Sketching: First Year Doctoral Students Finding Their Way

As part of a two-semester advanced research methodology course, five PhD students completed three sketches—beginning, middle, and end of course—to represent how they were thinking and feeling about themselves as doctoral students as they progressed through their first year. They also wrote reflections to complement the sketches and shared their sketches in class. At the end of the course, the students co-led a study with their two instructors to examine their learnings and understandings gained from sketching. The students wrote individual narratives about their experiences and the instructors wrote narratives about how sketching was part of their pedagogical thinking. The analysis revealed seven student themes, including positive outcomes and challenges associated with sketching. One positive outcome was that students felt empowered as the sketches gave them the opportunity to reflect back on their progress, both cognitively and emotionally, over their first year of doctoral studies. Sketching itself was a challenge for some, but all felt that it was a powerful experience. Sketching provided the instructors with insights they might not have gotten through words alone, enhancing their sense of teaching and learning, and gave them valuable information to support the students.

Results of the Simultaneous Combination of Ponatinib and Blinatumomab in Philadelphia Chromosome-Positive ALL.

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.In this analysis, we update our experience with the chemotherapy-free regimen of blinatumomab and ponatinib in 60 patients with newly diagnosed Philadelphia chromosome (Ph)-positive ALL. At a median follow-up of 24 months, the complete molecular response rate by reverse transcriptase-polymerase chain reaction was 83% (67% at the end of course one), and the rate of measurable residual disease negativity by next-generation clono-sequencing was 98% (45% at the end of course one). Only two patients underwent hematopoietic stem cell transplantation (HSCT). Seven patients relapsed: two with systemic disease, four with isolated CNS relapse, and one with extramedullary Ph-negative, CRLF2-positive pre-B ALL. The estimated 3-year overall survival rate was 91% and event-free survival rate was 77%. Three patients discontinued blinatumomab because of adverse events (related, n = 1; unrelated, n = 2) and nine discontinued ponatinib because of cerebrovascular ischemia, coronary artery stenosis, persistent rash, elevated liver function tests with drug-induced fatty liver, atrial thrombus, severe arterial occlusive disease of lower extremities, pleuro-pericardial effusion, and debilitation. In conclusion, the simultaneous combination of ponatinib and blinatumomab is a highly effective and relatively safe nonchemotherapy regimen. This regimen also reduces the need for intensive chemotherapy and HSCT in first remission in the majority of patients.

Is oral nano-curcumin formulation a safe and effective measure for preventing cisplatin-induced nephrotoxicity in cancer patients?

Nephrotoxicity is one of the most important complications in cancer patients under treatment with cisplatin-containing regimens. Curcumin, as the most important active component of Curcuma longa, is an antioxidant and anti-inflammatory compound. In this clinical trial, we assessed the preventive effect of nano-curcumin oral formulation against cisplatin-induced nephrotoxicity in cancer patients. In this triple-blind clinical trial 30 cancer patients on cisplatin were randomly included in the treatment group, receiving nano-curcumin 40 mg capsules ( n = 15) or the placebo group ( n = 15) twice a day during four chemotherapy courses. Kidney function was measured at the beginning of the study and then at the end of each course of chemotherapy. There was no significant difference in acute kidney injury occurrence rate and creatinine and blood urine nitrogen serum levels between the treatment and placebo groups at the end of each chemotherapy course ( P value >0.05). Just at the end of the first course, the difference was close to significant ( P = 0.055). We also found no difference in mortality and recurrence rate in an average 30-month follow-up. Nano-curcumin in the prescribed dose and duration was not effective in preventing cisplatin-induced nephrotoxicity in cancer patients in comparison with the placebo. Further studies with larger sample size using different doses and duration of nano-curcumin are recommended.

Impact of The NTN Design on Academic Outcomes

The effect of the New Tech Network (NTN) design on several academic measures was tested on ninth graders in four schools in the Southeastern United States. Results suggest that, when implemented with fidelity to the model, there is a significant effect of the NTN treatment on achievement test scores as students in NTN schools scored higher on both the End of Course (EOC) Math and ELA tests compared to students in control schools. This effect remained after controlling for Poverty, Race, and Preexisting Achievement Level. Students in NTN schools also were slightly more likely to earn dual credit compared to students in the control schools. However, there was no effect of the NTN treatment on dropout rate and students in NTN schools were more likely to be retained in their current grade level compared to students in the control schools.

Итоги открытого многоцентрового неинтервенционного наблюдательного проспективного исследования влияния на качество жизни препарата Кипферон®, применяемого у детей 0–7 лет с острыми респираторными вирусными инфекциями в условиях рутинной амбулаторно- поликлинической практики

Objective. To evaluate the dynamics of the quality of life of children aged 0 to 7 years with acute respiratory viral infections (ARVI) of mild and moderate severity when adding the drug Kipferon® (a mixture of normal human immunoglobulin and recombinant interferon α-2b) to standard therapy, as well as to determine the effect of this drug on the infectious morbidity of patients during 3 months following the course of treatment. Patients and Methods. A multicenter observational clinical study conducted at 19 clinical centers in Russia in routine outpatient and polyclinic practice included 855 children aged 0 to 7 years; the mean age was 3.5 ± 1.7 years. There were 460 (53.8%) boys and 395 (46.2%) girls. There were 89 children aged 0 to 1 year; older children were 766. Patients were divided into 2 groups: the main group (n = 656), children from which received Kipferon® (rectal suppositories, according to the instructions for use) for 7 days in addition to standard symptomatic therapy, and the control group (n = 199). The children were examined on admission, on the 3–5th and 6-8th day from the beginning of treatment; 1 and 3 months after the end of the course of therapy. The severity of the main clinical symptoms was evaluated using a 10-point system. The legal representatives of all patients signed informed consent. Statistical analysis of the results was performed using the methods of descriptive and variation statistics, Student and Mann–Whitney criteria; differences were considered reliable at p < 0.05. Results. The initial general level of discomfort, as well as the degree of severity of 11 main symptoms of acute respiratory infection were comparable in both groups and significantly improved by the end of the treatment course. On the 3-5th day from the beginning of treatment in patients receiving Kipferon® preparation, statistically significant (p < 0.05) improvement in all leading manifestations of ARVI was revealed, while in the control group improvement was registered only in 8 symptoms out of 11. In infants of the main group by the 3–5th day of treatment, difficulties in feeding and falling asleep significantly (p < 0.05) decreased; older patients significantly better ate and slept, and were more physically active. Bacterial complications of ARVI in the main group developed 2 times less frequently: 36 (5.7%) cases vs. 20 (10.3%); the differences are reliable (p = 0.026) according to the χ2 criterion. Repeated acute respiratory viral infections during 3 months of follow-up were significantly (p < 0.05) more frequent in children who did not receive Kipferon® (47.5% vs. 20.3%). No serious adverse events were detected during the use of Kipferon® preparation. Adverse events were recorded in 2 patients, none of them was classified as related to the use of the study drug; serious adverse events were absent during the entire observation period. Conclusion. The efficacy and safety of the immunomodulating drug Kipferon® allows us to recommend it as an important addition to symptomatic agents in the treatment of acute respiratory infections in pediatrics. Key words: children, interferons, Kipferon®, acute respiratory viral infections

The Benefit of Allogeneic Transplant in 1 st Complete Remission in NPM1 Mutated AML with or without FLT3 ITD Is Restricted to Those Testing MRD Positive after Induction - an Analysis of the UK NCRI AML17 and AML19 Studies

Background While there is accumulating evidence that measurable residual disease (MRD) negative patients with intermediate risk AML may not benefit from allogeneic transplantation in 1 st complete remission (CR1-allo), many consider the presence of a FLT3 Internal Tandem Duplication (ITD) an indication for this procedure. However, the studies supporting this practice were mainly performed before the development of sensitive molecular MRD techniques (Schlenk NEJM 2008).The UK NCRI AML17 and AML19 trials studied, then incorporated, MRD by RT-qPCR into the management of patients with NPM1 mutated AML. Methods NCRI AML17 (April 2009 to December 2014) and AML19 (November 2015 to November 2020) were sequential prospective randomised trials for younger adults (18 - 60 years) with newly diagnosed AML. In AML17, decisions regarding CR1-allo were made using a validated risk score incorporating baseline factors and response to induction. In AML19, for patients with NPM1 mutated AML ( NPM1mut) the protocol recommended CR1-allo only in patients testing MRD positive in the peripheral blood (PB) post cycle 2 (PC2), regardless of other baseline risk factors such as FLT3 ITD, based on findings from AML17 (Ivey et al, NEJM 2016). Both trials were performed prior to the availability of midostaurin and FLT3 ITD MRD assays. Here we compare the outcomes of patients with NPM1mut in these trials and assess the benefit of CR1-allo according to FLT3 ITD and molecular MRD status. Time-to-event variables are analysed using the Kaplan-Meier method, and the impact of alloSCT assessed using time-dependent Cox regression and visualised with Simon-Makuch plots. Molecular relapses were included as relapse events, and alloSCT performed after molecular relapse was not considered as CR1. Results 737 patients with NPM1mutAML who achieved CR/CRi and had a valid PC2 PB MRD result were included in the analysis. 60/348 (17%) patients from AML17 and 83/389 (21%) from AML19 tested PB PC2 MRD positive. Overall, CR1-allo was performed in 20% of patients in AML17 and 25% in AML19. Of the MRD positive patients CR1-allo was performed in 16/60 (27%) in AML17 compared to 50/83 (60%) in AML19 where these patients were recommended for transplant. CR1-allo was performed in 18% and 16% of MRD negative patients in AML17 and AML19 respectively. In AML17, as previously reported (Ivey et al, NEJM 2016), patients who were MRD+ had poor outcomes, with 3-year cumulative incidence of relapse (CIR) of 84% and overall survival (OS) of 25%. These outcomes were improved in AML19, with 3y CIR 50% and 3y OS 51%. Across both trials, CR1-allo was associated with a significant survival benefit in MRD+ patients (3y OS 61% vs 24%, HR 0.42, 95%CI 0.26-0.69, p<0.001, Figure A). Patients who were MRD negative had excellent outcomes in both trials (3y CIR 33% and 24% and 3y OS 75% and 83% for AML17 and AML19 respectively). AlloSCT in CR1 provided no survival advantage for MRD- patients (HR 0.83, 95%CI 0.51-1.34, p=0.4). There were a total of 286 patients with NPM1mutFLT3 ITD mut AML with a PC2 PB MRD result across both trials. 81/286 (28%) were PB PC2 MRD+ of whom 32/81 (40%) received CR1-allo (28% in AML17 and 49% in AML19). Outcomes in these high-risk patients were improved in AML19, with 3y CIR 91% vs 68% and 3y OS 22% and 31% for AML17 and AML19 respectively. Those who received CR1-allo had improved outcomes (3y OS 45% vs 18%, HR 0.52, 95% CI 0.29-0.93, p=0.03) consistent with the overall MRD+ population. In the 70% of NPM1mutFLT3 ITD mut AML patients who achieved PB PC2 MRD-, outcomes were encouraging in both AML17 (3y CIR 37%, 3y OS 75%) and AML19 (3y CIR 27%, 3y OS 80%). CR1-allo was performed in 20% (19% in AML17, 21% in AML19), with no survival benefit for transplant (HR 0.80, 95% CI 0.37-1.72, p=0.6, Figure B). There remained no benefit when restricted to those with high (>0.5) FLT3 ITD allelic ratio (HR 0.63, 95% CI 0.2 - 2.23, p = 0.50) and there was also no evidence of an interaction between allelic ratio and benefit from transplant for MRD negative patients (p=0.86). Conclusion Molecular MRD can be used to stratify decision making concerning post remission therapy in patients with NPM1mut AML. Patients who achieve MRD negativity in the peripheral blood by the end of course 2 are at low risk of relapse and we found no evidence of benefit from allogeneic transplant in CR1, including in the subset with FLT3 ITD. This finding contrasts with MRD+ patients where there was a significant survival benefit for CR1 transplant.

The effect of a medicinal plant preparation on the frequency of episodes of exacerbation of recurrent cystitis and metabolic parameters in patients with type 2 diabetes mellitus taking glyphlosins

The problem of recurrent urinary tract infections (UTI) in patients with type 2 diabetes mellitus (DM 2) is relevant, especially when there is a combination of predisposing factors, such as female gender, history of UTI episodes, and therapy with sodium glucose cotransporter type 2 (SGLT-2) inhibitors, and the choice of effective and safe means could cause some difficulties, including ina terms of the burden of antibiotic resistance. To evaluate the effectiveness and safety of the phytoproduct Canephron® N for the prevention of exacerbations of recurrent cystitis and the effect on metabolic parameters in patients with type 2 diabetes taking SGLT-2 inhibitors. Prospective, randomized, open, parallel group study in 60 women. The main group took the drug Canephron® N for 3 months. The main parameters for evaluating were the frequency of recurrence of cystitis, level of albuminuria and LDL-cholesterol peroxidation product - malondialdehyde. Within 3 months of taking Canephron® N, exacerbations of chronic cystitis were diagnosed 2 times less often, a decrease in albuminuria was found in the form of an increase in the proportion of patients with an optimal level of albuminuria by 20%, a 50% reduction in the frequency of the initial increase in albuminuria, and the absence of moderate albuminuria in all patients at the end of course of therapy. A decrease in the level of MDA by 1.4 times was noted (p=0.019). Thus, the herbal drug Canephron® N can be used for accompanying therapy and prophylactic treatment in patients with recurrent cystitis on the background of DM 2, taking SGLT-2 inhibitors. The course of therapy should last at least 3 months.

Рецидивуючий бактеріальний вагіноз: варіативний підхід з урахуванням можливих патогенетичних аспектів

Purpose - to evaluate the effectiveness, duration of the clinical result, safety and tolerability of the complex treatment of recurrent bacterial vaginosis (BV) with the sequential use of an antibacterial agent and probiotic suppositories. Materials and methods. 91 women of reproductive age with a symptomatic course and a diagnosis of recurrent BV participated in the study. Primary decontamination of the vaginal tract was performed by all subjects and consisted of a 10-day intravaginal administration of the drug Terzhinan. Subsequently, the participants were randomized into three comparable groups. After primary remediation, no additional medication was prescribed to patients in the Group 1 (n=30). Subjects of the Groups 2 (n=30) and 3 (n=31) were recommended daily administration of vaginal probiotic suppositories Bifolak for a 10-day course, followed by prolongation of their use twice a week for 2 months in the Group 3. The effectiveness of BV therapy was evaluated immediately after antibacterial treatment and after a 6-month follow-up period based on the results of clinical examination, microscopic analysis of smears, and determination of vaginal pH with litmus strips. Results. At the end of the 10-day course of vaginal sanitation, subjective and objective signs of bacterial infection were not detected among all study participants, the pH of the vaginal secretion was within physiological limits and did not differ statistically between the Groups. At the stage of the sixth month of observation, data from a gynecological examination, smear microscopy and pH-metry confirmed 4 recurrences of the disease in the Group 1. In the Group 2, whose women additionally received a ten-day course of probiotic therapy, the number of episodes of repeated development of the disease was significantly lower, and amounted to 1 case for the entire observation period. Patients of the Group 3 did not notice manifestations of reinfection during the study and had no objective signs of BV. The use of a probiotic for a continuous course of 10 days in the Group 2, as well as its prolongation in a maintenance regimen (twice a week for 2 months) in the Group 3, was combined with a stable normalization of the acidity of the vaginal secretion, which was evidenced by the preservation of optimal pH until the end of the observation period (4.07±0.14 and 3.94±0.17, respectively, in the Groups 2 and 3 against 4.43±0.14 in the Group 1, p<0.05). The complete absence of repeated cases of BV and the lower pH values (p>0,05) in the Group 3 allowed us to consider the greater anti-relapse effectiveness of the long-term use of the probiotic at the trend level. Conclusions. Traditional schemes for the use of antibacterial agents in the treatment of BV allow to achieve a clinical and laboratory effect at the end of the course, but do not ensure its complete preservation for a long period of time. The disadvantage of the etiotropic approach to the treatment of BV is the lack of attention to the competitive properties of the indigenous flora as a factor in countering dysbiosis. Taking into account the pathogenetic essence of BV, which consists in the violation of the growth balance between conditionally pathogenic microorganisms and its own flora, classical antibacterial schemes can be successfully supplemented by the external introduction of eubiotic strains. Our study showed the benefits of complex therapy with an antibacterial agent and a probiotic, which consisted in stabilizing the acidity of the vaginal space and reducing the rate of disease recurrence, with a tendency to increase the effect in parallel with the duration of treatment. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Evidence from a Smoking Management Service in a University Teaching Hospital in Dublin, Ireland monitored by repeat surveys, 1997–2022

St Vincent’s University Hospital (SVUH) has a comprehensive smoking management programme and since 1997 has conducted periodic surveys of inpatients, outpatients, staff and visitors to establish prevalence of smoking and associated attitudes towards the hospital’s smoke-free campus policy pioneered in 2009. We report trends and describe also the online community stop smoking course (SSC) developed more recently in response to COVID-19. A questionnaire examining attitudes and smoking status was administered by census surveys of inpatients, quota or random sub-sample surveys of staff, and quota surveys with outpatients and visitors in the time period of 1997–2018. Chi square test for trend was used. Smoking rates declined in all groups but significantly so in outpatients (19.5% vs. 10%; p < 0.01), visitors (27.4% vs. 9.5%; p < 0.0001) and staff (30.0% vs. 10.8%; p < 0.0001). Use of E-Cigarettes was low in all cohorts. Rates of smoking were borderline higher in inpatients eligible by income for state-funded General Medical Services (33.2% vs 26.8%, p = 0.099). Support for and awareness of the ban increased over time. Demographic and quit data was compared between participants of in-person or online SSC. The online courses were successful with a maintenance of quit rates (End of Course: 54.7% vs. 55.0%, 1 Month: 50.4% vs. 54.0%, 3 Month: 19.8% vs. 22.5%). While the hospital community’s smoking prevalence has decreased over time and attitudes to the smoking ban have been increasingly positive, the campus is not without difficulties in keeping it smoke-free. We continue to advocate for hospital staff support in enacting this flagship initiative.

Reducing the Fuel Consumption of an Hybrid Electric Vehicle With the Use of Model Predictive Control-Case Study

The article presents operational aspects related <p xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">to energy management strategy (EMS) - model predictive control (MPC). The mathematical model showing the synergy of working machines of the hybrid electric vehicle (HEV) was presented. Then the results of road tests have been shown. They were based on the factory control of the above-mentioned system. The results of the operating parameters of the system according to the factory control and the results of the operating parameters according to the MPC with different linear quadratic tracking (LQT) curves were compared. Application of thirteen reference LQT trajectories results in lower fuel consumption of the HEV. It led to changes in the power and the battery state of charge (SOC): for factory control - from 50.1% (the beginning) to 56.1% (the end of course) and for MPC from 50.1% (the beginning) to 59.9% (the end of the course). The applied MPC with 13 reference trajectories (LQT) of power machines of the series-parallel HEV allowed for fuel savings on the level of 4%.

Dasatinib plus prednisone as induction and consolidation for adults with Ph-positive acute lymphoblastic leukaemia: A single-arm, multicentre, phase 2 trial.

To reducing chemotherapy-related toxicity, the chemo-free regimens become a new trend of Ph + ALL treatment. Therefore, we conducted a phase 2 trial of dasatinib plus prednisone, as induction (Course I) and early consolidation (Courses II and III) treating newly diagnosed Ph + ALL. The trial was registered at www.chictr.org.cn, ChiCTR2000038053. Forty-one patients were enrolled from 15 hospitals. The complete remission (CR) was 95% (39/41), including two elderly induction deaths. By the end of Course III, 25.6% (10/39) of patients achieved a complete molecular response. With a median follow-up of 15.4 months, 2-year disease-free survival (DFS) were 100% and 33% for patients who receiving haematopoietic stem cell transplantation (HSCT) at CR1 and receiving chemotherapy alone respectively. When censored at time of HSCT, 2-year DFS were 51% and 45% for young and elderly patients (p = 0.987). 2-year overall survival were 45%, 86% and 100% for patients without HSCT, receiving HSCT after relapse and receiving HSCT at CR1 respectively. A total of 12 patients had marrow recurrences and one had CNS relapse, with 38% occurred early (between Courses I and III). IKZF1 gene deletion was shown to be associated with relapse (p = 0.019). This chemo-free induction and early consolidation regimen was efficacious and well-tolerated in de novo Ph + ALL. Allogeneic HSCT conferred definite survival advantage after chemo-free induction.

“You don't have to perform for the trees”: The longer-term effects of nature-based interventions on wellbeing

The health and wellbeing benefits of engagement with the natural environment are well documented, but a lack of prospective research means that the sustainability of effects is unknown. Nature-based interventions (NBIs) seek to extend benefits to a wide, socially inclusive range of people. The primary aim of this study was to develop an improved understanding of one such initiative on personal wellbeing over time.The study involved adults recruited from Actif Woods Wales, a pan-Wales woodland activity programme. A questionnaire using validated measures assessed participants at baseline (n = 120), end of course (n = 74) and three months later (n = 57), in terms of mental wellbeing, social trust, self-reported health, self-efficacy, self-esteem and physical activity. A parallel qualitative study sought in-depth appreciation of processes of change with five end of course and four follow up focus groups.Significant positive increases were demonstrated in all psychosocial measures by end of course. These gains held at the follow up stage providing critical evidence of maintained change. Thematic analysis of the qualitative data revealed positive shifts in self-perspective that were reflected in wider lifestyle changes. Participant narratives showed how social processes and nature played an important role in supporting the wellbeing benefits experienced.This mixed methods study addressed identified gaps for research that furthers understanding of how NBIs can support health and wellbeing longer term. Findings point to a need for sustainable funding and support for NBI projects to embed the role that they can play in delivering therapeutic and preventative outcomes.

0171 Assessment of Student Sleep and Well-Being During a Stress Inoculation Training at The U.S. Navy Surface Warfare Officers School

Abstract Introduction Military operations frequently take place in complex, volatile, and ambiguous environments, where important information may be uncertain. These circumstances are often highly stressful, and fatiguing due to sustained operations, shift work, sleep loss, and the taxing nature of the work. As a crucial part of their preparation for leading U.S. Navy sailors, prospective executive officers (PXOs) in the Surface Warfare community receive training at the Surface Warfare Schools Command (SWSC). At the request of SWSC, the NPS research team was asked to assess the stress loads of SWO students during their expanded 10-week training course, which included the implementation of a stress inoculation training (SIT) program. Methods SWOs (N=50) attending the Prospective Executive Officer (PXO) Course at SWSC participated in a quasi-experimental longitudinal study. They completed questionnaires three times during the PXO course: at the beginning of the study, at the mid-point, and at the end of the course. Standardized tools were used to assess perceived stress levels (Perceived Stress Scale – PSS), depression symptoms (Patient Health Questionnaire – PHQ-8), anxiety (General Anxiety Disorder questionnaire – GAD-7), and mood (Profile of Mood States – POMS). Sleep attributes were assessed by wearable devices (ŌURA rings). Results Overall, the scores of SWOs on the PSS, PHQ-8, GAD-7, and POMS were lower or equivalent to scores reported for the general population. However, reported levels of perceived stress increased significantly from the beginning to the end of the PXO course (average PSS=9 vs 12). However, PHQ-8, GAD-7, and POMS scores remained stable across the three time points. On average, PXOs received 6.6 ± 0.65 hours of sleep per night on weeknights at SWSC, with about one additional hour of sleep on weekends. Conclusion These findings indicate that, while SWOs experienced an increase in perceived stress during the PXO course, their overall well-being is not substantively different from the general population. Participants appear to use weekends for additional restorative sleep, obtaining adequate amounts of sleep on weekends. We did not observe evidence of impairments in mental or physical wellness of SWOs attending the PXO course at SWSC. Support (if any)

The Use of Simulation Models and Student-Owned Animals for Teaching Clinical Examination Procedures in Veterinary Medicine

Clinical examination procedures (CEPs) are cornerstone clinical skills for veterinary practitioners, being taught in all veterinary faculties. CEPs include innocuous procedures that are well tolerated by animals as well as more distressful and less tolerated ones. In a classical approach, institutional animals are used to teach and practice CEPs. Two hundred and thirty-one undergraduate students from four consecutive years were assigned to two groups that used institutional animals only (AO) or a combination of students' owned animals and simulation models (model-animal, MA) to teach and practice CEPs. This latter comprised stuffed teddy dogs, eye and ear models made of molding silicone, as well as skin models. The learning outcome of each system was compared through questionnaires (throughout classes and at the end of course), grades, and pass rates in objectively structured clinical examinations. Most veterinary students had their own animals, being easy to have a dog per group of two students in class. All the students' owned animals adapted well to this environment. The interest in the practical activities with the simulation models was comparable to that exhibited in the classical AO system. Students reported to learn more with the MA system than with the AO, while the interest on the subjects and the relevance were appraised similarly in both systems. No differences existed in the final grades and pass rates. The MA system was effective for learning CEPs. Beyond animal welfare advantages, this system increased the out-of-school training and had financial saving benefits, being a valuable option for the teaching and training of CEPs.

Modeling the fuel consumption by a HEV vehicle – a case study

The article presents a mathematical model demonstrating the synergy of HEV energetic machines in accordance with the model predictive control. Then the results of road tests are presented. They were based on the factory control of the above-mentioned system. The results of the operating parameters of the system according to the factory control and the results of the operating parameters according to the model predictive control were compared. On their basis, it could be concluded that the model predic-tive control contributed to changes in the power and electrochemical charge level of the energy storage system from 50.1% (the beginning) to 56.1% (the end of course) and for MPC from 50.1% (the begin-ning) to 59.9% (the end of the course). The applied MPC with 13 reference trajectories (LQT) of power machines of the series-parallel HEV allowed for fuel savings on the level of 4%.

TOPOMETRIC PREPARATION AND PLANNING OF NEOADJUVANT RADIOTHERAPY IN THE COMPLEX TREATMENT OF RECTAL CANCER

Objective(s). To evaluate the effectiveness of the use of topometry during neoadjuvant radiation therapy in the complex treatment of rectal cancer.&#x0D; Methods. The results of treatment of 113 patients with locally advanced rectal cancer (cT3c-4N1-2M0) were analyzed. The patients were divided into two groups: the first (main) group included 57 patients who received only a course of neoadjuvant radiation therapy as part of the neoadjuvant stage of treatment. The second group (control group) included 56 patients who underwent a course of radiation therapy with capecitabine potentiation. Topometric preparation, contouring of irradiated volumes, critical structures and radiation treatment of all patients included in the study were carried out according to standard principles and started 5 days before its implementation.&#x0D; Results. When comparing the results of MRI performed before the beginning and after the end of the radiation therapy course in 102 (90.2%) of 113, a positive trend was noted in the form of a decrease in the length of the tumor itself and an increase in the distance between the tumor and the anal edge, p=0.0001. No statistically significant differences were found when evaluating the influence of criteria of intragroup effects on the reduction of tumor length when choosing fractionation modes.&#x0D; Conclusions. In 52 (91.2%) patients of the main group and 51 (911%) of the control group had a positive CRM status. Analysis of CRM status in patients before and after the end of the course of neoadjuvant radiation therapy showed positive dynamics, both in the main and in the control group (p&lt;0.000). After a prolonged course of neoadjuvant radiation therapy, the number of patients with a positive CRM status decreased to 17 (30%) in the main group and 19 (34%) in the control group (p&lt;0.000). According to the MRI results performed before and after the course of neoadjuvant radiation therapy in 102 (90.2%) out of 113, positive dynamics were noted in the form of a decrease in the length of the tumor itself and an increase in the distance between the tumor and the anal edge, p=0, 0001.

Activity-Project-Problem (APB) Based Curriculum in Teaching Pre-Engineering High School Students: Basis for Policy Recommendation and Curriculum Enhancement

Project-problem-based learning is an emerging integrated instructional approach that is being adapted in some schools today. This study was conducted to assess the quality of the Activity-Project-Problem (APB) based curriculum, an integrated learning approach in teaching pre-engineering high school students, and its impact on student achievement and effectiveness in increasing students’ interest in pursuing STEM careers in college. The researcher utilized a descriptive-quantitative design to generate and analyze data. Respondents were 9th to 11th-grade students in the Charles Herbert Flowers High School pre-engineering program. The study revealed that the APB curriculum effectively increases students’ test scores from pretest to posttest and for students to score distinguished in the end-of-course (EOC) assessment. Moreover, the APB curriculum’s quality is high, and the students showed interest in pursuing STEM careers in college. But even if the curriculum was assessed as effective in general, the outcome of the test scores from pretest-to-posttest and EOC assessments must be improved. Overall, students are only moderately interested in pursuing STEM careers, which must be addressed. Some students showed concerns about the quality of the curriculum. These findings were the basis for formulating policy recommendations and curriculum enhancement strategies.