High Level Of Difficulty Research Articles

GCLDNet: Gastric cancer lesion detection network combining level feature aggregation and attention feature fusion.

BackgroundAnalysis of histopathological slices of gastric cancer is the gold standard for diagnosing gastric cancer, while manual identification is time-consuming and highly relies on the experience of pathologists. Artificial intelligence methods, particularly deep learning, can assist pathologists in finding cancerous tissues and realizing automated detection. However, due to the variety of shapes and sizes of gastric cancer lesions, as well as many interfering factors, GCHIs have a high level of complexity and difficulty in accurately finding the lesion region. Traditional deep learning methods cannot effectively extract discriminative features because of their simple decoding method so they cannot detect lesions accurately, and there is less research dedicated to detecting gastric cancer lesions.MethodsWe propose a gastric cancer lesion detection network (GCLDNet). At first, GCLDNet designs a level feature aggregation structure in decoder, which can effectively fuse deep and shallow features of GCHIs. Second, an attention feature fusion module is introduced to accurately locate the lesion area, which merges attention features of different scales and obtains rich discriminative information focusing on lesion. Finally, focal Tversky loss (FTL) is employed as a loss function to depress false-negative predictions and mine difficult samples.ResultsExperimental results on two GCHI datasets of SEED and BOT show that DSCs of the GCLDNet are 0.8265 and 0.8991, ACCs are 0.8827 and 0.8949, JIs are 0.7092 and 0.8182, and PREs are 0.7820 and 0.8763, respectively.ConclusionsExperimental results demonstrate the effectiveness of GCLDNet in the detection of gastric cancer lesions. Compared with other state-of-the-art (SOTA) detection methods, the GCLDNet obtains a more satisfactory performance. This research can provide good auxiliary support for pathologists in clinical diagnosis.

Factors associated with re-admission in the year after acute postpartum psychiatric treatment

PurposeTo examine factors associated with being re-admitted in the year after discharge from acute postpartum psychiatric treatment.MethodsSecondary data analysis of information collected from mothers who were admitted to acute psychiatric services in the year after childbirth between 2013 and 2017. We carried out univariable analyses and multivariable hierarchical logistic regression to examine risk factors for women’s re-admission to acute psychiatric care (inpatient or community crisis care) in the year following discharge.ResultsSixty-seven (24.1%) of 278 women were re-admitted in the year after discharge from acute care; the median number of days to re-admission was 86 (IQR 35–214), and women who were re-admitted accessed a median of two further acute services (IQR 1–3). In adjusted analyses, reporting a history of childhood trauma (aOR 1.02; 95% CI 1.00- 1.03, p = 0.036), a higher level of difficulties in the mother–infant bond (aOR 1.03; 95% CI 1.01–1.06, p = 0.009) and younger age (aOR 0.95; 95% CI 0.90–1.00, p = 0.066) were associated with re-admission.ConclusionThis study confirms that the role of childhood adverse experiences on mental health is relevant for outcomes in women experiencing acute postpartum psychiatric episodes. Ongoing parent–infant bonding difficulties are also independently associated with re-admission. Perinatal mental health services therefore need to offer evidence-based interventions to address histories of trauma and to support parent–infant bonding to optimise mental health in women following discharge from acute psychiatric services. However, further research is needed to explore what other factors, not measured in our study, are also influential to re-admission.

The developmental trajectory of mandarin Chinese-speaking children’s pure metonymy comprehension ability

This empirical study investigates Chinese children’s developmental trajectory of pure metonymy comprehension. In the light of the experiment design in Jiang’s (2019) and Köder and Falkum’s (2020) studies, the present study, adopting a quantitative approach, employed a modified behavioral experiment and an eye-tracking experiment. Drawing on the experimental data, the study finds that: a) children’s metonymy comprehension performance showed a tendency towards the U-shape in the behavioral experiment tasks; b) children’s target (metonymy) fixation proportion, however, developed with age in the eye-tracking tasks; c) children’s metonymy comprehension not only developed with age but also showed different features in different difficulty levels of metonymies. Thus, this study explains the U-shape by arguing that age-4 and -5 children’s pure metonymy comprehension ability can be masked not only by a literal preference reported in Köder and Falkum’s (2020) study but also by the high randomness of task results of the age-3 participants and the high level of difficulty of culture-related metonymies. Moreover, the study also argues that year six is a crucial stage for children’s metonymy comprehension development, which provides implications for children’s early figurative language education.

Parental stress and child mental health: a network analysis of Romanian parents.

Parental stress is related to child mental health problems, with numerous evidence indicating that it is an important predictor of parenting and parent-child relationship. New approaches to psychopathology could be particularly informative for clinical research, however, there is limited research that employs network analysis with parents. Network analysis could contribute to a better understanding of the relationship between child mental health problems and parental stress by highlighting the most central nodes and how the two constructs influence each other. The scope of the study was to identify potential new intervention targets to reduce the mental health problems of children and prevent contagion between parent stress and child psychopathology. Furthermore, we also sought to test whether the dynamic between parental stress and child psychopathology differs across the level of parent stress and child total difficulties. In this endeavor, we had three main directions. First, we estimated a network at the level of child mental health problems and identified the most central nodes. Second, we mapped the main paths through which parent stress and child mental health problems communicate with each other. Third, we investigated the network invariance across the level of parent stress (high vs moderate) and child mental health problems (low vs. high total difficulties). Participants (N = 1014) were parents of children with ages between four and 17 years old. The analyses were conducted in RStudio. Results indicated that perceived coping was a central node, bridging the two constructs. The global strength of the network was higher for parents who reported high levels of stress compared to those who reported only moderate levels of stress. In contrast, we found that the global strength of the network was lower for children with high levels of total difficulties compared to those with low levels of total difficulties. In conclusion, we argue the importance of focusing on the targeting nodes with high bridge centrality, such as perceived coping, for designing prevention and intervention programs. Future research should use temporal dynamics between parental stress and child mental health problems and explore mechanisms between the two constructs.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12144-022-03520-1.

Associations between mothers' emotion regulation and real-time experiences of negative emotion: The moderating role of caregiving context.

Parents' emotion regulation and emotional experiences have important consequences for family well-being and child outcomes. Little is known about whether traitlike emotion regulation abilities predict statelike experiences of real-time negative emotion. Using ecological momentary assessment (EMA), this study examines associations between mothers' self-reported emotion regulation abilities and their real-time experiences of negative emotion, as well as the moderating role of caregiving context among 145 mothers (41% Hispanic; 31% earned below $40,000) of young children (mean age = 20.9 months) across a 10-day period. Results indicated that on average, mothers who report high levels of traitlike rumination and difficulties in emotion regulation also report more statelike negative emotion. Further, the presence of children weakened the associations between mothers' traitlike reports of emotion dysregulation and statelike EMA negative emotion reports. The findings demonstrate the importance of parents' emotion regulation for supporting family well-being, especially when parents are separated from their children; the findings may have implications for developing family interventions.

Gauging secondary school students' terrorism‐related resilience in the Sahel region of Burkina Faso: A quantitative study

AbstractThis study appraised male and female students' levels of terrorism‐related resilience, its effect on emotion and achievement, and assessed gender differences. The sample size was 180 junior and high school students of which 66 females (36.3%) and 114 males (62.6%) in the Sahel. Participants' ages ranged from 13 to 24 with a mean of 17.1 (SD = 2.04). Descriptive, multiple linear regression, and t‐test analyses were implemented to test for the size of resilience, its effects on students' emotional health and achievement, and to assess gender differences. Students had low level of resilience. Academic performance did not predict resilience, though regression analyses were statistically significant. Furthermore, no gender differences were found. Low level of resilience implies that students possess high level of difficulties in coping with terrorism. Psychological services are suggested to help secondary school students cope with the adverse effects of the stated violence.

The Development of Problem Based Learning Geogebra-Assisted Teaching Materials to Improve Mathematics Communication Ability of Vocational School Students

This study aims to produce teaching materials based on the GeoGebra-assisted Problem Based Learning approach that are valid, effective and practical to improve mathematical mathematical communication skills in linear programming material. The subjects in this study werw 30 students for a limited trial, 60 students for a broad trial, and 60 students for product testing including 30 experimental class and 30 control class. The instruments used in this study were interview sheets, student observation sheets on learning, response questionnaires to learning, validation questionnaires, five questions about mathematical communication ability tests, and non-test questionnaires for students' self-confidence. The results of this study indicate that the process of developing teaching materials is carried out well and the product is feasible to use, mathematical communication skills and self-confidence of students who receive learning using the GeoGebra-assisted Problem Based Learning method are better than students who receive learning using the usual approach, difficulties during learning do not indicate a high level of difficulty, in terms of mathematical communication problems students have difficulty in perfoming algebraic operations and more than half of students respond positively to learning.

An MRI-based pelvimetry nomogram for predicting surgical difficulty of transabdominal resection in patients with middle and low rectal cancer.

ObjectiveThe current work aimed to develop a nomogram comprised of MRI-based pelvimetry and clinical factors for predicting the difficulty of rectal surgery for middle and low rectal cancer (RC).MethodsConsecutive mid to low RC cases who underwent transabdominal resection between June 2020 and August 2021 were retrospectively enrolled. Univariable and multivariable logistic regression analyses were carried out for identifying factors (clinical factors and MRI-based pelvimetry parameters) independently associated with the difficulty level of rectal surgery. A nomogram model was established with the selected parameters for predicting the probability of high surgical difficulty. The predictive ability of the nomogram model was assessed by the receiver operating characteristic (ROC) curve and decision curve analysis (DCA).ResultsA total of 122 cases were included. BMI (OR = 1.269, p = 0.006), pelvic inlet (OR = 1.057, p = 0.024) and intertuberous distance (OR = 0.938, p = 0.001) independently predicted surgical difficulty level in multivariate logistic regression analysis. The nomogram model combining these predictors had an area under the ROC curve (AUC) of 0.801 (95% CI: 0.719–0.868) for the prediction of a high level of surgical difficulty. The DCA suggested that using the nomogram to predict surgical difficulty provided a clinical benefit.ConclusionsThe nomogram model is feasible for predicting the difficulty level of rectal surgery, utilizing MRI-based pelvimetry parameters and clinical factors in mid to low RC cases.

Robotic Chef Versus Human Chef: The Effects of Anthropomorphism, Novel Cues, and Cooking Difficulty Level on Food Quality Prediction.

Robots have been increasingly common in hospitality and tourism, especially being favored under the threat of COVID-19. However, people generally do not think robots are appropriate for cooking food in hotels and restaurants, possibly because they hold low quality predictions for robot-cooked food. This study aimed to investigate the factors influencing people’s quality prediction for robot-cooked food. In three experiments, participants viewed pictures of human and robotic chefs and dishes cooked by them, and then made food quality predictions and rated their perceptions of the chefs. The results showed that participants predicted the foods cooked by robotic chefs were above average quality; however, they consistently held lower food quality prediction for robotic chefs than human chefs, regardless of dishes’ cooking difficulty level, novel cues in chefs and food, or the anthropomorphism level of robotic chefs. The results also showed that increasing the appearance of robotic chefs from low or medium to high anthropomorphism, or enabling robotic chefs to cook high cooking difficulty level food could promote food quality prediction. These results revealed the current acceptance of robot-cooked food, suggesting possible ways to improve food quality predictions.

The Relationship of Self-Efficacy Towards High Level of Thinking Ability of USK Physics Education Student in Basic Physics I Course

The high-order thinking ability of students is currently a problem that is so difficult to improve because it must be extra developed in teaching and learning activities. This can happen because students do not often improve their higher order thinking in everyday life and in the learning process. Most students tend to have difficulty solving problems when the lecturer gives problems with a higher level of difficulty than usual. The cause of this problem needs to be investigated. This study aims to determine the relationship between self-efficacy and higher-order thinking skills of students of the Department of Physics Education, FKIP USK. The approach used is a quantitative approach with a descriptive correlational type of research. The sample of this study was the 2019 USK FKIP Physics Education students which consisted of 71 students. Data collection techniques used are questionnaires and tests. Questionnaire and test data were analyzed by descriptive analysis and Product Moment correlation analysis. The results showed that self-efficacy had a relationship with higher-order thinking skills (Sig. (2-tailed) = 0.001 0.05). It is recommended that future studies use more samples so that the results of the analysis obtained will be more accurate

Utility of the Iwate difficulty scoring system for laparoscopic right posterior sectionectomy: do surgical outcomes differ for tumors in segments VI and VII?

The Iwate Score (IS) have not been well-validated for specific procedures, especially for right posterior sectionectomy (RPS). In this study, the utility of the IS was determined for laparoscopic (L)RPS and the effect of tumor location on surgical outcomes was investigated. Post-hoc analysis of 647 L-RPS performed in 40 international centers of which 596L-RPS cases met the inclusion criteria. Baseline characteristics and perioperative outcomes of patients stratified based on the Iwate score were compared to determine whether a correlation with surgical difficulty existed. A 1:1 Mahalanobis distance matching was utilized to investigate the effect of tumor location on L-RPS outcomes. The patients were stratified into 3 levels of difficulty (31 intermediate, 143 advanced, and 422 expert) based on the IS. When using a stepwise increase of the IS excluding the tumor location score, only Pringle's maneuver was more frequently used in the higher surgical difficulty level (35.5%, 54.6%, and 65.2%, intermediate, advanced, and expert levels, respectively, Z = 3.34, p = 0.001). Other perioperative results were not associated with a statistical gradation toward higher difficulty level. 80 of 85 patients with a segment VI lesion and 511 patients with a segment VII lesion were matched 1:1. There were no significant differences in the perioperative outcomes of the two groups including open conversion, operating time, blood loss, intraoperative blood transfusion, postoperative stay, major morbidity, and mortality. Among patients undergoing L-RPS, the IS did not significantly correlate with most outcome measures associated with intraoperative difficulty and postoperative outcomes. Similarly, tumor location had no effect on L-RPS outcomes.

A STUDY ON THE CORRELATION BETWEEN PSYCHOLOGICAL ANXIETY, SELF-EFFICACY AND FOREIGN LANGUAGE LEARNING ACHIEVEMENT

A STUDY ON THE CORRELATION BETWEEN PSYCHOLOGICAL ANXIETY, SELF-EFFICACY AND FOREIGN LANGUAGE LEARNING ACHIEVEMENT

Integrating interferon-gamma release assay testing into provision of tuberculosis preventive therapy is feasible in a tuberculosis high burden resource-limited setting: A mixed methods study.

The World Health Organization recommends the scale-up of tuberculosis preventive therapy (TPT) for persons at risk of developing active tuberculosis (TB) as a key component to end the global TB epidemic. We sought to determine the feasibility of integrating testing for latent TB infection (LTBI) using interferon-gamma release assays (IGRAs) into the provision of TPT in a resource-limited high TB burden setting. We conducted a parallel convergent mixed methods study at four tertiary referral hospitals. We abstracted details of patients with bacteriologically confirmed pulmonary tuberculosis (PBC TB). We line-listed household contacts (HHCs) of these patients and carried out home visits where we collected demographic data from HHCs, and tested them for both HIV and LTBI. We performed multi-level Poisson regression with robust standard errors to determine the associations between the presence of LTBI and characteristics of HHCs. Qualitative data was collected from health workers and analyzed using inductive thematic analysis. From February to December 2020 we identified 355 HHCs of 86 index TB patients. Among these HHCs, uptake for the IGRA test was 352/355 (99%) while acceptability was 337/352 (95.7%). Of the 352 HHCs that were tested with IGRA, the median age was 18 years (IQR 10-32), 191 (54%) were female and 11 (3%) were HIV positive. A total of 115/352 (32.7%) had a positive IGRA result. Among HHCs who tested negative on IGRA at the initial visit, 146 were retested after 9 months and 5 (3.4%) of these tested positive for LTBI. At multivariable analysis, being aged ≥ 45 years [PR 2.28 (95% CI 1.02, 5.08)], being employed as a casual labourer [PR 1.38 (95% CI 1.19, 1.61)], spending time with the index TB patient every day [PR 2.14 (95% CI 1.51, 3.04)], being a parent/sibling to the index TB patients [PR 1.39 (95% CI 1.21, 1.60)] and sharing the same room with the index TB patients [PR 1.98 (95% CI 1.52, 2.58)] were associated with LTBI. Implementation challenges included high levels of TB stigma and difficulties in following strict protocols for blood sample storage and transportation. Integrating home-based IGRA testing for LTBI into provision of TB preventive therapy in routine care settings was feasible and resulted in high uptake and acceptability of IGRA tests.

PENINGKATAN INTERAKSI SOSIAL DENGAN METODE PERMAINAN SIMULASI JARING LABA-LABA PADA PESERTA DIDIK KELAS VIIA DI SMP NEGERI 04 BATU

Social interaction is important in the new associations owned by class VII learners. Adolescents must be able to interact with their peers. Social interaction is very supportive of the creation of mature peer relationships. In the social interaction that occurs, conflict is found. This study aims to improve social interaction by using spider web simulation games for students of class VIIA of State Junior High School 04 Batu. This research design uses a class action research design. The subjects in this study were 34 class VII A learners for the 2018/2019 School Year. Research instruments use observation sheets and questionnaires. Data in the form of a description of the results of observations about the activities of learners. The results stated that social interaction can be increased through spider web simulation games. In cycle I, students' activities carry out spider web simulation games with low difficulty behavior, while in cycle II learners perform spider web simulation games with a higher level of difficulty.

체육 계열 전문교과 운영 양상 탐색

The purpose of this study was to explore aspects of how specialized subjects in physical education (SSPE) that is presented in the 2015 revised national physical education curriculum is taught in high schools. A high school and two physical education high schools participated in this project. A focus group interview with three teachers and document analysis were undertaken. Data collected were analyzed through categorial themes analysis. The results of the study were as follows. First, the SSPE was opened for performance enhance of athlete-student and sport-related career education. Second, collaborative teaching (a teacher and a coach), SSPE for athletic club’ drill, difference between the development propose of SSPS and aspects of taught in schools emerged. Third, lack of text books and educational resources, higher level of difficulty, and content that is focused too much on the improvement of performance were barriers to delivering effective SSPE education. A need of expanding the meaning of SSPE and directions for reconstructing subjects in SSPE were discussed.

한국의 대학수학능력시험과 호주, 영국, 프랑스의 고등학교 졸업 자격시험의 행렬 문항 비교

Matrix had been deleted from the national curriculum of Korea due to the reduction of learning burden, but it was recently suggested that matrix should be included again in the national curriculum as a part of restructuring future-oriented learning contents for the age of intelligence in the course of the research for 2022 revised mathematics curriculum. In relation to this suggestion, the items involving matrix in the past college scholastic ability tests of Korea were pointed out as a problem. As the matrix items have been criticized for the high level of difficulty due to demand of specific operation of matrix and overfull calculation proficiency, the need for discussion on improvement of assessment of matrix was proposed. The purpose of this study is to compare matrix items from various countries and find a way to improve assessment of matrix with focus on whether the mathematical thinking and mathematical modelling ability could be considered in the assessment of matrix in a balanced way. To this purpose, the cognitive levels of matrix items in college scholastic ability tests of Korea, and exams for senior secondary certificate of Australia, England, France were investigated and compared with each other. The result show that Korea has the highest percentage of the Connection item while the Reflection item accounts for the highest percentage for the other three nations. It was also found that most of Reflection items of Korea focused on the assessment of performing calculation process, but Reflection items of Australia, England and France assessed a variety of cognitive elements containing Integrating, Justifying and Modeling. The results suggest a way in which matrix could be assessed meaningfully in a variety of cognitive levels and cognitive elements as an alternative to calculation-focused assessment.

COVID-19 restrictions and psychological well-being of fathers with infants admitted to NICU-An exploratory cross-sectional study.

AimTo describe the impact of the COVID‐19 restrictions on the caregiving activities and psychological well‐being of fathers with infants admitted to neonatal units.MethodsCross‐sectional study using adapted COPE‐IS and COPE‐IU tools. Participants' recruitment occurred online via social media and parents' associations. Online survey in English, French and Italian were distributed and promoted via websites and social media platforms of parent's associations. The study was undertaken across 12 countries in Asia, Australia, Africa and Europe.ResultsA total of 108 fathers of NICU infants completed the survey. COVID‐19 related restrictions were categorised into 3 types: no restrictions, partial and severe restrictions. Fathers who experienced partial restrictions reported more involvement in caregiving activities but high levels of emotional difficulties and sleeping problems compared to those who experienced full or no restrictions.ConclusionGiven the impact on the psychological well‐being of fathers, restrictions should be avoided as much as possible in the neonatal unit and fathers given free access to their infants if they follow appropriate infection control precautions.

Assessing the argumentation ability of pre-service teachers. Case study concerning the chemical dissolution process

The scientific argumentation ability of pre-service teachers (PSTs) in the early stages of education is essential as they will provide students with their initial grounding in the scientific knowledge. A total of 133 pre-service Early Childhood (PSEC) and Primary (PSP) School teachers undertook an argumentation activity concerning how the dissolution process takes place. The design of this activity is as a clear example of the different levels of complexity of the argumentation ability in science. The results show that PSTs consolidated the categories identification of evidence and construction of warrant. However, the abilities to provide a counter-critique and construct a comparative argument are still not consolidated. The Mann-Whitney U test did not show any significant differences between groups with high levels of difficulty. In contrast, we found statistically significant differences for the identification of evidence in favour of PSPs.

PENGEMBANGAN TES HIGHER ORDER THINKING SKILL (HOTS) TENTANG PESAWAT SEDERHANA DI SMP PONTIANAK

This study aimed to produce a Higher Order Thinking Skill (HOTS) test that can be used to measure the higher-order thinking skills of junior high school students. This research is development research that uses the Four-D model. The developed test consists of 25 multiple choice questions which have been validated by two physics education lecturers, FKIP Untan, and three science teachers. The results of the content validation of the validator were 0.903 and analyzed using the Aiken formula. The experiment was conducted on 49 students in the small-scale trial and 163 students from three different schools in the large-scale trial. The results of the experiment show that the HOTS test developed is feasible to use, where the characteristics of the test have high reliability, easy, medium, and high difficulty levels. the readability level is met according to the junior high school level, the index is less than or equal to 6, and the validity is high. The validity of the items shows that there were 22 valid item test questions based on the SPSS application. the reliability of the items was 0.725 based on the KR20 calculation, the index of the difficulty level of the test is easy, medium, and high, and the readability level was 5.25 or fulfilled according to the junior high school level. Based on the characteristics of the HOTS test, researchers obtained test items that can be used to measure higher thinking skills in junior high school students. There were 21 questions out of 25 questions that have been developed.

A Competition-Based Problem-Posing Approach for Nursing Training.

Conventional nursing teaching usually adopts one-way teaching approaches. As such, students cannot think deeply and engage in learning, which results in lower learning motivation and learning achievement. Several studies have indicated that problem-posing is a learning process that has students think about problems and actively construct knowledge, which helps their in-depth thinking and promotes their learning achievement. However, problem-posing is a task with a higher difficulty level; in particular, with insufficient learning motivation, it is not easy for students to pose in-depth questions. Therefore, the present study introduced competition to a problem-posing activity to facilitate students’ motivation. This study adopted a quasi-experimental design and conducted an experiment in the unit of Care of Critically Ill Patients. The results showed that the proposed competition-based problem-posing mobile learning approach could significantly enhance students’ learning achievement and learning motivation and would not cause an excessive cognitive load. Moreover, competition increased students’ learning motivation, and fostered them to actively reflect on and revise their questions, thereby increasing their problem-posing quality and learning achievement. This study can serve as a reference for future clinical practice to enhance the quality and sustainability of apprenticeships.