Intermediate Grade Research Articles

Gender and Intermediate Microeconomics Course Performance: Does Course Type Matter?

This study examines the effects of gender on performance for students taking one of two different intermediate microeconomics courses: a quantitative, calculus-based course and a non-quantitative, non-calculus-based course. We also assess how gender differences in students’ math and verbal abilities and college achievement affect intermediate microeconomics course grades. Our results indicate gender is not a significant indicator of intermediate microeconomics course performance. Math SAT scores and principles of microeconomics course grades are significant predictors of performance for non-quantitative course students only. Cumulative GPAs have strong, positive correlations with grades for students in both course types. These findings have implications for students’ economics major selection and are positive in the context of closing the gender gap in economics degree attainment. JEL Codes: A20, A22

فاعلية برنامج GeoGebra في تحصيل مادة الرياضيات لدى طالبات الصف الأول المتوسط

The current research aims to identify the effectiveness of the GeoGebra program in the achievement of mathematics among middle first graders. For the purpose of verifying the objective of the research, the following null hypothesis was formulated: There is no statistically significant difference at the level of (0.05) between the average scores of the female students of the experimental group studying using the geogra program and the average scores of the female students of the control group studying in the usual way in the achievement test. The researcher used experimental design with partial control for the two equal groups,which includes two groups. The research sample consisted of (80) female students who were distributed equally between the two groups. The two groups were rewarded in variables (chronological age, intelligence, previous achievement). The researcher also adjusted extraneous variables such as the confidentiality of the experiment and processes related to maturity and experimental extinction. The researcher identified the scientific material represented in chapters (5 , 6) of the mathematics textbook for the first intermediate grade (I 3 of 2018 ) The researcher formulated behavioral goals for the scientific material, which reached (116) behavioral goals. She also prepared a teaching plan for the experimental group and a teaching plan for the control group. With regard to research tools, the researcher has prepared a post-acquisition test where (25) items were drafted for the achievement test (MCQ) for middle first grade students, and they were Answering the test according to four alternatives ( one true and three false ) , and the face validity of it was calculated by presenting it to a group of experienced and competent arbitrators. Reliability was calculated using the Kuder-Regardson equation (20) and calculating the coefficient of difficulty and its discernment and the effectiveness of the wrong alternatives for all items . The experiment was applied in the second course of the academic year (2022-2023) to the research sample of middle first grade students, where the researcher taught the two research groups, and after the end of the experiment, the results were analyzed statistically using the T-test for two independent samples. The results outperformed the experimental group taught using Geogbra software on control group students who studied in the normal way on the achievement test. Keywords: GeoGebra, achievement , Mathematics

المحاكمة العقلية لدى طلبة مدارس المتميزين واقرانهم العاديين

(mental judgment among distinguished school students and their ordinary peers) 1- The mental trial of the distinguished school students and their ordinary peers 2- Significance of differences in mental trial among students of distinguished schools and their ordinary peers according to the variables of gender (male - female), grade (second - fifth) and school (distinguished - normal) current research may be limited to students of the second intermediate grade and the fifth preparatory grade in the schools of the distinguished and their ordinary peers of the General Directorate of Diwaniyah Education for the year (2021-2022). To achieve the objectives of the research, the researcher took: 1- The researcher adopted the mental trial scale (Ibrahim 2020), which is based on the theory of Sternberg 1990 (Sternberg) and it was in the form of verbal attitudes distributed over (7) domains, and the scale was corrupted in its final form and after completing the psychometric properties: Honesty (apparent honesty / construction honesty) and stability (Alpha - Cronbach equation) includes (26) positions To complement this, the researcher applied the two scales to a sample of (650) students in the schools affiliated to the General Directorate of Education for Qadisiyah, which were chosen by the stratified random method according to the proportional method. After collecting and processing data statistically using the Statistical Portfolio for Social Sciences (SPSS), the research reached a number of results, including: 1- All coping strategies were statistically significant among the distinguished school students and their peers and normal peers, except for the emotional control and control strategy. 2- The differences in coping strategies were not statistically significant between the variable of the school (distinguished - normal), while it was a function between the variable of gender towards females, as well as the grade was a function towards the fifth grade 3- An indication of the distinction of middle school students, whether in regular schools or schools of excellence in mental trial 4- There are statistically significant differences in the mental trial between the gender variable towards females, as well as between the grade variable towards the fifth grade, while these differences were not statistically significant between the school variable Key words: mental judgment among distinguished school students and their ordinary peers

فاعلية برنامج GeoGebra في تحصيل مادة الرياضيات لدى طالبات الصف الأول المتوسط

The current research aims to identify the effectiveness of the GeoGebra program in the achievement of mathematics among middle first graders. For the purpose of verifying the objective of the research, the following null hypothesis was formulated: There is no statistically significant difference at the level of (0.05) between the average scores of the female students of the experimental group studying using the geogra program and the average scores of the female students of the control group studying in the usual way in the achievement test. The researcher used experimental design with partial control for the two equal groups,which includes two groups. The research sample consisted of (80) female students who were distributed equally between the two groups. The two groups were rewarded in variables (chronological age, intelligence, previous achievement). The researcher also adjusted extraneous variables such as the confidentiality of the experiment and processes related to maturity and experimental extinction. The researcher identified the scientific material represented in chapters (5 , 6) of the mathematics textbook for the first intermediate grade (I 3 of 2018 ) The researcher formulated behavioral goals for the scientific material, which reached (116) behavioral goals. She also prepared a teaching plan for the experimental group and a teaching plan for the control group. With regard to research tools, the researcher has prepared a post-acquisition test where (25) items were drafted for the achievement test (MCQ) for middle first grade students, and they were Answering the test according to four alternatives ( one true and three false ) , and the face validity of it was calculated by presenting it to a group of experienced and competent arbitrators. Reliability was calculated using the Kuder-Regardson equation (20) and calculating the coefficient of difficulty and its discernment and the effectiveness of the wrong alternatives for all items . The experiment was applied in the second course of the academic year (2022-2023) to the research sample of middle first grade students, where the researcher taught the two research groups, and after the end of the experiment, the results were analyzed statistically using the T-test for two independent samples. The results outperformed the experimental group taught using Geogbra software on control group students who studied in the normal way on the achievement test. Keywords: GeoGebra, achievement , Mathematics

Activity and Event-Free Survival in Intermediate Grade Non-Hodgkin's Lymphoma Treated with Chemoimmunotherapy Utilizing Single Dose Intravenous Methylprednisolone in Lieu of Oral Prednisone

Schein et al first noted that patients with intermediate grade lymphoma treated with combination chemotherapy leading to complete response lasting 24 months were likely to remain relapse-free (Schein, Chabner, Canellos, Young, Berard, DeVita,1975). Subsequent changes in that original C-MOPP regimen have included the use of anthracyclines and rituximab. The University of Iowa/Mayo Clinic Molecular Epidemiology Resource and the Groupe d'Etude des Lymphomes de l'Adulte (GELA) program found that patients with diffuse large B-cell lymphoma achieving event-free status at 24 months with chemoimmunotherapy have subsequent overall survival equivalent to that of the general population (Maurer, 2014). While Rituximab, Cyclophosphamide, Hydroxydaunorubicin [doxorubicin], Oncovin [vincristine] and Prednisone (RCHOP) has served as the reference therapy for intermediate grade non-Hodgkin's lymphoma for two decades (Coiffier, 2002; Pfreundschuh, 2006), oral prednisone given daily for 5 days is problematic for individuals with underlying medical conditions such as diabetes, sleep or psychiatric disorders, or gastrointestinal symptoms. In this retrospective study between January, 2007 and March, 2023, 33 patients with intermediate grade Non-Hodgkin's Lymphoma, (26 with Diffuse Large B-cell subtype, 6 with follicular grade III, 1 with T-cell Immunoblastic) received Methylprednisolone 125 mg intravenously on day 1 instead of oral prednisone for 5 days as part of anthracycline-based treatment that consisted of rituximab 375 mg/m2, cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, and vincristine 2 mg (total dose) all given intravenously on day 1 with peg-filgastrim 6 mg subcutaneously on day 2 every 21 days. Three patients received mitoxantrone 12 mg/m2 intravenously on day 1 instead of doxorubicin. Patient characteristics: 23 males/10 females, median age-55 (range: 24-85), stages: IV (17 patients), III (4 patients), II (12 patients), B symptoms (16), subtypes: non-germinal center (13), germinal center (12), diffuse B-cell NOS (1), follicular grade III (6), T-cell Immunoblastic (1). Median cycles received (range): 6 (5-8). No patients required dose reduction or omission of methylprednisolone. Complete responses (determined by PET/CT) occurred in 26 (81%). 1 additional patient was PET negative but was lost to follow-up and is not counted as CR here. Three patients having PR after chemoimmunotherapy were converted to CR after involved site radiation. Two other patients achieved only short-lived PR. One patient is too early to evaluate. The median event-free survival has not been reached at 24.8+ months. Median overall survival exceeds 32.6+ months. Chemoimmunotherapy with the substitution of intravenous methylprednisolone on day 1 in place of 5 days of oral prednisone displays activity in intermediate-grade non-Hodgkin lymphoma and event-free survival beyond 24 months.

Pan-sarcoma database (PSDB): A model-view-controller framework application utilizing REDCap, shiny, and R to create a continuous pipeline of sarcoma data that can inform the care of current patients.

589 Background: Sarcomas are a rare group of mesenchymal malignancies arising soft tissue and bone, often requiring multidisciplinary care. The Pan-Sarcoma Database (PSDB) is an innovative open-source research application developed to efficiently collect and manage data on sarcoma patients to create a reliable research pipeline by funneling data from multiple sources. This process can be customized to fit other institutions and can be used to explore disparities and improve quality for cancer patients. We will share our data structure, process, and code as an adaptable framework for other multidisciplinary research groups with overlapping patients. Methods: The Model-View-Controller (MVC) framework is a software design pattern used by many modern applications. In this framework, "model" is the database, including the structure and metadata; "view" is the user interface software; "controller" is the coding language used to handle user input, update the model, and interact with the viewer. PSDB uses REDCap, shiny, and R, respectively. We integrated relational database concepts in our design, such as normalization, and utilized standards from Clinical Data Interchange Standards Consortium (CDISC). The database is comprised of 290 data fields to capture demographics, survival data, initial HPI, pathology, stage, grade, detailed location, detailed progression history, and associated treatment data. Results: We captured data from 28,380 candidate sarcoma patients from 2010 to present, including 3,291 confirmed cases, with 751 cases reviewed to date, merging data from multiple databases, pathology, and prior projects. Currently, 30.6% of our cases are metastatic at diagnosis; 57.7% are High grade, 28.9% are Intermediate grade, and 8.9% low grade; the median age at diagnosis is 55; 93.5% of reviewed cases received systemic therapy and 73.1% received radiation. By capturing key data and organizing an open-source code base in R mapped to our “model”, we produced updating tables, statistics, time-to-endpoint analyses, and other modifiable outputs to identify outcome disparities. Conclusions: The PSDB successfully addresses the unique data challenges faced in sarcoma research group. The use of the MVC framework with REDCap, shiny, and R, enabled the creation of an application that is secure, user-friendly, and adaptable, supporting collaborative research efforts. This project also emphasizes the importance of employing appropriate tools for data management and encourages similar initiatives to enhance collaboration and benefit both research teams and the patients they study. Furthermore, because it is open-source it can be used and modified by other research teams to improve the quality of care for cancer patients.

Individualized assessment of brain Aβ deposition with fMRI using deep learning.

PET-based Alzheimer's disease (AD) assessment has many limitations in large-scale screening. Non-invasive techniques such as resting-state functional magnetic resonance imaging (rs-fMRI) have been proven valuable in early AD diagnosis. This study investigated feasibility of using rs-fMRI, especially functional connectivity (FC), for individualized assessment of brain amyloid-β deposition derived from PET. We designed a Graph Convolutional Networks (GCNs) and random forest (RF) based integrated framework for using rs-fMRI-derived multi-level FC networks to predict amyloid-β PET patterns with the OASIS-3 (N = 258) and ADNI-2 (N = 291) datasets. Our method achieved satisfactory accuracy not only in Aβ-PET grade classification (for negative, intermediate, and positive grades, with accuracy in the three-class classification as 62.8% and 64.3% on two datasets, respectively), but also in prediction of whole-brain region-level Aβ-PET standard uptake value ratios (SUVRs) (with the mean square errors as 0.039 and 0.074 for two datasets, respectively). Model interpretability examination also revealed the contributive role of the limbic network. This study demonstrated high feasibility and reproducibility of using low-cost, more accessible magnetic resonance imaging (MRI) to approximate PET-based diagnosis.

A CT-based radiomics classification model for the prediction of histological type and tumour grade in retroperitoneal sarcoma (RADSARC-R): a retrospective multicohort analysis

Retroperitoneal sarcomas are tumours with a poor prognosis. Upfront characterisation of the tumour is difficult, and under-grading is common. Radiomics has the potential to non-invasively characterise the so-called radiological phenotype of tumours. We aimed to develop and independently validate a CT-based radiomics classification model for the prediction of histological type and grade in retroperitoneal leiomyosarcoma and liposarcoma. A retrospective discovery cohort was collated at our centre (Royal Marsden Hospital, London, UK) and an independent validation cohort comprising patients recruited in the phase 3 STRASS study of neoadjuvant radiotherapy in retroperitoneal sarcoma. Patients aged older than 18 years with confirmed primary leiomyosarcoma or liposarcoma proceeding to surgical resection with available contrast-enhanced CT scans were included. Using the discovery dataset, a CT-based radiomics workflow was developed, including manual delineation, sub-segmentation, feature extraction, and predictive model building. Separate probabilistic classifiers for the prediction of histological type and low versus intermediate or high grade tumour types were built and tested. Independent validation was then performed. The primary objective of the study was to develop radiomic classification models for the prediction of retroperitoneal leiomyosarcoma and liposarcoma type and histological grade. 170 patients recruited between Oct 30, 2016, and Dec 23, 2020, were eligible in the discovery cohort and 89 patients recruited between Jan 18, 2012, and April 10, 2017, were eligible in the validation cohort. In the discovery cohort, the median age was 63 years (range 27-89), with 83 (49%) female and 87 (51%) male patients. In the validation cohort, median age was 59 years (range 33-77), with 46 (52%) female and 43 (48%) male patients. The highest performing model for the prediction of histological type had an area under the receiver operator curve (AUROC) of 0·928 on validation, based on a feature set of radiomics and approximate radiomic volume fraction. The highest performing model for the prediction of histological grade had an AUROC of 0·882 on validation, based on a radiomics feature set. Our validated radiomics model can predict the histological type and grade of retroperitoneal sarcomas with excellent performance. This could have important implications for improving diagnosis and risk stratification in retroperitoneal sarcomas. Wellcome Trust, European Organisation for Research and Treatment of Cancer-Soft Tissue and Bone Sarcoma Group, the National Institutes for Health, and the National Institute for Health and Care Research Biomedical Research Centre at The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research.

Pure Foamy Gland Carcinoma of Prostate - A Series of Rare Cases

Foamy gland carcinoma (FGC) is a distinct histological variant of prostatic acinar adenocarcinomas. It was first described by Epstein and Nelson in 1996. It is characterized by abundant xanthomatous cytoplasm, pyknotic nuclei, and intermediate Gleason grade. However, FGC with a high Gleason grade exists. FGC is found admixed with conventional acinar adenocarcinoma in 17 to 22% of needle biopsies and 13 to 22% of radical prostatectomy specimens and only rarely found in pure form. We report six cases of pure foamy gland carcinoma of prostate. The mean age in our study was 62.83 years and 5 out of the 6 cases presented with an elevated serum PSA level. Histopathological examination of our cases showed tumor cells with abundant foamy cytoplasm and low nucleo-cytoplasmic ratio. This deceptively benign-looking morphology can mimic nonneoplastic prostatic glands, Cowper’s gland, mucinous metaplasia, and xanthomatous prostatitis and hence often pose diagnostic challenges, especially in core needle biopsies. PNI was detected in two of our cases. PSA and AMACR staining was positive in all our cases (100%). p63 Staining was negative in all four cases where it was performed. Three, two, and one of our cases had a Gleason score of 7, 8, and 6 respectively. The prognosis depends on the Gleason score and the presence or absence of PNI or extraprostatic extension. Three of the cases presented with bony metastasis. We report this case series in view of the rarity and also to raise awareness of this entity which is often missed on small biopsies. Keywords: Foamy gland carcinoma, Gleason score, Prostate

A large hemangioma of the breast influencing the management of breast cancer

Introduction: Hemangiomas are a rare welldemarcated proliferation of mature blood vessels lined by a single layer of endothelial cells occurring in up to 1.3% of mastectomy specimens. Accurate diagnosis often requires the incorporation of clinical, radiological, and histological features. Case Report: A 61-year-old female presented with a self-detected right breast lesion. Initial work-up revealed a right breast lesion at 12 o’clock with core biopsy confirming intermediate grade ductal carcinoma in situ. The management was complicated by the presence of a large right chest wall congenital cavernous hemangioma. Wide local excision of the breast lesion was performed with no sentinel lymph node biopsy done due to extensive vascular malformation. Further excision of margins was required to achieve surgical clearance. Conclusion: Despite its rarity, clinicians should be aware of the potential occurrence of a hemangioma on the breast and potential implications for the surgical management of breast cancer.

Supplemental Material for Fraction Arithmetic Development: An Examination of Students’ Patterns of Growth and Errors Across the Intermediate Grades

Supplemental Material for Fraction Arithmetic Development: An Examination of Students’ Patterns of Growth and Errors Across the Intermediate Grades

Intraoperative ultrasound-assisted endoscopic treatment of primary intermediate and high-grade vesicoureteral reflux in children in a long-term follow-up

Endoscopic treatment of vesicoureteral reflux (VUR) is an important minimally invasive surgical approach in patients undergoing surgical treatment of VUR. In our past experience, we observed that a bulking agent mound sagittal diameter of 10mm is the main predictor of effectiveness of the procedure. Moreover we noticed that the use of intraoperative ultrasound, allows the surgeon to better identify the site, volume and shape of the bulking agent injected, finally reducing operative time. We aimed to evaluate if the intraoperative ultrasound assistance could definitively improve effectiveness of the endoscopic procedure. We retrospectively compared two series treated with endoscopic procedures for intermediate and high grade primary VUR, respectively without (series A) and with (series B) intraoperative ultrasound (IO-US). In all patients VCUG was performed to assess VUR grade and to verify resolution or VUR downgrading during the follow-up. A total of 177 ureteric units were treated. Endoscopic procedures globally were effective in 68/96 ureters (70.8%) in series A and in 68/81 ureters (83.9%) in series B. No significant differences in effectiveness were observed comparing the series with regard to VUR grades, but a significant difference is shown (p<0.05) when grouping grades III-V VUR. No significance in differences of volume injected were detected, but operative time was significantly lower in series B (27.5min vs 19.6min, p<0.05). Mean sagittal mound diameter measured during cystoscopy in series B was 10.45mm (range 8.5-14.2mm). The intraoperative ultrasound assistance during endoscopic treatment of VUR could represent a valid tool for surgeons to better identify location, volume and shape of the bulking agent. Furthermore, the use of an objective parameter of evaluation of the implant can overcome the subjective intraoperative evaluation of the implant itself, improving results for experienced surgeons and reducing the learning-curve for inexperienced ones. Results of endoscopic injection of bulking-agent can be improved with intraoperative ultrasound, allowing at the same time a significant reduction of operative time.

The Weakness of Iraqi Islamic High Schools Students During Reading Comprehension Activities in English , the Reasons and Remedies , Intermediate Grade as a Model

This study aims at figuring out The weakness of Islamic High Schools Students in Iraq during reading comprehension activities in English as a foreign language, The Reasons and Remedies, intermediate stage as a model”. The study examines the effect of teachers' variables (gender, qualification, and years of experience), In order to achieve the objectives of the study, the researcher developed a data collection instrument: a questionnaire developed in English for the teachers. It consisted of two parts. The first one is demographic questions and the second consisted from 14 questions. The researcher conducted this study on the intermediate stage students who are learning English as a foreign language and their teachers of English of Islamic High School in Iraq by using a stratified random sample. The whole population consisted of (140) teachers, (68) males and (72) females. The results of the present study showed that reading difficulties faced by students in learning English resulting from students' reading behaviors were high. In addition, the content (textbook), teaching aids and teaching methods had a significant effect on the reading difficulties. In the light of the findings of the study, the researcher recommended holding training courses for the teachers to provide them with sufficient experience to teach their students the reading skill in the right way besides Attention distraction, lack of motivation, difficulty in academic content, feeling of making mistakes in front of colleagues, lack of a library concerned in English language in the school and lack of resources in the English language, insufficient time to read during the lesson , their speed of reading is very slow, their efficiency in understanding the meaning of a text is very poor and there are other reasons mentioned in this study. .

Neuroepithelial tumor with EWSR1::PATZ1 fusion: A literature review.

We present the clinicopathological and molecular genetic characteristics of a neuroepithelial tumor (NET), EWSR1::PATZ1 fusion-positive with a literature review. This fusion has recently been discovered in rare central nervous system tumors and soft tissue sarcomas and was not included in the fifth edition of the WHO classifications. We identified this fusion in 2 NETs. The first case involved a 7-year-old girl and the second case occurred in a 53-year-old man; both presented with headaches and vomiting. The pediatric case initially showed an intermediate grade of the tumor, but upon recurrences, it transformed into a high-grade tumor with 2 relapses in 8.3 years. This case exhibited high mitotic activity (20/10 high-power fields), and a high Ki-67 index (21%). The TERT promoter (TERTp) mutation was present in both initial and recurrent tumors. In contrast, the adult case was a low-grade tumor with no mitotic activity or recurrence over 13.5 months after subtotal resection and gamma knife surgery. Interestingly, the pediatric case demonstrated a longer survival time compared to conventional glioblastoma. The TERTp mutation, similar to being a molecular signature in adult-type glioblastoma, could also be an indicator of high-grade behavior in PATZ1 fusion NET.

Prognostic Impact of AGR3 Protein Expression in Breast Cancer: A Systematic Review and Meta-analysis.

To investigate the clinicopathological significance and prognosis of the expression of the anterior gradient 3 (AGR3) protein in women with breast cancer. The PubMed, CINAHL, EMBASE, Scopus, and Web of Science databases were searched for studies published in English and without restrictions regarding the year of publication. The search terms were: breast cancer AND anterior gradient 3 OR AGR3 expression. We included observational or interventional studies, studies on AGR3 protein expression by immunohistochemistry, and studies on invasive breast cancer. Case reports, studies with animals, and reviews were excluded. In total, 4 studies were included, containing 713 cases of breast cancer. Data were extracted on clinicopathological characteristics and survival. A meta-analysis of the prevalence of AGR3 expression was performed according to the clinicopathological characteristics, hazard ratios (HRs), and overall survival and disease-free survival. The expression of AGR3 was found in 62% of the cases, and it was associated with histological grade II, positivity of estrogen and progesterone receptors, low expression of ki67, recurrence or distant metastasis, and lumen subtypes. In patients with low and intermediate histological grades, AGR3 expression was associated with worse overall survival (HR: 2.39; 95% confidence interval [95%CI]: 0.628-4.159; p = 0.008) and worse disease-free survival (HR: 3.856; 95%CI: 1.026-6.686; p = 0.008). The AGR3 protein may be a biomarker for the early detection of breast cancer and predict prognosis in luminal subtypes. In addition, in patients with low and intermediate histological grades, AGR3 protein expression may indicate an unfavorable prognosis in relation to survival.

The effect of using the Beggs model on developing reading comprehension among second grade intermediate students in Literature and Texts

The study aimed to identify the effect of using the Bigs model on developing reading comprehension among second grade intermediate students in Literature and Texts The researcher put the following two zero hypotheses: 1- There are statistically significant differences at the level of significance (0.05) between the average scores of the two experimental groups that studied according to the Beggs program and reading comprehension, and the average scores of the students of the control group that studied in the traditional way in the achievement of literature and texts for the second intermediate grade. 2- There is a statistically significant difference at the level of significance (0.05) between the average scores of the experimental group that studied using the Pages program and reading comprehension and the average scores of the students of the control group that studied in the traditional way in the subject of literature and texts for the second intermediate grade, as the following research included students preparatory stages; For day schools affiliated to the Directorate of Education of Salah al-Din / Department of Education of Tikrit (the center) for the academic year 2022-2023, where the researcher chose two schools located in the same residential block as a place for his experiment containing three divisions, and after the researcher visited the two schools, he chose Division (A) of Al-Tawhid Secondary School for Boys To represent the experimental group to be taught using the Beggs model and it consisted of 36 students and Division (B) from Al-Mazm Secondary School for Boys to represent the control group to be taught in the traditional way and consisted of 39 students. The preliminary form consists of 40 paragraphs, and in front of each paragraph there are four alternatives. And he extracted the virtual truthfulness by presenting it to a group of experts and specialists with specialization, where 4 paragraphs were modified and two paragraphs were deleted, so the scale became containing 38 items.

The Effect of Using Flipped Classrooms Based on Gamification in Developing Self-regulated Learning Skills and Educational Resilience among Third-intermediate Students in English Language

This research examined the effect of flipped classrooms based on gamification on developing self-regulated learning skills and educational resilience among students of intermediate schools in English language. The research sample included (90) students in the third intermediate grade who were selected from three schools in Jeddah, and they were distributed into three groups, with (30) students in each group. A quasi-experimental design was used to study the effect of using flipped classrooms based on gamification on self-regulated learning skills and educational resilience. The researcher developed a measure for self-regulated learning skills that included (28) phrases distributed over (4) axes, namely: goal setting, planning, monitoring, recitation and memorization, and requesting social assistance. An educational resilience scale was also developed consisting of (30) phrases distributed on (6) axes, namely: flexibility, facing challenges, personal competence, social support, and values. The research experiment was applied for two consecutive weeks in the second semester of the academic year 2021/2022. The research resulted in the development of a motivational design for the flipped classrooms based on (4) motivational elements, namely points, badges, levels, and leaderboards. The research recommended the need to expand the use of flipped classrooms based on gamification and to train teachers to use this strategy. Keywords: Flipped Classroom, Gamification, Self-regulated Learning Skills, Educational Resilience.

Clinical Outcomes and Patterns of Failure in Patients with High-Risk Atypical Meningioma Treated with Single Fraction vs. Hypofractionated Gamma Knife Radiosurgery

The recently completed RTOG 0539 supports fractionated radiation therapy for patients categorized as having intermediate (3 yr PFS 93.8%) or high-risk (3 yr LC 68.9%) meningiomas. Stereotactic radiosurgery (SRS) has not been widely established in the treatment of WHO grade 2 atypical meningiomas given concern that there is a greater risk of microscopic infiltration and therefore requires larger margins than safely achievable with SRS. We look to review a consecutive cohort of patients at our institution who have been diagnosed with atypical meningioma treated with either single fraction Gamma Knife SRS (GK-sfSRS) or hypofractionated Gamma Knife SRS (GK-hfSRS). We review both control rates and patterns of failure. Patients diagnosed with intermediate or high-risk WHO grade 2 meningioma per RTOG 0539 classification, without a history of prior radiation (RT) and treated with either GK-sfSRS or GK-hfSRS between 2014 to 2021 at our institution, were included. Patient charts were reviewed, and follow-up data were analyzed for local control (LC) and failure patterns. Local failure was defined as tumor recurrence within the prescription isodose line, marginal was ≤5 mm outside the prescription isodose line, and distant was >5 mm outside of the prescription isodose line Primary outcome was LC, and secondary outcomes were overall survival (OS) and progression free survival (PFS). We identified 47 pathologically confirmed WHO grade 2 meningiomas in 27 patients. 33 lesions were treated with GK-sfSRS and 14 lesions with GK-hfSRS. 6 lesions were intermediate risk, and 41 were high-risk per RTOG 0539. With a median follow up of 36 months (range 2-86 mo), the 3yr LC was 82.7%, PFS was 83.1%, and OS was 96.3%. A total of 4 patients with 8 lesions failed treatment - all with high-risk disease. All failures were local (4) or marginal (4). The 4 local failures were all from a single patient with 4 distinct meningiomas that were treated with GK-sfSRS without surgical resection. The 4 marginal failures were all in patients treated with GK-sfSRS. There were no failures in patients treated with GK-hfSRS. Our institutional data for patients with atypical meningiomas treated with radiosurgical techniques compare favorably to the patients treated with EBRT in RTOG 0539, though longer follow-up is needed to confirm these findings. Outside of one patient, no patients developed recurrence within the prescription volume. There were 4 tumors with marginal failures, suggesting that additional dural margins than what were prescribed may be meaningful. At our institution, we are increasingly moving to hypofractionated radiosurgery with 5 mm of dural margin when using radiosurgical techniques for high-risk atypical meningioma. However, longer term follow-up is needed to validate the use of radiosurgical techniques in atypical meningioma.

Meta-Analysis of Five Fraction Preoperative Radiotherapy for Soft Tissue Sarcoma

There is increasing interest in shorter courses of radiation therapy (RT) in the management of soft tissue sarcoma (STS). Studies investigating preoperative ultra-hypofractionated 5-fraction RT for STS are few and often limited to single institution experiences with less than 50 patients. We therefore performed a meta-analysis to determine the efficacy and safety of preoperative 5-fraction RT for STS based on currently published literature, with an analysis evaluating effects of dose delivered. This study level meta-analysis was conducted using Bayesian methods. Statistical estimation for risk of outcome rates were conducted by posterior mean and 95% highest posterior density (HPD) intervals. Studies with two-year local control (LC) and description of major wound complications (MWC) per the CAN-NCIC-SR2 study were included in this meta-analysis, and these served as the primary endpoints. Secondary endpoints included rates of acute and late toxicity. A total of ten studies were identified; seven met inclusion criteria (Kalbasi 2020, Kubicek 2021, Leite 2021, Spalek 2021, Gobo Silva 2021, Bedi 2022, Mayo 2022). Three studies (Kosela-Paterczyk 2014, Kosela-Paterczyk 2021, Potkrajcic 2021) did not include adequate information to accurately determine 2-year LC or MWC. Subgroup analyses were performed for ≥30 Gy vs <30 Gy as the EQD2 of 30 Gy in 5 fractions for an α/β of 3-4 is 50-54 Gy, equivalent to standard preoperative RT fractionation. A total of 208 patients were included from seven studies. Five studies used ≥30 Gy (n = 144) and 2 studies <30 Gy (n = 64). The median follow-up was 29 months (range: 21-57). Primary tumor location was lower extremity in 68%, upper extremity in 22%, and trunk in 10%. In studies with available information, most tumors were intermediate (27%, 46/169) or high grade (67%, 114/169) and 50% (79/158) were >10 cm. Two-year LC for the entire cohort was 96.9% (95% HPD: 0.9374-0.9889) and the rate of MWC was 30.6% (95% HPD: 0.2106-0.4149). Acute grade 2 and 3 dermatitis was seen in 12.7% and 2.2%, respectively. Late grade 2 toxicities included fibrosis (11.1%), stiffness (6.0%), and lymphedema (4.0%) and late grade 3 toxicities included fibrosis (1.8%) and stiffness (0.4%). Grade 4 toxicity was rare and included fibrosis (0.6%) and stiffness (0.6%). There was a trend toward improved LC with ≥ 30 Gy (95% HPD: 0.949-0.997 vs 0.838-0.986). There was no difference in MWC (95% HPD: 0.185-0.420 vs 0.172-0.553) or late toxicity between the two groups. Acute grade 3 dermatitis was seen less frequently with regimens <30 Gy (95% HPD: 0-0 vs 0.009-0.072), however rare overall. Preoperative 5-fraction RT for STS demonstrates excellent 2-year LC with MWC and toxicity similar to standard fractionation preoperative RT. Multi-institutional trials with a universal RT protocol and larger sample size are warranted to assess this novel treatment paradigm.

Geochemical and mineralogical analysis of the Upper Cretaceous dolomitic phosphates at Queih Mine, Quseir, Central Eastern Desert, Egypt: depositional environment implications and pollution indices

Soon for the security of phosphorus world supply, which comes primarily from non-renewable sources, the moderate carbonate phosphates will need further geochemical multidiscipline investigations to participate in the phosphorous supply chains necessary to increase human productivity. Dolomitic phosphates represented the main carbonate phosphate rocks of the Upper Member of Duwi Formation, at Um Queih Mine, South-Western Quseir, that phosphate can be classified as intermediate grade phosphate ore. It was enriched in V, Ni, Mo, U, Cu, Cr, Cd, Co as well as Zn and their ratios indicated that the deposition occurred in anoxic environment (reducing conditions). Mineralogical investigations indicated that the studied phosphorites are composed of two main mineral phases; fluorapatite and non-phosphatic minerals (dolomite, calcite, pyrite, gypsum, and quartz). The petrographic examination revealed that these phosphorites are composed of phosphatic lithoclasts, phosphatic bioclasts, opaques, and quartz grains embedded in a cryptocrystalline phosphatic matrix. The parent rocks of the studied phosphorites represented by basaltic mafic provenance were affected by low chemical weathering and deposited under marine anoxic environment. The mineralogical and geochemical characteristics indicated that the studied phosphorites deposited in marine anoxic condition. The weathering of these rocks can be harmful to the surrounding environment owing to its content of pyrite and potentially toxic elements (PTEs), the EF (enrichment factor) gives extremely high enriched with Mo, Cd, and Se.