Low Grade Research Articles

Spent Lithium-Ion Battery Recycling Using Flotation Technology: Effect of Material Heterogeneity on Separation Performance

In this study, two types of recycling scenarios are assessed for spent battery materials using froth flotation. The first is for a single cathode chemistry and would be considered as the most likely scenario for a large battery manufacturer, who takes back their own batteries for reprocessing. The second scenario is for mixed cathode chemistry, and this would be the most likely scenario for regional reprocessing. The mixed spent battery materials assessed in this work were sourced from such an industrial recycling operation in Australia. Good results were obtained for both recycling scenarios. The anode recovery and anode grade in the final concentrate for both materials evaluated were for the single spent battery material 80.1% and 90.3%, respectively, and for the mixed spent battery material, 77.4% and 82.0%, respectively. For the final tailings, the cathode grades for both materials tested were 93.9% and 87.1%, respectively, with the lower grade for the mixed spent battery attributed to the high content of impurities in the original material. These results highlight the importance of the preprocessing ahead of the flotation process. The results confirm froth flotation as a feasible technique that can be used to achieve the bulk of the separation.

Temperature-sensitive fragrance-releasing polymeric microcapsules

This research aimed to control release of fragrance using thermally-actuated microcapsules so that the release rate shows a considerable change at a certain temperature. Accordingly, four different polymers, namely, two grades of poly(methyl methacrylate) having different molecular weight as well as two poly[(methyl methacrylate)–co-(2-ethylhexyl acrylate)] copolymers, which were synthesized in this work, were designated as capsules’ shell. Number-average molecular weight of the copolymers and one of the two used PMMA grades was in the range of 47 to 56 kDa while that of the other PMMA grade was 344 kDa. Furthermore, Tg of the lower molecular weight grade PMMA and the two copolymers was determined as 119.3, 72.2 and 66.3 °C, respectively, using DSC experiments. Subsequently, R-Limonene as a model fragrance, was encapsulated by either of the polymers using solvent evaporation method. Effect of various parameters, including molecular weight and Tg of the shell polymer and concentration of emulsifier, on morphological characteristics of the microcapsules were investigated. Using two microscopic techniques, it was observed that increment of molecular weight of shell polymer enhances microcapsules’ size, shell thickness and porosity. Moreover, elevation of emulsifier concentration to a certain value of 1.5 wt% was shown to lessen size and porosity of microcapsules. The fragrance release profiles were determined and fitted to several mathematical models, proving that at least one more mechanism, in addition to diffusion, is involved in the release, which was attributed to capillary effects in the shell pores. Moreover, a pronounced increase in release rate upon elevation of temperature from 5 to 15 °C was observed for either of the copolymer shells. The effect was ascribed to remarkable strengthening of segmental mobility of the copolymers due to elevation of temperature and can be regarded as a promising way for the fabrication of smart microcapsules capable of thermal controlling fragrance release.

Clinical efficacy and safety of the self-developed Zangsiwei Qingfei Mixture combined with conventional treatment in patients with acute exacerbation of chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is a significant global public health issue. Modern medical treatments have both benefits and limitations, prompting increasing attention from scholars worldwide on traditional ethnic medicine, and the Zangsiwei Qingfei Mixture is a newly developed formula derived from the effective components of classical Tibetan medicine to treat chronic respiratory diseases. This study aims to investigate the clinical efficacy and safety of the Zangsiwei Qingfei Mixture combined with conventional treatment in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Sixty AECOPD patients admitted to the Second Xiangya Hospital of Central South University from May 2021 to May 2023 were enrolled and randomly divided into 2 groups, with 30 patients in each group. The control group received conventional treatment, including bronchodilators, anti-infection agents, expectorants, and oxygen therapy. The experimental group received the Zangsiwei Qingfei Mixture in addition to conventional treatment. The treatment duration was 7 d for both groups. Baseline data such as gender, age, body mass index (BMI), smoking status, Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, COPD course, and the number of COPD exacerbations in the past year were collected. The primary efficacy indicators were assessed using the modified Medical Research Council (mMRC) dyspnea scale and the modified Borg scale. Secondary indicators included arterial lactic acid (LAC) and serum tumor necrosis factor alpha (TNF-α) levels. Safety indicators included liver and kidney function [alanine transaminase (ALT), aspartate transaminase (AST), serum creatinine (SCr), serum uric acid (SUA)], coagulation function [activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB), and D-dimer]. The generalized linear mixed model (GLMM) was used to evaluate the clinical efficacy and safety of the Zangsiwei Qingfei Mixture. Before treatment, there were no statistically significant differences in general baseline data, grading of mMRC dyspnea scale, score of modified Borg scale, arterial LAC, ALT, AST, SCr, SUA, APTT, FIB, and D-dimer between the 2 groups (all P>0.05). However, serum TNF-α and PT levels in the experimental group were significantly lower than those in the control group (both P<0.05). GLMM analysis showed that after adjusting for pre- and post-treatment, gender, age, BMI, smoking status, GOLD classification, COPD course, and the number of COPD exacerbations in the past year, the experimental group demonstrated significantly lower grading of mMRC dyspnea scale (coefficient=-0.329, P=0.036), score of modified Borg scale (coefficient=-1.077, P=0.001), serum TNF-α level (coefficient=-14.378, P<0.001), and arterial LAC level (coefficient=-0.409, P=0.012) compared to the control group. The Zangsiwei Qingfei Mixture had no significant effect on liver, kidney, or coagulation function indicators (all P>0.05). The Zangsiwei Qingfei Mixture combined with conventional treatment can improve clinical symptoms and promote homeostasis in AECOPD patients, demonstrating safety and reliability. Combining modern medicine with traditional ethnic medicine offers a feasible approach to treating chronic respiratory diseases in the future.

Paternal intelligence affects school grades in children with and without ADHD - a register-based study.

ADHD profoundly impacts educational attainment, quality of life, and health in young adults. However, certain subgroups of ADHD patients seem to do quite well, potentially due to differences in intelligence and socioeconomic status. Here we used paternal intelligence from the Swedish Defence Conscription and Assessment register, to investigate the role of genetic propensity for intelligence, on school performance in a large cohort of ADHD patients and matched controls. Patients treated for ADHD in Linköping, Sweden between 1995 and 2020 (n = 3262), sex- and age-matched controls (n = 9591) as well as their parents and siblings were identified using regional and national registers. Socioeconomic and demographic data, ADHD diagnosis and treatment and school grades at age 16 for the study population were extracted from Swedish National registers. We explored the associations between paternal intelligence and child school performance using linear mixed models and mediation analyses, taking a wide range of potential covariates into account. Results indicate that paternal intelligence was positively associated with standardized school grades in their offspring (Zadjusted=0.09, 95%CI 0.07, 0.10). This effect was present in both ADHD patients and controls, but ADHD patients had significantly lower standardized grades (Zadjusted=-1.03, 95%CI -1.08, -0.98). Child ADHD did not serve as a mediator for how paternal intelligence affected school grades. Our findings indicate that ADHD prevents children from reaching their academic potential at all levels of paternal intelligence. Increased understanding of the contributions of ADHD, intelligence, and SES to functional outcomes can help clinicians to better personalize interventions to the unique preconditions in each patient.

Analysis of Refractive Error Changes in Elementary School Children under 13 Years of Age before and after COVID-19 Pandemic: A Hospital-Based Study

Purpose: To analyze changes in refractive error among elementary school children under the age of 13 who visited an outpatient clinic for eye examinations before and after the onset of the COVID-19 pandemic.Methods: A retrospective analysis of medical records was conducted to calculate the spherical equivalent refractive error of the right eye for 3,854 children aged 6 to 12 who attended our ophthalmology department from 2016 to 2023. We analyzed the average refractive error and myopia prevalence by year and subsequently performed a subgroup analysis by dividing the children into two age groups: 6-9 years old and 10-12 years old. To provide insight into long-term trends, data from 4,351 subjects aged 6-12 years from the 4th, 5th (2008-2012), and 7th (2016) Korea National Health and Nutrition Examination Surveys were also analyzed for reference.Results: The mean refractive error for subjects visiting our clinic throughout the study period was -1.51 ± 2.12 D. A trend of increasing myopic values in refractive error was observed from 2017 to 2021, with a more substantial change noted in 2020 compared to other years, though not reaching statistical significance. In the subgroup analysis, the change in refractive error for the 6-9-year-old group was more pronounced in 2020 but did not reach statistical significance, and no specific trend was identified in the 10-12-year-old group. Myopia prevalence exhibited a consistent increase since 2019 in the 6-9 age group, with a higher proportion of moderate myopia in 2020 compared to previous years. Conversely, no distinct trend was observed in the 10-12-year-old group.Conclusions: Although statistical significance was not reached, it appears that the increase in indoor activities due to COVID-19 had an impact on the changes in refractive values for elementary school children, especially in the lower grades of elementary school in 2020.

Examining the impact of pair programming on efficiency, motivation, and stress among students of different skills and abilities in lower grades in elementary schools

Examining the impact of pair programming on efficiency, motivation, and stress among students of different skills and abilities in lower grades in elementary schools

Educational outcomes among children with congenital heart disease compared to peers: a Scotland-wide record-linkage study of 715,850 schoolchildren

BackgroundNine in every thousand children born in the United Kingdom have congenital heart disease, and 250,000 adults are living with the condition. This study aims to investigate the associations between congenital heart disease and educational outcomes among school-aged children in Scotland.MethodsRoutine health and education databases were linked to produce a cohort of all singleton children born in Scotland and attending a local authority run primary, secondary, or special school in Scotland at some point between 2009 and 2013. Children with congenital heart disease within this cohort were compared with children unaffected by congenital conditions. Outcomes investigated were special educational need (SEN), absenteeism, exclusion, academic attainment, and unemployment. All analyses were adjusted for sociodemographic and maternity confounders. Absenteeism was investigated as a mediating factor in the associations with attainment and unemployment.ResultsOf the 715,850 children, 6,295 (0.9%) had congenital heart disease and 4,412 (6.1%) had isolated congenital heart disease. Congenital heart disease and isolated congenital heart disease were both significantly associated with subsequent special educational need (OR 3.45, 95% CI 3.26–3.65, p < 0.001 and OR 1.98, 95% CI 1.84–2.13, p < 0.001 respectively), absenteeism (IRR 1.13, 95% CI 1.10–1.16, p < 0.001 and IRR 1.10, 95% CI 1.06–1.13, p < 0.001 respectively), and low academic attainment (OR 1.69, 95% CI 1.39–2.07, p < 0.001 and OR 1.35, 95% CI 1.07–1.69, p = 0.011 respectively). Neither congenital heart disease nor isolated congenital heart disease were associated with school exclusion. Only congenital heart disease (OR 1.21, 95% CI 1.03–1.42, p = 0.022) but not isolated congenital heart disease was associated with unemployment. When days absent were included in the analyses investigating attainment and unemployment, the conclusions were not altered.ConclusionChildren with congenital heart disease have greater special educational need, lower school attendance, attain lower examination grades and have greater unemployment compared to peers. In addition to healthcare support, affected children need educational support to avoid additional impact on their long-term wellbeing.

Can Older Adult Patients with Hip Fractures Have Their Discharge Destination Predicted by Physical Performance Measures?

Background and Objectives: The majority of patients who undergo hip fracture surgery do not recover their former level of physical function; hence, it is essential to establish a specific rehabilitation strategy for maximal functional recovery of patients after a hip fracture. Knowing which indicators of physical function in hip fracture patients have a significant impact on the decision regarding the place or timing of discharge would make it possible to plan and prepare for discharge as soon as possible. Therefore, this study aimed to investigate the relationship between physical function and discharge destination for older adult patients with hip fracture. Materials and Methods: In this retrospective cohort study, 150 hip fracture patients (mean age 78.9 ± 10.6 years) between January 2019 and June 2021 were enrolled. Patients were categorized into two groups according to their discharge destination, either home or facility. Demographic and disease-related characteristic data were collected from the medical records. All the patients completed performance-based physical function tests including the 10 Meter Walk Test (10MWT), Timed Up and Go test (TUG), Koval's grade, and Berg Balance Scale (BBS) at the start of rehabilitation and at discharge. A backward stepwise binary logistic regression analysis was then performed to determine the independent factors of the discharge destination. Results: The home discharge group had a significantly lower Koval's grade, lower TUG, higher BBS both at baseline and discharge, and younger age. Backward stepwise logistic binary regression analysis showed that TUG, BBS, and 10MWT at baseline and discharge were significant variables affecting the discharge destination after hip fracture. Conclusions: These results demonstrate that balance and gait in older adult patients with hip fractures are highly influential factors in the determining the discharge destination.

Development of Flap Book Media Based on the Student Teams Achievement Division Model with the Assistance of Class AKM Efforts to Improve Puppet Figure Material for Lower Grade Students

Development of Flap Book Media Based on the Student Teams Achievement Division Model with the Assistance of Class AKM Efforts to Improve Puppet Figure Material for Lower Grade Students

Relating Consistent Improvement to Overall Performance in a Calculus I Course that Utilizes Standards-Based Grading

In this study, we analyzed student participation and success in a college-level Calculus I course that utilized standards-based grading. By measuring the level to which students participate in this class structure, we were able to use a clustering algorithm that revealed multiple groupings of students that were distinct based on activity throughout the semester. Additionally, we analyzed student progress, defined as the number of graded activities successfully completed each week. We found that students who progressed steadily throughout the semester, and thus had lower variability in the number of completed activities per week, tended to receive a higher overall grade. Students whose progress was less consistent, and thus exhibited higher variability in weekly activities completed, tended to receive a lower grade. Overall, this shows a relationship between understanding the expectations in standards-based grading and succeeding in a course.

Pedagogical Strategies Limitations and Practices Leading to Improved Teacher-Learners’ Classroom Interactions through English in Lower Primary Schools of Rwanda

Strategies employed by teachers and learners in lower primary schools in Rwanda were judged insufficient and ineffective, as learners’ learning performance, especially in rural schools, was still unsatisfactory in examinations set in English. The study aimed to investigate the limitations of the strategies used by teachers and learners in their English classroom interactions and to propose effective practices to enhance teacher-learner interactions in lower primary grades. The constructivism theory guided this study, employing a mixed method with a sequential exploratory research design. The research population consisted of 56,691 people, including 56,125 learners, 449 teachers, and 117 head teachers of primary schools in Musanze District. A sample of 115 respondents, including 109 teachers and six head teachers, were randomly selected. Semi-structured interviews with 18 teachers and 6 school head teachers yielded qualitative data, while 91 teachers completed a written questionnaire, which provided quantitative data. Thematic analysis helped to treat qualitative data, and descriptive statistical analysis by cross-tabulation was utilized in quantitative data cleaning and analysis. Findings revealed that strategies employed in teacher-learner classroom interactions present some limitations to effective teaching and learning through English. Furthermore, various practices, including special preparatory programs in preschool centers, improved methodology for pre- and in-service teachers’ training on the English language, and an emphasis on practical tasks to equip learners with sufficient knowledge and skills to solve school and real-life problems, were suggested. The study recommended the collaboration and cooperation of multiple educational partners during the implementation of the proposed practices. The proposed practices are expected to have a great impact on the journey of re-examining and re-contextualizing teaching and learning in Rwandan schools.

Association of Patient Satisfaction 2 Years After Hip Arthroscopy for Femoroacetabular Impingement Syndrome With Minimum 10-Year Patient-Reported Outcomes and Survivorship

Background: Previous studies have shown that short-term outcomes after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) predict midterm outcomes, but a limited number of studies have evaluated whether short-term outcomes predict long-term outcomes and survivorship. Purpose: To evaluate whether achieving clinically significant outcomes at 2 years after hip arthroscopy for FAIS can predict patient-reported outcomes (PROs) and survivorship at 10 years. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent primary hip arthroscopy for FAIS between June 2012 and December 2012 with a minimum 10-year follow-up were identified. Using previously established thresholds, we classified patients who achieved the 2-year Patient Acceptable Symptom State (PASS) for the visual analog scale (VAS) for satisfaction as the high satisfaction group and patients who did not as the low satisfaction group. Minimum 10-year PROs were then compared between the groups, including scores for the Hip Outcome Score (HOS)–Activities of Daily Living and –Sports Specific, the modified Harris Hip Score, the VAS for pain, and the VAS for satisfaction. Reoperation-free survivorship was compared. Results: Of 120 eligible consecutive patients, 85 patients were included (70.8% follow-up rate), of whom 61.2% were female. The mean age was 34.0 ± 12.8 years, and the mean body mass index was 25.4 ± 4.6. Of the 85 patients, 29 (34.1%) did not achieve PASS for the VAS for satisfaction at 2 years postoperatively compared with 56 (65.9%) who did. The low satisfaction group had significantly worse acetabular chondral grades at the time of surgery (P = .008). At minimum 10-year follow-up, the high satisfaction group showed significantly better HOS-Activities of Daily Living, HOS-Sports Specific, modified Harris Hip Score, VAS pain, and VAS satisfaction scores (P≤ .031). Compared with the low satisfaction group, the high satisfaction group had a significantly lower rate of secondary surgery (1.8% vs 24.1%, respectively; P = .002). Conclusion: Patients who achieved PASS for the VAS for satisfaction at 2 years after hip arthroscopy demonstrated superior minimum 10-year outcomes compared with patients who did not, including greater PRO scores and a higher survivorship rate. The high satisfaction group had lower grade acetabular cartilage damage at the time of surgery compared with those who did not achieve PASS for the VAS for satisfaction at 2 years.

Factors associated with problematic internet use among University of Gondar undergraduate students, Northwest Ethiopia: Structural equation modeling.

For young adults and adolescents, excessive internet use has become a serious public health concern due to its negative impact on their health. It has been associated with detrimental effects on both physical and mental health. Negative academic outcomes were observed in the students, including missing classes, lower grades, and academic dismissal. Therefore, the purpose of the current study was to identify factors associated with PIU among undergraduate students at the University of Gondar. A cross-sectional study was conducted at the University of Gondar among 1514 undergraduate students from June 1-20, 2022. The study participants were selected using a stratified simple random selection procedure. Using structural equation modeling, the degree of relationship was ascertained. A p-value of less than 0.05 and an adjusted regression coefficient with a 95% confidence interval (CI) were used to interpret the data. In our study, being from non-health departments [β = 0.11, 95% CI: 0.037, 0.181], current alcohol use [β = 0.12, 95% CI: 0.061, 0.187], depressive symptoms [β = 0.23, 95% CI: 0.175, 0.291], insomnia symptoms [β = 0.12, 95% CI: 0.060, 0.196], and ADHD symptoms [β = 0.11, 95% CI: 0.049, 0.166] had a significant positive effect on PIU, while having a history of head injury had a significant negative effect [β = -0.12, 95% CI: -0.226, -0.021] on PIU. Factors such as current alcohol use, non-health department type, depressive symptoms, insomnia, and ADHD symptoms were positively associated with PIU. However, a history of head injuries was negatively associated with PIU. Therefore, strategies aimed at the early identification of PIU may lead to an improvement in the psychosocial health of university students.

EPID-07. INCIDENCE OF PAEDIATRIC BRAIN TUMORS IN AN ITALIAN REGIONAL COHORT: AN EPIDEMIOLOGICAL STUDY FROM 2012 TO 2023

Abstract BACKGROUND Central nervous system (CNS) tumors are the most common solid cancer in children, second only to leukaemia. METHODS We conducted a retrospective epidemiological study of primary CNS tumors diagnosed in children up to 16 years of age between 2012 and 2023, in order to estimate the incidence in a regional cohort of 1,2 million inhabitants (Northeastern Italy). Only primitive lesions were enrolled, relapses were excluded. RESULTS Over a period of twelve years, 100 new diagnoses were made (44% Female, 56% Male) with a mean age of 8,92 years (range 0-16 years) at time of onset. In terms of location, we recorded an equal number of supratentorial and subtentorial diagnoses (50% vs 50%). A time-series analysis was performed to verify possible variations in the incidence rate of brain tumors over years, and no significant change was described (R2 0.301, p=0.06). However, after 2017 a significant increase was noted (R2 0.725, p=0.015), as the incidence of new diagnosis quite doubled, from 3.16 in 2018 (95%CI 3.15-3.17) to 5.59 in 2023 (95%CI 5.57-5,61). Data were therefore divided in two groups: 2012-2017 (group 1), and 2018-2023 (group 2). There were no differences in terms of gender or age. The number of low-grade (LG) and high-grade (HG) diagnosis were compared: HG tumors, including high grade glioma, ependymoma and medulloblastoma, were significantly higher in the group 2 than group 1 (27/50, 54% vs 6/43, 14%, p&amp;lt;0.001). CONCLUSIONS In childhood, CNS tumors incidence has been fairly stable in the last twelve years in our regional cohort, but a recent concern of an increased rate of high-grade diseases emerged according to our data. In case of a confirmation of this trend, further analysis will be required in order to understand the reason.

The Influence of Metal Impurities on NiOOH Electrocatalytic Activity in the Oxygen Evolution Reaction

AbstractThe energy transition and the implementation of new electrochemical technologies will result in an increased reliance on critical raw materials for electrodes. Their large‐scale application will ultimately mean working with lower grade materials. Here we study the influence of metal impurities on nickel foam electrocatalysts. We do this by electrodepositing known amounts of first‐row transition metals (Cu, Cr, Mn, Fe, Co and Ni) on nickel foam and studying their performance in the oxygen evolution reaction (OER) as a model reaction. The electrodes’ performance is studied using cyclic voltammetry (CV), linear sweep voltammetry (LSV), Tafel analysis, stepwise chronoamperometry (CA) and electrochemical impedance spectroscopy (EIS). Combining these results with microscopy analysis, we show that even small amounts of transition‐metal impurities have profound effects on the catalytic performance of nickel electrodes. The changes affect the OER onset potential (the energy that the system requires to convert OH– to O2) and the Tafel slope of each electrode (the electrode's initial activity in the OER onset region). Our results highlight the implications of such impurities on electrode design and future large‐scale application.

Process Design for Direct Production of Battery Grade Nickel Sulfate

The clean energy transition has increased the global demand of nickel sulfate used in the Li-ion batteries. A short-term solution is to refine the nickel sulfate product from nickel intermediates. In the long-term, new direct nickel sulfate production technologies are needed. This research focused on the modeling-based concept development of a novel direct hydrometallurgical nickel sulfate process consisting of chemical leaching, impurity removal by precipitation, solvent extraction, and crystallization as an alternative to the conventional nickel sulfate production route via a nickel matte intermediate. The conventional process route with the studied nickel concentrate had lower chemical consumption and waste production compared to direct hydrometallurgical process where approximately 60% of iron was leached consuming oxygen, and the following iron precipitation step consuming calcium carbonate resulted in a high amount of iron precipitate together with gypsum. However, hydrometallurgical alternatives are often suitable for lower ore grades or volumes and can recover copper as by-product metal. The biggest impacts on carbon footprint from chemical consumption in the direct hydrometallurgical process were generated in iron precipitation and oxygen use in leaching. With the studied nickel concentrate, pyrrhotite played a key role in both oxygen use and iron precipitation. In the leaching step, 68% of total oxygen consumption was related to pyrrhotite leaching, while in iron removal 73% of total iron originated from pyrrhotite. Thus, especially pyrrhotite removal prior to leaching needs to be developed to reduce the carbon dioxide footprint, when the pyrrhotite content in the material is high.Graphical

Analisis Kesulitan Membaca Permulaan pada Siswa Kelas Rendah: Systematic Literature Review

One important component in the world of education is the ability to read. Even though Indonesia's population is increasing, interest in reading tends to decrease, as evidenced by the percentage of illiterates, which will reach 3.18% in 2023. Reading is the main capital for progress in education, starting from an early age with initial reading in elementary school. However, several difficulties, such as difficulty pronouncing letters, reading diphthongs, and spelling difficulties, are often experienced by students. The aim of this research is to examine the initial reading difficulties of lower-grade students and the strategies implemented by teachers to overcome these problems. This research is useful in helping students master the shapes of letters, words, and sentences, as well as increasing their activity in class. Apart from that, this research aims to increase teacher creativity in creating interesting learning and providing input to improve Indonesian language learning outcomes in lower grades. This research follows PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the Dimensions and Google Scholar databases.

Early practice makes histology masters: The use of a formative assessment quiz to prepare histology learners for a high-stakes final examination.

Assessment of learners in the anatomical sciences is a complex task as it not only tests students' fact knowledge, but also the analysis of visual information. Sometimes, novice histology learners must acquire image recognition skills of microscopic structures in a short time frame. This paper describes a strategy of offering first year dental students at the University of Michigan a short, non-grade contributing, formative assessment quiz in order to better prepare them for a high-stakes, final summative histology examination. Data collected over 7 years indicate that students, who made use of this formative assessment opportunity, performed significantly better in their summative examination than students, who did not. Especially early practice quiz users profited most. Students, who used the practice quiz until they achieved a perfect score, also had statistically higher final examination scores. Students, who did not use the practice quiz, had a significantly lower cumulative D1-year Grade Point Average (D1-GPA) than students, who did, indicating that academically weaker students often underuse supporting learning resources. In general, scores from the Dental Admission Test (DAT) were weak predictors of learning success in the DENT 510 histology course. In contrast, the D1-GPA values had a medium strength positive correlation with final histology examination scores. The major problem that was encountered with this practice quiz strategy was that many students waited until close to the day of the final examination before taking advantage of this feedback opportunity, thereby reducing its potential benefit for improving their overall learning strategy for histology.

The Potential Adverse Impact of Post-Treatment Thrombocytopenia on Clinical Outcomes in Cancer Patients Treated With Immune Checkpoint Inhibitors.

The main goal of this study is to explore the prognostic and predictive implications of post-treatment thrombocytopenia on treatment efficacy and clinical outcomes in advanced-stage cancer treated with immune checkpoint inhibitors (ICIs). This retrospective study included 102 patients with advanced-stage cancer who were treated with ICIs. The simultaneous administration of chemotherapy and ICIs was omitted; nevertheless, the selection of chemotherapy agents employed in different treatment lines was left to the discretion of the attending clinician. Patients were stratified into distinct cohorts based on their post-treatment platelet counts (evaluated for up to four to six months after the completion of ICI). The primary endpoint of interest was progression-free survival (PFS), and overall survival (OS) was the secondary endpoint. Patients with superior Eastern Cooperative Oncology Group (ECOG) performance status and those who received ICI as second-line treatment displayed markedly elevated incidences of grade 1 thrombocytopenia (p < 0.05). Kaplan-Meier survival analysis confirmed that patients with high-grade thrombocytopenia had significantly shorter PFS (six vs. 13 vs. 19 months, p < 0.0001) and OS (10 vs. 21 vs. 25 months, p < 0.0001) than those with lower grades or without thrombocytopenia, respectively. Multivariate analysis revealed that decreased platelet levels were a negative independent prognostic factor for both PFS and OS in patients with advanced-stage cancer who received ICIs. The results of this retrospective study suggest that a decline in platelet levels after treatment represents a dependable adverse prognostic biomarker for clinical outcomes. Moreover, a decrease in platelet levels has been linked to reduced treatment efficacy in advanced-stage cancer patients receiving ICIs, thereby providing valuable prognostic insights for the implementation of personalized treatment strategies in cancer immunotherapy.

Implementasi Metode Pembelajaran Aktif Time Token Terhadap Motivasi Belajar Siswa SD Yapita pada Mata Pelajaran Bahasa Indonesia Kelas 6A

Indonesian is taught in grades 1-6 of primary school. Learning is divided into lower and upper grades, with a thematic approach and specialized teaching materials The uniqueness is seen in the thematic approach and teaching materials used. Indonesian language learning in the lower grades aims for students to focus on language skills, understand forms and functions, and use them creatively. This study uses qualitative methods to understand social phenomena from the views of participants. Data was collected from students who conducted teaching assistance at Yapita Surabaya Elementary School for three months. The purpose of the study was to determine the impact of the application of the time token learning method on the motivation of students in class 6A. The research sample consisted of 28 students. The learning strategy encourages changes in the motivation of Yapita Elementary School students in class 6A to learn Indonesian. The time token learning model has advantages in motivating students to participate more independently, improving students' communication skills, and helping students develop habits of listening, sharing, contributing, and accepting criticism. However, the disadvantage of this model is that it can only be used for certain subjects and is not suitable for classes with a large number of students. The steps in time token learning involve conditioning the class for discussion, giving each student a speaking coupon, and awarding points depending on the situation. Students who have used their coupons cannot speak.