Programming Procedure Research Articles

An evaluation of an innovative screening program based on risk criteria for early diagnosis of head and neck cancers.

Head and neck cancer represents 3% of all cancers and is the cause of 5% of the deaths caused by cancer. The purpose of this study is to evaluate the implementation of a screening program to diagnose the early phase of the head and neck oncological processes. We have studied 324 asymptomatic patients who had at least one major risk factor (habitual consumption of tobacco or alcohol) or two minor risk factors: family history of head and neck cancer of the upper aerodigestive tract, occupational exposure, poor oral hygiene and history of Human Papillomavirus or chronic inflammatory processes of the aerodigestive tract. Family and personal head and neck oncological medical history, ENT exploration, performance of CT scans or biopsies and program procedures were analyzed. The most usual referral criteria for being sent to a specialist was being a smoker (98.1%). 10.5% reported family histories of head and neck cancer, 9.9% reported occupational exposure, 7.1% were referred due to poor oral hygiene and 5.9% were referred for gastroesophageal reflux disease. Although being asymptomatic was a requirement for inclusion, we verified that, after the anamnesis, 9.6% of the patients had some symptom to which they did not give importance to 119 patients (36.7%) presented a lesion that potentially could become malignant, located in the larynx and hypopharynx (25%) and in the oral cavity and oropharynx (10.8%). Eighteen patients (5.56%) presented more than one lesion. The detection rate of neoplasia was 1.2% and the detection rate of pre-neoplastic lesions was 4.6%. There did exist a statistically significant ratio between the detection of pre-neoplastic lesions and occupational exposure to carcinogenic agents (p = 0.006), poor oral hygiene (p = 0.01) and gastroesophageal reflux disease (p = 0.007). Samples were taken for a pathological anatomy study in 30 patients (9.25%). In order to follow up the patients, 22.8% were controlled at hospital medical consultations, 11.1% were examined at outpatient consultation and 66% were given appointments for follow-up visits. The use of this screening program could be a tool for the early diagnosis of malignant head and neck tumors and to foster healthy habits for cancer prevention.

Programmable polymers with shape memory for biomedical applications

AbstractShape memory polymers (SMPs) are a type of programmable materials capable of transforming their shapes in a pre-programmed way upon the application of an external stimulus. These materials have been tested for various potential applications particularly in the biomedical field for polymers with general and specific requirements. This review focuses on the recent advances in biomedical applications, including self-tightening sutures, pressure bandages, self-expansion stents, tissue engineering scaffolds, artificial muscles, drug delivery, and orthodontic archwires, after a brief description of the concepts, classifications, programming procedures, and material requirements of SMPs.

The Impact of Human Resources Maintenance on Enhancing Organizational Agility: An Applied Study on Secretariat of Northern Borders Region

The study aims to identify the impact of human resources maintenance on enhancing organizational agility. The research was built based on a set of studies and previous theoretical frameworks related to the research subject. The research data was collected at the application agency (the Municipality of the Northern Borders Region) through a survey list distributed to 384 employees in the application area. Statistical Package for Social Sciences (SPSS) was used to analyze the data and verify the validity of the research hypotheses. There are no statistically significant differences between the opinions of the study sample due to the variable of gender, level of education, and experience concerning the level of human resources maintenance programs in the Municipality of the Northern Borders Region and the existence of a relationship between the maintenance of human resources in its various dimensions and organizational agility, as well as a strong positive impact of human resources maintenance on organizational agility. The study recommended the need to pay attention to human resources maintenance programs while working to raise awareness of the importance of enhancing organizational agility and increasing adequate financial support for the application of the philosophy of human resources maintenance and that the policies and procedures of human resources maintenance programs focus on taking into account supporting the agility of the organizational structure and organizational procedures at the level of the institution.

Evaluation of the Effect of Oral Motor Stimulation Exercises on Feeding Skills in Premature Infants.

Oral feeding in preterm infants is a complex and dynamic process involving oral motor development and interaction between the neurological, cardiorespiratory, and gastrointestinal systems. Oral motor stimulation (OMS) is defined as stimulating the oropharyngeal components such as the lips, jaw, tongue, and soft palate with fingers in preterm infants to increase their feeding skills. In this study, we aimed to evaluate the effect of OMS exercises on the sucking and swallowing skills of preterm infants and demonstrate the utility of objective scales to evaluate infants' readiness for oral feeding. This single-center, prospective cohort study was conducted between June 1st and December 31st, 2020, which included preterm infants born at ≤34 weeks of gestation and admitted to the neonatal intensive care unit of our hospital. All procedures of the OMS program were performed once a day, 5 times a week by a language and speech therapist who is an expert in oral feeding skills (OFS) staging and non-nutritive sucking (NNS) scoring. All infants were followed up until discharge with a weekly evaluation of OFS staging and NNS scoring. A total of 50 infants were included in this prospective cohort study. The mean birth weight was 1376.9±372 g, and the median gestational age was 30 weeks (interquartile range: 25-34). The comparison of OFS stages on day 5 and day 10 of OMS revealed a significant increase (p<0.001). Similarly, there was a significant improvement in the NNS scores on days 5 and 10 compared to the baseline. In preterm infants, OMS during the transition from gavage feeding to oral feeding improves feeding skills.

Development of drag force model for predicting the flow behavior of porous media based on genetic programming

Seepage in soils is a phenomenon related to the interaction between solid particles and fluid phase. The present study develops a drag force model by focusing on the voidage function using a genetic programing (GP) procedure. A systematic laboratory seepage tests was carried out on porous media with different materials by a self-made seepage apparatus. Based on the database obtained by the numerous seepage tests, the drag force model was developed with the aid of symbolic regression in genetic program. The results indicate that the developed drag force model by GP method composed of a constant and four gene items has satisfied performance in predicting the drag behavior of particles, which is attributed to the GP's advantages on optimizing both the parameters and structure of the model. Among the influencing factors, the gradation coefficient, porosity, and shape coefficient have a significant effect on the seepage characteristics of the porous media. The proposed model in this study could be used to analyze the flow characteristics of porous media in the field of geotechnical and ocean engineering. • A systematic laboratory investigation was carried out on different porous media by a self-made seepage apparatus. • A drag force model taking into account the main influencing factors was developed by genetic programing framework. • The effects of main factors on the flow characteristics were analyzed and discussed.

Penerapan Metode Multi Attribute Utility Theory Pada Sistem Pendukung Keputusan Seleksi Bantuan Untuk Madrasah

Madrasah is one form of religious education that has contributed greatly to the development of the nation. Through madrasas, they are able to give birth to a generation of Islamic character and national insight, but the selection process for madrasa aid recipients in the city of Gorontalo is currently not optimal in terms of determining madrasa aid recipients, this occurs due to inaccuracies between recipient data and existing requirements, the selection process for recipients of assistance requires a long time, lack of accuracy between the criteria and requirements of the beneficiary so that it is vulnerable to manipulation. The research objective is to design a Madrasah Assistance Selection Decision Support System applying the Website-Based Multi-Attribute Utility Theory Method so that the selection process for providing madrasah operational assistance can be carried out optimally and measurably using decision-making methods so that it is expected to determine more precise selection results. This study uses whitebox and blackbox testing. Whitebox testing is testing with testing techniques on program flow, logical structure and program procedures by mapping flowcharts, then calculating the number of edges and nodes. The black box testing method focuses on the functional importance of the software. Therefore, blackbox testing allows software developers to create a set of input conditions that will train all functional requirements of a program whether it runs as expected or vice versa. Based on the results of whitebox testing on one of the processes in this system, namely the value data module with balanced results, namely Cyclomatic Complexity (CC) = 4, then this system is declared to be running well. While the results of the blackbox test system can run as expected and efficient

Selecting a Programming Scheme for Memristor Elements

Introduction. An array of memristive elements can be used in prospective neural computing systems as a programmable resistance (analog multiplication factor) when performing operations of analog vector multiplication, discrete in time. To form the required resistance, the memristor should be subjected to a programming procedure. This article discusses conventional programming schemes and proposes a new versatile programming scheme for memristor elements.Aim. To identify or develop an optimal programming scheme for memristors by analyzing the advantages and disadvantages of existing methods.Materials and methods. The programming procedure can be carried out using either SET or RESET, depending on a different direction of movement according to the volt-ampere characteristic of the memory and its transfer to a particular state. The programming process is controlled in the LTspice circuit modeling program.Results. Typical programming schemes of memristors were analyzed; advantages and disadvantages of existing methods were revealed. A new versatile circuit based on a variable resistor was proposed. The circuit was simulated both under a fixed resistance of the variable resistor and when varying the memristor resistance values within their permissible range.Conclusion. In comparison with the RESET mode, the SET programming mode provides for a greater linearity of variations in the memristor resistance. The use of a circuit based on a variable resistor and a bipolar voltage source allows programming of any type and eliminates the need for recommutation of the memristor. The simulation results confirm the feasibility of the proposed method. The proposed circuit can be complemented not only with a comparator, but also with an ADC. This will provide the possibility of selecting various means for measuring the memristor resistance both during programming and for the purpose of monitoring the memristor resistance at the end of the procedure.

Simulation-Based Education in US Undergraduate Medical Education: A Descriptive Study.

Simulation-based education (SBE) provides experiential learning, improvement in quality of care, and reduction in errors. In 2011, the Association of American Medical Colleges described adoption of SBE in 68.0% of medical schools and 25.0% of teaching hospitals. We sought to examine current trends of SBE integration in American undergraduate medical education since previous publications. From 2016 to 2019, University of Texas Southwestern Medical Center postgraduate year 1 residents were invited to participate in a survey assessing medical school simulation experience with 26 clinical tasks from three categories: procedural, communication, and other. Deidentified results were analyzed to assess demographics including sex, specialty, residency program type, allopathic versus osteopathic medical school, and medical school region. Nine hundred sixty-seven of 1047 (92.3%) responses were obtained, representing 139 US medical schools, 91% from allopathic training. Of procedural tasks, most simulated was suturing (n = 848, 89.6%) and least simulated was thoracentesis (n = 737, 80.9%). Of communication tasks, most simulated was taking a history (n = 475, 51.1% reporting simulation >30) and least simulated (never or ≤1) were obtaining a consent (n = 669, 73.2%) and disclosing a medical error (n = 666, 72.4%). Of other tasks, most simulated was chest compressions (n = 898, 96.0%) and least simulated was operating a defibrillator (n = 206, 22.1%). Results were similar regardless of procedural or nonprocedural program. There was no significant difference in SBE exposure between allopathic and osteopathic students ( P = 0.89). Two participants (0.002%) reported no simulation exposure. Our study is the first to describe a high prevalence of SBE adoption in medical schools nationwide since the Association of American Medical Colleges' 2011 publication, with overall equal exposure for students regardless of residency type and allopathic or osteopathic medical school. Despite widespread adoption of simulation, opportunities remain to expand SBE use to teach critically important communication skills.

An online integrated programming platform to acquire students' behavior data for immediate feedback teaching

AbstractProgramming‐related courses prefer to put importance on practice rather than theoretical knowledge. However, the students' programming behavior data is difficult to be recorded and fed back to teachers anytime, allowing teachers to adjust their teaching in real‐time. Aiming at this problem, this study develops an online integrated programming platform that provides a unified programming environment for teachers and students and logs students' procedural programming behavior data automatically to assist teachers in providing real‐time feedback teaching. To verify the effectiveness of the data‐driven immediate feedback teaching method, an exploratory case was conducted in the 2020/2021 academic year autumn semester. As the control group, cloud201 adopted the traditional hybrid online/offline mode, while cloud202, as the experimental group, adopted the hybrid online/offline mode and immediate feedback teaching mode. The effect is demonstrated through the questionnaire, the programming behavior data analysis, and the performance analysis. The results of the questionnaire show that there are significant differences in the students' satisfaction with interaction, supervision, feedback, and evaluation, of which feedback is the biggest part. In addition, the two analysis results indicate that students' individual learning development and the learning status of the class are objectively characterized, the overall grade distribution of cloud202 is more concentrated in medium grades and the difference on average scores between cloud201 and cloud202 is gradually increased. Since the students' immediate and comprehensive programming behavior data is perceived by teachers, the teaching adjustment is so flexible that the improvement of teaching efficiency and teaching effect is promoted accordingly.

Implementation Degree of Quality Standards in the Special Education Program at Al-Balqa Applied University from the perspective of Faculty Members

Objectives: This study aimed to determine the implementation degree of quality standards in the special education program at Al-Balqa Applied University.&#x0D; Methods: The descriptive strategy was applied. A random cluster sample of 56 faculty members from Balqa Applied University made up the study sample. The Jordanian Universities Accreditation and Quality Assurance Authority's Manual of Jordanian Quality Assurance Standards for the Educational Sciences Program served as the foundation for the creation of the instrument.&#x0D; Results: According to the indicators of the standards for the three aspects of the standards, the study found that Al-Balqa Applied University's special education program applied quality standards to a high degree. However, the findings also revealed weaknesses in the policies that govern student transfer, a strained relationship between faculty members and library and database staff, and the absence of a more thorough, in-depth analysis. The demographics of faculty members' gender and academic rank are linked to how strictly quality standards are applied in Balqa Applied University's special education program.&#x0D; Conclusions: The study suggested updating academic materials for special education programs to achieve depth and current practices in special education, introducing periodic assessment procedures of special education programs, developing appropriate policies for students transferring from other academic programs, and strengthening the communication channel and relationship context among special education program's faculty members and workers in library and databases.

Surgical Therapeutic Algorithm in Facial Paralysis

Facial nerve paralysis is a debilitating condition with multiple etiologies, with aesthetic, functional, psychological and social impact. Given the complex multitude of causes that may generate such condition, a therapeutic algorithm is mandatory when attempting reconstruction. Severity, timing, patient adherence to a rehabilitation program, status of ipsilateral and contralateral facial nerves and particularities of each patient are all criteria which should be accounted when choosing a treatment option. After initial assessment, a variable treatment panel is available based on condition type include medicamentous therapy, rehabilitation program, dynamic and static procedures surgical procedures, having as primary aim functional restoration achieving aesthetic balanced facial features. This paper summarizes current knowledge in facial paralysis reconstruction and presents an algorithmic approach that eases decision making and therapeutic strategy.

ToMExO: A probabilistic tree-structured model for cancer progression.

Identifying the interrelations among cancer driver genes and the patterns in which the driver genes get mutated is critical for understanding cancer. In this paper, we study cross-sectional data from cohorts of tumors to identify the cancer-type (or subtype) specific process in which the cancer driver genes accumulate critical mutations. We model this mutation accumulation process using a tree, where each node includes a driver gene or a set of driver genes. A mutation in each node enables its children to have a chance of mutating. This model simultaneously explains the mutual exclusivity patterns observed in mutations in specific cancer genes (by its nodes) and the temporal order of events (by its edges). We introduce a computationally efficient dynamic programming procedure for calculating the likelihood of our noisy datasets and use it to build our Markov Chain Monte Carlo (MCMC) inference algorithm, ToMExO. Together with a set of engineered MCMC moves, our fast likelihood calculations enable us to work with datasets with hundreds of genes and thousands of tumors, which cannot be dealt with using available cancer progression analysis methods. We demonstrate our method's performance on several synthetic datasets covering various scenarios for cancer progression dynamics. Then, a comparison against two state-of-the-art methods on a moderate-size biological dataset shows the merits of our algorithm in identifying significant and valid patterns. Finally, we present our analyses of several large biological datasets, including colorectal cancer, glioblastoma, and pancreatic cancer. In all the analyses, we validate the results using a set of method-independent metrics testing the causality and significance of the relations identified by ToMExO or competing methods.

Computer simulation of the dynamics of heat release in diesel cylinders

The relevance of computer mathematical modeling, and processing of initial experimental data for follow-up assessment and analysis of the dynamics of heat release in diesel cylinders is growing every day. The main goal of our research consists in the development of a computer model defining the dynamics of heat release in diesel cylinders when it is running on fuels with different fractional composition, based on the application of the method of the Central Research Diesel Institute by analyzing the experimental data obtained in the form of an indicator diagram. The object of research is the method of processing the obtained experimental indicator diagrams. For this purpose, indicator diagrams of a 4CHN 11.0/12.5 diesel engine of the D-245.5S2 brand were obtained in the nominal mode. To implement the software module, a Java programming procedure was used, including the Java Development Kit where the writing, launching and compilation of Java code took place, the Java Runtime Environment, the Java runtime system, where the software distribution mechanism consisted of an autonomous Java virtual machine, standard Java libraries and tools for configuring it; and the Integrated Development Environment of an integrated development environment, where tools that helped launch, edit, and compile codes that provided thermal characteristics. As a result, an analysis of the available methods for determining the characteristics of the dynamics of diesel heat release was carried out, for the first time an algorithm was developed for performing calculations by the method of the Central Research Diesel Institute and a software module for calculating the characteristics of the dynamics of heat release in diesel cylinders when using fuels of various fractional composition based on experimentally obtained indicator diagrams. The use of the proposed technique and the corresponding software module for processing indicator diagrams, and subsequent analysis of the characteristics of the dynamics of heat release in diesel cylinders provides the required quality of the research results.

OP92 Impact Of Real-World Evidence On Health Technology Assessment And National Guidance For Interventional Procedures: A UK Perspective

IntroductionThe National Institute for Health and Care Excellence (NICE) interventional procedures programme (IPP) issues guidance on the safety and efficacy of new interventional procedures (IPS). The IPP considers a range of evidence from randomized controlled trials (RCTs) to case series to make final recommendations. Real-world evidence (RWE) can provide additional information on long-term outcomes and patient population characteristics that are not easily captured by RCTs. This study explores the impact of RWE in complementing RCTs on long-term safety and efficacy for national guidance development.MethodsWe review the impact of RWE in IPS guidance (IPG) updates and change in guidance recommendations in the last 5 years. This is done by analyzing NICE guidance updates and supporting evidence. A range of RWE was considered in the supporting evidence, for example, registries and clinical audits.ResultsThe addition of RWE evidence to IPP guidance update has led to significant changes in the recommendations. For example, in one recent IPG, standard arrangements recommendation based on short-term RCT evidence was changed to a research recommendation when RWE showed an increase in long-term adverse effects. In another recent IPG update, special arrangements recommendation based on short-term RCT evidence was changed to a research recommendation when RWE reported long-term inferior efficacy and safety for the new intervention compared to current standard of care. A complete overview of results of the last 5 years will also be presented at the meeting.ConclusionsThese findings indicate that increased availability of RWE in HTA has the potential to impact national guidance recommendations. In addition, it shows how RWE can fill the evidence base gaps created by RCTs. Such data can confirm or contradict the findings of RCTs, or generate questions needing further research, or support disinvestment in non-effective technologies.

Features of the method of teaching the For loop in Python language in secondary school

Today, in many educational institutions, the study of the Python programming language is included in the informatics curriculum. Possessing indisputable advantages, which are noted by both research educators and practicing teachers, the Python language has a number of features that students should pay attention to in order to prevent mistakes that they may make in the future when switching to other programming languages. This also applies to the study of cyclic constructions, in particular the For loop. The implementation of the For loop in the Python language is fundamentally different from the implementation of the loop with a parameter used in procedural programming languages that were studied earlier in the school curriculum (BASIC, Pascal, C/C++, etc.). Today, we have a situation where the method of learning a loop with a parameter cannot be applied to the For loop of the Python language. The article is devoted to the methods of studying this cyclic construction.

Iterated Maximum Large Neighborhood Search for the Traveling Salesman Problem with Time Windows and its Time-dependent Version

This article introduces a new algorithm for finding feasible or makespan-optimal solutions of Traveling Salesman Problems with Time Windows (TSPTWs) and Time-Dependent TSPTWs (TDTSPTWs). The algorithm starts from a sequence of visits of the customers involved in the problem, uses destroy and repair operations to iteratively improve this sequence, and applies perturbations to diversify search. For the destroy phase, customers are removed from the current sequence of visits as long as a parameter called the insertion-width is not too high. For the repair phase, the customers removed are reinserted for the best based on a dynamic programming procedure whose complexity is only linear in the number of customers. For the perturbation phase, some customers are randomly shifted in the sequence of visits. The algorithm obtained is called Iterated Maximum Large Neighborhood Search (ImaxLNS). On seven standard TSPTW benchmarks, it returns the best-known solution for each instance in less than one second on average. On two TDTSPTW benchmarks related to urban logistics, it provides new feasible solutions and best solutions. On a TDTSPTW benchmark related to Earth observing satellites, it solves most of the instances in less than a second.

LBMON198 Improving Knowledge And Implementation Of Healthcare Transition (HCT) Policy And Procedure For Transgender And Gender Diverse (TGD) Youth At The UCSF Child And Adolescent Gender Center (CAGC)

Abstract Introduction The UCSF CAGC has served TGD youth since 2009. Increased referrals coupled with an expanding young adult patient population has resulted in longer wait times and an increased need for transition to adult care services. As part of an ongoing quality improvement initiative to develop an equitable HCT program tailored to the unique needs of TGD youth at the UCSF CAGC, we developed and aimed to improve provider knowledge of a standardized policy and procedure for HCT from pediatric to adult gender care. Methods CAGC providers received training in 11/2021 on the HCT policy and procedure, including a standardized method to identify patients with whom to initiate HCT discussions. Providers completed pre- and post-training surveys evaluating knowledge and confidence regarding HCT practices. Knowledge was assessed with yes/no questions and confidence with 5-point Likert scales (1 = lowest, 5 = highest). Pre- and post-survey results were compared using proportions tests for dichotomous outcomes and Wilcoxon rank-sum tests for confidence levels. To evaluate effectiveness, baseline data on % of eligible TGD youth seen in the UCSF CAGC in 1-2/2021 with "Counseling for transition from pediatric to adult care provider" (Z71.89) added to their problem list in the electronic medical record were collected and compared to % of eligible TGD youth with Z71.89 added to their list the 4 consecutive months following the training session. Results Nine and 7 CAGC providers completed the pre- and post-training surveys, respectively. Knowledge increased in all areas although not all were statistically significant: Age limit for new patient referrals (78% to 100%, p = 0.18), upper age limit at which patients must transition to an adult provider (56% to 100%, p = 0. 04), standardized method to track patients with whom HCT discussions have been initiated (0% to 100%, p = 0. 0001), and list of criteria for assessing HCT readiness (11% to 100%, p = 0. 0004). Confidence increased in identifying patients with whom HCT has been initiated (median 2 to 4, p = 0. 02) but not in identifying patients ready to initiate the HCT process (median 4 to 4, p = 0.43). The % of eligible TGD youth seen in the UCSF CAGC with Z71.89 added to their problem list increased from 0% at baseline to 72%, 82%, 86%, and 90% in the 4 months consecutively following the training session. Conclusions Our findings indicate that standardized training led to increased provider knowledge, participation, patient identification, and implementation of HCT program policy and procedure tailored to our TGD youth population. Future initiatives will include collaboration with adult gender centers to transition TGD youth to adult care services and to evaluate the experiences of TGD youth and providers who receive them. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Teaching Programming by Revealing Thinking Process: Watching Experts’ Live Coding Videos With Reflection Annotations

Contribution: Programming is a complex cognitive activity that involves both conceptual understanding and procedural skills, which is challenging for novices. To develop both program comprehension and implementation competency, this study proposed a live-coding-based instruction. Experts’ live coding with think-aloud was recorded. Students then learn algorithmic planning and coding skills by observing experts’ thinking and coding processes from the videos. To deploy this pedagogical strategy, a learning platform was developed to present the videos to students who could also annotate their reflection about the videos in the system to deepen their understanding of syntax and concepts of computer programming. Background: Traditional lecture-based programming instruction focuses more on the explanation of syntax and concepts but lacks revealing the dynamic and nonlinear thinking and coding process. Research Questions: This study is to explore the effects of live-coding-based instruction on students’ programming knowledge, including declarative program knowledge (program comprehension) and procedural program knowledge (coding skills), and whether the instruction changes their attitude toward programming learning or not. Methodology: An empirical study was conducted with 33 high-school students who were novice programmers in one semester to explore the effectiveness of the live-coding-based instruction and the use of the learning platform. Findings: The experiment results show that watching flowcharting ( <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$r=0.369, p \mathbf { &lt; }0.05$ </tex-math></inline-formula> ) or coding processes ( <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$r=0.409, p \mathbf { &lt; }0.05$ </tex-math></inline-formula> ) of experts improves coding skills. This implies that explicit depiction of algorithmic planning and coding processes are essential for building procedural programming knowledge. In addition, reflection on syntactic content of experts’ programming plays an important role in programming ( <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$r=0.511,p \mathbf { &lt; }0.01$ </tex-math></inline-formula> ). The research findings suggest that programming instruction could focus more on developing students’ problem-solving abilities by demonstrating the dynamic and nonlinear programming processes and providing opportunities for students to reflect on how syntactic knowledge could be applied to programming.

Is Laparoscopy Underutilized for Sigmoid Volvulus?

Minimally invasive surgery has become increasingly prevalent. However, the majority of colectomies for volvulus are still performed via an open technique. The purpose of this study is to determine whether there is a difference in outcomes between laparoscopic and open procedures for sigmoid volvulus. The American College of Surgeons National Surgical Quality Improvement Program and colectomy-targeted procedure databases were queried from 2013 to 2018. Patients undergoing partial colectomy without ileal resection for the indication of volvulus were compared based on approach (planned laparoscopic vs. planned open). The 2 groups were propensity score matched for perioperative variables. A subgroup analysis was performed comparing unplanned laparoscopic conversion to open (CTO) with planned open procedures. The primary outcomes were overall morbidity, mortality, and length of stay. Total 2493 patients were identified. Four hundred ninety-two cases began laparoscopically (20%), of which 391 were completed laparoscopically (79%). Laparoscopic approach was associated with longer operative times (133 vs. 104min, P <0.001). Laparoscopic approach was associated with decreased overall morbidity (OR: 0.71, 95% CI, 0.54 to 0.93) and decreased length of stay when >7 days (OR: 0.70, 95% CI, 0.52 to 0.94). On subgroup analysis, there was no difference in outcomes when comparing unplanned CTO to planned open approach. Laparoscopic approach is used in a fraction of cases for colonic volvulus. When utilized, the majority are completed without CTO. Laparoscopy is associated with fewer complications and shorter hospital stays. Even with unplanned conversion to open, there is no difference in outcomes compared against planned open procedures. Surgeons should consider the utilization of laparoscopy for colonic volvulus.

Analysis Of Inhibiting Factors For The Effectiveness Of Public Information Policy In The Services Of BPJS During The Covid-19 Pandemic At Puskesmas Kartini, Pematang Siantar City

BPJS Health is a legal entity that was established in order to organize a health insurance program. The problem with the BPJS program to ensure public health is that people complain that the health services they receive at both the hospital and the puskesmas are not in accordance with program procedures, such as being treated with potluck and queues. Because there are still problems felt by the community, the health services provided are ineffective. As a result, the purpose of this research is to determine and describe the efficacy of the BPJS Health program in health services at the Kartini Health Center in Pematangsiantar City. The research method used in this study is a literature review. Data collection techniques include observing and documenting documents related to the BPJS health program's implementation. According to the study's findings, there are factors impeding the effectiveness of the BPJS Health Program in Health Services that have not been effective because there are still complaints from the community and the community is also not fully aware of the existence of the BPJS Health program to help the community, particularly the underprivileged. The interactions between the three components of program implementation (programs, beneficiaries, and organization) have not gone well, and the output has not met expectations.