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This study is a meta-analysis that identifies several publications focusing on the effect of computational thinking skills (CTS) on the academic achievement of engineering education students at the higher education level. Publications were sourced from Google Scholar and Scopus metadata using the Publish or Perish application, with a search time range of 2014-2023. Initial analysis was carried out using statistical formulas with Microsoft Excel, and meta-analysis results were generated using JASP software. A total of 6 publications were analyzed to determine how much influence CTS has on students' academic achievement. The results of the analysis provide evidence that the overall effect is 54%, which falls into the medium category. The study highlights that innovation, challenge, and opportunity significantly enhance student learning outcomes by fostering skill development, motivating problem-solving, and encouraging the exploitation of new opportunities. These findings offer valuable insights for curriculum developers, educators, and policymakers aiming to incorporate CTS-focused strategies to bolster academic achievement. [ABSTRACT FROM AUTHOR]

Augmented reality (AR) is currently becoming educational trend by offering visualization of learning and making abstract concepts more concrete. Therefore, this research aimed to investigate the effect of AR technology based on mobile application on self-competence of electronics engineering students. It also considered the role of self-regulated learning, intrinsic learning motivation, and perceived usefulness as moderating factors. A cross-sectional survey with quantitative method was conducted on 848 electronics engineering education students at Universitas Negeri Padang, Indonesia. The data were obtained through questionnaires, and Structural Equation Model (SEM) analysis was conducted using SmartPLS 3. Furthermore, a fuzzy C-means clustering analysis was carried out using JASP software. The results showed that perceived usefulness had a significant positive effect on students' self-competence and moderated the significant positive relationship between self-regulated learning and self-competence. These empirical results showed that an improved level of self-regulated learning and beneficial application of technology could increase self-competence. [ABSTRACT FROM AUTHOR]

Technological progress has brought about modifications in the educational process. This transformation has led to numerous technological innovations for supporting student learning, with smartphones being one of the prominent tools. Despite the widespread use, students have primarily used smartphones for online gaming and social media, leading to a decline in the effectiveness for educational purposes. Therefore, this study aimed to explore how students in electronics engineering education responded to a novel technology, augmented reality (AR), when integrated into the fundamental learning process, in order to maximize the utility of smartphones. A cross-sectional survey approach with a quantitative methodology comprising 101 students in the field of electronics engineering education in higher education institutions in Indonesia was adopted. Data were collected through a questionnaire, which was subsequently analyzed using the Structural Equation Model (SEM) method with SmartPLS 3 software. Additionally, this study used Fuzzy C-Means (FCM) clustering method to examine the influence of each cluster values on the others. The analytical results showed that Computational Thinking Skill (CTS) of students significantly impacted Actual System Use (ASU) of AR. Furthermore, perceived usefulness (PU) and perceived ease of use (PEU) of this technology played crucial roles as mediators in ASU of AR. [ABSTRACT FROM AUTHOR]

Objective: To use a customized smartphone application to prospectively measure QOL and the real-time patient experience during neoadjuvant therapy (NT). Background: NT is increasingly used for patients with localized gastrointestinal (GI) cancers. There is little data assessing patient experience and quality of life (QOL) during NT for GI cancers. Methods: Patients with GI cancers receiving NT were instructed on using a customized smartphone application through which the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire, a validated measure of health-related QOL, was administered at baseline, every 30 days, and at the completion of NT. Participants also tracked their moods and symptoms and used free-text journaling functionalities in the application. Mean overall and subsection health-related QOL scores were calculated during NT. Results: Among 104 enrolled patients, the mean age was 60.5 ± 11.5 years and 55% were males. Common cancer diagnoses were colorectal (40%), pancreatic (37%), and esophageal (15%). Mean overall FACT-G scores did not change during NT (P = 0.987). While functional well-being scores were consistently the lowest and social well-being scores the highest, FACT subscores similarly did not change during NT (all P > 0.01). The most common symptoms reported during NT were fatigue, insomnia, and anxiety (39.3%, 34.5%, and 28.3% of patient entries, respectively). Qualitative analysis of free-text journaling entries identified anxiety, fear, and frustration as the most common themes, but also the importance of social support systems and confidence in health care providers. Conclusions: While patient symptom burden remains high, results of this prospective cohort study suggest QOL is maintained during NT for localized GI cancers. [ABSTRACT FROM AUTHOR]

Objective: We sought to define the impact of community privilege on variations in travel patterns and access to care at high-volume hospitals for complex surgical procedures. Background: With increased emphasis on centralization of high-risk surgery, social determinants of health play a critical role in preventing equitable access to care. Privilege is a right, benefit, advantage, or opportunity that positively impacts all social determinants of health. Methods: The California Office of State-wide Health Planning Database identified patients who underwent esophagectomy (ES), pneumonectomy (PN), pancreatectomy (PA), or proctectomy (PR) for a malignant diagnosis between 2012 and 2016 and was merged using ZIP codes with the Index of Concentration of Extremes, a validated metric of both spatial polarization and privilege obtained from the American Community Survey. Clustered multivariable regression was performed to assess the probability of undergoing care at a high-volume center, bypassing the nearest and high-volume center, and total real driving time and travel distance. Results: Among 25,070 patients who underwent a complex oncologic operation (ES: n =1216, 4.9%; PN: n= 13,247, 52.8%; PD: n= 3559, 14.2%; PR: n= 7048, 28.1%), 5019 (20.0%) individuals resided in areas with the highest privilege (i.e., White, high-income homogeneity), whereas 4994 (19.9%) individuals resided in areas of the lowest privilege (i.e., Black, low-income homogeneity). Median travel distance was 33.1 miles (interquartile range 14.4--72.2). Roughly, three-quarters of patients (overall: 74.8%, ES: 35.0%; PN: 74.3%; PD: 75.2%; PR: 82.2%) sought surgical care at a high-volume center. On multivariable regression, patients residing in the least advantaged communities were less likely to undergo surgery at a high-volume hospital (overall: odds ratio 0.65, 95% CI 0.52--0.81). Of note, individuals in the least privileged areas had longer travel distances (28.5 miles, 95% CI 21.2--35.8) to reach the destination facility, as well as over 70% greater odds of bypassing a high-volume hospital to undergo surgical care at a low-volume center (odds ratio 1.74, 95% CI 1.29--2.34) versus individuals living in the highest privileged areas. Conclusions and Relevance: Privilege had a marked effect on access to complex oncologic surgical care at high-volume centers. These data highlight the need to focus on privilege as a key social determinant of health that influences patient access to and utilization of health care resources. [ABSTRACT FROM AUTHOR]

Surgical resection is typically necessary for curative-intent treatment of most solid organ cancers. However, even with meticulous preoperative evaluation, operative procedures are occasionally aborted. The incidence, outcomes, and long-term prognoses of aborted cancer surgery have not been thoroughly investigated. All oncologic operations performed at a single tertiary cancer center between 2011–2021 were retrospectively queried; natural language processing of operative reports was used to identify aborted cancer surgeries. Surgical indications, clinicopathologic characteristics, short- and long-term outcomes, and palliative care involvement were retrospectively reviewed from the electronic medical record. Overall, 345 patients underwent aborted cancer surgery for a rate of 36 patients per year. The most common cancers were pancreatic (28%), biliary (14%), and colorectal (9%). The most commonly aborted operations were pancreatoduodenectomy (34%) and hepatectomy (22%). Most operations were aborted due to unanticipated tumor unresectability (47%) and occult metastatic disease (43%). Sixty percent of patients returned to cancer-directed therapy; 9% underwent successful reattempt at resection. The median overall survival of all patients after aborted surgery was 13.6 months (95% confidence interval, 11.2–16.0 months). Those who returned to oncologic therapy had longer survival (18.6 months vs 5.4 months, P <.001). Palliative care consultation was received by 34% and 13% of patients overall and within 30 days of surgery, respectively. Aborted cancer surgery was associated with poor outcomes, particularly in patients with aggressive cancer types and those who did not receive further cancer-directed therapy. Future studies should identify interventions such as palliative care consultation that may improve patient-centered outcomes. [ABSTRACT FROM AUTHOR]

To evaluate single-institution outcomes of drug-eluting bead transarterial chemoembolization (DEB-TACE) in the treatment of locally advanced neuroendocrine tumor (NET) hepatic metastases with a focus on safety and efficacy of treatment. A single-center retrospective cohort study of the outcomes of consecutive patients with NELM who underwent DEB-TACE between 2014 and 2019 was performed. Clinicopathologic characteristics, radiologic response (modified Response Evaluation Criteria in Solid Tumors) at 1-month follow-up, adverse events, progression-free survival (PFS), and overall survival were calculated. Among 287 patients (mean age of 62 years; 39% male: 61% female), disease burden was bilobar (90.2%) with mean largest tumor diameter measuring 4.9 ± 2.8 cm. Of these patients, 14.6% had no evidence of tumor in other organs or lymph nodes. Complete response occurred in 60 (20.9%) patients while 133 (46.3%) had partial responses. Major complication occurred in 2.4%. Liver function tests including total bilirubin and AST were overall stable at the 1-month follow-up, with only a small increase in the ALT at +8.9% (p < 0.01). Overall survival was 80.1% at 1 year, 49.1% at 3 years, and 12.3% at 5 years with a mean PFS of 14.4 ± 12.5 months. Based on this institutional experience, DEB-TACE is an acceptable locoregional therapy choice for hepatic metastases of NET due to its tolerable safety profile and relative efficacy. [ABSTRACT FROM AUTHOR]

To evaluate single-institution outcomes of drug-eluting bead transarterial chemoembolization (DEB-TACE) in the treatment of locally advanced neuroendocrine tumor (NET) hepatic metastases with a focus on safety and efficacy of treatment. A single-center retrospective cohort study of the outcomes of consecutive patients with NELM who underwent DEB-TACE between 2014 and 2019 was performed. Clinicopathologic characteristics, radiologic response (modified Response Evaluation Criteria in Solid Tumors) at 1-month follow-up, adverse events, progression-free survival (PFS), and overall survival were calculated. Among 287 patients (mean age of 62 years; 39% male: 61% female), disease burden was bilobar (90.2%) with mean largest tumor diameter measuring 4.9 ± 2.8 cm. Of these patients, 14.6% had no evidence of tumor in other organs or lymph nodes. Complete response occurred in 60 (20.9%) patients while 133 (46.3%) had partial responses. Major complication occurred in 2.4%. Liver function tests including total bilirubin and AST were overall stable at the 1-month follow-up, with only a small increase in the ALT at +8.9% (p < 0.01). Overall survival was 80.1% at 1 year, 49.1% at 3 years, and 12.3% at 5 years with a mean PFS of 14.4 ± 12.5 months. Based on this institutional experience, DEB-TACE is an acceptable locoregional therapy choice for hepatic metastases of NET due to its tolerable safety profile and relative efficacy. [ABSTRACT FROM AUTHOR]

Familiarity with the surgical work environment has been demonstrated to improve outcomes. We sought to investigate the impact of the rate of fragmented practice on textbook outcomes, a validated composite outcome representing an "optimal" postoperative course. Patients who underwent a hepatic or pancreatic surgical procedure between 2013 and 2017 were identified from the Medicare Standard Analytic Files. The rate of fragmented practice was defined as the surgeon's volume over the study period relative to the number of facilities practiced at. The association between the rate of fragmented practice and textbook outcomes was assessed using multivariable logistic regression. A total of 37,599 patients were included (pancreatic: n = 23,701, 63.0%; hepatic: n = 13,898, 37.0%). After controlling for relevant characteristics, patients who underwent surgery by surgeons in higher rate of fragmented practice categories had lower odds of achieving a textbook outcome (reference: low rate of fragmented practice; intermediate rate of fragmented practice: odds ratio = 0.88 [95% confidence interval 0.84–0.93]; high rate of fragmented practice: odds ratio = 0.58 [95% confidence interval 0.54–0.61]) (both P <.001). Of note, the adverse effect of a high rate of fragmented practice on the achievement of textbook outcomes remained substantial, regardless of the county-level social vulnerability index [high rate of fragmented practice; low social vulnerability index: odds ratio = 0.58 (95% confidence interval 0.52–0.66); intermediate social vulnerability index: odds ratio = 0.56 (95% confidence interval 0.52–0.61); high social vulnerability index: odds ratio = 0.60 (95% confidence interval 0.54–0.68)] (all P <.001). Patients in intermediate and high social vulnerability index counties had 19% and 37% greater odds of undergoing surgery by a high rate of fragmented practice surgeon (reference: low social vulnerability index; intermediate social vulnerability index: odds ratio = 1.19 [95% confidence interval 1.12–1.26]; high social vulnerability index: odds ratio = 1.37 [95% confidence interval 1.28–1.46]). Owing to the impact of the rate of fragmented practice on postoperative outcomes, decreasing fragmentation of care may be an important target for quality initiatives and a means to alleviate social disparities in surgical care. [ABSTRACT FROM AUTHOR]

Patients with liver-only metastatic pancreatic adenocarcinoma have traditionally been offered palliative chemotherapy alone. Recent studies have explored the role of surgical resection among patients with limited metastatic disease. National practice patterns and the impact of surgery among these patients remains unknown. The National Cancer Database was queried for all patients with pancreatic adenocarcinoma between 2010 and 2015. The primary outcome was overall survival from the time of diagnosis. Patients with liver-only metastatic disease were included. Univariable and multivariable logistic regression models were constructed to determine the association of patient, hospital, and regional factors with receipt of surgical resection. A propensity score–matched cohort (1:1) was generated by matching patient- and tumor-related factors (age, sex, race, comorbidity burden, primary tumor site, primary tumor size) among patients with liver-only stage IV pancreatic adenocarcinoma who received chemotherapy alone compared to those who received chemotherapy and underwent pancreatectomy and liver metastatectomy. Among 312,426 patients who met the study criteria, one half (n = 140,043, 50.4%) had stage IV disease; metastatic sites included bone (n = 5493, 3.1%), brain (n = 620, 0.4%), lung (n = 16,580, 9.5%), and liver (n = 62,444, 35.7%). Patients with stage IV disease were more likely to be younger (odds ratio: 1.10, 95% confidence interval: 1.0–1.2; P =.03) and have poorly (odds ratio: 2.1, 95% confidence interval: 1.8–2.5; P <.001) or undifferentiated (odds ratio: 3.1, 95% confidence interval: 2.3–4.1; P <.001) tumors. Among stage IV patients with liver-only disease (n = 47,785, 14.9%), 891 patients (1.9%) underwent pancreatic resection. Patients who underwent resection were more likely to be younger (odds ratio 1.4, 95% confidence interval: 1.0–1.8; P =.03) and treated at an academic/research center (odds ratio 2.1, 95% confidence interval: 1.2–3.5; P =.006). Median overall survival among patients who underwent resection was 10.74 months versus 3.4 months among patients who did not undergo resection. After controlling for patient and disease-related factors, patients who underwent surgical resection had a lower risk of death versus patients who did not undergo surgery (hazard ratio: 0.5, 95% confidence interval: 0.4–0.6; P <.001). After propensity score matching, patients who received multimodality treatment for liver-only metastatic pancreatic adenocarcinoma (surgery, chemotherapy) had a longer median overall survival (15.6 months vs 8.1 months) compared to those who received chemotherapy alone (P <.001). This study suggests that pancreatic resection in patients with liver metastases, in combination with chemotherapy and/or chemoradiation, may be associated with improved survival in well-selected patients. However, attempts at an aggressive surgical approach for patients with liver-only stage IV pancreatic adenocarcinoma patients should only be performed only under a well-designed prospective clinical trial. [ABSTRACT FROM AUTHOR]

The rove beetle, Dalotia coriaria (Kraatz) (Coleoptera: Staphylinidae), and insidious flower bug, Orius insidiosus (Say) (Hemiptera: Anthocoridae), are biological control agents used in greenhouse production systems. However, there is no information available on the effects of five newly registered insecticides: pyrethrins and canola oil, cyclaniliprole, cyclaniliprole and flonicamid, afidopyropen, and Beauveria bassiana PPRI 5339 on adult survival of these biological control agents. Consequently, two experiments were conducted under laboratory conditions in 2020 to determine the direct effects of the five insecticides on rove beetle and insidious flower bug adults. Individual rove beetle or insidious flower bug adults were placed into Petri dishes with filter paper treated with the insecticides. After 24, 48, 72, and 96 hours, the number of live and dead adults was recorded. We found that afidopyropen at 0.27 mL/500 mL and Beauveria bassiana PPRI 5339 at 0.11 and 0.50 mL/500 mL, were not directly harmful to rove beetle or insidious flower bug adults with 100% survival. However, pyrethrins and canola oil, cyclaniliprole, and cyclaniliprole and flonicamid were directly harmful to rove beetles and insidious flower bugs with ≤ 60% adult survival. Based on our results, afidopyropen and Beauveria bassiana PPRI 5339 can be integrated into biological control programs that include the use of rove beetle or insidious flower bug adults. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess trends in the use as well as the outcomes of patients undergoing simultaneous versus staged resection for synchronous colorectal liver metastases. Patients undergoing resection for colorectal liver metastases between 2008 and 2018 were identified using a multi-institutional database. Trends in use and outcomes of simultaneous resection of colorectal liver metastases were examined over time and compared with that of staged resection after propensity score matching. Among 1,116 patients undergoing resection for colorectal liver metastases, 690 (61.8%) patients had synchronous disease. Among them, 314 (45.5%) patients underwent simultaneous resection, while 376 (54.5%) had staged resection. The proportion of patients undergoing simultaneous resection for synchronous colorectal liver metastases increased over time (2008: 37.2% vs 2018: 47.4%; p tre nd = 0.02). After propensity score matching (n = 201 per group), patients undergoing simultaneous resection for synchronous colorectal liver metastases had a higher incidence of overall (44.8% vs 34.3%; P =.03) and severe complications (Clavien-Dindo ≥III) (16.9% vs 7.0%; P =.002) yet comparable 90-day mortality (3.5% vs 1.0%; P =.09) compared with patients undergoing staged resection. The incidence of severe morbidity decreased over time (2008: 50% vs 2018: 11.1%; p tren d = 0.02). Survival was comparable among patients undergoing simultaneous versus staged resection of colorectal liver metastases (3-year overall survival: 66.1% vs 62.3%; P =.67). Following simultaneous resection, severe morbidity and mortality increased incrementally based on the extent of liver resection and complexity of colectomy. While simultaneous resection was associated with increased morbidity, the incidence of severe morbidity decreased over time. Long-term survival was comparable after simultaneous resection versus staged resection of colorectal liver metastases. [ABSTRACT FROM AUTHOR]

We sought to assess the relationship between Leapfrog minimum volume standards, Hospital Safety Grades, and Magnet recognition with outcomes among patients undergoing rectal, lung, esophageal, and pancreatic resection for cancer. Standard Analytical Files linked with the Leapfrog Hospital Survey and the Leapfrog Safety Scores Denominator Files were used to identify Medicare patients who underwent surgery for cancer from 2016 to 2017. Multivariable logistic regression analysis was used to examine textbook outcomes relative to Leapfrog volume, safety grades, and Magnet recognition. Among 26,268 Medicare beneficiaries, 7,491 (28.5%) were treated at hospitals meeting the quality trifactor (Leapfrog, safety grade A, and Magnet recognition) vs 18,777 (71.5%) at hospitals not meeting ≥1 designation. Patients at trifactor hospitals had lower odds of complications (odds ratio = 0.83, 95% confidence interval: 0.76–0.89), prolonged duration of stay (odds ratio = 0.89, 95% confidence interval: 0.82–0.97), and higher odds of experiencing textbook outcome (odds ratio = 1.12, 95% confidence interval: 1.06–1.19). Patients undergoing surgery for lung (odds ratio = 1.19, 95% confidence interval: 1.10–1.30) and pancreatic cancer (odds ratio = 1.37, 95% confidence interval: 1.21–1.55) at trifactor hospitals had higher odds of textbook outcome, whereas this effect was not noted after esophageal (odds ratio = 1.16, 95% confidence interval: 0.90–1.48) or rectal cancer (odds ratio = 1.11, 95% confidence interval: 0.98–1.27) surgery. Leapfrog minimum volume standards mediated the effect of the quality trifactor on patient outcomes. Quality trifactor hospitals had better short-term outcomes after lung and pancreatic cancer surgery compared with nontrifactor hospitals. [ABSTRACT FROM AUTHOR]

The objective of the current study was to evaluate the impact of the individual surgeon on the use of minimally invasive pancreatic resection. The Medicare 100% Standard Analytic Files were reviewed to identify Medicare beneficiaries who underwent pancreatic resection between 2013 and 2017. The impact of patient- and procedure-related factors on the likelihood of minimally invasive pancreatic resection was investigated. A total of 12,652 (85.4%) patients underwent open pancreatic resection, whereas minimally invasive pancreatic resection was performed in 2,155 (14.6%) patients. Unadjusted rates of minimally invasive pancreatic resection ranged from 0% in the bottom volume tertile to 35.3% in the top tertile. Although patients with emergency admission were less likely to undergo minimally invasive pancreatic resection (odds ratio = 0.43, 95% confidence interval 0.32–0.58), patients operated on more recently had a higher chance of minimally invasive pancreatic resection (year 2017; odds ratio = 1.51, 95% confidence interval 1.28–1.79). On multivariable analysis, there was over a 3-fold variation in the odds that a patient underwent minimally invasive versus open pancreatic resection based on the individual surgeon (median odds ratio = 3.27, 95% confidence interval 2.98–3.56). Patients who underwent pancreatectomy by a low-volume, minimally invasive pancreatic resection surgeon had higher odds of 90-day mortality after surgery (odds ratio = 1.33, 95% confidence interval: 1.16–1.59), as well as higher observed/expected mortality compared with individuals treated by high-volume surgeons. The likelihood of undergoing minimally invasive pancreatic resection among Medicare beneficiaries was markedly influenced by the individual treating surgeon rather than patient- or procedure-level factors. [ABSTRACT FROM AUTHOR]

Quality assessments of commercially available biological control (BC) agents is important to ensure the success of a BC program. It is important that greenhouse producers assess if BC agents received from BC suppliers are alive and functional before releasing into greenhouse production systems. We conducted a preliminary study to determine the quality of shipments from two suppliers of the whitefly parasitoid, Eretmocerus eremicus Rose & Zolnerowich (Hymenoptera: Aphelinidae). Release cards containing parasitized pupae of the sweetpotato whitefly, Bemisia tabaci (Gennadius) (Hemiptera: Aleyrodidae), were individually placed into 500 mL Mason jars and a 4 x 5 cm yellow sticky card was attached to the inner lids. We found differences between the two shipments received from the two suppliers. For the first shipment, supplier B had a higher mean number of adults captured on the yellow sticky cards than supplier A (Laboratory: 10.1 versus 4.2 and Distributor: 19.1 versus 5.9 adults, respectively). However, for the second shipment, supplier A had a higher mean number of adults captured on the yellow sticky cards than supplier B (Laboratory: 14.5 versus 8.1 and Distributor: 20.9 versus 8.0 adults, respectively). Our preliminary study shows that formulations (release cards) of BC agents and emergence of adults can vary depending on individual shipments from the supplier providing the BC agents. Therefore, greenhouse producers should develop protocols for quality assessments of purchased BC agents before releasing them into greenhouses to ensure they have the best chance of successfully regulating pest populations below damaging levels. [ABSTRACT FROM AUTHOR]