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This study presents and evaluates the methodology used in the ninety minutes microteaching lesson, which was carried out on a group of my fourth-year students who are studying English in the university and are training to become English teachers. It aims to assess the role of the teacher, students, materials, and activities used in the classroom and also to address the time shortage with microteaching. It deals with a brief overview of the topic and the class that the lesson is aimed at. Then, the methodology includes details about the method that has been used here, which is based on communicative language teaching (CLT) with the justifications of using it. This is followed by analysing the key features of the lesson plan critically and justifies each activity. Finally, the evaluation of the lesson is presented and microteaching as the best solution and strategy for developing teaching skill has been suggested.

Nowadays, one of the major concerns of teachers is usually about the material they intend to present to the students. The challenge that faces English classes is literature. The benefits of using literary texts in English language classes outweigh its shortcomings that specified by some literary critics, for instance, Chnara Khdhir and Mariwan Hasan pointed out this truth in their paper entitled, “The Importance of Literary Texts in Teaching Language in EFL Classes: The Waste Land as an Example”, which we strongly agree that one can easily learn a language through the literature of the target language. To learn a language one needs to study reading, writing, listening, and speaking; the four skills of the English language, which will all be available in the literature. Materials are provided, which are sufficient for these skills, but literary texts have ascertained a worthy source that accomplishes these abilities. Moreover, culture information is inferred via language learning, and yet with comprehension of the society. This is a characteristic of language that requires materials associating with culture. Culture is a basis for literature; namely; it does not merely imply that literature deals with culture, but literature about the culture of any specific user of that language. Furthermore, one can say the use of literary texts in language classes inspires more attentive and determined language learning. Thus, the students are not merely uncovered to the actual usage of language, but also they become critical scholars. As such, this study argues the causes behind focusing on the use of literary texts as a significant source in teaching the English language.

Vestibular migraine is an underdiagnosed but increasingly recognised neurological condition that causes episodic vertigo, associated with migrainous features. Making a diagnosis of VM relies on a clinical history, including the presence of recurrent episodes of vertigo or dizziness, on a background of migraine headaches, and associated migraine features that accompany the vestibular symptoms. It is the most common cause of spontaneous (non-positional) episodic vertigo, affecting up to 1% of the population, but remains under-diagnosed outside specialist centres, partly due to an absence of diagnostic biomarkers. Its pathophysiology remains poorly understood, and there is a paucity of high-quality treatment trials. Here we review the clinical features of vestibular migraine, highlight current theories that account for vestibular symptoms, and outline treatment guidelines.

Summary: Background: Uncertainty in patients' COVID-19 status contributes to treatment delays, nosocomial transmission, and operational pressures in hospitals. However, the typical turnaround time for laboratory PCR remains 12–24 h and lateral flow devices (LFDs) have limited sensitivity. Previously, we have shown that artificial intelligence-driven triage (CURIAL-1.0) can provide rapid COVID-19 screening using clinical data routinely available within 1 h of arrival to hospital. Here, we aimed to improve the time from arrival to the emergency department to the availability of a result, do external and prospective validation, and deploy a novel laboratory-free screening tool in a UK emergency department. Methods: We optimised our previous model, removing less informative predictors to improve generalisability and speed, developing the CURIAL-Lab model with vital signs and readily available blood tests (full blood count [FBC]; urea, creatinine, and electrolytes; liver function tests; and C-reactive protein) and the CURIAL-Rapide model with vital signs and FBC alone. Models were validated externally for emergency admissions to University Hospitals Birmingham, Bedfordshire Hospitals, and Portsmouth Hospitals University National Health Service (NHS) trusts, and prospectively at Oxford University Hospitals, by comparison with PCR testing. Next, we compared model performance directly against LFDs and evaluated a combined pathway that triaged patients who had either a positive CURIAL model result or a positive LFD to a COVID-19-suspected clinical area. Lastly, we deployed CURIAL-Rapide alongside an approved point-of-care FBC analyser to provide laboratory-free COVID-19 screening at the John Radcliffe Hospital (Oxford, UK). Our primary improvement outcome was time-to-result, and our performance measures were sensitivity, specificity, positive and negative predictive values, and area under receiver operating characteristic curve (AUROC). Findings: 72 223 patients met eligibility criteria across the four validating hospital groups, in a total validation period spanning Dec 1, 2019, to March 31, 2021. CURIAL-Lab and CURIAL-Rapide performed consistently across trusts (AUROC range 0·858–0·881, 95% CI 0·838–0·912, for CURIAL-Lab and 0·836–0·854, 0·814–0·889, for CURIAL-Rapide), achieving highest sensitivity at Portsmouth Hospitals (84·1%, Wilson's 95% CI 82·5–85·7, for CURIAL-Lab and 83·5%, 81·8–85·1, for CURIAL-Rapide) at specificities of 71·3% (70·9–71·8) for CURIAL-Lab and 63·6% (63·1–64·1) for CURIAL-Rapide. When combined with LFDs, model predictions improved triage sensitivity from 56·9% (51·7–62·0) for LFDs alone to 85·6% with CURIAL-Lab (81·6–88·9; AUROC 0·925) and 88·2% with CURIAL-Rapide (84·4–91·1; AUROC 0·919), thereby reducing missed COVID-19 cases by 65% with CURIAL-Lab and 72% with CURIAL-Rapide. For the prospective deployment of CURIAL-Rapide, 520 patients were enrolled for point-of-care FBC analysis between Feb 18 and May 10, 2021, of whom 436 received confirmatory PCR testing and ten (2·3%) tested positive. Median time from arrival to a CURIAL-Rapide result was 45 min (IQR 32–64), 16 min (26·3%) sooner than with LFDs (61 min, 37–99; log-rank p

Abstract Background Several studies have found increased risks of thrombosis with thrombocytopenia syndrome (TTS) following the ChAdOx1 vaccination. However, case ascertainment is often incomplete in large electronic health record (EHR)‐based studies. Objectives To assess for an association between clinically validated TTS and COVID‐19 vaccination. Methods We used the self‐controlled case series method to assess the risks of clinically validated acute TTS after a first COVID‐19 vaccine dose (BNT162b2 or ChAdOx1) or severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. Case ascertainment was performed uninformed of vaccination status via a retrospective clinical review of hospital EHR systems, including active ascertainment of thrombocytopenia. Results One hundred seventy individuals were admitted to the hospital for a TTS event at the study sites between January 1 and March 31, 2021. A significant increased risk (relative incidence [RI], 5.67; 95% confidence interval [CI], 1.02‐31.38) of TTS 4 to 27 days after ChAdOx1 was observed in the youngest age group (18‐ to 39‐year‐olds). No other period had a significant increase, although for ChAdOx1 for all ages combined the RI was >1 in the 4‐ to 27‐ and 28‐ to 41‐day periods (RI, 1.52; 95% CI, 0.88‐2.63; and (RI, 1.70; 95% CI, 0.73‐3.8, respectively). There was no significant increased risk of TTS after BNT162b2 in any period. Increased risks of TTS following a positive SARS‐CoV‐2 test occurred across all age groups and exposure periods. Conclusions We demonstrate an increased risk of TTS in the 4 to 27 days following COVID‐19 vaccination, particularly for ChAdOx1. These risks were lower than following SARS‐CoV‐2 infection. An alternative vaccine may be preferable in younger age groups in whom the risk of postvaccine TTS is greatest.

Background Adrenal sarcomas are rare malignant tumors with structural and clinical similarities to sarcomatoid adrenocortical carcinoma. Preoperative diagnosis of tumors of the adrenal gland can be challenging and often misleading thus detaining patients from appropriate oncological strategies. Objective This analysis of a case series evaluated the predictive capability of the primary clinical diagnosis in case of malignancies of the adrenal gland. Methods Thirty two patients were treated from 2009 to 2015 at our clinic and analyzed retrospectively. All patients had computed tomography and/or magnet resonance imaging and a primary histopathological examination at our institution after surgery. Ten questionable cases were surveyed by a reference pathologist. Results Twelve out of 32 diagnoses had to be revised (37.5%). Only 15 out of 24 tumors primarily classified as adrenocortical carcinoma were finally described as primary adrenal cancer. We found two leiomyosarcomas, one liposarcoma, one sarcomatoid adrenocortical carcinoma, and one epitheloid angiosarcoma among 12 misleading diagnoses. Other tumors turned out to be metastases of lung, hepatocellular, and neuroendocrine tumors. Larger tumors were significantly more often correctly diagnosed compared to smaller tumors. Four patients of the group of revised diagnoses died whereas all patients with confirmed diagnoses survived during the follow-up. Conclusion Preoperative assessment of tumors of the adrenal gland is still challenging. In case of wrong primary diagnosis, the prognosis could be impaired due to inadequate surgical procedures or insufficient preoperative oncological treatment.

BackgroundThe Mucin-family protein, MUC1, impacts on carcinogenesis and tumor invasion. We evaluated the impact of MUC1 expression on outcome in a cohort of 158 patients with resected pancreatic ductal adenocarcinomas (PDAC) in the CONKO-001 study (adjuvant gemcitabine [gem] vs. observation [obs]).MethodsThe percentage of MUC1-positive tumor cells by immunohistochemistry (IHC) and the staining intensity were evaluated by two observers blinded to outcome. The numeric values of both parameters were multiplied, resulting in an immunoreactivity score (IRS) ranging from 0 to 12. The level of MUC1 expression was defined as follows: IRS 0–4 (low) vs IRS >4 (high). Outcomes in terms of disease-free (DFS) and overall survival (OS) were evaluated by Kaplan–Meier method, log-rank tests and Cox regressions.ResultsIn total, tumors of 158 study patients were eligible for immunohistochemistry of MUC1. High cytoplasmic MUC1 expression was associated with impaired DFS and OS in the overall study population (hazard ratio (HR) for DFS: 0.49, 95% CI 0.31 to 0.78, p = .003; HR for OS: 0.46, 95% CI 0.29 to 0.73, p = .001). In the study arms, prognostic effects of MUC1 were also evident in the observation group (HR for DFS: 0.55; 95% CI 0.29 to 1.04, p = .062; HR for OS: 0.34, 95% CI 0.17 to 0.67, p = .001) and trending in the gem group (HR for DFS: 0.48, 95% CI 0.24 to 0.95, p = .041; HR for OS: 0.56, 95% CI 0.28 to1.11, p = .093).ConclusionOur data suggest that MUC1 expression is a powerful prognostic marker in patients with PDAC after curatively intended resection.

Recent studies show that Nanotechnology can be effectively used to enhance the characteristics of many types of trees including forest trees. Dalbergia Sissoo Roxb., which belongs to the Fabaceae family, is a forest tree that grows in dry land and water conservation areas. The aim of this study is to examine the effect of nano silver (NS) at (0, 30, 60 and 90 mg/L) and gibberellic acid (GA3) at (0, 50, 100 and 200 mg/L) concentrations on seed performance and subsequent growth of Dalbergia sissoo Roxb. The results reveal the enhancement of germination rate and velocity by using GA3 at 100 and 200 mg/L. NS90 treatment increased each of shoot and root fresh and dry weight, leaf area and plant height whereas GA50 treatment increased number of branches per plant and primary root length. Non-significant differences between treatments on Peroxidase enzyme activity and chlorophyll a content was observed whereas NS30 had the highest chlorophyll b and lowest total carotenoids. Shoot and root contents of some essential and non-essential elements differed between treatments. In roots, N90 treatment increased each of Cu and Mn elements, but it decreased Cl content. Although GA100 treatment increased Cl content, it decreased Mn. The paper concludes that the applications of nano-silver and GA3 on Dalbergia sissoo Roxb. have significant effects on its growth and physiological parameters.

Childhood marks a crucial phase in dental development, laying the foundation for lifelong oral health. This narrative review explores the role of oral hygiene applications (apps) in promoting optimal oral care habits among children. The article highlights the significance of childhood oral health beyond immediate concerns, emphasizing its impact on physical comfort, emotional wellbeing, and long-term habits. With the proliferation of mobile technology, oral hygiene apps have emerged as innovative tools to engage children in dental care. These apps leverage interactive features, gamification elements, and educational content to make learning about oral hygiene enjoyable and effective. Research indicates that oral hygiene apps can positively influence brushing frequency, technique refinement, and plaque reduction among children. Despite their potential, challenges such as digital equity disparities, privacy concerns, and app sustainability persist. Future directions suggest personalized interventions, integration with telehealth services, and leveraging emerging technologies like augmented reality and artificial intelligence to enhance app effectiveness and engagement. Practical recommendations for healthcare professionals, parents, and app developers are provided to maximize the adoption and effectiveness of oral hygiene apps. Collaboration among stakeholders is essential to address challenges and harness the full potential of oral hygiene apps in pediatric dental care. In conclusion, oral hygiene apps represent promising tools in promoting lifelong oral health habits and enhancing dental outcomes among children. Sustained research, innovation, and collaboration are vital to overcome obstacles and ensure widespread acceptance of these digital interventions. By embracing technological advancements and addressing challenges, oral hygiene apps can play a pivotal role in advancing pediatric dental care and improving oral health outcomes for future generations. [ABSTRACT FROM AUTHOR]

Abstract. Pancreatic ductal adenocarcinoma (PDAC) is a malignancy characterized by an aggressive tumor behavior. The present analysis seeks to identify and analyze a cohort that meets criteria for “inflammatory” PDAC (IPDAC). All patients who underwent a curative resection for PDAC at our institution between 1989 and 2015 were included in the retrospective analysis. Patients with histological proven adenocarcinoma and elevated C-reactive protein (CRP) (≥6 mg/L) serum concentrations, but no other suspicion of infection were included. We provide a matched control group with normal CRP serum levels from the same patient cohort. Thirty-six (6.8%) of 532 patients meet our criteria for an IPDAC group type. In-hospital (30 days) mortality was 13.9% in the IPDAC group vs 0% in the control group (P = .020). Median follow-up was 183.8 months (standard deviation [SD] = 53.3, range 14.3–285.4). Median overall survival was 8.5 months (SD = 16.8, range 0.3–89.6) in the IPDAC group and 24.8 months (SD = 19.4, range 0.7–80.4) in the control group (P = .002). Patients indicating an IPDAC in our cohort had a significantly and clinical meaningful decreased overall survival and a higher perioperative morbidity and mortality.

The present work carried out at the Oued Boussemane, Ain Zerga locality, is the first of its kind in terms of paleoenvironmental reconstitution aimed at highlighting the prehistoric man's way of life in this region. In this perspective, we proceeded with the digging works which allowed us to release a 180 cm thick section, in which we uncovered 8 different sedimentological levels. More than 500 archaeological objects have been discovered (flint tools, bone, ceramic pieces), as well as 27 samples have been collected and intended for several types of analysis (sedimentological, magnetic, geochemical, micromorphological, faunistic...). Sedimentological and geochemical analyses, as well as in situ observations, reveal the presence of two distinct strato-sedimentological units: - The first being located in the upper part of the section, rich in pottery and lithic industry, is attributed to the Holocene and the upper Pleistocene. It is relatively rich in organic matter and shiny blunted quartz grains, reflecting a period of humid weather. - The second is characterized by the presence of limestone crusts and shiny blunted quartz grains; it is older (dating from Pleistocene). This unit is set up under a hydrodynamic regime during a wet period as well. According to the data, the lithic industry can be attributed culturally, to the middle Paleolithic (Atéro-Mousterian), corresponding in North Africa at the interval 140000 - 20000 years BP.

Abstract Background Retroperitoneal sarcomas (RPS) include a heterogeneous group of rare malignant tumours, and various treatment algorithms are still controversially discussed until today. The present study aimed to examine postoperative and long-term outcomes after resection of primary RPS. Patients and methods Clinicopathological data of patients who underwent resection of primary RPS between 2005 and 2015 were assessed, and predictors for overall survival (OS) and disease-free survival (DFS) were identified. Results Sixty-one patients underwent resection for primary RPS. Postoperative morbidity and mortality rates were 31 and 3%, respectively. After a median follow-up time of 74 months, 5-year OS and DFS rates were 58 and 34%, respectively. Histologic high grade (5-year OS: G1: 92% vs. G2: 54% vs. G3: 43%, P = 0.030) was significantly associated with diminished OS in univariate and multivariate analyses. When assessing DFS, histologic high grade (5-year DFS: G1: 63% vs. G2: 24% vs. G3: 22%, P = 0.013), positive surgical resection margins (5-year DFS: R0: 53% vs. R1: 10% vs. R2: 0%, P = 0.014), and vascular involvement (5-year DFS: yes: 33% vs no: 39%, P = 0.001), were significantly associated with inferior DFS in univariate and multivariate analyses. Conclusions High-grade tumours indicated poor OS, while vascular involvement, positive surgical resection margins, and histologic grade are the most important predictors of DFS. Although multimodal treatment strategies are progressively established, surgical resection remains the mainstay in the majority of patients with RPS, even in cases with vascular involvement.