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In this paper we report on a study of the impact of digital technology (DT) innovations on students' learning in a Western Australian University. The innovations were implemented by 42 course coordinators (CC) following two days of learning design workshops. In collaboration with nine CCs, we conducted an evaluation of their innovations. Data were collected through two structured interviews with each CC and an online questionnaire for 1500 students. Elements of students' course feedback were incorporated into the final analysis of the data. A model for improving students learning in a digital environment was used as a guide to the evaluation process. The findings indicated that DT interventions helped students prepare for laboratory activities and class participation, increased their levels of interaction and collaboration, and provided effective and timely management of feedback from lecturers. Students also reported greater access to learning resources, plus more motivation and engagement. CCs were generally pleased with their innovations; however, in their second interview, at the end of the semester, CCs identified several aspects of their course design that warranted improvement, including the need for more professional support in making those improvements.

Introduction Von Hippel-Lindau disease (e.g. VHL) is an autosomal dominant multi-organ cancer syndrome caused by a mutation in the VHL tumour suppressor gene. In this study, we introduce a novel genetic variant found in 11 family members diagnosed initially with isolated Pheochromocytoma. Subsequent findings revealed its association with VHL syndrome and corresponds to the Type 2 C phenotype.Methods The VHL gene was amplified through the utilisation of the polymerase chain reaction (PCR). PCR fragments were sequenced using bidirectional Sanger sequencing, using BigDye™ Terminator v3.1 Cycle Sequencing Kit, running on the 3500 genetic analyser. Results were assembled and analysed Using Software SeqA and chromas pro.Results A heterozygous in-frame duplication of three nucleotides, specifically ATG, c.377_379dup; p.Asp126dup in exon 2, was identified in all the patients tested within the pedigree.Conclusion In this study, we disclose the identification of a novel genetic variant in a Jordanian family, affecting eleven family members with pheochromocytoma associated with VHL disease. This finding underscores the importance of screening family members and contemplating genetic testing for individuals newly diagnosed with pheochromocytoma and could enhance our comprehension of the potential adverse consequences associated with VHL germline mutations.

(Charcot-Marie-Tooth disease (CMT) is a genetic disorder affecting peripheral nerves. The human induced pluripotent stem cell (iPSC) line JUCTCi018-A was created using dermal fibroblasts from a Charcot-Marie-Tooth disease type 2EE (CMT2EE) patient with a homozygous missense mutation in the MPV17 gene (c. 122G > A, p.Arg41Gln). These fibroblasts were reprogrammed using Sendai viruses that encoded OCT4, SOX2, KLF4, and c-MYC reprogramming factors. The iPSCs demonstrated normal morphology and karyotype, expressed pluripotency markers, and the ability to differentiate into the three germ layers. This iPSC line is valuable for investigating the mechanisms underlying CMT2EE.

Although mesenchymal stem cells (MSCs) are extensively applied in the regenerative field, the majority of MSCs die after a few weeks of transplantation. Therefore, hypoxia pre-conditioning is a crucial step in increasing the MSCs' tolerance to physiological conditions. Meanwhile, induced pluripotent stem cell-derived MSCs (iMSCs) were proposed as a possible alternative to MSCs, and recently, the interest is growing in applying iMSCs in the regenerative field. This study examined the effect of hypoxia pre-conditioning on the proliferation, viability, and differentiation of iMSCs. Both iMSCs and MSCs were subjected to two rounds of severe short-term hypoxia (1 % O2 for 24h). After that, iMSCs and MSCs were characterized by testing their surface markers' expression, proliferation, viability, oxidative stress, and differentiation potential. Our findings revealed that hypoxia did not have a consistent effect among all the analyzed lines: the severe short-term hypoxia (1 % O2) reduced iMSCs proliferation, cell viability, and MMP while showing a benign effect on surface markers expression, colony formation, ROS accumulation, and osteogenic and adipogenic differentiation. Though hypoxia adversely affected iMSCs’ proliferation, this does not necessarily mean that hypoxia is harmful to iMSCs; on the contrary, our results suggest that short-term hypoxia might have a beneficial long-term effect on the proliferation of iMSCs. Thus, the effect of hypoxia on proliferation, viability, and differentiation should also be tested after a long recovery period from iMSCs. Our next step will be to test the effect of hypoxia for a longer period besides uncovering the changes in the expression profile of hypoxic iMSCs.

Abdelhalim A Awidi,1 Jiawei Zhao,2 Ximin Li,1 Fatemeh Rajaii,1 Meleha Ahmad,3 Adrianna Jensen,4 Fasika A Woreta1 1Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, MD, USA; 2Plastic Surgery Department, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 3Ophthalmic Plastic and Reconstructive Surgery Department, University of California, San Francisco, CA, USA; 4Ophthalmic Plastic and Reconstructive Surgery Department, Pacific Center for Oculofacial and Aesthetic Plastic Surgery, San Francisco, CA, USACorrespondence: Fasika A Woreta, Ophthalmology Department, Wilmer Eye Institute, Baltimore, MD, USA, Tel +1 410 955 5650, Email fworeta1@jhmi.eduPurpose: To investigate the etiology and demographic associations of patients presenting with eyelid lacerations to a US level 1 trauma center emergency department (ED).Patient and Methods: A retrospective chart review of all patients with eyelid lacerations presenting to the ED at a single level 1 trauma center was performed. Eyelid lacerations were categorized as simple eyelid lacerations, eyelid lacerations with eyelid margin involvement, and eyelid lacerations with nasolacrimal system involvement. Data on demographics and clinical characteristics were analyzed.Results: A total of 303 eyelid laceration cases were identified, 56% were simple eyelid lacerations, followed by 24% with nasolacrimal involvement and 20% involving the eyelid margin. Sixty percent of animal bites/scratches resulted in a nasolacrimal system involving laceration, most commonly affecting children. Falls were the most common etiology in children and patients over the age of 60. Black patients, patients presenting with concomitant ophthalmic injuries, and those with Medicaid insurance were more likely to have an assault etiology (p < 0.05 for all).Conclusion: Falls were the most common etiology for eyelid lacerations in children and the elderly, while assault was the most common in adults. Identifying the most common etiology by demographic factors can help raise awareness regarding targeted prevention strategies for high-risk populations.Keywords: eyelid lacerations, ocular trauma, eye injury, emergency department

Purpose: Informal learning is an effective and motivating strategy to support the learning process. Informal learning has received increased attention recently due to the coronavirus disease 2019 (COVID-19) pandemic. However, finding effective ways to facilitate innovative teaching and learning through open educational resources (OER) is a vital issue. The purpose of the current study is to investigate the informal learning characteristics (ILC) (i.e. observation, imitation, exploration, innovation and articulation) of teachers in using OER and whether these characteristics have any relationship with teachers' innovative work behavior (IWB, i.e. opportunity exploration, idea generation, idea promotion and idea realization) in schools. Design/methodology/approach: The current study utilized a descriptive quantitative survey approach. A survey with three parts was developed: the Open Educational Resources Scale (OERS), the Teachers' Informal Learning Characteristics Scale (TILCS) and the Teachers' Innovative Work Behavior Scale (TIWBS). The information was gathered from a sample of 2,024 teachers working in Kuwait's public schools through an online survey. Findings: The results revealed that social media, YouTube, PowerPoint and games were the most common open resources used by teachers. Teachers' responses on the TILCS showed that observation was the most common among teachers and exploration was the second. Responses on the TIWBS showed that idea generation was the highest. When using OER, the results showed that all five subscales of the TILCS and all four subscales of the TIWBS were linked in a good way. Research limitations/implications: This study had several limitations that should be considered in future research. First, the data collection method was self-report. Future research necessitates adopting qualitative methods such as participant observations where IWB can be monitored and documented. Another limitation is almost all teachers have smartphone with Internet access, which may have affected the results. This situation might not be found in other countries since a large percentage of young people in Kuwait use information and communication technology as is the case in other Gulf region countries. Practical implications: This study expects that this kind of support will be reflected on teachers' IWB which accelerates teachers' movement toward upper IWB tasks such as idea promotion and idea realization. This support will motivate teachers to transform teachers' innovative ideas into useful applications and try to assist teachers' colleagues through conducting workshops or inviting well-known educators to present their experiences to school personnel. Social implications: This study can be a guide to help teachers be independent, self-directed, problem-solving-oriented and internally motivated by incorporating the assumptions of andragogy theory. Furthermore, this study points out the high tendency of teachers to use OER and helps to plan teachers' professional development programs that take Andragogical tendencies into account in addition to developing teachers' lifelong learning skills. Originality/value: The results implied that teachers have obvious ILC toward OER, specifically through observation and exploration to create their own innovations in their work environments. With the appropriate internal and external incentives and support from school administrators, this study expects that teachers will move forward toward upper informal learning stages such as innovation and articulation and toward upper tasks in IWB such as idea promotion and idea realization. As a result, schools as places of work can go through a lot of changes if new OER-related applications and workshops are added.

Regional connectivity and land travel have been identified as important drivers of SARS-CoV-2 transmission. However, the generalizability of this finding is understudied outside of well-sampled, highly connected regions. In this study, we investigated the relative contributions of regional and intercontinental connectivity to the source-sink dynamics of SARS-CoV-2 for Jordan and the Middle East. By integrating genomic, epidemiological and travel data we show that the source of introductions into Jordan was dynamic across 2020, shifting from intercontinental seeding in the early pandemic to more regional seeding for the travel restrictions period. We show that land travel, particularly freight transport, drove introduction risk during the travel restrictions period. High regional connectivity and land travel also drove Jordan's export risk. Our findings emphasize regional connectedness and land travel as drivers of transmission in the Middle East.

Multiple sclerosis (MS) is a chronic neuro-inflammatory disease resulting in disabilities that negatively impact patients’ life quality. While current treatment options do not reverse the course of the disease, treatment using mesenchymal stromal/stem cells (MSC) is promising. There has yet to be a consensus on the type and dose of MSC to be used in MS. This work aims to study the safety and efficacy of two treatment protocols of MSCs derived from the umbilical cord (UC-MSCs) and their secretome. The study included two groups of MS patients; Group A received two intrathecal doses of UC-MSCs, and Group B received a single dose. Both groups received UC-MSCs conditioned media 3 months post-treatment. Adverse events in the form of a clinical checklist and extensive laboratory tests were performed. Whole transcriptome analysis was performed on patients’ cells at baseline and post-treatment. Results showed that all patients tolerated the cellular therapy without serious adverse events. The general disability scale improved significantly in both groups at 6 months post-treatment. Examining specific aspects of the disease revealed more parameters that improved in Group A compared to Group B patients, including a significant increase in the (CD3 + CD4 + ) expressing lymphocytes at 12 months post-treatment. In addition, better outcomes were noted regarding lesion load, cortical thickness, manual dexterity, and information processing speed. Both protocols impacted the transcriptome of treated participants with genes, transcription factors, and microRNAs (miRNAs) differentially expressed compared to baseline. Inflammation-related and antigen-presenting (HLA-B) genes were downregulated in both groups. In contrast, TNF-alpha, TAP-1, and miR142 were downregulated only in Group A. The data presented indicate that both protocols are safe. Furthermore, it suggests that administering two doses of stem cells can be more beneficial to MS patients. Larger multisite studies should be initiated to further examine similar or higher doses of MSCs.

Angela Gauthier,1 Abdelhalim A Awidi,1 Paige M Noble,2 Yassine J Daoud1 1Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA; 2Department of Ophthalmology, University of Iowa, Iowa City, IA, USACorrespondence: Yassine J Daoud, The Wilmer Eye Institute, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD, 21287, USA, Tel +1 410-955-5080, Fax +1 410-583-2842, Email ydaoud1@jhmi.eduPurpose: To identify factors related to suboptimal refractive outcomes after toric intraocular lens implantation.Patients and Methods: A retrospective case-control chart review of 446 eyes with toric lens insertion by the same surgeon at a university hospital from 2016 to 2020 was conducted. Pre-operative exam findings, biometry, and one month and three month post-operative vision and refraction were noted. Reviewed charts were considered cases if uncorrected distance visual acuity (UDVA) was worse than 20/40, spherical equivalent (SE) > 1 diopter (D) off target, or cylinder > 1 D off target.&#x00A0Results: Overall, 93.7% (n = 343) of eyes achieved UDVA of 20/40 or better, 92.7% (n = 306) were within 1 D of target SE, and 90.9% (n = 300) were within 1 D of target cylinder. UDVA cases had more eyes with prior LASIK (21.7% vs 7.0%, p = 0.01) and keratoconus (8.7% vs 0.6%, p < 0.001) than controls. More SE cases had prior radial keratotomy (RK) (8.3% vs 0%, p < 0.001) and keratoconus (12.5% vs 0%, p < 0.001) than controls. More cylinder cases had prior LASIK (30.0% vs 8.7%, p < 0.001) and higher mean astigmatism (2.3 vs 1.5 D, p = 0.02) than controls. More cases in all three analyses had higher toric cylinder power (T5-T9) than controls. Age, sex, eye laterality, axial length, anterior chamber depth, lens power, dry eye, anterior basement membrane dystrophy, and Fuchs’ endothelial dystrophy differences were not significant.Conclusion: Prior LASIK or RK, keratoconus, and higher astigmatism may increase the chance of a suboptimal outcome.Keywords: cataract surgery, refractive surgery, astigmatism

PURPOSEMyelodysplastic syndromes (MDS) include a heterogeneous group of clonal bone marrow disorders characterized by ineffective hematopoiesis. They manifest as dysplasia in bone marrow hemopoietic elements associated with peripheral cytopenias with variable risk of AML transformation.PATIENTS AND METHODSWe analyzed retrospectively registry data collected prospectively from patients with primary MDS and patients with MDS/myeloproliferative neoplasm (MPN) in the Jordan University Hospital between January 2007 and September 2021. The registry captured epidemiologic information such as date of diagnosis, age, gender, date of AML transformation, cytogenetics, MDS subtype, risk group according to Revised International Prognostic Scoring System, and survival. The registry also captured baseline ferritin, B12, and lactate dehydrogenase levels.RESULTSA total of 112 patients with MDS and MDS/MPN were included in the registry. Median age at diagnosis was 59 years. The male-to-female ratio was about 1.2. In a multivariate cox regression model, baseline serum ferritin significantly affected survival as patients with levels exceeding 1,000 μg/L had a risk of death three times higher compared with those with

This experimental-mixed methods investigates the impact of shifting from a traditional laboratory model to a hybrid laboratory model. The hybrid model consisted of (1) online instructions and pre-laboratory test, (2) compressed face-to-face laboratory time, and (3) post-laboratory data analysis. This study analyses whether student perceptions of a targeted intervention were correlated to a range of student performance indicators. Only a fractional improvement in student performance was observed, but evidence suggests that the use of online content led to more frequent student interaction with the learning material. The pre-laboratory tests encouraged a better preparation for the laboratory. Splitting the laboratory intervention into different phases was generally better perceived by students than the traditional style. The findings are expected to encourage course coordinators and developers to adopt concepts used in the delivery of hybrid solutions which is important due to the current emphasis on the use of online models of instruction.

Livelihood adaptation in refugee camps is often fragile and inherently problematic owing to their physical characteristics and policy restrictions. The Uganda refugee policy applauded as progressive exhibits internal contradictions which influence livelihoods. The purpose of this study is to explore the significant role of adult education in livelihood adaptation. The study used qualitative research methods of interviews and focus group discussions. Purposive sampling technique was used in selecting 70 participants from eight Common Interest Groups, of both refugees and Ugandan nationals. The findings indicate that access to agriculture extension education and financial literacy facilitates the acquisition of relevant skillsets for adaptation. The study concludes that adult education provides immediate, relevant skillsets for adaptation.

This study aimed to investigate the level of a relatively new phenomenon, fear of missing out or FoMO, demonstrated by smartphone use during lectures among 2084 undergraduate students at Kuwait University. Fear of missing out describes the situation where a student cannot resist using their smartphone during lectures because of their desire not to miss anything that is happening, especially on social media. The study also sought to investigate whether fear of missing out was a predictor for attention distraction and learning disengagement among the students. It used a descriptive survey involving three scales: an attention distraction scale, a learning disengagement scale, and a fear of missing out scale. The level of fear of missing out among students was high and was strongly correlated with both attention distraction and learning disengagement. No significant correlation was found between fear of missing out and students' academic background. These results suggest some practical policies for higher education faculty members to use to lessen the negative outcomes of smartphone use and promote responsible use of smartphones in the classroom.

The dynamics of SARS-CoV-2 transmission in the Middle East have been relatively under-studied. Here, the authors integrate genomic and travel data and show that introductions to the region were initially driven by intercontinental air travel, after which regional land travel became a more important driver.

Background: A significant clinical technology enabling the use of stem cells in dentistry is Photobiomodulation (PBM). The current study aimed to investigate various PBM treatment variables on human dental pulp stem cell proliferation, survival, and changes in cell cycle progression. Methods: Human third molar samples were collected, and human Dental Pulp Stem Cells (hDPSCs) were isolated, expanded, seeded, and cultured in media containing 0, 1, 5, or 10% FBS. PBM treatments using an 810 nm diode laser at various doses were performed 24, 48, and 72 h after seeding. Cell proliferation and apoptosis were assessed. A two-way ANOVA test was performed among all treatment groups, followed by multiple comparison tests (Tukey’s test) performed between each treated group and its control untreated group. Results: After 24 h, only cells cultured in 10% FBS showed a significant (p < 0.005) increase in the proliferation rate of cells treated with T7 (0.4 W × 10 s). After 48 h, hDPSCs cultured in both 5% and 10% FBS showed a significant (p < 0.005) increase in the proliferation rate of cells treated with T7 (0.4 W × 10 s) as compared to the untreated control. After 72 h, only cells cultured in 10% FBS showed a significant increase in the proliferation rate of the cells treated with T9 (1 W × 3 s) (p < 0.005) and T7 (0.4 W × 10 s) (p < 0.00005). Conclusions: Low-power laser therapy at a wavelength of 810 nm induced hDPSC proliferation at the following parameters: power output 0.4 W, irradiance 0.5 W/cm2, fluence 0.416 J/cm2, exposure time 10 s.

Higher education institutions are leveraging the attributes of digital devices to enhance student's learning. The capability of digital devices to present visual images is the subject of this article, specifically the potential for visual organizers (VOs) to support students in an undergraduate marketing research course. Students reported that VOs helped them to understand the course requirements and supported them to organize their study program. VOs were positively associated with student's course participation, collaboration, and knowledge construction. We argued that VOs have the potential to enhance the student learning experience. Lecturers should therefore consider incorporation of VOs when redesigning their courses.

The current study investigated change readiness for smartphone technology among 610 secondary school teachers in Kuwait. We assessed teachers' readiness to adopt smartphones as instructional tools, with respect to their personal concerns, technological competency and personal characteristics. We implemented a quantitative survey design, administering two questionnaires to all participants: the Stages of Concern Questionnaire (SoCQ), based on the concerns-based adoption model, and a newly developed SmartPhone Competency Scale. The findings indicated that teachers' perceptions of the adoption of smartphone technology were associated with their stages of concern and smartphone competency level. Scores on the six stages of concern were compared. Concerns were greatest at the personal stage and lowest at the management stage. In addition, teachers with moderate levels of teaching experience (5-10 years) and teachers who specialized in the sciences reported stronger management concerns than teachers specializing in the arts. The five stages of concern with the highest scores (informational, personal, consequences, collaboration, and refocusing) were positively and significantly correlated with the four smartphone competencies. These results suggest that the SoCQ is a practical tool with predictive value for assessing teachers' change readiness for the adoption of smartphone technology.

Reticulocyte hemoglobin (CHr) is a measure of the amount of hemoglobin in reticulocytes and a marker of cell hemoglobinization. In this study, we aimed to find the optimal cut-off point for reticulocyte hemoglobin to diagnose iron deficiency anemia using multiple methods. A total of 309 patients were included. The median age at diagnosis was 54 years. Most were females (71.2%). 68% had iron deficiency anemia. Patients with IDA had significantly lower levels of CHr compared to those who had non-IDA (p < 0.0001). The optimal cut-off value of CHr for detecting IDA, determined using various methods, was 30.15 pg. This cut-off point had a sensitivity of 87.8% and a specificity of 77.7%. CHr showed a significant positive correlation with hemoglobin, mean corpuscular volume, serum iron, serum ferritin, and transferrin saturation and a significant negative correlation with total iron-binding capacity. CHr levels correlate with most established laboratory tests for IDA. It reliably detects IDA. Our results indicate the importance of CHr in diagnosing IDA, and that CHr should be used more widely in suspected cases of IDA since it is a cheap, fast, and reliable test.

Gold nanoparticles (AuNPs) are one of the most stable nanoparticles that have been prevalently used as examples for biological and biomedical applications. Herein, we evaluate the effect of AuNPs on the biological processes of dental pulp stem cells derived from exfoliated deciduous teeth (SHED). Two different shapes of PEGylated AuNPs, rods (AuNR-PEG) and spheres (AuNS-PEG), were prepared and characterized. SHED cells were treated with different concentrations of AuNR-PEG and AuNS-PEG to determine their effect on the stemness profile of stem cells (SCs), proliferation, cytotoxicity, cellular uptake, and reactive oxygen species (ROS), for cells cultured in media containing-fetal bovine serum (FBS) and serum-free media (SFM). Our results showed that both nanoparticle shapes maintained the expression profile of MSC surface markers. Moreover, AuNS-PEG showed a stimulatory effect on the proliferation rate and lower toxicity on SHED, compared to AuNR-PEG. Higher concentrations of 0.5–0.125 nM of AuNR-PEG have been demonstrated to cause more toxicity in cells. Additionally, cells treated with AuNPs and cultured in FBS showed a higher proliferative rate and lower toxicity when compared to the SFM. For cellular uptake, both AuNS-PEG and AuNR-PEG were uptaken by treated cells efficiently. However, cells cultured in SFM media showed a higher percentage of cellular uptake. For ROS, AuNR-PEG showed a significant reduction in ROS at lower concentrations (