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In the recent years, flipped learning has become popular and been widely utilized as teaching approach to activate students’ learning engagement, which is frequently used to reverse the conventional teaching. However, much more efforts are necessary to enrich the literature about its practices across different teaching and learning contexts. This study is at the cutting edge of examining the practice of flipped learning in higher education contexts; as well as exploring its effects on students’ learning motivation, attitudes, and engagement. Data were collected using a questionnaire from 35 undergraduate students enrolled in “Introduction of Educational Technology” course at a college of education, and the data were tested using 24-version IBM-SPSS linear regression. The results demonstrated that flipped learning strategy is a positive predictor for students’ learning motivation (p-value 0.001 0.05), attitudes (p-value 0.007 0.05), and engagement (p-value 0.003 0.05). The results contribute to offering valuable insights for college stakeholders to enhance the efficacy of teaching and learning process, particularly for higher education curriculum designers to adapt to the current teaching approach. Instructional implication and research suggestions are provided based on the results of the study. more...

Burkitt lymphoma (BL) is a highly aggressive B-cell neoplasm that is well known to be associated with HIV. The presentation usually reflects the underline immunodeficiency state (like opportunistic infections and chronic diarrhea, and enlarged lymph nodes). The most common causes for 3rd cranial nerve palsy are intracranial aneurysm, ischemia, trauma, and migraine. But for our case, it turned out to be associated with underline HIV and BL, which is an unusual cause. Here, we present a 43-year-old gentleman with no past medical history presented to the emergency department with 4 days history of drooping of left eyelid and headache and binocular diplopia with no other neurological features. CT abdomen showed lymph node enlargement. Lymph node biopsy showed the characteristic of Burkitt's cell lymphoma. He was started on chemotherapy, but unfortunately, he died. We're enlightening this case of an isolated oculomotor nerve palsy to diagnose lethal pathology like disseminated BL. more...

A number of research studies have been conducted to examine the practices and challenges of online English language teaching in the age of Covid-19 pandemic. However, research on the teachers’ insights and suggestions to overcome the challenges of the emergency remote teaching still remains unexplored. The present study shed some light on EFL teachers’ teaching activities, challenges, and insights of the emergency remote teaching amidst the global pandemic. The data were obtained from 27 Indonesian EFL teachers (17 female and 10 male) by means of self-written reflection and semi-structured interview. The results revealed that the emergency remote teaching activities were conducted by administering online forum and discussion, integrating social media, and designing interactive exercises. Notwithstanding the facts, the teachers encountered some challenges such as unfamiliarity with digital platforms, inability to provide quick feedbacks, and lack of students’ motivation and engagement during the remote teaching. In responding to the challenges, this study further depicted that joining professional development programs, creating representative lesson plan, and designing interactive online classroom activities could became alternative solution. These results contribute to the realm of English language teaching as fruitful insights and as a ‘wake-up call’ for educational stakeholders in order to enhance the efficacy of online teaching and learning, particularly during the global pandemic. more...

This research investigates the critical thinking (CT) experiences of fourth-year English Language Teaching (ELT) students from five different backgrounds studying at the BA program in ELT at EMU. This research explores these pre-service teachers’ conceptualization of CT and CT-oriented pedagogy and perception of how the ELT program has contributed to developing their CT abilities. It also highlights some implications on the role of culture, education, and other factors in understanding and developing CT and CT-oriented pedagogies. The research questions focused on examining: 1) the participating pre-service teachers’ educational experiences with critical thinking; 2) their current conceptualization of critical thinking and CT-oriented pedagogy; 3) their perception regarding the BA program and its contribution in developing their CT; 4) their plans to incorporate CT in their teaching within their respective contexts. In order to achieve the aim of the study, qualitative data were gathered by conducting semi-structured, in-depth, 90-minute-long interviews with five pre-service teachers. Data obtained from the interviews were thematically analyzed using ATLAS.ti, a qualitative data analysis software. The rich data obtained in this research yielded many findings. In terms of educational background, the pre-service teachers’ past education was inadequate to develop their CT. Their parents’ involvement also had an impact on their CT development. It was concluded that language proficiency facilitates the expression of CT ability and that culture and education are two factors impacting CT that cannot be separated. In terms of CT conceptualization and the perceived role of CT in ELT, the pre-service teachers displayed a non-operant yet growing understanding of CT. Their approach to CT can be divided into ontological and epistemological approaches. Two of the participants failed to perceive the role of CT in education. This indicated a lack of understanding and misconceptions related to CT on the part of pre-service teachers. Regarding the teacher education received at the ELT program, the pre-service teachers perceived it to lack explicit instruction on CT and CT-oriented pedagogies. Some teaching practices and conditions were also found unsupportive of CT development at the ELT program. Finally, concerning pre-service teachers’ teaching for CT, vague and impractical strategies of incorporating CT in language instruction were observed. CT was reduced to language instruction with an omission of CP in ELT. However, the pre service teachers displayed comprehensive awareness of factors impacting CT and potential challenges in incorporating it into their future teaching. The research concludes with several pedagogical implications, which highlight introducing pre service teachers to CT and CP early on in their training and creating a critical space in the teacher education program to allow pre-service teachers to share their understanding of and experience with CT. Finally, the research findings emphasize the need for instructors/teacher educators to employ explicit instruction on CT and CT oriented pedagogy and for ELT programs to provide ELT-specific CT training as part of their curriculum. The qualitative nature of this study and its focus on pre-service teachers’ conceptualization of CT and CT-oriented pedagogy while taking into consideration the cultural and educational factors involved, sets it apart from the dominant number of quantitative studies available in the literature. Keywords: conceptualization, critical thinking (CT), CT-oriented pedagogy, English language teaching (ELT), Eastern Mediterranean University (EMU), pre-service teachers of English Master of Arts in English Language Teaching (ELT). Institute of Graduate Studies and Research. Thesis (M.A.) - Eastern Mediterranean University, Faculty of Education, Dept. of Foreign Language Education, 2021. Supervisor: Prof. Dr. Ülker Vancı Osam. more...

International audience; Analytical Quality Control (AQC) in centralised preparation units of oncology centers is a common procedure relying on the identification and quantification of the prepared chemotherapeutic solutions for safe intravenous administration to patients. Although the use of Raman spectroscopy for AQC has gained much interest, in most applications it remains coupled to a flow injection analyser (FIA) requiring withdrawal of the solution for analysis. In addition to current needs for more rapid and cost-effective analysis, the risk of exposure of clinical staff to the toxic molecules during daily handling is a serious concern to address. Raman spectroscopic analysis, for instance by Confocal Raman Microscopy (CRM), could enable direct analysis (non-invasive) for AQC directly in infusion bags. In this study, 3 anticancer drugs, methotrexate (MTX), 5-fluorouracil (5-FU) and gemcitabine (GEM) have been selected to highlight the potential of CRM for withdrawal free analysis. Solutions corresponding to the clinical range of each drug were prepared in 5% glucose and data was collected from infusion bags placed under the Raman microscope. Firstly, 100% discrimination has been obtained by Partial Least Squares Discriminant Analysis (PLS-DA) confirming that the identification of drugs can be performed. Secondly, using Partial Least Squares Regression (PLSR), quantitative analysis was performed with mean % error of predicted concentrations of respectively 3.31%, 5.54% and 8.60% for MTX, 5-FU and GEM. These results are in accordance with the 15% acceptance criteria used for the current clinical standard technique, FIA, and the Limits of Detection for all drugs were determined to be substantially lower than the administered range, thus highlighting the potential of confocal Raman spectroscopy for direct analysis of chemotherapeutic solutions. more...

In a clinical setting, analytical quality control of the administration of chemotherapeutic preparations is required to ensure patient safety with respect to the dose and more importantly the correct anticancer drug. As such, analytical tools enabling both qualitative and quantitative verification of the composition of prepared solutions can greatly benefit the hospital workflow, reducing cost and ultimately ensuring optimum patient care and outcome. Raman and infrared spectroscopy are rapid and cost-effective techniques, delivering label free molecular characterisation of samples. A comparative study has been conducted using four commercial intravenous formulations, DOXORUBICINE TEVA®, CERUBIDINE®, HOLOXAN® and METHOTREXATE MYLAN®, respectively containing doxorubicin, daunorubicin, ifosfamide and methotrexate as active drugs. Using clinically relevant concentration ranges prepared in 0.9 % NaCl or 5% glucose solutions, it is demonstrated that 100 % discrimination can be achieved for all formulations using either Raman or IR spectroscopic techniques, combined with multivariate discriminant analysis. Employing a partial least square regression analysis, Raman spectroscopy performed on liquid samples delivers a better accuracy compared to infrared for quantification, based on the mean squared error of cross validation. However, it is demonstrated that, despite the strong contribution of glucose and mannitol, an excipient found in CERUBIDINE®, infrared spectroscopy remains an equally viable option for translation into clinics. more...

International audience; The use of Raman spectroscopy for analytical quality control of anticancer drug preparations in clinical pharmaceutical dispensing units is increasing in popularity, notably supported by commercially available, purpose designed instruments. Although not legislatively compulsory, analytical methods are frequently used post-preparation to verify the accuracy of a preparation in terms of identity and quantity of the drug in solution. However, while the rapid, cost effective and label free analysis achieved with Raman spectroscopy is appealing, it is important to understand the molecular origin of the spectral contributions collected from the solution of actives and excipients, to evaluate the strength and limitation for the technique, which can be used to identify and quantify either the prescribed commercial formulation, and/or the active drug itself, in personalised solutions. In the current study, four commercial formulations, Erbitux®, Truxima®, Ontruzant® and Avastin® of monoclonal antibodies (mAbs), corresponding respectively to cetuximab, rituximab, trastuzumab and bevacizumab have been used to highlight the key role of excipients in discrimination and quantification of the formulations. It is demonstrated that protein based anticancer drugs such as mAbs have a relatively weak Raman response, while excipients such as glycine, trehalose or histidine contribute significantly to the spectra. Multivariate analysis (partial least square regression and partial least square discriminant analysis) further demonstrates that the signatures of the mAbs themselves are not prominent in mathematical models and that those of the excipients are solely responsible for the differentiation of formulation and accurate determination of concentrations. While Raman spectroscopy can successfully validate the conformity of mAbs intravenous infusion solutions, the basis for the analysis should be considered, and special caution should be given to excipient compositions in commercial formulations to ensure reliability and reproducibility of the analysis. more...

Pilonidal disease and hidradenitis suppurativa are chronic inflammatory diseases that affect young patients and can have a serious impact on their quality of life. The association between them was frequently reported but not well documented. This study aimed to determine the prevalence and characteristics of inflammatory skin lesions located in the intergluteal fold and axillae of patients with hidradenitis suppurativa and those with pilonidal disease. In retrospective manner the study based on data collection from records of a cohort of patients with hidradenitis suppurativa without histopathology and patients with pilonidal diseases with or without histopathology who had been managed in Almikhwah General Hospital, KSA during the period from January 2014 to April 2020. A total of 391 patients were recruited, 224(57.3%) with pilonidal diseases (Group A) and 167 (42.7%) with hidradenitis suppurativa diseases (Group B). Their mean age was 27.5 years (p=0.3). In group A, the lesions were found in sacrococcygeal region whereas in group B, it was found in axillae and sacrococcygeal region. Coincidences of the diseases were observed in 79 (20.2%) patients. In conclusion, it should be borne in mind that the pilonidal sinus can be a non-localized type of hidradenitis suppurativa. more...

International audience; Anticancer drugs are prescribed and administrated to an increasing number of patients on a daily basis. As a consequence, a number of concerns have been raised about the patient health and safety in the case that the drugs administered are not at the required concentration or even worse not the correct ones. Quality control of therapeutic solutions has therefore been extensively implemented in hospital environments, in order to avoid any failure in the intense workflow faced by administering pharmacists. In the present study, infrared (IR) and Raman spectroscopy have been employed for the analysis of 3 commercially available therapeutic solutions TEVA®, MYLAN®, CERUBIDINE®, respectively containing doxorubicin, epirubicin and daunorubicin. They perfectly illustrate the analytical difficulties encountered, as these 3 chemotherapeutic drugs are isomers, hardly distinguishable with conventional approaches such as UV/VIS spectrometry. Any analytical failure to identify these molecules can lead to delays in patient treatment. While Partial Least Squares Regression analysis demonstrates that both Raman and IR can deliver satisfactory quantitative analysis in the clinical range, with respective Root Mean Square Error of Cross Validation (RMSECV) between 0.0127 – 0.0220 g·L−1 and 0.0573 – 0.0759 g·L−1, the identification rate between the 2 techniques differs substantially. Indeed, Principal Component Analysis – Factorial Discriminant Analysis (PCA-FDA) highlights that, depending on the data preprocessing applied to Raman spectra, the discrimination between the 3 drugs is decreased, with in some cases specificity and sensitivity below 50%. However, IR analysis displays encouraging results with an overall specificity and sensitivity between 99 and 100%, suggesting that reliable validation of the therapeutic solution for administration to patients can be achieved. IR and Raman spectroscopy could assist and support quality control of chemotherapeutic solutions prepared in personalised concentrations for each patient. The effective and reliable characterisation of therapeutic solutions could have a lot to offer to improve current practices in a near future. more...