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The study focused on the use of video clips as instructional material and its impact on learning Creative Non-Fiction among Humanities and Social Sciences students in Subic National High School. The researchers used an experimental research design that involved a control group and an experimental group with a total of 60 participants. The researchers utilized a researcher-made pre-test and post-test and a survey questionnaire. The pre-test and post-test results of the control group and experimental group both showed a significant increase. Results show that the experimental group achieved a very satisfactory remark after receiving treatment which is the use of video clips presentation in learning Creative Nonfiction. Moreover, students perceived that video clips with subtitles will serve as better instructional material because they help them in learning Creative Nonfiction, understand difficult concepts, keep them engaged, and motivate them to suit their learning style. The study concluded that there is a significant difference in learning Creative Nonfiction according to the students' gender and age profile. The researchers strongly recommend that teachers should be encouraged to use video clip presentations as a supplementary tool for better academic achievement and teachers can also integrate the use of video clips in other subjects if it is applicable and suitable.

Abstract Sarcoidosis is a multisystem disorder characterised by granulomatous inflammation affecting various organs. The skin is commonly involved and can serve as an initial indicator of disease. While the precise aetiology of sarcoidosis remains elusive, evidence suggests involvement of T‐helper type (TH)‐1 and TH‐17 pathways. Psoriasis shares common inflammatory pathways with sarcoidosis, prompting the repurposing of biologic therapies approved for psoriasis for off‐label treatment of cutaneous sarcoidosis. However, this approach has raised concerns due to the development of granulomatous eruptions in some patients. We present a case of a patient with psoriasis who was diagnosed with systemic sarcoidosis while on ustekinumab. We review previous cases of ustekinumab‐associated sarcoidosis and discuss the challenges associated with utilising biologic agents originally intended for psoriasis treatment for sarcoidosis.

Acquired disorders of platelet function are an underdiagnosed cause of bleeding tendency. A 14-year-old girl developed moderate mucocutaneous bleeding two weeks after a Mycoplasma pneumoniae infection successfully treated with clarithromycin. The patient was referred to us 7 months later for laboratory investigation of the persisting bleeding diathesis. The patient’s personal and family histories were negative for bleeding disorders. Complete blood count, von Willebrand Factor levels and coagulation tests were normal; platelet aggregation, ATP secretion, δ-granules content and serum thromboxane B2 levels were defective. At follow-up visits, laboratory parameters and the bleeding diathesis progressively normalized within 2 years. The patient’s condition is compatible with a diagnosis of acquired Storage Pool Deficiency (SPD), associated with defective thromboxane A2 production. To our knowledge, this is the first case of acquired, transient SPD with spontaneous remission. The pathogenic role of Mycoplasma pneumoniae infection or clarithromycin is possible, albeit uncertain.

Introduction: Diabetes screening traditionally occurs in primary care settings, but many who are at high risk face barriers to accessing care and therefore delays in diagnosis and treatment. These same high-risk patients do frequently visit emergency departments (ED) and, therefore, might benefit from screening at that time. Our objective in this study was to analyze one year of results from a multisite, ED-based diabetes screening program.Methods: We assessed the demographics of patients screened, identified differences in rates of newly diagnosed diabetes by clinical site, and the geographic distribution of high and low hemoglobin A1c (HbA1c) results.Results: We performed diabetes screening (HbA1c) among 4,211 ED patients 40–70 years old, with a body mass index ≥25, and no prior history of diabetes. Of these patients screened for diabetes, 9% had a HbA1c result consistent with undiagnosed diabetes, and nearly half of these patients had a HbA1c ≥9.0%. Rates of newly diagnosed diabetes were notably higher at EDs located in neighborhoods of lower socioeconomic status.Conclusion: Emergency department-based diabetes screening may be a practical and scalable solution to screen high-risk patients and reduce health disparities experienced in specific neighborhoods and demographic groups.

Recently, multiphase drives have emerged as a notable alternative for three-phase drives in several domains, including electric marine propulsion, locomotive traction, and high-power industrial applications where fault tolerance and high reliability are required. This study uses a graphical approach to develop a new carrier-based Pulse-Width Modulation (PWM) that reduces the root-mean-square value of the output current ripple in two-level multiphase inverters with an odd number of phases. The optimization process calculates the optimal common-mode voltage for each switching period. Numerical models and experiments with five- and seven-phase inverters demonstrate the effectiveness of the developed PWM technique, which can reduce the number of commutations while obtaining the lowest output current ripple.

This paper presents an analysis of the operational characteristics of three-phase AC–DC matrix converters, which operate as rectifiers but possess a range of additional capabilities. These include the ability to reverse the power flow, control the input power factor, and generate a multilevel output voltage. The analysis yields a modulation strategy that minimizes switching losses. The proposed modulation strategy is compared with seven well-known space vector modulation strategies in terms of efficiency and distortion of input and output current. The performance is experimentally validated.

This work examined the influence of UV-A light modulation on the photocatalytic process coadjuvated with H2O2 to mineralize phenol in an aqueous solution. A fixed-bed batch photocatalytic reactor with a flat-plate geometry, irradiated by UV-A LEDs, was employed. The successful deposition of commercial TiO2 PC105 on a steel plate (SP) was achieved, and the structured photocatalyst was characterized using Raman spectroscopy, specific surface area (SSA) measurements, and UV–vis DRS analysis. These analyses confirmed the formation of a titania coating in the anatase phase with a bandgap energy of 3.25 eV. Various LED-dimming techniques, with both fixed and variable duty cycle values, were tested to evaluate the stability of the photocatalyst’s activity and the influence of operating parameters during the mineralization of 450 mL of a phenol solution. The optimal operating parameters were identified as an initial phenol concentration of 10 ppm, a hydrogen peroxide dosage of 0.208 g L−1, and triangular variable duty cycle light modulation. Under these conditions, the highest apparent phenol degradation kinetic constant (0.39 min−1) and the total mineralization were achieved. Finally, the energy consumption for mineralizing 90% phenol in one cubic meter of treated water was determined, showing the greatest energy savings with triangular light modulation.

Introduction: Diabetes screening traditionally occurs in primary care settings, but many who are at high risk face barriers to accessing care and therefore delays in diagnosis and treatment. These same high-risk patients do frequently visit emergency departments (ED) and, therefore, might benefit from screening at that time. Our objective in this study was to analyze one year of results from a multisite, ED-based diabetes screening program. Methods: We assessed the demographics of patients screened, identified differences in rates of newly diagnosed diabetes by clinical site, and the geographic distribution of high and low hemoglobin A1c (HbA1c) results. Results: We performed diabetes screening (HbA1c) among 4,211 ED patients 40–70 years old, with a body mass index ≥25, and no prior history of diabetes. Of these patients screened for diabetes, 9% had a HbA1c result consistent with undiagnosed diabetes, and nearly half of these patients had a HbA1c ≥9.0%. Rates of newly diagnosed diabetes were notably higher at EDs located in neighborhoods of lower socioeconomic status. Conclusion: Emergency department-based diabetes screening may be a practical and scalable solution to screen high-risk patients and reduce health disparities experienced in specific neighborhoods and demographic groups.

Abstract Background Food insecurity is a persistent concern in the United States and has been shown to affect child mental health and behavior. The SLC6A4 gene has been indicated as a moderator of the effects of chronic stress on anxiety in adolescents aged 14–21. However, it is unclear if SLC6A4 may also play a role in the effects of childhood food insecurity, a form of chronic stress, on adolescent mental health. This study aimed to identify effects of food insecurity on adolescents’ mental health and delinquent behavior when both mom and child go hungry in the child's early years, and the potential interaction with SLC6A4 variants (SS/LL). Methods The data and sample for this research are from the Future of Families and Child Wellbeing Study. The cohort consists of 4898 children (age 1–15 years, male = 47%, African American = 50%) and their respective caregivers sampled from large cities in the United States from 1998 to 2000. Results The SLC6A4 serotonin transporter short/short allele emerged statistically significant as a moderator of childhood food insecurity and adolescent mental health. Specifically, the presence of the short/short allele increased anxiety symptoms in adolescents with exposure to food insecurity in childhood. Conclusion The SLC6A4 short/short allele amplifies risk of anxiety‐related mental illness when children experience food insecurity. The gene–environment interaction provides insight into the mechanistic pathway of the effects of poverty‐related adversity, such as food insecurity, on developmental trajectories of mental health.

Through the monolingual bias and essentialist understandings of language in education, multilingual youth across the globe have consistently been portrayed as deficient based on their linguistic practices. Deficit approaches in education stem from a colonial project meant to silence the voices and erase the experiences of the Other, and although there is a long tradition of pedagogies that try to counteract this form of discrimination, these attempts are typically built on principles and assumptions that reproduce essentialism and dynamics of marginalization. In this position paper, I argue that it is necessary for educators to engage with non-essentialist understandings of language and multi-sided perspectives on multilingualism to develop pedagogies that are empowering for multilingual youth in Sweden. By engaging with the decolonial notion of linguistic citizenship, educators in Sweden can allow fluid understandings of multilingualism to enter the classroom, creating spaces for socio-political participation and dialogue at the margins of institutional arenas in which language can be negotiated. This measure creates opportunities for empowerment for all students, engaging them in the reconstruction of language and giving voice to stories that would otherwise remain silent.

The aim of the present study was to examine the effect´s relevance of scoring first in knockout promotion to the Spanish Liga Smartbank and succeeding´s probability in the knockout round according to contextual parameters. The sample consisted in all knockout rounds not ending scoreless (n = 199) played in the knockout promotion to Spanish Liga Smartbank between 2004/2005 to 2018/2019 season. Data were examined by descriptive analysis, chi-square tests and binary logistic regressions. Results shown statistically significant values when scoring first and moving through to the next qualifying round (χ² [1 df] = 32.37; p < .001). Teams opening knockout round as a home team and scoring first, move through to the next round 61.7% of times while teams opening knockout round as an away team and scoring first, move through to the next round 79.4% of the times (Total OR = 6.19). Moreover, significant results were found relative to the importance of gaining advantage in first-leg match and scoring first in the second-leg match. This information could be useful for coaches and performance analysts, being applicable to competition in order to prevent the opposite team from scoring a goal and to find tactical options that allow your team getting ahead on the scoreboard.

After years of experimentation, documents, meetings, consultations and negotiations, the SEEA EA re-ignited the debate on the monetary quantification of the value of nature. Now more than ever, there is a need for an original approach, able to align the SEEA EA to the principles of national accounting, to the relevant economic theory and to 'strong sustainability'. In this article, we outline a technically sound alternative to the currently dominant approach, namely "valuation" of ecosystem services (ESs). The basic idea is to recognise the specific meaning and usefulness of each of the numerous monetary estimates proposed for valuation, starting with those included in the SEEA EA, without forcing national accounting principles: we promote the transition from the narrow concept of "monetary value of ecosystem service" to the wider one of “monetary values connected to/dependent on ESs”. Nothing new in terms of evaluation techniques; only a simple, but rich in implications, innovation in terms of interpretation and conceptualisation of the values generated by existing monetary values estimation methods.

Background: Pharmacists working in the multidisciplinary gynaecological oncology pre-admission clinic (PAC) are involved in the perioperative assessment of patients for a comprehensive medication history and information provision regarding withholding of medications before surgery. Objective: To evaluate the current services provided by pharmacists to multidisciplinary staff and patients attending the PAC. Methods: A staff and a patient feedback survey on the value and impact of PAC pharmacy services were distributed within the PAC. The impact of the PAC pharmacist was also assessed by analysing pharmacist interventions and key performance indicators documented. Results: Fifteen staff responses were recorded, 5 nursing staff, 2 midwives and 8 anaesthetists. Eighty-seven percent (n = 13) strongly agreed or agreed that pharmacists at PAC help reduce medication errors on admission. Staff strongly agreed 73% (n = 11) pharmacists obtain a more accurate medication history. Staff reported benefits in having a pharmacist at the clinic to discuss medication related questions with 87% (n = 13) strongly agreeing or agreeing with the statement. A staff overall satisfaction rating of 4.87 out of 5 was recorded. In the patient survey, respondents (n = 6) gave a 4.83 out of 5 rating in confidence in making changes to their medication and their overall satisfaction with the service provided. In reviewing data from January to June 2022, the number of patients seen by the pharmacist were 178 of 681 patients (26.1%) who attended the clinic. The most common medications involved in the pharmacist intervention include those that were advised to be withheld and those that required other changes to therapy prior to their procedure. Conclusion: The role of a PAC pharmacist can be greatly appreciated by the multidisciplinary team and patients. Pharmacist interventions and key performance indicators have demonstrated the important activities of clinical pharmacy services in the PAC in optimising patient care in medication management.

The design and optimization of coils for Inductive Power Transfer (IPT) systems is an iterative process conducted in Finite Element (FE) tools that takes a lot of time and computational resources. In order to overcome such limitations in the design process, new empirical equations for the evaluation of the self-inductance and mutual inductance values are proposed in this work. By means of a multi-objective genetic programming algorithm, the self-inductance, the mutual inductance and the coupling factor values obtained from FE simulations of IPT link are accounted by analytical equations, based on the geometric parameters defining the IPT link. The behavioral modeling results are compared with both FE-based and experimental results, showing a good accuracy.

Abstract Background The burden of Parkinson’s disease (PD) worsens with disease progression. However, the lack of objective and uniform disease classification challenges our understanding of the incremental burden in patients with advanced Parkinson’s disease (APD) and suboptimal medication control. The 5–2-1 criteria was proposed by clinical consensus to identify patients with advancing PD. Our objective was to evaluate the screening accuracy and incremental clinical burden, healthcare resource utilization (HCRU), and humanistic burden in PD patients meeting the 5–2-1 screening criteria. Methods Data were drawn from the Adelphi Parkinson’s Disease Specific Program (DSP™), a multi-country point-in-time survey (2017–2020). People with PD who were naive to device-aided therapy and on oral PD therapy were included. Patients meeting the 5–2-1 screening criteria had one or more of the three clinical indicators of APD: (i) ≥5 doses of oral levodopa/day, OR (ii) “off” symptoms for ≥2 h of waking day, OR (iii) ≥1 h of troublesome dyskinesia. Clinician assessment of PD stage was used as the reference in this study. Clinical screening accuracy of the 5–2-1 criteria was assessed using area under the curve and multivariable logistic regression models. Incremental clinical, HCRU, and humanistic burden were assessed by known-group comparisons between 5 and 2-1-positive and negative patients. Results From the analytic sample (n = 4714), 33% of patients met the 5–2-1 screening criteria. Among physician-classified APD patients, 78.6% were 5–2-1 positive. Concordance between clinician judgment and 5–2-1 screening criteria was > 75%. 5–2-1-positive patients were nearly 7-times more likely to be classified as APD by physician judgment. Compared with the 5–2-1-negative group, 5–2-1-positive patients had significantly higher clinical, HCRU, and humanistic burden across all measures. In particular, 5–2-1-positive patients had 3.8-times more falls, 3.6-times higher annual hospitalization rate, and 3.4-times greater dissatisfaction with PD treatment. 5–2-1-positive patients also had significantly lower quality of life and worse caregiver burden. Conclusions 5–2-1 criteria demonstrated potential as a screening tool for identifying people with APD with considerable clinical, humanistic, and HCRU burden. The 5–2-1 screening criteria is an objective and reliable tool that may aid the timely identification and treatment optimization of patients inadequately controlled on oral PD medications.

Rationale: Contacts of patients with tuberculosis (TB) constitute an important target population for preventive measures because they are at high risk of infection with Mycobacterium tuberculosis and progression to disease.Objectives: We investigated biosignatures with predictive ability for incident TB.Methods: In a case-control study nested within the Grand Challenges 6-74 longitudinal HIV-negative African cohort of exposed household contacts, we employed RNA sequencing, PCR, and the pair ratio algorithm in a training/test set approach. Overall, 79 progressors who developed TB between 3 and 24 months after diagnosis of index case and 328 matched nonprogressors who remained healthy during 24 months of follow-up were investigated.Measurements and Main Results: A four-transcript signature derived from samples in a South African and Gambian training set predicted progression up to two years before onset of disease in blinded test set samples from South Africa, the Gambia, and Ethiopia with little population-associated variability, and it was also validated in an external cohort of South African adolescents with latent M. tuberculosis infection. By contrast, published diagnostic or prognostic TB signatures were predicted in samples from some but not all three countries, indicating site-specific variability. Post hoc meta-analysis identified a single gene pair, C1QC/TRAV27 (complement C1q C-chain / T-cell receptor-α variable gene 27) that would consistently predict TB progression in household contacts from multiple African sites but not in infected adolescents without known recent exposure events.Conclusions: Collectively, we developed a simple whole blood-based PCR test to predict TB in recently exposed household contacts from diverse African populations. This test has potential for implementation in national TB contact investigation programs.

The pathophysiology of generalized essential telangiectasia is not well understood. Generalized essential telangiectasia is an uncommon disorder in which widespread telangiectasias of unknown cause develop without associated systemic or antecedent dermatologic disease. We report a case of generalized essential telangiectasia in an otherwise healthy 49-year-old man.

Kaposi sarcoma (KS) is a vascular neoplasm that is one of the most common human immunodeficiency virus (HIV)-related malignancies. We present the case of a 42-year-old man with a new diagnosis of HIV and acquired immune deficiency syndrome (AIDS)-related epidemic KS.

Right ventricular myocardial infarction (RVMI) and right ventricular (RV) failure are complications from an acute occlusion of a dominant right coronary artery (RCA) or left anterior descending (LAD) artery. Although some patients have good long-term RV recovery, RVMI is associated with high rates of in-hospital morbidity and mortality driven by hemodynamic compromise, cardiogenic shock, and electrical complications. As such, it is important to identify specific clinical signs and symptoms, initiate resuscitation and commence reperfusion therapy with fibrinolytic therapy or percutaneous coronary intervention. This review will discuss RVMI pathophysiology, describe the current diagnostic measures, highlight current therapies, and explore future management options.

Epidermolysis bullosa acquisita (EBA) is a rare, acquired subepidermal blistering disease. EBA is characterized by autoantibodies to collagen VII,which serves to link the epidermis to the dermis. The two most common presentations of EBA are classical noninflammatory EBA and bullous pemphigoid-like EBA. Diagnosis of EBA can be challenging as it sharesclinical and histopathologic features with other blistering diseases. Treatment is often recalcitrant and will often necessitate multiple therapies. We presenta case of a thirty-six-year-old Chinese man with EBA and review the literature.

We present a 57 year-old man presented with generalized hyperhidrosis and widespread, smooth, flesh colored papules on the torso and extremities.Histological examination from multiple biopsies demonstrated morphologic alteration of the eccrine glands with an apocrine phenotype, suggesting eitherapocrine metaplasia or the presence of “apoeccrine glands.” The morphologic similarities between eccrine, apocrine, and apoeccrine as they relate to ourpatient’s histologic findings are discussed. We consider secondary causes of generalized hyperhidrosis, which may also play a role in this patient’s presentation. Treatment and further workup are discussed, whilemanagement of this patient remains in progress.

Anetoderma is a rare benign elastolytic disorder that is characterized by focal loss of elastin fibers on histopathology and is often recalcitrant to treatment. We present a case of a patient with a 20-year history of pruritic and painful hyperpigmented atrophic papules clustered on the neck, axillae, inframammary folds, and right medial thigh. Although the histopathologyof her axillary lesions was consistent with anetoderma, her clinical presentation is unusual given the extent of involvement, reported pain and pruritus, and sharp demarcation of the distribution. The diagnosticuncertainty of this case led to added difficulty in management of a disease that is already notoriously difficult to treat and may significantly impact patient’s quality of life.

B-cell lymphoproliferative diseases may be associated with acquired hemostasis disorders, such as acquired hemophilia A (AHA) caused by autoantibodies that neutralize factor VIII activity, and δ-storage pool deficiency, an abnormality of platelet function due to defective dense granules and impaired secretion. We describe the case of a 67-year-old man in whom these two acquired bleeding disorders were concomitantly present as the first clinical manifestation of an indolent non-Hodgkin lymphoma. Immunosuppressive therapy with prednisone was initially started to eradicate anti-FVIII antibodies, subsequently boosted with cyclophosphamide and rituximab, these medications being also chosen to treat the associated indolent lymphoma. Bleeding symptoms were first tackled with limited benefit by using rFVIIa and then rescued using recombinant porcine FVIII. After a 6 month’s follow-up lymphoma and AHA were in remission and platelet function was improved. This case underlines the need of multiple and complex diagnostic and therapeutic approaches to rare acquired bleeding disorders associated with lymphoproliferative diseases.

Background: Advances in percutaneous coronary intervention (PCI) has made the possibility of facilitating same day discharge (SDD) of patients undergoing intervention. We sought to investigate the feasibility, safety and economic impact of such a service. Methods: We retrospectively collected data on all patients undergoing outpatient PCI at our institution over a 12-month period. We included in-hospital and 30-day major adverse cardiac events (MACE), vascular complications, acute kidney injury and any re-hospitalisations. We analysed the cost effectiveness of SDD compared to overnight admission post PCI and staged PCI following diagnostic angiography. Results: A total of 147 patients undergoing PCI with 129 patients deemed suitable for SDD (88%). Mean age was 65.7 years. Most patients had type C lesions (60.3%); including 4 chronic total occlusions (CTOs). At 30-day follow-up there were no MACE events (0%). There were 10 (7.8%) re-hospitalisations of which majority (70%) were non cardiac presentations. We also included cost analysis for an elective PCI with SDD, which equated to $2090 per patient (total of $269 610 for cohort). Elective PCI with an overnight admission was $4440 per patient (total of $572 760 for cohort), an additional $2350 per patient (total $303 150). Total cost of an angiogram followed by a staged PCI with an overnight stay was $4700 per patient (total $606 300). Conclusion: SDD is safe and feasible in the majority of patients that have elective coronary angiography that require PCI. SDD leads to a significant reduction in total cost and hospital stay of patients undergoing elective PCI.

Abstract Low-dose aspirin (ASA) is used to prevent cardiovascular events. The most commonly used formulation is enteric-coated ASA (EC-ASA) that may be absorbed more slowly and less efficiently in some patients. To uncover these “non-responders” patients, the availability of proper analytical methods is pivotal in order to study the pharmacodynamics, the pharmacokinetics and the metabolic fate of ASA. We validated a high-throughput, isocratic reversed-phase, negative MRM, LC–MS/MS method useful for measuring circulating ASA and salicylic acid (SA) in blood and plasma. ASA-d4 and SA-d4 were used as internal standards. The method was applied to evaluate: (a) the "in vitro" ASA degradation by esterases in whole blood and plasma, as a function of time and concentration; (b) the "in vivo" kinetics of ASA and SA after 7 days of oral administration of EC-ASA or plain-ASA (100 mg) in healthy volunteers (three men and three women, 37–63 years). Parameters of esterases activity were V max 6.5 ± 1.9 and K m 147.5 ± 64.4 in plasma, and V max 108.1 ± 20.8 and K m 803.2 ± 170.7 in whole blood. After oral administration of the two formulations, t max varied between 3 and 6 h for EC-ASA and between 0.5 and 1.0 h for plain-ASA. Higher between-subjects variability was seen after EC-ASA, and one subject had a delayed absorption over eight hours. Plasma AUC was 725.5 (89.8–1222) for EC-ASA, and 823.1(624–1196) ng h/mL (median, 25–75% CI) for plain ASA. After the weekly treatment, serum levels of TxB2 were very low (

Wireless Power Transfer (WPT) is a key enabling technology towards the transportation electrification, able to overcome some limits of the plug-in charging of the Electric Vehicle (EV). In this frame, a special attention is paid to the dynamic WPT systems, where the EV is recharged during motion. This paper presents a model and a resultant method for the system level design of a series-series WPT Dynamic Battery Charger (WPT-DBC) for EVs. The model allows analyzing the joined influence of coil pair characteristics and power converter stages controls on the global performances of WPT-DBCs. The design method provides general guidelines for system level optimization, matching the characteristics of the power and control elements of a series-series WPT-DBC, to achieve the desired efficiency, receiver power loss and battery charge.