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Classroom communication is increasingly accepted as multimodal, through the orchestrated use of different semiotic modes, resources, and systems. There is growing interest in examining the meaning-making potential of other modes (e.g., gestural, visual, kinesthetic) beyond the semiotic mode of language, in classroom communication and in student reasoning in science. In this paper, we explore the use of a multi-layered analytical framework in an investigation of student reasoning during an open inquiry into the physical phenomenon of dissolving in a primary classroom. The 24 students, who worked in pairs, were video recorded in a facility purposefully designed to capture their verbal and non-verbal interactions during the science session. By employing a multi-layered analytical framework, we were able to identify the interplays between the different semiotic modes and the level of reasoning undertaken by the students as they worked through the tasks. This analytical process uncovered a variety of ways in which the students negotiated ideas and coordinated semiotic resources in their exploration of dissolving. This paper highlights the affordances and challenges of this multi-layered analytical framework for identifying the dynamic inter-relationships between different modes that the students drew on to grapple with the complexity of the physical phenomenon of dissolving.

Purpose Post-dural puncture headache (PDPH) is a well-known neurological outcome caused by leakage of cerebrospinal fluid during neuraxial anesthesia. Studies aimed at assessing the efficacy of finer gauged spinal needles to reduce the incidence of PDPH have produced conflicting results. We have therefore examined the effect of the gauge of cutting needles and pencil-point needles, separately, on the incidence of PDPH. Methods The PubMed, EMBASE and Google Scholar databases were searched for randomized studies which compared PDPH incidence in a head-to-head analysis of individual needle gauges of similar needle designs (cutting and pencil-point). A meta-regression analysis was performed taking into account various covariates, such as needle gauge and design, mean age of patient population, surgery type, percentage of males and females in study population and year of publication. Results Of the 22 studies (n = 5631) included in the analysis, 12 (n = 3148) and ten (n = 2483) compared different gauges of cutting needles and pencil-point needles, respectively. After adjusting for covariates, meta-regression analysis was performed for all studies that randomly compared individual needle gauges of similar needle design. Whereas the incidence of PDPH inversely correlated with gauge in cutting needles ([beta] = -1.36 % per gauge, P = 0.037), no relationship was noted in pencil-point needles ([beta] = -0.32 % per gauge, P = 0.114). Female gender was the only covariate that reached a statistically significant correlation with the incidence of PDPH in both models. Conclusions A significant relationship between needle gauge and subsequent rate of PDPH was noted in cutting needles, but not pencil-point needles., Author(s): Andres Zorrilla-Vaca[sup.1] [sup.2] , Ryan Healy[sup.1] , Carolina Zorrilla-Vaca[sup.2] Author Affiliations: (1) Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Hospital, 1800 Orleans Street, Sheikh Zayed Tower [...]

The purpose of this study was to determine whether there was a significant difference in static stretching (SS), dynamic stretching (DS), and no stretching (NS) on maximal strength (one-repetition maximum [1RM]) in the bench and leg presses using free weights on 19 college-aged men and 32 women. Most of the participants were moderately to very active and had previous experience with weight training. The design was repeated measures, with each treatment being randomly assigned. Each testing session was separated by 72 hours. Moderate-intensity stretching was defined as stretching as far as possible without any assistance, and subjects were encouraged to do their best. For the SS routine, the chest, shoulder, triceps, quadriceps, and hamstrings were stretched. Three repetitions were performed for 15 seconds, each separated by a 10-second rest. For DS, the upper-body stretch was swinging each arm, one at a time, as far forward and then as far backward as possible in a diagonal plane. For the legs, the same movement was done for each leg, except performed in a sagittal plane. Each forward and backward movement took about 2 seconds. Three 30-second sets were administered, and a 10-second rest was allowed between sets. Next, 1RM was determined for the bench and leg presses in random order. Two warm-up sets were given, followed by several 1RM attempts. The last successful lift was recorded as the 1RM. Data were reported using means [+ or -] SD. A one-way ANOVA with repeated measures was used with alpha set at 0.05. There was no significant difference among the treatments. Moderate-intensity stretching does not seem to adversely affect 1RM in the bench and leg presses. KEY WORDS 1RM, intensity, multijoint exercises

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Purpose: Although evidence from observational studies in a variety of clinical settings supports the utility of cerebral oximetry as a predictor of outcomes, prospective clinical trials thus far have reported conflicting results. This systematic review and meta-analysis was designed to evaluate the influence of management associated with intraoperative cerebral oximetry on postoperative outcomes. The primary outcome was postoperative cognitive dysfunction (POCD), with secondary outcomes that included postoperative delirium, length of intensive care unit (ICU) stay, and hospital length of stay (LOS).Source: After searching the PubMed, EMBASE, Cochrane Library, Scopus, and Google Scholar databases, all randomized controlled trials (RCTs) assessing the impact of intraoperative cerebral oximetry-guided management on clinical outcomes following surgery were identified.Principal Findings: Fifteen RCTs comprising 2,057 patients (1,018 in the intervention group and 1,039 in control group) were included. Intraoperative management guided by the use of cerebral oximetry was associated with a reduction in the incidence of POCD (risk ratio [RR] 0.54; 95% confidence interval [CI], 0.33 to 0.90; P = 0.02; I2 = 85%) and a significantly shorter length of ICU stay (standardized mean difference [SMD], -0.21 hr; 95% CI, -0.37 to -0.05; P = 0.009; I2 = 48%). In addition, overall hospital LOS (SMD, -0.06 days; 95% CI, -0.18 to 0.06; P = 0.29; I2 = 0%) and incidence of postoperative delirium (RR, 0.69; 95% CI, 0.36 to 1.32; P = 0.27; I2 = 0%) were not impacted by the use of intraoperative cerebral oximetry.Conclusions: Intraoperative cerebral oximetry appears to be associated with a reduction in POCD, although this result should be interpreted with caution given the significant heterogeneity in the studies examined. Further large (ideally multicentre) RCTs are needed to clarify whether POCD can be favourably impacted by the use of cerebral oximetry-guided management. [ABSTRACT FROM AUTHOR]