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Science centers provide an engaging way for young learners to explore related concepts. The hands-on nature of each exercise secures the stimulation necessary to maintain focused attention. In this article, the authors describe a multi-day 5E (Engage, Explore, Explain, Elaborate, Evaluate) lesson on nocturnal and diurnal animals with science centers embedded as the Explore portion. This child-centered approach was selected since it engrossed the authors' young students in meaningful learning. The lesson was taught with a Montessori-based multiple-age classroom of three- to six-year-old learners. This lesson is aligned to: K-LS1-1. Use observations to describe patterns of what plants and animals (including humans) need to survive. Students were introduced to patterns and structure and function while looking for adaptations that help nocturnal animals survive including: excellent eyesight, good sense of smell, good sense of hearing, specialized hairs, and echolocation. Though science centers were themed around nocturnal animals, the method transcends this topic. This 5E lesson is an excellent way to have young learners engage with hands-on science.

Hospital readmissions and emergency department (ED) visits after major thoracic surgery are common and carry a significant burden to the health care system. (1-4) Up to 14% of surgical patients [...], Background: Emergency department (ED) visits and readmissions after thoracic surgery are a major health care problem. We hypothesized that the addition of a novel post-discharge mobile app specific to thoracic surgery to an existing home care program would reduce ED visits and readmissions compared to a home care program alone. Methods: We conducted a prospective cohort study of patients undergoing major lung resection for malignant disease between November 2016 and May 2018. Patients received either home care alone (control group) or home care plus a patient-input mobile app (intervention group). Primary outcomes were 30-day readmission and ED visit rates. Secondary outcomes included reasons for ED visits and readmissions, perioperative complications, 30-day mortality, anxiety (assessed with the Generalized Anxiety Disorder-7 Scale [GAD-7]) and app-related adverse events. We compared outcomes between the 2 groups, analyzing the data on an intention-to-treat basis. Results: Despite the greater number of open surgery and anatomic resections in the intervention cohort, patients in that group were less likely than those in the control group to visit the ED within 30 days of discharge (24.0% v. 38.8%, p = 0.02). Thirty-day readmission rates were similar between the intervention and control groups (10.1% v. 12.2%, p = 0.6). In a subset of patients, there was no difference between the 2 groups in the proportion of patients with a GAD-7 score of 0 (control group 79.8%, intervention group 79.5%, p = NS), which indicated a similar absence of postdischarge anxiety and depression symptoms in the 2 cohorts. Conclusion: The addition of a mobile app to a home care program after thoracic surgery was associated with a reduced frequency of ED visits, in spite of the higher proportions of thoracotomies and anatomic resections in the app cohort. More studies are needed to evaluate the full effect of this new, emerging technology. Contexte : Les consultations aux urgences et les réadmissions après une chirurgie thoracique sont d'importants problèmes de santé. Selon notre hypothèse, l'ajout d'une nouvelle appli pour appareil intelligent à un programme existant de soins à domicile spécifique à la chirurgie thoracique, réduirait les consultations aux urgences et les réadmissions, comparativement au programme de soins à domicile seuls. Méthodes : Nous avons procédé à une étude de cohorte prospective auprès d'une population soumise à une résection pulmonaire majeure pour cancer entre novembre 2016 et mai 2018. Le groupe témoin recevait les soins à domicile seuls et le groupe sous intervention recevait les soins à domicile en plus de l'appli. Les paramètres principaux étaient la réadmission à 30 jours et les taux de consultations aux urgences. Les paramètres secondaires incluaient les motifs de consultations aux urgences et de réadmissions, les complications périopératoires, la mortalité à 30 jours, l'anxiété (mesurée au moyen de l'échelle GAD-7 [General Anxiety Disorder-7]) et les effets indésirables liés à l'utilisation de l'appli. Nous avons comparé les paramètres des 2 groupes et analysé les données selon l'intention de traiter. Résultats : Malgré le nombre plus élevé de chirurgies ouvertes et de résections anatomiques dans le groupe soumis à l'intervention, les membres de ce groupe étaient moins susceptibles de consulter aux urgences dans les 30 jours suivant leur congé (24,0% c. 38,8%, p = 0,02). Les taux de réadmission à 30 jours ont été similaires entre les 2 groupes (10,1% c. 12,2%, p = 0,6). Pour un sous-groupe, on n'a noté aucune différence entre les 2 groupes pour ce qui est de la proportion de patients ayant présenté un score GAD-7 de 0 (groupe témoin 79,8%, groupe soumis à l'intervention 79,5%, p = NS), ce qui indique une absence similaire de symptômes d'anxiété et de dépression consécutifs au congé dans les 2 groupes. Conclusion : L'ajout d'un appli pour téléphone intelligent à un programme de soins à domicile après une chirurgie thoracique a réduit le nombre de consultations aux urgences, malgré une proportion plus grande de thoracotomies et de résections anatomiques dans le groupe bénéficiant de l'appli. Il faudra procéder à d'autres études pour mesurer le plein effet ce cette nouvelle technologie émergente.

"Next Generation Science Standards" ("NGSS") three-dimensional learning is valuable for all students regardless of age. The "NGSS" integrate disciplinary core ideas, science and engineering practices, and crosscutting concepts, adding rigor to science teaching and learning. Though "NGSS" performance expectations begin at the kindergarten level, students can be introduced to the three dimensions prior to kindergarten. All students, including young learners, can actively engage in science and engineering practices, and everyone can benefit from learning crosscutting concepts--themes that bridge the science disciplines. Having students engage with crosscutting concepts is important because when taught in an explicit manner, crosscutting concepts "enable less privileged students, most from non-dominant groups, to make connections among big ideas that cut across science disciplines." This article describes using a 5E (Engagement, Exploration, Explanation, Elaboration, Evaluation) lesson on dinosaurs to engage three- to five-year-old students in three-dimensional learning. The lesson explores the research questions: How long were the dinosaurs from head to tail? How did their length compare to our height? This lesson teaches the mathematical construct of nonstandard measurement, meaning measuring with objects not traditionally used as measurement tools.

This article describes a three-dimensional 5E (Engagement, Exploration, Explanation, Elaboration, Evaluation) lesson that investigates 3-LS4-1: Analyze and interpret data from fossils to provide evidence of the organisms and the environments in which they lived. A phenomena-based approach was used to engage third graders in the story of Maya, who walks the beach in Maryland and sees what appears to be a piece of coral in the cliff. This is surprising because Maryland's current environment does not support coral. Maya gathers evidence that she takes home and photographs. Students are actively involved through exploring photographic evidence to determine why coral would be in the cliff and what can be inferred about the past.

Prolonged air leak (PAL), defined as an air leak lasting longer than 5 days after surgery, is one of the most common postoperative complications after lung surgery, with about 15% [...], Background: Prolonged air leaks are increasingly treated in the outpatient setting, with patients discharged with chest tubes in place. We evaluated the incidence and risk factors associated with readmission, empyema development and further interventions in this patient population. Methods: We undertook a retrospective cohort analysis of all patients from 4 tertiary academic centres (January 2014 to December 2017) who were discharged home with a chest tube after lung resection for a postoperative air leak lasting more than 5 days. We analyzed demographics, patient factors, surgical details, hospital readmission, reintervention, antibiotics at discharge, empyema and death. Results: Overall, 253 of 2794 patients were analyzed (9.0% of all resections), including 30 of 759 from centre 1 (4.0%), 67 of 857 from centre 2 (7.8%), 9 of 247 from centre 3 (3.6%) and 147 of 931 from centre 4 (15.8%) (p < 0.001). Our cohort consisted of 56.5% men, and had a median age of 69 (range 19-88) years. Despite similar initial lengths of stay (p = 0.588), 49 patients (19.4%) were readmitted (21%, 0%, 23% and 11% from centres 1 to 4, respectively, p = 0.029), with 18 (36.7%) developing empyema, 11 (22.4%) requiring surgery and 3 (6.1%) dying. Only chest tube duration was a significant predictor of read-mission (p < 0.001) and empyema development (p = 0.003), with a nearly threefold increased odds of developing empyema when the chest tube remained in situ for more than 20 days. Conclusion: Discharge with chest tube after lung resection is associated with serious adverse events. Given the high risk of empyema development, removal of chest tubes should be considered, when appropriate, within 20 days of surgery. Our data suggest a potential need for proactive postdischarge outpatient management programs to diminish risk of morbidity and death. Contexte : De plus en plus, les fuites aériennes prolongées sont traitées en contexte ambulatoire, le patient retournant à la maison avec un drain thoracique en place. Nous avons évalué l&apos;incidence et les facteurs de risque associés à la réadmission, au développement d&apos;un empyème et aux interventions ultérieures dans une population de patients de ce type. Méthodes : Nous avons mené une analyse de cohorte rétrospective de tous les patients rattachés à 4 centres universitaires tertiaires (de janvier 2014 à décembre 2017) qui, après une fuite aérienne de plus de 5 jours suivant une résection pulmonaire, sont retournés à la maison avec un drain thoracique. Nous avons examinés les paramètres suivants : données démographiques, facteurs liés au patient, détails chirurgicaux, réadmission à l&apos;hôpital, réintervention, antibiotiques prescrits lors du congé, empyème et décès. Résultats : Au total, nous avons analysé 253 patients sur 2794 (9,0% de toutes les résections), dont 30 des 759 patients du centre 1 (4,0%), 67 des 857 patients du centre 2 (7,8%), 9 des 247 patients du centre 3 (3,6%) et 147 des 931 patients du centre 4 (15,8%) (p < 0,001). La cohorte étudiée comprenait 56,5% d&apos;hommes, et l&apos;âge médian était de 69 ans (fourchette de 19 à 88 ans). Malgré des durées de séjour initial similaires (p = 0,588), 49 patients (19,4%) ont été réadmis (respectivement 21%, 0%, 23% et 11% pour les centres 1 à 4, p = 0,029), 18 (36,7%) ont développé un empyème, 11 (22,4%) ont dû subir une intervention chirurgicale et 3 (6,1%) sont décédés. Seule la durée d&apos;utilisation du drain thoracique était un prédicteur significatif de réadmission (p < 0,001) et de développement d&apos;un empyème (p = 0,003), le risque de développer ce trouble étant presque multiplié par 3 avec drain en place pendant plus de 20 jours. Conclusion : L&apos;utilisation d&apos;un drain thoracique pour des patients qui obtiennent leur congé après une résection pulmonaire est associée à des effets indésirables graves. Compte tenu du risque élevé de développement d&apos;un empyème, le retrait du drain devrait être envisagé, lorsque cela convient, dans les 20 jours suivant la chirurgie. Nos données montrent un besoin potentiel en matière de programmes proactifs de gestion des patients externes afin de diminuer le risque de morbidité et de décès.

Preschoolers are fascinated with dinosaurs, and they often have a wealth of knowledge about numerous dinosaur species. The authors capitalized on this interest by creating a three-dimensional 5E lesson (Engage, Explore, Explain, Elaborate, Evaluate; Bybee 2014) to introduce them to the science practice of modeling. Models are important as tools of reasoning that can be used to understand and explain parts of the world (Schwarz, Passmore, and Reiser 2017). In the Explore section of the lesson, students worked to "excavate" and put together physical model skeletons of dinosaurs. They used pictures and other resources to determine what parts of the skeleton were missing. For the Elaborate portion, they created their own model drawings of their ideas of what the dinosaur looked like when alive. The authors helped students write scientific claims and explain their reasoning for things like whether their dinosaur was bipedal or quadrupedal, what it ate, and special defensive features. This lesson also introduced students to the core idea and crosscutting concept of structure and function through learning how the shape of an object can give clues to how it was used. Students explored core ideas about common ancestry and diversity while learning about the discipline of paleontology. This relates to the lesson as students are comparing dinosaurs with living organisms and learning about how fossils help to infer the past.

While microparticles can be removed by a filtration step at a drinking water treatment plant (DWTP), engineered nanoparticles (ENPs), which are widely used in industry, commerce and households, pose a major problem due to their special properties, e.g., size, reactivity and polarity. In addition, many ENPs exhibit toxic potential, which makes their presence in drinking water undesirable. Therefore, this study investigated the removal of ENPs in the laboratory and at a pilot-scale DWTP. Eight ENPs were synthesized and tested for stability in different types of water. Only three of them were stable in natural water: cetyltrimethylammonium bromide-coated gold (CTAB/AuNPs), polyvinylpyrrolidone-stabilized gold and silver nanoparticles (PVP/AuNPs, PVP/AgNPs). Their retention on quartz sand, silica gel and fresh anthracite was low, but CTAB/AuNPs could be retained on fresh river sand and thus should not overcome riverbank filtration, while PVP/AuNPs and PVP/AgNPs showed no retention and may be present in raw water. During ozonation, PVP/AuNPs remained stable while PVP/AgNPs were partially degraded. The advanced oxidation process (AOP) was less effective than ozone. PVP/AgNPs were almost completely retained on the pilot plant anthracite sand filter coated with manganese(IV) oxide and ferrihydrite from raw water treatment. PVP/AuNPs passed the filter with no retention. In contrast to PVP/AuNPs, PVP/AgNPs and CTAB/AuNPs were also retained on activated carbon. The integration of a flocculation step with iron(III) salts can improve ENP removal, with PVP/AuNPs requiring higher flocculant doses than PVP/AgNPs. PVP/AuNPs, in particular, are well-suited for testing the effectiveness of water treatment. Further data on the occurrence of stable ENPs in raw water and their behavior during water treatment are needed to perform a risk assessment and derive the measures. [ABSTRACT FROM AUTHOR]