A STEAM game-based learning framework: Maximizing integrated and immersive learning in the classroom

Digital simulation tools exist to compliment teaching strategies; however, there is tremendous potential to enhance their functionality by integrating them into immersive, educational simulations across the STEAM disciplines. To accomplish this, McMaster University’s Biology students, together with George Brown College students enrolled in the Game–Art, Game– Programming, Game Design, and Concept Art for Entertainment programs, have come together to create an immersive biological video game, Cells at War. Through this continued partnership, students work during their field placement requirements, towards the continued development, expansion, and pilot of this video game platform. This now includes partnerships across multiple institutes (eg. with the University of Wollongong, Australia), and across other STEAM disciplines including physics and music. This innovative WIL partnership will enable these multi-disciplinary students to emulate professional work-place practices used in the game industry, while leveraging technology to facilitate access, progression, and completion of this unique work-integrated learning project. As a combined applied-research/community and industry-engaged project, our industry partners provide consultation on the simulation design, types of interactions integrated into the simulation, and the user experience while playing the simulation. Our STEAM Game-Based Learning framework facilitates student skill development and experiences, while driving educational innovation. Through this project, students from all backgrounds engage in innovative WIL, while producing a robust, video game (eg. Cells at War) that will be employed across educational sectors, and will now include other STEAM disciplines. Presentation attendees are encouraged to bring their own device (eg. smartphone, tablet, laptop) so that they can engage with a browser-based game. This research was approved by the McMaster Research Ethics Board

Use of fluorescence imaging during lymphatic surgery: A Delphi survey of experts worldwide

info:eu-repo/semantics/publishe

Via Egnatia after Egnatius: Imperial policy and inter-regional contacts

The Via Egnatia, which linked Dyrrachium to Kypsela and ultimately to Byzantium/ Constantinople, was the first Roman highway to be built east of the Adriatic. The studies published so far on this important road are devoted almost exclusively to its military importance, particularly during the Roman Republic. This author's goal instead was to assess the importance of the Egnatia at apolitical, social, and cultural level, by examining written sources (literary and epigraphical) and material remains. The article looks into the policy of Roman emperors regarding the Egnatia, and the role of the Via as a factor of commercial, social, and cultural interaction between the Italian peninsula and the Greek world, as well as among the cities and regions that it crossed. It also shows the contribution of the Egnatia to the spectacular development of certain cities and the parallel weakening of others, together with its impact upon the rural landscape

Pretreatment prediction of response to ursodeoxycholic acid in primary biliary cholangitis: development and validation of the UDCA Response Score.

BACKGROUND Treatment guidelines recommend a stepwise approach to primary biliary cholangitis: all patients begin treatment with ursodeoxycholic acid (UDCA) monotherapy and those with an inadequate biochemical response after 12 months are subsequently considered for second-line therapies. However, as a result, patients at the highest risk can wait the longest for effective treatment. We determined whether UDCA response can be accurately predicted using pretreatment clinical parameters. METHODS We did logistic regression analysis of pretreatment variables in a discovery cohort of patients in the UK with primary biliary cholangitis to derive the best-fitting model of UDCA response, defined as alkaline phosphatase less than 1·67 times the upper limit of normal (ULN), measured after 12 months of treatment with UDCA. We validated the model in an external cohort of patients with primary biliary cholangitis and treated with UDCA in Italy. Additionally, we assessed correlations between model predictions and key histological features, such as biliary injury and fibrosis, on liver biopsy samples. FINDINGS 2703 participants diagnosed with primary biliary cholangitis between Jan 1, 1998, and May 31, 2015, were included in the UK-PBC cohort for derivation of the model. The following pretreatment parameters were associated with lower probability of UDCA response: higher alkaline phosphatase concentration (p<0·0001), higher total bilirubin concentration (p=0·0003), lower aminotransferase concentration (p=0·0012), younger age (p<0·0001), longer interval from diagnosis to the start of UDCA treatment (treatment time lag, p<0·0001), and worsening of alkaline phosphatase concentration from diagnosis (p<0·0001). Based on these variables, we derived a predictive score of UDCA response. In the external validation cohort, 460 patients diagnosed with primary biliary cholangitis were treated with UDCA, with follow-up data until May 31, 2016. In this validation cohort, the area under the receiver operating characteristic curve for the score was 0·83 (95% CI 0·79-0·87). In 20 liver biopsy samples from patients with primary biliary cholangitis, the UDCA response score was associated with ductular reaction (r=-0·556, p=0·0130) and intermediate hepatocytes (probability of response was 0·90 if intermediate hepatocytes were absent vs 0·51 if present). INTERPRETATION We have derived and externally validated a model based on pretreatment variables that accurately predicts UDCA response. Association with histological features provides face validity. This model provides a basis to explore alternative approaches to treatment stratification in patients with primary biliary cholangitis. FUNDING UK Medical Research Council and University of Milan-Bicocca

Pretreatment prediction of response to ursodeoxycholic acid in primary biliary cholangitis: development and validation of the UDCA Response Score.

BACKGROUND: Treatment guidelines recommend a stepwise approach to primary biliary cholangitis: all patients begin treatment with ursodeoxycholic acid (UDCA) monotherapy and those with an inadequate biochemical response after 12 months are subsequently considered for second-line therapies. However, as a result, patients at the highest risk can wait the longest for effective treatment. We determined whether UDCA response can be accurately predicted using pretreatment clinical parameters. METHODS: We did logistic regression analysis of pretreatment variables in a discovery cohort of patients in the UK with primary biliary cholangitis to derive the best-fitting model of UDCA response, defined as alkaline phosphatase less than 1·67 times the upper limit of normal (ULN), measured after 12 months of treatment with UDCA. We validated the model in an external cohort of patients with primary biliary cholangitis and treated with UDCA in Italy. Additionally, we assessed correlations between model predictions and key histological features, such as biliary injury and fibrosis, on liver biopsy samples. FINDINGS: 2703 participants diagnosed with primary biliary cholangitis between Jan 1, 1998, and May 31, 2015, were included in the UK-PBC cohort for derivation of the model. The following pretreatment parameters were associated with lower probability of UDCA response: higher alkaline phosphatase concentration (p<0·0001), higher total bilirubin concentration (p=0·0003), lower aminotransferase concentration (p=0·0012), younger age (p<0·0001), longer interval from diagnosis to the start of UDCA treatment (treatment time lag, p<0·0001), and worsening of alkaline phosphatase concentration from diagnosis (p<0·0001). Based on these variables, we derived a predictive score of UDCA response. In the external validation cohort, 460 patients diagnosed with primary biliary cholangitis were treated with UDCA, with follow-up data until May 31, 2016. In this validation cohort, the area under the receiver operating characteristic curve for the score was 0·83 (95% CI 0·79-0·87). In 20 liver biopsy samples from patients with primary biliary cholangitis, the UDCA response score was associated with ductular reaction (r=-0·556, p=0·0130) and intermediate hepatocytes (probability of response was 0·90 if intermediate hepatocytes were absent vs 0·51 if present). INTERPRETATION: We have derived and externally validated a model based on pretreatment variables that accurately predicts UDCA response. Association with histological features provides face validity. This model provides a basis to explore alternative approaches to treatment stratification in patients with primary biliary cholangitis. FUNDING: UK Medical Research Council and University of Milan-Bicocca