Virtual Coaching: Throughout and Beyond a Pandemic

This article describes the implementation of virtual coaching to overcome barriers encountered with face to face coaching. The author gives an explanation of why virtual coaching was first explored and how it is currently being used with K-3 teachers to promote the use of the K-3 Essential Instructional Practices in Early Literacy. Additional information and specific documents are shared at the end of the article

Aircraft Cargo Compartment Fire Test Simulation Program

The objective of the test was to assess fire containment and fire extinguishment in the cargo by reducing the ventilation through the cargo compartment. Parameters which were measured included ignition time, burnthrough time, and physical damage to the cargo liner, composition of selected combustible gases, temperature-time histories, heat flux, and detector response. The ignitor load was made of a typical cargo consisting of filled cardboard cartons occupying 50% of the compartment volume

Prognostic significance of CD24 and claudin-7 immunoexpression in ductal invasive breast cancer

This study aimed to identify the CD24 and CD44 immunophenotypes within invasive ductal breast carcinoma (I DC) subgroups defined by immunohistochesmistry markers and to determine its influence on prognosis as well as its association with the expression of Ki-67, cytokeratins (CK5 and CK 18) and claudin-7. Immunohistochemical expression of CD44 and CD24 alone or in combination was investigated in 95 IDC cases arranged in a tissue microarray (TMA). The association with subgroups defined as luminal A and B; HER2 rich and triple negative, or with the other markers and prognosis was analyzed. CD44(+)/CD24(-) and CD44(-)/CD24(+) were respectively present in 8.4% and 16.8% of the tumors, a lack of both proteins was detected in 6.3%, while CD441(-)/CD24(+) was observed in 45.3% of the tumors. Although there was no significant correlation between subgroups and different phenotypes, the CD44(+)/CD24(-) phenotype was more common in the basal subgroups but absent in HER2 tumors, whereas luminal tumors are enriched in CD44(-)/CD24(+) and CD44(+)/CD24(+) cells. The frequency of CD44(+)/CD24(-) or CD44(-)/CD24(+) was not associated with clinical characteristics or biological markers. There was also no significant association of these phenotypes with the event free (DFS) and overall survival (OS). Single CD44(+) was evident in 57.9% of the tumors and was marginally associated to grading and not to any other tumor characteristics as well as OS and DFS. CD24(+) was positive in 74.7% of the tumors, showing a significant association with estrogen receptor, progesterone receptor and Ki-67 and a marginal association with CKI8 and claudin-7. Expression of claudin-7 and Ki-67 did not associate with the cancer subgroups, while a positive association between CK18 and the luminal subgroups was found (P=0.03). CK5, CK18 and Ki-67 expression had no influence in OS or DFS. Single CD24(+) (P=0.07) and claudin-7 positivity (P=0.05) were associated with reduced time of recurrence, suggesting a contribution of these markers to aggressiveness of breast cancer.FAPESPCNP

Tumores neuroendócrinos gastrointestinais e pulmonares: aspectos anatomopatológicos e correlações com KI67

Introdução: Os tumores neuroendócrinos (TNEs) possuem distribuição difusa por todo o corpo, sendo as sedes mais frequentes o trato gastrointestinal (TGI) e o pulmão. Os TNEs possuem significativas chances de metastizar e sua incidência aumentou mais de 5 vezes de 1975 para 2010. Assim, torna-se indispensável à utilização de técnicas que ajudem no diagnóstico e prognóstico, como imunohistoquímica com o marcador de proliferação celular Ki67. Objetivo: Avaliar os níveis expressos de Ki67 nos TNEs do TGI e pulmão e sua relação com o prognóstico. Metodologia: Foi feita uma análise retrospectiva de 61 casos de TNEs do TGI e pulmão, com avaliação das características patológicas do tumor, como extensão da lesão, presença de metástases e correlação com Ki67. Resultados: Na casuística analisada, os TNE do TGI corresponderam a 50,8% dos casos analisados. Ambas as sedes têm uma incidência maior no sexo masculino e na faixa etária entre 61 e 70 anos. Em relação aos pulmonares, a mediana de 65 anos no gênero masculino foi significantemente (P = 0,0043) maior do que a observada no feminino (52,5 anos). No TGI, a sede mais frequente foi o reto. A análise pelo teste do Qui Quadrado mostrou maior frequência de G1 e G2 no TGI e de G3 no pulmão (classificação da OMS). Dos 61 casos analisados, 20 apresentavam embolia carcinomatosa, metástases em outros sítios ou metástases em linfonodos, ora isoladas, ora concomitantes, sendo que as metástases em linfonodos foram significantemente (P = 0,0081) mais frequentes. Conclusão: Desta forma, conclui-se que para adequada avaliação diagnóstica dos TNE é fundamental a quantificação do Ki67, além da aferição do tamanho da lesão, para assim prever o prognóstico, auxiliando no diagnóstico e no tratamento. Os levantamentos feitos no presente trabalho são importantes para se conhecer a realidade local dos TNE em comparação com a literatura existente

The diagnostic accuracy of telerehabilitation for nonarticular lower-limb musculoskeletal disorders

Objective: Musculoskeletal conditions are highly prevalent and disabling, particularly in rural and remote areas. In these areas, access to rehabilitation services is limited by the availability of physical therapists. Telerehabilitation may be a feasible solution to the issue of rural physical therapy service access; however, there is little existing evidence for clinical efficacy. The aim of this study was to establish the criterion validity and reliability of remote physical assessment and diagnosis of nonarticular lower limb musculoskeletal conditions via telerehabilitation. Materials and Methods: Nineteen participants with existing nonarticular lower limb musculoskeletal conditions were assessed by a face-to-face therapist and a remote therapist to establish criterion validity of telerehabilitation. Video recordings from the telerehabilitation session were reviewed after 1 month by the remote therapist to establish intrarater reliability and by a second remote therapist to establish interrater reliability. Patho-anatomical diagnoses, system diagnoses, and the findings of the physical examination were compared statistically. Results: There was 79% or higher primary diagnosis agreement (same or similar diagnoses) and 79% or higher exact system diagnosis agreement for validity, intrarater reliability, and interrater reliability studies. The physical examination findings showed substantial agreement (0.61 < kappa < 0.80) in the validity study and almost perfect agreement 0.81 < kappa < 1.00) in the intrarater and interrater reliability studies. Conclusions: Using telerehabilitation for musculoskeletal physical therapy assessment of nonarticular lower limb conditions was found to be valid and reliable. Existing diagnostic reasoning can be applied; however, new methods of patient self-examination are needed to enable differential diagnosis

Physiotherapy assessment and diagnosis of musculoskeletal disorders of the knee via telerehabilitation

Introduction: Lower limb musculoskeletal disorders place a heavy burden on healthcare systems. Appropriate management of these conditions is critical, however access to appropriate physiotherapy services is difficult for those in geographically remote areas or those with mobility or transport difficulties. The aim of this study was to evaluate the accuracy and reliability of an online musculoskeletal physiotherapy assessment of the knee complex using telerehabilitation compared to traditional face-to-face assessment. Methods: In a repeated-measures design, 18 subjects who sought treatment for knee pain underwent a traditional face-to-face assessment and a remote telerehabilitation assessment. Telerehabilitation assessments were conducted with participants performing facilitated self-palpation, self-applied modified orthopaedic tests, active movements and functional tasks. Results: Primary pathoanatomical diagnoses were in exact agreement in 67% of cases and were similar in 89% of cases. The system of pathology was found to be in agreement in 17 out of 18 cases (94%). Comparisons of objective findings from the two physical assessments demonstrated substantial agreement (kappa = 0.635) for categorical data and binary data (chi-squared = 400.36; p < 0.001). A high level of intra-rater (89%) and moderate level of inter-rater (67%) reliability was evident for telerehabilitation assessments. Discussion: Telerehabilitation assessment of the knee complex appears to be feasible and reliable. This study has implications for clinical practice and the development of physiotherapy services to address the burden of lower limb musculoskeletal pain and disability