A Method of Teaching Oral Communications to Adults

This thesis addresses teaching public speaking to adult students. It takes into account the unique characteristics of adult learners in developing a ten-lesson course to teach confidence and proficiency in public speaking. Chapters One through Three explore ideas found in literature relating to the rapid growth of adult education, adult learning processes, and the specific ways to teach public speaking to adults. The works of important pioneers in public speaking education such as Dale Carnegie and Dr. Ralph Smedley are discussed . Also included are successful modern- day advocates o f polished speaking skills such as Lilly Waters and Jack Griffin. Chapters Four and Five present and discuss a ten-lesson course that teaches the skills and gives the confidence required to become a successful public speaker . Lesson content, teachers guide, and exercises are included . Special attention is given the fact that fear of public speaking plays a significant role in holding back most poor speakers. Specifically, lessons One, Two, and Three are intended to address the fear factor, and lay out the basics needed to begin developing public speaking skills. The next five lessons introduce skills such as using gestures, good eye contact, vocal variety, use of props, and other topics necessary to build on the basics of public speaking. Lesson Nine allows for the reinforcement of any material covered, introduction of any worthwhile new material brought to the class, and time to work with the students on their final presentation. Lesson Ten allows as formal a setting as possible for final presentations, giving the students as much a real world setting as possible. Students are encouraged to use their life experiences and skills to develop their presentations. Positive reinforcement is an important tool used in the learning process. As the students learn, apply, and see their progress, they gain confidence and proficiency

Unique case of vascularization: superficial brachial artery and radial persistent median artery

During a routine cadaveric dissection of a 93-year-old male donor, unique arterial variations were observed in the right upper extremity. This rare arterial branching pattern began at the third part of the axillary artery (AA), where it gave off a large superficial brachial artery (SBA) before bifurcating into the subscapular artery and a common stem. The common stem then gave off a division for the anterior and posterior circumflex humeral arteries, before continuing as a small brachial artery (BA). The BA terminated as a muscular branch to the brachialis muscle. The SBA bifurcated into a large radial artery (RA) and small ulnar artery (UA) in the cubital fossa. The UA branching pattern was atypical, giving off only muscular branches in the forearm and a deep UA before contributing to the superficial palmar arch (SPA). The RA provided the radial recurrent artery and a common trunk (CT) proximally before continuing its course to the hand. The CT from the RA gave off a branch that divided into anterior and posterior ulnar recurrent arteries, as well as muscular branches, before it bifurcated into the persistent median artery (PMA) and the common interosseous artery. The PMA anastomosed with the UA before entering the carpal tunnel and contributed to the SPA. This case presents a unique combination of arterial variations in the upper extremity and is clinically and pathologically relevant

Antibody-mediated procoagulant platelets in SARS-CoV-2-vaccination associated immune thrombotic thrombocytopenia

The COVID-19 pandemic has resulted in significant morbidity and mortality worldwide. To prevent severe infection, mass COVID-19 vaccination campaigns with several vaccine types are currently underway. We report pathological and immunological findings in 8 patients who developed vaccine-induced immune thrombotic thrombocytopenia (VITT) after administration of SARS-CoV-2 vaccine ChAdOx1 nCoV-19. We analyzed patient material using enzyme immune assays, flow cytometry and heparin-induced platelet aggregation assay and performed autopsies on two fatal cases. Eight patients (5 female, 3 male) with a median age of 41.5 years (range, 24 to 53) were referred to us with suspected thrombotic complications 6 to 20 days after ChAdOx1 nCoV-19 vaccination. All patients had thrombocytopenia at admission. Patients had a median platelet count of 46.5 x109/L (range, 8 to 92). Three had a fatal outcome and 5 were successfully treated. Autopsies showed arterial and venous thromboses in various organs and the occlusion of glomerular capillaries by hyaline thrombi. Sera from VITT patients contain high titer antibodies against platelet factor 4 (PF4) (OD 2.59±0.64). PF4 antibodies in VITT patients induced significant increase in procoagulant markers (P-selectin and phosphatidylserine externalization) compared to healthy volunteers and healthy vaccinated volunteers. The generation of procoagulant platelets was PF4 and heparin dependent. We demonstrate the contribution of antibody-mediated platelet activation in the pathogenesis of VITT