923 research outputs found
Tech EDGE Student Rubric K-1
This rubric can be used to evaluate formative and summative assessments of technology integrated products across the curriculum for grades K-1
Technological Pedagogical Content Knowledge in Teacher Preparation: Impact of Coaching Professional Development and Mobile Devices
This presentation explores the process of change for a teacher preparation program as it attempted to teach pre-service teachers how to integrate new technologies into instruction in elementary schools. The aim was to impact the instruction of preservice and inservice teachers in a way that would reach their current students. This study shows that it is possible to significantly increase the technological pedagogical content knowledge of pre-service teachers. This positive result is a clear indication that the approach of improving the quality of technology integration in Teacher Education, hand in hand with changes in technology integration in schools, had a multiplicative effect on outcomes
The Impact of a Teacher Education Program Redesign on Technology Integration in Elementary Preservice Teachers
This 5-year multicohort study examined the growth of elementary preservice teachers’ technology integration in the context of a teacher preparation program redesign that made integrating technologies into instruction a major focus. The authors examined how the teacher education program impacted preservice teachers’ technology integration in the classroom by increasing their efficacy to integrate technology and subject areas (i.e., technology, pedagogy, and content knowledge [TPACK] efficacy ) and their technology knowledge. Survey data collected from 891 participants were analyzed using thematic coding, analyses of variance, and structural equation modeling. The full program redesign showed across-cohort growth in TPACK efficacy, technology knowledge, and technology integration frequency, suggesting the possibility of increasing preservice teachers’ technology integration through redesigning the teacher education program. Findings indicated that modeling by teacher educators and cooperating teachers positively impacted TPACK efficacy, technology knowledge, and technology integration frequency. Technology knowledge predicted technology integration frequency. TPACK efficacy empowered preservice teachers with confidence to integrate technology but did not predict technology integration frequency. Implications for teacher education programs are discussed
Relative amplitude index: A new tool for hemodynamic evaluation of periprosthetic regurgitation after transcatheter valve implantation
ObjectiveThe impact of paravalvular aortic regurgitation (PAR) on hemodynamic performance after transcatheter aortic valve implantation (TAVI) remains disputable. Common parameters such as the diastolic blood pressure or the blood pressure amplitude do not provide reproducible results. The aim of our study was to evaluate the impact of PAR on hemodynamics and outcome using the relative amplitude index (RAI).MethodsPAR was prospectively evaluated by echocardiography before discharge in 110 patients. The RAI was calculated according to the formula: RAI = [(Post-TAVI BP amplitude)/(Post-TAVI SBP) − (Pre-TAVI BP amplitude)/(Pre-TAVI SBP)] × 100%, where BP is blood pressure and SBP is systolic blood pressure. Correlations of increased RAI with perioperative outcome were investigated and factors influencing mortality were isolated.ResultsThe incidence of moderate and severe PAR after TAVI was 9% and 1%, respectively. Diastolic pressure or post-TAVI amplitude did not correlate to perioperative outcome. RAI increased from 2 when PAR was <2+ to 7 when PAR was ≥2+ (P = .006). A cut-off value of RAI ≥14 was associated with increased perioperative mortality (29 vs 5%; P = .013) and acute renal injury requiring dialysis (71 vs 18%; P = .001). RAI ≥14 was also associated with higher follow-up mortality at 1 year (57 vs 16%; P = .007). RAI ≥14 (odds ratio [OR], 3.390; 95% confidence interval [CI], 1.6-7.194; P = .00146), PAR ≥2+ (OR, 4.717; 95% CI, 1.828-12.195; P = .00135), and perioperative renal replacement therapy (OR, 12.820; 95% CI, 5.181-31.250; P = .00031) were found to be independent predictors of mortality at 1 year.ConclusionsThe RAI is a useful tool to predict perioperative and 1-year outcome in patients with PAR after TAVI
Angiographically silent atherosclerosis detected by intravascular ultrasound in patients with familial hypercholesterolemia and familial combined hyperlipidemia: Correlation with high density lipoproteins
AbstractObjectives. This study sought to evaluate the extent of atherosclerosis in coronary and iliac arteries in patients with heterozygous familial hypercholesterolemia or familial combined hyperlipidemia, using intravascular ultraound imaging.Background. Intravascular ultrasound imaging provides cross-sectional tomographic views of the vessel wall and allows quantitative assessment of atherosclerosis.Methods. Forty-eight nonsmoking, asymptomatic patients with heterozygous familial hypercholesterolemia or familial combined hyperlipidemia underwent intravascular ultrasound imaging of the left anterior descending coronary, left main coronary and common iliac arteries. Angiography showed only minimal or no narrowing in these vessels. Intravascular ultrasound images obtained during catheter pullback underwent morphometric analysis. Plaque burden was expressed as the mean and maximal intimal index (ratio of plaque area and area within the internal elastic lamina) and as the percent of vessel surface covered by plaque.Results. Intravascular ultrasound detected plaque more frequently than angiography in the left anterior descending (80% vs. 29%, respectively), left main (44% vs. 16%) and iliac arteries (33% vs. 27%). Plaque burden was higher in the left anterior descending (mean intimal index [±SD] 0.25 ± 0.16) than in the left main (0.11 ± 0.16, p < 0.001) and iliac arteries (0.02 ± 0.04, p < 0.001). Angiography detected lumen narrowing only in coronary arteries with a maximal intimal index ⪰0.42 (left anterior descending artery) and ⪰0.43 (left main artery). The area within the internal elastic lamina increased with plaque area in the left anterior descending (r = 0.82, p < 0.001) and left main arteries (r = 0.53, p < 0.001). By stepwise multiple regression analysis, the strongest predictor for plaque burden in the left anterior descending artery was the level of high density lipoprotein (HDL) cholesterol and total/HDL cholesterol ratio for the left main artery.Conclusions. In patients with heterozygous familial hypercholesterolemia and familial combined hyperlipidemia, extensive coronary plaque is present despite minimal or no angiographic changes. Compensatory vessel enlargement and diffuse involvement with eccentric plaque may account for the lack of angiographic changes. Levels of HDL cholesterol and total/HDL cholesterol ratio are far more powerful predictors of coronary plaque burden than are low density lipoprotein cholesterol levels in these patients with early, asymptomatic disease
Impact of route of access and stenosis subtype on outcome after transcatheter aortic valve replacement
Introduction: Previous analyses have reported the outcomes of transcatheter aortic valve replacement (TAVR) for patients with low-flow, low-gradient (LFLG) aortic stenosis (AS), without stratifying according to the route of access. Differences in mortality rates among access routes have been established for high-gradient (HG) patients and hypothesized to be even more pronounced in LFLG AS patients. This study aims to compare the outcomes of patients with LFLG or HG AS following transfemoral (TF) or transapical (TA) TAVR.
Methods: A total of 910 patients, who underwent either TF or TA TAVR with a median follow-up of 2.22 (IQR: 1.22-4.03) years, were included in this multicenter cohort study. In total, 146 patients (16.04%) suffered from LFLG AS. The patients with HG and LFLG AS were stratified according to the route of access and compared statistically.
Results: The operative mortality rates of patients with HG and LFLG were found to be comparable following TF access. The operative mortality rate was significantly increased for patients who underwent TA access [odds ratio (OR): 2.91 (1.54-5.48), p = 0.001] and patients with LFLG AS [OR: 2.27 (1.13-4.56), p = 0.02], which could be corroborated in a propensity score-matched subanalysis. The observed increase in the risk of operative mortality demonstrated an additive effect [OR for TA LFLG: 5.45 (2.35-12.62), p < 0.001]. LFLG patients who underwent TA access had significantly higher operative mortality rates (17.78%) compared with TF LFLG (3.96%, p = 0.016) and TA HG patients (6.36%, p = 0.024).
Conclusions: HG patients experienced a twofold increase in operative mortality rates following TA compared with TF access, while LFLG patients had a fivefold increase in operative mortality rates. TA TAVR appears suboptimal for patients with LFLG AS. Prospective studies should be conducted to evaluate alternative options in cases where TF is not possible
Impact of route of access and stenosis subtype on outcome after transcatheter aortic valve replacement.
INTRODUCTION
Previous analyses have reported the outcomes of transcatheter aortic valve replacement (TAVR) for patients with low-flow, low-gradient (LFLG) aortic stenosis (AS), without stratifying according to the route of access. Differences in mortality rates among access routes have been established for high-gradient (HG) patients and hypothesized to be even more pronounced in LFLG AS patients. This study aims to compare the outcomes of patients with LFLG or HG AS following transfemoral (TF) or transapical (TA) TAVR.
METHODS
A total of 910 patients, who underwent either TF or TA TAVR with a median follow-up of 2.22 (IQR: 1.22-4.03) years, were included in this multicenter cohort study. In total, 146 patients (16.04%) suffered from LFLG AS. The patients with HG and LFLG AS were stratified according to the route of access and compared statistically.
RESULTS
The operative mortality rates of patients with HG and LFLG were found to be comparable following TF access. The operative mortality rate was significantly increased for patients who underwent TA access [odds ratio (OR): 2.91 (1.54-5.48), p = 0.001] and patients with LFLG AS [OR: 2.27 (1.13-4.56), p = 0.02], which could be corroborated in a propensity score-matched subanalysis. The observed increase in the risk of operative mortality demonstrated an additive effect [OR for TA LFLG: 5.45 (2.35-12.62), p < 0.001]. LFLG patients who underwent TA access had significantly higher operative mortality rates (17.78%) compared with TF LFLG (3.96%, p = 0.016) and TA HG patients (6.36%, p = 0.024).
CONCLUSIONS
HG patients experienced a twofold increase in operative mortality rates following TA compared with TF access, while LFLG patients had a fivefold increase in operative mortality rates. TA TAVR appears suboptimal for patients with LFLG AS. Prospective studies should be conducted to evaluate alternative options in cases where TF is not possible
La placa grabada de Balma Guilanyà (Prepirineo de Lleida) y las manifestaciones artísticas del Mesolítico de la Península Ibérica
El hallazgo de un bloque grabado de grandes dimensiones en Balma Guilanyà, con motivos geométricos y/o abstractos permite analizar la problemática referida a las manifestaciones artísticas que se desarrollan con posterioridad al arte del Paleolítico Superior en la región mediterránea ibérica. En este artículo se presenta el contexto arqueoestratigráfico, cronométrico y cronocultural de esta manifestación artística, durante el X milenio cal BP. El análisis de los motivos gráficos y su comparación con otras representaciones muebles y parietales de la vertiente mediterránea ibérica permite evaluar la problemática que rodea la caracterización del arte mesolítico en esta zonaA carved rock with geometric and/or abstract signs discovered at the Balma Guilanyà site has made possible the analysis of the artistic patterns developed after the end of the Upper Palaeolithic in the Iberian Mediterranean region. Archaeostratigraphic, chronometric and chrono-cultural attributes link this finding to the Mesolithic, probably during the tenth millennium cal BP. Graphic analysis and the comparison with different kinds of representations from this same area allows the evaluation of the problematic that surrounds the characterization of West Mediterranean Mesolithic ar
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