The Effect of E-Learning Sessions on the Development of Reading Comprehension: A Case of EFL Students’ Perceptions at Saudi Electronic University

This study investigated Saudi EFL university students’ perceptions toward the development of reading comprehension through e-learning sessions. A cross-sectional questionnaire was utilized and distributed to a sample of 140 participants at Saudi Electronic University. Descriptive statistics, independent sample paired t-test and one-way ANOVA were used to analyze the data. The findings revealed that EFL university students had positive perceptions of the use of online sessions to practice the reading comprehension skill. The majority agreed that reading comprehension strategies such as skimming and scanning were more appropriate to online sessions. E-learning helped these students to be more motivated and created an atmosphere conducive to independent learning. The participants appreciated the role of online sessions in enhancing their reading comprehension skills and facilitating the level of difficulty of any reading passage. Significant differences were identified relating to the respondents’ gender and academic year. Female students were more satisfied with e-learning than male students. It is recommended that in light of the rapid growth of e-learning in Saudi Arabia, educational institutions should provide online learning programs and develop well-structured courses for e-learning implementation

Immune Reconstitution in HIV-Infected Patients

The prognosis of patients infected with human immunodeficiency virus (HIV) type 1 has dramatically improved since the advent of potent antiretroviral therapies (ARTs), which have enabled sustained suppression of HIV replication and recovery of CD4 T cell counts. Knowledge of the function of CD4 T cells in immune reconstitution was derived from large clinical studies demonstrating that primary and secondary prophylaxis against infectious agents, such as Pneumocystis jirovecii (Pneumocystis carinii), Mycobacterium avium complex, cytomegalovirus, and other pathogens, can be discontinued safely once CD4 T cell counts have increased beyond pathogen-specific threshold levels (usually >200 CD4 T cells/mm3) for 3-6 months. The downside of immune reconstitution is an inflammatory syndrome occurring days to months after the start of ART, with outcomes ranging from minimal morbidity to fatal progression. This syndrome can be elicited by infectious and noninfectious antigens. Microbiologically, the possible pathogenic pathways involve recognition of antigens associated with ongoing infection or recognition of persisting antigens associated with past (nonreplicating) infection. Specific antimicrobial therapy, nonsteroidal anti-inflammatory drugs, and/or steroids for managing immune reconstitution syndrome should be considere

Genotypic and phenotypic resistance testing of HIV-1 in routine clinical care

Data on genotypic and phenotypic resistance testing of HIV-1 in the routine clinical setting are lacking. In a retrospective single-center study, all patients (n=102) for whom genotypic resistance typing (GRT) and phenotypic resistance typing (PRT) were performed during the calendar year 2002 were examined. GRT and PRT results were concordant for 79% of the drugs, being highest for nevirapine (92%) and lowest for didanosine (57%). Concordance of results for protease inhibitors was lowest for lopinavir (78%) and highest for indinavir (88%). Discordant results for lamivudine were observed in 16% of patients; 90% of these results corresponded to high-level resistance by PRT and susceptibility by GRT. Overall, HIV loads were lower and CD4+ cell counts higher after therapy following resistance testing, but a significant association with the number of active drugs as predicted by GRT or PRT could not be identified. In a subgroup of 43 patients with virological failure under antiretroviral therapy and sufficient follow-up data, HIV loads were significantly lower after 3 and 6months. More patients with HIV loads <400/ml had 2 or more active drugs according to PRT (21/29 [75%]) than according to GRT ([15/29 [52%]; p=0.109. This was also found for HIV loads <50/ml (PRT 16/22 [72%], GRT 10/22 [42%]; p=0.103), although the differences were not statistically significant. There was no discernable difference between GRT and PRT in the clinic-based population, but the numbers of resistance tests performed are not sufficient to draw definitive conclusion

Cost-Effectiveness of Genotypic Antiretroviral Resistance Testing in HIV-Infected Patients with Treatment Failure

BACKGROUND: Genotypic antiretroviral resistance testing (GRT) in HIV infection with drug resistant virus is recommended to optimize antiretroviral therapy, in particular in patients with virological failure. We estimated the clinical effect, cost and cost-effectiveness of using GRT as compared to expert opinion in patients with antiretroviral treatment failure. METHODS: We developed a mathematical model of HIV disease to describe disease progression in HIV-infected patients with treatment failure and compared the incremental impact of GRT versus expert opinion to guide antiretroviral therapy. The analysis was conducted from the health care (discount rate 4%) and societal (discount rate 2%) perspective. Outcome measures included life-expectancy, quality-adjusted life-expectancy, health care costs, productivity costs and cost-effectiveness in US Dollars per quality-adjusted life-year (QALY) gained. Clinical and economic data were extracted from the large Swiss HIV Cohort Study and clinical trials. RESULTS: Patients whose treatment was optimized with GRT versus expert opinion had an increase in discounted life-expectancy and quality-adjusted life-expectancy of three and two weeks, respectively. Health care costs with and without GRT were $US 421,000 and$US 419,000, leading to an incremental cost-effectiveness ratio of $US 35,000 per QALY gained. In the analysis from the societal perspective, GRT versus expert opinion led to an increase in discounted life-expectancy and quality-adjusted life-expectancy of three and four weeks, respectively. Health care costs with and without GRT were$US 551,000 and $US 549,000, respectively. When productivity changes were included in the analysis, GRT was cost-saving. CONCLUSIONS: GRT for treatment optimization in HIV-infected patients with treatment failure is a cost-effective use of scarce health care resources and beneficial to the society at large

Starting or Changing Therapy - A Prospective Study Exploring Antiretroviral Decision-Making

Background:: When to start or change antiretroviral treatment against HIV infection is of major importance. Patients' readiness is considered a major factor influencing such treatment decisions, in particular because no objective, absolute time point when to start antiretroviral therapy exists. We aimed at evaluating patients' readiness to start or change antiretroviral therapy (ART). Patients and Methods:: HIV-infected patients starting or changing ART between July 2002 and February 2003, treating physicians and nurses participated in this prospective, observational multicenter study. We assessed shared decision-making including qualitative aspects, expected treatment decisions and treatment status after 3 months. Results:: 75 patients were included. Of 34 patients for whom starting ART was considered, 27 (79%) indicated that they were willing to start treatment. After 3 months, 21 of 27 (78%) actually started therapy, six did not. Patients with depression were less likely to be ready for ART (p < 0.05). Of 41 patients for whom changing ART was considered, 35 (85%) indicated that they were willing to change treatment. Of the latter 35 patients, 33 (94%) finally changed ART within 3 months. Physicians and nurses were too optimistic in predicting the start or change of ART. The main reason to start or change ART was the sole recommendation of the physician (52% in those starting, 61% in those changing ART). Patients mainly judged the decision as shared and were very satisfied (71%) with the process. Qualitative findings revealed the importance of a dialectic decisionmaking, described with two categories: "dealing with oneself and others”‚ and "understanding and being understood.” Conclusion:: Patients mainly shared the decision made during consultation. Although physicians have an essential role concerning ART, patients, physicians, and nurses all contribute to the decision. Qualitative findings indicate the importance for health-care providers to include patients' expertise and contribution

In vitro establishment of embryonic primary cultures of silkworm, Bombyx mori (Lep.: Bombycidae)

Since the use of insect cell lines for producing bio-pesticides and recombinant proteins is increasing, the establishment of new cell lines will help to enrich this industry. Therefore, several primary cultures were initiated from embryonic tissues of silkworm, Bombyx mori L. using both enzymatic and mechanical methods. The cultures were incubated in TC-100 medium supplemented with 10 and 20% concentrations of fetal bovine serum (FBS) at 27ºC. Among the methods used, homogenizing the embryonic tissue represented the best culture, which reached the confluence state sooner. Six different morphologies were distinguished in the embryonic primary cultures of silkworm including fibroblast-like cells with three sub-forms of A to C, spindle shaped cells, spherical cells and epithelial-like cells. Also, developing primary cultures from B. mori using enzymatic method is not recommended because of its low efficiency

Engaging Learners Online: Use Interaction Gamification To Increase The Quality Of Learning, Independent, Interactive, And Fun On Ice-I Institute Online Course : Laporan Hibah Penelitian Kolaborasi Pusat Riset Dan Inovasi Pendidikan Terbuka Dan Jarak Jauh LPPM – Universitas Terbuka 2021

Penelitian ini akan membahas engaging learners online: use interaction gamification. Agar tidak terjadi learning loss dalam pembelajaran online maka diperlukan desain pem-belajaran yang dapat melibatkan pebelajar secara aktif dalam online learning, dengan memperhatikan kualitas, kemandirian dan pembelajaran yang menyenangkan. Salah satu yang dapat dikembangkan adalah pembelajaran interaktif gamification. Penelitian ini akan memfokuskan pada 3 hal, sebagai berikut: 1) Mengidentifikasi kesiapan mahasiswa dan dosen dalam mengikuti pembelajaran online dalam lingkungan MOOCs ICE-Insti-tute; 2) Mengembangkan gamifikasi interaktif dan menyenangkan dalam pembelajaran online ICE-Institute untuk meningkatkan kemandirian belajar mahasiswa; dan 3) Men-gukur kelayakan dan keefektifan hasil pengembangan gamifikasi dalam pembelajaran online dalam lingkungan ICE-Institute. Penelitian ini menerapkan pendekatan penelitian yang Research and Development (R&D) sementara kontennya di fokuskan pada mata kuliah Keguruan sebagai mata kuliah yang wajib diprogramkan mahasiswa kependidikan. Adapun prosedur pengembangannya adalah analisis, desain (rancangan gamefication dan MOOCs), pengembangan, implementasi, dan evaluasi. Hasil pengembangan dapat digunakan dalam mengatasi masalah yang terjadi dalam pembelajaran online salah satunya kekhawatiran akan terjadinya learning loss

Understanding the role of crystallographic shear on the electrochemical behavior of niobium oxyfluorides

The effects of shear planes in perovskite materials have been studied in order to identify their role in the electrochemical behavior of Li⁺ intercalation hosts. These planes modulate the structural stability and ionic transport pathways and therefore play an intimate role in the characteristics and performance of shear compounds. Herein, two Nb-based compounds, NbO₂F and Nb₃O₇F, were chosen as representative perovskite and shear derivatives respectively to investigate the role of crystallographic shear. A series of operando measurements, including X-ray diffraction and X-ray absorption spectroscopy, in conjunction with structural analysis, Raman spectroscopy, and detailed electrochemical studies identified the effect of shear planes. It was found that shear planes led to increased structural stability during Li⁺ (de)intercalation with shear layers being maintained, while perovskite layers were seen to degrade rapidly. However, disordering in the shear plane stacking introduced during delithiation ultimately led to poor capacity retention despite structural maintenance as Li⁺ diffusion channels are disrupted

Smoking and health-related quality of life in English general population: Implications for economic evaluations

Copyright @ 2012 Vogl et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.This article has been made available through the Brunel Open Access Publishing Fund.Background: Little is known as to how health-related quality of life (HRQoL) when measured by generic instruments such as EQ-5D differ across smokers, ex-smokers and never-smokers in the general population; whether the overall pattern of this difference remain consistent in each domain of HRQoL; and what implications this variation, if any, would have for economic evaluations of tobacco control interventions. Methods: Using the 2006 round of Health Survey for England data (n = 13,241), this paper aims to examine the impact of smoking status on health-related quality of life in English population. Depending upon the nature of the EQ-5D data (i.e. tariff or domains), linear or logistic regression models were fitted to control for biology, clinical conditions, socio-economic background and lifestyle factors that an individual may have regardless of their smoking status. Age- and gender-specific predicted values according to smoking status are offered as the potential 'utility' values to be used in future economic evaluation models. Results: The observed difference of 0.1100 in EQ-5D scores between never-smokers (0.8839) and heavy-smokers (0.7739) reduced to 0.0516 after adjusting for biological, clinical, lifestyle and socioeconomic conditions. Heavy-smokers, when compared with never-smokers, were significantly more likely to report some/severe problems in all five domains - mobility (67%), self-care (70%), usual activity (42%), pain/discomfort (46%) and anxiety/depression (86%) -. 'Utility' values by age and gender for each category of smoking are provided to be used in the future economic evaluations. Conclusion: Smoking is significantly and negatively associated with health-related quality of life in English general population and the magnitude of this association is determined by the number of cigarettes smoked. The varying degree of this association, captured through instruments such as EQ-5D, may need to be fed into the design of future economic evaluations where the intervention being evaluated affects (e.g. tobacco control) or is affected (e.g. treatment for lung cancer) by individual's (or patients') smoking status