ISSUES AND CHALLENGES IN THE USE OF COHERENCE AMONG JORDANIAN EFL STUDENTS IN WRITING ACADEMIC ESSAYS

Background and Purpose: Writing a coherent written composition is a challenging task for many English foreign learners, especially among English as Foreign Language (EFL) Jordanian students, as many of those learners cannot achieve writing well coherent essays at the university level due to various reasons such as lack of lexical competence and lack of motivation.  Due to the fact that very limited studies have focussed on investigating this phenomenon in-depth, especially in the Jordanian context, the present study aims to explore issues and challenges faced by Jordanian students in using coherence in academic essays under the perspectives of writing course instructors.   Methodology: This study used a qualitative approach to gather data. The sample comprises eight male instructors from two Jordanian universities. They were selected using a purposive sampling method. Semi-structured interviews were conducted with the participants to gain their insights into the issues and significant challenges faced by the students and the potential strategies to overcome the challenges. 20 academic essays produced by 4th year undergraduate students from the two universities were observed for the purpose.   Findings: The instructors found that the EFL Jordanian students were unable to achieve coherent writing in the essays mainly due to their limited vocabulary knowledge. They attributed this lack to learners’ inadequate attempts to enhance their writing and limited reading experience. Generally, they agreed that insufficient awareness of the importance of incorporating effective educational practices to enhance their students’ writing as the major contributing factor to their students’ failure to observe coherence in writing. The findings encompassed some potential strategies to cope with the current obstacles, such as training the EFL instructors and employing modern techniques and practices in teaching.   Contributions: Teaching and learning of coherent writing is very necessary at all higher learning institutions. The findings of the study have implications on all the stakeholders as a means of enriching the instructional practices widely.   Keywords: EFL Jordanian students, EFL writing, writing challenges, writing strategies, coherent writing, coherence.   Cite as: Alsariera, A. H., & Yunus, K. (2023). Issues and challenges in the use of coherence among Jordanian EFL students in writing academic essays. Journal of Nusantara Studies, 8(2), 139-154. http://dx.doi.org/10.24200/jonus.vol8iss2pp139-15

Internal Medicine Residency Newsletter, April 2023

A newsletter created by and for the Rochester General Hospital Internal Medicine Residency Program. This issue: A word from the PD News & announcements Resident corner Awards and scholarship Conferences and deadlines Introducing IMRC Article of the month Community outreach activities Happy birthday! Crossword puzzl

An Invading Stent: Conservative Management of a Penetrating Splenic Injury by a Migrated Pancreatic Duct Stent

Pancreatic duct (PD) stenting is a common treatment modality for PD calculi or strictures, which are common complications of chronic pancreatitis. PD stent migration is a described complication of the procedure. Penetrating splenic injury may result in life-threatening hemorrhage, often requiring splenic artery embolization or splenectomy. Herein, we describe a unique case of a 49- year-old female with chronic pancreatitis and PD stent who presented with abdominal pain. A computed tomography of her abdomen revealed the distal end of her PD stent to have migrated internally through her spleen with an associated perisplenic fluid collection. After initial clinical stabilization she underwent an endoscopic retrograde cholangiopancreatography which revealed the proximal end of the migrated stent in the duodenum and the stent was successfully with improvement in clinical status

Pseudo-Wellens syndrome: A rare entity associated with cocaine use

Wellens syndrome usually indicates critical left anterior descending artery (LAD) occlusion. Pseudo-Wellens syndrome consists of criteria of Wellens syndrome in the absence of critical LAD occlusion. We report a case of Pseudo-Wellens syndrome related to cocaine use. A 52-year-old male with a medical history of hypertension and diabetes, presented with acute retrosternal chest pain of 3 days duration. Physical examination was unremarkable. EKG on presentation showed deep T-wave inversions in leads V2 to V5. Highly sensitive troponin was elevated. The patient admitted to using cocaine daily for the past two months. Due to concerns for Wellens syndrome, the patient had an immediate coronary angiography which revealed mild disease of the LAD (\u3c 30%) only. Inpatient echocardiogram revealed preserved left ventricular ejection fraction and no segmental wall motion abnormalities. Subsequent EKG at the cardiology clinic showed improvement in T-wave inversion. The patient was advised to abstain from using cocaine. As Pseudo-Wellens syndrome is a diagnosis of exclusion, patients with a history of recent cocaine use presenting with acute chest pain history, evidence of myocardial injury, and EKG findings suggestive of Wellens syndrome should undergo an emergent coronary angiogram to exclude critical LAD occlusion

Recent Advancements in Fractal Geometric-Based Nonlinear Time Series Solutions to the Micro-Quasistatic Thermoviscoelastic Creep for Rough Surfaces in Contact

To understand the tripological contact phenomena, both mathematical and experimental models are needed. In this work, fractal mathematical models are used to model the experimental results obtained from literature. Fractal geometry, using a deterministic Cantor structure, is used to model the surface topography, where recent advancements in thermoviscoelastic creep contact of rough surfaces are introduced. Various viscoelastic idealizations are used to model the surface materials, for example, Maxwell, Kelvin-Voigt, Standard Linear Solid and Jeffrey media. Such media are modelled as arrangements of elastic springs and viscous dashpots in parallel and/or in series. Asymptotic power laws, through hypergeometric series, were used to express the surface creep as a function of remote forces, body temperatures and time. The introduced models are valid only when the creep approach of the contact surfaces is in the order of the size of the surface roughness. The obtained results using such models, which admit closed-form solutions, are displayed graphically for selected values of the systems' parameters; the fractal surface roughness and various material properties. Results obtained showed good agreement with published experimental results, where the utilized methodology can be further extended to the utilization for the contact of surfaces within micro- and nano-electronic devices, circuits and systems

Vibration Control of Fractionally-Damped Beam Subjected to a Moving Vehicle and Attached to Fractionally-Damped Multiabsorbers

This paper presents the dynamic response of Bernoulli-Euler homogeneous isotropic fractionally-damped simply-supported beam. The beam is attached to multi single-degree-of-freedom (SDOF) fractionally-damped systems, and it is subjected to a vehicle moving with a constant velocity. The damping characteristics of the beam and SDOF systems are described in terms of fractional derivatives. Three coupled second-order fractional differential equations are produced and then they are solved by combining the Laplace transform with the decomposition method. The obtained numerical results show that the dynamic response decreases as (a) the number of absorbers attached to the beam increases and (b) the damping-ratios of used absorbers and beam increase. However, there are some critical values of fractional derivatives which are different from unity at which the beam has less dynamic response than that obtained for the full-order derivatives model. Furthermore, the obtained results show very good agreements with special case studies that were published in the literature

Hydroxychloroquine Induced Cardiomyopathy

Hydroxychloroquine (HCQ) is one of the immunomodulatory medications used in treatment of autoimmune diseases. Rarely, HCQ can cause serious complications, such as cardiotoxicity. We present a rare case of HCQ-induced cardiomyopathy. 60-year-old female patient with a medical history of SLE on chronic HCQ therapy for 28 years, preexisting non-ischemic cardiomyopathy and heart failure with reduced ejection fraction for 7 years, and complete heart block status post pacemaker insertion presented with acute chest pain and severe weight loss. Patient underwent coronary angiogram that showed normal coronaries and right-sided heart catheterization that showed acute heart failure. Echocardiogram showed LVEF of 30% with global hypokinesis. Patient was started on dobutamine with an improvement of her symptoms. As HCQ-induced cardiomyopathy was suspected, patient underwent an endomyocardial biopsy that revealed a pathognomonic finding of myocyte vacuolization, consistent with HCQ-induced cardiomyopathy. HCQ was discontinued immediately. However, patient was a poor candidate for heart transplantation and durable mechanical circulatory support due to severe malnutrition secondary to end-stage heart failure. Patient accepted hospice care and passed away peacefully. This case highlights the need for high index of clinical suspicion, careful medication reconciliation for patients with non-ischemic cardiomyopathy, and tissue biopsy with careful histopathological examination to diagnose this rare complication

Efficacy and safety of cardioprotective drugs in chemotherapy-induced cardiotoxicity: an updated systematic review & network meta-analysis

BACKGROUND: Cancer patients receiving chemotherapy have an increased risk of cardiovascular complications. This limits the widespread use of lifesaving therapies, often necessitating alternate lower efficacy regimens, or precluding chemotherapy entirely. Prior studies have suggested that using common cardioprotective agents may attenuate chemotherapy-induced cardiotoxicity. However, small sample sizes and conflicting outcomes have limited the clinical significance of these results. HYPOTHESIS: A comprehensive network meta-analysis using updated and high-quality data can provide more conclusive information to assess which drug or drug class has the most significant effect in the management of chemotherapy-induced cardiotoxicity. METHODS: We performed a literature search for randomized controlled trials (RCTs) investigating the effects of cardioprotective agents in patients with chemotherapy-induced cardiotoxicity. We used established analytical tools (netmeta package in RStudio) and data extraction formats to analyze the outcome data. To obviate systematic bias in the selection and interpretation of RCTs, we employed the validated Cochrane risk-of-bias tools. Agents included were statins, aldosterone receptor antagonists (MRAs), ACEIs, ARBs, and beta-blockers. Outcomes examined were improvement in clinical and laboratory parameters of cardiac function including a decreased reduction in left ventricular ejection fraction (LVEF), clinical HF, troponin-I, and B-natriuretic peptide levels. RESULTS: Our study included 33 RCTs including a total of 3,285 patients. Compared to control groups, spironolactone therapy was associated with the greatest LVEF improvement (Mean difference (MD) = 12.80, [7.90; 17.70]), followed by enalapril (MD = 7.62, [5.31; 9.94]), nebivolol (MD = 7.30, [2.39; 12.21]), and statins (MD = 6.72, [3.58; 9.85]). Spironolactone was also associated with a significant reduction in troponin elevation (MD =  - 0.01, [- 0.02; - 0.01]). Enalapril demonstrated the greatest BNP reduction (MD =  - 49.00, [- 68.89; - 29.11]), which was followed by spironolactone (MD =  - 16.00, [- 23.9; - 8.10]). Additionally, patients on enalapril had the lowest risk of developing clinical HF compared to the control population (RR = 0.05, [0.00; 0.75]). CONCLUSION: Our analysis reaffirmed that statins, MRAs, ACEIs, and beta-blockers can significantly attenuate chemotherapy-induced cardiotoxicity, while ARBs showed no significant effects. Spironolactone showed the most robust improvement of LVEF, which best supports its use among this population. Our analysis warrants future clinical studies examining the cardioprotective effects of cardiac remodeling therapy in cancer patients treated with chemotherapeutic agents

JQPro : Join query processing in a distributed system for big RDF data using the hash-merge join technique

In the last decade, the volume of semantic data has increased exponentially, with the number of Resource Description Framework (RDF) datasets exceeding trillions of triples in RDF repositories. Hence, the size of RDF datasets continues to grow. However, with the increasing number of RDF triples, complex multiple RDF queries are becoming a significant demand. Sometimes, such complex queries produce many common sub-expressions in a single query or over multiple queries running as a batch. In addition, it is also difficult to minimize the number of RDF queries and processing time for a large amount of related data in a typical distributed environment encounter. To address this complication, we introduce a join query processing model for big RDF data, called JQPro. By adopting a MapReduce framework in JQPro, we developed three new algorithms, which are hash-join, sort-merge, and enhanced MapReduce-join for join query processing of RDF data. Based on an experiment conducted, the result showed that the JQPro model outperformed the two popular algorithms, gStore and RDF-3X, with respect to the average execution time. Furthermore, the JQPro model was also tested against RDF-3X, RDFox, and PARJs using the LUBM benchmark. The result showed that the JQPro model had better performance in comparison with the other models. In conclusion, the findings showed that JQPro achieved improved performance with 87.77% in terms of execution time. Hence, in comparison with the selected models, JQPro performs better

Characterizing the morbid genome of ciliopathies

Background Ciliopathies are clinically diverse disorders of the primary cilium. Remarkable progress has been made in understanding the molecular basis of these genetically heterogeneous conditions; however, our knowledge of their morbid genome, pleiotropy, and variable expressivity remains incomplete. Results We applied genomic approaches on a large patient cohort of 371 affected individuals from 265 families, with phenotypes that span the entire ciliopathy spectrum. Likely causal mutations in previously described ciliopathy genes were identified in 85% (225/265) of the families, adding 32 novel alleles. Consistent with a fully penetrant model for these genes, we found no significant difference in their “mutation load” beyond the causal variants between our ciliopathy cohort and a control non-ciliopathy cohort. Genomic analysis of our cohort further identified mutations in a novel morbid gene TXNDC15, encoding a thiol isomerase, based on independent loss of function mutations in individuals with a consistent ciliopathy phenotype (Meckel-Gruber syndrome) and a functional effect of its deficiency on ciliary signaling. Our study also highlighted seven novel candidate genes (TRAPPC3, EXOC3L2, FAM98C, C17orf61, LRRCC1, NEK4, and CELSR2) some of which have established links to ciliogenesis. Finally, we show that the morbid genome of ciliopathies encompasses many founder mutations, the combined carrier frequency of which accounts for a high disease burden in the study population. Conclusions Our study increases our understanding of the morbid genome of ciliopathies. We also provide the strongest evidence, to date, in support of the classical Mendelian inheritance of Bardet-Biedl syndrome and other ciliopathies