Preschool Metacognitive Skill Assessment in Order to Promote Educational Sensitive Response From Mixed-Methods Approach: Complementarity of Data Analysis

A child''s metacognitive skills contribute significantly to their learning and success. However, very few studies are focused on these skills at early education andmost of them are carried out from inappropriate methodological perspectives for the characteristics of the youngest students. To overcome such limitations, it is essential to carry out observational studies that analyze children''s metacognitive behaviors in the natural and habitual context of children''s learning, as well as appropriate tasks for their level of development. The aim of this study was to analyze the sequential and associative structure of the metacognitive skills used by 5-year-old children throughout the resolution of a playful task (a puzzle). It was interesting to know if there were different hidden structures in the use of metacognitive skills in the children who solved the puzzle and those who did not. From the methodological approach, this work was located in the perspective of mixed methods which is characterized by the integration of qualitative and quantitative elements. This integration was carried out from the "connect" option. The integration involved developing quantitizing, as one of its possibilities. Recent scientific literature has considered systematic observation, in which the QUAL-QUAN-QUAL macro stages take place, as a mixed method itself. Consequently, systematic observation was applied, because it was suitable for our aim. A Nomothetic/Punctual/Multidimensional observational design was used. The playful activity of 44 preschool children solving the puzzle individually was coded. It allowed us to obtain data matrices that respond to the QUAL stage. Regarding the QUAN stage, once the quality of data was controlled, the records were further analyzed by differentiating two groups of participants (those who had solved the puzzle and those who did not) using three quantitative techniques of observational analysis (T-pattern detection, lag sequential analysis, polar coordinate analysis). Finally data was returned to a QUAL stage to interpret the results. The use of these three techniques allowed a detailed and in-depth analysis of the children''s activity. Results reveal differences in the metacognitive abilities of the children that solved and didn''t solve the puzzle. These results have important implications for educational practice

Intra-abdominal pulmonary secuestration as an exceptional cause of abdominal mass in the adult

AbstractINTRODUCTIONPulmonary sequestration (PS) is an extremely rare malformation defined as a portion of lung tissue isolated from the pulmonary system. PSs are classified into intralobar type and intra-abdominal PS that represents only 2.5% of cases. There are 20 cases of PS reported in adults and only two were managed by laparoscopic approach. We report a case of intra-abdominal PS mimicking a gastroesophageal duplication cyst in an adult. Besides its rarity, this is the first intra-abdominal PS in an adult managed by an anterior laparoscopic approach.PRESENTATION OF CASEA 60-year-old female patient had had epigastric and left upper quadrant pain for several days. Physical examination was normal. Image test were consistent with a gastroesophageal duplication. The patient was taken to the operating room for laparoscopic exploration and resection. The pathological diagnosis was extralobar pulmonary sequestration.DISCUSSIONLess than 20 cases of PS have been reported in adults and only two cases were managed by a lateral laparoscopic approach. In contrast to these reports, we used an anterior approach due to the GEJ suspected origin of the mass.CONCLUSIONExtralobar intra-abdominal PS is an extremely rare condition during adulthood but this diagnosis should be included in the differential diagnosis of a left-sided suprarenal mass. Due to the difficulty in achieving a definitive preoperative diagnosis, surgery is recommended. Laparoscopic resection is safe and effective but careful preoperative imaging studies are recommended in order to plan the most suitable approach

Linfangioma quístico mesentérico en el diagnóstico diferencial de la enfermedad inflamatoria pélvica

La enfermedad inflamatoria pélvica (EIP) es un síndrome clínico que incluye todas aquellas alteraciones inflamatorias e infecciosas que comprenden los órganos de la pelvis menor. La infección es habitualmente polimicrobiana y está asociada a mujeres jóvenes con vida sexual activa, nulíparas y usuarias de dispositivo intrauterino (DIU Los abscesos tubo-ováricos son una complicación aguda o crónica, asociada a dicho proceso.). CASO CLÍNICO Presentamos el caso de una mujer de 47 años con dolor abdominal intenso, usuaria de DIU. La primera sospecha diagnóstica fue de EIP con presencia de absceso tuboovárico anexial. Sin embargo la exploración física no orientó en este sentido, por lo que se solicitó TAC abdominopélvico, en el que se informó de la posibilidad de linfangioma quístico mesentérico. Por ello, se contactó con el servicio de Cirugía General que procedió a su resección satisfactoria y sin incidencias. El estudio anatomopatológico confirmo la sospecha radiológica. CONCLUSIÓN Una adecuada exploración física es fundamental en el diagnóstico de la EIP y el absceso tuboovárico. El linfangioma quístico mesentérico puede formar parte del diagnóstico diferencial de las masas anexiales en este contexto. Pelvic inflammatory disease (PID) is a clinical syndrome involving all those inflammatory and infectious alterations affecting the minor pelvis organs. Any infection is often multibacterial and more frequent in sexually active nulliparous young women and intrauterine device (IUD) users. Tuboovarian abscesses can be an acute or chronic complication associated to that process. Our patient was a 47 year old IUD user consulting about intense abdominal pain. The initial clinical suspicion pointed at a case of PID associated to a tubo-ovarian anexial abscess. However, a physical examination did not support this suspicion and an abdominopelvian CAT scan was therefore requested, reporting a possible mesenteric cystic lymphangioma. The General Surgery service was reached for treatment, successfully excising the growth without further incident. Histological analysis confirmed the radiological diagnosis. An adequate physical examination is instrumental while diagnosing PID and tuboovarian abscesses. A mesenteric cystic lymphangioma should be included in a differential diagnosis of anexial growths in such a contex

Prevalence and progression of chronic kidney disease after a liver transplant: a prospective, real-life, observational, two-year multicenter study

Introduction: chronic kidney disease is a frequent complication after liver transplantation. The use of calcineurin inhibitors is one of the causes of this complication. Current immunsuppression regimens that reduce the use of calcineurin inhibitors may be associated with an improved preservation of renal function. Objective: the study aimed to assess the evolution of renal function after liver transplantation in the current routine clinical practice. Methods: an observational, prospective, multicenter study in adult liver transplant recipients was performed. Two hundred and thirty patients with a good renal function before transplantation were assessed six months post-transplantation (baseline) and every six months until month 30. Results: at baseline, 32% of the patients had a reduction in the glomerular filtration rate below < 60 ml/min/1.73 m2. The mean glomerular filtration rate increased from 72.3 to 75.6 ml/min/1.73 m2 at baseline and month 30 respectively (p < 0.01). The mean serum creatinine levels (mg/dl) decreased from 1.13 to 1.09 (p < 0.01). The percentage of patients with stage 3 chronic kidney disease decreased from 31.7% to 26.4%, whereas the percentage of patients with stage 4 remained unchanged (0.4% at baseline and 0.5% at month 30). No patients progressed to end-stage kidney disease that required dialysis or renal transplantation. Conclusion: in the routine clinical practice, a moderate deterioration of renal function is frequent after liver transplantation. However, advanced chronic kidney disease is infrequent in patients with a good pre-transplant renal function

Heliospheric Transport of Neutron-Decay Protons

We report on new simulations of the transport of energetic protons originating from the decay of energetic neutrons produced in solar flares. Because the neutrons are fast-moving but insensitive to the solar wind magnetic field, the decay protons are produced over a wide region of space, and they should be detectable by current instruments over a broad range of longitudes for many hours after a sufficiently large gamma-ray flare. Spacecraft closer to the Sun are expected to see orders-of magnitude higher intensities than those at the Earth-Sun distance. The current solar cycle should present an excellent opportunity to observe neutron-decay protons with multiple spacecraft over different heliographic longitudes and distances from the Sun.Comment: 12 pages, 4 figures, to be published in special issue of Solar Physic

Can we identify patients with high risk of osteoarthritis progression who will respond to treatment? A focus on epidemiology and phenotype of osteoarthritis

Osteoarthritis is a syndrome affecting a variety of patient profiles. A European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis and the European Union Geriatric Medicine Society working meeting explored the possibility of identifying different patient profiles in osteoarthritis. The risk factors for the development of osteoarthritis include systemic factors (e.g., age, sex, obesity, genetics, race, and bone density) and local biomechanical factors (e.g., obesity, sport, joint injury, and muscle weakness); most also predict disease progression, particularly joint injury, malalignment, and synovitis/effusion. The characterization of patient profiles should help to better orientate research, facilitate trial design, and define which patients are the most likely to benefit from treatment. There are a number of profile candidates. Generalized, polyarticular osteoarthritis and local, monoarticular osteoarthritis appear to be two different profiles; the former is a feature of osteoarthritis co-morbid with inflammation or the metabolic syndrome, while the latter is more typical of post-trauma osteoarthritis, especially in cases with severe malalignment. Other biomechanical factors may also define profiles, such as joint malalignment, loss of meniscal function, and ligament injury. Early- and late-stage osteoarthritis appear as separate profiles, notably in terms of treatment response. Finally, there is evidence that there are two separate profiles related to lesions in the subchondral bone, which may determine benefit from bone-active treatments. Decisions on appropriate therapy should be made considering clinical presentation, underlying pathophysiology, and stage of disease. Identification of patient profiles may lead to more personalized healthcare, with more targeted treatment for osteoarthritis

Functional principal component analysis as a new methodology for the analysis of the impact of two rehabilitation protocols in functional recovery after stroke

[EN] Background: This study addressed the problem of evaluating the effectiveness of two protocols of physiotherapy for functional recovery after stroke. In particular, the study explored the use of Functional Principal Component Analysis (FPCA), a multivariate data analysis in order to assess and clarify the process of regaining independence after stroke. Methods: A randomized double-blind controlled trial was performed. Thirteen subjects with residual hemiparesis after a single stroke episode were measured in both in- and outpatient settings at a district hospital. All subjects were able to walk before suffering the stroke and were hemodynamically stable within the first week after stroke. Control and target groups were treated with conventional physiotherapy for stroke, but specific techniques were added for treatment of the target group depending on patients' functional levels. Independence level was assessed with the Barthel Index (BI) throughout 7 evolution stages (hemodynamic stability, beginning of standing, beginning of physical therapy sessions in the physiotherapy ward and monthly assessment for 6 months after stroke). Results: FPCA was applied for data analysis. Statistically significant differences were found in the dynamics of the recovery process between the two physiotherapy protocols. The target group showed a trend of improvement six months after stroke that was not present in the control group. Conclusions: FPCA is a method which may be used to provide greater insight into the analysis of the rehabilitation process than that provided by conventional parametric methods. So, by using the whole curves as basic data parameters, subtle differences in the rehabilitation process can be found. FPCA represents a future aid for the fine analysis of similar physiotherapy techniques, when applied in subjects with a huge variability of functional recovery, as in the case of post-stroke patients.This contribution has been carried out with financial support from the European Commission within the Seventh Framework Programme under contract FP7-ICT-2009-247935: BETTER BNCI-dr. The authors wish to thank the Stroke Rehabilitation Team of Hospital Universitari i Politecnic La Fe (Valencia, Spain), specially Dr. M.R. Beseler, physiotherapist M. Matas and physiotherapist A. Estaun. We also gratefully acknowledge patients who have participated in this study with great enthusiasm.Sánchez-Sánchez, M.; Belda Lois, JM.; Mena Del Horno, S.; Viosca Herrero, E.; Gisbert-Morant, B.; Igual-Camacho, C.; Bermejo Bosch, I. (2014). Functional principal component analysis as a new methodology for the analysis of the impact of two rehabilitation protocols in functional recovery after stroke. Journal of NeuroEngineering and Rehabilitation. 11:1-9. https://doi.org/10.1186/1743-0003-11-134S191

Equation of state and phonon frequency calculations of diamond at high pressures

The pressure-volume relationship and the zone-center optical phonon frequency of cubic diamond at pressures up to 600 GPa have been calculated based on Density Functional Theory within the Local Density Approximation and the Generalized Gradient Approximation. Three different approaches, viz. a pseudopotential method applied in the basis of plane waves, an all-electron method relying on Augmented Plane Waves plus Local Orbitals, and an intermediate approach implemented in the basis of Projector Augmented Waves have been used. All these methods and approximations yield consistent results for the pressure derivative of the bulk modulus and the volume dependence of the mode Grueneisen parameter of diamond. The results are at variance with recent precise measurements up to 140 GPa. Possible implications for the experimental pressure determination based on the ruby luminescence method are discussed.Comment: 10 pages, 6 figure