Networked Blended Learning : Creation of Best Practices for Continuous Improvement

Education and learning is undergoing a worldwide change from the didactic model towards a learner-centred approach more sensitive to the needs of both the learners and the context in which learning takes place. Advances in Information and Communication Technologies (ICTs) have increasingly enabled global asynchronous interactive learning and teaching, thus offering greater flexibility and easier access to information in a life-long learning context. Also the Bologna Process for European Higher Education integration and various Quality Assurance procedures, as well as the emerging globalisation bring virtual networked academic courses into the scene. As a result of these prevailing requirements in combination with emphasis on specification of objectives and learning outcomes, pressure on teachers to rethink and redesign their courses has emerged. Through active, adaptive and cognitive project-based learning, including authentic activities, problem solving and reflective thinking, networked learning can facilitate a supportive and affordable model of learning that can benefit many groups in society. The department of Informatics at Alexander Technological Educational Institution of Thessaloniki responds to the new challenges by adopting a blended learning model that combines traditional classroom teaching and user-centred networked learning. This paper reports experiences and findings from different blended courses in the department revealed in a first assessment of the teaching-and-learning practices. The aim of the assessment was to identify strengths and weaknesses of the current practices. The assessment was carried out by using a questionnaire completed by 119 students. Emphasis is put on students’ views regarding the current teaching-and-learning practices. The findings reveal that the students consider that the most important advantages of e-learning environments are studies at own time followed by studies at own place. Concerning the disadvantages the most important factors are considered to be the student’s dependency on internet and technology in general. All students who take part in e-learning environments consider that their learning activities and outcome are improved and that e-learning provides independence and free choice of their personal learning strategy. The ultimate outcome of the assessment aims at creating guidelines for the best practice in networked learning. A first set of guidelines for the best practice in networked blended learning presented in this paper was created based on the results from the student survey and experiences from discussions between educators. The guidelines aim at serving as a roadmap and initiating the development of a list of relevant best practices. Continuous improvement of the research instruments together with regular assessments will ensure continuous improvement of processes and practices regarding networked blended learning

Estimation of the seismic hazard parameters for various sites in Greece using a probabilistic approach

International audienceThe probabilistic approach that was recently introduced by Kijko and Graham (1998,1999) was applied for the estimation of seismic hazard for various sites in Greece in terms of peak ground acceleration (PGA) and peak ground velocity (PGV). These sites represent geographically cities of Greece among which are the capital of Greece and some others with high, intermediate and low seismicity. The approach allows the use of earthquake catalogues with incomplete reported historical and complete instrumental data, the consideration of different magnitude thresholds, and the incorporation of magnitude uncertainties. One of the advantages of the method is that it does not require any determination of seismic zones. The estimated values of PGA for return periods of 476 years were grouped in 4 categories, the same ones used in the seismic hazard map for the New Seismic Code of Greece. Comparison results were quite interesting and very encouraging concerning the reliability of this probabilistic approach

Stress echocardiography in elderly patients with coronary artery disease Applicability, safety and prognostic value of dobutamine and adenosine echocardiography in elderly patients

AbstractObjectives. Our aim was to determine the applicability, safety and prognostic value of adenosine and dobutamine stress echocardiography in patients ≥70 years old.Background. These tests are sometimes mandatory because of difficulties and inaccuracies in interpreting traditional electrocardiographic stress tests. Furthermore, if these tests could be used to avoid coronary arteriography and cardiac catheterization, they would become essential in the care of the elderly, whose numbers are increasing.Methods. We performed coronary arteriography and dobutamine and adenosine stress echocardiographic tests in 120 patients (72 men) ≥70 years old who entered the hospital because of chest pain and had known or suspected coronary artery disease. The stress tests were performed on separate days, within 2 weeks of coronary arteriography. Both the arteriograms and the echocardiograms were analyzed by two experts who had no knowledge of the patients' other data or the other interpreter's report. Tests were judged to have positive or negative results, and the patients were followed up for the development of cardiac events. Univariate and multivariate analyses and other statistical modalities were applied for comparisons.Results. Documented coronary artery disease was found in 89 patients. During the 14 ± 7 months of follow-up, cardiac events developed in 50 patients, including 3 (7.9%) of 38 patients with negative dobutamine and 12 (20.7%) of 58 patients with negative adenosine test results. Demonstration of any abnormality on stress echocardiography was an independent factor for cardiac events, both for dobutamine (relative risk 7.3) and for adenosine (relative risk 3.0). Both cessation of dobutamine or adenosine tests and diagnosis of disease in two or more coronary vessels were also independent predictors. ST segment depression ≥1 mm was related to future events only with the dobutamine test.Conclusions. These echocardiographic stress tests proved safe and well tolerated. They successfully stratified this cohort of elderly patients with coronary artery disease to low or high risk subgroups for subsequent cardiac events

Spatio-temporal Models of Lymphangiogenesis in Wound Healing

Several studies suggest that one possible cause of impaired wound healing is failed or insufficient lymphangiogenesis, that is the formation of new lymphatic capillaries. Although many mathematical models have been developed to describe the formation of blood capillaries (angiogenesis), very few have been proposed for the regeneration of the lymphatic network. Lymphangiogenesis is a markedly different process from angiogenesis, occurring at different times and in response to different chemical stimuli. Two main hypotheses have been proposed: 1) lymphatic capillaries sprout from existing interrupted ones at the edge of the wound in analogy to the blood angiogenesis case; 2) lymphatic endothelial cells first pool in the wound region following the lymph flow and then, once sufficiently populated, start to form a network. Here we present two PDE models describing lymphangiogenesis according to these two different hypotheses. Further, we include the effect of advection due to interstitial flow and lymph flow coming from open capillaries. The variables represent different cell densities and growth factor concentrations, and where possible the parameters are estimated from biological data. The models are then solved numerically and the results are compared with the available biological literature.Comment: 29 pages, 9 Figures, 6 Tables (39 figure files in total

Superconducting spintronics

The interaction between superconducting and spin-polarized orders has recently emerged as a major research field following a series of fundamental breakthroughs in charge transport in superconductor-ferromagnet heterodevices which promise new device functionality. Traditional studies which combine spintronics and superconductivity have mainly focused on the injection of spin-polarized quasiparticles into superconducting materials. However, a complete synergy between superconducting and magnetic orders turns out to be possible through the creation of spin-triplet Cooper pairs which are generated at carefully engineered superconductor interfaces with ferromagnetic materials. Currently, there is intense activity focused on identifying materials combinations which merge superconductivity and spintronics in order to enhance device functionality and performance. The results look promising: it has been shown, for example, that superconducting order can greatly enhance central effects in spintronics such as spin injection and magnetoresistance. Here, we review the experimental and theoretical advances in this field and provide an outlook for upcoming challenges related to the new concept of superconducting spintronics.J.L. was supported by the Research Council of Norway, Grants No. 205591 and 216700. J.W.A.R. was supported by the UK Royal Society and the Leverhulme Trust through an International Network Grant (IN-2013-033).This is the accepted manuscript. The final version is available at http://www.nature.com/nphys/journal/v11/n4/full/nphys3242.html

Development and internal validation of a clinical prediction model for serious complications after emergency laparotomy

Purpose Emergency laparotomy (EL) is a common operation with high risk for postoperative complications, thereby requiring accurate risk stratification to manage vulnerable patients optimally. We developed and internally validated a predictive model of serious complications after EL. Methods Data for eleven carefully selected candidate predictors of 30-day postoperative complications (Clavien-Dindo grade >  = 3) were extracted from the HELAS cohort of EL patients in 11 centres in Greece and Cyprus. Logistic regression with Least Absolute Shrinkage and Selection Operator (LASSO) was applied for model development. Discrimination and calibration measures were estimated and clinical utility was explored with decision curve analysis (DCA). Reproducibility and heterogeneity were examined with Bootstrap-based internal validation and Internal–External Cross-Validation. The American College of Surgeons National Surgical Quality Improvement Program’s (ACS-NSQIP) model was applied to the same cohort to establish a benchmark for the new model. Results From data on 633 eligible patients (175 complication events), the SErious complications After Laparotomy (SEAL) model was developed with 6 predictors (preoperative albumin, blood urea nitrogen, American Society of Anaesthesiology score, sepsis or septic shock, dependent functional status, and ascites). SEAL had good discriminative ability (optimism-corrected c-statistic: 0.80, 95% confidence interval [CI] 0.79–0.81), calibration (optimism-corrected calibration slope: 1.01, 95% CI 0.99–1.03) and overall fit (scaled Brier score: 25.1%, 95% CI 24.1–26.1%). SEAL compared favourably with ACS-NSQIP in all metrics, including DCA across multiple risk thresholds. Conclusion SEAL is a simple and promising model for individualized risk predictions of serious complications after EL. Future external validations should appraise SEAL’s transportability across diverse settings

The Hellenic emergency laparotomy study (HELAS): a prospective multicentre study on the outcomes of emergency laparotomy in Greece

Background Emergency laparotomy (EL) is accompanied by high post-operative morbidity and mortality which varies significantly between countries and populations. The aim of this study is to report outcomes of emergency laparotomy in Greece and to compare them with the results of the National Emergency Laparotomy Audit (NELA). Methods This is a multicentre prospective cohort study undertaken between 01.2019 and 05.2020 including consecutive patients subjected to EL in 11 Greek hospitals. EL was defined according to NELA criteria. Demographics, clinical variables, and post-operative outcomes were prospectively registered in an online database. Multivariable logistic regression analysis was used to identify independent predictors of post-operative mortality. Results There were 633 patients, 53.9% males, ASA class III/IV 43.6%, older than 65 years 58.6%. The most common operations were small bowel resection (20.5%), peptic ulcer repair (12.0%), adhesiolysis (11.8%) and Hartmann’s procedure (11.5%). 30-day post-operative mortality reached 16.3% and serious complications occurred in 10.9%. Factors associated with post-operative mortality were increasing age and ASA class, dependent functional status, ascites, severe sepsis, septic shock, and diabetes. HELAS cohort showed similarities with NELA patients in terms of demographics and preoperative risk. Post-operative utilisation of ICU was significantly lower in the Greek cohort (25.8% vs 56.8%) whereas 30-day post-operative mortality was significantly higher (16.3% vs 8.7%). Conclusion In this study, Greek patients experienced markedly worse mortality after emergency laparotomy compared with their British counterparts. This can be at least partly explained by underutilisation of critical care by surgical patients who are at high risk for death