EUS-Guided Pancreatic Cyst Ablation: a Clinical and Technical Review

Purpose of Review Pancreatic cystic lesions represent a growing public health dilemma, particularly as our population ages and cross-sectional imaging becomes more sensitive. Mucinous cysts carry a clinically significant risk of developing pancreatic cancer, which carries an extremely poor prognosis. Determining which cysts will develop cancer may be challenging, and surgical resection of the pancreas carries significant morbidity. The goal of this paper is to review the rationale for cyst ablation and discuss prior and current research on cyst ablation techniques and efficacy. Indications, contraindications, and factors related to optimal patient selection are outlined. Recent Findings Endoscopic ultrasound-guided chemoablation of pancreatic cysts has been performed in neoplastic cysts, with varying levels of efficacy. Safety concerns arose due to the risk of pancreatitis in alcohol-based treatments; however, the most recent data using a non-alcohol chemoablation cocktail suggests that ablation is effective without the need for alcohol, resulting in a significantly more favorable adverse event profile. Summary Endoscopic ultrasound-guided chemoablation of neoplastic pancreatic cysts is a promising, minimally invasive approach for treatment of cysts, with recent significant advances in safety and efficacy, suggesting that it should play a role in the treatment algorithm

Developing Students\u27 Representational Fluency Using Virtual and Physical Algebra Balances

Both virtual and physical manipulatives are reported as effective learning tools when used with different groups of students in a variety of contexts to learn mathematical content. The use of multiple representations and the flexibility to translate among those representational forms facilitates students\u27 learning and has the potential to deepen their understanding. This classroom project involved two groups of third-grade students in a week-long unit focusing on algebraic relationships. The purpose of the unit was to engage students with different algebraic models and encourage students to use informal strategies to represent their relational thinking. The paper highlights examples of these student representations as evidence of the children\u27s developing algebraic thinking. Result from the pre- and post-test measures showed that students in the physical and virtual manipulative environments gained significantly in achievement and showed flexibility in translating and representing their understanding in multiple representations: manipulative model, pictorial, numeric and word problems. The researchers recorded field notes, interviewed students, and videotaped class sessions in order to identify unique features of the learning environments. The virtual environment had unique features that promoted student thinking such as: a) explicit linking of visual and symbolic modes; b) guided step-by-step support in algorithmic processes; and c) immediate feedback and self-checking system. In the physical environment, some unique features were: a) tactile features; b) opportunities for invented strategies; and c) mental mathematics. These results show that although the different manipulative models had different features, both the physical and virtual environments were effective in supporting students\u27 learning and encouraging relational thinking and algebraic reasoning

Learning Mathematics with Technology: The Influence of Virtual Manipulatives on Different Achievement Groups

This study examined the influence of virtual manipulatives on different achievement groups during a teaching experiment in four fifth-grade classrooms. During a two-week unit focusing on two rational number concepts (fraction equivalence and fraction addition with unlike denominators) one low achieving, two average achieving, and one high achieving group participated in two instructional treatments (three groups used virtual manipulatives and one group used physical manipulatives). Data sources included pre- and post-tests of students’ mathematical content knowledge and videotapes of classroom sessions. Results of paired samples t-tests examining the three groups using virtual manipulatives indicated a statistically significant overall gain following the treatment. Follow-up paired samples individual t-tests on the low, average, and high achieving groups indicated a statistically significant gain for students in the low achieving group, but only numerical gains for students in the average and high achieving groups. There were no significant differences between the average achieving student groups in the virtual manipulatives and physical manipulatives treatments. Qualitative data gathered during the study indicated that the different achievement groups experienced the virtual manipulatives in different ways, with the high achieving group recognizing patterns quickly and transitioning to the use of symbols, while the average and low achieving groups relied heavily on pictorial representations as they methodically worked step-by-step through processes and procedures with mathematical symbols

Impaired Wheel Running Exercise in CLC-1 Chloride Channel-Deficient Myotonic Mice

Background: Genetic deficiency of the muscle CLC-1 chloride channel leads to myotonia, which is manifested most prominently by slowing of muscle relaxation. Humans experience this as muscle stiffness upon initiation of contraction, although this can be overcome with repeated efforts (the “warm-up” phenomenon). The extent to which CLC-1 deficiency impairs exercise activity is controversial. We hypothesized that skeletal muscle CLC-1 chloride channel deficiency leads to severe reductions in spontaneous exercise. Methodology/Principal Findings: To examine this quantitatively, myotonic CLC-1 deficient mice were provided access to running wheels, and their spontaneous running activity was quantified subsequently. Differences between myotonic and normal mice in running were not present soon after introduction to the running wheels, but were fully established during week 2. During the eighth week, myotonic mice were running significantly less than normal mice (322 ± 177 vs 5058 ± 1253 m/day, P = 0.025). Furthermore, there were considerable reductions in consecutive running times (18.8 ± 1.5 vs 59.0 ± 3.7 min, P < 0.001) and in the distance per consecutive running period (58 ± 38 vs 601 ± 174 m, P = 0.048) in myotonic compared with normal animals. Conclusion/Significance: These findings indicate that CLC-1 chloride deficient myotonia in mice markedly impairs spontaneous exercise activity, with reductions in both total distance and consecutive running times

Root causes and social consequences of birth injuries in Western Uganda

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138287/1/ijgo12257.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138287/2/ijgo12257_am.pd

Introduction to the MSP-PE Special Issue on Math and Science Partnership Program: A First Comprehensive Evaluation

The United States faces significant challenges in the fields of science, technology, engineering, and mathematics (often collectively referred to as STEM). Numerous reports from governmental, scientific, and civic communities have raised concerns over the quality of STEM education at all levels of the educational system, the shortage in the STEM labor force, and the decreasing competitiveness of student performance in STEM fields at the international level

How Affordances and Constraints of Physical and Virtual Manipulatives Support the Development of Procedural Fluency and Algorithmic Thinking in Mathematics

The purpose of this study was to examine how the affordances and constraints of physical and virtual manipulatives influence the development of students’ algorithmic thinking when learning algebra and rational number concepts. Thirty-six third-grade students participated in two weeks of instruction using physical and virtual manipulatives as instructional tools. The primary design of the study was a teaching experiment in which quantitative and qualitative data were collected to provide a holistic examination. Pre- and post-test items were used in the quantitative analysis following a within-subjects crossover repeated measures design. Students’ written work, a user survey, student interviews, field notes, and classroom videotapes were used in a qualitative analysis by coding the text data for evidence of major themes. Quantitative results indicated a significant difference between the physical and virtual manipulatives teaching episodes on students’ pre- and post-test performance that was mediated by mathematics content type (fractions vs. algebra). Qualitative results confirmed that the affordances and constraints of the virtual manipulative fraction applets supported students’ development of algorithmic thinking

Applying Task Force Recommendations on Integrating Science and Practice in Health Service Psychology Education

The proper role of research skills and training to conduct research in professional psychology education has been controversial throughout the history of the field. An extensive effort was undertaken recently to address that issue and identify ways the field might move forward in a more unified manner. In 2015, the American Psychological Association (APA) Board of Educational Affairs convened a task force to address one of the recommendations made by the Health Service Psychology Education Collaborative in 2013. That recommendation stated that the education and training of health service psychologists (HSPs) include an integrative approach to science and practice that incorporates scientific-mindedness, training in research skills, and goes well beyond merely “consuming” research findings. The task force subsequently developed recommendations related to the centrality of science competencies for HSPs and how these competencies extend beyond training in evidence-based practice. This article discusses the findings of the task force and the implications of its recommendations for education and training in HSP. The challenges and opportunities associated with implementing these recommendations in HSP graduate programs are examined