Sakai: A Mobile Learning Platform

These days, humans have been witnessing related technological and social development, by means of which mobile technologies and Internet yield global access to information with mobility of knowledge. Mobile learning platforms are designed based on electronic learning (e-learning) and mobility. It is regarded as a useful way to enhance the learning process. Sakai as a mobile learning platform, design intentions are to be adaptable to any educational purposes, within or outside the institution, dependent on the provision of effectiveness in classroom instruction based on the learning style of the students, extensible in the cultivation of thinking skills in the learner, and efficient in communicating and exchanging data among its enrolled classroom members and other online platforms. This study employed a systematic review of related literature to investigate the predominant research methodology adopted by various scholars to assess necessary factors concerning mobile learning platform. Fifteen articles are selected based on established criteria. The findings indicated that most of the researchers used quantitative research methodology in investigating the effectiveness and concern variable of mobile learning. Also find out is that most of the outcome of the studies include, achievement, perception, pedagogy, motivation and mobile learning platform as a form of educational technology

Clinical criteria replenish high-sensitive troponin and inflammatory markers in the stratification of patients with suspected acute coronary syndrome

OBJECTIVES: In patients with suspected acute coronary syndrome (ACS), rapid triage is essential. The aim of this study was to establish a tool for risk prediction of 30-day cardiac events (CE) on admission. 30-day cardiac events (CE) were defined as early coronary revascularization, subsequent myocardial infarction, or cardiovascular death within 30 days. METHODS AND RESULTS: This single-centre, prospective cohort study included 377 consecutive patients presenting to the emergency department with suspected ACS and for whom troponin T measurements were requested on clinical grounds. Fifteen biomarkers were analyzed in the admission sample, and clinical parameters were assessed by the TIMI risk score for unstable angina/Non-ST myocardial infarction and the GRACE risk score. Sixty-nine (18%) patients presented with and 308 (82%) without ST-elevations, respectively. Coronary angiography was performed in 165 (44%) patients with subsequent percutaneous coronary intervention - accounting for the majority of CE - in 123 (33%) patients, respectively. Eleven out of 15 biomarkers were elevated in patients with CE compared to those without. High-sensitive troponin T (hs-cTnT) was the best univariate biomarker to predict CE in Non-ST-elevation patients (AUC 0.80), but did not yield incremental information above clinical TIMI risk score (AUC 0.80 vs 0.82, p = 0.69). Equivalence testing of AUCs of risk models and non-inferiority testing demonstrated that the clinical TIMI risk score alone was non-inferior to its combination with hs-cTnT in predicting CE. CONCLUSIONS: In patients presenting without ST-elevations, identification of those prone to CE is best based on clinical assessment based on TIMI risk score criteria and hs-cTnT

Baseline characteristics.

<p>Abbreviations: CAD, coronary artery disease; MI, myocardial infarction; PCI, percutaneous coronary intervention; CABG, coronary artery bypass grafting, PVD, peripheral vascular disease; CVD, cerebrovascular disease; ACE, angiotensin converting enzyme; CCB, calcium channel blocker; BMI, body mass index.</p

Diagnostic performance of high-sensitive cardiac troponin T (hs-cTnT), myeloperoxidase (MPO), myeloid-related protein 8/14 (MRP 8/14), and conventional cardiac troponin T (c-cTnT) in relation to the clinical TIMI risk score of patients with suspected ACS and no obvious ST-segment elevations at presentation (Non-ST-elevation patients).

<p>AUC indicates area under the curve. The clinical TIMI risk score is the sum of 6 clinical factors without the biomarker variable of the 7 originally described risk predictors of the TIMI unstable angina/Non-ST myocardial infarction risk score.</p

Study flow chart of the prospective, observational MyRiAD study.

<p>Abbreviations: ER, emergency room; CA, coronary angiography; CAD, coronary artery disease; CE, cardiac events (composite of early coronary revascularization by percutaneous coronary intervention [PCI] or coronary artery bypass grafting [CABG], subsequent myocardial infarction or cardiovascular death); c-cTnT, conventional cardiac troponin T; CK, creatine kinase; CK-MB, creatine kinase-myocardial band.</p

Predictiveness curves illustrating the prognostic performance of two different risk models in predicting cardiac events (CE).

<p>Risk model I: clinical TIMI risk score and gender; Risk model II: clinical TIMI risk score, gender, and hs-cTnT, respectively.</p

Biomarker levels in patients with and without cardiac events (CE).

<p>Abbreviations: CK, creatine kinase; CK-MB, creatine kinase-myocardial band; H-FABP, heart-type fatty acid-binding protein; c-cTnT, conventional cardiac troponin T; hs-cTnT, high-sensitive cardiac troponin T; NT-proBNP, N-terminal pro-brain natriuretic peptide; hs-CRP, high-sensitive C-reactive protein; Il-6, interleukin-6; MPO, myeloperoxidase; MRP 8/14, myeloid-related protein 8/14; PAPP-A, pregnancy-associated protein A; IGF-1, insulin-like growth factor 1.</p

Final diagnoses.

<p>Abbreviations: CAD, coronary artery disease; NSTEMI, non-ST-elevation myocardial infarction; UA, unstable angina.</p