Elephantiasis nostras verrucosa: an atypical presentation following intrapelvic lymphoma

Elephantiasis nostras verrucosa is a progressively debilitating and disfiguring disease commonly presenting with verrucous, cobblestone-like papules, nodules, or plaques with nonpitting edema in the lower extremities. Histopathology is marked by hyperkeratosis and dermal or subcutaneous fibrosis as a result of chronic lymphedema. Risk factors include obesity, recurrent cellulitis, chronic venous insufficiency, congestive heart failure, scleroderma, radiation, trauma, and tumors. We report a 72-year-old man who presented to the dermatology clinic for an 11-year history of edematous legs, occasionally associated with ulcerations. The findings developed within a year of intrapelvic non-Hodgkin lymphoma and progressed gradually over 10 years after lymphoma remission. Physical examination revealed atypical features including compressible cysts and pitting edema extending from the lower legs to the thighs bilaterally. The patient was noncompliant for the recommended compressive devices and the condition progressively worsened over the course of 7 months of follow-up. Early interdisciplinary management using compressive devices and a lymphatic pump are recommended. Underlying causative factors should be assessed with regular follow-up to optimize treatment outcomes

Integration of LoRa Wide Area Network with the 5G Test Network

Abstract. The global communication network is going through major transformation from conventional to more versatile and diversified network approaches. With the advent of virtualization and cloud technology, information technology (IT) is merging with telecommunications to alter the conventional approaches of traditional proprietary networking techniques. From radio to network and applications, the existing infrastructure lacks several features that we wished to be part of 5th Generation Mobile Networks (5G). Having a support for large number of applications, Internet of Things (IoT) will bring a major evolution by creating a comfortable, flexible and an automated environment for end users. A network having the capability to support radio protocols on top of basic networking protocols, when blended with a platform which can generate IoT use cases, can make the expectations of 5G a reality. Low Power Wide Area Network (LPWAN) technologies can be utilized with other emerging and suitable technologies for IoT applications. To implement a network where all the technologies can be deployed virtually to serve their applications within a single cloud, Network Functions Virtualization (NFV) and Software Defined Network (SDN) is introduced to implement such a networking possibility for upcoming technologies. The 5G Test Network (5GTN), a testbed for implementing and testing 5G features in real time, is deployed in virtual platform which allows to add other technologies for IoT applications. To implement a network with an IoT enabler technology, LoRa Wide Area Network (LoRaWAN) technology can be integrated to test the feasibility and capability of IoT implications. LoRaWAN being an IoT enabler technology is chosen out of several possibilities to be integrated with the 5GTN. Using MultiConnect Conduit as a gateway, the integration is realized by establishing point to point protocol (PPP) connection with eNodeB. Once the connection is established, LoRa packets are forwarded to the ThingWorx IoT cloud and responses can be received by the end-devices from that IoT cloud by using Message Queuing Telemetry Transport (MQTT) protocol. Wireshark, an open source packet analyser, is then used to ensure successful transmission of packets to the ThingWorx using the 5GTN default packet routes

Development of Activity-Based Science Learning Models with Inquiry Approaches

This study aims to develop an activity-based science learning model with an inquiry learning approach for early childhood that can be used to increase the sense of curiosity and sci-entific thinking in children aged 5-6 years. This study was conducted with research and de-velopment / R & D research methods. Data was collected through interviews, observations, questionnaires, pre-test and post-test for children. Data analysis using paired t-test. The re-sults showed that children were interested and enthusiastic in the learning process by using a science-based learning model with the inquiry approach, Sig. (2-tailed) showing results of 0.000, so the value of 0.000 <0.05 was different from before and after the use of learning models . Results show children can understand the material, more confident and has initiative to find answers for the teacher's questions about science, the child's curiosity increases to ex-amine the information provided by the teacher, the child's understanding of work processes and procedures from science learning with the inquiry approach getting bet-ter. It was con-cluded that an activity-based science learning model with an inquiry approach for children aged 5-6 years used an activity model with an inquiry learning approach based on children's interests and children's needs so that children's curiosity would emerge and continue to be optimally stimulated. Keywords: Inquiry approach, Learning model, Science Learning References Abdi, A. (2014). The Effect of Inquiry-based Learning Method on Students’ Academic Achievement in Science Course. Universal Journal of Educational Research, 2(1), 37–41. https://doi.org/10.13189/ujer.2014.020104 Anderson, R. D. (2002). 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Inquiry-Based Learning: an Innovative Proposal for Early C hildhood Education. Journal of Learning Styles, 11(22), 50–81. Cridge, B. J., & Cridhe, A. G. (2011). Evaluating How Universities Engage School Student with The Science: a Model Based on Analysis of The Literature. Australian University Review. Darmadi. (2017). Pengembangan Model dan Metode Pembelajaran dalam Dinamika Belajar Siswa. Yogyakarta: Deepublish. Doǧru, M., & Şeker, F. (2012). The effect of science activities on concept acquisition of age 5-6 children groups. Kuram ve Uygulamada Egitim Bilimleri, 12(SUPPL. 4), 3011–3024. Duran, M., & Dökme, I. (2016). The effect of the inquiry-based learning approach on student’s critical-thinking skills. Eurasia Journal of Mathematics, Science and Technology Education, 12(12), 2887–2908. https://doi.org/10.12973/eurasia.2016.02311a Falloon, G. (2019). Using simulations to teach young students science concepts: An Experiential Learning theoretical analysis. Computers & Education, 135(March), 138–159. https://doi.org/10.1016/j.compedu.2019.03.001 Gerli Silm, Tiitsaar, K., Pedaste, M., Zacharia, Z. C., & Papaevripidou, M. (2015). Teachers’ Readiness to Use Inquiry-based Learning: An Investigation of Teachers’ Sense of Efficacy and Attitudes toward Inquiry-based Learning. International Council of Association for Science Eduacation, 28(4), 315–325. Ginsburg, H. P., & Golbeck, S. (2004). Thoughts on the future of research on mathematics and science learning and education. Early Childhood Research Quarterly, 19(1), 190–200. Gross, C. M. (2012). Science concepts young children learn through water play. Dimensions of Early Childhood, 40(2), 3–11. Diambil dari http://www.proxy.its.virginia.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=78303868&site=ehost-live&scope=site Guo, Y., Piasta, S. B., & Bowles, R. P. (2015). Exploring Preschool Children’s Science Content Knowledge. Early Education and Development, 26(1), 125–146. https://doi.org/10.1080/10409289.2015.968240 Halim, L., Abd Rahman, N., Zamri, R., & Mohtar, L. (2018). The roles of parents in cultivating children’s interest towards science learning and careers. Kasetsart Journal of Social Sciences, 39(2), 190–196. https://doi.org/10.1016/j.kjss.2017.05.001 Jirout, J. J. (2011). Curiosity and the Development of Question Generation Skills, (1994), 27–30. Justice, L. M., & Kaderavek, J. (2004). Embedded-explicit emergent literacy I: Background and description of approach. Language, Speech, and Hearing Services in Schools, 35, 201–211. Lind, K. K. (1998). Science in Early Childhood: Developing and Acquring Fundamental Concepts and Skills. Retrieved from ERIC (ED418777), 85. Diambil dari http://files.eric.ed.gov/fulltext/ED418777.pdf Lind, K. K. (2005). Exploring science in early childhood. (4 ed.). New York: Thomson Delmar Learning. Lindholm, M. (2018). Promoting Curiosity ? Possibilities and Pitfalls in Science Education, (1), 987–1002. Lu, S., & Liu, Y. (2017). Integrating augmented reality technology to enhance children ’ s learning in marine education, 4622(November), 525–541. https://doi.org/10.1080/13504622.2014.911247 Lukas, M. (2015). Parental Involvement of Occupational Education for Their Children. International Multidicilinary Scientific Cocerence on Social Science and Arts. Maltese, A. V, & Tai, R. H. (2011). Pipeline Persistence; Examining The Association of Educational with Earn Degrees i STEM Among US Students. Science Education. Nugent, G., Barker, B., Welsch, G., Grandgenett, N., Wu, C., & Nelson, C. (2015). A Model of Factors Contributing to STEM Learning and Career Orientation. International Journal of Science Education. Pluck, G., & Johnson, H. L. (2011). Stimulating curiosity to enhance learning. Reiser, B. J. (2004). Scaffolding complex learning: The mechanisms of structuring and problematizing student work. Journal of the Learning Sciences, 13(3), 273–304. Sackes, M., Trundle, K. C., & Flevares, L. M. (2009). Using children’s literature to teach standard-based science concepts in early years. Early Childhood Education Journal, 36(5), 415–422. https://doi.org/10.1007/s10643-009-0304-5 Walin, H., & Grady, S. O. (2016). Curiosity and Its Influence on Children ’ s Memory, 872–876. Wang, F., Kinzie, M. B., McGuire, P., & Pan, E. (2010). Applying technology to inquiry-based learning in early childhood education. Early Childhood Education Journal, 37(5), 381–389. https://doi.org/10.1007/s10643-009-0364-6 Wu, S. C., & Lin, F. L. (2016). Inquiry-based mathematics curriculum design for young children-teaching experiment and reflection. Eurasia Journal of Mathematics, Science and Technology Education, 12(4), 843–860. https://doi.org/10.12973/eurasia.2016.1233a Yahya, A., & Ismail, N. (2011). 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Phacoemulsification with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract.

BACKGROUND: Age-related cataract is one of the leading causes of blindness worldwide. Therefore, it is important to establish the most effective surgical technique for cataract surgery. OBJECTIVES: The aim of this review is to examine the effects of two types of cataract surgery for age-related cataract: phacoemulsification and extracapsular cataract extraction (ECCE). SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 4), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to May 2013), EMBASE (January 1980 to May 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to May 2013), Web of Science Conference Proceedings Citation Index - Science (CPCI-S) (January 1970 to May 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 13 May 2013. SELECTION CRITERIA: We included randomised controlled trials of phacoemulsification compared to ECCE for age-related cataract. DATA COLLECTION AND ANALYSIS: Two authors independently selected and assessed all studies. We defined two primary outcomes: 'good functional vision' (presenting visual acuity of 6/12 or better) and 'poor visual outcome' (best corrected visual acuity of less than 6/60) at three and 12 months after surgery. We also collected data on intra and postoperative complications, and the cost of the procedures. MAIN RESULTS: We included 11 trials in this review with a total of 1228 participants, ranging from age 45 to 94. The studies were generally at unclear risk of bias due to poorly reported trial methods. No study reported presenting visual acuity, so we report both uncorrected (UCVA) and best corrected visual acuity (BCVA). Studies varied in visual acuity assessment methods and time frames at which outcomes were reported. Participants in the phacoemulsification group were more likely to achieve UCVA of 6/12 or more at three months (risk ratio (RR) 1.81, 95% confidence interval (CI) 1.36 to 2.41, two studies, 492 participants) and one year (RR 1.99, 95% CI 1.45 to 2.73, one study, 439 participants). People in the phacoemulsification group were also more likely to achieve BCVA of 6/12 or more at three months (RR 1.12, 95% CI 1.03 to 1.22, four studies, 645 participants) and one year (RR 1.06, 95% CI 0.99 to 1.14, one study, 439 participants), but the difference between the two groups was smaller. No trials reported BCVA less than 6/60 but three trials reported BCVA worse than 6/9 and 6/18: there were fewer events of this outcome in the phacoemulsification group than the ECCE group at both the three-month (RR 0.33, 95% CI 0.20 to 0.55, three studies, 604 participants) and 12-month time points (RR 0.62, 95% CI 0.36 to 1.05, one study, 439 participants). Three trials reported posterior capsule rupture: this occurred more commonly in the ECCE group than the phacoemulsification group but small numbers of events mean the true effect is uncertain (Peto odds ratio (OR) 0.56, 95% CI 0.26 to 1.22, three studies, 688 participants). Iris prolapse, cystoid macular oedema and posterior capsular opacification were also higher in the ECCE group than the phacoemulsification group. Phacoemulsification surgical costs were higher than ECCE in two studies. A third study reported similar costs for phacoemulsification and ECCE up to six weeks postoperatively, but following this time point ECCE incurred additional costs due to additional visits, spectacles and laser treatment to achieve a similar outcome. AUTHORS' CONCLUSIONS: Removing cataract by phacoemulsification may result in a better visual acuity compared to ECCE, with a lower complication rate. The review is currently underpowered to detect differences for rarer outcomes, including poor visual outcome. The lower cost of ECCE may justify its use in a patient population where high-volume surgery is a priority, however, there are a lack of data comparing phacoemulsification and ECCE in lower-income settings

Capturing cultural differences between UK and Malaysian drivers to inform the design of in-vehicle navigation systems

Attending to cultural diversity is important for products and technology intended for global placement, such as automobiles, yet many products (and associated interfaces) lack genuine cultural differentiation. For example, in-vehicle navigation systems are typically identical in form and function across world markets, differing only in the local language and map database. To capture and explore culturally-salient design factors, we utilised a scenario-based design methodology, involving 6 experienced drivers from the UK and Malaysia. Participants were asked to portray their ideal navigation system interface designs – by drawing pictograms and devising accompanying spoken messages – to direct drivers along 3 prescribed routes in the UK, Malaysia and Japan. Routes were presented using video and paper maps, with the order of presentation counterbalanced between groups; participants were not told in advance from which country each route was derived. Proposed designs highlight differences at a country level, which are consequently interpreted from a cultural perspective. For example, Malaysian drivers included a higher density of navigational elements in their designs, particularly in their home environment, compared to UK drivers. Malaysian drivers also created more incremental designs, particularly on the approach to a manoeuvre, suggesting a desire for greater navigational support at this point in the journey. Landmarks were consistently incorporated in designs, but differences were noted in cultural salience. Additionally, the phrasing of instructions (e.g. “go straight on”), nomenclature for road elements (e.g. ‘roundabout’) and distance declaration conventions (e.g. units) differed at a country level. The findings can be used to inform the design of culturally-attuned in-vehicle navigation systems

Capturing Children’s Mathematical Knowledge: An Assessment Framework

This paper explores an innovative assessment framework for measuring children’s formal and informal mathematical knowledge. Many existing standardized measures, such as the Early Grade Mathematics Assessment, measure children’s performance in early primary grade skills that have been identified by researchers and policy makers as foundational and predictive of later academic achievement (Platas, Ketterlin-Geller, & Sitabkhan, 2016; RTI International, 2014). However, these standardized assessments only provide information on children’s mathematical ability as it pertains to skills and concepts that are a focus of school instruction, referred to as formal mathematics. While valuable, they leave unmeasured the mathematics that children use and develop as part of their everyday life, such as the strategies they use to solve simple arithmetical problems that arise as they move through their day (Khan, 1999; Saxe, 1991; Taylor, 2009).  In this article, we draw from mixed methods studies which focus on capturing the informal mathematical skills that children develop outside of school in various contexts (Guberman, 1996; Nasir, 2000; Sitabkhan, 2009; Sitabkhan, 2015). We describe how the use of observations of children’s mathematical activities in natural settings and subsequent cognitive interviews using mathematical tasks derived from those observations can illuminate mathematical knowledge and skills that may otherwise remain hidden. We found that an assessment framework that focuses on both standardized measures of formal mathematical learning and contextualized measures of children’s everyday mathematics can provide a more complete and nuanced picture of children’s knowledge, and taken together can inform the development of curricular materials and teacher training focused on early learning