Integrating motivation in instructional design

This paper explores the construct of motivation from the perspective of the instructional designer or teacher. It describes the motivation to learn in the context of intrinsic motivation, Expectancy-value Theory, Self-efficacy Theory, and Attribution Theory. The ARCS motivational model is examined in detail before discussing how motivation can be integrated in instructional design to enhance learning. This paper also explicates Cheng and Yeh’s (2009) framework in the context of classroom learning

Oil palm (Elaeis guineensis) trunk as a resource of starch and other sugars

Large quantities of oil palm trunks are available annually during the replanting activities when the oil palm tree passed their economic age, on an average after 25 years are replace with young trees. Basically the oil palm trunks contains about 18- 21% of lignin, 65-80% of holocellulose (a-cellulose and hemicellulose) and quite significant amount starch. This work is aimed to determine the total extractable starch and sugars content from oil palm trunks by using steeping method and dilute acid hydrolysis. The effect of different oil palm trunk powder size on starch, xylose and glucose yield was evaluated. The effect of extraction parameter for each extraction method on the yield of starch and sugars were studied. The highest starch yield was obtained when steeped in the presence of lactic acid, while the highest xylose yield was obtained by 60 min hydrolysis of 60 mesh of oil palm powder with 2% sulfuric acid. For glucose yield, hydrolysis efficiency of 82% was obtained for conversion of oil palm trunk to glucose using two-stage concentrated sulfuric acid hydrolysis. Conclusively oil palm trunk can be considered as a resource of substantial amounts of starch and sugars

Epidemiology of injuries in Hong Kong elite badminton athletes

This study retrospectively reviewed the injury epidemiology on 44 Hong Kong elite badminton players in 2003. Team training records were reviewed to retrieve the training and competition hours, while the medical records from the physiotherapy department were reviewed to obtain information regarding injuries. A total of 253 injuries (128 recurrent and 125 new injuries) were recorded, which accounted for an overall incidence rate of 5.04 per 1,000 player hours. Elite senior athletes had a higher incidence rate of recurrent injuries, while elite junior and potential athletes had a higher incidence rate of new injuries. A total of 1,219 visits (4.82 per athlete) to the physiotherapy department were recorded, which cost HK$487,600 (HK$1,928 per injury). Most new injuries were strain (80 injuries), and the most frequently injured body sites were the back (17 injuries), the shoulder (15 injuries), the thigh (15 injuries), and the knee (15 injuries). One-sided exact test showed that a previous injury experience significantly associated with the occurrence of new injury

Parental presence during pediatric emergency procedures: finding answers in an Asian context

Objective The practice of allowing parental presence during invasive procedures in children varies depending on setting and individual provider preference. We aim to understand the attitudes, preferences, and practices of physicians and nurses with regard to parental presence during invasive pediatric emergency procedures in an Asian cultural context. Methods We surveyed physicians and nurses in the pediatric emergency department of a large tertiary hospital using separate self-administered questionnaires over three months. The data collected included the demographics and clinical experience of interview respondents. Each provider was asked about their attitude and preference regarding parental presence during specific invasive procedures. Results We surveyed 90 physicians and 107 nurses. Most physicians in our context preferred to perform pediatric emergency procedures without parental presence (82, 91.1%). Forty physicians (44.4%) reported that parental presence slowed down procedures, while 75 (83.3%) felt it increased provider stress. Most physicians made the decision to allow parents into the procedure room based on parental attitude (69, 76.7%) and the child’s level of cooperation (64, 71.1%). Most nurses concurred that parental presence would add to provider stress during procedures (69, 64.5%). We did not find a significant relationship between provider experience (P=0.26) or age (P=0.50) and preference for parental presence. Conclusion In our cultural context, most physicians and nurses prefer to perform procedures for children in the absence of parents. We propose that this can be changed by health professional training with role play and simulation, adequate supervision by experienced physicians, and clear communication with parents

Large language models approach expert-level clinical knowledge and reasoning in ophthalmology:A head-to-head cross-sectional study

Large language models (LLMs) underlie remarkable recent advanced in natural language processing, and they are beginning to be applied in clinical contexts. We aimed to evaluate the clinical potential of state-of-the-art LLMs in ophthalmology using a more robust benchmark than raw examination scores. We trialled GPT-3.5 and GPT-4 on 347 ophthalmology questions before GPT-3.5, GPT-4, PaLM 2, LLaMA, expert ophthalmologists, and doctors in training were trialled on a mock examination of 87 questions. Performance was analysed with respect to question subject and type (first order recall and higher order reasoning). Masked ophthalmologists graded the accuracy, relevance, and overall preference of GPT-3.5 and GPT-4 responses to the same questions. The performance of GPT-4 (69%) was superior to GPT-3.5 (48%), LLaMA (32%), and PaLM 2 (56%). GPT-4 compared favourably with expert ophthalmologists (median 76%, range 64–90%), ophthalmology trainees (median 59%, range 57–63%), and unspecialised junior doctors (median 43%, range 41–44%). Low agreement between LLMs and doctors reflected idiosyncratic differences in knowledge and reasoning with overall consistency across subjects and types (p > 0.05). All ophthalmologists preferred GPT-4 responses over GPT-3.5 and rated the accuracy and relevance of GPT-4 as higher (p < 0.05). LLMs are approaching expert-level knowledge and reasoning skills in ophthalmology. In view of the comparable or superior performance to trainee-grade ophthalmologists and unspecialised junior doctors, state-of-the-art LLMs such as GPT-4 may provide useful medical advice and assistance where access to expert ophthalmologists is limited. Clinical benchmarks provide useful assays of LLM capabilities in healthcare before clinical trials can be designed and conducted

Identifying central symptom clusters and correlates in children with acute leukemia undergoing chemotherapy: a network analysis

BackgroundPrevious studies have examined symptom clusters in children with acute leukemia, yet a knowledge gap persists regarding central symptom clusters and their influencing factors. By identifying these central clusters and associated factors, healthcare providers can enhance their understanding and effective management of symptoms. Our study seeks to address this gap by identifying symptom clusters, exploring central clusters, and investigating the demographic and health-related factors associated with these clusters in children with acute leukemia undergoing chemotherapy.MethodsA total of 586 children with acute leukemia from January 2021 to April 2023 were recruited from China. They were investigated using Memorial Symptom Assessment Scale 10-18 during chemotherapy. The principal component analysis was used to identify the symptom clusters. An association network was conducted to describe the relationships among symptoms and clusters. A multiple linear model was used to investigate the associated factors for the severity of overall symptoms and each symptom cluster.ResultsFive clusters were identified, including oral and skin cluster, somatic cluster, self-image disorder cluster, gastrointestinal cluster and psychological cluster. Gastrointestinal cluster was the most central symptom cluster. Age, sex, clinical classification, number of having chemotherapy and education degree and marital status of the primary caregiver are associated with the severity of these five symptom clusters.ConclusionOur study highlights the importance of evaluating symptom clusters in children with acute leukemia during chemotherapy. Specifically, addressing gastrointestinal symptoms is crucial for effective symptom management and overall care

Genome wide analysis of gene expression changes in skin from patients with type 2 diabetes

Non-healing chronic ulcers are a serious complication of diabetes and are a major healthcare problem. While a host of treatments have been explored to heal or prevent these ulcers from forming, these treatments have not been found to be consistently effective in clinical trials. An understanding of the changes in gene expression in the skin of diabetic patients may provide insight into the processes and mechanisms that precede the formation of non-healing ulcers. In this study, we investigated genome wide changes in gene expression in skin between patients with type 2 diabetes and non-diabetic patients using next generation sequencing. We compared the gene expression in skin samples taken from 27 patients (13 with type 2 diabetes and 14 non-diabetic). This information may be useful in identifying the causal factors and potential therapeutic targets for the prevention and treatment of diabetic related diseases

Unveiling prey preferences of endangered wild Malayan tiger, Panthera tigris jacksoni, in Peninsular Malaysia through scat analysis via COI DNA metabarcoding

Understanding the prey preference of Malayan tiger (Panthera tigris jacksoni) in Malaysia is important to guide conservation planning initiatives. The utilisation of DNA metabarcoding provides valuable insights, particularly in the field of carnivora diet research. This technique has been proven to be effective for identifying various species within complex mixtures such as scat materials, where visual identification is challenging. The Cytochrome c oxidase subunit I (COI) locus has been selected as it is a widely used as an effective non-invasive approach for diet studies. Hence, given this advance approach, Malayan tiger scats were collected on the basis of existing records of their presence in two types of habitats, namely, protected areas (PA) and human–tiger conflict (HTC) areas. This study aimed to identify prey species in Peninsular Malaysia, based on Malayan tiger scat samples using DNA metabarcoding. Based on the partial mitochondrial COI region, DNA metabarcoding led to the taxonomic resolution of prey DNA remnants in scats and the identification of prey species consumed by Malayan tiger, which were predominately small-to-medium-sized prey, including livestock. The dominant DNA prey detected belongs to the family Canidae, followed by Bovidae, Vespertilionidae, Homonidae, Felidae, Phasianidae and Muridae. A significant difference (p < 0.05) was observed in alpha and beta diversity using the Shannon index and PERMANOVA with regard to prey richness and evenness in two different habitat groups, namely, PA and HTC. Our finding provides insights into Malayan tiger dietary requirements, which can be used to develop conservation plans and strategies for Malayan tiger, particularly for habitat priorities