Drawing from research in the learning sciences, this article argues that educators, like Jesus, should use stories as we mentor students to move beyond passive reception of information and truly ...apply their learning to novel situations. Thus, students can go beyond "hearing" to "bearing fruit." This storytelling approach to mentorship strikes at the common query of students, "When will we ever need to know this?" Part of the disconnect sometimes experienced by students is that the moment of learning often looks very different than the moment when their learning needs to be deployed. In the Gospel of Luke, Jesus acknowledges this disconnect by making the distinction between "hearing the word" and the later "bearing of fruit with patience" and does so by employing a parable, a concrete story of a sower, seeds, and soils. Although stories may appear to conceal truths when compared to straightforward statements, research in the learning sciences suggests that learning from stories is better for producing understanding that could be applied to future situations. Why are stories so effective? To achieve transferable learning, students need to engage in productive struggle to make connections. Stories engaged Jesus's disciples in struggling with what parables meant because the truths did not lie at the surface. Instead, parables required disciples to actively make connections. Jesus, instead of removing their struggles, supported their struggle to make it more productive. Research has shown that the understanding that results from productive struggle is profound, useful, and transferable. As academic mentors, we should emulate Jesus to engage our students in making productive connections by integrating storytelling into our pedagogical practice.
Summary
Hyperangulated videolaryngoscopes are known to increase the success rate of tracheal intubation in the setting of difficult airway management when used with a stylet or bougie. However, there ...is controversy over which adjunct is more useful. This randomised study aimed to compare first attempt tracheal intubation success rate between a stylet and bougie when using a hyperangulated videolaryngoscope. We recruited patients aged > 20 years who were scheduled for elective surgery under general anaesthesia and required tracheal intubation. We only included patients with factors predicting difficult tracheal intubation based on pre‐anaesthesia airway evaluation. Tracheal intubation was attempted using a Glidescope® with either a stylet or bougie as an adjunct according to group assignment. Primary outcome was the success rate of the first tracheal intubation attempt, and secondary outcomes were success of second and third attempts; tracheal intubation time; and occurrence of sore throat, dysphagia or hoarseness. A total of 166 patients were included. The success rate of the first tracheal intubation attempt was significantly higher in patients allocated to the bougie group compared with those allocated to the stylet group (81/83 (98%) vs. 73/83 (88%), respectively; p = 0.032). The number of patients who needed two attempts was significantly lower in those allocated to the bougie group compared with those allocated to the stylet group (1/83 (1%) vs. 9/83 (11%), respectively; p = 0.018). Each group had one patient (1%) where tracheal intubation was achieved after a third attempt. There was no significant difference in the occurrence of sore throat, dysphagia and hoarseness between the two groups. When difficult tracheal intubation is anticipated and a hyperangulated videolaryngoscope is used, the success rate of the first attempt is higher when a bougie is used compared with a stylet.
Summary
Currently, propranolol is the preferred treatment for problematic proliferating infantile haemangiomas (IHs). The rapid action of propranolol has been shown to be especially dramatic in IHs ...involving dyspnoea, haemodynamic compromise, palpebral occlusion or ulceration. Another remarkable aspect of propranolol treatment revealed that the growth of the IHs was not only stabilized, but also that the improvement continued until complete involution was achieved, leading to a considerable shortening of the natural course of IH. However, the mechanisms underlying the effects of propranolol have not been fully elucidated. Recent studies have offered evidence of a variety of mechanisms. These include the promotion of pericyte‐mediated vasoconstriction, the inhibition of vasculogenesis and catecholamine‐induced angiogenesis, the disruption of haemodynamic force‐induced cell survival, and the inactivation of the renin–angiotensin system. This review summarizes these mechanisms and the new concepts that are emerging in this area of research. Moreover, several molecular mechanisms by which propranolol may modify neovascularization in IH have also been proposed. The antihaemangioma effect of propranolol may not be attributable to a single mechanism, but rather to a combination of events that have not yet been elucidated or understood. Further studies are needed to evaluate and verify these mechanisms to gain a greater understanding of the effects of the intake of propranolol on haemangioma involution.
What's already known about this topic?
In many centres, treatment with propranolol is now the preferred first‐line therapy for problematic infantile haemangioma (IH), despite the potential risk of side‐effects.
What does this study add?
We provide an up‐to‐date review of the literature regarding the mechanisms of action of propranolol in slowing the growth and accelerating involution of IH.
The antihaemangioma effect of propranolol may not be attributable to a single mechanism, but rather to a combination of events that have not yet been elucidated or understood.
The basic operating principles of the most common types of protection relays have not changed for more than half a century. However, the calculations used to measure power system fault signals ...continue to cause problems with relay performance. As a result, there is a need for developing a next generation of protection relays which are more accurate, more reliable and faster than the conventional relays. Protective Relaying of Power Systems Using Mathematical Morphology discusses the development of novel protective relaying algorithms using Mathematical Morphology (MM). MM is a nonlinear signal processing technique derived from set theory and geometry. It analyses signals in terms of shape by retrieving the features of the signals using a pre-defined structuring element. The book introduces the fundamental principles, and brings together the applications of MM to develop new protective relaying algorithms for the protection of a variety of power system components (including transmission lines, bus, and power transformers), as well as for the distorted waveform detection and compensation which are required for the operation of many conventional relays. Protective Relaying of Power Systems Using Mathematical Morphology is an ideal source of information for researchers or postgraduates in the fields of power and engineering, as well as for power engineers.
Glutathione S‐transferases (GSTs) are members of a multifunctional enzyme superfamily. Forty‐one GSTs have been identified in Tribolium castaneum; however, none of the 41 GSTs has been functionally ...characterized. Here, three delta‐class GSTs, TcGSTd1, TcGSTd2 and TcGSTd3, of T. castaneum were successfully cloned and expressed in Escherichia coli. All of the studied GSTs catalysed the conjugation of reduced glutathione with 1‐chloro‐2,4‐dinitrobenzene. Insecticide treatment showed that the expression levels of TcGSTd3 and TcGSTd2 were significantly increased after exposure to phoxim and lambda‐cyhalothrin, whereas TcGSTd1 was slightly upregulated only in response to phoxim. A disc diffusion assay showed that overexpression of TcGSTD3, but not TcGSTD1 or TcGSTD2, in E. coli increased resistance to paraquat‐induced oxidative stress. RNA interference knockdown of TcGSTd1 caused metamorphosis deficiencies and reduced fecundity by regulating insulin/target‐of‐rapamycin signalling pathway‐mediated ecdysteroid biosynthesis, and knockdown of TcGSTd3 led to reduced fertility and a decreased hatch rate of the offspring, probably caused by the reduced antioxidative activity in the reproductive organs. These results indicate that TcGSTd3 and TcGSTd2 may play vital roles in cellular detoxification, whereas TcGSTd1 may play essential roles in normal development of T. castaneum. These delta‐class GSTs in T. castaneum have obtained different functions during the evolution.
Three delta‐class glutathione S‐transferases (GSTs) were identified in Tribolium castaneum.
TcGSTd1 plays essential roles in metamorphosis and fecundity by regulating insulin/target‐of‐rapamycin mediated ecdysteroid biosynthesis.
TcGSTd2 contributes to insecticide detoxification, whereas TcGSTd3 plays vital roles in the detoxification of xenobiotics and protection against oxidative stress.
Cracks in solid-state materials are typically irreversible. Here we report electrically reversible opening and closing of nanoscale cracks in an intermetallic thin film grown on a ferroelectric ...substrate driven by a small electric field (~0.83 kV/cm). Accordingly, a nonvolatile colossal electroresistance on-off ratio of more than 10
is measured across the cracks in the intermetallic film at room temperature. Cracks are easily formed with low-frequency voltage cycling and remain stable when the device is operated at high frequency, which offers intriguing potential for next-generation high-frequency memory applications. Moreover, endurance testing demonstrates that the opening and closing of such cracks can reach over 10
cycles under 10-μs pulses, without catastrophic failure of the film.
This article models the partial discharge inception voltage (PDIV) as a function of ambient humidity (<inline-formula> <tex-math notation="LaTeX">{H}{)} </tex-math></inline-formula> at various ...temperatures (Ts) using Schumann's streamer inception criterion (SCSIC) for turn-to-turn insulation, which is the most vulnerable part in inverter-fed motors' insulation system. The Schumann constant (i.e., the natural logarithm of the critical electron number defining the Townsend-to-streamer discharge transition, <inline-formula> <tex-math notation="LaTeX">{K}{)} </tex-math></inline-formula> varies with <inline-formula> <tex-math notation="LaTeX">{H} </tex-math></inline-formula>, showing distinct patterns at low and high Ts. The <inline-formula> <tex-math notation="LaTeX">{K} </tex-math></inline-formula> equations are derived across a wide range of relative humidity (RH) levels (20%, 30%, 40%, 50%, 60%, 70%, 80%, and 90%) at four Ts (25 °C, 40 °C, 60 °C, and 90 °C). These equations can be used in finite element analysis software to predict PDIV under varying <inline-formula> <tex-math notation="LaTeX">{H} </tex-math></inline-formula> with outstanding accuracy. Additionally, a novel approach is presented for partial discharge (PD) phenomenology under <inline-formula> <tex-math notation="LaTeX">{H} </tex-math></inline-formula> variations at different Ts using SCSIC-derived streamer inception parameters (SIPs): critical field line length (CFLL), air effective ionization coefficient (<inline-formula> <tex-math notation="LaTeX">\alpha _{\text {eff}}{)} </tex-math></inline-formula>, PD inception field (<inline-formula> <tex-math notation="LaTeX">{E}_{\text {inc}}{)} </tex-math></inline-formula> and firing voltage (<inline-formula> <tex-math notation="LaTeX">{V}_{\text {firing}}{)} </tex-math></inline-formula>. Notably, at high Ts (e.g., 90 °C), a transition phase emerges concerning RH, leading to significant SIP changes due to the disappearance of a critical region (CritR) in <inline-formula> <tex-math notation="LaTeX">\alpha _{\text {eff}} </tex-math></inline-formula> at specific electric field intensities. The developed humidity-dependent PDIV model supports insulation designers in achieving PD-free designs that account for <inline-formula> <tex-math notation="LaTeX">{H} </tex-math></inline-formula> variations and sheds light on SIP variations concerning <inline-formula> <tex-math notation="LaTeX">{H} </tex-math></inline-formula> changes.
Recently, tumor budding (TB) found at the invasive margin has been related to lymph node involvement (LNI), local recurrence, and poor prognosis in various cancers. We assessed the presence of TB in ...endometrial endometrioid carcinoma (EEC), and examined the immunohistochemical (IHC) profiles to define its clinicopathological significance. Ninety-six EECs were obtained from 2008 to 2013. During the follow-up, ten patients experienced disease progression; of these, three patients succumbed to the disease. All hematoxylin and eosin-stained slides were scrutinized for the presence of TB. IHC stainings for estrogen receptor (ER), progesterone receptor (PR), β-catenin, and E-cadherin were performed. All cases were grouped as FIGO grade (G) 1 (47.9%), G2 (29.2%), and G3 (22.9%). The distribution for depth of invasion (DOI) was 68.5% with a DOI of less than half and 31.5% with a DOI of more than half. Myometrial invasion was characterized as infiltrating pattern (52.1%), adenomyosis-like (20.8%), microcystic, elongated, and fragmented (17.7%), or expansile (9.4%). TB was identified in 63 cases (65.6%). Lymphovascular invasion (LVI) and LNI were identified in 47 and 37 cases, respectively. TB was associated with deep DOI (
p
= 0.001), higher FIGO grade (
p
= 0.006), LVI (
p
< 0.0001), and LNI (
p
< 0.0001). TB showed loss of ER (
p
< 0.0001) and PR (
p
< 0.0001), reduced E-cadherin (
p
< 0.0001) expression, and aberrant β-catenin expression (
p
= 0.042). In EECs, TB was associated with deep DOI, less-differentiated histology, frequent LVI, and LNI; furthermore, TB was closely related to epithelial-mesenchymal transition phenotype and downregulation of hormonal receptors. Therefore, TB might be a determinant histologic clue for prediction of disease progression in EECs.
In this work, we apply a multi-scale model combining finite-element method (FEM) and phase-field model (PFM) to simulate the evolution of solidification microstructures at different locations within ...a molten pool of an additively manufactured IN718 alloy. Specifically, the FEM is used to calculate the shape of molten pool and the relative thermal gradient
G
at the macroscale. Then, the calculated thermal information is input into PFM for microstructure simulation. Finally, the morphology of solidification structures and formation of Laves phase at different sites are studied and compared. We found that the solidification site with a large angle between the temperature gradient and the preferred crystalline orientation could build up a high niobium (Nb) concentration in the liquid during solidification but has less possibility of forming continuous long chain morphology of Laves phase particles. This finding provides an understanding of the microstructure evolution inside the molten pool of IN718 alloy during solidification. Further, the finding indicates that the site with a large misorientation angle will have a good hot cracking resistance after solidification.
The aim of this study was to investigate the risk factors for restenosis after stent implantation in patients with ischemic cerebrovascular disease (ICVD), and to provide a reference for potential ...measures to prevent ICVD.
Relevant studies were identified by searching PubMed, ScienceDirect and Web of Science databases. Combined adjusted odds ratios and 95% confidence intervals were calculated.
Seven case-control studies were identified in the end. Diabetes mellitus and residual stenosis were the two main risk factors for restenosis (OR = 0.59, 95% CI: 0.39-0.91, p = 0.01; OR = 36.73, 95% CI: 19.72-70.02, p < 0.001). Gender, smoking, hypertension, dyslipidemia, and stent type were not significantly associated with restenosis (OR = 0.85, 95% CI: 0.53-1.38, p = 0.52; OR = 1.30, 95% CI: 0.91-1.86, p = 0.15; OR = 0.86, 95% CI: 0.16-4.66, p = 0.86; OR = 1.30, 95% CI: 0.58-2.91, p = 0.53; OR = 1.34, 95% CI: 0.72-2.48, p = 0.35).
The prevention of restenosis after stenting is particularly important for ICVD patients with diabetes or a high residual stenosis rate.
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