The purpose of this research was to determine the depth and scope of Global Citizenship Education (GCE) through the International Baccalaureate (IB) Primary Years Programme (PYP) exhibition. The ...small-scale qualitative study describes how a fifth-grade cohort and teachers at The International School of Azerbaijan uncover GCE in situ. Drawing on GCE literature, including Irene Davy’s IB position paper and UNESCO’s Global Citizenship: Education Topics and Learning Objectives, the study seeks to align current theory on GCE and the components of the exhibition. The research is underpinned by communicative action and reflection, denoting a critical stance on epistemology. The resulting conceptual GCE framework positions authentication, co-creation and substantiation as key enabling features of the PYP exhibition. As the presented framework is based on practice, the key assertions are applicable to educators, schools and networks seeking to enliven contextual modes of global learning.
New markers to help stratify coronary atherosclerosis are needed. Although attempts have been made to differentiate active lesions from those that are stable, none of these has ever been formalised ...into a discriminatory score. The aim of this study was to analyse the differences between culprit ACS lesions and culprit stable angina lesions with intravascular ultrasound-derived virtual histology and to construct and validate a plaque score.
Prior to percutaneous coronary intervention (PCI), we performed volumetric, intravascular ultrasound-derived virtual histology (IVUS-VH) analysis in acute coronary syndrome (ACS) culprit lesions (AC - n=70) and stable angina culprit lesions (SC - n=35). A direct statistical comparison of IVUS-VH data and multiple logistic regression analysis was undertaken. Four main factors were found to be associated (p<0.05) with an AC lesion phenotype: necrotic core/dense calcium (NC/DC) ratio; minimum lumen area <4 mm2 (MLA <4); remodelling index @MLA >1.05 and VH-TCFA presence. Calculation of each logistic regression coefficient and the equation produces an active plaque discrimination score with an AUC of 0.96 on receiver operating characteristics (ROC) analysis. Validation of the score in 50 independent plaques from the Thoraxcenter in Rotterdam revealed an AUC of 0.71, confirming continued diagnostic ability.
We have found four features on IVUS and VH that can predict and discriminate ACS culprit lesion phenotypes from those that are clinically stable. Subsequently, we have constructed and validated the Liverpool Active Plaque Score based upon these features. It is hoped this score may help diagnose active coronary plaques, in the future, to help prevent major adverse cardiac events.
Previous intravascular ultrasound-based virtual histology (IVUS-VH) measurement variability studies have been confined to single-frame or short-segment analysis in stable patients with minimal ...disease. We sought to determine the magnitude of human measurement variability in acute coronary syndrome (ACS) plaques.
Prior to percutaneous coronary intervention, we performed IVUS-VH analysis in troponin-positive ACS culprit lesions. A total of 3840 IVUS-VH frames were analysed by two operators to determine intra- and inter-observer variability. The plaque constituent area and volumes were compared using intra-class correlation coefficient (ICC); within-subjects standard deviation (WSSD, mm(2) or mm(3)) and the repeatability coefficient (RCO) to quantify the magnitude of operator error that 95% of future measurements should not exceed. The majority of intra- and inter-observer measurements had ICC of >0.92 confirming excellent agreement. Only the fibrous area (0.86), fibro-fatty (FF) area (0.72) and FF volume (0.87) had ICC levels suggesting an operator error >10%. However, the mean RCO and the percentage this represents in single-frame analysis (area error) varied across the plaque subtypes: fibrous area = 1.64 mm(2) (59%); FF area = 0.49 mm(2) (140%); necrotic core (NC) area = 0.39 mm(2) (21.3%); dense calcium (DC) area = 0.29 mm(2) (33.7%). For full lesion pullbacks (volume error): fibrous volume = 8.14 mm(3) (9.9%); FF volume = 5.63 mm(3) (53.8%); NC volume = 3.78 mm(3) (6.9%) and DC = 2.4 mm(3) (9.6%)
As in previous studies, intra- and inter-observer ICC suggests good agreement between observers. However, this can still represent large measurement error values and percentages. These findings could impact on the interpretation of previous studies and influence future studies using IVUS-VH measurements as endpoints.
The computing world is now populated with smartphones which combine the features of a phone with a general purpose computer and come loaded with sensors including digital cameras, global positioning ...system (GPS) receivers, accelerometers and many more. In this paper we argue that these devices are an ideal platform for collecting data for use in urgent computing simulations. We describe how these devices will have far reaching impacts on how people connect with and organize their communities and discuss how this coincides with the rise of community driven response to disasters and the need for decentralized command and control that is discussed in disaster management literature. We also that smartphones, by providing technology which can network people without the use of centralized infrastructure, and which are carried, used, and maintained as part of daily life, are a promising platform for building distributed disaster management applications, which could be part of the inputs provided to an urgent computing simulation. In this paper we describe not only the potential of the platform, but also analyze the challenges it faces in order to realize that potential, and discuss how our middleware is designed to meet these challenges and bring about the future of disaster management applications for smartphones using urgent computing.
The marriage of twenty-first-century horizons of technology and the global ideal constitutes techno-global rationality as it reflects contemporary impulses, frames and teleologies. Fast-paced ...automation, the importance of cosmopolitanism and the colonial legacy have come to dominate educational discourse and drive calls for streamlined educative practice. Although such efficiency models empower a transactional/linear mode of teaching and learning, they do little to privilege integrative voices, deliberation and intersubjective care found in global citizenship education (GCE) definitions. We argue such rationality has exacerbated a neo-colonial ethic that promulgates economic, political and cultural pressure to control and narrow otherwise diverse learning opportunities. Drawing from recent research into technology and GCE in two International Baccalaureate international schools, we note the importance of communicative outreach and agency in diversity. We also highlight the distorting effects of hyper-rationalised neo-colonial interpretations of global agency. This article will interest those seeking to develop global educational policy and practice along with revitalising interpretations of technology integration.
Marathon running transiently increases the risk of sudden cardiac death. Some previous studies have suggested that this is due to relatively advanced but asymptomatic atherosclerosis. Other theories ...suggest that potentiation of inflammation and the coagulation cascade, by extremes of exertion, is more important. We present a clinical case of a young, previously fit athlete who felt chest discomfort eight miles into a marathon but finished the race. Shortly after completion he felt very unwell and had chest pain. Ambulance electrocardiograms showed evidence of an evolving anterior myocardial infarction. Invasive assessment with coronary angiography and intravascular ultrasound was able to show the mechanism of thrombosis. Fissuring of a small rim of atherosclerosis potentiated a large pro-thrombotic response, the patient was also found to have sickle cell trait. Medical treatment with blood thinning drugs was able to restore normality to the vessel over a period of two weeks, without the need for angioplasty or stent implantation.
We can't get away from the importance of certain lifestyle choices, including adequate exercise and a healthy diet. This is all the more significant for kidney patients, argues Nicholas Palmer, who ...must do their best to avoid unhealthy temptations and be aware of the risks that exist.
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