Unordinary: An evaluation of lecture-free activities using a repertory grid

Lecture-free activities afford students with an engaging approach to knowledge acquisition and integration. When peppered throughout a course, experiential activities inject spontaneity, break up familiar patterns, and empower students to take responsibility of their learning. For an instructor, iteration is required to develop effective lecture-free engineering activities, necessitating thoughtful evaluation. The paper adopts Kelly's personal constructs theory, using repertory grid analysis to consider the effectiveness of six unordinary, lecture-free activities. Through a structured comparison of activities, 29 constructs were elicited with inherently subjective, dichotomous poles. The grid was populated ranking each activity between the poles of each construct such as directed learning or creative expression. Using a cluster analysis and descriptive statistics, various themes emerged revealing the author's preference, and connections between seemingly unrelated constructs such as how summative actives use the entire building whereas formative activities are in the classroom. Recommendations are made to generalize the tool to aid instructors in activity evaluation and development through understanding and challenging existing patterns.

Intimate Partner Femicide in Romania: An Analysis of the Online Media News

The study presents the results of the analysis of the way in which the Romanian online media covered the cases of intimate partner femicide committed between 2011-2015. The term intimate partner femicide was used to designate all the homicide committed intentionally by a current or former intimate partner against the woman partner (wife, girlfriend, concubine). The information regarding the intimate partener femicide was identified with the help of Google Chrome search engine and some key words. In the end, I identified N=2282 articles where 184 femicide cases committed between intimate partners. The analysis of the information regarding the intimate partner femicide cases was made with the help of a grid analysis structured on four dimensions: data regarding the violence act, data regarding the aggressor and victim, and data regarding the history of the relationship. The study highlights the journalists’ lack of interest in describing the context in which femicides occurred and the lack of correlation between the acts of domestic violence and intimate partner femicides. Moreover, few journalists include information regarding the way of contacting the institutions of victim protection and thus they do not use an important occasion to contribute to the readers’ information about the way in which they can interfere and help a victim.

Practical implementation of remote continuous glucose monitoring in hospitalized patients with diabetes

Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Inpatient diabetes management involves frequent assessment of glucose levels for treatment decisions. Here we describe a program for inpatient real-time continuous glucose monitoring (rtCGM) at a community hospital and the accuracy of rtCGM-based glucose estimates. Methods Adult inpatients with preexisting diabetes managed with intensive insulin therapy and a diagnosis of coronavirus disease 2019 (COVID-19) were monitored via rtCGM for safety. An rtCGM system transmitted glucose concentration and trending information at 5-minute intervals to nearby smartphones, which relayed the data to a centralized monitoring station. Hypoglycemia alerts were triggered by rtCGM values of ≤85 mg/dL, but rtCGM data were otherwise not used in management decisions; insulin dosing adjustments were based on blood glucose values measured via blood sampling. Accuracy was evaluated retrospectively by comparing rtCGM values to contemporaneous point-of-care (POC) blood glucose values. Results A total of 238 pairs of rtCGM and POC data points from 10 patients showed an overall mean absolute relative difference (MARD) of 10.3%. Clarke error grid analysis showed 99.2% of points in the clinically acceptable range, and surveillance error grid analysis showed 89.1% of points in the lowest risk category. It was determined that for 25% of the rtCGM values, discordances in rtCGM and POC values would likely have resulted in different insulin doses. Insulin dose recommendations based on rtCGM values differed by 1 to 3 units from POC-based recommendations. Conclusion rtCGM for inpatient diabetes monitoring is feasible. Evaluation of individual rtCGM-POC paired values suggested that using rtCGM data for management decisions poses minimal risks to patients. Further studies to establish the safety and cost implications of using rtCGM data for inpatient diabetes management decisions are warranted.

Blood glucose prediction using multi-objective grammatical evolution: analysis of the “agnostic” and “what-if” scenarios

In this paper we investigate the benefits of applying a multi-objective approach for solving a symbolic regression problem by means of Grammatical Evolution. In particular, we extend previous work, obtaining mathematical expressions to model glucose levels in the blood of diabetic patients. Here we use a multi-objective Grammatical Evolution approach based on the NSGA-II algorithm, considering the root-mean-square error and an ad-hoc fitness function as objectives. This ad-hoc function is based on the Clarke Error Grid analysis, which is useful for showing the potential danger of mispredictions in diabetic patients. In this work, we use two datasets to analyse two different scenarios: What-if and Agnostic, the most common in daily clinical practice. In the What-if scenario, where future events are evaluated, results show that the multi-objective approach improves previous results in terms of Clarke Error Grid analysis by reducing the number of dangerous mispredictions. In the Agnostic situation, with no available information about future events, results suggest that we can obtain good predictions with only information from the previous hour for both Grammatical Evolution and Multi-Objective Grammatical Evolution.

Fluorescence grid analysis for the evaluation of piecemeal surgery in sinonasal inverted papilloma: a proof-of-concept study

Purpose Local recurrence occurs in ~ 19% of sinonasal inverted papilloma (SNIP) surgeries and is strongly associated with incomplete resection. During surgery, it is technically challenging to visualize and resect all SNIP tissue in this anatomically complex area. Proteins that are overexpressed in SNIP, such as vascular endothelial growth factor (VEGF), may serve as a target for fluorescence molecular imaging to guide surgical removal of SNIP. A proof-of-concept study was performed to investigate if the VEGF-targeted near-infrared fluorescent tracer bevacizumab-800CW specifically localizes in SNIP and whether it could be used as a clinical tool to guide SNIP surgery. Methods In five patients diagnosed with SNIP, 10 mg of bevacizumab-800CW was intravenously administered 3 days prior to surgery. Fluorescence molecular imaging was performed in vivo during surgery and ex vivo during the processing of the surgical specimen. Fluorescence signals were correlated with final histopathology and VEGF-A immunohistochemistry. We introduced a fluorescence grid analysis to assess the fluorescence signal in individual tissue fragments, due to the nature of the surgical procedure (i.e., piecemeal resection) allowing the detection of small SNIP residues and location of the tracer ex vivo. Results In all patients, fluorescence signal was detected in vivo during endoscopic SNIP surgery. Using ex vivo fluorescence grid analysis, we were able to correlate bevacizumab-800CW fluorescence of individual tissue fragments with final histopathology. Fluorescence grid analysis showed substantial variability in mean fluorescence intensity (FImean), with SNIP tissue showing a median FImean of 77.54 (IQR 50.47–112.30) compared to 35.99 (IQR 21.48–57.81) in uninvolved tissue (p < 0.0001), although the diagnostic ability was limited with an area under the curve of 0.78. Conclusions A fluorescence grid analysis could serve as a valid method to evaluate fluorescence molecular imaging in piecemeal surgeries. As such, although substantial differences were observed in fluorescence intensities, VEGF-A may not be the ideal target for SNIP surgery. Trial registration NCT03925285.

Accuracy of Flash Glucose Monitoring During Postprandial Rest and Different Walking Conditions in Overweight or Obese Young Adults

Aims: To investigate the accuracy of FreeStyle LibreTM flash glucose monitoring (FGM) relevant to plasma glucose (PG) measurements during postprandial rest and different walking conditions in overweight/obese young adults.Methods: Data of 40 overweight/obese participants from two randomized crossover studies were pooled into four trials: (1) sitting (SIT, n = 40); (2) walking continuously for 30 min initiated 20 min before individual postprandial glucose peak (PPGP) (20iP + CONT, n = 40); (3) walking continuously for 30 min initiated at PPGP (iP + CONT, n = 20); and (4) accumulated walking for 30 min initiated 20 min before PPGP (20iP + ACCU, n = 20). Paired FGM and PG were measured 4 h following breakfast.Results: The overall mean absolute relative difference (MARD) between PG and FGM readings was 16.4 ± 8.6% for SIT, 16.2 ± 4.7% for 20iP + CONT, 16.7 ± 12.2% for iP + CONT, and 19.1 ± 6.8% for 20iP + ACCU. The Bland–Altman analysis showed a bias of −1.03 mmol⋅L–1 in SIT, −0.89 mmol⋅L–1 in 20iP + CONT, −0.82 mmol⋅L–1 in iP + CONT, and −1.23 mmol⋅L–1 in 20iP + ACCU. The Clarke error grid analysis showed that 99.6–100% of the values in all trials fell within zones A and B.Conclusion: Although FGM readings underestimated PG, the FGM accuracy was overall clinically acceptable during postprandial rest and walking in overweight/obese young adults.

A Quantitative GIS and AHP Based Analysis for Geodiversity Assessment and Mapping

In recent times, the issues of geodiversity assessment and mapping have been subject of great attention, and many evaluation methodologies, either quantitative or qualitative, have been developed. In this research, a first assessment of geodiversity in the Liguria region has been carried out, according to a quantitative method based on spatial analysis techniques implemented in a GIS environment. This method considers four diversity indices obtained by grid analysis, relevant to the four main aspects of geodiversity: geology, geomorphology, hydrogeology and pedology. The geodiversity index was calculated two times, first with a non-weighted sum, then with a weighted sum of the four diversity indices. In the second case, the weights have been assigned according to a semi-quantitative analytical hierarchy process method (AHP) based on experts’ judgment. The results show that the Liguria region is characterized by many areas with high geodiversity, most of them internationally known by geoscientists and tourists for their valuable geoheritage and for their stunning landscapes. The correspondence between these areas and the protected areas of the european Natura 2000 network suggests a link between geodiversity and biodiversity.