Virtualizing Project-Based Learning: An Abrupt Adaptation of Active Learning in the First Days of the COVID-19 Pandemic, with Promising Outcomes

Project-based learning (PBL) is renowned as an active learning practice that promotes the application of the accumulation of knowledge through real-world and often open-ended problems. This work assesses a case evaluation of an introductory PBL course in a typical industrial engineering curriculum in Brazil. This course is taken during the first semester, in which students must develop solutions for a single given problem through weekly meetings. The case presented herein highlights the forced abrupt virtualization of the learning process, which imposed an unprecedented scenario on the students and instructors, especially with regard to this course, which is based primarily on presented discussions and activities. The first weeks of class following the abrupt virtualization of activities encountered misinformation and a lack of clarity about the adaptation of the activities. Fortunately, through rapid iterations, the adjustment process resulted in time invested by the students and classes, with an active discussion, using the tools made available by the university. This work aims to present the forced abrupt changes applied to this first-semester course, highlighting the challenges faced, and the positive outcomes obtained and observed by both the students and the instructor, and to make a comparison to the evolution of the course over the past years.

KPI Evaluation Framework and Tools Performance: A Case Study from the inteGRIDy Project

This paper presents an assessment of the impacts of the different tools implemented within the inteGRIDy project through the analysis of key performance indicators (KPIs) that appropriately reflect the technical and economic domains of the inteGRIDy thematic pillars, comprising demand response and battery storage systems. The evaluation is based on improvements brought about by individual components of the inteGRIDy-enabled smart solution across the Isle of Wight (IOW) pilot site. The analyses and the interpretation of findings for the pilot use case evaluation are presented. The results indicate that the smart solution implementation across the IOW pilot site resulted in achieving the inteGRIDy set objectives. Overall, a 93% reduction in energy consumption, equivalent to 643 kWh was achieved, via the M7 energy storage system and heat pumps developed as part of inteGRIDy solution. Additionally, the grid efficiency and demand flexibility contribution to the distribution network operator (DNO)-triggered DR services, based on a 10% increase/decrease in demand, resulted in stabilizing the grid efficiency.

Management of Ascites in Patients with Cirrhosis: An Update

Ascites represents a critical event in the natural history of liver cirrhosis. From a prognostic perspective, its occurrence marks the transition from the compensated to the decompensated stage of the disease, leading to an abrupt worsening of patients’ life expectancy. Moreover, ascites heralds a turbulent clinical course, characterized by acute events and further complications, frequent hospitalizations, and eventually death. The pathophysiology of ascites classically relies on hemodynamic mechanisms, with effective hypovolemia as the pivotal event. Recent discoveries, however, integrated this hypothesis, proposing systemic inflammation and immune system dysregulation as key mechanisms. The mainstays of ascites treatment are represented by anti-mineralocorticoids and loop diuretics, and large volume paracentesis. When ascites reaches the stage of refractoriness, however, diuretics administration should be cautious due to the high risk of adverse events, and patients should be treated with periodic execution of paracentesis or with the placement of a trans-jugular intra-hepatic portosystemic shunt (TIPS). TIPS reduces portal hypertension, eases ascites control, and potentially modify the clinical course of the disease. Further studies are required to expand its indications and improve the management of complications. Long-term human albumin administration has been studied in two RCTs, with contradictory results, and remains a debated issue worldwide, despite a potential effectiveness both in ascites control and long-term survival. Other treatments (vaptans, vasoconstrictors, or implantable drainage systems) present some promising aspects but cannot be currently recommended outside clinical protocols or a case-by-case evaluation.

Anatomical and Symptomatic Outcomes in Patients With Le Fort Colpocleisis

Background: We aimed to evaluate the short term anatomical and symptomatic results of elderly patients on whom Le Fort colpocleisis operation was performed due to pelvic organ prolapse (POP) in our clinic. Methods: Medical records of fifty-nine sexually inactive and ≥65 aged women with stage 2 or higher vaginal or uterine prolapse who underwent Le Fort colpocleisis operation were prospectively analysed. Pre-operative and 12 months post-operative data were recorded. Turkish validated Global Pelvic Floor Bother Questionnaire (GPFBQ) were also evaluated at pre-operative and 12 months post-operative period in all patients. Anatomical success was determined as no prolapse of any POP-Q point at or below 1 cm above the hymen. Results: A total of 59 patients were conducted in this study. The average age of the patients was 71.67±7.01 (years). The mean BMI was 27.1±9.52 kg/m2. POP-Q point C as well as, Gh and TVL measurements were significantly higher after surgery than those at preoperative period (p<0.01, p<0.01, p<0.01, respectively). There was no recurrence in any case. Evaluation of complications at the pre-operative and post-operative 12th month revealed significant differences for SUI, urinary frequency, nocturia, and pelvic pain symptoms during post-operative period (p:0.007, p<0.001, p:0.01, p<0.001; respectively). Conclusions: Le Fort colpocleisis is a simple and effective procedure that has been found to provide successful anatomical and symptomatic outcomes in sexually inactive and elderly women for POP. However long-term results of this procedure needs further investigation.

Gut Microbiota and Autoimmune Diseases: a Charming Real World Together with Probiotics

Background: The role of gut microbiota in human disease is fascinating for hundreds of researchers worldwide. Many works have highlighted that gut microbiota modulates the immune system, and that its disruption can trigger autoimmune and inflammatory immune-mediated diseases. Probiotics are able to positively modify microbiota composition. Objective: Aim of this review is to report the most important findings regarding the effects of probiotics administration in the most common autoimmune disease and inflammatory immune-mediated diseases. Method: Literature research was performed in PubMed, Google Scholar and Medline, as well as in specific journal websites using the keywords: “autoimmunity”, “microbiota”, and “probiotics”. The article selection has been made independently by three authors, and controversies have been solved by a fourth researcher. Only English-language articles were included and preference was given to clinical trials, meta-analysis, and case series. After the review process, 68 articles have been considered. Results: Relying on this evidence, many studies have investigated the potential of probiotics in restoring gut eubiosis thus affecting pathogenesis, clinical manifestations, and course of these pathologies. Even in the light of few and sometimes contradictory studies, physicians should start to consider this preliminary findings when approaching patients suffering from autoimmune disease. After an accurate case-by-case evaluation of potential candidates, probiotics might be introduced beside the standard therapeutic plan, as supportive measures.

Assessing effectiveness of exclusion fences in protecting threatened plants

Overgrazing stands out as threat factors on biodiversity, being especially harmful in the Mediterranean, due to strong human pressure and an accelerated climate change acting synergistically. Fencing is a common tool used in conservation biology to tackle this problem. Advantages of fences are usually fast, intuitive, and easy to evaluate. However, disadvantages could also arise (increasing interspecific competition, disturbing habitat structure, limiting pollination, reducing dispersion). Together with management issues (maintenance, conflicts with stakeholders, and pulling effect). Effectiveness of fencing for conservation has been frequently assessed for animals, while it is almost a neglected topic in plants. We evaluated the outcome of fencing three threatened and narrow-endemic plants. Selected 5 populations were only partly fenced, which allowed comparing different variables inside and outside the fence. For evaluating the fencing effects, we sampled several habitats (vegetation cover, composition, density of target species), and target-species features (individual size, neighbouring species, and fruit-set). Fencing had strong effects on the habitat and on target-species individuals, showing contrasting responses at species and population level. Particularly, for Erodium cazorlanum, fence had a positive effect in one case, and negative in another. In Hormathophylla baetica effect was positive in all populations. Finally, fencing negatively affected Solenanthus reverchonii by increasing competition and limiting seed-dispersal. Fencing outcome was different in assessed species, highlighting the need to a case-by-case evaluation to determine the net balance (pros vs. cons), also its suitability and most favourable option (i.e. permanent vs. temporary fences).

Fingertip defects coverage using reverse-flow homodigital island flaps

BACKGROUND: The hand has always been a highly organized tool in humans daily and professional activity. Distal phalanges are most commonly exposed to trauma, which often cause defects that need to be covered through plastic surgery. One of the most reliable and universal methods for fingertip reconstruction is the reverse-flow homodigital island flap. CLINICAL CASES: This series of clinical cases describe three children aged 7, 8, and 11 years who underwent coverage of fingertip defects with the reverse-flow homodigital island flap. In all cases, mechanisms of injury were associated with crushing and rupture of soft tissues. All children underwent coverage of fingertip defects with the reverse-flow homodigital island flap. In the first case, evaluation results at 6 months after surgery revealed 4 mm in the Webers test and phalanx length deficit of 2 mm. In the second case, the assessment performed 1 month after surgery revealed 5 mm in the Webers test and the length of the operated phalanx corresponds to the contralateral one. In the third case, results of the 2-month observation period revealed 4 mm in the Webers test and lengths of the operated and contralateral phalanges were the same. DISCUSSION: The reverse-flow homodigital island flaps have irrefragable advantages among methods of surgical reconstruction of soft tissues of distal phalanges. These are single-stage reconstruction techniques that can possibly replenish sufficient amounts of soft tissues to the defect. A literature data analysis of the outcomes of the fingertip reconstruction through the reverse-flow homodigital island flaps revealed good and satisfactory results. CONCLUSIONS: The method of the reverse-flow homodigital island flap has potential to take a significant place in pediatric traumatology and reconstructive surgery.

Cognitive Biases in Criminal Case Evaluation: A Review of the Research

Psychological heuristics are an adaptive part of human cognition, helping us operate efficiently in a world full of complex stimuli. However, these mental shortcuts also have the potential to undermine the search for truth in a criminal investigation. We reviewed 30 social science research papers on cognitive biases in criminal case evaluations (i.e., integrating and drawing conclusions based on the totality of the evidence in a criminal case), 18 of which were based on police participants or an examination of police documents. Only two of these police participant studies were done in the USA, with the remainder conducted in various European countries. The studies provide supporting evidence that lay people and law enforcement professionals alike are vulnerable to confirmation bias, and there are other environmental, individual, and case-specific factors that may exacerbate this risk. Six studies described or evaluated the efficacy of intervention strategies, with varying evidence of success. Further research, particularly in the USA, is needed to evaluate different approaches to protect criminal investigations from cognitive biases.