CULTURE AND INTERLANGUAGE STAGES EFFECT ON EFL STUDENTS’ POLITENESS IN REFUSALS

ABSTRACTThe objectives of this study is to investigate the culture and interlanguage stages effect on EFL students’ politeness in refusals. This study was a qualitative research. The data were taken from refusal expressions made by EFL Malay and Batak Junior high school students with initial stage (stage 1 interlanguage) and free variation stage (stage 2 interlanguage). The data of this study were collected by using elicitation techniques by using Discourse Completion Task (DCT), pictures and Interview. The number of the subjects involved in this study was taken by using snowball technique and the total number were twelve subjects. The results of this study showed that both culture and interlanguage stages affect the EFL students’ politeness in refusals. In Bataknese EFL students, the realization of politeness in refusal tends to be more affected by the culture rather than the interlanguage stages. While in Malay, culture and interlanguage stages have the same effect in the realization of politeness in refusals.Keywords: Culture, Effect, Interlanguage Stages, Politeness, Refusals

Tibial Tubercle Apophyseal Stage to Determine Skeletal Age in Pediatric Patients Undergoing ACL Reconstruction: A Validation and Reliability Study

Background: Anterior cruciate ligament (ACL) injuries demand individualized treatments based on an accurate estimation of the child’s skeletal age. Wrist radiographs, which have traditionally been used to determine skeletal age, have a number of limitations, including cost, radiation exposure, and inconvenience. Purpose: To evaluate the reliability and validity of a radiographic staging system using tibial apophyseal landmarks as hypothetical proxies for skeletal age to use in the preoperative management of pediatric ACL tears. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The study included children younger than 16 years of age who underwent ACL reconstruction between July 2008 and July 2018 and received both skeletal age radiography and knee radiography within 3 months of each other. Skeletal age was calculated from hand and wrist radiographs using the Greulich and Pyle atlas. Tibial apophyseal staging was categorized into 4 stages: cartilaginous stage (stage 1), apophyseal stage (stage 2), epiphyseal stage (stage 3), and bony/fused stage (stage 4). Data were collected by 2 independent assessors. The analysis was repeated 1 month later with the same assessors. We calculated descriptive statistics, measures of agreement, and the correlation between skeletal age and apophyseal stage. Results: The mean chronological age of the 287 patients included in the analysis was 12.9 ± 1.9 years; 164 (57%) of the patients were male. The overall Spearman r between skeletal age and tibial apophyseal staging was 0.69 (0.77 in males; 0.60 in females). The interrater reliability for the tibial apophyseal staging was substantial (Cohen κ = 0.66), and the intrarater reliability was excellent (Cohen κ = 0.82). The interrater reliability for skeletal age was excellent (intraclass correlation coefficient [ICC] = 0.93), as was the intrarater reliability (ICC = 0.97). Conclusion: The observed correlation between skeletal age and tibial apophyseal staging as well as observed intra- and interrater reliabilities demonstrated that tibial apophyseal landmarks on knee radiographs may be used to estimate skeletal age. This study supports the validity of knee radiographs in determining skeletal age and provides early evidence in certain clinical presentations to simplify the diagnostic workup and operative management of pediatric knee injuries, including ACL tears.

Level Berpikir Geometri Peserta Didik Berdasarkan Teori Van Hiele pada Materi Bangun Ruang Sisi Datar

According to Van Hiele, in understanding geometry, students need to understand five stages, namely stage 1 (introduction stage), stage 2 (analysis stage), stage 3 (sequencing stage), stage 4 (deduction stage), and stage 5 (accuracy stage). Each student has different geometric thinking abilities. This study aims to examine the geometric abilities of junior high school students in the material of flat-sided geometry according to Van Hiele's Theory. This research belongs to the type of qualitative research with a case study design. It was conducted at three schools in Padang, West Sumatra, Indonesia. The subjects were students of SMP Negeri 1 Padang, SMP Negeri 7 Padang, and SMP Negeri 25 Padang. Data collection was carried out using tests, interviews, and documentation. Data analysis was carried out with the stages of data reduction, data presentation, and data verification or drawing conclusions. The data originality technique was carried out with the triangulation technique, where the researcher compared the test data with the results of interviews with students. Of the 94 students (male = 38, female 56) tested based on the geometric thinking level of Van Hiele Theory, 92.55% of the students reached the Van Hiele thinking stage at the visualization level. As many as 45.74% of students reached the level of geometric analysis, and 6.38% of students reached the level of abstraction. For the level of deduction and accuracy, no one has been able to solve the problem. The results obtained in this study are that most students are still at stages 1 and 2, unlike van Hiele's opinion, which revealed that the level of geometric thinking for junior high school students is at level 3. According to the study results, it is essential to carry out further checks on the level of geometric thinking of junior high school students in other areas.

Mineralization of the Tuwu Porphyry Cu Deposit in Eastern Tianshan, NW China: Insights From In Situ Trace Elements of Chlorite and Pyrite

The Tuwu porphyry copper deposit is located on the Dananhu-Haerlik island arc in eastern Tianshan, NW China. Based on geology, petrology, and in situ trace element studies of pyrite and chlorite, we redefined the characteristics of hydrothermal fluids and the following three mineralization stages: premineralization stage (stage Ⅰ), porphyry metallogenic stage (stage Ⅱ), and superimposed transformation stage (stage Ⅲ). Pyrite stage Ⅰ (Py-I) has the highest Co/Ni ratios, and the precipitation crystallization of chlorite (Chl-I2) has the similar rare earth element distribution patterns with those of volcanic rocks Carboniferous Qieshan (CQ), indicating intense volcanic hydrothermal activity. The Co/Ni ratios of Py-II1 and Py-II2 (stage Ⅱ) tend to decrease over time. Moreover, the rare earth element (REE) distribution patterns of Chl-II have similar LREE enrichment, and the Eu anomalies in Chl-II1, Chl-II2, and Chl-II3 range from positive to negative. The initial ore-forming fluid was mainly magmatic hydrothermal fluid, and with the late-stage addition of meteoric water and continuous sulfide precipitation, the trace element composition of the fluid changed, and the whole system became more oxidizing. Py-III (stage Ⅲ) has the lowest Co/Ni ratios, and the REE distribution pattern of Chl-III is characterized by LREE enrichment. Moreover, the Chl-III shows obvious shear deformation characteristics. The results indicate that the host rocks experienced intensely superimposed reformation. By combining and integrating our results with the regional evolution processes in the eastern Tianshan, we propose that the Tuwu porphyry deposit has undergone magmatic hydrothermal and metamorphic hydrothermal processes. Volcanism (stage Ⅰ) provided the space and initial conditions for the emplacement of the metallogenic body. With the emplacement of the plagiogranite porphyry (stage Ⅱ), the main copper mineralization occurred in the porphyry and surrounding rocks. After porphyry mineralization (stage Ⅲ), regional ductile shearing and collisional compression led to a copper reaction, and its accumulation along the faults formed an ore shoot.

Validation of a high performing blood test for multiple major cancer screenings.

10561 Background: Early detection at the localized stage is pivotal for the successful treatment of various cancer types. Although several cancers already have routine screening approaches, the comprehensive utilities are impeded for various reasons, e.g., low accuracy, high cost, limited availability of required facilities, especially in the developing countries. Therefore, an accurate, cost-effective, and non-invasive test for multiple major cancer screening is in high demand. We previously reported a cfDNA methylation test, which can detect five major cancer types with high specificity and sensitivity, especially at the early stage (stage I). These five major cancers, including lung cancer (LC), breast cancer (BC), colorectal cancer (CRC), gastric cancer (GC), and esophageal cancer (EC), account for 56% of new cancer cases and 60% of cancer-related deaths yearly in China. Here, we report the result in an independent cohort as a further validation of this multi-cancer screening test. Methods: The high-throughput targeted methylation profiling platform, Aurora, was used to analyze the plasma samples from an independent retrospective cohort containing 505 healthy controls and ̃200 cases for each cancer type. A locked model based on our previous pilot study (reported in AACR 2020 and 2021) was applied to this data set to assess the overall performance. Results: The Area Under Curves (AUC) of the classifier for LC, BC, CRC, GC and EC are 97.3%, 96.2%, 92.0%, 94.0% and 93.5%, respectively. At a fixed specificity of 99%, the sensitivities for LC, BC, CRC, GC and EC are 84%, 75%, 82%, 85% and 78%, respectively. Conclusions: A methylation blood test for five major cancer screening has been validated in a large retrospective cohort. Its high sensitivity for each cancer type, especially at the early stage (stage I), and easy to use suggests it can be implemented in real clinical world. A large prospective clinical trial is undergoing to further validate this test in asymptomatic populations.

Clinicopathologic characteristics of distinct molecular subtypes of endometrial carcinoma in Chinese population.

e17568 Background: Stratifying endometrial carcinoma (EC) based on molecular profiling is of importance. While, spectrum of molecular subtypes of EC in Chinese population needs to be elucidated. Conventional approaches involve methodologies including Sanger sequencing as well as immunohistochemistry which is highly dependent on experience of pathologists. This study is of first time to display clinical and pathological characters of molecular subtypes of EC which were defined by a simplified NGS panel in Chinese population. Methods: Paraffin-embedded tissues of 135 consented EC patients were retrospectively collected from Qilu Hospital, Shandong Province, China. Genomic DNA was extracted and subjected to a simplified panel covering POLE, TP53 as well as 55 MSI loci for massive parallel sequencing. Mutations annotated as Tier I, II were applied for subtyping. MSI was defined as instability in 22 or more microsatellite loci. Subtypes were stratified as POLE, MSI, TP53-wt or TP53-mut group. Correlations of clinicopathological characters as well as prognosis were further conducted. Results: Histology of collected samples were mostly Endometrioid EC (EEC, 93.33%). Most of samples were at stage I (80%). The fractions of POLE (n=10), MSI (n=29), TP53-wt (n=84) and TP53-mut (n=12) group were 7.41%, 21.48%, 62.22%, and 8.89%, respectively. POLE group was associated with earlier stage (Stage I, 90%), EEC (80%) and less lympho-vascular space invasion (LVSI) (10%). TP53-mutant subtype was correlated to later stage (Stage II-IV, 41.67%), higher grade (G2+G3, 83.33%), serous histology (25%) and higher rate of LVSI (25%). The median follow-up was 74 (1.5-122) months. The 8-year overall (OS) and disease-specific survival (DSS) rate were 100% in POLE group, while only 58.3% and 75% in TP53 mutant cases (P<0.001 for OS, P=0.01 for DSS). Conclusions: Molecular subtypes of EC significantly correlated with clinicopathologic characters, especially with patients’ prognosis. This simplified NGS-panel could accurately delineate different EC subgroups.[Table: see text]

KLF3 and PAX6 are candidate driver genes in late-stage, MSI-hypermutated endometrioid endometrial carcinomas

Endometrioid endometrial carcinomas (EECs) are the most common histological subtype of uterine cancer. Late-stage disease is an adverse prognosticator for EEC. The purpose of this study was to analyze EEC exome mutation data to identify late-stage-specific statistically significantly mutated genes (SMGs), which represent candidate driver genes potentially associated with disease progression. We exome sequenced 15 late-stage (stage III or IV) non-ultramutated EECs and paired non-tumor DNAs; somatic variants were called using Strelka, Shimmer, Somatic Sniper and MuTect. Additionally, somatic mutation calls were extracted from The Cancer Genome Atlas (TCGA) data for 66 late-stage and 270 early-stage (stage I or II) non-ultramutated EECs. MutSigCV (v1.4) was used to annotate SMGs in the two late-stage cohorts and to derive p-values for all mutated genes in the early-stage cohort. To test whether late-stage SMGs are statistically significantly mutated in early-stage tumors, q-values for late-stage SMGs were re-calculated from the MutSigCV (v1.4) early-stage p-values, adjusting for the number of late-stage SMGs tested. We identified 14 SMGs in the combined late-stage EEC cohorts. When the 14 late-stage SMGs were examined in the TCGA early-stage data, only KLF3 and PAX6 failed to reach significance as early-stage SMGs, despite the inclusion of enough early-stage cases to ensure adequate statistical power. Within TCGA, nonsynonymous mutations in KLF3 and PAX6 were, respectively, exclusive or nearly exclusive to the microsatellite instability (MSI)-hypermutated molecular subgroup and were dominated by insertions-deletions at homopolymer tracts. In conclusion, our findings are hypothesis-generating and suggest that KLF3 and PAX6, which encode transcription factors, are MSI target genes and late-stage-specific SMGs in EEC.

Evaluation of Impact of Tall Like Receptor 4 and Liposaccharide in Pathogenesis of Hepatic Cancer

Functional TLR4 expression has been linked to HCC development. TLR4 may serve an important role in HCC development by promoting the malignant transformation of epithelial cells and tumor growth. The consequences might be dependent on the complex signaling networks triggered by TLR4 activation and the tumor microenvironment. The study included 90 consecutive subjects classified into 3 group their age from 40 to 70 years old. Group (I): HCC patients on top of chronic HCV infection. they were 45 patients 30 male and 15 females, their age ranged from 45 to 55 who were subdivided into 3 subgroups according to Barcelona clinic liver cancer (BCLC): Group (Ia): included 8 HCC patients in early stage. (stage A). Group (Ib): included 12 HCC patients in intermediate stage (stage B). Group (Ic): included 25 HCC patients in advanced stage. (stage C). Group (II): 30 Cirrhotic patients with chronic HCV, 21 male and 9 females, their age ranged from 50 to 60. This group was subdivided into 2 subgroups according to Child–Pugh score Group (IIa): included 8 Child–Pugh A. Group (IIb): included 22 Child–Pugh B and C. Group (III): controlled group included 15 normal subjects. 10 male and 5 females, their age ranged from 45 to 60. They were selected to match patients’ groups in demographic and socioeconomic standards. In our study where 15 persons are control showed lower level in TLR4 with mean 1.0±0.2, however 30 patients with HCV and other 45 patients with HCC showed higher level in TLR with mean 2.27±0.6 and 4.2±1.06 respectively. In our study there is statistically significant difference in serum TLR4 level between group (Ia) (2.25±0.5) and other subgroups which shows more increase in serum level of TLR4 in Group IB (3.2-1.06) than Group IA. Also shows more increase in serum level of TLR4 in Group IC (4.0±2.0) than Group IA and IB In our study HCC group showed higher level of LPS with mean 4.5±1.26 however lower in HCV group with mean 2.9-1.0 and least in control group with mean 1.1±0.4 In our study there is statistically significant difference in serum LPS level between group (IA) with mean 3.0±0.5 and other subgroups which shows more increase in serum level of LPS in Group IB with mean 4.4-1.0 than Group IA. Also shows more increase in serum level of LPS in Group IC with mean 4.0±1.76 than Group IA and IB In our study there is statistically significant difference in serum LPS level between group (IIB) and group (IIA) which shows more increase in serum level of TLR4 in Group IIB with mean 2.7±1.1 than Group IIA with mean 2.20±0.2 In our study there is statistically insignificant difference of the mean value ± SD of sex as regard to LPS and TLR expression (t = 1.2, p = 0.22). (t = 0.16, p = 0.87) respectively.In our study there is statistically significant positive correlation between ALT, AST, Platelets, alpha fetoprotein and LPS as regard to TLR4 expression in group II more in IIB,C than IA . but insignificant of the mean value ± SD of other parameters. In our study there is statistically significant difference of the mean value ± SD of ALT, AST, Platelets, alpha fetoprotein and TLR4 as regard to LPS expression in group I more in IB, C than IA. but insignificant of the mean value ± SD of other parameters.In our study there is statistically significant difference of the mean value ± SD of ALT, AST, Platelets and TLR4 as regard to LPS expression in group II more in IIB than IIA. but insignificant of the mean value ± SD of other parameters. Conclusion: TLR4 and LPS measurement should be carried for all patient with HCV Who are at risk for HCC with close monitoring. Conduct a study on a Gut microbiota as therapeutic targets for HCC.

Chemical Composition and Genesis Implication of Garnet from the Laoshankou Fe-Cu-Au Deposit, the Northern Margin of East Junggar, NW China

In order to reveal the formation mechanism of different garnets and its implications for the fluid evolution in the Laoshankou Fe-Cu-Au deposit in the northern margin of East Junggar (NW China), three types of garnet have been investigated in detail in this study. (1) Type 1 grossular, formed at Ca-silicate stage (stage I, the pre-mineralization stage), was replaced by Type 2 garnet and magnetite, and displays a compositional range of Grs44–53Adr44–53, which has relatively lower total REE (rare earth elements) contents (8.14–32.8 ppm) and markedly depleted LREE (light rare earth elements) with distinctive positive Eu anomaly (1.36–9.61). (2) Type 2 Al-rich andradite, formed at the early sub-stage of amphibole-epidote-magnetite stage (stage II, the main magnetite mineralization stage), can be divided into two sub-types, i.e., Type 2a and Type 2b. Type 2a garnets exhibit polysynthetic twinning and relatively narrow compositional variations of Adr63–66Grs31–34 with HREE-(heavy rare-earth elements) enrichment and positive Eu anomalies (3.22–3.69). Type 2b garnets own wide compositional variations of Adr55–77Grs21–43 with relatively higher REE contents (49.1–124 ppm), markedly depleted LREE and a distinctive positive Eu anomaly (2.11–4.61). (3) Type 3 andradite (Adr>91) associated with sulfide stage (stage III, the main copper-gold mineralization stage) is different from other types of garnets in Laoshankou, which are characterized by lowest total REE contents (1.66–91.1 ppm), flat HREE patterns, LREE-enrichment and the strongest positive Eu anomalies (3.31–45.48). Incorporation of REE into garnet is largely controlled by external factors, such as fluid chemistry, pH, ƒO2 and water-rock ratios as well as its crystal chemistry. Type 1 and 2 garnets mainly follow the creation of X2+ (e.g., Ca2+) site vacancy, e.g., [X2+]−3VIII[]+1VIII[REE3+]+2VIII. The REE3+ substitution mechanism for Type 3 garnet is the Na+-REE3+ coupled substitutions, e.g., [X2+]−2VIII[X+]+1VIII[REE3+]+1VIII, without the evaluation of the creation of site vacancy. The compositional variations from Type 1 to Type 3 garnet indicate significant differences of fluid compositions and physicochemical conditions, and can be used to trace the fluid–rock interaction and hydrothermal evolution of garnet. Type 1 grossular was formed by magmatic fluid under low water–rock ratios and ƒO2, and neutral pH environment by diffusion metasomatism in a nearly closed system with the preferential incorporation into the grossular of HREE. As the long fluid pore residence and continuing infiltration metasomatism under nearly closed-system conditions, fluids with high water/rock ratios were characterized by increased ƒO2, more active incorporation of Fe3+ and REE, and formed Type 2 Al-rich andradite. In contrast, Type 3 garnet formed by oxidizing magmatic fluid under a mildly acidic environment with highest ƒO2 and water–rock ratios, and was influenced by externally derived high salinity and Ca-rich fluids in an open system. Thus, the geochemical features of different types and generations of garnets in the Laoshankou deposit can provide important information of fluid evolution, revealing a transition from neutral magmatic fluid to oxidizing magmatic fluid with addition of external non-magmatic Ca-rich fluid from the Ca-silicate stage to the sulfide stage. The above proved the fluid evolution process further indicates that the Laoshankou deposit prefers to be an IOCG-like (iron oxide-copper-gold) deposit rather than a typical skarn deposit.