Subtrochanteric femoral fracture during trochanteric nailing for the treatment of femoral shaft fracture.

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Yun, Ho Hyun; Oh, Chi Hun; Yi, Ju Won

2013-09-01

We report on three cases of subtrochanteric femoral fractures during trochanteric intramedullary nailing for the treatment of femoral shaft fractures. Trochanteric intramedullary nails, which have a proximal lateral bend, are specifically designed for trochanteric insertion. When combined with the modified insertion technique, trochanteric intramedullary nails reduce iatrogenic fracture comminution and varus malalignment. We herein describe technical aspects of trochanteric intramedullary nailing for femoral shaft fractures to improve its application and prevent implant-derived complications.

A NOVEL ANOMALY OF THE ANTERIOR DIGASTRIC MUSCLE. UNA ANOMALÍA NUEVA DEL MÚSCULO DIGÁSTRICO ANTERIOR

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Timothy W Hegeman

2016-03-01

Full Text Available Documentamos una anomalía del músculo digástrico anterior en un cadáver femenino de 85 años de edad. La anomalía consiste en cuatro vientres adicionales que salen entre los dos típicos digástricos anterior. Analizamos el significado embriológico y clínico de esta variante. El músculo digástrico es derivado de dos arcos branquiales o arcos faríngeos. El primer arco branquial forma el vientre anterior y el segundo forma el vientre posterior. Actuando juntos, los vientres ayudan a impulsar hacia abajo la mandíbula y a estabilizar el hioides. Varias anormalidades en el vientre anterior del digástrico han sido previamente descriptas en la literatura, pero ninguna ha replicado la formación precisa descripta aquí.  We document a novel anomaly of the anterior digastrics of an 85 year old female cadaver, consisting of four additional muscle bellies existing between the two typical anterior digastrics and go on to explain the embryologic and clinical significance of the variant. The digastric muscle is derived from two pharyngeal arches, the first pharyngeal arch forming the anterior belly and the second forming the posterior belly. Acting together, both bellies help to depress the mandible and stabilize the hyoid. Several abnormalities in the anterior belly of the digastric muscle have previously been described in the literature, but none have replicated the precise formation described here.

Bursectomy, Curettage, and Chemotherapy in Tuberculous Trochanteric Bursitis.

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Ramos-Pascua, Luis R; Carro-Fernández, José A; Santos-Sánchez, José A; Casas Ramos, Paula; Díez-Romero, Luis J; Izquierdo-García, Francisco M

2016-03-01

We presented three patients with trochanteric tuberculosis and described the clinical and imaging findings of the infection. Histology revealed a necrotizing granulomatous bursitis and microbiology confirmed tuberculosis. All cases were successfully treated with bursectomy and curettage of the trochanteric lesion and antituberculous chemotherapy including isoniazid, pyrazinamide, rifampicin, and ethambutol.

Greater trochanteric fracture with occult intertrochanteric extension.

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Reiter, Michael; O'Brien, Seth D; Bui-Mansfield, Liem T; Alderete, Joseph

2013-10-01

Proximal femoral fractures are frequently encountered in the emergency department (ED). Prompt diagnosis is paramount as delay will exacerbate the already poor outcomes associated with these injuries. In cases where radiography is negative but clinical suspicion remains high, magnetic resonance imaging (MRI) is the study of choice as it has the capability to depict fractures which are occult on other imaging modalities. Awareness of a particular subset of proximal femoral fractures, namely greater trochanteric fractures, is vital for both radiologists and clinicians since it has been well documented that they invariably have an intertrochanteric component which may require surgical management. The detection of intertrochanteric or cervical extension of greater trochanteric fractures has been described utilizing MRI but is underestimated with both computed tomography (CT) and bone scan. Therefore, if MRI is unavailable or contraindicated, the diagnosis of an isolated greater trochanteric fracture should be met with caution. The importance of avoiding this potential pitfall is demonstrated in the following case of an elderly woman with hip pain and CT demonstrating an isolated greater trochanteric fracture who subsequently returned to the ED with a displaced intertrochanteric fracture.

Factors influencing period from surgery to discharge in patients with femoral trochanteric fractures

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Shinoda, Soichiro; Mutsuzaki, Hirotaka; Watanabe, Arata; Morita, Hidetaka; Kamioka, Yumiko

2017-01-01

[Purpose] The purpose of this study was to investigate factors influencing the period from surgery to discharge in patients with femoral trochanteric fractures. [Subjects and Methods] Sixty patients with femoral trochanteric fractures were investigated retrospectively. Based on the mean period from surgery to discharge (85.6 ± 26.6 days), the patients were divided into two groups: an under-85-day group (range, 29–78 days) and an over-85-day group (87–128 days). Age, gender, fracture type, presence of lesser trochanteric displacement, discharge destination, and walking ability were investigated. The relationship between these factors and the period from surgery to discharge was analyzed with logistic regression analysis. [Results] Age and lesser trochanteric displacement were significantly higher in the over-85-day group, and walking ability before fracture and at discharge were significantly lower in the over-85-day group. Logistic regression analysis showed that lesser trochanteric displacement and age were predictors of the length from surgery to discharge. Lesser trochanteric displacement were observed in 87.5% of these. Immediate displacement after surgery occurred in 57.8% of lesser trochanteric fractures, while 26.3% displaced 1 to 3 weeks after surgery. [Conclusion] This study revealed that lesser trochanteric displacement, higher age, and lower walking ability before fracture and at discharge were associated with longer hospitalizations in patients with femoral trochanteric fractures. Lesser trochanteric displacement were observed in 87.5% of lesser trochanteric fractures. These displacements occurred within 3 weeks after surgery in 84.1% of cases. PMID:29200639

Trochanteric bursitis: radiological findings

International Nuclear Information System (INIS)

Revilla, T.Y.; Manjon, P.; Lozaono, C.

1997-01-01

To describe the radiological findings associated with trochanteric bursitis. Six patients studied by means of plain radiography (n=6), CT(n=4) and MR(n=2). The conventional radiography study was normal in two patients and disclosed bone abnormalities in four. US showed a hypoechoic or anechoic collection in all the patients. Two patients presented areas suggestive of calcification, and septa were observed in one. CT disclosed the presence of well defined, low-attenuation, unenhanced collections. MR images identified collections with a signal intensity similar to that of water. Trochanteric bursitis is a relatively common cause of hip pain, and can involve any one of a number of etiologies. US is a good imaging technique for diagnosing this pathology. (Author) 10 refs

Sonography of greater trochanteric pain syndrome and the rarity of primary bursitis.

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Long, Suzanne S; Surrey, David E; Nazarian, Levon N

2013-11-01

Greater trochanteric pain syndrome is a common condition with clinical features of pain and tenderness at the lateral aspect of the hip. Diagnosing the origin of greater trochanteric pain is important because the treatment varies depending on the cause. We hypothesized that sonographic evaluation of sources for greater trochanteric pain syndrome would show that bursitis was not the most commonly encountered abnormality. We performed a retrospective review of musculoskeletal sonographic examinations performed at our institution over a 6-year period for greater trochanteric pain syndrome; completed a tabulation of the sonographic findings; and assessed the prevalence of trochanteric bursitis, gluteal tendon abnormalities, iliotibial band abnormalities, or a combination of findings. Prevalence of abnormal findings, associations of bursitis, gluteal tendinosis, gluteal tendon tears, and iliotibial band abnormalities were calculated. The final study population consisted of 877 unique patients: 602 women, 275 men; average age, 54 years; and age range, 15-87 years). Of the 877 patients with greater trochanteric pain, 700 (79.8%) did not have bursitis on ultrasound. A minority of patients (177, 20.2%) had trochanteric bursitis. Of the 877 patients with greater trochanteric pain, 438 (49.9%) had gluteal tendinosis, four (0.5%) had gluteal tendon tears, and 250 (28.5%) had a thickened iliotibial band. The cause of greater trochanteric pain syndrome is usually some combination of pathology involving the gluteus medius and gluteus minimus tendons as well as the iliotibial band. Bursitis is present in only the minority of patients. These findings have implications for treatment of this common condition.

Effect of prophylactic trochanteric epiphyseodesis in older children with Perthes' disease.

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Shah, Hitesh; Siddesh, Nandi D; Joseph, Benjamin; Nair, Sreekumaran N

2009-12-01

To evaluate the effect of prophylactic epiphyseodesis of the greater trochanter in Perthes' disease, 62 children with unilateral Perthes' disease who underwent trochanteric epiphyseodesis combined with varus osteotomy of the femur during the active stage of the disease (mean age at surgery: 8.4 y) and 20 controls were followed up until skeletal maturity. On radiographs taken at skeletal maturity, the articulo-trochanteric distance, the center-trochanteric distance, the length of the abductor lever arm, the neck-shaft angle, the radius of the femoral head, and the Reimer's migration index of normal and affected hips were measured. The shape of the femoral head was assessed according to the criteria of Mose. The range of hip motion, the strength of hip abduction, and limb lengths were measured and the Trendelenburg sign was elicited. The mean values of articulo-trochanteric distance and center-trochanteric distance were greater and the frequency of a positive Trendelenburg sign was less in children who had undergone trochanteric epiphyseodesis than in children who had no surgery (P<0.01). Trochanteric epiphyseodesis achieved optimal trochanteric growth arrest in 60% of operated children; the procedure was not effective in 30%, and in 10% of children there was overcorrection. Logistic regression analysis showed that the size of the femoral head at healing and the age at surgery were variables that significantly influenced the effectiveness of trochanteric growth arrest. At skeletal maturity, the mean shortening of the affected limb in operated children was 0.44 cm (SD 0.68 cm), whereas that of non-operated children was 0.86 cm (SD 0.78 cm) (P<0.05). The range of motion of the hip was excellent and there were no significant differences in the range of motion among children with optimal correction, under-correction, and overcorrection. A probability curve plotted on the basis of a logistic regression model suggests that effective trochanteric arrest may be achieved in a

A study on management of extracapsular trochanteric fractures by proximal femoral nail

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K Ramaprathap Reddy

2016-01-01

Full Text Available Background: Trochanteric fractures of femur like intertrochanteric and subtrochanteric fractures are a leading cause of hospital admissions in elderly people. Conservative methods of treatment results in malunion with shortening and limitation of hip movement as well as complications of prolonged immobilizations such as bed sores, deep vein thrombosis, and respiratory infections. This study is done to analyze the surgical management of trochanteric fractures of the femur using a proximal femoral nail (PFN. Methodology: This is a prospective study of 40 cases of trochanteric and subtrochanteric fractures admitted to Government General Hospital, Vijayawada, Andhra Pradesh. Cases were taken according to inclusion and exclusion criteria, i.e., patients with trochanteric fractures femur above the age of 20 years. Medically unsuitable, open fractures and patients not willing for surgery were excluded from the study. Results: Forty percentage of cases were admitted due to slip and fall and with a slight predominance of the right side. Out of 40 cases, 26 were trochanteric, and 14 were subtrochanteric. In trochanteric class, 37.5% were body and griffin Type 2, in subtrochanteric class 12.5% were sinsheimer Type 3a and 10% were 2b. Out of 30 remaining cases, 25 were trochanteric, and 05 were subtrochanteric. Good to excellent results are seen in 100% cases of trochanteric fractures and 90% cases in subtrochanteric fractures. Conclusion: From this sample study, we consider that PFN is an excellent implant for the treatment of pertrochanteric fractures. The terms of successful outcome include a good understanding of fracture biomechanics, proper patient selection, good preoperative planning, accurate instrumentation, good image intensifier, and exactly performed osteosynthesis.

[Clinical Results of Endoscopic Treatment of Greater Trochanteric Pain Syndrome].

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Zeman, P; Rafi, M; Skala, P; Zeman, J; Matějka, J; Pavelka, T

2017-01-01

PURPOSE OF THE STUDY This retrospective study aims to present short-term clinical outcomes of endoscopic treatment of patients with greater trochanteric pain syndrome (GTPS). MATERIAL AND METHODS The evaluated study population was composed of a total of 19 patients (16 women, 3 men) with the mean age of 47 years (19-63 years). In twelve cases the right hip joint was affected, in the remaining seven cases it was the left side. The retrospective evaluation was carried out only in patients with greater trochanteric pain syndrome caused by independent chronic trochanteric bursitis without the presence of m. gluteus medius tear not responding to at least 3 months of conservative treatment. In patients from the followed-up study population, endoscopic trochanteric bursectomy was performed alone or in combination with iliotibial band release. The clinical results were evaluated preoperatively and with a minimum follow-up period of 1 year after the surgery (mean 16 months). The Visual Analogue Scale (VAS) for assessment of pain and WOMAC (Western Ontario MacMaster) score were used. In both the evaluated criteria (VAS and WOMAC score) preoperative and postoperative results were compared. Moreover, duration of surgery and presence of postoperative complications were assessed. Statistical evaluation of clinical results was carried out by an independent statistician. In order to compare the parameter of WOMAC score and VAS pre- and post-operatively the Mann-Whitney Exact Test was used. The statistical significance was set at 0.05. RESULTS The preoperative VAS score ranged 5-9 (mean 7.6) and the postoperative VAS ranged 0-5 (mean 2.3). The WOMAC score ranged 56.3-69.7 (mean 64.2) preoperatively and 79.8-98.3 (mean 89.7) postoperatively. When both the evaluated parameters of VAS and WOMAC score were compared in time, a statistically significant improvement (ppain syndrome yields statistically significant improvement of clinical results with the concurrent minimum incidence of

Differential impact of some risk factors on trochanteric and cervical hip fractures.

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Tal, Sari; Gurevich, Alexander; Sagiv, Shaul; Guller, Vladimir

2015-04-01

To investigate the potential distinct risk factors associated with trochanteric and cervical hip fractures. Elderly patients aged 65 years and older (n = 1161) were admitted to the orthopedic department with hip fractures during the years 2006-2011. Demographic and clinical data, as well as routine blood tests, were retrieved from the patient electronic medical records. Approximately 58% of patients had trochanteric fractures and 42% had cervical fractures. Women were more likely to have trochanteric fractures than men (P = 0.002). Female sex, frailty, falls, diabetes and subnormal calcium, as well as subnormal hemoglobin levels, were significant risk factors for trochanteric fractures (OR 1.39, P = 0.0202, OR 1.36, P = 0.0166, OR 1.49, P = 0.0015, OR 1.33, P = 0.0343, OR 0.68, P = 0.0054, OR 0.70, P = 0.0036, respectively). Patients with Parkinson's disease were at a lower risk for trochanteric fractures (OR 0.6, P = 0.007). As there are some differences between risk factors for trochanteric and cervical hip fractures, there is a need for further studies in order to understand the etiology of fractures and to be able to carry out effective preventive efforts. © 2014 Japan Geriatrics Society.

Trochanteric Stress Fracture in a Female Window Cleaner

OpenAIRE

Lee, Bong-Jin; Song, Jyewon

2016-01-01

Stress fractures may occur at various sites in the femur including the head, neck, shaft, supracondylar and condylar regions. To the best of our knowledge, stress fracture occurring in the trochanteric region has not been previously reported. We report here a case of trochanteric stress fracture in a 53-year-old female window cleaner treated with hip nailing without adverse consequences. Careful consideration of this entity is needed when evaluating patients who have repetitive jumping up and...

The art of trochanteric fracture reduction.

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Biber, Roland; Berger, Johanna; Bail, Hermann Josef

2016-12-01

The name of Ender is primarily associated with the Ender nails, which were popular for trochanteric fracture fixation more than thirty years ago. However, Ender's concepts were not limited to the implant. Ender developed a unique classification system for trochanteric and subtrochanteric fractures, which provided the theory for closed reduction maneuvers that made the method so successful in his hands. While Ender's nails have become history in the meantime, his principles of fracture reduction can be readily applied on surgery with modern implants such as proximal femoral nails. This article reflects the classification and the principles published by Hans Georg Ender in some print work hardly available nowadays. Copyright © 2016 Elsevier Ltd. All rights reserved.

Posterior belly of digastric muscle flap for contour deformity correction after superficial parotidectomy.

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Rai, A; Jain, A; Khan, M

2017-10-23

The correction of the contour deformity after parotidectomy has become an essential procedure in the recent times for the betterment of patients' quality of life. Various modalities have been highlighted in the literature for the same. We recommend the use of posterior belly of digastric muscle flap for correction of contour deformity post excision of parotid gland tumors, subsequently ameliorating the aesthetics of the face. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

[Trochanteric femoral fractures: anatomy, biomechanics and choice of implants].

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Bonnaire, F; Lein, T; Bula, P

2011-06-01

The objective of any surgical care of a trochanteric femoral fracture should be the achievement of a stable osteosynthesis that allows early full weight-bearing mobilisation of the patient, because long-term immobilisation soon becomes a vital threat to the affected patients who are usually elderly with correlating comorbidities. The anatomical references of the proximal femur and the structure of the hip joint contain some specifics that play an essential role in the incurrence of a trochanteric femoral fracture and the planning of the osteosynthesis as well. With reposition and fracture stabilisation particular importance must be attached to the collo-diaphyseal and the antetorsion angle so that they do not interfere with the functional interaction of the hip and knee joint. Uncomplex trochanteric fractures ordinarily stabilise sufficiently after reposition so that even an extramedullary implant can ensure full weight-bearing stability. With evermore distal fracture course and intertrochanteric comminution zone, rotational instability and pivot transfer of the fracture area to lateral and caudal are followed by an increase of the dislocating forces. These kinds of fractures (A2 and A3 according to the AO/ASIF classification) profit from an intramedullary and rotationally stable osteosynthesis. Basically primary total hip arthroplasty is a potential option for surgical care of a trochanteric fracture in elderly patients with relevant coxarthrosis. However this procedure can only be recommended in cases of a stable uncomplex fracture. The more the medial interlocking of the proximal femur is destroyed the more difficult it will be to primarily implant a total hip prosthesis with good offset and without a varus and rotational failure in the fracture zone.The current studies in the main show disadvantages due to increased complications in these patients, so that in cases of an unstable trochanteric fracture a primary osteosynthesis should be performed followed by

Repair of femoral trochanteric osteotomy in the dog

International Nuclear Information System (INIS)

Whitelock, R.G.; Dyce, J.; Houlton, J.E.F.

1997-01-01

The records and radiographs of 24 dogs that underwent femoral trochanteric osteotomy repair were reviewed. Osteotomy repair was performed with either a pin and tension band wire or a lag screw technique. Significant clinical complications associated with the osteotomy were identified in one dog (4 per cent) six weeks after surgery, although abnormal radiographic changes were evident in 15 dogs (62 per cent). The method of repair did not influence healing and there were comparable radiographic complication rates. It is concluded that femoral trochanteric osteotomy is not associated with significant clinical problems, despite a high incidence of abnormal radiographic findings

Trochanteric Soft Tissue Thickness and Hip Fracture in Older Men

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Nielson, Carrie M.; Bouxsein, Mary L.; Freitas, Sinara S.; Ensrud, Kristine E.; Orwoll, Eric S.

2009-01-01

Background: Greater thickness of the tissue extending laterally from the greater trochanter has been associated with a lower risk of hip fracture in women. The effect of trochanteric soft tissue thickness on the risk of incident hip fracture has not been evaluated in men. Methods: We measured trochanteric soft tissue thickness by dual-energy x-ray absorptiometry for all incident hip fracture cases (n = 70) and 222 randomly selected noncases in older men (≥65 yr) enrolled in the Osteoporotic Fractures in Men (MrOS) Study. Differences in tissue thickness between cases and controls were examined. Changes in fall force and factor-of-risk (the ratio of force from a sideways fall to femoral bone strength) associated with tissue thickness were determined. The relative risk for incident hip fracture per sd decrease in tissue thickness was calculated. Results: Mean trochanteric soft tissue thickness did not differ significantly between cases and noncases (29.1 ± 11.9 vs 31.0 ± 11.5 mm; P = 0.2). Although increased tissue thickness reduced both the estimates of fall force and the factor-of-risk, tissue thickness was not associated with the risk of hip fracture (age- and bone mineral density-adjusted relative risk per sd decrease in tissue thickness = 0.90; 95% confidence interval, 0.70–1.16). Conclusions: In this study of elderly community-dwelling men, we found no significant association between trochanteric soft tissue thickness and incident hip fracture. Trochanteric soft tissue thickness in these men was less than previously reported in older women and may explain the difference between these results and those reported in women. PMID:19017753

Trochanteric bursitis after total hip arthroplasty: incidence and evaluation of response to treatment.

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Farmer, Kevin W; Jones, Lynne C; Brownson, Kirstyn E; Khanuja, Harpal S; Hungerford, Marc W

2010-02-01

We examined the efficacy of corticosteroid injection as treatment for postarthroplasty trochanteric bursitis and the risk factors for failure of nonoperative treatment. There were 32 (4.6%) cases of postsurgical trochanteric bursitis in 689 primary total hip arthroplasties. Of the 25 hips with follow-up, 11 (45%) required multiple injections. Symptoms resolved in 20 (80%) but persisted in 5. We found no statistically significant differences between patients who did and did not develop trochanteric bursitis, or between those who did and did not respond to treatment. There was a trend toward younger age and greater limb-length discrepancy in nonresponders. In conclusion, (1) corticosteroid injection(s) for postoperative trochanteric bursitis is effective; and (2) nonoperative management may be more likely to fail in young patients and those with leg-length discrepancy. 2010 Elsevier Inc. All rights reserved.

Trochanteric fractures

International Nuclear Information System (INIS)

Herrlin, K.; Stroemberg, T.; Lidgren, L.; Walloee, A.; Pettersson, H.; Lund Univ.

1988-01-01

Four hundred and thirty trochanteric factures operated upon with McLaughlin, Ender or Richard's osteosynthesis were divided into 6 different types based on their radiographic appearance before and immediately after reposition with special reference to the medial cortical support. A significant correlation was found between the fracture type and subsequent mechanical complications where types 1 and 2 gave less, and types 4 and 5 more complications. A comparison of the various osteosyntheses showed that Richard's had significantly fewer complications than either the Ender or McLaughlin types. For Richard's osteosynthesis alone no correlation to fracture type could be made because of the small number of complications in this group. (orig.)

Variant Anterior Digastric Muscle Transfer for Marginal Mandibular Branch of Facial Nerve Palsy

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Matthew J. Zdilla, DC

2014-02-01

Full Text Available Summary: Marginal mandibular branch of facial nerve (MMBFN palsy is a common consequence of head and neck surgeries. MMBFN palsy results in paralysis of muscles which depress the inferior lip. Current management of MMBFN palsy involves ruination of normal neuromuscular anatomy and physiology to restore symmetry to the mouth. The article outlines the possibility to transfer variant anterior digastric musculature to accomplish reanimation of the mouth without adversely affecting normal nonvariant anatomy. The procedure may have the additional cosmetic benefit of correcting asymmetrical muscular bulk in the submental region.

Anatomical reconstruction of unstable trochanteric fractures through posterior approach

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Partha Saha

2015-01-01

Full Text Available Objective Unstable intertrochanteric fractures continue to be a challenge for orthopedic surgeons due to the functional limitations it results in the postoperative period. Anatomical reconstruction of the posteromedial fragment becomes difficult through conventional lateral approach, leading to excessive fracture collapse and limping. Materials and Methods: prospective, nonrandomized study was done with 40 patients. They were operated in prone position through posterior approach. Cancellous screws or SS-wires were used to fix the greater or lesser trochanteric fragments and dynamic hip screw (DHS or dynamic condylar screw (DCS for the main two fragments. Bone grafts were used to pack cavities at the posterior trochanteric regions. Results: Fracture healing occurred earlier compared to conventional lateral approach without excessive fracture collapse in majority of cases (average time to achieve union was 13.8 weeks; range: 10–18 weeks. Good functional recovery was noted with 75% 'Good' or 'Excellent' Harris Hip Scores at 24 weeks. Conclusion: Anatomical reconstruction of unstable trochanteric fractures becomes easier through posterior approach with earlier and better functional recovery.

[The rotationally stable screw-anchor with trochanteric stabilizing plate (RoSA/TSP) : First results in unstable trochanteric femur fractures].

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Maier, K-J; Bücking, B; Horst, K; Andruszkow, H; Hildebrand, F; Knobe, M

2017-12-01

In unstable trochanteric fractures, the extramedullary rotationally stable screw-anchor (RoSA) combines the benefits of the load and rotational stability of the blade with the advantages of the screw (pull-out resistance, compression capability) in a single load carrier, and was designed to prevent femoral neck shortening by using an additional locked trochanteric stabilizing plate (TSP). The aim of the current prospective cohort study was the clinical evaluation of the RoSA/TSP system regarding the mechanical re-operation rate and the amount of postoperative femoral neck shortening. From September 2011 to January 2014 80 patients with unstable trochanteric fractures underwent internal extramedullary fixation with the RoSA/TSP (Königsee Implantate GmbH, Allendorf, Germany). Due to fracture stability and after induction of compression, additional long locked antitelescoping screws (AT, n = 1-4) were placed reaching the femoral head. Radiological (femoral neck shortening) and clinical re-examination of patients (n = 61) was performed 6-10 weeks and 6-10 months later. In the 61 re-examined patients (76 %) femoral neck shortening was very low with 2 mm 6-10 months after operation. Re-operations occurred in 8 % (n = 6) and in 4 % (n = 3) as prophylactic surgical intervention. Whereas one-third (4 %) of re-operations occurred due to iatrogenic surgical problems from the first operation two-thirds of patients (8 %) had a re-operation due to delay of bone union (3× nonunion, 3 planned removals of AT-screws to improve healing). The in-hospital mortality was 3 % (n = 2). The fixation of unstable trochanteric femur fractures using the RoSA/TSP in a first clinical setting led to a great primary stability, with significant advantages with regard to limited femoral neck shortening. However, the rigidity of the construct with its consequences regarding bone healing can be challenging for the surgeon. Nevertheless, in some cases of revision it could be beneficial

Trochanteric bursitis--a frequent cause of 'hip' pain in rheumatoid arthritis.

Science.gov (United States)

Raman, D; Haslock, I

1982-01-01

One hundred consecutive patients with rheumatoid arthritis (RA) were examined for the presence of trochanteric bursitis. This condition was found in 15. Ten patients responded to a single local injection of corticosteroid and the remaining 5 to a second injection. Trochanteric bursitis is an underdiagnosed, easily remediable cause of pain in RA. Specific examination for in presence should be a routine in all patients with RA, especially those with hip pain. PMID:7149797

Older Male Physicians Have Lower Risk of Trochanteric but Not Cervical Hip Fractures

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Hsiu-Nien Shen

2015-02-01

Full Text Available Background: Osteoporosis is pathophysiologically related to trochanteric fractures, and this condition is more preventable by lifestyle modifications than cervical fractures. We investigated whether older physicians, who are health-conscious people, are at a lower risk of hip fractures because of fewer trochanteric fractures. Methods: Data regarding older (≥65 years physicians (n = 4303 and matched non-medical persons (control were retrieved from Taiwan’s National Health Insurance claims. All of the subjects were obtained from NHIRD with index dates from 1 January 2000 to 31 December 2008. Cox proportional hazard and competing risk regression models were established to estimate the hazard ratio (HR of hip fracture associated with older physicians. Results: The incidence rates of trochanteric fractures were lower in older physicians than in controls (1.73 and 3.07 per 1000 person-years, respectively, whereas the rates of cervical fractures were similar between the two groups (2.45 and 2.12 per 1000 person-years, respectively. Older physicians yielded 46% lower hazard of trochanteric fractures than controls (adjusted HR 0.54, 95% confidence interval 0.37–0.79; by contrast, hazards of cervical fractures were comparable between the two groups. The HRs estimated from the competing risk models remained unchanged. Conclusions: Our findings indicated that health risk awareness may pose a significant preventive effect on trochanteric hip fractures.

Older Male Physicians Have Lower Risk of Trochanteric but Not Cervical Hip Fractures

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Shen, Hsiu-Nien; Lin, Wei-Ting; Lu, Chin-Li; Li, Chung-Yi

2015-01-01

Background: Osteoporosis is pathophysiologically related to trochanteric fractures, and this condition is more preventable by lifestyle modifications than cervical fractures. We investigated whether older physicians, who are health-conscious people, are at a lower risk of hip fractures because of fewer trochanteric fractures. Methods: Data regarding older (≥65 years) physicians (n = 4303) and matched non-medical persons (control) were retrieved from Taiwan’s National Health Insurance claims. All of the subjects were obtained from NHIRD with index dates from 1 January 2000 to 31 December 2008. Cox proportional hazard and competing risk regression models were established to estimate the hazard ratio (HR) of hip fracture associated with older physicians. Results: The incidence rates of trochanteric fractures were lower in older physicians than in controls (1.73 and 3.07 per 1000 person-years, respectively), whereas the rates of cervical fractures were similar between the two groups (2.45 and 2.12 per 1000 person-years, respectively). Older physicians yielded 46% lower hazard of trochanteric fractures than controls (adjusted HR 0.54, 95% confidence interval 0.37–0.79); by contrast, hazards of cervical fractures were comparable between the two groups. The HRs estimated from the competing risk models remained unchanged. Conclusions: Our findings indicated that health risk awareness may pose a significant preventive effect on trochanteric hip fractures. PMID:25689999

Torsional malalignment, how much significant in the trochanteric fractures?

Science.gov (United States)

Kim, Tae Young; Lee, Yong Beom; Chang, Jun Dong; Lee, Sang Soo; Yoo, Jae Hyun; Chung, Kook Jin; Hwang, Ji Hyo

2015-11-01

The rotational alignment is definitely important in the long bones such as tibias and femurs. We also predict the importance of rotational alignment in the trochanteric fractures. So we measured torsional malalignment in trochanteric fracture and anlaysed their risk factors and their clinical significance. A total of 109 inpatients who had undergone internal fixation following trochanteric fracture and a postoperative pelvic CT scan between 2008 and 2013, with at least one year follow-up, were selected. Factors that affect torsional malalignment, such as age, gender, fracture stability, injured area, operative time, time of surgery after admission, and ASA status, were investigated. Factors that affect the patients' clinical results in malrotation, including ambulation time after surgery, postoperative complication rates, pain assessment of VAS one year postoperatively and Koval score, were also investigated. Of the 109 subjects, torsional malalignment was observed in 28 (25.7%) subjects with a mean torsional malalignment angle of 20.7° (range: -31.2° to 27.1°). Torsional malalignment risk factors were fracture stability (p=0.021) and operative time (p=0.043). In terms of the time to ambulation after surgery, the postoperative complication rates, and the VAS and Koval scores at one year postoperatively, no statistically significant difference was observed between the torsional malalignment patients and the non-deformity patients. In this study, 25.7% of the patients who had undergone internal fixation following trochanteric fracture experienced torsional malalignment. Major factors of the torsional malalignment were an unstable fracture and the consequent delay in the operative time. But the torsional malalignment was deemed to have no effect on clinical results. Copyright © 2015 Elsevier Ltd. All rights reserved.

Augmentation of proximal femoral nail in unstable trochanteric fractures

Directory of Open Access Journals (Sweden)

Gadegone Wasudeo M.

2017-01-01

Full Text Available Introduction: Biomechanically proximal femoral nail (PFN is a better choice of implant, still it is associated with screw breakage, cut out of screw through femoral head, Z effect, reverse Z effect, and lateral migration of screws. The purpose of this study is to evaluate the results of augmented PFN in terms of prevention of postoperative complications and failure rates in unstable trochanteric fractures. Material and methods: We carried out a prospective study of 82 cases with unstable trochanteric femoral fractures from April 2010 to December 2015. Forty-two females and 40 males in the age group between 58 and 81 years were included in this study. There were 45 cases of AO 31 A2 (2.2, 2.3 and 37 cases of AO 31 A3 (3.1, 3.2, 3.3. Fractures were fixed by PFN with augmentation by an additional screw from trochanter to inferior quadrant of femoral head or cerclage wire to strengthen the lateral trochanteric wall. Results: The bone healing is observed in all the cases in the mean period of 14.2 weeks. Nine patients developed complications, including lateral migration of neck screws (n = 5, Z effect (n = 1, infection (n = 2, and breakage of distal interlocking bolt in one case. Removal of screws was required in five cases. Patients were followed up for a mean of 8.4 months. At the end of follow-up the Salvati and Wilson hip function was 32 (out of 40 in 88% of patients. Conclusion: The stabilization of lateral trochanteric wall with additional screw or cerclage wire increases the stability of construct.

[Trochanteric bursitis due to tuberculosis in an immunocompetent young woman].

Science.gov (United States)

Soro Marín, Sandra; Sánchez Trenado, María Asunción; Mínguez Sánchez, María Dolores; Paulino Huertas, Marcos; García Morales, Paula Virginia; Salas Manzanedo, Verónica

2012-01-01

Soft tissue infection due to Mycobacterium tuberculosis can affect muscle, tendons, fascia, bursa and synovial tissue. Tuberculous trochanteric bursitis is a rare entity that usually affects immunocompromised patients. Manifestations usually occur insidiously, which delays diagnosis and treatment. We present the case of an immunocompetent young woman who came to our department for chronic left hip pain. The study confirms the diagnosis of tuberculous trochanteric bursitis. This case demonstrates the importance of considering a possible infectious origin of bursitis in immunocompetent patients. Copyright © 2010 Elsevier España, S.L. All rights reserved.

A COMPARATIVE-STUDY OF ELECTROMYOGRAMS OF THE MASSETER, TEMPORALIS, AND ANTERIOR DIGASTRIC MUSCLES OBTAINED BY SURFACE AND INTRAMUSCULAR ELECTRODES - RAW-EMG

NARCIS (Netherlands)

KOOLE, P; DEJONGH, HJ; BOERING, G

Electromyographic activity was synchronously recorded by surface and intramuscular electrodes in the same muscle. The activity of the left masseter, left temporalis, and both bellies of the anterior digastric muscle was studied by this double registration technique. In rest position no

The outcome of endoscopy for recalcitrant greater trochanteric pain syndrome.

Science.gov (United States)

Drummond, James; Fary, Camdon; Tran, Phong

2016-11-01

Greater trochanteric pain syndrome (GTPS), previously referred as trochanteric bursitis, is a debilitating condition characterised by chronic lateral hip pain. The syndrome is thought to relate to gluteal tendinopathy, with most cases responding to non-operative treatment. A number of open and endoscopic surgical techniques targeting the iliotibial band, trochanteric bursa and gluteal tendons have, however, been described for severe recalcitrant cases. We report the outcomes of one such endoscopic approach here. We retrospectively reviewed 49 patients (57 operations) who had undergone endoscopic longitudinal vertical iliotibial band release and trochanteric bursectomy. Inclusion criteria included diagnosed GTPS with a minimum of six months of non-operative treatment. Exclusion criteria included concomitant intra- or extra-articular hip pathology and previous hip surgery including total hip arthroplasty. Outcomes were assessed using the Visual Analogue Scale, Oxford hip Score and International Hip Outcome Tool (iHOT-33). The series included 42 females and 7 males with a mean age of 65.0 years (26.7-88.6). Mean follow-up time was 20.7 months (5.3-41.2). Eight patients had full thickness gluteal tendon tears, of which 7 were repaired. Adjuvant PRP was injected intraoperatively in 38 of 57 operations (67.2 %). At follow-up, overall mean Visual Analogue Scale values had decreased from 7.8 to 2.8 (p < 0.001), Oxford hip Scores had increased from 20.4 to 37.3 (p < 0.001) and iHOT-33 scores had increased from 23.8 to 70.2 (p < 0.001). Of the 57 operations performed, patients reported feeling very satisfied with the surgical outcome in 28 operations (49.1 %), satisfied in 17 operations (29.8 %) and less than satisfied in 12 operations (21.1 %). While the majority of patients with GTPS will improve with non-operative management, endoscopic iliotibial band release, trochanteric bursectomy and gluteal tendon repair is a safe and effective treatment for severe

MRI and US of gluteal tendinopathy in greater trochanteric pain syndrome

Energy Technology Data Exchange (ETDEWEB)

Kong, Andrew; Van der Vliet, Andrew [Regional Imaging Border, Albury, NSW (Australia); Zadow, Steven [Dr Jones and Partners Medical Imaging, Adelaide, SA (Australia)

2007-07-15

Greater trochanteric pain syndrome is commonly due to gluteus minimus or medius injury rather than trochanteric bursitis. Gluteal tendinopathy most frequently occurs in late-middle aged females. In this pictorial review the pertinent MRI and US anatomy of the gluteal tendon insertions on the greater trochanter and the adjacent bursae are reviewed. The direct (peritendinitis, tendinosis, partial and complete tear) and indirect (bursal fluid, bony changes and fatty atrophy) MRI signs of gluteal tendon injury are illustrated. The key sonographic findings of gluteal tendinopathy are also discussed. (orig.)

Treatment of Unstable Trochanteric Femur Fractures: Proximal Femur Nail Versus Proximal Femur Locking Compression Plate.

Science.gov (United States)

Singh, Ashutosh Kumar; Narsaria, Nidi; G R, Arun; Srivastava, Vivek

Unstable trochanteric femur fractures are common fractures that are difficult to manage. We conducted a prospective study to compare functional outcomes and complications of 2 different implant designs, proximal femur nail (PFN) and proximal femur locking compression plate (PFLCP), used in internal fixation of unstable trochanteric femur fractures. On hospital admission, 48 patients with unstable trochanteric fractures were randomly assigned (using a sealed envelope method) to treatment with either PFN (24 patients) or PFLCP (24 patients). Perioperative data and complications were recorded. All cases were followed up for 2 years. The groups did not differ significantly (P > .05) in operative time, reduction quality, complications, hospital length of stay, union rate, or time to union. Compared with the PFLCP group, the PFN group had shorter incisions and less blood loss. Regarding functional outcomes, there was no significant difference in mean Harris Hip Score (P = .48) or Palmer and Parker mobility score (P = .58). Both PFN and PFLCP are effective in internal fixation of unstable trochanteric femur fractures.

Avascular necrosis of the femoral head presenting as trochanteric bursitis.

Science.gov (United States)

Mandell, B F

1990-01-01

Five patients are described with avascular necrosis of the femoral head who presented with ipsilateral trochanteric bursitis, in the absence of clearcut hip joint disease. Avascular necrosis was indicated by magnetic resonance imaging. It is suggested that clinical trochanteric bursitis, especially when refractory to local corticosteroid treatment, may be the initial sign of hip disease. In the patient with risk factor(s) for avascular necrosis that diagnosis should be considered and evaluated with appropriate studies, such as magnetic resonance imaging, to prevent weight bearing at an early stage and permit possible surgical decompression in the hope of postponing or obviating the need for total hip replacement. PMID:2241294

Reconstruction of trochanteric pressure sores with pedicled anterolateral thigh myocutaneous flaps.

Science.gov (United States)

Wang, Chih-Hsin; Chen, Shih-Yi; Fu, Ju-Peng; Dai, Niann-Tzyy; Chen, Shao-Liang; Chen, Tim-Mo; Chen, Shyi-Gen

2011-05-01

To provide an alternative choice for covering trochanteric pressure sores, we report on a modified pedicle anterolateral thigh (ALT) myocutaneous flap based on the descending branch of the lateral circumflex femoral artery. From August 2007 to January 2010, 20 consecutive patients (10 men and 10 women) underwent 21 pedicled ALT myocutaneous flaps for reconstruction of trochanteric pressure sores. The flap was designed and elevated, resembling the ALT perforator flap including part of the vastus lateralis muscle but without skeletonisation of the perforators. The mean age of patients was 79.4 years (range: 46-103). The mean follow-up period was 13.9 months (range: 3-32). The flaps were 8-21 cm long and 5-11 cm wide. All flaps healed without major complications. All donor sites were closed primarily without skin grafting and showed good aesthetic results. No recurrence was observed. This modified design of pedicled ALT myocutaneous flap without skeletonisation of perforators is a reliable and easily harvested flap for reconstruction of trochanteric pressure sores with limited morbidity. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

Traumatic subchondral fracture of the femoral head in a healed trochanteric fracture.

Science.gov (United States)

Lee, Sang Yang; Niikura, Takahiro; Iwakura, Takashi; Kurosaka, Masahiro

2014-07-11

An 82-year-old woman sustained a trochanteric fracture of the left femur after a fall. Fracture fixation was performed using proximal femoral nail antirotation (PFNA) II, and she was able to walk with a T-cane after 3 months. Eleven months following the operation, the patient presented with left hip pain after a fall. Radiographs showed a subchondral collapse of the femoral head located above the blade tip. The authors removed the PFNA-II and subsequently performed cemented bipolar hemiarthroplasty. Histological evaluation of the femoral head showed osteoporosis with no evidence of osteonecrosis. Repair tissue, granulation tissue and callus formation were seen at the collapsed subchondral area. Based on these findings, a traumatic subchondral fracture of the femoral head in a healed trochanteric fracture was diagnosed. A traumatic subchondral fracture of the femoral head may need to be considered as a possible diagnosis after internal fixation of the trochanteric fracture. 2014 BMJ Publishing Group Ltd.

Tuberculous, trochanteric and ischial bursitis

International Nuclear Information System (INIS)

San Roman, R.; Manjon, P.; Revilla, Y.; Rodriguez, P.

1998-01-01

To analyze the radiological signs and clinical presentation of tuberculous bursitis arising in the ischial and trochanteric territories, given the limited available knowledge on these entities and in view of the growing prominence of extra pulmonary tuberculosis (TB) in the field of infectious diseases. We present seven cases dealt with in our hospital from the first medical consultation to the definitive diagnosis and treatment. Five of the patients presented greater trochanter involvement, while ischium was the site in the remaining two, in one of whom the bursitis extended toward pubis. The radiographic images revealed demineralization and/or erosion of the bone surface in six cases, soft tissue calcification in four, soft tissue mass in two, coccygeal involvement in one and avulsion of a bone fragment one. An ultrasound study was carried out in a of case soft tissue abscess and fistulography in a case of peri-ischial abscess reaching the cutaneous level. Images of the ischial and trochanteric tuberosities such as those described in the present report should lead to a suspicion of bursitis accompanied by local osteitis. One of the etiologies that should be considered, probably the most common one, is tuberculosis, given the serious consequences that poor initial management would have (if is often treated as pyogenic) and its growing incidence. (Author) 10 refs

Fixation of Trochanteric Fragments in Cementless Bipolar Hemiarthroplasty of Unstable Intertrochanteric Fracture: Cerclage Wiring.

Science.gov (United States)

Lee, Young-Kyun; Park, Chan Ho; Koo, Kyung-Hoi

2017-12-01

Bipolar hemiarthroplasty (HA) is an option for the treatment of unstable intertrochanteric fracture in elderly patients. There is a raising concern regarding cable-grip related complications for the fixation of trochanteric fragments. Therefore, the aim of this study was to evaluate outcome of cementless HA with fixation for the trochanteric fragments using monofilament wires in unstable intertrochanteric fracture. We reviewed 92 cementless bipolar HAs using a grit-blasted long stem design for unstable intertrochanteric fractures in 91 elderly patients with a mean age of 81.7 years. During the arthroplasty, trochanteric fracture fragments were fixed using 1 or 2 vertical wires and transverse wires. We evaluated the clinical outcomes such as abductor power, ambulatory ability and wire-related complications, and radiologic outcomes including the union of the trochanteric fragment and subsidence of stem. Sixty-two patients were followed for a minimum of 2 years (mean, 59 months) postoperatively. The mean abductor power and Koval category was 4.1 (range, 3 to 5) and 4.6 (range, 1 to 6). The wire was broken in 3 hips (4.8%) and the nonunion of the greater trochanter occurred in 1 hips (1.6%). Two stems subsided by 3 mm and 8 mm, respectively, during postoperative 6 weeks, after which the subsidence was not progressive. Cerclage wiring of the trochanter using monofilament wire leads to acceptable outcome in cementless HA for senile patients with unstable intertrochanteric fracture. Cerclage wiring using a monofilament wire is recommended for the fixation of trochanteric fragments.

Elderly patient's mortality and morbidity following trochanteric fracture. A prospective study of 100 cases.

Science.gov (United States)

Mnif, H; Koubaa, M; Zrig, M; Trabelsi, R; Abid, A

2009-11-01

Trochanteric fractures are a major source of mortality, morbidity and functional impairment in the elderly. Morbidity is closely related to the degree of instability and comminution and is substantially influenced by the quality of reduction and internal fixation. Advanced age and associated co-morbidities are two decisive factors of mortality secondary to trochanteric fracture. This prospective study examined the epidemiological profile of trochanteric fractures and assessed mortality and morbidity with the aim of establishing management guidelines and improving prevention strategies. One hundred patients were included; 60% were male. Mean age was 76 years (range, 60-96 yrs). One, or more than one, co-morbidities were present in 68% of cases. The fractures were caused by a simple fall in 90% of cases. Fractures were classified according to the criteria of Ramadier and the ones of Ender. Sixty-five percent of these fractures were unstable. A dynamic hip screw was systematically used as the standard means of internal fixation. Anatomic and functional results were analyzed in 82 patients (18 had died within the first year following fracture occurrence). Mean follow-up period was 24 months (range, 12-36 months). Bone healing was achieved in 96% of cases. There were numerous postoperative complications (four cases of thromboembolism, fourteen immobility-related complications, two infections, six secondary displacement combined to loss of fixation, four non-unions, and nine malunions). At 2 years follow-up, 28 patients had died. Mortality was strongly correlated with older age (over 90 years), associated co-morbidity and fracture instability. Good functional outcomes (72%) correlated with younger age (60-74 years), fracture stability, adequate reduction and internal fixation. In stable trochanteric fractures, osteosynthesis by dynamic screw-plate is more effective than alternative techniques (blade-plate, nail-plate, Ender nail or even trochanteric nail). In unstable

Extent and Morbidity of Lateralization of a Trochanteric Fixation Nail Blade.

Science.gov (United States)

Sandifer, Phillip A; Hulick, Robert M; Graves, Matthew L; Spitler, Clay A; Russell, George V; Hydrick, Josie M; Jones, LaRita C; Bergin, Patrick F

2017-09-01

This study examined the incidence and risk factors associated with lateral helical blade migration and trochanteric pain with the trochanteric fixation nail. A retrospective review was performed of 141 cases of pertrochanteric femur fracture treated with a trochanteric fixation nail at a level I trauma center over a period of 42 months. Exclusion criteria included follow-up of less than 60 days, preexisting osteonecrosis of the femoral head, and prophylactic trochanteric fixation nail treatment. Patient demographics, operative findings, and radiographic findings were recorded. Medical records were reviewed to identify symptomatic hardware. Overall, 27 patients (19.1%) were symptomatic, and 3 (2.1%) required revision surgery for blade prominence. Of the patients, 42 (30%) had lateralization of greater than 1 cm, and 16 of these (38.1%) were symptomatic (Pfractures showing lateralization of greater than 1 cm. The quality of calcar reduction nearly reached statistical significance, and 44.8% of patients who had inadequate reduction had lateralization of greater than 1 cm compared with 26.4% of patients who had adequate reduction (P=.054). Lateralization of greater than 1 cm was directly associated with the presence of symptoms (Ptrochanteric pain (P=.007). Multivariate analysis showed that increasing tip-apex distance, inadequate calcar reduction, and greater fracture severity were predictive of excessive lateralization of greater than 1 cm. Nearly 20% of patients had lateral hip pain associated with cephalomedullary fixation. Final lateralization of the helical blade of greater than 1 cm was a very strong predictor of symptoms. During preoperative counseling, surgeons should caution patients about this relatively frequent and likely underreported complication. [Orthopedics. 2017; 40(5):e886-e891.]. Copyright 2017, SLACK Incorporated.

Factors influencing period from surgery to discharge in patients with femoral trochanteric fractures

OpenAIRE

Shinoda, Soichiro; Mutsuzaki, Hirotaka; Watanabe, Arata; Morita, Hidetaka; Kamioka, Yumiko

2017-01-01

[Purpose] The purpose of this study was to investigate factors influencing the period from surgery to discharge in patients with femoral trochanteric fractures. [Subjects and Methods] Sixty patients with femoral trochanteric fractures were investigated retrospectively. Based on the mean period from surgery to discharge (85.6 ± 26.6 days), the patients were divided into two groups: an under-85-day group (range, 29–78 days) and an over-85-day group (87–128 days). Age, gender, fracture type, pre...

Trochanteric impingement: is it a source of pain after THR?

Directory of Open Access Journals (Sweden)

Mark J. Isaacson, DO

2015-09-01

Full Text Available While uncommon, trochanteric-pelvic impingement may lead to significant lateral hip pain. We defined “impingement distance” as the radiographic distance from the medial aspect of the greater trochanter and the corresponding lateral edge of the acetabular bone or component and compared this to the contralateral normal hip. We present two painful total hip replacement (THR cases, each featuring a patient with severe lateral hip pain when walking and sitting. Both patients had diminished femoral offset and trochanteric-pelvic clearance, compared to the contralateral normal hip. The impingement distance was increased an average of 10 mm with the exchange to a longer femoral head. Both patients had immediate and complete pain relief with operative treatment to increase the impingement distance.

DomFLIP++

International Nuclear Information System (INIS)

Hendrysiak, W.; Raggl, A.; Slany, W.

1996-01-01

DomFLIP++ is the knowledge engineering module of the *FLIP++ project. *FLIP++ is a tool for optimizing multiple criteria problems. It uses fuzzy constraints to model optimizing criteria and applies algorithms such as Tabu search or genetic algorithms to the problems. DomFLIP++ is a C++ library. It allows the definition of new optimization problems. It helps a domain engineer to design the structure of a new problem. However, there is a domain independent interface to other *FLIP++ modules such as OptiFLIP++, DynaFLIP++, and InterFLIP++. After each iteration in the optimization process, the considered instantiations of the problem are evaluated. Each evaluation produces a list of violated constraints. For each constraint in further iterations of the optimization. A domain can be fine-tuned through modifications of constraints, through editing their repair lists, and through change in the optimizing parameters. A well-tuned domain can be successfully applied for optimization. Object-oriented design and implementation makes this module easy to modify and to reuse. Definition of new domains, system extensions with new optimizing algorithms, and definition of specific domain-dependent repair steps can be done efficiently. DomFLIP++ is tested on real-world example, namely scheduling the steel plant LD3 in Linz, Austria

SU(5): to flip or not to flip

International Nuclear Information System (INIS)

Nanopoulos, D.V.; Wisconsin Univ., Madison,

1988-01-01

Flipped SU(5) possesses some unique features as a grand unified theory: elegant missing partner mechanism, see-saw neutrino masses, no Higgs adjoints. This last property makes flipped SU(5) the only known grand unified theory derivable from 4-dimensional superstrings. When derived from the superstrings, flipped SU(5) possesses, in addition a hierarchical fermion mass spectrum. All these recent developments involving flipped SU(5) are discussed in a detailed but simple way, including phenomenological consequences at low energies

Trochanteric Fixation With a Third-Generation Cable-Plate System: An Independent Experience.

Science.gov (United States)

Stewart, Andrew D; Abdelbary, Hesham; Beaulé, Paul E

2017-09-01

Greater trochanteric fracture/nonunion can be a devastating complication with significant functional impact after total hip arthroplasty, and their fixation remains a challenge because of the significant forces being transmitted as well as the poor bone quality often associated with these fractures. The objective of this study is to investigate the rates of reoperation and trochanteric nonunion using a third-generation cable-plate system at one center. Thirty-five patients, mean age 72.9 years (range 46-98 years) with 24 women and 11 men, underwent fixation of their fractured greater trochanter using a third-generation cable-plate system. The indications were: periprosthetic fracture (n = 17), complex primary arthroplasty (n = 5), and complex revision arthroplasty (n = 13). Primary outcomes included rates of reoperation and radiographic union. At a mean follow-up of 2.5 years, trochanteric union rate was 62.9% with nonunion rate of 31.4%, and fibrous union in 5.7%. In regard to quality of initial apposition, only 40% achieved a perfect bone on bone reduction. Ten patients (28.6%) had evidence of wire breakage. Five patients (14.3%) required reoperation and removal of the internal fixation because of lateral hip pain. Fixation of the trochanteric fractures remains a challenge with a relatively high reoperation rate. Poor bone quality and capacity to maintain a stable reduction continue to make this complication after total hip arthroplasty a difficult problem to solve. Copyright © 2017. Published by Elsevier Inc.

[DESIGN AND CLINICAL APPLICATION OF LESSER TROCHANTERIC REDUCTION FIXATION SYSTEM].

Science.gov (United States)

Guo, Xiaoze; Zhang, Ying; Xiao, Jin; Xie, Huibin; Yu, Jiefeng

2015-02-01

To design and produce a lesser trochanteric reduction fixation system and verify its value and effectiveness. A lesser trochanteric reduction fixation system was designed and produced according to the anatomical features of the lesser trochanteric fractures. Sixty-six patients with intertrochanteric fractures of Evans type III were included between January 2010 and July 2012. Of 66 patients, 32 were treated with dynamic hip screw (DHS) assisted with the lesser trochanteric reduction fixation system (study group), and 34 cases were treated with DHS only (control group). The 2 groups were comparable with no significant difference in gender, age, the reasons, and the types of the fractures (P > 0.05). The operation time, intraoperative blood loss, neck-shaft angle, bone healing time, ratio of successful fixations, and the functional evaluation of the hip joint after operation were compared between 2 groups. The study group had shorter operation time [(58.4 ± 5.3) minutes] and less intraoperative blood loss [(186.3 ± 6.6) mL than the control group [(78.5 ± 6.2)minutes and (246.2 ± 8.7) mL], showing significant differences (t = -14.040, P = 0.000; t = -31.145, P = 0.000). There was no significant difference in neck-shaft angle between study group [(138.6 ± 3.0)] and control group [(139.4 ± 2.9) degrees] (t = -1.044, P = 0.301). The wounds healed by first intention in both groups. The 30 and 31 patients were followed up 12 to 24 months (mean, 15 months) in the study group, and 13 to 25 months (mean, 16 months) in the control group, respectively. All fractures healed well in 2 groups. The study group had significantly shorter healing time [(8.8 ± 2.0) weeks] than the control group [(10.7 ± 3.4) weeks] (t = -2.871, P = 0.006). At 12 months after operation, coxa vara happened in 2 cases of the study group with a successful fixation ratio of 93.3% and in 10 cases of the control group with a successful fixation ratio of 67.7%, showing significant difference (Χ2 = 6

Influence of Lateral Muscle Loading in the Proximal Femur after Fracture Stabilization with a Trochanteric Gamma Nail (TGN)

Science.gov (United States)

Sitthiseripratip, Kriskrai; Mahaisavariya, Banchong; Suwanprateeb, Jintamai; Bohez, Erik; Vander Sloten, Jos

The purpose of this study was to investigate the influence of lateral muscle loading on the stress/strain distributions of the trochanteric Gamma nail (TGN) fixation within the healed, trochanteric and subtrochanteric femoral fractures by means of a finite element method. The effect of three muscle groups, the abductors (ABD), the vastus lateralis (VL) and the iliotibial band (ITB), were investigated. The analytical results showed that addition of lateral muscle forces, iliotibial band and vastus lateralis, produced compensation of forces and reduction of bending moments in the bone and in the trochanteric Gamma nail especially in the lateral aspect. The iliotibial band produced a higher impact as compared to the vastus lateralis. Therefore in the finite element analysis of the proximal femur with the trochanteric Gamma nail fracture fixation should include the lateral muscle forces to simulate load condition with maximal physiological relevance to the closed nailing technique.

Circumferential wires as a supplement to intramedullary nailing in unstable trochanteric hip fractures

DEFF Research Database (Denmark)

Ban, Ilija; Birkelund, Lasse; Palm, Henrik

2012-01-01

Fixation of unstable trochanteric fractures is challenging. Application of a circumferential wire may facilitate bone contact and avoid postoperative fracture displacement. However, the use of circumferential wires remains controversial due to possible disturbance of the blood supply to the under......Fixation of unstable trochanteric fractures is challenging. Application of a circumferential wire may facilitate bone contact and avoid postoperative fracture displacement. However, the use of circumferential wires remains controversial due to possible disturbance of the blood supply...... to the underlying bone. We evaluated the results of applied circumferential wires, concentrating mainly on complications and reoperations....

SURGICAL TREATMENT OF TROCHANTERIC FRACTURES BY GAMMA3 NAIL

Directory of Open Access Journals (Sweden)

Aleksandar Vukićević

2010-09-01

Full Text Available Fractures of the greater trochanter rank amongst severe injuries of bone tissue. They occur most frequently in patients over 65 years of age, nearly all of whom are diagnosed with osteoporosis. Non-surgical treatment does not prove to be satisfactory and results in high mortality rate. Surgical treatment is a method of fracture treatment of the trochanteric region, which enables early activation and thus prevents numerous complications in bedridden patients. Gamma3 nails are one of the most state-of-the-art implants for trochanteric fracture fixation. The implant is easy to embed, which does not require a large surgical team. This implant embedding requires the least invasive surgery and complications are rare.This paper describes 47 patients who received surgical treatment and is focused on the first nine months of 2009. The patients were treated at the Orthopaedics Ward of Health Centre Valjevo. They were in their seventies, average age: 72.21 years, with female sex prevailing (63.82%. The outcome was as follows: excellent in 65.96%, good in 17.02% and satisfactory in 4.25% of patients. Surface infections occurred in 6.38% of patients. One implant broke.We had one death outcome in the early post-surgical treatment.Surgical treatment of trochanteric fractures by Gamma3 implants proved very effective as it resulted in few complications and numerous excellent functional and anatomic outcomes. Thus we recommend it as an option when decision on treatment of this type of fractures is made.

Real frequency of ordinary and atypical sub-trochanteric and diaphyseal fractures in France based on X-rays and medical file analysis.

Science.gov (United States)

Beaudouin-Bazire, Constance; Dalmas, Noémie; Bourgeois, Julie; Babinet, Antoine; Anract, Philippe; Chantelot, Christophe; Farizon, Frédéric; Chopin, Florence; Briot, Karine; Roux, Christian; Cortet, Bernard; Thomas, Thierry

2013-03-01

Atypical sub-trochanteric and femoral shaft fractures have been reported in patients treated with bisphosphonates. Their incidence has been determined from registered data analysis using international codes. Therefore, the aim of our study was to estimate the real frequency of typical and atypical sub-trochanteric or diaphyseal fractures, based on radiological and clinical data compared to registered data. In the registers of three large French University Hospitals, patients identified with International Classification of Diseases, 10th Revision diagnosis codes for sub-trochanteric or diaphyseal fracture were selected. Frequencies of ordinary and atypical fractures were calculated after both registered data, radiological and clinical files analysis. Among the 4592 patients hospitalized for a femoral fracture over 5 years, 574 were identified to have had a sub-trochanteric or femoral shaft fracture. 47.7% of the sub-trochanteric and femoral shaft fractures were misclassified, predominantly in the sub-trochanteric fractures subset. 12 patients had an atypical fracture (4% of the sub-trochanteric and femoral shaft fractures) and 11 fractures presented radiological features of atypical fractures, whereas clinical files analysis revealed they were pathological or traumatic fractures. Atypical fractures frequency is very low. Because of their low frequency and the unreliability of registered databases, the risk of atypical fractures is very difficult to estimate retrospectively. A prospective study is needed to clarify the risk factors associated with these fractures. Copyright © 2012 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Unusual Presentation of Pseudoaneurysm with Trochanteric Fracture Femur with Associated Long-Term Antiepileptic Therapy

Directory of Open Access Journals (Sweden)

Nipun Rana

2014-01-01

Full Text Available Arterial injury following impalement due to a trochanteric hip fracture-fragment per se has been documented rarely. We report a case of pseudoaneurysm of profunda femoris artery at the first perforator branch in a 48-year-old male, with trochanteric hip fracture following a fall during an epileptic episode. Persistent recalcitrant pain, globular swelling in the groin, unexplained drop in the haemoglobin level, and color doppler ultrasonography findings were salient features to the diagnosis. Additionally, we collected all reported cases of pseudoaneurysm associated with hip fractures. We reviewed the literature regarding the incidence, treatment, and prognosis for the same. Acute vascular injury was probably caused by the spikes of fractured lesser trochanter which was found to be displaced superomedially. All trochanteric fractures especially those with displaced lesser trochanter fragment should be closely watched for the possibility of vascular injury. Early diagnosis and treatment in a staged manner can prevent the catastrophic vascular event and hence the limb.

Arthroscopic bursectomy for recalcitrant trochanteric bursitis after hip arthroplasty.

Science.gov (United States)

Van Hofwegen, Christopher; Baker, Champ L; Savory, Carlton G; Baker, Champ L

2013-01-01

This study evaluated the use of arthroscopic bursectomy for pain relief in patients with trochanteric bursitis after hip arthroplasty. In this retrospective case series of 12 patients undergoing arthroscopic treatment of recalcitrant trochanteric bursitis after hip arthroplasty, outcomes were assessed via phone interview with a numeric pain rating scale from 1 to 10 and were compared with preoperative pain ratings. Patients were asked the percentage of time they had painless hip function and whether they would have the surgery again. At an average 36-month follow-up (range, 4-85 months), the average numeric pain scale rating improved from 9.3 to 3.3. At an average of 62% of the time, patients had painless use of the hip. Ten of 12 patients in the study felt the pain relief gained was substantial enough to warrant having procedure again. In these patients, arthroscopic bursectomy was a viable option for patients with recalcitrant bursitis after hip arthroplasty.

Quantitative ultrasound parameters as well as bone mineral density are better predictors of trochanteric than cervical hip fractures in elderly women. Results from the EPIDOS study.

Science.gov (United States)

Schott, A M; Hans, D; Duboeuf, F; Dargent-Molina, P; Hajri, T; Bréart, G; Meunier, P J

2005-12-01

Hip fractures can be separated into cervical and trochanteric fractures. Trochanteric fractures have been associated with up to twice the short-term mortality of cervical fractures in the elderly. There is also evidence suggesting that the mechanisms are different. Evidence from the literature remains limited on the predictive power of bone mineral density (BMD) and quantitative ultrasounds (QUS) for both types of hip fractures. 5703 elderly women aged 75 years or more, who were recruited from the voting lists in the EPIDOS study, and had baseline calcaneal ultrasounds (QUS) and DXA measurements at the hip and the whole body, were analyzed in this paper. Among those, 192 hip fractures occurred during an average follow-up of 4 years, 108 cervical and 84 trochanteric fractures. Femoral neck, trochanteric and whole body BMD were able to predict trochanteric hip fracture (RR's and 95% CI were, respectively, 3.2 (2.4-4.2); 4.8 (3.5-6.6); and 2.8 (2.2-3.6)) more accurately than cervical fractures (respectively, 2.1 (1.7-2.7); 2.3 (1.8-3.0); 1.2 (1.0-1.6)). All ultrasound parameters, SOS, BUA, and stiffness index (SI) were significant predictors of trochanteric (RR's respectively 3.0 (2.2-4.1), 2.5(2.0-3.1), and 3.5(2.6-4.7)) but not cervical fractures. After adjustment for femoral neck or trochanteric BMD ultrasound parameters were still significant predictors of trochanteric fracture, and stiffness tended to be a better predictor of trochanteric fractures than either BUA or SOS with a relative risk of 2.25 (1.6-3.1). A significant decrease of all bone measurements, BMD and QUS, was highly predictive of trochanteric fractures, whereas a decrease of femoral neck and trochanteric BMD were only associated with a slight increase in cervical fracture risk and a low total body BMD or QUS parameters were not significant predictors of cervical fractures. In women who sustained a hip fracture, the decrease of BMD and QUS values increases the risk of trochanteric fracture as

Unilateral hypoplasia with contralateral hypertrophy of anterior belly of digastric muscle: a case report.

Science.gov (United States)

Ochoa-Escudero, Martin; Juliano, Amy F

2016-10-01

Anomalies of the anterior belly of the digastric muscle (DM) are uncommon. We present a case of hypoplasia of the anterior belly of the left DM with hypertrophy of the anterior belly of the contralateral DM. The importance of recognizing this finding is to differentiate hypoplasia of the anterior belly of the DM from denervation atrophy, and not to confuse contralateral hypertrophy with a submental mass or lymphadenopathy. In denervation atrophy of the anterior belly of the DM, associated atrophy of the ipsilateral mylohyoid muscle is present. Hypertrophy of the anterior belly of the contralateral DM can be differentiated from a submental mass or lymphadenopathy by recognizing its isodensity on computed tomography and isointensity on magnetic resonance imaging to other muscles, without abnormal contrast enhancement.

Necrotizing fasciitis after internal fixation of fracture of femoral trochanteric ? ??

OpenAIRE

Santos, Leandro Em?lio Nascimento; Pires, Robinson Esteves Santos; Figueiredo, Leonardo Brand?o; Soares, Eduardo Augusto Marques

2014-01-01

Necrotizing fasciitis is a rare and potentially lethal soft tissue infection. We report a case of trochanteric femur fracture in a patient who underwent fracture fixation and developed necrotizing fasciitis. A literature review on the topic will be addressed.

Hip fracture and anthropometric variations: dominance among trochanteric soft tissue thickness, body height and body weight during sideways fall.

Science.gov (United States)

Majumder, Santanu; Roychowdhury, Amit; Pal, Subrata

2013-01-01

Hip fracture depends on various anthropometric parameters such as trochanteric soft tissue thickness, body height and body weight. The objective was to evaluate the responses to the variations in anthropometric parameters during sideways fall, and to identify the most dominant parameter among them. Seven finite element models were developed having anthropometric variations in trochanteric soft tissue thickness (5-26 mm), body height (1.70-1.88 m), and body weight (63-93.37 kg). These were simulated for sideways fall with ANSYS-LS-DYNA® code. Significant effect of trochanteric soft tissue thickness variation was found on 'normalized peak impact force with respect to the body weight' (p=0.004, r²=0.808) and strain ratio (p=0.083, r²=0.829). But, variation in body height was found to be less significant on normalized peak impact force (p=0.478, r²=0.105) and strain ratio (p=0.292, r²=0.217). Same was true for the variation in body weight on normalized peak impact force (p=0.075, r²=0.456) and strain ratio (p=0.857, r²=0.007). The risk factor for fracture was also well correlated to the strain ratio for the inter-trochanteric zone (pfractures are clinically observed to happen. Trochanteric soft tissue thickness was found likely to be the most dominant parameter over body height and body weight, signifying that a slimmer elderly person, taller or shorter, with less trochanteric soft tissue thickness should be advised to take preventive measures against hip fracture under sideways fall. © 2013.

FLIP the Switch: Regulation of Apoptosis and Necroptosis by cFLIP

Directory of Open Access Journals (Sweden)

Yuichi Tsuchiya

2015-12-01

Full Text Available cFLIP (cellular FLICE-like inhibitory protein is structurally related to caspase-8 but lacks proteolytic activity due to multiple amino acid substitutions of catalytically important residues. cFLIP protein is evolutionarily conserved and expressed as three functionally different isoforms in humans (cFLIPL, cFLIPS, and cFLIPR. cFLIP controls not only the classical death receptor-mediated extrinsic apoptosis pathway, but also the non-conventional pattern recognition receptor-dependent apoptotic pathway. In addition, cFLIP regulates the formation of the death receptor-independent apoptotic platform named the ripoptosome. Moreover, recent studies have revealed that cFLIP is also involved in a non-apoptotic cell death pathway known as programmed necrosis or necroptosis. These functions of cFLIP are strictly controlled in an isoform-, concentration- and tissue-specific manner, and the ubiquitin-proteasome system plays an important role in regulating the stability of cFLIP. In this review, we summarize the current scientific findings from biochemical analyses, cell biological studies, mathematical modeling, and gene-manipulated mice models to illustrate the critical role of cFLIP as a switch to determine the destiny of cells among survival, apoptosis, and necroptosis.

Hemi replacement arthroplasty for unstable inter-trochanteric fractures of femur.

Science.gov (United States)

Singh, Sudhir; Shrivastava, Chetan; Kumar, Sanjiv

2014-10-01

Unstable inter-trochanteric fracture in the geriatric population is a common injury and is associated with poor bone quality, excessive collapse, loss of fixation, and cut-out of the lag screw, are the common problems of attempts to fix these fractures. Present study is an attempt to evaluate the functional outcome of primary cemented bipolar hemiarthroplasty in unstable inter-trochanteric fractures in elderly patients. This prospective study included 25 cases with unstable inter-trochanteric fracture of femur between 60 -75 y of age in whom primary Cemented Bipolar hemi - arthroplasty was performed. The patients were followed up at six week, three month, six month and one year postoperatively and assessed using Harris Hip Score (HHS), Lower Extremity Functional Scale (LEFS), Visual analogue scale (VAS) for evaluation of outcome. The mean HHS score was 78.86+8.13 by the end of one year. Similarly mean LEFS score was 34.36+7.01 by the end of one year, whereas the mean pain score on VAS Scale by the year end was 1.04+1.02. The changes in HHS, LEFS and VAS up to six months periods are much greater which starts showing a stable trend thereafter. Fair to good scores were observed in all the patients. We compared our results with those reported by other authors and our study gave quite comparable results. We also used lower extremity function status score (LEFS) for assessment of functional ability. The purpose of its use was that while Harris Hip Score (HHS) provides information on a multitude of factors, LEFS is more patient oriented and provides the correct information about the level of activities a patient can resume post-operatively and can be offered as a self assessment tool. No significant complication except for grade I pressure sores in four patients were seen in postoperative period but they all resolved with proper nursing care by six week follow up. No patient required revision surgery. The authors believe that primary cemented bipolar hemiarthroplasty for

Flipped Learning

DEFF Research Database (Denmark)

Holmboe, Peter; Hachmann, Roland

I FLIPPED LEARNING – FLIP MED VIDEO kan du læse om, hvordan du som underviser kommer godt i gang med at implementere video i undervisning, der har afsæt i tankerne omkring flipped learning. Bogen indeholder fire dele: I Del 1 fokuserer vi på det metarefleksive i at tænke video ind i undervisningen...

Trochanteric Soft Tissue Thickness and Hip Fracture in Older Men

OpenAIRE

Nielson, Carrie M.; Bouxsein, Mary L.; Freitas, Sinara S.; Ensrud, Kristine E.; Orwoll, Eric S.

2009-01-01

Background: Greater thickness of the tissue extending laterally from the greater trochanter has been associated with a lower risk of hip fracture in women. The effect of trochanteric soft tissue thickness on the risk of incident hip fracture has not been evaluated in men.

A Prospective Study to Evaluate the Management of Sub-trochanteric Femur Fractures with Long Proximal Femoral Nail

Directory of Open Access Journals (Sweden)

Kumar M

2017-11-01

Full Text Available INTRODUCTION: Sub-trochanteric fractures of the femur remains one of the most challenging fractures faced by orthopaedic surgeons. This study was done to analyse the management and complications of sub-trochanteric fractures using long proximal femoral nail (PFN. MATERIALS AND METHODS: This was a prospective study of 50 patients with sub-trochanteric fractures of femur who were treated with long PFN at a tertiary care center from July 2012 to June 2016. The fractures were classified according to Seinsheimer classification. All patients were assessed functionally by Harris Hip Score. RESULTS: Average duration of union was 17.08 weeks (range 13 to 32 weeks, union was achieved in 92% cases. Closed reduction was achieved in 68% cases and open reduction was required in 32% cases. Various intraoperative complications were seen in 12% and delayed complications in 26% of cases. Good anatomical results were achieved in 86% of cases and 14% were fair. As per Harris Hip score, excellent results were noted in 28% cases, good in 56% cases and fair in 16% cases. CONCLUSION: The long PFN is a reliable implant for sub-trochanteric femur fractures, with high rate of bone union and minimal soft tissue damage. Intramedullary fixation has biological and biomechanical advantages, but the surgery is technically demanding.

Efficacy of Treatment of Trochanteric Bursitis: A Systematic Review

Science.gov (United States)

Lustenberger, David P; Ng, Vincent Y; Best, Thomas M; Ellis, Thomas J

2013-01-01

Objective Trochanteric bursitis (TB) is a self-limiting disorder in the majority of patients and typically responds to conservative measures. However, multiple courses of nonoperative treatment or surgical intervention may be necessary in refractory cases. The purpose of this systematic review was to evaluate the efficacy of the treatment of TB. Data Sources A literature search in the PubMed, MEDLINE, CINAHL, and ISI Web of Knowledge databases was performed for all English language studies up to April 2010. Terms combined in a Boolean search were greater trochanteric pain syndrome, trochanteric bursitis, trochanteric, bursitis, surgery, therapy, drug therapy, physical therapy, rehabilitation, injection, Z-plasty, Z-lengthening, aspiration, bursectomy, bursoscopy, osteotomy, and tendon repair. Study Selection All studies directly involving the treatment of TB were reviewed by 2 authors and selected for further analysis. Expert opinion and review articles were excluded, as well as case series with fewer than 5 patients. Twenty-four articles were identified. According to the system described by Wright et al, 2 studies, each with multiple arms, qualified as level I evidence, 1 as level II, 1 as level III, and the rest as level IV. More than 950 cases were included. Data Extraction The authors extracted data regarding the type of intervention, level of evidence, mean age of patients, patient gender, number of hips in the study, symptom duration before the study, mean number of injections before the study, prior hip surgeries, patient satisfaction, length of follow-up, baseline scores, and follow-up scores for the visual analog scale (VAS) and Harris Hip Scores (HHS). Data Synthesis Symptom resolution and the ability to return to activity ranged from 49% to 100% with corticosteroid injection as the primary treatment modality with and without multimodal conservative therapy. Two comparative studies (levels II and III) found low-energy shock-wave therapy (SWT) to be

Trochanteric fracture-implant motion during healing - A radiostereometry (RSA) study.

Science.gov (United States)

Bojan, Alicja J; Jönsson, Anders; Granhed, Hans; Ekholm, Carl; Kärrholm, Johan

2018-03-01

Cut-out complication remains a major unsolved problem in the treatment of trochanteric hip fractures. A better understanding of the three-dimensional fracture-implant motions is needed to enable further development of clinical strategies and countermeasures. The aim of this clinical study was to characterise and quantify three-dimensional motions between the implant and the bone and between the lag screw and nail of the Gamma nail. Radiostereometry Analysis (RSA) analysis was applied in 20 patients with trochanteric hip fractures treated with an intramedullary nail. The following three-dimensional motions were measured postoperatively, at 1 week, 3, 6 and 12 months: translations of the tip of the lag screw in the femoral head, motions of the lag screw in the nail, femoral head motions relative to the nail and nail movements in the femoral shaft. Cranial migration of the tip of the lag screw dominated over the other two translation components in the femoral head. In all fractures the lag screw slid laterally in the nail and the femoral head moved both laterally and inferiorly towards the nail. All femoral heads translated posteriorly relative to the nail, and rotations occurred in both directions with median values close to zero. The nail tended to retrovert in the femoral shaft. Adverse fracture-implant motions were detected in stable trochanteric hip fractures treated with intramedullary nails with high resolution. Therefore, RSA method can be used to evaluate new implant designs and clinical strategies, which aim to reduce cut-out complications. Future RSA studies should aim at more unstable fractures as these are more likely to fail with cut-out. Copyright © 2018 Elsevier Ltd. All rights reserved.

Does a trochanteric lag screw improve fixation of vertically oriented femoral neck fractures? A biomechanical analysis in cadaveric bone.

Science.gov (United States)

Hawks, Michael A; Kim, Hyunchul; Strauss, Joseph E; Oliphant, Bryant W; Golden, Robert D; Hsieh, Adam H; Nascone, Jason W; O'Toole, Robert V

2013-10-01

We assessed the biomechanical performances of a trochanteric lag screw construct and a traditional inverted triangle construct in the treatment of simulated Pauwels type 3 femoral neck fractures. An inverted triangle construct (three 7.3-mm cannulated screws placed in inverted triangle orientation) and a trochanteric lag screw construct (two 7.3-mm cannulated screws placed across the superior portion of the femoral neck and one 4.5-mm lag screw placed perpendicular to the fracture in superolateral to inferomedial orientation) were tested in nine matched pairs of non-osteoporotic human cadaveric femora. We used a previously described vertically oriented femoral neck fracture model and testing protocol that incrementally loaded the constructs along the mechanical axis of the femur to 1400 N. Specimens that survived incremental loading underwent cyclic loading. Apparent construct stiffness, force at 3mm of displacement, and survival of incremental loading were recorded. The trochanteric lag screw group had a 70% increase in stiffness (261 N/mm [29 standard deviation] versus 153 N/mm [16 standard deviation]; P=0.026) and a 43% increase in force required for displacement (620 N versus 435 N; P=0.018) compared with the inverted triangle group. One trochanteric lag screw and no inverted triangle specimen survived incremental loading. A trochanteric lag screw construct applied to vertically oriented femoral neck fractures provides marked improvement in mechanical performance compared with the inverted triangle construct. © 2013.

Treatment of unstable trochanteric fractures : the balance between man and material

NARCIS (Netherlands)

I.B. Schipper (Inger)

2003-01-01

textabstractTreatment of unstable trochanteric fractures poses a challenge to surgeons in many ways. Accepting this challenge requires understanding of those parameters that determine the outcome. In operative fracture care at least four elements influence the outcome of treatment: the patient, the

PROXIMAL FEMURAL VALGUS SUBTROCHANTERIC OSTEOTOMY FOR NON UNION OF TROCHANTERIC FRACTURES.

Science.gov (United States)

Silva, Paulo; Coelho, Danilo Lopes; Curi, Calim; de Oliveira, Leandro Alves; de Moraes, Frederico Barra; do Amaral, Rogério Andrade; Rebello, Percival Rosa

2012-01-01

To evaluate valgus subtrochanteric osteotomy for the treatment of trochanteric non-union. A retrospective study of cases series. From 1998 September to 2009 January, seventeen (17) cases with a diagnosis of non-union of trochanteric fracture were re-operated by the hip group of the Ortophaedic And Traumatology service of the Hospital Geral de Goiania (HGG). The patients presented pain at the fracture site, a femoral varus angle of less than 120°, and non-union of the fracture in the 3(rd) months after the initial surgery. Patients with ages ranging from 30 to 73 years, with a maximum follow-up of 09 years and minimum of 09 years. The mean time from first surgery to osteotomy was six months. Bone union was observed in 16 patients, with a mean union time of 12 weeks after surgery. The mean hip varus angle was 105(0) (120(0) to 90(0)). After surgery, the mean hip valgus angle was 144(0) (155(0) to 135(0)). We had one unsuccessful case; a 78-year old patient who had osteogtomy, fixed with DHS of 150(0), with valgization to 154(0). After six months of follow-up without union of the fracture, it was decided to perform total cemented hip artroplasthy, without complications. Valgus subtrochanteric osteotomies can be indicated for the treatment of trochanteric treatment of pseudoarthroses, with good final results for bone union, avoiding the need for total hip artroplasthy and maintaining biological fixation, as well as reestablishing the mechanical and anatomical axis of the affected limb.

Risks of subsequent contralateral fractures of the trochanteric region in elderly.

Science.gov (United States)

Pogliacomi, Francesco; Pellegrini, Andrea; Tacci, Fabrizio; Pedrini, Martina Francesca; Costantino, Cosimo; Pedrazzini, Alessio; Pedrazzi, Giuseppe; Lauretani, Fulvio; Vaienti, Enrico; Ceccarelli, Francesco

2017-01-16

Fractures in elderly are always a dramatic event and the healing is often not complete. In a context of bone fragility, repeated fractures are a growing problem in the industrialized world, in which the mean age of population is increasing. The aim of this study was to identify those general factors which may increase the risk of subsequent trochanteric fractures after an initial lesion. Three-hundred and thirty-one patients who underwent intramedullary fixation for trochanteric fractures between January 2012 and December 2013 were studied. Forty subjects yet alive (group 1), affected by a subsequent contralateral hip fracture, were compared with 202 patients (group 2) affected by isolated trochanteric fracture. Days of hospitalization before surgery, hospitalization, period of rehabilitation, type of discharge and comorbidities, that are reported in literature as possible risk factors for hip refracture, were analyzed. In addition, all patients were interviewed in order to assess if a therapy for osteoporosis was prescribed after the initial fracture and how their gait had been modified by fractures. Days of hospitalization before surgery, hospitalization, period of rehabilitation and type of discharge were not predictive factors for subsequent fractures, as well as diabetes mellitus, hypertension and cardiac diseases. The presence of neurologic and respiratory diseases were associated to a higher risk of refractures, as well as the absence of specific medical treatment for osteoporosis. Neurologic and respiratory comorbidities and the absence of osteoporosis medical treatment are the variables associated to a higher risk of contralateral fractures. Physicians can do more in terms of prevention and strategies must consider these risk factors.

Some comments on flipped SU(5) times U(1) and flipped unification in general

Energy Technology Data Exchange (ETDEWEB)

Barr, S.M. (Bartol Research Institute, University of Delaware, Newark, Delaware 19716 (US))

1989-10-01

A general group-theoretical discussion of flipped embeddings is given. In addition to the well-known flipped SU(5) and flipped SO(10), the existence of flipped E{sub 6} and E{sub 7} is shown, as well as several families and special cases of flipped embeddings. A possible physical reason, essentially based on the group theory of flipped embeddings, why nature prefers the low-energy group SU(3){times}SU(2){times}U(1) to alternatives such as SU(4){times}U(1) and SU(5) is pointed out.

Some comments on flipped SU(5)xU(1) and flipped unification in general

International Nuclear Information System (INIS)

Barr, S.M.

1989-01-01

A general group-theoretical discussion of flipped embeddings is given. In addition to the well-known flipped SU(5) and flipped SO(10), the existence of flipped E 6 and E 7 is shown, as well as several families and special cases of flipped embeddings. A possible physical reason, essentially based on the group theory of flipped embeddings, why nature prefers the low-energy group SU(3)xSU(2)xU(1) to alternatives such as SU(4)xU(1) and SU(5) is pointed out

BMD T-score discriminates trochanteric fractures from unfractured controls, whereas geometry discriminates cervical fracture cases from unfractured controls of similar BMD.

Science.gov (United States)

Pulkkinen, P; Partanen, J; Jalovaara, P; Jämsä, T

2010-07-01

The ability of bone mineral density (BMD) to discriminate cervical and trochanteric hip fractures was studied. Since the majority of fractures occur among people who are not diagnosed as having osteoporosis, we also examined this population to elucidate whether geometrical risk factors can yield additional information on hip fracture risk beside BMD. The study showed that the T-score criterion was able to discriminate fracture patients from controls in the cases of trochanteric fractures, whereas geometrical measures may discriminate cervical fracture cases in patients with T-score >-2.5. Low bone mineral density (BMD) is a well-established risk factor for hip fracture. However, majority of fractures occur among people not diagnosed as having osteoporosis. We studied the ability of BMD to discriminate cervical and trochanteric hip fractures. Furthermore, we examined whether geometrical measures can yield additional information on the assessment of hip fracture risk in the fracture cases in subjects with T-score >-2.5. Study group consisted of postmenopausal females with non-pathologic cervical (n = 39) or trochanteric (n = 18) hip fracture (mean age 74.2 years) and 40 age-matched controls. BMD was measured at femoral neck, and femoral neck axis length, femoral neck and shaft cortex thicknesses (FNC and FSC), and femoral neck-shaft angle (NSA) were measured from radiographs. BMD T-score threshold of -2.5 was able to discriminate trochanteric fractures from controls (p trochanteric fractures occurred in individuals with T-score fractures. Twenty of these fractures (51.3%) occurred in individuals with BMD in osteoporotic range and 19 (48.7%) in individuals with T-score >-2.5. Within these non-osteoporotic cervical fracture patients (N = 19) and non-osteoporotic controls (N = 35), 83.3% were classified correctly based on a model including NSA and FNC (p trochanteric fractures could be discriminated based on a BMD T-score fracture cases would remain under-diagnosed if

Risk factors for cervical and trochanteric hip fractures in elderly women: a population-based 10-year follow-up study.

Science.gov (United States)

Jokinen, Heikki; Pulkkinen, Pasi; Korpelainen, Juha; Heikkinen, Jorma; Keinänen-Kiukaanniemi, Sirkka; Jämsä, Timo; Korpelainen, Raija

2010-07-01

We evaluated the contribution of lifestyle-related factors, calcaneal ultrasound, and radial bone mineral density (BMD) to cervical and trochanteric hip fractures in elderly women in a 10-year population-based cohort study. The study population consisted of 1,681 women (age range 70-73 years). Seventy-two percent (n = 1,222) of them participated in the baseline measurements. Calcaneal ultrasound was assessed with a quantitative ultrasound device. BMD measurements were performed at the distal and ultradistal radius by dual-energy X-ray absorptiometry. Forward stepwise logistic regression analysis was used to find the most predictive variables for hip fracture risk. During the follow-up, 53 of the women had hip fractures, including 32 cervical and 21 trochanteric ones. The fractured women were taller and thinner and had lower calcaneal ultrasound values than those without fractures. High body mass index (BMI) was a protective factor against any hip fractures, while low functional mobility was a risk factor of hip fractures. Specifically, high BMI protected against cervical hip fractures, while low physical activity was a significant predictor of these fractures. Similarly, high BMI protected against trochanteric fractures, whereas low functional mobility and high coffee consumption were significant predictors of trochanteric fractures. Cervical and trochanteric hip fractures seem to have different risk factors. Therefore, fracture type should be taken into account in clinical fracture risk assessment and preventative efforts, including patient counseling. However, the study is not conclusive due to the limited number of observed fractures during follow-up, and the results have to be confirmed in future studies.

Posterior trochanteric osteotomy in acetabular fractures for 32 cases.

Science.gov (United States)

Niu, Yunfei; An, Xiaofei; Xu, Shuogui; Wu, Dajiang; Zhang, Chuncai; Li, Ming

2014-11-01

The aim of this study is to explore the method and clinical outcome of posterior trochanteric osteotomy in acetabular fractures. From January 2000 to January 2008, 32 cases of acetabular fractures involving the dome of acetabulum underwent posterior trochanteric osteotomy for a better exposure and internal fixation with acetabular tridimensional memory fixation system. 28 cases (16 men and 12 women, mean age 39.9 years, range 16-73 years) were followed up with an average of 48.9 months (range of 19-95 months) and four were lost during follow up. Of 28 cases, 19 were fresh fractures and 9 were old fractures. The reduction was evaluated with Matta criteria. Clinical evaluation was based on modified Merle d'Aubigne and Postel scoring. Motor strength of the abductors was evaluated according to the Medical Research Council grading system. Ectopic ossification was classified according to Brooker criteria. Anatomical reduction was achieved in 17 cases and satisfied reduction in 10 patients. Poor reduction happened in an old fracture. All acetabular fractures got a direct bone union and no displacement and deep infection occurred. All osteotomies healed within 3.5 months without any nonunion, proximal migration of the greater trochanter, loosing or broken of instrumentation, and deep infection. Two superficial infections were healed with a regular dressing. Two patients underwent removal of implants from greater trochanter because of irritation. The strength of the abductors was of Grade 3/5 in two patients, Grade 4/5 in five patients, and normal in the rest. Clinical scoring was excellent to good in 84 %. Ectopic ossification occurred in five patients, grade 1 in two patients, grade 2 in two, and grade 3 in one. But function of hip joint was not seriously affected. Posterior trochanteric osteotomy can provide an adequate exposure of the dome of acetabulum without the associated complications like nonunion, proximal replacement, and weak of the abductors which often occur

Evaluation of the health-related quality of life in elderly patients according to the type of hip fracture: femoral neck or trochanteric

Directory of Open Access Journals (Sweden)

Tânia Maria da Silva Mendonça

2008-01-01

Full Text Available OBJECTIVE: To evaluate the effect the type of hip fracture (femoral neck or trochanteric has on the Health-Related Quality of Life of elderly subjects. METHODS: Forty-five patients with hip fractures (mean 74.30 ± 7.12 years, 24 with a femoral neck fracture and 21 with a trochanteric fracture, completed the 36-item Short Form Health Survey (SF-36 at baseline and four months after fracture. The Health-Related Quality of Life scores were compared according to fracture type, undisplaced and displaced femoral neck fractures, and stable and unstable trochanteric fractures. RESULTS: Compared to baseline, all patients scored lower in the physical functioning, role limitation-physical, bodily pain and vitality categories four months after the fracture had occurred. The SF-36 scores for all the scales did not differ significantly between patients with femoral neck versus trochanteric fractures, or between patients with displaced versus undisplaced femoral neck fractures and stable versus unstable trochanteric fractures. CONCLUSIONS: The mental and physical quality of life of elderly patients with a hip fracture is severely impaired one month after fracture, with partial recovery by the end of the fourth month. The negative impact on the Health-Related Quality of Life did not differ significantly according to fracture type.

Flipped Learning, Flipped Satisfaction, Getting the Balance Right

Science.gov (United States)

Swinburne, Rosemary Fisher; Ross, Bella; LaFerriere, Richard; Maritz, Alex

2017-01-01

This paper explores students' perceptions of their learning outcomes, engagement, and satisfaction with a technology-facilitated flipped approach in a third-year core subject at an Australian university during 2014. In this pilot study, findings reveal that students preferred the flipped approach to the traditional face-to-face delivery and…

Spatial Differences in the Distribution of Bone Between Femoral Neck and Trochanteric Fractures.

Science.gov (United States)

Yu, Aihong; Carballido-Gamio, Julio; Wang, Ling; Lang, Thomas F; Su, Yongbin; Wu, Xinbao; Wang, Manyi; Wei, Jie; Yi, Chen; Cheng, Xiaoguang

2017-08-01

There is little knowledge about the spatial distribution differences in volumetric bone mineral density and cortical bone structure at the proximal femur between femoral neck fractures and trochanteric fractures. In this case-control study, a total of 93 women with fragility hip fractures, 72 with femoral neck fractures (mean ± SD age: 70.6 ± 12.7 years) and 21 with trochanteric fractures (75.6 ± 9.3 years), and 50 control subjects (63.7 ± 7.0 years) were included for the comparisons. Differences in the spatial distributions of volumetric bone mineral density, cortical bone thickness, cortical volumetric bone mineral density, and volumetric bone mineral density in a layer adjacent to the endosteal surface were investigated using voxel-based morphometry (VBM) and surface-based statistical parametric mapping (SPM). We compared these spatial distributions between controls and both types of fracture, and between the two types of fracture. Using VBM, we found spatially heterogeneous volumetric bone mineral density differences between control subjects and subjects with hip fracture that varied by fracture type. Interestingly, femoral neck fracture subjects, but not subjects with trochanteric fracture, showed significantly lower volumetric bone mineral density in the superior aspect of the femoral neck compared with controls. Using surface-based SPM, we found that compared with controls, both fracture types showed thinner cortices in regions in agreement with the type of fracture. Most outcomes of cortical and endocortical volumetric bone mineral density comparisons were consistent with VBM results. Our results suggest: 1) that the spatial distribution of trabecular volumetric bone mineral density might play a significant role in hip fracture; 2) that focal cortical bone thinning might be more relevant in femoral neck fractures; and 3) that areas of reduced cortical and endocortical volumetric bone mineral density might be more relevant for

The flipped classroom

DEFF Research Database (Denmark)

Triantafyllou, Evangelia

2015-01-01

One of the novel ideas in teaching that heavily relies on current technology is the “flipped classroom” approach. In a flipped classroom the traditional lecture and homework sessions are inverted. Students are provided with online material in order to gain necessary knowledge before class, while...... class time is devoted to clarifications and application of this knowledge. The hypothesis is that there could be deep and creative discussions when teacher and students physically meet. This paper presents design considerations for flipped classrooms, and discusses how Moodle can facilitate...... with a discussion of the opportunities and challenges when implementing the flipped model in a virtual learning environment (VLE) like Moodle....

Flipped Classroom Approach

Directory of Open Access Journals (Sweden)

Fezile Ozdamli

2016-07-01

Full Text Available Flipped classroom is an active, student-centered approach that was formed to increase the quality of period within class. Generally this approach whose applications are done mostly in Physical Sciences, also attracts the attention of educators and researchers in different disciplines recently. Flipped classroom learning which wide-spreads rapidly in the world, is not well recognized in our country. That is why the aim of study is to attract attention to its potential in education field and provide to make it recognize more by educators and researchers. With this aim, in the study what flipped classroom approach is, flipped classroom technology models, its advantages and limitations were explained.

Perioperative lateral trochanteric wall fractures: sliding hip screw versus percutaneous compression plate for intertrochanteric hip fractures.

Science.gov (United States)

Langford, Joshua; Pillai, Gita; Ugliailoro, Anthony D; Yang, Edward

2011-04-01

This study was performed to determine the incidence of perioperative lateral wall fractures with a standard sliding hip screw (SHS) versus a percutaneous compression plate (PCCP) using identical meticulous closed reduction techniques in both groups. Retrospective analysis of a prospective trauma registry. Urban Level I trauma center. Over a 7-year period, 337 patients with intertrochanteric hip fractures were treated with either a SHS or a PCCP at our institution. The PCCP group (Group 1) consisted of 200 patients, of which 141 (71%) had adequate images to be included in the study. The SHS group (Group 2) consisted of 137 patients, of which 100 (73%) had adequate images to be included in the study. Closed reduction and plate application with either a standard sliding hip screw or a percutaneous compression plate for an Orthopaedic Trauma Association 31A1 or 31A2 intertrochanteric hip fracture. : Radiographic evidence of lateral trochanteric wall fracture as measured by intraoperative and perioperative radiographs. There was an overall lateral wall fracture incidence of 20% in the SHS group versus 1.4% in the PCCP group (P fracture types, there was a lateral wall fracture incidence of 29.8% in the SHS group versus 1.9% in the PCCP group (P trochanteric wall fracture compared with the SHS group. This difference became greater when just unstable intertrochanteric fractures were analyzed. An anatomic reduction, combined with a device (PCCP) that uses small-diameter defects in the lateral trochanteric wall, essentially eliminates perioperative lateral trochanteric wall fractures.

Detection of trans–cis flips and peptide-plane flips in protein structures

Energy Technology Data Exchange (ETDEWEB)

Touw, Wouter G., E-mail: wouter.touw@radboudumc.nl [Radboud University Medical Center, Geert Grooteplein-Zuid 26-28, 6525 GA Nijmegen (Netherlands); Joosten, Robbie P. [Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Vriend, Gert, E-mail: wouter.touw@radboudumc.nl [Radboud University Medical Center, Geert Grooteplein-Zuid 26-28, 6525 GA Nijmegen (Netherlands)

2015-07-28

A method is presented to detect peptide bonds that need either a trans–cis flip or a peptide-plane flip. A coordinate-based method is presented to detect peptide bonds that need correction either by a peptide-plane flip or by a trans–cis inversion of the peptide bond. When applied to the whole Protein Data Bank, the method predicts 4617 trans–cis flips and many thousands of hitherto unknown peptide-plane flips. A few examples are highlighted for which a correction of the peptide-plane geometry leads to a correction of the understanding of the structure–function relation. All data, including 1088 manually validated cases, are freely available and the method is available from a web server, a web-service interface and through WHAT-CHECK.

Detection of trans–cis flips and peptide-plane flips in protein structures

International Nuclear Information System (INIS)

Touw, Wouter G.; Joosten, Robbie P.; Vriend, Gert

2015-01-01

A method is presented to detect peptide bonds that need either a trans–cis flip or a peptide-plane flip. A coordinate-based method is presented to detect peptide bonds that need correction either by a peptide-plane flip or by a trans–cis inversion of the peptide bond. When applied to the whole Protein Data Bank, the method predicts 4617 trans–cis flips and many thousands of hitherto unknown peptide-plane flips. A few examples are highlighted for which a correction of the peptide-plane geometry leads to a correction of the understanding of the structure–function relation. All data, including 1088 manually validated cases, are freely available and the method is available from a web server, a web-service interface and through WHAT-CHECK

Differences in monthly variation, cause, and place of injury between femoral neck and trochanteric fractures: 6-year survey (2008-2013) in Kyoto prefecture, Japan.

Science.gov (United States)

Horii, Motoyuki; Fujiwara, Hiroyoshi; Mikami, Yasuo; Ikeda, Takumi; Ueshima, Keiichiro; Ikoma, Kazuya; Shirai, Toshiharu; Nagae, Masateru; Oka, Yoshinobu; Sawada, Koshiro; Kuriyama, Nagato; Kubo, Toshikazu

2016-01-01

The incidence of femoral neck and trochanteric fractures reportedly differ by age and regionality. We investigated differences in monthly variations of the occurrence of femoral neck and trochanteric fractures as well as place and cause of injury in the Kyoto prefecture over a 6-year period. Fracture type (neck or trochanteric fracture), age, sex, place of injury, and cause of injury were surveyed among patients aged ≥ 65 years with hip fractures that occurred between 2008 and 2013 who were treated in 1 of 13 participating hospitals (5 in an urban area and 8 in a rural area). The proportion of sick beds in the participating hospitals was 24.7% (4,151/16,781). Monthly variations in the number of patients were investigated in urban and rural areas in addition to the entire Kyoto prefecture. Place of injury was classified as indoors or outdoors, and cause of injury was categorized as simple fall, accident, or uncertain. There were 2,826 patients with neck fractures (mean age, 82.1 years) and 3,305 patients with trochanteric fractures (mean age, 85.0 years). There were similarities in the monthly variation of the number of fractures in addition to the place and cause of injury between neck and trochanteric fractures. Indoors (approximately 74%) and simple falls (approximately 78%) were the primary place and cause of injury, respectively. The place of injury was not significantly different by fracture type with each age group. Significantly more patients with neck fracture had "uncertain" as the cause of injury than trochanteric fracture in all age groups. Based on the results of the present study, the injury pattern might not have a great effect on the susceptibility difference between neck and trochanteric fractures.

Flip-J: Development of the System for Flipped Jigsaw Supported Language Learning

Science.gov (United States)

Yamada, Masanori; Goda, Yoshiko; Hata, Kojiro; Matsukawa, Hideya; Yasunami, Seisuke

2016-01-01

This study aims to develop and evaluate a language learning system supported by the "flipped jigsaw" technique, called "Flip-J". This system mainly consists of three functions: (1) the creation of a learning material database, (2) allocation of learning materials, and (3) formation of an expert and jigsaw group. Flip-J was…

Flipped Learning

DEFF Research Database (Denmark)

Hachmann, Roland; Holmboe, Peter

arbejde med faglige problemstillinger gennem problembaserede og undersøgende didaktiske designs. Flipped Learning er dermed andet og mere end at distribuere digitale materialer til eleverne forud for undervisning. Flipped Learning er i lige så høj grad et syn på, hvordan undervisning med digitale medier...

[Bilateral pathological sub-trochanteric fracture in a long-term biphosphonate user].

Science.gov (United States)

Kľoc, P; Tomčovčík, L; Kľoc, J

2011-01-01

The number of papers reporting the occurrence of specific pathological fractures in long-term biphosphonate users has recently increased. They refer to the forms of stress fracture probably resulting from an extreme decrease in bone turnover, which may involve sub-trochanteric or isolated transverse fractures, or short transverse fractures with a unicortical beak in an area of cortical hypertrophy. At the time of prodromal signs and symptoms, cortical bone at the site of impeding fracture appears rougher on radiographs. Gradually, an incomplete fracture develops, with a subsequent complete fracture often sustained without any mechanism of injury noted. The occurrence of such fractures is reported in the range of 2 to 8 years from the start of biphosphonate use. The fractures are often bilateral and, at the time the first occurs, it is often possible to diagnose contralateral pathological changes similar to those before the first fracture. The paper presents the case of a female patient who sustained a bilateral pathological sub-trochanteric fracture; the first fracture occurred after 5 and the other after 9 years of Rizendronat use. She was followed up for unilateral incomplete sub-trochanteric fracture from the fourth year of its use. In that period, magnetic resonance imaging showed a pathological finding in the contralateral extremity. She had already had prodromal signs manifested as lasting hip pain before the first fracture. Both fractures were surgically treated. Thirty-three months later she had to undergo repeat surgery for pseudoarthrosis at the site of the first fracture. The pseudoarthrosis healed without complications. However, in the second fracture non-union was still present at 7 months after surgery. The patient took Rizendronat during the whole treatment period and thereafter. In the discussion, certain aspects of long-term biphosphonate use are addressed, as well as some preventive, diagnostic and therapeutic procedures related to this rare

Flipped Classroom Experiences: Student Preferences and Flip Strategy in a Higher Education Context

Science.gov (United States)

McNally, Brenton; Chipperfield, Janine; Dorsett, Pat; Del Fabbro, Letitia; Frommolt, Valda; Goetz, Sandra; Lewohl, Joanne; Molineux, Matthew; Pearson, Andrew; Reddan, Gregory; Roiko, Anne; Rung, Andrea

2017-01-01

Despite the popularity of the flipped classroom, its effectiveness in achieving greater engagement and learning outcomes is currently lacking substantial empirical evidence. This study surveyed 563 undergraduate and postgraduate students (61% female) participating in flipped teaching environments and ten convenors of the flipped courses in which…

How to Flip the Classroom--"Productive Failure or Traditional Flipped Classroom" Pedagogical Design?

Science.gov (United States)

Song, Yanjie; Kapur, Manu

2017-01-01

The paper reports a quasi-experimental study comparing the "traditional flipped classroom" pedagogical design with the "productive failure" (Kapur, 2016) pedagogical design in the flipped classroom for a 2-week curricular unit on polynomials in a Hong Kong Secondary school. Different from the flipped classroom where students…

Differences in monthly variation, cause, and place of injury between femoral neck and trochanteric fractures: 6-year survey (2008–2013) in Kyoto prefecture, Japan

Science.gov (United States)

Horii, Motoyuki; Fujiwara, Hiroyoshi; Mikami, Yasuo; Ikeda, Takumi; Ueshima, Keiichiro; Ikoma, Kazuya; Shirai, Toshiharu; Nagae, Masateru; Oka, Yoshinobu; Sawada, Koshiro; Kuriyama, Nagato; Kubo, Toshikazu

2016-01-01

Summary Background The incidence of femoral neck and trochanteric fractures reportedly differ by age and regionality. We investigated differences in monthly variations of the occurrence of femoral neck and trochanteric fractures as well as place and cause of injury in the Kyoto prefecture over a 6-year period. Methods Fracture type (neck or trochanteric fracture), age, sex, place of injury, and cause of injury were surveyed among patients aged ≥ 65 years with hip fractures that occurred between 2008 and 2013 who were treated in 1 of 13 participating hospitals (5 in an urban area and 8 in a rural area). The proportion of sick beds in the participating hospitals was 24.7% (4,151/16,781). Monthly variations in the number of patients were investigated in urban and rural areas in addition to the entire Kyoto prefecture. Place of injury was classified as indoors or outdoors, and cause of injury was categorized as simple fall, accident, or uncertain. Results There were 2,826 patients with neck fractures (mean age, 82.1 years) and 3,305 patients with trochanteric fractures (mean age, 85.0 years). There were similarities in the monthly variation of the number of fractures in addition to the place and cause of injury between neck and trochanteric fractures. Indoors (approximately 74%) and simple falls (approximately 78%) were the primary place and cause of injury, respectively. The place of injury was not significantly different by fracture type with each age group. Significantly more patients with neck fracture had “uncertain” as the cause of injury than trochanteric fracture in all age groups. Conclusions Based on the results of the present study, the injury pattern might not have a great effect on the susceptibility difference between neck and trochanteric fractures. PMID:27252738

Flipped Learning in the Workplace

Science.gov (United States)

Nederveld, Allison; Berge, Zane L.

2015-01-01

Purpose: The purpose of this paper is to serve as a summary of resources on flipped learning for workplace learning professionals. A recent buzzword in the training world is "flipped". Flipped learning and the flipped classroom are hot topics that have emerged in K-12 education, made their way to the university and are now being noticed…

Flipping Excel

Science.gov (United States)

Frydenberg, Mark

2013-01-01

The "flipped classroom" model has become increasingly popular in recent years as faculty try new ways to engage students in the classroom. In a flipped classroom setting, students review the lecture online prior to the class session and spend time in class working on problems or exercises that would have been traditionally assigned as…

Flipped classroom

DEFF Research Database (Denmark)

Skov, Tobias Kidde; Jørgensen, Søren

2016-01-01

Artiklen beskriver Flipped Classroom som et didaktisk princip, der kan være med til at organisere og tilrettelægge en undervisning, med fokus på forskellige læringsformer. Det handler om at forstå Flipped Classroom som en opdeling i 2 faser og 3 led, som samlet set skaber en didaktisk organisering....

To Flip or Not to Flip? An Exploratory Study Comparing Student Performance in Calculus I

Science.gov (United States)

Schroeder, Larissa B.; McGivney-Burelle, Jean; Xue, Fei

2015-01-01

The purpose of this exploratory, mixed-methods study was to compare student performance in flipped and non-flipped sections of Calculus I. The study also examined students' perceptions of the flipping pedagogy. Students in the flipped courses reported spending, on average, an additional 1-2 hours per week outside of class on course content.…

Injuries of the trochanteric region: can analysis of radiographic indices help in prediction of recurrent osteoporotic hip fractures?

Science.gov (United States)

Pellegrini, Andrea; Tacci, Fabrizio; Leigheb, Massimiliano; Costantino, Cosimo; Pedrazzini, Alessio; Pedrazzi, Giuseppe; Vaienti, Enrico; Ceccarelli, Francesco; Pogliacomi, Francesco

2017-10-18

In a context of bone fragility, primitive and subsequent fractures are a growing problem in the industrialized countries where the mean age of the population is constantly increasing. Among the various factors that favor a fragility fracture, the most important is osteoporosis, a pathology that can be prevented through diagnostic screenings and treated by pharmacological and rehabilitative therapies. The aim of this study is to identify the subjects who are likely to have a higher risk of subsequent fractures of the trochanteric region through a retrospective radiographic evaluation of patients affected by low-energy trochanteric fractures and operated by intramedullary fixation between June 2013 and June 2015, so they can be targeted for prevention interventions. Three hundred and sixty-one patients yet alive were analyzed 2 years after surgery. Fifty-one (group 1), characterized by another contralateral trochanteric femoral fracture, were included. All subjects were retrospectively examined with the analysis of contralateral femur X-ray performed at the time of initial trauma in order to detect a condition of bone fragility and a predisposition to fractures by evaluating three radiographic indices (Singh index, Dorr's classification and Cortical Thickness Index). Patients of group 1 were compared to the other 310 patients (group 2) affected by isolated trochanteric fracture. Group 1 had all radiographic indices worse than group 2. The results observed suggest that orthopedists can use radiographic indices, in particular Cortical Thickness Index, as a valuable, simple and inexpensive screening tool for prevention of recurrent osteoporotic fractures.

Intramedullary nails versus sliding hip screws for AO/OTA 31-A2 trochanteric fractures in adults: A meta-analysis.

Science.gov (United States)

Zhu, Qianzheng; Xu, Xiaodong; Yang, Xi; Chen, Xingzuo; Wang, Liqiang; Liu, Chenggang; Lin, Peng

2017-07-01

The optimum treatment with intramedullary nails (IMN) or sliding hip screws (SHS) for type 31-A2 trochanteric fractures remains controversial. Therefore, we performed a meta-analysis of randomized controlled trials (RCTs) to compare IMN with SHS in AO/OTA 31-A2 trochanteric fractures. Databases including PubMed, Cochrane, and Embase were searched to identify RCTs published before December 2016, which compared IMN with SHS for intraoperative and postoperative outcomes in AO/OTA 31-A2 trochanteric fractures. A total of 909 patients from six RCTs were subjected to the meta-analysis. The results showed that the IMN group was associated with less operative blood loss, leg shortening, wound infections, length of hospital stay, and days to mobilization with walking aids and also yielded a higher Parker score as compared to the SHS group. No significant difference was seen in the other parameters including operative details, fracture fixation complications, postoperative complications, and 1 year mortality. IMN fixation was found to be the superior treatment of choice for 31-A2 trochanteric fractures as compared with SHS fixation in our meta-analysis. The adverse effects appeared comparable between the two groups. However, due to the variations in the included studies, more large-sample, measures-unified, and high-quality RCTs are needed to validate these conclusions. Copyright © 2017. Published by Elsevier Ltd.

Flipping the Graduate Qualitative Research Methods Classroom: Did It Lead to Flipped Learning?

Science.gov (United States)

Earley, Mark

2016-01-01

The flipped, or inverted, classroom has gained popularity in a variety of fields and at a variety of educational levels, from K-12 through higher education. This paper describes the author's positive experience flipping a graduate qualitative research methods classroom. After a review of the current literature on flipped classrooms in higher…

PRIMARY CEMENTED BIPOLAR HEMIARTHROPLASTY WITH TROCHANTERIC AND CALCAR RECONSTRUCTION IN UNSTABLE INTERTROCHANTERIC FRACTURES IN ELDERLY: A PROSPECTIVE STUDY

Directory of Open Access Journals (Sweden)

Pandu Ranga Vital

2015-09-01

Full Text Available INTRODUCTION : To avoid the complications and morbidity associated with attempted Osteosynthesis of the so called Unstable inter - trochanteric fractures in the elderly population, Primary Cemented Bipolar hemiarthroplasty been around for over three decades now. But, hardly any emphasis been given over the technical aspects to i mprove the functional outcome. Present study is one such, following reconstructive attempts ( O f primary cemented bipolar hemiarthroplasty with trochanter and calcar reconstruction in the elderly population to reduce the risk of unstable Hemiarthroplasty. MATERIALS AND METHODS: This prospective study included 20 cases of elderly patients with mean age of 73.5 years (Age range 66 to 82 yr who sustained multifragmentary/communited inter - trochanteric femur fracture treated with Primary cemented bipolar hemiar throplasty with trochanteric and calcar reconstruction to emphasize the importance of restoration soft tissue tension to reduce the risk of unstable Hemiarthroplasty. Essential Technical steps include Figure of eight / multiple wire loop technique of recons truction ( with or without K ‘wires of greater trochanter/ abductor mechanism and calcar reconstruction either by wiring Lesser trochanteric fragment and or insertion of cortical piece of bone graft (medially under the collar of the prosthesis harvested f rom head and neck fragment. The patients were followed up at six week, three month, six month and one year postoperatively and assessed using Harris Hip Score (HHS. RESULTS: The mean HHS score was 85 (range 69 to 91 at the end of one year. The main clini cal measures were early post - operative full weight bearing, post - operative complication & functional outcome. The time to full weight bearing, the rate of post - operative complications & functional outcome was significantly better in cemented bipolar arthro plasty group. CONCLUSION: The authors strongly believe that primary cemented bipolar

Treatment of recent trochanteric fracture in adults.

Science.gov (United States)

Adam, P

2014-02-01

Recent trochanteric fracture is frequent in adults, and mainly affects elderly patients who risk loss of independence. Treatment is surgical, of various sorts. Open reduction internal fixation (ORIF) with intra- or extra-medullary implants is the most frequent attitude in these fractures, which usually heal easily. In elderly patients, arthroplasty is an alternative of choice for some authors. These different treatment modalities are presented, focusing on technical details. Possible technical difficulties and the means of dealing with them are considered. Published results help in choosing the treatment most suitable for a particular type of fracture in a particular patient. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Flipping qubits

International Nuclear Information System (INIS)

Martini De, F.; Sciarrino, F.; Sias, C.; Buzek, V.

2003-01-01

On a classical level the information can be represented by bits, each of which can be either 0 or 1. Quantum information, on the other hand, consists of qubits which can be represented as two-level quantum systems with one level labeled |0> and the other |1>. Unlike bits, qubits cannot only be in one of the two levels, but in any superposition of them as well. This superposition principle makes quantum information fundamentally different from its classical counterpart. One of the most striking difference between the classical and quantum information is as follows: it is not a problem to flip a classical bit, i.e., to change the value of a bit, a 0 to a 1 and vice versa. This is accomplished by a NOT gate. Flipping a qubit, however, is another matter: there exists the fundamental bound which prohibits to flip a qubit prepared in an arbitrary state |Ψ>=α|0> and to obtain the state |Ψ T >=β*|0>-α*|1> which is orthogonal to it, i.e., T |Ψ>=0. We experimentally realize the best possible approximation of the qubit flipping that achieves bounds imposed by complete positivity of quantum mechanics

Advanced flip chip packaging

CERN Document Server

Lai, Yi-Shao; Wong, CP

2013-01-01

Advanced Flip Chip Packaging presents past, present and future advances and trends in areas such as substrate technology, material development, and assembly processes. Flip chip packaging is now in widespread use in computing, communications, consumer and automotive electronics, and the demand for flip chip technology is continuing to grow in order to meet the need for products that offer better performance, are smaller, and are environmentally sustainable. This book also: Offers broad-ranging chapters with a focus on IC-package-system integration Provides viewpoints from leading industry executives and experts Details state-of-the-art achievements in process technologies and scientific research Presents a clear development history and touches on trends in the industry while also discussing up-to-date technology information Advanced Flip Chip Packaging is an ideal book for engineers, researchers, and graduate students interested in the field of flip chip packaging.

Flip Video for Dummies

CERN Document Server

Hutsko, Joe

2010-01-01

The full-color guide to shooting great video with the Flip Video camera. The inexpensive Flip Video camera is currently one of the hottest must-have gadgets. It's portable and connects easily to any computer to transfer video you shoot onto your PC or Mac. Although the Flip Video camera comes with a quick-start guide, it lacks a how-to manual, and this full-color book fills that void! Packed with full-color screen shots throughout, Flip Video For Dummies shows you how to shoot the best possible footage in a variety of situations. You'll learn how to transfer video to your computer and then edi

Calcar femorale grafting in the hemiarthroplasty of the hip for unstable inter trochanteric fractures.

Science.gov (United States)

Thakkar, Chandrashekar J; Thakkar, Savyasachi; Kathalgere, Rajshekhar T; Kumar, Malhar N

2015-01-01

The sliding screw-plate devices and cephalo-medullary nail devices have performed well in stable inter-trochanteric fractures in patients with reasonably good quality of bone. However, their suboptimal performance in comminuted fractures in the presence of osteoporotic bone has prompted many surgeons to consider bipolar hemiarthroplasty as the primary modality of management of comminuted inter-trochanteric fractures in elderly patients. However, long term stability of the hemiarthroplasty implant also may be compromised due to the presence of postero-medial bone loss at the area of the calcar. We have presented a simple and effective technique of calcar grafting by harvesting cortical bone strut from the neck of the fractured femur. A total of 34 patients with inter-trochanteric fractures of the femur were treated with calcar grafting. The mean age was 79.2 years. The graft was harvested from the calcar region of the head and neck fragment of the femur and wedged between the medial femoral cortex and medial edge of the prosthesis. The mean followup period was 54.5 months. In 32 of 34 (94%) patients in our series, the calcar graft healed well without dislodgement. There was graft resorption in two patients associated with subsidence of the implant and loosening. Calcar grafting using this technique provides stability to the implant in the presence of comminution and incorporates well in the majority of patients. Donor site morbidity of graft harvesting is also avoided.

To Flip or Not to Flip? Analysis of a Flipped Classroom Pedagogy in a General Biology Course

Science.gov (United States)

Heyborne, William H.; Perrett, Jamis J.

2016-01-01

In an attempt to better understand the flipped technique and evaluate its purported superiority in terms of student learning gains, the authors conducted an experiment comparing a flipped classroom to a traditional lecture classroom. Although the outcomes were mixed, regarding the superiority of either pedagogical approach, there does seem to be a…

Comparing the Effectiveness of Blended, Semi-Flipped, and Flipped Formats in an Engineering Numerical Methods Course

Science.gov (United States)

Clark, Renee M.; Kaw, Autar; Besterfield-Sacre, Mary

2016-01-01

Blended, flipped, and semi-flipped instructional approaches were used in various sections of a numerical methods course for undergraduate mechanical engineers. During the spring of 2014, a blended approach was used; in the summer of 2014, a combination of blended and flipped instruction was used to deliver a semi-flipped course; and in the fall of…

Use of tranexamic acid in dynamic hip screw plate fixation for trochanteric fractures.

Science.gov (United States)

Baruah, Ranjit Kumar; Borah, Pranab Jyoti; Haque, Russel

2016-12-01

To evaluate perioperative blood loss and blood transfusion requirement in patients who underwent dynamic hip screw plate fixation for a stable trochanteric fracture with or without preoperative intravenous tranexamic acid (TXA). 49 men and 11 women (mean age, 56.5 years) who underwent open reduction and internal fixation with a dynamic hip screw plate for a stable trochanteric fracture by a single surgeon were equally randomised to receive either a single dose of intravenous TXA (15 mg/kg) 15 minutes prior to surgery or an equal volume of normal saline by slow infusion. Intra- and post-operative blood loss and the need for blood transfusion were assessed, as was any thromboembolic adverse event. The TXA and control groups were comparable in terms of age, gender, body mass index, blood pressure, pulse rate, time from injury to surgery, operating time, and preoperative haematological data. Blood loss was lower in the TXA than control group intraoperatively (320.3 vs. 403.33 ml, ptrochanteric fractures.

Treatment options for unstable trochanteric fractures: Screw or helical proxima femoral nail.

Science.gov (United States)

Bajpai, Jeetendra; Maheshwari, Rajesh; Bajpai, Akansha; Saini, Sumit

2015-01-01

To compare treatment outcome of screw proximal femoral nail (PFN) system with that of a helical PFN. The study included 77 patients with closed unstable intertrochanteric fracture classified as AO 31A2&31A3, between June 2008 to August 2011. Inclusion criteria were: all mature skeletons above 50 years of age; closed unstable trochanteric fracture classified as AO 31A2&A3. Exclusion criteria were: immature skeleton, pathological fracture of any cause other than osteoporosis, inability to walk inde- pendently prior to injury. Patients were randomized to 2 treatment groups based on admission sequence. Forty patients were treated with screw PFN and thirty seven were treated with helical PFN. Both groups were similar in respect of time of surgery, blood loss and functional assessment and duration of hospitalization. In screw PFN group 2 patients had superficial wound infection, 1 patient had persistent hip pain and 1 patient had shortening>1 cm buttrochanteric fractures even in Indian patients where the bones are narrow and neck diameter is small. It is an implant of choice for osteoporotic and unstable trochanteric fractures.

Flipped Classroom Approach

Science.gov (United States)

Ozdamli, Fezile; Asiksoy, Gulsum

2016-01-01

Flipped classroom is an active, student-centered approach that was formed to increase the quality of period within class. Generally this approach whose applications are done mostly in Physical Sciences, also attracts the attention of educators and researchers in different disciplines recently. Flipped classroom learning which wide-spreads rapidly…

Case report: AVN of the femoral head five year follow-up of the combination of ipsilateral femoral neck and sub-trochanteric fracture.

Science.gov (United States)

Zhang, Wei; Zhu, Feng; Dong, Hanqing; Xu, Yaozeng

2016-04-01

To our knowledge, the type of combination of ipsilateral femoral neck and sub-trochanteric fracture is rare. And the long term follow-up is seldom been reported. A 60 year old woman suffered from a traffic accident. We gave her the intramedullary nail treatment for the combination of ipsilateral femoral neck and sub-trochanteric fracture, and the fracture indeed cured after one year and there is no clue of necrosis of the femoral head, but after 5 years, there is an evidence of necrosis of the femoral head. Combination of ipsilateral femoral neck and sub-trochanteric fracture should be kept in mind. Patients with this unusual fracture should be kept under surveillance for longer than might be thought currently to be necessary for there is a possibility of necrosis of the femoral head, even a nondisplaced femoral neck fracture.

Flipping Freshman Mathematics

Science.gov (United States)

Zack, Laurie; Fuselier, Jenny; Graham-Squire, Adam; Lamb, Ron; O'Hara, Karen

2015-01-01

Our study compared a flipped class with a standard lecture class in four introductory courses: finite mathematics, precalculus, business calculus, and calculus 1. The flipped sections watched video lectures outside of class and spent time in class actively working on problems. The traditional sections had lectures in class and did homework outside…

Comparison in bone turnover markers during early healing of femoral neck fracture and trochanteric fracture in elderly patients

Directory of Open Access Journals (Sweden)

Shota Ikegami

2009-10-01

Full Text Available Healing of fractures is different for each bone and bone turnover markers may reflect the fracture healing process. The purpose of this study was to determine the characteristic changes in bone turnover markers during the fracture healing process. The subjects were consecutive patients with femoral neck or trochanteric fracture who underwent surgery and achieved bone union. There were a total of 39 patients, including 33 women and 6 men. There were 18 patients (16 women and 2 men with femoral neck fracture and 21 patients (17 women and 4 men with trochanteric fracture. Serum bone-specific alkaline phosphatase (BAP was measured as a bone formation marker. Urine and serum levels of N-terminal telopeptide of type I collagen (NTX, as well as urine levels of C-terminal telopeptide of type I collagen (CTX and deoxypyridinoline (DPD, were measured as markers of bone resorption. All bone turnover markers showed similar changes in patients with either type of fracture, but significantly higher levels of both bone formation and resorption markers were observed in trochanteric fracture patients than in neck fracture patients. BAP showed similar levels at one week after surgery and then increased. Bone resorption markers were increased after surgery in patients with either fracture. The markers reached their peak values at three weeks (BAP and urinary NTX, five weeks (serum NTX and DPD, and 2-3 weeks (CTX after surgery. The increase in bone turnover markers after hip fracture surgery and the subsequent decrease may reflect increased bone formation and remodeling during the healing process. Both fractures had a similar bone turnover marker profile, but the extent of the changes differed between femoral neck and trochanteric fractures.

Comparison in bone turnover markers during early healing of femoral neck fracture and trochanteric fracture in elderly patients.

Science.gov (United States)

Ikegami, Shota; Kamimura, Mikio; Nakagawa, Hiroyuki; Takahara, Kenji; Hashidate, Hiroyuki; Uchiyama, Shigeharu; Kato, Hiroyuki

2009-10-10

Healing of fractures is different for each bone and bone turnover markers may reflect the fracture healing process. The purpose of this study was to determine the characteristic changes in bone turnover markers during the fracture healing process. The subjects were consecutive patients with femoral neck or trochanteric fracture who underwent surgery and achieved bone union. There were a total of 39 patients, including 33 women and 6 men. There were 18 patients (16 women and 2 men) with femoral neck fracture and 21 patients (17 women and 4 men) with trochanteric fracture. Serum bone-specific alkaline phosphatase (BAP) was measured as a bone formation marker. Urine and serum levels of N-terminal telopeptide of type I collagen (NTX), as well as urine levels of C-terminal telopeptide of type I collagen (CTX) and deoxypyridinoline (DPD), were measured as markers of bone resorption. All bone turnover markers showed similar changes in patients with either type of fracture, but significantly higher levels of both bone formation and resorption markers were observed in trochanteric fracture patients than in neck fracture patients. BAP showed similar levels at one week after surgery and then increased. Bone resorption markers were increased after surgery in patients with either fracture. The markers reached their peak values at three weeks (BAP and urinary NTX), five weeks (serum NTX and DPD), and 2-3 weeks (CTX) after surgery. The increase in bone turnover markers after hip fracture surgery and the subsequent decrease may reflect increased bone formation and remodeling during the healing process. Both fractures had a similar bone turnover marker profile, but the extent of the changes differed between femoral neck and trochanteric fractures.

Flipping Radiology Education Right Side Up.

Science.gov (United States)

O'Connor, Erin E; Fried, Jessica; McNulty, Nancy; Shah, Pallav; Hogg, Jeffery P; Lewis, Petra; Zeffiro, Thomas; Agarwal, Vikas; Reddy, Sravanthi

2016-07-01

In flipped learning, medical students independently learn facts and concepts outside the classroom, and then participate in interactive classes to learn to apply these facts. Although there are recent calls for medical education reform using flipped learning, little has been published on its effectiveness. Our study compares the effects of flipped learning to traditional didactic instruction on students' academic achievement, task value, and achievement emotions. At three institutions, we alternated flipped learning with traditional didactic lectures during radiology clerkships, with 175 medical students completing a pretest on general diagnostic imaging knowledge to assess baseline cohort comparability. Following instruction, posttests and survey examinations of task value and achievement emotions were administered. Linear mixed effects analysis was used to examine the relationship between test scores and instruction type. Survey responses were modeled using ordinal category logistic regression. Instructor surveys were also collected. There were no baseline differences in test scores. Mean posttest minus pretest scores were 10.5% higher in the flipped learning group than in the didactic instruction group (P = 0.013). Assessment of task value and achievement emotions showed greater task value, increased enjoyment, and decreased boredom with flipped learning (all P flipped learning condition. Flipped learning was associated with increased academic achievement, greater task value, and more positive achievement emotions when compared to traditional didactic instruction. Further investigation of flipped learning methods in radiology education is needed to determine whether flipped learning improves long-term retention of knowledge, academic success, and patient care. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

A Prospective Study to Evaluate the Management of Sub-trochanteric Femur Fractures with Long Proximal Femoral Nail.

Science.gov (United States)

Kumar, M; Akshat, V; Kanwariya, A; Gandhi, M

2017-11-01

Introduction: Sub-trochanteric fractures of the femur remains one of the most challenging fractures faced by orthopaedic surgeons. This study was done to analyse the management and complications of sub-trochanteric fractures using long proximal femoral nail (PFN). Materials and Methods: This was a prospective study of 50 patients with sub-trochanteric fractures of femur who were treated with long PFN at a tertiary care center from July 2012 to June 2016. The fractures were classified according to Seinsheimer classification. All patients were assessed functionally by Harris Hip Score. Results: Average duration of union was 17.08 weeks (range 13 to 32 weeks), union was achieved in 92% cases. Closed reduction was achieved in 68% cases and open reduction was required in 32% cases. Various intraoperative complications were seen in 12% and delayed complications in 26% of cases. Good anatomical results were achieved in 86% of cases and 14% were fair. As per Harris Hip score, excellent results were noted in 28% cases, good in 56% cases and fair in 16% cases. Conclusion: The long PFN is a reliable implant for subtrochanteric femur fractures, with high rate of bone union and minimal soft tissue damage. Intramedullary fixation has biological and biomechanical advantages, but the surgery is technically demanding.

Spin flipping a stored polarized proton beam

International Nuclear Information System (INIS)

Caussyn, D.D.; Derbenev, Y.S.; Ellison, T.J.P.; Lee, S.Y.; Rinckel, T.; Schwandt, P.; Sperisen, F.; Stephenson, E.J.; von Przewoski, B.; Blinov, B.B.; Chu, C.M.; Courant, E.D.; Crandell, D.A.; Kaufman, W.A.; Krisch, A.D.; Nurushev, T.S.; Phelps, R.A.; Ratner, L.G.; Wong, V.K.; Ohmori, C.

1994-01-01

We recently studied the spin flipping of a vertically polarized, stored 139-MeV proton beam. To flip the spin, we induced an rf depolarizing resonance by sweeping our rf solenoid magnet's frequency through the resonance frequency. With multiple spin flips, we found a polarization loss of 0.0000±0.0005 per spin flip under the best conditions; this loss increased significantly for small changes in the conditions. Minimizing the depolarization during each spin flip is especially important because frequent spin flipping could significantly reduce the systematic errors in stored polarized-beam experiments

The evidence for 'flipping out': A systematic review of the flipped classroom in nursing education.

Science.gov (United States)

Betihavas, Vasiliki; Bridgman, Heather; Kornhaber, Rachel; Cross, Merylin

2016-03-01

The flipped classroom has generated interest in higher education providing a student-centred approach to learning. This has the potential to engage nursing students in ways that address the needs of today's students and the complexity of contemporary healthcare. Calls for educational reform, particularly in healthcare programs such as nursing, highlight the need for students to problem-solve, reason and apply theory into practice. The drivers towards student-based learning have manifested in team, problem and case-based learning models. Though there has been a shift towards the flipped classroom, comparatively little is known about how it is used in nursing curricula. The aims of this systematic review were to examine how the flipped classroom has been applied in nursing education and outcomes associated with this style of teaching. Five databases were searched and resulted in the retrieval of 21 papers: PubMed, CINAHL, EMBASE, Scopus and ERIC. After screening for inclusion/exclusion criteria, each paper was evaluated using a critical appraisal tool. Data extraction and analysis were completed on all included studies. This systematic review screened 21 titles and abstracts resulting in nine included studies. All authors critically appraised the quality of the included studies. Five studies were identified and themes identified were: academic performance outcomes, and student satisfaction implementing the flipped classroom. Use of the flipped classroom in higher education nursing programmes yielded neutral or positive academic outcomes and mixed results for satisfaction. Engagement of students in the flipped classroom model was achieved when academics informed and rationalised the purpose of the flipped classroom model to students. However, no studies in this review identified the evaluation of the process of implementing the flipped classroom. Studies examining the process and ongoing evaluation and refinement of the flipped classroom in higher education nursing

The Partially Flipped Classroom: The Effects of Flipping a Module on "Junk Science" in a Large Methods Course

Science.gov (United States)

Burgoyne, Stephanie; Eaton, Judy

2018-01-01

Flipped classrooms are gaining popularity, especially in psychology statistics courses. However, not all courses lend themselves to a fully flipped design, and some instructors might not want to commit to flipping every class. We tested the effectiveness of flipping just one component (a module on junk science) of a large methods course. We…

[Posterior partial trochanteric osteotomy for the treatment of the roof involved acetabular fractures].

Science.gov (United States)

Wang, Pan-Feng; Xu, Shuo-Gui; Zhang, Chun-Cai; Fu, Qing-Ge; Zhang, Yun-Tong; Liu, Xin-Wei; Niu, Yun-Fei; Tang, Yang

2013-11-01

To introduce a new trochanteric osteotomy,and evaluate the outcome of the procedure combined a posterior lateral approach in treating acetabular fractures which involving the roof. Between March 2007 and Novmber 2010,30 patients with displaced acetabular fractures involving the dome need trochanteric osteotomy were retrospectively reviewed. There were 21 males and 9 females,ranging in age from 18 to 70 years with an average of 35.2 years at the time of injury. According to Letournel-Judet classification, there were 10 posterior wall fractures,7 posterior column fractures,5 transverse fractures, 2 T-shape fractures, 1 transverse associated with posterior wall fracture, 3 posterior column and wall fractures and 2 bicolumn fractures. The standards of Matta,the modified Merle d'Aubigne-Postel, Medical Research Council were respectively used to evaluate the reduction result, function of hip joint and the strength of hip abduction. All patients were followed up with an average time of 25 months (18 to 40) and all osteotomy sites obtained bone union with an average time of 8.4 weeks (6 to 12). No bone non-union, bone block displaceing, internal fixation looseing and breaking,infection of deep part were found. Seventeen patients got anatomic reduction, 12 got satisfied reduction, and 1 got unsatisfied result according to the criteria of Matta. At final follow-up, function of hip joint obtained excellent results in 11 cases, good in 15, fair in 3 and poor in 1. The strength of the abductors of 3 patients were grade 4 and 27 patients were grade 5. Posterior partial great trochanteric osteotomy can enhance the exposure and provide a more accurate reduction and degrade the difficulty of acetabular fracture fixation without increasing the risk of complications. The method provide a new way for the treatment of the roof involved acetabular fractures.

Breakage of cephalomedullary nailing in operative treatment of trochanteric and subtrochanteric femoral fractures.

Science.gov (United States)

von Rüden, Christian; Hungerer, Sven; Augat, Peter; Trapp, Oliver; Bühren, Volker; Hierholzer, Christian

2015-02-01

Mechanical breakage of cephalomedullary nail osteosynthesis is a rare complication attributed to delayed fracture union or nonunion. This study presents a series of cases of breakage and secondary lag screw dislocation after cephalomedullary nailing. The aim of this study was to identify factors that contribute to cephalomedullary nail breakage. In a retrospective case series review between 02/2005 and 12/2013, we analyzed 453 patients with trochanteric and subtrochanteric fracture who had been treated by cephalomedullary nailing. Fractures were classified according to AO/OTA classification. 13 patients with cephalomedullary nail breakage were included (failure rate 2.9 %). Seven patients were women, and six men with a mean age of 72 years (range 35-94). Implant breakage occurred 6 months postoperatively (range 1-19 months). In ten cases, breakage was secondary to delayed or nonunion, which was thought to be mainly due to insufficient reduction of the fracture, and in two cases due to loss of the lag screw because of missing set screw. In one case, breakage was apparent during elective metal removal following complete fracture healing. Short-term outcome was evaluated 6 months after operative revision using Harris hip score in 11 out of 13 patients showing a mean score of 84 %. Complete radiological fracture healing has been found in 11 patients available for follow-up within 6 months after revision surgery. Breakage of cephalomedullary nail osteosynthesis of trochanteric fractures is a severe complication. The results of our study demonstrate that revision surgery provides good clinical and radiological short-term results. Predominately, failures of trochanteric fractures are related to lack of surgeon performance. Therefore, application of the implant requires accurate preoperative planning, advanced surgical experience to evaluate the patient and the fracture classification, and precise surgical technique including attention to detail and anatomical

[Application of the anatomic plate and trapezoid plate in comminuted intertrochanteric fracture combined with trochanteric coronal position fracture: a controlled clinical trial].

Science.gov (United States)

Zhen, Ping; Liu, Xing-Yan; Gao, Ming-Xuan; Tian, Qi

2010-05-01

To investigate the therapeutic effect and operative characteristic of the anatomic plate and trapezoid plate for treament of the comminuted intertrochanteric fracture combined with trochanteric coronal position fracture. From Jan. 1998 to Mar. 2007, 57 patients suffered from comminuted intertrochanteric fracture combined with trochanteric coronal position fracture were randomly divided into two groups, 21 patients in trapezoid plate group were treated with the trapezoid compression plate, included 11 males and 10 females with an average age of 41.8 years; and 36 patients in anatomic plate group were treated with the anatomic plate, included 17 males and 19 females with an average age of 42.1 years. All of the 57 fractures were A3 type according to AO classification. The functions of hip joints were evaluated according to the Harris hip functional standard score. All 57 patients were followed-up for 5 months to 9 years and 3 months with an average of 4.8 years. The healing time of the fractures was from 8 to 20 weeks with an average of 12.8 weeks. The results of Harris scoring showed the pain scores of the anatomic plate group were higher than that of the trapezoid plate group (P 0.05). In unstable comminuted intertrochanteric fracture combined with trochanteric coronal position fracture, the lateral wall of trochanteric is often destroyed. The anatomic plate and the trapeziod compression plate can provide effective internal fixation, while many othere internal fixation methods were limited in this kind of fracture. As compared with the anatomic plate fixation, the trapezoid compression plate fixation of comminuted intertrochanteric fracture combined with trochanteric coronal position fracture have several advantages, such as fewer complications, faster union of fracture and earlier recovery of joint functions.

Confchem Conference on Flipped Classroom: Student Engagement with Flipped Chemistry Lectures

Science.gov (United States)

Seery, Michael K.

2015-01-01

This project introduces the idea of "flipped lecturing" to a group of second-year undergraduate students. The aim of flipped lecturing is to provide much of the "content delivery" of the lecture in advance, so that the lecture hour can be devoted to more in-depth discussion, problem solving, and so on. As well as development of…

Dealing with sub-trochanteric fracture in a child with osteopetrosis : A case report.

Science.gov (United States)

Behera, P; Khurana, A; Saibaba, B; Aggarwal, S

2016-12-01

Osteopetrosis is a rare hereditary condition which may have autosomal recessive or autosomal dominant inheritance. Patients tend to present most commonly with fractures but involvement of cranial nerves and hematopoetic system is not uncommon. Patients with infantile and intermediate type tend to present more often with problems other than orthopaedic problems. While diagnosis can be made on the basis of radiographs, management needs to be customized for every patient. Non operative and operative management both have their advantages and disadvantages. We are here reporting a case of sub-trochanteric fracture in an eight-year-old child which was managed successfully with a dynamic hip screw (DHS). Surgery could be performed successfully by taking precautions during reduction, drilling and screw placement. At the latest follow up, which was after one and half years of surgery, the fracture had united well and the child faced no limitations of activities. Thus, open reduction and fixation with DHS can be considered as an effective management modality for pediatric sub-trochanteric fractures in osteopetrosis.

Uncertainty in T1 mapping using the variable flip angle method with two flip angles

International Nuclear Information System (INIS)

Schabel, Matthias C; Morrell, Glen R

2009-01-01

Propagation of errors, in conjunction with the theoretical signal equation for spoiled gradient echo pulse sequences, is used to derive a theoretical expression for uncertainty in quantitative variable flip angle T 1 mapping using two flip angles. This expression is then minimized to derive a rigorous expression for optimal flip angles that elucidates a commonly used empirical result. The theoretical expressions for uncertainty and optimal flip angles are combined to derive a lower bound on the achievable uncertainty for a given set of pulse sequence parameters and signal-to-noise ratio (SNR). These results provide a means of quantitatively determining the effect of changing acquisition parameters on T 1 uncertainty. (note)

Detection of trans-cis flips and peptide-plane flips in protein structures

NARCIS (Netherlands)

Touw, W.G.; Joosten, R.P.; Vriend, G.

2015-01-01

A coordinate-based method is presented to detect peptide bonds that need correction either by a peptide-plane flip or by a trans-cis inversion of the peptide bond. When applied to the whole Protein Data Bank, the method predicts 4617 trans-cis flips and many thousands of hitherto unknown

Vibration characteristics of an inclined flip-flow screen panel in banana flip-flow screens

Science.gov (United States)

Xiong, Xiaoyan; Niu, Linkai; Gu, Chengxiang; Wang, Yinhua

2017-12-01

A banana flip-flow screen is an effective solution for the screening of high-viscosity, high-water and fine materials. As one of the key components, the vibration characteristics of the inclined flip-flow screen panel largely affects the screen performance and the processing capacity. In this paper, a mathematical model for the vibration characteristic of the inclined flip-flow screen panel is proposed based on Catenary theory. The reasonability of Catenary theory in analyzing the vibration characteristic of flip-flow screen panels is verified by a published experiment. Moreover, the effects of the rotation speed of exciters, the incline angle, the slack length and the characteristics of the screen on the vertical deflection, the vertical velocity and the vertical acceleration of the screen panel are investigated parametrically. The results show that the rotation speed of exciters, the incline angle, the slack length and the characteristics of the screen have significant effects on the vibrations of an inclined flip-flow screen panel, and these parameters should be optimized.

The Flipped Journal Club.

Science.gov (United States)

Bounds, Richard; Boone, Stephen

2018-01-01

Educators struggle to develop a journal club format that promotes active participation from all levels of trainees. The explosion of social media compels residencies to incorporate the evaluation and application of these resources into evidence-based practice. We sought to design an innovative "flipped journal club" to achieve greater effectiveness in meeting goals and objectives among residents and faculty. Each journal club is focused on a specific clinical question based on a landmark article, a background article, and a podcast or blog post. With the "flipped" model, residents are assigned to prepare an in-depth discussion of one of these works based on their level of training. At journal club, trainees break into small groups and discuss their assigned readings with faculty facilitation. Following the small-group discussions, all participants convene to summarize key points. In redesigning our journal club, we sought to achieve specific educational outcomes, and improve participant engagement and overall impressions. Sixty-one residents at our emergency medicine program participated in the flipped journal club during the 2015-2016 academic year, with supervision by core faculty. Program evaluation for the flipped journal club was performed using an anonymous survey, with response rates of 70% and 56% for residents and faculty, respectively. Overall, 95% of resident respondents and 100% of faculty respondents preferred the flipped format. The "flipped journal club" hinges upon well-selected articles, incorporation of social media, and small-group discussions. This format engages all residents, holds learners accountable, and encourages greater participation among residents and faculty.

Comparison of femoral morphology and bone mineral density between femoral neck fractures and trochanteric fractures.

Science.gov (United States)

Maeda, Yuki; Sugano, Nobuhiko; Saito, Masanobu; Yonenobu, Kazuo

2011-03-01

Many studies that analyzed bone mineral density (BMD) and skeletal factors of hip fractures were based on uncalibrated radiographs or dual-energy xray absorptiometry (DXA). Spatial accuracy in measuring BMD and morphologic features of the femur with DXA is limited. This study investigated differences in BMD and morphologic features of the femur between two types of hip fractures using quantitative computed tomography (QCT). Forty patients with hip fractures with normal contralateral hips were selected for this study between 2003 and 2007 (trochanteric fracture, n=18; femoral neck fracture, n=22). Each patient underwent QCT of the bilateral femora using a calibration phantom. Using images of the intact contralateral femur, BMD measurements were made at the point of minimum femoral-neck cross-sectional area, middle of the intertrochanteric region, and center of the femoral head. QCT images also were used to measure morphologic features of the hip, including hip axis length, femoral neck axis length, neck-shaft angle, neck width, head offset, anteversion of the femoral neck, and cortical index at the femoral isthmus. No significant differences were found in trabecular BMD between groups in those three regions. Patients with trochanteric fractures showed a smaller neck shaft angle and smaller cortical index at the femoral canal isthmus compared with patients with femoral neck fractures. We conclude that severe osteoporosis with thinner cortical bone of the femoral diaphysis is seen more often in patients with trochanteric fracture than in patients with femoral neck fracture. Level IV, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

The Flipped Classroom in Counselor Education

Science.gov (United States)

Moran, Kristen; Milsom, Amy

2015-01-01

The flipped classroom is proposed as an effective instructional approach in counselor education. An overview of the flipped-classroom approach, including advantages and disadvantages, is provided. A case example illustrates how the flipped classroom can be applied in counselor education. Recommendations for implementing or researching flipped…

How evolution of the nailing system improves results and reduces orthopedic complications: more than 2000 cases of trochanteric fractures treated with the Gamma Nail System.

Science.gov (United States)

Pascarella, R; Fantasia, R; Maresca, A; Bettuzzi, C; Amendola, L; Violini, S; Cuoghi, F; Sangiovanni, P; Cerbasi, S; Boriani, S; Tigani, D S

2016-04-01

The incidence of trochanteric fractures has increased significantly during the last few decades, especially in elderly patients with osteoporosis. The dynamic/sliding hip screw and the cephalomedullary nail are the most commonly used fixation methods to treat trochanteric fractures. The improvements in the Gamma Nail System (GNS) associated with a correct surgical technique reduced the postoperative orthopedic complications. The purpose of this study was to compare the results of the different Gamma Nails. The present study is a retrospective analysis of 2144 patients treated with GNS between January 1997 and December 2011 for trochanteric fractures, classified according to AO classification method. The patients were divided into three groups according to the nailing system: 525 were treated with Standard Gamma Nail (SGN), 422 with Trochanteric Gamma Nail (TGN) and 1197 with Gamma3 Nail. The overall incidence of intra-operative complications was 1.21 %; the incidence of intra-operative complications for each group was 1.71 % for SGN group, 0.47 % for TGN group and 1.25 % for Gamma3 Nail group. The overall incidence of postoperative complications was 5.48 %, and the incidence for each group was 10.73 % for SGN group, 9.92 % for TGN group and 2.92 % for Gamma3 Nail group. The GNS is a safe device with a low rate of intra-operative complications. The evolution of this nail system reduces postoperative complications, thus improving the results at follow-up and confirming that the Gamma3 Nail is a safe and predictable device to fix trochanteric fracture.

Flipped Classroom, active Learning?

DEFF Research Database (Denmark)

Andersen, Thomas Dyreborg; Levinsen, Henrik; Philipps, Morten

2015-01-01

Action research is conducted in three physics classes over a period of eighteen weeks with the aim of studying the effect of flipped classroom on the pupils agency and learning processes. The hypothesis is that flipped classroom teaching will potentially allocate more time to work actively...

Treatment of unstable trochanteric fractures. Randomised comparison of the gamma nail and the proximal femoral nail.

NARCIS (Netherlands)

Schipper, I.B.; Steyerberg, E.W.; Castelein, R.M.; Heijden, F.H. van der; Hoed, P.T. den; Kerver, A.J.; Vugt, A.B. van

2004-01-01

The proximal femoral nail (PFN) is a recently introduced intramedullary system, designed to improve treatment of unstable trochanteric fractures of the hip. In a multicentre prospective clinical study, the intra-operative use, complications and outcome of treatment using the PFN (n = 211) were

Flipped Classroom Approach

OpenAIRE

Fezile Ozdamli; Gulsum Asiksoy

2016-01-01

Flipped classroom is an active, student-centered approach that was formed to increase the quality of period within class. Generally this approach whose applications are done mostly in Physical Sciences, also attracts the attention of educators and researchers in different disciplines recently. Flipped classroom learning which wide-spreads rapidly in the world, is not well recognized in our country. That is why the aim of study is to attract attention to its potential in education field and pr...

[Trochanteric femoral fractures].

Science.gov (United States)

Douša, P; Čech, O; Weissinger, M; Džupa, V

2013-01-01

At the present time proximal femoral fractures account for 30% of all fractures referred to hospitals for treatment. Our population is ageing, the proportion of patients with post-menopausal or senile osteoporosis is increasing and therefore the number of proximal femoral fractures requiring urgent treatment is growing too. In the age category of 50 years and older, the incidence of these fractures has increased exponentially. Our department serves as a trauma centre for half of Prague and part of the Central Bohemia Region with a population of 1 150 000. Prague in particular has a high number of elderly citizens. Our experience is based on extensive clinical data obtained from the Register of Proximal Femoral Fractures established in 1997. During 14 years, 4280 patients, 3112 women and 1168 men, were admitted to our department for treatment of proximal femoral fractures. All patients were followed up until healing or development of complications. In the group under study, 82% were patients older than 70 years; 72% of those requiring surgery were in their seventies and eighties. Men were significantly younger than women (pfractures were 2.3-times more frequent in women than in men. In the category under 60 years, men significantly outnumbered women (pfractures were, on the average, eight years older than the patients with intertrochanteric fractures, which is a significant difference (pTrochanteric fractures accounted for 54.7% and femoral neck fractures for 45.3% of all fractures. The inter-annual increase was 5.9%, with more trochanteric than femoral neck fractures. There was a non-significant decrease in intertrochanteric (AO 31-A3) fractures. On the other hand, the number of pertrochanteric (AO 31-A1+2) fractures increased significantly (pfractures were treated with a proximal femoral nail; a short nail was used in 1260 and a long nail in 134 of them. A dynamic hip screw (DHS) was employed to treat 947 fractures. Distinguishing between pertrochanteric (21-A1

Does "Flipping" Promote Engagement?: A Comparison of a Traditional, Online, and Flipped Class

Science.gov (United States)

Burke, Alison S.; Fedorek, Brian

2017-01-01

"Flipped" or inverted classrooms are designed to utilize class time for application and knowledge building, while course content is delivered through the use of online lectures and watched at home on the students' time. It is believed that flipped classrooms promote student engagement and a deeper understanding of the class material. The…

Variable-flip-angle spin-echo imaging (VFSE)

International Nuclear Information System (INIS)

Kasai, Toshifumi; Sugimura, Kazuro; Kawamitsu, Hideaki; Yasui, Kiyoshi; Ishida, Tetsuya; Tsukamoto, Tetsuji.

1990-01-01

T 2 weighted imaging provides images with high object contrast for pathologic conditions in which the water content of tissues is increased. The authors predicted theoretical analysis of the effects of changing flip angle, and analyzed the effects in MR imaging of both phantoms and humans. Variable flip angle spin echo MR imaging (VFSE) with a 1,000/80 (repetition time msec/echo time msec) can obtain T 2 weighted image when flip angle is smaller than 80 degrees. VFSE with 40 to 60 degrees flip angle have higher contrast than other flip angle images. Signal to noise ratio (S/N) of VFSE are 55% at a 30 degree, 76% at a 45 degree, 92% at a 60 degree respectively as compared with conventional spin echo image (2000/80, flip angle 90 degree). VFSE is applicable to obtain T 2 weighted image reduced imaging time. (author)

Improving greater trochanteric reattachment with a novel cable plate system.

Science.gov (United States)

Baril, Yannick; Bourgeois, Yan; Brailovski, Vladimir; Duke, Kajsa; Laflamme, G Yves; Petit, Yvan

2013-03-01

Cable-grip systems are commonly used for greater trochanteric reattachment because they have provided the best fixation performance to date, even though they have a rather high complication rate. A novel reattachment system is proposed with the aim of improving fixation stability. It consists of a Y-shaped fixation plate combined with locking screws and superelastic cables to reduce cable loosening and limit greater trochanter movement. The novel system is compared with a commercially available reattachment system in terms of greater trochanter movement and cable tensions under different greater trochanteric abductor application angles. A factorial design of experiments was used including four independent variables: plate system, cable type, abductor application angle, and femur model. The test procedure included 50 cycles of simultaneous application of an abductor force on the greater trochanter and a hip force on the femoral head. The novel plate reduces the movements of a greater trochanter fragment within a single loading cycle up to 26%. Permanent degradation of the fixation (accumulated movement based on 50-cycle testing) is reduced up to 46%. The use of superelastic cables reduces tension loosening up to 24%. However this last improvement did not result in a significant reduction of the grater trochanter movement. The novel plate and cables present advantages over the commercially available greater trochanter reattachment system. The plate reduces movements generated by the hip abductor. The superelastic cables reduce cable loosening during cycling. Both of these positive effects could decrease the risks related to grater trochanter non-union. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

Flipped classroom: a review of recent literature

Directory of Open Access Journals (Sweden)

Huseyin Uzunboylu

2015-07-01

Full Text Available The use of learning technologies, especially multimedia provide varied facilities for students’ learning that are not possible with other media. Pedagogical literature has proved that individuals have different learning styles. Flipped classroom is a pedagogical approach which means that activities that have traditionally taken place inside the classroom take place outside the classroom and vice versa. Flipped classroom environment ensures that students become more active participants compared with the traditional classroom. The purpose of this paper is to fulfil the needs regarding the review of recent literature on the use of flipped classroom approach in education. The contribution of flipped classroom to education is discussed in relation to the change of students' and instructors' role. Subsequently, flipped classroom applications in various disciplines of education are illustrated. The recommendations made in the literature for design specifications that integrate flipped classrooms with technology are discussed. The paper concludes that a careful consideration of the warnings and recommendations made in the literature can help to produce effective flipped classroom environments and also this paper attempts to inform those who are thinking of using new technologies and approaches to deliver courses.

Urban versus rural differences in the occurrence of hip fractures in Japan’s Kyoto prefecture during 2008–2010: a comparison of femoral neck and trochanteric fractures

Science.gov (United States)

2013-01-01

Background To investigate the differences in the characteristics of femoral neck and trochanteric fractures between urban and rural areas of Kyoto Prefecture in Japan. Methods Fracture type (neck vs. trochanteric), age, sex, place where fracture occurred (indoors vs. outdoors), and cause of injury were surveyed among patients aged ≥65 years who sustained hip fractures between 2008 and 2010 and who were treated at 1 of 13 participating hospitals (5 urban, 8 rural). The ratio of sick beds to total number of beds at the participating hospitals was 19.6% (2,188/11,158) in the urban area and 34.9% (1,963/5,623) in the rural area. We also investigated the incidence of hip fracture in Tango medical district as a representative rural area. Results There were 1,346 neck (mean age, 82.4 years) and 1,606 trochanteric fractures (mean age, 85.0 years). The ratio of neck to trochanteric fractures was higher in the urban area than in the rural area in all age groups (65–74, 75–84, and ≥ 85 years). There were no apparent differences in place or cause of injury. The incidence of hip fracture in the women of Tango medical district was lower than the national average. Conclusions There was a difference in the ratio of neck to trochanteric fractures between urban and rural areas. This difference is estimated to be caused by the high and low incidence of neck fracture in urban and rural areas, respectively. PMID:24156244

Dynamics of spin-flip photon-assisted tunneling

NARCIS (Netherlands)

Braakman, F.R.; Danon, J.; Schreiber, L.R.; Wegscheider, W.; Vandersypen, L.M.K.

2014-01-01

We present time-resolved measurements of spin-flip photon-assisted tunneling and spin-flip relaxation in a doubly occupied double quantum dot. The photon-assisted excitation rate as a function of magnetic field indicates that spin-orbit coupling is the dominant mechanism behind the spin-flip under

The Marriage of Constructivism and Flipped Learning

Science.gov (United States)

Chang, Sau Hou

2016-01-01

This report talks about how a constructivist teacher used flipped learning in a college class. To illustrate how to use flipped learning in a constructivist classroom, examples were given with the four pillars of F-L-I-P: Flexible environment, learning culture, intentional content, and professional educator.

Effect of greater trochanteric epiphysiodesis after femoral varus osteotomy for lateral pillar classification B and B/C border Legg-Calvé-Perthes disease: A retrospective observational study.

Science.gov (United States)

Kwon, Keun-Sang; Wang, Sung Il; Lee, Ju-Hyung; Moon, Young Jae; Kim, Jung Ryul

2017-08-01

This is a retrospective observational study. Greater trochanteric epiphysiodesis (GTE) has been recommended to prevent Trendelenburg gait and limitation of the hip joint motion due to trochanteric overgrowth after femoral varus osteotomy (FVO) in Legg-Calvé-Perthes disease (LCPD). However, capital femoral physeal arrest frequently occurs in patients with severe disease (lateral pillar C), so GTE might not be as effective in these patients. The aim of this study was to compare trochanteric growth inhibition due to GTE after FVO between 2 age groups (8 years) in patients with lateral pillar B and B/C border LCPD and evaluate the effectiveness of GTE compared with the normal, unaffected hip.This study included 19 children with lateral pillar B and B/C border LCPD in 1 leg who underwent FVO followed by GTE. Of the 19 children, 9 underwent GTE before the age of 8 years and 10 underwent GTE after 8 years of age. On radiographs taken at the immediate postoperative period and at skeletal maturity, the articulo-trochanteric distance (ATD), center-trochanteric distance (CTD), and neck-shaft angle (NSA) were compared between the 2 age groups. The amount of correction was compared between groups. The contralateral, unaffected hip was used as a control for trochanteric growth. The patients were clinically evaluated with Iowa hip score at the final follow-up.There was no significant difference between the 2 age groups in terms of time to GTE, length of follow-up, or lateral pillar classification. In the affected hip, the amount of correction of the ATD, CTD, and NSA was significantly greater in patients  8 years. However, in the unaffected hip, the change in the ATD, CTD, and NSA did not differ significantly between the 2 groups.We suggest that FVO followed by GTE for lateral pillar B and B/C border LCPD in patients under the age of 8 years can affect growth of the greater trochanter. However, effective growth inhibition due to GTE was not achieved after 8 years of age.

Targeting the Anti-Apoptotic Protein c-FLIP for Cancer Therapy

International Nuclear Information System (INIS)

Safa, Ahmad R.; Pollok, Karen E.

2011-01-01

Cellular FLICE (FADD-like IL-1beta-converting enzyme)-inhibitory protein (c-FLIP) is a major resistance factor and critical anti-apoptotic regulator that inhibits tumor necrosis factor-alpha (TNF-alpha), Fas-L, and TNF-related apoptosis-inducing ligand (TRAIL)-induced apoptosis as well as chemotherapy-triggered apoptosis in malignant cells. c-FLIP is expressed as long (c-FLIP L ), short (c-FLIP S ), and c-FLIP R splice variants in human cells. c-FLIP binds to FADD and/or caspase-8 or -10 in a ligand-dependent and-independent fashion, which in turn prevents death-inducing signaling complex (DISC) formation and subsequent activation of the caspase cascade. Moreover, c-FLIP L and c-FLIP S are known to have multifunctional roles in various signaling pathways, as well as activating and/or upregulating several cytoprotective signaling molecules. Upregulation of c-FLIP has been found in various tumor types, and its downregulation has been shown to restore apoptosis triggered by cytokines and various chemotherapeutic agents. Hence, c-FLIP is an important target for cancer therapy. For example, small interfering RNAs (siRNAs) that specifically knockdown the expression of c-FLIP L in diverse human cancer cell lines augmented TRAIL-induced DISC recruitment and increased the efficacy of chemotherapeutic agents, thereby enhancing effector caspase stimulation and apoptosis. Moreover, small molecules causing degradation of c-FLIP as well as decreasing mRNA and protein levels of c-FLIP L and c-FLIP S splice variants have been found, and efforts are underway to develop other c-FLIP-targeted cancer therapies. This review focuses on (1) the functional role of c-FLIP splice variants in preventing apoptosis and inducing cytokine and drug resistance; (2) the molecular mechanisms that regulate c-FLIP expression; and (3) strategies to inhibit c-FLIP expression and function

The digastric muscle is less involved in pharyngeal swallowing in rabbits.

Science.gov (United States)

Tsujimura, Takanori; Yamada, Aki; Nakamura, Yuki; Fukuhara, Takako; Yamamura, Kensuke; Inoue, Makoto

2012-06-01

The swallowing reflex is centrally programmed by the lower brain stem, the so-called swallowing central pattern generator (CPG), and once the reflex is initiated, many muscles in the oral, pharyngeal, laryngeal, and esophageal regions are systematically activated. The mylohyoid (MH) muscle has been considered to be a "leading muscle" according to previous studies, but the functional role of the digastric (DIG) muscle in the swallowing reflex remains unclear. In the present study, therefore, the activities of single units of MH and DIG neurons were recorded extracellularly, and the functional involvement of these neurons in the swallowing reflex was investigated. The experiments were carried out on eight adult male Japanese white rabbits anesthetized with urethane. To identify DIG and MH neurons, the peripheral nerve (either DIG or MH) was stimulated to evoke action potentials of single motoneurons. Motoneurons were identified as such if they either (1) responded to antidromic nerve stimulation of DIG or MH in an all-or-none manner at threshold intensities and (2) followed stimulation frequencies of up to 0.5 kHz. As a result, all 11 MH neurons recorded were synchronously activated during the swallowing reflex, while there was no activity in any of the 7 DIG neurons recorded during the swallowing reflex. All neurons were anatomically localized ventromedially at the level of the caudal portion of the trigeminal motor nucleus, and there were no differences between the MH and DIG neuron sites. The present results strongly suggest that at least in the rabbit, DIG motoneurons are not tightly controlled by the swallowing CPG and, hence, the DIG muscle is less involved in the swallowing reflex.

Neutrino helicity flips via electroweak interactions

International Nuclear Information System (INIS)

Gaemers, K.J.F.; Gandhi, R.; Lattimer, J.M.; Department of Earth and Space Sciences, State University of New York, Stony Brook, New York 11794)

1989-01-01

Electroweak mechanisms via which neutrinos may flip helicity are examined in detail. Exact and approximate expressions for a variety of flip processes relevant in astrophysics and cosmology, mediated by W, Z, and γ exchange, including their interference, are derived for both Dirac and Majorana neutrinos (with emphasis on the former). It is shown that in general flip and nonflip cross sections differ by more than just a multiplicative factor of m/sub ν/ 2 /4E/sub ν/ 2 contrary to what might be expected and that this additional dependence on helicities can be significant. It is also shown that within the context of the standard model with massive neutrinos, for νe yields νe scattering, σ/sub Z//sup flip//σ/sub γ//sup flip/ ∼ 10 4 , independent of particle masses and energies to a good approximation. As an application, using some general considerations and the fact that the observed bar nu/sub e/ burst from SN 1987A lasted several seconds, these weak-interaction flip cross sections are used to rule out μ and tau neutrino masses above 30 keV. Finally, some other consequences for astrophysics in general and supernovae in particular are briefly discussed

Flipping a Calculus Class: One Instructor's Experience

Science.gov (United States)

Palmer, Katrina

2015-01-01

This paper describes one instructor's experiences during a year of flipping four calculus classes. The first exploration attempts to understand student expectations of a math class and their preference towards a flipped classroom. The second examines success of students from a flipped classroom, and the last investigates relationships with student…

Studenters erfaringer med Flipped Classroom i en helsefagutdanning

Directory of Open Access Journals (Sweden)

Christine Tørris

2015-12-01

Full Text Available Background: The flipped classroom approach has gained increased attention in educational research literature. The purpose of this study was to investigate how students experience a flipped classroom approach in health education, compared to ordinary lectures. Method: Bachelor students (n=25 who watched the video-based material in the flipped classrooms pre-session, answered a questionnaire to evaluate their flipped classroom experience. The questionnaire consisted of both closed and open questions. Results: Ninety six per cent (24/25 of respondents found the video-based material in the pre-session useful. Seventy six per cent (19/25 of respondents found that the flipped classroom approach resulted in the highest learning outcome, over the traditional approach (16%, 4/25. Barriers to the flipped classroom approach was technical problems with the video-based material, such as screen view. Conclusion: The flipped classroom approach is promising as an acceptable approach for teaching in health science curricular in higher education.

Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note.

Science.gov (United States)

Lee, Joong-Myung; Cho, Yongsuk; Kim, Junhyun; Kim, Dong-Won

2017-03-01

Femoral intertrochanteric fractures are common in the elderly. Appropriate surgical fixation of trochanteric fracture fragments can restore normal anatomical structure and ambulation, and can aid in the recovery of biomechanical function of the hip. We evaluated clinical outcomes of bipolar hemiarthroplasty using a wiring technique for trochanteric fracture fragment fixation. From September 2006 to February 2015, a total of 260 cases underwent simultaneous bipolar hemiarthroplasty and wire fixation. A total of 65 patients (69 hips) with an average age of 78 years and more than one year of follow-up was included in the study. Using pre-, postoperative and follow-up radiograms, we evaluated wire fixation failure and also assessed changes in walking ability. Loosening or osteolysis around the stem was not observed; however, we did observe bone growth around the stem (54 cases), cortical hypertrophy (6 cases), a wide range of sclerotic lines but no stem subsidence (1 case), wire breakage (9 cases), and fracture fragment migration with no significant functional deficiency (2 cases). Our study showed that additional wiring for trochanteric fracture fragment fixation following bipolar hemiarthroplasty can help restore normal anatomy. The added stability results in faster rehabilitation, and good clinical and radiographic outcomes. We recommend this procedure in this type of fracture.

FLIPPED LEARNING: PRACTICAL ASPECTS

Directory of Open Access Journals (Sweden)

Olena Kuzminska

2016-03-01

Full Text Available The article is devoted to issues of implementation of the flipped learning technology in the practice of higher education institutions. The article defines the principles of technology and a model of the educational process, it notes the need to establish an information support system. The article defines online platforms and resources; it describes recommendations for the design of electronic training courses and organization of the students in the process of implementing the proposed model, as well as tools for assessing its effectiveness. The article provides a description of flipped learning implementation scenario and formulates suggestions regarding the use of this model as a mechanism to improve the efficiency of the learning process in the ICT-rich environment of high school: use of learning management systems (LMS and personal learning environments (PLE of participants in a learning process. The article provides an example of implementation of the flipped learning model as a part of the Information Technologies course in the National University of Life and Environmental Sciences of Ukraine (NULES. The article gives examples of tasks, resources and services, results of students’ research activity, as well as an example of the personal learning network, established in the course of implementation of the flipped learning model and elements of digital student portfolios. It presents the results of the monitoring of learning activities and students’ feedback. The author describes cautions against the mass introduction of the flipped learning model without monitoring of readiness of the participants of the educational process for its implementation

The Flipped Journal Club

Directory of Open Access Journals (Sweden)

Richard Bounds

2017-12-01

Full Text Available Introduction Educators struggle to develop a journal club format that promotes active participation from all levels of trainees. The explosion of social media compels residencies to incorporate the evaluation and application of these resources into evidence-based practice. We sought to design an innovative “flipped journal club” to achieve greater effectiveness in meeting goals and objectives among residents and faculty. Methods Each journal club is focused on a specific clinical question based on a landmark article, a background article, and a podcast or blog post. With the “flipped” model, residents are assigned to prepare an in-depth discussion of one of these works based on their level of training. At journal club, trainees break into small groups and discuss their assigned readings with faculty facilitation. Following the small-group discussions, all participants convene to summarize key points. In redesigning our journal club, we sought to achieve specific educational outcomes, and improve participant engagement and overall impressions. Results Sixty-one residents at our emergency medicine program participated in the flipped journal club during the 2015–2016 academic year, with supervision by core faculty. Program evaluation for the flipped journal club was performed using an anonymous survey, with response rates of 70% and 56% for residents and faculty, respectively. Overall, 95% of resident respondents and 100% of faculty respondents preferred the flipped format. Conclusion The “flipped journal club” hinges upon well-selected articles, incorporation of social media, and small-group discussions. This format engages all residents, holds learners accountable, and encourages greater participation among residents and faculty.

A Flipped Classroom Redesign in General Chemistry

Science.gov (United States)

Reid, Scott A.

2016-01-01

The flipped classroom continues to attract significant attention in higher education. Building upon our recent parallel controlled study of the flipped classroom in a second-term general chemistry course ("J. Chem. Educ.," 2016, 93, 13-23), here we report on a redesign of the flipped course aimed at scaling up total enrollment while…

Dual head screw hip nailing for trochanteric fractures

Science.gov (United States)

Mavrogenis, Andreas F.; Igoumenou, Vasilios G.; Megaloikonomos, Panayiotis D.; Panagopoulos, George N.; Galanopoulos, Ioannis P.; Vottis, Christos Th.; Karamanis, Eirinaios; Koulouvaris, Panayiotis; Papagelopoulos, Panayiotis J.

2017-01-01

Introduction: There are limited information and inconclusive results for dual head screw intramedullary hip nails for trochanteric fractures. Therefore, we performed a prospective study to evaluate the healing of fractures, and survival, function, and complications of patients operated with this implant. Methods: We prospectively studied 79 patients (61 women and 18 men; mean age: 84.7 years; range: 65–96 years) with a low-energy trochanteric fracture, treated with a dual head screw intramedullary hip nail from 2013 to 2016. The mean follow-up was 2.1 years (range: 1–3 years); seven patients were lost to follow up. This left 72 patients for further analysis. We evaluated the healing of fractures, and survival, function, and complications of patients. Results: Fracture healing was evident in 70 patients (97.2%) at 2–3 months postoperatively. One patient experienced cut-out and z-effect phenomenon of the head screws. Another patient experienced a periprosthetic femoral diaphysis fracture at the distal tip of the nail. A third patient experienced an acute postoperative superficial skin infection that was treated successfully with wound dressing changes and a course of antibiotics. Sixteen patients (22.2%) deceased within 12 months postoperatively. In the remaining patients, the Harris Hip Score (HHS) at 12 months postoperatively was excellent in 16 (28.6%), good in 23 (41.1%), fair in 10 (17.8%), and poor in 7 patients (12.5%). The function declined after the patients’ fracture. Fair and poor results were related to age > 85 years, poor pre-fracture level of function, and AO/OTA-31-A3 fracture types. Conclusion: The dual head screw intramedullary hip nail is associated with high healing and low complication rates for intertrochanteric fractures. The function of the patients is good or excellent in most cases; however, it declines, especially for those patients with age > 85 years, poor pre-fracture level of function, and AO/OTA-31-A3 fracture types

Dual head screw hip nailing for trochanteric fractures

Directory of Open Access Journals (Sweden)

Mavrogenis Andreas F.

2017-01-01

Full Text Available Introduction: There are limited information and inconclusive results for dual head screw intramedullary hip nails for trochanteric fractures. Therefore, we performed a prospective study to evaluate the healing of fractures, and survival, function, and complications of patients operated with this implant. Methods: We prospectively studied 79 patients (61 women and 18 men; mean age: 84.7 years; range: 65–96 years with a low-energy trochanteric fracture, treated with a dual head screw intramedullary hip nail from 2013 to 2016. The mean follow-up was 2.1 years (range: 1–3 years; seven patients were lost to follow up. This left 72 patients for further analysis. We evaluated the healing of fractures, and survival, function, and complications of patients. Results: Fracture healing was evident in 70 patients (97.2% at 2–3 months postoperatively. One patient experienced cut-out and z-effect phenomenon of the head screws. Another patient experienced a periprosthetic femoral diaphysis fracture at the distal tip of the nail. A third patient experienced an acute postoperative superficial skin infection that was treated successfully with wound dressing changes and a course of antibiotics. Sixteen patients (22.2% deceased within 12 months postoperatively. In the remaining patients, the Harris Hip Score (HHS at 12 months postoperatively was excellent in 16 (28.6%, good in 23 (41.1%, fair in 10 (17.8%, and poor in 7 patients (12.5%. The function declined after the patients’ fracture. Fair and poor results were related to age > 85 years, poor pre-fracture level of function, and AO/OTA-31-A3 fracture types. Conclusion: The dual head screw intramedullary hip nail is associated with high healing and low complication rates for intertrochanteric fractures. The function of the patients is good or excellent in most cases; however, it declines, especially for those patients with age > 85 years, poor pre-fracture level of function, and AO/OTA-31-A3

Just in Time to Flip Your Classroom

Science.gov (United States)

Lasry, Nathaniel; Dugdale, Michael; Charles, Elizabeth

2014-01-01

With advocates like Sal Khan and Bill Gates, flipped classrooms are attracting an increasing amount of media and research attention.2 We had heard Khan's TED talk and were aware of the concept of inverted pedagogies in general. Yet it really hit home when we accidentally flipped our classroom. Our objective was to better prepare our students for class. We set out to effectively move some of our course content outside of class and decided to tweak the Just-in-Time Teaching approach (JiTT).3 To our surprise, this tweak—which we like to call the flip-JiTT—ended up completely flipping our classroom. What follows is narrative of our experience and a procedure that any teacher can use to extend JiTT to a flipped classroom.

En didaktisk model for Flipped Classroom

DEFF Research Database (Denmark)

Levinsen, Henrik; Foss, Kristian Kildemoes; Andersen, Thomas Dyreborg

2016-01-01

I artiklen præsenterer vi en model over flipped classroom som didaktisk metode udviklet med henblik på at stilladsere både de lærere, som gerne vil prøve kræfter med en flipped classroom-baseret praksis, og dem som allerede har erfaring, men kan have glæde af at bruge modellen til at kvalificere...... deres flipped classroom-undervisning. Modellen kan bidrage til erkendelsen af, at flipped classroom er noget nær et paradigmeskifte i forståelsen af god undervisning. Her tænkes på det skift i fokus metoden indebærer fra, at læreren er mest aktiv, til at eleverne er de mest aktive. Særligt for den...

Femoral neck fractures after removal of hardware in healed trochanteric fractures.

Science.gov (United States)

Barquet, Antonio; Giannoudis, Peter V; Gelink, Andrés

2017-12-01

Hardware removal in healed trochanteric fractures (TF) in the absence of infection or significant mechanical complications is rarely indicated. However, in patients with persistent pain, prominent material and discomfort in the activities of daily living, the implant is eventually removed. Publications of ipsilateral femoral neck fracture after removal of implants from healed trochanteric fractures (FNFARIHTF) just because of pain or discomfort are rare. The purpose of this systematic review of the literature is to report on the eventual risk factors, the mechanisms, the clinical presentation, and frequency, and to pay special emphasis in their prevention. A comprehensive review of the literature was undertaken using the PRISMA guidelines with no language restriction. Case reports of FNFARIHTF and series of TF with cases of FNFARIHTF due to pain or discomfort published between inception of journals to December 2016 were eligible for inclusion. Relevant information was divided in two parts. Part I included the analysis of cases of FNFARIHTF, with the objective of establishing the eventual risk factors, mechanisms and pathoanatomy, clinical presentation and diagnosis, treatment and prevention. Part II analyzed series of TF which included cases of FNFARIHTF for assessing the incidence of femoral neck fractures in this condition. Overall 24 publications with 45 cases of FNFARIHTF met the inclusion criteria. We found that the only prevalent factors for FNFARIHTF were: 1) preexisisting systemic osteoporosis, as most patients were older and elder females, with lower bone mineral density and bone mass; 2) local osteoporosis as a result of preloading by the fixation device in the femoral neck, leading to stress protection, reducing the strain at the neck, and increasing bone loss and weakness; and 3) the removal of hardware from the femoral neck, with reduction of the failure strength of the neck. The femoral neck fractures were spontaneous, i.e. not related to trauma or

Relationships in the Flipped Classroom

Science.gov (United States)

McCollum, Brett M.; Fleming, Cassidy L.; Plotnikoff, Kara M.; Skagen, Darlene N.

2017-01-01

This study examines the effectiveness of flipped classrooms in chemistry, and identifies relationships as a major factor impacting the success of flipped instruction methods. Examination of student interview data reveals factors that affect the development of peer-peer, peer-peer leader, and peer-expert relationships in firstyear general chemistry…

Mapping of low flip angles in magnetic resonance

International Nuclear Information System (INIS)

Balezeau, Fabien; Saint-Jalmes, Herve; Eliat, Pierre-Antoine; Cayamo, Alejandro Bordelois

2011-01-01

Errors in the flip angle have to be corrected in many magnetic resonance imaging applications, especially for T1 quantification. However, the existing methods of B1 mapping fail to measure lower values of the flip angle despite the fact that these are extensively used in dynamic acquisition and 3D imaging. In this study, the nonlinearity of the radiofrequency (RF) transmit chain, especially for very low flip angles, is investigated and a simple method is proposed to accurately determine both the gain of the RF transmitter and the B1 field map for low flip angles. The method makes use of the spoiled gradient echo sequence with long repetition time (TR), such as applied in the double-angle method. It uses an image acquired with a flip angle of 90 0 as a reference image that is robust to B1 inhomogeneity. The ratio of the image at flip angle alpha to the image at a flip angle of 90 0 enables us to calculate the actual value of alpha. This study was carried out at 1.5 and 4.7 T, showing that the linearity of the RF supply system is highly dependent on the hardware. The method proposed here allows us to measure the flip angle from 1 0 to 60 0 with a maximal uncertainty of 10% and to correct T1 maps based on the variable flip angle method.

The administration of intermittent parathyroid hormone affects functional recovery from trochanteric fractured neck of femur: a randomised prospective mixed method pilot study.

Science.gov (United States)

Chesser, T J S; Fox, R; Harding, K; Halliday, R; Barnfield, S; Willett, K; Lamb, S; Yau, C; Javaid, M K; Gray, A C; Young, J; Taylor, H; Shah, K; Greenwood, R

2016-06-01

We wished to assess the feasibility of a future randomised controlled trial of parathyroid hormone (PTH) supplements to aid healing of trochanteric fractures of the hip, by an open label prospective feasibility and pilot study with a nested qualitative sub study. This aimed to inform the design of a future powered study comparing the functional recovery after trochanteric hip fracture in patients undergoing standard care, versus those who undergo administration of subcutaneous injection of PTH for six weeks. We undertook a pilot study comparing the functional recovery after trochanteric hip fracture in patients 60 years or older, admitted with a trochanteric hip fracture, and potentially eligible to be randomised to either standard care or the administration of subcutaneous PTH for six weeks. Our desired outcomes were functional testing and measures to assess the feasibility and acceptability of the study. A total of 724 patients were screened, of whom 143 (20%) were eligible for recruitment. Of these, 123 were approached and 29 (4%) elected to take part. However, seven patients did not complete the study. Compliance with the injections was 11 out of 15 (73%) showing the intervention to be acceptable and feasible in this patient population. Only 4% of patients who met the inclusion criteria were both eligible and willing to consent to a study involving injections of PTH, so delivering this study on a large scale would carry challenges in recruitment and retention. Methodological and sample size planning would have to take this into account. PTH administration to patients to enhance fracture healing should still be considered experimental. Cite this article: Bone Joint J 2016;98-B:840-5. ©2016 Chesser et al.

Long versus short cephalomedullary nail for trochanteric femur fractures (OTA 31-A1, A2 and A3): a systematic review.

Science.gov (United States)

Dunn, John; Kusnezov, Nicholas; Bader, Julia; Waterman, Brian R; Orr, Justin; Belmont, Philip J

2016-12-01

Both long and short cephalomedullary nails (CMN) may be used to treat trochanteric femur fractures. The objective of this paper was to compare the clinical outcomes between long and short CMN in the treatment of trochanteric hip fractures. A literature search was performed, identifying 135 papers; 4 of which met inclusion and exclusion criteria. Papers included were those that compared cohorts of long and short nails for stable trochanteric femur fractures of level III evidence or superior. Data was pooled and analyzed, focusing on reoperation rate, secondary femoral shaft fracture rate, estimated blood loss, transfusion rate, operative time and length of stay. Included in the analysis were 1276 patients, with 438 short and 838 long CMN. The average age was 82.0 years for short CMN and 79.0 years for long CMN (P = 0.0002). The average follow up was 18 months, 46 % were male, and 71 % had an ASA (American Society of Anesthesiologists score) classification ≥3. The rate of reoperation was 5.0 % and 3.8 % for short and long CMN, respectively (P = 0.31). The rate of refracture was 1.6 % and 0.95 % for short and long CMN, respectively (P = 0.41). As compared to long nails, short nails had an average blood loss of 39 mL less (P = 0.0003), an 8.8 % decrease in transfusion rate (P = 0.07), and incurred 19 min less operative time (P trochanteric femur fractures, short CMN have a low reoperation rate while significantly decreasing operative time and estimated blood loss with the additional benefit of being cost effective. Level 3.

Do PFNA devices and Intertan nails both have the same effects in the treatment of trochanteric fractures? A prospective clinical study.

Science.gov (United States)

Seyhan, Mustafa; Turkmen, Ismail; Unay, Koray; Ozkut, Afsar Timucin

2015-11-01

To clinically and radiologically compare third-generation intramedullary nails used in the treatment of trochanteric hip fractures and to determine their efficacy. Seventy-five of 88 patients admitted to our hospital with trochanteric fractures were enrolled in the study; 43 were treated with PFNA devices and 32 with Intertan nails. The amount of compression applied during the procedure, duration of the procedure, amount of subsequent shortening in the proximal femoral area, subsequent backup of proximal screws, and changes in the tip-apex and tip-cortex distances were compared between groups. The postoperative change in the varus angle of the proximal femur and times to mobilization, full weight bearing, and fracture union were also evaluated. On early postoperative radiographs, the tip-apex distance was ≤25 mm in 86 % of patients in the PFNA group and 96.9 % of those in the Intertan group. Twelve months postoperatively, the tip-apex distance did not differ between groups. No cut-out of the screws into the coxofemoral joint was observed. Fracture healing was achieved in all patients. At 12 months postoperatively, the rates of proximal screw backup, proximal femoral shortening, and decrease in the varus angle of the proximal femur were significantly higher in the PFNA group than in the Intertan group. Trochanteric fractures may be treated effectively with PFNA devices or Intertan nails. During the healing period, the rates of reverse displacement of the proximal screw, shortening of the proximal femur, and decrease in the varus angle of the proximal femur were significantly higher in the PFNA group than in the Intertan group. Surgical technique, implant positioning, and the choice of implant play roles in the successful treatment of trochanteric fractures. Level 1, prospective, prognostic study.

Interval hypoxic training in complex treatment of fractures of trochanteric area of the femur

Directory of Open Access Journals (Sweden)

Василь Михайлович Шимон

2015-05-01

Full Text Available The method of interval hypoxic training (IHT is used to increase physical endurance of athletes and for treatment of certain systemic diseases, due to the ability of IHT affect metabolism, homeostasis and the immune system. The aims of the article are improving the results of treatment and rehabilitation of patients with fractures of the trochanteric area of the femur by the method of interval hypoxic training and study its influence on bone metabolism.Materials and methods. 17 patients who were hospitalized in the clinic of general surgery UzhNU with fractures of the trochanteric area of the femur are examined in the period from 2012 to 2015.The first group consisted of 6 patients who from day-patient treatment is conducted IHT by gas mixture of 12 % oxygen. The second group consisted of 4 patients with thyrotoxicosis who are also receiving IHT by gas mixture of 12% oxygen.The control group consisted of 7 patients with fractures of the trochanteric area of the femur who refused from IHT.Results and its discussion. The best physical activity is observed in the first group. Starting physical activity is the lowest in the second group, but its development is faster. Slowly increase the duration of physical activity compared with the first two groups is observed in the control group.In the control study after 1 month it is noted that calcium level increased in all three groups. Increase in the second group is biggest. The level of phosphorus decreased in the first and the control group and increased in the second group.The levels of osteocalcin and alkaline phosphatase increased. Rates were higher and increase was substantial in the first two groups in comparison with the control group.Conclusions.• Intensive growth of length of one-time physical activity most notably in patients with thyrotoxicosis is observed in patients who are receiving IHT.• Improvement of the activity of bone metabolism is observed in patients after IHT

Use of Flipped Classroom Technology in Language Learning

OpenAIRE

Evseeva, Arina Mikhailovna; Solozhenko, Anton

2015-01-01

The flipped classroom as a key component of blended learning arouses great interest among researchers and educators nowadays. The technology of flipped classroom implies such organization of the educational process in which classroom activities and homework assignments are reversed. The present paper gives the overview of the flipped classroom technology and explores its potential for both teachers and students. The authors present the results obtained from the experience of the flipped class...

How we flipped the medical classroom.

Science.gov (United States)

Sharma, Neel; Lau, C S; Doherty, Iain; Harbutt, Darren

2015-04-01

Flipping the classroom centres on the delivery of print, audio or video based material prior to a lecture or class session. The class session is then dedicated to more active learning processes with application of knowledge through problem solving or case based scenarios. The rationale behind this approach is that teachers can spend their face-to-face time supporting students in deeper learning processes. In this paper we provide a background literature review on the flipped classroom along with a three step approach to flipping the classroom comprising implementing, enacting and evaluating this form of pedagogy. Our three step approach is based on actual experience of delivering a flipped classroom at the University of Hong Kong. This initiative was evaluated with positive results. We hope our experience will be transferable to other medical institutions.

Adventures in Flipping College Algebra

Science.gov (United States)

Van Sickle, Jenna

2015-01-01

This paper outlines the experience of a university professor who implemented flipped learning in two sections of college algebra courses for two semesters. It details how the courses were flipped, what technology was used, advantages, challenges, and results. It explains what students do outside of class, what they do inside class, and discusses…

Information Literacy and the Flipped Classroom: Examining the Impact of a One-Shot Flipped Class on Student Learning and Perceptions

Directory of Open Access Journals (Sweden)

Andrea Wilcox Brooks

2014-12-01

Full Text Available This article examines the flipped classroom approach in higher education and its use in one-shot information literacy instruction sessions. The author presents findings from a pilot study of student learning and student perceptions pertaining to flipped model IL instruction. Students from two sections of the same course participated in this study. One section received one-shot information literacy instruction using a flipped approach, while the other section received traditional one-shot instruction. No difference was found between the two groups on a pre- and post-test analysis; however, an analysis of students’ final papers from the flipped section showed more bibliography citations to scholarly journal articles. In addition, a survey was conducted showing the majority of students preferred the flipped approach.

Flipped Learning With Simulation in Undergraduate Nursing Education.

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Kim, HeaRan; Jang, YounKyoung

2017-06-01

Flipped learning has proliferated in various educational environments. This study aimed to verify the effects of flipped learning on the academic achievement, teamwork skills, and satisfaction levels of undergraduate nursing students. For the flipped learning group, simulation-based education via the flipped learning method was provided, whereas traditional, simulation-based education was provided for the control group. After completion of the program, academic achievement, teamwork skills, and satisfaction levels were assessed and analyzed. The flipped learning group received higher scores on academic achievement, teamwork skills, and satisfaction levels than the control group, including the areas of content knowledge and clinical nursing practice competency. In addition, this difference gradually increased between the two groups throughout the trial. The results of this study demonstrated the positive, statistically significant effects of the flipped learning method on simulation-based nursing education. [J Nurs Educ. 2017;56(6):329-336.]. Copyright 2017, SLACK Incorporated.

Posterior dislocation of a native hip joint associated with ipsilateral per-trochanteric fracture: A rare case report

Directory of Open Access Journals (Sweden)

Mazin Fageir

2018-02-01

Full Text Available We describe a case of traumatic posterior dislocation of a native hip joint associated with ipsilateral comminuted inter-trochanteric femoral fracture. In our case, closed reduction was attempted but proved unsuccessful. Taking into account the planned subsequent intra-medullary femoral nail, open reduction through a lateral incision was undertaken. Post-operatively, the planned mobility was for a non-weight bearing period of 6 weeks followed by a partial-weight bearing period of 6 weeks before progressing to full-weight bearing. Post-operatively, the patient completed a comprehensive course of physiotherapy. At five months, he was able to walk for five miles over the course of a weekend. At six months, the patient was looking at phased return to work as a fire fighter. Radiographs taken at the time demonstrated evidence of healing to his inter-trochanteric fracture. At ten months, the patient was back to normal duties at work as a fire fighter.

Twelve tips for "flipping" the classroom.

Science.gov (United States)

Moffett, Jennifer

2015-04-01

The flipped classroom is a pedagogical model in which the typical lecture and homework elements of a course are reversed. The following tips outline the steps involved in making a successful transition to a flipped classroom approach. The tips are based on the available literature alongside the author's experience of using the approach in a medical education setting. Flipping a classroom has a number of potential benefits, for example increased educator-student interaction, but must be planned and implemented carefully to support effective learning.

Flip-flopping binary black holes.

Science.gov (United States)

Lousto, Carlos O; Healy, James

2015-04-10

We study binary spinning black holes to display the long term individual spin dynamics. We perform a full numerical simulation starting at an initial proper separation of d≈25M between equal mass holes and evolve them down to merger for nearly 48 orbits, 3 precession cycles, and half of a flip-flop cycle. The simulation lasts for t=20 000M and displays a total change in the orientation of the spin of one of the black holes from an initial alignment with the orbital angular momentum to a complete antialignment after half of a flip-flop cycle. We compare this evolution with an integration of the 3.5 post-Newtonian equations of motion and spin evolution to show that this process continuously flip flops the spin during the lifetime of the binary until merger. We also provide lower order analytic expressions for the maximum flip-flop angle and frequency. We discuss the effects this dynamics may have on spin growth in accreting binaries and on the observational consequences for galactic and supermassive binary black holes.

UNSTABLE INTERTROCHANTERIC FRACTURE IN ELDERLY TREATED WITH CEMENTED BIPOLAR HEMIARTHROPLASTY AND TROCHANTERIC RECONSTRUCTION

Directory of Open Access Journals (Sweden)

Jagadeesh Kumar

2015-06-01

Full Text Available INTRODUCTION : Unstable inter - trochanteric fracture in the geriatric population is a common injury and is associated with poor bone quality, excessive collapse, loss of fixation, and cut - out of the lag screw, are the common problems of attempts to fix these fractures. Pr esent study is an attempt to evaluate the functional outcome of primary cemented bipolar hemiarthroplasty and trochanter reconstruction in these patients. MATERIALS AND METHOD S : This prospective study included 30 cases of elderly osteoporotic patients with mean age of 65.4 years who sustained comminuted inter - trochanteric femur fracture treated with cemented bipolar hemiarthroplasty& tension band wiring for greater trochanter rec onstruction. It is an essential technical step to avoid complication like abductor lurch gait. W e here describe a technique of reconstruction and fixation of greater trochanter using tension band wiring in figure of eight pattern. The patients were followe d up at six week, three month, six month and one year postoperatively and assessed using Harris Hip Score (HHS. RESULTS : The mean HHS score was was 85.6+SD 9.5 (range from 74 to 96. B y the end of one year. The main clinical measures were early post - opera tive full weight bearing, post - operative complication & functional outcome. The time to full weight bearing, the rate of post - operative complications & functional outcome was significantly better in cemented bipolar arthroplasty group . DISCUSSION : The chan ges in HHS up to six months periods are much greater which starts showing a stable trend thereafter. Fair to good scores were observed in all the patients. The purpose of its use was that while Harris Hip Score (HHS provides information on a multitude of factors. Superficial infection in 2 patients, anterior thigh pain in a patient, shortening less than 2cms in 2 patients, abductor lurch in a patient are the complications noted in post - operative period, but no patient required

Development of a Flipped Medical School Dermatology Module.

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Fox, Joshua; Faber, David; Pikarsky, Solomon; Zhang, Chi; Riley, Richard; Mechaber, Alex; O'Connell, Mark; Kirsner, Robert S

2017-05-01

The flipped classroom module incorporates independent study in advance of in-class instructional sessions. It is unproven whether this methodology is effective within a medical school second-year organ system module. We report the development, implementation, and effectiveness of the flipped classroom methodology in a second-year medical student dermatology module at the University of Miami Leonard M. Miller School of Medicine. In a retrospective cohort analysis, we compared attitudinal survey data and mean scores for a 50-item multiple-choice final examination of the second-year medical students who participated in this 1-week flipped course with those of the previous year's traditional, lecture-based course. Each group comprised nearly 200 students. Students' age, sex, Medical College Admission Test scores, and undergraduate grade point averages were comparable between the flipped and traditional classroom students. The flipped module students' mean final examination score of 92.71% ± 5.03% was greater than that of the traditional module students' 90.92% ± 5.51% ( P flipped methodology to attending live lectures or watching previously recorded lectures. The flipped classroom can be an effective instructional methodology for a medical school second-year organ system module.

[Treatment of trochanteric fractures of the femoral bone].

Science.gov (United States)

Wierer, I; Pospísil, M; Holubár, J; Volf, V

1994-01-01

The authors present the evaluation of some most often methods of treatment of trochanteric fractures of femur. They analyze the group of 235 patients in the years 1987 - 1991 treated for fractures by the McLaughlin technique and by Ender nailing. The first method was performed on 121 people and the technique of Ender nailing on 97 people. The results and complications of these methods of osteosynthesis are presented in the paper. The experiences of the authors confirm the advantage of Ender nailing in treating fractures of the oldest injured patients. The Ender nailing method of osteosynthesis is the more advantageous, because the operation takes less time and is easier for patients. After Ender nailing, the possibility of functional rehabilitation and walking on crutches is greater. McLaughlin osteosynthesis of these fractures proved the more advantageous in younger injured patients.

Trochanteric fragility fractures : Treatment using the cement-augmented proximal femoral nail antirotation.

Science.gov (United States)

Neuerburg, C; Mehaffey, S; Gosch, M; Böcker, W; Blauth, M; Kammerlander, C

2016-06-01

Use of standardized cement augmentation of the proximal femur nail antirotation (PFNA) for the treatment of trochanteric fragility fractures, which are associated with high morbidity and mortality, to achieve safer conditions for immediate full weight-bearing and mobilization, thus, improving preservation of function and independency of orthogeriatric patients. Trochanteric fragility fractures (type 31-A1-3). Ipsilateral arthritis of the hip, leakage of contrast agent into the hip joint, femoral neck fractures. Reduction of the fracture on a fracture table if possible, or minimally invasive open reduction of the proximal femur, i. e., using collinear forceps if necessary. Positioning of guidewires for adjustment of the PFNA and the spiral blade, respectively. Exclusion of leakage of contrast agent and subsequent injection of TRAUMACEM™ V(+) into the femoral head-neck fragment via a trauma needle kit introduced into the spiral blade. Dynamic or static locking of the PFNA at the diaphyseal level. Immediate mobilization of the patients with full weight-bearing and secondary prevention, such as osteoporosis management is necessary to avoid further fractures in the treatment of these patients. A total of 110 patients older than 65 years underwent the procedure. Of the 72 patients available for follow-up (average age 85.3 years), all fractures healed after an average of 15.3 months. No complications related with cement augmentation were observed. Approximately 60 % of patients achieved the mobility level prior to trauma.

Presence of a nail in the medullary canal; is it enough to prevent femoral neck shortening in trochanteric fracture?

Science.gov (United States)

Song, Hyung Keun; Yoon, Han Kuk; Yang, Kyu Hyun

2014-09-01

Presence of a cephalomedullary nail (CMN) in the medullary canal has been thought as advantageous in the control of femoral neck shortening (FNS) and lag screw sliding in trochanteric fracture compared to extramedullary fixation system. However, researches on the factors that influence the degree of FNS after cephalomedullary nailing are lacking. We observed 95 patients (mean age, 75±2.8 years) with trochanteric fractures who were treated with a CMN, and evaluated the relationship between FNS and patient factors including age, gender, fracture type (AO/OTA), bone mineral density, medullary canal diameter, canal occupancy ratio (COR=nail size/canal diameter), and tip-apex distance using initial, immediate postoperative, and follow-up radiography. Univariate regression analyses revealed that the degree of FNS was significantly correlated with fracture type (A1 versus A3, pfracture type (pfracture.

Unifying flipped SU(5) in five dimensions

International Nuclear Information System (INIS)

Barr, S.M.; Dorsner, Ilja

2002-01-01

It is shown that embedding a four-dimensional flipped SU(5) model in a five-dimensional SO(10) model preserves the best features of both flipped SU(5) and SO(10). The missing partner mechanism, which naturally achieves both doublet-triplet splitting and suppression of d=5 proton decay operators, is realized as in flipped SU(5), while the gauge couplings are unified as in SO(10). The masses of down quarks and charged leptons, which are independent in flipped SU(5), are related by the SO(10). Distinctive patterns of quark and lepton masses can result. The gaugino mass M 1 is independent of M 3 and M 2 , which are predicted to be equal

Assessing Behavioral Engagement in Flipped and Non-Flipped Mathematics Classrooms: Teacher Abilities and Other Potential Factors

Science.gov (United States)

Hodgson, Theodore R.; Cunningham, Abby; McGee, Daniel; Kinne, Lenore J.; Murphy, Teri J.

2017-01-01

There is a growing evidence that flipped classrooms are associated with increased levels of student engagement, as compared to engagement in "traditional" settings. Much of this research, however, occurs in post-secondary classrooms and is based upon self-reported engagement data. This study seeks to extend existing flipped classroom…

Flipped Science Inquiry@Crescent Girls' School

Directory of Open Access Journals (Sweden)

Peishi Goh

2017-06-01

Full Text Available This study shares the findings of a school-based Action Research project to explore how inquiry-based science practical lessons designed using the Flipped Science Inquiry@CGS classroom pedagogical model influence the way students learn scientific knowledge and also students' development of 21st century competencies, in particular, in the area of Knowledge Construction. Taking on a broader definition of the flipped classroom pedagogical model, the Flipped Science Inquiry@CGS framework adopts a structure that inverted the traditional science learning experience. Scientific knowledge is constructed through discussions with their peers, making use of their prior knowledge and their experiences while engaging in hands-on activities. Through the study, it is found that with the use of the Flipped Science Inquiry@CGS framework, learning experiences that are better aligned to the epistemology of science while developing 21st century competencies in students are created.

Deep Exploration of the Flipped Classroom before Implementing

Science.gov (United States)

Logan, Brenda

2015-01-01

This paper is a review of the literature that attempts to explain and document the literature on the flipped classroom. It examines 49 studies that explain the flipped approach in the classroom. This paper, particularly, delineates the history, the theory, benefits, criticisms, recommended practices, and what the research on flipping reveals.…

Using lightboard to flip the course

DEFF Research Database (Denmark)

Timcenko, Olga; Triantafyllou, Evangelia; Nilsson, Niels Chr.

, and exercises for in-class work. However, the quality of videos that students have to watch before coming to the class is also important. In this paper, we will describe videos prepared for flipped classroom using light board, an invention from 2014. That allows natural flow of presentation, as it combines......Authors of the paper have several years of experience with flipping parts of the courses, and the whole courses. Crucial for successful flipping the class are well-chosen exercises that students need to do before the class, as a confirmation that they come prepared for in-class exercises...

Evaluation of flipped teaching

OpenAIRE

Henderson, K.; Hobbs, C.; Last, K.

2017-01-01

We report on our evaluation of flipping the classroom for two modules: a compulsory first year calculus module and an optional second year coding theory module taken by Mathe-matics students at the University of the West of England, Bristol (UWE). Flipped teaching is a change to the traditional lecture model used in universities for hundreds of years. In the traditional model the lecturer is in charge of the class and largely dictates the content and pace at which this is delivered. The idea ...

Retention of Content Utilizing a Flipped Classroom Approach.

Science.gov (United States)

Shatto, Bobbi; LʼEcuyer, Kristine; Quinn, Jerod

The flipped classroom experience promotes retention and accountability for learning. The authors report their evaluation of a flipped classroom for accelerated second-degree nursing students during their primary medical-surgical nursing course. Standardized HESI® scores were compared between a group of students who experienced the flipped classroom and a previous group who had traditional teaching methods. Short- and long-term retention was measured using standardized exams 3 months and 12 months following the course. Results indicated that short-term retention was greater and long- term retention was significantly great in the students who were taught using flipped classroom methodology.

Conceptualizing "Homework" in Flipped Mathematics Classes

Science.gov (United States)

de Araujo, Zandra; Otten, Samuel; Birisci, Salih

2017-01-01

Flipped instruction is becoming more common in the United States, particularly in mathematics classes. One of the defining characteristics of this increasingly popular instructional format is the homework teachers assign. In contrast to traditional mathematics classes in which homework consists of problem sets, homework in flipped classes often…

Flipped Classroom Instruction for Inclusive Learning

Science.gov (United States)

Altemueller, Lisa; Lindquist, Cynthia

2017-01-01

The flipped classroom is a teaching methodology that has gained recognition in primary, secondary and higher education settings. The flipped classroom inverts traditional teaching methods, delivering lecture instruction outside class, and devoting class time to problem solving, with the teacher's role becoming that of a learning coach and…

High energy hadron spin-flip amplitude

International Nuclear Information System (INIS)

Selyugin, O.V.

2016-01-01

The high-energy part of the hadron spin-flip amplitude is examined in the framework of the new high-energy general structure (HEGS) model of the elastic hadron scattering at high energies. The different forms of the hadron spin-flip amplitude are compared in the impact parameter representation. It is shown that the existing experimental data of the proton-proton and proton-antiproton elastic scattering at high energy in the region of the diffraction minimum and at large momentum transfer give support in the presence of the energy-independent part of the hadron spin-flip amplitude with the momentum dependence proposed in the works by Galynskii-Kuraev. [ru

Interaction-flip identities in spin glasses

NARCIS (Netherlands)

Contucci, P.; Giardinà, C.; Giberti, C.

2009-01-01

We study the properties of fluctuation for the free energies and internal energies of two spin glass systems that differ for having some set of interactions flipped. We show that their difference has a variance that grows like the volume of the flipped region. Using a new interpolation method, which

STEM Teacher Efficacy in Flipped Classrooms

Science.gov (United States)

Kelly, Daniel; Denson, Cameron

2017-01-01

The flipped classroom instructional model continues to grow in adoption and use in K-12 classrooms. Although there are an increasing number of studies into the implementation of the flipped classroom, there is limited empirical research into its effectiveness and even fewer into the educational, psychological, and theoretical constructs underlying…

Plate fixation in periprosthetic femur fractures Vancouver type B1-Trochanteric hook plate or subtrochanterical bicortical locking?

Science.gov (United States)

Lenz, Mark; Stoffel, Karl; Kielstein, Heike; Mayo, Keith; Hofmann, Gunther O; Gueorguiev, Boyko

2016-12-01

Proximal plate fixation in periprosthetic femur fractures can be improved by plate anchorage in the greater trochanter (lateral tension band principle) or bicortical locking screw placement beside the prosthesis stem in an embracement configuration. Both concepts were compared in a biomechanical test using a femoral hook plate (hook) or a locking attachment plate (LAP). After bone mineral density (BMD) measurement in the greater trochanter, six pairs of fresh frozen human femora were assigned to two groups and instrumented with cemented hip endoprostheses. A transverse osteotomy was set distal to the tip of the prosthesis, simulating a Vancouver B1 fracture. Each pair was instrumented using a plate tensioner with either hook or LAP construct. Cyclic testing (2Hz) with physiologic profile and monotonically increasing load was performed until catastrophic failure. Plate stiffness was compared in a four-point-bending-test. Paired student's-t-test was used for statistical evaluation (pTrochanteric fixation is highly BMD dependent and may be restricted to major greater trochanteric involvement requiring stabilization. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of esophageal motility utilizing the functional lumen imaging probe (FLIP)

Science.gov (United States)

Carlson, Dustin A.; Kahrilas, Peter J.; Lin, Zhiyue; Hirano, Ikuo; Gonsalves, Nirmala; Listernick, Zoe; Ritter, Katherine; Tye, Michael; Ponds, Fraukje A.; Wong, Ian; Pandolfino, John E.

2016-01-01

Background Esophagogastric junction (EGJ) distensibility and distension-mediated peristalsis can be assessed with the functional lumen imaging probe (FLIP) during a sedated upper endoscopy. We aimed to describe esophageal motility assessment using FLIP topography in patients presenting with dysphagia. Methods 145 patients (ages 18 – 85, 54% female) with dysphagia that completed upper endoscopy with a 16-cm FLIP assembly and high-resolution manometry (HRM) were included. HRM was analyzed according to the Chicago Classification of esophageal motility disorders; major esophageal motility disorders were considered ‘abnormal’. FLIP studies were analyzed using a customized program to calculate the EGJ-distensibility index (DI) and generate FLIP topography plots to identify esophageal contractility patterns. FLIP topography was considered ‘abnormal’ if EGJ-DI was esophageal motility and 29 normal motility. 17 (50%) had abnormal FLIP topography including 13 (37%) with abnormal EGJ-DI. Conclusions FLIP topography provides a well-tolerated method for esophageal motility assessment (especially to identify achalasia) at the time of upper endoscopy. FLIP topography findings that are discordant with HRM may indicate otherwise undetected abnormalities of esophageal function, thus FLIP provides an alternative and complementary method to HRM for evaluation of non-obstructive dysphagia. PMID:27725650

Online Learning Room for ”Flipped Classroom”

DEFF Research Database (Denmark)

Bugge, Ellen Margrethe; Nielsen, Linda Susanna Hauschildt

2014-01-01

working actively and innovatively to create a didactic design in our online learning rooms in our LMS that satisfy the demands for flipped learning and at the same time adapted to the special needs of each learning module at the nursing education programme. Keywords: Online learning, flipped classroom......Abstract The “flipped classroom” learning concept is an alternative way of teaching & learning. The fundamental idea of the "flipped classroom" is to change the way students prepare for classes and the work that takes place when the students are together in the classroom. This integrates online...... learning with learning in the classroom. The learning room must support the students’ unassisted learning, their preparation for class and their preparation for supervision in both a motivating and clear way. At the Nursing Education Programme at University College Lillebaelt in Denmark, we have been...

Teaching & Learning Tips 6: The flipped classroom.

Science.gov (United States)

Shi, Connie R; Rana, Jasmine; Burgin, Susan

2018-04-01

Challenge: The "flipped classroom" is a pedagogical model in which instructional materials are delivered to learners outside of class, reserving class time for application of new principles with peers and instructors. Active learning has forever been an elusive ideal in medical education, but the flipped class model is relatively new to medical education. What is the evidence for the "flipped classroom," and how can these techniques be applied to the teaching of dermatology to trainees at all stages of their medical careers? © 2018 The International Society of Dermatology.

Impacts of Flipped Classroom in High School Health Education

Science.gov (United States)

Chen, Li-Ling

2016-01-01

As advanced technology increasingly infiltrated into classroom, the flipped classroom has come to light in secondary educational settings. The flipped classroom is a new instructional approach that intends to flip the traditional teacher-centered classroom into student centered. The purpose of this research is to investigate the impact of the…

Do Students Learn More from a Flip? An Exploration of the Efficacy of Flipped and Traditional Lessons

Science.gov (United States)

DeSantis, Joshua; Van Curen, Rebecca; Putsch, Jake; Metzger, Justin

2015-01-01

Flipped lesson planning, as popularized by Bergman & Sams (2012a), has been viewed by many as a revolutionary pedagogy, tailor-made for the twenty-first century classroom. Enthusiasm for flipped lesson planning has out-paced the collection of data that might determine its effectiveness. This paper presents the results of a study that compared…

A new functional and structural generation of JK edge-triggered flip-flops

International Nuclear Information System (INIS)

Stefanescu, I.

1977-01-01

A new type of logical structure for a JK edge-triggered flip-flop is proposed by the author. The structure facilitates flip-flop realizations, named ''jk-JK edge-triggered flip-flops'', satisfying more functional requirements, and offering an increased flexibility in logical design, with respect to the conventional JK edge-triggered flip-flops. The function of new flip-flops covers the function of JK edge-triggered flip-flops, known as integrated circuits. (author)

The Flipped Learning Approach in Nursing Education: A Literature Review.

Science.gov (United States)

Presti, Carmen Rosa

2016-05-01

This integrative review examines the application of the pedagogical methodology-the flipped classroom-in nursing education. A literature search of the CINAHL, ERIC, and the National Library of Medicine (PubMed and MEDLINE) databases was conducted, using the following key words: flipped classroom, inverted classroom, and nursing education. Results of a literature search yielded 94 articles, with 13 meeting the criteria of the flipped classroom approach in nursing education. Themes identified include the theoretical underpinning, strategies for implementation of a flipped classroom, and student satisfaction with and outcomes of the flipped classroom approach. Syntheses of the findings indicate that the flipped classroom approach can yield positive outcomes, but further study of this methodology is needed to guide future implementation. [J Nurs Educ. 2016;55(5):252-257.]. Copyright 2016, SLACK Incorporated.

Treatment of trochanteric fractures using the Gamma nail

Directory of Open Access Journals (Sweden)

Botnaru V.

2015-02-01

Full Text Available A retrospective study on 2 years and 4 months (April 2012 - August 2014 on 430 patients admitted with trochanteric fractures in our Clinic. The surgical indications depended on the patients age, degree of osteoporosis, level activity, associated pathologies and the anatomo-clinical particularity of the fractures. The fractures were operated with gamma nail. The surgery was done in the first 24-72 hours, patients were followed clinically and radiographically at 2, 4, 6 months postoperative. The age of the patients were between 28-95 years, female sex was predominant in 65% of case. It was reported a case of a fracture produced intraoperatory during progression of the nail, 11 bronhopulmonary complications, 5 phlebitis, 7 cases of hematoma after surgery, a case of pseudarthrosis with loosening of implant and 4 dead. There were no septic complications. Fractures consolidate within 12- 14 weeks. The results were appreciated according to fracture reduction, stability of implant, consolidation time and possibility of walking and weight bearing on operated limb.

Flipped physics

International Nuclear Information System (INIS)

Nanopoulos, D.V.

1991-01-01

This paper is a revamp of a flipped SU(5) x U(1) model derived from the heterotic superstring. The author assumes that the reader is familiar with the general structure of the flipped SU(5) x U(1) model, either in its (pointlike) field theory form, or its stringy derivation. Ideally, one would like to derive directly from the superstring the standard model SU(3) x SU(2) x U(1), without possibly any extra structure (gauge or particle content). Well, this has been proven to be very difficult. Until now, always the standard model is accompanied with extra structure and usually one needs the ordinary Higgs mechanism to get rid of unwanted forms. This may happen at a superhigh energy scale (close to M Planck ) or at intermediate seals (10 13 --10 15 GeV). But if so, our original motivation of deriving directly the standard model from the superstring has been dispersed

The trochanteric gamma nail versus the dynamic hip screw

DEFF Research Database (Denmark)

Ovesen, Ole; Andersen, Mikkel; Poulsen, Thomas

2006-01-01

In a prospective, randomized trial we compared the trochanteric gamma nail (TGN) and the dynamic hip screw (DHS) in the treatment of 146 intertrochanteric fractures. Follow-up was after four and 12 months. The operation time was significantly shorter in the DHS group. At discharge the need...... for walking aids was less in the DHS group. There were no differences in intraoperative blood loss, medical complications, mortality or length of hospital stay. Major fracture complications occurred twiceas often in the TGN group compared with the DHS group, however they were not statistically significant....... Any potential for the TGN leading to a less invasive procedure and a more rapid postoperative mobilisation could not be demonstrated. Compared with the TGN we prefer the DHS for most intertrochanteric fractures in a setting where the majority of these fractures are treated by younger doctors...

New quantitative ultrasound techniques for bone analysis at the distal radius in hip fracture cases: differences between femoral neck and trochanteric fractures.

Science.gov (United States)

Horii, Motoyuki; Fujiwara, Hiroyoshi; Sakai, Ryo; Sawada, Koshiro; Mikami, Yasuo; Toyama, Syogo; Ozaki, Etsuko; Kuriyama, Nagato; Kurokawa, Masao; Kubo, Toshikazu

2017-01-01

Ample evidence on etiological and pathological differences between femoral neck and trochanteric fracture cases suggests the possibility of individualized treatment. There are many issues related to areal bone mineral density and other quantitative computed tomography parameters of the proximal femur. Although osteoporosis is a systemic problem, little has been reported regarding differences in bone structural parameters, including bone mineral density, between them in regions other than the proximal femur. Participants were consecutive female patients >50 years of age admitted to the Saiseikai Suita Hospital (Osaka prefecture, Japan) for their first hip fracture between January 2012 and September 2014. Cortical thickness (CoTh, mm), volumetric trabecular bone mineral density (TBD, mg/cm 3 ), and elastic modulus of trabecular bone (EMTb, GPa) were obtained as the new QUS parameters using the LD-100 system (Oyo Electric, Kyoto, Japan). The mean values of these parameters were compared between femoral neck and trochanteric fracture cases. In addition, correlations between age and each QUS parameter were investigated for each fracture type. A receiver operating characteristic (ROC) curve analysis was performed to examine the degree of effect each parameter on the fracture types. The area under the curve (AUC) for each parameter was compared to the AUC for age. There were 63 cases of femoral neck fracture (mean age, 78.2 years) and 37 cases of trochanteric fracture (mean age, 85.9 years). Mean TBD and EMTb were significantly higher for femoral neck fractures. There were significant negative correlations between QUS parameters and age for femoral neck fractures (P fractures were above those for trochanteric fractures for TBD and EMTb. AUCs were 0.72 for age, and 0.61, 0.65, and 0.65 for CoTh, TBD, and EMTb, respectively. The new QUS parameters indicated that TR fracture cases were more osteoporotic than were FN fracture cases, even at the distal radius. There might be

Flipping the Continuing Medical Education Classroom: Validating a Measure of Attendees' Perceptions.

Science.gov (United States)

Stephenson, Christopher R; Wang, Amy T; Szostek, Jason H; Bonnes, Sara L; Ratelle, John T; Mahapatra, Saswati; Mandrekar, Jayawant N; Beckman, Thomas J; Wittich, Christopher M

2016-01-01

New teaching approaches for CME are needed. In flipped classrooms, coursework is completed beforehand and applied during class time. Studies of flipped classrooms and their potential benefits in CME have not been published. We sought to develop and validate an instrument measuring flipped classroom perceptions, identify whether participation changed perceptions, and determine which flipped classroom components were perceived as most effective. In this cross-sectional validation study, 167 participants in the Mayo Clinic's 2015 Internal Medicine Board Review course received surveys. Online modules were developed to deliver content before flipped classroom courses on acid-base disorders and electrolyte disorders. A flipped classroom perception instrument (FCPI) was developed and validated. The FCPI, with eight items structured on 5-point Likert scales, was given to participants before and after their flipped classroom experiences. Of the 167 participants, 111 returned surveys. Flipped classroom perceptions improved, with mean (SD) FCPI scores increasing from 3.74 (0.75) to 3.94 (0.76) (P flipped classrooms increased from 38% before the course to 53% after (P = .002). Positive changes in FCPI scores were unrelated to module completion. Most participants thought knowledge was enhanced by in-class sessions and online modules equally. The FCPI, the first validated measure of participants' perceptions of a CME flipped classroom, has strong validity evidence. Participants' perceptions of and preference for the flipped classroom improved after experiencing the flipped CME classroom. These findings support the need to further explore flipped classroom models in CME.

An evaluation of flipped e-learning experiences.

Science.gov (United States)

Jones-Bonofiglio, Kristen Dawn; Willett, Timothy; Ng, Stella

2017-12-22

The "flipped" classroom is an educational strategy gaining popularity for its growing evidence base that suggests it may successfully improve learning outcomes. Also known as reverse instruction, this approach has been typically implemented and studied in in-person post-secondary settings. The utilization of a flipped approach in the healthcare education literature has been examined in a wide range of contexts, but little has been written regarding continuing professional development (CPD). Therefore, with success in other contexts there is potential for the flipped classroom approach to enhance student satisfaction, learner engagement, and learning outcomes in the context of online education for CPD. In this paper, we describe the structure and format of such a course using a qualitative case study framework. This study contributes to a more comprehensive understanding of effective ways of overcoming distributed learning challenges in online CPD using a flipped approach.

Fat fraction bias correction using T1 estimates and flip angle mapping.

Science.gov (United States)

Yang, Issac Y; Cui, Yifan; Wiens, Curtis N; Wade, Trevor P; Friesen-Waldner, Lanette J; McKenzie, Charles A

2014-01-01

To develop a new method of reducing T1 bias in proton density fat fraction (PDFF) measured with iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL). PDFF maps reconstructed from high flip angle IDEAL measurements were simulated and acquired from phantoms and volunteer L4 vertebrae. T1 bias was corrected using a priori T1 values for water and fat, both with and without flip angle correction. Signal-to-noise ratio (SNR) maps were used to measure precision of the reconstructed PDFF maps. PDFF measurements acquired using small flip angles were then compared to both sets of corrected large flip angle measurements for accuracy and precision. Simulations show similar results in PDFF error between small flip angle measurements and corrected large flip angle measurements as long as T1 estimates were within one standard deviation from the true value. Compared to low flip angle measurements, phantom and in vivo measurements demonstrate better precision and accuracy in PDFF measurements if images were acquired at a high flip angle, with T1 bias corrected using T1 estimates and flip angle mapping. T1 bias correction of large flip angle acquisitions using estimated T1 values with flip angle mapping yields fat fraction measurements of similar accuracy and superior precision compared to low flip angle acquisitions. Copyright © 2013 Wiley Periodicals, Inc.

Spin flipping a stored polarized proton beam with an rf magnetic field

International Nuclear Information System (INIS)

Hu, S.Q.; Blinov, B.B.; Caussyn, D.D.

1995-01-01

The authors studied the spin flipping of a vertically polarized, stored 139 MeV proton beam with an rf solenoid magnetic field. By sweeping the rf frequency through an rf depolarizing resonance, they made the spin flip. The spin flipping was more efficient for slower ramp times, and the spin flip efficiency peaked at some optimum ramp time that is not yet fully understood. Since frequent spin flipping could significantly reduce the systematic errors in scattering experiments using a stored polarized beam, it is very important to minimize the depolarization after each spin flip. In this experiment, with multiple spin flips, the authors found a polarization loss of 0.0000 ± 0.0005 per spin flip under the best conditions; this loss increased significantly for small changes in the conditions

Flipping and Still Learning: Experiences of a Flipped Classroom Approach for a Third-Year Undergraduate Human Geography Course

Science.gov (United States)

Graham, Marnie; McLean, Jessica; Read, Alexander; Suchet-Pearson, Sandie; Viner, Venessa

2017-01-01

The flipped classroom approach, a form of blended learning, is currently popular in education praxis. Initial reports on the flipped classroom include that it offers opportunities to increase student engagement and build meaningful learning and teaching experiences. In this article, we analyse teacher and student experiences of a trial flipped…

Fitness Probability Distribution of Bit-Flip Mutation.

Science.gov (United States)

Chicano, Francisco; Sutton, Andrew M; Whitley, L Darrell; Alba, Enrique

2015-01-01

Bit-flip mutation is a common mutation operator for evolutionary algorithms applied to optimize functions over binary strings. In this paper, we develop results from the theory of landscapes and Krawtchouk polynomials to exactly compute the probability distribution of fitness values of a binary string undergoing uniform bit-flip mutation. We prove that this probability distribution can be expressed as a polynomial in p, the probability of flipping each bit. We analyze these polynomials and provide closed-form expressions for an easy linear problem (Onemax), and an NP-hard problem, MAX-SAT. We also discuss a connection of the results with runtime analysis.

Teachers' development and reflection in the flipped classroom

DEFF Research Database (Denmark)

Triantafyllou, Evangelia; Timcenko, Olga; Kofoed, Lise

2017-01-01

The flipped classroom is an instruction method that has gained momentum during the last years due to technological advances allowing the online sharing of teaching material and learning activities. Bishop and Verleger defined the flipped classroom as “...an educational technique that consists...... of two parts: interactive group learning activities inside the classroom, and direct computer-based individual instruction outside the classroom” (Bishop & Verleger, 2013). So far, research on flipped classroom has mostly concentrated on student perceptions, engagement and achievement level, e...... course in order to adjust it to the flipped classroom model. We have also seen that these considerations have forced teachers to also reconsider the learning objectives of specific activities. Another aspect that promoted reflection was the production of video lectures. Finally, teachers reflected...

Rework of flip chip bonded radiation pixel detectors

International Nuclear Information System (INIS)

Vaehaenen, S.; Heikkinen, H.; Pohjonen, H.; Salonen, J.; Savolainen-Pulli, S.

2008-01-01

In this paper, some practical aspects of reworking flip chip hybridized pixel detectors are discussed. As flip chip technology has been advancing in terms of placement accuracy and reliability, large-area hybrid pixel detectors have been developed. The area requirements are usually fulfilled by placing several readout chips (ROCs) on single sensor chip. However, as the number of ROCs increases, the probability of failure in the hybridization process and the ROC operation also increases. Because high accuracy flip chip bonding takes time, a significant part of the price of a pixel detector comes from the flip chip assembly process itself. As large-area detector substrates are expensive, and many flip chip placements are required, the price of an assembled detector can become very high. In a typical case, there is just one bad ROC (out of several) on a faulty detector to be replaced. Considering the high price of pixel detectors and the fact that reworking faulty ROCs does not take much longer than the original placement, it is worthwhile to investigate the feasibility of a rework process

Rework of flip chip bonded radiation pixel detectors

Energy Technology Data Exchange (ETDEWEB)

Vaehaenen, S. [VTT MEMS and Micropackaging, Espoo 02150 (Finland)], E-mail: sami.vahanen@vtt.fi; Heikkinen, H.; Pohjonen, H.; Salonen, J.; Savolainen-Pulli, S. [VTT MEMS and Micropackaging, Espoo 02150 (Finland)

2008-06-11

In this paper, some practical aspects of reworking flip chip hybridized pixel detectors are discussed. As flip chip technology has been advancing in terms of placement accuracy and reliability, large-area hybrid pixel detectors have been developed. The area requirements are usually fulfilled by placing several readout chips (ROCs) on single sensor chip. However, as the number of ROCs increases, the probability of failure in the hybridization process and the ROC operation also increases. Because high accuracy flip chip bonding takes time, a significant part of the price of a pixel detector comes from the flip chip assembly process itself. As large-area detector substrates are expensive, and many flip chip placements are required, the price of an assembled detector can become very high. In a typical case, there is just one bad ROC (out of several) on a faulty detector to be replaced. Considering the high price of pixel detectors and the fact that reworking faulty ROCs does not take much longer than the original placement, it is worthwhile to investigate the feasibility of a rework process.

What millennial medical students say about flipped learning

Directory of Open Access Journals (Sweden)

Pettit RK

2017-07-01

Full Text Available Robin K Pettit, Lise McCoy, Marjorie Kinney School of Osteopathic Medicine in Arizona, A. T. Still University, Mesa, AZ, USA Abstract: Flipped instruction is gaining popularity in medical schools, but there are unanswered questions such as the optimum amount of the curriculum to flip and whether flipped sessions should be mandatory. We were in a unique position to evaluate feedback from first-year medical students who had experienced both flipped and lecture-based courses during their first semester of medical school. A key finding was that the students preferred a variety of different learning formats over an “all or nothing” learning format. Learning format preferences did not necessarily align with perceptions of which format led to better course exam performance. Nearly 70% of respondents wanted to make their own decisions regarding attendance. Candid responses to open-ended survey prompts reflected millennial preferences for choice, flexibility, efficiency, and the ability to control the pace of their learning, providing insight to guide ­curricular improvements. Keywords: flipped classroom, mandatory attendance, medical education, lecture-based, variety

On flipping first-semester calculus: a case study

Science.gov (United States)

Petrillo, Joseph

2016-05-01

High failure rates in calculus have plagued students, teachers, and administrators for decades, while science, technology, engineering, and mathematics programmes continue to suffer from low enrollments and high attrition. In an effort to affect this reality, some educators are 'flipping' (or inverting) their classrooms. By flipping, we mean administering course content outside of the classroom and replacing the traditional in-class lectures with discussion, practice, group work, and other elements of active learning. This paper presents the major results from a three-year study of a flipped, first-semester calculus course at a small, comprehensive, American university with a well-known engineering programme. The data we have collected help quantify the positive and substantial effects of our flipped calculus course on failure rates, scores on the common final exam, student opinion of calculus, teacher impact on measurable outcomes, and success in second-semester calculus. While flipping may not be suitable for every teacher, every student, and in every situation, this report provides some evidence that it may be a viable option for those seeking an alternative to the traditional lecture model.

Flipping Preservice Elementary Teachers' Mathematics Anxieties

Science.gov (United States)

Dove, Anthony; Dove, Emily

2017-01-01

In preparing future elementary educators in mathematics, helping them overcome their anxieties of mathematics and teaching mathematics is paramount. This study examined how different instructional practices (in-class lecture, flipped learning with teacher-created videos, flipped classroom with Khan Academy videos) compared in improving students'…

The Flipped Classroom: A Twist on Teaching

Science.gov (United States)

Schmidt, Stacy M. P.; Ralph, David L.

2016-01-01

The traditional classroom has utilized the "I Do", "We Do", "You Do" as a strategy for teaching for years. The flipped classroom truly flips that strategy. The teacher uses "You Do", "We Do", "I Do" instead. Homework, inquiry, and investigation happen in the classroom. At home students…

Causes and treatments of lag screw's cut out after intramedullary nailing osteosinthesis for trochanteric fractures.

Science.gov (United States)

Gazzotti, Gabriele; Matino, Giovanni; Tsatsis, Christos; Sacchetti, GianLuigi; Baudi, Paolo; Catani, Fabio

2014-08-20

Background. Superior cut-out of a lag screw remains a serious complication in the treatment of trochanteric or subtrochanteric fractures and it is related to many factors: the type of fracture, osteoporosis and the stability of fracture reduction. Little is known about the outcome after revision surgery for complications of the gamma nail. We assessed the outcome in patients who had revision surgery because of lag screw's cut out after gamma nailing for a trochanteric fracture.Material and Method. We present a study of 20 consecutive patients who underwent treatment after 20 cut-out of the lag screw fixation of a trochanteric fracture with Gamma Locking Nail from September 2004 to November 2010. In 16 patients hip prothesis was performed, in 1 the removal of the implant and in 3 the reosteosynthesis. We reviewed 13 patients: 10 total hip arthroplasty, 2 endoprothesis and 1 reosteosynthesis of nail and lag screw (mean follow up: 26 months, mean age: 73 years old), 7 patients died. Patients were reviewed retrospectively by an independent observer. Clinical evaluation was performed, Oxford score and Harris Hip score were measured. X-Ray examination was performed after a minimum of 12 months of follow up.Results. Mean Harris Hip Score mean was 67 and mean Oxford score was 32 in hip prothesis group (12 patients). We had several complications, Implant-related complications were: 2 ipometria > 2cm, 2 recurrent hip arthroplasty dislocations (1 reoperated), 4 persistent thigh pain. In only 4 patients none complications were observed. Another patient,  who had been subjected to reosteosinthesis, obtained better results (HHS:95, Oxford score:45) but with a 2 cm ipometria and occasional pain in the thigh.Conclusion. Cut out after gamma nail is consequent to biological or mechanical causes. Treatment of this complication is hip prosthesis (parzial or total hip arthroplasty), reosteosynthesis of the lag screw and/or the nail and the removal of the implant. Conversion to total

Errors and corrections in the separation of spin-flip and non-spin-flip thermal neutron scattering using the polarization analysis technique

International Nuclear Information System (INIS)

Williams, W.G.

1975-01-01

The use of the polarization analysis technique to separate spin-flip from non-spin-flip thermal neutron scattering is especially important in determining magnetic scattering cross-sections. In order to identify a spin-flip ratio in the scattering with a particular scattering process, it is necessary to correct the experimentally observed 'flipping-ratio' to allow for the efficiencies of the vital instrument components (polarizers and spin-flippers), as well as multiple scattering effects in the sample. Analytical expressions for these corections are presented and their magnitudes in typical cases estimated. The errors in measurement depend strongly on the uncertainties in the calibration of the efficiencies of the polarizers and the spin-flipper. The final section is devoted to a discussion of polarization analysis instruments

A STUDY OF UNSTABLE INTERTROCHANTERIC FEMORAL FRACTURES TREATED BY TROCHANTERIC FEMORAL NAIL

Directory of Open Access Journals (Sweden)

Sreenivasa Neikar

2017-11-01

Full Text Available BACKGROUND Intertrochanteric fracture is one of the most common fracture of the hip especially in the elderly. The incidence of intertrochanteric fracture is rising because of the increase in number of elderly population along with superadded osteoporosis. MATERIALS AND METHODS Study included cases of unstable intertrochanteric fractures (AO and OTA Classification 31-A2 and 31-A3 fracture patterns that were operated with the short trochanteric femoral nail, which fitted into the inclusion criteria done in medical college hospital, Vijayanagara Institute of Medical Sciences, Bellary, from February 2015 to September 2016. RESULTS The age distribution was from 40 to 80 years. The largest group of patients were from 61 to 70 years. The average age was 60.5 years. The number of male patients in our series was 20 (66.7% and female was 10 (33.3%. Right side was affected in 11 cases (36.7% and left side in 19 cases (63.3%. Good reduction was achieved in 23 patients (76.7%. Acceptable reduction was achieved in 7 (23.3% patients due to severe comminution. In our study, 25 patients (83.33% had no complications. We encountered one intraoperative complication in the form of greater trochanter splintering, while inserting the nail. In our study, we encountered following postoperative complications. We noticed one case of delayed union, one case of Z effect and 2 cases of varus malunion. CONCLUSION We conclude that short trochanteric femoral nail provides good fixation for unstable intertrochanteric fractures if proper preoperative planning, good reduction and surgical technique are followed leading to high rate of bone union and minimal soft tissue damage especially for Asian patients with relatively small femora.

Flipped SO(10) model

Energy Technology Data Exchange (ETDEWEB)

Maekawa, Nobuhiro; Yamashita, Toshifumi

2003-08-14

This Letter demonstrates that, as in flipped SU(5) models, doublet-triplet splitting is accomplished by a missing partner mechanism in flipped SO(10) models. The gauge group SO(10){sub F}xU(1){sub V'{sub F}} includes SU(2){sub E} gauge symmetry, which plays an important role in solving the supersymmetric (SUSY) flavor problem by introducing non-abelian horizontal gauge symmetry and anomalous U(1){sub A} gauge symmetry. The gauge group can be broken into the standard model gauge group by VEVs of only spinor fields; such models may be easier to derive than E{sub 6} models from superstring theory.

Control of phospholipid flip-flop by transmembrane peptides

International Nuclear Information System (INIS)

Kaihara, Masanori; Nakao, Hiroyuki; Yokoyama, Hirokazu; Endo, Hitoshi; Ishihama, Yasushi; Handa, Tetsurou; Nakano, Minoru

2013-01-01

Highlights: ► Phospholipid flip-flop in transmembrane peptide-containing vesicles was investigated. ► Peptides that contained polar residues in the center of the transmembrane region promoted phospholipid flip-flop. ► A bioinformatics approach revealed the presence of polar residues in the transmembrane region of ER membrane proteins. ► Polar residues in ER membrane proteins possibly provide flippase-like activity. - Abstract: We designed three types of transmembrane model peptides whose sequence originates from a frequently used model peptide KALP23, and we investigated their effects on phospholipid flip-flop. Time-resolved small-angle neutron scattering and a dithionite fluorescent quenching assay demonstrated that TMP-L, which has a fully hydrophobic transmembrane region, did not enhance phospholipid flip-flop, whereas TMP-K and TMP-E, which have Lys and Glu, respectively, in the center of their transmembrane regions, enhanced phospholipid flip-flop. Introduction of polar residues in the membrane-spanning helices is considered to produce a locally polar region and enable the lipid head group to interact with the polar side-chain inside the bilayers, thereby reducing the activation energy for the flip-flop. A bioinformatics approach revealed that acidic and basic residues account for 4.5% of the central region of the transmembrane domain in human ER membrane proteins. Therefore, polar residues in ER membrane proteins are considered to provide flippase-like activity

Surgical treatment of synovial osteochondromatosis of the hip using a modified-Hardinge approach with a Z-shaped capsular incision

Directory of Open Access Journals (Sweden)

Yu Takeda

2015-12-01

Full Text Available Synovial osteochondromatosis of the hip is a rare condition, and the surgical treatment approach for this condition requires complete removal of loose bodies combined with synovectomy. While these, procedures are generally accepted as the optimal treatment method, this is still controversial topic. Recent studies have reported that open surgical procedures remain acceptable for synovial osteochondromatosis of the hip. These procedures include the dislocation of the femoral head, and complications such as femoral head necrosis and bursitis or great trochanter non-union due to trochanteric osteotomy have been reported. The present study reports a modified technique for surgical dislocation through a Z-shaped capsular incision without trochanteric flip osteotomy for the treatment of synovial osteochondromatosis of the hip.

Best Practices for Launching a Flipped Classroom

Science.gov (United States)

Hall, Ashley A.; DuFrene, Debbie D.

2016-01-01

Popularity is growing for flipped classroom instruction, which replaces lectures with out-of-class delivery of streaming video, reading materials, online chats, and other modalities. Face-to-face class time is spent on instructor-student and student-student interaction, including small group problem solving and discussion. Classroom flipping has…

Step to improve neural cryptography against flipping attacks.

Science.gov (United States)

Zhou, Jiantao; Xu, Qinzhen; Pei, Wenjiang; He, Zhenya; Szu, Harold

2004-12-01

Synchronization of neural networks by mutual learning has been demonstrated to be possible for constructing key exchange protocol over public channel. However, the neural cryptography schemes presented so far are not the securest under regular flipping attack (RFA) and are completely insecure under majority flipping attack (MFA). We propose a scheme by splitting the mutual information and the training process to improve the security of neural cryptosystem against flipping attacks. Both analytical and simulation results show that the success probability of RFA on the proposed scheme can be decreased to the level of brute force attack (BFA) and the success probability of MFA still decays exponentially with the weights' level L. The synchronization time of the parties also remains polynomial with L. Moreover, we analyze the security under an advanced flipping attack.

Flipped Classroom as an Alternative Strategy for Teaching Stoichiometry

Directory of Open Access Journals (Sweden)

Norrie E. Gayeta

2017-11-01

Full Text Available This study aimed to compare the effectiveness of flipped classroom and traditional classroom instruction in measuring conceptual change and to determine if flipped classroom instruction would be an alternative method of teaching to traditional lecture method. This study covered the level of conceptual understanding of students on stoichiometry and the type of conceptual change before and after exposure to flipped and traditional classroom environment. Qualitative and quantitative research methods were used in the study. Respondents were two sections of third year Bachelor of Secondary Education, Biological Science. Frequency, percentage, ranking, mean, standard deviation, Hake factor test, and t-test were the statistical tools applied to answer specific questions. Results showed profound increase towards conceptual change representing a shift from intuitive understanding to correct incomplete understanding level. Thus, change for the better, in theoretical type was determined from pretest to posttest of students exposed to flipped and traditional classroom. Results also indicated that there is no significant difference on students’ conceptual change on stoichiometry exposed to flipped and traditional classroom environment thus, flipped classroom instruction can be used as an alternative teaching method to traditional lecture method in teaching stoichiometry

Applying the Flipped Classroom Model to English Language Arts Education

Science.gov (United States)

Young, Carl A., Ed.; Moran, Clarice M., Ed.

2017-01-01

The flipped classroom method, particularly when used with digital video, has recently attracted many supporters within the education field. Now more than ever, language arts educators can benefit tremendously from incorporating flipped classroom techniques into their curriculum. "Applying the Flipped Classroom Model to English Language Arts…

Examining the Flipped Classroom through Action Research

Science.gov (United States)

Lo, Chung Kwan

2017-01-01

There is a growing interest in using a flipped classroom format in day-to-day teaching. Direct computer-based individual instruction outside the classroom and interactive group learning activities inside the classroom are the two essential components of the flipped classroom model. By watching instructional videos, students can work through some…

Flipped Classroom as an Alternative Strategy for Teaching Stoichiometry

OpenAIRE

Norrie E. Gayeta

2017-01-01

This study aimed to compare the effectiveness of flipped classroom and traditional classroom instruction in measuring conceptual change and to determine if flipped classroom instruction would be an alternative method of teaching to traditional lecture method. This study covered the level of conceptual understanding of students on stoichiometry and the type of conceptual change before and after exposure to flipped and traditional classroom environment. Qualitative and quantitative ...

Performance and Motivation in a Middle School Flipped Learning Course

Science.gov (United States)

Winter, Joshua W.

2018-01-01

Flipped learning is a teaching approach that promotes collaboration by using technology to 'flip' traditional instruction. Content is delivered outside of class in the individual space (online) and the group space (classroom) is used to engage in collaborative activities. Flipped learning shifts the teacher's role toward facilitation. Research on…

Flipped Learning fra et elevperspektiv

DEFF Research Database (Denmark)

Holmboe, Peter; Hachmann, Roland

2016-01-01

Antologi er et resultat af et toårigt udviklingsprojekt om Flipped Learning baseret på et samarbejde mellem IT-Center Fyn og Region Syddanmark. Bidraget her præsenterer en række overvejelser, vi har gjort os på baggrund af observationer af undervisning og interviews med elever i projektet. Vores...... overordnede undersøgelsesspørgsmål var: "Hvilke forhold i undervisning og læringsmiljø fremme hhv. begrænser elevens opfattelse af mening og fagligt udbytte i et Flipped Learning design?"....

Does the Flipped Classroom Improve Learning in Graduate Medical Education?

Science.gov (United States)

Riddell, Jeff; Jhun, Paul; Fung, Cha-Chi; Comes, James; Sawtelle, Stacy; Tabatabai, Ramin; Joseph, Daniel; Shoenberger, Jan; Chen, Esther; Fee, Christopher; Swadron, Stuart P

2017-08-01

The flipped classroom model for didactic education has recently gained popularity in medical education; however, there is a paucity of performance data showing its effectiveness for knowledge gain in graduate medical education. We assessed whether a flipped classroom module improves knowledge gain compared with a standard lecture. We conducted a randomized crossover study in 3 emergency medicine residency programs. Participants were randomized to receive a 50-minute lecture from an expert educator on one subject and a flipped classroom module on the other. The flipped classroom included a 20-minute at-home video and 30 minutes of in-class case discussion. The 2 subjects addressed were headache and acute low back pain. A pretest, immediate posttest, and 90-day retention test were given for each subject. Of 82 eligible residents, 73 completed both modules. For the low back pain module, mean test scores were not significantly different between the lecture and flipped classroom formats. For the headache module, there were significant differences in performance for a given test date between the flipped classroom and the lecture format. However, differences between groups were less than 1 of 10 examination items, making it difficult to assign educational importance to the differences. In this crossover study comparing a single flipped classroom module with a standard lecture, we found mixed statistical results for performance measured by multiple-choice questions. As the differences were small, the flipped classroom and lecture were essentially equivalent.

What millennial medical students say about flipped learning.

Science.gov (United States)

Pettit, Robin K; McCoy, Lise; Kinney, Marjorie

2017-01-01

Flipped instruction is gaining popularity in medical schools, but there are unanswered questions such as the optimum amount of the curriculum to flip and whether flipped sessions should be mandatory. We were in a unique position to evaluate feedback from first-year medical students who had experienced both flipped and lecture-based courses during their first semester of medical school. A key finding was that the students preferred a variety of different learning formats over an "all or nothing" learning format. Learning format preferences did not necessarily align with perceptions of which format led to better course exam performance. Nearly 70% of respondents wanted to make their own decisions regarding attendance. Candid responses to open-ended survey prompts reflected millennial preferences for choice, flexibility, efficiency, and the ability to control the pace of their learning, providing insight to guide curricular improvements.

Flipped Physics

Science.gov (United States)

Kettle, Maria

2013-01-01

This paper defines flipped learning and then examines its practical implementation in AS and A2 level physics classes, that is, classes for 16-18 year olds. The effect of this teaching style on student learning behaviour and its impact on test results are evaluated. The paper recounts the difficulties of implementing it and evaluates student…

Intramedullary femoral nailing through the trochanteric fossa versus greater trochanter tip : a randomized controlled study with in-depth functional outcome results

NARCIS (Netherlands)

Moein, C. M. Ansari; ten Duis, H. J.; Oey, P. L.; de Kort, G. A. P.; van der Meulen, W.; van der Werken, Chr

2011-01-01

In a level 1 university trauma center, an explorative randomized controlled study was performed to compare soft tissue damage and functional outcome after antegrade femoral nailing through a trochanteric fossa (also known as piriform fossa) entry point to a greater trochanter entry point in patients

The flipped classroom: practices and opportunities for health sciences librarians.

Science.gov (United States)

Youngkin, C Andrew

2014-01-01

The "flipped classroom" instructional model is being introduced into medical and health sciences curricula to provide greater efficiency in curriculum delivery and produce greater opportunity for in-depth class discussion and problem solving among participants. As educators employ the flipped classroom to invert curriculum delivery and enhance learning, health sciences librarians are also starting to explore the flipped classroom model for library instruction. This article discusses how academic and health sciences librarians are using the flipped classroom and suggests opportunities for this model to be further explored for library services.

Model studies of lipid flip-flop in membranes

DEFF Research Database (Denmark)

Parisio, Giulia; Ferrarini, Alberta; Sperotto, Maria Maddalena

2016-01-01

, and growth heavily depend. Such transverse motion—commonly called flip-flop—has been studied both experimentally and computationally. Experimental investigations face difficulties related to time-scales and probe-induced membrane perturbation issues. Molecular dynamics simulations play an important role...... for the molecular-level understanding of flip-flop. In this review we present a summary of the state of the art of computational studies of spontaneous flip-flop of phospholipids, sterols and fatty acids. Also, we highlight critical issues and strategies that have been developed to solve them, and what remains...

Polarizing a stored proton beam by spin flip?

International Nuclear Information System (INIS)

Oellers, D.; Barion, L.; Barsov, S.; Bechstedt, U.; Benati, P.; Bertelli, S.; Chiladze, D.; Ciullo, G.; Contalbrigo, M.; Dalpiaz, P.F.; Dietrich, J.; Dolfus, N.; Dymov, S.; Engels, R.; Erven, W.; Garishvili, A.; Gebel, R.; Goslawski, P.

2009-01-01

We discuss polarizing a proton beam in a storage ring, either by selective removal or by spin flip of the stored ions. Prompted by recent, conflicting calculations, we have carried out a measurement of the spin-flip cross section in low-energy electron-proton scattering. The experiment uses the cooling electron beam at COSY as an electron target. The measured cross sections are too small for making spin flip a viable tool in polarizing a stored beam. This invalidates a recent proposal to use co-moving polarized positrons to polarize a stored antiproton beam.

Diverse Perspectives on a Flipped Biostatistics Classroom

Science.gov (United States)

Schwartz, Todd A.; Andridge, Rebecca R.; Sainani, Kirstin L.; Stangle, Dalene K.; Neely, Megan L.

2016-01-01

"Flipping" the classroom refers to a pedagogical approach in which students are first exposed to didactic content outside the classroom and then actively use class time to apply their newly attained knowledge. The idea of the flipped classroom is not new, but has grown in popularity in recent years as the necessary technology has…

Characterization of hybrid integrated all-optical flip-flop

NARCIS (Netherlands)

Liu, Y.; McDougall, R.; Seoane, J.; Kehayas, E.; Hill, M.T.; Maxwell, G.D.; Zhang, S.; Harmon, R.; Huijskens, Frans; Rivers, L.; Van Holm-Nielsen, P.; Martinez, J.M.; Herrera Llorente, J.; Ramos, F.; Marti, J.; Avramopoulos, H.; Jeppesen, P.; Koonen, A.M.J.; Poustie, A.; Dorren, H.J.S.

2006-01-01

We present a fully-packaged, hybrid-integrated all-optical flip-flop with separate optical set and reset operation. The flip-flop can control a wavelength converter to route 40 Gb/s data packets all-optically. The experimental results are given

Out of Classroom Instruction in the Flipped Classroom

DEFF Research Database (Denmark)

Triantafyllou, Evangelia; Timcenko, Olga

2015-01-01

This article presents experiences and student perceptions on the introduction of the flipped classroom model in two consecutive semesters at Media Technology department of Aalborg University, Copenhagen, Denmark. We introduced the flipped instruction model to a statistics course and a mathematics...

Characterisation of hybrid integrated all-optical flip-flop

DEFF Research Database (Denmark)

Liu, Y.; McDougall, R.; Seoane, Jorge

2006-01-01

We present a fully-packaged, hybrid-integrated all-optical flip-flop with separate optical set and reset operation. The flip-flop can control a wavelength converter to route 40 Gb/s data packets all-optically. The experimental results are given....

Enhancing student engagement using the flipped classroom.

Science.gov (United States)

Gilboy, Mary Beth; Heinerichs, Scott; Pazzaglia, Gina

2015-01-01

The flipped classroom is an innovative pedagogical approach that focuses on learner-centered instruction. The purposes of this report were to illustrate how to implement the flipped classroom and to describe students' perceptions of this approach within 2 undergraduate nutrition courses. The template provided enables faculty to design before, during, and after class activities and assessments based on objectives using all levels of Bloom's taxonomy. The majority of the 142 students completing the evaluation preferred the flipped method compared with traditional pedagogical strategies. The process described in the report was successful for both faculty and students. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Evaluation of a flipped classroom approach to learning introductory epidemiology.

Science.gov (United States)

Shiau, Stephanie; Kahn, Linda G; Platt, Jonathan; Li, Chihua; Guzman, Jason T; Kornhauser, Zachary G; Keyes, Katherine M; Martins, Silvia S

2018-04-02

Although the flipped classroom model has been widely adopted in medical education, reports on its use in graduate-level public health programs are limited. This study describes the design, implementation, and evaluation of a flipped classroom redesign of an introductory epidemiology course and compares it to a traditional model. One hundred fifty Masters-level students enrolled in an introductory epidemiology course with a traditional format (in-person lecture and discussion section, at-home assignment; 2015, N = 72) and a flipped classroom format (at-home lecture, in-person discussion section and assignment; 2016, N = 78). Using mixed methods, we compared student characteristics, examination scores, and end-of-course evaluations of the 2016 flipped classroom format and the 2015 traditional format. Data on the flipped classroom format, including pre- and post-course surveys, open-ended questions, self-reports of section leader teaching practices, and classroom observations, were evaluated. There were no statistically significant differences in examination scores or students' assessment of the course between 2015 (traditional) and 2016 (flipped). In 2016, 57.1% (36) of respondents to the end-of-course evaluation found watching video lectures at home to have a positive impact on their time management. Open-ended survey responses indicated a number of strengths of the flipped classroom approach, including the freedom to watch pre-recorded lectures at any time and the ability of section leaders to clarify targeted concepts. Suggestions for improvement focused on ways to increase regular interaction with lecturers. There was no significant difference in students' performance on quantitative assessments comparing the traditional format to the flipped classroom format. The flipped format did allow for greater flexibility and applied learning opportunities at home and during discussion sections.

Spin-flipping a stored polarized proton beam with an rf dipole

International Nuclear Information System (INIS)

Blinov, B.B.; Derbenev, Ya.S.; Kageya, T.; Kantsyrev, D.Yu.; Krisch, A.D.; Morozov, V.S.; Sivers, D.W.; Wong, V.K.; Anferov, V.A.; Schwandt, P.; Przewoski, B. von

2000-01-01

Frequent polarization reversals, or spin-flips, of a stored polarized high-energy beam may greatly reduce systematic errors of spin asymmetry measurements in a scattering asymmetry experiment. We studied the spin-flipping of a 120 MeV horizontally-polarized proton beam stored in the IUCF Cooler Ring by ramping an rf-dipole magnet's frequency through an rf-induced depolarizing resonance in the presence of a nearly-full Siberian snake. After optimizing the frequency ramp parameters, we used multiple spin-flips to measure a spin-flip efficiency of 86.5±0.5%. The spin-flip efficiency was apparently limited by the rf-dipole's field strength. This result indicates that an efficient spin-flipping a stored polarized beam should be possible in high energy rings such as RHIC and HERA where Siberian snakes are certainly needed and only dipole rf-flipper-magnets are practical

Just in Time to Flip Your Classroom

Science.gov (United States)

Lasry, Nathaniel; Dugdale, Michael; Charles, Elizabeth

2014-01-01

With advocates like Sal Khan and Bill Gates, flipped classrooms are attracting an increasing amount of media and research attention. We had heard Khan's TED talk and were aware of the concept of inverted pedagogies in general. Yet it really hit home when we accidentally flipped our classroom. Our objective was to better prepare our students…

Study and practice of flipped classroom in optoelectronic technology curriculum

Science.gov (United States)

Shi, Jianhua; Lei, Bing; Liu, Wei; Yao, Tianfu; Jiang, Wenjie

2017-08-01

"Flipped Classroom" is one of the most popular teaching models, and has been applied in more and more curriculums. It is totally different from the traditional teaching model. In the "Flipped Classroom" model, the students should watch the teaching video afterschool, and in the classroom only the discussion is proceeded to improve the students' comprehension. In this presentation, "Flipped Classroom" was studied and practiced in opto-electronic technology curriculum; its effect was analyzed by comparing it with the traditional teaching model. Based on extensive and deep investigation, the phylogeny, the characters and the important processes of "Flipped Classroom" are studied. The differences between the "Flipped Classroom" and the traditional teaching model are demonstrated. Then "Flipped Classroom" was practiced in opto-electronic technology curriculum. In order to obtain high effectiveness, a lot of teaching resources were prepared, such as the high-quality teaching video, the animations and the virtual experiments, the questions that the students should finish before and discussed in the class, etc. At last, the teaching effect was evaluated through analyzing the result of the examination and the students' surveys.

Assessment of learning gains in a flipped biochemistry classroom.

Science.gov (United States)

Ojennus, Deanna Dahlke

2016-01-01

The flipped classroom has become an increasingly popular pedagogical approach to teaching and learning. In this study, learning gains were assessed in a flipped biochemistry course and compared to gains in a traditional lecture. Although measured learning gains were not significantly different between the two courses, student perception of learning gains did differ and indicates a higher level of satisfaction with the flipped lecture format. © 2015 The International Union of Biochemistry and Molecular Biology.

What millennial medical students say about flipped learning

Science.gov (United States)

Pettit, Robin K; McCoy, Lise; Kinney, Marjorie

2017-01-01

Flipped instruction is gaining popularity in medical schools, but there are unanswered questions such as the optimum amount of the curriculum to flip and whether flipped sessions should be mandatory. We were in a unique position to evaluate feedback from first-year medical students who had experienced both flipped and lecture-based courses during their first semester of medical school. A key finding was that the students preferred a variety of different learning formats over an “all or nothing” learning format. Learning format preferences did not necessarily align with perceptions of which format led to better course exam performance. Nearly 70% of respondents wanted to make their own decisions regarding attendance. Candid responses to open-ended survey prompts reflected millennial preferences for choice, flexibility, efficiency, and the ability to control the pace of their learning, providing insight to guide curricular improvements. PMID:28769600

Sliding hip screw versus IM nail in reverse oblique trochanteric and subtrochanteric fractures. A study of 2716 patients in the Norwegian Hip Fracture Register.

Science.gov (United States)

Matre, Kjell; Havelin, Leif Ivar; Gjertsen, Jan-Erik; Vinje, Tarjei; Espehaug, Birgitte; Fevang, Jonas Meling

2013-06-01

Intramedullary nailing is commonly recommended as the treatment of choice for transverse/reverse oblique trochanteric (AO/OTA type A3=intertrochanteric) and subtrochanteric fractures. However, only to a limited extent is this approach supported by superior results in well designed clinical trials, and the sliding hip screw (SHS) is still a frequently used implant for these fractures. The aim of the present study was to compare IM nails and SHS in the treatment of transverse/reverse oblique trochanteric and subtrochanteric fractures using data from the Norwegian Hip Fracture Register (NHFR). Data on 2716 operations for acute transverse/reverse oblique trochanteric or subtrochanteric fractures were collected from the NHFR from 2005 to 2010. Surgeons reported patient characteristics and details from initial surgery and reoperations, and patients answered questionnaires about pain, satisfaction, and quality of life (EQ-5D) 4, 12, and 36 months postoperatively. Reoperation rates were calculated using Kaplan-Meier analyses. Primary outcome measures were pain (Visual Analogue Scale (VAS)), satisfaction (VAS), quality of life (EQ-5D), and reoperation rates at one year. The treatment groups were similar regarding age, gender, ASA-class, cognitive impairment, and preoperative EQ-5Dindex score. At one year reoperation rates were 6.4% and 3.8% for SHS and IM nails, respectively (p=0.011). Patients treated with SHS also had slightly more pain (VAS 30 vs. 27, p=0.037) and were less satisfied (VAS 31 vs. 36, p=0.003) compared to patients treated with IM nail. There was no statistically significant difference in the EQ-5Dindex score, but the mobility was significantly better for the IM nail group. 12 months postoperatively patients with transverse/reverse oblique trochanteric and subtrochanteric fractures operated with a SHS had a higher reoperation rate compared to those operated with an IM nail. Small differences regarding pain, satisfaction, quality of life, and mobility were

Switched Flip-Flop based Preprocessing Circuit for ISFETs

Directory of Open Access Journals (Sweden)

Martin Kollár

2005-03-01

Full Text Available In this paper, a preprocessing circuit for ISFETs (Ion-sensitive field-effecttransistors to measure hydrogen-ion concentration in electrolyte is presented. A modifiedflip-flop is the main part of the circuit. The modification consists in replacing the standardtransistors by ISFETs and periodically switching the supply voltage on and off.Concentration of hydrogen ions to be measured discontinues the flip-flop value symmetry,which means that by switching the supply voltage on the flip-flop goes to one of two stablestates, ‘one’ or ‘zero’. The recovery of the value symmetry can be achieved by changing abalanced voltage, which is incorporated to the flip-flop, to bring the flip-flop to a 50%position (probability of ‘one’ equals to probability of ‘zero’. Thus, the balanced voltagereflects the measured concentration of hydrogen ions. Its magnitude is set automatically byusing a feedback circuit whose input is connected to the flip-flop output. The preprocessingcircuit, as the whole, is the well-known δ modulator in which the switched flip-flop servesas a comparator and a sampling circuit. The advantages of this approach in comparison tothose of standard approaches are discussed. Finally, theoretical results are verified bysimulations with TSPICE and a good agreement is reported.

FLIP-MHD: A particle-in-cell mehtod for magnetohydrodynamics

International Nuclear Information System (INIS)

Brackbill, J.U.

1990-01-01

A particle-in-cell (PIC) method, FLIP is extended to magnetohydrodynamic (MHD) flow in two dimensions. Particles are used to reduce computational diffusion of the magnetic field. FLIP is an extension of ''classical'' PIC, where particles have mass, but every other property of the fluid is stored on a grid. In FLIP, particles have every property of the fluid, so that they provide a complete Lagrangian description not only to resolve contact discontinuities but also to reduce computational diffusion of linear and angular momentum. The interactions among the particles are calculated on a grid, for convenience and economy. The present study extends FLIP to MHD, by including information about the magnetic field among the attributes of the particles. 6 refs

Results of a Flipped Classroom Teaching Approach in Anesthesiology Residents.

Science.gov (United States)

Martinelli, Susan M; Chen, Fei; DiLorenzo, Amy N; Mayer, David C; Fairbanks, Stacy; Moran, Kenneth; Ku, Cindy; Mitchell, John D; Bowe, Edwin A; Royal, Kenneth D; Hendrickse, Adrian; VanDyke, Kenneth; Trawicki, Michael C; Rankin, Demicha; Guldan, George J; Hand, Will; Gallagher, Christopher; Jacob, Zvi; Zvara, David A; McEvoy, Matthew D; Schell, Randall M

2017-08-01

In a flipped classroom approach, learners view educational content prior to class and engage in active learning during didactic sessions. We hypothesized that a flipped classroom improves knowledge acquisition and retention for residents compared to traditional lecture, and that residents prefer this approach. We completed 2 iterations of a study in 2014 and 2015. Institutions were assigned to either flipped classroom or traditional lecture for 4 weekly sessions. The flipped classroom consisted of reviewing a 15-minute video, followed by 45-minute in-class interactive sessions with audience response questions, think-pair-share questions, and case discussions. The traditional lecture approach consisted of a 55-minute lecture given by faculty with 5 minutes for questions. Residents completed 3 knowledge tests (pretest, posttest, and 4-month retention) and surveys of their perceptions of the didactic sessions. A linear mixed model was used to compare the effect of both formats on knowledge acquisition and retention. Of 182 eligible postgraduate year 2 anesthesiology residents, 155 (85%) participated in the entire intervention, and 142 (78%) completed all tests. The flipped classroom approach improved knowledge retention after 4 months (adjusted mean = 6%; P  = .014; d  = 0.56), and residents preferred the flipped classroom (pre = 46%; post = 82%; P  flipped classroom approach to didactic education resulted in a small improvement in knowledge retention and was preferred by anesthesiology residents.

Flipped classroom model for learning evidence-based medicine

Directory of Open Access Journals (Sweden)

Rucker SY

2017-08-01

Full Text Available Sydney Y Rucker,1 Zulfukar Ozdogan,1 Morhaf Al Achkar2 1School of Education, Indiana University, Bloomington, IN, 2Department of Family Medicine, School of Medicine, University of Washington, Seattle, WA, USA Abstract: Journal club (JC, as a pedagogical strategy, has long been used in graduate medical education (GME. As evidence-based medicine (EBM becomes a mainstay in GME, traditional models of JC present a number of insufficiencies and call for novel models of instruction. A flipped classroom model appears to be an ideal strategy to meet the demands to connect evidence to practice while creating engaged, culturally competent, and technologically literate physicians. In this article, we describe a novel model of flipped classroom in JC. We present the flow of learning activities during the online and face-to-face instruction, and then we highlight specific considerations for implementing a flipped classroom model. We show that implementing a flipped classroom model to teach EBM in a residency program not only is possible but also may constitute improved learning opportunity for residents. Follow-up work is needed to evaluate the effectiveness of this model on both learning and clinical practice. Keywords: evidence-based medicine, flipped classroom, residency education

Multi spin-flip dynamics: a solution of the one-dimensional Ising model

International Nuclear Information System (INIS)

Novak, I.

1990-01-01

The Glauber dynamics of interacting Ising spins (the single spin-flip dynamics) is generalized to p spin-flip dynamics with a simultaneous flip of up to p spins in a single configuration move. The p spin-flip dynamics is studied of the one-dimensional Ising model with uniform nearest-neighbour interaction. For this case, an exact relation is given for the time dependence of magnetization. It was found that the critical slowing down in this model could be avoided when p spin-flip dynamics with p>2 was considered. (author). 17 refs

On Flipping First-Semester Calculus: A Case Study

Science.gov (United States)

Petrillo, Joseph

2016-01-01

High failure rates in calculus have plagued students, teachers, and administrators for decades, while science, technology, engineering, and mathematics programmes continue to suffer from low enrollments and high attrition. In an effort to affect this reality, some educators are "flipping" (or inverting) their classrooms. By flipping, we…

Evaluating the Flipped Classroom: A Randomized Controlled Trial

Science.gov (United States)

Wozny, Nathan; Balser, Cary; Ives, Drew

2018-01-01

Despite recent interest in flipped classrooms, rigorous research evaluating their effectiveness is sparse. In this study, the authors implement a randomized controlled trial to evaluate the effect of a flipped classroom technique relative to a traditional lecture in an introductory undergraduate econometrics course. Random assignment enables the…

Precise placement of lag screws in operative treatment of trochanteric femoral fractures with a new guide system.

Science.gov (United States)

Poyanli, Oguz S; Soylemez, Salih; Ozkut, Afsar T; Uygur, Esat; Kemah, Bahattin; Unal, Omer K

2015-11-01

We assessed the accuracy of a new guide system that we developed to place lag screws in the proper position with the minimum number of attempts for operative treatment of trochanteric femoral fractures. A total of 55 consecutive trochanteric femoral fractures were treated with a cephalomedullary nail. The first 27 consecutive patients were treated with the standard operation (group A), while the new guide system was used in the last 28 consecutive patients (group B). The numbers of attempts to place K wires and the duration of surgery were noted. Accuracy of lag screw placement was evaluated by measuring the angle of deviation from the central axis of the femoral head. Deviation values ranged from -11̊ to +15̊ for the 27 cases in group A, with a median absolute deviation of 8̊±6̊. That in the 28 cases after the introduction of the new guide system (group B) ranged from -5̊ to +6̊, with a median absolute deviation of 0.5̊±3̊ (Pfractures. The present study indicated that this new guide system and nail facilitate accurate placement of lag screws in the appropriate position with the minimum number of attempts. Copyright © 2015 Elsevier Ltd. All rights reserved.

Flipped classroom model for learning evidence-based medicine.

Science.gov (United States)

Rucker, Sydney Y; Ozdogan, Zulfukar; Al Achkar, Morhaf

2017-01-01

Journal club (JC), as a pedagogical strategy, has long been used in graduate medical education (GME). As evidence-based medicine (EBM) becomes a mainstay in GME, traditional models of JC present a number of insufficiencies and call for novel models of instruction. A flipped classroom model appears to be an ideal strategy to meet the demands to connect evidence to practice while creating engaged, culturally competent, and technologically literate physicians. In this article, we describe a novel model of flipped classroom in JC. We present the flow of learning activities during the online and face-to-face instruction, and then we highlight specific considerations for implementing a flipped classroom model. We show that implementing a flipped classroom model to teach EBM in a residency program not only is possible but also may constitute improved learning opportunity for residents. Follow-up work is needed to evaluate the effectiveness of this model on both learning and clinical practice.

Flipped classrooms and student learning: not just surface gains.

Science.gov (United States)

McLean, Sarah; Attardi, Stefanie M; Faden, Lisa; Goldszmidt, Mark

2016-03-01

The flipped classroom is a relatively new approach to undergraduate teaching in science. This approach repurposes class time to focus on application and discussion; the acquisition of basic concepts and principles is done on the students' own time before class. While current flipped classroom research has focused on student preferences and comparative learning outcomes, there remains a lack of understanding regarding its impact on students' approaches to learning. Focusing on a new flipped classroom-based course for basic medical sciences students, the purpose of the present study was to evaluate students' adjustments to the flipped classroom, their time on task compared with traditional lectures, and their deep and active learning strategies. Students in this course worked through interactive online learning modules before in-class sessions. Class time focused on knowledge application of online learning module content through active learning methods. Students completed surveys and optional prequiz questions throughout the term to provide data regarding their learning approaches. Our results showed that the majority of students completed their prework in one sitting just before class. Students reported performing less multitasking behavior in the flipped classroom compared with lecture-based courses. Students valued opportunities for peer-peer and peer-instructor interactions and also valued having multiple modes of assessment. Overall, this work suggests that there is the potential for greater educational gains from the flipped classroom than the modest improvements in grades previously demonstrated in the literature; in this implementation of the flipped classroom, students reported that they developed independent learning strategies, spent more time on task, and engaged in deep and active learning. Copyright © 2016 The American Physiological Society.

The Implementation of A Flipped Classroom in Foreign Language Teaching

Directory of Open Access Journals (Sweden)

Ahmet BASAL

2015-10-01

Full Text Available Alongside the rise of educational technology, many teachers have been taking gradual but innovative steps to redesign their teaching methods. For example, in flipped learning or a flipped classroom, students watch instructional videos outside the classroom and do assignments or engage in activities inside the classroom. Language teachers are one group of educators exploring the flipped classroom. In foreign language classes, such an approach may offer great benefits for both the teachers and students since classroom time can be applied to more interactive tasks. By extending classroom hours in this way, language teachers can focus on successfully addressing all subjects in the curriculum. The aim of this study is (a to gain insights into the perceptions of prospective English language teachers at a state university in Turkey on flipped classrooms and (b to introduce the implementation of a flipped classroom into an English language class. A total of 47 prospective English teachers participated in the study. Qualitative research design was used and data were collected via an open-ended question. Findings of the study indicated that pre-service English teachers had positive perceptions towards the use of the flipped classroom as an integral part of face-to-face courses. It can be concluded that flipped classroom was beneficial in terms of 4 categories based on the content analysis of the responses: learning at one’s own pace, advance student preparation, overcoming the limitations of class time, increasing the participation in the classroom. The study also provides recommendations towards LMS integration into courses in other English language teaching departments and for implementing flipped classrooms in language teaching.

Restricted active space spin-flip configuration interaction: theory and examples for multiple spin flips with odd numbers of electrons.

Science.gov (United States)

Zimmerman, Paul M; Bell, Franziska; Goldey, Matthew; Bell, Alexis T; Head-Gordon, Martin

2012-10-28

The restricted active space spin flip (RAS-SF) method is extended to allow ground and excited states of molecular radicals to be described at low cost (for small numbers of spin flips). RAS-SF allows for any number of spin flips and a flexible active space while maintaining pure spin eigenfunctions for all states by maintaining a spin complete set of determinants and using spin-restricted orbitals. The implementation supports both even and odd numbers of electrons, while use of resolution of the identity integrals and a shared memory parallel implementation allow for fast computation. Examples of multiple-bond dissociation, excited states in triradicals, spin conversions in organic multi-radicals, and mixed-valence metal coordination complexes demonstrate the broad usefulness of RAS-SF.

Quenching of spin-flip quadrupole transitions

International Nuclear Information System (INIS)

Castel, B.; Blunden, P.; Okuhara, Y.

1985-01-01

An increasing amount of experimental data indicates that spin-flip quadrupole transitions exhibit quenching effects similar to those reported earlier in (p,n) reactions involving l = 0 and l = 1 transitions. We present here two model calculations suggesting that the E2 spin-flip transitions are more affected than their M1 and M3 counterparts by the tensor and spin-orbit components of the nuclear force and should exhibit the largest quenching. We also review the experimental evidence corroborating our observations

Blended Course with Flipped Classroom Approach

DEFF Research Database (Denmark)

Timcenko, Olga; Purwins, Hendrik; Triantafyllou, Evangelia

2015-01-01

This paper presents and analyses design decisions and development process of producing teaching materials for a blended course with flipped classroom approach at bachelor level at Aalborg University in Copenhagen, Denmark. Our experiences, as well as students’ reactions and opinions will be descr......This paper presents and analyses design decisions and development process of producing teaching materials for a blended course with flipped classroom approach at bachelor level at Aalborg University in Copenhagen, Denmark. Our experiences, as well as students’ reactions and opinions...

Do intramedullary implants improve survival in elderly patients with trochanteric fractures? A retrospective study.

Science.gov (United States)

Vermesan, D; Prejbeanu, R; Poenaru, D V; Petrescu, H; Apostol, E; Inchingolo, F; Dipalma, G; Abbinante, A; Caprio, M; Potenza, M A; Cagiano, R; Malcangi, G; Inchingolo, A D; Haragus, H

2015-01-01

There is currently no consensus regarding superiority of the intramedullary fixation over the sliding hip screw. Regional variation remains high and not backed up by solid evidence. Given these premises we aimed to analyze weather implant preference can influence the postoperative survival. Secondary objectives were determining the trend for implant choice and confounding factors associated with intramedullary nails compared to sliding hip screws. Retrospective data was obtained from patient charts with the main diagnosis of extracapsular/ trochanteric fractures, corresponding to ICD S72.1 codes. Between 2008-2012, 441 patients underwent osteosynthesis with a dynamic hip screw and 155 with intramedullary nail respectively. The living status was determined by comparing the patient identification number against the national population evidence records. The lifetable shows similar survival for both implants over the 5 year period. The yearly mortality was 19.4% for the dynamic hip screw and 21.8% for the intramedullary implant respectively, even though the later were used predominantly in older patients. This age difference is significant according to both parametric and non-parametric tests whereas duration of hospital stay are similar. We found a clear increase in the proportion of intramedullary implants, for a total of 11.2% over the 5 year period. There is no difference for the one year mortality and overall survival between sliding screw plates and intramedullary constructs. A clear increase in the use of intramedullary implants for trochanteric fractures was observed. This is even more apparent for older ages, presumably due to an higher surgeon confidence with the biomechanical stability of the intramedullary constructs.

Gamma nail in the treatment of closed trochanteric fractures. Results and indications of 121 cases.

Science.gov (United States)

Kempf, I; Grosse, A; Taglang, G; Favreul, E

2014-02-01

The Gamma Nail is the latest advance in the treatment of trochanteric fractures based on intramedullary nailing principles during closed procedures. Its design is based on Küntscher's Y-nail and locking intramedullary (IM) nails. This paper reports the results from the first-ever series of 121 patients operated between 1988 and 1990. They were followed until bone union was achieved. The mean patient age was 75 years. Most patients were in poor general health and had unstable fractures. Anatomical preoperative reduction was achieved in 72% of cases. Fixation was good in 66% of cases and acceptable in 27% of cases. Intra-operative complications consisted of nine fractures without consequences. Of the treated patients, 83.4% resumed weight-bearing during the first week. There was one case of deep infection that resolved with treatment. The mortality rate was 12.3% at three months. We noted 7 alunions in varus, 3 in valgus, 2 in external rotation and 1 in internal rotation. There were no cases of non-union. In six cases, the screw had cut out of the femoral head. The drawbacks associated with surgical treatment methods for trochanteric fractures also apply to the Gamma nail. Nevertheless, one of its primary advantages is the possibility of using a closed procedure. When compared to Ender nailing, knee pain is absent and weight-bearing can be achieved in all patients, no matter the fracture type. Copyright © 2014. Published by Elsevier Masson SAS.

Spin flipping a stored polarized proton beam at the IUCF cooler ring

International Nuclear Information System (INIS)

Phelps, R.A.

1995-01-01

We recently studied the spin flip of a vertically polarized 139 MeV proton beam stored in the IUCF Cooler Ring. We used an rf solenoid to induce a depolarizing resonance in the ring; we flipped the spin by varying the solenoid field's frequency through this resonance. We found a polarization loss after multiple spin flips less than 0.1% per flip; we also found that this loss increased for very slow frequency changes. This spin flip could reduce systematic errors in stored polarization beam experiments by allowing frequent beam polarization reversals during the experiment. copyright 1995 American Institute of Physics

Nonlinear stability of spin-flip excitations

International Nuclear Information System (INIS)

Arunasalam, V.

1975-01-01

A rather complete discussion of the nonlinear electrodynamic behavior of a negative-temperature spin system is presented. The method presented here is based on a coupled set of master equations, one describing the time evolution of the photon (i.e., the spin-flip excitation) distribution function and the other describing the time evolution of the particle distribution function. It is found that the initially unstable (i.e., growing) spin-flip excitations grow to such a large amplitude that their nonlinear reaction on the particle distribution function becomes important. It is then shown that the initially totally inverted two-level spin system evolves rapidly (through this nonlinear photon-particle coupling) towards a quasilinear steady state where the populations of the spin-up and the spin-down states are equal to each other. Explicit expressions for the time taken to reach this quasilinear steady state and the energy in the spin-flip excitations at this state are also presented

Element nodes of sports equipment double back flip factions and double back flip hunched performed gymnast in floor exercise

Directory of Open Access Journals (Sweden)

V.A. Potop

2014-07-01

Full Text Available Purpose: to identify the node elements of sports equipment double back somersault tuck and double back flip bent. To compare the two types of nodes for double somersault. Material : the study involved eight gymnasts (age 12 - 14 years. All finalists in the competition floor exercise - reserve team Romania. The method of video - computer research and method of postural orientation movements. Results : identified nodal elements of sports equipment double back somersault tuck and double back flip bent. In the preparatory phase of motor actions - launcher body posture for reaching is repulsive to flip. In the phase of basic motor action - animation body postures (double back somersault tuck and bent (bent double back flip. Exercises are performed on the ascending and descending parts of the flight path of the demonstration of individual maximum lift height common center of mass. In the final phase of motor actions - final body posture - steady landing. Conclusions : indicators of key elements of sports equipment acrobatic exercises contain new scientific facts kinematic and dynamic structures of motor actions. They are necessary for the development of modern training programs acrobatic exercises in step specialized base preparation.

Research, Perspectives, and Recommendations on Implementing the Flipped Classroom.

Science.gov (United States)

Rotellar, Cristina; Cain, Jeff

2016-03-25

Flipped or inverted classrooms have become increasingly popular, and sometimes controversial, within higher education. Many educators have touted the potential benefits of this model and initial research regarding implementation has been primarily positive. The rationale behind the flipped classroom methodology is to increase student engagement with content, increase and improve faculty contact time with students, and enhance learning. This paper presents a summary of primary literature regarding flipped classrooms, discusses concerns and unanswered questions from both a student and faculty member perspective, and offers recommendations regarding implementation.

The flipped classroom for professional development: part I. Benefits and strategies.

Science.gov (United States)

McDonald, Katie; Smith, Charlene M

2013-10-01

Individualizing the educational encounter is supported by flipping the classroom experience. This column offers an overview and describes the benefits of flipping the classroom. Part II will explore the practicalities and pedagogy of lecture capture using podcasts and videos, a technology strategy used in flipping the classroom. Copyright 2013, SLACK Incorporated.

Flipped Instruction with English Language Learners at a Newcomer High School

Science.gov (United States)

Graziano, Kevin J.; Hall, John D.

2017-01-01

Research on flipped instruction with English Language Learners (ELLs) is sparse. Data-driven flipped research conducted with ELLs primarily involves adult learners attending a college or university. This study examined the academic performance of secondary ELLs who received flipped instruction in an algebra course at a newcomer school compared to…

Re-Envisioning the Archaic Higher Education Learning Environment: Implementation Processes for Flipped Classrooms

Science.gov (United States)

Rabidoux, Salena; Rottmann, Amy

2018-01-01

Flipped classrooms are often utilized in PK-12 classrooms; however, there is also a growing trend of flipped classrooms in higher education. This paper presents the benefits and limitations of implementing flipped classrooms in higher education as well as resources for integrating a flipped classroom design to instruction. The various technology…

Flipping the Calculus Classroom: A Cost-Effective Approach

Science.gov (United States)

Young, Andrea

2015-01-01

This article discusses a cost-effective approach to flipping the calculus classroom. In particular, the emphasis is on low-cost choices, both monetarily and with regards to faculty time, that make the daunting task of flipping a course manageable for a single instructor. Student feedback and overall impressions are also presented.

Intersecting Branes Flip SU(5)

CERN Document Server

Ellis, Jonathan Richard; Nanopoulos, Dimitri V; Ellis, John

2002-01-01

Within a toroidal orbifold framework, we exhibit intersecting brane-world constructions of flipped SU(5) \\times U(1) GUT models with various numbers of generations, other chiral matter representations and Higgs representations. We exhibit orientifold constructions with integer winding numbers that yield 8 or more conventional SU(5) generations, and orbifold constructions with fractional winding numbers that yield flipped SU(5) \\times U(1) models with just 3 conventional generations. Some of these models have candidates for the 5 and {\\bar 5} Higgs representations needed for electroweak symmetry breaking, but not for the 10 and {\\bar 10} representations needed for GUT symmetry breaking, or vice-versa.

Neutrino helicity flips via electroweak interactions and SN1987a

International Nuclear Information System (INIS)

Gaemers, K.J.F.; Gandhi, R.; Lattimer, J.M.

1988-10-01

Electroweak mechanisms via which neutrinos may flip helicity and become sterile are examined in detail. Exact and approximate expressions for a variety of flip processes relevant in astrophysics and cosmology, mediated by W,Z, and γ exchange, including their interference, are derived. It is shown that within the context of the Standard Model with massive neutrinos, for νe→νe scattering, σ Z flip /σ γ flip ∼ 6 X 10 3 , independent of particle masses and energies to a good approximation. It is also shown that using some general considerations and the fact that the observed anti ν e burst from SN1987a lasted several seconds, these weak interaction flip cross-sections can be used to derive an upper limit on μ and τ neutrino masses of ∼ 40 keV. Finally, some other consequences for astrophysics in general and supernovae in particular are briefly discussed. 29 refs.; 47 schemes

Implementeringen af flipped learning i fysik/kemi undervisningen i grundskolen

DEFF Research Database (Denmark)

Nissen, Stine Karen; Levinsen, Henrik

2017-01-01

This paper presents the preliminary findings and methodological framework from a study on the implementation of Flipped Learning in science classrooms in the Danish elementary school system. As a mixed methods case study consisting of observations and interviews, three science classrooms have bee...... for changes in classroom practices as expected. However, the experience of Flipped Learning by students and teachers offers a different and more optimistic set of narratives.......This paper presents the preliminary findings and methodological framework from a study on the implementation of Flipped Learning in science classrooms in the Danish elementary school system. As a mixed methods case study consisting of observations and interviews, three science classrooms have been...... and cultural contexts, the empirical contributions are few. The purpose of this study is to gain insight into the experiences and practice of teachers and students when engaging in Flipped Learning. The preliminary findings suggest that the implementation of Flipped Learning does not necessarily make way...

Flipped Classrooms for Advanced Science Courses

Science.gov (United States)

Tomory, Annette; Watson, Sunnie Lee

2015-12-01

This article explains how issues regarding dual credit and Advanced Placement high school science courses could be mitigated via a flipped classroom instructional model. The need for advanced high school courses will be examined initially, followed by an analysis of advanced science courses and the reform they are experiencing. Finally, it will conclude with an explanation of flipped classes as well as how they may be a solution to the reform challenges teachers are experiencing as they seek to incorporate more inquiry-based activities.

Scaffolded Semi-Flipped General Chemistry Designed to Support Rural Students' Learning

Science.gov (United States)

Lenczewski, Mary S.

2016-01-01

Students who lack academic maturity can sometimes feel overwhelmed in a fully flipped classroom. Here an alternative, the Semi-Flipped method, is discussed. Rural students, who face unique challenges in transitioning from high school learning to college-level learning, can particularly profit from the use of the Semi-Flipped method in the General…

Identifying Professional Competencies of the Flip-Chip Packaging Engineer in Taiwan

Science.gov (United States)

Guu, Y. H.; Lin, Kuen-Yi; Lee, Lung-Sheng

2014-01-01

This study employed a literature review, expert interviews, and a questionnaire survey to construct a set of two-tier competencies for a flip-chip packaging engineer. The fuzzy Delphi questionnaire was sent to 12 flip-chip engineering experts to identify professional competencies that a flip-chip packaging engineer must have. Four competencies,…

cFLIP Regulates Skin Homeostasis and Protects against TNF-Induced Keratinocyte Apoptosis

Directory of Open Access Journals (Sweden)

Diana Panayotova-Dimitrova

2013-10-01

Full Text Available FADD, caspase-8, and cFLIP regulate the outcome of cell death signaling. Mice that constitutively lack these molecules die at an early embryonic age, whereas tissue-specific constitutive deletion of FADD or caspase-8 results in inflammatory skin disease caused by increased necroptosis. The function of cFLIP in the skin in vivo is unknown. In contrast to tissue-specific caspase-8 knockout, we show that mice constitutively lacking cFLIP in the epidermis die around embryonic days 10 and 11. When cFLIP expression was abrogated in adult skin of cFLIPfl/fl-K14CreERtam mice, severe inflammation of the skin with concomitant caspase activation and apoptotic, but not necroptotic, cell death developed. Apoptosis was dependent of autocrine tumor necrosis factor production triggered by loss of cFLIP. In addition, epidermal cFLIP protein was lost in patients with severe drug reactions associated with epidermal apoptosis. Our data demonstrate the importance of cFLIP for the integrity of the epidermis and for silencing of spontaneous skin inflammation.

Partially Flipped Linear Algebra: A Team-Based Approach

Science.gov (United States)

Carney, Debra; Ormes, Nicholas; Swanson, Rebecca

2015-01-01

In this article we describe a partially flipped Introductory Linear Algebra course developed by three faculty members at two different universities. We give motivation for our partially flipped design and describe our implementation in detail. Two main features of our course design are team-developed preview videos and related in-class activities.…

Flipped @ SBU: Student Satisfaction and the College Classroom

Science.gov (United States)

Gross, Benjamin; Marinari, Maddalena; Hoffman, Mike; DeSimone, Kimberly; Burke, Peggy

2015-01-01

In this paper, the authors find empirical support for the effectiveness of the flipped classroom model. Using a quasi-experimental method, the authors compared students enrolled in flipped courses to their counterparts in more traditional lecture-based ones. A survey instrument was constructed to study how these two different groups of students…

Spin Flipping in the Presence of a Full Siberian Snake

International Nuclear Information System (INIS)

Blinov, B.B.; Anferov, V.A.; Derbenev, Y.S.; Kageya, T.; Krisch, A.D.; Lorenzon, W.; Ratner, L.G.; Sivers, D.W.; Sourkont, K.V.; Wong, V.K.; Chu, C.M.; Lee, S.Y.; Rinckel, T.; Schwandt, P.; Sperisen, F.; Przewoski, B. von; Sato, H.

1998-01-01

We have demonstrated for the first time spin flipping of a polarized proton beam stored in a ring containing a nearly 100% Siberian snake; we did this using a 'snake' depolarizing resonance induced by an rf solenoid magnet. By varying the rf solenoid close-quote s ramp time, frequency range, and voltage, we reached a spin-flip efficiency of about 91% . This spin-flip efficiency was probably reduced because the horizontal stable spin direction was not perpendicular to the longitudinal field of the rf solenoid, and was possibly reduced by nearby synchrotron sideband resonances. The planned use of a vertical rf dipole may improve the spin-flip efficiency. copyright 1998 The American Physical Society

PENGARUH FLIPPED MASTERY CLASSROM TERHADAP PEROLEHAN HASIL BELAJAR KOGNITIF MAHASISWA

Directory of Open Access Journals (Sweden)

Muhammad Ridha

2016-04-01

Tujuan dari penelitian ini adalah untuk mengetahui pengaruh penerapan strategi flipped mastery classroom terhadap perolehan hasil belajar kognitif mahasiswa pada matakuliah psikologi pendidikan. Subjek dalam penelitian ini adalah mahasiswa Jurusan Teknologi Pendidikan Universitas Negeri Malang semester genap tahun ajaran 2015/2016 pada kelas utuh. Kelas eksperimen dibelajarkan dengan strategi flipped-mastery classroom dan kelas kontrol dibelajarkan dengan strategi tradisional.  Penelitian ini menggunakan rancangan kuasi eksperimen Non Equivalent Control Group Design. Hasil penelitian menunjukkan bahwa penerapan strategi flipped mastery classroom memberikan pengaruh positif terhadap perolehan hasil belajar kognitif mahasiswa. Perolehan hasil belajar kognitif mahasiswa yang dibelajarkan dengan strategi flipped-mastery lebih tinggi secara signifikan dari pada perolehan hasil belajar mahasiswa yang dibelajarkan dengan strategi tradisional.

Integral Optimization of Systematic Parameters of Flip-Flow Screens

Institute of Scientific and Technical Information of China (English)

翟宏新

2004-01-01

The synthetic index Ks for evaluating flip-flow screens is proposed and systematically optimized in view of the whole system. A series of optimized values of relevant parameters are found and then compared with those of the current industrial specifications. The results show that the optimized value Ks approaches the one of those famous flip-flow screens in the world. Some new findings on geometric and kinematics parameters are useful for improving the flip-flow screens with a low Ks value, which is helpful in developing clean coal technology.

Using the Flipped Classroom to Enhance EFL Learning

Science.gov (United States)

Chen Hsieh, Jun Scott; Wu, Wen-Chi Vivian; Marek, Michael W.

2017-01-01

Instruction in English is a priority around the globe, but instructional methodologies have not always kept pace with the changing needs of students. To explore the benefits of the flipped classroom model for learners of English as a Foreign Language, the researchers used flipped learning and Wen's Output-driven/Input-enabled model to design a…

Flipped Learning in TESOL: Definitions, Approaches, and Implementation

Science.gov (United States)

Bauer-Ramazani, Christine; Graney, John M.; Marshall, Helaine W.; Sabieh, Christine

2016-01-01

As the use of flipped learning spreads throughout educational disciplines, TESOL educators need to consider its potential for our field. This article, based on a computer-aided language learning (CALL) interest session at TESOL 2015, first looks at how best to describe and define flipped learning and examines the factors needed to make it…

Flipping a College Calculus Course: A Case Study

Science.gov (United States)

Sahin, Alpaslan; Cavlazoglu, Baki; Zeytuncu, Yunus E.

2015-01-01

As online videos have become more easily available and more attractive to the new generation of students, and as new student-learning approaches tend to have more technology integration, the flipped classroom model has become very popular. The purpose of this study was to understand college students' views on flipped courses and investigate how…

Flipped Instruction in a High School Science Classroom

Science.gov (United States)

Leo, Jonathan; Puzio, Kelly

2016-01-01

This paper reports on a quasi-experimental study examining the effectiveness of flipped instruction in a 9th grade biology classroom. This study included four sections of freshmen-level biology taught by the first author at a private secondary school in the Pacific Northwest. Using a block randomized design, two sections were flipped and two…

The Implementation of A Flipped Classroom in Foreign Language Teaching

OpenAIRE

Ahmet BASAL

2015-01-01

Alongside the rise of educational technology, many teachers have been taking gradual but innovative steps to redesign their teaching methods. For example, in flipped learning or a flipped classroom, students watch instructional videos outside the classroom and do assignments or engage in activities inside the classroom. Language teachers are one group of educators exploring the flipped classroom. In foreign language classes, such an approach may offer great benefits for both the teachers and ...

Extended trochanteric osteotomy: current concepts review.

Science.gov (United States)

Sambandam, Senthil Nathan; Duraisamy, Gopinath; Chandrasekharan, Jayadev; Mounasamy, Varatharaj

2016-04-01

Revision total hip arthroplasty is a technically demanding procedure which has gained importance for more than two decades. It was a nightmare for revision surgeons during its initial years of inception before the advent of extended trochanteric osteotomy (ETO). This technique gains access to the femoral medullary canal without compromising the bone stock and aids removal of primary implant and cement mantle without further damaging the parent bone. Like any other surgery, ETO does have certain limitations and complications as reported by various authors. Though it has been routinely used by revision surgeons, thorough knowledge of technical details of ETO is still lacking. So this review article is aimed at addressing the indications, surgical procedure, fixation technique, implant selection and complication of ETO which has been presented over a period of years by various authors. We searched in the most commonly used portals like MEDLINE (PubMed) and Google scholar using appropriate terminologies for the literature regarding the various preoperative, intraoperative and postoperative clinical scenarios in which revision surgeons utilized ETO. ETO is an important tool in the revision surgeon's armamentarium and can be used in variety of clinical scenarios and for various intraoperative needs and goals. Awareness about biomechanics of ETO, indications, implants selection, fixation techniques and complications is paramount for good intraoperative and postoperative outcome. ETO by posterior approach continues to be a work horse approach for most revision surgeons all over the world.

Flipped Instruction in a High School Science Classroom

Science.gov (United States)

Leo, Jonathan; Puzio, Kelly

2016-10-01

This paper reports on a quasi-experimental study examining the effectiveness of flipped instruction in a 9th grade biology classroom. This study included four sections of freshmen-level biology taught by the first author at a private secondary school in the Pacific Northwest. Using a block randomized design, two sections were flipped and two remained traditional. The quiz and posttest data were adjusted for pretest differences using ANCOVA. The results suggest that flipped instruction had a positive effect student achievement, with effect sizes ranging from +0.16 to +0.44. In addition, some students reported that they preferred watching video lectures outside of class and appreciated more active approaches to learning.

Strange attractors in a chaotic coin flip simulation

International Nuclear Information System (INIS)

Cooper, Crystal

2006-01-01

Presented is a computer simulation used to model a variation of the game known as the gambler's ruin. A rich player gambles with a set amount of money m. The poor player starts out with zero capital, and is allowed to flip a coin in order to try to win the money. If the coin is heads, the poor player wins a dollar but if it is tails, the player loses a dollar. The poor player is always allowed to win the first flip, and is allowed to flip n times, even when the amount of money lost reaches zero. The dynamics of this process is chaotic due to fluctuations in the variance of the amount of money

Flipped Library Instruction Does Not Lead to Learning Gains for First-Year English Students

Directory of Open Access Journals (Sweden)

Kimberly Miller

2017-09-01

Full Text Available A Review of: Rivera, E. (2017. Flipping the classroom in freshman English library instruction: A comparison study of a flipped class versus a traditional lecture method. New Review of Academic Librarianship, 23(1, 18-27. http://dx.doi.org/10.1080/13614533.2016.1244770 Abstract Objective – To determine whether a flipped classroom approach to freshman English information literacy instruction improves student learning outcomes. Design – Quasi-experimental. Setting – Private suburban university with 7,000 graduate and undergraduate students. Subjects – First-year English students. Methods – Students in six sections of first-year “English 2” received library instruction; three sections received flipped library instruction and three sections received traditional library instruction. Students in the flipped classroom sections were assigned two videos to watch before class, as an introduction to searching the Library’s catalog and key academic databases. These students were also expected to complete pre-class exercises that allowed them to practice what they learned through the videos. The face-to-face classes involved a review of the flipped materials alongside additional activities. Works cited pages from the students’ final papers were collected from all six sections, 31 from the flipped sections and 34 from the non-flipped sections. A rubric was used to rate the works cited pages. The rubric was based on the Association of College and Research Libraries’ Information Literacy Competency Standards for Higher Education (ACRL, 2000, Standard Two, Outcome 3a, and included three criteria: “authority,” “timeliness,” and “variety.” Each criterion was rated at one of three levels: “exemplary,” “competent,” or “developing.” Main Results – Works cited pages from the students who received non-flipped instruction were more likely to score “exemplary” for at least one of the three criteria when compared to works

Flips for 3-folds and 4-folds

CERN Document Server

Corti, Alessio

2007-01-01

This edited collection of chapters, authored by leading experts, provides a complete and essentially self-contained construction of 3-fold and 4-fold klt flips. A large part of the text is a digest of Shokurov's work in the field and a concise, complete and pedagogical proof of the existence of 3-fold flips is presented. The text includes a ten page glossary and is accessible to students and researchers in algebraic geometry.

EFFECTIVENESS OF FLIPPED CLASSROOM IN MATHEMATICS TEACHING

OpenAIRE

Dr. N. Ramakrishnan; Mrs. J. Johnsi Priya

2016-01-01

Flipped Classroom is an instructional strategy and a type of blended learning that reverses the traditional learning environment by delivering instructional content, often online, outside of the classroom. It moves activities, including those that may have traditionally been considered homework, into the classroom. In a flipped classroom, students watch online lectures, collaborate in online discussions, or carry out research at home and engage in concepts in the classroom with the guidance o...

Proposal of new classification of femoral trochanteric fracture by three-dimensional computed tomography and relationship to usual plain X-ray classification.

Science.gov (United States)

Shoda, Etsuo; Kitada, Shimpei; Sasaki, Yu; Hirase, Hitoshi; Niikura, Takahiro; Lee, Sang Yang; Sakurai, Atsushi; Oe, Keisuke; Sasaki, Takeharu

2017-01-01

Classification of femoral trochanteric fractures is usually based on plain X-ray findings using the Evans, Jensen, or AO/OTA classification. However, complications such as nonunion and cut out of the lag screw or blade are seen even in stable fracture. This may be due to the difficulty of exact diagnosis of fracture pattern in plain X-ray. Computed tomography (CT) may provide more information about the fracture pattern, but such data are scarce. In the present study, it was performed to propose a classification system for femoral trochanteric fractures using three-dimensional CT (3D-CT) and investigate the relationship between this classification and conventional plain X-ray classification. Using three-dimensional (3D)-CT, fractures were classified as two, three, or four parts using combinations of the head, greater trochanter, lesser trochanter, and shaft. We identified five subgroups of three-part fractures according to the fracture pattern involving the greater and lesser trochanters. In total, 239 femoral trochanteric fractures (45 men, 194 women; average age, 84.4 years) treated in four hospitals were classified using our 3D-CT classification. The relationship between this 3D-CT classification and the AO/OTA, Evans, and Jensen X-ray classifications was investigated. In the 3D-CT classification, many fractures exhibited a large oblique fragment of the greater trochanter including the lesser trochanter. This fracture type was recognized as unstable in the 3D-CT classification but was often classified as stable in each X-ray classification. It is difficult to evaluate fracture patterns involving the greater trochanter, especially large oblique fragments including the lesser trochanter, using plain X-rays. The 3D-CT shows the fracture line very clearly, making it easy to classify the fracture pattern.

[Curative effect analysis on proximal frmoral nail antirotation for the treatment of femoral intertrochanteric fracture and integrity of lateral trochanteric wall].

Science.gov (United States)

Wei, Jie; Qin, De-an; Guo, Xiu-sheng

2015-06-01

To explore clinical efficacy and key matters for the treatment of femoral intertrochanteric fracture and integrity of lateral trochanteric wall by proximal frmoral nail antirotation (PFNA). From June 2010 to December 2012,210 femoral intertrochanteric fracture patients treated with PFNA were retrospectively analyzed, including 76 males and 134 females aged from 46 to 96 years old with an average of 71 years old. All fracture were caused by injury and classified to type I (5 cases) type II (16 cases), type III (73 cases) and type IV (116 cases) according to Evans classification. The time of getting out of bed, postoperative complications and displacement of screw blade and fracture healing were observed, Baumgaertner criteria were used to evaluate quality of fracture reduction, Harris criteria were used to evaulate hip joint function. All incisions were healed at stage I, no complications occurred except incomplete of lateral trochanteric wall patients without reconstruction, other patients could get out of bed with crutches at one week and all patients discharged from hospital at 10 days after operation. One hundred and seventy-eight patients were followed up from 3 to 17 months with an average of 10 months. One case occurred unhealed fracture displacement caused by screw blade cutting, 2 cases occurred screw blade transfomed to proximal and out femoral head, other patients obtained fracture healing at 12 to 16 weeks after operation. According to Baumgaertner criteria, 130 cases obtained good results, 45 cases acceptable, and 3 poor; while 107 cases obtained excellent results, 65 good, 3 good and 3 poor according to Harris score. PFNA with mechanical advantage of intramedullary fixation has advantsges of stable fixation, shorter operation time, minimally invasive. Satisfied clinical effects could obtained by grasping fixation principle, dealing with negative factors in operation. Intraoperative reconstruction for integrity of lateral trochanteric wall could assure

The Flipped Classroom Teaching Model and Its Use for Information Literacy Instruction

Directory of Open Access Journals (Sweden)

Sara Arnold-Garza

2014-07-01

Full Text Available The “flipped classroom” teaching model has emerged in a variety of educational settings. It provides many advantages for students and exploits the affordances of modern technology. This article describes some of the pedagogical and logistical characteristics of the flipped teaching model. It situates the flipped classroom in higher education and library instruction, and make the case that there are characteristics of information literacy instruction that fit well with the flipped teaching model, in addition to providing some unique challenges.

Trochanteric fractures. Classification and mechanical stability in McLaughlin, Ender and Richard osteosynthesis

Energy Technology Data Exchange (ETDEWEB)

Herrlin, K.; Stroemberg, T.; Lidgren, L.; Walloee, A.; Pettersson, H.

Four hundred and thirty trochanteric factures operated upon with McLaughlin, Ender or Richard's osteosynthesis were divided into 6 different types based on their radiographic appearance before and immediately after reposition with special reference to the medial cortical support. A significant correlation was found between the fracture type and subsequent mechanical complications where types 1 and 2 gave less, and types 4 and 5 more complications. A comparison of the various osteosyntheses showed that Richard's had significantly fewer complications than either the Ender or McLaughlin types. For Richard's osteosynthesis alone no correlation to fracture type could be made because of the small number of complications in this group.

Giant trochanteric pressure sore: Use of a pedicled chimeric perforator flap for cover

Directory of Open Access Journals (Sweden)

Mehrotra Sandeep

2009-01-01

Full Text Available Pressure sores are increasing in frequency commensurate with an ageing population with multi-system disorders and trauma. Numerous classic options are described for providing stable wound cover. With the burgeoning knowledge on perforator anatomy, recent approaches focus on the use of perforator-based flaps in bedsore surgery. A giant neglected trochanteric pressure sore in a paraplegic is presented. Since conventional options of reconstruction appeared remote, the massive ulcer was successfully managed by a chimeric perforator-based flap. The combined muscle and fasciocutaneous flaps were raised as separate paddles based on the anterolateral thigh perforator branches and provided stable cover without complications. Perforators allow versatility in managing complex wounds without compromising on established principles.

Best voltage bias-flipping strategy towards maximum piezoelectric power generation

International Nuclear Information System (INIS)

Liang, Junrui; Chung, Henry Shu-Hung

2013-01-01

In piezoelectric energy harvesting (PEH) systems, energy extracted from piezoelectric structure can be increased by making piezoelectric voltage in phase with vibration velocity and raising the voltage amplitude. Such voltage manipulations can be realized by synchronously flipping the piezoelectric voltage with respect to a bias dc source at every displacement extremum. Given that net harvested energy is obtained by deducting dissipated energy from total extracted energy, a sophisticated voltage bias-flipping scheme, which can maximize extracted energy at low dissipative cost, is required towards harvested energy optimization. This paper extends the state of the art by proposing the best bias-flip strategy, which is delivered on conceptual synchronized multiple bias-flip (SMBF) interface circuits. The proposed strategy coordinates both requirements on larger voltage change in synchronized instant for more extracted energy and smaller voltage change in each bias-flip action for less dissipated energy. It not only leads to further enhancement of harvesting capability beyond existing solutions, but also provides an unprecedented physical insight on maximum achievable harvesting capability of PEH interface circuit

Characteristics of magnetic resonance imaging with partial flip angle and gradient field echo

International Nuclear Information System (INIS)

Hamada, Tatsumi; Uto, Tatsurou; Okafuji, Tatsumasa; Ookusa, Akihiko; Oonishi, Takuya; Mabuchi, Nobuhisa; Fujii, Kouichi; Yoshioka, Hiroyasu; Ishida, Osamu

1988-01-01

Characteristics of a magnetic resonance (MR) imaging pulse sequence with short repetition time (Tr), short echo time (Te), partial flip angle and gradient field echo, at 0.5 T, were studied. A series of sagittal images of the cerebrospinal region was obtained with varied Tr, Te and flip angle, signal intensities were measured by means of a region of interest (ROI) function, and optimal parameters to achieve maximum tissue contrast were found. Of the parameters flip angle had the greatest effect on tissue contrast. Flip angles less than 20 or more than 60 degrees were necessary to discriminate between spinal cord and cerebrospinal fluid. So called MR myelography was obtained with the flip angle of 15 degrees. Opposed and inphase images were obtained at the Te levels of 21 and 28 ms, respectively. Likewise, a series of transverse images of the abdomen with short Tr, short Te and varied flip angles was obtained in a breath-holding interval, and signal intensities of ROIs were measured. Maximum intensities of the liver, the spleen and perirenal fat were obtained at the flip angles of 40, 30 and 60 degrees, respectively. Although maximum intensity was found at the flip angle of 30 degrees for both of the renal cortex and medulla, the maximum contrast between the two tissues was obtained at the flip angles of 50-60 degrees. The image contrast obtained by these pulse sequences was also theoretically predictable, and so it is thought possible that flip angle, Tr and Te are manipulated to yield a desired contrast. (author)

Greater Trochanteric Pain Syndrome: Percutaneous Tendon Fenestration Versus Platelet-Rich Plasma Injection for Treatment of Gluteal Tendinosis.

Science.gov (United States)

Jacobson, Jon A; Yablon, Corrie M; Henning, P Troy; Kazmers, Irene S; Urquhart, Andrew; Hallstrom, Brian; Bedi, Asheesh; Parameswaran, Aishwarya

2016-11-01

The purpose of this study was to compare ultrasound-guided percutaneous tendon fenestration to platelet-rich plasma (PRP) injection for treatment of greater trochanteric pain syndrome. After Institutional Review Board approval was obtained, patients with symptoms of greater trochanteric pain syndrome and ultrasound findings of gluteal tendinosis or a partial tear (Pain scores were recorded at baseline, week 1, and week 2 after treatment. Retrospective clinic record review assessed patient symptoms. The study group consisted of 30 patients (24 female), of whom 50% were treated with fenestration and 50% were treated with PRP. The gluteus medius was treated in 73% and 67% in the fenestration and PRP groups, respectively. Tendinosis was present in all patients. In the fenestration group, mean pain scores were 32.4 at baseline, 16.8 at time point 1, and 15.2 at time point 2. In the PRP group, mean pain scores were 31.4 at baseline, 25.5 at time point 1, and 19.4 at time point 2. Retrospective follow-up showed significant pain score improvement from baseline to time points 1 and 2 (P.99). Our study shows that both ultrasound-guided tendon fenestration and PRP injection are effective for treatment of gluteal tendinosis, showing symptom improvement in both treatment groups. © 2016 by the American Institute of Ultrasound in Medicine.

Implementing and Assessing a Flipped Classroom Model for First-Year Engineering Design

Science.gov (United States)

Saterbak, Ann; Volz, Tracy; Wettergreen, Matthew

2016-01-01

Faculty at Rice University are creating instructional resources to support teaching first-year engineering design using a flipped classroom model. This implementation of flipped pedagogy is unusual because content-driven, lecture courses are usually targeted for flipping, not project-based design courses that already incorporate an abundance of…

Resonant Homoclinic Flips Bifurcation in Principal Eigendirections

Directory of Open Access Journals (Sweden)

Tiansi Zhang

2013-01-01

Full Text Available A codimension-4 homoclinic bifurcation with one orbit flip and one inclination flip at principal eigenvalue direction resonance is considered. By introducing a local active coordinate system in some small neighborhood of homoclinic orbit, we get the Poincaré return map and the bifurcation equation. A detailed investigation produces the number and the existence of 1-homoclinic orbit, 1-periodic orbit, and double 1-periodic orbits. We also locate their bifurcation surfaces in certain regions.

Teachers’ development in a flipped classroom for applied mathematics

DEFF Research Database (Denmark)

Triantafyllou, Evangelia; Timcenko, Olga; Kofoed, Lise

2016-01-01

In this paper, we discuss how the flipped classroom approach promoted teacher reflection and development. We look at the teaching cycle from a flipped instruction model perspective and we adjust it to cater for the reflection loops teachers are involved when designing, implementing and re-designi...

Packaged and hybrid integrated all-optical flip-flop memory

NARCIS (Netherlands)

Liu, Y.; McDougall, R.; Hill, M.T.; Maxwell, G.D.; Zhang, S.; Harmon, R.; Huijskens, Frans; Rivers, L.; Dorren, H.J.S.; Poustie, A.

2006-01-01

A fully-packaged hybrid-integrated all-optical flip-flop, where InP-based semiconductor optical amplifiers are assembled onto a planar silica waveguide board, is demonstrated. It is shown experimentally that the flip-flop can dynamically toggle between its two states by injecting 150 ps optical

Experimental plug and play quantum coin flipping

Science.gov (United States)

Pappa, Anna; Jouguet, Paul; Lawson, Thomas; Chailloux, André; Legré, Matthieu; Trinkler, Patrick; Kerenidis, Iordanis; Diamanti, Eleni

2014-04-01

Performing complex cryptographic tasks will be an essential element in future quantum communication networks. These tasks are based on a handful of fundamental primitives, such as coin flipping, where two distrustful parties wish to agree on a randomly generated bit. Although it is known that quantum versions of these primitives can offer information-theoretic security advantages with respect to classical protocols, a demonstration of such an advantage in a practical communication scenario has remained elusive. Here we experimentally implement a quantum coin flipping protocol that performs strictly better than classically possible over a distance suitable for communication over metropolitan area optical networks. The implementation is based on a practical plug and play system, developed by significantly enhancing a commercial quantum key distribution device. Moreover, we provide combined quantum coin flipping protocols that are almost perfectly secure against bounded adversaries. Our results offer a useful toolbox for future secure quantum communications.

The flipped classroom allows for more class time devoted to critical thinking.

Science.gov (United States)

DeRuisseau, Lara R

2016-12-01

The flipped classroom was utilized in a two-semester, high-content science course that enrolled between 50 and 80 students at a small liberal arts college. With the flipped model, students watched ~20-min lectures 2 days/wk outside of class. These videos were recorded via screen capture and included a detailed note outline, PowerPoint slides, and review questions. The traditional format included the same materials, except that lectures were delivered in class each week and spanned the entire period. During the flipped course, the instructor reviewed common misconceptions and asked questions requiring higher-order thinking, and five graded case studies were performed each semester. To determine whether assessments included additional higher-order thinking skills in the flipped vs. traditional model, questions across course formats were compared via Blooms Taxonomy. Application-level questions that required prediction of an outcome in a new scenario comprised 38 ± 3 vs. 12 ± 1% of summative assessment questions (flipped vs. traditional. Final letter grades in both formats of the course were compared with major GPA. Students in the flipped model performed better than their GPA predicted, as 85.5% earned a higher grade (vs. 42.2% in the traditional classroom) compared with their major GPA. These data demonstrate that assessments transitioned to more application-level compared with factual knowledge-based questions with this particular flipped model, and students performed better in their final letter grade compared with the traditional lecture format. Although the benefits to a flipped classroom are highlighted, student evaluations did suffer. More detailed studies comparing the traditional and flipped formats are warranted. Copyright © 2016 the American Physiological Society.

The flipped classroom and cooperative learning: Evidence from a randomised experiment

OpenAIRE

Foldnes, Njål

2016-01-01

This article describes a study which compares the effectiveness of the flipped classroom relative to the traditional lecturebased classroom.We investigated two implementations of the flipped classroom. The first implementation did not actively encourage cooperative learning, with students progressing through the course at their own pace. With this implementation student examination scores did not differ between the lecture classes and the flipped classroom. The second implementation ...

Flipped SO(10)

Energy Technology Data Exchange (ETDEWEB)

Tamvakis, K.

1988-01-28

We construct an N=1 supersymmetric SO(10) GUT broken down to SU(3)c x SU(2)/sub L/ x U(1)/sub ..gamma../ with an intermediate flipped SU(5) x U(1)/sub chi/ gauge symmetry. A solution to the triplet-doublet mass-splitting problem is proposed in terms of a non-minimal missing-partner mechanism.

Chaotic spin exchange: is the spin non-flip rate observable?

International Nuclear Information System (INIS)

Senba, Masayoshi

1994-01-01

If spin exchange is of the Poisson nature, that is, if the time distribution of collisions obeys an exponential distribution function and the collision process is random, the muon spin depolarization is determined only by the spin flip rate regardless of the spin non-flip rate. In this work, spin exchange is discussed in the case of chaotic spin exchange, where the distribution of collision time sequences, generated by a deterministic equation, is exponential but not random (deterministic chaos). Even though this process has the same time distribution as a Poisson process, the muon polarization is affected by the spin non-flip rate. Having an exponential time distribution function is not a sufficient condition for the non-observation of the spin non-flip rate and it is essential that the process is also random. (orig.)

Flipped neutrino emissivity from strange matter

Energy Technology Data Exchange (ETDEWEB)

Goyal, A.; Dutta, S. (Department of Physics and Astrophysics, University of Delhi, Delhi 110007 (India))

1994-04-15

Energy loss due to wrong helicity sterile neutrinos through spin flip processes leads to rapid cooling of nascent neutron stars. The observed cooling of neutron stars associated with SN 1987A seems to preclude the existence of Dirac neutrinos with a mass in excess of 20 keV. Assuming that nuclear matter in the core of the neutron star undergoes a phase transition to quark matter leading to a strange star or a neutron star with a strange matter core, we examine the emission of flipped Dirac neutrinos for two dominant processes: quark-neutrino scattering [[ital q]+[nu][sub [minus

Implementing the Flipped Classroom: An Exploration of Study Behaviour and Student Performance

Science.gov (United States)

Boevé, Anja J.; Meijer, Rob R.; Bosker, Roel J.; Vugteveen, Jorien; Hoekstra, Rink; Albers, Casper J.

2017-01-01

The flipped classroom is becoming more popular as a means to support student learning in higher education by requiring students to prepare before lectures and actively engaging students during lectures. While some research has been conducted into student performance in the flipped classroom, students' study behaviour throughout a flipped course…

Failure after osteosynthesis of trochanteric fractures. Where is the limit of osteoporosis?

Science.gov (United States)

Konstantinidis, L; Papaioannou, C; Blanke, P; Hirschmüller, A; Südkamp, N P; Helwig, P

2013-10-01

The aim of this study is to identify osteoporosis values, beyond which there is a high risk of osteosynthesis failure. Bone mineral density (BMD) of 30 cadaveric femora with a pertrochanteric fracture osteotomy was correlated to the risk of cut out after osteosynthesis on a biomechanical testing approach. For a BMD less than 250 mg/cm(3), there is a high risk of fixation failure after surgical treatment of pertrochanteric fractures. This value can be regarded as a reference value for future experimental and clinical studies. Despite continuous modification of intramedullary load carriers for the surgical stabilization of trochanteric fractures, cut out remains the most frequent complication. The aim of this experimental study was to identify threshold osteoporosis values, beyond which there is a high risk of osteosynthesis failure. Bone mineral density (BMD) of 30 cadaveric femora was recorded for the femoral head by QCT measurement. Subsequently, a standardized osteotomy mimicking an unstable trochanteric type fracture was stabilized by intramedullary nailing. The constructs were loaded axially at a force of 2,100 N up to 20,000 cycles. Cut out at the femoral head was documented by radiograph. Statistical evaluation of the cohort group was performed by calculation of relative risk in relation to the BMD values. In total, there were six cases of cut out after 10,000 cycles. The incidence of cut out for BMD less than 250 mg/cm(3) was 0.55 (5 of 9) and for BMD greater than 250 mg/cm(3), it was 0.05 (1 of 21). Therefore, the relative risk of cut out for BMD 250 mg/cm(3). After 20,000 cycles, an additional test caused one cut out (relative risk of cut out for a BMD fractures. Although this value is based on an experimental in vitro study design with all its associated limitations, it can be regarded as a reference value for future experimental and clinical studies.

Pharmacy student engagement, performance, and perception in a flipped satellite classroom.

Science.gov (United States)

McLaughlin, Jacqueline E; Griffin, LaToya M; Esserman, Denise A; Davidson, Christopher A; Glatt, Dylan M; Roth, Mary T; Gharkholonarehe, Nastaran; Mumper, Russell J

2013-11-12

To determine whether "flipping" a traditional basic pharmaceutics course delivered synchronously to 2 satellite campuses would improve student academic performance, engagement, and perception. In 2012, the basic pharmaceutics course was flipped and delivered to 22 satellite students on 2 different campuses. Twenty-five condensed, recorded course lectures were placed on the course Web site for students to watch prior to class. Scheduled class periods were dedicated to participating in active-learning exercises. Students also completed 2 course projects, 3 midterm examinations, 8 graded quizzes, and a cumulative and comprehensive final examination. Results of a survey administered at the beginning and end of the flipped course in 2012 revealed an increase in students' support for learning content prior to class and using class time for more applied learning (p=0.01) and in the belief that learning key foundational content prior to coming to class greatly enhanced in-class learning (p=0.001). Significantly more students preferred the flipped classroom format after completing the course (89.5%) than before completing the course (34.6%). Course evaluation responses and final examination performance did not differ significantly for 2011 when the course was taught using a traditional format and the 2012 flipped-course format. Qualitative findings suggested that the flipped classroom promoted student empowerment, development, and engagement. The flipped pharmacy classroom can enhance the quality of satellite students' experiences in a basic pharmaceutics course through thoughtful course design, enriched dialogue, and promotion of learner autonomy.

Facing the challenges in ophthalmology clerkship teaching: Is flipped classroom the answer?

Directory of Open Access Journals (Sweden)

Ying Lin

Full Text Available Recent reform of medical education highlights the growing concerns about the capability of the current educational model to equip medical school students with essential skills for future career development. In the field of ophthalmology, although many attempts have been made to address the problem of the decreasing teaching time and the increasing load of course content, a growing body of literature indicates the need to reform the current ophthalmology teaching strategies. Flipped classroom is a new pedagogical model in which students develop a basic understanding of the course materials before class, and use in-class time for learner-centered activities, such as group discussion and presentation. However, few studies have evaluated the effectiveness of the flipped classroom in ophthalmology education. This study, for the first time, assesses the use of flipped classroom in ophthalmology, specifically glaucoma and ocular trauma clerkship teaching. A total number of 44 international medical school students from diverse background were enrolled in this study, and randomly divided into two groups. One group took the flipped glaucoma classroom and lecture-based ocular trauma classroom, while the other group took the flipped ocular trauma classroom and lecture-based glaucoma classroom. In the traditional lecture-based classroom, students attended the didactic lecture and did the homework after class. In the flipped classroom, students were asked to watch the prerecorded lectures before the class, and use the class time for homework discussion. Both the teachers and students were asked to complete feedback questionnaires after the classroom. We found that the two groups did not show differences in the final exam scores. However, the flipped classroom helped students to develop skills in problem solving, creative thinking and team working. Also, compared to the lecture-based classroom, both teachers and students were more satisfied with the flipped

Facing the challenges in ophthalmology clerkship teaching: Is flipped classroom the answer?

Science.gov (United States)

Lin, Ying; Zhu, Yi; Chen, Chuan; Wang, Wei; Chen, Tingting; Li, Tao; Li, Yonghao; Liu, Bingqian; Lian, Yu; Lu, Lin; Zou, Yuxian; Liu, Yizhi

2017-01-01

Recent reform of medical education highlights the growing concerns about the capability of the current educational model to equip medical school students with essential skills for future career development. In the field of ophthalmology, although many attempts have been made to address the problem of the decreasing teaching time and the increasing load of course content, a growing body of literature indicates the need to reform the current ophthalmology teaching strategies. Flipped classroom is a new pedagogical model in which students develop a basic understanding of the course materials before class, and use in-class time for learner-centered activities, such as group discussion and presentation. However, few studies have evaluated the effectiveness of the flipped classroom in ophthalmology education. This study, for the first time, assesses the use of flipped classroom in ophthalmology, specifically glaucoma and ocular trauma clerkship teaching. A total number of 44 international medical school students from diverse background were enrolled in this study, and randomly divided into two groups. One group took the flipped glaucoma classroom and lecture-based ocular trauma classroom, while the other group took the flipped ocular trauma classroom and lecture-based glaucoma classroom. In the traditional lecture-based classroom, students attended the didactic lecture and did the homework after class. In the flipped classroom, students were asked to watch the prerecorded lectures before the class, and use the class time for homework discussion. Both the teachers and students were asked to complete feedback questionnaires after the classroom. We found that the two groups did not show differences in the final exam scores. However, the flipped classroom helped students to develop skills in problem solving, creative thinking and team working. Also, compared to the lecture-based classroom, both teachers and students were more satisfied with the flipped classroom

Assessment of Learning Gains in a Flipped Biochemistry Classroom

Science.gov (United States)

Ojennus, Deanna Dahlke

2016-01-01

The flipped classroom has become an increasingly popular pedagogical approach to teaching and learning. In this study, learning gains were assessed in a flipped biochemistry course and compared to gains in a traditional lecture. Although measured learning gains were not significantly different between the two courses, student perception of…

Enhancing the Design and Analysis of Flipped Learning Strategies

Science.gov (United States)

Jenkins, Martin; Bokosmaty, Rena; Brown, Melanie; Browne, Chris; Gao, Qi; Hanson, Julie; Kupatadze, Ketevan

2017-01-01

There are numerous calls in the literature for research into the flipped learning approach to match the flood of popular media articles praising its impact on student learning and educational outcomes. This paper addresses those calls by proposing pedagogical strategies that promote active learning in "flipped" approaches and improved…

Flipping College Algebra: Effects on Student Engagement and Achievement

Science.gov (United States)

Ichinose, Cherie; Clinkenbeard, Jennifer

2016-01-01

This study compared student engagement and achievement levels between students enrolled in a traditional college algebra lecture course and students enrolled in a "flipped" course. Results showed that students in the flipped class had consistently higher levels of achievement throughout the course than did students in the traditional…

Evaluation of a "Flipped Classroom" Approach in Management Education

Science.gov (United States)

Bergfjord, Ole Jakob; Heggernes, Tarjei

2016-01-01

In this paper, a "flipped classroom" approach is evaluated using three different datasets. We use student evaluations of the "flipped classroom" in particular, in addition to regular course evaluations and exam results for the past three years in order to allow for statistical comparisons. Overall, the results are quite…

The Perceived Effects of Flipped Teaching on Knowledge Acquisition

Science.gov (United States)

Newman, Galen; Kim, Jun-Hyun; Lee, Ryun Jung; Brown, Brandy A.; Huston, Sharon

2016-01-01

Increased demands for technological integration in higher education have resulted in new forms of course instruction. Under a flipped approach, students learn course materials outside the classroom while active learning methods are employed inside. This study focuses on the perceived effects of flipped instruction on knowledge acquisition in…

RECOILING SUPERMASSIVE BLACK HOLES IN SPIN-FLIP RADIO GALAXIES

International Nuclear Information System (INIS)

Liu, F. K.; Wang Dong; Chen Xian

2012-01-01

Numerical relativity simulations predict that coalescence of supermassive black hole (SMBH) binaries leads not only to a spin flip but also to a recoiling of the merger remnant SMBHs. In the literature, X-shaped radio sources are popularly suggested to be candidates for SMBH mergers with spin flip of jet-ejecting SMBHs. Here we investigate the spectral and spatial observational signatures of the recoiling SMBHs in radio sources undergoing black hole spin flip. Our results show that SMBHs in most spin-flip radio sources have mass ratio q ∼> 0.3 with a minimum possible value q min ≅ 0.05. For major mergers, the remnant SMBHs can get a kick velocity as high as 2100 km s –1 in the direction within an angle ∼< 40° relative to the spin axes of remnant SMBHs, implying that recoiling quasars are biased to be with high Doppler-shifted broad emission lines while recoiling radio galaxies are biased to large apparent spatial off-center displacements. We also calculate the distribution functions of line-of-sight velocity and apparent spatial off-center displacements for spin-flip radio sources with different apparent jet reorientation angles. Our results show that the larger the apparent jet reorientation angle is, the larger the Doppler-shifting recoiling velocity and apparent spatial off-center displacement will be. We investigate the effects of recoiling velocity on the dust torus in spin-flip radio sources and suggest that recoiling of SMBHs would lead to 'dust-poor' active galactic nuclei. Finally, we collect a sample of 19 X-shaped radio objects and for each object give the probability of detecting the predicted signatures of recoiling SMBH.

Hardened Flip-Flop Optimized for Subthreshold Operation Heavy Ion Characterization of a Radiation

Directory of Open Access Journals (Sweden)

Eric Bozeman

2012-05-01

Full Text Available A novel Single Event Upset (SEU tolerant flip-flop design is proposed, which is well suited for very-low power electronics that operate in subthreshold ( < Vt ≈ 500 mV. The proposed flip-flop along with a traditional (unprotected flip-flop, a Sense-Amplifier-based Rad-hard Flip-Flop (RSAFF and a Dual Interlocked storage Cell (DICE flip-flop were all fabricated in MIT Lincoln Lab’s XLP 0.15 μm fully-depleted SOI CMOS technology—a process optimized for subthreshold operation. At the Cyclotron Institute at Texas A&M University, all four cells were subjected to heavy ion characterization in which the circuits were dynamically updated with alternating data and then checked for SEUs at both subthreshold (450 mV and superthreshold (1.5 V levels. The proposed flip-flop never failed, while the traditional and DICE designs did demonstrate faulty behavior. Simulations were conducted with the XLP process and the proposed flip-flop provided an improved energy delay product relative to the other non-faulty rad-hard flip-flop at subthreshold voltage operation. According to the XLP models operating in subthreshold at 250 mV, performance was improved by 31% and energy consumption was reduced by 27%.

Spin-flip processes in low-energy Fe17+ + He collisions

International Nuclear Information System (INIS)

Bruch, R.; Altick, P.L.; Rauscher, E.; Wang, H.; Schneider, D.

1993-01-01

Spin-nonconserving electron transfer processes violating the ''Wigner rule'' have been studied for slow multiply charged ion-atom collisions. Experimentally a strong population of highly metastable sodium-like quartet states in low energy Fe 17+ + He single collision events has been observed. The possibility of double-electron capture plus spin-flip mechanisms has been discussed experimentally and theoretically, Our theoretical model using time dependent perturbation theory predicts that spin-flip processes are as likely as no spin flip under the conditions of our experiment

Flipping Every Student? A Case Study of Content-Based Flipped Language Classrooms

Science.gov (United States)

Sun, Yu-Chih

2017-01-01

The study aims to explore university-level foreign language learners' perceptions of the content-based flipped classroom approach and factors influencing their perceptions. The research questions guiding the study are three-fold. (a) What attitudes and perceptions do students have about language and knowledge acquisition in the content-based…

Quantifying the Impact of Single Bit Flips on Floating Point Arithmetic

Energy Technology Data Exchange (ETDEWEB)

Elliott, James J [ORNL; Mueller, Frank [North Carolina State University; Stoyanov, Miroslav K [ORNL; Webster, Clayton G [ORNL

2013-08-01

In high-end computing, the collective surface area, smaller fabrication sizes, and increasing density of components have led to an increase in the number of observed bit flips. If mechanisms are not in place to detect them, such flips produce silent errors, i.e. the code returns a result that deviates from the desired solution by more than the allowed tolerance and the discrepancy cannot be distinguished from the standard numerical error associated with the algorithm. These phenomena are believed to occur more frequently in DRAM, but logic gates, arithmetic units, and other circuits are also susceptible to bit flips. Previous work has focused on algorithmic techniques for detecting and correcting bit flips in specific data structures, however, they suffer from lack of generality and often times cannot be implemented in heterogeneous computing environment. Our work takes a novel approach to this problem. We focus on quantifying the impact of a single bit flip on specific floating-point operations. We analyze the error induced by flipping specific bits in the most widely used IEEE floating-point representation in an architecture-agnostic manner, i.e., without requiring proprietary information such as bit flip rates and the vendor-specific circuit designs. We initially study dot products of vectors and demonstrate that not all bit flips create a large error and, more importantly, expected value of the relative magnitude of the error is very sensitive on the bit pattern of the binary representation of the exponent, which strongly depends on scaling. Our results are derived analytically and then verified experimentally with Monte Carlo sampling of random vectors. Furthermore, we consider the natural resilience properties of solvers based on the fixed point iteration and we demonstrate how the resilience of the Jacobi method for linear equations can be significantly improved by rescaling the associated matrix.

What is the optimal salvage procedure for cut-out after surgical fixation of trochanteric fractures with the PFNA or TFN?: A multicentre study.

Science.gov (United States)

Brunner, Alexander; Büttler, Markus; Lehmann, Uwe; Frei, Hans Curd; Kratter, Renato; Di Lazzaro, Marco; Scola, Alexander; Sermon, An; Attal, Rene

2016-02-01

To evaluate the outcome after different types of revision operations for blade 'cut-out' and 'cut-through' after fixation of trochanteric fractures with proximal femoral nail antirotation (PFNA) or a trochanter fixation nail (TFN). Twenty hospitals participated in this multicentre study. A total of 4109 patients were retrospectively screened for cut-out or cut-through complications after nailing of trochanteric fractures using PFNA or TFN. Fifty-seven patients (28 with 'cut-through' and 29 with 'cut-out') were included in the study. In the 'cut-through' group, 16 patients underwent a blade exchange, six patients had a blade exchange with bone cement augmentation, and six received total hip arthroplasty (THA). In the 'cut-out' group, three patients had a blade exchange, one had a blade exchange with augmentation, three underwent re-nailing of the fracture with a new PFNA, one had a girdlestone procedure and 21 had THA procedures. In the 'cut-through' group, eight patients who had a blade exchanges (50%) and two patients with blade exchange and augmentation (33%) required further revision operations. THA was the definite treatment in all 6 cases. In the 'cut-out' group, two patients (66%) who had blade exchanges and two (66%) who underwent re-nailing required additional revision operations during the subsequent course. One patient (4%) who had total hip arthroplasty needed revision surgery for acetabular replacement. Overall, a total of 81 revision procedures were performed. Based on the data from this study, we recommend THA as the only valid salvage procedure for 'cut-out' and 'cut-through' of helical blades after fixation of trochanteric fractures with the PFNA and TFN. Copyright © 2015 Elsevier Ltd. All rights reserved.

Physical and transportation requirements for a FLIP fueled TRIGA

International Nuclear Information System (INIS)

Johnson, A.G.; Ringle, J.C.; Anderson, T.V.

1977-01-01

Several major changes to the OSTR Physical Security Plan were required by the NRC prior to the August 1976 receipt and installation of a new core consisting entirely of FLIP fuel. The general nature of these changes will be reviewed along with several decisions we faced during their implementation. At the previous TRIGA Owners' Conference in Salt Lake City, Utah, we reported on Oregon's regulatory program for research reactor emergency response planning and physical security. The latter program was of particular interest to us in light of the projected FLIP fuel shipments. The impact of the State's program for physical security of FLIP fuel during transportation will be presented. (author)

Re-Visiting the Flipped Classroom in a Design Context

Science.gov (United States)

Coyne, Richard David; Lee, John; Denitsa, Petrova

2017-01-01

After explaining our experience with a flipped classroom model of learning, we argue that the approach brings to light the dramaturgical and mediatized aspects of learning experiences that favour a closer connection between recorded content and "live" presentation by the lecturer. We adopted the flipped classroom approach to learning and…

Flipped Classrooms and Student Learning: Not Just Surface Gains

Science.gov (United States)

McLean, Sarah; Attardi, Stefanie M.; Faden, Lisa; Goldszmidt, Mark

2016-01-01

The flipped classroom is a relatively new approach to undergraduate teaching in science. This approach repurposes class time to focus on application and discussion; the acquisition of basic concepts and principles is done on the students' own time before class. While current flipped classroom research has focused on student preferences and…

Observation of Beam Size Flip-Flop in PEP-II

International Nuclear Information System (INIS)

Holtzapple, Robert luther

2002-01-01

The asymmetric B-factory, PEP-II, has delivered a peak luminosity of 4.6 x 10 33 cm -2 s -1 with less than half the design number of bunches, requiring a luminosity per bunch crossing more than three times larger than the design. As a result, strong beam-beam effects are present. The strong beam-beam forces between colliding electron and positron bunches can result in a ''flip-flop'' of the transverse beam size of some bunches. Focusing on one positron-electron colliding bunch pair, a flip-flop occurs when the transverse size of the positron bunch shrinks and the electron bunch grows. The flip-flop accounts for a reduction in luminosity, a lower positron lifetime, and increased background in the BABAR detector. The flip-flop phenomenon occurs not for all of the colliding bunches, but for the bunches at the front of a mini-train. Once a colliding pair has flipped to its reduced luminosity state it can be changed back to its normal state by raising the horizontal tune in the low-energy ring (LER, positrons) by 0.01. Afterwards the LER x-tune can be reduced nearly back to its original point, resulting in higher luminosity. These observations were verified and quantified with a new time-gated camera with a resolution of 2 ns, making it possible to observe single bunches

Quasilinear theory of a spin-flip laser

International Nuclear Information System (INIS)

Arunasalam, V.

1973-09-01

A discussion of the nonlinear electrodynamic behavior of a gas of spin 1/2 particles in a uniform external magnetic field is presented. In particular, the quasilinear time evolution of a spin-flip laser system is examined in detail both from the point of view of the thermodynamics of negative temperature systems and the quantum kinetic methods of nonequilibrium statistical mechanics. It is shown that the quasilinear steady state of a spin-flip laser system is that state at which the populations of the spin-up and the spin-down states are equal to each other, and this quasilinear steady state is the state of minimum entropy production. The maximum output power of the spin-flip laser predicted by the theory presented in this paper is shown to be in reasonably good agreement with experimental results. The method used here is based on the general principles of nonrelativistic quantum theory and takes account of the Doppler broadening, collisional broadening, and Compton recoil effects. 30 refs., 1 fig

Flipped classroom improves student learning in health professions education: a meta-analysis.

Science.gov (United States)

Hew, Khe Foon; Lo, Chung Kwan

2018-03-15

The use of flipped classroom approach has become increasingly popular in health professions education. However, no meta-analysis has been published that specifically examines the effect of flipped classroom versus traditional classroom on student learning. This study examined the findings of comparative articles through a meta-analysis in order to summarize the overall effects of teaching with the flipped classroom approach. We focused specifically on a set of flipped classroom studies in which pre-recorded videos were provided before face-to-face class meetings. These comparative articles focused on health care professionals including medical students, residents, doctors, nurses, or learners in other health care professions and disciplines (e.g., dental, pharmacy, environmental or occupational health). Using predefined study eligibility criteria, seven electronic databases were searched in mid-April 2017 for relevant articles. Methodological quality was graded using the Medical Education Research Study Quality Instrument (MERSQI). Effect sizes, heterogeneity estimates, analysis of possible moderators, and publication bias were computed using the COMPREHENSIVE META-ANALYSIS software. A meta-analysis of 28 eligible comparative studies (between-subject design) showed an overall significant effect in favor of flipped classrooms over traditional classrooms for health professions education (standardized mean difference, SMD = 0.33, 95% confidence interval, CI = 0.21-0.46, p flipped classroom approach was more effective when instructors used quizzes at the start of each in-class session. More respondents reported they preferred flipped to traditional classrooms. Current evidence suggests that the flipped classroom approach in health professions education yields a significant improvement in student learning compared with traditional teaching methods.

Malaysian Students' Perceptions of Flipped Classroom: A Case Study

Science.gov (United States)

Zainuddin, Zamzami; Attaran, Mohammad

2016-01-01

The purpose of this study was to evaluate a class in University of Malaya where flipped learning was applied, and to examine students' perceptions and feedback towards flipped classroom. Data were collected using both quantitative and qualitative methods, i.e. survey, focus group and individual interviews. The results indicated that most students…

Efektivitas Flipped Classroom Terhadap Sikap Dan Ketrampilan Belajar Matematika Di Smk

OpenAIRE

Damayanti, Herry Novis; Sutama, Sutama

2016-01-01

The aim of the research is developed attitude resposiility, and skill learning of mathematic teaching based Flipped Classroom. The final result of the research is to taste effectiveness of mathematic teaching model based Flipped Classroom. The research method is research and development that includes introduction, field study of teaching management in the school, planning and preparing Flipped Classroom model, implementation of teaching first cycle, second cycle, and third cycle, and exam of ...

The flipped classroom for medical students.

Science.gov (United States)

Morgan, Helen; McLean, Karen; Chapman, Chris; Fitzgerald, James; Yousuf, Aisha; Hammoud, Maya

2015-06-01

The objectives of this curricular innovation project were to implement a flipped classroom curriculum for the gynaecologic oncology topics of the obstetrics and gynaecology medical student clerkship, and to evaluate student satisfaction with the change. Four short online videos on the topics of endometrial hyperplasia, cervical dysplasia, evaluation of an adnexal mass, and ovarian cancer were created, and students were instructed to view them prior to a class-time active learning session. The Learning Activity Management System (lams) open-source online platform was used to create an active learning class-time activity that consisted of a coached discussion of cases. Student satisfaction with the two aspects of the flipped curriculum was obtained. In addition, lecture assessment for the gynaecologic oncology topics and aggregate student performance on the gynaecological oncology questions of the US National Board of Medical Examiners (NBME) Subject Examination were compared before and after implementation of the curriculum. Eighty-nine students rotated on the clerkship during the pilot period of analysis. Seventy-one students (80%) viewed the videos prior to the class session, and 84 (94%) attended the session. Student satisfaction was very high for both parts of the curriculum. There was no significant difference in aggregate student performance on the gynaecological oncology questions of the NBME Subject Examination. The flipped classroom curriculum demonstrates a promising platform for using technology to make better use of students' time Our implementation of the flipped classroom curriculum for the gynaecologic oncology topics successfully demonstrates a promising platform for using technology to make better use of our students' time, and for increasing their satisfaction with the necessary didactic learning of the clerkship. © 2015 John Wiley & Sons Ltd.

Development of gold based solder candidates for flip chip assembly

DEFF Research Database (Denmark)

Chidambaram, Vivek; Hald, John; Hattel, Jesper Henri

2009-01-01

Flip chip technology is now rapidly replacing the traditional wire bonding interconnection technology in the first level packaging applications due to the miniaturization drive in the microelectronics industry. Flip chip assembly currently involves the use of high lead containing solders...

Just in Time to Flip Your Classroom

OpenAIRE

Lasry, Nathaniel; Dugdale, Michael; Charles, Elizabeth

2013-01-01

With advocates like Sal Khan and Bill Gates, flipped classrooms are attracting an increasing amount of media and research attention. We had heard Khan's TED talk and were aware of the concept of inverted pedagogies in general. Yet, it really hit home when we accidentally flipped our classroom. Our objective was to better prepare our students for class. We set out to effectively move some of our course content outside of class and decided to tweak the Just-in-Time-Teaching approach (JiTT). To ...

Flipping the Classroom Revisited

Science.gov (United States)

Riendeau, Diane

2013-02-01

I received many emails following the first column on flipping the classroom. Many of my local colleagues also approached me at our physics alliance, Physics Northwest. Teachers are very interested in this new pedagogy. As I result, I wanted to share some more videos to inspire you.

Quark loops and spin-flip effects in pomeron exchange

International Nuclear Information System (INIS)

Goloskokov, S.V.

1991-01-01

On the basis of QCD at large distances with taking account of some nonperturbative properties of the theory, the possibility of spin-flip effects in high energy hadron processes at fixed momenta transfer is investigated. It is shown that the diagrams with the quark loops in QCD at large distances may lead to the spin-flip amplitude growing as s for s→∞, t-fixed. The confirmation of this result is obtained by calculations of the nonleading contributions from quark loops in t-channel exchange in QED up to the end. Physical mechanisms leading to that behaviour of the spin-flip amplitude is discussed. So we conclude that the pomeron has a complicated spin structure. (orig.)

Polarizing a stored proton beam by spin-flip?

International Nuclear Information System (INIS)

Oellers, Dieter Gerd Christian

2010-01-01

The present thesis discusses the extraction of the electron-proton spin-flip cross-section. The experimental setup, the data analysis and the results are pictured in detail. The proton is described by a QCD-based parton model. In leading twist three functions are needed. The quark distribution, the helicity distribution and the transversity distribution. While the first two are well-known, the transversity distribution is largely unknown. A self-sufficient measurement of the transversity is possible in double polarized proton-antiproton scattering. This rises the need of a polarized antiproton beam. So far spin filtering is the only tested method to produce a polarized proton beam, which may be capable to hold also for antiprotons. In-situ polarization build-up of a stored beam either by selective removal or by spin-flip of a spin-(1)/(2) beam is mathematically described. A high spin-flip cross-section would create an effective method to produce a polarized antiproton beam by polarized positrons. Prompted by conflicting calculations, a measurement of the spin-flip cross-section in low-energy electron-proton scattering was carried out. This experiment uses the electron beam of the electron cooler at COSY as an electron target. The depolarization of the stored proton beam is detected. An overview of the experiment is followed by detailed descriptions of the cycle setup, of the electron target and the ANKE silicon tracking telescopes acting as a beam polarimeter. Elastic protondeuteron scattering is the analyzing reaction. The event selection is depicted and the beam polarization is calculated. Upper limits of the two electron-proton spin-flip cross-sections σ parallel and σ perpendicular to are deduced using the likelihood method. (orig.)

Flipped SU(5) times U(1) in superconformal models

Energy Technology Data Exchange (ETDEWEB)

Bailin, D.; Katechou, E.K. (Sussex Univ., Brighton (United Kingdom). School of Mathematical and Physical Sciences); Love, A. (London Univ. (United Kingdom))

1992-01-10

This paper reports that flipped SU(5) {times} U(1) models are constructed in the framework of tensoring of N = 2 superconformal minimal models quotiented by discrete symmetries. Spontaneous breaking of flipped SU(5) {times} U(1) and extra U(1) factors in the gauge group along F-flat directions of the effective potential is studied.

Spin-flip and spin orbit interactions in heavy ion systems

International Nuclear Information System (INIS)

Bybell, D.P.

1983-01-01

The role of spin orbit forces in heavy ion reactions is not completely understood. Experimental data is scarce for these systems but the data that does exist indicates a stronger spin orbit force than predicted by the folding models. The spin-flip probability of non-spin zero projectiles is one technique used for these measurements and is often taken as a direct indicator of a spin orbit interaction. This work measures the projectile spin-flip probability for three inelastic reactions; 13 C + 24 Mg, E/sub cm/ = 22.7 MeV; 13 C + 12 C, E/sub cm/ = 17.3 MeV; and 6 Li + 12 C, E/sub cm/ = 15.2 MeV, all leading to the first J/sup π/ = 2 + state of the target. The technique of particle-γ angular correlations was used for measuring the final state density matrix elements, of which the absolute value M = 1 magnetic substate population is equivalent to the spin-flip probability. The method was explored in detail and found to be sensitive to spin-flip probabilities smaller than 1%. The technique was also found to be a good indicator of the reaction mechanism involved. Nonzero and occasionally large spin-flip probabilities were observed in all systems, much larger than the folding model predictions. Information was obtained on the non-spin-flip density matrix elements. In the 13 C + 24 Mg reaction, these were found to agree with calculations when the finite size of the particle detector is included

Evaluation of the flipped classroom approach in a veterinary professional skills course

Directory of Open Access Journals (Sweden)

Moffett J

2014-11-01

Full Text Available Jenny Moffett,1 Aileen C Mill2 1Ross University School of Veterinary Medicine, West Farm, St Kitts, West Indies; 2Modelling Suite, School of Biology, Newcastle University, Newcastle upon Tyne, UK Background: The flipped classroom is an educational approach that has had much recent coverage in the literature. Relatively few studies, however, use objective assessment of student performance to measure the impact of the flipped classroom on learning. The purpose of this study was to evaluate the use of a flipped classroom approach within a medical education setting to the first two levels of Kirkpatrick and Kirkpatrick's effectiveness of training framework. Methods: This study examined the use of a flipped classroom approach within a professional skills course offered to postgraduate veterinary students. A questionnaire was administered to two cohorts of students: those who had completed a traditional, lecture-based version of the course (Introduction to Veterinary Medicine [IVM] and those who had completed a flipped classroom version (Veterinary Professional Foundations I [VPF I]. The academic performance of students within both cohorts was assessed using a set of multiple-choice items (n=24 nested within a written examination. Data obtained from the questionnaire were analyzed using Cronbach's alpha, Kruskal–Wallis tests, and factor analysis. Data obtained from student performance in the written examination were analyzed using the nonparametric Wilcoxon rank sum test. Results: A total of 133 IVM students and 64 VPF I students (n=197 agreed to take part in the study. Overall, study participants favored the flipped classroom approach over the traditional classroom approach. With respect to student academic performance, the traditional classroom students outperformed the flipped classroom students on a series of multiple-choice items (IVM mean =21.4±1.48 standard deviation; VPF I mean =20.25±2.20 standard deviation; Wilcoxon test, w=7,578; P<0

Celecoxib promotes c-FLIP degradation through Akt-independent inhibition of GSK3.

Science.gov (United States)

Chen, Shuzhen; Cao, Wei; Yue, Ping; Hao, Chunhai; Khuri, Fadlo R; Sun, Shi-Yong

2011-10-01

Celecoxib is a COX-2 inhibitor that reduces the risk of colon cancer. However, the basis for its cancer chemopreventive activity is not fully understood. In this study, we defined a mechanism of celecoxib action based on degradation of cellular FLICE-inhibitory protein (c-FLIP), a major regulator of the death receptor pathway of apoptosis. c-FLIP protein levels are regulated by ubiquitination and proteasome-mediated degradation. We found that celecoxib controlled c-FLIP ubiquitination through Akt-independent inhibition of glycogen synthase kinase-3 (GSK3), itself a candidate therapeutic target of interest in colon cancer. Celecoxib increased the levels of phosphorylated GSK3, including the α and β forms, even in cell lines, where phosphorylated Akt levels were not increased. Phosphoinositide 3-kinase inhibitors abrogated Akt phosphorylation as expected but had no effect on celecoxib-induced GSK3 phosphorylation. In contrast, protein kinase C (PKC) inhibitors abolished celecoxib-induced GSK3 phosphorylation, implying that celecoxib influenced GSK3 phosphorylation through a mechanism that relied upon PKC and not Akt. GSK3 blockade either by siRNA or kinase inhibitors was sufficient to attenuate c-FLIP levels. Combining celecoxib with GSK3 inhibition enhanced attenuation of c-FLIP and increased apoptosis. Proteasome inhibitor MG132 reversed the effects of GSK3 inhibition and increased c-FLIP ubiquitination, confirming that c-FLIP attenuation was mediated by proteasomal turnover as expected. Our findings reveal a novel mechanism through which the regulatory effects of c-FLIP on death receptor signaling are controlled by GSK3, which celecoxib acts at an upstream level to control independently of Akt.

Using the Flipped Classroom to Bridge the Gap to Generation Y.

Science.gov (United States)

Gillispie, Veronica

2016-01-01

The flipped classroom is a student-centered approach to learning that increases active learning for the student compared to traditional classroom-based instruction. In the flipped classroom model, students are first exposed to the learning material through didactics outside of the classroom, usually in the form of written material, voice-over lectures, or videos. During the formal teaching time, an instructor facilitates student-driven discussion of the material via case scenarios, allowing for complex problem solving, peer interaction, and a deep understanding of the concepts. A successful flipped classroom should have three goals: (1) allow the students to become critical thinkers, (2) fully engage students and instructors, and (3) stimulate the development of a deep understanding of the material. The flipped classroom model includes teaching and learning methods that can appeal to all four generations in the academic environment. During the 2015 academic year, we implemented the flipped classroom in the obstetrics and gynecology clerkship for the Ochsner Clinical School in New Orleans, LA. Voice-over presentations of the lectures that had been given to students in prior years were recorded and made available to the students through an online classroom. Weekly problem-based learning sessions matched to the subjects of the traditional lectures were held, and the faculty who had previously presented the information in the traditional lecture format facilitated the problem-based learning sessions. The knowledge base of students was evaluated at the end of the rotation via a multiple-choice question examination and the Objective Structured Clinical Examination (OSCE) as had been done in previous years. We compared demographic information and examination scores for traditional teaching and flipped classroom groups of students. The traditional teaching group consisted of students from Rotation 2 and Rotation 3 of the 2014 academic year who received traditional

Flipping to Teach the Conceptual Foundations of Successful Workplace Writing

Science.gov (United States)

Campbell, Kim Sydow

2016-01-01

Flipping originated in science, technology, engineering, and mathematics fields, where didactic transmission of conceptual knowledge has been the standard pedagogy. Flipping has resulted in additional focus on procedural knowledge within class meetings. This article argues that business and professional writing pedagogy, which already focuses…

Flipping a Dental Anatomy Course: A Retrospective Study Over Four Years

Directory of Open Access Journals (Sweden)

Mahmoud M. Bakr

2016-01-01

Full Text Available Flipped classrooms have been successfully used to increase student engagement and support student learning in a range of educational fields, including health education. These advantages for student learning supported implementation of the flipped classroom in introductory sciences and preclinical courses in dental education. We report on a 4-year retrospective study which compared two methods of delivery of a first-year dental anatomy course. The first method used the traditional method, consisting of face to face contact teaching hours, which was compared to a partial flipped classroom, where lecture contact was maintained but practical classes were flipped. A series of online videos demonstrating different practical tasks such as wax carving and tooth identification. An online digital library and online quizzes for self-reflected learning were developed and trialled. Students’ Evaluations of Course (SEC and students’ overall performance in practical and theoretical assessments were used to evaluate the impact on student engagement and success, respectively, after implementation of the modified course offerings. This study evidences the success of the transition to a partially flipped course design. Careful design and consideration of implementation of the flipped classroom method in dental education are recommended to ensure that there is reliable availability of online resources and dedicated teaching staff for construction of resources and delivery of relevant in-class activities.

[Flipped classroom as a strategy to enhance active learning].

Science.gov (United States)

Wakabayashi, Noriyuki

2015-03-01

This paper reviews the introduction of a flipped class for fourth grade dentistry students, and analyzes the characteristics of the learning method. In fiscal 2013 and 2014, a series of ten three-hour units for removable partial prosthodontics were completed with the flipped class method; a lecture video of approximately 60 minutes was made by the teacher (author) and uploaded to the university's e-learning website one week before each class. Students were instructed to prepare for the class by watching the streaming video on their PC, tablet, or smartphone. In the flipped class, students were not given a lecture, but were asked to solve short questions displayed on screen, to make a short presentation about a part of the video lecture, and to discuss a critical question related to the main subject of the day. An additional team-based learning (TBL) session with individual and group answers was implemented. The average individual scores were considerably higher in the last two years, when the flipped method was implemented, than in the three previous years when conventional lectures were used. The following learning concepts were discussed: the role of the flipped method as an active learning strategy, the efficacy of lecture videos and short questions, students' participation in the class discussion, present-day value of the method, cooperation with TBL, the significance of active learning in relation with the students' learning ability, and the potential increase in the preparation time and workload for students.

Student performance in a flipped classroom dental anatomy course.

Science.gov (United States)

Chutinan, S; Riedy, C A; Park, S E

2017-11-09

The purpose of this study was to assess dental student learning in a dental anatomy module between traditional lecture and flipped classroom cohorts. Two cohorts of predoctoral dental students (N = 70 within each cohort) participated in a dental anatomy module within an Introduction to the Dental Patient (IDP) course ([traditional/lecture cohort: academic year (AY) 2012, 2013] and [flipped classroom cohort: AY 2014, 2015]). For the dental anatomy module, both cohorts were evaluated on pre-clinical tooth waxing exercises immediately after each of five lectures and tooth identification after all lectures were given. Additionally, the cohorts' performance on the overall IDP course examination was compared. The flipped classroom cohort had statistically significant higher waxing scores (dental anatomy module) than students in the traditional classroom. There was no statistically significant difference for tooth identification scores and the overall IDP course examination between the traditional vs flipped approach cohorts. This is due to the latter two assessments conducted at the end of the course gave all students enough time to review the lecture content prior to the assessment resulting in similar scores for both cohorts. The flipped classroom cohort promoted students' individual learning and resulted in improved students' performance on immediate evaluation but not on the end of the course evaluation. Redesign of courses to include a new pedagogical approach should be carefully implemented and evaluated for student's educational success. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The influence of flip angle on the magic angle effect

International Nuclear Information System (INIS)

Zurlo, J.V.; Blacksin, M.F.; Karimi, S.

2000-01-01

Objective. To assess the impact of flip angle with gradient sequences on the ''magic angle effect''. We characterized the magic angle effect in various gradient echo sequences and compared the signal- to-noise ratios present on these sequences with the signal-to-noise ratios of spin echo sequences.Design. Ten normal healthy volunteers were positioned such that the flexor hallucis longus tendon remained at approximately at 55 to the main magnetic field (the magic angle). The tendon was imaged by a conventional spin echo T1- and T2-weighted techniques and by a series of gradient techniques. Gradient sequences were altered by both TE and flip angle. Signal-to-noise measurements were obtained at segments of the flexor hallucis longus tendon demonstrating the magic angle effect to quantify the artifact. Signal-to-noise measurements were compared and statistical analysis performed. Similar measurements were taken of the anterior tibialis tendon as an internal control.Results and conclusions. We demonstrated the magic angle effect on all the gradient sequences. The intensity of the artifact was affected by both the TE and flip angle. Low TE values and a high flip angle demonstrated the greatest magic angle effect. At TE values less than 30 ms, a high flip angle will markedly increase the magic angle effect. (orig.)

Critical role of DNA intercalation in enzyme-catalyzed nucleotide flipping

Science.gov (United States)

Hendershot, Jenna M.; O'Brien, Patrick J.

2014-01-01

Nucleotide flipping is a common feature of DNA-modifying enzymes that allows access to target sites within duplex DNA. Structural studies have identified many intercalating amino acid side chains in a wide variety of enzymes, but the functional contribution of these intercalating residues is poorly understood. We used site-directed mutagenesis and transient kinetic approaches to dissect the energetic contribution of intercalation for human alkyladenine DNA glycosylase, an enzyme that initiates repair of alkylation damage. When AAG flips out a damaged nucleotide, the void in the duplex is filled by a conserved tyrosine (Y162). We find that tyrosine intercalation confers 140-fold stabilization of the extrahelical specific recognition complex, and that Y162 functions as a plug to slow the rate of unflipping by 6000-fold relative to the Y162A mutant. Surprisingly, mutation to the smaller alanine side chain increases the rate of nucleotide flipping by 50-fold relative to the wild-type enzyme. This provides evidence against the popular model that DNA intercalation accelerates nucleotide flipping. In the case of AAG, DNA intercalation contributes to the specific binding of a damaged nucleotide, but this enhanced specificity comes at the cost of reduced speed of nucleotide flipping. PMID:25324304

Comparison of cutout resistance of dynamic condylar screw and proximal femoral nail in reverse oblique trochanteric fractures: A biomechanical study

Directory of Open Access Journals (Sweden)

Gursimrat Singh Cheema

2012-01-01

Results: The bending moment of the PFN group was approximately 50% less than that of the DCS group (P<0.0001. The PFN group resisted more number of cycles than the DCS group (P=0.03 and showed lesser number of component failures as compared with the DCS group (P=0.003. Conclusions: The PFN is biomechanically superior to DCS for the fixation of reverse oblique trochanteric fractures of femur.

The Flipped Classroom - From Theory to Practice in Health Professional Education.

Science.gov (United States)

Persky, Adam M; McLaughlin, Jacqueline E

2017-08-01

The flipped classroom is growing in popularity in health professional education. As such, instructors are experiencing various growing pains in functionalizing this model, from justifying the approach to managing time inside and outside of class to assessing impact on learning. This review focuses on some key theories that support the flipped model and translates those key theories into practice across core aspects of the flipped classroom: pre-class preparation, in-class activities, after-class activities and assessment of student learning.

FlipADAM: a potential new SPECT imaging agent for the serotonin transporter

Energy Technology Data Exchange (ETDEWEB)

Wang, Julie L.; Deutsch, Eric C. [Department of Pharmacology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104 (United States); Oya, Shunichi [Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104 (United States); Kung, Hank F., E-mail: kunghf@gmail.co [Department of Pharmacology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104 (United States); Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104 (United States)

2010-07-15

Introduction: Single photon emission computed tomography (SPECT) imaging of the serotonin transporter (SERT) in the brain is a useful tool for examining normal physiological functions and disease states involving the serotonergic system. The goal of this study was to develop an improved SPECT radiotracer with faster kinetics than the current leading SPECT tracer, [{sup 123}I]ADAM, for selective SERT imaging. Methods: The in vitro binding affinities of (2-(2'-((dimethylamino)methyl)-4'-iodophenylthio)benzenamine) (FlipADAM) (1c), were determined using Hampshire pig kidney cells stably overexpressing the serotonin, norepinephrine (NET) or dopamine transporter (DAT). Localization of [{sup 125}I]FlipADAM (1c) was evaluated through biodistribution and autoradiography in male Sprague Dawley rats, and the specificity of binding was assessed by injecting selective SERT or NET inhibitors prior to [{sup 125}I]FlipADAM (1c). Results: FlipADAM (1c) displayed a high binding affinity for SERT (K{sub i}=1.0 nM) and good selectivity over NET and DAT binding (43-fold and 257-fold, respectively). [{sup 125}I]FlipADAM (1c) successfully penetrated the blood brain barrier, as evidenced by the brain uptake at 2 min (1.75% dose/g). [{sup 125}I]FlipADAM(1c) also had a good target to non-target (hypothalamus/cerebellum) ratio of 3.35 at 60 min post-injection. In autoradiography studies, [{sup 125}I]FlipADAM (1c) showed selective localization in SERT-rich brain regions such as the thalamic nuclei, amygdala, dorsal raphe nuclei and other areas. Conclusion: [{sup 125}I]FlipADAM (1c) exhibited faster clearance from the brain and time to binding equilibrium when compared to [{sup 125}I]2-(2'-((dimethylamino)methyl)-phenylthio)-5-iodophenylamine [{sup 125}I]ADAM (1b) and a higher target to non-target ratio when compared to [{sup 125}I]5-iodo-2-(2'-((dimethylamino)methyl)-phenylthio)benzyl alcohol [{sup 125}I]IDAM (1a). Therefore, [{sup 123}I]FlipADAM (1c) may be an improved

Separation of flip and non-flip parts of np → pn charge exchange at energies Tn = 0,5-2,0 GeV

International Nuclear Information System (INIS)

Shindin, R.A.; Gur'ev, D.K.; Morozov, A.A.; Nomofilov, A.A.; Strunov, L.N.

2011-01-01

The new 'Delta-Sigma' experimental data on the ratio R dp allowed separating the Flip and Non-Flip parts of the differential cross section of np → pn charge exchange process at the zero angle by the Dean formula. The PSA solutions for the np → np elastic scattering are transformed to the np → pn charge exchange representation using unitary transition, and good agreement is obtained

Formation of very short pulse by neutron spin flip chopper for J-PARC

International Nuclear Information System (INIS)

Ebisawa, T.; Soyama, K.; Yamazaki, D.; Tasaki, S.; Sakai, K.; Oku, T.; Maruyama, R.; Hino, M.

2004-01-01

We have developed neutron spin flip choppers with high S/N ratio and high intensity for pulsed sources using multi-stage spin flip choppers. It is not easy for us to obtain a very short neutron pulse less than 10 μs using a spin flip chopper, due to the time constant L/R in the normal LR circuit. We will discuss a method obtaining a very short neutron pulse applying the modified push-pull circuit proposed by Ito and Takahashi [4] to the double spin flip chopper with polarizing guides

Students' Perceptions and Emotions Toward Learning in a Flipped General Science Classroom

Science.gov (United States)

Jeong, Jin Su; González-Gómez, David; Cañada-Cañada, Florentina

2016-10-01

Recently, the inverted instruction methodologies are gaining attentions in higher educations by claiming that flipping the classroom engages more effectively students with the learning process. Besides, students' perceptions and emotions involved in their learning process must be assessed in order to gauge the usability of this relatively new instruction methodology, since it is vital in the educational formation. For this reason, this study intends to evaluate the students' perceptions and emotions when a flipped classroom setting is used as instruction methodology. This research was conducted in a general science course, sophomore of the Primary Education bachelor degree in the Training Teaching School of the University of Extremadura (Spain). The results show that the students have the overall positive perceptions to a flipped classroom setting. Particularly, over 80 % of them considered that the course was a valuable learning experience. They also found this course more interactive and were willing to have more courses following a flipped model. According to the students' emotions toward a flipped classroom course, the highest scores were given to the positive emotions, being fun and enthusiasm along with keyword frequency test. Then, the lowest scores were corresponded to negative emotions, being boredom and fear. Therefore, the students attending to a flipped course demonstrated to have more positive and less negative emotions. The results obtained in this study allow drawing a promising tendency about the students' perceptions and emotions toward the flipped classroom methodology and will contribute to fully frame this relatively new instruction methodology.

The Flipped Classroom in Systems Analysis & Design: Leveraging Technology to Increase Student Engagement

Science.gov (United States)

Saulnier, Bruce M.

2015-01-01

Problems associated with the ubiquitous presence of technology on college campuses are discussed and the concept of the flipped classroom is explained. Benefits of using the flipped classroom to offset issues associated with the presence of technology in the classroom are explored. Fink's Integrated Course Design is used to develop a flipped class…

An Investigation of the Use of the ‘Flipped Classroom’ Pedagogy in Secondary English Language Classrooms

OpenAIRE

Chi Cheung Ruby Yang

2017-01-01

Aim/Purpose : To examine the use of a flipped classroom in the English Language subject in secondary classrooms in Hong Kong. Background: The research questions addressed were: (1) What are teachers’ perceptions towards the flipped classroom pedagogy? (2) How can teachers transfer their flipped classroom experiences to teaching other classes/subjects? (3) What are students’ perceptions towards the flipped classroom pedagogy? (4) How can students transfer their flipped classroom experience...

THE IMPLEMENTATION OF FLIPPED CLASSROOM MODEL IN EFL WRITING

Directory of Open Access Journals (Sweden)

Rida Afrilyasanti

2016-10-01

Full Text Available Flipped classroom is an approach to learning to write that allows teachers to have one-on-one assistance to help learners in the “during writing” stage in the classroom. Theories are given to the students in a video lectures to watch before class. Because problems in writing mostly occur in “during writing” stage, teacher assistance is crucial. This paper aims to share theoretical review and research findings pertaining to the implementation of flipped classroom model to EFL writing. Research findings show that flipped classroom is able to give greater opportunities for interactive sessions in class which focus on the students’ own concerns, questions, and needs. Therefore, students’ difficulties in “during writing” stage can be minimized

99.9% Spin-Flip Efficiency in the Presence of a Strong Siberian Snake

International Nuclear Information System (INIS)

Morozov, V.S.; Blinov, B.B.; Etienne, Z.B.; Krisch, A.D.; Leonova, M.A.; Lin, A.M.T.; Lorenzon, W.; Peters, C.C.; Sivers, D.W.; Wong, V.K.; Yonehara, K.; Anferov, V. A.; Schwandt, P.; Stephenson, E.J.; Przewoski, B. von; Sato, H.

2003-01-01

We recently studied the spin-flipping efficiency of an rf-dipole magnet using a 120-MeV horizontally polarized proton beam stored in the Indiana University Cyclotron Facility Cooler Ring, which contained a full Siberian snake. We flipped the spin by ramping the rf dipole's frequency through an rf-induced depolarizing resonance. By adiabatically turning on the rf dipole, we minimized the beam loss, while preserving almost all of the beam's polarization. After optimizing the frequency ramp parameters, we used up to 400 multiple spin flips to measure a spin-flip efficiency of 99.93 ± 0.02%. This result indicates that spin flipping should be possible in very-high-energy polarized storage rings, where Siberian snakes are certainly needed and only dipole rf-flipper magnets are practical

Evaluation of the Effects of Flipped Learning of a Nursing Informatics Course.

Science.gov (United States)

Oh, Jina; Kim, Shin-Jeong; Kim, Sunghee; Vasuki, Rajaguru

2017-08-01

This study evaluated the effects of flipped learning in a nursing informatics course. Sixty-four undergraduate students attending a flipped learning nursing informatics course at a university in South Korea participated in this study in 2013. Of these, 43 students participated at University A, and 46 students participated at University B, as a comparison group. Three levels of Kirkpatrick's evaluation model were used: level one (the students' satisfaction), level two (achievement on the course outcomes), and level three (self-perceived nursing informatics competencies). Students of the flipped learning course reported positive effects above the middle degree of satisfaction (level one) and achieved the course outcomes (level two). In addition, self-perceived nursing informatics competencies (level three) of the flipped learning group were higher than those of the comparison group. A flipped learning nursing informatics course is an effective teaching strategy for preparing new graduate nurses in the clinical setting. [J Nurs Educ. 2017;56(8):477-483.]. Copyright 2017, SLACK Incorporated.

FLIP for FLAG model visualization

Energy Technology Data Exchange (ETDEWEB)

Wooten, Hasani Omar [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-11-15

A graphical user interface has been developed for FLAG users. FLIP (FLAG Input deck Parser) provides users with an organized view of FLAG models and a means for efficiently and easily navigating and editing nodes, parameters, and variables.

Evaluation of the flipped classroom approach in a veterinary professional skills course.

Science.gov (United States)

Moffett, Jenny; Mill, Aileen C

2014-01-01

The flipped classroom is an educational approach that has had much recent coverage in the literature. Relatively few studies, however, use objective assessment of student performance to measure the impact of the flipped classroom on learning. The purpose of this study was to evaluate the use of a flipped classroom approach within a medical education setting to the first two levels of Kirkpatrick and Kirkpatrick's effectiveness of training framework. This study examined the use of a flipped classroom approach within a professional skills course offered to postgraduate veterinary students. A questionnaire was administered to two cohorts of students: those who had completed a traditional, lecture-based version of the course (Introduction to Veterinary Medicine [IVM]) and those who had completed a flipped classroom version (Veterinary Professional Foundations I [VPF I]). The academic performance of students within both cohorts was assessed using a set of multiple-choice items (n=24) nested within a written examination. Data obtained from the questionnaire were analyzed using Cronbach's alpha, Kruskal-Wallis tests, and factor analysis. Data obtained from student performance in the written examination were analyzed using the nonparametric Wilcoxon rank sum test. A total of 133 IVM students and 64 VPF I students (n=197) agreed to take part in the study. Overall, study participants favored the flipped classroom approach over the traditional classroom approach. With respect to student academic performance, the traditional classroom students outperformed the flipped classroom students on a series of multiple-choice items (IVM mean =21.4±1.48 standard deviation; VPF I mean =20.25±2.20 standard deviation; Wilcoxon test, w=7,578; Pflipped classroom approach. The flipped classroom was rated more positively than the traditional classroom on many different characteristics. This preference, however, did not translate into improved student performance, as assessed by a series of

Assisted crack tip flipping under Mode I thin sheet tearing

DEFF Research Database (Denmark)

Felter, Christian Lotz; Nielsen, Kim Lau

2017-01-01

Crack tip flipping, where the fracture surface alternates from side to side in roughly 45° shear bands, seems to be an overlooked propagation mode in Mode I thin sheet tearing. In fact, observations of crack tip flipping is rarely found in the literature. Unlike the already established modes...

The Flipped Class: Experience in a University Business Communication Course

Science.gov (United States)

Sherrow, Tammy; Lang, Brenda; Corbett, Rod

2016-01-01

Business, like many other programs in higher education, continues to rely largely on traditional classroom environments. In this article, another approach to teaching and learning, the flipped classroom, is explored. After a review of relevant literature, the authors present their experience with the flipped classroom approach to teaching and…

Flipped Classroom: Effects on Education for the Case of Economics

Science.gov (United States)

Kurihara, Yutaka

2016-01-01

The notion of the flipped classroom has been received much attention in the literature as it may increase learning outcomes and learning effectiveness elementary and secondary education as well as university learning. In the author's class on international finance (economics) features a blended flipped classroom and lecture; questionnaires were…

Exploring Flipped Classroom Effects on Second Language Learners' Cognitive Processing

Science.gov (United States)

Kim, Jeong-eun; Park, Hyunjin; Jang, Mijung; Nam, Hosung

2017-01-01

This study investigated the cognitive effects of the flipped classroom approach in a content-based instructional context by comparing second language learners' discourse in flipped vs. traditional classrooms in terms of (1) participation rate, (2) content of comments, (3) reasoning skills, and (4) interactional patterns. Learners in two intact…

Curriculum Design of a Flipped Classroom to Enhance Haematology Learning

Science.gov (United States)

Porcaro, Pauline A.; Jackson, Denise E.; McLaughlin, Patricia M.; O'Malley, Cindy J.

2016-01-01

A common trend in higher education is the "flipped" classroom, which facilitates active learning during class. The flipped approach to teaching was instituted in a haematology "major" class and the students' attitudes and preferences for the teaching materials were surveyed. The curriculum design was explicit and involved four…

Student evaluation of the flipped classroom instruction method: is it aligned with Problem-Based Learning?

DEFF Research Database (Denmark)

Triantafyllou, Evangelia; Timcenko, Olga; Kofoed, Lise

2017-01-01

The flipped classroom approach is an instructional method that has gained momentum in the last years. In a flipped classroom the traditional lecture and homework sessions are inverted. We believe that the flipped classroom, which employs computer-based individual instruction outside the classroom...... presents data from the second year, where we conducted a survey study among students participating in the flipped statistics course. This study consisted of two surveys designed to gather student perceptions on the out-of-classroom preparation material (videos and quizzes) and the flipped classroom...

K-12 Teacher Perceptions Regarding the Flipped Classroom Model for Teaching and Learning

Science.gov (United States)

Gough, Evan; DeJong, David; Grundmeyer, Trent; Baron, Mark

2017-01-01

A great deal of evidence can be cited from higher education literature on the effectiveness of the flipped classroom; however, very little research was discovered on the flipped classroom at the K-12 level. This study examined K-12 teachers' perceptions regarding the flipped classroom and differences in teachers' perceptions based on grade level…

Polarizing a stored proton beam by spin-flip?

Energy Technology Data Exchange (ETDEWEB)

Oellers, Dieter Gerd Christian

2010-04-15

The present thesis discusses the extraction of the electron-proton spin-flip cross-section. The experimental setup, the data analysis and the results are pictured in detail. The proton is described by a QCD-based parton model. In leading twist three functions are needed. The quark distribution, the helicity distribution and the transversity distribution. While the first two are well-known, the transversity distribution is largely unknown. A self-sufficient measurement of the transversity is possible in double polarized proton-antiproton scattering. This rises the need of a polarized antiproton beam. So far spin filtering is the only tested method to produce a polarized proton beam, which may be capable to hold also for antiprotons. In-situ polarization build-up of a stored beam either by selective removal or by spin-flip of a spin-(1)/(2) beam is mathematically described. A high spin-flip cross-section would create an effective method to produce a polarized antiproton beam by polarized positrons. Prompted by conflicting calculations, a measurement of the spin-flip cross-section in low-energy electron-proton scattering was carried out. This experiment uses the electron beam of the electron cooler at COSY as an electron target. The depolarization of the stored proton beam is detected. An overview of the experiment is followed by detailed descriptions of the cycle setup, of the electron target and the ANKE silicon tracking telescopes acting as a beam polarimeter. Elastic protondeuteron scattering is the analyzing reaction. The event selection is depicted and the beam polarization is calculated. Upper limits of the two electron-proton spin-flip cross-sections {sigma} {sub parallel} and {sigma} {sub perpendicular} {sub to} are deduced using the likelihood method. (orig.)

High failure rate of trochanteric fracture osteosynthesis with proximal femoral locking compression plate.

Science.gov (United States)

Wirtz, C; Abbassi, F; Evangelopoulos, D S; Kohl, S; Siebenrock, K A; Krüger, A

2013-06-01

Stable reconstruction of proximal femoral (PF) fractures is especially challenging due to the peculiarity of the injury patterns and the high load-bearing requirement. Since its introduction in 2007, the PF-locking compression plate (LCP) 4.5/5.0 has improved osteosynthesis for intertrochanteric and subtrochanteric fractures of the femur. This study reports our early results with this implant. Between January 2008 and June 2010, 19 of 52 patients (12 males, 7 females; mean age 59 years, range 19-96 years) presenting with fractures of the trochanteric region were treated at the authors' level 1 trauma centre with open reduction and internal fixation using PF-LCP. Postoperatively, partial weight bearing was allowed for all 19 patients. Follow-up included a thorough clinical and radiological evaluation at 1.5, 3, 6, 12, 24, 36 and 48 months. Failure analysis was based on conventional radiological and clinical assessment regarding the type of fracture, postoperative repositioning, secondary fracture dislocation in relation to the fracture constellation and postoperative clinical function (Merle d'Aubigné score). In 18 patients surgery achieved adequate reduction and stable fixation without intra-operative complications. In one patient an ad latus displacement was observed on postoperative X-rays. At the third month follow-up four patients presented with secondary varus collapse and at the sixth month follow-up two patients had 'cut-outs' of the proximal fragment, with one patient having implant failure due to a broken proximal screw. Revision surgeries were performed in eight patients, one patient receiving a change of one screw, three patients undergoing reosteosynthesis with implantation of a condylar plate and one patient undergoing hardware removal with secondary implantation of a total hip prosthesis. Eight patients suffered from persistent trochanteric pain and three patients underwent hardware removal. Early results for PF-LCP osteosynthesis show major

Flipping around the classroom: Accelerated Bachelor of Science in Nursing students' satisfaction and achievement.

Science.gov (United States)

El-Banna, Majeda M; Whitlow, Malinda; McNelis, Angela M

2017-09-01

The flipped classroom approach is based on shared responsibility for learning by students and teachers, and empowers students to take an active role in the learning process. While utilization of this approach has resulted in higher exam scores compared to traditional approaches in prior studies, the flipped classroom has not included learners in Accelerated Bachelor of Science in Nursing (ABSN) programs. To examine differences on exam scores and satisfaction of teaching between a 3-week flipped and traditional classroom approach. Mixed methods, crossover repeated measures design. Private school of nursing located in the eastern United States. 76 ABSN students. Two separate sections of a Pharmacology course received either 3-weeks of flipped or traditional classroom during Period 1, then switched approaches during Period 2. Two exam scores measuring knowledge and a questionnaire assessing satisfaction of teaching were collected. Focus groups were conducted to learn about students' experience in the flipped classroom. Descriptive statistics, Wilcoxon rank sum test, and stepwise linear mixed model were used to analyze quantitative data. Focus group data were transcribed, coded, and categorized in themes. Students in the flipped classroom achieved significantly higher scores on the first Pharmacology exam than students in the traditional classroom, but there was no significant difference on the second exam. Three themes emerged from focus groups on student perception of integrating the flipped approach: don't fix what isn't broken; treat me as an adult; and remember the work is overwhelming. Both traditional and flipped classroom approaches successfully prepared students for the Pharmacology exams. While results support the use of the flipped approach, judicious use of this instructional pedagogy with dense or difficult content, particularly in accelerated programs, is recommended. Instructors should also provide students with enough information and rationale for using

Preliminary investigations of a mixed standard-flip core for a TRIGA Mark II

International Nuclear Information System (INIS)

Ringle, John C.; Johnson, A.G.; Anderson, T.V.

1974-01-01

Several years ago it became apparent that due to our rapidly- increasing use rate, we would need a substantial amount of new fuel by late 1974 or early 1975. After investigations and discussions with GA, we decided that FLIP fuel would best meet our requirements for maximum fuel economy and high peak pulsing power. A proposal was submitted to the AEC for fuel assistance, and late in 1973 we were awarded a grant of $61,875. This will allow us to buy 3 FLIP-fueled-follower control rods, 1 instrumented FLIP fuel element, and 26 standard FLIP elements, giving us then a mixed core of approximately one-third FLIP and two-thirds standard elements. License amendments to accommodate this change are rather straightforward; modifications to the Technical Specifications will be somewhat more involved. The largest revisions which we envision are to our Safety Analysis Report. Although a few reactors have operated with a full FLIP core, and a few others have converted to mixed standard-FLIP cores, none of these has a standard Mark II core configuration. Those who have already converted to a mixed core have data and calculations which may be helpful to us, but the extent to which we can use these remains to be seen. The present status of our investigations into the analysis of a mixed standard-FLIP core will be presented. Any problems in calculational methods, finding appropriate data, modifications to Technical Specifications, etc., will be identified, and suggestions and help in these areas will be welcomed. (author)

Preliminary investigations of a mixed standard-flip core for a TRIGA Mark II

Energy Technology Data Exchange (ETDEWEB)

Ringle, John C; Johnson, A G; Anderson, T V [Oregon State University (United States)

1974-07-01

Several years ago it became apparent that due to our rapidly- increasing use rate, we would need a substantial amount of new fuel by late 1974 or early 1975. After investigations and discussions with GA, we decided that FLIP fuel would best meet our requirements for maximum fuel economy and high peak pulsing power. A proposal was submitted to the AEC for fuel assistance, and late in 1973 we were awarded a grant of $61,875. This will allow us to buy 3 FLIP-fueled-follower control rods, 1 instrumented FLIP fuel element, and 26 standard FLIP elements, giving us then a mixed core of approximately one-third FLIP and two-thirds standard elements. License amendments to accommodate this change are rather straightforward; modifications to the Technical Specifications will be somewhat more involved. The largest revisions which we envision are to our Safety Analysis Report. Although a few reactors have operated with a full FLIP core, and a few others have converted to mixed standard-FLIP cores, none of these has a standard Mark II core configuration. Those who have already converted to a mixed core have data and calculations which may be helpful to us, but the extent to which we can use these remains to be seen. The present status of our investigations into the analysis of a mixed standard-FLIP core will be presented. Any problems in calculational methods, finding appropriate data, modifications to Technical Specifications, etc., will be identified, and suggestions and help in these areas will be welcomed. (author)

The regulation and role of c-FLIP in human Th cell differentiation.

Science.gov (United States)

Kyläniemi, Minna K; Kaukonen, Riina; Myllyviita, Johanna; Rasool, Omid; Lahesmaa, Riitta

2014-01-01

The early differentiation of T helper (Th) cells is a tightly controlled and finely balanced process, which involves several factors including cytokines, transcription factors and co-stimulatory molecules. Recent studies have shown that in addition to the regulation of apoptosis, caspase activity is also needed for Th cell proliferation and activation and it might play a role in Th cell differentiation. The isoforms of the cellular FLICE inhibitory protein (c-FLIP) are regulators of CASPASE-8 activity and the short isoform, c-FLIPS, has been shown to be up-regulated by IL-4, the Th2 driving cytokine. In this work, we have studied the expression and functional role of three c-FLIP isoforms during the early Th cell differentiation. Only two of the isoforms, c-FLIPS and c-FLIPL, were detected at the protein level although c-FLIPR was expressed at the mRNA level. The knockdown of c-FLIPL led to enhanced Th1 differentiation and elevated IL-4 production by Th2 cells, whereas the knockdown of c-FLIPS diminished GATA3 expression and IL-4 production by Th2 cells. In summary, our results provide new insight into the role of c-FLIP proteins in the early differentiation of human Th cells.

Assessing the Flipped Classroom in Operations Management: A Pilot Study

Science.gov (United States)

Prashar, Anupama

2015-01-01

The author delved into the results of a flipped classroom pilot conducted for an operations management course module. It assessed students' perception of a flipped learning environment after making them experience it in real time. The classroom environment was construed using a case research approach and students' perceptions were studied using…

Examining Student Perceptions of Flipping an Agricultural Teaching Methods Course

Science.gov (United States)

Conner, Nathan W.; Rubenstein, Eric D.; DiBenedetto, Cathy A.; Stripling, Christopher T.; Roberts, T. Grady; Stedman, Nicole L. P.

2014-01-01

To meet the needs of the 21st century student, college instructors have been challenged to transform their classrooms from passive to active, "minds-on" learning environments. This qualitative study examined an active learning approach known as a flipped classroom and sought to explore student perceptions of flipping a teaching methods…

The Implementation of a Flipped Classroom in Foreign Language Teaching

Science.gov (United States)

Basal, Ahmet

2015-01-01

Alongside the rise of educational technology, many teachers have been taking gradual but innovative steps to redesign their teaching methods. For example, in flipped learning or a flipped classroom, students watch instructional videos outside the classroom and do assignments or engage in activities inside the classroom. Language teachers are one…

Serial composition of quantum coin flipping and bounds on cheat detection for bit commitment

International Nuclear Information System (INIS)

Mochon, Carlos

2004-01-01

Quantum protocols for coin flipping can be composed in series in such a way that a cheating party gains no extra advantage from using entanglement between different rounds. This composition principle applies to coin-flipping protocols with cheat sensitivity as well, and is used to derive two results: There are no quantum strong coin-flipping protocols with cheat sensitivity that is linear in the bias (or bit-commitment protocols with linear cheat detection) because these can be composed to produce strong coin flipping with arbitrarily small bias. On the other hand, it appears that quadratic cheat detection cannot be composed in series to obtain even weak coin flipping with arbitrarily small bias

Higgs Mass Textures in Flipped SU(5)

CERN Document Server

Ellis, Jonathan Richard; Rizos, J; Ellis, John

1999-01-01

We analyze the Higgs doublet-triplet mass splitting problem in the version of flipped SU(5) derived from string theory. Analyzing non-renormalizable terms up to tenth order in the superpotential, we identify a pattern of field vev's that keeps one pair of electroweak Higgs doublets light, while all other Higgs doublets and all Higgs triplets are kept heavy, with the aid of the economical missing-doublet mechanism found in the field-theoretical version of flipped SU(5). The solution predicts that second-generation charge -1/3 quarks and charged leptons are much lighter than those in the third generation.

Spin flip in inelastic scattering of protons on 28Si nuclei

International Nuclear Information System (INIS)

Wang Syn Chan; Komsan, M.N.Kh.; Osetinskij, G.M.; Golubev, S.L.; Kurepin, A.B.; Likhosherstov, V.N.

1975-01-01

We measured the energy and angular dependences of the spin-flip probability and of the differential cross section for inelastic scattering of protons in the resonance region of the reaction 28 Si(p,p') 23 Si* (2 + , 1.78 MeV) at E sub(p) = 3.095 and 3.34 MeV. The energy dependence of the spin-flip probability was found to have a resonance character. The angular distribution of the inelastic scattering and of the spin-flip probability is asymmetrical with respect to 90 deg in the c.m.s

Investigating Flipped Learning: Student Self-Regulated Learning, Perceptions, and Achievement in an Introductory Biology Course

Science.gov (United States)

Sletten, Sarah Rae

2017-06-01

In flipped classrooms, lectures, which are normally delivered in-class, are assigned as homework in the form of videos, and assignments that were traditionally assigned as homework, are done as learning activities in class. It was hypothesized that the effectiveness of the flipped model hinges on a student's desire and ability to adopt a self-directed learning style. The purpose of this study was twofold; it aimed at examining the relationship between two variables—students' perceptions of the flipped model and their self-regulated learning (SRL) behaviors—and the impact that these variables have on achievement in a flipped class. For the study, 76 participants from a flipped introductory biology course were asked about their SRL strategy use and perceptions of the flipped model. SRL strategy use was measured using a modified version of the Motivated Strategies for Learning Questionnaire (MSLQ; Wolters et al. 2005), while the flipped perceptions survey was newly derived. Student letter grades were collected as a measure of achievement. Through regression analysis, it was found that students' perceptions of the flipped model positively predict students' use of several types of SRL strategies. However, the data did not indicate a relationship between student perceptions and achievement, neither directly nor indirectly, through SRL strategy use. Results suggest that flipped classrooms demonstrate their successes in the active learning sessions through constructivist teaching methods. Video lectures hold an important role in flipped classes, however, students may need to practice SRL skills to become more self-directed and effectively learn from them.

Quantum protocol for cheat-sensitive weak coin flipping.

Science.gov (United States)

Spekkens, R W; Rudolph, Terry

2002-11-25

We present a quantum protocol for the task of weak coin flipping. We find that, for one choice of parameters in the protocol, the maximum probability of a dishonest party winning the coin flip if the other party is honest is 1/sqrt[2]. We also show that if parties restrict themselves to strategies wherein they cannot be caught cheating, their maximum probability of winning can be even smaller. As such, the protocol offers additional security in the form of cheat sensitivity.

Clinical profiles and risk factors for outcomes in older patients with cervical and trochanteric hip fracture: similarities and differences

Science.gov (United States)

2012-01-01

Background Data on clinical characteristics and outcomes in regard to hip fracture (HF) type are controversial. This study aimed to evaluate whether clinical and laboratory predictors of poorer outcomes differ by HF type. Methods Prospective evaluation of 761 consecutively admitted patients (mean age 82.3 ± 8.8 years; 74.9% women) with low-trauma non-pathological HF. Clinical characteristics and short-term outcomes were recorded. Haematological, renal, liver and thyroid status, C-reactive protein, cardiac troponin I, serum 25(OH) vitamin D, PTH, leptin, adiponectin and resistin were determined. Results The cervical compared to the tronchanteric HF group was younger, have higher mean haemoglobin, albumin, adiponectin and resistin and lower PTH levels (all P trochanteric HF only hyperparathyroidism; for post-operative myocardial injury dementia, smoking and renal impairment in the former group and coronary artery disease (CAD), hyperparathyroidism and hypoleptinaemia in the latter; for LOS > 20 days CAD, and age > 75 years and hyperparathyroidism, respectively. Need of institutionalisation was predicted by age > 75 years and dementia in both groups and also by hypovitaminosis D in the cervical and by hyperparathyroidism in the trochanteric HF. Conclusions Clinical characteristics and incidence of poorer short-term outcomes in the two main HF types are rather similar but risk factors for certain outcomes are site-specific reflecting differences in underlying mechanisms. PMID:22333003

Case Study: Guidelines for Producing Videos to Accompany Flipped Cases

Science.gov (United States)

Prud'homme-Généreux, Annie; Schiller, Nancy A.; Wild, John H.; Herreid, Clyde Freeman

2017-01-01

Three years ago, the "National Center for Case Study Teaching in Science" (NCCSTS) was inspired to merge the case study and flipped classroom approaches. The resulting project aimed to create the materials required to teach a flipped course in introductory biology by assigning videos as homework and case studies in the classroom. Three…

An Inquiry into Flipped Learning in Fourth Grade Math Instruction

Science.gov (United States)

D'addato, Teresa; Miller, Libbi R.

2016-01-01

The objective of this action research project was to better understand the impact of flipped learning on fourth grade math students in a socioeconomically disadvantaged setting. A flipped instructional model was implemented with the group of students enrolled in the researcher's class. Data was collected in the form of classroom observations,…

Implementing the Flipped Classroom in Teacher Education: Evidence from Turkey

Science.gov (United States)

Kurt, Gökçe

2017-01-01

The flipped classroom, a form of blended learning, is an emerging instructional strategy reversing a traditional lecture-based teaching model to improve the quality and efficiency of the teaching and learning process. The present article reports a study that focused on the implementation of the flipped approach in a higher education institution in…

Flipped Classroom Research and Trends from Different Fields of Study

Science.gov (United States)

Zainuddin, Zamzami; Halili, Siti Hajar

2016-01-01

This paper aims to analyse the trends and contents of flipped classroom research based on 20 articles that report on flipped learning classroom initiatives from 2013-2015. The content analysis was used as a methodology to investigate methodologies, area of studies, technology tools or online platforms, the most frequently used keywords and works…

A New Pixels Flipping Method for Huge Watermarking Capacity of the Invoice Font Image

Directory of Open Access Journals (Sweden)

Li Li

2014-01-01

Full Text Available Invoice printing just has two-color printing, so invoice font image can be seen as binary image. To embed watermarks into invoice image, the pixels need to be flipped. The more huge the watermark is, the more the pixels need to be flipped. We proposed a new pixels flipping method in invoice image for huge watermarking capacity. The pixels flipping method includes one novel interpolation method for binary image, one flippable pixels evaluation mechanism, and one denoising method based on gravity center and chaos degree. The proposed interpolation method ensures that the invoice image keeps features well after scaling. The flippable pixels evaluation mechanism ensures that the pixels keep better connectivity and smoothness and the pattern has highest structural similarity after flipping. The proposed denoising method makes invoice font image smoother and fiter for human vision. Experiments show that the proposed flipping method not only keeps the invoice font structure well but also improves watermarking capacity.

A new pixels flipping method for huge watermarking capacity of the invoice font image.

Science.gov (United States)

Li, Li; Hou, Qingzheng; Lu, Jianfeng; Xu, Qishuai; Dai, Junping; Mao, Xiaoyang; Chang, Chin-Chen

2014-01-01

Invoice printing just has two-color printing, so invoice font image can be seen as binary image. To embed watermarks into invoice image, the pixels need to be flipped. The more huge the watermark is, the more the pixels need to be flipped. We proposed a new pixels flipping method in invoice image for huge watermarking capacity. The pixels flipping method includes one novel interpolation method for binary image, one flippable pixels evaluation mechanism, and one denoising method based on gravity center and chaos degree. The proposed interpolation method ensures that the invoice image keeps features well after scaling. The flippable pixels evaluation mechanism ensures that the pixels keep better connectivity and smoothness and the pattern has highest structural similarity after flipping. The proposed denoising method makes invoice font image smoother and fiter for human vision. Experiments show that the proposed flipping method not only keeps the invoice font structure well but also improves watermarking capacity.

Flipped Classroom Research: From “Black Box” to “White Box” Evaluation

OpenAIRE

Christian Stöhr; Tom Adawi

2018-01-01

The flipped (or inverted) classroom model has gained increasing interest among university teachers in recent years. In the flipped classroom approach, students are encouraged to watch short video lectures as preparation for class, and classroom time is dedicated to more active forms of learning. In this editorial, we provide a thumbnail sketch of the origins and concept of the flipped classroom followed by a summary of the contributions to this special issue, which highlight the importance of...

Comparative study of the second and third generation of gamma nail for trochanteric fractures: review of 218 cases.

Science.gov (United States)

Mingo-Robinet, Juan; Torres-Torres, Miguel; Martínez-Cervell, Carmen; Alonso Del Olmo, Juan Antonio; Rivas Laso, Jose A; Aguado-Hernández, Hector; Burón-Alvarez, Isidro

2015-03-01

The aim of this study was to compare the complications of the trochanteric gamma nail (TGN) and the Gamma3 Nail (G3), focusing on cutout failure. Retrospective comparative cohort analysis. Level II Teaching Trauma Center academic trauma center. Two hundred eighteen trochanteric fractures with a mean follow-up of 15 months were included in the study. They were treated either with the TGN or the G3 between January 2005 and December 2010. Bivariate, stratified, and logistic regression analysis was conducted to determine the association between cutout and the independent variables. Proximal anterograde nailing with either the TGN or the G3. Patient age, sex, type of intramedullary device, stability fracture pattern, tip-apex distance (TAD), distraction at the fracture site, cervical angle, and cutout. The relative risk (RR) of cutout was 4.71 times higher in the group treated with G3 (P fractures compared with stable fractures was 3.07 (1.01-9.35). In unstable fractures, the RR of cutout was 8.78 times higher in patients with G3 (P 25 mm (P = 0.4). We have not found any relationship between cutout rate and TAD. Only the fracture pattern and the type of implant have shown to be associated with cutout risk. In our study, Gamma3 Nail has higher cutout rates than TGN in unstable fractures. Therapeutic level III. See Instructions for Authors for a complete description of levels of evidence.

Sliding hip screw versus the Targon PFT nail for trochanteric hip fractures: a randomised trial of 400 patients.

Science.gov (United States)

Parker, M J; Cawley, S

2017-09-01

To compare the outcomes for trochanteric fractures treated with a sliding hip screw (SHS) or a cephalomedullary nail. A total of 400 patients with a trochanteric hip fracture were randomised to receive a SHS or a cephalomedullary nail (Targon PFT). All surviving patients were followed up to one year from injury. Functional outcome was assessed by a research nurse blinded to the implant used. Recovery of mobility, as assessed by a mobility scale, was superior for those treated with the intramedullary nail compared with the SHS at eight weeks, three and nine months (p-values between 0.01 and 0.04), the difference at six and 12 months was not statistically significant (p = 0.15 and p = 0.18 respectively). The mean difference was around 0.4 points (0.3 to 0.5) on a nine point scale. Surgical time for the nail was four minutes less than that for the SHS (p Fracture healing complications were similar for the two groups. There were no statistically significant differences between implants for any other recorded outcomes including the need for post-operative blood transfusion, wound healing complications, general medical complications, hospital stay or mortality. This study confirms the findings of a previous study that both methods of treatment produce similar results, although intramedullary fixation does result in marginally improved regain of mobility in comparison with the SHS. Cite this article: Bone Joint J 2017;99-B:1210-15. ©2017 The British Editorial Society of Bone & Joint Surgery.

Thermally excited proton spin-flip laser emission in tokamaks

International Nuclear Information System (INIS)

Arunasalam, V.; Greene, G.J.

1993-07-01

Based on statistical thermodynamic fluctuation arguments, it is shown here for the first time that thermally excited spin-flip laser emission from the fusion product protons can occur in large tokamak devices that are entering the reactor regime of operation. Existing experimental data from TFTR supports this conjecture, in the sense that these measurements are in complete agreement with the predictions of the quasilinear theory of the spin-flip laser

The Flipped Classroom in Medical Education: Engaging Students to Build Competency

Directory of Open Access Journals (Sweden)

Larry Hurtubise

2015-01-01

Full Text Available The flipped classroom represents an essential component in curricular reform. Technological advances enabling asynchronous and distributed learning are facilitating the movement to a competency-based paradigm in healthcare education. At its most basic level, flipping the classroom is the practice of assigning students didactic material, traditionally covered in lectures, to be learned before class while using face-to-face time for more engaging and active learning strategies. The development of more complex learning systems is creating new opportunities for learning across the continuum of medical education as well as interprofessional education. As medical educators engage in the process of successfully flipping a lecture, they gain new teaching perspectives, which are foundational to effectively engage in curricular reform. The purpose of this article is to build a pedagogical and technological understanding of the flipped classroom framework and to articulate strategies for implementing it in medical education to build competency.

A brief description of the biomechanics and physiology of a strongman event: the tire flip.

Science.gov (United States)

Keogh, Justin W L; Payne, Amenda L; Anderson, Brad B; Atkins, Paul J

2010-05-01

The purpose of this study was to (a) characterize the temporal aspects of a popular strongman event, the tire flip; (b) gain some insight into the temporal factors that could distinguish the slowest and fastest flips; and (c) obtain preliminary data on the physiological stress of this exercise. Five resistance-trained subjects with experience in performing the tire flip gave informed consent to participate in this study. Each subject performed 2 sets of 6 tire flips with a 232-kg tire with 3 minutes of rest between sets. Temporal variables were obtained from video cameras positioned 10 m from the tire, perpendicular to the intended direction of the tire flip. Using the "stopwatch" function in Silicon Coach, the duration of each tire flip and that of the first pull, second pull, transition, and push phases were recorded. Physiological stress was estimated via heart rate and finger-prick blood lactate response. Independent T-tests revealed that the 2 faster subjects (0.38 +/- 0.17 s) had significantly (p tire flip performance and that this exercise provides relatively high degrees of physiological stress.

FLIPPED: A Case Study in Fundamental of Accounting in Malaysian Polytechnic

Science.gov (United States)

Jamaludin, Rozinah; Osman, Siti Zuraidah Md; Yusof, Wan Mustaffa Wan; Jasni, Nur Farrah Azwa

2016-01-01

The new pedagogical flipped classroom was designed, developed and implemented using Flexible environments, Learning culture, Intentional content, Professional educators, Progressive activities, Engaging experiences, and Diversified platforms, also known as the FLIPPED model. The objective of this study is to investigate the effect of student…

ConfChem Conference on Flipped Classroom: Using a Blog to Flip a Classroom

Science.gov (United States)

Haile, January D.

2015-01-01

This communication summarizes one of the invited papers to the Flipped Classroom ACS Division of Chemical Education Committee on Computers in Chemical Education online ConfChem held from May 18 to June 24, 2014. Just in Time Teaching is a technique in which students read the material before class and respond to a few questions. In a first-year…

Variable flip angle excitation for reduced acquisition time magnetic resonance imaging

International Nuclear Information System (INIS)

Mills, T.C.; Ortendahl, D.A.; Hylton, N.M.; Carlson, J.W.; Crooks, L.E.; Kaufman, L.

1987-01-01

This paper describes an MRI technique which can be used to acquire images at short TR values while maintaining the sensitivity to disease found in longer TR images. For spin echo imaging there are three acquisition parameters that can be set in the imaging protocol; TR, the repetition interval; TE, the time of echo and Θ, the excitation flip angle. Standard imaging techniques set Θ to 90 degrees regardless of the TR value. With Θ fixed, imaging systems have been optimized by varying the value for TE and TR with the results in general indicating the need for long TR values. However, if the flip angle is included as a variable acquisition parameter the optimal operating point can be changed. The solution to the Bloch equation shows a functional relationship between the flip angle and the ratio TR/T1. This functionality was first observed by Ernst and Anderson as a method to increase the signal generated in fourier transform magnetic resonance spectroscopy. When TR/T1<1 the optimum flip angle for producing maximum magnetization in the transverse plane is less then 90 degrees. Therefore, by reducing both TR and flip angle it is possible to maintain signal intensity while reducing the time of data acquisition

Flip-chip bonded optoelectronic integration based on ultrathin silicon (UTSi) CMOS

Science.gov (United States)

Hong, Sunkwang; Ho, Tawei; Zhang, Liping; Sawchuk, Alexander A.

2003-06-01

We describe the design and test of flip-chip bonded optoelectronic CMOS devices based on Peregrine Semiconductor's 0.5 micron Ultra-Thin Silicon on sapphire (UTSi) technology. The UTSi process eliminates the substrate leakage that typically results in crosstalk and reduces parasitic capacitance to the substrate, providing many benefits compared to bulk silicon CMOS. The low-loss synthetic sapphire substrate is optically transparent and has a coefficient of thermal expansion suitable for flip-chip bonding of vertical cavity surface emitting lasers (VCSELs) and detectors. We have designed two different UTSi CMOS chips. One contains a flip-chip bonded 1 x 4 photodiode array, a receiver array, a double edge triggered D-flip flop-based 2047-pattern pseudo random bit stream (PRBS) generator and a quadrature-phase LC-voltage controlled oscillator (VCO). The other chip contains a flip-chip bonded 1 x 4 VCSEL array, a driver array based on high-speed low-voltage differential signals (LVDS) and a full-balanced differential LC-VCO. Each VCSEL driver and receiver has individual input and bias voltage adjustments. Each UTSi chip is mounted on different printed circuit boards (PCBs) which have holes with about 1 mm radius for optical output and input paths through the sapphire substrate. We discuss preliminary testing of these chips.

Polarizing a stored proton beam by spin flip? - A high statistic reanalysis

International Nuclear Information System (INIS)

Oellers, Dieter

2011-01-01

Prompted by recent, conflicting calculations, we have carried out a measurement of the spin flip cross section in low-energy electron-proton scattering. The experiment uses the cooling electron beam at COSY as an electron target. A reanalysis of the data leeds to a reduced statistical errors resulting in a factor of 4 reduced upper limit for the spin flip cross section. The measured cross sections are too small for making spin flip a viable tool in polarizing a stored beam.

The Flipped Classroom – From Theory to Practice in Health Professional Education

Science.gov (United States)

McLaughlin, Jacqueline E.

2017-01-01

The flipped classroom is growing in popularity in health professional education. As such, instructors are experiencing various growing pains in functionalizing this model, from justifying the approach to managing time inside and outside of class to assessing impact on learning. This review focuses on some key theories that support the flipped model and translates those key theories into practice across core aspects of the flipped classroom: pre-class preparation, in-class activities, after-class activities and assessment of student learning. PMID:28970619

Moving toward heutagogical learning: Illuminating undergraduate nursing students' experiences in a flipped classroom.

Science.gov (United States)

Green, Rebecca D; Schlairet, Maura C

2017-02-01

Nurse educators rely on the tenets of educational theory and evidence-based education to promote the most effective curriculum and facilitate the best outcomes. The flipped classroom model, in which students assume personal responsibility for knowledge acquisition in a highly engaging and interactive environment, supports self-directed learning and the unique needs of clinical education. To understand how students perceived their experiences in the flipped classroom and how students' learning dispositions were affected by the flipped classroom experience. A phenomenological approach was used to gain deeper understanding about students' perspectives, perceptions and subjective experiences of the flipped classroom model. The focus of the study was on characteristics of student learning. Fourteen Bachelors of Science of Nursing (BSN) students at a regional university in the southeastern United States. Using data transcribed from face-to-face, semi-structured interviews, experiential themes were extracted from the qualitative data (student-reported experiences, attributes, thoughts, values, and beliefs regarding teaching and learning in the context of their experience of the flipped classroom) using Graneheim's and Lundman's (2004) guidelines; and were coded and analyzed within theoretical categories based on pedagogical, andragogical or heutagogical learning dispositions. Experiential themes that emerged from students' descriptions of their experiences in the flipped classroom included discernment, challenge, relevance, responsibility, and expertise. The flipped classroom model offers promising possibilities for facilitating students' movement from learning that is characteristic of pedagogy and andragogy toward heutagogical learning. Copyright © 2016 Elsevier Ltd. All rights reserved.

Calculability and stability in the flipped string

Energy Technology Data Exchange (ETDEWEB)

Lopez, J.L.; Nanopoulos, D.V. (Texas A and M Univ., College Station, TX (USA). Center for Theoretical Physics Houston Advanced Research Center (HARC), The Woodlands, TX (USA). Astroparticle Physics Group)

1991-03-07

We show that the highly successful structure of the recently proposed superstring flipped SU(5) model remains intact after the inclusion in the superpotential of the low-energy effective theory of all relevant string-induced nonrenormalizable terms. This structure provides for only two light Higgs doublets, hierarchical fermion mass matrices, and an adequate proton lifetime. We reach this conclusion explicit calculations using a recently derived set of rules to evaluate nonrenormalizable terms in the four-dimensional free fermionic formulation of superstrings. This remarkable stability of the infrared limit of the flipped string makes its experimental predictions trustworthy and hence its physical existence falsifiable. (orig.).

I mål med flipped learning

DEFF Research Database (Denmark)

Hachmann, Roland

2016-01-01

Kapitlet belyser, hvordan synlige læringsmål og stilladsering er to vigtige elementer i Flipped Learning. Kapitlet belyser en række metoder til at bringe eleven i centrum for sin egen læring og hvorledes underviseren kan differentiere sin undervisning for netop at støtte denne proces......Kapitlet belyser, hvordan synlige læringsmål og stilladsering er to vigtige elementer i Flipped Learning. Kapitlet belyser en række metoder til at bringe eleven i centrum for sin egen læring og hvorledes underviseren kan differentiere sin undervisning for netop at støtte denne proces...

Flipped learning: should it replace didactic learning?

Directory of Open Access Journals (Sweden)

Osman A

2017-10-01

Full Text Available Abdirahman Osman, Seyed Ramin Jalal, Saeed Azizi Faculty of Medicine, St George’s Hospital Medical School, London, UKWe read with great interest the article by Pettit et al1 on the implementation of flipped learning. We wish to offer our perspective as medical students. The study concluded that a combination of lecture-based teaching accompanied with flipped learning activities appealed to most students. We find this response unsurprising. Pettit et al’s1 article documents the reason – the need for a variation in teaching styles for different themes by millennial learners of the modern student community.View the original paper by Pettit and colleagues.  

Grounding the Flipped Classroom Approach in the Foundations of Educational Technology

Science.gov (United States)

Lo, Chung Kwan

2018-01-01

The flipped classroom approach is becoming increasingly popular. This instructional approach allows more in-class time to be spent on interactive learning activities, as the direct lecturing component is shifted outside the classroom through instructional videos. However, despite growing interest in the flipped classroom approach, no robust…

Correlations between Learners' Initial EFL Proficiency and Variables of Clicker-Aided Flipped EFL Class

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Yu, Zhonggen; Yu, Liheng

2017-01-01

Although the flipped class has been hotly discussed, the clicker-aided flipped EFL class (CFEC) still remains a mystery for most scholars. This study aims to determine the correlations between the initial EFL proficiency and other variables of the clicker-aided EFL flipped class. The sample was made up of randomly selected 79 participants (Female…

The flipped classroom: A learning model to increase student engagement not academic achievement

Directory of Open Access Journals (Sweden)

Masha Smallhorn

2017-07-01

Full Text Available A decrease in student attendance at lectures both nationally and internationally, has prompted educators to re-evaluate their teaching methods and investigate strategies which promote student engagement. The flipped classroom model, grounded in active learning pedagogy, transforms the face-to-face classroom. Students prepare for the flipped classroom in their own time by watching short online videos and completing readings. Face-to-face time is used to apply learning through problem-solving with peers. To improve the engagement and learning outcomes of our second year cohort, lectures were replaced with short online videos and face-to-face time was spent in a flipped classroom. The impact of the flipped classroom was analysed through surveys, attendance records, learning analytics and exam data before and after the implementation of the flipped classroom. Results suggest an increase in student engagement and a positive attitude towards the learning method. However, there were no measurable increases in student learning outcomes.

Fully simulatable quantum-secure coin-flipping and applications

DEFF Research Database (Denmark)

Lunemann, Carolin; Nielsen, Jesper Buus

2011-01-01

schemes which we show how to construct in the given setting. We then show that the interactive generation of random coins at the beginning or during outer protocols allows for quantum-secure realizations of classical schemes, again without any set-up assumptions. As example applications we discuss quantum...... zero-knowledge proofs of knowledge and quantum-secure two-party function evaluation. Both applications assume only fully simulatable coin-flipping and mixed commitments. Since our framework allows to construct fully simulatable coin-flipping from mixed commitments, this in particular shows that mixed...

Introducing a Flipped Classroom for a Statistics Course

DEFF Research Database (Denmark)

Triantafyllou, Eva; Timcenko, Olga

2014-01-01

before class, while class time is devoted to clarifications and application of this knowledge. The hypothesis is that there could be deep and creative discussions when teacher and students physically meet. This has inspired an experiment utilizing this approach in a statistics course for fourth semester......One of the novel ideas in teaching that heavily relies on current technology is the “flipped classroom” approach, or “inverse teaching”. In a flipped classroom the traditional lecture and homework sessions are inverted. Students are provided with online material in order to gain necessary knowledge...

Comparison between flipped classroom and lecture-based classroom in ophthalmology clerkship

Science.gov (United States)

Tang, Fen; Chen, Chuan; Zhu, Yi; Zuo, Chengguo; Zhong, Yimin; Wang, Nan; Zhou, Lijun; Zou, Yuxian; Liang, Dan

2017-01-01

ABSTRACT Background: In recent years, the flipped classroom method of teaching has received much attention in health sciences education. However, the application of flipped classrooms in ophthalmology education has not been well investigated. Objective: The goal of this study was to investigate the effectiveness and acceptability of the flipped classroom approach to teaching ophthalmology at the clerkship level. Design: Ninety-five fourth year medical students in an ophthalmology clerkship were randomly divided into two groups. An ocular trauma module was chosen for the content of this study. One group (FG (flipped group), n = 48) participated in flipped classroom instruction and was asked to watch a recorded lecture video and to read study materials before a face-to-face class meeting. They used the in-class time for discussion. The other group (TG (traditional group), n = 47) was assigned to traditional lecture-based instruction. These students attended a didactic lecture and completed assigned homework after the lecture. Feedback questionnaires were collected to compare students’ perspectives on the teaching approach they experienced and to evaluate students’ self-perceived competence and interest in ocular trauma. Pre- and post-tests were performed to assess student learning of the course materials. Results: More students in the FG agreed that the classroom helped to promote their learning motivation, improve their understanding of the course materials, and enhance their communication skill and clinical thinking. However, students in the FG did not show a preference for this method of teaching, and also reported more burden and pressure than those from the TG. Students from the FG performed better on the post test over the ocular trauma-related questions when compared to those from the TG. Conclusions: The flipped classroom approach shows promise in ophthalmology clerkship teaching. However, it has some drawbacks. Further evaluation and modifications

Comparison between flipped classroom and lecture-based classroom in ophthalmology clerkship.

Science.gov (United States)

Tang, Fen; Chen, Chuan; Zhu, Yi; Zuo, Chengguo; Zhong, Yimin; Wang, Nan; Zhou, Lijun; Zou, Yuxian; Liang, Dan

2017-01-01

In recent years, the flipped classroom method of teaching has received much attention in health sciences education. However, the application of flipped classrooms in ophthalmology education has not been well investigated. The goal of this study was to investigate the effectiveness and acceptability of the flipped classroom approach to teaching ophthalmology at the clerkship level. Ninety-five fourth year medical students in an ophthalmology clerkship were randomly divided into two groups. An ocular trauma module was chosen for the content of this study. One group (FG (flipped group), n = 48) participated in flipped classroom instruction and was asked to watch a recorded lecture video and to read study materials before a face-to-face class meeting. They used the in-class time for discussion. The other group (TG (traditional group), n = 47) was assigned to traditional lecture-based instruction. These students attended a didactic lecture and completed assigned homework after the lecture. Feedback questionnaires were collected to compare students' perspectives on the teaching approach they experienced and to evaluate students' self-perceived competence and interest in ocular trauma. Pre- and post-tests were performed to assess student learning of the course materials. More students in the FG agreed that the classroom helped to promote their learning motivation, improve their understanding of the course materials, and enhance their communication skill and clinical thinking. However, students in the FG did not show a preference for this method of teaching, and also reported more burden and pressure than those from the TG. Students from the FG performed better on the post test over the ocular trauma-related questions when compared to those from the TG. The flipped classroom approach shows promise in ophthalmology clerkship teaching. However, it has some drawbacks. Further evaluation and modifications are required before it can be widely accepted and implemented

A gross anatomy flipped classroom effects performance, retention, and higher-level thinking in lower performing students.

Science.gov (United States)

Day, Leslie J

2018-01-22

A flipped classroom is a growing pedagogy in higher education. Many research studies on the flipped classroom have focused on student outcomes, with the results being positive or inconclusive. A few studies have analyzed confounding variables, such as student's previous achievement, or the impact of a flipped classroom on long-term retention and knowledge transfer. In the present study, students in a Doctor of Physical Therapy program in a traditional style lecture of gross anatomy (n = 105) were compared to similar students in a flipped classroom (n = 112). Overall, students in the flipped anatomy classroom had an increase in semester average grades (P = 0.01) and performance on higher-level analytical questions (P flipped anatomy classroom performing at a higher level in kinesiology (P flipped anatomy class, outperformed their traditional anatomy class counterparts in anatomy semester grades (P flipped classroom may benefit lower performing student's knowledge acquisition and transfer to a greater degree than higher performing students. Future studies should explore the underlying reasons for improvement in lower performing students. Anat Sci Educ. © 2018 American Association of Anatomists. © 2018 American Association of Anatomists.

Increased cFLIP expression in thymic epithelial tumors blocks autophagy via NF-κB signalling.

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Belharazem, Djeda; Grass, Albert; Paul, Cornelia; Vitacolonna, Mario; Schalke, Berthold; Rieker, Ralf J; Körner, Daniel; Jungebluth, Philipp; Simon-Keller, Katja; Hohenberger, Peter; Roessner, Eric M; Wiebe, Karsten; Gräter, Thomas; Kyriss, Thomas; Ott, German; Geserick, Peter; Leverkus, Martin; Ströbel, Philipp; Marx, Alexander

2017-10-27

The anti-apoptotic cellular FLICE-like inhibitory protein cFLIP plays a pivotal role in normal tissues homoeostasis and the development of many tumors, but its role in normal thymus (NT), thymomas and thymic carcinomas (TC) is largely unknown. Expression, regulation and function of cFLIP were analyzed in biopsies of NT, thymomas, thymic squamous cell carcinomas (TSCC), thymic epithelial cells (TECs) derived thereof and in the TC line 1889c by qRT-PCR, western blot, shRNA techniques, and functional assays addressing survival, senescence and autophagy. More than 90% of thymomas and TSCCs showed increased cFLIP expression compared to NT. cFLIP expression declined with age in NTs but not in thymomas. During short term culture cFLIP expression levels declined significantly slower in neoplastic than non-neoplastic primary TECs. Down-regulation of cFLIP by shRNA or NF-κB inhibition accelerated senescence and induced autophagy and cell death in neoplastic TECs. The results suggest a role of cFLIP in the involution of normal thymus and the development of thymomas and TSCC. Since increased expression of cFLIP is a known tumor escape mechanism, it may serve as tissue-based biomarker in future clinical trials, including immune checkpoint inhibitor trials in the commonly PD-L1 high thymomas and TCs.

Flipping the Classroom for English Language Learners to Foster Active Learning

Science.gov (United States)

Hung, Hsiu-Ting

2015-01-01

This paper describes a structured attempt to integrate flip teaching into language classrooms using a WebQuest active learning strategy. The purpose of this study is to examine the possible impacts of flipping the classroom on English language learners' academic performance, learning attitudes, and participation levels. Adopting a…

The Flipped Classroom and Cooperative Learning: Evidence from a Randomised Experiment

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Foldnes, Njål

2016-01-01

This article describes a study which compares the effectiveness of the flipped classroom relative to the traditional lecture-based classroom. We investigated two implementations of the flipped classroom. The first implementation did not actively encourage cooperative learning, with students progressing through the course at their own pace. With…

Enhancing Academic Achievement and Satisfaction by Flipping the Teacher Preparation Classroom

Science.gov (United States)

Zuniga, Rene R.

2015-01-01

This study compared flipped classrooms versus online courses to study the effects of the two instructional methodologies on student achievement and satisfaction in an undergraduate "Introduction to Education," EDUC 1301, course. Students self-matriculated in either traditional EDUC 1301 courses which were flipped or in EDUC 1301 online…

Comparison of Flipped Model to Traditional Classroom Learning in a Professional Pharmacy Course

Directory of Open Access Journals (Sweden)

Colleen McCabe

2017-09-01

Full Text Available The flipped classroom is an approach to incorporate active learning that is being used in secondary education, higher education, and professional schools. This study investigates its impact on student learning and confidence in a professional degree program course. A quasi-experimental study was conducted to evaluate pharmacy students enrolled in a semester-long didactic traditional classroom course compared to students learning the same material using a flipped model through online self-study modules in a hands-on experiential learning course. Before and after each learning experience, students of each group completed a 16-item knowledge assessment on four topic areas and rated their level of confidence with each topic area on a Likert scale. There was a significant difference in knowledge with students in the traditional course scoring higher than students using flipped approach in the experiential course. Furthermore, the flipped experiential course students did not improve assessment scores from pre-test to post-test. For confidence rating, the traditional course group ranked confidence higher than the flipped experiential group for all topics. These findings challenge the notion that the flipped model using self-study in an experiential setting can be a substitution for didactic delivery of pharmacy education.

An Investigation of the Use of the ‘Flipped Classroom’ Pedagogy in Secondary English Language Classrooms

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Chi Cheung Ruby Yang

2017-01-01

Full Text Available Aim/Purpose\t: To examine the use of a flipped classroom in the English Language subject in secondary classrooms in Hong Kong. Background:\tThe research questions addressed were: (1 What are teachers’ perceptions towards the flipped classroom pedagogy? (2 How can teachers transfer their flipped classroom experiences to teaching other classes/subjects? (3 What are students’ perceptions towards the flipped classroom pedagogy? (4 How can students transfer their flipped classroom experiences to studying other subjects? (5 Will students have significant gain in the knowledge of the lesson topic trialled in this study? Methodology: A total of 57 students from two Secondary 2 classes in a Band 3 secondary school together with two teachers teaching these two classes were involved in this study. Both quantitative and quantitative data analyses were conducted. Contribution: Regarding whether the flipped classroom pedagogy can help students gain significantly in their knowledge of a lesson topic, only one class of students gained statistically significantly in the subject knowledge but not for another class. Findings: Students in general were positive about the flipped classroom. On the other hand, although the teachers considered that the flipped classroom pedagogy was creative, they thought it may only be useful for teaching English grammar. Recommendations for Practitioners: Teachers thought that flipping a classroom may only be useful for more motivated students, and the extra workload of finding or making suitable pre-lesson online videos is the main concern for teachers. Recommendations for Researchers: Both quantitative and qualitative analyses should be conducted to investigate the effectiveness of a flipped classroom on students’ language learning. Impact on Society\t: Teachers and students can transfer their flipped classroom experiences in English Language to teaching and studying other subjects. Future Research:\tMore classes should be

The implementation of flipped classroom model in CIE in the environment of non-target language

Science.gov (United States)

Xiao, Renfei; Mustofa, Ali; Zhang, Fang; Su, Xiaoxue

2018-01-01

This paper sets a theoretical framework that it’s both feasible and indispensable of flipping classroom in Chinese International Education (CIE) in the non-target language environments. There are mainly three sections included: 1) what is flipped classroom and why it becomes inevitable existence; 2) why should we flip the classroom in CIE environments, especially in non-target language environments; 3) take Pusat Bahasa Mandarin Universitas Negeri Surabaya as an instance to discuss the application of flipped classroom in non-target language environments.

Student performance and attitudes in a collaborative and flipped linear algebra course

Science.gov (United States)

Murphy, Julia; Chang, Jen-Mei; Suaray, Kagba

2016-07-01

Flipped learning is gaining traction in K-12 for enhancing students' problem-solving skills at an early age; however, there is relatively little large-scale research showing its effectiveness in promoting better learning outcomes in higher education, especially in mathematics classes. In this study, we examined the data compiled from both quantitative and qualitative measures such as item scores on a common final and attitude survey results between a flipped and a traditional Introductory Linear Algebra class taught by two individual instructors at a state university in California in Fall 2013. Students in the flipped class were asked to watch short video lectures made by the instructor and complete a short online quiz prior to each class attendance. The class time was completely devoted to problem solving in group settings where students were prompted to communicate their reasoning with proper mathematical terms and structured sentences verbally and in writing. Examination of the quality and depth of student responses from the common final exam showed that students in the flipped class produced more comprehensive and well-explained responses to the questions that required reasoning, creating examples, and more complex use of mathematical objects. Furthermore, students in the flipped class performed superiorly in the overall comprehension of the content with a 21% increase in the median final exam score. Overall, students felt more confident about their ability to learn mathematics independently, showed better retention of materials over time, and enjoyed the flipped experience.

Spin-polarized free electron beam interaction with radiation and superradiant spin-flip radiative emission

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A. Gover

2006-06-01

Full Text Available The problems of spin-polarized free-electron beam interaction with electromagnetic wave at electron-spin resonance conditions in a magnetic field and of superradiant spin-flip radiative emission are analyzed in the framework of a comprehensive classical model. The spontaneous emission of spin-flip radiation from electron beams is very weak. We show that the detectivity of electron spin resonant spin-flip and combined spin-flip/cyclotron-resonance-emission radiation can be substantially enhanced by operating with ultrashort spin-polarized electron beam bunches under conditions of superradiant (coherent emission. The proposed radiative spin-state modulation and the spin-flip radiative emission schemes can be used for control and noninvasive diagnostics of polarized electron/positron beams. Such schemes are of relevance in important scattering experiments off nucleons in nuclear physics and off magnetic targets in condensed matter physics.

Competency-Based Blended Learning: Flipping Professional Practice Classes to Enhance Competence Development

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Mark Ragg

2017-08-01

Full Text Available In the past decade, health and human service educational programs have transitioned to competence-based outcomes to enhance the quality of graduating professionals. While such outcomes are a critical step in ensuring professional quality, they require curricular and pedagogical adjustments that do not fit easily within university environments. Technology has eased many problems of fit through the development of hybrid and flipped courses that allow on-campus time to be better focused on developing professional skills. This study explored the question: Can flipped delivery improve competence-based outcomes in social work practice classes? The study assessed pedagogical adjustments that integrated competence-based learning principles with flipped classroom delivery. Principles of organizing the class to maximize competence development are explored and illustrated. Improved competence development and student satisfaction were demonstrated in three flipped practice courses with a combined sample size of 269 Bachelor of Social Work (BSW and Masters of Social Work (MSW students. Researchers concluded that using flipped-classroom methods enhanced the students’ capacity to apply concepts and develop skills. In particular, the ability to receive and process feedback on applied skills was improved.

The effectiveness of flipped classroom learning model in secondary physics classroom setting

Science.gov (United States)

Prasetyo, B. D.; Suprapto, N.; Pudyastomo, R. N.

2018-03-01

The research aimed to describe the effectiveness of flipped classroom learning model on secondary physics classroom setting during Fall semester of 2017. The research object was Secondary 3 Physics group of Singapore School Kelapa Gading. This research was initiated by giving a pre-test, followed by treatment setting of the flipped classroom learning model. By the end of the learning process, the pupils were given a post-test and questionnaire to figure out pupils' response to the flipped classroom learning model. Based on the data analysis, 89% of pupils had passed the minimum criteria of standardization. The increment level in the students' mark was analysed by normalized n-gain formula, obtaining a normalized n-gain score of 0.4 which fulfil medium category range. Obtains from the questionnaire distributed to the students that 93% of students become more motivated to study physics and 89% of students were very happy to carry on hands-on activity based on the flipped classroom learning model. Those three aspects were used to generate a conclusion that applying flipped classroom learning model in Secondary Physics Classroom setting is effectively applicable.

Healthcare students' experiences when integrating e-learning and flipped classroom instructional approaches.

Science.gov (United States)

Telford, Mark; Senior, Emma

2017-06-08

This article describes the experiences of undergraduate healthcare students taking a module adopting a 'flipped classroom' approach. Evidence suggests that flipped classroom as a pedagogical tool has the potential to enhance student learning and to improve healthcare practice. This innovative approach was implemented within a healthcare curriculum and in a module looking at public health delivered at the beginning of year two of a 3-year programme. The focus of the evaluation study was on the e-learning resources used in the module and the student experiences of these; with a specific aim to evaluate this element of the flipped classroom approach. A mixed-methods approach was adopted and data collected using questionnaires, which were distributed across a whole cohort, and a focus group involving ten participants. Statistical analysis of the data showed the positive student experience of engaging with e-learning. The thematic analysis identified two key themes; factors influencing a positive learning experience and the challenges when developing e-learning within a flipped classroom approach. The study provides guidance for further developments and improvements when developing e-learning as part of the flipped classroom approach.

Effectiveness of the Surgery Core Clerkship Flipped Classroom: a prospective cohort trial.

Science.gov (United States)

Liebert, Cara A; Lin, Dana T; Mazer, Laura M; Bereknyei, Sylvia; Lau, James N

2016-02-01

The flipped classroom has been proposed as an alternative curricular approach to traditional didactic lectures but has not been previously applied to a surgery clerkship. A 1-year prospective cohort of students (n = 89) enrolled in the surgery clerkship was taught using a flipped classroom approach. A historical cohort of students (n = 92) taught with a traditional lecture curriculum was used for comparison. Pretest and post-test performance, end-of-clerkship surveys, and National Board of Medical Examiners (NBME) scores were analyzed to assess effectiveness. Mean pretest and post-test scores increased across all modules (P flipped classroom contributed to this increase. Implementation of a flipped classroom in the surgery clerkship is feasible and results in high learner satisfaction, effective knowledge acquisition, and increased career interest in surgery with noninferior NBME performance. Copyright © 2016 Elsevier Inc. All rights reserved.

Flipped clinical training: a structured training method for undergraduates in complete denture prosthesis.

Science.gov (United States)

K, Anbarasi; K, Kasim Mohamed; Vijayaraghavan, Phagalvarthy; Kandaswamy, Deivanayagam

2016-12-01

To design and implement flipped clinical training for undergraduate dental students in removable complete denture treatment and predict its effectiveness by comparing the assessment results of students trained by flipped and traditional methods. Flipped training was designed by shifting the learning from clinics to learning center (phase I) and by preserving the practice in clinics (phase II). In phase I, student-faculty interactive session was arranged to recap prior knowledge. This is followed by a display of audio synchronized video demonstration of the procedure in a repeatable way and subsequent display of possible errors that may occur in treatment with guidelines to overcome such errors. In phase II, live demonstration of the procedure was given. Students were asked to treat three patients under instructor's supervision. The summative assessment was conducted by applying the same checklist criterion and rubric scoring used for the traditional method. Assessment results of three batches of students trained by flipped method (study group) and three traditionally trained previous batches (control group) were taken for comparison by chi-square test. The sum of traditionally trained three batch students who prepared acceptable dentures (score: 2 and 3) and unacceptable dentures (score: 1) was compared with the same of flipped trained three batch students revealed that the number of students who demonstrated competency by preparing acceptable dentures was higher for flipped training (χ 2 =30.996 with p<0.001). The results reveal the supremacy of flipped training in enhancing students competency and hence recommended for training various clinical procedures.

A Mixed Methods Study on the Effect of Flipping the Undergraduate Medical Classroom

Directory of Open Access Journals (Sweden)

Kelly W. Burak

2017-11-01

Full Text Available The flipped classroom model is increasingly being adopted in healthcare education, despite the fact that recent systematic reviews in the nursing and medical education literature suggest that this method of instructional design is not inherently better or worse than the traditional classroom. In this study, we used a sequential, explanatory mixed methods design to assess the impact of flipping the hepatology classroom for preclinical medical students. Compared to students in the traditional classroom, students in the flipped classroom had significantly lower mean (SD ratings of their learning experiences (3.48 (1.10 vs. 4.50 (0.72, p < 0.001, d = 1.10, but better performance on the hepatology content of the end-of-course examination (78.0% (11.7% vs. 74.2 (15.1%, respectively, p < 0.01, d = 0.3. Based upon our qualitative data analyses, we propose that the flipped classroom induced a change in the learning process of students by requiring increased preparation for classroom learning and promoting greater learner autonomy, which resulted in better retention of learned material, but reduced enjoyment of the learning experience. This dissonance in outcomes is captured in the words of one flipped classroom student: “…I hated it while I was learning it, but boy did I remember it…”. Based upon our dissonant outcomes and the inconsistent findings in the literature, we feel that there is still equipoise regarding the effectiveness of the flipped classroom, and further studies are needed to describe ways of making the flipped classroom a more effective (±more enjoyable learning experience.

Rates and energetics of tyrosine ring flips in yeast iso-2-cytochrome c

International Nuclear Information System (INIS)

Nall, B.T.; Zuniga, E.H.

1990-01-01

Isotope-edited nuclear magnetic resonance spectroscopy is used to monitor ring flip motion of the five tyrosine side chains in the oxidized and reduced forms of yeast iso-2-cytochrome c. With specifically labeled protein purified from yeast grown on media containing [3,5- 13 C]tyrosine, isotope-edited one-dimensional proton spectra have been collected over a 5-55 degree C temperature range. The spectra allow selective observation of the 10 3,5 tyrosine ring proton resonances and, using a two-site exchange model, allow estimation of the temperature dependence of ring flip rates from motion-induced changes in proton line shapes. For the reduced protein, tyrosines II and IV are in fast exchange throughout the temperature range investigated, or lack resolvable differences in static chemical shifts for the 3,5 ring protons. Tyrosines I, III, and V are in sloe exchange at low temperatures and in fast exchange at high temperatures. Spectral simulations give flip rates for individual tyrosines in a range of one flip per second at low temperatures to thousands of flips per second at high temperatures. Eyring plots show that two of the tyrosines (I and III) have essentially the same activation parameters. Tentative sequence-specific assignments for the tyrosines in reduced iso-2 are suggested by comparison to horse cytochrome c. For oxidized iso-2, five resonances are observed at high temperatures, suggesting flip rates for all five tyrosines sufficient to average static chemical shift differences. At lower temperatures, there is evidence of intermediate and slow flipping for some of the rings

Comparison of Pharmaceutical Calculations Learning Outcomes Achieved Within a Traditional Lecture or Flipped Classroom Andragogy

Science.gov (United States)

Frazier, Lisa; Anderson, Stephanie L.; Stanton, Robert; Gillette, Chris; Broedel-Zaugg, Kim; Yingling, Kevin

2017-01-01

Objective. To compare learning outcomes achieved from a pharmaceutical calculations course taught in a traditional lecture (lecture model) and a flipped classroom (flipped model). Methods. Students were randomly assigned to the lecture model and the flipped model. Course instructors, content, assessments, and instructional time for both models were equivalent. Overall group performance and pass rates on a standardized assessment (Pcalc OSCE) were compared at six weeks and at six months post-course completion. Results. Student mean exam scores in the flipped model were higher than those in the lecture model at six weeks and six months later. Significantly more students passed the OSCE the first time in the flipped model at six weeks; however, this effect was not maintained at six months. Conclusion. Within a 6 week course of study, use of a flipped classroom improves student pharmacy calculation skill achievement relative to a traditional lecture andragogy. Further study is needed to determine if the effect is maintained over time. PMID:28630511

Comparison of Pharmaceutical Calculations Learning Outcomes Achieved Within a Traditional Lecture or Flipped Classroom Andragogy.

Science.gov (United States)

Anderson, H Glenn; Frazier, Lisa; Anderson, Stephanie L; Stanton, Robert; Gillette, Chris; Broedel-Zaugg, Kim; Yingling, Kevin

2017-05-01

Objective. To compare learning outcomes achieved from a pharmaceutical calculations course taught in a traditional lecture (lecture model) and a flipped classroom (flipped model). Methods. Students were randomly assigned to the lecture model and the flipped model. Course instructors, content, assessments, and instructional time for both models were equivalent. Overall group performance and pass rates on a standardized assessment (Pcalc OSCE) were compared at six weeks and at six months post-course completion. Results. Student mean exam scores in the flipped model were higher than those in the lecture model at six weeks and six months later. Significantly more students passed the OSCE the first time in the flipped model at six weeks; however, this effect was not maintained at six months. Conclusion. Within a 6 week course of study, use of a flipped classroom improves student pharmacy calculation skill achievement relative to a traditional lecture andragogy. Further study is needed to determine if the effect is maintained over time.

[Evaluation of flipped classroom teaching model in undergraduates education of oral and maxillofacial surgery].

Science.gov (United States)

Cai, Ming; Cao, Xia; Fang, Xiao; Wang, Xu-dong; Zhang, Li-li; Zheng, Jia-wei; Shen, Guo-fang

2015-12-01

Flipped classroom is a new teaching model which is different from the traditional teaching method. The history and characteristics of flipped classroom teaching model were introduced in this paper. A discussion on how to establish flipped classroom teaching protocol in oral and maxillofacial surgery education was carried out. Curriculum transformation, construction of education model and possible challenges were analyzed and discussed.

An Integrative Review of Flipped Classroom Teaching Models in Nursing Education.

Science.gov (United States)

Njie-Carr, Veronica P S; Ludeman, Emilie; Lee, Mei Ching; Dordunoo, Dzifa; Trocky, Nina M; Jenkins, Louise S

Nursing care is changing dramatically given the need for students to address complex and multiple patient comorbidities. Students experience difficulties applying knowledge gained from didactic instruction to make important clinical decisions for optimal patient care. To optimize nursing education pedagogy, innovative teaching strategies are required to prepare future nurses for practice. This integrative review synthesized the state of the science on flipped classroom models from 13 empirical studies published through May 2016. The purpose of the review was to evaluate studies conducted on flipped classroom models among nursing students using a validated framework by Whittemore and Knafl. Multiple academic databases were searched, ranging in scope including PubMed, Embase (Elsevier), CINAHL (Ebsco), Scopus, Web of Science, and Google Scholar, resulting in 95 unique records. After screening and full-text reviews, 82 papers were removed. Thirteen empirical studies were included in the final analysis and results provided (a) design and process information on flipped classroom models in nursing education, (b) a summary of the state of the evidence to inform the implementation of flipped classrooms, and (c) a foundation to build future research in this area of nursing education. To develop sound evidence-based teaching strategies, rigorous scientific methods are needed to inform the implementation of flipped classroom approaches. Copyright © 2016 Elsevier Inc. All rights reserved.

An Investigation of the Use of the "Flipped Classroom" Pedagogy in Secondary English Language Classrooms

Science.gov (United States)

Yang, Chi Cheung Ruby

2017-01-01

Aim/Purpose: To examine the use of a flipped classroom in the English Language subject in secondary classrooms in Hong Kong. Background: The research questions addressed were: (1) What are teachers' perceptions towards the flipped classroom pedagogy?; (2) How can teachers transfer their flipped classroom experiences to teaching other…

Implementation of a Flipped Classroom for Nuclear Medicine Physician CME.

Science.gov (United States)

Komarraju, Aparna; Bartel, Twyla B; Dickinson, Lisa A; Grant, Frederick D; Yarbrough, Tracy L

2018-06-21

Increasingly, emerging technologies are expanding instructional possibilities, with new methods being adopted to improve knowledge acquisition and retention. Within medical education, many new techniques have been employed in the undergraduate setting, with less utilization thus far in the continuing medical education (CME) sphere. This paper discusses the use of a new method for CME-the "flipped classroom," widely used in undergraduate medical education. This method engages learners by providing content before the live ("in class") session that aids in preparation and fosters in-class engagement. A flipped classroom method was employed using an online image-rich case-based module and quiz prior to a live CME session at a national nuclear medicine meeting. The preparatory material provided a springboard for in-depth discussion at the live session-a case-based activity utilizing audience response technology. Study participants completed a survey regarding their initial experience with this new instructional method. In addition, focus group interviews were conducted with session attendees who had or had not completed the presession material; transcripts were qualitatively analyzed. Quantitative survey data (completed by two-thirds of the session attendees) suggested that the flipped method was highly valuable and met attendee educational objectives. Analysis of focus group data yielded six themes broadly related to two categories-benefits of the flipped method for CME and programmatic considerations for successfully implementing the flipped method in CME. Data from this study have proven encouraging and support further investigations around the incorporation of this innovative teaching method into CME for nuclear imaging specialists.

A Flipped Writing Classroom: Effects on EFL Learners’ Argumentative Essays

Directory of Open Access Journals (Sweden)

Fatemeh Soltanpour

2018-02-01

Full Text Available According to the literature, flipped teaching is a relatively new pedagogical approach in which the typical activities of classroom lectures followed by homework in common teaching practice are reversed in order, and most often integrated or supplemented with some types of instructional materials, such as instructional videos or PowerPoint files. This experimental study, using a pre-test-treatment-posttest-delayed posttest design, was aimed at investigating the effect of flipped instruction on Iranian EFL learners’ quality of argumentative essays. The participants were 55 students, who were assigned to two groups: the flipped classroom (FC and the traditional classroom (TC. Each group received 3 sessions of treatment. First, whether there was any significant difference between the FC and TC in the overall quality of the essays was investigated. The FC group significantly outperformed the TC one. Then, whether the difference between the groups varied over time was explored, and it was revealed that the FC was still significantly superior over the TC. Next, whether there would be any significant change in the FC in the long run was examined, and no significant change was seen. The promising results found in FC group can be attributed to not only the flipped instruction but also the process of actively engaging the learners in their learning in addition to incorporating different techniques, such as the video screencasting, collaborative writing, as well as in-class teacher-learner interaction and negotiation because it is argued that the crucial point in flipped instruction is how teachers best use in-class-time with students.

Three-dimensional bone-implant movements in trochanteric hip fractures: Precision and accuracy of radiostereometric analysis in a phantom model.

Science.gov (United States)

Bojan, Alicja J; Bragdon, Charles; Jönsson, Anders; Ekholm, Carl; Kärrholm, Johan

2015-05-01

The accuracy and precision of RSA were evaluated in the experimental study of screw cut-out complication after fixation of trochanteric fractures. A plastic bone model of a two-part trochanteric fracture was constructed with a Gamma nail implant incorporating RSA markers. The femoral head fragment was attached to a separate rotational table and the femoral shaft was mounted on the micrometer. Three main motions were simulated: Femoral head translation and rotation along the axis of the lag screw and fracture fragment translation along anatomical axes. Accuracy and precision were determined according to ISO 16,087 and ASTM standard F2385-04. Translations along the lag screw axis were measured with a precision within  ±0.14 mm and an accuracy within ±0.03 mm. With simultaneous translations along all three anatomical axes, lowest precision was measured for the x-axis (±0.29, 0.07 mm, respectively), but improved when analyzed as a vector (±0.08, 0.03 mm). The precision and accuracy of femoral head rotations were within 0.5° and 0.18°, respectively. The resolution of the RSA method tested in this model was high, though it varied depending on the type of analyzed motion. This information is valuable when selecting and interpreting outcome parameters evaluating implant migration and osteosynthesis stability in future clinical RSA studies. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

A comparison of two fixation methods for femoral trochanteric fractures: a new generation intramedullary system vs sliding hip screw.

Science.gov (United States)

Carulli, Christian; Piacentini, Federico; Paoli, Tommaso; Civinini, Roberto; Innocenti, Massimo

2017-01-01

Trochanteric fractures are frequent and generally associated with bone fragility. There is still debate on the best fixation device to treat stable or rather stable trochanteric fractures: we report our clinical and radiological results of fixation with Proximal Femoral Nail "antirotation" (PFNa) in a population of patients compared to a control group treated by Sliding Hip Screw (SHS). A prospective study was conducted in 71 consecutive patients treated by PFNa (group A), and 69 by a SHS (group B), with a mean age of 81.6 and 83.4 years respectively. Short Form 12 was administered to check postoperative results, and the following parameters were evaluated: range of motion, evaluation of pain, gait ability, X-rays, and Tip Apex Distance Index. A minimum follow-up was conducted in 128 patients: 66 subjects belonging to the PFNa group and 62 to the DHS group. All patients in the group A were able to reach partial or full weight-bearing on the operated leg before leaving the hospital. Forty-four patients (63.8%) of the group B were able to walk with partial weight-bearing before discharge. We recorded 17 complications with a final overall percentage of 17.2% on the overall study population with one single case of failure in both the two groups. A statistical significance (ptrochanteric fractures as well as DHS. The light superiority of PFNa may be principally related to its mechanical advantages.

Relationships in the Flipped Classroom

Directory of Open Access Journals (Sweden)

Brett M. McCollum

2017-12-01

Full Text Available This study examines the effectiveness of flipped classrooms in chemistry, and identifies relationships as a major factor impacting the success of flipped instruction methods. Examination of student interview data reveals factors that affect the development of peer-peer, peer-peer leader, and peer-expert relationships in first-year general chemistry and second-year organic chemistry flipped classrooms. Success was measured in terms of student perceptions of the effectiveness of the instruction, as well as student academic development. Furthermore, analysis of research participant interviews reveals that academic reading circles, open-response multiple-attempt group quizzes, and peer leaders are important elements of a text-centric flipped approach at a small-classroom, commuter-campus university. Student reflections and classroom observations provide further support for these conclusions. Cet étude examine l’efficacité des salles de classe inversées en chimie et identifie la création de liens en tant que facteur important qui affecte la réussite des méthodes d’instruction inversée. L’examen des données provenant d’entrevues avec les étudiants révèle les facteurs qui affectent le développement des rapports d’étudiant à étudiant, d’étudiant à leader et d’étudiant à expert dans un cours inversé de chimie générale de première année et dans un cours de chimie organique de deuxième année. La réussite a été mesurée en termes de perceptions des étudiants de l’efficacité de l’instruction, ainsi que du développement académique des étudiants. De plus, l’analyse des entrevues des participants à la recherche révèle que les cercles de lecture universitaires, les tests de groupes à essais multiples et à réponses ouvertes, ainsi que les leaders de groupes sont des éléments importants d’une approche inversée centrée sur un texte en petite salle de classe, dans une université de banlieusards. Les

Using Flipped Classroom Approach to Explore Deep Learning in Large Classrooms

Science.gov (United States)

Danker, Brenda

2015-01-01

This project used two Flipped Classroom approaches to stimulate deep learning in large classrooms during the teaching of a film module as part of a Diploma in Performing Arts course at Sunway University, Malaysia. The flipped classes utilized either a blended learning approach where students first watched online lectures as homework, and then…

The effect of flipped teaching combined with modified team-based learning on student performance in physiology.

Science.gov (United States)

Gopalan, Chaya; Klann, Megan C

2017-09-01

Flipped classroom is a hybrid educational format that shifts guided teaching out of class, thus allowing class time for student-centered learning. Although this innovative teaching format is gaining attention, there is limited evidence on the effectiveness of flipped teaching on student performance. We compared student performance and student attitudes toward flipped teaching with that of traditional lectures using a partial flipped study design. Flipped teaching expected students to have completed preclass material, such as assigned reading, instructor-prepared lecture video(s), and PowerPoint slides. In-class activities included the review of difficult topics, a modified team-based learning (TBL) session, and an individual assessment. In the unflipped teaching format, students were given PowerPoint slides and reading assignment before their scheduled lectures. The class time consisted of podium-style lecture, which was captured in real time and was made available for students to use as needed. Comparison of student performance between flipped and unflipped teaching showed that flipped teaching improved student performance by 17.5%. This was true of students in both the upper and lower half of the class. A survey conducted during this study indicated that 65% of the students changed the way they normally studied, and 69% of the students believed that they were more prepared for class with flipped learning than in the unflipped class. These findings suggest that flipped teaching, combined with TBL, is more effective than the traditional lecture. Copyright © 2017 the American Physiological Society.

Equine First Aid Information Flip Booklet

OpenAIRE

Nay, Karah; Hoopes, Karl

2017-01-01

This is a flip chart type booklet with first aid information for horses, including checking vitals, pulse rate, respiration, mucus membrane color and capillary refill, signs of colic, deworming, vaccinations recommended for Utah, hoof care, and dental care.

NMR investigation of spin flip in TmCrO3

International Nuclear Information System (INIS)

Karnachev, A.S.; Klechin, Yu.I.; Kovtun, N.M.; Moskvin, A.S.; Solov'ev, E.E.; Tkachenko, A.A.

1987-01-01

Spin flip in the rare earth orthochromate TmCrO 3 is studied by the double-pulse NMR technique. It is shown that below 5.6 K spin flip in the absence of an external magnetic field takes place as a first order phase transition from the high temperature phase Γ 2 to the low temperature phase Γ 4 with a region of coexistence of the two phases of more than 3.8 K. The spin flip phase transitions Γ 2 ↔ Γ 4 induced by an external magnetic field and the attendant phenomenon of magnetic and electric nonequivalence of 53 Cr nuclei from different magnetic sublattices are investigated. The anisotropy parameters of the hyperfine interactions and nuclear quadrupole interactions are calculated on the basis of the experimental data

Is neutralino dark matter compatible with flipped SU(5) models

Energy Technology Data Exchange (ETDEWEB)

McDonald, J.

1989-07-13

We consider the possibility that the lightest supersymmetric particle in flipped SUSY SU(5)xU(1) models is cosmologically stable and corresponds to a neutralino. Previous studies of dark matter in flipped SUSY SU(5) models have suggested that the decay of the oscillations of the SU(5) breaking scalar field would result in too many neutralinos, if they are stable. We show that it is possible for an acceptable density of neutralinos to occur in the case where the neutralino corresponds to a light photino, if the temperature at the end of the oscillation dominated period is flipped SU(5) models. Direct detection of dark matter in forthcoming experiments will therefore not eliminate this class of models. (orig.).

The FLIP fuel experience at Washington State University

International Nuclear Information System (INIS)

Lovas, Thomas A.

1977-01-01

The Washington State University TRIGA-fueled modified G.E. reactor was refueled with a partial TRIGA-FLIP core in February, 1976. The final core loading consisted of 35 FLIP and 75 Standard TRIGA fuel rods and provided a core excess reactivity of $7.98. The observed performance of the reactor did not deviate significantly from the design predictions and specifications. Pulsing tests revealed a maximum power output of 1850 MW with a fuel temperature of 449 deg. C from a $2.50 pulse. Slight power fluctuations at 1 Megawatt steady-state operation and post-pulse power oscillations were observed. (author)

THE IMPLEMENTATION OF FLIPPED CLASSROOM MODEL IN EFL WRITING

OpenAIRE

Rida Afrilyasanti

2016-01-01

Flipped classroom is an approach to learning to write that allows teachers to have one-on-one assistance to help learners in the “during writing” stage in the classroom. Theories are given to the students in a video lectures to watch before class. Because problems in writing mostly occur in “during writing” stage, teacher assistance is crucial. This paper aims to share theoretical review and research findings pertaining to the implementation of flipped classroom model to EFL writing. Research...

Implementing the Flipped Classroom : An exploration of study behaviour and student performance

NARCIS (Netherlands)

Boevé, Anna J.; Meijer, Rob R.; Bosker, Roel J.; Vugteveen, Jorien; Hoekstra, Rink; Albers, Casper J.

2017-01-01

The flipped classroom is becoming more popular as a means to support student learning in higher education by requiring students to prepare before lectures and actively engaging students during lectures. While some research has been conducted into student performance in the flipped classroom,

Search Strategy Development in a Flipped Library Classroom: A Student-Focused Assessment

Science.gov (United States)

Goates, Michael C.; Nelson, Gregory M.; Frost, Megan

2017-01-01

Librarians at Brigham Young University compared search statement development between traditional lecture and flipped instruction sessions. Students in lecture sessions scored significantly higher on developing search statements than those in flipped sessions. However, student evaluations show a strong preference for pedagogies that incorporate…

Flipping HCI

Directory of Open Access Journals (Sweden)

C. Evans

2016-08-01

Full Text Available This paper presents the results of two studies involving “flipping the classroom”. Teaching material was delivered via interactive “e-lectures”, allowing face-to-face sessions to focus instead on practice. The e-lectures were designed according to standard usability principles coupled with recent research into the effect of interactivity on learning. The effectiveness of the use of e-lectures was then evaluated using an online survey. The results suggest that students prefer the flexibility offered by e-lectures compared to conventional lectures. The results contribute to our understanding of how this technology fits with face-to-face teaching in the digital age.

Flip chip assembly of thinned chips for hybrid pixel detector applications

International Nuclear Information System (INIS)

Fritzsch, T; Zoschke, K; Rothermund, M; Oppermann, H; Woehrmann, M; Ehrmann, O; Lang, K D; Huegging, F

2014-01-01

There is a steady trend to ultra-thin microelectronic devices. Especially for future particle detector systems a reduced readout chip thickness is required to limit the loss of tracking precision due to scattering. The reduction of silicon thickness is performed at wafer level in a two-step thinning process. To minimize the risk of wafer breakage the thinned wafer needs to be handled by a carrier during the whole process chain of wafer bumping. Another key process is the flip chip assembly of thinned readout chips onto thin sensor tiles. Besides the prevention of silicon breakage the minimization of chip warpage is one additional task for a high yield and reliable flip chip process. A new technology using glass carrier wafer will be described in detail. The main advantage of this technology is the combination of a carrier support during wafer processing and the chip support during flip chip assembly. For that a glass wafer is glue-bonded onto the backside of the thinned readout chip wafer. After the bump deposition process the glass-readout chip stack is diced in one step. Finally the glass carrier chip is released by laser illumination after flip chip assembly of the readout chip onto sensor tile. The results of the flip chip assembly process development for the ATLAS IBL upgrade are described more in detail. The new ATLAS FEI4B chip with a size of 20 × 19 mm 2 is flip chip bonded with a thickness of only 150 μm, but the capability of this technology has been demonstrated on hybrid modules with a reduced readout chip thickness of down to 50 μm which is a major step for ultra-thin electronic systems

A Study on the Motivational Strategies in College English Flipped Classroom

Science.gov (United States)

Suo, Jia; Hou, Xiuying

2017-01-01

Flipped classroom is a great reform that brings a huge impact on the classroom teaching. Its essence is autonomous leaning, whose effect is determined by students' motivation. Therefore, to bring the advantages of the flipped classroom into full play, the top priority is to stimulate students' motivation. The paper makes a study on the…

Acceptability of the flipped classroom approach for in-house teaching in emergency medicine.

Science.gov (United States)

Tan, Eunicia; Brainard, Andrew; Larkin, Gregory L

2015-10-01

To evaluate the relative acceptability of the flipped classroom approach compared with traditional didactics for in-house teaching in emergency medicine. Our department changed its learning model from a 'standard' lecture-based model to a 'flipped classroom' model. The 'flipped classroom' included provided pre-session learning objectives and resources before each 2 h weekly session. In-session activities emphasised active learning strategies and knowledge application. Feedback was sought from all medical staff regarding the acceptability of the new approach using an online anonymous cross-sectional qualitative survey. Feedback was received from 49/57 (86%) medical staff. Ninety-eight per cent (48/49) of respondents preferred the flipped classroom over the traditional approach. Aspects of the flipped classroom learners liked most included case-based discussion, interaction with peers, application of knowledge, self-directed learning and small-group learning. Barriers to pre-session learning include work commitments, 'life', perceived lack of time, family commitments, exam preparation and high volume of learning materials. Reported motivational factors promoting pre-session learning include formal assessment, participation requirements, more time, less material, more clinical relevance and/or more interesting material. Case studies and 'hands-on' activities were perceived to be the most useful in-session activities. The flipped classroom shows promise as an acceptable approach to in-house emergency medicine teaching. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

To What Extent Does 'Flipping' Make Lessons Effective in a Multimedia Production Class?

Science.gov (United States)

Choi, Jaeho; Lee, Youngju

2018-01-01

This study examines the effects of a flipped classroom in a technology integration course for pre-service teachers. In total, 79 students were randomly assigned into a flipped classroom or a traditional classroom group and given three multimedia production tasks. Students in the flipped group reviewed an e-book for lessons on multimedia…

The features of the Cosmic Web unveiled by the flip-flop field

Science.gov (United States)

Shandarin, Sergei F.; Medvedev, Mikhail V.

2017-07-01

Currently the dark matter environment is widely accepted as a framework for understanding of the observed structure in the universe. N-body simulations are indispensable for the analysis of the formation and evolution of the dark matter web. Two primary fields - density and velocity fields - are used in most of studies. Dark matter provides two additional fields that are unique for collisionless media only. They are the multistream field in Eulerian space and flip-flop field in Lagrangian space. The flip-flop field represents the number of sign reversals of an elementary volume of each collisionless fluid element. This field can be estimated by counting the sign reversals of the Jacobian at each particle at every time step of the simulation. The Jacobian is evaluated by numerical differentiation of the Lagrangian submanifold, I.e. the three-dimensional dark matter sheet in the six-dimensional space formed by three Lagrangian and three Eulerian coordinates. We present the results of the statistical study of the evolution of the flip-flop field from z = 50 to the present time z = 0. A number of statistical characteristics show that the pattern of the flip-flop field remains remarkably stable from z ≈ 30 to the present time. As a result the flip-flop field evaluated at z = 0 stores a wealth of information about the dynamical history of the dark matter web. In particular one of the most intriguing properties of the flip-flop is a unique capability to preserve the information about the merging history of haloes.

High-Tc dc-SQUID gradiometers in flip-chip configuration

International Nuclear Information System (INIS)

Peiselt, K; Schmidl, F; Linzen, S; Anton, A S; Huebner, U; Seidel, P

2003-01-01

We describe a new design of a gradiometric flip-chip antenna, which is inductively coupled to a dc-SQUID gradiometer. Both components are patterned out of thin films of the high-T c superconductor YBa 2 Cu 3 O 7-x (YBCO). For the flip-chip antenna, a 40 mm x 10 mm SrTiO 3 single crystalline substrate is used, while the gradiometer sensors are prepared on 10 mm x 10 mm SrTiO 3 bicrystal substrates. Special attention is paid to the inductive coupling between the flip-chip antenna and the read-out gradiometer antenna. We investigate different designs of coupling loops in order to optimize the coupling inductance between both components of the sensor. With optimized coupling the sensor achieves a field-gradient resolution of 12 fT cm -1 Hz -1/2 in the white noise region and of 310 fT cm -1 Hz -1/2 at 1 Hz in the unshielded laboratory environment

High-Tc dc-SQUID gradiometers in flip-chip configuration

Science.gov (United States)

Peiselt, K.; Schmidl, F.; Linzen, S.; Anton, A. S.; Hübner, U.; Seidel, P.

2003-12-01

We describe a new design of a gradiometric flip-chip antenna, which is inductively coupled to a dc-SQUID gradiometer. Both components are patterned out of thin films of the high-Tc superconductor YBa2Cu3O7-x (YBCO). For the flip-chip antenna, a 40 mm × 10 mm SrTiO3 single crystalline substrate is used, while the gradiometer sensors are prepared on 10 mm × 10 mm SrTiO3 bicrystal substrates. Special attention is paid to the inductive coupling between the flip-chip antenna and the read-out gradiometer antenna. We investigate different designs of coupling loops in order to optimize the coupling inductance between both components of the sensor. With optimized coupling the sensor achieves a field-gradient resolution of 12 fT cm-1 Hz-1/2 in the white noise region and of 310 fT cm-1 Hz-1/2 at 1 Hz in the unshielded laboratory environment.

The effects of flipped learning for bystander cardiopulmonary resuscitation on undergraduate medical students.

Science.gov (United States)

Nakanishi, Taizo; Goto, Tadahiro; Kobuchi, Taketsune; Kimura, Tetsuya; Hayashi, Hiroyuki; Tokuda, Yasuharu

2017-12-22

To compare bystander cardiopulmonary resuscitation skills retention between conventional learning and flipped learning for first-year medical students. A post-test only control group design. A total of 108 participants were randomly assigned to either the conventional learning or flipped learning. The primary outcome measures of time to the first chest compression and the number of total chest compressions during a 2-minute test period 6 month after the training were assessed with the Mann-Whitney U test. Fifty participants (92.6%) in the conventional learning group and 45 participants (83.3%) in the flipped learning group completed the study. There were no statistically significant differences 6 months after the training in the time to the first chest compression of 33.0 seconds (interquartile range, 24.0-42.0) for the conventional learning group and 31.0 seconds (interquartile range, 25.0-41.0) for the flipped learning group (U=1171.0, p=0.73) or in the number of total chest compressions of 101.5 (interquartile range, 90.8-124.0) for the conventional learning group and 104.0 (interquartile range, 91.0-121.0) for the flipped learning group (U=1083.0, p=0.75). The 95% confidence interval of the difference between means of the number of total chest compressions 6 months after the training did not exceed a clinically important difference defined a priori. There were no significant differences between the conventional learning group and the flipped learning group in our main outcomes. Flipped learning might be comparable to conventional learning, and seems a promising approach which requires fewer resources and enables student-centered learning without compromising the acquisition of CPR skills.

Flipped GUT inflation

OpenAIRE

Ellis, John; Gonzalo, Tomás E.; Harz, Julia; Huang, Wei-Chih

2015-01-01

We analyse the prospects for constructing hybrid models of inflation that provide a dynamical realisation of the apparent closeness between the supersymmetric GUT scale and the possible scale of cosmological inflation. In the first place, we consider models based on the flipped SU(5)×U(1) gauge group, which has no magnetic monopoles. In one model, the inflaton is identified with a sneutrino field, and in the other model it is a gauge singlet. In both cases we find regions of the model paramet...

Flipping for success: evaluating the effectiveness of a novel teaching approach in a graduate level setting.

Science.gov (United States)

Moraros, John; Islam, Adiba; Yu, Stan; Banow, Ryan; Schindelka, Barbara

2015-02-28

Flipped Classroom is a model that's quickly gaining recognition as a novel teaching approach among health science curricula. The purpose of this study was four-fold and aimed to compare Flipped Classroom effectiveness ratings with: 1) student socio-demographic characteristics, 2) student final grades, 3) student overall course satisfaction, and 4) course pre-Flipped Classroom effectiveness ratings. The participants in the study consisted of 67 Masters-level graduate students in an introductory epidemiology class. Data was collected from students who completed surveys during three time points (beginning, middle and end) in each term. The Flipped Classroom was employed for the academic year 2012-2013 (two terms) using both pre-class activities and in-class activities. Among the 67 Masters-level graduate students, 80% found the Flipped Classroom model to be either somewhat effective or very effective (M = 4.1/5.0). International students rated the Flipped Classroom to be significantly more effective when compared to North American students (X(2) = 11.35, p Students' perceived effectiveness of the Flipped Classroom had no significant association to their academic performance in the course as measured by their final grades (r s = 0.70). However, students who found the Flipped Classroom to be effective were also more likely to be satisfied with their course experience. Additionally, it was found that the SEEQ variable scores for students enrolled in the Flipped Classroom were significantly higher than the ones for students enrolled prior to the implementation of the Flipped Classroom (p = 0.003). Overall, the format of the Flipped Classroom provided more opportunities for students to engage in critical thinking, independently facilitate their own learning, and more effectively interact with and learn from their peers. Additionally, the instructor was given more flexibility to cover a wider range and depth of material, provide in-class applied learning

QED polarization asymmetries for e+e- scattering due to helicity flips

International Nuclear Information System (INIS)

Anders, T.B.; Sell, E.W.

1992-01-01

The polarization asymmetries for the e + e - scattering with polarized incoming of outgoing beams, which are proportional to the amplitudes φ 5 describing one helicity flip and φ 2 describing two helicity flips, have been calculated including their pure QED radiative corrections. These asymmetries are partly large and can be observed well at low energies. (orig.)

Flipped Classrooms: A Review of Key Ideas and Recommendations for Practice

Science.gov (United States)

DeLozier, Sarah J.; Rhodes, Matthew G.

2017-01-01

Flipped classrooms refer to the practice of assigning lectures outside of class and devoting class time to a variety of learning activities. In this review, we discuss the range of approaches to the flipped classroom and focus on activities frequently used in these settings. Amongst these, we examine both out-of-class activities (e.g., video…

The Flipped Journal Club

OpenAIRE

Bounds, Richard; Boone, Stephen

2018-01-01

Introduction: Educators struggle to develop a journal club format that promotes active participation from all levels of trainees. The explosion of social media compels residencies to incorporate the evaluation and application of these resources into evidence-based practice. We sought to design an innovative “flipped journal club” to achieve greater effectiveness in meeting goals and objectives among residents and faculty. Methods: Each journal club is focused o...

Outcomes of osteoporotic trochanteric fractures treated with cement-augmented dynamic hip screw

Science.gov (United States)

Gupta, Rakesh Kumar; Gupta, Vinay; Gupta, Navdeep

2012-01-01

Background: Dynamic hip screw (DHS) has been the standard treatment for stable trochanteric fracture patterns, but complications of lag screw cut out from a superior aspect, due to inadequate bone anchorage, occur frequently in elderly osteoporotic patients. Polymethylmethacrylate (PMMA) has been used as an augmentation tool to facilitate fixation stability in cadaveric femora for biomechanical studies and in pathological fractures. However, there are very few reports on the utilization of PMMA cement to prevent these complications in fresh intertrochanteric fractures. A prospective study was conducted to evaluate the outcome and efficacy of PMMA augmented DHS in elderly osteoporotic patients with intertrochanteric fractures. Materials and Methods: The study included 64 patients (AO type31-A2.1 in eight, A2.2 in 29, A2.3 in 17 patients, and 31-A3.1 in five, A3.2 in three, and A3.3 in two patients) with an average age of 72 years (60 – 94 years) of which 60 were available for final followup. PMMA augmentation of DHS was performed in all cases by injecting PMMA cement into the femoral head with a custommade gun designed by the authors. The clinical outcome was rated as per the Salvati and Wilson scoring system at the time of final followup of one year. Results were graded as excellent (score > 31), good (score 24 – 31), fair (score 16 – 23), and poor (score < 16). Results: Fracture united in all patients and the average time to union was 13.8 weeks (range 12 – 16 weeks). At an average followup of 18 months (range 12 – 24 months), no incidence of varus collapse or superior screw cut out was observed in any of the patients in spite of weightbearing ambulation from the early postoperative period. There was no incidence of avascular necrosis (AVN) or cement penetration into the joint in our series. Most of the patients were able to regain their prefracture mobility status with a mean hip pain score of 8.6. Conclusion: Cement augmentation of DHS appears to be an

Outcomes of osteoporotic trochanteric fractures treated with cement-augmented dynamic hip screw

Directory of Open Access Journals (Sweden)

Rakesh Kumar Gupta

2012-01-01

Full Text Available Background: Dynamic hip screw (DHS has been the standard treatment for stable trochanteric fracture patterns, but complications of lag screw cut out from a superior aspect, due to inadequate bone anchorage, occur frequently in elderly osteoporotic patients. Polymethylmethacrylate (PMMA has been used as an augmentation tool to facilitate fixation stability in cadaveric femora for biomechanical studies and in pathological fractures. However, there are very few reports on the utilization of PMMA cement to prevent these complications in fresh intertrochanteric fractures. A prospective study was conducted to evaluate the outcome and efficacy of PMMA augmented DHS in elderly osteoporotic patients with intertrochanteric fractures. Materials and Methods: The study included 64 patients (AO type31-A2.1 in eight, A2.2 in 29, A2.3 in 17 patients, and 31-A3.1 in five, A3.2 in three, and A3.3 in two patients with an average age of 72 years (60 − 94 years of which 60 were available for final followup. PMMA augmentation of DHS was performed in all cases by injecting PMMA cement into the femoral head with a custommade gun designed by the authors. The clinical outcome was rated as per the Salvati and Wilson scoring system at the time of final followup of one year. Results were graded as excellent (score > 31, good (score 24 − 31, fair (score 16 − 23, and poor (score < 16. Results: Fracture united in all patients and the average time to union was 13.8 weeks (range 12 − 16 weeks. At an average followup of 18 months (range 12 − 24 months, no incidence of varus collapse or superior screw cut out was observed in any of the patients in spite of weightbearing ambulation from the early postoperative period. There was no incidence of avascular necrosis (AVN or cement penetration into the joint in our series. Most of the patients were able to regain their prefracture mobility status with a mean hip pain score of 8.6. Conclusion: Cement augmentation of DHS appears

Quasi-experimental study on the effectiveness of a flipped classroom for teaching adult health nursing.

Science.gov (United States)

Park, Esther O; Park, Ji Hyun

2018-04-01

The effectiveness of flipped learning as one of the teaching methods of active learning has been left unexamined in nursing majors, compared to the frequent attempts to uncover the effectiveness of it in other disciplines. The purpose of this study was to reveal the effectiveness of flipped learning pedagogy in an adult health nursing course, controlling for other variables. The study applied a quasi-experimental approach, comparing pre- and post-test results in learning outcomes. Included in this analysis were the records of 81 junior nursing major students. The convenience sampling method was used to select the participants. Those in the experimental group were exposed to a flipped classroom experience that was given after the completion of their traditional class. The students' learning outcomes and the level of critical thinking skills were evaluated before and after the intervention of the flipped classroom. After the flipped classroom experience, the scores of the students' achievement in subject topics and critical thinking skills, specifically intellectual integrity and creativity, showed a greater level of increase than those of their controlled counterparts. This remained true even after controlling for previous academic performance and the level of creativity. This study confirmed the effectiveness of the flipped classroom as a measure of active learning by applying a quantitative approach. But, regarding the significance of the initial contribution of flipped learning in the discipline of nursing science, carrying out a more authentic experimental study could justify the impact of flipped learning pedagogy. © 2017 Japan Academy of Nursing Science.

Scariest thing about climate change: climate flips

International Nuclear Information System (INIS)

Beaulieu, P.

1997-01-01

The idea that an increase in greenhouse gases will cause the global average temperature to rise slowly over the next decades was discussed. Studies of ice core from Greenland have shown that in the past climate shifts seem to have happened quickly. Some scientists fear that increasingly frequent extreme weather events could be a sign that the climate system is nearing its threshold and a rapid climate flip may be just ahead. In the case of global climatic system, the danger is that stresses from greenhouse gas effects are pushing the present system over the threshold where it must flip into a new warmer system that will be stable, but different from the climate on which our agriculture, economy, settlements and lives depend. 4 refs

Counting and tensorial properties of twist-two helicity-flip nucleon form factors

International Nuclear Information System (INIS)

Chen Zhang; Ji Xiangdong

2005-01-01

We perform a systematic analysis on the off-forward matrix elements of the twist-two quark and gluon helicity-flip operators. By matching the allowed quantum numbers and their crossing channel counterparts (a method developed by Ji and Lebed), we systematically count the number of independent nucleon form factors in off-forward scattering of matrix elements of these quark and gluon spin-flip operators. In particular, we find that the numbers of independent nucleon form factors of twist-two, helicity-flip quark (gluon) operators are 2n-1 (2n-5) if n is odd, and 2n-2 (2n-6) if n is even, with n≥2 (n≥4). We also analyze and write down the tensorial/Lorentz structure and kinematic factors of the expansion of these operators' matrix elements in terms of the independent form factors. These generalized form factors define the off-forward quark and gluon helicity-flip distributions in the literature

Spin-flip transitions between Zeeman sublevels in semiconductor quantum dots

International Nuclear Information System (INIS)

Khaetskii, Alexander V.; Nazarov, Yuli V.

2001-01-01

We have studied spin-flip transitions between Zeeman sublevels in GaAs electron quantum dots. Several different mechanisms which originate from spin-orbit coupling are shown to be responsible for such processes. It is shown that spin-lattice relaxation for the electron localized in a quantum dot is much less effective than for the free electron. The spin-flip rates due to several other mechanisms not related to the spin-orbit interaction are also estimated

Flat directions in flipped SU(5). I: All-order analysis

Energy Technology Data Exchange (ETDEWEB)

Cleaver, G.B. E-mail: gcleaver@rainbow.physics.tamu.edu; Ellis, J. E-mail: john.ellis@cern.ch; Nanopoulos, D.V. E-mail: dimitri@soda.physics.tamu.edu

2001-04-23

We present a systematic classification of field directions for the string-derived flipped SU(5) model that are D- and F-flat to all orders. Properties of the flipped SU(5) model with field values in these directions are compared to those associated with other flat directions that have been shown to be F-flat to specific finite orders in the superpotential. We discuss the phenomenological Higgs spectrum, and quark and charged-lepton mass textures.

Flat Directions in Flipped SU(5); 1, All-Order Analysis

CERN Document Server

Cleaver, G B; Nanopoulos, Dimitri V

2001-01-01

We present a systematic classification of field directions for the string-derived flipped SU(5) model that are D- and F-flat to all orders. Properties of the flipped SU(5) model with field values in these directions are compared to those associated with other flat directions that have been shown to be F-flat to specific finite orders in the superpotential. We discuss the phenomenological Higgs spectrum, and quark and charged-lepton mass textures.

Report on damaged FLIP TRIGA fuel

International Nuclear Information System (INIS)

Feltz, Donald E.; Randall, John D.; Schumacher, Robert F.

1977-01-01

Damaged FLIP elements were discovered, positioned adjacent to the transient rod. It then became apparent that this was not the failure of a defective, element but a heretofore unknown operating or design problem. The damaged elements are described as having bulges in the cladding and unevenly spaced dark rings along the fuelled portion of the element. Possible causes are investigated, including: defective fuel elements, incorrectly calculated power distributions in the core and in the elements, water leakage into the void follower of the transient rod, and improper safety limit for FLIP fuel. Based on measurements and calculations that have been experimentally verified it is concluded that the safety limit was not exceeded or even closely approached. It is also concluded that the problem is due entirely due to some phenomena occurring during pulsing, and that the steady state history of the fuel is not a factor

Flipped Classrooms: An Agenda for Innovative Marketing Education in the Digital Era

Science.gov (United States)

Green, Teegan

2015-01-01

Flipped classrooms reverse traditional lecturing because students learn content before class through readings and prerecorded videos, freeing lectures for hands-on activities and discussion. However, there is a dearth of literature in marketing education addressing flipped classrooms. This article fills this void using grounded theory to develop a…

Reversible Flip-Flops in Quantum-Dot Cellular Automata

Science.gov (United States)

Rad, Samaneh Kazemi; Heikalabad, Saeed Rasouli

2017-09-01

Quantum-dot cellular automata is a new technology to design the efficient combinational and sequential circuits at the nano-scale. This technology has many desirable advantages compared to the CMOS technology such as low power consumption, less occupation area and low latency. These features make it suitable for use in flip-flop design. In this paper, with knowing the characteristics of reversible logic, we design new structures for flip-flops. The operations of these structures are evaluated with QCADesigner Version 2.0.3 simulator. In addition, we calculate the power dissipation of these structures by QCAPro tool. The results illustrated that proposed structures are efficient compared to the previous ones.

A comparison of generalized hybrid Monte Carlo methods with and without momentum flip

International Nuclear Information System (INIS)

Akhmatskaya, Elena; Bou-Rabee, Nawaf; Reich, Sebastian

2009-01-01

The generalized hybrid Monte Carlo (GHMC) method combines Metropolis corrected constant energy simulations with a partial random refreshment step in the particle momenta. The standard detailed balance condition requires that momenta are negated upon rejection of a molecular dynamics proposal step. The implication is a trajectory reversal upon rejection, which is undesirable when interpreting GHMC as thermostated molecular dynamics. We show that a modified detailed balance condition can be used to implement GHMC without momentum flips. The same modification can be applied to the generalized shadow hybrid Monte Carlo (GSHMC) method. Numerical results indicate that GHMC/GSHMC implementations with momentum flip display a favorable behavior in terms of sampling efficiency, i.e., the traditional GHMC/GSHMC implementations with momentum flip got the advantage of a higher acceptance rate and faster decorrelation of Monte Carlo samples. The difference is more pronounced for GHMC. We also numerically investigate the behavior of the GHMC method as a Langevin-type thermostat. We find that the GHMC method without momentum flip interferes less with the underlying stochastic molecular dynamics in terms of autocorrelation functions and it to be preferred over the GHMC method with momentum flip. The same finding applies to GSHMC

Flipped version of the supersymmetric strongly coupled preon model

Energy Technology Data Exchange (ETDEWEB)

Fajfer, S. (Institut za Fiziku, University of Sarajevo, Sarajevo, (Yugoslavia)); Milekovic, M.; Tadic, D. (Zavod za Teorijsku Fiziku, Prirodoslovno-Matematicki Fakultet, University of Zagreb, Croatia, (Yugoslavia))

1989-12-01

In the supersymmetric SU(5) (SUSY SU(5)) composite model (which was described in an earlier paper) the fermion mass terms can be easily constructed. The SUSY SU(5){direct product}U(1), i.e., flipped, composite model possesses a completely analogous composite-particle spectrum. However, in that model one cannot construct a renormalizable superpotential which would generate fermion mass terms. This contrasts with the standard noncomposite grand unified theories (GUT's) in which both the Georgi-Glashow electrical charge embedding and its flipped counterpart lead to the renormalizable theories.

Markov chain analysis of single spin flip Ising simulations

International Nuclear Information System (INIS)

Hennecke, M.

1997-01-01

The Markov processes defined by random and loop-based schemes for single spin flip attempts in Monte Carlo simulations of the 2D Ising model are investigated, by explicitly constructing their transition matrices. Their analysis reveals that loops over all lattice sites using a Metropolis-type single spin flip probability often do not define ergodic Markov chains, and have distorted dynamical properties even if they are ergodic. The transition matrices also enable a comparison of the dynamics of random versus loop spin selection and Glauber versus Metropolis probabilities

Use of the Gamma3™ nail in a teaching hospital for trochanteric fractures: mechanical complications, functional outcomes, and quality of life.

Science.gov (United States)

Buecking, Benjamin; Bliemel, Christopher; Struewer, Johannes; Eschbach, Daphne; Ruchholtz, Steffen; Müller, Thorben

2012-11-23

Trochanteric fractures are common fractures in the elderly. Due to characteristic demographic changes, the incidence of these injuries is rapidly increasing. Treatment of these fractures is associated with high rates of complications. In addition, the long-term results remain poor, with high morbidity, declines in function, and high mortality. Therefore, in this study, complication rates and patients' outcomes were evaluated after fixation of geriatric trochanteric fractures using the Gamma3™ nail. Patients aged 60 years old or older, with pertrochanteric and subtrochanteric femoral fractures, were included. Patients with polytrauma or pathological fractures were excluded. Age, sex, and fracture type were collected on admission. In addition, data were recorded concerning the surgeon (resident vs. consultant), time of operation, and local or systemic perioperative complications. Complications were also collected at the 6- and 12-month follow-ups after trauma. Barthel Index, IADL, and EQ-5D measurements were evaluated retrospectively on admission, as well as at discharge and during the follow-up. Ninety patients were prospectively included between April 2009 and September 2010. The patients' average age was 81 years old, and their average ASA score was 3. The incision/suture time was 53 min (95% CI 46-60 min). Hospital mortality was 4%, and overall mortality was 22% at the 12-month follow-up. Eight local complications occurred (4 haematomas, 1 deep infection, 1 cutting out, 1 irritation of the iliotibial tract, 1 periosteosynthetic fracture). The incidence of relevant systemic complications was 6%. Forty-two percent of the patients were operated on by residents in training, without significant differences in duration of surgery, complication rate, or mortality rate. The Barthel Index (82 to 71, p fracture levels during the follow-up period of 12 months. The results showed a relatively low complication rate using the Gamma3™ nail, even if the nailing was performed

Flipped Statistics Class Results: Better Performance than Lecture over One Year Later

Science.gov (United States)

Winquist, Jennifer R.; Carlson, Keith A.

2014-01-01

In this paper, we compare an introductory statistics course taught using a flipped classroom approach to the same course taught using a traditional lecture based approach. In the lecture course, students listened to lecture, took notes, and completed homework assignments. In the flipped course, students read relatively simple chapters and answered…

The Flipped Classroom: Implementing Technology to Aid in College Mathematics Student's Success

Science.gov (United States)

Buch, George R.; Warren, Carryn B.

2017-01-01

August 2016 there was a call (Braun, Bremser, Duval, Lockwood & White, 2017) for post-secondary instructors to use active learning in their classrooms. Once such example of active learning is what is called the "flipped" classroom. This paper presents the need for, and the methodology of the flipped classroom, results of…

Use of the Flipped Classroom Instructional Model in Higher Education: Instructors' Perspectives

Science.gov (United States)

Long, Taotao; Cummins, John; Waugh, Michael

2017-01-01

The flipped classroom model is an instructional model in which students learn basic subject matter knowledge prior to in-class meetings, then come to the classroom for active learning experiences. Previous research has shown that the flipped classroom model can motivate students towards active learning, can improve their higher-order thinking…

FLIPPED LEARNING: PRACTICAL ASPECTS

OpenAIRE

Olena Kuzminska

2016-01-01

The article is devoted to issues of implementation of the flipped learning technology in the practice of higher education institutions. The article defines the principles of technology and a model of the educational process, it notes the need to establish an information support system. The article defines online platforms and resources; it describes recommendations for the design of electronic training courses and organization of the students in the process of implementing the proposed model,...

Flipped-Adversarial AutoEncoders

OpenAIRE

Zhang, Jiyi; Dang, Hung; Lee, Hwee Kuan; Chang, Ee-Chien

2018-01-01

We propose a flipped-Adversarial AutoEncoder (FAAE) that simultaneously trains a generative model G that maps an arbitrary latent code distribution to a data distribution and an encoder E that embodies an "inverse mapping" that encodes a data sample into a latent code vector. Unlike previous hybrid approaches that leverage adversarial training criterion in constructing autoencoders, FAAE minimizes re-encoding errors in the latent space and exploits adversarial criterion in the data space. Exp...