FLIPPED CLASSROOM LEARNING METHOD TO IMPROVE CARING AND LEARNING OUTCOME IN FIRST YEAR NURSING STUDENT

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Ni Putu Wulan Purnama Sari

2017-08-01

Full Text Available Background and Purpose: Caring is the essence of nursing profession. Stimulation of caring attitude should start early. Effective teaching methods needed to foster caring attitude and improve learning achievement. This study aimed to explain the effect of applying flipped classroom learning method for improving caring attitude and learning achievement of new student nurses at nursing institutions in Surabaya. Method: This is a pre-experimental study using the one group pretest posttest and posttest only design. Population was all new student nurses on nursing institutions in Surabaya. Inclusion criteria: female, 18-21 years old, majoring in nursing on their own volition and being first choice during students selection process, status were active in the even semester of 2015/2016 academic year. Sample size was 67 selected by total sampling. Variables: 1 independent: application of flipped classroom learning method; 2 dependent: caring attitude, learning achievement. Instruments: teaching plan, assignment descriptions, presence list, assignment assessment rubrics, study materials, questionnaires of caring attitude. Data analysis: paired and one sample t test. Ethical clearance was available. Results: Most respondents were 20 years old (44.8%, graduated from high school in Surabaya (38.8%, living with parents (68.7% in their homes (64.2%. All data were normally distributed. Flipped classroom learning method could improve caring attitude by 4.13%. Flipped classroom learning method was proved to be effective for improving caring attitude (p=0.021 and learning achievement (p=0.000. Conclusion and Recommendation: Flipped classroom was effective for improving caring attitude and learning achievement of new student nurse. It is recommended to use mix-method and larger sample for further study.

Assessment of trochanteric osteotomy fragment union after acetabular fracture surgery.

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Dubina, Andrew G; Wickramaratne, Niluka; O'Toole, Robert V; Manson, Theodore T

2017-02-01

Trochanteric osteotomies are performed in conjunction with standard approaches to improve surgical exposure during open reduction and internal fixation (ORIF) of acetabular fractures. The literature on total hip arthroplasty reports nonunion rates as high as 30% associated with trochanteric osteotomies; however, few data exist regarding the outcomes of trochanteric osteotomies for acetabular fracture surgery. Our hypotheses were 1) patients receiving trochanteric osteotomies during ORIF of acetabular fractures have a low rate of nonunion of the osteotomy fragment, and 2) hip abduction precautions are not necessary with digastric type osteotomies. A retrospective review was conducted to identify patients with acetabular fractures between July 2002 and June 2010 (n=734 fractures) who required trochanteric osteotomies (n=64, 9% of fractures). Forty-seven met inclusion criteria of adequate follow-up (>56days). No excluded patient experienced a complication. Fractures were classified using the Letournel-Judet classification system. Only seven (20%) of 35 patients who received digastric osteotomies had hip abduction precautions applied during the postoperative period. All study patients were shown to have radiographic union at the trochanteric osteotomy site (100% union rate, n=47). Hip abduction precautions intended to protect the osteotomy site and reduce the risk of nonunion and fixation failure were infrequently applied to patients with digastric osteotomies (20%) in this cohort. Multiple protective factors against nonunion were present in this study population compared with previous arthroplasty studies from other institutions. Trochanteric osteotomies are not associated with a significant nonunion rate, and digastric osteotomies might be safely managed without hip abduction precautions. Copyright © 2016. Published by Elsevier Ltd.

Triple pelvic osteotomy in the treatment of hip dysplasia

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Vukašinović Zoran

2009-01-01

Full Text Available Introduction. Insufficient femoral head coverage is found in a variety of diseases, with acetabular dysplasia as the most frequent disorder and triple pelvic osteotomy as the most recently introduced surgical treatment. Objective. This study analyses pre- and postoperative pathoanatomic characteristics of triple in comparison to Salter and Chiari osteotomies, with a logistic regression analysis of outcome predictor and effect explanator factors in relation to the chosen type of operation. Methods. The study involved 136 adolescents treated with Salter and Chiari osteotomies or a triple pelvic osteotomy at the Institute of Orthopaedic Surgery 'Banjica' in Belgrade. The patients were between 10-20 years old at the time of operation. We collected and analyzed data from all the patients: illness history, operative parameters, preoperative and postoperative pathoanatomic data. The data was statistically processed using the statistical software SPSS, defining standard descriptive values, and by using the appropriate tests of analytic statistics: t-test for dependent and independent variables, χ2-test, Fisher's exact test, Wilcoxon's test, parameter correlation, one-way ANOVA, multi-factorial ANOVA and logistic regression, according to the type of the analyzed data and the conditions under which the statistical methods were applied. Results. The average CE angle after triple pelvic osteotomy was 43.5°, more improved than after the Salter osteotomy (33.0° and Chiari osteotomy (31.4° (F=16.822; p<0.01. Postoperative spherical congruence was also more frequent after the triple osteotomy than after the other two types of operations, and with a high significance. Preoperative painful discomfort was found to be a valid predictor of indications for the triple osteotomy over both Chiari and Salter osteotomies. The valid explanators of effect for the triple osteotomy are: postoperative joint congruence (compared to the Chiari osteotomy and increase in joint

Biomechanical optimization of different fixation modes for a proximal femoral L-osteotomy

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Chen Hsih-Hao

2009-09-01

Full Text Available Abstract Background Numerous proposed surgical techniques have had minimal success in managing greater trochanter overgrowth secondary to retarded growth of the femoral capital epiphysis. For reconstruction of residual hip deformities, a novel type of proximal femur L-osteotomy was performed with satisfactory results. Although the clinical outcome was good, the biomechanical characteristics of the femur after such an osteotomy have not been clearly elucidated. Therefore, this study presents a three dimensional finite element analysis designed to understand the mechanical characteristics of the femur after the L-osteotomy. Methods A patient with left hip dysplasia was recruited as the study model for L-osteotomy. The normal right hip was used as a reference for performing the corrective surgery. Four FEA models were constructed using different numbers of fixation screws but the same osteotomy lengths together with four FEA models with the same number of fixation screws but different osteotomy lengths. The von Mises stress distributions and femoral head displacements were analyzed and compared. Results The results revealed the following: 1. The fixation devices (plate and screws sustained most of the external loading, and the peak value of von Mises stress on the fixation screws decreased with an increasing number of screws. 2. Additional screws are more beneficial on the proximal segment than on the distal segment for improving the stability of the postoperative femur. 3. The extent of osteotomy should be limited because local stress might be concentrated in the femoral neck region with increasing length of the L-osteotomy. Conclusion Additional screw placement on the proximal segment improves stability in the postoperative femur. The cobra-type plate with additional screw holes in the proximal area might improve the effectiveness of L-osteotomies.

Varus femoral osteotomy improves sphericity of the femoral head in older children with severe form of Legg-Calvé-Perthes disease.

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Terjesen, Terje; Wiig, Ola; Svenningsen, Svein

2012-09-01

In the Norwegian prospective study on Legg-Calvé-Perthes disease (LCPD), we found varus femoral osteotomy gave better femoral head sphericity at a mean of 5 years postoperative than physiotherapy in children older than 6.0 years at diagnosis with femoral head necrosis of more than 50%. That study did not include separate analyses for hips with 100% necrosis and those with a percentage of necrosis between 50% and 100%. We asked whether (1) femoral osteotomy improves femoral head sphericity at followup in all patients with more than 50% femoral head necrosis or in selected groups only and (2) there is a critical age between 6.0 and 10.0 years over which femoral osteotomy does not improve the prognosis. We treated 70 patients with unilateral LCPD, age at diagnosis of more than 6.0 years, and femoral head necrosis of more than 50% with varus femoral osteotomy between 1996 and 2000. We classified necrosis using the Catterall classification. We established a control group of 51 similar children who received physiotherapy. At the 5-year followup visit, the hips were graded according to femoral head shape: spherical, ovoid, or flat. At 5-year followup, there was no difference between the treatment groups in radiographic outcome in Catterall Group 3 hips. In Catterall Group 4 hips, femoral head sphericity was better in the osteotomy group, with flat femoral heads in 14% compared to 75% after physiotherapy. The same trend toward better head sphericity occurred when the lateral pillar classification was used. In children aged 6.0 to 10.0 years, in whom the whole femoral head is affected, femoral head sphericity 5 years after femoral osteotomy was better than that after physiotherapy.

Youngswick-Austin versus distal oblique osteotomy for the treatment of Hallux Rigidus.

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Viladot, Antonio; Sodano, Luca; Marcellini, Lorenzo; Zamperetti, Marco; Hernandez, Elsa Sanchez; Perice, Ramon Viladot

2017-08-01

Hallux Rigidus is the most common degenerative joint pathology of the foot. Several procedures are described for the management of this deformity. In this prospective study we compared Youngswick-Austin and distal oblique osteotomy in the treatment of grade II Hallux Rigidus, in terms of clinical outcomes, efficacy and complications. Forty-six patients (50 feet) with moderate Hallux Rigidus (Regnauld grade II) were recruited and operated between March 2009 and December 2012. Surgical technique was Youngswick-Austin osteotomy (Group A) or distal oblique osteotomy (Group B). Mean follow-up was 42.7 ±12.2 (range, 24-70) months. Both groups achieved significant improvement of AOFAS score and first metatarsophalangeal joint range of motion (p value Austin and distal oblique osteotomies provides subjective patient improvement and increases the first metatarsophalangeal joint range of motion. The results of grade II Hallux Rigidus treatment were comparable when using a Youngswick-Austin or distal oblique osteotomy. Level II, prospective comparative study. Copyright © 2017 Elsevier Ltd. All rights reserved.

Open wedge metatarsal osteotomy versus crescentic osteotomy to correct severe hallux valgus deformity

DEFF Research Database (Denmark)

Wester, Jens Ulrik; Hamborg-Petersen, Ellen; Herold, Niels

2016-01-01

BACKGROUND: Different techniques of proximal osteotomies have been introduced to correct severe hallux valgus. The open wedge osteotomy is a newly introduced method for proximal osteotomy. The aim of this prospective randomized study was to compare the radiological and clinical results after...... operation for severe hallux valgus, comparing the open wedge osteotomy to the crescentic osteotomy which is our traditional treatment. METHODS: Forty-five patients with severe hallux valgus (hallux valgus angle >35̊, and intermetatarsal angle >15̊) were included in this study. The treatment was proximal...... and 12 months after the operation. RESULTS: In group 1 the hallux valgus angle decreased from 39.0̊ to 24.1̊ after 4 months and 27.9̊ after 12 months. In group 2 the angle decreased from 38.3̊ to 21.4̊ after 4 months and 27.0̊ after 12 months. The intermetatarsal angle in group 1 was 19.0̊ preoperatively...

Outcomes of a Stepcut Lengthening Calcaneal Osteotomy for Adult-Acquired Flatfoot Deformity.

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Demetracopoulos, Constantine A; Nair, Pallavi; Malzberg, Andrew; Deland, Jonathan T

2015-07-01

Lateral column lengthening is used to correct abduction deformity at the midfoot and improve talar head coverage in patients with flatfoot deformity. It was our hypothesis that following a stepcut lengthening calcaneal osteotomy (SLCO), patients would have adequate correction of the deformity, a high union rate of the osteotomy, and improvement in clinical outcome scores. We retrospectively reviewed 37 consecutive patients who underwent SLCO for the treatment of stage IIB flatfoot deformity with a minimum 2-year follow-up. Deformity correction was assessed using preoperative and postoperative weight-bearing radiographs. Healing of the osteotomy was assessed by computed tomography. Clinical outcomes included the FAOS and SF-36 questionnaires. The Wilcoxon signed-rank test was used to compare clinical outcome scores. An alpha level of .05 was deemed statistically significant. Healing of the osteotomy occurred at a mean of 7.7 weeks postoperatively. The talonavicular (TN) coverage angle improved from 34.0 to 8.8 (P lengthening. Level IV, retrospective case review. © The Author(s) 2015.

Improving the Teaching of ICT Engineering using Flipped Learning: a personalized model and a case study

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Abdelhak Aqqal

Full Text Available Abstract In recent years, Flipped Classroom started to be used as an effective way of teaching Engineering among various strategies in higher education. However, enabling and using the flipped learning is a complicated task, not a straightforward goal that can be simply achieved through a combination of face-to-face and online activities. It requires a more sophisticated understanding of effective teaching methods to manage the shift from the traditional to the flipped learning and the optimum adaptation of technology as part of this change. Given this challenge, this research work provides a personalized model of the flipped classroom and investigates through a case study in an Engineering School how our approach can be used to improve teaching of Information and Communication Technology (ICT Engineering. It assesses by using empirically data related to the interaction of the various actors at different levels of abstraction, particularly from a gender perspective, the relevance and the impact of the flipped classroom on student learning and achievement in ICT Engineering Education.

Periacetabulaer osteotomi og hoftedysplasi hos yngre voksne

DEFF Research Database (Denmark)

Troelsen, Anders; Søballe, Kjeld

2009-01-01

% of cases for more than ten years following surgery. A new minimally invasive technique is safe and reduces blood loss, transfusion requirements and duration of surgery. Overall, the results support the use of periacetabular osteotomy, though further documentation of long-term effects is warranted.......The periacetabular osteotomy is recognized as the surgical treatment of choice in young adults with symptomatic hip dysplasia. The procedure is performed to delay or prevent the development of osteoarthritis. The procedure has the ability to improve function and preserve hip joints in > 80...

Sports activities after lower limb osteotomy.

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Gougoulias, Nikolaos; Khanna, Anil; Maffulli, Nicola

2009-01-01

Active sports participation can be important in some patients with degenerative joint disease in the lower limb. We investigated whether this is possible after an osteotomy for osteoarthritis of the hip, knee and ankle joints. We performed a literature search using Medline, Cochrane, CINAHL and Google Scholar with no restriction to time period or language using the keywords: 'osteotomy and sports'. Eleven studies (all level IV evidence) satisfied our inclusion and exclusion criteria. Nine reported on high tibial osteotomies, one on periacetabular osteotomies and one on distal tibial osteotomies. The Coleman Methodology Score to assess the quality of studies showed much heterogeneity in terms of study design, patient characteristics, management methods and outcome assessment. Participation in recreational sports is possible in most patients who were active in sports before lower limb osteotomy. In no study were patients able to participate in competitive sports. Intensive participation in sports after osteotomy may adversely affect outcome and lead to failures requiring re-operation. Patients may be able to remain active in selected sports activities after a lower limb osteotomy for osteoarthritis. More rapid progression of arthritis is however a possibility. Prospective comparative studies investigating activities and sports participation in age-matched patients undergoing osteotomy or joint replacement could lead to useful conclusions. Increased activity and active sports participation may lead to progression of arthritis and earlier failure requiring additional surgery.

Design e-learning with flipped learning model to improve layout understanding the concepts basic of the loop control structure

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Handayani, D. P.; Sutarno, H.; Wihardi, Y.

2018-05-01

This study aimed in design and build e-learning with classroom flipped model to improve the concept of understanding of SMK students on the basic programming subject. Research and development obtained research data from survey questionnaire given to students of SMK class X RPL in SMK Negeri 2 Bandung and interviews to RPL productive teacher. Data also obtained from questionnaire of expert validation and students' assessment from e-learning with flipped classroom models. Data also obtained from multiple-choice test to measure improvements in conceptual understanding. The results of this research are: 1) Developed e- learning with flipped classroom model considered good and worthy of use by the average value of the percentage of 86,3% by media experts, and 85,5% by subjects matter experts, then students gave judgment is very good on e-learning either flipped classroom model with a percentage of 79,15% votes. 2) e-learning with classroom flipped models show an increase in the average value of pre-test before using e-learning 26.67 compared to the average value post-test after using e- learning at 63.37 and strengthened by the calculation of the index gains seen Increased understanding of students 'concepts by 50% with moderate criteria indicating that students' understanding is improving.

Osteotomy of the knee

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... joint. A tibial osteotomy may make you look "knock-kneed." A femoral osteotomy may make you look " ... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic ...

Short Lingual Osteotomy Using a Piezosurgery Ultrasonic Bone-Cutting Device During Sagittal Split Ramus Osteotomy.

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Kawase-Koga, Yoko; Mori, Yoshiyuki; Kanno, Yuki; Hoshi, Kazuto; Takato, Tsuyoshi

2015-10-01

Short lingual osteotomy is a useful method for the performance of sagittal split ramus osteotomy involving interference between the proximal and distal bone fragments when lateral differences exist in the setback distance. However, this procedure occasionally results in abnormal fracture and nerve injury; expert surgical skill is thus required. We herein describe a novel technique involving the use of an ultrasonic bone-cutting device (Piezosurgery; Mectron Medical Technology, Carasco, Italy) for vertical osteotomy posterior to the mandibular foramen. Successful short lingual osteotomy was performed using this technique with avoidance of abnormal fracture and neurovascular bundle damage.

Comparative Outcomes Between Step-Cut Lengthening Calcaneal Osteotomy vs Traditional Evans Osteotomy for Stage IIB Adult-Acquired Flatfoot Deformity.

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Saunders, Stuart M; Ellis, Scott J; Demetracopoulos, Constantine A; Marinescu, Anca; Burkett, Jayme; Deland, Jonathan T

2018-01-01

The forefoot abduction component of the flexible adult-acquired flatfoot can be addressed with lengthening of the anterior process of the calcaneus. We hypothesized that the step-cut lengthening calcaneal osteotomy (SLCO) would decrease the incidence of nonunion, lead to improvement in clinical outcome scores, and have a faster time to healing compared with the traditional Evans osteotomy. We retrospectively reviewed 111 patients (143 total feet: 65 Evans, 78 SLCO) undergoing stage IIB reconstruction followed clinically for at least 2 years. Preoperative and postoperative radiographs were analyzed for the amount of deformity correction. Computed tomography (CT) was used to analyze osteotomy healing. The Foot and Ankle Outcome Scores (FAOS) and lateral pain surveys were used to assess clinical outcomes. Mann-Whitney U tests were used to assess nonnormally distributed data while χ 2 and Fisher exact tests were used to analyze categorical variables (α = 0.05 significant). The Evans group used a larger graft size ( P lengthening. Level III, retrospective cohort study.

A Modified Triple Pelvic Osteotomy for the Treatment of Hip Hypoplasia

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Hassan Rahimi

2013-09-01

Full Text Available Background: The prevalence of hip dysplasia is 1 in 1000. Several pelvic osteotomy methods have been developed to prevent early osteoarthritis, such as triple osteotomy. In this study we are going to introduce our new technique that was done on 4 patients with favorable short-term results.   Methods: Four patients underwent triple osteotomy and fixation using a reconstruction plate and early weight bearing was started. Results: The Harris Hip Score, limb length, center-edge angle, and acetabular inclination showed improvement. Conclusion: This modified technique is suggested for corrective surgery on adult dysplastic hips.

New modified technique of osteotomy for hallux valgus.

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Oh, I S; Kim, M K; Lee, S H

2004-12-01

To improve the technique of osteotomy for hallux valgus (bunion). 38 cases of a new modified osteotomy procedure for hallux valgus were performed for 22 patients (21 women and one man). During a 3-year (range, 2-5 years) follow-up, the patients underwent physical examination; and their American Orthopedic Foot and Ankle Society hallux-metatarso-phalangeal-interphalangeal scale scores and standard foot radiographic measurements were recorded. 20 of the 22 patients (38 cases) had no pain, achieved good cosmesis, and were completely satisfied with the results of the operation. The remaining 2 patients had occasional mild discomfort. The mean hallux-metatarso-phalangeal-interphalangeal scale score was 93 points (range, 78-100 points). The mean preoperative and postoperative metatarsophalangeal angles were 34 degrees and 11 degrees, respectively. The mean postoperative reduction of the intermetatarsal angle and metatarsophalangeal angle were 6 degrees and 23 degrees, respectively. The new technique of osteotomy achieved even greater stability and accurate correction of the deformity in our 38 cases. Furthermore, it was more effective than conventional 'chevron' osteotomy in terms of correction of the deformity. Therefore, it should be used more widely.

[Application of computer-aided osteotomy template design in treatment of developmental dysplasia of the hip with steel osteotomy].

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Tong, Kuang; Zhang, Yuanzhi; Zhang, Sheng; Yu, Bin

2013-06-01

To provide an accurate method for osteotomy in the treatment of developmental dysplasia of the hip with steel osteotomy by three-dimensional reconstruction and Reverse Engineering technique. Between January 2011 and December 2012, 13 children with developmental dysplasia of the hip underwent steel osteotomy. 3D CT scan pelvic images were obtained and transferred via a DICOM network into a computer workstation to construct 3D models of the hip using Materialise Mimics 14.1 software in STL format. These models were imported into Imageware 12.0 software for steel osteotomy simulation until a stable hip was attained in the anatomical position for dislocation or subluxation of the hip in older children. The osteotomy navigational templates were designed according to the anatomical features after a stable hip was reconstructed. These navigational templates were manufactured using a rapid prototyping technique. The reconstruction hips in these children show good matching property and acetabulum cover. The computer-aided design of osteotomy template provides personalized and accurate solutions in the treatment of developmental dysplasia of the hip with steel osteotomy in older children.

Improvement in operating characteristics resulting from the addition of FLIP fuel to a standard TRIGA core

International Nuclear Information System (INIS)

Randall, J.D.; Feltz, D.E.; Godsey, T.A.; Schumacher, R.F.

1974-01-01

To overcome problems associated with fuel burnup the Nuclear Science Center of Texas A and M University decided to convert from standard TRIGA fuel to FLIP-TRIGA fuel. FLIP fuel, which incorporates erbium as a burnable poison and is enriched to 70 percent in U-235, has a calculated lifetime of 9/MW-years. Due to limited funds a core was designed with a central region of 35 FLIP elements surrounded by 63 standard elements. Calculations indicated that the core excess and neutron fluxes were satisfactory, but no prediction was made of the improvements in core lifetime. The reactivity loss due to burnup for a standard core was measured to be 1.54 cents/MW-day. The addition of 35 FLIP fuel elements has reduced this value to approximately 0.5 cents/MW-day. The incorporation of FLIP fuel has, therefore, increased the lifetime of the core by a factor of three using fuel that is only 20 percent more expensive. The mixed core has other advantages as well. The power coefficient is less, the effect of xenon is less, and the fluxes in experimental facilities are higher. Thus, the mixed core has significant advantages over standard TRIGA fuel. (U.S.)

A modified implementation of tristate inverter based static master-slave flip-flop with improved power-delay-area product.

Science.gov (United States)

Singh, Kunwar; Tiwari, Satish Chandra; Gupta, Maneesha

2014-01-01

The paper introduces novel architectures for implementation of fully static master-slave flip-flops for low power, high performance, and high density. Based on the proposed structure, traditional C(2)MOS latch (tristate inverter/clocked inverter) based flip-flop is implemented with fewer transistors. The modified C(2)MOS based flip-flop designs mC(2)MOSff1 and mC(2)MOSff2 are realized using only sixteen transistors each while the number of clocked transistors is also reduced in case of mC(2)MOSff1. Postlayout simulations indicate that mC(2)MOSff1 flip-flop shows 12.4% improvement in PDAP (power-delay-area product) when compared with transmission gate flip-flop (TGFF) at 16X capacitive load which is considered to be the best design alternative among the conventional master-slave flip-flops. To validate the correct behaviour of the proposed design, an eight bit asynchronous counter is designed to layout level. LVS and parasitic extraction were carried out on Calibre, whereas layouts were implemented using IC station (Mentor Graphics). HSPICE simulations were used to characterize the transient response of the flip-flop designs in a 180 nm/1.8 V CMOS technology. Simulations were also performed at 130 nm, 90 nm, and 65 nm to reveal the scalability of both the designs at modern process nodes.

Is McMurray′s osteotomy obsolete?

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Phaltankar P

1995-10-01

Full Text Available A review of the method of performing, advantages, disadvantages of McMurray′s displacement osteotomy with regard to treatment of nonunion of transcervical fracture neck femur with viable femoral head was carried out in this study of ten cases, in view of the abandonment of the procedure in favour of angulation osteotomy. Good results obtained in the series attest to the usefulness of McMurray′s osteotomy in the difficult problem of nonunion of transcervical fracture neck femur in well selected cases with certain advantages over the angulation osteotomy due to the ′Armchair effect′.

High tibial closing wedge osteotomy for medial compartment osteoarthrosis of knee

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Tuli S

2008-01-01

Full Text Available Background: Most patients of symptomatic osteoarthrosis of knee are associated with varus malalignment that is causative or contributory to painful arthrosis. It is rational to correct the malalignment to transfer the functional load to the unaffected or less affected compartment of the knee to relieve symptoms. We report the outcome of a simple technique of high tibial osteotomy in the medial compartment of osteoarthrosis of the knee. Materials and Methods: Between 1996 and 2004 we performed closing wedge osteotomy in 78 knees in 65 patients. The patients selected for osteotomy were symptomatic essentially due to medial compartment osteoarthrosis associated with moderate genu varum. Of the 19 patients who had bilateral symptomatic disease 11 opted for high tibial osteotomy of their second knee 1-3 years after the first operation. Preoperative grading of osteoarthrosis and postoperative function was assessed using Japanese Orthopaedic Association (JOA rating scale. Results: At a minimum follow-up of 2 years (range 2-9 years 6-10° of valgus correction at the site of osteotomy was maintained, there was significant relief of pain while walking, negotiating stairs, squatting and sitting cross-legged. Walking distance in all patients improved by two to four times their preoperative distance of 200-400 m. No patient lost any preoperative knee function. The mean JOA scoring improved from preoperative 54 (40-65 to 77 (55-85 at final follow-up. Conclusion: Closing wedge high tibial osteotomy performed by our technique can be undertaken in any setup with moderate facilities. Operation related complications are minimal and avoidable. Kirschner wire fixation is least likely to interfere with replacement surgery if it becomes necessary.

Dimensions of Velopharyngeal Space following Maxillary Advancement with Le Fort I Osteotomy Compared to Zisser Segmental Osteotomy: A Cephalometric Study

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Furkan Erol Karabekmez

2015-01-01

Full Text Available The objectives of this study are to assess the velopharyngeal dimensions using cephalometric variables of the nasopharynx and oropharynx as well as to compare the Le Fort I osteotomy technique to Zisser’s anterior maxillary osteotomy technique based on patients’ outcomes within early and late postoperative follow-ups. 15 patients with severe maxillary deficiency treated with Le Fort I osteotomy and maxillary segmental osteotomy were assessed. Preoperative, early postoperative, and late postoperative follow-up lateral cephalograms, patient histories, and operative reports are reviewed with a focus on defined cephalometric landmarks for assessing velopharyngeal space dimension and maxillary movement (measured for three different tracing points. A significant change was found between preoperative and postoperative lateral cephalometric measurements regarding the distance between the posterior nasal spine and the posterior pharyngeal wall in Le Fort I osteotomy cases. However, no significant difference was found between preoperative and postoperative measurements in maxillary segmental osteotomy cases regarding the same measurements. The velopharyngeal area calculated for the Le Fort I osteotomy group showed a significant difference between the preoperative and postoperative measurements. Le Fort I osteotomy for advancement of upper jaw increases velopharyngeal space. On the other hand, Zisser’s anterior maxillary segmental osteotomy does not alter the dimension of the velopharyngeal space significantly.

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

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.

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

Periacetabulaer osteotomi og hoftedysplasi hos yngre voksne

DEFF Research Database (Denmark)

Troelsen, Anders; Søballe, Kjeld

2009-01-01

The periacetabular osteotomy is recognized as the surgical treatment of choice in young adults with symptomatic hip dysplasia. The procedure is performed to delay or prevent the development of osteoarthritis. The procedure has the ability to improve function and preserve hip joints in > 80...

Tibial rotational osteotomy for idiopathic torsion. A comparison of the proximal and distal osteotomy levels.

Science.gov (United States)

Krengel, W F; Staheli, L T

1992-10-01

A retrospective analysis was done of 52 rotational tibial osteotomies (RTOs) performed on 35 patients with severe idiopathic tibial torsion. Thirty-nine osteotomies were performed at the proximal or midtibial level. Thirteen were performed at the distal tibial level with a technique previously described by one of the authors. Serious complications occurred in five (13%) of the proximal and in none of the distal RTOs. For severe and persisting idiopathic tibial torsion, the authors recommend correction by RTO at the distal level. Proximal level osteotomy is indicated only when a varus or valgus deformity required concurrent correction.

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.

Relative strength of tailor's bunion osteotomies and fixation techniques.

Science.gov (United States)

Haddon, Todd B; LaPointe, Stephan J

2013-01-01

A paucity of data is available on the mechanical strength of fifth metatarsal osteotomies. The present study was designed to provide that information. Five osteotomies were mechanically tested to failure using a materials testing machine and compared with an intact fifth metatarsal using a hollow saw bone model with a sample size of 10 for each construct. The osteotomies tested were the distal reverse chevron fixated with a Kirschner wire, the long plantar reverse chevron osteotomy fixated with 2 screws, a mid-diaphyseal sagittal plane osteotomy fixated with 2 screws, the mid-diaphyseal sagittal plane osteotomy fixated with 2 screws, and an additional cerclage wire and a transverse closing wedge osteotomy fixated with a box wire technique. Analysis of variance was performed, resulting in a statistically significant difference among the data at p chevron was statistically the strongest construct at 130 N, followed by the long plantar osteotomy at 78 N. The chevron compared well with the control at 114 N, and they both fractured at the proximal model to fixture interface. The other osteotomies were statistically and significantly weaker than both the chevron and the long plantar constructs, with no statistically significant difference among them at 36, 39, and 48 N. In conclusion, the chevron osteotomy was superior in strength to the sagittal and transverse plane osteotomies and similar in strength and failure to the intact model. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

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'…

Clinical accuracy of a patient-specific femoral osteotomy guide in minimally-invasive posterior hip arthroplasty.

Science.gov (United States)

Schneider, Adrian K; Pierrepont, Jim W; Hawdon, Gabrielle; McMahon, Stephen

2018-04-01

Patient specific guides can be a valuable tool in improving the precision of planned femoral neck osteotomies, especially in minimally invasive hip surgery, where bony landmarks are often inaccessible. The aim of our study was to validate the accuracy of a novel patient specific femoral osteotomy guide for THR through a minimally invasive posterior approach, the direct superior approach (DSA). As part of our routine preoperative planning 30 patients underwent low dose CT scans of their arthritic hip. 3D printed patient specific femoral neck osteotomy guides were then produced. Intraoperatively, having cleared all soft tissue from the postero-lateral neck of the enlocated hip, the guide was placed and pinned onto the posterolateral femoral neck. The osteotomy was performed using an oscillating saw and the uncemented hip components were implanted as per routine. Postoperatively, the achieved level of the osteotomy at the medial calcar was compared with the planned level of resection using a 3D/2D matching analysis (Mimics X-ray module, Materialise, Belgium). A total of 30 patients undergoing uncemented Trinity™ acetabular and TriFit TS™ femoral component arthroplasty (Corin, UK) were included in our analysis. All but one of our analysed osteotomies were found to be within 3 mm from the planned height of osteotomy. In one patient the level of osteotomy deviated 5 mm below the planned level of resection. Preoperative planning and the use of patient specific osteotomy guides provides an accurate method of performing femoral neck osteotomies in minimally invasive hip arthroplasty using the direct superior approach. IV (Case series).

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.

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.

[APPLICATION OF PHOTOSHOP CS16.0 SOFTWARE IN PREOPERATIVE OSTEOTOMY DESIGN OF ANKYLOSING SPONDYLITIS KYPHOSIS].

Science.gov (United States)

Wang, Fei; Tao, Huiren; Liu, Zhibin; Zhang, Jianhua; Han, Fangmin

2015-02-01

To introduce the application of Photoshop CS16.0 (PS) software in preoperative osteotomy design of ankylosing spondylitis kyphosis (ASK), and to investigate applied values of the preoperative design. Between March 2009 and March 2013, 21 cases of ASK were treated through preoperative osteotomy design by using PS software. There were 16 males and 5 females, aged from 23 to 50 years (mean, 34.2 years). The deformity included thoracolumbar kyphosis in 14 cases, thoracic kyphosis in 2 cases, and lumbar kyphosis in 5 cases. The ultimate osteotomy angle of preoperative plans and the location and extent of osteotomy were determined by the osteotomy design, which guided operation procedures of the surgeon. The actual osteotomy angle was obtained by measuring Cobb angle of osteotomy segment before and after operation. The sagittal parameters of spine and pelvis including global kyphosis (GK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), and chin brow-vertical angle (CBVA) were measured at preoperation, at 1 week after operation, and last follow-up. The clinical outcomes were assessed by simplified Chinese Scoliosis Research Society-22 (SRS-22) questionnaire and Oswestry disability index (ODI). No complications occurred in the other cases except 1 case of dural tear during operation and 1 case of nerve injury after operation, and primary healing of incision was obtained. All patients were followed up 14 to 45 months (mean, 26.3 months). The SRS-22 and ODI scores at 1 week after operation and last follow-up were significantly improved when compared with preoperative scores (P 0.05). The preoperative planned osteotomy angle and the postoperative actual osteotomy angle were (34.2 ± 10.5) degrees and (33.7 ± 9.7) degrees respectively, showing no significant difference (t = 0.84, P = 0.42). The CBVA, GK, SVA, PT, and LL were significantly improved when compared with the preoperative values (P 0.05). At last follow-up, no failures

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...

Spinal pedicle subtraction osteotomy for fixed sagittal imbalance patients

Science.gov (United States)

Hyun, Seung-Jae; Kim, Yongjung J; Rhim, Seung-Chul

2013-01-01

In addressing spinal sagittal imbalance through a posterior approach, the surgeon now may choose from among a variety of osteotomy techniques. Posterior column osteotomies such as the facetectomy or Ponte or Smith-Petersen osteotomy provide the least correction, but can be used at multiple levels with minimal blood loss and a lower operative risk. Pedicle subtraction osteotomies provide nearly 3 times the per-level correction of Ponte/Smith-Petersen osteotomies; however, they carry increased technical demands, longer operative time, and greater blood loss and associated significant morbidity, including neurological injury. The literature focusing on pedicle subtraction osteotomy for fixed sagittal imbalance patients is reviewed. The long-term overall outcomes, surgical tips to reduce the complications and suggestions for their proper application are also provided. PMID:24340276

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.

FULLPROF as a new tool for flipping ratio analysis: further improvements

International Nuclear Information System (INIS)

Frontera, C.; Rodriguez-Carvajal, J.

2004-01-01

In the international workshop on polarized neutron for condensed matter investigation (Juelich, September 2002), we presented the implementations done in FULLPROF in order to introduce the ability of performing flipping ratio analysis. During this year we have modified the program in order to extend the initial features. We have tested these new implementations by re-analyzing flipping ratio data on Metrz-Nit (C 10 H 16 N 5 O 2 ) compound

[How to make your own custom cutting guides for both mandibular and fibular stair step osteotomies?

Science.gov (United States)

Rem, K; Bosc, R; De Kermadec, H; Hersant, B; Meningaud, J-P

2017-12-01

Using tailored cutting guides for osteocutaneous free fibula flap in complex mandibular reconstruction after cancer resection surgery constitutes a substantial improvement. Autonomously conceiving and manufacturing the cutting guides within a plastic surgery department with computer-aided design (CAD) and three-dimensional (3D) printing allows planning more complex osteotomies, such as stair-step osteotomies, in order to achieve more stable internal fixations. For the past three years, we have been producing by ourselves patient-tailored cutting guides using CAD and 3D printing. Osteotomies were virtually planned, making the cutting lines more complex in order to optimize the internal fixation stability. We also printed reconstructed mandible templates and shaped the reconstruction plates on them. We recorded data including manufacturing techniques and surgical outcomes. Eleven consecutive patients were operated on for an oral cavity cancer. For each patient, we planned the fibular and mandibular stair-step osteotomies and we produced tailored cutting guides. In all patients, we achieved to get immediately stable internal fixations and in 10 patients, a complete bone consolidation after 6 months. Autonomously manufacturing surgical cutting guides for mandibular reconstruction by free fibula flap is a significant improvement, regarding ergonomics and precision. Planning stair-step osteotomies to perform complementary internal fixation increases contact surface and congruence between the bone segments, thus improving the reconstructed mandible stability. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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

External osteotomy in rhinoplasty: Piezosurgery vs osteotome.

Science.gov (United States)

Tirelli, Giancarlo; Tofanelli, Margherita; Bullo, Federica; Bianchi, Max; Robiony, Massimo

2015-01-01

To achieve the desired outcome in rhinoplasty depends on many factors. Osteotomy and surgical reshaping of nasal bones are important steps that require careful planning and execution. The availability of different tools raises the question of which one provides significant advantages for both technique and surgical outcome. Our prospective randomized pilot study compared the outcome of post-traumatic rhinoplasty performed with two different external techniques: ultrasound osteotomic cut using the Piezosurgery Medical Device (Mectron, Carasco, Italy) and traditional external osteotomy. Forty-four lateral osteotomies of the nasal wall were performed in twenty-two patients. In twelve patients the osteotomies were conducted with a 2-mm traditional osteotome (control group), while in the remaining ten patients these were done with the Piezosurgery Medical Device (experimental group). At the postoperative evaluation, significantly lower pain, edema and ecchymosis were noticed in the experimental group (pPiezosurgery Medical Device allowed for safe lateral osteotomies in rhinoplasty preliminarily demonstrating the potential to reduce some of the most frequent complications of rhinoplasty. Copyright © 2015 Elsevier Inc. All rights reserved.

Flip angle modulations in late phase Gd-EOB-DTPA MRI improve the identification of the biliary system

Energy Technology Data Exchange (ETDEWEB)

Stelter, Lars, E-mail: lars.stelter@charite.de [Klinik fuer Radiologie, Charite - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); Grieser, Christian, E-mail: christian.grieser@charite.de [Klinik fuer Radiologie, Charite - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); Fernandes, Carmen Maria Perez, E-mail: carmen.perez-fernandez@charite.de [Klinik fuer Radiologie, Charite - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); Rothe, Jan Holger, E-mail: jan-holger.rothe@charite.de [Klinik fuer Radiologie, Charite - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); Streitparth, Florian, E-mail: florian.streitparth@charite.de [Klinik fuer Radiologie, Charite - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); Seehofer, Daniel, E-mail: daniel.seehofer@charite.de [Klinik fuer Allgemein-, Viszeral- und Transplantationschirurgie, Charite - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin (Germany); and others

2012-11-15

Objectives: To assess the improvement of bile duct visualization in Gd-EOB-DTPA enhanced MR-cholangiography (EOB-MRC) by using an increased flip angle. Methods: 35 patients underwent Gd-EOB-DTPA enhanced MRI of the liver including T2-weighted MRCP and hepatobiliary phase EOB-MRC using a flip angle of 10 Degree-Sign (FA10) and of 35 Degree-Sign (FA35), respectively. Images were evaluated regarding the delineation of biliary ducts, the order of branching and anatomic visualization of the biliary tree. ROI analysis was performed to estimate the signal-to-noise (SNR) and contrast-to-noise (CNR) ratios. Results: Applying the FA35 resulted in a significantly better SNR and CNR as compared to FA10. The overall image quality was rated as good for both, FA10 and FA35. The overall rating for regional delineation of the biliary system was rated significantly better for FA35 than for FA10 (p = 0.02). Classification of bile duct anatomy variations, however, was equivalent in both techniques. Conclusions: Increasing the flip angle of a T1-weighted 3D-sequence from 10 Degree-Sign to 35 Degree-Sign during the hepatobiliary phase of Gd-EOB enhanced MRI visually and quantitatively improved the visualization of the biliary ducts.

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.

Staple fixation for akin proximal phalangeal osteotomy in the treatment of hallux valgus interphalangeus.

Science.gov (United States)

Neumann, Julie A; Reay, Kathleen D; Bradley, Kendall E; Parekh, Selene G

2015-04-01

The Akin proximal phalangeal osteotomy is commonly used in conjunction with metatarsal osteotomies to treat hallux valgus. Multiple fixation methods including suture, wire, screw, and staple fixation have been described. The aims of this study were to assess the intraoperative and postoperative complications and to evaluate short-term postoperative outcomes in patients who underwent Akin osteotomy with staple fixation. Forty-four patients (51 feet) with painful hallux valgus were retrospectively reviewed at an average of 40.4 ± 15.8 (range, 25.9 to 79.9) weeks following an Akin osteotomy with staple fixation. Patient reported preoperative and postoperative Visual Analog Score (VAS) (0 to 10, 0 = no pain) was recorded. Level of activity was reported postoperatively. Hallux valgus angles (HVAs), intermetatarsal angles (IMAs), and hallux valgus interphalangeus angles (IPAs) were evaluated on preoperative as well as final postoperative radiographs. Postoperative clinical and radiographic examinations were used to evaluate for complications. Mean VAS improved from 4.4 ± 2.6 to 1.0 ± 1.2 (P hallux valgus correction with improvement in pain and hallux valgus deformity with a low risk for complications. Level IV, case series. © The Author(s) 2014.

Periacetabular osteotomy

DEFF Research Database (Denmark)

Klit, Jakob; Hartig-Andreasen, Charlotte; Jacobsen, Steffen

2013-01-01

Hip joint survivorship and functional outcome are traditional outcome measures applied after periacetabular osteotomy (PAO). Younger adults however have greater demands and expectations on the function of their hip joints and these demands are not expressed using traditional outcome assessment to...

Quality-Improving Strategies of College English Teaching Based on Microlesson and Flipped Classroom

Science.gov (United States)

Zhang, Fan

2017-01-01

Microlesson and flipped classroom, which incorporate the educational information technologies, are a new trend of college English teaching. Exploration on how the flipped classroom and microlesson promote innovation and application of educational information technology are of great significance. According to a survey among teachers, strategies…

Correction of moderate to severe hallux valgus with combined proximal opening wedge and distal chevron osteotomies: a reliable technique.

Science.gov (United States)

Jeyaseelan, L; Chandrashekar, S; Mulligan, A; Bosman, H A; Watson, A J S

2016-09-01

The mainstay of surgical correction of hallux valgus is first metatarsal osteotomy, either proximally or distally. We present a technique of combining a distal chevron osteotomy with a proximal opening wedge osteotomy, for the correction of moderate to severe hallux valgus. We reviewed 45 patients (49 feet) who had undergone double osteotomy. Outcome was assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) and the Short Form (SF) -36 Health Survey scores. Radiological measurements were undertaken to assess the correction. The mean age of the patients was 60.8 years (44.2 to 75.3). The mean follow-up was 35.4 months (24 to 51). The mean AOFAS score improved from 54.7 to 92.3 (p hallux valgus and intermetatarsal angles were improved from 41.6(o) to 12.8(o) (p < 0.001) and from 22.1(o) to 7.1(o), respectively (p < 0.001). The mean distal metatarsal articular angle improved from 23(o) to 9.7(o). The mean sesamoid position, as described by Hardy and Clapham, improved from 6.8 to 3.5. The mean length of the first metatarsal was unchanged. The overall rate of complications was 4.1% (two patients). These results suggest that a double osteotomy of the first metatarsal is a reliable, safe technique which, when compared with other metatarsal osteotomies, provides strong angular correction and excellent outcomes with a low rate of complications. Cite this article: Bone Joint J 2016;98-B:1202-7. ©2016 The British Editorial Society of Bone & Joint Surgery.

The effects of femoral external derotational osteotomy on frontal plane alignment.

Science.gov (United States)

Nelitz, M; Wehner, T; Steiner, M; Dürselen, L; Lippacher, S

2014-11-01

Femoral osteotomies are the preferred treatment in significant torsional deformity of the femur. The influence of torsional osteotomies on frontal plane alignment is poorly understood. Therefore, the aim of the present study was to evaluate the effects of external derotational osteotomies on proximal, mid-shaft and distal levels onto frontal plane alignment. The effect of rotation around the anatomical axis of the femur on frontal plane alignment was determined with a 3D computer model, created from CT data of a right human cadaver femur. Virtual torsional osteotomies of 10°, 20° and 30° were performed at proximal, mid-shaft and distal levels under five antecurvatum angles of the femur. The change of the frontal plane alignment was expressed by the mechanical lateral femoral angle. Proximal derotational osteotomies resulted in an increased mechanical lateral distal femoral angle (mLDFA) of 0.8°-2.6° for 10°, of 1.6°-5.1° for 20° and of 2.3-7.9° for 30° derotational osteotomy, indicating an increased varus angulation. Supracondylar derotational osteotomy resulted in a decreased mLDFA of -0.1° to -1.7° for 10°, of -0.2 to -3.7° for 20° and of -0.7 to -6.9° for 30° derotational osteotomy, indicating an increased valgus angulation. The effect increased with the amount of torsional correction and virtually increased antecurvatum angles. Mid-shaft torsional osteotomies had the smallest effect on frontal plane alignment. This three-dimensional computer model study demonstrates the relationship between femoral torsional osteotomies and frontal plane alignment. Proximal external derotational osteotomies tend to result in an increased varus angulation, whilst distal external derotational osteotomies tend to result in an increased valgus angulation. As a clinical consequence, torsional osteotomies have an increased risk of unintentional implications on frontal plane alignment.

Tibial valgus aperture osteotomy

International Nuclear Information System (INIS)

De los Rios G, Adolfo Leon; Saavedra Abadia, Adolfo Leon; Palacios, Julio

2005-01-01

This study is based on work carried out a The knee clinic at the arthroscopic surgery unit of the Institute of osteo-articular diseases, Imbanaco Medical Centre, The University Hospital of the Valle (Cali-Colombia) and The Fractures Clinic Ltd. (Palmira-Valle). This is a descriptive study, which demonstrates very positive outcomes for aperture osteotomy, without detracting from the importance of, and the progress made in uni-compartmental and total joint articular replacements of the knee. 10 patients were treated with a highs tibial open osteotomy between November 1988 and December 2002: 3 had post-traumatic deformities, without arthrosic alterations; 1 had pseudo-arthrosis caused by a failed corrective procedure; 1 had complex instability of the knee with osseous varus; 6 had a degenerative lesion of the medial meniscus with medial condral alterations. Follow-up was form 12 to 54 months. Treatment involved a tibial valgus aperture osteotomy and osteo-synthesis. Evaluation was carried out using the International Knee Documentation Committee (IKDC) scale, the For Special Surgery and The Knee Society Score

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

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.

A comparison of piezosurgery with conventional techniques for internal osteotomy.

Science.gov (United States)

Koçak, I; Doğan, R; Gökler, O

2017-06-01

To compare conventional osteotomy with the piezosurgery medical device, in terms of postoperative edema, ecchymosis, pain, operation time, and mucosal integrity, in rhinoplasty patients. In this prospective study, 49 rhinoplasty patients were randomly divided into two groups according to osteotomy technique used, either conventional osteotomy or piezosurgery. For all patients, the total duration of the operation was recorded, and photographs were taken and scored for ecchymosis and edema on postoperative days 2, 4, and 7. In addition, pain level was evaluated on postoperative day 2, and mucosal integrity was assessed on day 4. All scoring and evaluation was conducted by a physician who was blinded to the osteotomy procedure. In the piezosurgery group, edema scores on postoperative day 2 and ecchymosis scores on postoperative days 2, 4, and 7 were significantly lower than in the conventional osteotomy group (p piezosurgery group than in the conventional osteotomy group (p piezosurgery group. When total operation duration was compared, there was no significant difference between the groups (p > 0.05). Piezosurgery is a safe osteotomy method, with less edema (in the early postoperative period) and ecchymosis compared with conventional osteotomy, as well as less pain, a similar operation duration, and no mucosal damage.

Improvements from a Flipped Classroom May Simply Be the Fruits of Active Learning

Science.gov (United States)

Jensen, Jamie L.; Kummer, Tyler A.; Godoy, Patricia D. d. M.

2015-01-01

The "flipped classroom" is a learning model in which content attainment is shifted forward to outside of class, then followed by instructor-facilitated concept application activities in class. Current studies on the flipped model are limited. Our goal was to provide quantitative and controlled data about the effectiveness of this model.…

Revisional Surgery for Hallux Valgus with Serial Osteotomies at Two Levels

Directory of Open Access Journals (Sweden)

Jason B. T. Lim

2011-01-01

Full Text Available The aetiology and form of hallux valgus (HV is varied with many corrective procedures described. We report a 39-year-old woman, previously treated with a Chevron osteotomy, who presented with recurrent right HV, metatarsus primus varus, and associated bunion. Osteotomies were performed at two levels as a revisional procedure. This report highlights (1 limitations of the Chevron osteotomy and (2 the revisional procedure of the two level osteotomies: (i proximal opening-wedge basal osteotomy and (ii distal short Scarf with medial closing wedges. If a Chevron osteotomy is used inappropriately, for example, in an attempt to correct too large a deformity, it may angulate laterally causing a malunion with an increased distal metatarsal articular angle. Secondly, it is feasible to correct this combined deformity using a combination of proximal opening-wedge and distal short Scarf osteotomies.

Does intraoperative navigation improve the accuracy of mandibular angle osteotomy: Comparison between augmented reality navigation, individualised templates and free-hand techniques.

Science.gov (United States)

Zhu, Ming; Liu, Fei; Zhou, Chaozheng; Lin, Li; Zhang, Yan; Chai, Gang; Xie, Le; Qi, Fazhi; Li, Qingfeng

2018-04-11

Augmented reality (AR)-based navigation surgery has evolved to be an advanced assisted technology. The aim of this study is to manifest the accuracy of AR navigation for the intraoperative mandibular angle osteotomy by comparing the navigation with other interventional techniques. A retrospective study was conducted with 93 post-surgical patients with mandibular angle hypertrophy admitted at our plastic and reconstructive surgery department between September 2011 and June 2016. Thirty-one patients received osteotomy conducted using a navigation system based on augmented reality (AR group), 28 patients received osteotomy conducted using individualised templates (IT group) and the remaining 34 patients received osteotomy performed by free hand (free-hand group). The post-operative computed tomography (CT) images were reviewed and analysed by comparing with pre-surgical planning generated by three-dimensional (3D) software. The preparation time, cutting time, whole operating time and discrepancy in osteotomy lines were measured. The preparation time was much shorter for the free-hand group than that for the AR group and the IT group (P  0.05). In addition, the discrepancy in osteotomy lines was lower for the AR group and in the IT group than for the free-hand group (P < 0.01). The navigation system based on AR has a higher accuracy, more reliability and better user friendliness for some particular clinical procedures than for other techniques, which has a promising clinical prospect. Copyright © 2018. Published by Elsevier Ltd.

Use of TRIGA flip fuel for improved in-core irradiations

Energy Technology Data Exchange (ETDEWEB)

Whittemore, W L [General Atomic Co., San Diego, CA (United States)

1974-07-01

Use of standard TRIGA fuel (20% enriched uranium) in a reactor provides a suitable facility for in-core irradiations. However, large numbers of in-core samples irradiated for long periods (many months) can be handled more economically with a TRIGA loaded with FLIP fuel. As an example, ten or more in-core thermionic devices (each worth 50 to 80 cents with respect to a water-filled position) were irradiated in the Mark III TRIGA at General Atomic Company for 18 months with only a modest change in excess reactivity due to core burnup. A core loading of FLIP fuel has been added to the General Atomic Mark F reactor in order to provide numerous in-core irradiation sites for the production of radioisotopes. Since the worth of a 500-gram sample of a molybdenum compound (used for the production of {sup 99}Mo) is about 25 to 50 cents with respect to a water-filled position, use of a FLIP- TRIGA core will permit the irradiation of more than 5 kilograms of a molybdenum compound. A procedure is under development for the production of {sup 99}Mo with relatively high specific activity. Several techniques to concentrate {sup 99}Mo have been tested experimentally. The results will be reported. (author)

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.

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…

Flipped classroom model improves graduate student performance in cardiovascular, respiratory, and renal physiology.

Science.gov (United States)

Tune, Johnathan D; Sturek, Michael; Basile, David P

2013-12-01

The purpose of this study was to assess the effectiveness of a traditional lecture-based curriculum versus a modified "flipped classroom" curriculum of cardiovascular, respiratory, and renal physiology delivered to first-year graduate students. Students in both courses were provided the same notes and recorded lectures. Students in the modified flipped classroom were required to watch the prerecorded lectures before class and then attend class, where they received a quiz or homework covering material in each lecture (valued at 25% of the final grade) followed by a question and answer/problem-solving period. In the traditional curriculum, attending lectures was optional and there were no quizzes. Evaluation of effectiveness and student performance was achieved by having students in both courses take the same multiple-choice exams. Within a comparable group of graduate students, participants in the flipped course scored significantly higher (P ≤ 0.05) on the cardiovascular, respiratory, and weighted cumulative sections by an average of >12 percentage points. Exam averages for students in the flipped course also tended to be higher on the renal section by ∼11 percentage points (P = 0.06). Based on our experience and responses obtained in blinded student surveys, we propose that the use of homework and in-class quizzes were critical motivating factors that likely contributed to the increase in student exam performance. Taken together, our findings support that the flipped classroom model is a highly effective means in which to disseminate key physiological concepts to graduate students.

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.

Shortening Scarf osteotomy for correction of severe hallux valgus. Does shortening affect the outcome?

Science.gov (United States)

Karpe, Prasad; Killen, Marie C; Pollock, Raymond D; Limaye, Rajiv

2016-12-01

Translation and shortening of Scarf osteotomy allows correction of severe hallux valgus deformity. Shortening may result in transfer metatarsalgia. To evaluate outcome of patients undergoing shortening Scarf osteotomy for severe hallux valgus deformities. Fifteen patients (20feet, mean age 58 years) underwent shortening Scarf osteotomy for severe hallux valgus deformities. Outcomes were pre and postoperative AOFAS scores, IM and HV angles, patient satisfaction. Mean follow-up was 25 months (range 22-30). The IM angle improved from a median of 18.60 (range 13.4-26.20) preoperatively to 9.70 (range 8.0-13.70) postoperatively (8.9; 95% CI=7.6-10.3; phallux valgus deformities with no transfer metatarsalgia. Copyright © 2016 Elsevier Ltd. All rights reserved.

Secondary Subacromial Impingement after Valgus Closing-Wedge Osteotomy for Proximal Humerus Varus

Directory of Open Access Journals (Sweden)

Hirotaka Sano

2015-01-01

Full Text Available A 31-year-old construction worker had been suffering from both the motion pain and the restriction of elevation in his right shoulder due to severe varus deformity of humeral neck, which occurred after proximal humeral fracture. The angle for shoulder flexion and abduction was restricted to 50 and 80 degrees, respectively. Valgus closing-wedge osteotomy followed by the internal fixation using a locking plate was carried out at 12 months after injury. Postoperatively, the head-shaft angle of the humerus improved from 65 to 138 degrees. Active flexion and abduction angles improved from 80 to 135 degrees and from 50 to 135 degrees, respectively. However, the patient complained from a sharp pain with a clicking sound during shoulder abduction even after removal of the locking plate. Since subacromial steroid injection temporarily relieved his shoulder pain, we assumed that the secondary subacromial impingement was provoked after osteotomy. Thus, arthroscopic subacromial decompression was carried out at 27 months after the initial operation, which finally relieved his symptoms. In the valgus closing-wedge osteotomy, surgeons should pay attention to the condition of subacromial space to avoid causing the secondary subacromial impingement.

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

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.

A new technique for mandibular osteotomy

Directory of Open Access Journals (Sweden)

Puricelli Edela

2007-03-01

Full Text Available Abstract Sagittal split osteotomy (SSO is a surgical technique largely employed for mandibular mobilizations in orthognatic procedures. However, the traditional design of buccal osteotomy, located at the junction of mandibular ramus and body, may prevent more extensive sliding between the bone segments, particularly on the advance, laterality and verticality of the mandibular body. The author proposes a new technical and conceptual solution, in which osteotomy is performed in a more distal region, next to the mental formamen. Technically, the area of contact between medullary-cancellous bone surfaces is increased, resulting in larger sliding rates among bone segments; it also facilitates the use of rigid fixation systems, with miniplates and monocortical screws. Conceptually, it interferes with the resistance arm of the mandible, seen as an interpotent lever of the third gender.

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.

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

Correction of Hallux Valgus Interphalangeus With an Osteotomy of the Distal End of the Proximal Phalanx (Distal Akin Osteotomy).

Science.gov (United States)

Vander Griend, Robert

2017-02-01

Operative correction of a symptomatic hallux valgus interphalangeus (HVI) deformity is often achieved with an osteotomy at the proximal end of the proximal phalanx (Akin osteotomy). However, the apex of the typical HVI deformity (center of rotation angle) is at the interphalangeal joint of the hallux. This study was done to evaluate the results of performing a medial closing wedge osteotomy at the distal end of the proximal phalanx. Thirty-three patients (33 feet) underwent an osteotomy at the distal end of the proximal phalanx for correction of HVI. All of the patients had other forefoot deformities which were corrected at the same time. Eight of these were revision procedures of prior forefoot operations. The length of follow-up was determined by the associated procedures with a minimum follow-up of 4 months. The preoperative hallux valgus interphalangeus angle averaged 16 degrees of valgus (range 7-32 degrees) and was corrected to an average of 2 degrees of valgus (range 5 degrees valgus to 5 degrees varus). All of the patients were satisfied with the postoperative appearance and function of the first toe. Because of simultaneous correction of numerous other forefoot problems, it was not possible to specifically isolate or evaluate the effects and benefits of this osteotomy using outcomes measures. There was one intraoperative complication resulting in a fracture extending into the adjacent IP joint. Correction of an HVI deformity can be achieved with an osteotomy at the distal end of the proximal phalanx. This was a safe technique with few complications and with good results in terms of both correction and patient satisfaction. Level IV, retrospective case series.

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…

Torsional osteotomies of the tibia in patellofemoral dysbalance.

Science.gov (United States)

Dickschas, Jörg; Tassika, Aliki; Lutter, Christoph; Harrer, Jörg; Strecker, Wolf

2017-02-01

Anterior knee pain or patellofemoral instability is common symptom of patellofemoral dysbalance or maltracking. Tibial torsional deformities can be the reason of this pathology. After appropriate diagnostic investigation, the treatment of choice is a torsional osteotomy. This study addresses the diagnostic investigation, treatment, and the outcome of torsional osteotomies of the tibia. Does this treatment result in patellofemoral stability and provide pain relief? Forty-nine tibial torsional osteotomies were included. The major symptoms were patellofemoral instability in 19 cases and anterior knee pain in 42 cases. In addition to clinical and radiographic analysis, a torsional angle CT scan was performed pre-operatively. A visual analog scale (VAS), the Japanese Knee Society score, the Tegner activity score, and the Lysholm score were assessed pre-operatively and at the 42-month follow-up. Mean tibial external torsion was 47.4° (SD 5.41; range 37°-66°; standard value 34°). Surgical treatment consisted of an acute supratuberositary tibial internal torsional osteotomy (mean 10.8°; SD 3.01°; range 5°-18°). At the follow-up investigation, the Tegner activity score was increased 0.4 points (p value 0.014) from 3.9 (SD 1.33; range 2-7) to 4.3 (SD 1.25; range 0-7). The Lysholm score increased 26 points (SD 16.32; p value 0.001) from 66 (SD 14.94; range 32-94) to 92 (SD 9.29; range 70-100) and the Japanese Knee Society score increased 18 points (SD 14.70; p value 0.001) from 72 (SD 13.72, range 49-100) to 90 (SD 9.85, range 60-100). VAS was reduced 3.4 points (SD 2.89; p value 0.001) from 5.7 (SD 2.78; range 0-10) to 2.3 (SD 1.83; range 0-7). As regards patellofemoral instability, no redislocation occurred in the follow-up period. The results of this study show that in cases of tibial maltorsion, a torsional osteotomy can lead to patellofemoral stability and pain relief, and should be considered as a treatment option. The improved clinical scores in the present

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...

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%.

Total knee replacement with tibial tubercle osteotomy in rheumatoid patients with stiff knee.

Science.gov (United States)

Eid, Ahmed Salem; Nassar, Wael Ahmed Mohamed; Fayyad, Tamer Abdelmeguid Mohamed

2016-11-01

Total knee arthroplasty (TKA) is a well-proven modality that can provide pain relief and restore mobility for rheumatoid arthritis (RA) patients with advanced joint destruction. Patellar ligament avulsion, especially in presence of poor bone quality and knee stiffness, is one of the special considerations that must be addressed in this unique population of patients. This study aimed to determine the functional results in a series of rheumatoid patients with stiff knee and end-stage joint destruction who underwent tibial tubercle osteotomy during TKA. Twenty-three knees in 20 patients (16 women; four men) at a mean age of 54 years with end-stage arthritis and knee stiffness due to RA were operated upon for TKA using tibial tubercle osteotomy as a step during the operation. Patients were reviewed clinically and radiographically with a minimum follow-up of two years. Complications were noted. Hospital for Special Surgery (HSS) score was recorded pre-operatively and at six and 12 months postoperatively. Union occurred at the osteotomy site in 21 of 23 cases. One case had deep venous thrombosis (DVT). There was no infection or periprosthetic fracture, and at last follow-up, no patient required revision. HSS score improved from 46 (15-60) pre-operatively to 85 (71-96) post-operatively. Tibial tubercle osteotomy during TKA in patients with RA and stiff knee is technically demanding yet proved to be effective in improving post-operative range of movement and minimising the complication of patellar ligament avulsion.

The early functional outcome of Mau osteotomy for the correction of moderate-severe hallux valgus

Directory of Open Access Journals (Sweden)

Tanujan Thangarajah

2013-11-01

Full Text Available Hallux valgus is one of the commonest conditions of the foot and has been reported to affect nearly half of the adult population. It is most effectively treated by a corrective osteotomy of which there a numerous subtypes. The Mau osteotomy confers the greatest structural stability but is not thought to provide adequate correction of moderate-severe deformities. Accordingly, complications such as under correction and non-union are common. The aim of this study was to determine the functional outcome in patients with moderate-severe hallux valgus following a Mau osteotomy. A retrospective review of 23 patients with moderate-severe hallux valgus treated by Mau osteotomy was conducted. Patients were assessed clinically by the American Orthopedic Foot and Ankle Society (AOFAS scoring system and radiologically by measuring the first intermetatarsal (IM and hallux abductovalgus angles (HAV. The mean AOFAS score had improved from 47 preoperatively to 92 postoperatively (P<0.01. Additionally, preoperative HAV and IM angles improved from 39° and 15° respectively to 15° and 9° respectively (P<0.01. There were no cases of undercorrection or non-union. In this series, the Mau osteotomy was able to achieve good correction of the IM and HAV angles in patients with moderate-severe hallux valgus. This was reflected in a significantly higher postoperative AOFAS score. Contrary to other studies there were no cases of undercorrection and despite allowing patients to fully weight-bear postoperatively there were no cases of non-union.

The Level of Fibula Osteotomy and Incidence of Peroneal Nerve ...

African Journals Online (AJOL)

2010-06-29

Jun 29, 2010 ... Journal of Surgical Technique and Case Report | Jan-Jun 2010 | Vol-2 | Issue-1. 17. The Level of Fibula Osteotomy and Incidence of Peroneal. Nerve Palsy in Proximal Tibial Osteotomy. A. O. Ogbemudia, P. F. A. Umebese, A. Bafor, E. Igbinovia, P. E. Ogbemudia. INTRODUCTION. Osteotomy of the fibula is ...

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

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

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…

Student Views about a Flipped Physics Course: A Tool for Program Evaluation and Improvement

Science.gov (United States)

Ramlo, Susan

2015-01-01

Flipped classrooms are a relatively new teaching strategy where the typical lecture and homework elements of a course are reversed. Although flipped classrooms are gaining popularity, evaluations of this type of pedagogical model are limited. The purpose of this study was to investigate student views related to the effectiveness of a flipped…

Competency-Based Blended Learning: Flipping Professional Practice Classes to Enhance Competence Development

Directory of Open Access Journals (Sweden)

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.

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

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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.…

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.

Patellofemoral dysbalance and genua valga: outcome after femoral varisation osteotomies.

Science.gov (United States)

Dickschas, Jörg; Ferner, Felix; Lutter, Christoph; Gelse, Kolja; Harrer, Jörg; Strecker, Wolf

2018-01-01

Patellofemoral dysbalance may be caused by trochlear dysplasia, an elevated TTTG distance, femoral or tibial torsional deformities, patella alta, or a genu valgum. The surgical procedure for the treatment of a genu valgum is varisation osteotomy, usually in the femoral aspect. Several authors believe that a genu valgum is one cause of patellofemoral dysbalance, but studies about the outcome of the treatment with a varisation osteotomy are rare. Nineteen knees in 18 patients, aged on average 28 (16-52) years were investigated in a retrospective study. The patients had symptoms of patellofemoral instability or anterior knee pain due to a genu valgum, without symptoms of a lateral femorotibial compartment. All patients underwent a femoral varisation osteotomy. The diagnostic investigation prior to surgery included full-leg radiographs and torsional angle CT scans. The pre-surgery and follow-up investigation included the visual analog scale (VAS), the Kujala score, the Japanese Knee Society score, the Lysholm score. The mean duration of follow-up was 44(10-132) months. The mean preoperative mechanical valgus was 5.6° (range 4-10°). Twelve patients mentioned patellar instability as the main symptom while 14 mentioned anterior knee pain. No redislocation occurred in the follow-up period. Anterior knee pain on the VAS (p value patellofemoral dysbalance, treatment of this condition is femoral varisation osteotomy. In this study, patellofemoral stability was achieved and anterior knee pain was significantly reduced. Significant improvements in clinical scores proved the success of the treatment. IV, case series.

Proximal supination osteotomy of the first metatarsal for hallux valgus.

Science.gov (United States)

Yasuda, Toshito; Okuda, Ryuzo; Jotoku, Tsuyoshi; Shima, Hiroaki; Hida, Takashi; Neo, Masashi

2015-06-01

Risk factors for hallux valgus recurrence include postoperative round-shaped lateral edge of the first metatarsal head and postoperative incomplete reduction of the sesamoids. To prevent the occurrence of such conditions, we developed a proximal supination osteotomy of the first metatarsal. Our aim was to describe this novel technique and report the outcomes in this report. Sixty-six patients (83 feet) underwent a distal soft tissue procedure combined with a proximal supination osteotomy. After the proximal crescentic osteotomy, the proximal fragment was pushed medially, and the distal fragment was abducted, and then the distal fragment of the first metatarsal was manually supinated. Outcomes were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) score and radiographic examinations. The average follow-up duration was 34 (range, 25 to 52) months. The mean AOFAS score improved significantly from 58.0 points preoperatively to 93.8 points postoperatively (P hallux valgus and intermetatarsal angle decreased significantly from 38.6 and 18.0 degrees preoperatively to 11.0 and 7.9 degrees postoperatively, respectively (both, P hallux valgus, defined as a hallux valgus angle ≥ 25 degrees. The rates of occurrence of a positive round sign and incomplete reduction of the sesamoids significantly decreased postoperatively, which may have contributed to the low hallux valgus recurrence rates. We conclude that a proximal supination osteotomy was an effective procedure for correction of hallux valgus and can achieve a low rate of hallux valgus recurrence. Level IV, retrospective case series. © The Author(s) 2015.

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…

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.

The True Ponte Osteotomy: By the One Who Developed It.

Science.gov (United States)

Ponte, Alberto; Orlando, Giuseppe; Siccardi, Gian Luigi

2018-01-01

Technique and applications. To define the anatomy, biomechanics, indications, and surgical technique of the true Ponte osteotomy. The Ponte osteotomy, originally developed for thoracic kyphosis, was the first one to obtain posterior shortening of the thoracic spine, maintaining the anterior column load-sharing capacity. It has become a widely applied technique in various types of spine deformities and a frequent topic of presentations at meetings and in scientific articles. Several of them offer unquestionable evidence of an incorrect execution, with consequently distorted outcomes and erroneous conclusions. A clearing up became essential. Our original experience is based on a series of 240 patients with thoracic hyperkyphosis operated in the years 1969-2015, at first with a standard posterior Harrington technique and then by using the Ponte osteotomy with different instrumentations. A series of 78 of them, operated in the years 1987-1997, who had Ponte osteotomies at every level, is presented. The average preoperative kyphosis has been corrected from 80° (range 61°-102°) to 31° (range 15°-50°) by a substantial posterior shortening. A number of publications use the term Ponte osteotomy loosely for by far incomplete resections and mixing it up with Smith-Petersen's osteotomy. The true Ponte osteotomy is capable of producing marked flexibility in extension, flexion and rotation, justifying its wide use in thoracic deformities, mainly in scoliosis. An exact performance of the osteotomy with adequate bony resections, including the laminae, is an absolute condition to take full advantage of its properties. Level IV, therapeutic study. Copyright © 2017 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

Cranial nerve injury after Le Fort I osteotomy.

Science.gov (United States)

Kim, J-W; Chin, B-R; Park, H-S; Lee, S-H; Kwon, T-G

2011-03-01

A Le Fort I osteotomy is widely used to correct dentofacial deformity because it is a safe and reliable surgical method. Although rare, various complications have been reported in relation to pterygomaxillary separation. Cranial nerve damage is one of the serious complications that can occur after Le Fort I osteotomy. In this report, a 19-year-old man with unilateral cleft lip and palate underwent surgery to correct maxillary hypoplasia, asymmetry and mandibular prognathism. After the Le Fort I maxillary osteotomy, the patient showed multiple cranial nerve damage; an impairment of outward movement of the eye (abducens nerve), decreased vision (optic nerve), and paraesthesia of the frontal and upper cheek area (ophthalmic and maxillary nerve). The damage to the cranial nerve was related to an unexpected sphenoid bone fracture and subsequent trauma in the cavernous sinus during the pterygomaxillary osteotomy. Copyright © 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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…

Treatment of moderate hallux valgus by percutaneous, extra-articular reverse-L Chevron (PERC) osteotomy.

Science.gov (United States)

Lucas y Hernandez, J; Golanó, P; Roshan-Zamir, S; Darcel, V; Chauveaux, D; Laffenêtre, O

2016-03-01

The aim of this study was to report a single surgeon series of consecutive patients with moderate hallux valgus managed with a percutaneous extra-articular reverse-L chevron (PERC) osteotomy. A total of 38 patients underwent 45 procedures. There were 35 women and three men. The mean age of the patients was 48 years (17 to 69). An additional percutaneous Akin osteotomy was performed in 37 feet and percutaneous lateral capsular release was performed in 22 feet. Clinical and radiological assessments included the type of forefoot, range of movement, the American Orthopedic Foot and Ankle (AOFAS) score, a subjective rating and radiological parameters. The mean follow-up was 59.1 months (45.9 to 75.2). No patients were lost to follow-up. The mean AOFAS score increased from 62.5 (30 to 80) pre-operatively to 97.1 (75 to 100) post-operatively. A total of 37 patients (97%) were satisfied. At the last follow up there was a statistically significant decrease in the hallux valgus angle, the intermetatarsal angle and the proximal articular set angle. The range of movement of the first metatarsophalangeal joint improved significantly.. There was more improvement in the range of movement in patients who had fixation of the osteotomy of the proximal phalanx. Preliminary results of this percutaneous approach are promising. This technique is reliable and reproducible. Its main asset is that it maintains an excellent range of movement. The PERC osteotomy procedure is an effective approach for surgical management of moderate hallux valgus which combines the benefits of percutaneous surgery with the versatility of the chevron osteotomy whilst maintaining excellent first MTPJ range of motion. ©2016 The British Editorial Society of Bone & Joint Surgery.

Triple pelvic osteotomy in Legg-Calve-Perthes disease using a single anterolateral incision: a 4-year review.

LENUS (Irish Health Repository)

Conroy, Eimear

2010-07-01

Femoral head incongruency at skeletal maturity is associated with the development of osteoarthritis in early adulthood. Containment of the femoral head provides a larger surface area for remodelling of the collapsed femoral head and the development of spherical congruency. Triple pelvic osteotomy has a role to play in Legg-Calve-Perthes\\' disease by improving femoral head containment and preventing subluxation. This is traditionally a two-incision approach with significant associated morbidity. In our unit we perform triple osteotomies through a single anterolateral incision. To retrospectively review the clinical and radiographic outcome of children who had triple osteotomies performed through a single incision over a 4-year period. In our unit from 2003 to 2006 we performed eight triple osteotomies through a single incision in children aged between 6 and 12 years with Legg-Calve-Perthes\\' disease. The procedure was performed through a single anterolateral incision made beneath the middle of the iliac crest and carried forward according to Salter\\'s osteotomy. Image intensification was used to confirm iliac, pubic and ischial cuts. After performing a standard Salter\\'s osteotomy the acetabular fragment was free to rotate anteriorly and laterally. None of the children were casted and all were allowed immediate mobilization nonweight bearing with crutches for 6 weeks. Clinical results and hip function were measured preoperatively and postoperatively using the modified Harris hip score. The average length of hospital stay was 4.7 days. None of the children had a nonunion. The centre edge angle of Wiberg was measured on all preoperative and postoperative anteroposterior pelvic radiographs. In all our patients there was an improvement in the centre edge angle of Wiberg and in the modified Harris hip score. The preoperative modified Harris hip scores ranged from 38 to 60 and postoperatively ranged from 77 to 92. The preoperative centre edge angle of Wiberg ranged

The results of high tibial open wedge osteotomy in patients with varus deformity

Directory of Open Access Journals (Sweden)

Mahmood Jabalameli

2013-07-01

Full Text Available Background: High tibial open wedg osteotomy is one of the most important modality for treatment of varus deformity in order to correct deformity and improving signs and symptoms of patients with primary degenerative osteoarthritis. The aim of this study was to investigate the results of high tibial open wedge osteotomy in patients with varus deformities.Methods: This retrospective study conducted on twenty nine patients (36 knees undergone proximal tibial osteotomy operation in Shafa Yahyaian University Hospital from 2004 to 2010. Inclusion criteria were: age less than 60 years, high physical activity, varus deformity and involvement of medical compartment of knee. Patients with obesity, smoking, patelofemoral pain, lateral compartment lesion, deformity degree more than 20 degree, extension limitation and range of motion less than 90 degree were excluded. The clinical and radiologic characteristics were measured before and after operation.Results: Fourteen patients were females. All of them were younger than 50 years, with mean (±SD 27.64 (±10.88. The mean (±SD of follow up time was 4.33 (±1.7. All the patients were satisfied with the results of operation. Tenderness and pain decreased in all of them. In all patients autologus bone graft were used, in 15 cases (42.5% casting and in the rest T.Buttress plate were used for fixation of fractures. In both groups of primary and double varus the International knee documentation committee (IKDC and modified Larson indices were improved after operation, but there was no significant difference between two groups.Conclusion: High tibial open wedge osteotomy can have satisfying results in clinical signs and symptoms of patients with primary medial joint degenerative osteoarthritis. This procedure also may correct the deformity and improves the radiologic parameters of the patients.

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

Hallux valgus with Scarf Osteotomy - A revision of 82 cases

International Nuclear Information System (INIS)

Mendez Gonzalez, Mauricio; Gamba Sanchez, Carlos Enrique

2005-01-01

Descriptive observational study, type series of cases, whose objective was to describe the treatment of hallux valgus with Scarf Osteotomy; this study reviewed the clinical, radiological and subjective aspects of 82 feet, mean age of 49 years, and a mean of 14 degrades and 31 degrades to 9 degrades and 14 degrades (p<0,0001). The mean of the AOFAS scale improved from 49 points preoperatively to 92 points (p<0,0001). 61% of the patients were very satisfied, 34% were satisfied and 5% were not satisfied with the procedure. The recurrence of the deformity appeared in 3% of the patients. The rate of complications was of 6%. The SCARF osteotomy is a safe procedure. We recommended it like an effective technique for the correction of hallux valgus mild, moderate and severe

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

Active Learning and Flipped Classroom, Hand in Hand Approach to Improve Students Learning in Human Anatomy and Physiology

Science.gov (United States)

Entezari, Maria; Javdan, Mohammad

2016-01-01

Because Human Anatomy and Physiology (A&P), a gateway course for allied health majors, has high dropout rates nationally, it is challenging to find a successful pedagogical intervention. Reports on the effect of integration of flipped classrooms and whether it improves learning are contradictory for different disciplines. Thus many educators…

Single absorbable polydioxanone pin fixation for distal chevron bunion osteotomies.

Science.gov (United States)

Deorio, J K; Ware, A W

2001-10-01

The distal chevron osteotomy is a well-established technique for correction of symptomatic mild to moderate metatarsus primus varus with hallux valgus deformity. Fixation of the osteotomy ranges from none to bone pegs, Kirschner wires, screws, or absorbable pins. We evaluated one surgeon's (J.K.D.) results of distal chevron osteotomy fixation with a single, nonpredrilled, 1.3-mm poly-p-dioxanone pin and analyzed any differences in patients with unilateral or bilateral symptomatic metatarsus primus varus with hallux valgus deformities. All osteotomies healed without evidence of infection, osteolysis, nonunion, or necrosis. Equal correction was achieved in unilateral and bilateral procedures. The technique is quick and easy, and adequate fixation is achieved.

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…

Ratio of lumbar 3-column osteotomy closure: patient-specific deformity characteristics and level of resection impact correction of truncal versus pelvic compensation.

Science.gov (United States)

Diebo, Bassel G; Lafage, Renaud; Ames, Christopher P; Bess, Shay; Obeid, Ibrahim; Klineberg, Eric; Cunningham, Matthew E; Smith, Justin S; Hostin, Richard; Liu, Shian; Passias, Peter G; Schwab, Frank J; Lafage, Virginie

2016-08-01

The resection point of a lumbar three-column osteotomy (3CO) creates separation of the spino-pelvic complex. This study investigates the impact of patients' baseline deformity and level of 3CO resection on the distribution of correction between the trunk and the pelvis following osteotomy closure. Patients who underwent single lumbar 3CO, upper instrumented vertebra (UIV) T1-T10, and 6 month follow-up were included. The truncal and pelvic closures were calculated based on the vertebrae adjacent to the osteotomy level and the impact of radiographic parameters and level of 3CO on the closures were analyzed. 113 patients were included. Patients who experienced more pelvic correction had significantly higher Pelvic Tilt and lower Sagittal Vertical Axis at baseline. Patients who underwent more caudal osteotomies with higher pelvic compensation with modest SVA sustained more pelvic correction. The osteotomy closure is driven by patient's specific deformity. More caudal osteotomy level leads to greater pelvic tilt improvement. III.

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…

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

Segmental sandwich osteotomy and tunnel technique for three-dimensional reconstruction of the jaw atrophy: a case report.

Science.gov (United States)

Santagata, Mario; Sgaramella, Nicola; Ferrieri, Ivo; Corvo, Giovanni; Tartaro, Gianpaolo; D'Amato, Salvatore

2017-12-01

A three-dimensionally favourable mandibular bone crest is desirable to be able to successfully implant placement to meet the aesthetic and functional criteria in the implant-prosthetic rehabilitation. Several surgical procedures have been advocated for bone augmentation of the atrophic mandible, and the sandwich osteotomy is one of these techniques. The aim of the present case report was to assess the suitability of segmental mandibular sandwich osteotomy combined with a tunnel technique of soft tissue. Based on our knowledge, nobody described before the sandwich osteotomy with tunnel technique to improve the healing of the wound and meet the dimensional requirements of preimplant bone augmentation in cases of a severely atrophic mandible. A 59-year-old woman with a severely atrophied right mandible was treated with the sandwich osteotomy technique filled with autologous bone graft harvested by a cortical bone collector from the ramus. Clinical examination revealed that the mandible was edentulous bilaterally from the first molar to the second molar region. Radiographically, atrophy of the mandibular alveolar ridge in the same teeth site was observed. We began to treat the right side. A horizontal osteotomy of the edentulous mandibular bone was then made with a piezoelectric device after tunnel technique of the soft tissue. The segmental mandibular sandwich osteotomy (SMSO) was finished by two (mesial and distal) slightly divergent vertical osteotomies. The entire bone fragment was displaced cranially, and the desirable position was obtained. The gap was filled completely with autologous bone chips harvested from the mandibular ramus through a cortical bone collector. No barrier membranes were used to protect the grafts. The vertical incisions were closing with interruptive suturing of the flaps with a resorbable material. In this way, the suture will not fall on the osteotomy line of the jaw; the result will be a better predictability of soft and hard tissue

Bamboo Osteotomy for Blount’s Disease

Directory of Open Access Journals (Sweden)

PU Siregar

2010-03-01

Full Text Available Blount disease is a common childhood condition that requires surgical correction. The conventional method of osteotomy and acute correction is associated with risk of neurovascular complications and occasionally displacement of the intra operative alignment. This case report describes a new technique that involves multiple longitudinal osteotomies over the proximal tibia without loss of cortical continuity between the proximal and distal tibia. It simulates an incomplete (greenstick fracture that allows plastic deformation at the site of correction. This correction is more stable, and can be expected to heal more rapidly than conventional treatments.

Computer assisted SCFE osteotomy planning

International Nuclear Information System (INIS)

Drapikowski, Pawel; Tyrakowski, Marcin; Czubak, Jaroslaw; Czwojdzinski, Adam

2008-01-01

Slipped capital femoral epiphysis (SCFE) is a common pediatric orthopedic disorder that requires surgical correction. Preoperative planning of a proximal femoral osteotomy is essential in cases of SCFE. This planning is usually done using 2D radiographs, but 3D data can be acquired with CT and analyzed with 3D visualization software. SCFEanalyzer is a computer program developed for preoperative planning of proximal femoral osteotomy to correct SCFE. Computed tomography scans were performed on human bone specimens: one pelvis and two femoral bones (right and left) and volume data of a patient. The CT data were used to test the abilities of the SCFEanalyzer software, which utilizes 3D virtual models of anatomic structures constructed from CT image data. Separation of anatomical bone structures is done by means of ''cutting'' 3D surface model of the pelvis. The software enables qualitative and quantitative spatial analysis of chosen parameters analogous to those done on the basis of plain radiographs. SCFEanalyzer makes it possible to evaluate the function of the hip joint by calculating the range of motion depending on the shape of bone structures based on oriented bounding box object representation. Pelvic and hip CT scans from a patient with SCFE were subjected to femoral geometry analysis and hip joint function assessment. These were done to plan and simulate osteotomy of the proximal femur. Analogous qualitative and quantitative evaluation after performing the virtual surgery were evaluated to determine the potential treatment effects. The use of computer assistance in preoperative planning enable us to increase objectivity and repeatability, and to compare the results of different types of osteotomy on the proximal femur, and thus to choose the optimal operation in each individual case. (orig.)

Computer assisted SCFE osteotomy planning

Energy Technology Data Exchange (ETDEWEB)

Drapikowski, Pawel [Poznan University of Technology, Institute of Control and Information Engineering, Poznan (Poland); Tyrakowski, Marcin; Czubak, Jaroslaw; Czwojdzinski, Adam [Postgraduate Medical Education Center, Department of Orthopaedics, Warsaw (Poland)

2008-11-15

Slipped capital femoral epiphysis (SCFE) is a common pediatric orthopedic disorder that requires surgical correction. Preoperative planning of a proximal femoral osteotomy is essential in cases of SCFE. This planning is usually done using 2D radiographs, but 3D data can be acquired with CT and analyzed with 3D visualization software. SCFEanalyzer is a computer program developed for preoperative planning of proximal femoral osteotomy to correct SCFE. Computed tomography scans were performed on human bone specimens: one pelvis and two femoral bones (right and left) and volume data of a patient. The CT data were used to test the abilities of the SCFEanalyzer software, which utilizes 3D virtual models of anatomic structures constructed from CT image data. Separation of anatomical bone structures is done by means of ''cutting'' 3D surface model of the pelvis. The software enables qualitative and quantitative spatial analysis of chosen parameters analogous to those done on the basis of plain radiographs. SCFEanalyzer makes it possible to evaluate the function of the hip joint by calculating the range of motion depending on the shape of bone structures based on oriented bounding box object representation. Pelvic and hip CT scans from a patient with SCFE were subjected to femoral geometry analysis and hip joint function assessment. These were done to plan and simulate osteotomy of the proximal femur. Analogous qualitative and quantitative evaluation after performing the virtual surgery were evaluated to determine the potential treatment effects. The use of computer assistance in preoperative planning enable us to increase objectivity and repeatability, and to compare the results of different types of osteotomy on the proximal femur, and thus to choose the optimal operation in each individual case. (orig.)

Triple osteotomy for the correction of severe hallux valgus deformity: Patient reported outcomes and radiological evaluation.

Science.gov (United States)

Booth, Sean; Bhosale, Abhijit; Mustafa, Abubakar; Shenoy, Ravi; Pillai, Anand

2016-08-01

Symptomatic Hallux valgus can be treated with metatarsal osteotomy combined with proximal phalangeal osteotomy, however this might not be sufficient to treat severe HV deformities. Fifteen feet in eleven female patients treated with double first metatarsal and proximal phalanx osteotomies without lateral release were prospectively studied and outcome measures including radiological angles and validated patient reported outcome scores collected. Mean radiological follow up was 15 months and PROMs data 17 months. Mean hallux valgus and intermetatarsal angles were corrected from 45 to 24.7° and 18.7 to 7.4° respectively. There was an eight degree recurrence of hallux valgus angle. There was no wound problems, non-unions or evidence of avascular necrosis. The EQ-5D descriptive index showed a non-statistically significant improvement. All three elements of the MOxFQ score showed a statistically significant improvement: Forefoot pain (59-26.8), Walking and Stability (49.9-29.6) and Social Interaction (56.4-33.1) CONCLUSION: Triple osteotomy, without a lateral soft tissue release, leads to good radiological and functional outcomes in those with severe hallux valgus deformity. Patients need to be warned of the recovery time and potential for future metalwork removal. The risk of early recurrence suggests that a lateral release should be included in order to maintain a long lasting correction. Copyright © 2016 Elsevier Ltd. All rights reserved.

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…

Healthcare students' experiences when integrating e-learning and flipped classroom instructional approaches.

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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.

Triple pelvic osteotomy: effect on limb function and progression of degenerative joint disease

International Nuclear Information System (INIS)

Johnson, A.L.; Smith, C.W.; Pijanowski, G.J.; Hungerford, L.L.

1998-01-01

The objective of this study was to evaluate prospectively the outcome of 21 clinical patients treated with triple pelvic osteotomies during the year following surgery. Specific aims included documenting the time of and extent of improved limb function as measured by force plate analysis, evaluating the progression of degenerative joint disease (DJD) in the treated and untreated coxofemoral joints, and determining whether or not triple pelvic osteotomy resulted in degenerative joint changes in the ipsilateral stifle and hock. Twelve dogs were treated unilaterally and nine dogs were treated bilaterally with triple pelvic osteotomies. There were no differences in mean anteversion angles, angles of inclination, or preoperative DJD between treated hips and untreated hips. Degenerative joint disease progressed significantly in all hips regardless of treatment. Two cases developed hyperextension of their hocks after the triple pelvic osteotomies. However, no radiographic evidence of DJD was observed for any of the stifles or hocks at any observation time. A significant increase in vertical peak force (VPF) scores was noted for treated legs by two-to-three months after surgery, which continued over time. Untreated legs did not show a significant change in VPF scores over time. No differences were found in progression to higher scores when unilaterally treated legs, first-side treated legs, and second-side treated legs were compared

Flipping Freshman Mathematics

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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…

Evaluation of a flipped classroom approach to learning introductory epidemiology.

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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.

SURGICAL TREATMENT OF MALUNITED COLLES’ FRACTURE BY CORRECTIVE OSTEOTOMY

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Gopinath

2015-12-01

Full Text Available BACKGROUND Malunion occurs more often after Colles fracture than any other and can result in considerable disability. Multiple techniques for corrective osteotomy have been developed in recent years with objective of restoring the normal anatomy of distal end of radius and also to evaluate the results with respect to pain, restoration of function of wrist and forearm. MATERIALS AND METHODS A prospective randomized controlled study was conducted in 20 cases of malunited Colles fracture who underwent Corrective osteotomy with a Dorsal Ellis T plate and bone graft. Post operatively all patients were immobilized on a Sugar-Tong splint and followed up at 4, 6 and 12 weeks. RESULTS All measurements of Pain, final range of motion and grip strength significantly improved compared with preoperative measurements. Based on Fernandez et al scoring system we obtained Excellent results in 8 cases, Good in 7 cases, Fair in 3 cases and Poor in 2 cases which was attributed to infection in 1 case and RSD in the other case. Radiologically a mean radial length of 6.14mm (N:10mm, Radial Angle of 21.25⁰ (N:22⁰ and Volar angle of -3.4⁰ (N: +4⁰ was achieved. CONCLUSION Corrective Osteotomy with Bone graft is a preferred and an Ideal procedure if performed after Proper selection of patients i.e in young adults and extra articular malunions with good range of movements.

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

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

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

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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 "Flipped Classroom" Approach: Stimulating Positive Learning Attitudes and Improving Mastery of Histology among Medical Students

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Cheng, Xin; Ka Ho Lee, Kenneth; Chang, Eric Y.; Yang, Xuesong

2017-01-01

Traditional medical education methodologies have been dramatically impacted by the introduction of new teaching approaches over the past few decades. In particular, the "flipped classroom" format has drawn a great deal of attention. However, evidence regarding the effectiveness of the flipped model remains limited due to a lack of…

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

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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

A guiding oblique osteotomy cut to prevent bad split in sagittal split ramus osteotomy: a technical note

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Gururaj Arakeri

2015-06-01

Full Text Available Aim: To present a simple technical modification of a medial osteotomy cut which prevents its misdirection and overcomes various anatomical variations as well as technical problems. Methods: The medial osteotomy cut is modified in the posterior half at an angle of 15°-20° following novel landmarks. Results: The proposed cut exclusively directs the splitting forces downwards to create a favorable lingual fracture, preventing the possibility of an upwards split which would cause a coronoid or condylar fracture. Conclusion: This modification has proven to be successful to date without encountering the complications of a bad split or nerve damage.

Flipped classrooms and student learning: not just surface gains.

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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.

Use of the Flipped Classroom Instructional Model in Higher Education: Instructors' Perspectives

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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…

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

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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…

Boomerang proximal tibial osteotomy for the treatment of severe varus gonarthrosis.

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Sangkaew, Chanchit; Piyapittayanun, Peerapong

2013-06-01

The purpose of the study was to review the results of modified infratubercle displacement osteotomy in patients with severe varus gonarthrosis and to determine the factors influencing outcomes. A total of 177 knees in 133 patients with severe varus gonarthrosis were treated with infratubercle boomerang-shaped osteotomy, stabilised with dual plates. The mean age of the patients was 63.8 years (range 43-80 years), and the mean follow-up period was 61.4 months (range 24 -139 months). The factors associated with clinical and survival outcomes were analysed including age, gender, body mass index (BMI), preoperative and post-operative femorotibial angle and femorotibial angle at one year after surgery. Using the Knee Society clinical rating system 149 knees or 84.2 % were rated as having good to excellent results and 21 knees or 15.8 % as having fair to poor results. Overall, the mean preoperative knee score of 33.6 points had improved significantly to 80.7 points at the final follow-up (p boomerang osteotomy can create adequate valgus alignment in severe varus gonarthrosis. The one-year post-operative knee alignment of 11° valgus provided the most satisfactory results and that between six and 15° valgus the longest survival time.

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

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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…

[Z-osteotomy of distal fibula to correct widened ankle mortice after fracture].

Science.gov (United States)

Tao, Xu; Tang, Kanglai; Zhou, Jianbo

2012-07-01

To analyse the clinical outcomes of the Z-osteotomy of the distal fibula to correct widened mortice of the ankle after fracture. Between September 2009 and February 2011, 5 patients (5 feet) with widened ankle mortice after fracture underwent Z-osteotomy. There were 4 males and 1 female, aged from 23 to 58 years (mean, 38 years). At 3 months after operation of internal fixation when function exercises were done, patients got pains. The interval between trauma and operation ranged from 5 to 36 months (mean, 13.2 months). Lateral pressure test showed positive in 2 cases and negative in 3 cases. American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 50.2 +/- 17.3. Primary healing of incision was achieved in all cases. Five patients were followed up 9 to 24 months (mean, 15.6 months). Mild to moderate swelling of the affected limb and anterolateral skin numbness of the ipsilateral dorsal foot occurred, and gradually improved. The clinical exam and radiology showed bone union at 12-15 weeks (mean, 13.5 weeks). Postoperative range of motion of ankle had no significant improvement. AOFAS ankle-hindfoot scores were 76.8 +/- 11.2 at 6 months after operation, and 85.4 +/- 3.2 at last follow-up, showing significant differences when compared with preoperative score (P ankle mortice after fracture; Z-osteotomy can effectively reduce the width of the ankle mortice, increase the stability of ankle joint, and decrease the complication rate.

Intra-Articular Osteotomy for Distal Humerus Malunion

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René K. Marti

2009-01-01

Full Text Available Intra-articular osteotomy is considered in the rare case of malunion after a fracture of the distal humerus to restore humeral alignment and gain a functional arc of elbow motion. Traumatic and iatrogenic disruption of the limited blood flow to the distal end of the humerus resulting in avascular necrosis of capitellum or trochlea is a major pitfall of the this technically challenging procedure. Two cases are presented which illustrate the potential problems of intra-articular osteotomy for malunion of the distal humerus.

Proximal Opening Wedge Osteotomy Provides Satisfactory Midterm Results With a Low Complication Rate.

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Oravakangas, Rami; Leppilahti, Juhana; Laine, Vesa; Niinimäki, Tuukka

2016-01-01

Hallux valgus is one of the most common foot deformities. Proximal opening wedge osteotomy is used for the treatment of moderate and severe hallux valgus with metatarsus primus varus. However, hypermobility of the first tarsometatarsal joint can compromise the results of the operation, and a paucity of midterm results are available regarding proximal open wedge osteotomy surgery. The aim of the present study was to assess the midterm results of proximal open wedge osteotomy in a consecutive series of patients with severe hallux valgus. Thirty-one consecutive adult patients (35 feet) with severe hallux valgus underwent proximal open wedge osteotomy. Twenty patients (35.5%) and 23 feet (34.3%) were available for the final follow-up examination. The mean follow-up duration was 5.8 (range 4.6 to 7.0) years. The radiologic measurements and American Orthopaedic Foot and Ankle Society hallux-metatarsophalangeal-interphalangeal scores were recorded pre- and postoperatively, and subjective questionnaires were completed and foot scan analyses performed at the end of the follow-up period. The mean hallux valgus angle decreased from 38° to 23°, and the mean intermetatarsal angle correction decreased from 17° to 10°. The mean improvement in the American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal-interphalangeal score increased from 52 to 84. Two feet (5.7%) required repeat surgery because of recurrent hallux valgus. No nonunions were identified. Proximal open wedge osteotomy provided satisfactory midterm results in the treatment of severe hallux valgus, with a low complication rate. The potential instability of the first tarsometatarsal joint does not seem to jeopardize the midterm results of the operation. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Improvements from a flipped classroom may simply be the fruits of active learning.

Science.gov (United States)

Jensen, Jamie L; Kummer, Tyler A; d M Godoy, Patricia D

2015-03-02

The "flipped classroom" is a learning model in which content attainment is shifted forward to outside of class, then followed by instructor-facilitated concept application activities in class. Current studies on the flipped model are limited. Our goal was to provide quantitative and controlled data about the effectiveness of this model. Using a quasi-experimental design, we compared an active nonflipped classroom with an active flipped classroom, both using the 5-E learning cycle, in an effort to vary only the role of the instructor and control for as many of the other potentially influential variables as possible. Results showed that both low-level and deep conceptual learning were equivalent between the conditions. Attitudinal data revealed equal student satisfaction with the course. Interestingly, both treatments ranked their contact time with the instructor as more influential to their learning than what they did at home. We conclude that the flipped classroom does not result in higher learning gains or better attitudes compared with the nonflipped classroom when both utilize an active-learning, constructivist approach and propose that learning gains in either condition are most likely a result of the active-learning style of instruction rather than the order in which the instructor participated in the learning process. © 2015 J. L. Jensen et al. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Postoperative dysesthesia in lumbar three-column resection osteotomies.

Science.gov (United States)

Zhang, Zhengfeng; Wang, Honggang; Zheng, Wenjie

2016-08-01

Three-column lumbar spinal resection osteotomies including pedicle subtraction osteotomy (PSO), vertebral column resection (VCR), and total en bloc spondylectomy (TES) can potentially lead to dorsal root ganglion (DRG) injury which may cause postoperative dysesthesia (POD). The purpose of retrospective study was to describe the uncommon complication of POD in lumbar spinal resection osteotomies. Between January 2009 and December 2013, 64 patients were treated with lumbar three-column spinal resection osteotomies (PSO, n = 31; VCR, n = 29; TES, n = 4) in investigator group. POD was defined as dysesthetic pain or burning dysesthesia at a proper DRG innervated region, whether spontaneous or evoked. Non-steroidal antiinflammatory drugs, central none-opioid analgesic agent, neuropathic pain drugs and/or intervertebral foramen block were selectively used to treat POD. There were 5 cases of POD (5/64, 7.8 %), which consisted of 1 patient in PSO (1/31, 3.2 %), 3 patients in PVCR (3/29, 10.3 %), and 1 patient in TES (1/4, 25 %). After the treatment by drugs administration plus DRG block, all patients presented pain relief with duration from 8 to 38 days. A gradual pain moving to distal end of a proper DRG innervated region was found as the beginning of end. Although POD is a unique and rare complication and maybe misdiagnosed as nerve root injury in lumbar spinal resection osteotomies, combination drug therapy and DRG block have an effective result of pain relief. The appearance of a gradual pain moving to distal end of a proper DRG innervated region during recovering may be used as a sign for the good prognosis.

Midterm outcome after correction of hallux valgus deformity using scarf osteotomy in adult population

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Laura Ibrahim Alolayan

2017-01-01

Full Text Available Context: Determining the efficacy of any surgical treatment is the key to achieve better practice and best outcomes for patients. Aims: This study is designed to address midterm outcome in adult patients with moderate-to-severe hallux valgus (HV, who underwent scarf osteotomy from 2012 to 2014. Settings and Design: This is a retrospective cohort study in which charts of all adult patients with moderate-to-severe HV who underwent scarf osteotomy from 2011 to 2014 were reviewed. Subjects and Methods: Between 2011 and 2014, 39 patients (41 feet who underwent scarf osteotomy for correction of HV deformity were retrospectively evaluated. Standard weight-bearing dorsoplantar radiographs were obtained pre- and postoperatively. HV angle (HVA, intermetatarsal angle (IMA and distal metatarsal articular angles (DMAA were measured pre- and postoperatively to evaluate the efficacy of the surgery. The complication rate was reported. The average follow-up was 13.5 months, and the patients' mean age was 37 years. Statistical Analysis Used: Data were compared using Chi-square test or Fisher's exact test whichever was appropriate. All tests were two-sided, and a P> 0.01 was considered statistically significant. Results: The average preoperative HVA and IMA were 32° and 14.3°, which improved to 11° and 7.9°, respectively. The changes were statistically significant (P 0.18. Conclusions: This study suggests that scarf osteotomy surgery is a very versatile osteotomy in correcting moderate-to-severe HV deformity. It offers a greater degree of correction and stability, lower rate of complications and good outcome. However, long-term follow-up studies are still needed.

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)

A modified Austin/chevron osteotomy for treatment of hallux valgus and hallux rigidus.

Science.gov (United States)

Vasso, Michele; Del Regno, Chiara; D'Amelio, Antonio; Schiavone Panni, Alfredo

2016-03-01

The purpose of this brief paper is to present the preliminary results of a modified Austin/chevron osteotomy for treatment of hallux valgus and hallux rigidus. In this procedure, the dorsal arm of the osteotomy is performed orthogonal to the horizontal plane of the first metatarsal, the main advantage being that this allows much easier and more accurate multiplanar correction of first metatarsal deformities. From 2010 to 2013, 184 consecutive patients with symptomatic hallux valgus and 48 patients with hallux rigidus without severe metatarsophalangeal joint degeneration underwent such modified chevron osteotomy. Mean patient age was 54.9 (range 21-70) years, and mean follow-up duration was 41.7 (range 24-56) months. Ninety-three percent of patients were satisfied with the surgery. Mean American Orthopaedic Foot and Ankle Society (AOFAS) score improved from 56.6 preoperatively to 90.6 at last follow-up, and mean visual analog scale (VAS) pain score decreased from 5.7 preoperatively to 1.6 at final follow-up (p hallux valgus, mean hallux valgus angle decreased from 34.1° preoperatively to 6.2° at final follow-up, and mean intermetatarsal angle decreased from 18.5° preoperatively to 4.1° at final follow-up (p < 0.05). One patient developed postoperative transfer metatarsalgia, treated successfully with second-time percutaneous osteotomy of the minor metatarsals, whilst one patient had wound infection that resolved with systemic antibiotics. Level IV.

A Learning Analytics Approach to Investigating Factors Affecting EFL Students' Oral Performance in a Flipped Classroom

Science.gov (United States)

Lin, Chi-Jen; Hwang, Gwo-Jen

2018-01-01

Flipped classrooms have been widely adopted and discussed by school teachers and researchers in the past decade. However, few studies have been conducted to formally evaluate the effectiveness of flipped classrooms in terms of improving EFL students' English oral presentation, not to mention investigating factors affecting their flipped learning…

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.

Alphabet Soup: Sagittal Balance Correction Osteotomies of the Spine-What Radiologists Should Know.

Science.gov (United States)

Takahashi, T; Kainth, D; Marette, S; Polly, D

2018-04-01

Global sagittal malalignment has been demonstrated to have correlation with clinical symptoms and is a key component to be restored in adult spinal deformity. In this article, various types of sagittal balance-correction osteotomies are reviewed primarily on the basis of the 3 most commonly used procedures: Smith-Petersen osteotomy, pedicle subtraction osteotomy, and vertebral column resection. Familiarity with the expected imaging appearance and commonly encountered complications seen on postoperative imaging studies following correction osteotomies is crucial for accurate image interpretation. © 2018 by American Journal of Neuroradiology.

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…

Piezosurgery versus conventional osteotomy in orthognathic surgery: a paradigm shift in treatment.

Science.gov (United States)

Bertossi, Dario; Lucchese, Alessandra; Albanese, Massimo; Turra, Matteo; Faccioni, Fiorenzo; Nocini, Pierfrancesco; Rodriguez Y Baena, Ruggero

2013-01-01

The aim of the study was to compare in a randomized controlled clinical trial the use of the piezoelectric osteotomy as an alternative to the conventional approach in terms of surgery time, intraoperative blood loss, cut quality, nerve injury, and costs.One hundred ten patients who had orthognathic surgery procedures with bimaxillary osteotomy were divided into 2 groups: group A was treated with a piezosurgery device, and group B, with a reciprocating saw and bur.The piezosurgical bone osteotomy permitted individualized cut designs. The surgical time in group A was reduced, with a mean for the mandibular osteotomy (1 side) between 3 minutes 31 seconds and 5 minutes 2 seconds, whereas in group B, the surgical time was between 7 minutes 23 seconds and 10 minutes 22 seconds. The surgical time in group A for the Le Fort I osteotomy was between 5 minutes 17 seconds and 7 minutes 55 seconds in group A and between 8 minutes 38 seconds and 15 minutes 11 seconds in group B. All patients in group A had a low blood loss (500 mL). Inferior alveolar nerve sensation was retained in 98.2% of group A versus 92.7% in group B at 6 months postoperative testing.Piezoelectric osteotomy reduced surgical time, blood loss, and inferior alveolar nerve injury in bimaxillary osteotomy. Absence of macrovibrations makes the instrument more manageable and easy to use and allows greater intraoperative control with higher safety in cutting in difficult anatomical regions.

Neck osteotomy for malunion of neglected radial neck fractures in children: a report of 2 cases.

Science.gov (United States)

Ceroni, Dimitri; Campos, José; Dahl-Farhoumand, Agnes; Holveck, Jérôme; Kaelin, André

2010-01-01

Radial neck fractures are a common injury in children as a result of a fall on an extended and supinated outstretched hand. We present 2 cases of osteotomy of the neck of the radius performed in 2 children with neglected radial neck fractures. Preoperatively, both patients complained of pain and severely reduced mobility of the elbow. Surgery was performed at 6 weeks and 3 months, respectively, after the initial injury and the 2 children were reviewed at 6 and 16 months follow-up. Osteotomies healed within the usual time and no avascular necrosis of the radial head, proximal radioulnar synostosis, or myositis ossificans were observed. The Mayo Elbow Performance Index Score improved significantly after the operation with the 2 patients rated as excellent. In this small series, we present a novel technique of proximal osteotomy of the radius to correct this deformity in children. Case series, level IV evidence.

The history, evolution and basic science of osteotomy techniques

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John Dabis

2017-10-01

Full Text Available Abstract Osteotomy techniques date back to Hippocrates circa 415 BC (Jones Hippocrates collected works I, Harvard University Press, Cambridge, 2006; Brorson in Clin Orthop Relat Res 467(7:1907–1914, 2009. There is debate about the best way to divide the bone surgically and which technique yields the best bone regenerate in lengthening; ensuring predictable new bone formation and healing of the osteotomy are the primary goals. We review the history and techniques of the osteotomy and consider the evidence for optimum bone formation. Methods discussed include variants of the ‘drill and osteotome’ technique, use of the Gigli saw and use of a power saw. Differences in bone formation through the different techniques are covered.

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...

Students' perceptions of the flipped classroom model in an engineering course: a case study

Science.gov (United States)

Baytiyeh, Hoda; Naja, Mohamad K.

2017-11-01

The flipped classroom model is an innovative educational trend that has been widely adopted in the social sciences but not engineering education. In this model, an active instructional approach shifts the educational strategy from a teacher- to a student-centred approach. The purpose of this study is to compare the learning outcomes of engineering students attending a flipped-model section of the Dynamics of Structures course with students attending a traditional, lecture-based section of the same course taught by the same instructor. The results confirm previous research showing that test scores in the flipped course sections were slightly higher than traditional sections. Although the improvement in test scores was statistically insignificant, student statements indicated that the flipped model promoted a deeper, broader perspective on learning, facilitated problem-solving strategies and improved critical-thinking abilities, self-confidence and teamwork skills, which are needed for a successful engineering career.

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.

Endoscopic-assisted osteotomies for the treatment of craniosynostosis.

Science.gov (United States)

Hinojosa, J; Esparza, J; Muñoz, M J

2007-12-01

The development of multidisciplinar units for Craniofacial Surgery has led to better postoperative results and a considerable decrease in morbidity in the treatment of complex craniofacial patients. Standard correction of craniosynostosis involves calvarial remodeling, often considerable blood losses that need to be replaced and lengthy hospital stay. The use of minimally invasive techniques for the correction of some of these malformations are widespread and allows the surgeon to minimize the incidence of complications by means of a decreased surgical time, blood salvage, and shortening of postoperative hospitalization in comparison to conventional craniofacial techniques. Simple and milder craniosynostosis are best approached by endoscopy-assisted osteotomies and render the best results. Extended procedures other than simple suturectomies have been described for more severe patients. Different osteotomies resembling standard fronto-orbital have been developed for the correction, and the use of postoperative cranial orthesis may improve the final cosmetic appearance. Thus, endoscopic-assisted procedures differ from the simple strategy of single suture resection that rendered insufficient results in the past, and different approaches can be tailored to solve these cases in patients in the setting of a case-to-case bases.

A minimally invasive technique using a modified stoppa approach for periacetabular osteotomy: A preliminary cadaveric study

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Turgut Akgul

2017-01-01

Full Text Available Background: Developmental hip dysplasia is diagnosed when the femoral head is not sufficiently covered by the acetabulum. Anterior and lateral cover deficiency is seen, as a result a dysplastic hip joint. Various incision modifications have been developed because of the muscle dissection and wide wound scar in Smith-Peterson incision, which was originally used in Bernese osteotomy. This study evaluates applicability of the modified Stoppa approach in the performance of Bernese periacetabular osteotomy (PAO. Materials and Methods: Ten hemipelvises of five donor cadavers were used. The transverse Stoppa incision was made 2 cm over the symphysis pubis for quadrilateral surface exposure and pubic and ischial bone osteotomies. The second skin incision, a few centimeters lateral to the original incision, was made along the tensor fascia lata. Iliac bone osteotomy was performed starting just above the rectus femoris insertion. The displacement of the osteotomy was measured clinically and radiographically. Results: The mean anterior coverage calculated with center-edge angle was improved from 22.8° ±2.8 (range 20° min–28° max preoperatively to 44.1° ± 3.7 (range 36° min–48° max. The displacement of the osteotomy at the iliopectineal line calculated on the iliac inlet view radiographs was 22.1 ± 3.4 mm (range 15 mm min–26 mm max. The clinical amount of the anterior displacement on the cadavers was 17.8 ± 3.35 mm (range 11 mm–21 mm and lateral displacement was 20.3 ± 3.23 mm (range 15 mm–24 mm. The amount of the posterior intact bone enlargement at the quadrilateral surface was 5.3 ± 0.48 mm. Conclusion: This less traumatic two-incision exposure is an adequate technique for Bernese PAO, allowing the bone to be cut under direct visual observation and reducing the need to use fluoroscopy.

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

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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.

A new algorithm for finite element simulation of wedge osteotomies in voxel models with application to the tibia

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Thomas Pressel

2010-01-01

Full Text Available Thomas Pressel1, Markus D Schofer1, Jörg Meiforth2, Markus Lengsfeld1, Jan Schmitt11Department of Orthopaedics and Rheumatology, University Hospital Marburg, Marburg, Germany; 2St. Vincentius Kliniken, Klinik für Orthopädie, Karlsruhe, GermanyAbstract: Wedge osteotomies are used to correct bone deformities or change the forces acting on bones and joints in the human body. Finite element models can be employed to simulate the effect of such operations on the bone or adjacent joints. The automatic generation of voxel models derived from computed tomography data is a common procedure, but the major drawback of the method lies in irregular model surfaces. Therefore, the concept of hybrid models combining voxel and tetrahedron meshes was developed. We present an algorithm to simulate wedge osteotomies in voxel models by adding tetrahedron to brick elements. Applicability of the procedure was tested by performing a parametric study using a tibia model created from computed tomography scans taken in vivo applying individually calculated force conditions. The osteotomy angle largely affected maximum stresses: at 2.5 degrees valgus, the stresses at the medial and lateral tibial plateau were equivalent, while increasing valgus angles reduced medial stresses. The algorithm described here is an improvement of former mesh generation procedures and allows a better representation of the geometry at the osteotomy level. The algorithm can be used for all wedge osteotomies and is not limited to the tibia.Keywords: finite element/osteotomy/voxel/pre-operative planning, simulation, mesh algorithm

Open wedge high tibial osteotomy using three-dimensional printed models: Experimental analysis using porcine bone.

Science.gov (United States)

Kwun, Jun-Dae; Kim, Hee-June; Park, Jaeyoung; Park, Il-Hyung; Kyung, Hee-Soo

2017-01-01

The purpose of this study was to evaluate the usefulness of three-dimensional (3D) printed models for open wedge high tibial osteotomy (HTO) in porcine bone. Computed tomography (CT) images were obtained from 10 porcine knees and 3D imaging was planned using the 3D-Slicer program. The osteotomy line was drawn from the three centimeters below the medial tibial plateau to the proximal end of the fibular head. Then the osteotomy gap was opened until the mechanical axis line was 62.5% from the medial border along the width of the tibial plateau, maintaining the posterior tibial slope angle. The wedge-shaped 3D-printed model was designed with the measured angle and osteotomy section and was produced by the 3D printer. The open wedge HTO surgery was reproduced in porcine bone using the 3D-printed model and the osteotomy site was fixed with a plate. Accuracy of osteotomy and posterior tibial slope was evaluated after the osteotomy. The mean mechanical axis line on the tibial plateau was 61.8±1.5% from the medial tibia. There was no statistically significant difference (P=0.160). The planned and post-osteotomy correction wedge angles were 11.5±3.2° and 11.4±3.3°, and the posterior tibial slope angle was 11.2±2.2° pre-osteotomy and 11.4±2.5° post-osteotomy. There were no significant differences (P=0.854 and P=0.429, respectively). This study showed that good results could be obtained in high tibial osteotomy by using 3D printed models of porcine legs. Copyright © 2016 Elsevier B.V. All rights reserved.

Modified french osteotomy for cubitus varus deformity

International Nuclear Information System (INIS)

Ahmad, I.; Idrees, M.

2007-01-01

To evaluate the outcome of Modified French Osteotomy for correction of cubitus varus deformity. All children, aged 3-12 years, with cubitus varus deformity were included in the study. Pre-operative clinical as well as radiological assessment of upper extremities were done in all cases. Modified French osteotomy was done to correct the deformity. All patients were followed for seven months. Physical examination for the range of motion, scar and post-operative complications were assessed. Antero-posterior and lateral radiographs of the elbow were obtained, and the carrying angles and lateral condylar prominence index were measured and recorded. Out of the total 30 patients, 26 were male and four female. Left side was involved in 24 cases and the right side in six. The average age at the time of osteotomy was seven years (range 3.5-12 years). The average pre-operative carrying angle was 25.2 degree (range 18-30 degree) and the post-operative angle 8.7 degree (range 5-13 degree valgus). The average pre- operative range of motion was 122.6 degree (range 105-135 degree) and the post-operative range 123.86 degree (range 90-135 degree). The average pre-operative lateral condylar prominence index (LCPI) was 175.56 (range 128-232) and the post-operative lateral condylar prominence 156 (range 100-240). Based on Bellmore criteria, 25 patients showed excellent, three good and two a poor result. Modified French technique of supracondylar osteotomy has excellent results in the management of cubitus varus in terms of cosmesis, radiological findings and fewer complications. (author)

The effects of Mandibular Osteotomy on articulation and resonance

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Delsa Geffen

1978-11-01

Full Text Available Pre- and post-operative speech samples were studied in nine adult cases who received Mandibular Osteotomy. Lateral cephalograms were taken during sustained production of selected sounds and trained listeners judged recordings. In most cases there was an improvement in the general quality of the speech. Considering that the functional  relationships between the speech organs had altered, it would appear that some form of adaptation by the speaker had in fact taken place.

Multiple Osteochondral Allograft Transplantation with Concomitant Tibial Tubercle Osteotomy for Multifocal Chondral Disease of the Knee.

Science.gov (United States)

Cotter, Eric J; Waterman, Brian R; Kelly, Mick P; Wang, Kevin C; Frank, Rachel M; Cole, Brian J

2017-08-01

Symptomatic patellofemoral chondral lesions are a challenging clinical entity, as these defects may result from persistent lateral patellar maltracking or repetitive microtrauma. Anteromedializing tibial tubercle osteotomy has been shown to be an effective strategy for primary and adjunctive treatment of focal or diffuse patellofemoral disease to improve the biomechanical loading environment. Similarly, osteochondral allograft transplantation has proven efficacy in physiologically young, high-demand patients with condylar or patellofemoral lesions, particularly without early arthritic progression. The authors present the surgical management of a young athlete with symptomatic tricompartmental focal chondral defects with fresh osteochondral allograft transplantation and anteromedializing tibial tubercle osteotomy.

Early weight bearing versus delayed weight bearing in medial opening wedge high tibial osteotomy: a randomized controlled trial.

Science.gov (United States)

Lansdaal, Joris Radboud; Mouton, Tanguy; Wascher, Daniel Charles; Demey, Guillaume; Lustig, Sebastien; Neyret, Philippe; Servien, Elvire

2017-12-01

The need for a period of non-weight bearing after medial opening wedge high tibial osteotomy remains controversial. It is hypothesized that immediate weight bearing after medial opening wedge high tibial osteotomy would have no difference in functional scores at one year compared to delayed weight bearing. Fifty patients, median age 54 years (range 40-65), with medial compartment osteoarthritis, underwent a medial opening wedge high tibial osteotomy utilizing a locking plate without bone grafting. Patients were randomized into an Immediate or a Delayed (2 months) weight bearing group. All patients were assessed at one-year follow-up and the two groups compared. The primary outcome measure was the IKS score. Secondary outcome measures included the IKDC score, the VAS pain score and rate of complications. The functional scores significantly improved in both groups. The IKS score increased from 142 ± 31 to 171 ± 26 in the Immediate group (p bearing after medial opening wedge high tibial osteotomy had no effect on functional scores at 1 year follow-up and did not significantly increase the complication rate. Immediate weight bearing after medial opening wedge high tibial osteotomy appears to be safe and can allow some patients a quicker return to activities of daily living and a decreased convalescence period. II.

Minimally invasive distal first metatarsal osteotomy can be an option for recurrent hallux valgus.

Science.gov (United States)

Magnan, Bruno; Negri, Stefano; Maluta, Tommaso; Dall'Oca, Carlo; Samaila, Elena

2018-01-12

Recurrence rate of surgical treatment of hallux valgus ranges in the literature from 2.7% to 16%, regardless of used procedure. In this study, long-term results of a minimally invasive distal osteotomy of the first metatarsal bone for treatment of recurrent hallux valgus are described. 32 consecutive percutaneous distal osteotomies of the first metatarsal were performed in 26 patients for treatment of recurrent hallux valgus. Primary surgery had been soft tissue procedures in 8 cases (25%), first metatarsal or phalangeal osteotomies in 19 cases (59.4%) and Keller procedures in 5 cases (15.6%). Patients were assessed with a mean follow-up of 9.8±4.3 years. All patients reported the disappearance or reduction of the pain. The mean overall AOFAS score improved from 46.9±17.8 points to 85.2±14.9 at final follow-up. The mean hallux valgus angle decreased from 26.1±9.1 to 9.7±5.4°, the intermetatarsal angle decreased from 11.5±4.5 to 6.7±4.0°. No major complications were recorded with a re-recurrence rate of 3.1% (1 case). Percutaneous distal osteotomy of the first metatarsal can be a reliable and safe surgical option in the recurrent hallux valgus with low complication rate and the advantages of a minimally invasive surgery. IV, Retrospective Case Series. Copyright © 2018 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Clinical Comparison of Sinus Lift via Summers Osteotomy and Piezosurgery

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Mehrdad Radvar

2017-12-01

Full Text Available Introduction: Sinus lift is a process that could be performed by two methods. In the closed sinus lift, hybrid materials enter a suitable position through a created cavity. Afterwards, the materials are pressed without damaging the sinus membrane, and the implants are usually placed at the same time. Closed sinus lift is carried out via osteotomy and piezosurgery, and each of the techniques has certain advantages and limitations. The present study aimed to compare the clinical results of closed sinus lift using the summers osteotomy and piezosurgery. Materials and Methods: In this study, 20 patients requiring dental implants in the posterior segment of the maxilla via sinus lift surgery were randomly divided into two groups. The first group received piezosurgery, and the second group underwent summers osteotomy for sinus lift. Postoperative Schneiderian membrane perforation, inflammation, pain, bone gain, and bone loss were compared between the groups six months after the surgery using Mann-Whitney U test and two-sample t-test. Results: In the groups receiving piezosurgery and summers osteotomy, mean sinus lift was 3.6±0.9 and 4.0±2.2 mm, pain score was 1.1±1.2 and 0.9±0.8, bone gain was 2.2±0.8 and 3.1±1.3 mm, and crestal bone loss was 1.1±1.2 and 0.9±0.8 mm, respectively. Moreover, no Schneiderian membrane perforation was observed in the two methods, and the differences between the groups were not considered significant (P>0.05. Conclusion: According to the results, the clinical outcomes of piezosurgery in sinus lift are similar to those of summers osteotomy. Therefore, piezosurgery could be a proper alternative to summers osteotomy in sinus lift surgery.

Evaluation of Hallux Valgus Correction With Versus Without Akin Proximal Phalanx Osteotomy.

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Shibuya, Naohiro; Thorud, Jakob C; Martin, Lanster R; Plemmons, Britton S; Jupiter, Daniel C

2016-01-01

Although the efficacy of Akin proximal phalanx closing wedge osteotomy as a sole procedure for correction of hallux valgus deformity is questionable, when used in combination with other osseous corrective procedures, the procedure has been believed to be efficacious. However, a limited number of comparative studies have confirmed the value of this additional procedure. We identified patients who had undergone osseous hallux valgus correction with first metatarsal osteotomy or first tarsometatarsal joint arthrodesis with (n = 73) and without (n = 81) Akin osteotomy and evaluated their radiographic measurements at 3 points (preoperatively, within 3 months after surgery, and ≥6 months after surgery). We found that those people who had undergone the Akin procedure tended to have a larger hallux abduction angle and a more laterally deviated tibial sesamoid position preoperatively. Although the radiographic correction of the deformity was promising immediately after corrective surgery with the Akin osteotomy, maintenance of the correction was questionable in our cohort. The value of additional Akin osteotomy for correction of hallux valgus deformity is uncertain. Published by Elsevier Inc.

The flipped classroom: A learning model to increase student engagement not academic achievement

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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.

Equivalent correction in scarf and chevron osteotomy in moderate and severe hallux valgus: a randomized controlled trial.

NARCIS (Netherlands)

Deenik, A.; Mameren, H. van; Visser, E. de; Waal Malefijt, M.C. de; Draijer, F.; Bie, R. de

2008-01-01

BACKGROUND: Chevron osteotomy is a widely accepted osteotomy for correction of hallux valgus.(18) Algorithms were developed to overcome the limitations of distal osteotomies. Scarf osteotomy has become popular as a versatile procedure that should be able to correct most cases of acquired hallux

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...

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…

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.

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.

Inicial nasal mucosa detachment using piezoelectric device in the Le Fort I osteotomy: A technical note

OpenAIRE

Shinohara, Elio Hitoshi; Kaba, Shajadi Carlos Pardo; Ruiz, Marcelo Martinson; Horikawa, Fernando Kendi

2013-01-01

In maxillary Le Fort I type osteotomy the detachment of the nasal mucosa should be done carefully. Piezoelectric surgery contributed much to increase the safety of osteotomies, despite the initial advantage of minimizing the risk of injury in nervous tissue, mainly in bilateral sagittal split osteotomy; we use the piezoelectric device for the initial detachment of the nasal mucosa in the maxillary osteotomy.

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

Science.gov (United States)

Gillispie, Veronica

2016-01-01

classroom-based instruction. The flipped classroom group consisted of students from Rotation 2 and Rotation 3 of the 2015 academic year who received formal didactics via voice-over presentation and had the weekly problem-based learning sessions. When comparing the students taught by traditional methods to those taught in the flipped classroom model, we saw a statistically significant increase in test scores on the multiple-choice question examination in both the obstetrics and gynecology sections in Rotation 2. While the average score for the flipped classroom group increased in Rotation 3 on the obstetrics section of the multiple-choice question examination, the difference was not statistically significant. Unexpectedly, the average score on the gynecology portion of the multiple-choice question examination decreased among the flipped classroom group compared to the traditional teaching group, and this decrease was statistically significant. For both the obstetrics and the gynecology portions of the OSCE, we saw statistically significant increases in the scores for the flipped classroom group in both Rotation 2 and Rotation 3 compared to the traditional teaching group. With the exception of the gynecology portion of the multiple-choice question examination in Rotation 3, we saw improvement in scores after the implementation of the flipped classroom. The flipped classroom is a feasible and useful alternative to the traditional classroom. It is a method that embraces Generation Y's need for active learning in a group setting while maintaining a traditional classroom method for introducing the information. Active learning increases student engagement and can lead to improved retention of material as demonstrated on standard examinations.

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)

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.

Inicial nasal mucosa detachment using piezoelectric device in the Le Fort I osteotomy: A technical note

Science.gov (United States)

Shinohara, Elio Hitoshi; Kaba, Shajadi Carlos Pardo; Ruiz, Marcelo Martinson; Horikawa, Fernando Kendi

2013-01-01

In maxillary Le Fort I type osteotomy the detachment of the nasal mucosa should be done carefully. Piezoelectric surgery contributed much to increase the safety of osteotomies, despite the initial advantage of minimizing the risk of injury in nervous tissue, mainly in bilateral sagittal split osteotomy; we use the piezoelectric device for the initial detachment of the nasal mucosa in the maxillary osteotomy. PMID:23853472

Inicial nasal mucosa detachment using piezoelectric device in the Le Fort I osteotomy: A technical note

Directory of Open Access Journals (Sweden)

Elio Hitoshi Shinohara

2013-01-01

Full Text Available In maxillary Le Fort I type osteotomy the detachment of the nasal mucosa should be done carefully. Piezoelectric surgery contributed much to increase the safety of osteotomies, despite the initial advantage of minimizing the risk of injury in nervous tissue, mainly in bilateral sagittal split osteotomy; we use the piezoelectric device for the initial detachment of the nasal mucosa in the maxillary osteotomy.

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.

The "Flipped Classroom" Model for Teaching in the Intensive Care Unit.

Science.gov (United States)

Tainter, Christopher R; Wong, Nelson L; Cudemus-Deseda, Gaston A; Bittner, Edward A

2017-03-01

The intensive care unit (ICU) is a dynamic and complex learning environment. The wide range in trainee's experience, specialty training, fluctuations in patient acuity and volume, limitations in trainee duty hours, and additional responsibilities of the faculty contribute to the challenge in providing a consistent experience with traditional educational strategies. The "flipped classroom" is an educational model with the potential to improve the learning environment. In this paradigm, students gain exposure to new material outside class and then use class time to assimilate the knowledge through problem-solving exercises or discussion. The rationale and pedagogical foundations for the flipped classroom are reviewed, practical considerations are discussed, and an example of successful implementation is provided. An education curriculum was devised and evaluated prospectively for teaching point-of-care echocardiography to residents rotating in the surgical ICU. Preintervention and postintervention scores of knowledge, confidence, perceived usefulness, and likelihood of use the skills improved for each module. The quality of the experience was rated highly for each of the sessions. The flipped classroom education curriculum has many advantages. This pilot study was well received, and learners showed improvement in all areas evaluated, across several demographic subgroups and self-identified learning styles.

Planning for corrective osteotomy of the femoral bone using 3D-modeling. Part I

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Alexey G Baindurashvili

2016-09-01

Full Text Available Introduction. In standard planning for corrective hip osteotomy, a surgical intervention scheme is created on a uniplanar paper medium on the basis of X-ray images. However, uniplanar skiagrams are unable to render real spatial configuration of the femoral bone. When combining three-dimensional and uniplanar models of bone, human errors inevitably occur, causing the distortion of preset parameters, which may lead to glaring errors and, as a result, to repeated operations. Aims. To develop a new three-dimensional method for planning and performing corrective osteotomy of the femoral bone, using visualizing computer technologies. Materials and methods. A new method of planning for corrective hip osteotomy in children with various hip joint pathologies was developed. We examined the method using 27 patients [aged 5–18 years (32 hip joints] with congenital and acquired femoral bone deformation. The efficiency of the proposed method was assessed in comparison with uniplanar planning using roentgenograms. Conclusions. Computerized operation planning using three-dimensional modeling improves treatment results by minimizing the likelihood of human errors and increasing planning and surgical intervention  accuracy.

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.

Why No Difference? A Controlled Flipped Classroom Study for an Introductory Differential Equations Course

Science.gov (United States)

Yong, Darryl; Levy, Rachel; Lape, Nancy

2015-01-01

Flipped classrooms have the potential to improve student learning and metacognitive skills as a result of increased time for active learning and group work and student control over pacing, when compared with traditional lecture-based courses. We are currently running a 4-year controlled study to examine the impact of flipping an Introductory…

Changes in ankle joint motion after Supramalleolar osteotomy: a cadaveric model.

Science.gov (United States)

Kim, Hak Jun; Yeo, Eui Dong; Rhyu, Im Joo; Lee, Soon-Hyuck; Lee, Yeon Soo; Lee, Young Koo

2017-09-09

Malalignment of the ankle joint has been found after trauma, by neurological disorders, genetic predisposition and other unidentified factors, and results in asymmetrical joint loading. For a medial open wedge supramalleolar osteotomy(SMO), there are some debates as to whether concurrent fibular osteotomy should be performed. We assessed the changes in motion of ankle joint and plantar pressure after supramalleolar osteotomy without fibular osteotomy. Ten lower leg specimens below the knee were prepared from fresh-frozen human cadavers. They were harvested from five males (10 ankles)whose average age was 70 years. We assessed the motion of ankle joint as well as plantar pressure for SS(supra-syndesmotic) SMO and IS(intra-syndesmotic) SMO. After the osteotomy, each specimen was subjected to axial compression from 20 N preload to 350 N representing half-body weight. For the measurement of the motion of ankle joint, the changes in gap and point, angles in ankle joint were measured. The plantar pressure were also recorded using TekScan sensors. The changes in the various gap, point, and angles movements on SS-SMO and IS-SMO showed no statistically significant differences between the two groups. Regarding the shift of plantar center of force (COF) were noted in the anterolateral direction, but not statistically significant. SS-SMO and IS-SMO with intact fibula showed similar biomechanical effect on the ankle joint. We propose that IS-SMO should be considered carefully for the treatment of osteoarthrosis when fibular osteotomy is not performed because lateral cortex fracture was less likely using the intrasyndesmosis plane because of soft tissue support.

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

Modified Chevron osteotomy for hallux valgus deformity in female athletes. A 2-year follow-up study.

Science.gov (United States)

Giotis, Dimitrios; Paschos, Nikolaos K; Zampeli, Franceska; Giannoulis, Dionisios; Gantsos, Apostolos; Mantellos, George

2016-09-01

Hallux valgus is an increasingly common deformity in young female athletes that constricts their daily athletic activities and influences foot cosmesis. The aim of this study was to evaluate the outcome of modified Chevron osteotomy for hallux valgus deformity in this specific population. Forty-two cases of modified Chevron osteotomies were carried out in 33 patients with mild to moderate hallux valgus deformity. Each participant was evaluated for AOFAS score, pain, range of motion, cosmetic and radiological outcome. Mean AOFAS score improved to 96.3 (phallux valgus deformity in young female athletes, with excellent clinical outcome. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Comparison of maxillary stability after Le Fort I osteotomy for occlusal cant correction surgery and maxillary advanced surgery.

Science.gov (United States)

Ueki, Koichiro; Hashiba, Yukari; Marukawa, Kohei; Yoshida, Kan; Shimizu, Chika; Nakagawa, Kiyomasa; Yamamoto, Etsuhide

2007-07-01

To compare postoperative maxillary stability following Le Fort I osteotomy for the correction of occlusal cant as compared with conventional Le Fort I osteotomy for maxillary advancement. The subjects were 40 Japanese adults with jaw deformities. Of these, 20 underwent a Le Fort I osteotomy and intraoral vertical ramus osteotomy (IVRO) to correct asymmetric skeletal morphology and inclined occlusal cant. The other 20 patients underwent a Le Fort I osteotomy and sagittal split ramus osteotomy (SSRO) to advance the maxilla. Lateral and posteroanterior cephalograms were taken postoperatively and assessed statistically. Thereafter, the 2 groups were followed for time-course changes. There was no significant difference between the 2 groups with regard to time-course changes during the immediate postoperative period. This suggests that maxillary stability after Le Fort I osteotomy for cant correction does not differ from that after Le Fort I osteotomy for maxillary advancement.

Minimally Invasive Distal Metatarsal Osteotomy for Mild-to-Moderate Hallux Valgus Deformity

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Yu-Chuan Lin

2009-08-01

Full Text Available Minimally invasive surgery has recently been introduced for foot and ankle surgery, and hallux valgus surgery is no exception. The purpose of our study was to analyze the early results and to present our experience of minimally invasive distal metatarsal osteotomy in correcting mild-to-moderate hallux valgus deformities. Between September 2005 and December 2006, 31 consecutive patients (47 feet with mild-to-moderate hallux valgus deformities underwent minimally invasive distal metatarsal osteotomies. The clinical and radiographic outcomes were assessed. The satisfaction rate was 90.32%. The mean total American Orthopedic Foot and Ankle Society halluxmetatarsophalangeal-interphalangeal scale was 92.7 points. Complications included two (4.26% episodes of stiffness, six (12.77% episodes of pin tract infection, and one (2.13% deep infection. There were no cases with nonunion, malunion, overcorrection, transfer metatarsalgia or osteonecrosis. On weight-bearing anteroposterior foot radiographs, the mean hallux valgus angle and first intermetatarsal angle corrections were 11.8° and 6.3°, respectively, which is a statistically significant difference (p < 0.001 between the preoperative and postoperative status. Here, minimally invasive distal metatarsal osteotomy was associated with good satisfaction, functional improvement and low complication rates. This technique offers an effective, safe and simple way to treat hallux valgus with a first intermetatarsal angle less than 15°.

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.

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.

Piezoelectric osteotomy in hand surgery: first experiences with a new technique

Science.gov (United States)

Hoigne, Dominik J; Stübinger, Stefan; Kaenel, Oliver Von; Shamdasani, Sonia; Hasenboehler, Paula

2006-01-01

Background In hand and spinal surgery nerve lesions are feared complications with the use of standard oscillating saws. Oral surgeons have started using a newly developed ultrasound bone scalpel when performing precise osteotomies. By using a frequency of 25–29 kHz only mineralized tissue is cut, sparing the soft tissue. This reduces the risk of nerve lesions. As there is a lack of experience with this technique in the field of orthopaedic bone surgery, we performed the first ultrasound osteotomy in hand surgery. Method While performing a correctional osteotomy of the 5th metacarpal bone we used the Piezosurgery® Device from Mectron [Italy] instead of the usual oscillating saw. We will report on our experience with one case, with a follow up time of one year. Results The cut was highly precise and there were no vibrations of the bone. The time needed for the operation was slightly longer than the time needed while using the usual saw. Bone healing was good and at no point were there any neurovascular disturbances. Conclusion The Piezosurgery® Device is useful for small long bone osteotomies. Using the fine tip enables curved cutting and provides an opportunity for new osteotomy techniques. As the device selectively cuts bone we feel that this device has great potential in the field of hand- and spinal surgery. PMID:16611362

Piezoelectric osteotomy in hand surgery: first experiences with a new technique

Directory of Open Access Journals (Sweden)

Kaenel Oliver Von

2006-04-01

Full Text Available Abstract Background In hand and spinal surgery nerve lesions are feared complications with the use of standard oscillating saws. Oral surgeons have started using a newly developed ultrasound bone scalpel when performing precise osteotomies. By using a frequency of 25–29 kHz only mineralized tissue is cut, sparing the soft tissue. This reduces the risk of nerve lesions. As there is a lack of experience with this technique in the field of orthopaedic bone surgery, we performed the first ultrasound osteotomy in hand surgery. Method While performing a correctional osteotomy of the 5th metacarpal bone we used the Piezosurgery® Device from Mectron [Italy] instead of the usual oscillating saw. We will report on our experience with one case, with a follow up time of one year. Results The cut was highly precise and there were no vibrations of the bone. The time needed for the operation was slightly longer than the time needed while using the usual saw. Bone healing was good and at no point were there any neurovascular disturbances. Conclusion The Piezosurgery® Device is useful for small long bone osteotomies. Using the fine tip enables curved cutting and provides an opportunity for new osteotomy techniques. As the device selectively cuts bone we feel that this device has great potential in the field of hand- and spinal surgery.

Minimizing the Translation Error in the Application of an Oblique Single-Cut Rotation Osteotomy: Where to Cut?

Science.gov (United States)

Dobbe, Johannes G G; Strackee, Simon D; Streekstra, Geert J

2018-04-01

An oblique single cut rotation osteotomy enables correcting angular bone alignment in the coronal, sagittal, and transverse planes, with just a single oblique osteotomy, and by rotating one bone segment in the osteotomy plane. However, translational malalignment is likely to exist if the bone is curved or deformed and the location of the oblique osteotomy is not obvious. In this paper, we investigate how translational malalignment depends on the osteotomy location. We further propose and evaluate by simulation in 3-D, a method that minimizes translational malalignment by varying the osteotomy location and by sliding the distal bone segment with respect to the proximal bone segment within the oblique osteotomy plane. The method is finally compared to what three surgeons achieve by manually selecting the osteotomy location in 3-D virtual space without planning in-plane translations. The minimization method optimized for length better than the surgeons did, by 3.2 mm on average, range (0.1, 9.4) mm, in 82% of the cases. A better translation in the axial plane was achieved by 4.1 mm on average, range (0.3, 14.4) mm, in 77% of the cases. The proposed method generally performs better than subjectively choosing an osteotomy position along the bone axis. The proposed method is considered a valuable tool for future alignment planning of an oblique single-cut rotation osteotomy since it helps minimizing translational malalignment.

Intravenous Tranexamic Acid Decreases Allogeneic Transfusion Requirements in Periacetabular Osteotomy.

Science.gov (United States)

Bryan, Andrew J; Sanders, Thomas L; Trousdale, Robert T; Sierra, Rafael J

2016-01-01

Bernese (Ganz) periacetabular osteotomy is associated with significant blood loss and the need for perioperative transfusion. Tranexamic acid decreases blood loss and minimizes transfusion rates in total joint arthroplasty. However, no reports have described its use in patients undergoing Bernese periacetabular osteotomy. This study reports the use of intravenous tranexamic acid in these patients. The study included 137 patients (150 hips) who underwent isolated periacetabular osteotomy at a single institution between 2003 and 2014. Of these, 68 patients (75 hips) received intravenous tranexamic acid 1 g at the time of incision and 1 g at the time of closure. A group of 69 patients (75 hips) served as control subjects who underwent periacetabular osteotomy without administration of intravenous tranexamic acid. Thromboembolic disease was defined as deep venous thrombosis or pulmonary embolism occurring within 6 weeks of surgery. Outcomes measured included transfusion requirements, pre- and postoperative hemoglobin values, operative times, and thromboembolic disease rates. Aspirin was used as the thromboembolic prophylactic regimen in 95% of patients. The rate of allogeneic transfusion was 0 in the tranexamic acid group compared with 21% in the control group (P=.0001). No significant difference was found in the autologous cell salvage requirement (.96 vs 1.01; P=.43) or the thromboembolic disease rate between the tranexamic acid group and the control group (2.67% vs 1.33%; P=.31). The use of intravenous tranexamic acid led to a decreased transfusion requirement with no increased risk of thromboembolic disease in this contemporary cohort of patients undergoing periacetabular osteotomy. Copyright 2016, SLACK Incorporated.

A Quantitative Evaluation of the Flipped Classroom in a Large Lecture Principles of Economics Course

Science.gov (United States)

Balaban, Rita A.; Gilleskie, Donna B.; Tran, Uyen

2016-01-01

This research provides evidence that the flipped classroom instructional format increases student final exam performance, relative to the traditional instructional format, in a large lecture principles of economics course. The authors find that the flipped classroom directly improves performance by 0.2 to 0.7 standardized deviations, depending on…

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…

[Osteotomies for treating developmental disorders of the neurocranium and visceral cranium].

Science.gov (United States)

Mühling, J

1991-02-01

Craniofacial deformities are primarily caused by premature synostosis of cranial sutures. Depending on the involved sutures, typical deformities of the neuro- and visceral cranium are produced. They result in severe functional and aesthetic disturbances. Several osteotomies, which do not only make an aesthetic improvement possible but a correction of severe malfunction, are available for therapy. Preoperative planning and postoperative treatment require the combination of orthodontics and maxillofacial surgery.

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...

Lengthening of the shortened first metatarsal after Wilson's osteotomy for hallux valgus.

Science.gov (United States)

Singh, D; Dudkiewicz, I

2009-12-01

Metatarsalgia is a recognised complication following iatrogenic shortening of the first metatarsal in the management of hallux valgus. The traditional surgical treatment is by shortening osteotomies of the lesser metatarsals. We describe the results of lengthening of iatrogenic first brachymetatarsia in 16 females. A Scarf-type osteotomy was used in the first four cases and a step-cut of equal thicknesses along the axis of the first metatarsal was performed in the others. The mean follow-up was 21 months (19 to 26). Relief of metatarsalgia was obtained in the six patients in whom 10 mm of lengthening had been achieved, compared to only 50% relief in those where less than 8 mm of lengthening had been gained. One-stage step-cut lengthening osteotomy of the first metatarsal may be preferable to shortening osteotomies of the lesser metatarsals in the treatment of metatarsalgia following surgical shortening of the first metatarsal.

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.

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…

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

Digital Storytelling in a Flipped Classroom for Effective Learning

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Clemens Bechter

2017-06-01

Full Text Available Conclusive empirical evidence on whether virtual classrooms result in higher performance, satisfaction, or an improvement in problem solving skills when compared with traditional face-to-face lecturing does not exist. Various studies point in different directions. However, blended learning outperforms the traditional classroom in student performance and satisfaction. A flipped classroom is one type of blended learning. For more than 20 years, this approach has been used at a European executive MBA (EMBA program delivering online content combined with six residential weeks where students collaborate and reflect upon their online learning. Our research examined the overall setup of this program, and assessed one course in depth. As part of the course—International Management—an intercultural negotiation project was chosen to highlight the integration of online and offline activities. The flipped classroom is a demonstration of the reform-based teaching approach. The power of reform-based learning in executive education is the engaging combination of practice and theory, which improves the performance of executives. The participants considered the flipped approach exciting, dynamic, and insightful. The emphasis on a negotiation process involving classmates from around the world increased their global understanding. Beginning with a negotiation experience in the digital story project gave them a better appreciation of the relevant theories, techniques, and applications. Focusing on the practice of international negotiation and a cross-cultural analysis with reflection on cultural intelligence improved the competencies of the participants both during the course and after it.

Comparison of fixed-bearing and mobile-bearing total knee arthroplasty after high tibial osteotomy.

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Hernigou, Philippe; Huys, Maxime; Pariat, Jacques; Roubineau, François; Flouzat Lachaniette, Charles Henri; Dubory, Arnaud

2018-02-01

There is no information comparing the results of fixed-bearing total knee replacement and mobile-bearing total knee replacement in the same patients previously treated by high tibial osteotomy. The purpose was therefore to compare fixed-bearing and mobile-bearing total knee replacements in patients treated with previous high tibial osteotomy. We compared the results of 57 patients with osteoarthritis who had received a fixed-bearing prosthesis after high tibial osteotomy with the results of 41 matched patients who had received a rotating platform after high tibial osteotomy. The match was made for length of follow-up period. The mean follow-up was 17 years (range, 15-20 years). The patients were assessed clinically and radiographically. The pre-operative knee scores had no statistically significant differences between the two groups. So was the case with the intra-operative releases, blood loss, thromboembolic complications and infection rates in either group. There was significant improvement in both groups of knees, and no significant difference was observed between the groups (i.e., fixed-bearing and mobile-bearing knees) for the mean Knee Society knee clinical score (95 and 92 points, respectively), or the Knee Society knee functional score (82 and 83 points, respectively) at the latest follow-up. However, the mean post-operative knee motion was higher for the fixed-bearing group (117° versus 110°). In the fixed-bearing group, one knee was revised because of periprosthetic fracture. In the rotating platform mobile-bearing group, one knee was revised because of aseptic loosening of the tibial component. The Kaplan-Meier survivorship for revision at ten years of follow-up was 95.2% for the fixed bearing prosthesis and 91.1% for the rotating platform mobile-bearing prosthesis. Although we did manage to detect significant differences mainly in clinical and radiographic results between the two groups, we found no superiority or inferiority of the mobile

MO-DE-BRA-01: Flipped Physics Courses Within a Radiologic Technologist Program: Video Production and Long Term Outcomes

International Nuclear Information System (INIS)

Oshiro, T; Donaghy, M; Slechta, A

2016-01-01

Purpose: To determine if the flipped class format has an effect on examination results for a radiologic technologist (RT) program and discuss benefits from creating video resources. Methods: From 2001–2015, students had taken both a radiological physics and quality control (QC) class as a part of their didactic training. In 2005/2006, the creation of videos of didactic lectures and QC test demonstrations allowed for a flip where content was studied at home while exercises and reviews were done in-class. Final examinations were retrospectively reviewed from this timeframe. 12 multiple choice physics questions (MCP) and 5 short answer QC questions (SAQC) were common to pre and post flip exams. The RT program’s ARRT exam scores were also obtained and compared to national averages. Results: In total, 36 lecture videos and 65 quality control videos were created for the flipped content. Data was ∼2.4GB and distributed to students via USB or CD media. For MCP questions, scores improved by 7.9% with the flipped format and significance (Student’s t-test, p<0.05) was found for 3 of the 12 questions. SAQC questions showed improvement by 14.6% and significance was found for 2 of the 5 questions. Student enrollment increased from ∼14 (2001–2004) to ∼23 students (2005–15). Content was continuously added post-flip due to the efficiency of delivery. The QC class in 2003 covered 45 test setups in-class while 65 were covered with video segments in 2014. Flipped materials are currently being repurposed. In 2015, this video content was restructured into an ARRT exam review guide and in 2016, the content was reorganized for fluoroscopy training for physicians. Conclusion: We believe that flipped classes can improve efficiency of content delivery and improve student performance even with an increase in class size. This format allows for flexibility in learning as well as re-use in multiple applications.

MO-DE-BRA-01: Flipped Physics Courses Within a Radiologic Technologist Program: Video Production and Long Term Outcomes

Energy Technology Data Exchange (ETDEWEB)

Oshiro, T [UCLA, Los Angeles, CA (United States); Donaghy, M [California State University, Northridge, Northridge, CA (United States); Slechta, A [California State University, Northridge, Northridge, CA (United States)

2016-06-15

Purpose: To determine if the flipped class format has an effect on examination results for a radiologic technologist (RT) program and discuss benefits from creating video resources. Methods: From 2001–2015, students had taken both a radiological physics and quality control (QC) class as a part of their didactic training. In 2005/2006, the creation of videos of didactic lectures and QC test demonstrations allowed for a flip where content was studied at home while exercises and reviews were done in-class. Final examinations were retrospectively reviewed from this timeframe. 12 multiple choice physics questions (MCP) and 5 short answer QC questions (SAQC) were common to pre and post flip exams. The RT program’s ARRT exam scores were also obtained and compared to national averages. Results: In total, 36 lecture videos and 65 quality control videos were created for the flipped content. Data was ∼2.4GB and distributed to students via USB or CD media. For MCP questions, scores improved by 7.9% with the flipped format and significance (Student’s t-test, p<0.05) was found for 3 of the 12 questions. SAQC questions showed improvement by 14.6% and significance was found for 2 of the 5 questions. Student enrollment increased from ∼14 (2001–2004) to ∼23 students (2005–15). Content was continuously added post-flip due to the efficiency of delivery. The QC class in 2003 covered 45 test setups in-class while 65 were covered with video segments in 2014. Flipped materials are currently being repurposed. In 2015, this video content was restructured into an ARRT exam review guide and in 2016, the content was reorganized for fluoroscopy training for physicians. Conclusion: We believe that flipped classes can improve efficiency of content delivery and improve student performance even with an increase in class size. This format allows for flexibility in learning as well as re-use in multiple applications.

Acetabular osteotomy for double boarding in lateral decubitus. Anatomical bases and surgical technique

International Nuclear Information System (INIS)

Lazennec, J Y; Del Vecchio, R; Saillant, G

2001-01-01

The periacetabular osteotomies of reorientation of the eotilo have a reputation of being difficult from the technical point of view. The authors present a technique of juxta acetabular osteotomy that respects the posterior column of the acetabulo the same as the GANZ technique. The osteotomy is of simpler realization thanks to an installation that allows carrying out two simultaneous boarding. The osteotomy lines, their rectilinear and controllable in permanency through of images intensificator and they don't constitute any risk for the essential vascular contribution of the obturatriz artery and their branches. Their other interest comes represented by the possibility of correcting easily the parasitic retroversion associated to the descent of the whole eotilo, that it allows to avoid the bad positions that they affect the center of the articulation and the widths acetabular

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.

Strategic camouflage treatment of skeletal Class III malocclusion (mandibular prognathism) using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy.

Science.gov (United States)

Seo, Yu-Jin; Lin, Lu; Kim, Seong-Hun; Chung, Kyu-Rhim; Nelson, Gerald

2016-01-01

This case report presents the camouflage treatment that successfully improved the facial profile of a patient with a skeletal Class III malocclusion using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy. The patient was an 18-year-old woman with chief complaints of crooked teeth and a protruded jaw. Camouflage treatment was chosen because she rejected orthognathic surgery under general anesthesia. A hybrid type of bone-borne rapid maxillary expander with palatal mini-implants was used to correct the transverse discrepancy, and a mandibular anterior subapical osteotomy was conducted to achieve proper overjet with normal incisal inclination and to improve her lip and chin profile. As a result, a Class I occlusion with a favorable inclination of the anterior teeth and a good esthetic profile was achieved with no adverse effects. Therefore, the hybrid type of bone-borne rapid maxillary expander and a mandibular anterior subapical osteotomy can be considered effective camouflage treatment of a skeletal Class III malocclusion, providing improved inclination of the dentition and lip profile. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

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.

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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.

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

Directory of Open Access Journals (Sweden)

Moffett J

2014-11-01

.001. Conclusion: This study demonstrates that learners seem to prefer a flipped 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 multiple-choice items delivered during a written examination. Keywords: active learning, assessment, didactic, flipped classroom, lecture, professional skills, student perception

Adventures in Flipping College Algebra

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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.

Twelve tips for "flipping" the classroom.

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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.

Does the Concept of the "Flipped Classroom" Extend to the Emergency Medicine Clinical Clerkship?

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Heitz, Corey; Prusakowski, Melanie; Willis, George; Franck, Christopher

2015-11-01

Linking educational objectives and clinical learning during clerkships can be difficult. Clinical shifts during emergency medicine (EM) clerkships provide a wide variety of experiences, some of which may not be relevant to recommended educational objectives. Students can be directed to standardize their clinical experiences, and this improves performance on examinations. We hypothesized that applying a "flipped classroom" model to the clinical clerkship would improve performance on multiple-choice testing when compared to standard learning. Students at two institutions were randomized to complete two of four selected EM clerkship topics in a "flipped fashion," and two others in a standard fashion. For flipped topics, students were directed to complete chief complaint-based asynchronous modules prior to a shift, during which they were directed to focus on the chief complaint. For the other two topics, modules were to be performed at the students' discretion, and shifts would not have a theme. At the end of the four-week clerkship, a 40-question multiple-choice examination was administered with 10 questions per topic. We compared performance on flipped topics with those performed in standard fashion. Students were surveyed on perceived effectiveness, ability to follow the protocol, and willingness of preceptors to allow a chief-complaint focus. Sixty-nine students participated; examination scores for 56 were available for analysis. For the primary outcome, no difference was seen between the flipped method and standard (p=0.494.) A mixed model approach showed no effect of flipped status, protocol adherence, or site of rotation on the primary outcome of exam scores. Students rated the concept of the flipped clerkship highly (3.48/5). Almost one third (31.1%) of students stated that they were unable to adhere to the protocol. Preparation for a clinical shift with pre-assigned, web-based learning modules followed by an attempt at chief-complaint-focused learning during a

Flip-flopping binary black holes.

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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.

Pre-operative simulation of periacetabular osteotomy via a three-dimensional model constructed from salt

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Fukushima Kensuke

2017-01-01

Full Text Available Introduction: Periacetabular osteotomy (PAO is an effective joint-preserving procedure for young adults with developmental dysplasia of the hip. Although PAO provides excellent radiographic and clinical results, it is a technically demanding procedure with a distinct learning curve that requires careful 3D planning and, above all, has a number of potential complications. We therefore developed a pre-operative simulation method for PAO via creation of a new full-scale model. Methods: The model was prepared from the patient’s Digital Imaging and Communications in Medicine (DICOM formatted data from computed tomography (CT, for construction and assembly using 3D printing technology. A major feature of our model is that it is constructed from salt. In contrast to conventional models, our model provides a more accurate representation, at a lower manufacturing cost, and requires a shorter production time. Furthermore, our model realized simulated operation normally with using a chisel and drill without easy breakage or fissure. We were able to easily simulate the line of osteotomy and confirm acetabular version and coverage after moving to the osteotomized fragment. Additionally, this model allowed a dynamic assessment that avoided anterior impingement following the osteotomy. Results: Our models clearly reflected the anatomical shape of the patient’s hip. Our models allowed for surgical simulation, making realistic use of the chisel and drill. Our method of pre-operative simulation for PAO allowed for the assessment of accurate osteotomy line, determination of the position of the osteotomized fragment, and prevented anterior impingement after the operation. Conclusion: Our method of pre-operative simulation might improve the safety, accuracy, and results of PAO.

Tibial condylar valgus osteotomy (TCVO) for osteoarthritis of the knee: 5-year clinical and radiological results.

Science.gov (United States)

Chiba, Ko; Yonekura, Akihiko; Miyamoto, Takashi; Osaki, Makoto; Chiba, Goji

2017-03-01

Tibial condylar valgus osteotomy (TCVO) is a type of opening-wedge high tibial osteotomy for advanced medial knee osteoarthritis (OA) with subluxated lateral joint. We report the concept, the current surgical technique with a locking plate, and the short-term clinical and radiological results of this procedure. 11 knees with medial OA and a widened lateral joint were treated by TCVO (KL stage III: 6, IV: 5). In this procedure, by the L-shaped osteotomy from the medial side of the proximal tibia to the intercondylar eminence and the valgus correction, lateralization of the mechanical axis and reduction of the subluxated lateral joint are obtained with early postoperative weight-bearing. Before, 6 months, 1, and 5 years after the operation, a visual analog scale (VAS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), alignment of the lower extremity, and congruency and stability of the femorotibial joint were investigated. The VAS improved from an average of 73 mm to 13 mm, and the total WOMAC score from 52 to 14 before to 5 years after the operation, respectively. The mechanical axis changed from 1 to 60%, and the FTA changed from 186° to 171°. The joint line convergence angle (JLCA) changed from 6° to 1°, and the angle difference of JLCA between varus and valgus stress improved from 8° to 4° after the procedure. Improvements in pain and activities of daily living were observed by TCVO along with valgus correction of the lower extremity and stabilization of the femorotibial joint.

Intraoperative blood loss in bimaxillary orthognathic surgery with multisegmental Le Fort I osteotomies and additional procedures.

Science.gov (United States)

Kretschmer, W B; Baciut, G; Bacuit, Mihaela; Zoder, W; Wangerin, K

2010-06-01

Autologous blood donation is not currently recommended by most authors for routine bimaxillary osteotomies. There are few data about bimaxillary procedures with multisegmental maxillary osteotomies. Our aim was to investigate the effect of additional osteotomies and iliac crest grafts on operative blood loss. A total of 225 consecutive patients having bimaxillary multisegmental osteotomies during a three-year period (January 2006-January 2009) were examined to see if their haemoglobin concentration and packed cell volume were reduced. The influence of iliac crest grafts, additional osteotomies (genioplasty, malar osteotomy, iliac crest graft, anterior mandibular segmental osteotomy), operating time, age, and sex were assessed. Neither age nor sex influenced blood loss, whereas operating time correlated significantly with reductions in haemoglobin concentration and packed cell volume. Blood loss was significantly higher in the group who had additional procedures (p 0.001 for haemoglobin concentration and packed cell volume) than in the group who had no additional procedures, whereas there were no significant differences among the three subgroups who had additional procedures (additional osteotomies, iliac crest grafts, or both procedures). Four patients who had additional procedures required transfusion, whereas no blood was given in the group who had no additional procedures. Because the transfusion rate was so low, we could make no general recommendation for preoperative blood donation in such cases. Copyright 2009 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Temperature and time variations during osteotomies performed with different piezosurgical devices: an in vitro study.

Science.gov (United States)

Delgado-Ruiz, R A; Sacks, D; Palermo, A; Calvo-Guirado, J L; Perez-Albacete, C; Romanos, G E

2016-09-01

The aim of this experimental in vitro study was to evaluate the effects of the piezoelectric device in temperature and time variations in standardized osteotomies performed with similar tip inserts in bovine bone blocks. Two different piezosurgical devices were used the OE-F15(®) (Osada Inc., Los Angeles, California, USA) and the Surgybone(®) (Silfradent Inc., Sofia, Forli Cesena, Italy). Serrated inserts with similar geometry were coupled with each device (ST94 insert/test A and P0700 insert/test B). Osteotomies 10 mm long and 3 mm deep were performed in bone blocks resembling type II (dense) and type IV (soft) bone densities with and without irrigation. Thermal changes and time variations were recorded. The effects of bone density, irrigation, and device on temperature changes and time necessary to accomplish the osteotomies were analyzed. Thermal analysis showed significant higher temperatures during piezosurgery osteotomies in hard bone without irrigation (P  0.05). Time analysis showed that the mean time values necessary to perform osteotomies were shorter in soft bone than in dense bone (P piezosurgery osteotomies in dense bone without irrigation; the time to perform the osteotomy with piezosurgery is shorter in soft bone compared to hard bone; and the piezosurgical device have a minimal influence in the temperature and time variations when a similar tip design is used during piezosurgery osteotomies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Planning corrective osteotomy of the femoral bone using three-dimensional modeling. Part II

Directory of Open Access Journals (Sweden)

Vladimir E. Baskov

2017-10-01

Full Text Available Introduction. Three-dimensional (3D modeling and prototyping are increasingly being used in various branches of surgery for planning and performing surgical interventions. In orthopedics, this technology was first used in 1990 for performing knee-joint surgery. This was followed by the development of protocols for creating and applying individual patterns for navigation in the surgical interventions for various bones. Aim. The study aimed to develop a new 3D method for planning and performing corrective osteotomy of the femoral bone using an individual pattern and to identify the advantages of the proposed method in comparison with the standard method of planning and performing surgical intervention. Materials and methods. A new method for planning and performing corrective osteotomy of the femoral bone in children with various pathologies of the hip joint is presented. The outcomes of planning and performing corrective osteotomy of the femoral bone in 27 patients aged 5 to 18 years (32 hip joints with congenital and acquired deformity of the femoral bone were analyzed. Conclusion. The use of computer 3D modeling for planning and implementing corrective interventions on the femoral bone improves the treatment results owing to an almost perfect performance accuracy achieved by the minimization of possible human errors reduction in the surgery duration; and reduction in the radiation exposure for the patient.

Guided Modern Endodontic Surgery: A Novel Approach for Guided Osteotomy and Root Resection.

Science.gov (United States)

Strbac, Georg D; Schnappauf, Albrecht; Giannis, Katharina; Moritz, Andreas; Ulm, Christian

2017-03-01

Continuous improvements in techniques, instruments, and materials have established modern endodontic microsurgery as a state-of-the-art treatment method. The purpose of this approach was to introduce a new surgical endodontic technique by using a three-dimensional printed template for guided osteotomy and root resection. A 38-year-old patient was diagnosed with periapical lesions of teeth #3 and #4 and extruded gutta-percha material. Three-dimensional radiographic and optical scan files were imported into surgical planning software designed for guided implant surgery. Within the adapted software program the periapical lesions and the extruded gutta-percha were visualized and marked. With the aid of virtually positioned surgical pins and piezoelectric instruments, the osteotomy size, the apical resection level, and the bevel angle were defined before treatment. Three-dimensional surgical templates for each tooth were designed within the software program for a guided treatment approach. This approach comprised the treatment of periapical lesions of teeth #3 and #4 with root-end fillings and the detection and complete removal of the extruded gutta-percha material without perforation of sinus membrane. There were no postoperative complications, and clinical and radiologic assessments verified complete healing of the teeth. The guided microsurgical endodontic treatment presented appears to be a viable technique that allows for predefined osteotomies and root resections. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Changes in patellofemoral alignment do not cause clinical impact after open-wedge high tibial osteotomy.

Science.gov (United States)

Lee, Yong Seuk; Lee, Sang Bok; Oh, Won Seok; Kwon, Yong Eok; Lee, Beom Koo

2016-01-01

The objectives of this study were (1) to evaluate the clinical and radiologic outcomes of open-wedge high tibial osteotomy focusing on patellofemoral alignment and (2) to search for correlation between variables and patellofemoral malalignment. A total of 46 knees (46 patients) from 32 females and 14 males who underwent open-wedge high tibial osteotomy were included in this retrospective case series. Outcomes were evaluated using clinical scales and radiologic parameters at the last follow-up. Pre-operative and final follow-up values were compared for the outcome analysis. For the focused analysis of the patellofemoral joint, correlation analyses between patellofemoral variables and pre- and post-operative weight-bearing line (WBL), clinical score, posterior slope, Blackburn Peel ratio, lateral patellar tilt, lateral patellar shift, and congruence angle were performed. The minimum follow-up period was 2 years and median follow-up period was 44 months (range 24-88 months). The percentage of weight-bearing line was shifted from 17.2 ± 11.1 to 56.7 ± 12.7%, and it was statistically significant (p patellofemoral malalignment, the pre-operative weight-bearing line showed an association with the change in lateral patellar tilt and lateral patellar shift (correlation coefficient: 0.3). After open-wedge high tibial osteotomy, clinical results showed improvement, compared to pre-operative values. The patellar tilt and lateral patellar shift were not changed; however, descent of the patella was observed. Therefore, mild patellofemoral problems should not be a contraindication of the open-wedge high tibial osteotomy. Case series, Level IV.

Development of a Flipped Medical School Dermatology Module.

Science.gov (United States)

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.

The Gibson and Piggott osteotomy for adult hallux valgus.

Science.gov (United States)

Rangrez, Arshad Bashir; Dar, Tahir Ahmed; Badoo, Abdul Rashid; Wani, Sharief Ahmed; Dhar, Shabir Ahmed; Mumtaz, Imran; Ahmed, Muzzaffar

2012-01-01

The Gibson and Piggott procedure for hallux valgus is based on sound surgical principles addressing the basic pathologies of this disorder. However, this procedure has not been studied extensively in the literature in comparison to the Mitchell and Chevron osteotomies. We report a prospective study conducted on 50 adult feet with hallux valgus. The Gibson and Piggot osteotomy was done on all the feet. We obtained 76% excellent and 18% good results with this procedure. The results bear out the fact that this procedure is a useful procedure for the management of this disorder.

The Effects of the Flipped Model of Instruction on Student Engagement and Performance in the Secondary Mathematics Classroom

Directory of Open Access Journals (Sweden)

Kevin R. Clark

2015-01-01

Full Text Available In many of the secondary classrooms across the country, students are passively engaged in the mathematics content, and academic performance can be described, at best, as mediocre. This research study sought to bring about improvements in student engagement and performance in the secondary mathematics classroom through the implementation of the flipped model of instruction and compared student interaction in the flipped classroom with a traditional format. The flipped model of instruction is a relatively new teaching strategy attempting to improve student engagement and performance by moving the lecture outside the classroom via technology and moving homework and exercises with concepts inside the classroom via learning activities. Changes in the student participants’ perceptions and attitudes were evidenced and evaluated through the completion of a pre- and post-survey, a teacher-created unit test, random interviews, and a focus group session. In addition, the researcher documented observations, experiences, thoughts, and insights regarding the intervention in a journal on a daily basis. Quantitative results and qualitative findings revealed the student participants responded favorably to the flipped model of instruction and experienced an increase in their engagement and communication when compared to the traditional classroom experience. The student participants also recognized improvements in the quality of instruction and use of class of time with the flipped model of instruction. In terms of academic performance, no significant changes were demonstrated between the flipped model of instruction students and those taught in a traditional classroom environment.

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

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.

A Quatro-Based 65-nm Flip-Flop Circuit for Soft-Error Resilience

Science.gov (United States)

Li, Y.-Q.; Wang, H.-B.; Liu, R.; Chen, L.; Nofal, I.; Shi, S.-T.; He, A.-L.; Guo, G.; Baeg, S. H.; Wen, S.-J.; Wong, R.; Chen, M.; Wu, Q.

2017-06-01

A flip-flop circuit hardened against soft errors is presented in this paper. This design is an improved version of Quatro for further enhanced soft-error resilience by integrating the guard-gate technique. The proposed design, as well as reference Quatro and regular flip-flops, was implemented and manufactured in a 65-nm CMOS bulk technology. Experimental characterization results of their alpha and heavy ions soft-error rates verified the superior hardening performance of the proposed design over the other two circuits.

Application of a novel bone osteotomy plate leads to reduction in heat-induced bone tissue necrosis in sheep.

Science.gov (United States)

Bekić, Marijo; Davila, Slavko; Hrskanović, Mato; Bekić, Marijana; Seiwerth, Sven; Erdeljić, Viktorija; Capak, Darko; Butković, Vladimir

2008-12-01

Previous studies have shown substantial effect thermal damage can have on new bone formation following osteotomy. In this study we evaluated the extent of thermal damage which occurs in four different methods of osteotomy and the effects it can have on bone healing. We further wanted to test whether a special osteotomy plate we constructed can lead to diminished heat generation during osteotomy and enhanced bone healing. The four methods evaluated included osteotomy performed by chisel, a newly constructed osteotomy plate, Gigly and oscillating saw. Twelve adult sheep underwent osteotomy performed on both tibiae. Bone fragments were stabilized using a fixation plate. Callus size was assessed using standard radiographs. Densitometry and histological evaluation were performed at 8 weeks following osteotomy. Temperature measurements were performed both in vivo during the operation, and ex vivo on explanted tibiae. The defects healed without complications and showed typical course of secondary fracture healing with callus ingrowth into the osteotomy gap. Radiographic examination of bone healing showed a tendency towards more callus formation in bones osteotomized using Gigly and oscillating saw, but this difference lacked significance. Use of Gigly and oscillating saw elicited much higher temperatures at the bone cortex surface, which subsequently lead to slightly impaired bone healing according to histological analysis. BMD was equal among all bones. In conclusion, the time required for complete healing of the defect differed depended greatly on the instruments used. The newly constructed osteotomy plate showed best results based on histological findings of capillary and osteoblast density.

Reliability of the imaging software in the preoperative planning of the open-wedge high tibial osteotomy.

Science.gov (United States)

Lee, Yong Seuk; Kim, Min Kyu; Byun, Hae Won; Kim, Sang Bum; Kim, Jin Goo

2015-03-01

The purpose of this study was to verify a recently developed picture-archiving and communications system-photoshop method by comparing reliabilities between real-size paper template and the PACS-photoshop methods in preoperative planning of open-wedge high tibial osteotomy. A prospective case series was conducted, including patients with medial osteoarthritis undergoing open-wedge high tibial osteotomy. In the preoperative planning, the picture-archiving and communications system-photoshop method and real-size paper template method were used simultaneously in all patients. Preoperative hip-knee-ankle angle, height, and angle of the osteotomy were evaluated. The reliability of this newly devised method was evaluated, and the consistency between the two methods was also evaluated using intra-class correlation coefficient. Using the picture-archiving and communications system-photoshop method, the mean correction angle and height of osteotomy gap of rater-1 were 11.7° ± 3.6° and 10.7 ± 3.6 mm, respectively. The mean correction angle and height of osteotomy gap of rater-2 were 12.0 ± 2.6 and 10.8 ± 3.6, respectively. The inter- and intra-rater reliabilities of the correction angle were 0.956 ~ 0.979 and 0.980 ~ 0.992, respectively. The inter- and intra-rater reliabilities of the height of the osteotomy gap were 0.968 ~ 0.985 and 0.971 ~ 0.994, respectively (p photoshop method, mean values of the correction angle and height of the osteotomy gap were 11.9° ± 3.6° and 10.8 ± 3.6 mm, respectively. Consistency between the two methods by comparing the means of the correction angle and the height of the osteotomy gap were 0.985 and 0.985, respectively (p photoshop method enables direct measurement of the height of the osteotomy gap with high reliability.

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

INNOVATIVE TEACHING IN ACCOUNTING SUBJECTS: ANALYSIS OF THE FLIPPED CLASSROOM

Directory of Open Access Journals (Sweden)

E. Lubbe

2016-07-01

Full Text Available Accounting students often have a negative attitude towards the subject andstruggle to understand core concepts of accounting standards. A large percentageof accounting students do not prepare for class and homework is either not doneor neglected. Many factors contributed to students struggling to prepare for classand complete homework assignments. The flipped classroom approach has grownat a rapid pace and was perceived very successful in many subjects. Little researchhas been done on the effectiveness of this approach for accounting students.Videos was created whereby accounting theory was explained and questions withexamples were given and explained. All contact sessions were transformed into anactive learning environment. During contact sessions, students were provided withquestions. Guidance was given with regards to the interpretation of a practicalcase study. Students had to analyze questions before feedback was provided tothem. Contact sessions commenced with easy questions, and progressedto moredifficult questions.Research was conducted in order to determine whether a flipped classroommethod could improve the learning experience of accounting students at a highereducation institution. The study indicated that students watched the videos beforecontact sessions, they felt more positive about their performance in accountingand improved their time management. The majority of students that completed thesurvey preferred the flipped classroom method. It enables students to learn fromtheir own mistakes in class.

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.

Minimizing the translation error in the application of an oblique single-cut rotation osteotomy: Where to cut?

NARCIS (Netherlands)

Dobbe, Johannes G. G.; Strackee, Simon D.; Streekstra, Geert J.

2017-01-01

An oblique single cut rotation osteotomy enables correcting angular bone alignment in the coronal, sagittal and transverse planes, with just a single oblique osteotomy, and by rotating one bone segment in the osteotomy plane. However, translational malalignment is likely to exist if the bone is

Patella height changes post high tibial osteotomy

Directory of Open Access Journals (Sweden)

Siew Ghim Gooi

2017-01-01

Full Text Available Background: Medial opening wedge high tibial osteotomy (HTO is a well-described treatment in early medial compartmental osteoarthritis of the knee. However, two undesirable sequelae may follow –patella baja and changes in the posterior tibial slope (TS. Materials and Methods: We conducted a retrospective study in patients who underwent HTO in our center between September 2009 and February 2017. Preoperative and 6-week postoperative long-leg weight bearing films and lateral knee radiographs were assessed. Pre- and postoperative radiological measurements include the Caton-Deschamps Index (CDI, the mechanical axis deviation (MAD, and the posterior TS. Independant t-test and Pearson correlation test were performed. Results: A total of 106 knees were recruited. The mean age was 48.8 ± 10.8 years. 66 (62.3% and 40 (37.7% knees were from males and females, respectively. The mean pre- and postoperative measurements was (−9.70° ± 3.67° to 0.08° ± 2.80° (−varus; +valgus for the MAD, (7.14° ± 1.78° to 8.72° ± 3.11° for posterior TS, and (0.93° ± 0.084° to 0.82° ± 0.13° for CDI (P ≤ 0.001 for all. The association between patella height change and the level of osteotomy (supra-tubercle vs. infra-tubercle was statistically significant (P < 0.001. A supra-tubercle osteotomy cut significantly lowering patella height (P = 0.011. There was otherwise no statistically significant correlations between patella height changes and the correction angle (P = 0.187 or posterior TS change (P = 0.744. Conclusions: A medial opening wedge HTO above the tibial tubercle was significantly associated with lowering patella height or reducing CDI postoperatively. Based on our results, we would recommend the use of an infra-tubercle osteotomy during the corrective surgery to prevent the complication of patella baja.

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.

Outcomes in chevron osteotomy for Hallux Valgus in a large cohort.

Science.gov (United States)

van Groningen, Bart; van der Steen, M C Marieke; Reijman, Max; Bos, Janneke; Hendriks, Johannes G E

2016-12-01

Clinical and radiological related outcomes have been reported for Chevron osteotomy as correction for mild to moderate hallux valgus, but only for relatively small patient series. Moreover, evaluation of the patient's point of view has mostly been conducted by means of more physician-based outcome measures. The goal of this study was to evaluate the effect of the Chevron osteotomy for hallux valgus on patients' daily lives using the Foot and Ankle Outcome Score (FAOS) as a validated and a hallux valgus specific patient reported outcome measure (PROM). Secondary outcome measures were radiological correction, complication rate, and re-operations. All 438 Chevron procedures (336 patients), at two surgical hospital sites in the period between January 2010 and October 2014, were retrospectively evaluated with a follow-up of at least 6 months. Patients were invited to fill in a cross-sectional online FAOS. For the FAOS, a total response of 60% was achieved. The FAOS ranged between 71 and 88 with a follow-up of on average 36 months. Patients with an undercorrection of their hallux valgus (11.6% of the procedures) scored significantly lower on three subscales of the FAOS (range between 61 and 77 versus 72-84). Patients who had a reoperation (12.6% of the procedures) also scored significantly lower on four subscales: 58-100 versus 73-89. Postoperative radiological measurements improved significantly with a mean difference of 6.1 (5.9; 6.4) degrees for the intermetatarsal angle and 13.7 (13.0; 14.5) degrees for the hallux valgus angle. In this large study cohort, Chevron osteotomy for hallux valgus offers good PROM scores on FAOS. These scores were significantly lower in patients with radiological undercorrection or with a reoperation. Results of the FAOS appear to modulate with physician based outcomes and therapeutic incidents. Improvement of outcome may therefore well be possible by increased attention on these surgical details. Copyright © 2016 Elsevier Ltd. All rights

Complex Osteotomies of Tibial Plateau Malunions Using Computer-Assisted Planning and Patient-Specific Surgical Guides.

Science.gov (United States)

Fürnstahl, Philipp; Vlachopoulos, Lazaros; Schweizer, Andreas; Fucentese, Sandro F; Koch, Peter P

2015-08-01

The accurate reduction of tibial plateau malunions can be challenging without guidance. In this work, we report on a novel technique that combines 3-dimensional computer-assisted planning with patient-specific surgical guides for improving reliability and accuracy of complex intraarticular corrective osteotomies. Preoperative planning based on 3-dimensional bone models was performed to simulate fragment mobilization and reduction in 3 cases. Surgical implementation of the preoperative plan using patient-specific cutting and reduction guides was evaluated; benefits and limitations of the approach were identified and discussed. The preliminary results are encouraging and show that complex, intraarticular corrective osteotomies can be accurately performed with this technique. For selective patients with complex malunions around the tibia plateau, this method might be an attractive option, with the potential to facilitate achieving the most accurate correction possible.

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.…

Percutaneous dorsal closing wedge osteotomy of the metatarsal neck in management of metatarsalgia.

Science.gov (United States)

Lui, Tun Hing

2014-12-01

Metatarsalgia can be caused by plantarflexion of a central metatarsal or discrepancies in the metatarsals' length. Nonsurgical management is usually sufficient to achieve satisfactory results. For those recalcitrant cases, metatarsal osteotomy is needed to relieve the pain. We describe a technique of percutaneous dorsal closing wedge osteotomy of the metatarsal to manage the recalcitrant metatarsalgia. A case series was reviewed retrospectively. From March 2010 to March 2013, percutaneous dorsal closing wedge osteotomy of the metatarsal neck has been performed in 33 patients. Thirty six feet with 63 metatarsals were operated on. Thirty two second metatarsals, 22 third metatarsals, 5 fourth metatarsals and 4 fifth metatarsals were operated on. All the osteotomy sites healed up without any transverse plane deformity. The painful callosities subsided except in one operated metatarsal. Recurrence of painful callosities occurred in 2 operated metatarsals. Transfer metatarsalgia occurred in 2 feet. Floating toe deformity occurred in 2 operated rays. There was no nerve injury noted. Two patients had delayed wound healing with serous discharge and the wounds were eventually healed up with wound dressing. Percutaneous dorsal closing wedge osteotomy of the metatarsal neck is an effective and safe surgical treatment of recalcitrant metatarsalgia. Copyright © 2014 Elsevier Ltd. All rights reserved.

Can Double Osteotomy Be a Solution for Adult Hallux Valgus Deformity With an Increased Distal Metatarsal Articular Angle?

Science.gov (United States)

Park, Chul Hyun; Cho, Jae Ho; Moon, Jeong Jae; Lee, Woo Chun

2016-01-01

No previous study has reported the results of double metatarsal osteotomy for adult hallux valgus deformity with an increased distal metatarsal articular angle (DMAA). The purpose of the present study was to evaluate the results after double metatarsal osteotomy in adult patients with incongruent hallux valgus deformity. We retrospectively reviewed 16 cases of consecutive first metatarsal double metatarsal osteotomy without lateral soft tissue release in 14 patients with symptomatic hallux valgus associated with an increased DMAA (≥15° after proximal chevron osteotomy on intraoperative radiographs). Clinical results were assessed using the American Orthopaedic Foot and Ankle Society scale and the visual analog scale. The radiographic results were assessed over time, and changes in the DMAA and the relative length of the first metatarsal were assessed by measuring each value preoperatively and at the last follow-up visit. The American Orthopaedic Foot and Ankle Society and visual analog scale scores were significantly improved after surgery. The hallux valgus angle and intermetatarsal angle were stabilized >3 months after surgery. The sesamoid position did not increase significantly beyond the immediate postoperative period. The mean DMAA was corrected from 21.6° (range 15° to 29°) preoperatively to 11.1° (range -2° to 17°) at the last follow-up visit. The mean amount of shortening of the first metatarsal after surgery was 5.5 (range 4 to 7) mm. In conclusion, double metatarsal osteotomy without lateral soft tissue release in adult hallux valgus deformity results in high postoperative recurrence and complication rates. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Flipped Classroom Model Improves Graduate Student Performance in Cardiovascular, Respiratory, and Renal Physiology

Science.gov (United States)

Tune, Johnathan D.; Sturek, Michael; Basile, David P.

2013-01-01

The purpose of this study was to assess the effectiveness of a traditional lecture-based curriculum versus a modified "flipped classroom" curriculum of cardiovascular, respiratory, and renal physiology delivered to first-year graduate students. Students in both courses were provided the same notes and recorded lectures. Students in the…

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...

The influence of foot geometry on the calcaneal osteotomy angle based on two-dimensional static force analyses

NARCIS (Netherlands)

Reilingh, M.L.; Tuijthof, G.J.M.; Van Dijk, C.N.; Blankevoort, L.

2011-01-01

Background: Malalignment of the hindfoot can be corrected with a calcaneal osteotomy (CO). A well-selected osteotomy angle in the sagittal plane will reduce the shear force in the osteotomy plane while walking. The purpose was to determine the presence of a relationship between the foot geometry and

The influence of foot geometry on the calcaneal osteotomy angle based on two-dimensional static force analyses

NARCIS (Netherlands)

Reilingh, M. L.; Tuijthof, G. J. M.; van Dijk, C. N.; Blankevoort, L.

2011-01-01

Malalignment of the hindfoot can be corrected with a calcaneal osteotomy (CO). A well-selected osteotomy angle in the sagittal plane will reduce the shear force in the osteotomy plane while walking. The purpose was to determine the presence of a relationship between the foot geometry and loading of

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 ...

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

Biomechanical consequences of adding plantar fascia release to metatarsal osteotomies: Changes in forefoot plantar pressures.

Science.gov (United States)

Aydogan, Umur; Roush, Evan P; Moore, Blake E; Andrews, Seth H; Lewis, Gregory S

2017-04-01

Destruction of the normal metatarsal arch by a long metatarsal is often a cause for metatarsalgia. When surgery is warranted, distal oblique, or proximal dorsiflexion osteotomies of the long metatarsal bones are commonly used. The plantar fascia has anatomical connection to all metatarsal heads. There is controversial scientific evidence on the effect of plantar fascia release on forefoot biomechanics. In this cadaveric biomechanical study, we hypothesized that plantar fascia release would augment the plantar metatarsal pressure decreasing effects of two common second metatarsal osteotomy techniques. Six matched pairs of foot and ankle specimens were mounted on a pressure mat loading platform. Two randomly assigned surgery groups, which had received either distal oblique, or proximal dorsiflexion osteotomy of the second metatarsal, were evaluated before and after plantar fasciectomy. Specimens were loaded up to a ground reaction force of 400 N at varying Achilles tendon forces. Average pressures, peak pressures, and contact areas were analyzed. Supporting our hypothesis, average pressures under the second metatarsal during 600 N Achilles load were decreased by plantar fascia release following proximal osteotomy (p plantar fascia release following modified distal osteotomy, under multiple Achilles loading conditions (p Plantar fasciotomy should not be added to distal metatarsal osteotomy in the treatment of metatarsalgia. If proximal dorsiflexion osteotomy would be preferred, plantar fasciotomy should be approached cautiously not to disturb the forefoot biomechanics. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:800-804, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Does the Concept of the “Flipped Classroom” Extend to the Emergency Medicine Clinical Clerkship?

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Heitz, Corey; Prusakowski, Melanie; Willis, George; Franck, Christopher

2015-01-01

Introduction Linking educational objectives and clinical learning during clerkships can be difficult. Clinical shifts during emergency medicine (EM) clerkships provide a wide variety of experiences, some of which may not be relevant to recommended educational objectives. Students can be directed to standardize their clinical experiences, and this improves performance on examinations. We hypothesized that applying a “flipped classroom” model to the clinical clerkship would improve performance on multiple-choice testing when compared to standard learning. Methods Students at two institutions were randomized to complete two of four selected EM clerkship topics in a “flipped fashion,” and two others in a standard fashion. For flipped topics, students were directed to complete chief complaint-based asynchronous modules prior to a shift, during which they were directed to focus on the chief complaint. For the other two topics, modules were to be performed at the students’ discretion, and shifts would not have a theme. At the end of the four-week clerkship, a 40-question multiple-choice examination was administered with 10 questions per topic. We compared performance on flipped topics with those performed in standard fashion. Students were surveyed on perceived effectiveness, ability to follow the protocol, and willingness of preceptors to allow a chief-complaint focus. Results Sixty-nine students participated; examination scores for 56 were available for analysis. For the primary outcome, no difference was seen between the flipped method and standard (p=0.494.) A mixed model approach showed no effect of flipped status, protocol adherence, or site of rotation on the primary outcome of exam scores. Students rated the concept of the flipped clerkship highly (3.48/5). Almost one third (31.1%) of students stated that they were unable to adhere to the protocol. Conclusion Preparation for a clinical shift with pre-assigned, web-based learning modules followed by an

Does the Concept of the “Flipped Classroom” Extend to the Emergency Medicine Clinical Clerkship?

Directory of Open Access Journals (Sweden)

Corey Heitz

2015-10-01

Full Text Available Introduction: Linking educational objectives and clinical learning during clerkships can be difficult. Clinical shifts during emergency medicine (EM clerkships provide a wide variety of experiences, some of which may not be relevant to recommended educational objectives. Students can be directed to standardize their clinical experiences, and this improves performance on examinations. We hypothesized that applying a “flipped classroom” model to the clinical clerkship would improve performance on multiple-choice testing when compared to standard learning. Methods: Students at two institutions were randomized to complete two of four selected EM clerkship topics in a “flipped fashion,” and two others in a standard fashion. For flipped topics, students were directed to complete chief complaint-based asynchronous modules prior to a shift, during which they were directed to focus on the chief complaint. For the other two topics, modules were to be performed at the students’ discretion, and shifts would not have a theme. At the end of the four-week clerkship, a 40-question multiple-choice examination was administered with 10 questions per topic. We compared performance on flipped topics with those performed in standard fashion. Students were surveyed on perceived effectiveness, ability to follow the protocol, and willingness of preceptors to allow a chief-complaint focus. Results: Sixty-nine students participated; examination scores for 56 were available for analysis. For the primary outcome, no difference was seen between the flipped method and standard (p=0.494. A mixed model approach showed no effect of flipped status, protocol adherence, or site of rotation on the primary outcome of exam scores. Students rated the concept of the flipped clerkship highly (3.48/5. Almost one third (31.1% of students stated that they were unable to adhere to the protocol. Conclusion: Preparation for a clinical shift with pre-assigned, web-based learning

[The minimally invasive Chevron and Akin osteotomy (MICA)].

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Altenberger, Sebastian; Kriegelstein, Stefanie; Gottschalk, Oliver; Dreyer, Florian; Mehlhorn, Alexander; Röser, Anke; Walther, Markus

2018-04-18

Percutaneous correction of a hallux valgus deformity with or without transfer metatarsalgia. Hallux valgus deformity up to 20° intermetatarsal angle, without instability of the first tarsometatarsal joint. Symptomatic arthritis of the first metatarsophalangeal joint, as well as instability of the first tarsometatarsal joint. Percutaneous performed osteotomy of the distal metatarsal 1 in combination with a medial closing wedge osteotomy of the proximal phalanx of the first toe. The use of a postoperative shoe with a rigid sole allows adapted weight bearing in the first 6 weeks. Active and passive mobilization can start immediately after surgery. The method is very effective to treat even severe deformities with or without metatarsalgia. The amount of correction is similar to open procedures. We recommend cadaver training to become familiar with this technique. Thus, complications such as nerve, vessel or tendon injuries can be avoided. The intraoperative radiation exposure remains significantly elevated even for experienced surgeons. In addition to the aesthetic benefits, there is less soft tissue traumatization compared to conventional open procedures. There is no need of bloodlessness. The minimally invasive Chevron and Akin osteotomy is a safe and powerful technique for the treatment of hallux valgus deformity.

Retention of Content Utilizing a Flipped Classroom Approach.

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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.

Mini-Invasive floating metatarsal osteotomy for resistant or recurrent neuropathic plantar metatarsal head ulcers.

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Tamir, Eran; Finestone, Aharon S; Avisar, Erez; Agar, Gabriel

2016-07-11

Patients with peripheral neuropathy and pressure under a relatively plantar deviated metatarsal head frequently develop plantar foot ulcers. When conservative management with orthotics and shoes does not cure the ulcer, surgical metatarsal osteotomy may be indicated to relieve the pressure and enable the ulcer to heal. The purpose of this study is to evaluate the use of a mini-invasive floating metatarsal osteotomy in treating recalcitrant ulcers or recurrent ulcers plantar to the metatarsal heads in patients with diabetes mellitus (DM) related neuropathy. Computerized medical files of patients with diabetic neuropathy treated with an osteotomy during 2013 and 2014 were retrospectively reviewed. There were 20 osteotomies performed on 17 patients (mean age 58 years). The patients had a diagnosis of DM for a mean of 17 years. All ulcers were University of Texas grade 1A; mean ulcer age was 19 months. After 17/20 operations, the ulcer completely resolved after 6 weeks and did not recur after a mean follow-up of 11.5 months. One patient developed an early post-operative infection with osteomyelitis at the osteotomy site (proximal shaft of the fifth metatarsal) that needed debridement and IV antibiotics. In the other 19 cases, the surgical wound healed within 1 week. Asymptomatic radiological non-union developed in six cases (30 %). Mini-invasive floating metatarsal osteotomy can cure resistant and recurrent University of Texas grade 1A ulcerations plantar to the metatarsal heads in neuropathic patients.

Student and Instructor Perceptions of a Flipped College Algebra Classroom

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Jaster, Robert W.

2017-01-01

Each year about half a million students fail to make planned academic progress due to college algebra, hence the need for researchers to find ways of improving the quality of instruction in the course. Recent research suggests that flipping college algebra to allow time for active learning in the classroom may improve student performance. Also,…

Conceptualizing "Homework" in Flipped Mathematics Classes

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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

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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…

Comparison between piezosurgery and conventional osteotomy in cranioplasty with fronto-orbital advancement.

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Martini, Markus; Röhrig, Andreas; Reich, Rudolf Hermann; Messing-Jünger, Martina

2017-03-01

Cranioplasty of patients with craniosynostosis requires rapid, precise and gentle osteotomy of the skull to avoid complications and benefit the healing process. The aim of this prospective clinical study was to compare two different methods of osteotomy. Piezosurgery and conventional osteotomy were compared using an oscillating saw and high speed drill while performing cranioplasties with fronto-orbital advancement. Thirty-four children who required cranioplasty with fronto-orbital advancement were recruited consecutively. The operations were conducted using piezosurgery or a conventional surgical technique, alternately. Operative time, blood count, CRP and transfusion rate, as well as soft tissue injuries, postoperative edema, pain development and secondary bone healing were investigated. The average age of patients was 9.7 months. The following indications for craniosynostosis were surgically corrected: trigonocephaly (23), anterior plagiocephaly (8), brachycephaly (1), and syndromic craniosynostosis (2). Piezosurgery was utilized in 18 cases. There were no group differences with regard to the incidence of soft tissue injuries (dura, periorbita), pain, swelling, blood loss or bony integration. The duration of osteotomy was significantly longer in the piezosurgery group, leading to slightly increased blood loss, while the postoperative CRP increase was higher using the conventional method. The piezosurgery method is a comparatively safe surgical method for conducting osteotomy during cranioplasty. With regard to soft tissue protection and postoperative clinical course, the same procedural precautions and controls are necessary as those needed for conventional methods. The osteotomy duration is considerably longer using piezosurgery, although it is accompanied by lower initial postoperative CRP values. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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

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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…

Valgus osteotomy of the tibia with a Puddu plate combined with anterior cruciate ligament reconstruction

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Albuquerque Roberto Freire da Mota e

2003-01-01

Full Text Available Anterior knee instability associated with a varus deformity is a complex condition with several treatment possibilities. Among these, anterior cruciate ligament (ACL associated to a simultaneous valgus tibial osteotomy is a increasing indication. This simultaneous procedure adds technical issues to those related to the isolated surgeries. Thus, the osteotomy plane and location of fixation hardware shouldn?t conflict with tibial tunnel and ACL graft fixation. Authors analyze the relations between a opening tibial valgus osteotomy stabilized with a Puddu plate and ACL reconstruction with a patellar tendon graft fixated with interference screws in 10 human cadaver knees. A straight oblique tibial osteotomy starting on the medial tibial cortex and oriented laterally and proximally was performed on all knees with a 10mm opening medially and stabilized with a Puddu plate on the most posterior aspect of the medial tibia, and a tibial tunnel drilled 50° to tibial plateau. With this technique there was no intersection between tibial tunnel or interference screw and the osteotomy or the plate fixation screws.

High Rate of Recurrence Following Proximal Medial Opening Wedge Osteotomy for Correction of Moderate Hallux Valgus.

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Iyer, Sravisht; Demetracopoulos, Constantine A; Sofka, Carolyn M; Ellis, Scott J

2015-07-01

The proximal medial opening wedge (PMOW) osteotomy has become more popular to treat moderate to severe hallux valgus with the recent development of specifically designed, low-profile modular plates. Despite the promising results previously reported in the literature, we have noted a high incidence of recurrence in patients treated with a PMOW. The purpose of this study was to report the clinical and radiographic outcomes of an initial cohort of patients treated with a PMOW osteotomy for moderate hallux valgus. We retrospectively analyzed prospectively gathered data on a cohort of 17 consecutive patients who were treated by the senior author using a PMOW osteotomy for moderate hallux valgus deformity. Average time to follow-up was 2.4 years (range, 1.0-3.5 years). The intermetatarsal angle (IMA), the hallux valgus angle (HVA), and the distal metatarsal articular angle (DMAA) were assessed on standard weightbearing radiographs of the foot preoperatively and at all follow-up visits. The Foot and Ankle Outcome Score (FAOS) was collected on all patients preoperatively and at final follow-up. Despite demonstrating good correction of their deformity initially, 11 of the 17 patients (64.7%) had evidence of recurrence of their hallux valgus deformity at final follow-up. Patients who recurred had a greater preoperative HVA (P = .023) and DMAA (P = .049) than patients who maintained their correction. Improvement in the quality-of-life subscale of the FAOS was noted at final follow-up for all patients (P = .05). There was no significant improvement in any of the other FAOS subscales. There was a high rate of recurrence of the hallux valgus deformity in this cohort of patients. Recurrence was associated with greater preoperative deformity and an increased preoperative DMAA. The PMOW without a concomitant distal metatarsal osteotomy may be best reserved for patients with mild hallux valgus deformity without an increased DMAA. Level IV, retrospective case series. © The Author

Radiographic evaluation for AVN following distal metatarsal Stoffella bunion osteotomy.

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Klein, Christian; Zembsch, Alexander; Dorn, Ulrich

2009-01-01

Avascular necrosis of the metatarsal head, delayed bone healing and nonunion are complications that may occur after distal first metatarsal osteotomies. Intraoperative damage to the extraosseous blood supply, the location of the osteotomy and postoperative vasospasm have been cited as possible causes of such changes. We evaluated Stoffella's subcapital osteotomies which were performed at our department for the correction of moderate to severe hallux valgus deformities. Standardized radiographs of 300 feet, taken 6weeks, 3 months, and 6 months postoperatively and at the final followup were examined with regard to postoperative AVN or signs of delayed bone healing. Of 228 patients, 202 were women and 26 were men. The patients' mean age was 49 years, and the mean followup was 12 months. In 278 cases the radiographs revealed an unremarkable first metatarsal head. Seventeen cases showed diffuse or localized osteopenia or small cysts in the subchondral bone. These changes fully resolved on subsequent radiographs. The X-rays of two patients revealed progressive narrowing of the joint space, irregular contours on the surface of the joint and an abnormal bone structure. The patients subsequently developed a characteristic picture of avascular necrosis, in one case combined with nonunion. Three patients had delayed bone healing, but ultimately healed successfully. Ischemic changes in bone are known to occur after distal first metatarsal osteotomies. There is a very low incidence of postoperative perfusion problems after Stoffella;s technique, even with lateral soft tissue release.

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

Friend or Foe? Flipped Classroom for Undergraduate Electrocardiogram Learning: a Randomized Controlled Study.

Science.gov (United States)

Rui, Zeng; Lian-Rui, Xiang; Rong-Zheng, Yue; Jing, Zeng; Xue-Hong, Wan; Chuan, Zuo

2017-03-07

Interpreting an electrocardiogram (ECG) is not only one of the most important parts of clinical diagnostics but also one of the most difficult topics to teach and learn. In order to enable medical students to master ECG interpretation skills in a limited teaching period, the flipped teaching method has been recommended by previous research to improve teaching effect on undergraduate ECG learning. A randomized controlled trial for ECG learning was conducted, involving 181 junior-year medical undergraduates using a flipped classroom as an experimental intervention, compared with Lecture-Based Learning (LBL) as a control group. All participants took an examination one week after the intervention by analysing 20 ECGs from actual clinical cases and submitting their ECG reports. A self-administered questionnaire was also used to evaluate the students' attitudes, total learning time, and conditions under each teaching method. The students in the experimental group scored significantly higher than the control group (8.72 ± 1.01 vs 8.03 ± 1.01, t = 4.549, P = 0.000) on ECG interpretation. The vast majority of the students in the flipped classroom group held positive attitudes toward the flipped classroom method and also supported LBL. There was no significant difference (4.07 ± 0.96 vs 4.16 ± 0.89, Z = - 0.948, P = 0.343) between the groups. Prior to class, the students in the flipped class group devoted significantly more time than those in the control group (42.33 ± 22.19 vs 30.55 ± 10.15, t = 4.586, P = 0.000), whereas after class, the time spent by the two groups were not significantly different (56.50 ± 46.80 vs 54.62 ± 31.77, t = 0.317, P = 0.752). Flipped classroom teaching can improve medical students' interest in learning and their self-learning abilities. It is an effective teaching model that needs to be further studied and promoted.

Can blended learning and the flipped classroom improve student learning and satisfaction in Saudi Arabia?

Science.gov (United States)

Sajid, Muhammad R; Laheji, Abrar F; Abothenain, Fayha; Salam, Yezan; AlJayar, Dina; Obeidat, Akef

2016-09-04

To evaluate student academic performance and perception towards blended learning and flipped classrooms in comparison to traditional teaching. This study was conducted during the hematology block on year three students. Five lectures were delivered online only. Asynchronous discussion boards were created where students could interact with colleagues and instructors. A flipped classroom was introduced with application exercises. Summative assessment results were compared with previous year results as a historical control for statistical significance. Student feedback regarding their blended learning experience was collected. A total of 127 responses were obtained. Approximately 22.8% students felt all lectures should be delivered through didactic lecturing, while almost 35% felt that 20% of total lectures should be given online. Students expressed satisfaction with blended learning as a new and effective learning approach. The majority of students reported blended learning was helpful for exam preparation and concept clarification. However, a comparison of grades did not show a statistically significant increase in the academic performance of students taught via the blended learning method. Learning experiences can be enriched by adopting a blended method of instruction at various stages of undergraduate and postgraduate education. Our results suggest that blended learning, a relatively new concept in Saudi Arabia, shows promising results with higher student satisfaction. Flipped classrooms replace passive lecturing with active student-centered learning that enhances critical thinking and application, including information retention.

A flipped mode teaching approach for large and advanced electrical engineering courses

Science.gov (United States)

Ravishankar, Jayashri; Epps, Julien; Ambikairajah, Eliathamby

2018-05-01

A fully flipped mode teaching approach is challenging for students in advanced engineering courses, because of demanding pre-class preparation load, due to the complex and analytical nature of the topics. When this is applied to large classes, it brings an additional complexity in terms of promoting the intended active learning. This paper presents a novel selective flipped mode teaching approach designed for large and advanced courses that has two aspects: (i) it provides selective flipping of a few topics, while delivering others in traditional face-to-face teaching, to provide an effective trade-off between the two approaches according to the demands of individual topics and (ii) it introduces technology-enabled live in-class quizzes to obtain instant feedback and facilitate collaborative problem-solving exercises. The proposed approach was implemented for a large fourth year course in electrical power engineering over three successive years and the criteria for selecting between the flipped mode teaching and traditional teaching modes are outlined. Results confirmed that the proposed approach improved both students' academic achievements and their engagement in the course, without overloading them during the teaching period.

Unstable recent intracapsular femoral neck fractures in young adults: Osteosynthesis and primary valgus osteotomy using broad dynamic compression plate

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Singh M

2008-01-01

Full Text Available Background: Displaced intracapsular femoral neck fractures continue to be a difficult problem to treat. Various treatment modalities and their modifications have been proposed to improve the outcome. Osteosynthesis and primary valgus angulation osteotomy is one of them. Technique and outcome in a consecutive series of recent intracapsular femoral neck fractures in young adults, from a single center, is presented. Materials and Methods: Fifty-five patients of recent (< 3 weeks old displaced intracapsular fracture neck femur (Garden III and IV, Pauwels III, with or without comminution in the age group 20-50 years (mean 35.4±10.4 years were subjected to osteosynthesis and primary valgus intertrochanteric osteotomy using contoured broad dynamic compression plate (DCP. The patients were followed up from two to six years (mean 4.6 years. Results: Fifty-one fractures united by six months of the index procedure (92.7% union range. Avascular necrosis (AVN developed in six patients (11%. The other complications were shortening (six, coxa vara (two, infection (two and delayed union at osteotomy site (one. Excellent results were achieved in 48, good/fair in four and poor in three patients. Conclusion: Osteosynthesis with cancellous screw and primary valgus intertrochanteric osteotomy stabilized by a contoured broad DCP is a simple, easy to perform, biological treatment. Failure in a particular case can be treated with any appropriate second procedure. Level of Evidence: IV

Complete Cranial Iliac Osteotomy to Approach the Lumbosacral Foramen

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Barbara Dyall

2017-05-01

Full Text Available An approach using a complete cranial iliac osteotomy (CCIO to access the lumbosacral (LS foramen in dogs from lateral was developed using cadavers and applied in a clinical patient with degenerative lumbosacral stenosis (DLSS. The foraminal enlargement in the cadavers and the patient was documented on postoperative CT scans. The preoperative CT scan of the patient showed moderate cranial telescoping of the sacral roof and a moderate central disk protrusion, leading to moderate to severe compression of the cauda equina. In addition, there was lateral spondylosis with consequential stenosis of the right LS foramen. The right L7 nerve had lost its fat attenuation and appeared thickened. After a routine L7S1 dorsal laminectomy with a partial discectomy, a CCIO was performed, providing good access to the LS foramen and the adhesions around the proximal L7 nerve caudoventral to the foramen. The osteotomy was stabilized with a locking plate and a cerclage wire. The dog recovered well from the procedures and after 36 h, the dog walked normally and was discharged from the hospital. Eight and 16 weeks later, the signs of the DLSS had markedly improved. From these data, it can be concluded that the CCIO is a useful approach to the LS foramen and intervertebral disk in selected patients with DLSS, giving good access to the structures around the LS foramen.

How I Used Flipped Learning to Inform My Teaching

Science.gov (United States)

Chang, Sau Hou

2016-01-01

This paper aims to reflect upon the experience of using flipped learning in a college class. After presenting the alignment of learning objectives and assessments, evidence-based evaluation was provided as rationale for changes. Approaches taken to improve learning were then elaborated. Further assessment of impact of change on student learning…

[Biomechanical study of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate].

Science.gov (United States)

Hou, Min; Shi, Guang-Yu; Pu, Li-Chen; Song, Da-Li; Zhang, Xi-Zhong; Liu, Chun-Ming

2009-09-01

To investigate the biomechanical changes of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate (CLP). 3-D finite element (FEM) analysis was used. 3-D models of Le Fort I, II, III osteotomy and soft tissue were established. Based on the new pattern of internal midface distractor, the distraction of maxillary complex was simulated to advance 10 mm anteriorly. The mechanical change was studied. The maxillary complex in CLP were advanced after distraction. Constriction of alveolar crest and palate occurred in Le Fort I osteotomy, but not in Le Fort II and III osteotomy. The maxillary complex was moved anteriorly en bloc after Le Fort III osteotomy, but some degree of rotation of maxillary complex was observed during the distraction after Le Fort I and II osteotomy. In vertical direction, the maxillary complex had more counterclockwise rotation after Le Fort II osteotomy. 3-D FEM analysis can be used for the study of internal distraction. It can reflect the maxillary movement and provide the theory basis for preoperative design.

Vodcasts and active-learning exercises in a "flipped classroom" model of a renal pharmacotherapy module.

Science.gov (United States)

Pierce, Richard; Fox, Jeremy

2012-12-12

To implement a "flipped classroom" model for a renal pharmacotherapy topic module and assess the impact on pharmacy students' performance and attitudes. Students viewed vodcasts (video podcasts) of lectures prior to the scheduled class and then discussed interactive cases of patients with end-stage renal disease in class. A process-oriented guided inquiry learning (POGIL) activity was developed and implemented that complemented, summarized, and allowed for application of the material contained in the previously viewed lectures. Students' performance on the final examination significantly improved compared to performance of students the previous year who completed the same module in a traditional classroom setting. Students' opinions of the POGIL activity and the flipped classroom instructional model were mostly positive. Implementing a flipped classroom model to teach a renal pharmacotherapy module resulted in improved student performance and favorable student perceptions about the instructional approach. Some of the factors that may have contributed to students' improved scores included: student mediated contact with the course material prior to classes, benchmark and formative assessments administered during the module, and the interactive class activities.

Improvement of surface light extraction from flip-chip GaN-based LED by embossing of thermosetting polymers

Energy Technology Data Exchange (ETDEWEB)

Bao, Kui; Zhang, Bei; Wang, ZhiMin; Dai, Tao; Kang, XiangNing; Chen, ZhiZhong; Xu, Ke; Ji, Hang; Chen, Yong; Gan, ZiZhao [School of Physics and State Key Laboratory for Artificial Microstructures and Mesoscopic Physics, Peking University, Beijing 100871 (China)

2007-07-01

In this report, a further improvement of surface light extraction from flip-chip GaN-based LED was obtained by the micro patterning of encapsulation on the sapphire. The two dimensional taper arrays with period from 6 to 10 micron were successfully realized on polymer encapsulation by a simple and low cost technique so called embossing of thermosetting polymers. As a preliminary demonstration, at least 1.74 enhancement of the surface output intensity was achieved in the 1 mm x 1 mm GaN-based LED device under the injection current of 350 mA. (copyright 2007 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

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...

Experimental Fracture Model versus Osteotomy Model in Metacarpal Bone Plate Fixation

Directory of Open Access Journals (Sweden)

S. Ochman

2011-01-01

Full Text Available Introduction. Osteotomy or fracture models can be used to evaluate mechanical properties of fixation techniques of the hand skeleton in vitro. Although many studies make use of osteotomy models, fracture models simulate the clinical situation more realistically. This study investigates monocortical and bicortical plate fixation on metacarpal bones considering both aforementioned models to decide which method is best suited to test fixation techniques. Methods. Porcine metacarpal bones (=40 were randomized into 4 groups. In groups I and II bones were fractured with a modified 3-point bending test. The intact bones represented a further control group to which the other groups after fixation were compared. In groups III and IV a standard osteotomy was carried out. Bones were fixated with plates monocortically (group I, III and bicortically (group II, IV and tested for failure. Results. Bones fractured at a mean maximum load of 482.8 N ± 104.8 N with a relative standard deviation (RSD of 21.7%, mean stiffness was 122.3 ± 35 N/mm. In the fracture model, there was a significant difference (=0.01 for maximum load of monocortically and bicortically fixed bones in contrast to the osteotomy model (=0.9. Discussion. In the fracture model, because one can use the same bone for both measurements in the intact state and the bone-plate construct states, the impact of inter-individual differences is reduced. In contrast to the osteotomy model there are differences between monocortical and bicortical fixations in the fracture model. Thus simulation of the in vivo situation is better and seems to be suitable for the evaluation of mechanical properties of fixation techniques on metacarpals.

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.

Use of a percutaneous osteotomy with plate fixation in hallux valgus correction.

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Díaz Fernández, Rodrigo

2017-09-20

With hundreds of operative methods described for correction of hallux valgus we can state that the ideal surgical treatment is still controversial. The Bösch technique has been used as a percutaneous way of correcting hallux valgus deformities with the use of a pin fixation. The aim of this study is to evaluate a new method of fixation by using a percutaneous locking plate. Between June 2013 and January 2015, 24 consecutive percutaneous subcapital osteotomies of the first metatarsal bone were performed for the treatment of painful hallux valgus deformities in 24 patients. Additional surgical procedures included DMMO's (Distal Metatarsal Minimally-Invasive Osteotomies) in 12 of the operated feet (44.44%); minor digits were corrected in 7 cases (25.9%). An Akin procedure was performed in 81% of cases and all cases underwent an adductor hallucis tenotomy. All patients were clinically assessed using the AOFAS score. Radiographic measures included the preoperative and postoperative values of the Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), and the Distal Metatarsal Articular Angle (DMAA). The mean correction achieved improved for AHV from 36.57±7.1 to 12.22±8.69°, for IMA from 13.8±1.59 to 7.08±2.72 and for DMAA from 13.98±7.38 to 6.07±4.99. Clinically, scores on the AOFAS scale improved from a 45.8±9.6 to 91.29±9.8. Although healing of the osteotomies was observed radiographically within 6 to 12 weeks, two cases (8.3%) exhibited delayed healing. There were no cases of nonunion. There were no superficial or deep infections or wound healing problems. Plate had to be removed in 3 cases (12.5%). This technique modification is an acceptable procedure to correct hallux valgus in patients with a moderate level of deformity. Level IV. Copyright © 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Impacts of Flipped Classroom in High School Health Education

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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

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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 results of Scarf osteotomy combined with distal soft tissue procedure are mostly satisfactory in surgical management of moderate to severe hallux valgus.

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Şaylı, Uğur; Akman, Budak; Tanrıöver, Altuğ; Kaspar, Çiğdem; Güven, Melih; Özler, Turhan

2017-05-29

Intrinsically stable diaphyseal osteotomy gained popularity in recent years for symptomatic hallux valgus deformities. In this study, Scarf osteotomy results, in surgical management of moderate to severe hallux valgus, are presented. Study group consisted of 40 feet of 32 (28 females, four males) patients surgically managed by Scarf osteotomy between September 2009 and 2011, with a mean age of 52,98 (range, 31-75) years at the time of surgery. Patient satisfaction and VAS were used for subjective evaluation while for objective measures AOFAS score, first metatarsophalangeal joint ROM and radiological measurements (intermetatarsal, hallux valgus and distal metatarsal articular angles) were evaluated. Mean follow-up period was 38 (range, 24-60) months. Sixteen feet (40%) were reported as very satisfied, 19 (47,5%) as satisfied and the remaining five (12,5%) as unsatisfied resulting with a total of 35 (87,5%) satisfaction. The mean preoperative VAS and AOFAS forefoot scores improved from 8,13±0,791 to 2,68±1,228 (p=0,0001) and from 58,25±6,15 to 78,25±8,13 (p=0,0001) on the final follow-up, respectively. The postoperative change of first metatarsophalangeal joint ROM was not statistically significant (p=0,281). On the radiological evaluation; intermetatarsal and hallux valgus angles improved from a mean value of 14,77±1,76 to 8,13±1,52° (p=0,0001) and from 35,28±5,86 to 20,10±5,55° (p=0,0001), respectively. Distal metatarsal articular angle did not show any statistically significant change (p=0,195). Scarf osteotomy combined with distal soft tissue procedure is a technically demanding procedure. The osteotomy is intrinsically stable and the correction power is high and the results are mostly satisfactory. Copyright © 2017. Published by Elsevier Ltd.

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

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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.

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

Predicted osteotomy planes are accurate when using patient-specific instrumentation for total knee arthroplasty in cadavers: a descriptive analysis.

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Kievit, A J; Dobbe, J G G; Streekstra, G J; Blankevoort, L; Schafroth, M U

2018-06-01

Malalignment of implants is a major source of failure during total knee arthroplasty. To achieve more accurate 3D planning and execution of the osteotomy cuts during surgery, the Signature (Biomet, Warsaw) patient-specific instrumentation (PSI) was used to produce pin guides for the positioning of the osteotomy blocks by means of computer-aided manufacture based on CT scan images. The research question of this study is: what is the transfer accuracy of osteotomy planes predicted by the Signature PSI system for preoperative 3D planning and intraoperative block-guided pin placement to perform total knee arthroplasty procedures? The transfer accuracy achieved by using the Signature PSI system was evaluated by comparing the osteotomy planes predicted preoperatively with the osteotomy planes seen intraoperatively in human cadaveric legs. Outcomes were measured in terms of translational and rotational errors (varus, valgus, flexion, extension and axial rotation) for both tibia and femur osteotomies. Average translational errors between the osteotomy planes predicted using the Signature system and the actual osteotomy planes achieved was 0.8 mm (± 0.5 mm) for the tibia and 0.7 mm (± 4.0 mm) for the femur. Average rotational errors in relation to predicted and achieved osteotomy planes were 0.1° (± 1.2°) of varus and 0.4° (± 1.7°) of anterior slope (extension) for the tibia, and 2.8° (± 2.0°) of varus and 0.9° (± 2.7°) of flexion and 1.4° (± 2.2°) of external rotation for the femur. The similarity between osteotomy planes predicted using the Signature system and osteotomy planes actually achieved was excellent for the tibia although some discrepancies were seen for the femur. The use of 3D system techniques in TKA surgery can provide accurate intraoperative guidance, especially for patients with deformed bone, tailored to individual patients and ensure better placement of the implant.

Osteotomy around young deformed knees: 38-year super-long-term follow-up to detect osteoarthritis.

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Koshino, Tomihisa

2010-02-01

Since 1969 corrective osteotomy has been performed at our institute in young patients (under 40 years) with bowlegs, knock knees and flexion or rotational deformities around the knee. Fifty-seven knees (29 left, 28 right) of 45 patients (19 boys, 26 girls) were followed-up for a period ranging from 30 to 38 years in seven patients with seven knees, from 20 to 29 years in nine patients with 11 knees, and from ten to 19 years in 29 patients with 39 knees. Supracondylar femoral osteotomy was performed on 12 knees (11 patients), high tibial osteotomy above the tibial tuberosity on eight knees (six patients) and below the tuberosity on 37 knees (28 patients). At the final follow-up (age range 42-73 years), all of the deformities were satisfactorily corrected, with no symptoms apart from nine knees, seven of which had dull pain after strenuous sport with osteophytes, etc. in the radiograph. Total knee arthroplasty was performed in the remaining two knees, at ten and 26 years, respectively, after the initial osteotomy. Osteoarthritis developed in the contralateral knee to the initial osteotomy in two patients after 34 years at age 73 and after 33 years at age 67.

Flipping social determinants on its head: Medical student perspectives on the flipped classroom and simulated patients to teach social determinants of health.

Science.gov (United States)

Gostelow, N; Barber, J; Gishen, F; Berlin, A

2018-02-19

Inequalities in healthcare are increasing. Engaging medical students to tackle this urgent challenge alongside clinical sciences can be demanding. This study examines medical student perceptions of a flipped approach to health inequalities co-designed by faculty and sixth-year students. A flipped learning session was piloted for year 4 medical students combining an online lesson followed by a tutorial with a simulated patient. A mixed-methods approach collected questionnaire data using 4-point Likert scales and free text answers. A semi-structured group interview was conducted with six voluntary participants. Two hundred and eighty-nine students completed questionnaires. 85% (n = 246) completed the online lesson. Students agreed the session helped their understanding of key concepts (mean 3.2), was improved by having an actor (mean = 3.6), and was enjoyable (mean = 3.2). Thematic analysis of qualitative questionnaire and interview data revealed three themes: engagement; structure; and attitudes towards social determinants of health. The simulation increased clinical relevance and students gained understanding of the impact of health inequalities upon individuals. This paper indicates flipped learning can increase clinical relevance and engagement in population health and person-centered care. Further work could assess changes in practice and attitudes of future doctors in tackling such global health challenges.

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.

Can blended learning and the flipped classroom improve student learning and satisfaction in Saudi Arabia?

Science.gov (United States)

Sajid, Muhammad R.; Abothenain, Fayha; Salam, Yezan; AlJayar, Dina; Obeidat, Akef

2016-01-01

Objectives To evaluate student academic performance and perception towards blended learning and flipped classrooms in comparison to traditional teaching. Methods This study was conducted during the hematology block on year three students. Five lectures were delivered online only. Asynchronous discussion boards were created where students could interact with colleagues and instructors. A flipped classroom was introduced with application exercises. Summative assessment results were compared with previous year results as a historical control for statistical significance. Student feedback regarding their blended learning experience was collected. Results A total of 127 responses were obtained. Approximately 22.8% students felt all lectures should be delivered through didactic lecturing, while almost 35% felt that 20% of total lectures should be given online. Students expressed satisfaction with blended learning as a new and effective learning approach. The majority of students reported blended learning was helpful for exam preparation and concept clarification. However, a comparison of grades did not show a statistically significant increase in the academic performance of students taught via the blended learning method. Conclusions Learning experiences can be enriched by adopting a blended method of instruction at various stages of undergraduate and postgraduate education. Our results suggest that blended learning, a relatively new concept in Saudi Arabia, shows promising results with higher student satisfaction. Flipped classrooms replace passive lecturing with active student-centered learning that enhances critical thinking and application, including information retention.  PMID:27591930

Implementing the Flipped Classroom Model in the Teaching of History

Directory of Open Access Journals (Sweden)

Siti Waznah Abdul Latif

2017-11-01

Full Text Available This study investigated the effectiveness in implementing the Flipped Classroom model in teaching History and to identify the students’ perceptions using this approach towards their learning. The chosen History topic was on ‘James Brooke’s activities in Sarawak in the 1840s’. The sample consisted of twelve students from two Year 9 classes in one of the secondary schools in Brunei Darussalam. In adopting the Flipped Classroom approach, the students were required to watch a video lesson outside the classroom setting. To measure its effectiveness, a test instrument was used, and five students were interviewed. The findings revealed that the utilisation of this instructional method was effective in teaching History, as there were improvements in the students’ test results. The analyses of the students’ perceptions using this approach revealed that while some students believed that it helped them improve in their communication and writing skills, others did not perceive it effective for their learning.

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.

Comparison of Puddu osteotomy with or without autologous bone grafting: a prospective clinical trial

Directory of Open Access Journals (Sweden)

Marcus Ceregatti Passarelli

Full Text Available ABSTRACT Objectives: To test the hypothesis that autologous iliac bone grafts do not enhance clinical results and do not decrease complication rates in patients undergoing medial opening-wedge high tibial , osteotomy. Methods: Forty patients allocated in a randomized, two-armed, double-blinded clinical trial were evaluated between 2007 and 2010. One group received bone graft, and the other group was left without filling the osteotomy defect. The primary outcome was the Knee Society Score. , Radiographic measurement of the frontal anatomical femoral-tibial angle and the progression of osteoarthritis according to the modified Ahlback classification were used as secondary outcomes., Results: There was no difference in KSS scale between the graft group (64.4 ± 21.8 and the graftless group (61.6 ± 17.3; p= 0.309. There was no difference of angle between the femur and tibia in the frontal plane between the groups (graft, = 184 ± 4.6 degrees, graftless = 183.4 ± 5.1 degrees; p= 1.0, indicating that there is no loss of correction due to the lack of the graft. There was significant aggravation of osteoarthritis in a greater number of patients in a graft group (p= 0.005 . Conclusion: Autologous iliac bone graft does not improve clinical outcomes in medium and long-term follow-up of medial opening-wedge high tibial osteotomy fixed with a first generation Puddu plate in the conditions of this study.

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...

Extraction of impacted mandibular third molars - the effect of osteotomy at two speeds on peripheral bone: a histopathological analysis.

Science.gov (United States)

Siroraj, A Pearlcid; Giri G V V; Ramkumar, Subramaniam; Narasimhan, Malathi

2016-05-01

The aim of this study was to find out the ideal speed for making a precise osteotomy with minimal damage to the surrounding bone. Thirty-six patients were divided into two groups (n=18 in each) depending on the speed of the handpiece used for osteotomy (slow=20000rpm and fast=40000rpm). Samples were taken from the peripheral bone and examined histologically to measure the margins of the osteotomy, the amount of debris produced, and the degree of thermal osteonecrosis. The osteotomy made with the high speed handpiece was better than that made with the low speed one on all counts. The margins in the high speed group were more or less precisely as required, with less debris and no thermal necrosis, which illustrated the efficacy of a high speed osteotomy. These findings can apply to other procedures that involve osteotomies in maxillofacial surgery. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Clinical and radiological outcome after periacetabular osteotomy

DEFF Research Database (Denmark)

Dahl, Line B; Dengsø, Kristine; Bang-Christiansen, Karl

2014-01-01

PURPOSE: Few papers have described results after periacetabular osteotomy (PAO) and risk factors for conversion to total hip arthroplasty (THA). The aim of the present paper was to analyse clinical and radiographic outcome, survival of the hip joint and risk factors of early conversion to THA in ...

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.

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.

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…

Nasomaxillary hypoplasia with a congenitally missing tooth treated with LeFort II osteotomy, autotransplantation, and nickel-titanium alloy wire.

Science.gov (United States)

Ishida, Takayoshi; Ikemoto, Shigehiro; Ono, Takashi

2015-09-01

In some skeletal Class III adult patients with nasomaxillary hypoplasia, the LeFort I osteotomy provides insufficient correction. This case report describes a 20-year-old woman with a combination of nasomaxillary hypoplasia and a protrusive mandible with a congenitally missing mandibular second premolar. We performed a LeFort II osteotomy for maxillary advancement. Autotransplantation of a tooth was also performed; the donor tooth was used to replace the missing permanent tooth. To increase the chance of success, we applied light continuous force with an improved superelastic nickel-titanium alloy wire technique before extraction and after transplantation. The patient's profile and malocclusion were corrected, and the autotransplanted tooth functioned well. The postero-occlusal relationships were improved, and ideal overbite and overjet relationships were achieved. The methods used in this case represent a remarkable treatment. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

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

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

Minimally Invasive Calcaneal Displacement Osteotomy Site Using a Reference Kirschner Wire: A Technique Tip.

Science.gov (United States)

Lee, Moses; Guyton, Gregory P; Zahoor, Talal; Schon, Lew C

2016-01-01

As a standard open approach, the lateral oblique incision has been widely used for calcaneal displacement osteotomy. However, just as with other orthopedic procedures that use an open approach, complications, including wound healing problems and neurovascular injury in the heel, have been reported. To help avoid these limitations, a percutaneous technique using a Shannon burr for calcaneal displacement osteotomy was introduced. However, relying on a free-hand technique without direct visualization at the osteotomy site has been a major obstacle for this technique. To address this problem, we developed a technical tip using a reference Kirschner wire. A reference Kirschner wire technique provides a reliable and accurate guide for minimally invasive calcaneal displacement osteotomy. Also, the technique should be easy to learn for surgeons new to the procedure. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Using Flipped Classroom Approach to Explore Deep Learning in Large Classrooms

Directory of Open Access Journals (Sweden)

Brenda Danker

2015-01-01

Full Text Available 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 completed their assignments and practical work in class; or utilized a guided inquiry approach at the beginning of class using this same process. During the class the lecturers were present to help the students, and in addition, the students were advantaged by being able to help one another. The in-class learning activities also included inquiry-based learning, active learning, and peer-learning. This project used an action research approach to improve the in-class instructional design progressively to achieve its impact of deep learning among the students. The in-class learning activities that was included in the later flipped classes merged aspects of blended learning with an inquiry-based learning cycle which focused on the exploration of concepts. Data was gathered from questionnaires filled out by the students and from short interviews with the students, as well as from the teacher’s reflective journals. The findings verified that the flipped classrooms were able to remodel large lecture classes into active-learning classes. The results also support the possibility of individualised learning for the students as being high as a result of the teacher’s ability to provide one-on-one tutoring through technology-infused lessons. It is imperative that the in-class learning activities are purposefully designed as the inclusion of the exploratory learning through guided inquiry-based activities in the flipped classes was a successful way to engage students on a deeper level and increased the students’ curiosity and engaged them to develop higher-order thinking skills. This project also concluded that

Preoperative low level laser therapy in dogs undergoing tibial plateau levelling osteotomy: A blinded, prospective, randomized clinical trial.

Science.gov (United States)

Rogatko, Cleo P; Baltzer, Wendy I; Tennant, Rachel

2017-01-16

To evaluate the influence of preoperative low-level laser therapy (LLLT) on therapeutic outcomes of dogs undergoing tibial plateau levelling osteotomy (TPLO). Healthy dogs undergoing TPLO were randomly assigned to receive either a single preoperative LLLT treatment (800-900 nm dual wavelength, 6 W, 3.5 J/cm 2 , 100 cm 2 area) or a sham treatment. Lameness assessment and response to manipulation, as well as force plate analysis, were performed preoperatively, then again at 24 hours, two weeks, and eight weeks postoperatively. Radiographic signs of healing of the osteo-tomy were assessed at eight weeks postoperatively. Twenty-seven dogs (27 stifles) were included and no major complications occurred. At eight weeks postoperatively, a significant difference in peak vertical force analysis was noted between the LLLT (39.6% ± 4.7%) and sham groups (28.9% ± 2.6%), (p dogs in the LLLT group (6.6 ± 1.6 years) was greater than that for the sham group (4.5 ± 2.0, p dogs (5/8) had healed at the eight-week time point than in the sham group (3/12) despite the age difference (p = 0.11) Clinical significance: The results of this study demonstrate that improved peak vertical force could be related to the preoperative use of LLLT for dogs undergoing TPLO at eight weeks postoperatively. The use of LLLT may improve postoperative return to function following canine osteotomies and its use is recommended.

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…

Using a flipped classroom in an algebra-based physics course

Science.gov (United States)

Smith, Leigh

2013-03-01

The algebra-based physics course is taken by Biology students, Pre-Pharmacy, Pre-Medical, and other health related majors such as medical imaging, physical therapy, and so on. Nearly 500 students take the course each Semester. Student learning is adversely impacted by poor math backgrounds as well as extensive work schedules outside of the classroom. We have been researching the use of an intensive flipped-classroom approach where students spend one to two hours each week preparing for class by reading the book, completing a series of conceptual problems, and viewing videos which describe the material. In class, the new response system Learning Catalytics is used which allows much richer problems to be posed in class and includes sketching figures, numerical or symbolic entries, short answers, highlighting text, etc in addition to the standard multiple choice questions. We make direct comparison of student learning for 1200 sudents who have taken the same tests, 25% of which used the flipped classroom approach, and 75% who took a more standard lecture. There is significant evidence of improvements in student learning for students taking the flipped classroom approach over standard lectures. These benefits appear to impact students at all math backgrounds.

Intra-articular osteotomy for distal humerus malunion

NARCIS (Netherlands)

Marti, René K.; Doornberg, Job

2009-01-01

Intra-articular osteotomy is considered in the rare case of malunion after a fracture of the distal humerus to restore humeral alignment and gain a functional arc of elbow motion. Traumatic and iatrogenic disruption of the limited blood flow to the distal end of the humerus resulting in avascular

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

PERBANDINGAN MEDIA POWER POINT DENGAN FLIP CHART DALAM MENINGKATKAN PENGETAHUANKESEHATAN GIGI DAN MULUT

Directory of Open Access Journals (Sweden)

Oki Nurhidayat

2012-07-01

Full Text Available Tujuan dari penelitian ini adalah untuk mengetahui apakah ada perbedaan peningkatan pengetahuan kesehatan gigi dan mulut antara menggunakan media power point dan flip chart. Jenis penelitian ini adalah penelitian ekperimen semu, menggunakan metode desain pretes-postes dengan kelompok kontrol. Populasi dalam penelitian ini adalah siswa SD Negeri Sukorejo 02 dan 03 Gunungpati Semarang Tahun 2011 yang berjumlah 84 siswa. Sampel berjumlah 70 siswa. Instrumen yang digunakan adalah kuesioner. Berdasarkan hasil uji t berpasangan diketahui bahwa terdapat perbedaan yang bermakna antara nilai pretest dan postest pada masing-masing kelompok yaitu kelompok ekperimen (p=0,001 dan kontrol (p=0,001, sedangkan berdasarkan uji t tidak berpasangan diperoleh hasil nilai p=0,006, yang artinya terdapat perbedaan peningkatan pengetahuan kesehatan gigi dan mulut pada siswa sekolah dasar yang signifikan antara post test kelompok I (media power point dan kelompok kontrol (flip chart. Kesimpulan dari penelitian ini adalah ada perbedaan peningkatan pengetahuan kesehatan gigi dan mulut antara menggunakan media power point dan flip chart. Purpose of this research is determine whether there is difference improving dental and oral health knowledge between media use power point and flip chart. This type of research is to study quasi ekperiment, using the method of pretest postes control group design. The population in this study were students of SDN Sukorejo 02 and SDN Sukorejo 03 District Gunungpati Semarang in 2011, amounting to 84 students. The Sample is 70 students. Instrument used was a questionnaire. Based on the results of paired t test is known that there were significant differences between pretest and postest value in each group of experimental group (p = 0.001 and controls (p = 0.001, whereas the unpaired t test based on the results obtained p-value = 0.006, which means that there are differences in the increase of knowledge of oral health in primary school students

Walking pattern in 9 women with hip dysplasia 18 months after periacetabular osteotomy

DEFF Research Database (Denmark)

Pedersen, Eva N G; Alkjaer, Tine; Søballe, Kjeld

2006-01-01

. METHODS: The gait pattern of 9 women (median age 39 years) with hip dysplasia who were treated with unilateral periacetabular osteotomy was analyzed before periacetabular osteotomy and an average of 1.5 years afterwards. Data were collected using 5 video cameras and 2 force plates. An inverse dynamics...... upright walking pattern but continued to relieve the hip joint by maintaining a reduced flexor moment....

Achievability of 3D planned bimaxillary osteotomies: maxilla-first versus mandible-first surgery

OpenAIRE

Liebregts, Jeroen; Baan, Frank; de Koning, Martien; Ongkosuwito, Edwin; Berg?, Stefaan; Maal, Thomas; Xi, Tong

2017-01-01

The present study was aimed to investigate the effects of sequencing a two-component surgical procedure for correcting malpositioned jaws (bimaxillary osteotomies); specifically, surgical repositioning of the upper jaw?maxilla, and the lower jaw?mandible. Within a population of 116 patients requiring bimaxillary osteotomies, the investigators analyzed whether there were statistically significant differences in postoperative outcome as measured by concordance with a preoperative digital 3D vir...

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…

Case report - curved femoral osteotomy for management of medial patellar luxation

DEFF Research Database (Denmark)

Allpass, Maja; Miles, James Edward

2015-01-01

Medial patellaluxation kan forårsages af femoral varus hos hund. Førhen har patienter med excessiv femoralvarus været korrigeret ved en lateralt placeret femoral kile-ostektomi. Her præsenteres en case, hvor en buet osteotomi blev anvendt til behandling af medial patellaluxation.......Medial patellaluxation kan forårsages af femoral varus hos hund. Førhen har patienter med excessiv femoralvarus været korrigeret ved en lateralt placeret femoral kile-ostektomi. Her præsenteres en case, hvor en buet osteotomi blev anvendt til behandling af medial patellaluxation....

Piezosurgical osteotomy for harvesting intraoral block bone graft

Science.gov (United States)

Lakshmiganthan, Mahalingam; Gokulanathan, Subramanium; Shanmugasundaram, Natarajan; Daniel, Rajkumar; Ramesh, Sadashiva B.

2012-01-01

The use of ultrasonic vibrations for the cutting of bone was first introduced two decades ago. Piezoelectric surgery is a minimally invasive technique that lessens the risk of damage to surrounding soft tissues and important structures such as nerves, vessels, and mucosa. It also reduces damage to osteocytes and permits good survival of bony cells during harvesting of bone. Grafting with intraoral bone blocks is a good way to reconstruct severe horizontal and vertical bone resorption in future implants sites. The piezosurgery system creates an effective osteotomy with minimal or no trauma to soft tissue in contrast to conventional surgical burs or saws and minimizes a patient's psychological stress and fear during osteotomy under local anesthesia. The purpose of this article is to describe the harvesting of intraoral bone blocks using the piezoelectric surgery device. PMID:23066242

Piezosurgical osteotomy for harvesting intraoral block bone graft

Directory of Open Access Journals (Sweden)

Mahalingam Lakshmiganthan

2012-01-01

Full Text Available The use of ultrasonic vibrations for the cutting of bone was first introduced two decades ago. Piezoelectric surgery is a minimally invasive technique that lessens the risk of damage to surrounding soft tissues and important structures such as nerves, vessels, and mucosa. It also reduces damage to osteocytes and permits good survival of bony cells during harvesting of bone. Grafting with intraoral bone blocks is a good way to reconstruct severe horizontal and vertical bone resorption in future implants sites. The piezosurgery system creates an effective osteotomy with minimal or no trauma to soft tissue in contrast to conventional surgical burs or saws and minimizes a patient′s psychological stress and fear during osteotomy under local anesthesia. The purpose of this article is to describe the harvesting of intraoral bone blocks using the piezoelectric surgery device.

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 ...

University and Flipped Learning TIC & DIL Project: Framework and Design

Science.gov (United States)

Pinnelli, Stefania; Fiorucci, Andrea

2015-01-01

The flipped classroom approach (FC) is for the educational world a chance of recovery and improvement of pedagogical student-centered model and collaborative teaching methods aimed at optimizing the time resource and to promote personalization and self-learning in a perspective of autonomy. The paper moving from a pedagogical reflection on…

Neurosensory changes of palatal mucousa following Le Fort I osteotomy

Directory of Open Access Journals (Sweden)

Bijan Movahedian Attar

2009-09-01

Full Text Available

• BACKGROUND: This study evaluated the sensation of palatal ucosa before and after Le Fort I osteotomy and compared it based on whether greater palatine nerve has been dissected or not.
• METHODS: Sixteen patients were studied within one week before  urgery and then one week, 6 weeks, 3 months and 6 months after surgery. Four tests including sharp-blunt discrimination, cold perception, pin prick sensation and electrical stimulation were performed.
• RESULTS: Mean values of electrical stimulation were significantly higher 6 months after surgery (p < 0.05, on the other hand mean values of pin-prick sensation were significantly lower (p < 0.05. All patients regardless of the condition of greater palatine nerve were responsive to cold perception and sharp-blunt discrimination 6 months after surgery.
• CONCLUSIONS: Following Le Fort I osteotomy, palatal  esponsiveness to electrical stimulation decreases and mechanical hyper sensitization occurs. Dissection of greater palatine nerve was shown to have no effect on the results.
• KEYWORDS: Lefort I Osteotomy, Palatal Mocousa, Nerve Recovery.

New Technique: A Novel Femoral Derotation Osteotomy for Malrotation following Intramedullary Nailing

Directory of Open Access Journals (Sweden)

S. Jagernauth

2012-01-01

Full Text Available A 19-year-old female patient sustained a closed spiral midshaft femoral fracture and subsequently underwent femoral intramedullary nail insertion. At followup she complained of difficulty in walking and was found to have a unilateral in-toeing gait. CT imaging revealed 30 degrees of internal rotation at the fracture site, which had healed. A circumferential osteotomy was performed distal to the united fracture site using a Gigli saw with the intramedullary femoral nail in situ. The static distal interlocking screws were removed and the malrotation was corrected. Two further static distal interlocking screws were inserted to secure the intramedullary nail in position. The osteotomy went on to union and her symptoms of pain, walking difficulty, and in-toeing resolved. Our paper is the first to describe a technique for derotation osteotomy following intramedullary malreduction that leaves the intramedullary nail in situ.

[Construction of the study platform for Meridians and Acupoints and the application in the flipped classroom].

Science.gov (United States)

Hu, Rong

2016-11-12

To construct the study platform for meridians and acupoints by analyzing the status and current problems of teaching Meridians and Acupoints and in accordance with the principles as "knowledge fragmentation, game breakthrough and overall assessment" and observe the application effect in the flipped classroom. Totally two hundred and five 2014 grade bachelor candidates from four classes of the department of acupuncture-moxibustion and tuina were selected from Hunan Junior College of TCM. They were randomized into an observation group (102 cases) and a control group (103 cases). in the observation group, the flipped classroom was performed by adopting the study platform of meridians and acupoints. Additionally, the team cooperation learning and overall assessment were conducted. In the control group, the traditional teaching system was adopted, in which, the mode of "teacher's demonstration-to-discussion in group-to-teachers' assessment" and the operation check at the end of the semester were applied. The learning effect and the self-learning ability were evaluated at the end of semester in the two groups. The satisfaction survey was conducted in the observation group. In the observation group, the drawing of meridian running course and locating the acupoints, as well as the self-learning ability were better than those in the control group, indicating the significant differences (all P flipped classroom and the satisfaction of participation were slightly low. The study platform of learning Meridians and Acupoints was applied in the flipped classroom and has effectively improved the practical manipulation results and self-learning ability. However, the interestingness and interactivity of the platform are expected to be improved. The effective teaching design should be adopted in the flipped classroom to improve the students' desire of participation.

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…

[Austin's horizontal V-shaped sliding osteotomy of the metatarsal head [Chevron-osteotomy) in the treatment of hallux valgus].

Science.gov (United States)

Steinböck, G

1996-08-01

From 1983 to 1995, 1587 patients suffering from hallux abductovalgus were treated with the Austin bunionectomy. The operation consists of a medial exostosis removal, a V-shaped laterally directed displacement osteotomy of the metatarsal head, lateral release and medial reefing of the capsulo-ligamentous structures. Lateral transposition is facilitated by performing a sufficient lateral release consisting of dissection of the lateral metatarsophalangeal ligament and separation of the adductor tendon from the base of the phalanx and the lateral sesamoid. In the case of intermetatarsal angles greater than 15 degrees, the metatarsal-sesamoid ligament is also severed just above the lateral sesamoid. The periosteum is stripped in a limited fashion dorsally and toward the plantar, leaving its insertion at the metatarsal head intact. After this procedure, reposition of the metatarsal head onto the sesamoids is usually possible and is maintained by reconstruction of the medial metatarsal-sesamoid ligament. In the author's own research material, metatarsophalangeal angles larger than 50 degrees and intermetatarsal angles of over 20 degrees could be corrected. Pronation of the toe is usually corrected by tenotomy of the abductor tendon near the base of the phalanx. Avascular necrosis is extremely rare with a careful operative technique. In our extensive research material, four cases of AVN were recognized. Provided there is free motion of the joint (60-0-20), mild radiological signs of osteoarthritis are no contraindication for the operation. Even in the aged, good results can be achieved provided there are no trophic problems. The Austin bunionectomy has proved to be a versatile method for treating bunion problems. The possibility of transposing the metatarsal head laterally, toward the plantar, proximally and distally by altering the direction of the osteotomy, as well as tilting it medially or laterally, has made this osteotomy an invaluable tool for addressing various

Surgical advances in periacetabular osteotomy for treatment of hip dysplasia in adults

DEFF Research Database (Denmark)

Troelsen, Anders

2009-01-01

Hip dysplasia is characterized by an excessively oblique and shallow acetabulum with insufficient coverage of the femoral head. It is a known cause of pain and the development of early osteoarthritis in young adults. The periacetabular osteotomy is the joint-preserving treatment of choice in young...... adults with symptomatic hip dysplasia. The surgical aim of this extensive procedure is to reorient the acetabulum to improve coverage and eliminate the pathological hip joint mechanics. Intraoperative assessment of the achieved acetabular reorientation is therefore crucial. The "classic" surgical...

Flipping Core Courses in the Undergraduate Mechanical Engineering Curriculum: Heat Transfer

Science.gov (United States)

Schrlau, Michael G.; Stevens, Robert J.; Schley, Sara

2016-01-01

Flipped classrooms support learner-centered approaches to improve conceptualization, comprehension, and problem solving skills by delivering content outside the classroom and actively engaging students inside the classroom. While literature in engineering and science education supports and encourages the use of inverted instruction, many core…

The effect of platelet-rich plasma on osseous healing in dogs undergoing high tibial osteotomy.

Directory of Open Access Journals (Sweden)

Samuel P Franklin

Full Text Available The purpose of this study was to investigate whether platelet-rich plasma (PRP enhances osseous healing in conjunction with a high tibial osteotomy in dogs.Randomized controlled trial.Sixty-four client-owned pet dogs with naturally occurring rupture of the anterior cruciate ligament and that were to be treated with a high tibial osteotomy (tibial plateau leveling osteotomy were randomized into the treatment or control group. Dogs in the treatment group received autologous platelet-rich plasma activated with calcium chloride and bovine thrombin to produce a well-formed PRP gel that was placed into the osteotomy at the time of surgery. Dogs in the control group received saline lavage of the osteotomy. All dogs had the osteotomy stabilized with identical titanium alloy implants and all aspects of the surgical procedure and post-operative care were identical among dogs of the two groups. Bone healing was assessed at exactly 28, 49, and 70 days after surgery with radiography and ultrasonography and with MRI at day 28. The effect of PRP on bone healing was assessed using a repeated measures analysis of covariance with radiographic and ultrasonographic data and using a t-test with the MRI data.Sixty dogs completed the study. There were no significant differences in age, weight, or gender distribution between the treatment and control groups. Twenty-seven dogs were treated with PRP and 33 were in the control group. The average platelet concentration of the PRP was 1.37x106 platelets/μL (±489x103 with a leukocyte concentration of 5.45x103/μL (±3.5x103. All dogs demonstrated progressive healing over time and achieved clinically successful outcomes. Time since surgery and patient age were significant predictors of radiographic healing and time since surgery was a significant predictor of ultrasonographic assessment of healing. There was no significant effect of PRP treatment as assessed radiographically, ultrasonographically, or with MRI.The PRP used

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?"....

A Prospective Study of Distal Metatarsal Chevron Osteotomies with K-Wire Fixations to Treat Hallux Valgus Deformities

Science.gov (United States)

Baig, Usman; Tariq, Ali; Din, Robert

2017-01-01

Introduction Hallux valgus is one of the most common forefoot deformities worldwide. Females are affected more often than males. The three most common clinical symptoms are the painful bunion, transfer metatarsalgia, and hammer or claw toes. Methods This case series consisted of 20 patients who had chevron osteotomy from January 2015 to January 2016. The clinical assessment was measured by The American Orthopedic Foot and Ankle Score (AOFAS), and radiologic assessment was determined by preoperative and postoperative hallux valgus angle (HVA) and intermetatarsal angle (IMA). Results The patients’ mean age was 56 years. Out of 20 patients, 19 were female, and one was male. The mean AOFAS improved from 51 preoperatively to 82 postoperatively. The HVA improved from 26° preoperatively to 14°. There were five complications including four Kirschner (K)-wire complications. Conclusion Distal chevron osteotomy is a reliable and time-tested procedure. The K-wire fixation has a relatively high complication rate. We planned to use other methods of fixation and then compared them with K-wires fixation results for future studies. PMID:29167752

Effects of mandibular setback with or without maxillary advancement osteotomies on pharyngeal airways: An overview of systematic reviews.

Directory of Open Access Journals (Sweden)

Su Keng Tan

Full Text Available Mandibular setback osteotomies potentially lead to narrowing of the pharyngeal airways, subsequently resulting in post-surgical obstructive sleep apnea (OSA.To summarize current evidence from systematic reviews that has evaluated pharyngeal airway changes after mandibular setback with or without concomitant upper jaw osteotomies.PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched with no restriction of language or date. Systematic reviews studying changes in pharyngeal airway dimensions and respiratory parameters after mandibular setback with or without concomitant upper jaw osteotomies have been identified, screened for eligibility, included and analyzed in this study.Six systematic reviews have been included. While isolated mandibular setback osteotomies result in reduced oropharyngeal airway dimensions, the reduction is lesser in cases with concomitant upper jaw osteotomies. Only scarce evidence exists currently to what happens to naso- and hypo-pharyngeal airways. There is no evidence for post-surgical OSA, even though some studies reported reduced respiratory parameters after single-jaw mandibular setback with or without concomitant upper jaw osteotomies.Although mandibular setback osteotomies reduce pharyngeal airway dimensions, evidence confirming post-surgical OSA was not found. Nevertheless, potential post-surgical OSA should be taken into serious consideration during the treatment planning of particular orthognathic cases. As moderate evidence exists that double-jaw surgeries lead to less compromised post-surgical pharyngeal airways, they should be considered as the method of choice especially in cases with severe dentoskeletal Class III deformity.PROSPERO (registration number: CRD42016046484.

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…

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…

Evaluation of instability after transtrochanteric anterior rotational osteotomy for nontraumatic osteonecrosis of the femoral head

International Nuclear Information System (INIS)

Hiranuma, Yasunari; Atsumi, Takashi; Kajiwara, Toshihisa; Tamaoki, Satoshi; Asakura, Yasuhiro

2009-01-01

Transtrochanteric anterior rotational osteotomy results in improvement of joint congruity and prevention of progressive collapse and osteoarthritic changes in patients with femoral head osteonecrosis. However, this procedure remains controversial for patients with extensive collapse due to potential osteoarthritis caused by postoperative instability. The purpose of this study was to evaluate hip instability after osteotomy and determine the relation between instability and radiological and clinical outcomes. In all, 27 hips of 24 patients that were followed up for a mean period of 3.8 years were included. Instability was defined as more than 1 mm translation of the femoral head in transverse computed tomography scans obtained at 0 deg and 45 deg flexion of the hip joint. Hips were divided into instability and stability groups. Eleven hips (40%) developed instability after surgery. Osteophytes on the femoral head in 10 hips of the instability group and 2 hips of the stability group had increased in size at follow-up. There was a significant relation between postoperative instability and osteophyte formation. Joint space narrowing was not seen in any of the cases. There was no significant difference between the groups in either the postoperative intact ratio of the femoral head or the Japanese Orthopaedic Association hip score. Neither instability nor osteophyte formation on the femoral head after transtrochanteric anterior rotational osteotomy correlated with progressive osteoarthritic changes or clinical outcome in the presence of an adequate femoral head intact ratio facing the weight-bearing area. (author)

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....

Application of computer-aided design osteotomy template for treatment of cubitus varus deformity in teenagers: a pilot study.

Science.gov (United States)

Zhang, Yuan Z; Lu, Sheng; Chen, Bin; Zhao, Jian M; Liu, Rui; Pei, Guo X

2011-01-01

Treatment of cubitus varus deformity from a malunited fracture is a challenge. Anatomically accurate correction is the key to obtaining good functional outcomes after corrective osteotomy. The aim of this study was to attempt to increase the accuracy of treatment by use of 3-dimensional (3D) computer-aided design. We describe a novel method for ensuring an accurate osteotomy method in the treatment of cubitus varus deformity in teenagers by means of 3D reconstruction and reverse engineering. Between January 2006 and May 2008, 12 male and 6 female patients with cubitus varus deformities underwent scanning with spiral computed tomography (CT) preoperatively. The mean age was 15.7 years, ranging from 13 to 19 years. Three-dimensional CT image data of the affected and contralateral normal bones of cubitus were transferred to a computer workstation. Three-dimensional models of cubitus were reconstructed by use of MIMICS software. The 3D models were then processed by Imageware software. An osteotomy template that best fitted the angle and range of osteotomy was "reversely" built from the 3D model. These templates were manufactured by a rapid prototyping machine. The osteotomy templates guide the osteotomy of cubitus. An accurate angle of osteotomy was confirmed by postoperative radiography. After 12 to 24 months' follow-up, the mean postoperative carrying angle in 18 patients with cubitus varus deformity was 7.3° (range, 5° to 11°), with a mean correction of 21.9° (range, 12° to 41°). The patient-specific template technique is easy to use, can simplify the surgical act, and generates highly accurate osteotomy in cubitus varus deformity in teenagers. Copyright © 2011 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

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.

A novel conductive-polymer-based integration process for high-performance flip-chip packages

Science.gov (United States)

Lohokare, Saurabh

Conductive polymers have recently attracted considerable attention for low-temperature fabrication of lead-free, reworkable, and flexible flip-chip interconnects. Using these materials, I demonstrate in this thesis a process that enables low-cost and high-resolution flip-chip interconnects using conventional micro-fabrication techniques. This fabrication process offers improved performance as compared to conventional flip-chip techniques, such as screen-printing, and allows for definition of interconnects with excellent surface uniformity and control over the bump profile. In order to demonstrate the utility and wide applicability of this process, several test implementations that serve as case studies were investigated. Specifically, novel InGaAsSb avalanche photodiodes (APDs), operating around lambda = 2m and targeted for free-space communication and biomedical spectroscopy applications, were fabricated and flip-chip-integrated to test the static electrical characteristics of the polymer bumps. Additionally, the dynamic electrical performance characteristics of the polymer bumps were studied by using AlGaAsSb/AlGaSb p-i-n photodetectors as a case study. The fabrication of these photodetectors, operating around lambda = 1.55mum and targeted for optical communication applications, was accomplished using a customized inductively coupled plasma (ICP) etch process that resulted in a low dark current and excellent speed (3dB bandwidth of 10GHz) and, responsivity (60% external quantum efficiency) characteristics. Furthermore, flip-chip integration was used to demonstrate a three-dimensional, point-to-point micro-optical interconnect, which was 2.33mm-long in a system 15.27mm3 in volume. Lastly, high-speed parallel optical interconnects were demonstrated using polymer-flip-chip-integrated 10GHz vertical-cavity surface-emitting laser (VCSEL) and DOEs. Such interconnects offer the ability to alleviate the communication bottleneck that is projected to occur in future, high

The Big Five, Learning Goals, Exam Preparedness, and Preference for Flipped Classroom Teaching: Evidence from a Large Psychology Undergraduate Cohort

Science.gov (United States)

Lyons, Minna; Limniou, Maria; Schermbrucker, Ian; Hands, Caroline; Downes, John J.

2017-01-01

Previous research has found that the flipped classroom (i.e., learning prior to the lecture, and using the lecture time for consolidating knowledge) increases students' deep learning, and has an association with improved grades. However, not all students benefit equally from flipping the classroom, and there may be important individual differences…

[Double Osteotomy of the First Metatarsal for Treatment of Juvenile Hallux Valgus Deformity - Our Experience].

Science.gov (United States)

Jochymek, J; Peterková, T

2016-01-01

The aim of the study was to evaluate the mid-term results in a group of selected patients undergoing corrective surgery for juvenile hallux valgus, using double osteotomy of the first metatarsal. The group included eight patients, seven girls and one boy, with a more severe form of this deformity treated by double osteotomy of the first metatarsal between 2010 and 2013. The indication for corrective surgery was serious pain when walking; all patients had previously undergone conservative treatment with no effect. All patients had pre-operative clinical examination, the affected foot was X-rayed with the patient standing and radiographic assessments of the intermetatarsal and hallux valgus angles were made. The evaluation of treatment outcomes was based on the scoring system of the American Orthopaedic Foot and Ankle Society (AOFAS) and X-ray images of the foot. The average follow-up was 37 months. Post-operatively, none of the patients reported pain while walking, only two of them experienced pain during sports activities. The average post-operative AOFAS score was 92 points. Both the intermetatarsal angle and the hallux valgus angle improved after surgery in all patients, with two reporting only mild hallux valgus deformity. One patient showed postoperative restriction of motion at the first metatarsophalangeal joint. This was the only complication recorded in association with the surgery. Almost all authors dealing with the treatment of hallux valgus deformity primarily prefer conservative therapy. However, this treatment is usually not very effective in severe forms of the disorder. Surgical management is indicated in symptomatic patients or in those with severe juvenile hallux valgus deformity. In paediatric patients it is necessary to respect the presence of an epiphyseal growth plate in the first proximal metatarsal and therefore it is often preferred to use distal first metatarsal osteotomy. At our department, Mitchell's osteotomy for hallux valgus deformity

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

Piezosurgery for Sagittal Split Osteotomy: Procedure Duration and Postoperative Sensory Perturbation.

Science.gov (United States)

Köhnke, Robert; Kolk, Andreas; Kluwe, Lan; Ploder, Oliver

2017-09-01

To evaluate piezosurgery for bilateral sagittal split osteotomy (BSSO) for its duration and inferior alveolar nerve (IAN) perturbation. In this prospective randomized study, the authors evaluated 100 BSSO procedures in 50 patients. Piezoelectric (group I) and conventional (group II) osteotomies were carried out on each side of the mandible of a patient by 2 specialists. The surgeons had at least 1 year of experience using piezosurgery. The period from incision to complete splitting of the mandibular bone was recorded (ie, procedure duration). The intraoperative status (visibility and relocation) of the IAN also was recorded. The neurosensory function of the IAN was measured by the 2-point discrimination threshold and static light touch methods before surgery and postoperatively (1, 3, and 6 weeks and 6 and 12 months). Parameters were compared between the test groups by the paired t, nonparametric Wilcoxon, or χ 2 test. Intergroup comparison showed the mean duration of osteotomy was significantly shorter for group I (17 ± 6 vs 25 ± 9 minutes; P < .001). The rate of intraoperative exposures of the IAN was slightly lower for group I (68%) compared with group II (81%). However, the difference was not relevant. Neurosensory disturbance and recovery of the IAN did not differ between groups. Piezoelectric osteotomy requires considerably less time than conventional mechanical approaches, but shows no advantage in preventing neurosensory perturbation. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

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…

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.

[The use of Piezosurgery osteotomy in treatment of long-standing maxillary fractures: report of 12 consecutive patients].

Science.gov (United States)

Guo, Zhao-Zhong; Liu, Xue; Li, Yan; Deng, Yan-Fang; Wang, Yang

2007-02-01

To evaluate the clinical applicability of Piezosurgery osteotomy: a new safe technique in managing long standing maxillary fractures. 12 patients with long-standing maxillary fractures were surgically treated using Le Fort I osteotomy. During operation, Piezosurgery osteotomy was used for bone cutting and splitting. After repositioning, the bone segments were rigidly fixed with micro Ti-plate, Ti-mesh. All the patients were followed up for 6 to 12 months, and the functional and esthetic results were evaluated. Ultrasonic microvibrations allow accurate bone cutting without oscillating injuries to the soft tissue. All the wounds healed primarily without complications. The postoperative occlusion and appearance were satisfactory. Maximal recovery of mastication and appearance can be achieved by using Piezosurgery osteotomy with fixation materials such as Ti-plates and Ti-meshes in selected patients with long-standing maxillary fractures.

Brachymetatarsia of the fourth metatarsal, lengthening scarf osteotomy with bone graft.

Science.gov (United States)

Desai, Ankit; Lidder, Surjit; R Armitage, Andrew; S Rajaratnam, Samuel; D Skyrme, Andrew

2013-01-01

A 16-year-old girl presented with left fourth metatarsal shortening causing significant psychological distress. She underwent lengthening scarf osteotomy held with an Omnitech(®) screw (Biotech International, France) with the addition of two 1 cm cancellous cubes (RTI Biologics, United States). A lengthening zplasty of the extensor tendons and skin were also performed. At 6 weeks the patient was fully weight bearing and at one-year follow up, the patient was satisfied and discharged. A modified technique of lengthening scarf osteotomy is described for congenital brachymatatarsia. This technique allows one stage lengthening through a single incision with graft incorporation by 6 weeks.

Flipped Learning: Can Rheumatology Lead the Shift in Medical Education?

Science.gov (United States)

El Miedany, Yasser; El Gaafary, Maha; El Aroussy, Nadia; Youssef, Sally

2018-04-16

To: 1. implement flipped classroom rheumatology teaching for undergraduate education. 2. Evaluate outcomes of teaching using OSCE assessment and student perceived effectiveness and satisfaction survey. The flipped classroom education was conducted in 3 phases. Phase 1: carried out in the students' own time. Web links were emailed to assist exposure of the instructional part of the lesson online. Phase 2: interactive in-class activity to share personal reflection and reinforce the key aspects. Phase 3: a simulated OSCE assessment. A cohort of 56-students, who were taught in the last educational year on the same topics according to standard teaching protocols, were included as control group. The clinical Outcomes were assessed using the scores of the OSCE examination model. Academic outcomes included the engagement measure as well as the students' answers to perceived effectiveness and satisfaction survey. There was no significant difference regarding demographics between the 2 students' groups. There was significant improvement (plearning, in contrast to the control group, in terms of clinical (OSCE score) as well as communication skills. Student perceived effectiveness and satisfaction was significantly higher among the flipped learning (plearning cohort showed a state of engagement significantly higher than the control group (plearning implementation musculoskeletal learning successfully demonstrated a promising platform for using technology to make better use of the students' time, and for increasing their satisfaction. Active learning increases student engagement and can lead to improved retention of knowledge. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

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

Primary stability of different plate positions and the role of bone substitute in open wedge high tibial osteotomy.

Science.gov (United States)

Takeuchi, Ryohei; Woon-Hwa, Jung; Ishikawa, Hiroyuki; Yamaguchi, Yuichiro; Osawa, Katsunari; Akamatsu, Yasushi; Kuroda, Koichi

2017-12-01

The purpose of this study was to compare the mechanical fixation strengths of anteromedial and medial plate positions in osteotomy, and clarify the effects of bone substitute placement into the osteotomy site. Twenty-eight sawbone tibia models were used. Four different models were prepared: Group A, the osteotomy site was open and the plate position was anteromedial; Group B, bone substitutes were inserted into the osteotomy site and the plate position was anteromedial; Group C, the osteotomy site was open and the plate position was medial; and Group D, bone substitutes were inserted into the osteotomy site and the plate position was medial. The loading condition ranged from 0 to 800N and one hertz cycles were applied. Changes of the tibial posterior slope angle (TPS), stress on the plate and lateral hinge were measured. The changes in the TPS and the stress on the plate were significantly larger in Group A than in Group C. These were significantly larger in Group A than in Group B, and in Group C than in Group D. There was no significant difference between Group B and Group D, and no significant difference between knee flexion angles of 0° and 10°. Stress on the lateral hinge was significantly smaller when bone substitute was used. A medial plate position was biomechanically superior to an anteromedial position if bone substitute was not used. Bone substitute distributed the stress concentration around the osteotomy gap and prevented an increase in TPS angle regardless of the plate position. Copyright © 2017. Published by Elsevier B.V.

Three-dimensional computed tomographic evaluation of bilateral sagittal split osteotomy lingual fracture line and le fort I pterygomaxillary separation in orthognathic surgery using cadaver heads: ultrasonic osteotome versus conventional saw.

Science.gov (United States)

Dammous, Sophie; Dupont, Quentin; Gilles, Roland

2015-06-01

The purpose of this study was to observe the quality of the fracture line on the lingual side of the mandible after sagittal split osteotomy and the quality of pterygomaxillary separation after Le Fort I osteotomy using the BoneScalpel ultrasonic osteotome. Bimaxillary procedures, according to the standard protocol, were performed using 10 fresh cadaver heads. The ultrasonic osteotome was used in the study group, and a reciprocating saw was used in the control group. Three-dimensional reconstructions of postoperative computed tomographic scans were obtained. The lingual ramus fracture pattern and the pterygomaxillary separation pattern were observed, classified, and compared. Postoperative dissections of the skulls were performed to assess the integrity of the infra-alveolar nerve and the descending palatine artery. No significant differences were found in the cutting time of bone between the BoneScalpel and the sagittal saw. Of the sagittal split osteotomies in the study group, 90% showed a good pattern (vertical pattern of fracture line extending to the inferior border of the mandible running behind the mandibular canal) compared with 50% of the sagittal split osteotomies in the control group. Ideal separation of the pterygoid plates without fractures was observed in 80% of the Le Fort I osteotomies in the study group compared with 50% of the osteotomies in the control group. High-level fractures occurred in 30% of cases in the control group compared with none in the study group. The integrities of the infra-alveolar nerve and the descending palatine artery were preserved in all cases. Use of the ultrasonic BoneScalpel did not require more time than the conventional method. An improved pattern of lingual fracture lines in mandibular sagittal split osteotomy procedures and the pattern of pterygomaxillary separation in Le Fort I osteotomy procedures were observed. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc

A Parallel Controlled Study of the Effectiveness of a Partially Flipped Organic Chemistry Course on Student Performance, Perceptions, and Course Completion

Science.gov (United States)

Shattuck, James C.

2016-01-01

Organic chemistry is very challenging to many students pursuing science careers. Flipping the classroom presents an opportunity to significantly improve student success by increasing active learning, which research shows is highly beneficial to student learning. However, flipping an entire course may seem too daunting or an instructor may simply…

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

Case series of 17 modified Weil's osteotomies for Freiberg's and Köhler's II AVN, with AOFAS scoring pre- and post-operatively.

Science.gov (United States)

Edmondson, M C; Sherry, K R; Afolayan, J; Armitage, A R; Skyrme, A D

2011-03-01

Treatment for metatarsal head avascular necrosis is largely conservative. For severe or refractory cases there are various surgical options. We have performed a 'modified Weil's osteotomy' of the distal metatarsal in order to manage this problem. We present the largest case series, to our knowledge, with 17 such cases. The patients were scored pre- and post-operatively using the AOFAS Forefoot scoring system. We found that this procedure provided a mean score improvement of 36 points, with a complication rate of 5.9%. We would advocate this modified osteotomy as an effective, reliable and safe treatment option. Copyright © 2009 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

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.

2016-06-01

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 major components (1) the preparation of the students; (2) the weekly pre-class work; (3) the in-class active learning strategies and (4) closing the learning loop using formative quizzes. Each of these components is discussed in detail and was informed by sound pedagogical strategies. Several different sources of information and several freely available software tools to engage the students are discussed. Two iterations are reported here, with improved pass rate for the final examination from 47 to 48 % in the traditional class to 56-65 % in the flipped classroom approach. The majority of students (93 and 89 %) came to the class prepared, after viewing the screencasts and engaged fully with the activities within the face-to-face time. The students perceived that solving case studies (93 %) was the most beneficial activity for their learning and this was closely followed by the production of essay plans (71 %). The majority of students recommended that this approach be repeated the following year (69 and 75 %).

Evaluation of Mandibular Anatomy Associated With Bad Splits in Sagittal Split Ramus Osteotomy of Mandible.

Science.gov (United States)

Wang, Tongyue; Han, Jeong Joon; Oh, Hee-Kyun; Park, Hong-Ju; Jung, Seunggon; Park, Yeong-Joon; Kook, Min-Suk

2016-07-01

This study aimed to identify risk factors associated with bad splits during sagittal split ramus osteotomy by using three-dimensional computed tomography. This study included 8 bad splits and 47 normal patients without bad splits. Mandibular anatomic parameters related to osteotomy line were measured. These included anteroposterior width of the ramus at level of lingula, distance between external oblique ridge and lingula, distance between sigmoid notch and inferior border of mandible, mandibular angle, distance between inferior outer surface of mandibular canal and inferior border of mandible under distal root of second molar (MCEM), buccolingual thickness of the ramus at level of lingula, and buccolingual thickness of the area just distal to first molar (BTM1) and second molar (BTM2). The incidence of bad splits in 625 sagittal split osteotomies was 1.28%. Compared with normal group, bad split group exhibited significantly thinner BTM2 and shorter sigmoid notch and inferior border of mandible (P bad splits. These anatomic data may help surgeons to choose the safest surgical techniques and best osteotomy sites.

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…

Total mandibular subapical osteotomy and Le Fort I osteotomy using piezosurgery and computer-aided designed and manufactured surgical splints: a favorable combination of three techniques in the management of severe mouth asymmetry in Parry-Romberg syndrome.

Science.gov (United States)

Scolozzi, Paolo; Herzog, Georges

2014-05-01

Although its pathogenesis remains obscure, Parry-Romberg syndrome (PRS) has been associated with the linear scleroderma en coup de sabre. PRS is characterized by unilateral facial atrophy of the skin, subcutaneous tissue, muscles, and bones with at least 1 dermatome supplied by the trigeminal nerve. Facial asymmetry represents the most common sequela and can involve the soft tissues, craniomaxillofacial skeleton, dentoalveolar area, and temporomandibular joint. Although orthognathic procedures have been reported for skeletal reconstruction, treatment of facial asymmetry has been directed to augmentation of the soft tissue volume on the atrophic side using different recontouring or volumetric augmentation techniques. Total mandibular subapical osteotomy has been used in the management of dentofacial deformities, such as open bite and mandibular dentoalveolar retrusion or protrusion associated with an imbalance between the lower lip and the chin. Management of orthognathic procedures has been improved by the recent introduction of stereolithographic surgical splints using computer-aided design (CAD) and computer-aided manufacturing (CAM) technology and piezosurgery. Piezosurgery has increased security during surgery, especially for delicate procedures associated with a high risk of nerve injury. The present report describes a combined total mandibular subapical osteotomy and Le Fort I osteotomy using piezosurgery and surgical splints fabricated using CAD and CAM for the correction of severe mouth asymmetry related to vertical dentoalveolar disharmony in a patient with PRS. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Use of condensed videos in a flipped classroom for pharmaceutical calculations: Student perceptions and academic performance.

Science.gov (United States)

Gloudeman, Mark W; Shah-Manek, Bijal; Wong, Terri H; Vo, Christina; Ip, Eric J

2018-02-01

The flipped teaching method was implemented through a series of multiple condensed videos for pharmaceutical calculations with student perceptions and academic performance assessed post-intervention. Student perceptions from the intervention group were assessed via an online survey. Pharmaceutical exam scores of the intervention group were compared to the control group. The intervention group spent a greater amount of class time on active learning. The majority of students (68.2%) thought that the flipped teaching method was more effective to learn pharmaceutical calculations than the traditional method. The mean exam scores of the intervention group were not significantly different than the control group (80.5 ± 15.8% vs 77.8 ± 16.8%; p = 0.253). Previous studies on the flipped teaching method have shown mixed results in regards to student perceptions and exam scores, where either student satisfaction increased or exam scores improved, but rarely both. The flipped teaching method was rated favorably by a majority of students. The flipped teaching method resulted in similar outcomes in pharmaceutical calculations exam scores, and it appears to be an acceptable and effective option to deliver pharmaceutical calculations in a Doctor of Pharmacy program. Copyright © 2017 Elsevier Inc. All rights reserved.

Effectiveness of the Flipped Classroom Model in Anatomy and Physiology Laboratory Courses at a Hispanic Serving Institution

Science.gov (United States)

Sanchez, Gerardo

A flipped laboratory model involves significant preparation by the students on lab material prior to entry to the laboratory. This allows laboratory time to be focused on active learning through experiments. The aim of this study was to observe changes in student performance through the transition from a traditional laboratory format, to a flipped format. The data showed that for both Anatomy and Physiology (I and II) laboratories a more normal distribution of grades was observed once labs were flipped and lecture grade averages increased. Chi square and analysis of variance tests showed grade changes to a statistically significant degree, with a p value of less than 0.05 on both analyses. Regression analyses gave decreasing numbers after the flipped labs were introduced with an r. 2 value of .485 for A&P I, and .564 for A&P II. Results indicate improved scores for the lecture part of the A&P course, decreased outlying scores above 100, and all score distributions approached a more normal distribution.

Evaluation of Bernese periacetabular osteotomy: prospective studies examining projected load-bearing area, bone density, cartilage thickness and migration.

Science.gov (United States)

Mechlenburg, Inger

2008-06-01

The typical dysplastic hip joint is characterised by maldirection of the acetabulum and femoral neck, insufficient coverage of the femoral head focally and globally and erosions of the limbus acetabuli (1). An unknown number of persons with hip dysplasia will suffer from pain in hip or groin, decreased hip function and development of osteoarthritis at a young age. The Bernese periacetabular osteotomy is performed to prevent osteoarthritis in patients with hip dysplasia and has been carried out at Aarhus University Hospital, Denmark since 1996 with more than 500 osteotomies performed. Throughout the years, research and quality improvement of the treatment has taken place and this PhD thesis is part of that process. The aims of this PhD thesis were to evaluate outcome aspects after periacetabular osteotomy in terms of I) estimating the projected loadbearing surface before and after periacetabular osteotomy, II) estimating bone density changes in the acetabulum after periacetabular osteotomy, III) developing a technique to precisely and efficiently estimate the thickness of the articular cartilage in the hip joint and IV) examining the stability of the re-orientated acetabulum after periacetabular osteotomy. In study I, we applied a stereologic method based on 3D computed tomography (CT) to estimate the projected loadbearing surface in six normal hip joints and in six dysplastic hips. The dysplastic hips were CT scanned before and after periacetabular osteotomy. We found that the average area of the projected loadbearing surface of the femoral head preoperatively was 7.4 (range 6.5-8.4) cm2 and postoperatively 11 (9.8-14.3) cm2. The area of the projected loadbearing surface was increased significantly with a mean of 49% (34-70%) postoperatively and thus comparable with the load-bearing surface in the normal control group. Double measurements were performed and the error variance of the mean was estimated to be 1.6%. The effect of overprojection, on the projected

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.

Osteosynthesis techniques used for mandibular sagittal split osteotomy – history of orthognathic procedures and modern practice.

Science.gov (United States)

Nowak, Rafał; Trybek, Grzegorz

Choosing an appropriate fixation technique after maxillary or mandibular osteotomy is one of the key factors affecting the success of orthognathic surgery. In line with the development of new surgical methods and techniques, the surgeons’ approach to the fixation of bone fragments has evolved accordingly, varying from non-fusion to different osteosynthesis techniques. Advances in medical sciences and medical technologies, have changed our attitudes to bone fragment reduction in orthopaedics and traumatology, and also in maxillofacial surgery. The pivotal underlying principle which determines bone healing – that is proper positioning so as to ensure appropriate contact area and immobilisation so as to ensure osteosynthesis – has remained unchanged for centuries. However, over the years, patient comfort and the predictability of treatment outcomes have vastly improved. The paper provides an overview of the techniques and methods used for the fixation of osteotomized fragments after bilateral sagittal split osteotomy since its introduction by Hugo Obwegeser up to the present day.

Surgical risk factors and maxillary nerve function after le fort I osteotomy

DEFF Research Database (Denmark)

Thygesen, Torben Henrik; Jensen, Allan Bardow; Norholt, SE

2009-01-01

PURPOSE: Data on intraoperative risk factors for long-term postoperative complications after Le Fort I osteotomy (LFO) are limited. The aim of this study was to describe prospectively the overall postoperative changes in maxillary nerve function after LFO, and to correlate these changes with a nu......PURPOSE: Data on intraoperative risk factors for long-term postoperative complications after Le Fort I osteotomy (LFO) are limited. The aim of this study was to describe prospectively the overall postoperative changes in maxillary nerve function after LFO, and to correlate these changes...

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...

The flipped classroom stimulates greater learning and is a modern 21st century approach to teaching today's undergraduates.

Science.gov (United States)

Mortensen, C J; Nicholson, A M

2015-07-01

Many classrooms in higher education still rely on a transformative approach to teaching where students attend lectures and earn course grades through examination. In the modern age, traditional lectures are argued by some as obsolete and do not address the learning needs of today’s students. An emerging pedagogical approach is the concept of the flipped classroom. The flipped classroom can simply be described as students viewing asynchronous video lectures on their own and then engaging in active learning during scheduled class times. In this study, we examined the flipped classroom teaching environment on student learning gains in an Introduction to Equine Science course. Students (n = 130) were asked to view 7.5 h of recorded lectures divided into 8 learning modules, take online quizzes to enforce lecture viewing, take 3 in-class exams, and prepare to participate in active learning during scheduled class times. Active learning approaches included individual activities, paired activities, informal small groups, and large group activities. When compared to students in the traditional lecture format in earlier years, students in the flipped format scored higher on all 3 exams (P flipped format students were asked to take the Cornell Critical Thinking Exam (version X). Scores improved from the pretest (50.8 ± 0.57) to the posttest (54.4 ± 0.58; P flipped course, no correlations were found with student performance and interactions with online content. Students were asked in class to evaluate their experiences based on a 5-point Likert scale: 1 (strongly disagree) to 5 (strongly agree). The flipped classroom was ranked as an enjoyable learning experience with a mean of 4.4 ± 0.10, while students responded positively to other pointed questions. In formal course evaluations, flipped format students ranked the following higher (P flipped classroom proved to be a positive learning experience for students. As the classroom continues to modernize, pedagogical approaches

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

Effects of long-term administration of carprofen on healing of a tibial osteotomy in dogs.

Science.gov (United States)

Ochi, Hiroki; Hara, Yasushi; Asou, Yoshinori; Harada, Yasuji; Nezu, Yoshinori; Yogo, Takuya; Shinomiya, Kenichi; Tagawa, Masahiro

2011-05-01

To evaluate effects of long-term administration of carprofen on healing of a tibial osteotomy in dogs. 12 healthy female Beagles. A mid-diaphyseal transverse osteotomy (stabilized with an intramedullary pin) of the right tibia was performed in each dog. The carprofen group (n = 6 dogs) received carprofen (2.2 mg/kg, PO, q 12 h) for 120 days; the control group (6) received no treatment. Bone healing and change in callus area were assessed radiographically over time. Dogs were euthanized 120 days after surgery, and tibiae were evaluated biomechanically and histologically. The osteotomy line was not evident in the control group on radiographs obtained 120 days after surgery. In contrast, the osteotomy line was still evident in the carprofen group. Callus area was significantly less in the carprofen group, compared with the area in the control group, at 20, 30, and 60 days after surgery. At 120 days after surgery, stiffness, elastic modulus, and flexural rigidity in the carprofen group were significantly lower than corresponding values in the control group. Furthermore, histologic evaluation revealed that the cartilage area within the callus in the carprofen group was significantly greater than that in the control group. Long-term administration of carprofen appeared to inhibit bone healing in dogs that underwent tibial osteotomy. We recommend caution for carprofen administration when treating fractures that have delays in healing associated with a reduction in osteogenesis as well as fractures associated with diseases that predispose animals to delays of osseous repair.

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.

Effect of a combination of flip and zooming stimuli on the performance of a visual brain-computer interface for spelling.

Science.gov (United States)

Cheng, Jiao; Jin, Jing; Daly, Ian; Zhang, Yu; Wang, Bei; Wang, Xingyu; Cichocki, Andrzej

2018-02-13

Brain-computer interface (BCI) systems can allow their users to communicate with the external world by recognizing intention directly from their brain activity without the assistance of the peripheral motor nervous system. The P300-speller is one of the most widely used visual BCI applications. In previous studies, a flip stimulus (rotating the background area of the character) that was based on apparent motion, suffered from less refractory effects. However, its performance was not improved significantly. In addition, a presentation paradigm that used a "zooming" action (changing the size of the symbol) has been shown to evoke relatively higher P300 amplitudes and obtain a better BCI performance. To extend this method of stimuli presentation within a BCI and, consequently, to improve BCI performance, we present a new paradigm combining both the flip stimulus with a zooming action. This new presentation modality allowed BCI users to focus their attention more easily. We investigated whether such an action could combine the advantages of both types of stimuli presentation to bring a significant improvement in performance compared to the conventional flip stimulus. The experimental results showed that the proposed paradigm could obtain significantly higher classification accuracies and bit rates than the conventional flip paradigm (p<0.01).

Improved imaging of cochlear nerve hypoplasia using a 3-Tesla variable flip-angle turbo spin-echo sequence and a 7-cm surface coil.

Science.gov (United States)

Giesemann, Anja M; Raab, Peter; Lyutenski, Stefan; Dettmer, Sabine; Bültmann, Eva; Frömke, Cornelia; Lenarz, Thomas; Lanfermann, Heinrich; Goetz, Friedrich

2014-03-01

Magnetic resonance imaging of the temporal bone has an important role in decision making with regard to cochlea implantation, especially in children with cochlear nerve deficiency. The purpose of this study was to evaluate the usefulness of the combination of an advanced high-resolution T2-weighted sequence with a surface coil in a 3-Tesla magnetic resonance imaging scanner in cases of suspected cochlear nerve aplasia. Prospective study. Seven patients with cochlear nerve hypoplasia or aplasia were prospectively examined using a high-resolution three-dimensional variable flip-angle turbo spin-echo sequence using a surface coil, and the images were compared with the same sequence in standard resolution using a standard head coil. Three neuroradiologists evaluated the magnetic resonance images independently, rating the visibility of the nerves in diagnosing hypoplasia or aplasia. Eight ears in seven patients with hypoplasia or aplasia of the cochlear nerve were examined. The average age was 2.7 years (range, 9 months-5 years). Seven ears had accompanying malformations. The inter-rater reliability in diagnosing hypoplasia or aplasia was greater using the high-resolution three-dimensional variable flip-angle turbo spin-echo sequence (fixed-marginal kappa: 0.64) than with the same sequence in lower resolution (fixed-marginal kappa: 0.06). Examining cases of suspected cochlear nerve aplasia using the high-resolution three-dimensional variable flip-angle turbo spin-echo sequence in combination with a surface coil shows significant improvement over standard methods. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Brachymetatarsia of the fourth metatarsal, lengthening scarf osteotomy with bone graft

Directory of Open Access Journals (Sweden)

Ankit Desai

2013-09-01

Full Text Available A 16-year-old girl presented with left fourth metatarsal shortening causing significant psychological distress. She underwent lengthening scarf osteotomy held with an Omnitech® screw (Biotech International, France with the addition of two 1 cm cancellous cubes (RTI Biologics, United States. A lengthening z-plasty of the extensor tendons and skin were also performed. At 6 weeks the patient was fully weight bearing and at one-year follow up, the patient was satisfied and discharged. A modified technique of lengthening scarf osteotomy is described for congenital brachymatatarsia. This technique allows one stage lengthening through a single incision with graft incorporation by 6 weeks.

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.

["Flipped classroom" teaching model into the curriculum of Theories of Different Schools of Acupuncture and Moxibustion:exploration and practice].

Science.gov (United States)

Liu, Mailan; Yuan, Yiqin; Chang, Xiaorong; Tang, Yulan; Luo, Jian; Li, Nan; Yu, Jie; Yang, Qianyun; Liu, Mi

2016-08-12

The "flipped classroom" teaching model practiced in the teaching of Theories of Different Schools of Acupuncture and Moxibustion curriculum was introduced. Firstly, the roles and responsibilities of teachers were clarified, indicating teachers provided examples and lectures, and a comprehensive assessment system was established. Secondly, the "flipped classroom" teaching model was split into online learning, classroom learning and offline learning. Online learning aimed at forming a study report by a wide search of relevant information, which was submitted to teachers for review and assessment. Classroom learning was designed to communicate study ideas among students and teachers. Offline learning was intended to revise and improve the study report and refined learning methods. Lastly, the teaching practice effects of "flip classroom" were evaluated by comprehensive rating and questionnaire assessment, which assessed the overall performance of students and overall levels of paper; the learning ability was enhanced, and the interest and motivation of learning were also improved. Therefore, "flipped classroom" teaching mode was suitable for the curriculum of Theories of Different Schools of Acupuncture and Moxibustion , and could be recommended into the teaching practice of related curriculum of acupuncture and tuina.

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.

Minimally Invasive and Open Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus.

Science.gov (United States)

Brogan, Kit; Lindisfarne, Edward; Akehurst, Harold; Farook, Usama; Shrier, Will; Palmer, Simon

2016-11-01

Minimally invasive surgical (MIS) techniques are increasingly being used in foot and ankle surgery but it is important that they are adopted only once they have been shown to be equivalent or superior to open techniques. We believe that the main advantages of MIS are found in the early postoperative period, but in order to adopt it as a technique longer-term studies are required. The aim of this study was to compare the 2-year outcomes of a third-generation MIS distal chevron osteotomy with a comparable traditional open distal chevron osteotomy for mild-moderate hallux valgus. Our null hypothesis was that the 2 techniques would yield equivalent clinical and radiographic results at 2 years. This was a retrospective cohort study. Eighty-one consecutive feet (49 MIS and 32 open distal chevron osteotomies) were followed up for a minimum 24 months (range 24-58). All patients were clinically assessed using the Manchester-Oxford Foot Questionnaire. Radiographic measures included hallux valgus angle, the intermetatarsal angle, hallux interphalangeal angle, metatarsal phalangeal joint angle, distal metatarsal articular angle, tibial sesamoid position, shape of the first metatarsal head, and plantar offset. Statistical analysis was done using Student t test or Wilcoxon rank-sum test for continuous data and Pearson chi-square test for categorical data. Clinical and radiologic postoperative scores in all domains were substantially improved in both groups (P .05). There were no significant differences in complications between the 2 groups ( > .5). The midterm results of this third-generation technique show that it was a safe procedure with good clinical outcomes and comparable to traditional open techniques for symptomatic mild-moderate hallux valgus. Level III, retrospective comparative study. © The Author(s) 2016.

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

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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,…

Creating a contemporary clerkship curriculum: the flipped classroom model in emergency medicine.

Science.gov (United States)

Lew, Edward K

2016-12-01

The teaching modality of "flipping the classroom" has garnered recent attention in medical education. In this model, the lecture and homework components are reversed. The flipped classroom lends itself to more interaction in "class" and theoretically improved clinical decision-making. Data is lacking for this model for students in emergency medicine clerkships. We trialed the flipped classroom in our fourth-year student clerkship. Our aim was to learn student and faculty facilitator perceptions of the experience, as it has not been done previously in this setting. We evaluated this in two ways: (1) participant perception of the experience and (2) facilitator (EM physician educator) perception of student preparation, participation, and knowledge synthesis. With permission from its creators, we utilized an online video series derived from the Clerkship Directors in Emergency Medicine. Students were provided the link to these 1 week prior to the classroom experience as the "homework." We developed patient cases generated from the videos that we discussed during class in small-group format. Afterward, students were surveyed about the experience using four-point Likert items and free-text comments and also were evaluated by the facilitator on a nine-point scale. Forty-six clerkship students participated. Students deemed the online modules useful at 2.9 (95 % CI 2.7-3.2). Further, they reported the in-class discussion to be of high value at 3.9 (95 % CI 3.8-4.0), much preferred the flipped classroom to traditional lecturing at 3.8 (95 % CI 3.6-3.9), and rated the overall experience highly at 3.8 (95 % CI 3.7-3.9). Based on preparation, participation, and knowledge synthesis, the facilitator judged participants favorably at 7.4 (95 % CI 7.0-7.8). Students commented that the interactivity, discussion, and medical decision-making were advantages of this format. Students found high value in the flipped classroom and prefer it to traditional lecturing, citing

A Flipped First-Year Digital Circuits Course for Engineering and Technology Students

Science.gov (United States)

Yelamarthi, Kumar; Drake, Eron

2015-01-01

This paper describes a flipped and improved first-year digital circuits (DC) course that incorporates several active learning strategies. With the primary objective of increasing student interest and learning, an integrated instructional design framework is proposed to provide first-year engineering and technology students with practical knowledge…

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…

IoTFLiP: IoT-based flipped learning platform for medical education

Directory of Open Access Journals (Sweden)

Maqbool Ali

2017-08-01

Full Text Available Case-Based Learning (CBL has become an effective pedagogy for student-centered learning in medical education, which is founded on persistent patient cases. Flippped learning and Internet of Things (IoTs concepts have gained significant attention in recent years. Using these concepts in conjunction with CBL can improve learning ability by providing real evolutionary medical cases. It also enables students to build confidence in their decision making, and efficiently enhances teamwork in the learing environment. We propose an IoT-based Flip Learning Platform, called IoTFLiP, where an IoT infrastructure is exploited to support flipped case-based learning in a cloud environment with state of the art security and privacy measures for personalized medical data. It also provides support for application delivery in private, public, and hybrid approaches. The proposed platform is an extension of our Interactive Case-Based Flipped Learning Tool (ICBFLT, which has been developed based on current CBL practices. ICBFLT formulates summaries of CBL cases through synergy between students' and medical expert knowledge. The low cost and reduced size of sensor device, support of IoTs, and recent flipped learning advancements can enhance medical students' academic and practical experiences. In order to demonstrate a working scenario for the proposed IoTFLiP platform, real-time data from IoTs gadgets is collected to generate a real-world case for a medical student using ICBFLT.

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.

No midterm benefit from low intensity pulsed ultrasound after chevron osteotomy for hallux valgus.

Science.gov (United States)

Zacherl, Max; Gruber, Gerald; Radl, Roman; Rehak, Peter H; Windhager, Reinhard

2009-08-01

Chevron osteotomy is a widely accepted method for correction of symptomatic hallux valgus deformity. Full weight bearing in regular shoes is not recommended before 6 weeks after surgery. Low intensity pulsed ultrasound is known to stimulate bone formation leading to more stable callus and faster bony fusion. We performed a randomized, placebo-controlled, double-blinded study on 44 participants (52 feet) who underwent chevron osteotomy to evaluate the influence of daily transcutaneous low intensity pulsed ultrasound (LIPUS) treatment at the site of osteotomy. Follow-up at 6 weeks and 1 year included plain dorsoplantar radiographs, hallux-metatarsophalangeal-interphalangeal scale and a questionnaire on patient satisfaction. There was no statistical difference in any pre- or postoperative clinical features, patient satisfaction or radiographic measurements (hallux valgus angle, intermetatarsal angle, sesamoid index and metatarsal index) except for the first distal metatarsal articular angle (DMAA). The DMAA showed statistically significant (p = 0.046) relapse in the placebo group upon comparison of intraoperative radiographs after correction and fixation (5.2 degrees) and at the 6-week follow-up (10.6 degrees). Despite potential impact of LIPUS on bone formation, we found no evidence of an influence on outcome 6 weeks and 1 year after chevron osteotomy for correction of hallux valgus deformity.

Synchronous Premaxillary Osteotomy with Primary Cheiloplasty for BCLP Patients with Protrusion of the Premaxillae

Directory of Open Access Journals (Sweden)

Shinji Kobayashi, MD

2017-11-01

Conclusions:. As advantages, the patients’ facial structures improved, and the alveolar bones were formed by GPP. As a disadvantage, premaxillary necrosis might occur because of poor blood circulation. It is important to secure the following 2 blood supplies: from the periosteum and soft-tissue of the anterior premaxillae and from the periosteum and mucosa of the nasal septum. Synchronous premaxillary osteotomy and GPP with primary cheiloplasty are appropriate when the premaxillae cannot be properly repositioned by PSO or PSO cannot be done.

Mini-Invasive floating metatarsal osteotomy for resistant or recurrent neuropathic plantar metatarsal head ulcers

OpenAIRE

Tamir, Eran; Finestone, Aharon S.; Avisar, Erez; Agar, Gabriel

2016-01-01

Background Patients with peripheral neuropathy and pressure under a relatively plantar deviated metatarsal head frequently develop plantar foot ulcers. When conservative management with orthotics and shoes does not cure the ulcer, surgical metatarsal osteotomy may be indicated to relieve the pressure and enable the ulcer to heal. The purpose of this study is to evaluate the use of a mini-invasive floating metatarsal osteotomy in treating recalcitrant ulcers or recurrent ulcers plantar to the ...

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…

Comparison of the Modified McBride Procedure and the Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus.

Science.gov (United States)

Choi, Gi Won; Kim, Hak Jun; Kim, Taik Seon; Chun, Sung Kwang; Kim, Tae Wan; Lee, Yong In; Kim, Kyoung Ho

2016-01-01

Distal metatarsal osteotomy and the modified McBride procedure have each been used for the treatment of mild to moderate hallux valgus. However, few studies have compared the results of these 2 procedures for mild to moderate hallux valgus. The purpose of the present study was to compare the results of distal chevron osteotomy and the modified McBride procedure for treatment of mild to moderate hallux valgus according to the severity of the deformity. We analyzed the data from 45 patients (49.5%; 48 feet [49.0%]), who had undergone an isolated modified McBride procedure (McBride group), and 46 patients (50.5%; 50 feet [51.0%]), who had a distal chevron osteotomy (chevron group). We subdivided each group into those with mild and moderate deformity and compared the clinical and radiologic outcomes between the groups in relation to the severity of the deformity. The improvements in the American Orthopaedic Foot and Ankle Society scale score and the visual analog scale for pain were significantly better for the chevron group for both mild and moderate deformity. The chevron group experienced significantly greater correction in the hallux valgus angle and intermetatarsal angle for both mild and moderate deformity. The chevron group experienced a significantly greater decrease in the grade of sesamoid displacement for patients with moderate deformity. The McBride group had a greater risk of recurrence than did the chevron group for moderate deformity (odds ratio 14.00, 95% confidence interval 3.91 to 50.06, p hallux valgus recurrence than did the distal chevron group. Therefore, we recommend distal chevron osteotomy rather than a modified McBride procedure for the treatment of mild and moderate hallux valgus. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Flipped learning in science education

DEFF Research Database (Denmark)

Andersen, Thomas Dyreborg; Foss, Kristian Kildemoes; Nissen, Stine Karen

2017-01-01

During the last decade, massive investment in ICT has been made in Danish schools. There seems, however, to be a need to rethink how to better integrate ICT in education (Bundgaard et al. 2014 p. 216) Flipped learning might be a didactical approach that could contribute to finding a method to use...... research questions are “To what extent can teachers using the FL-teaching method improve Danish pupils' learning outcomes in science subject’s physics / chemistry, biology and geography in terms of the results of national tests?” And “What factors influence on whether FL-teaching improves pupils' learning...... will be addressed. Hereafter an array of different scaffolding activities will be conducted, among these are individual supervision, sharing of materials used in lessons and involving local school leaders in the program. During this 3-year period we will follow the progress of the students involved in the program...

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 ...

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

Outcome of periacetabular osteotomy for the management of acetabular dysplasia: experience in an academic centre.

LENUS (Irish Health Repository)

Burke, Neil G

2011-02-01

Periacetabular osteotomy (PAO) is a very effective reconstructive procedure for treatment of acetabular dysplasia. An orthopaedic paediatric surgeon and a reconstructive hip arthroplasty surgeon performed this procedure together in the early phase of their learning curve and then performed it individually. The early clinical and radiographic results of 85 consecutive PAOs performed in this academic orthopaedic unit were reviewed. The mean Merle-d\\'Aubigné score increased from 12.4 preoperatively to 16 at follow-up. Pre-operatively 73 hips were anteverted and 12 were neutral or retroverted. The mean angle of Wiberg improved from 5 degrees to 21 degrees (p < 0.0001) in anteverted hips, and from 9 degrees to 30 degrees in neutral or retroverted hips. The mean angle of Lequesne and de Sèze improved from 6 degrees to 35 degrees (p < 0.0001) in anteverted hips, and in neutral or retroverted hips from 9 degrees to 30 degrees (p < 0.0001). The acetabular index improved from 26 degrees to 8 degrees (p < 0.0001) in anteverted hips, and from 21 degrees to 7 degrees (p < 0.0001) in neutral or retroverted hips. Over the 7 year period the blood loss and operative time improved from 2000 ml to 900 ml and 4 hours to 2 hours respectively. Four hips (four patients) required conversion to total hip replacement. The radiographic correction and improved clinical scores are similar to those in previous studies. This study shows a survival rate of 94% at 58 months following periacetabular osteotomy. The learning curve and the early results of this procedure performed in our academic unit are encouraging.

Clinical and radiographic outcomes of medial open-wedge high tibial osteotomy with Anthony-K plate: prospective minimum five year follow-up data.

Science.gov (United States)

Altay, Mehmet Akif; Ertürk, Cemil; Altay, Nuray; Mercan, Ahmet Şükrü; Sipahioğlu, Serkan; Kalender, Ali Murat; Işıkan, Uğur Erdem

2016-07-01

The purpose of this study was to prospectively evaluate the clinical and radiographic outcomes, and complication rates, after a minimum of five years of follow-up after medial open wedge high tibial osteotomy (MOWHTO) using an Anthony-K plate. MOWHTO was performed on 35 knees of 34 consecutive patients. A visual analogue scale (VAS), and Western Ontario and McMaster University Osteoarthritis (WOMAC) and Lysholm scores, were used in clinical evaluation. Upon radiographic assessment, alignment was expressed as the femorotibial angle (FTA). The posterior tibial slope (PTS) and the Insall-Salvati Index (ISI) were also measured. VAS, WOMAC, and Lysholm scores improved significantly upon follow-up (p FTA was 4.68 ± 4.39° varus pre-operatively; at the last post-operative follow-up, the value was 8.43 ± 2.02° valgus. The mean correction angle was 13.1 ± 2.7°. A significant increase in PTS was evident (p < 0.01), as was a significant decrease in the ISI (p < 0.01). The overall complication rate was 8.6 %. The Anthony-K plate affords accurate correction, initially stabilises the osteotomy after surgery, and maintains such stability until the osteotomy gap is completely healed, without correction loss. The plate survival rate was 97.2 % after a minimum of five years of follow-up. The plate increased the PTS, as do other medial osteotomy fixation plates.

Pedicle subtraction osteotomy in elderly patients with degenerative sagittal imbalance.

Science.gov (United States)

Cho, Kyu-Jung; Kim, Ki-Tack; Kim, Whoan-Jeang; Lee, Sang-Hoon; Jung, Jae-Hoon; Kim, Young-Tae; Park, Hae-Bong

2013-11-15

Retrospective, radiographical analysis. To evaluate pedicle subtraction osteotomy (PSO) as a means of correcting severe degenerative sagittal imbalance in elderly patients. PSO in patients with degenerative sagittal imbalance is likely to cause more complications than in patients with iatrogenic flatback deformity. This study analyzed 34 patients who underwent fusion to the sacrum, with a minimum 2-year follow-up. Age of the patients were in the range from 58 to 73 with the mean at 65.5 years. PSO was performed at one segment in all cases, consisting of L3 (n = 26), L4 (n = 4), L2 (n = 3), and L1 (n = 1). The average number of levels fused was 8.15. Ten patients had structural interbody fusion at the lumbosacral junction. Applying PSO at one segment, the mean correction of the lordotic angle at the osteotomy site was 33.3°, of which the loss of correction (LOC) was 4.0° at the last visit. The correction of lumbar lordosis was 33.7° and the LOC was 8.5°. The sagittal C7 plumb was 215.9 mm before surgery, corrected to 35.1 mm after surgery, and changed to 95.9 mm by the last visit. The correction of the sagittal C7 plumb was 119.9 mm and the LOC was 60.9 mm. There was substantial LOC in lumbar lordosis and sagittal C7 plumb. In 10 patients with addition of posterior lumbar interbody fusion, the LOC of lumbar lordosis was 7.4°, which was less than 9° in those without it. PSO for the correction of degenerative sagittal imbalance in elderly patients resulted in correction of sagittal alignment with a significant LOC of lumbar lordosis and sagittal C7 plumb. The LOC of lumbar lordosis occurred at both the osteotomy and non-osteotomy site. The addition of anterior column support is helpful to maintain correction and reduce complications. N/A.

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...

Modified Wilson’s Osteotomy for Hallux Valgus Deformity. A New Approach

Science.gov (United States)

Xarchas, Konstantinos C; Mavrolias, Dimitrios; Kyriakopoulos, Georgios

2014-01-01

We introduce a new set of modifications and present the results from 48 patients (a total of 60 feet operated), who underwent this modified Wilson’s osteotomy for the correction of Hallux Valgus. Patients were of an average age of 52 years old (from 21 to 75 years of age) and were followed up for a mean of 12 months post-operatively. Patient evaluation was made with the symptom scoring system as presented by Kataraglis et al., with the final outcome being satisfactory in all of the cases. This set of modifications introduced to the original Wilson’s osteotomy, proved to offer a stable, predictable and satisfactory outcome in all cases and we strongly recommend it. PMID:25352929

Controlling T2 blurring in 3D RARE arterial spin labeling acquisition through optimal combination of variable flip angles and k-space filtering.

Science.gov (United States)

Zhao, Li; Chang, Ching-Di; Alsop, David C

2018-02-09

To improve the SNR efficiency and reduce the T 2 blurring of 3D rapid acquisition with relaxation enhancement stack-of-spiral arterial spin labeling imaging by using variable refocusing flip angles and k-space filtering. An algorithm for determining the optimal combination of variable flip angles and filtering correction is proposed. The flip angles are designed using extended phase graph physical simulations in an analytical and global optimization framework, with an optional constraint on deposited power. Optimal designs for correcting to Hann and Fermi window functions were compared with conventional constant amplitude or variable flip angle only designs on 6 volunteers. With the Fermi window correction, the proposed optimal designs provided 39.8 and 27.3% higher SNR (P variable flip angle designs. Even when power deposition was limited to 50% of the constant amplitude design, the proposed method outperformed the SNR (P variable flip angles can be derived as the output of an optimization problem. The combined design of variable flip angle and k-space filtering provided superior SNR to designs primarily emphasizing either approach singly. © 2018 International Society for Magnetic Resonance in Medicine.

Salter%u2019s Innominate Osteotomy in the Treatment of Congenital Hip Dislocation

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Eyup Cagatay Zengin

2014-03-01

Full Text Available Aim: Developmental displazy of hip is much seenillness which interest orthopaedic surgery in Turkey and around the world. In early times of illness conservative treatment is succesful but late times of illness surgery is necessary. Salter’s innominate osteotomy, since its initial description in 1961, has become a well-established surgical procedure in the treatment of congenital dislocation of the hip.Material and Method: We reviewed 59 patients with 74 congenitally dislocated hips, all managed by open reduction and Salter’s innominate osteotomy. Mean follow-up period was 4,2 years (range, 2 to 7 years; %82,4 of the hips had a excellent clinical result, and %75,7 were excellent radiologically. The patients who underwent Salter’s innominate osteotomy before the age of 3 had beter clinical and radiological results (%90,4 and %82,5, respectively. The radiographs of the unilateral normal hips were compared to the surgically treated hips according to their acetabular index angles, center-edge angles of Wiberg and femoral neck-shaft angles. No statistical differences were found between these two groups. The Kalamchi-McEwen classification of avascular necrosis. The late radiographic signs of types 2, 3 and 4 avasculer necrosis were seen in %10,8 of this series. Discussion: The results show that Salter’s innominate osteotomy provides good lateral coverage of the femoral head. The results are beter if the operation is performed between the ages 18 months and 3 years.

"Flipping" the introductory clerkship in radiology: impact on medical student performance and perceptions.

Science.gov (United States)

Belfi, Lily M; Bartolotta, Roger J; Giambrone, Ashley E; Davi, Caryn; Min, Robert J

2015-06-01

Among methods of "blended learning" (ie, combining online modules with in-class instruction), the "flipped classroom" involves student preclass review of material while reserving class time for interactive knowledge application. We integrated blended learning methodology in a "flipped" introductory clerkship in radiology, and assessed the impact of this approach on the student educational experience (performance and perception). In preparation for the "flipped clerkship," radiology faculty and residents created e-learning modules that were uploaded to an open-source website. The clerkship's 101 rising third-year medical students were exposed to different teaching methods during the course, such as blended learning, traditional lecture learning, and independent learning. Students completed precourse and postcourse knowledge assessments and surveys. Student knowledge improved overall as a result of taking the course. Blended learning achieved greater pretest to post-test improvement of high statistical significance (P value, .0060) compared to lecture learning alone. Blended learning also achieved greater pretest to post-test improvement of borderline statistical significance (P value, .0855) in comparison to independent learning alone. The difference in effectiveness of independent learning versus lecture learning was not statistically significant (P value, .2730). Student perceptions of the online modules used in blended learning portions of the course were very positive. They specifically enjoyed the self-paced interactivity and the ability to return to the modules in the future. Blended learning can be successfully applied to the introductory clerkship in radiology. This teaching method offers educators an innovative and efficient approach to medical student education in radiology. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

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.

[Prophylactic osteotomy of pelvis in dysplastic acetabulum.].

Science.gov (United States)

Richtr, M; Sosna, A

1998-01-01

Acetabular dysplasia and anatomical changes of pelvis accompanied with gracility of iliac bone pose a problem for a reliable fixation of acetabular component. In extreme cases the bone stock is not sufficient to accommodate the smallest size of the cup. Sometimes even reaming of the bed down to lamina interna is not sufficient for an adequate covering of the implant. Consequently, weakening of the bottom of acetabulum may be not only one of the causes of the failure of the implant but it makes difficult also the following revision surgeries. Therefore in acetabular dysplasia the authors recommend acetabuloplasty of the bottom of acetabulum preserving its original thickness including inner cortex. They recommend to perform osteotomy of the full thickness of the medial wall of acetabulum and move the massive bone graft created in this way farther into pelvis. At the same time they take care to preserve blood supply of the bone graft by retaining corticoperiostal bridge by means of osteoclasia. The suggested procedure allows full coverage of the implant by iliac bone and at the same time preserves a firm support of acetabular fossa. The original thickness of the medial wall of acetabulum is considered by authors as a significant antimigration barrier. In the period 1991 -1994 the authors used this method at Ist Orthopaedic Clinic of 1st Medical Faculty, Charles University in Prague in total in 16 patients. In all of them after 6 months the bone graft was fully absorbed. Remodelling of the bone graft occurred 1 to 2 years after the surgery and after that the thickness of the graft remained the same. Neither any change of the structure nor reduction of the thickness of the graft was found between 3rd and 4th year after the surgery. The nature of trabecular remodelling of the bone graft corresponds to the transfer of forces in loading the graft by acetabular cup. Key words: acetabuloplasty, osteotomy of the medial wall of acetabulum, osteotomy of pelvis, THR, acetabular

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)

Risks in surgery-first orthognathic approach: complications of segmental osteotomies of the jaws. A systematic review.

Science.gov (United States)

Pelo, S; Saponaro, G; Patini, R; Staderini, E; Giordano, A; Gasparini, G; Garagiola, U; Azzuni, C; Cordaro, M; Foresta, E; Moro, A

2017-01-01

To date, no systematic review has been undertaken to identify the complications of segmental osteotomies. The aim of the present systematic review was to analyze the type and incidence of complications of segmental osteotomies, as well as the time of subjective and/or clinical onset of the intra- and post-operative problems. A search was conducted in two electronic databases (MEDLINE - Pubmed database and Scopus) for articles published in English between 1 January 2000 and 30 August 2015; only human studies were selected. Case report studies were excluded. Two independent researchers selected the studies and extracted the data. Two studies were selected, four additional publications were recovered from the bibliography search of the selected articles, and one additional article was added through a manual search. The results of this systematic review demonstrate a relatively low rate of complications in segmental osteotomies, suggesting this surgical approach is safe and reliable in routine orthognathic surgery. Due to the small number of studies included in this systematic review, the rate of complication related to surgery first approach may be slightly higher than those associated with traditional orthognathic surgery, since the rate of complications of segmental osteotomies must be added to the complication rate of basal osteotomies. A surgery-first approach could be considered riskier than a traditional one, but further studies that include a greater number of subjects should be conducted to confirm these findings.

Imaging features of iBalance, a new high tibial osteotomy: what the radiologist needs to know.

Science.gov (United States)

Alaia, Erin FitzGerald; Burke, Christopher J; Alaia, Michael J; Strauss, Eric J; Ciavarra, Gina A; Rossi, Ignacio; Rosenberg, Zehava Sadka

2017-01-01

To describe the post-surgical imaging appearance and complications of high tibial osteotomy in patients with the iBalance implant system (iHTO; Arthrex, Naples, FL, USA). Retrospective, institutional review board-approved, Health Insurance Portability and Accountability Act-compliant review of imaging after 24 iBalance procedures was performed with attention to: correction of varus malalignment, healing at the osteotomy site, resorption of the osteoinductive compound, and complications. Immediate correction of the varus deformity was present in all cases. Lobular radiolucency was present in all cases, more pronounced on the lateral knee radiograph, simulating infection or erosive disease. Four radiographic signs of healing were observed: blurring at the opposing osteotomy bony margins and at the osteoinductive compound and the adjacent bone interface, callus formation, and resorption of the osteoinductive compound. Complications were present in 33 % of cases, including fracture through the lateral tibial cortex (21 %), genu varum recurrence (8 %), painful exuberant bone formation (4 %), persistent pain, requiring total knee arthroplasty (4 %), and non-union (after >6 months' follow-up), with suspected infection (4 %). Radiologists should be aware of the normal radiographic appearance following iBalance high tibial osteotomy, which may be confused with infection. Radiologists should also be aware of potential post-operative complications and compare all post-operative radiographs with the immediate post-operative examination to detect collapse of the osteotomy site and recurrence of varus angulation.

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.

Weighted-Bit-Flipping-Based Sequential Scheduling Decoding Algorithms for LDPC Codes

Directory of Open Access Journals (Sweden)

Qing Zhu

2013-01-01

Full Text Available Low-density parity-check (LDPC codes can be applied in a lot of different scenarios such as video broadcasting and satellite communications. LDPC codes are commonly decoded by an iterative algorithm called belief propagation (BP over the corresponding Tanner graph. The original BP updates all the variable-nodes simultaneously, followed by all the check-nodes simultaneously as well. We propose a sequential scheduling algorithm based on weighted bit-flipping (WBF algorithm for the sake of improving the convergence speed. Notoriously, WBF is a low-complexity and simple algorithm. We combine it with BP to obtain advantages of these two algorithms. Flipping function used in WBF is borrowed to determine the priority of scheduling. Simulation results show that it can provide a good tradeoff between FER performance and computation complexity for short-length LDPC codes.

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.)

The flipped learning approach in teaching degrees: students’ perceptions

Directory of Open Access Journals (Sweden)

Déborah Martín R.

2017-05-01

Full Text Available In this paper, we analyze the students' perception of a university teaching-learning strategy, with a flipped learning approach, in the development of the subject Orientación educativa y plan de acción tutorial del Grado de Educación Primaria. The 21st century skills proposed by Fullan (2013 and known as the six Cs (Character, Communication, Collaboration, Citizenship, Critical Thinking and Creativity are used as a frame of reference. An experimental design of two groups, with a non-equivalent control group, has been used to analyze the students' perceptions of their learning in a conventional teaching environment and under a flipped environment based on m-learning. The differences found were statistically significant in all the analyzed dimensions, with favorable increases in the experimental methodology in all cases. The differences in Citizenship, Character, and Communication are of particular relevance. The analysis of the items reveals some difficulties in the functional literacy of students in the use of digital technology to improve their learning. Likewise, it is evident that the active methodologies improve, according to the perception of the students, the skills development, and learning. It is confirmed the hypothesis proposed in this study that the use of m-learning with a pedagogical approach centered on learning, with active methodologies, is a support that improves the development of the competences of the 21st century and, specifically, those described as the 6C's.

Flipped neutrino emissivity from strange matter