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Tongue reduction surgery is often pursued to manage the adverse effects of macroglossia in patients with Beckwith-Wiedemann syndrome (BWS). This study characterized dental outcomes in patients with BWS based on surgical timing and molecular diagnosis. A retrospective study was designed to include patients with BWS over the age of two who had clinical or radiographic documentation of dental development. Patients were grouped by history of tongue reduction surgery and surgical timing (early: <12 months). One hundred three patients were included (55 no tongue reduction, 18 early, 30 late). Patients who underwent late surgery had lower odds of class I occlusion (OR 0.11, 95% CI 0.02–0.58, p = 0.009) and higher odds of anterior open bite (OR 7.5, 95% CI 1.14–49.4, p = 0.036). Patients with clinical diagnoses and negative molecular testing had anterior open bite less frequently than patients with imprinting center 2 loss of methylation and paternal uniparental isodisomy of 11p15.5 (p = 0.009). Compared to reference values, patients who had tongue reductions had an increased mandibular plane angle (32.0 ± 4.5° versus 36.9 ± 5.0°, p = 0.001), indicative of hyperdivergent growth. The results of this study help to understand the complex nature of dentoskeletal growth in BWS and shed insight on how surgical timing and molecular diagnosis influence prognosis. [ABSTRACT FROM AUTHOR]

Background/Objective: Implant-based breast reconstruction is a common plastic surgery procedure with well-documented clinical outcomes. Despite this, the natural history and timing of key complication endpoints are not well described. The goal of this study is to determine when patients are most likely to experience specific adverse events after implant-based reconstruction. Methods: Retrospective consecutive series of patients who received mastectomy and implant-based reconstruction over a 6-year period were included. Complications and unfavorable outcomes including hematoma, seroma, wound infection, skin flap necrosis, capsular contracture, implant rippling, and implant loss were identified. A time-to-event analysis was performed and Cox regression models identified patient and treatment characteristics associated with each outcome. Results: Of 1473 patients and 2434 total reconstructed breasts, 785 complications/unfavorable outcomes were identified. The 12-month cumulative incidence of hematoma was 1.4%, seroma: 4.3%, infection: 3.2%, skin flap necrosis: 3.9%, capsular contracture: 5.7%, implant rippling: 7.1%, and implant loss: 3.9%. In the analysis, 332/785 (42.3%) complications occurred within 60 days of surgery; 94% of hematomas, 85% of skin necrosis events, and 75% of seromas occurred during this period. Half of all infections and implant losses also occurred within 60 days. Of the remaining complications, 94% of capsular contractures and 93% of implant rippling occurred >60 days from surgery. Conclusions: Complications following mastectomy and implant-based reconstruction exhibit a discrete temporal distribution. These data represent the first comprehensive study of the timing of adverse events following implant-based reconstruction. These findings are immediately useful to guide postoperative care, follow-up, and clinical trial design. [ABSTRACT FROM AUTHOR]

As a medium for learning, digital games provide promising possibilities to motivate and engage students in subject learning. In this study, a game-based learning system, My-Pet-My-Quest, is developed to support pupils' math learning. This is due to the fact that most students in Taiwan have relatively lower positive attitude towards math learning, even though their math performance is prominent. To this end, a three-tire framework is proposed to guide the design of the My-Pet-My-Quest system. A quasi-experiment was conducted to examine the influence of game quests on pupils' enjoyment and goal-pursuing in math learning. The results revealed that game quests were favored by students in terms of enjoyment, goal orientation, and goal intensity. Possible reasons for these results and a discussion of related issues are presented in this paper. (Contains 5 tables and 6 figures.)

In the last decade, more and more games have been developed for handheld devices. Furthermore, the popularity of handheld devices and increase of wireless computing can be taken advantage of to provide students with more learning opportunities. Games also could bring promising benefits--specifically, motivating students to learn/play, sustaining their interest, reflecting their learning/playing status, and facilitating the learning/playing progress. However, most of these have been designed for entertainment rather than education. Hence, in this study we incorporate game elements into a learning environment. The My-Mini-Pet system is a handheld pet-nurturing game environment, in which students learn with an animal learning companion, their My-Mini-Pet. Three design strategies are adopted. First, the pet-nurturing strategy, which simulates the relationship between the pet and its owner, the My-Mini-Pet becomes a motivator/sustainer of learning. Second, the pet appearance-changing strategy, which externalizes the learning status of the student. In other words, the My-Mini-Pet plays the role of a reflector. Third, the pet feedback strategy, which links the behaviours of the student and his/her pet, the My-Mini-Pet acts as a facilitator of learning. A pilot study was also conducted to preliminarily investigate the effectiveness and experiences of the strategies on allowing the student to understand arithmetic practices. The results showed that the strategy was effective, encouraging the students to engage in learning activities. Furthermore, the game attracted the students' attention and stimulated discussion between peers. Some implications about the further developments are also discussed. (Contains 7 tables.)

Competition, despite its potential drawbacks, is an easily adopted and frequently used motivator in classrooms. Individual abilities, in the years of schooling, are inevitably different, and performance in competition is heavily ability dependent, resulting that more-able students always win while less-able students always lose. Students easily perceive how well they perform through the result of competition, which is termed as perceived performance in this paper. Consistently demonstrating lower perceived performance than their peers, the less-able students feel discouraged and frustrated, hardly having the same opportunity for owning the sense of achievement as the more-able students. In this study, the authors designed a computerized mechanism, equal opportunity tactic, to lessen the difference in perceived performance between more-able and less-able students. Equal opportunity tactic is incorporated into a version of a competitive learning game called AnswerMatching, in which every student is assigned an opponent with similar ability. An experiment was also conducted to preliminarily investigate the effectiveness and effects of the tactic. Results showed that equal opportunity tactic could reduce the effect of individual ability difference on the perceived performance as well as the belief about how well students could achieve. In other words, less-able students could have similar opportunity of success and build confidence similar to more-able students in a competition. (Contains 1 table and 5 figures.)

This experiment is designed to teach entry-level, nonchemistry-major students some basic organic chemistry through the procedure for making cosmetics. The experiment combines facial toner preparation with distillation techniques to create a stimulating learning environment. During the experiment, students perform a distillation to collect some fragrant components from the plants. By combining this distillate with other ingredients, students learn to prepare a cosmetic product and acquire knowledge in both organic and cosmetic chemistry. Because the facial toner is a colloid, students also learn the properties of colloidal mixtures by investing the Tyndall effect. (Contains 1 table and 1 figure.)