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BACKGROUND: Gliomas are the most common primary malignant brain tumor. Diffuse low-grade and intermediate-grade gliomas, which together compose the lower-grade gliomas (LGGs; World Health Organization [WHO] grades II and III), present a therapeutic challenge to physicians due to the heterogeneity of their clinical behavior. Nomograms are useful tools for individualized estimation of survival. This study aimed to develop and independently validate a survival nomogram for patients with newly diagnosed LGG. METHODS: Data were obtained for newly diagnosed LGG patients from The Cancer Genome Atlas (TCGA) and the Ohio Brain Tumor Study (OBTS) with the following variables: tumor grade (II or III), age at diagnosis, sex, Karnofsky performance status (KPS), and molecular subtype (IDH mutant with 1p/19q codeletion [IDHmut-codel], IDH mutant without 1p/19q codeletion, and IDH wild-type). Survival was assessed using Cox proportional hazards regression, random survival forests, and recursive partitioning analysis, with adjustment for known prognostic factors. The models were developed using TCGA data and independently validated using the OBTS data. Models were internally validated using 10-fold cross-validation and externally validated with calibration curves. RESULTS: A final nomogram was validated for newly diagnosed LGG. Factors that increased the probability of survival included grade II tumor, younger age at diagnosis, having a high KPS, and the IDHmut-codel molecular subtype. CONCLUSIONS: A nomogram that calculates individualized survival probabilities for patients with newly diagnosed LGG could be useful to health care providers for counseling patients regarding treatment decisions and optimizing therapeutic approaches. Free online software for implementing this nomogram is provided: https://hgittleman.shinyapps.io/LGG_Nomogram_H_Gittleman/. KEY POINTS: 1. A survival nomogram for lower-grade glioma patients has been developed and externally validated. 2. Free online software for implementing this nomogram is provided allowing for ease of use by practicing health care providers.

We aimed to determine the value of MR-based preoperative nomograms in predicting DNA copy number (CN) subtype in lower grade glioma (LGG) patients. The overall survival (OS) data were analyzed. MRI data of 170 subjects were retrospectively analyzed. The correlation was explored by univariate and multivariate regression analysis. CN2 subtype was associated with shortest median OS (CN2 subtype vs. others: 46.8 vs. 221.7 months, p < 0.05). The time-dependent receiver operating characteristic for the CN2 subtype was 0.80 (95% CI: 0.74–0.85) for survival at 1 year, 0.80 (95% CI: 0.75–0.85) for survival at 2 years, and 0.77 (95% CI: 0.73–0.83) for survival at 3 years. On multivariate analysis, hemorrhage (OR: 0.118; p < 0.001; 95% CI: 0.037–0.376), poorly defined margin (OR: 4.592; p < 0.001; 95% CI: 1.965–10.730), extranodular growth (OR: 0.247; p = 0.006; 95% CI: 0.091–0.671), and volume ≥ 60 cm3 (OR: 4.734.256; p < 0.001; 95% CI: 2.051–10.924) were associated with CN1 subtype (AUC: 0.781). Proportion CE tumor (OR: 5.905; p = 0.007; 95% CI: 1.622–21.493), extranodular growth (OR: 9.047; p = 0.001; 95% CI: 2.349–34.846), width ≥ median (OR: 0.231; p = 0.049; 95% CI: 0.054–0.998), and depth ≥ median (OR: 0.192; p = 0.023; 95% CI: 0.046–0.799) were associated with CN2 subtype (AUC: 0.854). Necrosis/cystic (OR: 6.128; p = 0.007; 95% CI: 1.635–22.968), hemorrhage (OR: 5.752; p = 0.002; 95% CI: 1.953–16.942), poorly defined margin (OR: 0.164; p < 0.001; 95% CI: 0.063–0.427), and volume ≥ median (OR: 4.422; p < 0.001; 95% CI: 1.925–10.160) were associated with CN3 subtype (AUC: 0.808). All three nomograms showed good discrimination and calibration. Decision curve analysis supported that all nomograms were clinically useful. The average accuracy of the tenfold cross-validation was 0.680 (CN1), 0.794 (CN2), and 0.894 (CN3), respectively. The shortest OS was observed in patients with CN2 subtype. This preliminary radiogenomics analysis revealed that the MR-based preoperative nomograms provide individualized prediction of DNA copy number subtype in LGG patients. • This preliminary radiogenomics analysis of LGG revealed that the MR-based preoperative nomograms provide individualized prediction of DNA copy number subtype in LGG patients. • The AUC for the ROC curve was 0.781 for CN1 subtype, 0.854 for CN2 subtype, and 0.808 for CN3 subtype. Decision curve analysis supported that all nomograms were clinically useful. • The sensitivity was 0.779 (CN1), 0.731 (CN2), and 0.851 (CN3), respectively. The specificity was 0.664 (CN1), 0.872 (CN2), and 0.625 (CN3), respectively. And the accuracy was 0.717 (CN1), 0.849 (CN2), and 0.692 (CN3), respectively.

Objectives To determine the prevalence of and the risk factors associated with burnout and stress for medical students in Saudi Arabia. Methods A cross-sectional, survey-based study was distributed between January and February 2018 among all 500 medical students from the first to fifth years in a medical college; 356 of the students responded (71.2% response rate). Burnout was measured using the Maslach Burnout Inventory-Student Survey (MBI-SS) while the stress level was measured using the 12-item General Health Questionnaire (GHQ-12). Socio-demographics, professional characteristics, and participation in extracurricular activities were also included as possible predictors of burnout and stress. Results The study revealed that the stress level was (51.7%, n= 184) and the rate of high burnout was (38.2%, n= 136), expressing high exhaustion (77.8%, n=277), high cynicism (65.7%, n=234), and low academic efficiency (45.5%, n=162). Half of the students (50%, n=178) participated in extracurricular activities and were involved in one or more activities such as organizing activities and medical volunteering (n = 52, 14.6%), research (n = 59, 16.6%), and physical exercise (n = 71, 10.4%). There was a statistically significant positive correlation between overall burnout and a lower grade point average (GPA) (OR = 0.581, p 0.004, 95% CI = 0.400 to 0.843). A statistically significant positive correlation was found between stress and students with a lower GPA (OR = 0.737, P = 0.0.23, 95% CI = 0.566 to 0.959); stress was also higher in students who were not involved in any extracurricular activities (OR 1.893, P = 0.004, 95% CI = 1.22 to 2.918). Conclusion Our study shows high burnout rates among medical students. Low GPA students in this study showed a higher overall burnout. Stress was high in our study participants and was higher in students with a low GPA and in students who were not involved in any extracurricular activities.

A previously reported botanical search application for tablet computers has been improved to enable elementary school students to actively learn while using information, communication, and telecommunication technologies in accordance with educational guidelines issued by the Japanese government. The functions and displays were improved to address seven problems identified by two experts in designing educational applications. To evaluate the feasibility of using the improved application at the elementary school level, an elementary school teacher conducted a class on plant search with six elementary school students who were familiar with using a tablet computer as an extracurricular summer lesson. They practiced using the application, took photos of plants on the school grounds, and searched for the plant names using the application. Three of the students (in grades 4, 5 and 6) could do the task by themselves while the other three students (in grade 1) searched for the plant names with help from assistant teachers. The lower grade students had difficulty in using the application because they were unable to prepare an initial worksheet giving input for the application. Nevertheless, all the students enjoyed using the application and participating in the class activities. The results revealed that this application can make searching enjoyable and promote natural conversation and that a class like this one can give students the opportunity not only to learn about plants but also to learn actively.

In this paper, the design criteria of ‘Design Thinking’ for teaching toolkit based on the ‘Empathy Design Thinking’ course is studied for the lower-grade students in primary schools. First of all, the teaching toolkit requirements of Design Thinking courses in primary schools, as well as the characteristics of physical and mental development of lower-grade students in primary schools are indicated. Then, the teaching toolkit is designed accordingly to produce various teaching toolkit corresponding to the paper version and their supporting materials. Afterwards, the designed teaching toolkit is applied to the actual teaching and the research method is adopted in combination with observation method and interview method to collect the feedback from both students and teachers. By conducting qualitative analysis of the observation and interview results, the characteristics of the teaching toolkit are obtained and finally the teaching toolkit design criteria of ‘Empathy Design Thinking’ for lower-grade students in primary schools are obtained to provide guidance on the subsequent design of teaching toolkit.

Choroid plexus tumors are rare tumors, predominantly found in pediatric patients. Lower grade tumors histologically resemble native choroid plexus while higher grade lesions are progressively more disordered and less differentiated. They are commonly associated with hydrocephalus and usually present with symptoms of that condition. Complete resection is typically curative in the case of low grade lesions. Higher grade lesions may be treated with adjuvant chemotherapy or radiotherapy. The hydrocephalus often resolves but in some cases may persist after resection and may require additional treatment.

Background Update 3 of the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy (cIMPACT-NOW) recognizes amplification of epidermal growth factor receptor (EGFR) as one important aberration in diffuse gliomas (World Health Organization [WHO] grade II/III). While these recommendations endorse testing, a cost-effective, clinically relevant testing paradigm is currently lacking. Here, we use real-world clinical data to propose a financially effective diagnostic test algorithm in the context of new guidelines. Methods To determine the prevalence, distribution, neuroradiographic features (Visually Accessible REMBRANDT Images [VASARI]), and prognostic relevance of EGFR amplification in lower-grade gliomas, we assembled a consecutive series of diffuse gliomas. For validation we included publicly available data from The Cancer Genome Atlas. For a cost-utility analysis we compared combined EGFR and isocitrate dehydrogenase (IDH) testing, EGFR testing based on IDH results, and no EGFR testing. Results In n = 71 WHO grade II/III gliomas, we identified EGFR amplification in 28.2%. With one exception, all EGFR amplifications occurred in IDH-wildtype gliomas. Comparison of overall survival showed that EGFR amplification denotes a significantly more aggressive subset of tumors (P 5% tumor contrast enhancement (75%, P = 0.016), and mild (not avid) enhancement (P = 0.016). The proposed testing algorithm reserves EGFR fluorescence in situ hybridization (FISH) testing for IDH-wildtype cases. Implementation would result in ~37.9% cost reduction at our institution, or about $1.3-4 million nationally. Conclusion EGFR-amplified diffuse gliomas are "glioblastoma-like" in their behavior and may represent undersampled glioblastomas, or subsets of IDH-wildtype diffuse gliomas with inherently aggressive biology. EGFR FISH after IDH testing is a financially effective and clinically relevant test algorithm for routine clinical practice.

Objective: We aimed to identify a radiomic signature to be used as a noninvasive biomarker of prognosis in patients with lower-grade gliomas (LGGs) and to reveal underlying biological processes through comprehensive radiogenomic investigation. Methods: We extracted 55 radiomic features from T2-weighted images of 233 patients with LGGs (training cohort: n = 85; validation cohort: n = 148). Univariate Cox regression and linear risk score formula were applied to generate a radiomic-based signature. Gene ontology analysis of highly expressed genes in the high-risk score group was conducted to establish a radiogenomic map. A nomogram was constructed for individualized survival prediction. Results: The six-feature radiomic signature stratified patients in the training cohort into low- or high-risk groups for overall survival (P = 0.0018). This result was successfully verified in the validation cohort (P = 0.0396). Radiogenomic analysis revealed that the prognostic radiomic signature was associated with hypoxia, angiogenesis, apoptosis, and cell proliferation. The nomogram resulted in high prognostic accuracy (C-index: 0.92, C-index: 0.70) and favorable calibration for individualized survival prediction in the training and validation cohorts. Conclusions: Our results suggest a great potential for the use of radiomic signature as a biological surrogate in providing prognostic information for patients with LGGs.

Purpose : The purpose of this study was to apply as the basic data on hyperopic refractive error through comparison and analysis of manifest refreaction (MR) and cycloplegic refraction (CR) in elementary school students with hyperopia in gangwon-do region. Methods : Total of 50 eyes; 30 eyes of lower grades (grade 1.2.3) 20 eyes of the upper grades (Grades 4.5.6) participated , and were divided into 2 groups such as the mild hyperopia (+0.25D ~ +2.00D), moderate hyperopia (+2.25D ~+5.00D). MR and CR were performed with auto-refractometer and retinoscope. Results : The mean values of spherical power of MR and CR were +1.00±0.52D and +1.59±1.23D respectively, and that of CR power was 0.59±0.59D (p

Objectives The chromosome 1p/19q co-deletion is a favorable prognostic factor in patients with low grade glioma. In the current analysis, we examined MycBP expression in low grade glioma. MycBP lies on chromosome 1p. Patients and methods We evaluated the association between MycBP and overall survival in the TCGA Lower Grade Glioma (LGG) dataset in TCGA (The Cancer Genome Atlas). Results Loss of MycBP copy number segment expression coincides with co-deletion of 1 P. The deleterious effect of MycBP on survival is significant (p = 0.00006306, hazard ratio 2.02, 95% CI 1.4–2.9). Patients with astrocytoma have the poorest survival of low grade glioma patients. MycBP mRNA is significantly overexpressed in astrocytomas when compared to normal brain (2.156 fold change, p = 0.0000488). Conclusion Our report that Chromosome 1 P co-deletion may confer better survival in patients with lower grade glioma in part because of loss of MycBP corroborates other studies of the importance of MycBP in glioma development. Further work with microRNAs may lead to new treatments.

The purpose of this study was to examine the underlying mechanism between goal orientations and academic expectation for online learners. We simultaneously studied the structural relationships among 2×2 achievement goal orientations, self-regulated learning strategies (SRL), supportive online learning behaviors, and expected academic outcome in various online courses with 93 respondents (70 undergraduate and 23 graduate students). Specifically, we tested the mediation effects of both self-regulated learning strategies and supportive online learning behaviors on the relation between achievement goal orientations and students’ academic expectations. The results showed that two of the achievement goal orientations – mastery-approach goals (MAP) and mastery-avoidance goals (MAV) – predicted the adoption of the self-regulated learning strategies and supportive online learning behaviors, which, in turn, predicted students’ expected academic outcome for their online course. Specifically, students with higher mastery-approach goals were more likely to adopt different types of self-regulated learning strategies and supportive online learning behaviors to facilitate their learning experience, which further enhanced their expectation for their academic outcome. By contrast, students with higher mastery-avoidance goals were less likely to adopt self-regulated learning strategies and supportive online learning behaviors, which, in turn, led to lower grade expectations.

The history and variety of commercial Platinum Group Metal (PGM) matte converting processes are explored. Aspects unique to pneumatic converting of high iron, lower grade mattes (typically up to 30...

This study aimed to evaluate the relationships between androgen receptor (AR) expression and clinicopathologic features of sebaceous gland carcinoma (SGC) of the eyelid. AR expression was evaluated via immunohistochemistry analysis of surgically derived samples from 11 patients with SGC of the eyelid. The expression of AR was evident in 9 of 11 patients (82%). We divided patients into high AR (7 patients) and low AR (4 patients: 2 patients with low expression and 2 patients with no expression) groups. The low AR group showed significantly greater progression than the high AR group with regard to T category and exhibited a lower grade of differentiation. In patients with SGC of the eyelid, a marked decrease in AR expression may be associated with a poor prognosis. AR may be a prognostic factor and a potential therapeutic target in cases of SGC of the eyelid.

In intensive shrimp farming systems, formulated feed represents the main nutrition source and its adequate management significantly influences the economic feasibility of the farm. Based on that, the present study evaluated two dynamic feeding strategies: fuzzy logic (FL) and mathematical functions (MF). For both strategies, the temperature and dissolved oxygen were modified in a controlled way. A conventional feeding table was the control treatment. The results showed that DO was the parameter that mostly influences the feeding rate (74%) while the temperature also did it, but in a lower grade (26%). The results showed that feed conversion rate (FCR) was significantly better when the FL strategy was used, saving around 35% of feed when compared to the control. An expert system based on FL may replace the traditional feeding strategies with no significant adverse effects on growth, survival and FCR, and may easily be adapted to some other culture systems.

This study investigates how students and their parents perceive issues related to teaching English to primary school first and second graders. The participants were 163 primary school students and 119 parents from three regions in Korea: Seoul, Gyeonggi, and Incheon. They responded respectively to the survey questions provided in slightly differentiated types, one for students and the other for parents. Nearly 80% of the students had English learning experience before entering the primary school and about 55% of them experienced English learning through the regular curriculum at their kindergarten or day care center. About 48% of the students and 44% of the parents agreed with teaching English to the lower grades at primary school. More than half of the students disagreed that learning English would interfere with learning Korean. Both students and parents preferred the Creative Exercise class as a way for offering early English education. Slightly more than 70% of the students preferred their homeroom teacher as an English teacher. Based on these results, implications are discussed and a few suggestions are made for policy making regarding teaching English to the lower grade classes at primary schools in Korea.

A career developed through the optimization of one’s potentials will irrevocably play a role in the development of self-identity as well as the psychological well-being of the individual. When children are introduced and allowed to explore as many career options as possible during their developmental stage, they are more likely to have a fruitful career development in the future. The preceding study showed that the career interests and knowledge of lower-grade primary students fit the Holland Career Categories: realistic, investigative, artistic, social, enterprising, and conventional (RIASEC). It was also found that the students’ career interest and knowledge levels varied, with most in the low level. This second-year study aims to expand the results of the previous study by developing the use of Quartet cards as the media of career exploration for lower-grade primary students. By using the research and development method, this study develops Quartet Career Cards into three difficulty levels: low, medium, and high. The Quartet cards media have undergone feasibility tests conducted by experts in theory and media, as well as a series of field testing consisting of preliminary, main, and operational stages among a total of 266 primary students of grades 1, 2, and 3. A revision was made on several components including the images, information, colors, font sizes, illustration styles, and card sizes. The findings show that Quartet Career Cards meet the feasibility standards for the media of career exploration

India being one of the leading coal consumer, is striving hard to improve the quality of coal supplied to steel and power sectors. In the last 10 years, there has been hardly any improvement in designing of new process technology to beneficiate inferior quality coals. Owing to the stringent quality specification requirements of the end user industry, utilization of lower grade coals through effective beneficiation techniques has become the need of the day. Under these circumstances, multi gravity separator, can augment some solution through beneficiation of ultrafine size (below − 75 µm) coal fines. The present paper outlines an approach made for identifying the utility of MGS for treating coal fines below − 75 µm. A series of 15 tests were conducted by varying three operational variables such as Drum Inclination, Drum speed and its shake frequency following the Box–Behnken design. Effect of these parameters on yield percent, ash percent and recovery of combustibles to clean product, were estimated for each of the experiments. From the results obtained and with the help of RSM approach, levels of operational parameter were optimized to achieve the highest yield of 74.59%, with a combustibles recovery of 84.56% and the lowest ash content obtained was 19.22% from a coal of feed ash 33.5%.

Background: On April 25, 2015 at 11:56 local time, a great earthquake of massive magnitude-7.8 trembler was experienced in Nepal. Along with the physical and economical loss, such disasters can have devastating consequences in adolescent’s mental health. The purpose of this study is to determine the prevalence of Post-Traumatic Stress Disorder and associated factors among adolescents after 2015 Nepal Earthquake.Methods: A total of 140 adolescents from grade 8, 9 and 10 of two higher secondary schools were recruited in this study. Post-Traumatic Stress Disorder CheckList-5 (PCL-5) of DSM-V criteria was used for the diagnosis of Post-Traumatic Stress Disorder. Chi-square test was used to assess the association.Results: Among 140 adolescents, the age range was 12 to 19 years with a mean age of 14.8 (SD=1.1) where 27.1% of the participants had Post-Traumatic Stress Disorder. A statistically significant association was found between Post-Traumatic Stress Disorder and grade (χ² = 9.324, p

AimsTo investigate the association of the paired box gene 6 (PAX6) with different severities of myopia.MethodsA total of four haplotype-tagging single-nucleotide polymorphisms (SNPs; rs2071754, rs3026354, rs3026390 and rs628224) and two previously reported SNPs (rs644242 and rs662702) in the PAX6 gene were analysed in a Hong Kong Chinese cohort of 1288 myopia subjects (including 252 extreme myopia, 277 high myopia, 393 moderate myopia and 366 mild myopia) and 791 no myopia controls. Allelic association analyses were performed for individual SNPs in different subgroups of myopia and in combined myopia, followed by a meta-analysis of our current data with reported data on PAX6 in myopia.ResultsThe association of tagging SNPs rs2071754 and rs644242 with extreme myopia could not withstand multiple correction (rs2071754: OR=1.25, P value=0.031; rs644242: OR=1.33, P value=0.032). In the meta-analysis, rs644242 showed an enhanced, significant association with extreme myopia (OR=1.27, 95% CI 1.10 to 1.46, P value=0.001; I2=0%). In contrast, there was no significant association between the PAX6SNPs and high, moderate or mild myopia. No linear correlation was found between the PAX6SNPs and axial length.ConclusionThis study provides additional evidence suggesting that the PAX6 SNP rs644242 is associated with extreme myopia but not lower grade myopia. Thus, PAX6 may be implicated in the development or progression into severe myopia. Further longitudinal studies are warranted.

Cognitive and motivational variables are significant correlates and predictors of scholastic achievement. In upper elementary school grade levels, intelligence seems to be more important compared to motivational variables. Regarding motivational variables, (competence) self-concept revealed higher path coefficients in reported grades than interest. Extending these findings to lower grade levels, the present study with N = 858 students that stemmed from grade levels 2, 3, and 4 (n = 253/321/284) revealed that, when all three predictors were jointly considered, self-concept and interest contributed substantially to the prediction of reported grades in mathematics and German beyond intelligence in all three examined grade levels, with the exception of interest of fourth graders in German. Self-concept was the numerically stronger motivational predictor. Significant grade level-related differences of the predictors were not evidenced. The importance of cognitive and motivational predictors for scholastic success in elementary school is discussed.

The rapid increase in student loan debt outstanding has garnered significant media and policy attention over the past several years. In contrast, little is known about the short‐term academic consequences of borrowing to finance college attendance. We use detailed student‐level administrative data to examine the relationship between the type and amount of student loans used to pay for college and students' academic performance, choice of major, and retention rates. The results suggest that students who take out loans have lower grade point averages (GPAs) than students who do not. Among students with debt, those with greater student loan balances have lower GPAs, take fewer credits per semester, and have lower retention rates. This is true conditioning on detailed background characteristics as well as in individual fixed effect specifications that control for unobserved time‐constant characteristics of students. These results can help inform policies to mitigate the adverse effects of increasing education debt.

The faculty in a biology department at a four-year public comprehensive university adopted e-texts for all 100 and 200 level biology courses with the primary motivation of reducing textbook costs to students. This study examines the students’ perceptions of the e-texts adopted for these 100 and 200 level biology courses. An online questionnaire was developed and administered in multiple sections of six 100 and 200 level biology courses during the spring and fall semesters of 2014 to measure student perceptions of the e-texts used in these courses. Results suggest a bimodal distribution among our sample (N = 2,152) of student participants. However, there are statistically significant and noteworthy exceptions to this general pattern. Black students reported a significantly higher satisfaction with e-texts compared to white students, and students repeating one of these courses reported significantly higher levels of satisfaction with the e-text compared to students taking the for the first time. Additionally, students with lower grade point averages (GPAs) preferred the e-text significantly more compared to those with higher GPAs. Further analyses reveal that the majority of student participants perceived the use of value-added technologies, such as e-homework, favorably.

Objective The aim of this study was to develop a radiomics signature for prediction of progression-free survival (PFS) in lower-grade gliomas and to investigate the genetic background behind the radiomics signature. Methods In this retrospective study, training (n = 216) and validation (n = 84) cohorts were collected from the Chinese Glioma Genome Atlas and the Cancer Genome Atlas, respectively. For each patient, a total of 431 radiomics features were extracted from preoperative T2-weighted magnetic resonance images. A radiomics signature was generated in the training cohort, and its prognostic value was evaluated in both the training and validation cohorts. The genetic characteristics of the group with high-risk scores were identified by radiogenomic analysis, and a nomogram was established for prediction of PFS. Results There was a significant association between the radiomics signature (including 9 screened radiomics features) and PFS, which was independent of other clinicopathologic factors in both the training (P, Highlights • We developed a non-invasive model for the prediction of PFS in patients with lower-grade gliomas. • We further revealed the biological processes underlying the radiomic signature by using comprehensive radiogenomic analysis. • PFS of lower-grade gliomas could be predicted effectively based on the radiomics model.

The production of high filler-loaded recycled papers is often affected by high values of linting and low values of strength. In the first case, the accumulation of lint particles from paper’s surface on the printing blanket affects the quality of the printed paper and the pressroom’s productivity. In the second case, increasing the use of fillers and recycling cycles lead to poor paper strength. Cellulose nanofibers (CNFs) are receiving a great deal of attention due to their potential as a reinforcement aid for high filler-loaded papers through filler–fiber interaction and interfiber bonding. It is already proven that high quality CNFs can reduce linting, although their industrial application is limited by their high production cost. The objective of this research is, therefore, to quantify the effect of applying lower grade, more sustainable CNFs on linting phenomena and on the mechanical properties of recycled papers. Eucalyptus, pine and triticale residues were used as cellulose sources, and the CNFs were produced minimizing the chemical pretreatment before homogenization. Addition of 3 wt% of CNFs from pine residues into the recycled paper with 15.7 wt% of total filler reduced linting by 40% and increased tensile strength by 15.1%; further improvements on linting and mechanical properties were achieved at 5 wt%. Moreover, the increase in drainage time can be overcome by the addition of a retention aid, in this case a coagulant-cationic polyacrylamide-bentonite system, commonly used in paper mills.

The aim of this study is to investigate the thermo-economic performance of the transcritical organic Rankine cycle (TORC) system using R1234yf/R32 mixtures as the working fluids for the lower-grade waste heat recovery (WHR). The components of R32 and R1234yf are selected due to their zero ozone depletion potential, lower global warming potential and complementary thermodynamic properties. The influences of the mass fractions of R1234yf/R32 mixtures, isentropic efficiencies of the expander, condensation temperature, turbine inlet pressure and temperature on performances have been investigated. The results show that R1234yf/R32 at optimal mass fraction is superior to pure R1234yf and pure R32 by 1.46% and 4.88% in thermo-economic performance, respectively. The optimal compositions of mixtures and the optimal temperature entropy diagrams are obtained to fit the various isentropic efficiencies possessed by the different types of expanders. In thermo-economic evaluation, the lower the condensation temperature is, the larger the optimal mass fraction of R32 in the mixtures will be. The increase of optimal expander inlet pressure and temperature are proportional to that of mass fraction of R32 in mixtures. The relationships among mass fraction, optimal expander inlet pressure and temperature and performance are expressed as the correlations for convenient design in lower-grade WHR.

Phase 1 trials of molecularly targeted agents (MTA) often do not use toxicity data beyond the first cycle of treatment to determine a recommended phase 2 dose (RP2D). We investigated the potential utility of longitudinal relative dose intensity (RDI) that may be a better new way of determining a more accurate RP2D as a lower dose that is presumably more tolerable over the long term without compromising efficacy. All consecutive patients who initially were treated using a single MTA at the conventional RP2D or at one level lower dose (OLLD) of that RP2D in nine phase 1 trials sponsored by the National Cancer Institute were included. The associations between longitudinal RDI, time to first progression, and response rate were analyzed. The RDIs of the conventional RP2D group were maintained a rate of ≥70% throughout 10 cycles, and were higher than those of the OLLD group, although in both groups the RDI gradually decreased with additional treatment cycles. The RP2D group was similar to the OLLD group with respect to time to first progression and response rate. In the both groups, however, the decreasing relative dose intensity (RDI) over time was significantly associated with shorter time to first disease progression; therefore, the longitudinal RDI, which takes into account lower grade toxicity occurrences, may be useful in determining a more desirable dose to use in phase 2 and 3 studies. This article is protected by copyright. All rights reserved.

Polymer samples based on polydicyclopentadiene produced from Russian dicyclopentadiene are investigated by thermogravimetric analysis and differential scanning calorimetry. A second stage of polymerization—that is, heat treatment of the samples—is found to increase the degree of polymerization and improve the physicomechanical properties of the polydicyclopentadiene.

Cervical cancer is the fourth more common type of cancer to affect women worldwide existing a strong correlation of it with the incidence of human papillomavirus (HPV), and even with the existence of a national tracking program in the Unic Health System, the coverage of this service has never achieved its ideal rate. In this context, there is a growth of subnotifications and following-ups of lower grade precursor lesions that, in failing, stops preserving cases that could be treated before complications. This paper discusses three important questions related to this dynamic: a) what factors lead women not to do the preventive exams? b) What are the preventive methods that impede the contagion by the virus and what are their efficiencies? c) What detection methods for HPV presence and precursor lesions are available and are they efficient? It is concluded that there is an agreement between the bibliography that the most important reasons for not doing the preventive exams are of psychological, socioeconomic and of awareness. There is evidence that preventive methods are being thought to suit both men and women, and are mostly thought of by the use of condoms and mass HPV vaccination of the youth. Finishing, the detection methods available today are capable of diagnosing the specific infection present at the exam subject, and when different methods are used in different combinations, they enable the possibility of foreseeing the development of oncologic lesions or not in each specific case.

Purpose/Objective(s) Lower grade gliomas (LGG, World Health Organization Grade II and III) are characterized by variable clinical behavior and variable outcomes. While previously identified clinically molecular stratification factors add prognostic insight over histologic classification alone, significant heterogeneity exists with respect to overall outcome among patients. The purpose of this study was to evaluate nine machine learning algorithms on a combined clinical, mutational and methylation data of 293 adult LGGs. Materials/Methods 293 clinically annotated LGG samples with genome-wide methylation data available in the TCGA atlas were included in the study. Clinically relevant information included age at diagnosis, sex, IDH, TP53, ATRX mutations, 1p/19q status, tumor grade, histology, disease status and overall survival status. Methylation data of 450 genes with the highest variance across all samples were included. We used a total of nine machine learning algorithms in RapidMiner to evaluate the accuracy of each in predicting the overall survival status (deceased/living.) Those included tree-based and neural networks-based algorithms, support vector machine, and linear regression. Results Gradient boosted trees achieved the greatest predictive accuracy (86.76%, living and deceased class recall of 84.75% and 91.67%, respectively), followed by Decision Tree (84.52%, class recall of 85.25 and 82.61%, respectively). The largest weight in each model was disease-free status. Combined clinical and methylation data achieved greater sensitivity and specificity compared to either methylation or clinical data only: methylation data-based analysis without inclusion of clinical data achieved maximum accuracy of 79.56% with Deep Learning (living and deceased class recall of 95% and 39.13%, respectively), while clinical data-only based analysis showed highest accuracy of 89.16% with Random Forests, with a class recall for living and deceased of 98.36% and 63.64%, respectively. Conclusion The combination of clinical and methylation data achieves a remarkable accuracy in predicting overall survival outcome in LGG patients, with highest overall class recall. The class recall (true positive rate or sensitivity) for deceased patients of combined data is superior to both clinical data-only and methylation data-only based analysis.

Prekindergarten to 12th-grade teachers of computer science (CS) face many challenges, including isolation, limited CS professional development resources, and low levels of CS teaching self-efficacy that could be mitigated through communities of practice (CoPs). This study used survey data from 420 PK–12 CS teacher members of a virtual CoP, CS for All Teachers, to examine the needs of these teachers and how CS teaching self-efficacy, community engagement, and sharing behaviors vary by teachers’ instructional experiences and school levels taught. Results show that CS teachers primarily join the CoP to gain high-quality pedagogical, assessment, and instructional resources. The study also found that teachers with more CS teaching experience have higher levels of self-efficacy and are more likely to share resources than teachers with less CS teaching experience. Moreover, teachers who instruct students at higher grade levels (middle and high school) have higher levels of CS teaching self-efficacy than do teachers who instruct lower grade levels (elementary school). These results suggest that CoPs can help CS teachers expand their professional networks, gain more professional development resources, and increase CS teaching self-efficacy by creating personalized experiences that consider teaching experience and grade levels taught when guiding teachers to relevant content. This study lays the foundation for future explorations of how CS education–focused CoPs could support the expansion of CS education in PK–12 schools.

Mathematical reading is one of the methods to gain information actively, absorb knowledge, develop mathematical thinking, and learn the Mathematical language. It is also an essential method to shape good Mathematical reading habits and master learning skills. Reading is a necessity for mathematics literacy, as well as the most demanding for migrant workers’ families. Shaping a good reading habit must cultivate from Grade One. During the teaching process, teachers need to fully take advantage of the textbook’s reading value and attach importance to the reading teaching of textbooks. Meanwhile, they have to enrich the system of Mathematical language. In this way, students can read orderly, thoughtfully, and actively. Centered on reading ability, teachers can cultivate students’ ability to gain mathematical knowledge independently. Moreover, students can have the capability of lifelong learning.

Family plays an important role in students’ creative thinking development. However, the effect of parenting styles on creative thinking remains unclear. Using a sample of 2,143 students from a high school in northern China (58.47% girls; Mage = 16.45), the study examined the relationship between parenting styles and creative thinking. We find that the dimension of parental emotional warmth is positively related to students’ creative thinking, while parental rejection and overprotection are negatively associated with creative thinking. Father's emotional warmth has a larger positive effect on creative thinking than mother's, while maternal rejection and overprotection have a greater negative effect on creative thinking than father's. We provide some suggestive evidence that students’ internal locus of control and self-esteem mediate the relationship between parenting styles and creative thinking. The results of heterogeneity analysis show that parenting styles play a greater role in the creative thinking of girls, lower grade students, and those with disadvantaged family background. In a sense, parenting interventions that target creative thinking among underprivileged students will yield higher returns. This study unraveled the effect of parenting styles on students’ creative thinking, explored the mechanisms of the development of this relationship, and examined the heterogeneous effects of different groups. Implications, limitations and recommendations for further research were also discussed.

PURPOSE: To evaluate the feasibility and accuracy of simulated postcontrast T1-weighted brain MR images generated by using precontrast MR images in patients with brain glioma. MATERIALS AND METHODS: In this retrospective study, a three-dimensional deep convolutional neural network was developed to simulate T1-weighted postcontrast images from eight precontrast sequences in 400 patients (mean age, 57 years; 239 men; from 2015 to 2020), including 332 with glioblastoma and 68 with lower-grade gliomas. Performance was evaluated by using quantitative image similarity and error metrics and enhancing tumor overlap analysis. Performance was also assessed on a multicenter external dataset (n = 286 from the 2019 Multimodal Brain Tumor Segmentation Challenge; mean age, 60 years; ratio of men to women unknown) by using transfer learning. A subset of cases was reviewed by neuroradiologist readers to assess whether simulated images affected the ability to determine the tumor grade. RESULTS: Simulated whole-brain postcontrast images were both qualitatively and quantitatively similar to the real postcontrast images in terms of quantitative image similarity (structural similarity index of 0.84 ± 0.05), pixelwise error (symmetric mean absolute percent error of 3.65%), and enhancing tumor compartment overlap (Dice coefficient, 0.65 ± 0.25). Similar results were achieved with the external dataset (Dice coefficient, 0.62 ± 0.27). There was no difference in the ability of the neuroradiologist readers to determine the tumor grade in real versus simulated images (accuracy, 87.7% vs 90.6%; P = .87). CONCLUSION: The developed model was capable of producing simulated postcontrast T1-weighted MR images that were similar to real acquired images as determined by both quantitative analysis and radiologist assessment. Keywords: MR-Contrast Agent, MR-Imaging, CNS, Brain/Brain Stem, Contrast Agents-Intravenous, Neoplasms-Primary, Experimental Investigations, Technology Assessment, Supervised Learning, Transfer Learning, Convolutional Neural Network, Deep Learning Algorithms, Machine Learning Algorithms Supplemental material is available for this article. © RSNA, 2021

Key Points• Radiomics might help predict survival of patients with lower-grade gliomas.• Several different models using different radiomics features have been proposed with only little overlap in included features.• Prospective trials and validation studies are needed to establish which models offer clinical benefit and which do not.

Porphyry ores and E-wastes/WEEE are two of the most important copper-bearing materials on the planet. Over 60% of world copper output comes from porphyry copper ores while E-waste(s) is globally the largest copper-bearing waste category since the 1980s. They also contain critical elements for low-carbon technologies essential in the clean energy transition's success. In this review, a critical analysis of ore distribution/processing, metal extraction, E-waste generation and E-waste recycling is presented, focusing on identifying challenges and how to address them with emerging technologies and sustainable socio-environmental strategies. Access to ore deposits is a major hurdle for mine development while the absence of a consistent E-waste classification and legislation, including poor collection rates, remains serious problems in E-waste recycling. As lower grade porphyry ores are exploited, difficulties in processing/extraction due to mineralogical complexities, very fine particles and the generation of “dirty” concentrates will become more prevalent. For E-wastes recycling, current trends are to develop smaller, more mobile, and eco-friendly hydrometallurgical alternatives to pyrometallurgy that can handle localised compositional and feed variabilities. Finally, more sustainable mine waste management strategies, including better LCIA tools with spatial and temporal dimensions, are needed to limit socio-environmental impacts of resources exploitation and maintain the sector's SLO.

Highlights • The IMriskScore can predict the prognosis and immunotherapy efficacy of LGG patients. • Based on deep learning models, MRI radiomics can be used to predict the IMriskScore. • Mutations in CIC improve the prognosis of patients in the high IMriskScore group., Background This study aimed to identify a series of prognostically relevant immune features by immunophenoscore. Immune features were explored using MRI radiomics features to prediction the overall survival (OS) of lower-grade glioma (LGG) patients and their response to immune checkpoints. Method LGG data were retrieved from TCGA and categorized into training and internal validation datasets. Patients attending the First Affiliated Hospital of Harbin Medical University were included in an external validation cohort. An immunophenoscore-based signature was built to predict malignant potential and response to immune checkpoint inhibitors in LGG patients. In addition, a deep learning neural network prediction model was built for validation of the immunophenoscore-based signature. Results Immunophenotype-associated mRNA signatures (IMriskScore) for outcome prediction and ICB therapeutic effects in LGG patients were constructed. Deep learning of neural networks based on radiomics showed that MRI radiomic features determined IMriskScore. Enrichment analysis and ssGSEA correlation analysis were performed. Mutations in CIC significantly improved the prognosis of patients in the high IMriskScore group. Therefore, CIC is a potential therapeutic target for patients in the high IMriskScore group. Moreover, IMriskScore is an independent risk factor that can be used clinically to predict LGG patient outcomes. Conclusions The IMriskScore model consisting of a sets of biomarkers, can independently predict the prognosis of LGG patients and provides a basis for the development of personalized immunotherapy strategies. In addition, IMriskScore features were predicted by MRI radiomics using a deep learning approach using neural networks. Therefore, they can be used for the prognosis of LGG patients.

Due to the health benefits of extra virgin olive oil (EVOO) and its increasing consumption patterns, adulteration of these oils using lower grade olive oils like virgin olive oil (VOO) and then later sold as EVOO to unsuspecting consumers has become a concern in the industry. There is a need for quick, reliable and inexpensive detection techniques to unmask such vice in order to realize its benefits. In this study, adulteration of EVOO is made using VOO at different proportions; their Excitation Emission Matrices (EEM) were examined using Front-face fluorescence spectroscopy and their corresponding fluorescence images captured using 365 nm ultra-violet (UV) LED for analysis. Specific regions for both the EEM and imaging were explored using Support Vector Machine (SVM) classification analysis and their sensitivities evaluated using Partial Least Squares Regression (PLSR) analysis. It was found that EEM excitation 230–500 and emission 260–620 nm could easily discriminate between different samples as EVOO mixed (at different ratios) and VOO. The significant fluorescence peaks for the discrimination forms a combination of Tocopherols, Tocotrienols, Phenolic compounds, Oxidation products and Vitamin E. The results show that Front-face fluorescence spectroscopy and UV-induced fluorescence imaging can potentially discriminate between pure EVOO and adulterated olive oils.

The nomogram represents a statistical model that incorporates multiple risk factors to estimate individualized survival probabilities. In this study, we developed a nomogram which provides an important tool for individulized survival predicition for newly diagnosed low-grade gliomas (LGG). A total number of 582 newly diagnosed LGG patients were included; the median age was 39.93 years and 42% were female. Cox regression analysis showed that younger age at diagnosis, WHO grade II vs. III, the IDHmut-codel vs. the IDHwt, and the IDHmut-non-codel vs. the IDHwt were significantly associated with better prognosis. The adjuvant treatment following surgery showed a trend towards improved survival. Subsequently, the nomogram to estimate 60-, 90-, and 120-month survival probabilities was established. Our data showed that the age at diagnosis was the largest contributor to patient survival, followed by molecular subtype, WHO grade, treatment and gender. The calibration plot showed that the observed and the nomogram predicted OS curves were well-aligned. In addition, we also validated our nomogram for LGG patients who received postsurgical adjuvant therapy through cross-validation and the calibration plot. Finally, we developed a free online tool for this nomogram (softwarewebsite:https://rrlnnomogram.shinyapps.io/LGG_Nom_Asian/). Overall, this model should be a useful tool for counseling patients in clinical practice including treatment decisions, follow-up, and prognosis.

BACKGROUND AND PURPOSE: WHO grade II gliomas are divided into three classes: isocitrate dehydrogenase (IDH)-wildtype, IDH-mutant and no 1p/19q codeletion, and IDH-mutant and 1p/19q-codeleted. Different molecular subtypes have been reported to have prognostic differences and different chemosensitivity. Our aim was to evaluate the predictive value of imaging phenotypes assessed with the Visually AcceSAble Rembrandt Images lexicon for molecular classification of lower grade gliomas. MATERIALS AND METHODS: MR imaging scans of 175 patients with lower grade gliomas with known IDH1 mutation and 1p/19q-codeletion status were included (78 grade II and 97 grade III) in the discovery set. MR imaging features were reviewed by using Visually AcceSAble Rembrandt Images (VASARI); their associations with molecular markers were assessed. The predictive power of imaging features for IDH1-wild type tumors was evaluated using the Least Absolute Shrinkage and Selection Operator. We tested the model in a validation set (40 subjects). RESULTS: Various imaging features were significantly different according to IDH1 mutation. Nonlobar location, larger proportion of enhancing tumors, multifocal/multicentric distribution, and poor definition of nonenhancing margins were independent predictors of an IDH1 wild type according to the Least Absolute Shrinkage and Selection Operator. The areas under the curve for the prediction model were 0.859 and 0.778 in the discovery and validation sets, respectively. The IDH1-mutant, 1p/19q-codeleted group frequently had mixed/restricted diffusion characteristics and showed more pial invasion compared with the IDH1-mutant, no codeletion group. CONCLUSIONS: Preoperative MR imaging phenotypes are different according to the molecular markers of lower grade gliomas, and they may be helpful in predicting the IDH1-mutation status.

On the basis of physicochemical prediction of the effect of component content on the phase and structural transformations, it is shown that in order to prepare a favourable ferrite-pearlite microstructure and to ensure the key capacity of round rolled product for cold upsetting, it is preferable to obtain in special alloy steels 40Х, 38KhGNM, 35KhGSA, 30G1R, and 12KhN an element content close to the lower grade limit. A study of the microstructure and hardness of round-rolled specimens from steels 35KhGSA, 38KhGNM, and 40Х establishes that isothermal annealing at 20–50°C below the А1 temperature and nonisothermal annealing at 1–30°C below the А1 temperature are the optimum for spheroidizing heat treatment. In this case, a different fraction of globular pearlite is obtained in the metal microstructure depending on the steel grade: 35KhGSA about 90%, 38KhGNM and 40Х about 30%, and in all cases there are favorable results for cold upsetting tests. The defining effect of surface defects and rolled product structural state on cold upsetting capacity is demonstrated.

The Hyde-Macraes Shear Zone in southern New Zealand contains the circa 10 million ounce Macraes gold deposit, one of the larger Phanerozoic orogenic gold deposits discovered to date globally. Approximately 50% of this 10 million ounce resource is hosted by 5 major ore shoots up to 400 m wide and 1500 m long in the Frasers area at the southern end of the mine. Higher grade (>1.5 g/t Au) ore shoots are located along and immediately below the Hangingwall Shear, the principal strand of the Hyde-Macraes Shear Zone at the Frasers deposit. They typically trend parallel to the intersection of the shear and foliation in the underlying schist, commonly where the foliation dips more steeply that the overlying Hangingwall Shear. Especially thick zones of higher grade mineralised rock are located between the Hangingwall Shear and underlying second order splay shears whose position correlates with minor right-hand bends in the strike of the overlying Hangingwall Shear. Lower grade (

Interparental conflict has been shown to have a negative effect on the academic success of children and adolescents. This study examined the relationship between college students' (N = 143) perceived levels of interparental conflict, their living arrangement, and their current self-reported grade point average. Participants who experienced more interparental conflict, specifically female students and those living away from home, reported a lower grade point average. Implications for college counselors are discussed.

The article presents research results of the screening process of bulk materials with a new vibroscreen design with additional feed elements. Changes of the traditional screen structure is shown, the use of them increases the screening process efficiency and passage intensity of lower grade of bulk material to the sieve. It is established that the most simple, accessible, effective and efficient way to increase the effectiveness of the screening is the use of additional feed elements. According to the developed mathematical model of cell screening process, numerical studies to identify the effect of process parameters on the screening kinetics carried out. It is proved that the use of additional feed elements has a significant effect on the screening process kinetics and the state evolution of fine particle concentration in the bulk layer. It increases the screening effectiveness by improving the sieve filling and reduces the screening time. It is proved the performance, possibility to use, benefits, efficiency, and prospects for further research of the new vibroscreen scheme with feed elements. Description and results of comparative experimental studies of vibroscreens with different variants of additional bulk material excitation are presented.