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The problem of mastering English does not involve students alone. The English language teachers, policy makers and curriculum developers are also affected. Thus, teachers have resorted to using higher order thinking skills (HOT) as a means to teach writing to weak ESL learners. The study aimed at developing and validating a higher order thinking skills module for teaching writing to weak ESL learners. It employed a qualitative research paradigm using documents analysis, interviews, observations and validation form. It was conducted in two phases. The first phase was completed with needs analysis specifically identifying problems teachers faced in teaching writing using higher order thinking skills in six selected secondary schools. The ADDIE model approach was used by the ESL teachers and experts in HOTs to create the module content. In the second phase, the teachers were observed ten times to investigate the effectiveness of using the HOTs module developed for teaching writing. The findings revealed that the HOTs module served as a guideline for the teachers in applying and integrating thinking skills in the process of teaching writing. These findings were used to guide decisions on implementing the appropriate teaching pedagogy to apply HOTS for teaching writing.

The present study investigated the beliefs and efficacy of a teacher teaching English to students who were weak at the language. The objective of the study was mainly to investigate the beliefs and efficacy of the ESL teacher for teaching writing to weak learners. The research was a case study of the English Language teacher teaching Form Three class of students whose English proficiency was very low. An interview was conducted with the teacher to further probe the instructional strategies applied to enhance her beliefs and efficacy in her own capabilities to make learning happen in her classroom. Observations were made to investigate the teacher's efficacy in teaching and the performance of the students specifically for writing. Results show the teacher's beliefs of her students' capabilities and their language needs helped shape the teacher's instructional strategies. The teacher's efficacy enabled her to decide to undertake the task of teaching writing to her students because she was confident in her ability. The teacher provided clues to the students to facilitate their learning. This kind of feedback from the teacher indirectly motivated them to learn. The teacher's beliefs and efficacy contributed to her teaching practice and the instructional strategies that she used in turn enhanced her beliefs and efficacy. The study implicates that teacher's beliefs and efficacy can assist the weak learners in improving their writing skills and also facilitate language learning.

Recent advances in techniques, technologies and proven superiority over anti-arrhythmic drugs have made catheter ablation the cornerstone of management for atrial fibrillation (AF), which has shown a steady increase in prevalence in the ageing population worldwide. The aim of therapeutic interventions is to achieve stable sinus rhythm that would improve the quality of life and reduce the risk of AF-associated complications. Pulmonary veins (PVs) were first described as the source of initiation of ectopic triggers driving AF, which led to the establishment of PV isolation (PVI) as the most widely practiced procedure to treat AF. Antral PVI is still recognized as the stand-alone ablation strategy for newly diagnosed paroxysmal AF (PAF). However, in non-PAF patients, PVI seems to be inadequate and several adjunctive strategies, including ablation of left atrial posterior wall and non-PV triggers, AF mapping and ablation of rotors and drivers, ethanol infusion of vein of Marshall and renal denervation, etc. have been reported with mixed results. Recent trials have also documented the benefits of early rhythm control in preventing cardiovascular events in addition to slowing the progression of PAF to more persistent forms. Similarly, very late relapse of the arrhythmia after successful PVI has drawn attention to the critical role of non-PV triggers and highlighted their relevance as potential ablation targets during repeat procedures. Ablation technology is also under constant evolution with the introduction of non-thermal energy sources and new tools to create durable lesions. This review summarizes the indications, advancements, and future perspective of AF ablation. [ABSTRACT FROM AUTHOR]

Cerebral small vessel disease (SVD) is a major cause of cognitive impairment in older people. As secondary endpoints in a phase-2 randomised clinical trial, we tested the effects of single administration of a widely-used PDE5 inhibitor, tadalafil, on cognitive performance in older people with SVD. In a double-blinded, placebo-controlled, cross-over trial, participants received tadalafil (20 mg) and placebo on two visits ≥ 7 days apart (randomised to order of treatment). The Montreal Cognitive Assessment (MOCA) was administered at baseline, alongside a measure to estimate optimal intellectual ability (Test of Premorbid Function). Then, before and after treatment, a battery of neuropsychological tests was administered, assessing aspects of attention, information processing speed, working memory and executive function. Sixty-five participants were recruited and 55 completed the protocol (N = 55, age: 66.8 (8.6) years, range 52–87; 15/40 female/male). Median MOCA score was 26 (IQR: 23, 27], range 15–30). No significant treatment effects were seen in any of the neuropsychological tests. There was a trend towards improved performance on Digit Span Forward (treatment effect 0.37, C.I. 0.01, 0.72; P = 0.0521). We did not identify significant treatment effects of single-administration tadalafil on neuropsychological performance in older people with SVD. The trend observed on Digit Span Forward may help to inform future studies. Clinical trial registration: http://www.clinicaltrials.gov. Unique identifier: NCT00123456, https://eudract.ema.europa.eu. Unique identifier: 2015–001,235–20NCT00123456.

Introduction: Diabetic kidney disease (DKD), as a diabetes mellitus type 2 (DMT2) complications, is getting more prevalent nowadays. Inflammation is one of the renal injury mechanisms evaluated through the surge in in TNF-α and NF-κβ expression. Impaired expression of gluten transporter 1 (GLUT1) and GLUT2 reduces glucose uptake. DBLS3233 is a novel anti-diabetes agent and Indonesian herbal product responsible for glucose control and upregulation of insulin signal transduction. We performed an experiment on DLBS3233 to examine the response of TNF-α and NF-κβ and the expression of GLUT 1 and GLUT2. Methods: A total of 30 adult male Wistar rats were randomly divided into six groups (n=5 per group): nondiabetic rats in the control group (group 1); untreated diabetic rats (group 2); diabetic rats treated with DLBS3233 4,5mg/kgBW (group 3); 9mg/kgBW (group 4); 18mg/kgBW (group 5), and diabetic rats treated with pioglitazone (group 6). Immunohistochemistry was performed to examine the expression of GLUT1 and GLUT2 in the pancreas and expression of TNF-α and NF-κβ in the kidney. The data was then analyzed by ANOVA. Results: In the DBLS3233 group, reduced expression of both TNF-α and NF-κβ was seen through immunohistochemistry, whereas GLUT1 and GLUT2 were intensified compared to untreated groups. From statistical analysis, we obtained significantly lower expression of TNF-α and NF-κβ, as well as enhanced GLUT1 and GLUT2 expression compared to untreated groups (p Conclusions: DBLS3233 significantly reduces the inflammatory process and enhances the expression of GLUT1 and GLUT2 diabetic rats.

This study examined the test taking strategies of weak ESL students of an English language proficiency course. Test taking strategies are known as the methods that test takers use as an alternative aimed at attaining correct answers on a specified form of language assessment. The study adopted a qualitative study. The participants in this study were forty-four learners from the Bachelor of Arts Program. The learners were asked to think aloud while reading an assigned text to answer the questions. Four learners’ thinking aloud recordings were transcribed and analysed. Focus group interviews were carried out for triangulation purposes. Data collected were analysed manually. The ESL learners implemented many test taking strategies as they coped with the reading comprehension test. The findings of the study show how ESL students used cognitive, metacognitive, compensating, and social strategies. Participants expressed that understanding and reading the passage allowed them to draw conclusions better in answering the multiple choice questions. The findings revealed that they used a compensation strategy whereby they tried guessing the answers on a number of occasions. The findings of the study implicate teachers’ roles in L2 reading and also to guide the ESL learners in the process of answering reading passage and answer the comprehension questions.

Background: This study was an attempt to evaluate the knowledge and awareness among dentists about COVID-19 infection. Methodology: This study was conducted among 580 dental professionals that comprised graduates (BDS), masters (MDS), postgraduates, and PhD fellows. A questionnaire containing information about knowledge, attitude, and awareness about COVID-19 infection was administered and recorded. Results: A total of 493 (85%) respondents replied correct answer that SARS-CoV-2 causes COVID-19. A total of 464 (80%) respondents replied that SARS-CoV-2 is the highest infectious virus among all. A total of 510 (88%) respondents replied the correct answer that 2–14 days is the incubation period of COVID-19 virus. Only 116 (20%) respondents replied the correct answer that MERS has high mortality. Only 87 (15%) respondents were aware of the appropriate mortality rate of COVID-19 disease. A total of 455 (78.4%) respondents had knowledge of the method of detecting COVID-19 infection (real-time reverse transcription-polymerase chain reaction). Knowledge level was good as seen in 81%, fair in 9.5%, and poor in 10.5% of the respondents. Conclusion: The authors found that dental professionals had fair knowledge and awareness regarding COVID-19 infection.

Propranolol hydrochloride is a beta-blocker used for the management and treatment of hypertension, angina, coronary artery disease, heart failure, fibrillation, tremors, migraine etc. The objective of the present study was to design Propranolol Hydrochloride floating tablets by direct compression method and to explore the role of a new gum as a matrix former. A 22 full factorial design was selected for the present study. Prunus domestica gum and HPMC (K4M) were used as independent variables, swelling index and drug dissolution at 12 hours as dependent variables. Formulations were subjected to pre- and post-compression tests that showed good micromeritics and buoyancy characteristics (Carr's index 11.76%-14.00%, Hausner's ratio 1.13°-1.16°, angle of repose 22.67°-25.21°, floating lag time 56-76 seconds, total floating time 18-25 hours and swelling index 59.87%-139.66%). The cumulative drug release in 0.1 N HCl at 12 hours was 72%-90% (p0.99) among all other studied models. Multiple regression showed a significant effect of Prunus domestica gum and HPMC K4M on the swelling index and dissolution profiles of propranolol HCl (p

This paper presents novel mobile phone antenna for radiations simultaneously in ten frequency bands for applications of LTE (Long-Term Evolution), GPS (Global Positioning System), GSM (Global System for Mobile Communications), PCS (Public and Commercial Services), DCS (Distributed Control System), UMTS (Universal Mobile Telecommunications System) and WiMAX (Worldwide Interoperability for Microwave Access). The antenna demonstrates novel characteristics for resolving the challenge of simultaneous radiation capabilities for the GSM and GPS applications with frequencies of 850/900 and 1575 MHz respectively, along with resonances at frequency band of 700 MHz for LTE applications, 1800 and 1900 MHz for PCS and DCS applications, 2100 MHz for UMTS applications, 2400 and 2500 MHz for LTE applications and 3300 MHz for WiMAX applications with S11 = - 6 dB matching criteria (VSWR 3:1). The antenna architecture comprises top and bottom copper layers embedded with monopole radiating element, branch line, slots and various stub lines. The desired operating bands are achieved in a compact area with overall dimensions of 0.8x60x120 mm for the height, width and length respectively of the antenna providing suitable platform for mobile handset applications. Omni-directional radiation pattern characteristics are achieved throughout the range of frequencies by designing the proposed antenna in monopole configuration. Proposed antenna is fabricated and results for the surface currents, s-parameters and 3D (Three-Dimensional) gain plots are illustrated for the proof of concept.

Rumex hastatus being used for medicinal and nutritional purposes as a functional food in various countries is hereby evaluated by the gas chromatography-mass spectroscopy, proximate analysis, physicochemical (fluorescence) analysis, quantitative analysis of secondary metabolites and sensory evaluations studies. Various samples of R. hastatus were also evaluated for in vitro anti-diabetic potential. The investigational study demonstrated that R. hastatus is a rich source of carbohydrate, i.e., 432.4 mg/g. Moisture content, protein, fiber, ash content and fats were recorded as 22.8%, 133.9 mg/g, 124.4 mg/g, 54.5 mg/g and 25.6 mg/g, respectively. In the same way, the secondary metabolite displayed a relatively greater amount of flavonoids (84.5 mg/g) followed by saponins (65.5 mg/g) and alkaloids (49.5 mg/g). Similarly, the GC (FID-MS) analysis of R. hastatus revealed the detection of 120 compounds. Out of those identified compounds, selected anti-diabetic compounds were sorted out, viz butyl phthalate, phytol, ethylthreonine, dihydrobenzofuran, indoline, guanidine, nerolidol, myristic acid, palmitic acid, caryophyllene, anozol. In physicochemical fluorescence analysis and the sensory evaluation, data were also recorded along with the anti-diabetic with IC50 value of 42.09 µg/ml. The overall investigational analysis of R. hastatus obviously demonstrated that this plant was a rich source of primary and secondary metabolites. It may be concluded from the GC (FID-MS) analysis that R. hastatus is a potential source of anti-diabetic constituents, which may confer hypoglycemic potential. Based on the recorded data it may also be inferred that R. hastatus is among safe and nutritious herbs, which can be used in lieu of green vegetables and functional food with anti-diabetic potential.

Background Changes in brain structure and cognitive decline occur in Chronic Obstructive Pulmonary Disease (COPD). They also occur with smoking and coronary artery disease (CAD), but it is unclear whether a common mechanism is responsible. Methods Brain MRI markers of brain structure were tested for association with disease markers in other organs. Where possible, principal component analysis (PCA) was used to group markers within organ systems into composite markers. Univariate relationships between brain structure and the disease markers were explored using hierarchical regression and then entered into multivariable regression models. Results 100 participants were studied (53 COPD, 47 CAD). PCA identified two brain components: brain tissue volumes and white matter microstructure, and six components from other organ systems: respiratory function, plasma lipids, blood pressure, glucose dysregulation, retinal vessel calibre and retinal vessel tortuosity. Several markers could not be grouped into components and were analysed as single variables, these included brain white matter hyperintense lesion (WMH) volume. Multivariable regression models showed that less well organised white matter microstructure was associated with lower respiratory function (p = 0.028); WMH volume was associated with higher blood pressure (p = 0.036) and higher C-Reactive Protein (p = 0.011) and lower brain tissue volume was associated with lower cerebral blood flow (pConclusions Measures of brain structure were associated with a range of markers of disease, some of which appeared to be common to both COPD and CAD. No single common pathway was identified, but the findings suggest that brain changes associated with smoking-related diseases may be due to vascular, respiratory, and inflammatory changes.

Orthogonal Frequency Division Multiplexing (OFDM) is a modern and suitable modulation strategy for commercial high-speed broadband wireless communication systems. This is because wireless services and demands have grown so quickly in recent years. While creating wireless communication, the channel environment is crucial. A square grid with identical vertical and horizontal spacing is used for the constellation points in quadrature amplitude modulation (QAM). More bits can be transferred per symbol to higher-order modulation forms. This research has looked at how Orthogonal Frequency Division Multiplexing OFDM systems perform using different modulation techniques on channels with additive white Gaussian noise (AWGN). Using MATLAB software to do an experiment with different modulation methods and parameters such as FFT length and cyclic prefix findings showed that 64-QAM modulation sends the same amount of data faster and with fewer symbols than QPSK 16-QAM. Here, the 64- QAM modulation technique performs better. An extensive literature survey has been carried out. The work done here involved working on many parameters to improve the performance of OFDM, i.e., by reducing BER, changing modulation techniques, and analyzing the trade-off between cyclic prefix length and Bit Error Rate. Compared to the existing work, the proposed system provides better performance. [ABSTRACT FROM AUTHOR]

Aim. This study sought to compare short- and long-term outcomes of drug-eluting stents (DESs) versus bare-metal stents (BMSs) implantation in patients with end-stage renal disease on hemodialysis (ESRD-HD) undergoing percutaneous coronary intervention (PCI). Methods. Adult patients with ESRD-HD who underwent PCI at all nonfederal hospitals in Massachusetts between July 1, 2003, and September 30, 2007, were stratified based on the stent type placed at index hospitalization: DES or BMS. The primary outcome compared was a composite of all-cause death, myocardial infarction (MI), congestive heart failure (CHF), target vessel revascularization (TVR), and stroke at 30 days and one year. Results. HD patients had a high mortality (31%) and were more likely to receive a DES than a BMS (77% versus 23%). Propensity score analysis of 2 : 1 matched DES (268) versus BMS (134) patients demonstrated the DES group to more likely have proximal LAD disease and a history of prior PCI. Conditional logistic regression analysis demonstrated no significant difference in the composite cardiovascular endpoint measured at 30 days (hazard ratio (HR) 1.09; 95% confidence interval (CI) 0.61–1.94) and one year (HR 1.03; 95% CI 0.68–1.57). Conclusions. There were no significant differences in 30-day or 1-year major cardiovascular outcomes in HD patients undergoing PCI using the DES compared to the BMS in this high-mortality patient cohort.