Continence, potency and oncological outcomes after robotic-assisted radical prostatectomy: early trifecta results of a high-volume surgeon

OBJECTIVE center dot To evaluate early trifecta outcomes after robotic-assisted radical prostatectomy (RARP) performed by a high-volume surgeon. PATIENTS AND METHODS center dot We evaluated prospectively 1100 consecutive patients who underwent RARP performed by one surgeon. In all, 541 men were considered potent before RARP; of these 404 underwent bilateral full nerve sparing and were included in this analysis. center dot Baseline and postoperative urinary and sexual functions were assessed using self-administered validated questionnaires. center dot Postoperative continence was defined as the use of no pads; potency was defined as the ability to achieve and maintain satisfactory erections for sexual intercourse > 50% of times, with or without the use of oral phosphodiesterase type 5 inhibitors; Biochemical recurrence (BCR) was defined as two consecutive PSA levels of > 0.2 ng/mL after RARP. center dot Results were compared between three age groups: Group 1, < 55 years, Group 2, 56-65 years and Group 3, > 65 years. RESULTS center dot The trifecta rates at 6 weeks, 3, 6, 12, and 18 months after RARP were 42.8%, 65.3%, 80.3%, 86% and 91%, respectively. center dot There were no statistically significant differences in the continence and BCR-free rates between the three age groups at all postoperative intervals analysed. center dot Nevertheless, younger men had higher potency rates and shorter time to recovery of sexual function when compared with older men at 6 weeks, 3, 6 and 12 months after RARP (P < 0.01 at all time points). center dot Similarly, younger men also had a shorter time to achieving the trifecta and had higher trifecta rates at 6 weeks, 3 and 6 months after RARP compared with older men (P < 0.01 at all time points). CONCLUSION center dot RARP offers excellent short-term trifecta outcomes when performed by an experienced surgeon. center dot Younger men had a shorter time to achieving the trifecta and higher overall trifecta rates when compared with older men at 6 weeks, 3 and 6 months after RARP.

Mice with genetic deletion of the heparin-binding growth factor midkine exhibit early preclinical features of Parkinson`s disease

There is considerable evidence showing that the neurodegenerative processes that lead to sporadic Parkinson`s disease (PD) begin many years before the appearance of the characteristic motor symptoms and that impairments in olfactory, cognitive and motor functions are associated with time-dependent disruption of dopaminergic neurotransmission in different brain areas. Midkine is a 13-kDa retinoic acid-induced heparin-binding growth factor involved in many biological processes in the central nervous system such as cell migration, neurogenesis and tissue repair. The abnormal midkine expression may be associated with neurochemical dysfunction in the dopaminergic system and cognitive impairments in rodents. Here, we employed adult midkine knockout mice (Mdk(-/-)) to further investigate the relevance of midkine in dopaminergic neurotransmission and in olfactory, cognitive and motor functions. Mdk(/-) mice displayed pronounced impairments in their olfactory discrimination ability and short-term social recognition memory with no gross motor alterations. Moreover, the genetic deletion of midkine decreased the expression of the enzyme tyrosine hydroxylase in the substantia nigra reducing partially the levels of dopamine and its metabolites in the olfactory bulb and striatum of mice. These findings indicate that the genetic deletion of midkine causes a partial loss of dopaminergic neurons and depletion of dopamine, resulting in olfactory and memory deficits with no major motor impairments. Therefore, Mdk(-/-) mice may represent a promising animal model for the study of the early stages of PD and for testing new therapeutic strategies to restore sensorial and cognitive processes in PD.

Early intervention: Narratives of learning, discipline and enculturation

Current understandings about literacy have moved away from the belief that literacy is simply a process that individuals do in their heads. These understandings do not negate the importance of the individual aspects of literacy learning, but they emphasize understandings of literacy as a social practice. In many cases, responses to early literacy intervention seem to be grounded in theories that appear out of step with current literacy research and consequent evidence that literacy is socially and culturally constructed. One such response is the Reading Recovery programme based on Clay’s theory of literacy acquisition. Clay (1992) describes the programme as a second chance to learn. However, others have suggested that programmes like Reading Recovery may in fact work toward the marginalization of particular groups, thereby helping to maintain the status quo along class, gender and ethnic lines. This article allows two professionals to bring their insider’s knowledge of Reading Recovery to an analysis of the construction of the programme. The article interweaves this analysis with the personal narratives of the researchers as they negotiated the borders between different understandings and beliefs about literacy and literacy pedagogy.

Engaging with theories of dialogue and voice: Using Bakhtin as a framework to understand teaching and learning Indigenous Australian women's performance

In this paper I explore the Indigenous Australian women's performance classroom (hereafter ANTH2120) as a dialectic and discursive space where the location of possibility is opened for female Indigenous performers to enter into a dialogue from and between both non-Indigenous and Indigenous voices. The work of Bakhtin on dialogue serves as a useful standpoint for understanding the multiple speaking positions and texts in the ANTH2120 context. Bakhtin emphasizes performance, history, actuality and the openness of dialogue to provide an important framework for analysing multiple speaking positions and ways of making meaning through dialogue between shifting and differing subjectivities. I begin by briefly critiquing Bakhtin's "dialogic imagination" and consider the application and usefulness of concepts such as dialogism, heteroglossia and the utterance to understanding the ANTH2120 classroom as a polyphonic and discursive space. I then turn to an analysis of dialogue in the ANTH2120 classroom and primarily situate my gaze on an examination of the interactions that took place between the voices of myself as family/teacher/student and senior Yanyuwa women from the r e m o t e N o r t h e r n T e r r i t o r y A b o r i g i n a l c o m m u n i t y o f B o r r o l o o l a as family/performers/teachers. The 2000 and 2001 Yanyuwa women's performance workshops will be used as examples of the way power is constantly shifting in this dialogue to allow particular voices to speak with authority, and for others to remain silent as roles and relationships between myself and the Yanyuwa women change. Conclusions will be drawn regarding how my subject positions and white race privilege affect who speaks, who listens and on whose terms, and further, the efficacy of this pedagogical platform for opening up the location of possibility for Indigenous Australian women to play a powerful part in the construction of knowledges about women's performance traditions.

Data mining framework for fatty liver disease classification in ultrasound: a hybrid feature extraction paradigm

PURPOSE: Fatty liver disease (FLD) is an increasing prevalent disease that can be reversed if detected early. Ultrasound is the safest and ubiquitous method for identifying FLD. Since expert sonographers are required to accurately interpret the liver ultrasound images, lack of the same will result in interobserver variability. For more objective interpretation, high accuracy, and quick second opinions, computer aided diagnostic (CAD) techniques may be exploited. The purpose of this work is to develop one such CAD technique for accurate classification of normal livers and abnormal livers affected by FLD. METHODS: In this paper, the authors present a CAD technique (called Symtosis) that uses a novel combination of significant features based on the texture, wavelet transform, and higher order spectra of the liver ultrasound images in various supervised learning-based classifiers in order to determine parameters that classify normal and FLD-affected abnormal livers. RESULTS: On evaluating the proposed technique on a database of 58 abnormal and 42 normal liver ultrasound images, the authors were able to achieve a high classification accuracy of 93.3% using the decision tree classifier. CONCLUSIONS: This high accuracy added to the completely automated classification procedure makes the authors' proposed technique highly suitable for clinical deployment and usage.

Adaptive learning in agents behaviour: a framework for electricity markets simulation

Electricity markets are complex environments with very particular characteristics. A critical issue regarding these specific characteristics concerns the constant changes they are subject to. This is a result of the electricity markets’ restructuring, which was performed so that the competitiveness could be increased, but it also had exponential implications in the increase of the complexity and unpredictability in those markets scope. The constant growth in markets unpredictability resulted in an amplified need for market intervenient entities in foreseeing market behaviour. The need for understanding the market mechanisms and how the involved players’ interaction affects the outcomes of the markets, contributed to the growth of usage of simulation tools. Multi-agent based software is particularly well fitted to analyze dynamic and adaptive systems with complex interactions among its constituents, such as electricity markets. This dissertation presents ALBidS – Adaptive Learning strategic Bidding System, a multiagent system created to provide decision support to market negotiating players. This system is integrated with the MASCEM electricity market simulator, so that its advantage in supporting a market player can be tested using cases based on real markets’ data. ALBidS considers several different methodologies based on very distinct approaches, to provide alternative suggestions of which are the best actions for the supported player to perform. The approach chosen as the players’ actual action is selected by the employment of reinforcement learning algorithms, which for each different situation, simulation circumstances and context, decides which proposed action is the one with higher possibility of achieving the most success. Some of the considered approaches are supported by a mechanism that creates profiles of competitor players. These profiles are built accordingly to their observed past actions and reactions when faced with specific situations, such as success and failure. The system’s context awareness and simulation circumstances analysis, both in terms of results performance and execution time adaptation, are complementary mechanisms, which endow ALBidS with further adaptation and learning capabilities.

Relatório de estágio: que desafios(s) para a avaliação das aprendizagens? uma análise a partir de um mestrado em educação pré-escolar numa Escola Superior de Educação

A formação profissional, nomeadamente a formação profissionalizante (2ºCiclo de Estudos no âmbito de Bolonha) tem vindo a ser alvo de discussão entre as diferentes áreas do conhecimento, nomeadamente no que respeita às possíveis metodologias de avaliação a adotar (práticas profissionais supervisionadas, elaboração de portefólios individuais, realização de trabalhos de grupo com acompanhamento tutorial, redação de Relatórios de Estágio, entre outras). A presente comunicação tem como principal objetivo discutir e analisar as conceções dos educadores de infância recém-formados acerca da educação de infância e das aprendizagens realizadas no âmbito da Prática Profissional Supervisionada (PPS), através da análise dos Relatórios de Estágio elaborados no âmbito do Mestrado em Educação Pré-Escolar de uma escola superior de educação, especificamente os que dizem respeito a um grupo de mestrandos dos anos letivos 2010-2011, 2011-2012 e 2012-2013. Nesta análise, serão privilegiados os seguintes eixos: i) a caracterização reflexiva do contexto socioeducativo; ii) a análise reflexiva da intervenção; iii) as considerações finais realizadas. Pretende-se, a partir desta análise, identificar e compreender os potenciais desafios (que elementos e critérios de avaliação? Como caracterizar, de forma reflexiva, um determinado contexto socioeducativo?) trazidos ao processo de avaliação das aprendizagens dos mestrandos do curso em questão. O quadro teórico de referência centra-se numa revisão de literatura sobre a formação profissional dos educadores de infância e sobre a avaliação das aprendizagens dos adultos. A metodologia utilizada, de natureza qualitativa, inclui análise documental (objetivos do curso, perfil profissional de saída, guião para a elaboração dos Relatórios de Estágio), e a subsequente análise de conteúdo. Os resultados obtidos apontam para asseguintes conclusões: se por um lado, todos (12) os mestrandos do estudo seguiram, escrupulosamente, o guião fornecido pela equipa de docentes da Prática Profissional Supervisionada para a elaboração dos Relatórios de Estágio, por outro lado e no que se relaciona com a caracterização reflexiva do contexto socioeducativo, a análise reflexiva da intervenção e as considerações finais realizadas, constata-se que existem diferenças significativas na estrutura organizativa do discurso escrito, na escolha do quadro teórico de referência bem como nas reflexões pessoais realizadas. Enquanto que os mestrandos (5) do ano letivo 2010-2011 demonstram ter optado por construir um quadro teórico de referência ancorado, preferencialmente, por referências bibliográficas relacionadas com a Educação de Infância e facultadas pela equipa de docentes do mestrado em estudo, os mestrandos do ano letivo 2011-2012 (3) optaram por recorrer a um quadro teórico de referência mais alargado e abrangente, no qual se pode verificar, também, a existência de uma consulta e análise documental frequente sobre a legislação em vigor para o âmbito da Educação de Infância. Por sua vez, os mestrandos que terminaram a sua formação no ano letivo 2012-2013 (4) demonstraram, na elaboração dos seus relatórios de estágio, uma preocupação e intenção claras em dar resposta a todas as questões colocadas, fazendo emergir algumas questões de fundo: 1) por que razão os relatórios de estágio analisados apresentam diferenças significativas nas aprendizagens realizadas pelos mestrandos em estudo? 2) Quais as possíveis razões para estas diferenças? 3) Que aprendizagens realizaram estes mestrandos e quais foram as mais significativas? Estes são alguns dos possíveis desafios colocados à avaliação das aprendizagens.

Lean learning academy: an innovative framework for lean manufacturing training

Worldwide competitiveness poses enormous challenges on managers, demanding a continuous quest to increase rationality in the use of resources. As a management philosophy, Lean Manufacturing focuses on the elimination of activities that do not create any type of value and therefore are considered waste. For companies to successfully implement the Lean Manufacturing philosophy it is crucial that the human resources of the organization have the necessary training, for which proper tools are required. At the same time, higher education institutions need innovative tools to increase the attractiveness of engineering curricula and develop a higher level of knowledge among students, improving their employability. This paper describes how Lean Learning Academy, an international collaboration project between five EU universities and five companies, from SME to Multinational/Global companies, developed and applied an innovative training programme for Engineers on Lean Manufacturing, a successful alternative to the traditional teaching methods in engineering courses.

E-learning frameworks: a survey

In recent years the concept of eLearning Framework emerged associated with several initiatives promoted by educational organizations. These initiatives share a common goal: to create flexible learning environments by integrating heterogeneous systems already available in many educational institutions. The paper provides an introductory survey on eLearning Frameworks. It gathers information on these initiatives categorizes them and compares their features regarding a set of predefined criteria such as: architecture, business model, primary user groups, technical implementations, adopted standards, maturity and future development.

Using the learning tools interoperability framework for LMS integration in service oriented architectures

The LMS plays an indisputable role in the majority of the eLearning environments. This eLearning system type is often used for presenting, solving and grading simple exercises. However, exercises from complex domains, such as computer programming, require heterogeneous systems such as evaluation engines, learning objects repositories and exercise resolution environments. The coordination of networks of such disparate systems is rather complex. This work presents a standard approach for the coordination of a network of eLearning systems supporting the resolution of exercises. The proposed approach use a pivot component embedded in the LMS with two roles: provide an exercise resolution environment and coordinate the communication between the LMS and other systems exposing their functions as web services. The integration of the pivot component with the LMS relies on the Learning Tools Interoperability. The validation of this approach is made through the integration of the component with LMSs from two vendors.

Modelling a network of heterogeneous e-learning systems

In recent years emerged several initiatives promoted by educational organizations to adapt Service Oriented Architectures (SOA) to e-learning. These initiatives commonly named eLearning Frameworks share a common goal: to create flexible learning environments by integrating heterogeneous systems already available in many educational institutions. However, these frameworks were designed for integration of systems participating in business like processes rather than on complex pedagogical processes as those related to automatic evaluation. Consequently, their knowledge bases lack some fundamental components that are needed to model pedagogical processes. The objective of the research described in this paper is to study the applicability of eLearning frameworks for modelling a network of heterogeneous eLearning systems, using the automatic evaluation of programming exercises as a case study. The paper surveys the existing eLearning frameworks to justify the selection of the e-Framework. This framework is described in detail and identified the necessary components missing from its knowledge base, more precisely, a service genre, expression and usage model for an evaluation service. The extensibility of the framework is tested with the definition of this service. A concrete model for evaluation of programming exercises is presented as a validation of the proposed approach.

Adaptive learning in agents behaviour: A framework for electricity markets simulation

Electricity markets are complex environments, involving a large number of different entities, playing in a dynamic scene to obtain the best advantages and profits. MASCEM (Multi-Agent System for Competitive Electricity Markets) is a multi-agent electricity market simulator that models market players and simulates their operation in the market. Market players are entities with specific characteristics and objectives, making their decisions and interacting with other players. This paper presents a methodology to provide decision support to electricity market negotiating players. This model allows integrating different strategic approaches for electricity market negotiations, and choosing the most appropriate one at each time, for each different negotiation context. This methodology is integrated in ALBidS (Adaptive Learning strategic Bidding System) – a multiagent system that provides decision support to MASCEM's negotiating agents so that they can properly achieve their goals. ALBidS uses artificial intelligence methodologies and data analysis algorithms to provide effective adaptive learning capabilities to such negotiating entities. The main contribution is provided by a methodology that combines several distinct strategies to build actions proposals, so that the best can be chosen at each time, depending on the context and simulation circumstances. The choosing process includes reinforcement learning algorithms, a mechanism for negotiating contexts analysis, a mechanism for the management of the efficiency/effectiveness balance of the system, and a mechanism for competitor players' profiles definition.

B-learning quality: dimensions, criteria and pedagogical approach

Measuring the quality of a b-learning environment is critical to determine the success of a b-learning course. Several initiatives have been recently conducted on benchmarking and quality in e-learning. Despite these efforts in defining and examining quality issues concerning online courses, a defining instrument to evaluate quality is one of the key challenges for blended learning, since it incorporates both traditional and online instruction methods. For this paper, six frameworks for quality assessment of technological enhanced learning were examined and compared regarding similarities and differences. These frameworks aim at the same global objective: the quality of e-learning environment/products. They present different perspectives but also many common issues. Some of them are more specific and related to the course and other are more global and related to institutional aspects. In this work we collected and arrange all the quality criteria identified in order to get a more complete framework and determine if it fits our b-learning environment. We also included elements related to our own b-learning research and experience, acquired during more than 10 years of experience. As a result we have create a new quality reference with a set of dimensions and criteria that should be taken into account when you are analyzing, designing, developing, implementing and evaluating a b-learning environment. Besides these perspectives on what to do when you are developing a b-learning environment we have also included pedagogical issues in order to give directions on how to do it to reach the success of the learning. The information, concepts and procedures here presented give support to teachers and instructors, which intend to validate the quality of their blended learning courses.