J-Quizmaker

Lehrvideos erfreuen sich dank aktueller Entwicklungen im Bereich der Online-Lehre (Videoplattformen, MOOCs) auf der einen Seite und einer riesigen Auswahl sowie einer einfachen Produktion und Distribution auf der anderen Seite großer Beliebtheit bei der Wissensvermittlung. Trotzdem bringen Videos einen entscheidenden Nachteil mit sich, welcher in der Natur des Datenformats liegt. So sind die Suche nach konkreten Sachverhalten in einem Video sowie die semantische Aufbereitung zur automatisierten Verknüpfung mit weiteren spezifischen Inhalten mit hohem Aufwand verbunden. Daher werden die lernerfolg-orientierte Selektion von Lehrsegmenten und ihr Arrangement zur auf Lernprozesse abgestimmten Steuerung gehemmt. Beim Betrachten des Videos werden unter Umständen bereits bekannte Sachverhalte wiederholt bzw. können nur durch aufwendiges manuelles Spulen übersprungen werden. Selbiges Problem besteht auch bei der gezielten Wiederholung von Videoabschnitten. Als Lösung dieses Problems wird eine Webapplikation vorgestellt, welche die semantische Aufbereitung von Videos hin zu adaptiven Lehrinhalten ermöglicht: mittels Integration von Selbsttestaufgaben mit definierten Folgeaktionen können auf Basis des aktuellen Nutzerwissens Videoabschnitte automatisiert übersprungen oder wiederholt und externe Inhalte verlinkt werden. Der präsentierte Ansatz basiert somit auf einer Erweiterung der behavioristischen Lerntheorie der Verzweigten Lehrprogramme nach Crowder, die auf den Lernverlauf angepasste Sequenzen von Lerneinheiten beinhaltet. Gleichzeitig werden mittels regelmäßig eingeschobener Selbsttestaufgaben Motivation sowie Aufmerksamkeit des Lernenden nach Regeln der Programmierten Unterweisung nach Skinner und Verstärkungstheorie gefördert. Durch explizite Auszeichnung zusammengehöriger Abschnitte in Videos können zusätzlich die enthaltenden Informationen maschinenlesbar gestaltet werden, sodass weitere Möglichkeiten zum Auffinden und Verknüpfen von Lerninhalten geschaffen werden.

Tuberculosis in antiretroviral treatment programs in lower income countries: availability and use of diagnostics and screening

OBJECTIVES In resource-constrained settings, tuberculosis (TB) is a common opportunistic infection and cause of death in HIV-infected persons. TB may be present at the start of antiretroviral therapy (ART), but it is often under-diagnosed. We describe approaches to TB diagnosis and screening of TB in ART programs in low- and middle-income countries. METHODS AND FINDINGS We surveyed ART programs treating HIV-infected adults in sub-Saharan Africa, Asia and Latin America in 2012 using online questionnaires to collect program-level and patient-level data. Forty-seven sites from 26 countries participated. Patient-level data were collected on 987 adult TB patients from 40 sites (median age 34.7 years; 54% female). Sputum smear microscopy and chest radiograph were available in 47 (100%) sites, TB culture in 44 (94%), and Xpert MTB/RIF in 23 (49%). Xpert MTB/RIF was rarely available in Central Africa and South America. In sites with access to these diagnostics, microscopy was used in 745 (76%) patients diagnosed with TB, culture in 220 (24%), and chest X-ray in 688 (70%) patients. When free of charge culture was done in 27% of patients, compared to 21% when there was a fee (p = 0.033). Corresponding percentages for Xpert MTB/RIF were 26% and 15% of patients (p = 0.001). Screening practices for active disease before starting ART included symptom screening (46 sites, 98%), chest X-ray (38, 81%), sputum microscopy (37, 79%), culture (16, 34%), and Xpert MTB/RIF (5, 11%). CONCLUSIONS Mycobacterial culture was infrequently used despite its availability at most sites, while Xpert MTB/RIF was not generally available. Use of available diagnostics was higher when offered free of charge.

The Effect on Meat Quality of Integrating Pasturing Systems into Cattle Finishing Programs

The effect on meat quality of integrating pasturing systems into cattle finishing programs was observed over a two-year period. Year one consisted of 84 fall born calves and 28 spring born calves and year two consisted of 116 fall born calves. The effect of using Rumensinâ for cattle on bromegrass pasture was incorporated into year one. In year two cattle on pasture received bromegrass pasture, and one treatment group received switchgrass during the warm season. In both years there was a control group of calves that went directly to the feedlot with the remaining calves going to pasture for varying periods of time before being finished in drylot. At the conclusion of the feeding trial, cattle were processed into beef, and a ribeye steak was removed from each carcass for sensory evaluation. In year one cattle that were on pasture the longest had the lowest (P<0.05) average quality grades. In year two this trend was reversed, and cattle placed directly into drylot had the lowest (P<0.05) average quality grades. In both years cattle carcasses in all treatments averaged yield grade 2. Warner Bratzler shear force values were not affected by treatments. Sensory panel evaluations indicated tenderness was unaffected by treatments, and in year two flavor and flavor intensity were unaffected by treatments. In year one flavor intensity was lowest (P<0.05) for steaks derived from cattle that were on pasture the longest and received Rumensinâ. Inclusion of Rumensinâ for cattle on pasture did not influence yield and quality grades or affect tenderness, juiciness, and flavor. Results of this study indicate that steer calves placed on cool and warm season pastures prior to being finished in drylot, can produce carcasses with acceptable yield and quality grades and that the meat eating qualities will be largely unaffected by the inclusion of pasture.

Integration of Pasturing Systems for Cattle Finishing Programs

A 3-year study, using 84 fall-born and 28 spring-born calves of similar genotypes, was conducted to integrate pasturing systems with drylot feeding systems. Calves were started on test following weaning in May and October. Seven treatments were imposed: 1) fall-born calves directly into feedlot; 2 and 3) fall-born calves put on pasture with or without ionophore and moved to the feedlot at the end of July; 4 and 5) fall-born calves put on pasture with or without ionophore and moved to the feedlot at the end of October; 6 and 7) spring-born calves put on pasture with or without ionophore and moved to the feedlot at the end of October. A bromegrass pasture consisting of 16 paddocks, each 1.7 acre in size, was available. Each treatment group had access to 1 paddock at a time and was rotated at approximately 3-day intervals. In the feedlot, steers were provided an 82% concentrate diet containing whole-shelled corn, ground alfalfa hay, and a protein, vitamin and mineral supplement containing ionophore and molasses. As pens of cattle reached about 1150 lb. average live weight, they were processed and carcass traits were evaluated. Pasture daily gains were highest for cattle on pasture for the longest duration (P < .03), and overall daily gains were highest for drylot cattle (P < .01) and decreased with increased time spent on pasture. Although differences among treatments existed in numerical scores for yield and quality grades (P < .05 and P < .03, respectively), all treatments provided average yield grade scores of 2 and quality grades of low Choice or higher. Use of four production costs and pricing scenarios revealed that fall-born calves placed on pasture for varying lengths of time were the most profitable (P < .04) among the treatments. Furthermore, employing a 5% price sensitivity analysis, indicated that fed-cattle selling price had great impact on profit potential and was followed in importance by feeder purchase price and corn grain price. Overall, these findings should provide significant production alternatives for some segments of the cattle feeding industry and also lend substantial credence to the concept of sustainable agriculture.

Integration of Pasturing Systems for Cattle Finishing Programs: A Progress Report

A three-year study was conducted to integrate pasturing systems with drylot feeding systems. Each year 84 fall-born and 28 spring-born calves of similar genotypes were used. Fall-born calves were started on test in May, and spring-born calves were started in October. Seven treatments were imposed: 1) fall-born calves directly into the feedlot (28 steers); 2 and 3) fall-born calves put on pasture with or without an ionophore and moved to the feedlot at the end of July (14 steers in each treatment); 4 and 5) fall-born calves put on pasture with or without an ionophore and moved to the feedlot at the end of October (14 steers in each treatment); and 6 and 7) spring-born calves put on pasture with or without an ionophore and moved to the feedlot at the end of October (14 steers in each treatment). Cattle on pasture receiving an ionophore gained faster (P=.009), but lost this advantage in drylot (P>.10). Overall, cattle started directly in the feedlot had higher gains (P<.001). Cattle receiving an ionophore on pasture had lower KPH than those that did not receive an ionophore (P<.01). Treatment influenced yield grade (P<0.001), although all treatments were YG 2. The percentage of cattle grading Prime and Choice was 75 % or higher for all treatment groups. The results show that using an ionophore improved pasture gains and that pasture treatments did not adversely influence yield and quality grades.

Integration of Pasturing Systems for Cattle Finishing Programs: A Progress Report

This progress report presents the findings of the first two years of a multi-year study. Each year 84 fall-born and 28 spring-born calves of similar genetic background were used to evaluate the incorporation of rotational pasturing systems into cattle finishing programs. The fall-born calves were started on test on May 7, 1996, and May 8, 1997, whereas the spring-born calves were started on test on October 1, 1996, and September 13, 1997. A total of seven treatments were imposed: 1) fall-born calves directly into the feedlot; 2) fall-born calves put on pasture and receiving an ionophore and moved to the feedlot on July 30, 1996, and July 29, 1997 in the first and second years, respectively; 3) fall-born calves put on pasture without an ionophore and moved to the feedlot on July 30, 1996 and July 29, 1997, in the first and second years, respectively; 4) fall-born calves put on pasture and receiving an ionophore and moved to the feedlot on October 22, 1996, and October 21, 1997, in the first and second years, respectively; 5) fall-born calves put on pasture without an ionophore and moved to the feedlot on October 22, 1996, and October 21, 1997, in the first and second years, respectively; 6) spring-born calves put on pasture and receiving an ionophore and moved to the feedlot on October 22, 1996, and October 21, 1997, in the first and second years, respectively; and 7) spring-born calves put on pasture without an ionophore and moved to the feedlot on October 22, 1996, and October 21, 1997, in the first and second years, respectively. Cattle receiving an ionophore on pasture gained more rapidly; however, cattle without access to an ionophore gained more rapidly in drylot thus negating the advantage obtained on pasture. Overall daily gains and feed conversions in drylot only, improved with increasing numbers of days fed in drylot; however, this may not be very cost effective. At similar end weights no real differences were observed in yield grades among the treatments; however, for fall-born calves the percentage grading Prime and Choice was higher for cattle fed longer in drylot.

Integration of Pasturing Systems for Cattle Finishing Programs: A Progress Report

In this study, 84 fall-born and 28 spring-born calves of similar genetic background were used to evaluate the incorporation of rotational pasturing systems into cattle finishing programs. Because the second-year trial is not complete, this report will include only the first year of the five-year study. Seven treatments were imposed: 1) fall-born calves put directly into the feedlot on May 7, 1996; 2) fall-born calves put on pasture and receiving an ionophore and moved to the feedlot on July 30, 3) fall born calves put on pasture on May 7 and not receiving an ionophore and moved to the feedlot on July 30; 4) fall-born calves put on pasture on May 7 and receiving an ionophore and moved to the feedlot on October 22; 5) fall-born calves put on pasture on May 7 and not receiving an ionophore and moved to the feedlot on October 22; 6) spring-born calves put on pasture on October 1 and receiving an ionophore and moved to the feedlot on October 22; and 7) spring-born calves put on pasture on October 1 and not receiving an ionophore and moved to feedlot on October 22. Performance data showed that cattle on pasture receiving an ionophore had higher gains than those not receiving an ionophore on pasture. This trend was reversed in the feedlot period. Yield grades were not greatly influenced by treatment, although quality grades tended to be higher for older cattle and those cattle that were in drylot for a longer period of time.

Prognosis of Children with HIV-1 Infection Starting Antiretroviral Therapy in Southern Africa: A Collaborative Analysis of Treatment Programs

BACKGROUND: Prognostic models for children starting antiretroviral therapy (ART) in Africa are lacking. We developed models to estimate the probability of death during the first year receiving ART in Southern Africa. METHODS: We analyzed data from children ≤10 years old who started ART in Malawi, South Africa, Zambia or Zimbabwe from 2004-2010. Children lost to follow-up or transferred were excluded. The primary outcome was all-cause mortality in the first year of ART. We used Weibull survival models to construct two prognostic models: one with CD4%, age, WHO clinical stage, weight-for-age z-score (WAZ) and anemia and one without CD4%, because it is not routinely measured in many programs. We used multiple imputation to account for missing data. RESULTS: Among 12655 children, 877 (6.9%) died in the first year of ART. 1780 children were lost to follow-up/transferred and excluded from main analyses; 10875 children were included. With the CD4% model probability of death at 1 year ranged from 1.8% (95% CI: 1.5-2.3) in children 5-10 years with CD4% ≥10%, WHO stage I/II, WAZ ≥-2 and without severe anemia to 46.3% (95% CI: 38.2-55.2) in children <1 year with CD4% <5%, stage III/IV, WAZ< -3 and severe anemia. The corresponding range for the model without CD4% was 2.2% (95% CI: 1.8-2.7) to 33.4% (95% CI: 28.2-39.3). Agreement between predicted and observed mortality was good (C-statistics=0.753 and 0.745 for models with and without CD4% respectively). CONCLUSION: These models may be useful to counsel children/caregivers, for program planning and to assess program outcomes after allowing for differences in patient disease severity characteristics.

Maternal cholestasis during pregnancy programs metabolic disease in offspring

The intrauterine environment is a major contributor to increased rates of metabolic disease in adults. Intrahepatic cholestasis of pregnancy (ICP) is a liver disease of pregnancy that affects 0.5%-2% of pregnant women and is characterized by increased bile acid levels in the maternal serum. The influence of ICP on the metabolic health of offspring is unknown. We analyzed the Northern Finland birth cohort 1985-1986 database and found that 16-year-old children of mothers with ICP had altered lipid profiles. Males had increased BMI, and females exhibited increased waist and hip girth compared with the offspring of uncomplicated pregnancies. We further investigated the effect of maternal cholestasis on the metabolism of adult offspring in the mouse. Females from cholestatic mothers developed a severe obese, diabetic phenotype with hepatosteatosis following a Western diet, whereas matched mice not exposed to cholestasis in utero did not. Female littermates were susceptible to metabolic disease before dietary challenge. Human and mouse studies showed an accumulation of lipids in the fetoplacental unit and increased transplacental cholesterol transport in cholestatic pregnancy. We believe this is the first report showing that cholestatic pregnancy in the absence of altered maternal BMI or diabetes can program metabolic disease in the offspring.

Environment and climate of the last 51,000 years – new insights from the Potrok Aike maar lake Sediment Archive Drilling prOject (PASADO)

In this introductory paper we summarize the history and achievements of the Potrok Aike maar lake Sediment Archive Drilling prOject (PASADO), an interdisciplinary project embedded in the International Continental Scientific Drilling Program (ICDP). The stringent multiproxy approach adopted in this research combined with radiocarbon and luminescence dating provided the opportunity to synthesize a large body of hydrologically relevant data from Laguna Potrok Aike (southern Patagonia, Argentina). At this site, lake level was high from 51 ka until the early Holocene when the Southern Hemisphere Westerlies (SHW) were located further to the north. At 9.3 ka cal. BP the SHW moved southward and over the latitude of the study area (52 degrees S) causing a pronounced negative water balance with a lake level decrease of more than 50 m. Two millennia later, the SHW diminished in intensity and lake level rose to a subsequent maximum during the Little Ice Age. Since the 20th century, a strengthening of the SHW increased the evaporative stress resulting in a more negative water balance. A comparison of our data with other hydrological fluctuations at a regional scale in south-eastern Patagonia, provides new insights and also calls for better chronologies and high-resolution records of climate variability.

Seismic stratigraphy of the Blue Hole (Lighthouse Reef, Belize), a late Holocene climate and storm archive

Five seismic units may be identified in the similar to 8 m thick Holocene sediment package at the bottom of the Blue Hole, a 120 m deep sinkhole located in the atoll lagoon of Lighthouse Reef, Belize. These units may be correlated with the succession of an existing 5.85-m-long sediment core that reaches back to 1385 kyrs BP. The identification of seismic units is based on the fact that uniform, fine-grained background sediments show weak reflections while alternating background and coarser-grained event (storm) beds exhibit strong reflections in the seismic profiles. The main source of sediments is the marginal atoll reef and adjacent lagoon area to the east and north. Northeasterly winds and storms transport sediment into the Blue Hole, as seen in the eastward increase in sediment thickness, i.e., the eastward shallowing of the Blue Hole. Previous assumptions of much thicker Holocene sediment packages in the Blue Hole could not be confirmed. So far, close to 6-m-long cores were retrieved from the Blue Hole but the base of the sedimentary succession remains to be recovered. The nature of the basal sediments is unknown but mid-Holocene and possibly older, Pleistocene sinkhole deposits can be expected. The number of event beds identified in the Blue Hole (n = 37) during a 1.385 kyr-long period and the number of cyclones listed in historical databases suggest that only strong hurricanes (categories 4 and 5) left event beds in the Blue Hole sedimentary succession. Storm beds are numerous during 13-0.9 kyrs BP and 0.8-0.5 kyrs BP.

Integrating Web-based Curricula into Allied Health Programs

This workshop will include \"Best Practices\" related to the integration of web-based instruction into allied health programs or courses. [See PDF for complete abstract]

Laparoscopic-Simulator Box: a Simple Design for Surgical Residency Programs to Improve Trainees’ Laparoscopic Skills

Introduction: Since the introduction and evolution of laparoscopic surgery, there have been some concerns related to surgical training in this field. Laparoscopic box trainers and virtual simulators appear as useful devices which have been demonstrating effectiveness in learning surgical skills. However, these tools remain inaccessible for many centers around the world. Our intent is to share our experience in successful design to inspire others in surgical residency programs to build such boxes for training in laparoscopic techniques and also to encourage the use of simulators in educational centers. [See PDF for complete abstract]