Factors Influencing Instructors' Adoption and Continued Use of Computing Science Technologies: A Case Study in the Context of Cell Collective.

Acquiring computational modeling and simulation skills has become ever more critical for students in life sciences courses at the secondary and tertiary levels. Many modeling and simulation tools have been created to help instructors nurture those skills in their classrooms. Understanding the factors that may motivate instructors to use such tools is crucial to improve students' learning, especially for having authentic modeling and simulation learning experiences. This study designed and tested a decomposed technology acceptance model in which the perceived usefulness and perceived ease of use constructs are split between the teaching and learning sides of the technology to examine their relative weight in a single model. Using data from instructors using the Cell Collective modeling and simulation software, this study found that the relationship between perceived usefulness-teaching and attitude toward behavior was insignificant. Similarly, all relationships between perceived ease of use-teaching and the other variables (i.e., perceived usefulness-teaching and attitude toward behavior) became insignificant. In contrast, we found the relationships between perceived ease of use-learning and the other variables (i.e., perceived usefulness-teaching, perceived usefulness-learning, and attitude toward behavior) significant. These results suggest that priority should be given to the development of features improving learning over features facilitating teaching.

Teaching Metabolism in Upper-Division Undergraduate Biochemistry Courses using Online Computational Systems and Dynamical Models Improves Student Performance.

Understanding metabolic function requires knowledge of the dynamics, interdependence, and regulation of metabolic networks. However, multiple professional societies have recognized that most undergraduate biochemistry students acquire only a surface-level understanding of metabolism. We hypothesized that guiding students through interactive computer simulations of metabolic systems would increase their ability to recognize how individual interactions between components affect the behavior of a system under different conditions. The computer simulations were designed with an interactive activity (i.e., module) that used the predict-observe-explain model of instruction to guide students through a process in which they iteratively predict outcomes, test their predictions, modify the interactions of the system, and then retest the outcomes. We found that biochemistry students using modules performed better on metabolism questions compared with students who did not use the modules. The average learning gain was 8% with modules and 0% without modules, a small to medium effect size. We also confirmed that the modules did not create or reinforce a gender bias. Our modules provide instructors with a dynamic, systems-driven approach to help students learn about metabolic regulation and equip students with important cognitive skills, such as interpreting and analyzing simulation results, and technical skills, such as building and simulating computer-based models.

The N ratio predicts recurrence and poor prognosis in patients with node-positive early gastric cancer.

BACKGROUND: The metastatic status of the regional node is the most significant prognostic factor for early gastric cancer (EGC). However, diverse prognoses are evident even among the same N classifications of the current tumor-node-metastasis system. The aim of this study was to evaluate the prognostic significance of the ratio of metastatic to retrieved lymph nodes (N ratio) in identifying a high-risk subgroup with node-positive EGC. METHODS: From a prospective database of 1264 EGC patients between 1987 and 1997, 156 (12.4%) were found to have histologically confirmed node metastasis. A number of prognostic factors, including the N ratio, were evaluated by univariate and multivariate analysis. RESULTS: The recurrence rate of node-positive EGC was 16.7% (n = 26). The overall 5-year survival rate of all patients was 84.0%. It was 26.9% and 95.4% in patients with and without recurrence, respectively (P < .0001; log-rank test). The cutoff value of the N ratio was set at .07. The 5-year survival rate of patients with an N ratio <.07 was 94.0%; this was significantly higher than the rate (72.6%) for those with a ratio >.07 (P < .0001; log-rank test). Both univariate and multivariate analysis identified the N ratio as the most significant predictive factor for recurrence and overall survival. Regarding stage migration, it shows superiority in comparison to the number-based N classification. CONCLUSIONS: The N ratio is a more effective and rational indicator for prognostic stratification of patients with lymph node-positive EGC than the current N classification of the tumor-node-metastasis system.

Percutaneous needle decompression during laparoscopic gastric surgery: a simple alternative to nasogastric decompression.

Laparoscopic gastric surgeries are routinely performed with use of a nasogastric tube to decompress the upper gastrointestinal tract. A distended upper gastrointestinal tract can complicate successful laparoscopic gastric surgery as the distention compromises not only the visual field but also the laparoscopic manipulation of the stomach. Since nasogastric intubation is not without risks, we have attempted laparoscopic-assisted gastric cancer surgeries without nasogastric tubes. In this article we describe a simple method of aspirating gastric contents using a 9 cm long 19-gauge needle inserted percutaneously during laparoscopic-assisted gastrectomy. First, a 9 cm long 19-gauge disposable needle was introduced through the abdominal wall. This needle was then introduced to the stomach through the anterior wall and the stomach gases and fluids were aspirated by connecting the needle to suction. Thus, a collapsed upper gastrointestinal tract was easily obtained. We performed this procedure instead of nasogastric decompression on twenty-two patients with gastric cancer who underwent laparoscopic-assisted distal subtotal gastrectomy with lymph node dissection. The results were good with only one patient experiencing wound infection (4.5%) and one patient with postoperative acalculus cholecystitis (4.5%). There were no patients with either intraabdominal infection or anastomotic leakage and none of the patients needed postoperative nasogastric decompression, except the patient who experienced acaculus cholecystitis. Percutaneous needle aspiration is a very simple and efficient technique with little risk of postoperative complications. It can be used as an alternative to nasogastric tube decompression of the gastrointestinal tract for laparoscopic-assisted gastrectomy.