Papilledema is a swelling of the optic disc secondary to elevated intracranial pressure (ICP). We analyzed 79 peer-review journal articles and provided a concise summary of the etiology, epidemiology, pathophysiology, clinical presentation, evaluation, natural history, differential diagnosis, treatment, and prognosis of papilledema. Only studies written in English with the full text available were included. Although many etiologies of papilledema exist, idiopathic intracranial hypertension is the most common and, thus, a large focus of this review.

AimsThis study aimed to assess the impact of different antidiabetic agents on individuals with diabetes and COVID-19.MethodsWe searched PubMed, Web of Science, Embase, and Cochrane Library databases from inception to October 31, 2021 and included seven antidiabetic agents. The data were pooled via traditional pairwise meta-analysis and Bayesian network meta-analysis.ResultsThe pairwise meta-analysis included 35 studies. Metformin (odds ratio (OR), 0.74; P=0.001), dipeptidyl peptidase-4 inhibitors (DPP4i) (OR, 0.88; P=0.04), sodium-glucose cotransporter-2 inhibitors (SGLT2i) (OR, 0.82; P=0.001), and glucagon-like peptide-1 receptor agonists (GLP1RA) (OR, 0.91; P=0.02) treatment were associated with lower COVID-19 mortality in individuals with diabetes compared to respective non-users. However, insulin treatment resulted in higher mortality (OR, 1.8; P=0.001). Mortality did not significantly differ in sulfonylurea (OR, 0.97; P=0.56) and thiazolidinediones (TZDs) (OR, 1.00; P=0.96) users. Furthermore, due to limited data, we analyzed five antidiabetic agents (metformin, DPP4i, sulfonylurea, insulin, and SGLT2i) and found no association between them and severe disease risk (all P>0.05). The Bayesian network meta-analysis included 18 studies. GLP1RA and SGLT2i had the highest first and second rank probability (67.3% and 62.5%, respectively). Insulin showed the maximum probability of ranking seventh (97.0%). Metformin had the third and fourth highest rank probability of 44.8% and 38.9%, respectively. Meanwhile, DPP4i had the fifth-highest rank probability of 42.4%, followed by sulfonylurea at 45.1%.ConclusionMetformin, DPP4i, SGLT2i, and GLP1RA treatments were highly possible to reduced COVID-19 mortality risk in individuals with diabetes, while insulin might be related to increased mortality risk. Sulfonylurea and TZDs treatments were not associated with mortality. None of the antidiabetic agents studied were associated with the risk of severe disease. Additionally, GLP1RA probably had the most significant protective effect against death, followed by SGLT2i and metformin.Systematic Review RegistrationPROSPERO (CRD42021288200)

One of the important features in developing science curriculum in Malaysia is the emphasis on the education system that allows students to master higher order thinking skills (HOTS). However, the current teaching practice tends to inhibit students' HOTS by which students are given drills and tutorials to perform better in examination. The contextual learning is deem as a suitable approach to develop HOTS, as it enables students to build their knowledge in the context of their minds, then later makes use of linkages and applies it to their real life. Additionally, the advancement of technology offers opportunity for integrated contextual learning with Virtual Learning Environment (VLE) to foster HOTS. This study aims at developing an integrated model to implement contextual learning with VLE for promoting HOTS in Malaysian schools. Using the constant comparison analysis for analyzing the literature, this study analyzed previous literatures to develop the integrated model. Findings show that limited research exists on the integration of contextual learning with VLE to promote HOTS, leaving some vacuum for further study and improvement and the need to formulate an integrated model.

The role of chemistry in the development of any society cannot be overemphasized. Chemistry students are therefore expected to acquire flexible knowledge and problem solving skills to facilitate the expected development of our modern society. The purpose of this article is to investigate the roles of teachers and student in the development of self-directed learning and skills in Nigerian Secondary Schools. PBL is a student-centered pedagogy which helps students develop problem solving skills and improved knowledge through self-directed learning under teacher's supervision. It is supported by Cognitive and Constructive psychologists. The learning process in Nigeria schools does not produce students with the required skills and knowledge, because of traditional instructions by teachers, poor learning environment and inadequate learning facilities. This gives a reason for the research. The study used a qualitative approach with explanatory design. Fifteen (15) chemistry students (16 years) and a teacher were purposefully selected in one Senior Secondary School as participants. The participants received 6 weeks of PBL lessons using a topic purification of water. The researchers collected data through observations field notes during the intervention process and also interview a focus group of 5 students after the PBL lessons. The data were transcribed, triangulated and analyzed using content analysis. The results showed students have improved learning and acquisition of problem solving skills including life-long learning and information management due effective self-directed learning activities among them. The researchers therefore recommend the introduction of self-directed learning approach in Nigerian Secondary Schools and other higher educational institutions.

AbstrackProblem-based learning (PBL) (Lim, 2007;Abu Hassan Kassim, 2003;Anuar Zaini, et al., 2003;Ng & Siow, 2003; Sharifah Maimunah, 2000). Students learning are in the form of passively accepting information from the teacher, copying notes, drill and practice, Indonesian Journal of Educational Review, Vol. 4 (1), July 2017 2 and 'cookbook style' practical activities. In such a learning environment, students become passive and dependent learners. Students face difficulties in learning and working with other when they enter tertiary education. Most students entering university are not prepared for active learning as they come from a passive, spoonfed and exam-oriented schooling system (Hussain & Berhannudin, 2009; Khairiyah, et al., 2009). There is a need to nurture students with the skills and capabilities to learn and collaborate with others since their schooling years. A transition from passive learning to actively engage in their own learning is the first step towards the development of well-rounded students. Thus, a learning environment providing real context learning and opportunity for students to work by themselves and among themselves has been designed and introduced into Malaysia secondary school. Problem-Based LearningProblem-based learning was developed by Howard S. Barrows and first implemented in McMaster University medical education in the 1960's (Barrows & Tamblyn, 1980). Medical students were not able to apply their knowledge in real clinical settings even though having passed the written examinations. PBL was thus developed to provide students with a learning environment that mirrored clinical practices, which could facilitate students' skills relevant to the real practice as well as promote deep learning. Various adaptations were made and PBL has been implemented across most disciplines, spread across the globe and was introduced into K-12 education (Tan & Mohammad Yusof Arshad, 2011).PBL is a pedagogical approach centered on ill-structured real world problem, which stimulate the practice of information-gathering, reasoning and problem-solving skills, interpersonal and team working skills, as well as the acquisition of content knowledge, in the process of working out the problem in collaborative groups. Students are responsible for their own learning while the instructor's role is to facilitate students' learning process without imparting direct answers or knowledge.There is limited research found about using PBL in Malaysia secondary schools even though there is an increase interest worldwide to implement PBL. Majority of Malaysia secondary school students as well as teachers have never come across PBL approach at schools (Faaizah & Halimah, 2007). Whether PBL is able to be implemented across Malaysia schools with large classes conducted by only one teacher remains a question. What will happen when teachers and students new to PBL experience PBL lessons? How will the learning proceeds? Are students able to work collaboratively and self-directly within their PBL groups and how does it occ...