The majority of ED physicians had low knowledge regarding the diagnosis and treatment of dentofacial traumatic injuries. There is a need for education during and after medical training for ED physicians to provide appropriate primary management of dentofacial trauma.

ObjectivesThe aim of this study was to compare the performance of the Glasgow‐Blatchford and the AIMS65 scoring systems as early risk assessment tools for accurately identifying patients with upper gastrointestinal (GI) bleeding who are at a low risk of requiring clinical interventions, including emergency endoscopy. The secondary objective was to compare their performance regarding relevant clinical outcomes.MethodsData were collected prospectively over a 2‐year period in the emergency department of a university hospital. Adult patients with upper GI bleeding from either variceal or nonvariceal sources were included. Composite clinical outcomes consisted of a need for surgical or endoscopic intervention, rebleeding, intensive care unit admission, or in‐hospital mortality. Patients who required blood transfusions or suffered composite clinical outcomes were considered high‐risk patients. Glasgow‐Blatchford score (GBS) and AIMS65 score were calculated for each patient. The sensitivity and specificity of the scoring systems were calculated. The areas under the receiver‐operating characteristic curve (AUC) of the scores were compared.ResultsThere were 254 patients in the study, of whom 163 (64.2%) were men. The median age was 61 years (interquartile range = 45 to 72 years). Among the patients, 211 (83.1%) underwent endoscopy, of whom 49 (19.3%) required endoscopic intervention to achieve hemostasis. Five (2%) patients required surgical intervention. Rebleeding was observed in 33 (13%) patients. A total of 143 (56.3%) patients received blood transfusions. A total of 152 (59.8%) were defined as high risk. Eighty‐one (31.9%) experienced at least one component of the composite clinical outcomes, 18 (7.1%) of whom suffered in‐hospital mortality. A GBS of 0 was observed in 16 patients (6.3%) in the study group. Two of these were high‐risk patients. A total of 101 (39.8%) patients had AIMS65 scores of 0. Thirty‐four of these were high‐risk patients. A GBS of 0 had higher sensitivity than an AIMS65 score of 0 (98.68% vs. 77.6%). The negative predictive values of the GBS and AIMS65 of 0 were 87.5 and 66.3%, respectively. The GBS and AIMS65 were similar with regard to the composite outcome prediction, with AUCs of 0.795 (95% confidence interval [CI] = 0.74 to 0.843) and 0.746 (95% CI = 0.688 to 0.798), respectively (p = 0.137). The scores were also similar with respect to predicting in‐hospital mortality (AUCs of 0.85 vs. 0.81; p = 0.342). The GBS was superior to the AIMS65 in identifying high‐risk patients, with AUCs of 0.896 (95% CI = 0.85 to 0.93) and 0.771 (95% CI = 0.714 to 0.821; p < 0.001), respectively. The GBS was also more accurate than the AIM65 in predicting the need for blood transfusions (AUCs of 0.904 vs. 0.796; p < 0.001) and interventions (AUCs of 0.727 vs. 0.647; p = 0.05).ConclusionsThese results suggest that the GBS has superior sensitivity relative to the AIMS65 in identifying patients who were not likely to require interventions, including emergency endoscopy. Additional work to determine the use in real‐time decision making may be warranted and helpful in providing guidance to clinicians.

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ÖZ:Çalışmanın amacı, açık sorgulamaya dayalı öğrenmenin ilköğretim 7. sınıf öğrencilerinin akademik başarılarına ve bilimsel süreç becerilerinin gelişimine etkisini araştırmaktır. Aynı zamanda açık sorgulamaya dayalı öğrenme yaklaşımının sınıf içerisinde uygulanabilirliğini ve öğretmen açısından karşılaşılan sorunları ortaya koymaktır. Araştırmada, amaçlar doğrultusunda karma yöntem kullanılmıştır. Araştırmanın nicel boyutunda yarı-deneysel desen kullanılırken, nitel boyutunda ise öğretmen ile uygulamadan sonra yarı yapılandırılmış görüşme yapılmıştır. Çalışma, uygun örnekleme ile seçilen bir devlet okulunun 7. sınıflarını oluşturan beş şubeden rastgele seçilen iki tanesiyle yürütülmüştür. Toplam 33 öğrenciden oluşan deney grubunda, açık sorgulamaya dayalı öğrenmeye uygun olarak geliştirilmiş etkinlikler kullanılarak ders işlenmiştir. Toplam 32 öğrenciden oluşan kontrol grubunda ise aynı öğretmen tarafından öğretim programı ve ders kitabının önerdiği şekilde ders işlenmiştir. Nicel verilerin toplanmasında bilimsel süreç becerileri testi ve "Kuvvet ve Hareket" ünitesine yönelik bir başarı testi kullanılmıştır. Yapılan çoklu kovaryans analizi (MANCOVA) sonucunda, deney grubu lehine istatistiksel olarak anlamlı bir fark bulunmuştur. Nitel verilerin analizinde ortaya çıkan temel bulgu ise öğretmenin etkinlikler sırasında öğrencilere ne zaman ve ne kadar destek sağlaması veya onları nasıl yönlendirmesi gerektiği konularında kararsızlıklar yaşamasıdır. Araştırma sonuçlarına paralel olarak öğrencilerin akademik başarılarının artırılması ve bilimsel süreç becerilerinin gelişimi için açık sorgulamaya dayalı öğrenmeye uygun etkinliklerin fen sınıflarında kullanılması önerilmektedir.Anahtar sözcükler: sorgulamaya dayalı fen eğitimi, açık sorgulama, bilimsel süreç becerileri, başarı. ABSTRACT:The aim of this research is to investigate the effect of open inquiry based learning on the development of 7th grade students' academic achievement and science process skills. At the same time, the practicability of open inquiry in the science classroom and problems encountered by the teacher were examined. Mixed-method was used regarding the aims of the study. In the quantitative part, quasi-experimental study was designed whereas semi-structured interview was conducted with the teacher after the treatment in the qualitative part. The sample of this study was composed of randomly selected 2 classes from a conveniently selected public school with 7 classes. Open inquiry based learning activities developed by the researchers were conducted in the experimental group (n=33 students) by their science teacher. In the control group (n=32 students), lessons were conducted as suggested in the science curriculum by the same teacher. Science process skills test and an achievement test about "Force and Motion" unit were used to collect the quantitative data. The results of MANCOVA indicated statistically significant differences on behalf of the experimental group. The teacher was unsure about when and to what extent she should have given scaffold...

BACKGROUND: Measuring and monitoring end-tidal carbon dioxide (P ETCO 2 ) is an important aspect of caring for critically ill patients. The 2 methods used for P ETCO 2 measurement are the mainstream and sidestream methods. OBJECTIVE: To assess the agreement between P ETCO 2 measurements performed by mainstream and sidestream methods with the P aCO 2 values. METHODS: This was a prospective observational study. A total of 114 subjects were enrolled in the study. P ETCO 2 measurements using mainstream and sidestream methods were performed simultaneously with the arterial blood sampling in subjects who were observed in the emergency department and required arterial blood gas analysis. Agreement between the P ETCO 2 measurements and the P aCO 2 values obtained from arterial blood gas analysis were evaluated using the Bland-Altman method. RESULTS: Sixty subjects (52.6%) were female, and the mean age was 60.9 years (95% CI 58.3-63.6). The mean P aCO 2 was 35.16 mm Hg (95% CI 33.81-36.51), the mainstream P ETCO 2 was 22.11 (95% CI 21.05-23.18), and the sidestream P ETCO 2 was 25.48 (95% CI 24.22-26.75). Bland-Altman analysis showed an average difference between mainstream P ETCO 2 and P aCO 2 values of 13 mm Hg (95% limits of agreement ؊0.6 to 25.5) and moderate correlation (r ‫؍‬ 0.55, P < .001). The average difference between the sidestream P ETCO 2 and P aCO 2 values was 9.7 mm Hg (95% limits of agreement ؊5.4 to 24.7) and poor correlation (r ‫؍‬ 0.41, P < .001). CONCLUSIONS: P ETCO 2 values obtained by mainstream and sidestream methods were found to be significantly lower than the P aCO 2 values. There was essentially no agreement between the measurements obtained by 2 different methods and the P aCO 2 values.