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Wireless World: 'Card-less' loyalty promos
Isn't it frustrating when you go to the corner drug store, buy some milk and bread, and at checkout have to fumble when the girl asks you if you have your store discount card? Experts tell United Press International's Wireless World that one, small, everyday humiliation will soon disappear from your existence here, as wireless technology renovates retail processes.
So-called card-less loyalty programs are emerging that enable consumers to pay for their purchases with their mobile phones, and receive automatic updates on their account status, including extra savings, or planned promotions, via secure messaging service (SMS). No more cards to find in your cavernous wallet, or cash to pull out of your pocket. Just present your phone, and the credit card, linked to the phone account, is billed automatically by the merchant.
"Merchants can take advantage of cost-effective, high-impact interactive card-less loyalty programs, and let customers pay with their mobile phones, speeding check-out, and cutting costs by offering flexible payment options," a spokesman for MobileLime, a mobile marketing service, based in Watertown, Mass., told Wireless World.
Customers dial a toll free number to sign up for the service -- 866-360-LIME -- and pre-pay for purchases. Then when they are at the store, they enter the merchant's location ID number into the phone, followed by the "pound" sign. After that, they give the cashier the last four digits of their mobile number to complete the transaction.
The service is available for a number of transactions, including groceries, cab fare, ordering flowers, buying clothes or even paying a bar tab.
The technology is seen as the latest evolution in the SMS or mobile messaging service field. "Today, carriers are looking to evolve toward a more integrated messaging experience beyond basic SMS and MMS protocols," Francisco Kattan, director of product marketing at Openwave, a software developer that works with mobile phone companies, told Wireless World.
As video mail becomes common on mobile phones in the coming years -- it is offered in some locales now, on a provisional basis -- consumers will expect even more advanced messaging, like video messaging. This will be integrated into customer service processes too -- for merchants, experts said. "This is a fundamental shift in the way messaging services have previously operated, requiring the user to adapt new protocols," said Kattan. "New services should adapt to the user's needs."
In a sense, the technology trend here is similar to that which is seen on the Internet -- personalization of marketing. "We're seeing a movement beyond person-to-person services," said Kattan. "We expect the coming year to bring a variety of personalized and adaptive messaging services."
In addition to the texting and messaging developments on phones, new media are developing that cross a number of platforms. For example, an interactive advertising agency, based in Atlanta, called Think Interactive, created an online banner for Alltel's launch of its BlackBerry service. The banner enabled consumers to text message a friend -- by clicking on the banner, something of a new approach. The texting banner is available at: www.thinkinc.com/awards/blackberry.
There is also the arrival of so-called Interactive Messaging Unlimited (IMU), which takes that concept even further, enabling messaging from any platform to any platform. "IMU has been used for both entertainment and business purposes at concerts, clubs, bars, sporting events and tradeshows around the country, and even around the world," said a spokesman for Pangolin SMS, a software developer, active in that field, based in Orlando, Fla. "It uses the texting technology already embedded in most cell phones, and enables the video display of SMS/MMS messages, including combining messages with other video content, i.e., live feeds, static or animated graphics, and scrolling text," the spokesman told Wireless World. Now that will make for some interesting in-store coupons.
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Citation: Wireless World: 'Card-less' loyalty promos (2006, June 30) retrieved 16 July 2019 from https://phys.org/news/2006-06-wireless-world-card-less-loyalty-promos.html
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Full lace wig is the savior of women suffering from medical hair loss, because they are able to accomplish the specifics and styles of what wearer want to be. in order to create a whole new looking to meet the client's natural style.we must match hair color,length,hair style,To Dye a lace wig, you need to take some precautions, but this process has become easier with practice.
To ensure a clean, dry full lace wig mannequin head wig stand, and the stand is placed in the center of your workspace.
Some hair duckbill clip holds quadrant.
Wear rubber gloves, and then open any hair care product bottles. Mixed colors, according to the manufacturer's instructions, and stirred for a brush of the appliance use.
Start a full lace wig dye application. If you plan to apply only to the highlight of your foil and apply to the part you want. If you apply the color, remove the thin line of hair from the first quadrant, foot rest with other duckbill clip.
Using the applicator brush, paint the entire length of the row direction of the cuticle of the hair dye to the hair, start 1 mm away from the laces. This is done in order to protect the lace, the dye will be slightly expanded, because it deals with. Through each line of and each quadrant hair, repeat the above steps.
Let the full lace wigs, wig stand. Dye per the manufacturer's instructions processing. Be careful, do not tangle into the hat color hair. The heat may be used.
Keep wig wig stand, rinse the dye from the rear part of the move from back to front run until the water is clear. Shampoo, condition and comb your full lace wig.
Allow air drying, the desired style.
View next:How to Attach Hair Wefts & Top Closures?


Here by means of sprinkler width at work pediment, sprinkle, spray side three functional parts, these points when sanitation sprinkler or conservation sites use more, will be used when a small number of flower beds on both sides of the road greening is the most important of several major functions. Many users in the car after one year (especially in winter when used) to reflect, to a large extent reduce the sprinkler width What is the reason?
1. Why say after the winter, which is a focus. Some users after use, do not pay attention to water in the pump have not drained after the water freezes in the cold pump pumps the cracking, caused when a slight seepage, can not be used directly after severe cold break. Just think, when the pump each functional element is greatly reduced water pressure, how well the previous ideal sprinkler width, not good maintenance is an important cause of a large number of users to buy the sprinkler pump.
2. pay attention to the quality of water in water is a major cause. Sometimes pieces of gravel. Impurities into the pump, when minor impurities to filter plugging point, severe internal wheel might break, not a long time to clean up and cause blockages wheel seal will reduce the pressure decreases, the function decreases, sprinkler width below standard.
3. Effect of the tank. If too many impurities, or when the sprinkler has been without water tank, a large amount of rust cause pipe blockage will have some influence.
4. Each conduit connections are not sealed, larger water seepage, in general, a sprinkler pipe directly affect the front member function. Water seepage immediately with green tape or sealant to seal.
5. If the above components are good, it is possible engine failure, lack of horsepower, the speed of the pump can not reach, the pressure is reduced. This should go to the service station for maintenance treatment.
Just click to check the above points, you can rule out the sprinkler width good reasons for the decrease.


I follow the coast line along in the breaking zone doing some jumping but more about surfing/playing on the waves anything from 2' to 8' they are all good. Running along the top as they break. Crossing them forwards and backwards. Getting into tight spots all the time and need something that is light, maneuverable, and good instant responce acceleration.
I have a 2013 Yamaha VXR now, which has been great, my ski before was a Kawasaki 260x which couldn't surf as well, too heavy or too v nose, I'm not sure which but the lip on the bow would catch an edge turning at the bottom of a wave and roll. The VXR can do this easily and I can't really fault it except maybe a bit more thrust might be handy, and maybe lighter but it's time for a new ski.
Just wondering what is out there now that might be better.
I'd like good power but don't need supercharged, but that would be ok too, but no turbocharged.
I don't need any gadgets like trim or cruise just a throttle and handlebars.
My 2013 Yamaha FX Sho does all the things you listed.
I did try one back when mine was new it was a bit heavier and not quite as nimble as the vrx but definitely fast.
When I hear "ocean" and long range....that's why I suggested it.
97 XP good surf ski ?


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Why Does a Chateau in Missouri's Ozarks Have Weird Roof Symbols?
Doc Holliday Published: November 9, 2022
Springfield Daily Citizen/Kansas City Star via YouTube/Canva
It's one of the most mysterious abodes in all of Missouri. It's a chateau that sits up in the hills of the Missouri Ozarks that is built to withstand earthquakes, bombs and even an EF5 tornado plus it has strange symbols on the roof.
If you look up the strangest homes in Missouri, you'll almost always see this home mentioned. It's the Pensmore Chateau built in Highlandville, Missouri south of Springfield by Stephen Huff. It's a 72,000 square foot fortress that looks like someone's preparing for the end of the world.
The Providence Forum says this mysterious chateau is "a retreat center for scholars and "deep thinkers". Hmm.
So, what about the symbols on the roof?
The Providence Forum says that "the visible symbols of the roof line are the mathematical symbol Pi and the early American historic symbol of the Liberty Tree." But, the meaning goes deeper than just math. It apparently is Stephen Huff's tribute to God with the symbols representing the Trinity.
A few years ago, Stephen gave The Kansas City Star a tour with some explanations about the stranger parts of his...estate.
The Wikipedia page for this unique structure adds one more twist. It states that Mr. Huff built the home in the part of Missouri he did due to the fact that it's not subject to government surveys or regulations. Curious.
What does it all mean? Is it just the abode of an eccentric businessman who's researching climate, disaster and building technologies and concepts? Or, is it a symbol of something else going on?
The only known fact is that it's one of the most curious buildings in all of Missouri and it's likely the mystery surrounding it will only deepen.
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Filed Under: Mansions, Mysteries, Ozarks
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redpajama_set_name: RedPajamaCommonCrawl


The common practice today is to use esrogim that have begun to turn yellow, even if they are still mostly green. This is not universally accepted; some, such as the Brisker rabbanim, insist on fully yellow esrogim. In this essay we will explore some of the elements of a centuries-old dispute that continues to this very day.
The Problem with Green Esrogim In the third chapter of Maseches Succah, the Mishnah discusses the status of a green-colored esrog with characteristic brevity: "If it is green like a leek [hayarok kikarsi] — Rabi Meir says it is kosher, and Rabi Yehuda says it is pasul." The halachah follows Rabi Yehuda, and at first glance, things look pretty bleak for the green esrogim.
But the Gemara teases out a nuance regarding the problem with green esrogim. The esrog is described in the Torah as pri eitz hadar, and we derive from the word hadar that it must be free of certain aesthetic blemishes. Thus an esrog that is totally dried out, or that has certain discolorations, is pasul. The initial assumption of the Gemara is that greenness, too, is an absence of hadar.
The Gemara concludes, however, that this cannot be Rabi Yehuda's reasoning. Elsewhere we find that Rabi Yehuda, unlike his colleagues, permits using a dried-out esrog, for he interprets the word hadar differently and does not require that the esrog be beautiful. (The halachah does not follow Rabi Yehuda on this point, and we require hadar for our arba minim.) Rather, Rabi Yehuda's reason is that a green esrog is assumed be immature (lo gamar peira).
Tosafos introduce a considerable leniency based on this explanation, namely that if one has an esrog that is currently green but will turn yellow over time, it would be kosher even according to Rabi Yehuda, since it clearly was not picked too early to ripen. This leniency is adopted by the Rosh , the Tur, and the Shulchan Aruch.
As understood by the Taz and Magen Avraham, this allows the use of such an esrog even before it turns yellow, so long as one knows that it will do so. We only need to know that it stayed on the tree long enough to be able to turn yellow later.
The Vilna Gaon, Chayei Adam, Shulchan Aruch Harav, and Elya Rabbah agree with this interpretation, and Mishnah Berurah incorporates it into his commentary, albeit with one caveat: Based on a ruling of Maharil mentioned in Magen Avraham, Mishnah Berurah rules that one should only use a green esrog if it has already begun to turn yellow, for otherwise one can't be certain that it will in fact change color in the future.
The Bach raises an objection to this leniency. The Gemara clearly assumed from the outset that a green esrog lacked hadar, and only invoked the gamar peira reason to explain why Rabi Yehuda, who does not require hadar, nevertheless considers green invalid. Since we, unlike Rabi Yehuda, rule that an esrog must be hadar, we have no reason to disregard the initial assumption that a green esrog lacks this qualification.
Hence, argues the Bach, a green esrog is pasul for two reasons: it is not hadar, and it may be immature. Even if we know it will turn yellow later, Tosafos's leniency as understood by the aforementioned authorities would only cover the second reason, but the first problem — hadar — would still apply until it finishes turning yellow. This stringency is endorsed by Bikkurei Yaakov, Beis Meir, Shiyarei Knesses Hagedolah, Olas Shabbos, and Mishkenos Yaakov.
What about the Tosafos we mentioned above, which allows the use of an esrog that will change color after picking? Several of the aforementioned authorities adopt a different interpretation of the Tosafos, and argue that Tosafos only mean to allow the use of a green esrog after it turns yellow, not before.
Obviously, once an esrog turns yellow, there will be no hadar issue, as hadar is dependent solely on its status at the time of use. Tosafos, according to this view, wish to clarify further that the problem of gamar peira also resolves itself once the esrog changes color, even though that at the time of picking it was unfinished. In other words, one might have argued that an esrog picked before ripening on the tree is permanently disqualified, and Tosafos are dispelling such an assertion.
By reading Tosafos this way, these Acharonim are arguing with the Taz and Magen Avraham on two counts: 1) They hold that green lacks hadar, and that 2) a yellow coloration is per se required for the esrog to be considered gamar peira.
(1) Although the Mishnah flatly disqualifies green esrogim, many poskim understand the sole problem to be the assumption of immaturity. They accept any esrog that is known to be mature enough to turn yellow in the future.
(2) The Bach objected because he argues that a green esrog lacks hadar and thus remains pasul until it turns yellow.
(3) A stringent reading of Tosafos alleges that the maturity problem, too, applies until final ripening.
The idea that Esther had a tinge of yarok is mentioned in the Gemara: "Esther was yerakrokes, yet a thread of grace was strung upon her." But only the Zohar draws a connection between her color and the esrog. What is the connection between Esther and the esrog? Bikkurei Yaakov hints that they share some secret connection ("meramzim l'sod echad") but declines to reveal said secret. At any rate, this Zohar tells us that green is not only acceptable, but preferable. How are we to reconcile this with the established halachah?


Once you have thought about your wishes, it is important to write them down in a legal document. The following documents are called advance directives. Advance directives should be updated regularly and shared with your health care agent, loved ones, doctor, and hospital. You may complete one or both documents.
Durable Power of Attorney for Health Care is a legal document where you can select a health care agent to make health care decisions for you if you cannot.
Health Care Directive (Living Will) is a legal document that tells your doctor what treatments you would or would not want if you were permanently unconscious or not expected to recover.
The Advance Directive includes both the Durable Power of Attorney for Health Care and the Health Care Directive, along with directions for how to complete it and make sure it is legally valid.
There is more information about each document below.
One of the best ways to make sure your wishes are followed is to name a health care agent and have a conversation with them about your wishes for future health care. The person that you choose can make health care decisions for you if you cannot.
A health care agent should be someone you know and trust to follow your wishes about future health care. They must be over 18 years old, and cannot be your doctor or an employee of your doctor or health care facility unless they are also your close family member.
Are you willing to take on this role and responsibility?
Do you understand my wishes for future health care?
Can you make the decisions I would want to make, even if you disagree?
Can you make important health care decisions under stressful circumstances?
Watch a video that explains the role.
*If any group (like Adult Children) has more than one person, all the people in the group must agree to the same care. You can download a chart that illustrates the order here.
A Health Care Directive is a legal document that tells your doctor what treatments you would or would not want if you were permanently unconscious or not expected to recover.
Must be at least 18 years of age and competent.
Must watch you sign this form and complete their section of the form below.
Cannot be related to you or your health care agent by blood, marriage, or state registered domestic partnership.
Cannot be your home care provider or a care provider at an adult family home or long-term care facility where you live.
Cannot be your designated health care agent(s).
Click here to find a notary near you.
Must watch you sign this form.
Would not be entitled to any portion of your estate upon your death.
Cannot be your attending physician or an employee of your attending physician or health care facility where you are a patient.
Cannot be any person who has claim against any portion of your estate at the time of signature of this document.
Please note that the witness requirements for the Durable Power of Attorney for Health Care differ from the Health Care Directive, and that the Health Care Directive cannot be notarized. These laws are in place to ensure it is truly your voice that is heard if you are unable to communicate.
Once you complete the written documents, it is important that you share your wishes and the documents.


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Day Trips In Kissamos
Day Trips in Chania
Kissamos, a place near paradise. Visit the most famous beaches and places, explore Kissamos area.
Falasarna Beach
A stunning beach and one of the most important ports of ancient Crete.
Falassarna beach (or Falasarna) is located in Kissamos, in the western part of the prefecture of Chania, Crete, 13 km from the town of Kissamos. Crystal clear waters, aquamarine sea and fine golden sand, are those which characterize Falasarna, which is considered to be one of the best beaches in the prefecture of Chania and all over Crete.
Falasarna, Crete, is not just known for its beach, but also for its archaeological site, as ancient Falasarna was a powerful city-state in its time and the remnants of the ancient city are impressive. In addition, Falasarna, due to its very good climate, is a centre for agricultural production in West Crete, with many olive trees in the plain near the beach and numerous greenhouses, most of which are cultivating tomatoes.
You can learn more about the area here: http://visitfalassarna.com/
You can learn more about Kissamos here: https://inkissamos.gr/
14 Km, about 19 minutes driving, Bus accessible
Elafonisi:
Elafonisi beach is one of the prettiest beaches in the west coast of Crete and equally famous with Vai palm-forest beach. Pink sand, very shallow water and really crowded till 16:00 when the tourist buses depart. This is the time to enjoy the beach of Elafonissi. Elafonisi -or Elafonissos or Elafonissi- is something like an island and a peninsula, because to reach the island you have to walk through the sea. It is located in the southwest end, about 25km from the Kissamos. Elafonissi is a place of an exceptional natural beauty, and it has been included in the Natura 2000 Protection Program. Someone could say that nature made its wonder in Elafonissi.
That's why Elafonissi beach is such a popular destination in the prefecture of Chania, and a top of the top things to do / excursion from all over Crete.
Balos Lagoon:
Balos beach – lagoon is located on the northwestern corner of Crete, 15 Km from the town of Kissamos. Balos is an exotic beach-lagoon formed between the peninsula of Gramvousa and cape Tigani, while further to the north lie two islands, Imeri Gramvousa and Agria Gramvousa. Balos beach & lagoon as well as the island of Imeri Gramvousa can be reached by cruise ship that departs from the port of Kissamos. Also you have the ability to come here by yourself, driving up to a point and then continuing on foot.
To get to Balos you need to drive along the northern coastal road past the town of Kissamos. then past the port of Kissamos (located 2.5km to the West of the town). About 1.5km after you pass the port take a right turn on a small road with a sign to Kaliviani. Pass through the village then keep following the road heading towards the North. The road will soon turn into a dirt road but contrary to what many say it is perfectly drivable for normal cars if you go slowly and pay attention to stones and pot holes.
Keep going on this very scenic dirt road for just under 8 km and you'll get to the end where you can park your car. This "car park" could be very full in summer and you might have to park some way away. From there follow the path to Balos, about 20 to 30 minutes easy walking down (it's less easy and much hotter coming back up).
Since 2013 (during the tourist season from April to October) there is a charge of 1 Euro per person levied by the municipality of Kissamos for the use of that road. This goes towards the maintenance and protection of the area.
15 Km, about 40 minutes driving (dirt road), Bus or boat accessible
Telonio beach:
The old Telonio beach is located about 200 meters from Christina beach Hotel, along a pedestrian precinct by the sea. Here you will find traditional restaurants, taverns, fast food, cafe and bars next to the sea with view to the Kissamos bay.
200 meters, about 3 minutes walking.
Polirinia: An ancient city-state of great power, in a location offering excellent view to two seas of Crete
Polirinia was an ancient city-state, famous all over Crete in its time, which dominated in the region of the west coast of Crete.
Today, near the remnants of the ancient city of Polirinia lays the homonymous Polirinia village, as a reminder of its great past.
Polirinia – a city built to last
Ancient Polirinia was built on top of a high hill – more than 400 metres high. The location of the city offers excellent view to all the surrounding area.
The city was heavily fortified – many historians believe it was the most fortified city in Crete. Part of the strong fortification of Polirinia is still visible today.
The name "Polirinia" comes from the ancient Greek words "poly", which means many and "renea", which means sheep. The name implies that the main occupation of the residents of Polirinia was stock farming. It might be in the beginning, but, historically, the city and its people were very warlike. The warriors of Polirinia were very skilled – we could say that Polirinia was the Sparta of Crete.
Apart from their warrior abilities, the residents of ancient Polirinia were good merchants, too. There is historical evidence that one of the main occupations of the locals was the construction and the trade of weapons, which, among others, brought wealth to the city. Ancient Polirinia was so wealthy that it issued its own coin, which on one of its sides featured the head of a bull, which was the symbol of the city.
Regarding religion, in Polirinia two goddesses were worshipped: Artemis and Athena. During the excavations, a temple dedicated to Artemis was found in the acropolis of Polirinia. Also, ancient coins of Polirinia were found, which featured goddess Athena as a warrior, with a helmet and a spear in hand.
The turbulent history of ancient Polirinia
Polirinia was an ancient city-state with great power. But the same was true for its neighbouring city-state to the east, Kydonia, which was based near Chania city. In fact, Kydonia was more powerful than Polirinia.
During ancient times, many times ancient Kydonia and ancient Polirinia encountered each other in battle. Generally, in ancient Crete, battles between city-states were common and frequent, its main reasons being territorial claims and competition for natural resources.
Polirinia was founded in the archaic period from Achaeans. The city flourished during the ancient Greek period, although fights were frequent, especially with Kydonia city. According to some sources, during that period, Agamemnon, when returning from Troy, stopped with his fleet in Polirinia in order to make a sacrifice.
When the Romans came to Crete, Polirinia moved fast and strategically and made an alliance with them. This gave them an advantage over their neighbouring Kydonia city. During the Roman period, the two ports of the city, Falasarna and Kissamos also flourished. Gradually, the center of activity moved from Polirinia to Kissamos.
Polirinia was also a prominent city in the Byzantine years, but it was during that historical period that the city of Polirinia was gradually abandoned. However, the fortifications of Polirinia were still in use for many centuries. The walls of Polirinia were used and improved by the Venetians. Another noteworthy fact is that many of the remnants of ancients Polirinia were used as construction material for the building of the present village of Polirinia.
Polirinia was a famous city-state of the ancient Greek world, which managed to flourish for more than a thousand years, mainly because of the warrior abilities of its people. Although the remnants of the ancient city are not as impressive as other ancient cities in Crete, a visit to Polirinia is recommended, for the rich history of the city, but also for the breathtaking view to the northwest part of the island.
8 Km, about 15 minutes driving, Bus accessible
Elos traditional Village:
The traditional village of Elos is located 22km south west of Kissamos, on the way to the well-known Monastery of Chrissoskalitissa and the unique, great, sandy beach of Elafonissi.
Elos is a small village with few stone houses where its inhabitants are mostly engaged in agriculture cattle breeding.
The village is surrounded by lush greenery, olive groves and plane trees.
In late October, there is the Chestnut Festival. In the village you can find several traditional taverns with home made foods.
Tip: Combine it with an excursion to Elafonissi.
22 Km, about 35 minutes driving.
adminDay Trips In Kissamos 05.09.2016
In amazing Crete, 37 Km of westwards city Chania is found the beautiful town of Kissamos. Christina Beach Hotel is a new hotel on the seaside, only a few minutes away from the centre of picturesque Kissamos.
tel: +302822083333 - fax: +302822083334
info@christina-beach.gr
CRN LICENCE: 1042Κ032Α0202401
Kissamos 73400,
Chania, Crete, Greece
© 2016 Christina Beach Hotel


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Jennifer Lopez & Bad Bunny "Te Guste" (Official Music Video)
by PhillyCustoms November 8, 2018 9:09 pm
Watch "Te Guste" by Jennifer Lopez & Bad Bunny
Jennifer Lopez shows the masses she still has it with an extremely sexy visual for "Te Guste" featuring Bad Bunny.
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Jennifer Lopez – Booty Remix (Feat. Iggy Azalea)
Jennifer Lopez and Iggy Azalea team up on the ass-shaking remix to her "Booty" single. I can't wait to watch the video on mute.
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CHOC recognized as one of nation's best children's hospitals
June 16, 2020 CHOC Children's
CHOC Children's is one of a select group of pediatric facilities nationwide to have been ranked today as a best children's hospital by U.S. News & World Report.
The following CHOC specialties are honored in the 2020-21 Best Children's Hospitals rankings: neonatology; cancer; diabetes and endocrinology; neurology and neurosurgery; orthopaedics; pulmonology; and urology. Both orthopaedics and diabetes and endocrinology earned a "Top 20" spot.
"At CHOC, we are committed to the highest standards of care, safety and service – and this honor reflects that unwavering dedication," said Dr. James Cappon, CHOC's vice president, chief quality and patient safety officer and interim chief medical officer. "Not only does this recognition of our excellence in these subspecialties, including two on the top 20 lists, validate our efforts, but it also offers our patients and families additional assurance of our commitment to their health and safety."
The Best Children's Hospitals rankings were introduced by U.S. News in 2007 to help families of children with rare or life-threatening diseases find the best medical care available. Only the nation's top 50 pediatric facilities are distinguished in 10 pediatric specialties, based on survival rates, nurse staffing, procedure and patient volumes, reputation and additional outcomes data. The availability of clinical resources, infection rates and compliance with best practices are also factored into the rankings.
The U.S. News Best Children's Hospitals rankings rely on clinical data and on an annual survey of pediatric specialists. The rankings methodology factors in patient outcomes, such as mortality and infection rates, as well as available clinical resources and compliance with best practices.
Learn more about Best Children's Hospitals rankings.
CHOC Children's Neuroscience InstituteCHOC Children's Orthopaedic Institutediabetes & endocrinologyhyundai cancer instituteneonatologyPulmonologyurologyUS News & World Report
News, Our Experts
CHOC AYA Oncology Team to Present at International Conference
December 1, 2017 CHOC Children's
A team of CHOC Children's staff members will offer two poster presentations at an upcoming international meeting of health care professionals who work with adolescent and young adult (AYA) patients with cancer.
The team involved in CHOC's AYA Treatment Program will provide insight at the second annual Global Adolescent and Young Adult Cancer Congress into two topics: building the ideal AYA program and implementing an AYA retreat and education curriculum.
Designing, implementing a program
The first poster presentation, "Building the Ideal Adolescent and Young Adult (AYA) Program Model to Empower AYA Cancer Patients to Succeed, Lead and Thrive," is authored by Sharon Bergeron, RN, BSN, CPON; Kara Noskoff, BS, CCLS; and Nadia Torres-Eaton, PsyD.
The presentation details CHOC's efforts to establish a community where AYA patients with cancer can find support and assistance in developing leadership, life and survivorship skills. The program is designed to meet the psychosocial needs of a unique patient population.
Among other features, the program includes monthly empowerment activities, an inpatient fitness program and a leadership team. As a result, CHOC found a decrease in social isolation commonly reported by these patients, as well as a confidence boost and increased passion to embrace their experiences and advocate for their peers.
Investing in emerging AYA leaders
Also authored by Bergeron, Noskoff and Dr. Torres-Eaton, as well as Matthew Cawthon, RN, BSN; Danielle Mucker, RN, BSN; Karlie Allen, MS, CCLS; and Eric Mammen, MT-BC, the second poster presentation is "Implementing an Adolescent and Young Adult Mentor Retreat and Education Curriculum: Wise Investment for Emerging AYA Patient Leaders."
Building upon efforts described in the first poster, the second presentation will detail how the AYA program cultivated emerging leaders among the patient participants by designing and implementing a weekend mentor retreat. During the event, participants learned mentorship skills, as well as specific knowledge about AYA cancer diseases.
As feedback, retreat attendees said the event was empowering and provided them with the essential knowledge to grow as leaders. They also noted increased confidence in meeting new patients with differing experiences and diagnoses.
Themed "Working Together-Achieving More," the Global Adolescent and Young Adult Cancer Congress will be held Dec. 5 through 7 in Atlanta.
Learn more about CHOC Children's AYA Treatment Program.
AYAcancerhyundai cancer institute
Two Oncologists with Special Interest in Immunotherapy Join Hyundai Cancer Institute at CHOC Children's
February 3, 2017 CHOC Children's
The Hyundai Cancer Institute at CHOC Children's has added two oncologists, Dr. Josephine HaDuong and Dr. Ashley Plant, to its team of nationally recognized specialists. Both physicians were fellowship trained at two of the country's top cancer programs, and share research interest in immunotherapy and targeted therapies.
Dr. Josephine HaDuong and Dr. Ashley Plant
Dr. Josephine HaDuong
Board-certified in pediatric hematology and oncology, Dr. HaDuong was drawn to the Cancer Institute for what she refers to as its gold standard of care. "The Hyundai Cancer Institute is a growing center that strives to be among the best. The team provides patients access to cutting-edge clinical trials that may lead to breakthroughs in pediatric cancer," says Dr. HaDuong.
A published author and principal investigator in a number of studies, Dr. HaDuong's major research activities include exploring developmental therapeutics in solid tumors using immunomodulatory and targeted agents, as well as functional imaging in bone and soft tissue sarcomas using magnetic resonance spectroscopy. Her research is driven, in large part, by her clinical interest in caring for patients with solid tumors.
Following medical school at the University of Pittsburgh, where she earned a full tuition merit scholarship, Dr. HaDuong completed her residency and pediatric hematology/oncology fellowship training at Children's Hospital Los Angeles. She was honored with the Fellow of the Year, Excellence in Teaching Award.
Dr. HaDuong is a member of numerous professional associations, including American Society of Clinical Oncology, American Society of Pediatric Hematology and Oncology, and North American Consortium for Histiocytosis. In addition to English, she speaks Spanish and Vietnamese.
Raised in Orange County, Dr. HaDuong is thrilled to be back in her hometown. "I have always wanted to return home to serve the children and families in Orange County. I look forward to being a part of an incredible team who works relentlessly to end cancer," explains Dr. HaDuong.
Dr. Ashley Plant
Committed to growing CHOC's neuro-oncology treatment program, Dr. Plant is eager to bring new and exciting therapies to patients with brain tumors. "I look forward to collaborating with academia and industry to bring early clinical trials to CHOC, especially in the area of immunotherapy. I am also excited to partner with my new colleagues to advance the work the Cancer Institute has been doing to reduce the long-term toxicities of cancer therapy," says Dr. Plant.
A published author, Dr. Plant's research interests include early phase clinical trial design for pediatric brain tumors. Her most recent project is a phase 1 clinical trial for a neo-antigen heat shock protein vaccine for diffuse intrinsic pontine glioma, a fatal brain tumor. She hopes to enroll patients in this trial within the next year. She considers herself fortunate to have worked under world-renowned immuno-oncologists Dr. Glenn Dranoff and Dr. Jerome Ritz at Dana Farber Cancer Institute in Boston. There, she won the Young Investigator Award for a project evaluating clonality of T cell receptors in pediatric gliomas.
Following medical school at Stanford University, Dr. Plant finished her residency at University of California, Los Angeles. Her fellowship training in pediatric hematology/oncology was completed at Boston Children's Hospital. She received additional training in clinical trials and public health at Harvard Chan School of Public Health.
"I was attracted to CHOC because the hospital prioritizes excellent clinical care of patients above all else," says Dr. Plant. "The hospital's commitment to patient-and-family-centered care is something I wholeheartedly support. Cancer affects everyone in the family – physically, emotionally, psychologically and sometimes even financially. If we fail to address these issues, we are not completely caring for our patients and their families."
ashley-s-plant-mdcancerDr. Ashley PlantDr. Josephine HaDuonghyundai cancer institutejosephine-haduong-md
What CHOC Physicians are Grateful for this Thanksgiving
November 21, 2016 CHOC Children's
As Thanksgiving approaches, CHOC Children's physicians explain what they'll consider when giving thanks this holiday.
"CHOC has provided me with lifel ong blessings. I am grateful to have grown up at and with this hospital, from the initial CHOC Tower to the current Bill Holmes Tower, through pediatric residency training and beyond. To now be a member of such a remarkable team of providers — including our nurses and support staff — is both humbling and inspiring. Every day, I am especially thankful for the families who cross our threshold, and entrust the care of their most precious children to us. With continued commitment and dedication toward the health and well-being of our children, the future will be brighter than any of us can imagine."
– Dr. Neda Zadeh, genetics
"I am thankful to be working for an organization that creates an environment where our patients become our family. I am also grateful that CHOC Children's has the foresight to invest in the innovative ideas we have to improve the health care we provide."
– Dr. Kenneth Grant, gastroenterology
"I am thankful for the opportunity with be partnered with an excellent children's hospital. I am also thankful for the pleasure of working with other positive people who provide outstanding care to the children of Orange County. Together, we work to improve the care and services we deliver to our most important resource — our children."
– Dr. Daniel Mackey, pediatrics
"I am grateful for the incredible team we have in oncology, inlcuding doctors, nurse practitioners, physician assistants, nurses, the research team, members of ancillary services, our inpatient, clinic and OPI staff, administrative support, and other subspecialists, who all have great minds and compassionate hearts, and walk the difficult cancer journey with our patients and their families. I am humbled to be with such great company here at CHOC, who care deeply for children."
– Dr. Lilibeth Torno, oncology
"I am most grateful to the people behind the scenes at the hospital who do all the invisible jobs that are so important to keep CHOC Children's running: the housekeepers, lab and x-ray technologists, bio-medical engineers, pharmacy technicians, scrub technicians, security guards and maintenance staff that work tirelessly, 24-hours a day."
– Dr. Gary Goodman, critical care
"I am most thankful for the ability to practice alongside of the caring and professional staff and physicians at CHOC, who all share the common goal of caring for children. Working together, we are able to tackle incredibly complex and varied problems that present in the amazingly diverse population of children that we serve."
– Dr. William Loudon, neurosurgery
"I am thank ful for so many things here at CHOC. I feel truly blessed every day to have found a professional community of like-minded caregivers who share a passion and dedication for continued improvement in the care we provide. I am also so grateful for the opportunity to meet and care for such incredibly courageous patients and to become a part of their families. Finally, I am thankful to my teams within the pulmonary division, the Cystic Fibrosis Center and the muscular dystrophy clinics for their selfless care of our patients. I wish our entire community a healthy and happy holiday season."
– Dr. Amy Harrison, pulmonology
"I'm thankful for the opportunity to serve my patients and families, and to help them secure bright futures through CHOC's world-class care. I am also so grateful to work among a team that is steadfastly committed to the health and well-being of children in our community and beyond. "
– Dr. Mary Zupanc, neurology
"I am thankful for the platform CHOC has given us to provide service to a community that inspires me daily. I am humbled to just be part of it all."
– Dr. Afshin Aminian, orthopaedics
afshin-aminian-mdamy-harrison-mdcritical caredaniel-mackey-mdDr. Afshin AminianDr. Amy HarrisonDr. Daniel MackeyDr. Gary GoodmanDr. Kenneth GrantDr. Lilibeth TornoDr. Mary ZupancDr. Neda ZadehDr. William Loudongary-goodman-mdgastroenterologygeneticshyundai cancer institutekenneth-grant-mdlilibeth-torno-mdmary-zupanc-mdneda-zadeh-mdneurologyneurosurgeryorthopaedicspediatric intensive care unitPulmonologyThanksgivingwilliam-loudon-md-phd
Domnic Fernandez Joins CHOC as Director, Hyundai Cancer Institute
September 30, 2016 CHOC Children's
Domnic Fernandez has been named director of the Hyundai Cancer Institute at CHOC Children's. Working closely with hospital and physician leaders, he is responsible for advancing CHOC's position as a leading destination for innovative pediatric and adolescent cancer treatments.
"The Hyundai Cancer Institute at CHOC has a stellar reputation, including being ranked a top pediatric cancer program by U.S. News & World Report. Its physicians, researchers and staff are dedicated to changing the future of cancer treatments: finding a cure and securing meaningful survivorship for our patients. I am honored to be a part of this team, and look forward to helping continue to secure the brightest and healthiest futures for children," said Domnic.
Fernandez joins CHOC from Adventist Healthcare, where he served as a vice president overseeing outpatient practices at four regional hospitals. Service lines under his purview included primary care, urgent care, pediatrics, endocrinology, cardiology, oncology, orthopedics, neurology, electrophysiology and obstetrics/gynecology. In addition to improving productivity and increasing referrals, he created a patient experience team that helped increase patient satisfaction scores by 22 percent.
Previously, Fernandez has worked in a variety of leadership positions at hospitals in Virginia and Minnesota. His healthcare experience includes practice management, strategic planning, business development, revenue cycle management, physician and patient satisfaction initiatives, regulatory compliance, clinical outcomes and continuous process improvements, and marketing. In addition to launching new clinics and managing practice acquisitions, he's assumed responsibility for several electronic health record (EHR) go lives and optimizations.
After earning his bachelor's degree in physical therapy, Fernandez completed the master's in health care administration program at St. Xavier University in Chicago. He is a member of the Medical Group Management Association and American College of Medical Practice Executives.
"The Hyundai Cancer Institute is a gem in our community, and I look forward to working with our subspecialists and referring community physicians to ensure children get the excellent care they need close to home," stated Domnic.
Domnic can be reached at dfernandez@choc.org.
cancerhyundai cancer institutereferralsstaff stories


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# Done Deal
Juventus complete €75m signing of Vlahovic from Fiorentina
The Serbian striker has signed a contract until 2026 to join the Turin giants.
Updated Jan 28th 2022, 7:35 PM
LAST UPDATE | Jan 28th 2022, 7:35 PM
Alamy Stock Photo Serbian international Dusan Vlahovic. Alamy Stock Photo
DUSAN VLAHOVIC HAS completed his £63million (€75.6m) move from Fiorentina to Juventus.
The Serbia striker has signed a contract until 2026 to join the Turin giants, completing his switch on his 22nd birthday.
Vlahovic has hit 17 goals in 21 Serie A appearances this term and had been a reported target for both Arsenal and Tottenham.
Juventus branded Vlahovic "a force of nature" in a lengthy statement hailing the high-profile signing.
Fiorentina had precious little option but to sell Vlahovic in order to realise a big fee for their most prized asset, given he had 18 months to run on his existing contract with the club.
"Vlahovic has coldness in front of goal, technique, quality and power," read the Juventus statement.
𝗤𝗨𝗜, 𝗔𝗗𝗘𝗦𝗦𝗢, #𝗗𝗩𝟳! 🔥✅
— JuventusFC (@juventusfc) January 28, 2022
"From 2020/2021, Vlahovic is the footballer who has scored the most goals in Serie A, 38, one more than Immobile and at least 10 more than all the other strikers who still play in our league.
"With 44 goals he is also one of only two footballers born since 2000 to have scored at least 40 goals in the top 5 European leagues, alongside Erling Haaland."
SERIE A DONE DEAL DUSAN VLAHOVIC MEDICAL NEARLY THERE FIORENTINA JUVENTUS TURIN
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Email "Juventus complete €75m signing of Vlahovic from Fiorentina".
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Jimmy Fallon hosted Saturday Night Live on Saturday, December 21, 2013 with musical guest Justin Timberlake. During the musical sketch "(Do It On My) Twin Bed," Jimmy and the ladies of Saturday Night Live sang about hooking up on their childhood twin bed while staying with family during the holidays.
When you're home for the holidays, sometimes you've got to get busy on your childhood twin bed.


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Flipped Classroom Combined With Case-based Learning Is an Effective Teaching Modality in Nephrology Clerkship
Fuye Yang, Wanbing Lin, Yan Wang
posted 07 Jan, 2021
Both flipped classroom (FC) and case-based learning (CBL) are recognized as new effective teaching approaches by emphasizing on different aspects of teaching activities; however, the implementation of FC combined with CBL has not been well explored in nephrology education. The present study aims to investigate the efficacy of FC combined with CBL in teaching nephrology via comparing with the traditional lecture-based teaching (LBT).
Sixty-two medical clerkship students at Zhejiang University School of Medicine were equally allocated into either LBT or FC group demographically matched. The glomerular diseases module was chosen for the teaching content. Students from the FC group were required to study the pre-class materials in annotated PPT format before the face-to face discussion on the relevant cases during the class. Students from the LBT group attended a didactic lecture during the class. Quiz and questionnaires were performed to assess the efficacy of FC.
Participants from the FC group performed better than those from the LBT group in the quiz with higher scores in the case analysis-related questions. FC was also considered more helpful than LBT in improving high order cognitive abilities in the survey. Meanwhile, more participants agreed increased in-class pressure in FC than in LBT.
This study shows the positive impact of FC combined with CBL approach on nephrology education and provides an alternative pre-class and in-class format for the FC implementation.
Educational Philosophy and Theory
Traditional lecture-based teaching
Chronic kidney disease is a globally major health care problem with the prevalence growing, especially in the elder population, and causes an increased demand for nephrologists[1,2]. Despite an apparent demand, interest in nephrology as a career choice has decreased as shown from the published data that have documented a decline in the number of medical graduates pursuing nephrology fellowships. Nephrology is widely viewed as a more highly specialized field focusing on rare and severe diseases as compared to other medical branches and not treated as a preferable choice [3,4] Teaching nephrology is also a demanding, complex and often frustrating task. Evidence have shown endeavors in teaching could enhance learning and interest in nephrology [5,6]. However, innovation and research in nephrology education are lacking and the literature of best teaching practices pertinent to nephrology education is very scarce [7].
Flipped classroom (FP), which represents an ongoing paradigmatic shift in education from teacher-centered passive instructional strategies to student-centered active learning strategies, is growing in popularity in medical education [8-12].FP reverses the traditional educational framework of lecture-based teaching (LBT), where the students are given faculty-provided instructional content to review outside the classroom and take part in active learning under faculty guidance based on their preparatory work in the classroom with the goal of facilitating higher order learning of the material. Literature has reported that FP has been incorporated into several various health sciences education including pharmacology, radiology, emergency medicine, dermatology, physiology and other subjects in the past decades [11-15]. FC approach has also been extended to the medical clerkship and pre-vocational training with encouraging outcomes [16-20]. Studies have demonstrated that the use of FC improves board scores, increase resident satisfaction and enhance the self-perceived competence of the material [21,22]. However, the implementation of FC in nephrology education has not been well explored. The aim of this study was to evaluate the students' learning outcomes and enjoyment of the pedagogies between traditional LBT and FP in nephrology clerkship.
A total of 62 fourth-year medical students majoring in clinical medicine at Zhejiang University School of Medicine were enrolled at the Second Affiliated Hospital of Zhejiang University School of Medicine. They had attended all the nephrology lessons provided in by the same instructors. These participants were allocated into either FC (n = 31) group or LBT (n = 31) group with gender matched (Table 1). The research was approved by the Institutional Review Board and Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine.
Table 1. Demographic information of participants in the study.
Number of participants (percentage)
FC (n=31)
LBT (n=31)
FC: flipped classroom group; LBT: lecture-based teaching group
We chose the module of glomerular diseases to apply the teaching approaches in this study for two reasons. First, the glomerular diseases are among the leading causes of end stage renal diseases, which is one of the most important modules in nephrology teaching. Second, they share similar symptoms and signs but possess differential pathogenesis and pathological patterns, which is complicated and energy-spending for students to understand and master.
The study was carried out following the flowchart as demonstrated in Figure 1. Briefly, FC proceeded as follows: participants were provided with instructor-generated lecture notes in annotated PPT format and required to view the materials on his/her own time one week before the class. The class session started with a brief introduction of the topic, learning objectives and class agenda by the instructor. An active learning format is utilized where students encountered the real clinical cases and were challenged to take turns interpreting and discussing the cases which are representative of the glomerular diseases covered in the preassigned reading materials. The attending nephrologist provided guidance and feedback as the students interpreted the representative cases, pointing out characteristic and atypical findings for each case as well as providing clinical correlation. Finally, the instructor made the summary for the class and went over the tough questions raised by students during discussions. LBT run as follows: participants were encouraged to preview the related textbook or reference materials prior to the class and then attended a didactic lecture followed by a question-and-answer session which was aligned with the same learning objectives as those in FC group.
Data evaluation and statistical analysis
To evaluate the learning outcomes, students were required to complete a post-class quiz related with the glomerular diseases when they had finished the study of this module. All items in the quiz were A2-type questions aiming to evaluate both basic theoretical knowledge and clinical case analysis ability based on the Bloom's Taxonomy of cognitive activities with "remember" and "understand" categories collapsed into "basic theoretical knowledge" and items in any of the other categories considered "clinical case analysis" [23,24]. The scores were calculated and compared between the two groups by an independent samples t-test.
The participants from both groups were also required to complete a questionnaire with questions on their perception of and experience with the teaching models (items covering both positive and negative aspects) as well as their self-evaluations using a three-point Likert-type scale (−1, disagree; 0, neutral; 1, agree). The questionnaire was modified from Paul Ramsden's Course Experience Questionnaire and Biggs' Study Process questionnaire with verified reliability and validity [25-27].
All methods were carried out in accordance with relevant guidelines and regulations.
Students' performance in the post-class quiz
A total of 62 students were enrolled in the study, including 31 students assigned to the FC group and 31 students assigned to the LBT group. The gender for the two groups are matched (Table 1.). The class attendance rates of both groups were 100%. The efficacy of teaching modalities on the students' performance were assessed by the post-class quiz which was conducted when the study of the glomerular disease module was finished. The data showed that students in FC group had higher average scores than those in LBT group (78.06±2.515 vs. 65.16±3.209, 95% CI: 4.748 to 21.06, p=0.0024). Further analysis revealed that there was no difference in scores related with basic theoretical knowledge between the two groups (42.26±1.518 vs. 37.74±2.006, 95% CI: -0.5152 to 9.54, p=0.0776), while higher score regarding with the clinical analysis ability was observed in the FC group than the traditional LBT group (35.81±1.657 vs. 27.42±1.910, 95% CI: 3.328 to 13.45, p=0.0016) (Figure 2). These findings suggested that both LBT and FC were suitable for the delivery of basic theoretical knowledge, but in case of training for the higher level of cognitive abilities, FC presented greater advantages than LBT.
Students' self-perceived competence and satisfaction survey
Next, students' self-perceived competence was compared after taking the FC and LBT classes respectively. The response rates for the questionnaire of both groups were 100%. As shown in Figure 3, more students agreed that the FC could help improve their abilities of comprehension (p=0.0245), critical thinking (p=0.0014) and patient management (p=0.0007) compared with the LBT, while there was no difference in learning fundamental knowledge (p=0.0765) between two groups. This was consistent with the students' performance in the quiz where students from the FC group performed better in high order cognitive abilities than those from the LBT group. Meanwhile, more students agreed that the FC could benefit their teamwork (p=0.0117). These positive perspectives produced a higher rate of satisfaction with FC than LBT (p=0.0142). In contrast, more in-class pressure was considered by students from the FC group than LBT group (p=0.0054). Although pre-class study is the critical component for FC, there was no significant difference in the students' opinion about the pre-class workload (p=0.1835) (Figure 3).
The interest in nephrology fades and the need for nephrology care and insights into the functioning of the kidney grows make us a must to prepare our medical students to practice quality clinical care and undertake research to understand renal physiology and pathophysiology in future [1-4]. Effective and enthusiastic teaching in medical school and residency is a first step in this direction [5-7].In the present study, we implemented FC in clerkship students and compared the students' perspectives and performance with those experienced LBT teaching modality, which was a novel attempt and provided insights for teaching of other modules in nephrology.
We demonstrated that FC was more effective in terms of culturing high levels of cognitive abilities compared with LBT. This effectiveness of FC may be attributed to several aspects during the preparation and implementation of the course [9,10]. In the pre-class session, FC provides self-paced pre-class learning and students can use their time more efficiently. During the class, FC emphasizes on the high levels of cognitive abilities by encouraging students to utilize what they have learned to solve the more complex problems. This output process is involved in not only the knowledge and comprehension but also the ability of application, analysis and synthesis. Thus, FC offers a sequential and gradual learning process which bridges the gap between pre-class learning of foundational knowledge and in-class training of application and problem-solving abilities [9,10]. Consistent with previous studies in other subjects, our findings have also demonstrated that the FC approach improves students' learning performance in nephrology clerkship [12,13,18,20]. Meanwhile, students in the FC group felt more confident in their teamwork than those in the LBT group. These findings should be particularly encouraging to educators to consider applying the FC model to other nephrology modules since it is evidently effective in improving the wide-spectrum cognitive abilities of students.
Interestingly, although participants in FC group performed better as a whole, some of them gave negative feedback about the in-class pressure. This negative feedback might be partly attributed to the learner's reluctance to change when a new teaching modality is introduced. The FC model is characterized by the student-centered, active learning, which can be challenging to students who are accustomed to the passive learning in medical school. The requirement of active involvement in the in-class presentation and discussion was considered an extra burden by these students. The burden and pressure may thus compromise the satisfaction with the course. Therefore, a few points should be taken into accounted when FC is considered to be implemented [28,29]. First, start FC with a clear definition of learning objectives and ensure that all activities are aligned to achieve the desired objectives by providing the framework for the pre-class workload and straightforward leaning objectives during the class. Second, optimized the pre-class workload that is suitable for students using the FC approach. There is no conclusive suggestion yet from previous literature on what the pre-class workload should be. Future studies may be warranted in order to optimize the time dedicated to the flipped classroom approach. Third, create a friendly and comfortable atmosphere in the class which is critical to encourage students to express themselves during learning process.
There is a limitation in this study. We did not extend the study to the after-class work but just focused on pre-class and in-class activities, while after-class activities help in reinforcing and optimizing the prior learning with ongoing practice. Complexity, spacing, and time constraints are critical factors influencing the implementation of after-class work, which can be achieved in a structured way through additional programs.
In summary, FC combined with CBL represents an effective and flexible approach in medicine education and can be tailored to meet the various education situations. Further studies with elaborated design to optimize FC in terms of specific subjects, student's workload, optimal strategies and the evaluation system could help further advance the impact and effectiveness of FC.
FC: flipped classroom; LBT: lecture-based teaching.
F Yang designed the study, conducted the teaching activities and drafted the manuscript; W Lin coordinated with the students, facilitated with the teaching activities and analyzed the questionnaire and the post-class quiz. Y Wang edited and revised the manuscript. All authors contributed to the critical revision of the paper and approved the final manuscript for publication.
This work was supported by the Zhejiang University School of Medicine under Grant yxyb20172018.
The related materials including the teaching materials, forms, quiz and questionnaire are kept in hard and/or soft copies in the Department of Nephrology Zhejiang University School of Medicine Second Affiliated Hospital. The datasets generated during and analysed during the current study are available from the corresponding author on reasonable request.
This study was waived for the ethics approval by the Institutional Review board and Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine. The informed consent was obtained from all subjects as students have participated in the study.
Consent to publish
The authors report no declarations of interest.
Fuye Yang, Department of Nephrology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Wanbing Lin, Department of Nephrology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Yan Wang, College of Life Science, Xinyang Normal University, Xinyang, Henan, China.
Glassock RJ, Warnock DG, Delanaye P. The global burden of chronic kidney disease: estimates, variability and pitfalls. Nat Rev Nephrol. 2017;13:104-14.
Yang C, Wang H, Zhao X, Matsushita K, Coresh J, Zhang L, Zhao MH. 2020. CKD in China: Evolving Spectrum and Public Health Implications. Am J Kidney Dis. 76(2):258-64.
Jhaveri KD, Sparks MA, Shah HH, Khan S, Chawla A, Desai T, Iglesia E, Ferris M, Parker MG, Kohan DE. Why not nephrology? A survey of US internal medicine subspecialty fellows. Am J Kidney Dis. 2013;61:540–6.
Roberts JK, Sparks MA, Lehrich RW. Medical student attitudes toward kidney physiology and nephrology: a qualitative study. Renal Failure. 2016;38:1683-93.
Jhaveri KD, Sparks MA, Shah HH. Novel educational approaches to enhance learning and interest in nephrology. Adv Chronic Kidney. 2013;20:336–46.
Rondon-Berrios H, Johnston JR. Applying effective teaching and learning techniques to nephrology education. Clin Kidney J. 2016;9:755-62.
Bayefsky SD, Shah HH, Jhaveri KD. Nephrology education for medical students: a narrative review. Renal Failure. 2016;38:1151-9.
Prober CG, Heath C. Lecture halls without lectures–a proposal for medical education. N Engl J Med. 2012;366:1657–9.
Tucker B. 2012. The flipped classroom. Educ Next. 12(1):82–3.
Tolks D, Schafer C, Raupach T, Kruse L, Sarikas A, Gerhardt-Szep S, et al. An introduction to the inverted/flipped classroom model in education and advanced training in medicine and in the healthcare professions. GMS J Med Educ. 2016;33:Doc46.
Persky AM, Mclaughlin JE. The Flipped Classroom - From Theory to Practice in Health Professional Education. Am J Pharm Educ. 2017;81:118.
Ge L, Chen Y, Yan C, Chen Z, Liu J. Effectiveness of flipped classroom vs traditional lectures in radiology education: A meta-analysis. Medicine (Baltimore). 2020;99:e22430.
Tune JD, Sturek M, Basile DP. Flipped classroom model improves graduate student performance in cardiovascular, respiratory, and renal physiology. Adv Physiol Educ. 2013;37(4):316–20.
Tan E, Brainard A, Larkin GL. Acceptability of the flipped classroom approach for in-house teaching in emergency medicine. 2015;27:453-9.
Liu KJ, Tkachenko E, Waldman A, Boskovski MT, Hartman RI, Levin AA, et al. A video-based, flipped classroom, simulation curriculum for dermatologic surgery: A prospective, multi-institution study. J Am Acad Dermatol. 2019;81:1271-6.
Park SE, Howell TH. Implementation of a flipped classroom educational model in a predoctoral dental course. J Dent Educ. 2015;79:563–70.
Lew EK. Creating a contemporary clerkship curriculum: the flipped classroom model in emergency medicine. Int J Emerg Med. 2016;9:25.
Bonnes SL, Ratelle JT, Halvorsen AJ, Carter KJ, Hafdahl LT, Wang AT, Mandrekar JN, Oxentenko AS, Beckman TJ, Wittich CM. Flipping the Quality Improvement Classroom in Residency Education. cad Med. 2017;92:101-7.
Lucardie AT, Berkenbosch L, van den Berg J, Busari JO. Flipping the classroom to teach Millennial residents medical leadership: a proof of concept. Adv Med Educ Pract. 2017;8:57-61.
Tang F, Chen C, Zhu Y, Zuo C, Zhong Y, Wang N, et al. Comparison between flipped classroom and lecture-based classroom in ophthalmology clerkship. Medical Education Online. 2017;22:1395679.
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Roadtests
HomeRoadtests 2017 July SEAT Ibiza SE 1.0TSI 95PS 5sp manual
SEAT Ibiza SE 1.0TSI 95PS 5sp manual 24 | 07 | 2017Scotcars rating
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New Spanish supermini gunning for young generation, but does Ibiza have wider appeal?
NOT THAT I want to big-up the significance of the new fifth-generation Seat Ibiza, but this is an important car; not just for Seat, but for the VW Group.
In many ways, the new Ibiza is crucial to the future growth of Seat, as it's the car the manufacturer — with its proud Spanish origins — is using to target a young audience. And it's those young customers who, Seat hopes, will continue to drive the firm's already-positive financial turnaround.
Of equal significance — and highlighting the importance of Seat to the VW Group — is the fact the new Ibiza is the first to use Volkswagen's new MQB-A0 platform. Why is that important? The platform is the same which will underpin the new-generation VW Polo/Audi A1/Skoda Fabia. It'll also spawn a host of small SUVs, including the forthcoming Seat Arona.
Throw in the fact the Ibiza has sold more than 5.4 million units since it was first launched in 1984 and, that for the first time in its history, in March this year the UK was Seat's largest export market, this launch is crucial.
So, the new Seat Ibiza is, without question, a big deal.
It will come as no surprise to you, given the fact it's intended to appeal to the younger generation, that connectivity plays a big part in the latest Ibiza. FR and Xcellence models get DAB radio and a large 8in glass touchscreen to control Apple CarPlay, Android Auto and Mirror Link. And if that's not enough, a powerful seven-speaker Beats audio system is available across all trim levels as an option.
There are four spec levels at launch: S, SE, the sporty FR and more luxurious Xcellence. Seat are remaining tightlipped on a Cupra version, but don't rule it out.
Engines? At launch there's three petrols. All are three-cylinder, 1.0-litre units with 74bhp, or turbocharged TSI versions delivering 94 or 113bhp. The smaller engine makes do with a five-speed manual, while the larger 113bhp unit get a six-speed. A DSG auto will arrive later this year.
Also arriving before the end of 2017 is a new 1.5-litre, four-cylinder, 148bhp petrol, plus a range of 1.6-litre turbo diesels.
Prices start at £13,130 for the 74bhp 1.0S and rise to £17,310 for the 95bhp 1.0TSI Excellence. We're focusing on the 94bhp 1.0TSI which Seat believe will be the big seller in Scotland, with prices starting at £14,595 in SE trim.
The new Ibiza is definitely something of a looker. Seat's design chief Alejandro Mesonero is a lover of triangles — he believes they suggest motion and direction — so you'll spot them in the full-LED headlights, the door mirrors, the tail-lights, the interior door handles, the door-pocket openings and even the speaker grilles.
Externally there are a lot of clean, sharp, crisp edges, and they combine to give the Ibiza a strong, positive stance which certainly makes it stand out from the crowd of rival superminis. Though, such has been its growth in its maturity, that Seat now sees the Ibiza more akin to a family car.
And cleverly, despite being 2mm shorter than the previous Ibiza, there's a feeling of much more space in the cabin; a fact confirmed when you learn the new model is a not insignificant 87mm wider than its predecessor, and the wheelbase has been stretched by 95mm to 2654mm.
Worth highlighting, it's also available only as a five-door, with the previous three-door variants being jettisoned.
The crisp, stylised lines of the exterior are continued into the cabin where the bold dashboard — which incorporates the screen — manages to deliver easy access to those everyday driving functions other manufactures hide behind layers of impenetrable menus.
And don't think the entry price of £13,130 equates to plasticky-feel surfaces and rattles: right across the range panels and other components fit tightly, leaving the driver and occupants sensing how well everything has been put together. Thanks to the new MQB platform, the latest Ibiza also enjoys a near-30% increase in torsional stiffness.
Ok, some might question the slightly harder surfaces where your fingertips might expect a higher degree of soft-touch luxury, but there are times when it pays to 'get real'.
There's plenty of room in the cabin, with even enough space in the rear for three adults, who can all enjoy the 35mm of extra legroom. As for bootspace, it's grown by 63-litres to 355-litres.
What's also noticeable in the cabin is the increase in quietness: clearly there's been some serious attention paid to reducing the level of noise which seeps intothe interior of the latest Ibiza.
Having previously driven the non-turbo 74bhp 1.0, it's instantly noticeable how the larger 94bhp 1.0TSI delivers a more enjoyable zip thanks to its turbocharging. Remember, this is still a three-cylinder 1.0-litre, but it was equally capable and at ease coping with the nose-to-tail city centre traffic in Liverpool, as it was hustling across a bleak North Wales landscape.
Interestingly, and one slight downside of the new-found quietness in the cabin, is that while the Ibiza cruised effortlessly at the legal maximum on the motorway, the tyres did produce just a gently intrusive hum. But that's becoming more noticeable on a growing number of cars, and is certainly tyre-dependant.
It does nothing though to take away from the fact the latest Ibiza is an extremely polished car which has benefitted from the r&d might of the giant VW Group.
It is though in an extremely tough sector of the market, and while it is a far more attractive proposition than the likes of the Nissan Micra or Citroen C3, it does face stiff competition from the new Ford Fiesta and VW Polo.
That said, if you're in the market for a supermini/small family car, and you want to stand out from the crowd in a car which combines refinement, clever technology, fun driving dynamics and is handsome on the road, make sure you test drive the new Seat Ibiza before you make your decision.
Related: New Ford Fiesta lands in the UK
Keep up-to-date with all the latest news by following us on twitter.com/Scotcars
Jim McGill
Price OTR/As Tested
£14,595 / £16,945
Engine / Power:
3cyl, 999cc, turbocharged, petrol, 5spd maul / 94bhp
How fast?:
0-62mph 10.9sec / Max 120mph
How big/heavy?:
L4059mm W1942mm (incl mirrors) H1444mm / 1140kg
How thirsty/CO2?:
60.1mpg / 106g/km CO2
InsGP/Road tax:
11E / Band F
New Ford Fiesta & VW Polo, plus Nissan Micra, Citroen C3
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It looks like lots of gamers are enjoying Apex Legends. Respawn Entertainment's battle royale managed to break the 50 million players mark over the weekend.
Part of what makes Apex Legends exciting is that we're only at the starting lap. There are more unique moments, possible new modes, and legends to be revealed. One of those happens to be Octane. The hero was leaked recently by a source who claimed to have taken a picture while someone in the studio was working on it. And the player base has gone ga-ga while waiting for official news.
He's got a passive that lets him heal when not taking damage. He's also got a tactical skill that increases movement and prevents slowing effects at the cost of health. Octane's ultimate skill might be something that provides some hilarious fun since it'll let your squad hop great distances by way of a launch pad. Trampoline-based assaults, anyone?
Another leak from user HansLandaBlackout shares the names of new heroes that might be added in Apex Legends. The existing characters are listed, and Octane's there are well. There's also "Crypto," "Husaria," "Jericho," and, well, a template.
Whether you're eagerly anticipating announcements, or just enjoying the ride, Apex Legends has proven that the hype and the buzz are indeed real. The game's continued success and player base growth are indications that it can only get bigger from here.
Humble Monthly March-April 2019: Mutant Year Zero Is Here!