Alpha, Beta, Launch: A Newbie\u27s Guide to Educational Video Game Development

This paper details the process we went through to develop an educational video game, which includes: research on implementing video games into the classroom, vendor selection, video game design, and curriculum development. Throughout the video game development process, we faced challenges such as budget, time constraint, and varying areas of expertise. This paper serves as a guideline for similar organizations interested in educational video game development. Play game on desktop or tablet: www.avma.org/videogame Play within browser: https://www.avma.org/KB/K12/videogame/index.htm

Visual outcomes in patients with meningiomas compressing optic nerve

BackgroundMeningiomas compressing the optic nerve can lead to progressive visual loss due to the nerve’s complex intraorbital, intracanalicular, and intracranial anatomy. Although observation, radiation, and surgical decompression are available, optimal strategies for preserving vision remain controversial. This study retrospectively evaluates the impact of surgical intervention on visual recovery in patients with optic nerve–compressing meningiomas to refine patient selection and treatment strategies.MethodsA retrospective review was conducted on medical records from the Neurosurgical Clinic at Olomouc University Hospital for patients undergoing surgical treatment for meningiomas near the optic nerve from 2015 to 2023. Inclusion criteria required high-quality preoperative and postoperative MRI, complete ophthalmic records, and a minimum one-year follow-up. Data on demographics, tumor characteristics (size, location, and relationship with the optic nerve), and visual function (acuity and field) were collected. Tumors were categorized by size and degree of optic nerve involvement, and visual outcomes were assessed pre- and postoperatively.ResultsSeventy-nine patients (66 females, 13 males; mean age 58) met inclusion criteria. A longer duration of visual impairment correlated with more severe preoperative vision loss. Although postoperative visual function did not significantly correlate with tumor size, location, or duration of preoperative symptoms, patients with shorter impairment durations demonstrated better postoperative recovery.ConclusionThe duration of preoperative visual impairment is a critical predictor of visual outcomes, supporting early surgical intervention for optic nerve–compressing meningiomas. While tumor size and location did not directly influence recovery, further investigation into tumor-anatomy relationships is warranted to optimize visual prognosis

Hydrographic Surveys at Seven Chutes and Three Backwaters on the Missouri River in Nebraska, Iowa, and Missouri, 2011-13

The United States Geological Survey (USGS) cooperated with the United States Army Corps of Engineers (USACE), Omaha District, to complete hydrographic surveys of seven chutes and three backwaters on the Missouri River yearly during 2011–13. These chutes and backwaters were constructed by the USACE to increase the amount of available shallow water habitat (SWH) to support threatened and endangered species, as required by the amended “2000 Biological Opinion” on the operation of the Missouri River main-stem reservoir system. Chutes surveyed included Council chute, Plattsmouth chute, Tobacco chute, Upper Hamburg chute, Lower Hamburg chute, Kansas chute, and Deroin chute. Backwaters surveyed included Ponca backwater, Plattsmouth backwater, and Langdon backwater. Hydrographic data from these chute and backwater surveys will aid the USACE to assess the current (2011–13) amount of available SWH, the effects river flow have had on evolving morphology of the chutes and backwaters, and the functionality of the chute and backwater designs. Chutes and backwaters were surveyed from August through November 2011, June through November 2012, and May through October 2013. During the 2011 surveys, high water was present at all sites because of the major flooding on the Missouri River. The hydrographic survey data are published along with this report in comma-separated-values (csv) format with associated metadata.Hydrographic surveys included bathymetric and Real-Time Kinematic Global Navigation Satellite System surveys. Hydrographic data were collected along transects extending across the channel from top of bank to top of bank. Transect segments with water depths greater than 1 meter were surveyed using a single-beam echosounder to measure depth and a differentially corrected global positioning system to measure location. These depth soundings were converted to elevation using water-surface-elevation information collected with a Real-Time Kinematic Global Navigation Satellite System. Transect segments with water depths less than 1 meter were surveyed using Real-Time Kinematic Global Navigation Satellite Systems. Surveyed features included top of bank, toe of bank, edge of water, sand bars, and near-shore areas.Discharge was measured at chute survey sites, in both the main channel of the Missouri River upstream from the chute and the chute. Many chute entrances and control structures were damaged by floodwater during the 2011 Missouri River flood, allowing a larger percentage of the total Missouri River discharge to flow through the chute than originally intended in the chute design. Measured discharge split between the main channel and the chute at most chutes was consistent with effects of the 2011 Missouri River flood damages and a larger percent of the total Missouri River discharge was flowing through the chute than originally intended. The US Army Corps of Engineers repaired many of these chutes in 2012 and 2013, and the resulting hydraulic changes are reflected in the discharge splits

Cortisol evaluation during the acute phase of traumatic brain injury - a prospective study

Background: Biochemical diagnosis of adrenal insufficiency (AI) is difficult in the context of traumatic brain injury (TBI) Aim: to assess the frequency and predictive factors of AI in victims of TBI from Algiers. Methods: Between November 2009 and December 2013, TBI victims had a single 8-9 a.m. serum cortisol measurement during the acute post injury period (0-7 days). AI was defined according to basal cortisol levels of 83, 276 and 414 nmol/L. Variables studied were TBI severity according to Glasgow coma scale, duration of intubation and coma, pupillary status, hypotension, anemia, brain imaging findings, diabetes insipidus and medication. Insulin tolerance test was performed during the recovery phase, defining AI as peak cortisol <500 nmol/L. Results: Cortisol samples were obtained at median 3 (1-7) days from 277 patients (257M: 20F) aged 32 (18-65) years. Acute AI frequency was 8 (2.8%), 20 (21%) and 35 (37%) respectively using the three cortisol cut-offs. Factors predicting AI were diastolic hypotension, sedative medication, diabetes insipidus, skull base fracture and intra-parenchymal haematoma. Mortality was highest in patients with acute cortisol <276nmol/L (44.6% with OR for death 1.64, 95% CI 0.92-3.0, p=0.12). During the recovery phase, AI was present in 3/3, 12/24, 4/16 and 20/66 patients with week 1 cortisol <83, 83-276, 277-414 and >414nmol/L. Conclusion: Hydrocortisone replacement is advised in TBI patients with morning cortisol <276 nmol/L or those <414 nmol/L with additional risk factors for AI. Since acute and subsequent AI are poorly correlated patients with moderate/severe TBI require adrenal re-evaluation during the recovery phase