Research suggests thatself-explanation functionality can effectively support learningin the context of digital games. Research also highlights challenges, however,in balancing and integrating the demands and abstraction of self-explanation functionality with the demands and structure of the game. These challenges are particularly true for games that are, themselves, cognitively more complex. The current study presents an approach that adapts the abstraction of self-explanation prompts based on a player's performance. The results demonstrate that students in this condition (a) scored significantly higher on the post-test than students whose selfexplanation prompts were not adaptively adjusted and were always abstract and (b) scored higher, but not significantly so, than students who did not receive the self-explanation functionality. Analyses of gameplay metrics suggest that trade-offs in terms of progress through the game may explain some aspects of these post-test comparisons. Analyses also demonstrate that both self-explanation conditions significantly outperformed the navigation-only comparison conditionon agameplay metric that suggests deeper model-based thinking.

No abstract

No abstract

The aim of the current study is to identify underlying pathology associated with elevated serum alpha-fetoprotein (AFP; >20 ng/ml) among patients referred to a tertiary-care academic medical center with emphasis in liver diseases, hepatobiliary surgery, and liver transplantation. From May 1992 to April 1997, 386 patients (320 adults and 66 children) with elevated AFP (>20 ng/ml) were identified from the Medical Archival System (MARS) database at the University of Pittsburgh Medical Center. The medical records from all these patients were retrospectively reviewed. Radiological, pathological, and biochemical profiles were obtained at the time of documented elevated AFP. These patients included: 218 adults with malignancies, 102 adults without malignancies, 18 children and infants with malignancies, and 48 children and infants without malignancies. Thirty-two percent of adults were found to have raised AFP with liver disease and without hepatocellular carcinoma and 78% had some type of malignancy, predominantly hepatocellular carcinoma. Seventy-three percent of infants and children had elevated AFP without malignancy. Based on our findings, we recommend that all patients (adults, infants and children) with raised AFP of >20 ng/ml should undergo thorough evaluation to rule out malignant disease.

No abstract