ind Yes, Colleges Can Rescind Admission Offers. Here's What Educators Need to Know By feedproxy.google.com Published On :: Wed, 19 Jun 2019 00:00:00 +0000 In a recent high-profile case, Harvard College rescinded its offer to a school-shooting survivor after racist comments he’d written online surfaced. But how common is it for colleges to take back offers? And do students have any recourse? Full Article College+and+career
ind Cyberbullying Is on the Rise Among Teenagers, National Survey Finds By blogs.edweek.org Published On :: Mon, 15 Jul 2019 00:00:00 +0000 A growing number of students—especially girls—are experiencing bullying online, according to the latest federal data on bullying and crime in schools. Full Article Bullying
ind Students Who Feel They Belong Are Less Likely to Bully, Study Finds By blogs.edweek.org Published On :: Thu, 15 Aug 2019 00:00:00 +0000 A study of 900 middle schoolers finds that students who report having a sense of belonging both at home and school are less likely to engage in bullying. Full Article Bullying
ind With camps shut, families face summer in the great indoors By feedproxy.google.com Published On :: Tue, 05 May 2020 00:00:00 +0000 Full Article Homeschooling
ind Educators Need Mindfulness. Their Mental Health May Depend On It. By feedproxy.google.com Published On :: Sun, 19 Aug 2018 00:00:00 +0000 The mental health of school counselors, nurses, school leaders, and teachers are at risk, and they may only need 10 minutes to help alleviate their stress. Full Article Health
ind The Baffling Specter of Windows 7 By www.pcmag.com Published On :: Why hasn't every PC user on the planet upgraded to Windows 10 by now? Because Microsoft, as usual, can't communicate to anyone why they should. Full Article
ind Babies as Young as 12 Months Get Nearly an Hour of Screen Time a Day, Study Finds By feedproxy.google.com Published On :: Mon, 02 Dec 2019 00:00:00 +0000 Babies as young as 12 months are exposed to nearly an hour a day of screen time, despite warnings from pediatricians to avoid digital media exposure for children under a year and a half, according to a new analysis. Full Article Earlychildhood
ind Indiana Voucher Bill Close to Becoming Law? By feedproxy.google.com Published On :: Fri, 22 Apr 2011 00:00:00 +0000 Indiana's state Senate has approved a measure that would create access for middle-income families for private-school vouchers. As it stands, it's one of the most ambitious voucher proposals ever offered in the states. Full Article Specific+populations
ind Why Instructional Coaching Matters in Independent Schools By feedproxy.google.com Published On :: Tue, 03 Apr 2018 00:00:00 +0000 While independent schools can feel quite different from their public, charter, and parochial counterparts, the glue that holds all schools together is this noble charge we call teaching. Full Article Specific+populations
ind New 'What Works Clearinghouse' Aims to Help Districts Find Research for ESSA By feedproxy.google.com Published On :: Mon, 12 Sep 2016 00:00:00 +0000 A new version of the federal research site allows users to find research related to specific school populations. Full Article Specific+populations
ind GAO Finds Uneven Landscape of State Rules for Tax-Credit Scholarships By feedproxy.google.com Published On :: Sun, 27 Oct 2019 00:00:00 +0000 Tax-credit scholarship programs in 17 states collected $1.1 billion in contributions in 2017, a new analysis from the GAO finds. Full Article Specific+populations
ind Learning Menus: Giving Options & Independence (Video) By feedproxy.google.com Published On :: Wed, 13 Jul 2016 00:00:00 +0000 Crystal Morey, a 6th grade math teacher at Enumclaw Middle School in Washington, uses learning menus as a differentiation strategy to help students become independent and engaged learners. Full Article Middleschools
ind Cyberbullying On the Rise in U.S. Schools, Federal Report Finds By feedproxy.google.com Published On :: Thu, 25 Jul 2019 00:00:00 +0000 The report found that roughly a third of middle and high schools reported disciplinary problems stemming from cyberbullying at least once a week or daily. Full Article Middleschools
ind 'Walls That Talk' Give Students Tools for Writing Independently (Video) By feedproxy.google.com Published On :: Wed, 26 Sep 2018 00:00:00 +0000 High school teacher Kateryna Haggerty explains how visual aids in her classroom help her English-language learner students write more confidently. Full Article Englishlanguagelearners
ind States' ESSA Plans Fall Short on Educator Equity, NCTQ Analysis Finds By feedproxy.google.com Published On :: Tue, 14 Nov 2017 00:00:00 +0000 More than half of the state plans fail to publicly report data on educator equity gaps, the National Council of Teacher Quality found in its analyses. Full Article Teacherquality
ind The God of India, Singapore and the Middle East By feedproxy.google.com Published On :: Fri, 19 Jul 2019 15:19:15 +0000 Doron's experience on Logos Hope shows him God's faithfulness and uncovers leadership abilities he is using today in a new role. Full Article
ind Schuylkill Speaks: Raquele Amato finds passion for communications at Schuylkill By news.psu.edu Published On :: Wed, 06 May 2020 14:00 -0400 Few students become more engaged in clubs, academics and student life activities than Raquele Amato. A prominent figure on Penn State Schuylkill’s campus, Amato has served as an officer in more than half a dozen student organizations, swept spring awards ceremonies, worked as a resident assistant, and helped her family run their pizza shop in Frackville, Pennsylvania, all while maintaining a full-time course load. Before she closes the book on her time at Penn State Schuylkill, Amato reflected on her time at the campus and considered what’s next. Full Article
ind Santa Claus shows kindness By feedproxy.google.com Published On :: Fri, 04 Jul 2014 11:21:56 +0000 Leung Wai, from Hong Kong, is burned to pray for Japan after dressing as Santa Claus and being warmly greeted by passers-by last December. Full Article
ind Chlamydia Screening Among Young Women: Individual- and Provider-Level Differences in Testing By pediatrics.aappublications.org Published On :: 2011-01-24T04:00:42-08:00 Chlamydia testing among adolescents and young women without symptoms is recommended by the US Preventive Services Task Force, but only approximately one-half of eligible young women presenting for health care are screened appropriately. Our work indicates that providers screen young women for chlamydia differentially according to patient age, race/ethnicity, insurance status, and sexual health history. Biases in chlamydia screening may contribute to higher reported rates of chlamydia among minority and poor young women. (Read the full article) Full Article
ind Bronchoscopic Findings in Children With Chronic Wet Cough By pediatrics.aappublications.org Published On :: 2012-01-09T00:06:35-08:00 Chronic wet cough is a common symptom well recognized by pediatricians. Protracted bacterial bronchitis is defined as more than 4 weeks of wet cough that responds to antibiotic treatment. Diagnosis of protracted bacterial bronchitis is not readily accepted by pediatriciansChildren with chronic wet cough often have bronchitis, which is evident during bronchoscopy. Purulent bronchial secretions suggest the presence of bacterial infection. Children with chronic wet cough frequently have a bacterial infection of the lower airway. (Read the full article) Full Article
ind Multicenter Analysis of Quality Indicators for Children Treated in the Emergency Department for Asthma By pediatrics.aappublications.org Published On :: 2012-01-16T00:06:47-08:00 Studies of the association between process and outcome measures of the quality of acute asthma care for children have been mixed. These studies are limited by small, single-institution settings or by examining the association at the aggregate level.This first multicenter analysis of the process-outcome association in acute asthma care for children revealed no association. Because the validity of process measures depends on association with outcomes, further study is needed before implementing existing process measures as performance metrics. (Read the full article) Full Article
ind Childhood Gender Nonconformity: A Risk Indicator for Childhood Abuse and Posttraumatic Stress in Youth By pediatrics.aappublications.org Published On :: 2012-02-20T00:08:22-08:00 Childhood gender nonconformity has been associated with poorer relationships with parents, but it is unknown if childhood gender nonconformity is associated with childhood abuse or with posttraumatic stress disorder.We identify gender nonconformity before age 11 years as a risk indicator for physical, sexual, and psychological abuse in childhood and lifetime probable posttraumatic stress disorder in youth. (Read the full article) Full Article
ind Interrater Reliability of Clinical Findings in Children With Possible Appendicitis By pediatrics.aappublications.org Published On :: 2012-03-05T00:08:32-08:00 Few studies have examined the reliability of clinical findings in pediatric appendicitis. Clinical prediction rules are most useful if the included variables are reliable across practice settings and practitioners.Among children who present with possible appendicitis, the interrater reliability varied considerably for patient history and physical examination variables. Those variables with the highest degree of reliability may be best suited for inclusion in appendicitis clinical prediction rules. (Read the full article) Full Article
ind Impact of Rotavirus Vaccine on Diarrhea-Associated Disease Burden Among American Indian and Alaska Native Children By pediatrics.aappublications.org Published On :: 2012-03-19T00:07:56-07:00 In the prerotavirus vaccine era, diarrhea-associated hospitalization and outpatient rates among American Indian and Alaska Native children were higher than those among the general US population. Routine rotavirus vaccination has dramatically decreased rotavirus diarrhea burden in the general US population.Decreases in diarrhea-associated hospitalization and outpatient rates among American Indian and Alaska Native children in postvaccine years were observed in all Indian Health Service regions, with declines greater in each subsequent year after vaccine introduction. (Read the full article) Full Article
ind Randomized Trial of Probiotics and Calcium on Diarrhea and Respiratory Tract Infections in Indonesian Children By pediatrics.aappublications.org Published On :: 2012-04-09T00:07:34-07:00 Some but not all randomized trials have shown effects of probiotics on incidence and duration of diarrhea and respiratory tract infections among children in developing countries. Calcium improves resistance to intestinal infections in adults, but efficacy in children is unknown.Lactobacillus reuteri DSM17938 may prevent diarrhea, especially in children with lower nutritional status. Regular calcium milk, alone or with Lactobacillus casei CRL431, did not reduce diarrhea. None of the interventions affected respiratory tract infections in these Indonesian children. (Read the full article) Full Article
ind Effectiveness and Net Cost of Reminder/Recall for Adolescent Immunizations By pediatrics.aappublications.org Published On :: 2012-05-07T00:07:47-07:00 Rates of coverage for recommended vaccinations in adolescents are substantially lower than Healthy People 2010 goals. Reminder/recall is an evidence-based strategy that is proven to increase immunization rates in both adults and young children.This study shows that reminder/recall is effective in increasing adolescent immunization rates. Practices may also benefit financially from conducting reminder/recall in this age group if they are able to generate additional well visits and keep supply costs low. (Read the full article) Full Article
ind A Double-Blind, Placebo-Controlled Trial of Omega-3 Fatty Acids in Tourette's Disorder By pediatrics.aappublications.org Published On :: 2012-05-14T00:07:40-07:00 Omega-3 fatty acids (O3FA) are commonly used as complementary treatments in pediatric psychiatric disorders, including Tourette’s disorder (TD), and are well known to have anti-inflammatory properties. However, no studies to date have examined the effects of O3FA on pediatric TD.This is the first double-blind, placebo-controlled clinical trial of O3FA in pediatric TD. The results indicate that O3FA supplementation may be beneficial in the reduction of tic-related impairment for some children and adolescents with TD, but not tics per se. (Read the full article) Full Article
ind Montelukast for Children With Obstructive Sleep Apnea: A Double-blind, Placebo-Controlled Study By pediatrics.aappublications.org Published On :: 2012-08-06T00:08:24-07:00 Children with obstructive sleep apnea (OSA) are usually treated by surgical removal of their upper airway lymphadenoid tissue. Recently, medications were offered to patients with nonsevere OSA. Montelukast, for this indication, had never been studied in a randomized controlled manner.Montelukast effectively reduced polysomnographic findings, symptoms, and the size of the adenoidal tissue in children with nonsevere OSA. The findings support the potential of a leukotriene modifier as a novel, safe, noninvasive alternative for children with mild to moderate OSA. (Read the full article) Full Article
ind Effect of Honey on Nocturnal Cough and Sleep Quality: A Double-blind, Randomized, Placebo-Controlled Study By pediatrics.aappublications.org Published On :: 2012-08-06T00:08:21-07:00 Honey is recommended as a cough medication by the World Health Organization. To date, the efficacy of this treatment has been shown in 2 studies: one tested only buckwheat honey and the other study was not blinded.In a randomized controlled trial, we compared 3 types of honey versus placebo as a treatment of upper respiratory tract infection–associated cough. These types of honey were superior to placebo in alleviating cough. (Read the full article) Full Article
ind Maternal Multiple Micronutrient Supplements and Child Cognition: A Randomized Trial in Indonesia By pediatrics.aappublications.org Published On :: 2012-08-20T00:07:43-07:00 Micronutrients are essential for brain development during gestation and infancy. Few randomized trials of maternal multiple micronutrient supplementation during pregnancy and postpartum have examined child outcomes beyond the neonatal period or tested which cognitive domains show long-term effects.Children of undernourished mothers given multiple micronutrients performed as well as children of well-nourished mothers in motor and visual attention/spatial ability at age 42 months; children of undernourished mothers given iron/folic acid showed 4- to 5-month delays in these abilities. (Read the full article) Full Article
ind Vaccination Coverage Among American Indian and Alaska Native Children, 2006-2010 By pediatrics.aappublications.org Published On :: 2012-11-19T00:08:02-08:00 Disparities in vaccination coverage between American Indian/Alaska Native and white children previously existed between 2001 and 2004 but were not present in 2005.This study updates a previous study by analyzing data through 2010 and found that these gains have been maintained. (Read the full article) Full Article
ind Theoretical Breast Cancer Induction Risk From Thoracic Spine CT in Female Pediatric Trauma Patients By pediatrics.aappublications.org Published On :: 2012-11-26T05:32:40-08:00 High doses of radiation have been linked to cancer induction in irradiated populations such as atomic bomb survivors. Medical imaging directs significant radiation doses to human tissues. Epidemiological studies have demonstrated that children are more sensitive to radiation than adults.The link between cancer induction from moderate radiation doses such as diagnostic imaging is controversial. This study uses Food and Drug Administration–accepted formulas to calculate theoretical risk of breast cancer induction in female pediatric trauma patients receiving diagnostic imaging of the thoracic spine. (Read the full article) Full Article
ind Physical Activity During School in Urban Minority Kindergarten and First-Grade Students By pediatrics.aappublications.org Published On :: 2012-12-03T00:07:45-08:00 Physical inactivity is one of the major modifiable factors contributing to the growing national epidemic of childhood obesity. There is lack of literature on pedometer-determined physical activity (PA) during the school day in US minority kindergarten and first-grade students.This is the first study to assess school-day PA in US urban minority kindergarten and first-grade students. Higher grade level, participation in physical education class, and outdoor recess were found to be independent predictors of PA. (Read the full article) Full Article
ind Exercise-Induced Wheeze, Urgent Medical Visits, and Neighborhood Asthma Prevalence By pediatrics.aappublications.org Published On :: 2012-12-17T00:07:26-08:00 The prevalence of asthma and associated urgent medical visits vary dramatically across neighborhoods in New York City. Some, but not all, children with asthma wheeze when they exercise.Exercise-induced wheeze was more common for asthmatic children living in neighborhoods with higher versus lower asthma prevalence. Because exercise-induced symptoms indicate a propensity for rapid-onset symptoms, this increased prevalence may contribute to the observed increase in urgent medical visits. (Read the full article) Full Article
ind Computer-Generated Reminders and Quality of Pediatric HIV Care in a Resource-Limited Setting By pediatrics.aappublications.org Published On :: 2013-02-25T00:06:59-08:00 Of more than 2 million children infected with HIV, almost 90% live in resource-limited settings where pediatric HIV care is often suboptimal. Implementing electronic health records with computerized decision support offers a potential tool for improving care.This randomized, controlled trial demonstrates that computer-generated clinical reminders can significantly improve clinician compliance with HIV care guidelines for children in a resource-limited setting. This intervention is scalable as developing countries implement electronic health record systems. (Read the full article) Full Article
ind Heliox Therapy in Bronchiolitis: Phase III Multicenter Double-Blind Randomized Controlled Trial By pediatrics.aappublications.org Published On :: 2013-03-18T00:07:06-07:00 Bronchiolitis, a leading cause of infant hospitalization, has few proven treatments. A few small studies have reported the beneficial effects of a mixture of 21% oxygen + 79% helium (Heliox). The 2010 Cochrane Review concluded that additional large randomized controlled trials were needed to determine the therapeutic role of Heliox in bronchiolitis.The Bronchiolitis Randomized Controlled Trial Emergency-Assisted Therapy with Heliox—An Evaluation (BREATHE) trial is the largest multicenter randomized controlled trial to date to investigate the efficacy of Heliox in acute bronchiolitis. The delivery method for Heliox therapy was found to be crucial to its efficacy. (Read the full article) Full Article
ind Cluster (School) RCT of ParentCorps: Impact on Kindergarten Academic Achievement By pediatrics.aappublications.org Published On :: 2013-04-15T00:06:42-07:00 At least half of the achievement gap for low-income, minority children is present at kindergarten entry; however, there are no population-level early childhood interventions that effectively engage and support families and teachers to ameliorate the impact of adversity on achievement.This study evaluated ParentCorps, a family-centered, school-based intervention to promote self-regulation and learning for all children entering school in disadvantaged, urban neighborhoods. ParentCorps results in higher kindergarten achievement among low-income, minority children. (Read the full article) Full Article
ind Honey Pacifier Use Among an Indigent Pediatric Population By pediatrics.aappublications.org Published On :: 2013-05-06T00:07:32-07:00 Botulinum spores are ubiquitous, found in the soil of most countries worldwide, and also in honey. It is well established that ingestion of honey by children aged <1 year can lead to infant botulism.This study examines the prevalence of honey pacifier use among a pediatric population aged <1 year. We also assessed parental knowledge of the dangers of giving honey to children in this age group. (Read the full article) Full Article
ind Elevated Blood Lead Levels and Reading Readiness at the Start of Kindergarten By pediatrics.aappublications.org Published On :: 2013-05-13T00:07:00-07:00 Blood lead levels well below 10 µg/dL are now recognized as causing adverse cognitive effects, including lower scores on standardized reading and math tests.This is the first study to show that reading readiness early in kindergarten is independently associated with blood lead levels well below 10 µg/dL. Results suggest that lead exposure may have a larger impact on urban education than national estimates suggest. (Read the full article) Full Article
ind Individual and Center-Level Factors Affecting Mortality Among Extremely Low Birth Weight Infants By pediatrics.aappublications.org Published On :: 2013-06-10T00:08:52-07:00 Significant variation in the mortality of preterm infants has been observed among NICUs. Factors explaining this variation have been difficult to identify.Sizable center differences in mortality exist, even among similarly sized NICUs in academic centers. Patient characteristics and center treatment rates explain some of the center effect, especially for the youngest infants, but a significant portion of these differences remains unexplained. (Read the full article) Full Article
ind "Eczema Coxsackium" and Unusual Cutaneous Findings in an Enterovirus Outbreak By pediatrics.aappublications.org Published On :: 2013-06-17T01:07:31-07:00 Coxsackievirus A6 (CVA6) was identified as an important cause of "severe" hand, foot, and mouth disease (HFMD) during the 2011–2012 outbreak in North America. The atypical cutaneous features in this outbreak have not been well documented.The cutaneous manifestations of CVA6-associated HFMD may be more extensive and variable than classic HFMD. Four distinct morphologies characterize this exanthem: (1) widespread vesiculobullous and erosive lesions, (2) "eczema coxsackium," (3) an eruption similar to Gianotti-Crosti, and (4) purpuric lesions. (Read the full article) Full Article
ind Racial and Ethnic Disparities in ADHD Diagnosis From Kindergarten to Eighth Grade By pediatrics.aappublications.org Published On :: 2013-06-24T00:07:08-07:00 Minority children are less likely than white children to be diagnosed and treated with attention-deficit/hyperactivity disorder. However, diagnosis patterns over time in early and middle childhood and whether confounding factors explain these disparities are not currently well understood.Racial/ethnic disparities in attention-deficit/hyperactivity disorder diagnosis occur by kindergarten and continue until eighth grade. Racial/ethnic disparities among diagnosed children in medication use occur in both fifth and eighth grades. These disparities are not attributable to confounding factors. (Read the full article) Full Article
ind Incidental Findings in Children With Blunt Head Trauma Evaluated With Cranial CT Scans By pediatrics.aappublications.org Published On :: 2013-07-22T00:07:41-07:00 The evaluation of blunt head trauma in children who undergo cranial computed tomography will occasionally reveal incidental findings. These findings may require further evaluation or intervention. The prevalence of incidental findings has previously been described using small cohorts, limiting generalizability.This study is the largest pediatric multicenter description of the prevalence of incidental findings on cranial computed tomography. Incidental findings are categorized by urgency to describe the spectrum of abnormalities, providing a context for clinicians faced with these unexpected results. (Read the full article) Full Article
ind Indiscriminate Behaviors in Previously Institutionalized Young Children By pediatrics.aappublications.org Published On :: 2014-02-02T06:31:57-08:00 Children who have experienced early psychosocial deprivation are at high risk of persistent, socially indiscriminate behaviors. These behaviors may decline slowly with high-quality caregiving but generally are associated with ongoing impairment.This study suggests that placement in foster care reduces indiscriminate behaviors to an intermediate level between those in institutional care and community control subjects. It also demonstrates the importance of disorganized early attachment in predicting later indiscriminate behaviors. (Read the full article) Full Article
ind Attention Deficit Disorder, Stimulant Use, and Childhood Body Mass Index Trajectory By pediatrics.aappublications.org Published On :: 2014-03-17T00:06:40-07:00 Childhood attention-deficit/hyperactivity disorder has been associated with both childhood and adult obesity, whereas treatment with stimulants has been associated with delayed child growth. No longitudinal studies with details about dates of diagnosis, treatment, and duration of stimulant use have been published.Using electronic health record data, this was the first study to evaluate the independent associations of attention-deficit/hyperactivity disorder diagnosis, stimulant treatment, age at first stimulant use, and duration of stimulant use on longitudinal BMI trajectories throughout childhood and adolescence. (Read the full article) Full Article
ind Renal Cortical Abnormalities in Siblings of Index Patients With Vesicoureteral Reflux By pediatrics.aappublications.org Published On :: 2014-03-24T00:06:20-07:00 The familial nature of vesicoureteral reflux (VUR) is well recognized. Several studies have shown that siblings of children with VUR are at much higher risk for reflux than the general pediatric population with a reported prevalence between 26% and 50%.There is increased risk of renal cortical abnormalities in siblings with a previous urinary tract infection, siblings with high-grade VUR, and siblings >1 year of age. This information may be useful when counseling parents about the risk of familial VUR. (Read the full article) Full Article
ind Baby-MONITOR: A Composite Indicator of NICU Quality By pediatrics.aappublications.org Published On :: 2014-06-02T00:06:38-07:00 The traditional process-focused approach to quality improvement has not remedied NICUs’ inconsistency in quality of care delivery across clinically important measures. Global measurement of quality may induce broad, systems-based improvement, but must be formally studied.We present a systematically developed and robust composite indicator, the Baby-MONITOR, to assess the quality of care delivered to very low birth weight infants in the NICU setting. (Read the full article) Full Article
ind Early-Onset Basal Cell Carcinoma and Indoor Tanning: A Population-Based Study By pediatrics.aappublications.org Published On :: 2014-06-23T00:07:21-07:00 Indoor tanning has gained widespread popularity among adolescents and young adults. Incidence rates of early-onset basal cell carcinoma also appear to be rising. Scant evidence exists on the impacts of early exposure and whether it leads to early occurrence of this malignancy.In a US population-based study, indoor tanning was associated with an elevated risk of basal cell carcinomas occurring at or before the age of 50 years, with an increasing trend in risk with younger age at exposure among adolescents and young adults. (Read the full article) Full Article
ind Prenatal and Newborn Screening for Critical Congenital Heart Disease: Findings From a Nursery By pediatrics.aappublications.org Published On :: 2014-10-06T00:06:22-07:00 The detection of critical congenital heart disease by fetal echocardiography or neonatal physical examination can have limitations. The addition of pulse oximetry screening in the newborn nursery increases the rate of diagnosis of these conditions before hospital discharge.In a tertiary-care center with comprehensive fetal echocardiography, nearly all newborns with critical congenital heart disease are diagnosed prenatally. Pulse oximetry will identify more infants from settings with lower prenatal detection. Improving access to and training in fetal echocardiography should also improve detection of these conditions. (Read the full article) Full Article
ind Prophylactic Indomethacin and Intestinal Perforation in Extremely Low Birth Weight Infants By pediatrics.aappublications.org Published On :: 2014-10-27T00:06:34-07:00 Prophylactic indomethacin in extremely low birth weight infants decreases severe intraventricular hemorrhage and patent ductus arteriosus but it is unknown whether concurrent enteral feeding and prophylactic indomethacin is associated with increased risk of spontaneous intestinal perforation.The combination of prophylactic indomethacin and enteral feeding during the first 3 days after birth does not increase the risk of spontaneous intestinal perforation. (Read the full article) Full Article