Ready or Not: A Crossover Study of (Un)graded Individual Readiness Assurance Tests in Team-Based Learning

OBJECTIVE

This study aimed to measure the effects of graded vs ungraded individual readiness assurance tests (iRATs) on the students' test scores and achievement goals in a team-based learning classroom.

METHODS

A 2 × 2 crossover study was conducted in a required second-year pharmacotherapy course. Teams 1 to 8 were assigned to a UG iRAT during the first half of the course, followed by a G iRAT the second half of the course (G/UG group). Teams 9 to 16 were assigned to the opposite grading sequence (ie, UG/G). A multivariate analysis of variance was used to analyze the differences in test scores, as measured using iRAT and examination scores. A separate multivariate analysis of variance was used to examine the differences in achievement goals.

RESULTS

There was a significant difference in test scores based on the iRAT grading condition. Individual readiness assurance tests were higher in the G condition (72.51% vs 67.99%); however, the examination scores were similar in the G and UG conditions (81.07% vs 80.32%). There was no statistically significant difference in the achievement goals based on the iRAT grading condition.

CONCLUSION

In a required second-year pharmacotherapy course that uses team-based learning, student performance on the iRAT was modestly lower in the UG iRAT condition; however, the students' examination scores were unchanged. Achievement goals were unchanged based on the iRAT grading condition.

Sluggish Cognitive Tempo (Cognitive Disengagement Syndrome) and Academic Functioning: A Systematic Review and Agenda for Future Research

The past two decades have witnessed substantial interest in sluggish cognitive tempo (SCT), a set of symptoms (e.g., excessive daydreaming, mental confusion, slowed behavior) distinct from attention-deficit/hyperactivity disorder (ADHD) and other psychopathology symptoms. Despite evidence linking SCT to a range of functional outcomes, findings for academic functioning are unclear. The current review summarizes the literature on SCT and academic functioning and offers an agenda for future research. A systematic review was conducted to identify studies assessing SCT and academic outcomes, including academic impairments and performance, in childhood, adolescence, and young adulthood. Sixty studies were retained (53 cross-sectional, 7 longitudinal) from 44 separate samples, with the majority (n = 32, 53%) assessing global ratings of academic impairment and fewer measuring specific academic domains or standardized achievement test scores. Findings were generally consistent in showing SCT to be correlated with global ratings of academic impairment, lower grades, and inconsistently associated with poorer math and reading scores. Findings were more mixed when controlling for ADHD symptoms, intelligence, and/or demographic factors. Overall, SCT is associated with poorer academic functioning, although inconsistencies and key limitations are common across studies. Ten directions for future research are offered to advance understanding of how SCT may be associated with or impact academic functioning.

Association of residential and school green- and bluespace with academic performance in 10-13-year-old Polish schoolchildren with and without attention deficit hyperactivity disorder

BACKGROUND

Several studies, mostly based on the USA data, have reported that school greenspace was associated with better academic performance. However, nearly all of them were conducted on aggregated data. We are among the first individual data-based studies worldwide to examine whether exposure to school and residential green- and bluespace can boost academic performance.

METHODS

NeuroSmog is an ongoing case-control study investigating the impact of air pollution on brain development in children with and without attention deficit hyperactivity disorder (ADHD). 658 children aged 10 to 13 years from 18 large and small towns in southern Poland constituted the analytical sample. Information about latest end-of-year school grades in Polish and maths was collected by the parent report while perceived academic performance in these subjects was collected by the Youth Self-Report. Tree, grass, and water cover, as well as overall vegetation, were abstracted in Euclidean buffers of 500 and 1000 m around concurrent school and residential addresses. Perceived green- and bluespace data were also collected. Adjusted for age, sex, parent education, financial situation, and urbanicity, logistic models were fitted to assess the associations between each exposure-outcome pair.

RESULT

We found no consistent associations between academic performance and school or residential green- and bluespace. This held true for children with and without ADHD.

CONCLUSIONS

Higher residential and school green- and bluespace do not seem to be sufficient for better academic performance.

The developmental unfolding of substance use disorder symptoms and academic achievement in the transition into and out of college

This study aimed to explore the prospective associations between both alcohol and cannabis use (frequency and DSM-5 substance use disorder symptom counts) as they relate to academic performance over a period of ∼ four years. The study members were students enrolled in college in the Southeastern United States (N = 209, 62 % female, 90 % white). Baseline survey data were obtained in the first year of college while participants finished the follow-up assessments ∼ 1 and ∼ 4 years from baseline (80+ % retention rates). We aimed to tease apart antecedent from consequence in the associations between substance use and academic performance using a sophisticated modeling technique that accounts for between-person influences in evaluating within-person change over time. Results showed that greater alcohol use disorder symptoms in the first year of college were associated with a within-person decline in grades in the second year of college. This was not demonstrated for alcohol or cannabis frequency, alcohol quantity, or cannabis use disorder symptoms or in relation to the later developmental transition out of college. In addition to widely implemented prevention efforts, these results indicate that screening first-year college students for alcohol use disorder symptoms and connecting them with resources and treatment may be beneficial in attempts to promote academic performance.

Principal component analysis of texture features for grading of meningioma: not effective from the peritumoral area but effective from the tumor area

PURPOSE

To investigate whether texture features from tumor and peritumoral areas based on sequence combinations can differentiate between low- and non-low-grade meningiomas.

METHODS

Consecutive patients diagnosed with meningioma by surgery (77 low-grade and 28 non-low-grade meningiomas) underwent preoperative magnetic resonance imaging including T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and contrast-enhanced T1WI (CE-T1WI). Manual segmentation of the tumor area was performed to extract texture features. Segmentation of the peritumoral area was performed for peritumoral high-signal intensity (PHSI) on T2WI. Principal component analysis was performed to fuse the texture features to principal components (PCs), and PCs of each sequence of the tumor and peritumoral areas were compared between low- and non-low-grade meningiomas. Only PCs with statistical significance were used for the model construction using a support vector machine algorithm. k-fold cross-validation with receiver operating characteristic curve analysis was used to evaluate diagnostic performance.

RESULTS

Two, one, and three PCs of T1WI, apparent diffusion coefficient (ADC), and CE-T1WI, respectively, for the tumor area, were significantly different between low- and non-low-grade meningiomas, while PCs of T2WI for the tumor area and PCs for the peritumoral area were not. No significant differences were observed in PHSI. Among models of sequence combination, the model with PCs of ADC and CE-T1WI for the tumor area showed the highest area under the curve (0.84).

CONCLUSION

The model with PCs of ADC and CE-T1WI for the tumor area showed the highest diagnostic performance for differentiating between low- and non-low-grade meningiomas. Neither PHSI nor PCs in the peritumoral area showed added value.

Tracheostomy in traumatic cervical spinal cord injury: Early versus late tracheostomy

OBJECTIVE

The purpose of this study was to characterize the relationship between predictors and the time of tracheostomy after traumatic cervical spinal cord injury (TCSCI).

METHODS

Five hundred twenty-six patients with TCSCI treated between January,2012 and December, 2021 were retrospectively reviewed. Patients were subdivided into two groups: early tracheostomy (≤7 days from initiation of endotracheal intubation) and late tracheostomy. Comparisons between early tracheostomy and late tracheostomy were statistically analyzed. Logistic regression analysis was applied to identify independent predictors of tracheostomy and calculate probability for different grades of combining predictors to predict tracheostomy. Spearman's correlation coefficient was used to evaluate the association between the grade of combining predictors and the time to tracheostomy.

RESULTS

Among 526 eligible patients, 63(12.0%) had a tracheostomy performed. Compared with late tracheostomy group, patients in early tracheostomy group had higher ISS, more severe neurological status while fewer In-hospital LOS days and ICU LOS days. By Logistic regression analysis, severe American Spinal Injury Association Impairment Scale (AIS A), the neurological level of injury (NLI>C5), higher Injury Severity Score (ISS>16) and advanced age (over 50 years old) were identified as independent predictors for tracheostomy. Depending on the likelihood of tracheostomy, the combining predictors were graded into five categories. As the value of probability was higher than 50%, Grade I-III made optimistic predictions about tracheostomy. According to Spearman's correlation analysis, early tracheostomy had a strong association with Grade I, while late tracheostomy was closely correlated with Grade III.

CONCLUSIONS

Factors related to the decision of tracheostomy were ASIA impairment scale, neurological level of injury, injury severity score and age. The grades of combining predictors could support indication for predicting the time of tracheostomy.

Celiac disease and upper secondary school achievement in Sweden A retrospective cohort study

BACKGROUND

Both undiagnosed celiac disease and some chronic childhood diseases are associated with lower academic achievement. However, there is little knowledge of achievements in those diagnosed with celiac disease. Our aim was to investigate school achievements in upper secondary school among Swedish adolescents with celiac disease.

METHODS

We performed a retrospective cohort study using register data. We analyzed choice of upper secondary school program, completion of upper secondary school including achievements of basic eligibility for college/university, and final grade in individuals with celiac disease diagnosed before 15 years of age, born 1991-97. We compared with the Swedish population of the same birth years. Analyses were adjusted for sex, year of birth, living region at 17 years of age, and parental education as well as income.

RESULTS

The cohort included 734 074 individuals, whereof 3 257 (62% females) with celiac disease. There was no significant difference in choice of upper secondary school program. No significant difference was found in completion or achieving basic eligibility for college/university in adjusted analyses. The mean final grade in the celiac disease group was 13.34 (standard deviation 4.85) compared to 12.78 (standard deviation 5.01) in the reference population (p < 0.001), out of a maximum of 20. The effect of celiac disease on final grade remained in adjusted analyses (p = 0.012).

CONCLUSIONS

We found that diagnosed celiac disease does not negatively affect school achievements in upper secondary school. This finding suggests the diagnosis, treatment and follow-up programs of celiac disease could reverse potential deleterious academic processes.

Correlation of Narrative Evaluations to Clerkship Grades Using Statistical Sentiment Analysis

Introduction

Narrative evaluations are essential components of medical student assessment. This study evaluated how well narrative clerkship evaluation word choice correlated with an assigned letter grade.

Methods

One hundred clerkship evaluations, 50 from family medicine (FM) and 50 from internal medicine (IM), with even distribution of "Honors" and "Near-Honors" among medical students that graduated in 2020 from the Oregon Health and Science University (OHSU) were examined. A textual sentiment analysis, which evaluates positive and negative word choice, was used to determine each evaluation's collective sentiment. An average sentiment score and character count were calculated for Honors and Near-Honors evaluations from both clerkship disciplines. Sentiment word totals were used to form "word clouds" that highlight the most frequent word selections.

Results

While sentiment scores positively correlated with the assigned grade, there was no statistically significant difference between the average sentiment scores among Honors and Near Honors graded evaluations within the FM or IM clerkship evaluation sets. There was no significant difference in evaluation character length among the assigned grades. Among FM evaluations, "outstanding" and "excellent" were the two most common sentiment words used in both Honors and Near-Honors. Among IM evaluations, outstanding and excellent were most commonly used in Honors evaluations, while "excellent" and "good" were most common in Near-Honors.

Conclusion

This study outlines a novel text analysis method for analyzing narrative evaluation association with assigned grade that other institutions can utilize. Sentiment word choices are not significantly different among Honors and Near Honors clerkship narrative evaluations.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-022-01654-2.

Physical activity and academic achievement: an analysis of potential student- and school-level moderators

BACKGROUND

Many children do not engage in sufficient physical activity, and schools provide a unique venue for children to reach their recommended 60 daily minutes of moderate-to-vigorous physical activity (MVPA). Prior research examining effects of MVPA on academic achievement is inconclusive, and few studies have investigated potential moderators of this relationship. This study examined whether student-level characteristics (gender, race/ethnicity, free/reduced-price lunch status) and school-level characteristics (proportion of students qualifying for free/reduced-price lunch, physical activity environment and opportunities) moderate the relationship between MVPA and academic achievement.

METHODS

In a large, diverse metropolitan public school district in Georgia, 4,936 students in Grade 4 were recruited from 40 elementary schools. Students wore accelerometers to measure school-day MVPA for a total of 15 days across three semesters (fall 2018, spring 2019, fall 2019). Academic achievement data, including course marks (grades) for math, reading, spelling, and standardized test scores in writing, math, reading, and Lexile (reading assessment), were collected at baseline (Grade 3, ages 8-9) and at follow-up in Grade 4 (ages 9-10). Standardized test scores were not measured in Grade 5 (ages 10-11) due to COVID-19-related disruptions. Multilevel modeling assessed whether student-level and/or school-level characteristics were moderators in the cross-sectional and longitudinal MVPA-academic achievement relationship.

RESULTS

Cross sectional analyses indicated that the MVPA and AA relationship was moderated only by student Hispanic ethnicity for Grade 4 fall spelling marks (β = -0.159 p < 0.001). The relationship for Grade 4 fall spelling marks was also moderated by school physical activity opportunities (β = -0.128 (p < 0.001). Longitudinally, there was no significant moderation of the MVPA-academic achievement. A relationship by student gender, free/reduced-price lunch status, race/ethnicity; nor for school-level factors including proportion of students qualifying for free/reduced-price lunch, physical activity environment, and physical activity opportunities.

CONCLUSIONS

Overall, our results did not suggest that student- or school-level characteristics moderate the MVPA-academic achievement relationship. While statistically significant results were observed for certain outcomes, practical differences were negligible. In this population, school-based MVPA does not appear to differently affect academic performance based on student gender, race/ethnicity, free/reduced-price lunch, nor school characteristics.

TRIAL REGISTRATION

This study was registered with the National Institutes of Health (NIH) ClinicalTrials.gov system, with ID NCT03765047 . Registered 05 December 2018-Retrospectively registered.

Association of a longitudinal, preclinical ultrasound curriculum with medical student performance

INTRODUCTION

Point-of-care ultrasound (US) is used in clinical practice across many specialties. Ultrasound (US) curricula for medical students are increasingly common. Optimal timing, structure, and effect of ultrasound education during medical school remains poorly understood. This study aims to retrospectively determine the association between participation in a preclinical, longitudinal US curriculum and medical student academic performance.

METHODS

All first-year medical students at a medical school in the Midwest region of the United States were offered a voluntary longitudinal US curriculum. Participants were selected by random lottery. The curriculum consisted of five three-hour hands on-sessions with matching asynchronous content covering anatomy and pathologic findings. Content was paired with organ system blocks in the standard first year curriculum at our medical school. Exam scores between the participating and non-participating students were compared to evaluate the objective impact of US education on performance in an existing curriculum. We hypothesized that there would be an association between participation in the curriculum and improved medical student performance. Secondary outcomes included shelf exam scores for the surgery, internal medicine, neurology clerkships and USMLE Step 1. A multivariable linear regression model was used to evaluate the association of US curriculum participation with student performance. Scores were adjusted for age, gender, MCAT percentile, and science or engineering degree.

RESULTS

76 of 178 students applied to participate in the curriculum, of which 51 were accepted. US curriculum students were compared to non-participating students (n = 127) from the same class. The US curriculum students performed better in cardiovascular anatomy (mean score 92.1 vs. 88.7, p = 0.048 after adjustment for multiple comparisons). There were no significant differences in cumulative cardiovascular exam scores, or in anatomy and cumulative exam scores for the gastroenterology and neurology blocks. The effect of US curriculum participation on cardiovascular anatomy scores was estimated to be an improvement of 3.48 points (95% CI 0.78-6.18). No significant differences were observed for USMLE Step 1 or clerkship shelf exams. There were no significant differences in either preclinical, clerkship or Step 1 score for the 25 students who applied and were not accepted and the 102 who did not apply.

CONCLUSIONS

Participation in a preclinical longitudinal US curriculum was associated with improved exam performance in cardiovascular anatomy but not examination of other cardiovascular system concepts. Neither anatomy or comprehensive exam scores for neurology and gastrointestinal organ system blocks were improved.

School start times and academic achievement - A systematic review on grades and test scores

Early school times clash with the late sleep of adolescents, leading to wide-spread sleep restriction in students. Evidence suggests that delaying school starts is beneficial for sleep and recent studies investigated whether this also translates into improved academic achievement. We thus conducted a systematic review of the literature on school start times, grades and test scores in middle and high-school students. We reviewed 21 studies following the PRISMA guidelines and assessed the evidence quality using a pre-defined risk of bias tool. Nine studies reported no association of later starts with achievement, while the remaining reported mixed (5), positive (5), negative (1) or unclear (1) results. Considering the heterogeneity in academic outcomes, study types, amount of delay and exposure, and the substantial risk of bias, a meta-analysis was not warranted - instead we provide grouped reviews and discussion. Overall, no generalisable improvements in achievement with later starts emerge beyond the level of single studies. This does not necessarily preclude improvements in students' learning but highlights shortcomings of the literature and the challenges of using grades and test scores to operationalise academic achievement. Given other previously reported positive outcomes, our results suggest that schools could start later while achievement is likely maintained.

Is adherence to 24-Hour Movement Guidelines associated with a higher academic achievement among adolescent males and females?

OBJECTIVES

This study aims to examine the independent and combined associations of 24-Hour Movement Guidelines for physical activity, screen time, and sleep duration with academic achievement in adolescent males and females.

DESIGN

Cross-sectional study.

METHODS

1290 Spanish adolescents (565 females), aged 11 to 16 years (13.06 ± 0.84), participated in this study. Self-reported physical activity, screen time, and sleep duration questionnaires were assessed. Academic achievement was calculated as an average score of the adolescents'' grades in first language (Spanish), first foreign language (English), and mathematics subjects. A multiple linear regression model was used to examine the association between meeting 24-Hour Movement Guidelines and academic achievement. Covariates included age, sex, socioeconomic status, body mass index, and cardiorespiratory fitness.

RESULTS

Not meeting any of the three 24-Hour Movement Guidelines was associated with lower academic achievement in the whole sample (p < 0.001). Meeting physical activity and sleep duration guidelines, both independently and together, was associated with higher academic achievement in the whole sample (p < 0.001). Meeting at least two recommendations was associated with higher academic achievement in males (p < 0.01). However, trend analysis revealed that participants who met two or three recommendations had higher academic achievement compared to those who met one or none of these recommendations (p < 0.05). All these results were similar for males and females.

CONCLUSIONS

Our findings suggest the importance of promoting more than one 24-Hour Movement Guidelines, mainly physical activity and sleep duration, which seems to contribute positively to increased academic performance in adolescents.

No significant differences in absenteeism or academic achievements in a Norwegian multiple sclerosis case control study

BACKGROUND

The duration and features of the multiple sclerosis (MS) prodrome are not well defined. We aimed to ascertain whether people with a future MS diagnosis have more days of absence and perform worse in upper secondary school than age, gender and county-matched controls.

METHODS

Using registry data from the southeast of Norway, we identified people with MS born ≥1978. Statistics Norway provided information on grades and days of absence in cases and matched controls. We looked at absence in the three years of upper secondary school and grades in the compulsory subjects Norwegian, English, mathematics and physical education.

RESULTS

We identified 107 cases with disease onset one year or more after graduation and 626 controls. There were no significant differences in absence or grades achieved in the population as a whole or in those with disease onset within four years of diagnosis, and no association between time to disease onset and days of absence or grades.

CONCLUSION

There was no difference in days of absence or grades achieved in upper secondary school in the four years leading up to disease onset in cases compared to controls. A potential prodrome may not affect cognition enough to impact school achievements.

Semester Course Load and Student Performance

Many college students in the United States take longer than four years to complete their bachelor's degrees. Long time-to-degree can increase higher education costs by billions. Time-to-degree can be reduced if students take more credits each term. While academic momentum theory suggests that additional credits may also improve student performance, and there is a strong positive correlation between course load and student performance, high course load may reduce time investment in each course, giving high course load a negative causal effect on performance. Concern about the negative impact of course load on performance, especially for struggling students, may lead to pushback against policies to reduce time-to-degree by increasing course load. Using longitudinal data from a regional four-year university with a high average time-to-degree, we find no evidence that high course loads have a negative impact on student grades, even for students at the low end of the performance distribution. This result is consistent with a model where students substitute time away from non-education activities when their course loads increase.

Schooling for Pupils with Autism Spectrum Disorder: Parents' Perspectives

The current study, based on a survey of 1799 parents, explored parental perspectives of school absence in relation to approved grades, challenges, demands and obstacles in education for children with autism spectrum disorder. The results revealed a relatively high rate of school absenteeism for reasons other than illness. Girls had higher rates of absenteeism than boys for short durations of absence. Absenteeism was primarily caused by a lack of teacher competence regarding autism and inadequate adaptation of teaching. There were no significant differences between genders in approved grades, but the rate of failure to achieve approved grades was approximately 50%. The most common form of educational support was support from special needs teachers and adapted pedagogy.

Frequency of participation in student response system activities as a predictor of final grade: An observational study

OBJECTIVES

The purpose of this study was to determine whether frequency of participation in activities offered in a student response system was associated with students' final course grades in four different nursing courses and to explore whether that effect was dependent on the specific pedagogical context of each course.

DESIGN

An observational approach with a predictive model was used to examine the effect of a student's frequency of responses to prompts in a student response system (Nearpod) on final grade.

SETTING

This investigation was carried out in four high-enrollment nursing courses in a large Midwestern university in the United States.

PARTICIPANTS

Students who participated in this study were enrolled in one of four core nursing courses: Pathophysiology, Health Assessment, Nursing Care of the Adult at the undergraduate level, and Pathophysiology at the graduate level.

METHODS

Multiple regression analysis was conducted to examine the association between a student's frequency of Nearpod use and their final grade.

RESULTS

The regression model explained 25.42% of the variance in final grade when controlling for course differences. The key finding from this study is that the more a student responded to prompts in Nearpod, the more likely they were to earn a higher final grade, but this effect was statistically significant only in undergraduate Pathophysiology.

CONCLUSIONS

The positive association between more frequent Nearpod use and higher final grade appears to be dependent on contextual factors. These factors may include consistent use of Nearpod in class, detailed feedback and elaboration on student responses, and required participation in Nearpod activities.

Academic Motivation Deficits in Adolescents with ADHD and Associations with Academic Functioning

The present study evaluates differences in self-reported intrinsic and extrinsic academic motivation and amotivation between eighth-grade adolescents with (n = 162) and without (n = 140) ADHD. This study also examines associations between motivation and academic functioning with objective (i.e., grade point average, standardized reading and math scores) and cross-rater measurement (i.e., parent-reported homework performance). Multivariate analysis of variance controlling for sex, intelligence, and medication status found that adolescents with ADHD exhibited a significant motivational deficit compared to adolescents without ADHD across all areas of academic motivation, including intrinsic motivation (d = 0.49), extrinsic motivation (d = 0.43), and amotivation (d = 0.42). To examine whether motivation was differentially associated with academic impairment in the ADHD and comparison groups, a multi-group path analysis was conducted controlling for sex, intelligence, and medication status. Findings showed that motivation was differentially associated with academic impairment for adolescents with and without ADHD. For the comparison group, higher amotivation was associated with poorer homework performance and lower intrinsic motivation was associated with lower reading accuracy. In the ADHD group, higher amotivation was associated with poorer homework performance and math fluency, higher extrinsic motivation was associated with better homework performance and higher GPA, and higher intrinsic motivation was associated with higher reading accuracy. This study builds upon previous research in demonstrating that adolescents with ADHD have academic motivational deficits when compared to their peers without ADHD. Research is needed to understand the longitudinal interplay of academic motivation and academic functioning, with an eye towards developing or modifying interventions to increase academic motivation and academic success.

Residential and school greenspace and academic performance: Evidence from the GINIplus and LISA longitudinal studies of German adolescents

BACKGROUND

Few studies have reported the association between greenspace and academic performance at school level. We examined associations between both residential and school greenspace and individual school grades in German adolescents.

METHODS

German and maths grades from the latest school certificate, residential and school greenspace, and covariates were available for 1351 10 and 15 years old Munich children and 1078 Wesel children from two German birth cohorts - GINIplus and LISA. Residential and school greenspace was assessed by the Normalized Difference Vegetation Index (NDVI), tree cover, and (in Munich only) proportion of agricultural land, forest, and urban green space in 500-m and 1000-m circular buffers. Longitudinal associations between each exposure-outcome pair were assessed by logistic mixed effects models with person and school as random intercepts and adjusted for potential confounders.

RESULTS

No associations were observed between any of the greenspace variables and grades in Wesel children. Several statistically significant associations were observed with German and maths grades in Munich children, however associations were inconsistent across sensitivity analyses.

CONCLUSIONS

There is no evidence of an association of higher greenspace at residence, school or combined with improved academic performance in German adolescents from the GINIplus and LISA longitudinal studies.

Association between grades of Hydronephrosis and detection of urinary stones by ultrasound imaging

Objective:

To correlate between hydronephrosis grades and detection of urinary stones by B-mode ultrasound imaging.

Methods:

This study included 210 ultrasound reports of patients who underwent abdominal ultrasound imaging in the period from 1st January 2016 to 31st October 2017, and diagnosed as hydronephrosis. Data collected from the ultrasound reports. The detection rates of stones using B-mode ultrasound imaging compared in different grades of hydronephrosis. Chi-square test and Odds Ratio (OR) were performed to assess the relationship between variables.

Results:

Of 210 patients, hydronephrosis was unilateral in 91.8% of patients and bilateral in 8.1%. It was distributed in grade 2, grade 3, grade 1 and grade 4 in 58.57%, 20%, 12.38% and 9.1% of the patients respectively. B-mode ultrasound imaging determined the cause of hydronephrosis in 65.2% of cases. Urinary stones were the cause in 60% of the patients. The detection rate of urinary stones was 50%, 61% and 71.4% for grades 1, 2 and 3 hydronephroses respectively. On simple logistic regression analysis, urinary stones detected in Grade-3 were four times more compared to that in grade 4 (P=0.016) (OR 4.125, 95% CI 1.29-13.136%).

Conclusion:

Detection of urinary stones as the cause of hydronephrosis increases with increasing the grade of hydronephrosis from Grade-I to Grade-III and decrease in Grade-IV. Urinary stones were the cause of hydronephrosis in 60% of the patients in this study.

School is a game: Faculty set the rules

Some students often exhibit less-than-ideal learning behaviors such as cramming for exams, focusing on memorization versus comprehension, multi-tasking during class, etc. One approach to understanding and addressing these issues is through a "school as game" mental model. Success in the "game of school", especially in rigorous professional and graduate programs, requires not only knowledge and skill, but also strategy. Because of time demands, students must often make strategic decisions regarding class attendance, attention, study time, and study methods. This commentary describes a mental model in which faculty can examine student learning behaviors within the context of their teaching and assessment criteria. Instructors should consider how both the written and unwritten rules of their courses may actually incentivize undesirable student learning behaviors.

Active commuting to school was inversely associated with academic achievement in primary but not secondary school students

AIM

Physical activity has numerous benefits for children when it comes to academic achievements. This study determined whether active commuting - walking or cycling - to school, as a way of increasing total physical activity levels, was associated with academic achievements in students aged seven to 18 years.

METHODS

A total of 2138 students participated in the study, which took place in the 2012/2013 academic year in three Spanish cities. We used a self-reported questionnaire to assess how the students travelled to and from school and their final school grades.

RESULTS

We enrolled 489 primary schoolchildren and 1649 secondary schoolchildren, with similar numbers of boys and girls. The primary schoolchildren who travelled to school by motorbike, car or bus had better grades for all the selected school subjects (p ≤ 0.009) than those who walked or cycled. No significant associations were found for secondary schoolchildren, except for mathematics and their grade point averages. All models were adjusted for sex, age and school.

CONCLUSION

Active commuting to school was inversely associated with academic achievement in primary school students but not those at secondary school. Longitudinal and intervention studies are needed to further understand our findings.

Longitudinal evaluation of the importance of homework assignment completion for the academic performance of middle school students with ADHD

The primary goal of this study was to longitudinally evaluate the homework assignment completion patterns of middle school age adolescents with ADHD, their associations with academic performance, and malleable predictors of homework assignment completion. Analyses were conducted on a sample of 104 middle school students comprehensively diagnosed with ADHD and followed for 18 months. Multiple teachers for each student provided information about the percentage of homework assignments turned in at five separate time points and school grades were collected quarterly. Results showed that agreement between teachers with respect to students assignment completion was high, with an intraclass correlation of .879 at baseline. Students with ADHD were turning in an average of 12% fewer assignments each academic quarter in comparison to teacher-reported classroom averages. Regression analyses revealed a robust association between the percentage of assignments turned in at baseline and school grades 18 months later, even after controlling for baseline grades, achievement (reading and math), intelligence, family income, and race. Cross-lag analyses demonstrated that the association between assignment completion and grades was reciprocal, with assignment completion negatively impacting grades and low grades in turn being associated with decreased future homework completion. Parent ratings of homework materials management abilities at baseline significantly predicted the percentage of assignments turned in as reported by teachers 18 months later. These findings demonstrate that homework assignment completion problems are persistent across time and an important intervention target for adolescents with ADHD.

Strategic parenting, birth order, and school performance

Fueled by new evidence, there has been renewed interest about the effects of birth order on human capital accumulation. The underlying causal mechanisms for such effects remain unsettled. We consider a model in which parents impose more stringent disciplinary environments in response to their earlier-born children's poor performance in school in order to deter such outcomes for their later-born offspring. We provide robust empirical evidence that school performance of children in the National Longitudinal Study Children (NLSY-C) declines with birth order as does the stringency of their parents' disciplinary restrictions. When asked how they will respond if a child brought home bad grades, parents state that they would be less likely to punish their later-born children. Taken together, these patterns are consistent with a reputation model of strategic parenting.

Expression Profile of MiR-128 in the Astrocytoma Patients and Cell Lines

Malignant astrocytomas are the most common primary brain tumors. The critical characterizes of astrocyomas are their aggressive and infiltrative in the brain, which leads to uncontrollable by conventional forms of therapy. MicroRNAs are small RNAs that had been found to regulate their targets by specific binding to the 3'-untranslated region (3'UTR) of mRNA. Recent advances in understanding the molecular biology of these tumors have revealed that microRNA (miRNA) disruption may play important roles in the pathogenesis of astrocytomas. And some of the miRNA alterations were found in the serum of astrocytoma patients. In this study, we studied the expression profile of miR-128, in the different stages of astrocytoma tissues and two human astrocytoma cell lines, A172 and T98G cells. We found that the levels of miR-128 are decreased in the A172 and T98G cells when compared to normal human astrocyte (NHA). Furthermore, the levels of miR-128 decreased gradually to the pathological stages of astrocytomas. We also identified that TROVE2 is a novel target of miR-128 by the luciferase reporter system. Furthermore, the expression levels of TROVE2 are dramatically increased with the pathological stages increasing. Finally, the levels of TROVE2 are negatively correlated with miR-128 in astrocytoma tissues. Our data provided novel evidence for the miR-128 and TROVE2 in the development of human astrocytomas.

The surgical management of metastatic spinal tumors based on an Epidural Spinal Cord Compression (ESCC) scale

BACKGROUND CONTEXT

There have been no previous studies looking at the outcome of surgical decompression (+/-stabilization) for various grades of epidural spinal cord compression (ESCC) due to spinal metastases.

PURPOSE

The aim of this study was to determine the outcome of surgical treatment in patients with ESCC using the Bilsky six-point scale.

STUDY DESIGN/SETTING

This was a retrospective cohort review of prospectively collected data.

PATIENT SAMPLE

A consecutive series of 101 patients managed over the period of 3 years for ESCC due to spinal metastases in a tertiary spine surgery referral unit were included.

METHODS

Data on age, gender, revised Tokuhashi score, preoperative Frankel grade, tumor histology, magnetic resonance imaging scan-based Bilsky cord compression grade, postoperative Frankel grade at last follow-up, complications, and survivorship were collected.

OUTCOME MEASURES

Frankel grading system for function was used to evaluate the patient's preoperative and postoperative neurologic status. Patient survival and postoperative complications were also collected.

RESULTS

Average patient age was 64.7 years (13-88 years): 62 males and 39 females. Mean follow-up was 7.3 months (3-23.3 months). Most primary tumors were in prostate, breast, renal, lung, and the blood dyscrasias. Within the lower grade of compression (Group 1; Bilsky Grades 0,1a, 1b, and 1c; n=40), 29 patients (72.5%) had no improvement in Frankel grade, seven patients (17.5%) improved, whereas four patients (10%) deteriorated neurologically after surgery. Within the higher compression grade (Group 2; Bilsky Grades 2 and 3; n=61), 37 patients (60%) did not experience neurologic change, 20 (33%) improved, whereas neurology worsened in four patients (7%). When compared with Group 2 patients, Group 1 patients had better preoperative Frankel scores but a greater number of patients in Group 2 improved their Frankel scores significantly postoperatively. The mean revised Tokuhashi score for Groups 1 and 2 was 10 and 9.1, respectively (p=.1). The complication rate for Groups 1 and 2 was 25% and 42.6%, respectively (p=.052). Survival analysis showed no difference between the groups (Group 1: median 376 days [12-1052]; Group 2: median 326 days [12-979]; p=.62).

CONCLUSIONS

Surgery can achieve improvements in neurology even in higher grades of cord compression. There is a trend toward more complications and worse survival with spinal surgery in patients with higher grades of compression.

Gatekeepers of the American Dream: how teachers' perceptions shape the academic outcomes of immigrant and language-minority students

High school teachers evaluate and offer guidance to students as they approach the transition to college based in part on their perceptions of the student's hard work and potential to succeed in college. Their perceptions may be especially crucial for immigrant and language-minority students navigating the U.S. educational system. Using the Educational Longitudinal Study of 2002 (ELS:2002), we consider how the intersection of nativity and language-minority status may (1) inform teachers' perceptions of students' effort and college potential, and (2) shape the link between teachers' perceptions and students' academic progress towards college (grades and likelihood of advancing to more demanding math courses). We find that teachers perceive immigrant language-minority students as hard workers, and that their grades reflect that perception. However, these same students are less likely than others to advance in math between the sophomore and junior years, a critical point for preparing for college. Language-minority students born in the U.S. are more likely to be negatively perceived. Yet, when their teachers see them as hard workers, they advance in math at the same rates as nonimmigrant native English speaking peers. Our results demonstrate the importance of considering both language-minority and immigrant status as social dimensions of students' background that moderate the way that high school teachers' perceptions shape students' preparation for college.

Self-regulatory mode (locomotion and assessment), well-being (subjective and psychological), and exercise behavior (frequency and intensity) in relation to high school pupils' academic achievement

Background. Self-regulation is the procedure implemented by an individual striving to reach a goal and consists of two inter-related strategies: assessment and locomotion. Moreover, both subjective and psychological well-being along exercise behaviour might also play a role on adolescents academic achievement.

Method. Participants were 160 Swedish high school pupils (111 boys and 49 girls) with an age mean of 17.74 (sd = 1.29). We used the Regulatory Mode Questionnaire to measure self-regulation strategies (i.e., locomotion and assessment). Well-being was measured using Ryff’s Psychological Well-Being Scales short version, the Temporal Satisfaction with Life Scale, and the Positive Affect and Negative Affect Schedule. Exercise behaviour was self-reported using questions pertaining to frequency and intensity of exercise compliance. Academic achievement was operationalized through the pupils’ mean value of final grades in Swedish, Mathematics, English, and Physical Education. Both correlation and regressions analyses were conducted.

Results. Academic achievement was positively related to assessment, well-being, and frequent/intensive exercise behaviour. Assessment was, however, negatively related to well-being. Locomotion on the other hand was positively associated to well-being and also to exercise behaviour.

Conclusions. The results suggest a dual (in)direct model to increase pupils’ academic achievement and well-being—assessment being directly related to higher academic achievement, while locomotion is related to frequently exercising and well-being, which in turn, increase academic achievement.

Does weight affect children's test scores and teacher assessments differently?

The prevalence of childhood overweight and obesity increased dramatically in the United States during the past three decades. This increase has adverse public health implications, but its implication for children's academic outcomes is less clear. This paper uses data from five waves of the Early Childhood Longitudinal Study-Kindergarten to examine how children's weight is related to their scores on standardized tests and to their teachers' assessments of their academic ability. The results indicate that children's weight is more negatively related to teacher assessments of their academic performance than to test scores.