Must Clinics Replace 2D by 3D Environments for an Efficient Training of Laparoscopic Novices? A Critical Analysis of the Learning Curve for Basic Skills

Background and AimsPublished studies repeatedly demonstrate an advantage of three-dimensional (3D) laparoscopic surgery over two-dimensional (2D) systems but with quite heterogeneous results. This raises the question whether clinics must replace 2D technologies to ensure effective training of future surgeons.MethodsWe recruited 45 students with no experience in laparoscopic surgery and comparable characteristics in terms of vision and frequency of video game usage. The students were randomly allocated to 3D (n = 23) or 2D (n = 22) groups and performed 10 runs of a laparoscopic “peg transfer” task in the Luebeck Toolbox. A repeated-measures ANOVA for operation times and a generalized linear mixed model for error rates were calculated. The main effects of laparoscopic condition and run, as well as the interaction term between the two, were examined.ResultsNo statistically significant differences in operation times and error rates were observed between 2D and 3D groups (p = 0.10 and p = 0.72, respectively). The learning curve showed a significant reduction in operation time and error rates (both p's < 0.001). No significant interactions between group and run were detected (operation time: p = 0.342, error rates: p = 0.83). With respect to both endpoints studied, the learning curves reached their plateau at the 7th run.ConclusionThe result of our study with laparoscopic novices revealed no significant difference between 2D and 3D technology with respect to performance time and the error rate in a simple standardized test. In the future, surgeons may thus still be trained in both techniques.

In Vitro Systems for Toxicity Evaluation of Microbial Volatile Organic Compounds on Humans: Current Status and Trends

Microbial volatile organic compounds (mVOC) are metabolic products and by-products of bacteria and fungi. They play an important role in the biosphere: They are responsible for inter- and intra-species communication and can positively or negatively affect growth in plants. But they can also cause discomfort and disease symptoms in humans. Although a link between mVOCs and respiratory health symptoms in humans has been demonstrated by numerous studies, standardized test systems for evaluating the toxicity of mVOCs are currently not available. Also, mVOCs are not considered systematically at regulatory level. We therefore performed a literature survey of existing in vitro exposure systems and lung models in order to summarize the state-of-the-art and discuss their suitability for understanding the potential toxic effects of mVOCs on human health. We present a review of submerged cultivation, air-liquid-interface (ALI), spheroids and organoids as well as multi-organ approaches and compare their advantages and disadvantages. Furthermore, we discuss the limitations of mVOC fingerprinting. However, given the most recent developments in the field, we expect that there will soon be adequate models of the human respiratory tract and its response to mVOCs.

Associations between early efficiency in language processing and learning outcomes in children born full term and preterm: Similarities and differences

•Associations between early language processing efficiency in toddlerhood and later standardized test performance inform the extent to which information processing skills support learning across domains.•Comparing patterns of associations in children from different clinical groups (e.g., children born full term and preterm) further informs whether neurobiological risk alters developmental pathways.•Early language processing efficiency was associated with language and pre-literacy outcomes to a similar extent for preterm and full term children, suggesting similar underlying mechanisms. •Association between processing speed and non-verbal IQ differed by group; processing speed supports learning in a broader range of domains in preterm than term children.

DUbbing Language-therapy CINEma-based in Aphasia post-Stroke (DULCINEA): study protocol for a randomized crossover pilot trial

Background Communication is one of the most important predictors of social reintegration after stroke. Approximately 15–42% of stroke survivors experience post-stroke aphasia. Helping people recover from aphasia is one of the research priorities after a stroke. Our aim is to develop and validate a new therapy integrating dubbing techniques to improve functional communication. Methods The research project is structured as three work packages (WP). WP1: development of the dubbed language cinema-based therapy: Two research assistants (a speech therapist and a dubbing actor) will select the clips, mute specific words/sentences in progressive speech difficulty, and guide patients to dub them across sessions. Words to be dubbed will be those considered to be functionally meaningful by a representative sample of aphasic patients and relatives through an online survey. WP2: a randomized, crossover, interventional pilot study with the inclusion of 54 patients with post-stroke non-fluent aphasia. Patients will be treated individually in 40-min sessions twice per week for 8 weeks. Primary outcomes will be significant pre/post differences in scores in the Communicative Activity Log (CAL) questionnaire and Boston Diagnostic Aphasia Examination (BDAE) administered by a psychologist blinded to the patients’ clinical characteristics. Secondary outcomes: General Health Questionnaire (GHQ)-12, Stroke Aphasia Quality of Life Scale (SAQOL-39), Western Aphasia Battery Revised (WAB-R), and the Stroke Aphasic Depression Questionnaire (SADQ10). WP3: educational activities and dissemination of results. WP3 includes educational activities to improve public knowledge of aphasia and dissemination of the results, with the participation of the Spanish patients’ association Afasia Activa. Discussion This pilot clinical trial will explore the efficacy of a new therapeutic tool based on dubbing techniques and computer technology to improve functional communication of patients suffering from post-stroke aphasia with the use of standardized test assessment. Trial registration ClinicalTrials.govNCT04289493. Registered on 28 February 2020.

Examining the validity of chiropractic grade point averages for predicting National Board of Chiropractic Examiners Part I exam scores

ABSTRACT Objective The main objective of this study was to evaluate the validity of grade point average (GPA) for predicting the National Board of Chiropractic Examiners (NBCE) Part I exam scores using chiropractic GPA. Methods Data were collected during the January 2019 computer-based testing administration of the NBCE's Part I exam. The sample size was n = 2278 of test takers from 18 domestic and 4 international chiropractic educational institutions. Six regression models were developed and tested to predict the Part I domain scores from chiropractic GPA while controlling for self-reported demographic variables. Residuals from the models were disaggregated by pre–chiropractic GPA. Results Chiropractic GPA revealed a positive, statistically significant correlation with sex. The chiropractic GPA was found to be a significant predictor of the Part I domain scores. A different perspective was obtained when residuals (observed minus predicted) were collected and split by the pre–chiropractic GPA. Very good students tended to be underpredicted, while other students were overpredicted. Conclusion This study builds on the cascading evidence from educational literature by providing additional results suggesting that undergraduate (prechiropractic) GPA as well as the GPA obtained in doctor of chiropractic programs are related to the future performance on the NBCE Part I exam. The results provide a first glance at the connection between the standardized test scores, which are often used for instructors' and institutional evaluation and the GPA obtained in a doctor of chiropractic program.

Absorption Kinetics of Berberine and Dihydroberberine and Their Impact on Glycemia: A Randomized, Controlled, Crossover Pilot Trial

Berberine is a natural alkaloid used to improve glycemia but displays poor bioavailability and increased rates of gastrointestinal distress at higher doses. Recently, dihydroberberine has been developed to combat these challenges. This study was designed to determine the rate and extent to which berberine appeared in human plasma after oral ingestion of a 500 mg dose of berberine (B500) or 100 mg and 200 mg doses of dihydroberberine (D100 and D200). In a randomized, double-blind, crossover fashion, five males (26 ± 2.6 years; 184.2 ± 11.6 cm; 91.8 ± 10.1 kg; 17.1 ± 3.5% fat) completed a four-dose supplementation protocol of placebo (PLA), B500, D100, and D200. The day prior to their scheduled visit, participants ingested three separate doses with breakfast, lunch, and dinner. Participants fasted overnight (8–10 h) and consumed their fourth dose with a standardized test meal (30 g glucose solution, 3 slices white bread) after arrival. Venous blood samples were collected 0, 20, 40, 60, 90, and 120 minutes (min) after ingestion and analyzed for BBR, glucose, and insulin. Peak concentration (CMax) and area under the curve (AUC) were calculated for all variables. Baseline berberine levels were different between groups (p = 0.006), with pairwise comparisons indicating that baseline levels of PLA and B500 were different than D100. Berberine CMax tended to be different (p = 0.06) between all conditions. Specifically, the observed CMax for D100 (3.76 ± 1.4 ng/mL) was different than PLA (0.22 ± 0.18 ng/mL, p = 0.005) and B500 (0.4 ± 0.17 ng/mL, p = 0.005). CMax for D200 (12.0 ± 10.1 ng/mL) tended (p = 0.06) to be different than B500. No difference in CMax was found between D100 and D200 (p = 0.11). Significant differences in berberine AUC were found between D100 (284.4 ± 115.9 ng/mL × 120 min) and PLA (20.2 ± 16.2 ng/mL × 120 min, p = 0.007) and between D100 and B500 (42.3 ± 17.6 ng/mL × 120 min, p = 0.04). Significant differences in D100 BBR AUC (284.4 ± 115.9 ng/mL×120 min) were found between PLA (20.2 ± 16.2 ng/mL × 120 min, p = 0.042) and B500 (42.3 ± 17.6 ng/mL × 120 min, p = 0.045). Berberine AUC values between D100 and D200 tended (p = 0.073) to be different. No significant differences in the levels of glucose (p = 0.97) and insulin (p = 0.24) were observed across the study protocol. These results provide preliminary evidence that four doses of a 100 mg dose of dihydroberberine and 200 mg dose of dihydroberberine produce significantly greater concentrations of plasma berberine across of two-hour measurement window when compared to a 500 mg dose of berberine or a placebo. The lack of observed changes in glucose and insulin were likely due to the short duration of supplementation and insulin responsive nature of study participants. Follow-up efficacy studies on glucose and insulin changes should be completed to assess the impact of berberine and dihydroberberine supplementation in overweight, glucose intolerant populations.

Cognition in Interaction: Challenges in Assessing Persons with Sensory and Multiple disabilities

This article reports a qualitative study of cognitive assessments of three teenagers with sensory and multiple disabilities, including moderate to profound developmental disability. The aim was to evaluate the possibilities for adapting standardized tests and the implementation of interactional partnership in assessment. Cognitive assessments were made with an individually-adapted psychological assessment tool, the Bayley Scales of Infant and Toddler Development. The assessment situations were video-recorded and analyzed based on sociocultural theories of early interaction, dynamic assessment, and the bodily-tactile modality of cognition. The results showed that the requirements for assessment are complex and highly individualized, extending beyond universal guidelines on test adaptations. The assessments were built on developmental steps within the standardized test, but required a special emphasis on individuality and interaction. We conclude that the study provides novel insights into an under-researched area of cognitive assessment, confirming earlier findings that cognitive skills become observable in unique moments of intensive interaction. The assessor must follow the principles of dynamic assessment, applying competent partner strategies such as providing safety, supporting attention, activity, and alertness, and scaffolding the target skills in the zone of proximal development. Conducted thus, the cognitive assessment process can enable the assessor to recognize, support and authenticate the agency of persons with complex disabilities.

Wildfire Smoke Exposure Worsens Learning Outcomes

Wildfires and associated smoke exposure have increased in frequency and severity over the past two decades, threatening to undo decades of air quality improvements. Our understanding of the impacts of these growing exposures on a range of societal outcomes remains incomplete. Building on emerging evidence that environmental exposures can negatively affect cognition, we investigate the effect of wildfire smoke exposure on learning outcomes across the US. We combine standardized test score data from 2009-2016 for nearly 11,700 public school districts across 6 grades with satellite-derived estimates of daily smoke exposure. We estimate that relative to a school year with no smoke, average cumulative daily smoke-attributable PM2.5 exposure during the school year (~35 ug/m^3) reduces both English language arts and math scores by ~0.16% of a standard deviation. These impacts are more pronounced among younger primary school students and are apparent across communities with differing levels of economic disadvantage and racial-ethnic composition. Using previous estimates of the relationship between test score performance and future earnings, we estimate that smoke PM2.5 exposure in 2016 reduced discounted future earnings by $117 per student, resulting in cumulative future earning losses of nearly $1.9 billion across the US. Roughly 80% of these costs are borne by disadvantaged districts. Our findings quantify a previously unaccounted for social cost of wildfire that is likely to worsen under a warming climate.

Influence of Language Preference on Vocabulary Proficiency and Reading Comprehension of Selected Grade 10 Bilingual Students at MSU Sulu Laboratory High School

The primary purpose of this study is to determine the influence of language preference on bilingual student’s vocabulary and reading comprehension among selected Grade 10 students of the Mindanao State University- Sulu Laboratory High School. The respondents were taken from Grade 10 classes with a total of ninety (99) student respondents. The data consisted of the scores of vocabulary proficiency test and reading comprehension test administered to the pupils. Furthermore, this study made use of a standardized test for vocabulary proficiency and reading comprehension. This study made use of the descriptive-quantitative research design to determine the influence of language preference on student’s vocabulary and reading comprehension among the bilingual Grade 10 students of the Mindanao State University-Sulu Laboratory High School. This study yielded the following findings: (1) Majority of the Grade 10 students of Mindanao State University-Sulu Laboratory High School prefer to use their vernacular language or lingua franca (L1), Bahasa Sug and English; (2) The level of vocabulary proficiency of bilingual Grade 10 students of Mindanao State University- Sulu Laboratory High School is proficient to advance levels; (3) No significant relationship exists between language preference and vocabulary proficiency of bilingual Grade 10 students of Mindanao State University- Sulu Laboratory High School; (4) The level of reading comprehension of bilingual Grade 10 students of Mindanao State University- Sulu Laboratory High School is proficient to advance levels; (5) There is no significant correlation between language preference and reading comprehension of bilingual Grade 10 students of Mindanao State University- Sulu Laboratory High School; and (6) There is no significant relationship between vocabulary proficiency and reading comprehension of bilingual Grade VI pupils. Based on the findings, it can be concluded that there is no significant relationship between language preference and vocabulary proficiency and likewise for language preference and reading comprehension of bilingual Grade 10 students. This only draws one conclusion that language preference of bilingual Grade 10 students does not influence the bilingual children’s vocabulary proficiency and reading comprehension. This finding invites possible evaluations and further studies of the Grade 10 curriculum, empowering English language, and pupil-related factor to determine the outlook of the pupils. Based on the said findings, the researcher would like to recommend the following: (1) This study would help future researchers which will comprehensively assist the pupils for a more effective and relevant vocabulary and reading enhancement activity to advance their skills; (2) This study would aid future studies that will explore the factors regarding the influence of language preference on children’s vocabulary proficiency and reading comprehension; and (3) This study would serve as an appraisal of enhancing to advance the skills of the children on vocabulary proficiency and reading comprehension.

Remote elementary education: a comparative analysis of learner development (part 1)

PurposeThe purpose of this two-part research was to investigate the effect of remote learning on student progress in elementary education. Part one, presented in this paper, examined achievement differences between learners in a fully remote learning environment and those in a hybrid setting.Design/methodology/approachA quantitative, quasi-experimental study with factorial design was used to investigate group differences in student achievement between the different learning environments. Ex-post-facto data from standardized test scores were utilized to examine in which ways the learning environment may have affected learner progress in two distinct subject areas crucial to elementary education: English language (ELA) and math.FindingsFindings revealed a significant difference between the two learning environments in both subject areas. While preexisting group differences, selection biases and testing inconsistencies could be effectively ruled out as potential causes for the observed differences, other factors such as developmental and environmental differences between the learning environments seemed to be influential. Therefore, the follow-on research aimed at further investigating and confirming the influence of such factors and will be presented in a Part 2 paper.Practical implicationsKnowledge of the observed differences in learning achievements between the different environments, as well as the factors likely causing them, may aid educators and school administrators in their decision processes when faced with difficult circumstances such as during the pandemic.Originality/valueWhen the SARS-CoV-2 virus started to rapidly spread around the globe, educators across the world were looking for alternatives to classroom instruction. Remote learning became an essential tool. However, in contrast to e-learning in postsecondary education, for which an abundance of research has been conducted, relatively little is known about the efficacy of such approaches in elementary education. Lacking this type of information, it seems that educators and administrators are facing difficult decisions when trying to align the often conflicting demands of public health, local politics and parent pressure with what may be best for student learning.