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BackgroundLower urinary tract symptoms (LUTS) are common in children and adolescents. Non-invasive tests evaluating bladder function are generally preferred over invasive tests, yet few studies have explored the range of normative values for these tests in healthy, asymptomatic children.ObjectiveTo define normative reference ranges for non-invasive tests of bladder function in healthy, asymptomatic girls and adolescents.Study designA comprehensive search strategy was performed in seven electronic databases through October 2019. English-language studies reporting data on voiding frequency, voided and postvoid residual volumes (PVR) and uroflowmetry results in healthy, asymptomatic girls (mean age ≥ 5 years) were included. Two independent reviewers performed study review, data extraction, and quality assessment. Overall mean estimates and 95% confidence intervals for each bladder function parameter were calculated using random effects models, and 95% normative reference values were estimated.ResultsTen studies met eligibility criteria for the meta-analysis (n = 2143 girls, age range: 3-18). Mean estimates of maximum voided volume and PVR were 233.4 ml (95% CI 204.3-262.6; n = 1 study) and 8.6 ml (95% CI 4.8-12.4; n = 2 studies) respectively. Pooled mean estimates for uroflowmetry parameters were: 21.5 ml/s (95% CI 20.5-2.5) for maximum flow rate (n = 6 studies), 12.5 ml/s (95% CI 11.2-13.8) for mean flow rate (n = 6 studies), 6.8 s (95% CI 4.4-9.3) for time to maximum flow (n = 3 studies), 15.7 s (95% CI 13.0-18.5) for flow time (n = 3 studies), and 198.7 ml (95% CI 154.2-234.2) for voided volume (n = 9 studies). No studies reported estimates of voiding frequency. Between-study heterogeneity was high (89.0-99.6%).ConclusionsAlthough we were able to calculate pooled mean estimates for several parameters, the small number of included studies and the wide age ranges of participants preclude generalization of reference values to all healthy girls. Further research is needed to determine normative reference values within specific age groups.

ObjectiveThe menopausal transition is characterized by progressive changes in ovarian function and increasing circulating levels of gonadotropins, with some women having irregular menstrual cycles well before their final menstrual period. These observations indicate a progressive breakdown of the hypothalamic-pituitary-ovarian axis often associated with an increase in menopausal symptoms. Relationships between vasomotor symptoms (VMS) and depressed mood and sleep as well as a bidirectional association between VMS and depressed mood in mid-life women have been reported, but the endocrine foundations and hormone profiles associated with these symptoms have not been well described. Our objective was to determine the relationship between daily urinary hormone profiles and daily logs of affect and VMS during the early perimenopausal transition.Study designSWAN, the Study of Women's Health Across the Nation, is a large, mutli-ethnic, multisite cohort study of 3302 women aged 42-52 at baseline, designed to examine predictors of health and disease in women as they traversed the menopause. Inclusion criteria were: an intact uterus and at least one ovary present, at least one menstrual period in the previous three months, no use of sex steroid hormones in the previous three months, and not pregnant or lactating. A subset (n = 849) of women aged 43-53 years from all study sites in the first Daily Hormone Study collection were evaluated for this substudy.Outcome measuresWe measured daily VMS, and urinary hormones: follicle stimulating hormone (FSH), luteinizing hormone (LH), pregnanediol glucuronide (PdG) and estradiol (estrone conjugate, E1C).ResultsA variable pattern of LH and negative LH feedback were the hormone patterns most strongly associated with increased VMS. In contrast, no hormone pattern was significantly related to negative mood.ConclusionFluctuations of LH associated with low progesterone production were associated with VMS but not negative mood, suggesting different endocrine patterns may be related to increased negative mood than to the occurrence of VMS.

The Classroom Observation Protocol for Undergraduate STEM (COPUS) provides descriptive feedback to instructors by capturing student and instructor behaviors occurring in the classroom. Due to the increasing prevalence of COPUS data collection, it is important to recognize how researchers determine whether groups of courses or instructors have unique classroom characteristics. One approach uses cluster analysis, highlighted by a recently developed tool, the COPUS Analyzer, that enables the characterization of COPUS data into one of seven clusters representing three groups of instructional styles (didactic, interactive, and student centered). Here, we examine a novel 250 course data set and present evidence that a predictive cluster analysis tool may not be appropriate for analyzing COPUS data. We perform a de novo cluster analysis and compare results with the COPUS Analyzer output and identify several contrasting outcomes regarding course characterizations. Additionally, we present two ensemble clustering algorithms: 1) k-means and 2) partitioning around medoids. Both ensemble algorithms categorize our classroom observation data into one of two clusters: traditional lecture or active learning. Finally, we discuss implications of these findings for education research studies that leverage COPUS data.

This paper provides insight into an established successful means in which prospective students are brought to campus and retained. Survey research has been conducted to confirm original anecdotal evidence that suggested a high school business contest hosted at the College is one successful method. Results indicate these type of events enhance positive relationships between colleges and high school instructors/students, leading to enriched student recruitment and retention.

The past decade has brought increased focus on STEM learning (Bell, Lewenstein, Shouse, & Feder, 2009; NGSS Lead States, 2013; U.S. Department of Education, 2015). The growth of STEM-related industries and the power associated with STEM fields make access to STEM careers an equity issue (Buechley, 2016). Despite gains in educational achievement, women and individuals from nondominant cultures remain underrepresented in STEM majors and careers (National Science Foundation, 2017). Afterschool programs offer a promising context for engaging diverse students: African American and Latinx children attend afterschool programs at rates twice that of White students (Afterschool Alliance, 2015). STEM programs at youth-centered sites capitalize on the resources of spaces children find welcoming and accessible. The natural curricular flexibility of afterschool programs enables immersive exploration and experimentation in STEM as well as authentic opportunities for building skills and developing relationships helpful to STEM careers (Afterschool Alliance, 2015; Krishnamurthi, Ballard, & Noam, 2014). Afterschool science programs naturally blur disciplinary boundaries and incorporate diverse ways of knowing (Calabrese Barton, Birmingham, Sato, Tan, & Calabrese Barton, 2013). These factors can be leveraged to broaden young people's definition of science and to foster "productive hybrid STEM identity work for underrepresented youth" (Calabrese Barton, Tan, & Greenberg, 2017, p. 21). Science education in youth-centered sites can value the cultures of underrepresented students while encouraging them to explore new science-related interests and identities (Calabrese Barton & Tan, 2010). Despite widespread acceptance of the benefits of afterschool STEM, more research is needed on how program factors affect student engagement and learning (Laursen, Thiry, Archie, & Crane, 2013). Coburn and Penuel (2016) call for more studies on program processes, collaboration strategies, and productive responses to challenges. The STEMinist Program, created by the authors, was a research-practice collaboration between university researchers and an afterschool program for female students in grades 4 to 6. This article describes how the program's ongoing design transformations increased girls' understanding of and interest in STEM. Design-based framing (Barab & Squire, 2009) enabled ongoing adjustments to the program while also identifying best practices for afterschool STEM learning. To understand the program's progression and outcomes, the authors examined the features of the learning environment and the relationships among design components by analyzing qualitative data collected before, during, and after program implementation. Participants' perceptions of science and scientists helped them understand the impact of the program and ways to improve it.

Studies have demonstrated students' resistance to active learning, despite evidence illustrating that their learning is improved relative to students in lectures. Specifically, while active learning and group work are effective at engaging students in their learning process, studies report that students' perceptions of active learning approaches are not always positive. What remains underexplored is whether students' perceptions of active learning improve with effective instructor facilitation and whether there exists differential perceptions between racially minoritized students and represented students. Here, we estimate students' perceptions of effective instructor facilitation as the mediator in the relationship between active learning and perceptions of learning and perceived utility for class activities (task value). Then, we examine differences by racial identification. We collected classroom observation data to empirically categorize courses as active learning or lecture-based and surveyed 4,257 college students across 25 STEM classrooms at a research-intensive university. We first examined the relationship between active learning on student perceptions and found a negative relationship between active learning and perceptions of learning and task value for both racially minoritized students and represented students. Next, we assessed whether students' perceptions of instructor effectiveness in facilitating group activities mediate these negative relationships. We found that, on average, students of all races were more likely to positively perceive instructor facilitation in active learning classes relative to lectures. In turn, the positive perceptions of instructor facilitation partially suppressed the negative relationship between active learning and perceptions of learning and task value. These results demonstrate that effective instructor facilitation can influence both students' self-assessment of learning and perceived utility of the learning activities, and underscores the importance of developing pedagogical competence among college instructors.

Background & aimsNonalcoholic fatty liver disease (NAFLD) is the most common pediatric chronic liver disease. Little is known about outcomes in recognized youth.MethodsWe compared paired liver biopsies from 122 of 139 children with NAFLD (74% male; 64% white; 71% Hispanic; mean age, 13 ± 3 years; age range, 8-17 years) who received placebo and standard of care lifestyle advice in 2 double-blind, randomized clinical trials within the nonalcoholic steatohepatitis (NASH) clinical research network from 2005 through 2015. We analyzed histologic changes with respect to baseline and longitudinal change in clinical variables using regression analysis.ResultsAt enrollment, 31% of the children had definite NASH, 34% had borderline zone 1 NASH, 13% had borderline zone 3 NASH, and 21% had fatty liver but not NASH. Over a mean period of 1.6 ± 0.4 years, borderline or definite NASH resolved in 29% of the children, whereas 18% of the children with fatty liver or borderline NASH developed definite NASH. Fibrosis improved in 34% of the children but worsened in 23%. Any progression to definite NASH and/or in fibrosis was associated with adolescent age, and higher waist circumference, levels of alanine or aspartate aminotransferase, total and low-density lipoprotein cholesterol at baseline (

BackgroundThe onset of menopause increases the risk of metabolic syndrome (MetS). Adiponectin is an adipokine associated with insulin sensitivity that is lower in people with MetS. Supplementing diets with linoleic acid (LA)-rich oil increased adiponectin concentrations and improved glucose control in women with type 2 diabetes. The effect of LA on adipokines, especially total and the bioactive form of adiponectin, high-molecular-weight (HMW) adiponectin, in women with MetS is unknown.ObjectivesThe aim of this study was to explore the effect of supplementation of the diet with an oil rich in LA on adipokines in women with MetS. The effect of the LA-rich oil (LA-oil) on oxylipins, key metabolites that may influence inflammation and metabolism, was also explored.MethodsIn this open-label single-arm pilot study, 18 postmenopausal nondiabetic women with MetS enrolled in a 2-phase study were instructed to consume LA-rich vegetable oil (10 mL/d) as part of their habitual diets. Women consumed an oleic acid-rich oil (OA-oil) for 4 wk followed by an LA-oil for 16 wk. Fasting concentrations of adipokines, fatty acids, oxylipins, and markers of glycemia and inflammation were measured.ResultsAfter 4 wk of OA-oil consumption, fasting glucose and total adiponectin concentrations decreased whereas fasting C-reactive protein increased. After 16 wk of LA-oil supplementation total and HMW adiponectin and plasma oxylipins increased. Markers of inflammation and glycemia were unchanged after LA-oil consumption.ConclusionsSupplementation with LA-oil increased total and HMW adiponectin concentrations and altered plasma oxylipin profiles. Larger studies are needed to elucidate the links between these changes and MetS.This trial was registered at clinicaltrials.gov as NCT02063165.

Background: Little research to date has investigated the spectrum of bladder health in women, including both bladder function and well-being. Therefore, we expanded our previous baseline analysis of bladder health in the Boston Area Community Health (BACH) Survey to incorporate several additional measures of bladder-related well-being collected at the 5-year follow-up interview, including one developed specifically for women. Methods: At follow-up, participants reported their frequency of 15 lower urinary tract symptoms (LUTS), degree of life impact from and thought related to urinary symptoms or pelvic/bladder pain/discomfort, and perception of their bladder condition. Prevalence ratios were calculated by generalized linear models with robust variance estimation, adjusting for LUTS risk factors and individual LUTS. The BACH Survey was approved by the New England Research Institutes Institutional Review Board and all participants provided written informed consent. Results: Generally similar findings were observed in the 5-year cross-sectional analysis as at baseline, irrespective of how we categorized LUTS or measured bladder-related well-being. Approximately one in five women (16.2%-18.0% of 2527 eligible women) reported no LUTS and no diminished bladder-related well-being, the majority (55.8%-65.7%) reported some LUTS and/or diminished well-being, and a further one in five (16.9%-26.6%) reported the maximum frequency, number, or degree of LUTS and/or diminished well-being. Measures of storage function (urinating again after

This applied paper is intended to serve as a "how to" guide for public health researchers, practitioners, and policy makers who are interested in building conceptual models to convey their ideas to diverse audiences. Conceptual models can provide a visual representation of specific research questions. They also can show key components of programs, practices, and policies designed to promote health. Conceptual models may provide improved guidance for prevention and intervention efforts if they are based on frameworks that integrate social ecological and biological influences on health and incorporate health equity and social justice principles. To enhance understanding and utilization of this guide, we provide examples of conceptual models developed by the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium. PLUS is a transdisciplinary U.S. scientific network established by the National Institutes of Health in 2015 to promote bladder health and prevent lower urinary tract symptoms, an emerging public health and prevention priority. The PLUS Research Consortium is developing conceptual models to guide its prevention research agenda. Research findings may in turn influence future public health practices and policies. This guide can assist others in framing diverse public health and prevention science issues in innovative, potentially transformative ways.

AIMS: Prior research on lower urinary tract symptoms (LUTS) has focused on the treatment and management of these conditions with scant attention to prevention. The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium was formed to address the complexities of preventing LUTS and promoting bladder health. METHODS: Herein, we describe challenges faced and strategies used to develop the PLUS Research Consortium into an engaged and productive transdisciplinary scientific team. We apply four previously defined team science phases (development, conceptualization, implementation, and translation) to frame our progress. RESULTS: Strategies to progress through the development phase included the generation of a shared mission, and valuing of other disciplinary perspectives. The conceptualization phase included generating a shared language and developing a team transdisciplinary orientation. During the implementation phase, the group developed roles and procedures and focused on conflict management. The translation phase includes continued refinement of the mission and goals, implementation of research protocols, and robust dissemination of the scientific work products related to bladder health. CONCLUSION: A diverse group has matured into a productive transdisciplinary team science consortium. Achieving this outcome required dedicated effort for each member to engage in activities that often required more time than single discipline research activities. Provision of the necessary time and tools has fostered a transdisciplinary team science culture and rich research agenda that reflects the complexity of the health issue to be addressed. Our experience may be useful for others embarking on team science projects.

BackgroundMagnetic resonance elastography (MRE) can determine the presence and stage of liver fibrosis. Data on normative MRE values, while reported in adults, are limited in children.PurposeTo determine the distribution of MRE-measured liver stiffness in children without liver disease.Study typeProspective, observational.PopulationEighty-one healthy children (mean 12.6 ± 2.6 years, range 8-17 years).Field strength/sequence3.0T Signa HDxt, General Electric MR Scanner; 2D GRE MRE sequence.AssessmentHistory, examination, laboratory evaluation, and (MR) exams (proton density fat fraction, PDFF, and MRE) were performed. MR elastograms were analyzed manually at two reading centers and compared with each other for agreement and with published values in healthy adults and thresholds for fibrosis in adult and pediatric patients.Statistical testsDescriptive statistics, Bland-Altman analysis, t-test to compare hepatic stiffness values with reference standards.ResultsStiffness values obtained at both reading centers were similar, without significant bias (P = 0.362) and with excellent correlation (intraclass correlation coefficient [ICC] = 0.782). Mean hepatic stiffness value for the study population was 2.45 ± 0.35 kPa (95th percentile 3.19 kPa), which was significantly higher than reported values for healthy adult subjects (2.10 ± 0.23 kPa, P

Students are integral to all universities, and online students have long been a growing and important population within higher education. Understanding the shifts of demographics and needs of online students through a global pandemic is crucial for university administrators, instructors, and librarians. For this analysis, a librarian at a mid-sized, public university performed a mixed-method study with interviews and surveys to virtual students about their academic needs before and during the COVID-19 pandemic. This study found that online students continue to want versatile and diverse library tools and resources to advance their academic success to face world challenges.

Background: Teaching-focused faculty positions have grown in popularity in higher education and provide novel opportunities to transform undergraduate science, technology, engineering, and mathematics (STEM) education. The University of California (UC) system employs a unique teaching-focused faculty position, officially called the Lecturer with Potential Security of Employment (L(P)SOE), with the working title called Professor of Teaching (PoT). The UC PoT position is a tenure-track position with teaching as the primary tenure expectation. We present findings from interviews with stakeholder faculty in STEM departments at three UC campuses to identify reasons for hiring PoT, capture accomplishments of PoT in their departments and disciplinary fields, and identify potential barriers to PoT success. Results: Overall, this study highlights stakeholder's perspectives on the value of teaching-focused faculty in research-intensive universities. Stakeholders described the goals for hiring Professors of Teaching, which included easing the burden of teaching responsibilities of the departments and adding consistency of instruction. While the stakeholders expressed that PoT were meeting the goals for being hired, they also identified many barriers for PoT being fully integrated and successful. The stakeholders expressed concern about unclear and unfair expectations related to tenure and promotion. Conclusions: The findings point to a general undervaluing and underappreciation of teaching-focused faculty and suggest that in order for PoT to have a positive impact on STEM higher education, they need more support and inclusion from their colleagues and institutions.

The practice of persisting and learning from design failures is essential to engineering design and offers unique ways of knowing and learning for K-12 students. To understand how students engage in the practice of persisting and learning from design failures, we must first understand how, if at all, they recognize that a design failure has occurred. We studied a classroom of fourth-grade students engaged in an engineering design challenge and examined the ways in which design failure occurred and how students recognized, neglected to recognize, or misinterpreted design failure. We found that, in addition to anticipating failure, conducting fair tests, and making focused observations, students must have an understanding and awareness of the evolving criteria and constraints of the design problem in order to recognize design failure. If lacking an understanding and awareness of criteria and constraints represents a barrier to recognizing an initial design failure, it also represents a barrier to recognizing any subsequent design failures in the design process and thus a barrier to persisting and learning from design failures. [This paper was presented at the 2022 ASEE Annual Conference & Exposition, Minneapolis, MN.]

The study of educational simulations at the secondary level has typically centered on programs that are competitive, shorter in duration, and characterized by their low fidelity, or a lack of realism. The resources required to hold longer, more immersive, and nuanced programs are often prohibitive for teachers of political science programs. As such, their effects on student learning outcomes have remained relatively unknown. In this paper, we explore the impact of a Model G20 (MG20) curriculum for high school and early college-aged students on students' sense of self-efficacy and 21st century skills. MG20 is a weeklong, immersive international conference modeled after the real G20 summit. In it, students learn about global governance and roleplay as heads of state and government ministers to negotiate for their collective interests. Using a mixed methods approach, we examine student learning outcomes from two MG20 summits, held in the United States and in the UK. Results show that internationally diverse, immersive, collaborative role-playing simulations significantly improve students' self-ascribed cross-cultural communication and public speaking skills, as well as students' sense self-efficacy. This research suggests future study into new and emerging formats of educational simulations may reveal greater potential for such programs to enhance student learning.

The activity presented in this article is part of a four-part module that centers earthquakes as a common phenomenon that students experience and introduces the idea of a resonant frequency. When the seismic waves from an earthquake encounter a building, the subsequent oscillating motion of the ground causes the building to move back and forth. The activity described in this article was implemented on a field trip to an interactive science center. In the first activity the authors have developed, students explore various structures around their schools to develop an understanding of common stabilizing methods used in construction. In the second activity, students explore the resonant frequencies of different-size strips of cardstock as they vary the frequency of the shaking motion applied to the strips. During this activity, they develop an understanding of how waves can cause objects to move as they transfer energy to the cardstock strips. The activity presented in this article pulls upon the knowledge and experiences gained in the first two classroom activities as students are challenged to stabilize three-dimensional buildings on variable frequency shaker tables. This was piloted as a field trip program to the interactive science center with fourth and fifth graders. This article outlines the full activity, provides sample student ideas that were shared during the authors' testing, and offers some suggestions for adapting this activity to a classroom environment.

Quantum computers are at the forefront of computing; however, few people understand how they work and their capabilities. We present two versions of an interactive activity designed for high school students (ages 13 to 18) that introduce a core quantum concept--"entanglement." The first version illustrates a simple connection between two particles, and the second explores different ways that two particles could be entangled. This activity works well for entry-level quantum computing learning and requires minimal materials.

Teaching faculty are a potential mechanism to generate positive change in undergraduate STEM education. One such type of faculty is the Lecturer with Potential Security of Employment (L(P)SOE), a tenure-track faculty line within the University of California (UC) system. As a foundation for future studies, we sought to characterize individuals in the L(P)SOE position in terms of their background training, job expectations, and resources available for their success. Data were collected through an online survey completed by over 80% of STEM L(P)SOEs across the UC system, as well as interviews with over 20 deans and chairs in STEM departments at three UC campuses. From this work, we found that the majority of current L(P)SOEs were formally trained within their disciplines and not in an education field; however, they possessed substantial education experience, such as classroom teaching or participation in professional development opportunities. Expectations for time spent on teaching, research, and service are aligned between individuals within varying ranks of the L(P)SOE faculty and between L(P)SOEs and administrators. L(P)SOEs and administrators are also in agreement about what constitutes acceptable professional development activities. Interestingly, we identified differences that may reflect changes in the position over time, including increased start-up funds for more recently hired L(P)SOE faculty and a differing perspective on the role of discipline-based education research and scholarly activities between non-tenured and more senior L(P)SOEs. Overall, these data provide a snapshot of the L(P)SOE position that will aid in future work to identify the potential institutional impact of these individuals.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

We present a consensus-based checklist to improve and document the transparency of research reports in social and behavioural research. An accompanying online application allows users to complete the form and generate a report that they can submit with their manuscript or post to a public repository.

ObjectiveTo determine the magnitude of relationships of early life factors with child development in low/middle-income countries (LMICs).DesignMeta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data.Data sourcesWe searched Medline, bibliographies of key articles and reviews, and grey literature to identify studies from LMICs that collected data on early life exposures and child development. The most recent search was done on 4 November 2014. We then invited the first authors of the publications and investigators of unpublished studies to participate in the study.Eligibility criteria for selecting studiesStudies that assessed at least one domain of child development in at least 100 children under 7 years of age and collected at least one early life factor of interest were included in the study.AnalysesLinear regression models were used to assess SMDs in child development by parental and child factors within each study. We then produced pooled estimates across studies using random effects meta-analyses.ResultsWe retrieved data from 21 studies including 20 882 children across 13 LMICs, to assess the associations of exposure to 14 major risk factors with child development. Children of mothers with secondary schooling had 0.14 SD (95% CI 0.05 to 0.25) higher cognitive scores compared with children whose mothers had primary education. Preterm birth was associated with 0.14 SD (-0.24 to -0.05) and 0.23 SD (-0.42 to -0.03) reductions in cognitive and motor scores, respectively. Maternal short stature, anaemia in infancy and lack of access to clean water and sanitation had significant negative associations with cognitive and motor development with effects ranging from -0.18 to -0.10 SDs.ConclusionsDifferential parental, environmental and nutritional factors contribute to disparities in child development across LMICs. Targeting these factors from prepregnancy through childhood may improve health and development of children.

We use the Einstein-Hilbert gravitational path integral to investigate gravita- tional entanglement at leading order O(1/G). We argue that semiclassical states prepared by a Euclidean path integral have the property that projecting them onto a subspace in which the Ryu-Takayanagi or Hubeny-Rangamani-Takayanagi surface has definite area gives a state with a flat entanglement spectrum at this order in gravitational perturbation theory. This means that the reduced density matrix can be approximated as proportional to the identity to the extent that its Renyi entropies Sn are independent of n at this order. The n-dependence of Sn in more general states then arises from sums over the RT/HRT- area, which are generally dominated by different values of this area for each n. This provides a simple picture of gravitational entanglement, bolsters the connection between holographic systems and tensor network models, clarifies the bulk interpretation of alge- braic centers which arise in the quantum error-correcting description of holography, and strengthens the connection between bulk and boundary modular Hamiltonians described by Jafferis, Lewkowycz, Maldacena, and Suh.

Background: Little research to date has focused on lower urinary tract symptom (LUTS) prevention and bladder health promotion in women. To address this gap, the Prevention of LUTS Research Consortium developed the following working bladder health definition: "A complete state of physical, mental, and social well-being related to bladder function [that] permits daily activities [and] allows optimal well-being." To begin to inform and quantify this definition, we used data from the Boston Area Community Health Survey, drawing upon its rare collection of information on LUTS and LUTS-specific interference with activities. Methods: At baseline, participants reported their frequency of 15 LUTS and interference with 7 activities. Prevalence ratios (PRs) were calculated by generalized linear models with robust variance estimation, adjusting for LUTS risk factors and individual LUTS. Results: Of the 3169 eligible participants, 17.5% reported no LUTS or interference, whereas the remaining 82.5% reported some frequency of LUTS/interference: 15.1% rarely; 21.7% a few times; 22.6% fairly often/usually; and 22.9% almost always. LUTS independently associated with interference were urgency incontinence, any incontinence, urgency, nocturia, perceived frequency, and urinating again after

ObjectivesTo determine the prevalence of nonalcoholic fatty liver disease (NAFLD) in children with obesity because current estimates range from 1.7% to 85%. A second objective was to evaluate the diagnostic accuracy of alanine aminotransferase (ALT) for NAFLD in children with obesity.Study designWe evaluated children aged 9-17 years with obesity for the presence of NAFLD. Diseases other than NAFLD were excluded by history and laboratories. Hepatic steatosis was measured by liver magnetic resonance imaging proton density fat fraction. The diagnostic accuracy of ALT for detecting NAFLD was evaluated.ResultsThe study included 408 children with obesity that had a mean age of 13.2 years and mean body mass index percentile of 98.0. The study population had a mean ALT of 32 U/L and median hepatic magnetic resonance imaging proton density fat fraction of 3.7%. The estimated prevalence of NAFLD was 26.0% (95% CI 24.2%-27.7%), 29.4% in male patients (CI 26.1%-32.7%) and 22.6% in female patients (CI 16.0%-29.1%). Optimal ALT cut-point was 42 U/L (47.8% sensitivity, 93.2% specificity) for male and 30 U/L (52.1% sensitivity, 88.8% specificity) for female patients. The classification and regression tree model with sex, ALT, and insulin had 80% diagnostic accuracy for NAFLD.ConclusionsNAFLD is common in children with obesity, but NAFLD and obesity are not concomitant. In children with obesity, NAFLD is present in nearly one-third of boys and one-fourth of girls.

The statistical package chosen to aid in teaching quantitative methods is at the instructor's discretion, but little research has investigated student attitude toward these different packages. This study compared Google Sheets, a spreadsheet package similar to Microsoft Excel, and a traditional package, SPSS, to determine which of the two programs students preferred to use. One hundred and thirty-nine students enrolled in a quantitative methods course completed surveys at the middle and end of the semester during Spring 2016 and Fall 2016. The results suggested Google Sheets was preferred to SPSS at both time points, and attitudes toward Google Sheets improved over time. Further research could investigate the perspectives of students in other levels of experience with statistics and other statistical packages.

Innovations in digital media have created new opportunities to engage young readers--opportunities that can stimulate teachers to use technology in ways that support the skills students need to fully participate in a digital society. However, research shows that today's literacy educators are still largely focused on print-based literature. Transmedia literature has the potential to challenge this tendency. Specifically, the born-digital novel "Inanimate Alice" shows promise in empowering twenty first-century readers and writers through multimodal narratives. This paper presents the work in progress from a collaborative research group that was assembled to identify solutions for integrating "Inanimate Alice" into both formal and informal education. The primary goal of the group is to position "Inanimate Alice" as an exemplar for a new canon of digital literature, thus legitimating the role of innovative literary forms in supporting twenty first-century literacies. The group has adopted a cross-disciplinary approach to examine the design and usability of the story's platform as well as explore the relationship between the complexity of its reading experience and the complexity of its medium. This paper offers a discussion of ongoing research findings and emerging understandings of the literacy experiences that underlie young readers' interactions with "Inanimate Alice" through a multi-disciplinary perspective.

The "Technological Pedagogical and Content Knowledge" (TPACK) conceptual framework captures the complex nature of teacher knowledge essential for effective teaching in the digital age. TPACK is difficult to assess, however, particularly among teacher candidates whose pedagogical knowledge is developing. This study aimed to examine multiple ways to assess teacher candidates' TPACK development and its application in response to a technology-focused coursework. Using a mixed-method, multi-assessment design, the study sampled 26 teacher candidates enrolled in a graduate-level course. TPACK survey at two time points and multiple course artifacts including course reflection, lesson delivery reflection and unit plan design were used for analysis. Quantitative survey data pointed to the significant growth in all domains of TPACK except for PK. Qualitative reflection data revealed themes supporting the growth in key TPACK domains. However, unit plan analysis revealed some inconsistency with the self-reported survey results, showing the limitation of TPACK survey. Unit plan data revealed variability and limited application of TPACK knowledge among teacher candidates who reported biggest TPACK growth, suggesting the necessity for providing more opportunities for acquiring TPACK in meaningful application. The study extends earlier research findings about the necessity of using multiple sources of information to assess teacher candidates' TPACK development.

In an increasingly digital world, the elementary school students of today who learn to program will be positioned to re-imagine and build the future. As educators, it is essential to consider how such an important skill is made accessible for a diverse range of students, including those diagnosed with learning disabilities. In this article, the authors build on previous work conducted to connect computer programming to science learning. In Hansen et al. (2015), the authors described an engaging activity that challenged fourth-grade students to program a digital story or animation depicting science content such as how volcanoes form or the stages of chemical reactions. The authors now revisit the same activity through the lens of Universal Design for Learning (UDL) and discuss how the activity was adapted to support the learning of children with learning disabilities in the classroom.