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Abstract INTRODUCTION Overlooking the heterogeneity in Alzheimer's disease (AD) may lead to diagnostic delays and failures. Neuroanatomical normative modeling captures individual brain variation and may inform our understanding of individual differences in AD‐related atrophy. METHODS We applied neuroanatomical normative modeling to magnetic resonance imaging from a real‐world clinical cohort with confirmed AD (n = 86). Regional cortical thickness was compared to a healthy reference cohort (n = 33,072) and the number of outlying regions was summed (total outlier count) and mapped at individual‐ and group‐levels. RESULTS The superior temporal sulcus contained the highest proportion of outliers (60%). Elsewhere, overlap between patient atrophy patterns was low. Mean total outlier count was higher in patients who were non‐amnestic, at more advanced disease stages, and without depressive symptoms. Amyloid burden was negatively associated with outlier count. DISCUSSION Brain atrophy in AD is highly heterogeneous and neuroanatomical normative modeling can be used to explore anatomo‐clinical correlations in individual patients.

This article explores the evolving perceptions of science and scientists from the unique perspective of Italian primary school children by comparing students’ drawings from two distinct periods, 2011 and 2021. A notable research gap exists in understanding how the perceptions of science and scientists among primary school children have evolved over time and if it is different for gender and grade level. The methodology involves a qualitative analysis of drawings examining the presence, the number and gender of depicted scientists, stereotypes, scientific topics, inventions, tools, location, and accompanying speech bubbles. The statistical analysis emphasizes the differences between how girls and boys represent science and scientists. From the data, a generally positive picture of the work of scientists emerges, as well as a great level of confidence in the potential of science. Notably, while the prevailing image of a scientist is still predominantly male, the 2021 dataset demonstrates a significant increase in depictions of female scientists, primarily drawn by girls, signaling an increased sense of belonging and potential for girls to pursue careers in science. Environmental and health-related scientific themes have gained prominence, accompanied by an increase in inventive ideas. The data highlights the children’s awareness of pressing global issues, such as climate change and healthcare, caused by Covid emergency. Furthermore, the results contribute to evaluate how science showed itself over ten years, if it has led to an effective shared science and a less stereotyped image, also encouraging gender equality.

Esta investigación nace de la necesidad de fortalecer los procesos de producción escrita en los estudiantes de grado quinto de la I.E.D Diana Turbay en la ciudad de Bogotá. Se tuvo en cuenta los bajos resultados de las Pruebas Saber en el área de Lengua Castellana y las dificultades escriturales que se evidenciaron a partir de un diagnóstico basado en las habilidades y características que debe tener un buen escrito (Cassany, 1995). En consecuencia, diseñamos una estrategia pedagógica utilizando el cómic como herramienta didáctica. Trabajamos un enfoque cualitativo con un tipo de Investigación Acción apoyada en el modelo constructivista a través de cuatro etapas: a) elaboración de diagnóstico a partir de observación, entrevista y pruebas escritas; b) diseño de la estrategia pedagógica; c) implementación de la secuencia didáctica; d) análisis de resultados, logrando avances significativos, ya que los manuscritos mostraron un aprendizaje formal dentro de la escritura, teniendo en cuenta estructuras como la coherencia, redacción y conciencia ortográfica.

ABSTRACT This research paper analyzes the Influence of IS innovation diffusion on the performance/ outcome of the village government. Besides this paper also determines the role of organizational support and technological advantage in determining performance. Finally, this study researched these variables as moderating between IS innovation diffusion and implementation. The primary data was collected through a survey and analyzed using the smart-pls. The result shows that the technological advantage is significantly associated with the performance of the village government. This finding contributes to the technology organization environment. ABSTRAK Penelitian ini menganalisis pengaruh difusi inovasi SI terhadap kinerja pemerintah desa. Selain itu, penelitian ini juga menentukan peran dukungan organisasi dan keunggulan teknologi dalam menentukan kinerja. Terakhir, penelitian ini juga meneliti variabel-variabel tersebut sebagai variabel pemoderasi antara difusi inovasi SI dan kinerja. Data primer dikumpulkan melalui survei dan dianalisis menggunakan smart-pls. Hasil penelitian menunjukkan bahwa keunggulan teknologi berpengaruh secara signifikan dengan kinerja pemerintah desa. Temuan ini secara teoritis berkontribusi pada technology organization environment.

Abstract Objectives Visual rating scales (VRS) are the quantification method closest to the approach used in routine clinical practice to assess brain atrophy. Previous studies have suggested that the medial temporal atrophy (MTA) rating scale is a reliable diagnostic marker for AD, equivalent to volumetric quantification, while others propose a higher diagnostic utility for the Posterior Atrophy (PA) scale in early‐onset AD. Methods Here, we reviewed 14 studies that assessed the diagnostic accuracy of PA and MTA, we explored the issue of cut‐off heterogeneity, and assessed 9 rating scales in a group of patients with biomarker‐confirmed diagnosis. A neuroradiologist blinded to all clinical information rated the MR images of 39 amyloid‐positive and 38 amyloid‐negative patients using 9 validated VRS assessing multiple brain regions. Automated volumetric analyses were performed on a subset of patients (n = 48) and on a group of cognitively normal individuals (n = 28). Results No single VRS could differentiate amyloid‐positive from amyloid‐negative patients with other neurodegenerative conditions. 44% of amyloid‐positive patients were deemed to have age‐appropriate levels of MTA. In the amyloid‐positive group, 18% had no abnormal MTA or PA scores. These findings were substantially affected by cut‐off selection. Amyloid‐positive and amyloid‐negative patients had comparable hippocampal and parietal volumes, and MTA but not PA scores correlated with the respective volumetric measures. Interpretation Consensus guidelines are needed before VRS can be recommended for use in the diagnostic workup of AD. Our data are suggestive of high intragroup variability and non‐superiority of volumetric quantification of atrophy over visual assessment.

This qualitative case study explores the experiences of former [Supplemental Instruction] SI leaders who worked at a four-year, private university in the Mid-Atlantic while completing their undergraduate degrees. The insights offered by participants through interviews and graphic elicitation reveal the ways in which serving as an SI leader prepares students for their post-graduation lives through the transferability of skills. This study also seeks to fill a void in research, as studies on academic assistance programs tend to explore benefits for student participants, such as increased retention and course grades, but fail to explore the development of the programs' student leaders.

Many students in American schools are facing educational limitations due to the effects of poverty and homelessness. Educator preparation programs must address the needs of this special population of poverty by providing training in trauma-informed pedagogy. The goal is to make teachers more aware of the effects of poverty and provide additional tools to reach and successfully teach students by developing relationships and creating safe learning environments that acknowledge and address the emotional states of students who face chronic stress from poverty. The use of aesthetic strategies for literacy and learning will also make school more meaningful and relevant for students with learned hopelessness. This article addressed trauma-informed pedagogy for literacy and learning through action steps and examples designed by pre-service teachers in training.

The proliferation of generative artificial intelligence (AI) and its extensive potential for integration into many aspects of health care signal a transformational shift within the health care environment. In this context, medical education must evolve to ensure that medical trainees are adequately prepared to navigate the rapidly changing health care landscape. Medical education has moved toward a competency-based education paradigm, leading the Association of American Medical Colleges (AAMC) to define a set of Entrustable Professional Activities (EPAs) as its practical operational framework in undergraduate medical education. The AAMC’s 13 core EPAs for entering residencies have been implemented with varying levels of success across medical schools. In this paper, we critically assess the existing core EPAs in the context of rapid AI integration in medicine. We identify EPAs that require refinement, redefinition, or comprehensive change to align with the emerging trends in health care. Moreover, this perspective proposes a set of “emerging” EPAs, informed by the changing landscape and capabilities presented by generative AI technologies. We provide a practical evaluation of the EPAs, alongside actionable recommendations on how medical education, viewed through the lens of the AAMC EPAs, can adapt and remain relevant amid rapid technological advancements. By leveraging the transformative potential of AI, we can reshape medical education to align with an AI-integrated future of medicine. This approach will help equip future health care professionals with technological competence and adaptive skills to meet the dynamic and evolving demands in health care.

Background Context: Lumbar spine fusion (LSF) surgery is a viable form of treatment for several spinal disorders. Treatment effects are preferably to be endorsed in real-life settings. Methods: This prospective study evaluated the 10-year outcomes of LSF. A population-based series of elective LSFs performed at 2 spine centers between January 2008 and June 2012 were enrolled. Surgeries for tumor, acute fracture, or infection, neuromuscular scoliosis, or postoperative conditions were excluded. The following patient-reported outcome measures (PROMs) were collected at baseline, and 1, 2, 5, and 10 years postsurgery: VAS for back and leg pain, ODI, SF-36. Longitudinal measures of PROMs were analyzed using mixed-effects models. Results: A total of 683 patients met the inclusion criteria, and 630 (92%) of them completed baseline and at least 1 follow-up PROMs, and they constituted the study population. Mean age was 61 (SD 12) years, 69% women. According to surgical indication, patients were stratified into degenerative spondylolisthesis (DS, n=332, 53%), spinal stenosis (SS, n=102, 16%), isthmic spondylolisthesis (IS, n=97, 15%), degenerative disc disease (DDD, n=52, 8%), and deformity (DF, n=47, 7%).All diagnostic cohorts demonstrated significant improvement at 1 year, followed by a partial loss of benefits by 10 years. ODI baselines and changes at 1 and 10 years were: (DS) 45, −21, and −14; (SS) 51, −24, and −13; (IS) 41, −24, and −20; (DDD) 50, −20, and −20; and (DF) 50, −21, and −16, respectively. Comparable patterns were seen in pain scores. Significant HRQoL achievements were recorded in all cohorts, greatest in physical domains, but also substantial in mental aspects of HRQoL. Conclusions: Benefits of LSF were partially lost but still meaningful at 10 years of surgery. Long-term benefits seemed milder with degenerative conditions, reflecting the progress of the ongoing spinal degeneration. Benefits were most overt in pain and physical function measures.

ABSTRACTBackground Medical student burnout and anxiety has received growing attention in the past decade. The culture of competition and assessment has resulted in increasing stress levels amongst medical students, causing a decline in their academic performance and overall mental health. The objective of this qualitative analysis was to characterize recommendations from educational experts to aid students’ academic progress.Methods At an international meeting in 2019, worksheets were completed by medical educators during a panel discussion. Participants responded to four scenarios representing common challenges medical students face in school (eg. Postponing Step 1, failing clerkships, etc.). For each case, participants addressed what students, faculty and medical schools could do to mitigate the challenge. Inductive thematic analysis was conducted by two authors followed by deductive categorization using an individual-organizational resilience model.Results Across the four cases, common suggestions made for students, faculty and medical schools were aligned to a resilience model representing the complex interplay between individuals and organizations and the impact on student wellbeing.Discussion Using suggestions from medical educators from across the US, we were able to identify recommendations for students, faculty, and medical schools to help students succeed in medical school. By applying a model of resilience, faculty serve as a critical bridge to connect students to the medical school administration. Our findings also support a pass/fail curriculum to ease the competition and burden students place on themselves.

Learning curves can be used to design, implement, and evaluate educational interventions. Attention to key aspects of the method can improve the fidelity of this representation of learning as well as its suitability for education and research purposes. This paper addresses when to use a learning curve, which graphical properties to consider, how to use learning curves quantitatively, and how to use observed thresholds to communicate meaning. We also address the associated ethics and policy considerations. We conclude with a best practices checklist for both educators and researchers seeking to use learning curves in their work.

Abstract Background There is a critical need for novel primary endpoints designed to detect early and subtle changes in cognition in clinical trials targeting the asymptomatic (preclinical) phase of Alzheimer’s disease (AD). The Alzheimer’s Prevention Initiative (API) Generation Program, conducted in cognitively unimpaired individuals at risk of developing AD (e.g., enriched by the apolipoprotein E (APOE) genotype), used a novel dual primary endpoints approach, whereby demonstration of treatment effect in one of the two endpoints is sufficient for trial success. The two primary endpoints were (1) time to event (TTE)—with an event defined as a diagnosis of mild cognitive impairment (MCI) due to AD and/or dementia due to AD—and (2) change from baseline to month 60 in the API Preclinical Composite Cognitive (APCC) test score. Methods Historical observational data from three sources were used to fit models to describe the TTE and the longitudinal APCC decline, both in people who do and do not progress to MCI or dementia due to AD. Clinical endpoints were simulated based on the TTE and APCC models to assess the performance of the dual endpoints versus each of the two single endpoints, with the selected treatment effect ranging from a hazard ratio (HR) of 0.60 (40% risk reduction) to 1 (no effect). Results A Weibull model was selected for TTE, and power and linear models were selected to describe the APCC score for progressors and non-progressors, respectively. Derived effect sizes in terms of reduction of the APCC change from baseline to year 5 were low (0.186 for HR = 0.67). The power for the APCC alone was consistently lower compared to the power of TTE alone (58% [APCC] vs 84% [TTE] for HR = 0.67). Also, the overall power was higher for the 80%/20% distribution (82%) of the family-wise type 1 error rate (alpha) between TTE and APCC compared to 20%/80% (74%). Conclusions Dual endpoints including TTE and a measure of cognitive decline perform better than the cognitive decline measure as a single primary endpoint in a cognitively unimpaired population at risk of AD (based on the APOE genotype). Clinical trials in this population, however, need to be large, include older age, and have a long follow-up period of at least 5 years to be able to detect treatment effects.

The problem delivered in this study is that some fighters are easily caught when performing side kicks, need help attacking rivals with a higher posture, and need to reach the optimal point when performing splits. This study aims to determine the correlation between leg length and flexibility with the speed of side kicks in martial arts. This quantitative research defines the correlation between the independent and dependent variables. This research uses sampling of 30 fighters by utilizing purposive sampling. The research instrument for limb length uses a rolling meter and flexibility using a side split test, while a statistical test uses multiple correlations. The results showed that (1) there was no significant correlation between leg length and sidekick speed with a sig. of 0.621; (2) There is a significant correlation between flexibility with sidekick speed and the sig value of 0.002;(3) There is a significant correlation between leg length and flexibility with sidekick speed, with an r-value of 0.007. This study concludes that anthropometric components are needed to do side kicks quickly and well in martial arts, especially leg length and physical condition aspects of flexibility.

Urgensi masalah yang sedang dihadapi dalam dunia pendidikan karena ketidakpastian masyarakat dalam mengambil informasi yang berimbas pada tidak fokusnya lembaga pendidikan memperoleh pengetahuan yang siap dalam setiap mata pelajaran. Maka siswa harus dipersiapkan untuk tujuan baru yang tidak berorientasi pada konvensional terus menerus. Siswa harus sadar akan tujuan pendidikan mereka sendiri dalam merancang maupun mengimplementasikan rute pendidikan mereka yang sejalan dengan perubahan kehidupan nyata. Dasar aksiologi pada hakikatnya tidak lepas dari ontologi dan epistemologi. Kebergunaan aksiologi untuk mengukur kebermanfaatan nilai dari dunia pendidikan yang diharapkan dapat menciptakan pendidikan yang modern. Penelitian dilakukan secara literer, dengan kajian pustaka yang dipilih buku-buku dan jurnal atau majalah ilmiah yang memuat uraian mengenai orientasi aksiologi, filsafat ilmu, dan pemecahan masalah pendidikan. Data yang dibutuhkan adalah data kualitatif yang diolah dengan metode reflektif, dilengkapi dengan metode ‘verstehen’. Artikel ini berusaha untuk menentukan karakteristik esensial aksiologi dalam pendidikan universal modern sebagai proses implementasi aksiologi dalam penentuan nasib sendiri guru dan siswa. The urgency of the problem that is being faced in the world of education is due to the uncertainty of the community in taking information which has an impact on the focus of educational institutions on obtaining ready knowledge in each subject. Then students must be prepared for new goals that are not conventionally oriented continuously. Students should be aware of their own educational goals in designing as well as implementing their educational routes in line with real-life changes. The basis of axiology is essentially inseparable from ontology and epistemology. This research was carried out in a literal way, with a literature review that selected scientific books and journals or magazines which contained descriptions of axiological orientation, philosophy of science, and educational problem solving. The data needed is qualitative data which is processed using a reflective method, supplemented by the 'verstehen' method. This article attempts to determine the essential characteristics of axiology in modern universal education as a process of implementing axiology in the self-determination of teachers and students.