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To build knowledge, separate yet related learning episodes can be integrated with one another and then used to derive new knowledge. Separate episodes are often experienced through different formats, such as text passages and graphic representations. Accordingly, in the present research, we tested integration of learning episodes provided through different presentation formats with children in the laboratory (Experiment 1; n = 24; M = 8.36 years) and in classrooms (Experiment 2; n = 85; M = 9.34 years and Experiment 3; n = 154; M = 10.67 years). Children in the laboratory were successful in both same-format and different-format conditions. Children in the classroom were also successful in both conditions, but in Exp. 2 showed a cost to integration across two different presentation formats compared to the same-format condition. In Exp. 3, greater support for encoding the graphic information was added and performance no longer showed a cost between conditions.

Success in mathematics contributes to children's future career and lifelong financial security. There have been reports that dual-language education conveys academic advantages in mathematics achievement, although there is debate. This study aimed to investigate whether dual-language education benefits children's mathematics achievement and examine executive functions as a potential mechanism through which dual-language education influences math achievement. Fourth grade children (n = 465; aged 9-10 years) attending either dual-language education or mainstream education programs within the same school were tested on both mathematics achievement and executive functions. Results showed that children in the dual-language education program had higher math scores as well as higher executive functions performance. Executive functions also significantly mediated the relation between education program and mathematics achievement, providing support for executive functions as a mechanism through which advanced mathematics performance is achieved. All analyses controlled for primary caregiver education. Attrition rate of the education program as well as bilingual proficiency were considered in the analysis. Results suggest that bilingual experience gained from a dual-language program may benefit children's executive functions and that dual-language education may be an effective program for children's mathematics achievement through cognitive advantages that contribute to academic success. [For the corresponding grantee submission, see ED624564.]

Semantic knowledge accumulates through explicit means and productive processes (e.g., analogy). These means work in concert when information explicitly acquired in separate episodes is integrated, and the integrated representation is used to self-derive new knowledge. We tested whether (a) self-derivation through memory integration extends beyond general information to science content, (b) self-derived information is retained, and (c) details of explicit learning episodes are retained. Testing was in second-grade classrooms (children 7-9 years). Children self-derived new knowledge; performance did not differ for general knowledge (Experiment 1) and science curriculum facts (Experiment 2). In Experiment 1, children retained self-derived knowledge over one week. In Experiment 2, children remembered details of the learning episodes that gave rise to self-derived knowledge; performance suggests that memory integration is dependent on explicit prompts. The findings support nomination of self-derivation through memory integration as a model for accumulation of semantic knowledge and inform the processes involved.

A primary objective of development is to build a knowledge base. To accumulate knowledge over time and experiences, learners must engage in productive processes, going beyond what is explicitly given to generate new knowledge. Though important to accumulating knowledge, these processes are also easily disrupted. Individuals often depend on surface level similarities, such as visual features, to recognize the relation between learning episodes. When the surface level similarity is low, performance on tasks that depend on productive processes, such as self-derivation through integration of new knowledge, suffers. The major purpose of the present research was to examine whether presentation of related information in different languages poses a challenge to memory integration and self-derivation, due to low levels of surface similarity between episodes of learning through different languages. In Study 1, 62 children (Grade 2; mean age=8;1 years) listened to story-passages containing novel facts that could be integrated to self-derive new knowledge. Related passages were presented either through the same language or through two different languages (cross-language condition; Spanish and English). There were no significant differences between presentation conditions. In Study 2, 100 children (Grades 3 and 4; mean age=9.7 years) heard novel facts in single sentences, again presented in either a same-language or cross-language condition. Whereas 3rd-grade cross-language performance suffered compared to same-language English controls, 4th-grade performance did not. Results suggest that in addition to language proficiency, rich contextual support and experience in a bilingual environment facilitate cross-language integration.

We describe research results and lessons learned from a laboratory/ classroom collaboration with a school system offering both traditional English-only education and a dual-language track (Spanish/English). Through this collaboration, we addressed basic research questions informing malleable factors that impact cognitive development. In a reciprocal manner, ongoing communication with the school system and community has directed the research questions to provide information the school system seeks for program evaluation and to maintain community support. In this report, we share results of the effects of participation in a dual-language model of education in the areas of executive functions, academic performance, and English-language development. Our research revealed no evidence of detrimental effects of participation in the dual-language education program compared with the traditional English-only instructional track in any of these areas. There was some evidence for emerging benefits to executive functions and academic performance for children participating in dual-language education. We also share the implications of the research for the way in which academic content is delivered in the dual-language education model. We conclude with lessons learned from collaborating with the school system that will direct our future research and might aid researchers interested in pursuing similar partnerships. [This article was published in "Journal of Cognition and Development" (EJ1219015).]

Children are on a quest for knowledge. To achieve it, children must integrate separate but related episodes of learning. The theoretical model of memory integration posits that the process is supported by component cognitive abilities. In turn, memory integration predicts accumulation of a knowledge base. We tested this model in two studies (data collected in 2016-2018) with second (8-year-olds; n = 391; 196 female; 36% Black, 27% Hispanic/Latinx, 29% White, and 8% multiracial) and third (9-year-olds; n = 282; 148 female; 36% Black, 31% Hispanic/Latinx, 27% White, and 5% multiracial) graders. The results support the theoretical model and the role of verbal comprehension in learning new information, and also indicate that verbal comprehension alone is not sufficient to build knowledge.

Self-derivation of new factual knowledge through integration of separate episodes of learning is one means by which children build knowledge. Content generated in this manner becomes incorporated into the knowledge base and is retained over time; successful self-derivation predicts academic achievement. Yet the component processes on which self-derivation through integration depends are as yet unknown. In parallel studies with 6- and 8-year-olds (N = 41; Experiment 1) and 8- and 10-year-olds (N = 40; Experiment 2), we tested a number of predictors related to other productive processes and learning (reasoning, executive functions, verbal comprehension, and long-term retrieval). Across studies, with different methods, only verbal comprehension, a measure of accumulated semantic knowledge, accounted for unique variance in self-derivation through integration performance. The results indicate that self-derivation through integration of separate episodes relates to accumulation of knowledge and the ability to recruit the knowledge in the service of specific task demands. Implications for cognitive training and transfer are discussed.

Although risk calculators are used to prognosticate postoperative outcomes following revision total hip and knee arthroplasty (total joint arthroplasty [TJA]), machine learning (ML) based predictive tools have emerged as a promising alternative for improved risk stratification. This study aimed to compare the predictive ability of ML models for 30-day mortality following revision TJA to that of traditional risk-assessment indices such as the CARDE-B score (congestive heart failure, albumin (< 3.5 mg/dL), renal failure on dialysis, dependence for daily living, elderly (> 65 years of age), and body mass index (BMI) of < 25 kg/m2), 5-item modified frailty index (5MFI), and 6MFI. Adult patients undergoing revision TJA between 2013 and 2020 were selected from the American College of Surgeons National Surgical Quality Improvement Program database and randomly split 80:20 to compose the training and validation cohorts. There were 3 ML models - extreme gradient boosting, random forest, and elastic-net penalized logistic regression (NEPLR) - that were developed and evaluated using discrimination, calibration metrics, and accuracy. The discrimination of CARDE-B, 5MFI, and 6MFI scores was assessed individually and compared to that of ML models. All models were equally accurate (Brier score = 0.005) and demonstrated outstanding discrimination with similar areas under the receiver operating characteristic curve (AUCs, extreme gradient boosting = 0.94, random forest = NEPLR = 0.93). The NEPLR was the best-calibrated model overall (slope = 0.54, intercept = −0.004). The CARDE-B had the highest discrimination among the scores (AUC = 0.89), followed by 6MFI (AUC = 0.80), and 5MFI (AUC = 0.68). Albumin < 3.5 mg/dL and BMI (< 30.15) were the most important predictors of 30-day mortality following revision TJA. The ML models outperform traditional risk-assessment indices in predicting postoperative 30-day mortality after revision TJA. Our findings highlight the utility of ML for risk stratification in a clinical setting. The identification of hypoalbuminemia and BMI as prognostic markers may allow patient-specific perioperative optimization strategies to improve outcomes following revision TJA. [ABSTRACT FROM AUTHOR]

Arthroplasty surgeons use a variety of patient-reported outcome measures (PROMs) to assess functional well-being, including the Knee Injury and Osteoarthritis Outcome Score (KOOS) Physical Function short form (KOOS-PS), Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Short Form 10a (PROMIS PF SF 10a), and PROMIS Global-10 Physical Health subscale. However, there is a paucity of literature assessing their concurrent validity and performance. Between June 2016 and December 2020, patient visits at an arthroplasty clinic for knee concerns were identified. Patients who completed KOOS-PS, PROMIS PF SF 10a, and PROMIS Global-10, including its physical and mental health subscales, at the same visit were identified. Spearman rho (ρ) correlations were calculated and ceiling and floor effects identified. Overall, 5,303 patient encounters were included. Among physical function domains, strong correlation existed between the KOOS-PS and PROMIS PF SF 10a (ρ = 0.76, P <.001), KOOS-PS and PROMIS Global Physical Health (ρ = 0.71, P <.001), and PROMIS PF SF 10a and PROMIS Global Physical Health (ρ = 0.78, P <.001). No physical function–focused PROM had an appreciable floor effect (ie, at or more than 1%). The KOOS-PS had a small but measurable ceiling effect (n = 105 [2.0%]). All of the examined PROMs are acceptable to measure the functional status of patients with knee pathology, with the PROMIS Global-10 also being able to capture elements of mental health too. The PROMIS Global-10 may be of most value of the PROMs assessed, as the United States Centers for Medicare and Medicaid Services already incorporate the mental health component into new alternative payment models. [ABSTRACT FROM AUTHOR]

We investigated 7- to 10-year-old children's productive extension of semantic memory through self-generation of new factual knowledge derived through integration of separate yet related facts learned through instruction or through reading. In Experiment 1, an experimenter read the to-be-integrated facts. Children successfully learned and integrated the information and used it to further extend their semantic knowledge, as evidenced by high levels of correct responses in open-ended and forced-choice testing. In Experiment 2, on half of the trials, the to-be-integrated facts were read by an experimenter (as in Experiment 1) and on half of the trials, children read the facts themselves. Self-generation performance was high in both conditions (experimenter- and self-read); in both conditions, self-generation of new semantic knowledge was related to an independent measure of children's reading comprehension. In Experiment 3, the way children deployed cognitive resources during reading was predictive of their subsequent recall of newly learned information derived through integration. These findings indicate self-generation of new semantic knowledge through integration in school-age children as well as relations between this productive means of extension of semantic memory and cognitive processes engaged during reading.

This investigation is an initial examination of possible enhancement of executive function through a dual-language (50:50) education model. The ethnically diverse, low-income sample of 120 children from Grades K, 2, and 4 consisted of approximately equal numbers of children enrolled in dual-language and traditional classrooms. Dual-language students in Grades 2 and 4 performed better on a measure from the Trail Making Task requiring inhibition and rule-switching. The results indicate that the established benefits of bilingual exposure can be generalized across SES and ethnicity and can be acquired within the context of elementary school programs.

Postoperative discharge to facilities account for over 33% of the $ 2.7 billion revision total knee arthroplasty (TKA)-associated annual expenditures and are associated with increased complications when compared to home discharges. Prior studies predicting discharge disposition using advanced machine learning (ML) have been limited due to a lack of generalizability and validation. This study aimed to establish ML model generalizability by externally validating its prediction for nonhome discharge following revision TKA using national and institutional databases. The national and institutional cohorts comprised 52,533 and 1,628 patients, respectively, with 20.6 and 19.4% nonhome discharge rates. Five ML models were trained and internally validated (five-fold cross-validation) on a large national dataset. Subsequently, external validation was performed on our institutional dataset. Model performance was assessed using discrimination, calibration, and clinical utility. Global predictor importance plots and local surrogate models were used for interpretation. The strongest predictors of nonhome discharge were patient age, body mass index, and surgical indication. The area under the receiver operating characteristic curve increased from internal to external validation and ranged between 0.77 and 0.79. Artificial neural network was the best predictive model for identifying patients at risk for nonhome discharge (area under the receiver operating characteristic curve = 0.78), and also the most accurate (calibration slope = 0.93, intercept = 0.02, and Brier score = 0.12). All five ML models demonstrated good-to-excellent discrimination, calibration, and clinical utility on external validation, with artificial neural network being the best model for predicting discharge disposition following revision TKA. Our findings establish the generalizability of ML models developed using data from a national database. The integration of these predictive models into clinical workflow may assist in optimizing discharge planning, bed management, and cost containment associated with revision TKA. • Machine learning model generalizability was established using external validation. • Models were interpreted using local surrogate models to improve transparency. • Age was the most important predictor of nonhome discharge. • Model predictive performance improved in the external validation dataset. [ABSTRACT FROM AUTHOR]

Results of a survey of 92 nonhandicapped first and second graders (9 of whom had previously participated in a structured integration program and 52 of whom had had unstructured informal contact with the handicapped) suggested that contact with handicapped persons, regardless of type or timing, improved attitudes. (Author/JW)

Nine studies reporting child change data for nonhandicapped children participating in integrated preschool settings were analyzed in terms of methodology and specific classroom practices. The studies suffered from methodological weaknesses common to many early intervention efficacy studies. Documentation of child progress is only one measure of the effectiveness of integration. (Author/VW)

Two hearing-impaired children, aged three and five, were observed in free play as they alternated between integrated and segregated settings. Results indicated that the level of cognitive play was not consistently influenced by the social setting, and that the children engaged in more socially advanced play in the integrated setting. (Author/JDD)

Background: The management of the patella during total knee arthroplasty (TKA) remains controversial. The aim of this study is to evaluate the evidence regarding the use of patellar resurfacing in TKA.Methods: A meta-analysis of randomized controlled trials (RCTs) was performed to compare outcomes between knees receiving patellar resurfacing vs those not receiving resurfacing during primary TKA. Outcomes of interest were the Knee Society Scores, reoperation rates, anterior knee pain, patient satisfaction, Oxford Knee Score, Knee Injury and Osteoarthritis Outcome Score subscores, and range of motion.Results: Twenty RCTs met all eligibility criteria and were included in the analysis. There were statistically significant differences favoring the resurfaced group in the knee component and functional component of Knee Society Scores that were not clinically significant. There was an increased risk of reoperation among knees that did not receive resurfacing with number needed to treat to prevent one case of reoperation of 25 knees (for reoperation for any reason) and 33 knees (for reoperation for anterior knee pain). There were no statistically significant differences in any other outcomes.Conclusion: The only clear relationship is that knees that do not receive patellar resurfacing are more likely to receive reoperation, most often for secondary resurfacing. However, the disease burden of differing complication profiles associated with resurfacing and nonresurfacing groups remains unclear. Continuing to collect data from large, well-designed RCTs would be beneficial in guiding management of the patella during TKA. [ABSTRACT FROM AUTHOR]

The article responds to a criticism (EC 221 612) of a previous article by the authors (EC 212 323) and suggests the criticism is biased. They note the fallacy of value-free research, reject the allegation that their bias guided their research, and identify points of agreement and disagreement with the criticism. (DB)

Four severely handicapped children participated for 21 weekly sessions in snack time, outdoor play, and a structured group activity with nine nonhandicapped kindergarteners. The handicapped children made significant increases in social gains, and the nonhandicapped children significantly increased their positive attitudes, as measured by the Primary Student Survey of Handicapped Peers. (CL)