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Bruna Wageck,1 Narelle S Cox,1– 3 Christine F McDonald,3– 5 Angela T Burge,1– 3,6 Ajay Mahal,7 Catherine J Hill,3,8 Annemarie L Lee,2,3,6 Rosemary Moore,3,8 Caroline Nicolson,9,10 Paul O’Halloran,11 Aroub Lahham,1– 3 Rebecca Gillies,1,8 Anne E Holland1– 3,6 1La Trobe University, Melbourne, Australia; 2Monash University, Melbourne, Australia; 3Institute for Breathing and Sleep, Melbourne, Australia; 4Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, Australia; 5Department of Medicine, The University of Melbourne, Melbourne, Australia; 6Department of Physiotherapy, Alfred Health, Melbourne, Australia; 7The Nossal Institute of Global Health, The University of Melbourne, Melbourne, Australia; 8Department of Physiotherapy, Austin Health, Melbourne, Australia; 9Department of Pulmonary Hypertension, Alfred Health, Melbourne, Australia; 10Physiotherapy Department, Monash University, Melbourne, Australia; 11Department of Public Health, La Trobe University, Melbourne, AustraliaCorrespondence: Anne E HollandMonash University, Central Clinical School, Level 6, Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, AustraliaTel +61 3 99030214Email a.holland@alfred.org.auBackground: Pulmonary rehabilitation is an effective treatment for people with chronic obstructive pulmonary disease (COPD), but its benefits are poorly maintained. The aim of this study was to evaluate the impact of COPD exacerbations in the year following pulmonary rehabilitation on outcomes at 12 months.Methods: This was a secondary analysis from a trial of home versus hospital-based rehabilitation in COPD, with 12 months of follow-up. Moderate and severe exacerbations were identified using administrative data (prescriptions) and hospital records (admissions) respectively. The impact of exacerbations at 12 months following pulmonary rehabilitation was evaluated for quality of life (Chronic Respiratory Questionnaire, CRQ), dyspnea (modified Medical Research Council, mMRC), exercise capacity (6-minute walk distance, 6MWD) and objectively measured physical activity (moderate-to-vigorous physical activity, MVPA).Results: A total of 166 participants were included, with mean age (SD) 69 (9) years and forced expiratory volume in one second (FEV1) 49 (19)% predicted. Moderate exacerbations occurred in 68% and severe exacerbations in 34% of participants. Experiencing a severe exacerbation was an independent predictor of worse 12-month outcomes for CRQ (total, fatigue and emotional function domains), mMRC, 6MWD and MVPA (all p< 0.05). Participants who completed pulmonary rehabilitation were less likely to have a severe exacerbation (29% vs 48%, p=0.02). Severe exacerbations were more likely in those with worse baseline CRQ total (odds ratio 0.97, 95% CI 0.95 to 0.99) and FEV1%predicted (0.98, 95% CI 0.96 to 0.99).Conclusion: Severe exacerbations occur frequently following pulmonary rehabilitation and predict worse 12-month outcomes. Strategies to maintain the benefits of pulmonary rehabilitation should address exacerbation prevention and management.Keywords: COPD, exacerbations, pulmonary rehabilitation, long term maintenance, predictors

Despite a general consensus on the educational effectiveness of inquiry-based instruction, the enacted type of inquiry in science classrooms remains debatable in many countries including Saudi Arabia. This study compared guided-inquiry based teachers' professional development to teacher-directed approach in supporting Saudi students to understand the topic of density. One hundred and seven, sixth-grade, Saudi students in six classes were randomly assigned, by school, to one of two conditions (guided or teacher-directed condition) while they studied the same unit on density in their science curriculum. The three teachers in the guided condition attended an intervention on using guided-inquiry activities to teaching a unit on density. The three teachers in the teacher-directed condition used their regular approach to teaching the same unit. Pre- and post-tests of the students' understanding and explanation of density was adopted for the study. A one-way analysis of variance (ANOVA) and repeated analyses were performed to assess the students' understanding and explanation of density. In comparison to the teacher-directed condition, the students in the guided-inquiry condition demonstrated significant improvements in both conceptual understanding and their levels of explaining the concept of density.

A network of 30‐MHz riometers distributed across Canada have been monitoring auroral absorption for decades. Electron precipitation can cause enhanced densities to develop below ∼100 km where the higher neutral density can cause absorption of High Frequency (HF) signals. Modeling D‐region absorption accurately can be challenging due to the large distances between riometer monitoring sites. It is of interest to develop an understanding of the typical scale sizes of these regions for assimilation in ionospheric models. Using the entire network of GO‐Canada riometers, auroral absorption events may be monitored as they develop through a wide MLT sector. By examining correlations between sites, proxies for the scale sizes of absorption regions may be estimated. It was found that the sizes of the absorbing regions in the zonal direction are on the order of 900 km. Conversely, the characteristic scale sizes of the regions in the meridional direction were ∼700 km. These results are consistent with the general magnetospheric structure which sees higher energy electrons primarily present in the nightside transition region, and ring current. This creates a natural limit in latitudinal correlations, while the spread in longitude is likely connected to the size of precipitation regions in MLT. Our results also show significant spread in scale sizes in both directions from a few hundred to several thousand km. In this paper, we summarize these results in terms of the observed trends in high energy electron precipitation spatial and temporal scales and discuss future work to connect these scales to magnetospheric drivers. Key Points: A statistical examination of absorption data from the GO‐Canada network is performedTime‐series correlations between separated riometer sites across Canada provide indications of auroral absorption region scalesAbsorption regions have variable scale sizes of several hundred km and are elongated in the zonal direction [ABSTRACT FROM AUTHOR]