Day Of Exam Research Articles

Patient-centered radiology: a roadmap for outpatient imaging.

Creating a patient-centered experience is becoming increasingly important for radiology departments around the world. The goal of patient-centered radiology is to ensure that radiology services are sensitive to patients' needs and desires. This article provides a framework for addressing the patient's experience by dividing their imaging journey into three distinct time periods: pre-exam, day of exam, and post-exam. Each time period has aspects that can contribute to patient anxiety. Although there are components of the patient journey that are common in all regions of the world, there are also unique features that vary by location. This paper highlights innovative solutions from different parts of the world that have been introduced in each of these time periods to create a more patient-centered experience. CLINICAL RELEVANCE STATEMENT: Adopting innovative solutions that help patients understand their imaging journey and decrease their anxiety about undergoing an imaging examination are important steps in creating a patient centered imaging experience. KEY POINTS: • Patients often experience anxiety during their imaging journey and decreasing this anxiety is an important component of patient centered imaging. • The patient imaging journey can be divided into three distinct time periods: pre-exam, day of exam, and post-exam. • Although components of the imaging journey are common, there are local differences in different regions of the world that need to be considered when constructing a patient centered experience.

The Discipline of Handwriting Quality and Essay Scoring

In the United States, many high school students take various Advanced Placement (AP) courses offered by the non-profit organization, Collegeboard. Specifically, AP English Language and AP English and Literature requires students to write three essays on the day of exam. These essays allow students to demonstrate their penmanship and quality of handwriting. However, it is unknown whether the quality of penmanship plays a role in essay scoring. Very few research has been done on this discipline, specifically handwriting and intelligence. To fill this research gap, this paper will explore and attempt to demonstrate an understanding of the potential correlation between the illegible ratio of handwriting to the overall essay rubric score. 68 samples were taken from CollegeBoard and analyzed through a content analysis with a mathematical equation, the ILR equation. The data was further analyzed with a Line of Best Fit, Pearson Correlation Coefficient, and P-value. The results showed that there were no clear significant differences between neat and messy handwriting and how well it scored on the AP exam. However, the overall length of the essay and its word counts had a strong positive correlation with the essay score. Due to various limitations of this research study, further research must be conducted and tailored to this study to find a clearer understanding of this phenomenon. Nevertheless, this research can serve as the basis and foundation for later studies in this field.

PROBLEMS WITH ORTHOPEDIC SURGERY TRAINING IN PAKISTAN

PROBLEMS WITH ORTHOPEDIC SURGERY TRAINING IN PAKISTAN

Prevalence of anxiety depression and stress among first year medical students in Tamilnadu.

The present study was to evaluate the examination stress of the first year MBBS students, prior to their university exam by assessing the mood parameters and cortisol level. A cross sectional study was conducted in 150 students of Indira Medical College, Thiruvallur from January to February 2022. The assessment methods implemented were Self-administered, pre-designed questionnaire of DASS 10 scale scoring 0-40, and salivary cortisol by using quantitative ELISA on relaxed (before exam) and stressed (on day of exam) students with prior consent. Respondent data were analysed using the independent t-test and Odds ratio logistic regression analysis was done for strength of association by using (SPSS) version 26.0 and the level of significance *p≤0.05. The prevalence of stress (43%), anxiety (35%), depression (22%) and level of cortisol (2.61±0.41 and 5.14±0.35) between relaxed and stressed respectively were significantly increased due to examination stress despite any significant change in academic performance. Odds ratio of stress (95% CI 2.153), anxiety (3.038), depression (2.513) and salivary cortisol (2.872) were significantly high in stressed. Female students were found to be more susceptible to stress than male students due to examination (p≤0.001**). This study suggests that the medical education and examination are unavoidable stressor in first year students. This could be prevented by providing stress reduction interventions and orientation programmes which could improve student mental well-being and reduce the psychological distress.

In Remembrance of Professor Wieslaw Dobrzycki

I first met Professor Dobrzycki on the day of my final Defence exam for my Master’s thesis. My dissertation focused on the Concept and Activities of In-tegration within the Caribbean Basin, which had apparently caught Professor Do-brzycki’s attention and, because he was the Specialist on Western Hemisphere affairs he functioned as one of the academic reviewers of my work...

S222 Oral Sulfate Tablets Are Safe in Cardiac and Hypertensive Patients Undergoing Colonoscopy—Results of a Post-Hoc Analysis

Introduction: A new Oral Sulfate Tablet (OST) prep was recently FDA approved, and contains sodium and magnesium sulfates, along with potassium chloride to minimize electrolyte loss due to diarrhea. Two pivotal studies evaluated OST safety and efficacy compared to FDA-approved preps sodium picosulfate and magnesium citrate (P/MC) and PEG3350 plus electrolytes and ascorbate (PEG-EA). A post-hoc safety analysis of patients with a history of cardiac disorders and/or hypertension was conducted comparing OST to controls preps. Methods: Two studies of OST were conducted in adult patients undergoing colonoscopy. Patients with a cardiac history and/or hypertension were eligible unless they had a clinically significant ECG at baseline, a NYHA classification of 3/4, or uncontrolled hypertension (systolic >170 mmHg, diastolic >100 mmHg). Dosing followed FDA approved labeling (split-dose PM/AM) for PEG-EA or P/MC. OST patients consumed 12 tablets and 48 oz of water, per-dose. Labs and ECGs were collected at baseline, day of exam, 24-48 hrs post exam, and days 7 and 30 (if follow-up was required). Treatment-emergent adverse events (AEs) were collected via spontaneous reports and solicited collection of expected GI symptoms (cramping, bloating, nausea, vomiting). Results: 380 patients (average age 62 years, 52% female) had a history of cardiac disorders and/or hypertension (OST=201, PEG-EA=110 and P/MC=69). There were no differences in ECG parameters between treatment groups (cardiac vs non-cardiac). The proportion of patients with an abnormal ECG post dosing (normal baseline) was also similar between preps. No patients had a QT interval above 500ms. More patients who took P/MC experienced a cardiac AE compared to OST (4% vs 0%, P=0.016). Compared to PEG-EA, fewer cardiac patients experienced dizziness with OST (3% vs 0%, P=0.043). OST cardiac patients experienced a higher rate of solicited GI symptoms, however most were mild, with very few (< 3%) rated as severe. There was no difference between cardiac and non-cardiac OST patients for any AE, and no reported serious AEs. Transient shifts from normal to abnormal (post dose) for key electrolytes (Na, K, Cl, CO2) were infrequent and similar between preps, except for Mg which was higher for both P/MC and OST due to their Mg content. Conclusion: In this post-hoc analysis, OST was shown to be as safe as PEG-EA and P/MC in cardiac patients, with no difference in safety seen when compared to non-cardiac OST patients.

123 Deep-Learning Generated B-Line Score Mirrors Clinical Progression of Disease for Patients Admitted With Shortness of Breath or Hypoxia

Thoracic ultrasound can evaluate the lungs for fluid in the alveolar and interstitial spaces of the lung, based on the presence of artifacts known as B-lines. Degree of B-lines may provide an independent measure of severity of pulmonary edema in congestive heart failure. Artificial intelligence can be used to provide objective data, improve interpretations by novice users, and allow processing of large amount of data for research. The aim of this study is to determine the association between a B-line score using a deep learning algorithm with the degree of pulmonary congestion based on clinical assessment and its variation with response to treatment. This single-center, prospective, observational study enrolled adult patients presenting with dyspnea or hypoxia and suspected to have congestive heart failure at an urban academic ED from July 2018 to May 2019. Subjects found to have any B-lines on initial lung ultrasound were followed through their hospital course and included in this analysis. Admitted patients underwent daily ultrasonography. Clips of 8 lung zones (right and left anterior/lateral and superior/inferior) were obtained using the Philips LumifyTM ultrasound system with sector probe. Demographics, vital signs, lab values, and imaging results were also collected. A previously published deep learning algorithm was refined to rate the severity of B-lines on a scale of 0-4 in 0.5 increments. Average severity for all 8 zones at each time-point for each patient was calculated. A clinical congestion score (0-18 scale), based on presence of dyspnea, orthopnea, fatigue, JVD, rales and pedal edema was calculated. Mixed effects modeling was used to investigate the association between B-line score as independent variable and clinical congestion score as dependent variable, accounting for variation on the person level and longitudinal data. Missing data was excluded from analysis. Covariates tested included patient and exam level data (sex, age, presence of selected comorbidities, baseline sodium and hemoglobin, creatinine, vital signs, oxygen delivery amount and delivery method, diuretic dose). There were 242 unique subjects with 722 complete sets of 8-zone clips included in the analysis. For the mixed effects model, chosen covariates were: sex, baseline sodium, baseline hemoglobin, respiratory rate, CHF, chronic obstructive pulmonary disease, fraction of inspired oxygen, oxygen delivery method (eg, nasal cannula, non-rebreather, ventilator), total loop diuretic dose on day of exam, and the 8-zone DL obtained B-line score. There was no collinearity. The 8-zone B-line score was significantly associated with clinical congestions core, with coefficient of 0.73 (p<0.001). A deep learning generated B-line score mirrors clinical course for subjects admitted patients with shortness of breath or hypoxia, independent of other patient and clinical factors. B-line quantification using AI can provide an objective and independent measure of pulmonary congestion in patients with congestive heart failure and can be used to help monitor clinical progress.

Analysis of the effects of anatomy committee exam stress on visual and auditory reaction time and cortisol level: A neuroperformance study

Objective: The present study aims to find out the effects of exam stress, which exists in every moment of education life, on visual and auditory reaction time (VRT, ART), cortisol level and stress perception. Material and methods: A total of 66 students (36 males, 30 females) were included in the study. VRT and ART measurements were carried out with reaction timer by asking the participants to use their dominant hands. Reaction times were recorded on two occasions, namely 30 days before the committee exam (relaxed period) and, again, on the day of exam (stressed period). Additionally, students provided salivary samples and filled in State Trait Anxiety Inventory-I (STAI-I) on both occasions. Results: Median values of cortisol, STAI-I, VRT and ART scores of male and female students were higher during stress period than that of the relaxed period (p<0.05). Correlation analysis showed a positive weak correlation between cortisol level and STAI-I scores of students in exam period (male: r=0.317, p<0.05; female: r=0.253, p<0.05). Moreover, cortisol levels were positively correlated with VRT (male: r=0.155, p<0.05; female: r=0.227, p<0.05) and ART (male: r=0.159, p<0.05; female: r=0.163, p<0.05) scores both male and female students. Conclusion: The results show that stress increase was found to increase cortisol level and STAI-I scores. Increased cortisol level was associated with longer reaction times as measured by VRT and ART.

Negative Affect and Performance on Exam Day in College Students: The Role of Self-Regulation

In the U.S., college transition grows increasingly difficult, with students experiencing rising levels of stress and anxiety. Such challenges may arise as students face normative but novice stressors while working towards professional goals. Students’ ability to engage in successful self-regulation may be especially important in response to these challenges. The goals of the present study were to assess a) the mediating role of self-regulatory behaviors on the relationship between trait emotion regulation and negative affect (NA) on the day of a first major college exam; and, b) the mediating role of exam-day NA on the relationship between self-regulatory behaviors and exam performance. Results show that trait-level challenges in emotion regulation are associated with increased procrastination behaviors in the days before the exam, which in turn is associated with higher NA on exam day. Implications are discussed for well-being and success of students, particularly for students who struggle with self-regulation.

The effect of femoral stem collar on implant migration and clinical outcomes following direct anterior approach total hip arthroplasty.

The direct anterior (DA) approach has been associated with rapid patient recovery after total hip arthroplasty (THA) but may be associated with more frequent femoral complications including implant loosening. The objective of this study was to determine whether the addition of a collar to the femoral stem affects implant migration, patient activity, and patient function following primary THA using the DA approach. Patients were randomized to either a collared (n = 23) or collarless (n = 26) cementless femoral stem implanted using the DA approach. Canal fill ratio (CFR) was measured on the first postoperative radiographs. Patients underwent a supine radiostereometric analysis (RSA) exam postoperatively on the day of surgery and at two, four, six, 12, 26, and 52 weeks postoperatively. Patient-reported outcome measures (Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index, the 12-item Short Form Health Survey Mental and Physical Score, and University of California, Los Angeles (UCLA) Activity Score) were measured preoperatively and at each post-surgery clinic visit. Activity and function were also measured as the weekly average step count recorded by an activity tracker, and an instrumented timed up-and-go (TUG) test in clinic, respectively. Comparing the RSA between the day of surgery baseline exam to two weeks postoperatively, subsidence was significantly lower (mean difference 2.23 mm (SD 0.71), p = 0.023) with collared stems, though these patients had a greater CFR (p = 0.048). There was no difference (p = 0.426) in subsidence between stems from a two-week baseline through to one year postoperatively. There were no clinically relevant differences in PROMs; and there was no difference in the change in activity (p = 0.078) or the change in functional capacity (p = 0.664) between the collared stem group and the collarless stem group at any timepoint. Presence of a collar on the femoral stem resulted in reduced subsidence during the first two postoperative weeks following primary THA using the DA approach. However, the clinical implications are unclear, and larger studies examining patient activity and outcomes are required. Cite this article: Bone Joint J 2020;102-B(12):1654-1661.

Prevalence of foot lesions in Québec dairy herds from 2015 to 2018

Our first objective was to estimate the prevalence of foot lesions by type of milking system in dairy cows examined during regular hoof-trimming sessions between 2015 and 2018 in Québec dairy herds. A secondary objective was to describe the effect of day-to-day variation, cow, and herd characteristics on the prevalence of foot lesions. Data included 52,427 observations (on a cow during a specific trimming session) performed on 28,470 cows (≥2 yr old) from 355 herds. Only observations from trimming sessions in which ≥90% of the lactating herd was trimmed were considered. Lesions were recorded at the hoof level by 17 trained hoof trimmers between March 23, 2015, and July 10, 2018, using a computerized recording system. Hoof-level information was then matched with cow information and centralized at the Eastern Canada Dairy Herd Improvement. Foot lesions were classified into 6 categories: infectious, white line disease, heel erosion, ulcers, hemorrhages, and any type of foot lesions. Prevalence of each outcome was quantified using the marginal predicted mean probability estimated from a null generalized linear mixed model with a logit link, and accounted for clustering of observations by cow and by herd. Variance was partitioned to assess the variation in the probability of the outcomes attributable to each level of the data structure (day of exam, cow, and herd). Prevalence of a given foot lesion as function of milking system and of various explanatory variables (mean herd size, herd average daily production, breed of the cow, age of the cow at trimming, and year of the visit) was then estimated using a generalized linear mixed model. At least 1 foot lesion was observed in 29% of cows examined during regular trimming sessions in Québec from 2015 to 2018. Prevalence for any type of lesion was 27% for pipeline, 38% for robotic milking, and 41% for milking parlors. The highest prevalence of infectious lesions (mainly digital dermatitis) was observed in milking parlors and robotic systems, while the most prevalent lesions in pipeline were hemorrhages. Herd-level factors explained most of the disease probability for infectious diseases, heel erosion, and hemorrhages. Therefore, control of these diseases should be based on applying best herd-management practices. On the other hand, probabilities of white line disease and sole ulcers were mainly determined by cow-level characteristics.

Auricular stimulation vs. expressive writing for exam anxiety in medical students - A randomized crossover investigation.

ObjectiveAuricular stimulation (AS) is a promising method in the treatment of situational anxiety. Expressive writing (EW) is an established psychological method, which reduces test anxiety and improves exam results. The aim of this crossover trial was to compare AS with EW, and with the no intervention (NI) condition, for treatment of exam anxiety.MethodsHealthy medical students underwent 3 comparable anatomy exams with an interval of one month, either performing EW, receiving AS or NI prior to the exam; the order of interventions was randomized. AS was applied using indwelling fixed needles bilaterally at the areas innervated mostly by the auricular branch of the vagal nerve on the day before the exam. Anxiety level, measured using State-Trait-Anxiety Inventory (STAI) before and after the interventions and immediately before exam, was the primary outcome. Quality of night sleep, blood pressure, heart rate and activity of salivary alpha-amylase (sAA) were analyzed across 3 conditions.ResultsAll 37 included participants completed the study. Anxiety level (STAI) decreased immediately after AS in comparison with baseline (P = 0.02) and remained lower in comparison with that after EW and NI (P<0.01) on the day of exam. After EW and NI anxiety increased on the day of exam in comparison with baseline (P<0.01). Quality of sleep improved after AS in comparison with both control conditions (P<0.01). The activity of sAA decreased after EW and after AS (P<0.05) but not after NI condition.ConclusionAuricular stimulation, but not expressive writing, reduced exam anxiety and improved quality of sleep in medical students. These changes might be due to reduced activity of the sympathetic nervous system.

EFFECT OF OXIDATIVE STRESS ON LIPID PROFILE AND BLOOD PARAMETERS TO A SAMPLE OF STUDENTS AT UNIVERSITY OF ZAKHO DURING EXAMES

Worry, anxiety through Study and preparative to exam may lead to mental stress. Mental stress may contribute to oxidative stress in the body which is the change in balance between oxidants and antioxidants.&#x0D; In this study a concentration of Malondialdehyde (MDA) as a lipid oxidation biomarker, lipid profile and some blood parameters like Minmum Inhibitory dilution (MID) were estimated in twenty chemistry and biology students at the day of exam as Stress Condition (SC) compared with the same parameters which obtained from the same students during the university vacation after a month of doing the latest exam as non-Stress Condition (nSC).&#x0D; A significant increase in MDA (p=0.0019), Total Cholesterol (p&lt;0.05), Triglyceride (p&lt;0.05), Low Density Lipoprotein LDL-Cholesterol (p&lt;0.05), Very Low density lipoprotein VLDL-cholesterol (p&lt;0.05) and A significant decrease in High - Density Lipoprotein HDL - Cholesterol (p&lt;0.05), HDL-Cholesterol to total cholesterol ratio(p=0.0012) in stress condition were observed when compared with “non-stress” conditions. Also there were high significant decreases in lymphocyte and minimum inhibitory dilution (MID) (p=0.0001, p&lt;0.0001 respectively) and significant increases in granulocyte and platelets (PLT) (P=0.0113, P=0.0031 respectively) in stress condition compared to non-stress condition. Whereas no significant changes in total WBCs and RBCs in stress and non-stress conditions.&#x0D; These results suggested that during university examinations when students are under mental stress or psychiatric disorder may put them at risk of developing inflammatory disorders like atherosclerosis and/or coronary arteries disorders.

Endometrial and Myometrial Multidimensional Growth During the Cycle

Three-dimensional sonography enables assessment of uterine morphology. While the pattern of endometrial growth has been well described, little information is available on changes in endometrial and myometrial volume, area, and perimeters. We evaluated the ratio between myometrial and endometrial dimensions and its relation to endometrial thickness of inpatients with normal uterine morphology from our hospital. Routine hormonal assessment on the day of the sonographic exam was extracted from electronic medical records. Correlations between different dimensions of the uterus were examined. A total of 38 3D sonographic data sets were reviewed. A significant correlation was found between estradiol blood levels and endometrial thickness, area, and volume (R = 0.35, 0.53, 0.55, respectively; P &lt; .05). The ratio between the endometrial and myometrial area remained constant regardless of endometrial thickness. The findings of this study suggest that endometrial thickness, area, and volume may correlate with circulating estradiol levels. Endometrial and myometrial changes correlated in more than one dimension.

Effect of increase in cortisol level due to stress in healthy young individuals on dynamic and static balance scores.

OBJECTIVE:Stress is a condition caused by various factors and characterized by imbalance in body functioning, impair in nervous system, and tension. The purpose of this study was to examine the effects of cortisol level, which increases in healthy young individuals due to stress, on dynamic and static balance scores as well as to present the results caused by high levels of stress.METHODS:In this study, 107 healthy medicine faculty students in their second year (who will take the same committee exam) aged between 19 and 23 years were included. The first balance measurements and saliva samples were taken 40 days before the committee exam, and this period was acknowledged as the relaxed period. The same students were considered for balance measurements again on the day of committee exam; saliva samples were collected, and cortisol concentration was determined. This period was acknowledged as the stressful period. The State-Trait Anxiety Inventory (STAI) was given to the participants in their relaxed and stressful periods. Dynamic balance scores were measured with Star Excursion Balance Test (SEBT). Static balance scores were measured with One Leg Standing Balance Test (OLSBT).RESULTS:The mean cortisol level was found to increase approximately 9 times in stressful periods compared with that in relaxed periods. STAI, which shows state anxiety, showed an increase supporting this increase. In stressful periods, dynamic balance scores showed obvious decrease in all directions. In addition, in stressful periods, an obvious decrease was observed in static balance scores compared with those in relaxed periods.CONCLUSION:This study showed that stress negatively affected dynamic and static balance, even for short periods of time. We believe that our study will form a positive source and basis when correlated with long terms stress and balance measurements.

Use of iPad and ExamSoft&amp;[trade] in administering morphological sciences practical examination in an integrated curriculum

At Cooper Medical School of Rowan University, morphological sciences are taught in an integrated organ system based curriculum. In the first year students in the last 8 weeks completed the skin, muscle and skeleton module. In the second year, the remainder of the organ systems is studied. Each practical exam includes cadaver, histology, pathology, radiology and embryology questions. As the class size has increased and with a limited number of faculty, manual grading of the practical exam had become onerous. Furthermore, manual grading challenged the validity and reliability of the assessment instrument. Therefore migration to an automated testing system was made. This move has proven to increase the validity, made the grading process more efficient and students are able to receive their practical exam scores faster with greater qualitative feedback than previous years. Recognizing the deficiency, the authors of the abstract met and operationalized the innovative system and purchased the required number of iPads through the Office of Medical Education. Student and faculty development using a mock exam was conducted. On the day of the practical exam, unique exam specific password was distributed to each student prior to the start of the practical. In addition, instructions were given on how to navigate, submit answers, and close out of the exam. IT personnel were on‐hand to solve technical problems. This poster will describe the step‐by‐step process of the approach, as well as present student and faculty perceptions.Support or Funding InformationThis study was supported by the Office of Medical Education.

Preliminary report on cardiac dysfunction after isolated traumatic brain injury.

The aim of this study was to examine cardiac dysfunction during the first 2 weeks after isolated traumatic brain injury and its association with in-hospital mortality. Retrospective. Level 1 regional trauma center. Adult patients with severe traumatic brain injury. After institutional review board approval, data from adult patients with isolated traumatic brain injury who underwent echocardiography during the first 2 weeks after traumatic brain injury between 2003 and 2010 were examined. Patients with preexisting cardiac disease were excluded. Clinical characteristics and echocardiogram reports were abstracted. Cardiac dysfunction was defined as left ventricular ejection fraction less than 50% or presence of regional wall motion abnormality. None. We examined data from 139 patients with isolated traumatic brain injury who underwent echocardiographic evaluation. Patients were 58 ± 20 years old, 66% were male patients, and 62.6% had subdural hematoma; admission Glasgow Coma Scale score was 3 ± 1 (3-15) and head Abbreviated Injury Scale was 4 ± 1 (2-5). Of this cohort, 22.3% had abnormal echocardiogram: reduced left ventricular ejection fraction was documented in 12% (left ventricular ejection fraction, 43% ± 8%) and 17.5% of patients had a regional wall motion abnormality. Hospital day 1 was the most common day of echocardiographic exam. Abnormal echocardiogram was independently associated with all cause in-hospital mortality (9.6 [2.3-40.2]; p = 0.002). Cardiac dysfunction in the setting of isolated traumatic brain injury occurs and is associated with increased in-hospital mortality. This finding raises the question as to whether there are uncharted opportunities for a more timely recognition of cardiac dysfunction and subsequent optimization of the hemodynamic management of these patients.

HEAPS STUDY RESULTS: HEALTH EFFECTS OF AIR POLLUTION IN ANTWERP SCHOOLS

Background: Air pollution exposure has been associated with respiratory, cardiovascular, and neurological health problems. It is hypothesized that health effects mainly occur through the induction of oxidative stress. Aims: Our goal was to investigate the relation between air pollutants and biomarkers for oxidative stress and airway inflammation in primary school children. Methods: The study design is described in detail in the abstract “HEAPS study design: health effects of air pollution in Antwerp schools”. In short, 130 children from 2 schools were examined in spring and autumn of 2011. Air quality was monitored at school (UFP, PM, BC, NOx and O3 measurements) and at home (BC and NO2 based on LUR) for several short and long term exposures. Noninvasive markers for oxidative stress (8-isoprostane in exhaled breath condensate (EBC) and 8-oxodG in urine) and inflammation (FeNO, EBC pH, IL-? in EBC and IL-8, ECP, tryptase and allergic IgE responses in the nose) were analyzed. ISAAC-type questionnaires were used to assess allergic symptoms. Results: NOx, O3, PM10, PM2.5 and UFP at school the day before or the day of medical exam were associated with FeNO, EBC markers (pH and IL-1?), and 8-oxodG in urine. Exposure to NO2 and BC (modeled with LUR) up to 10 days before medical exam was related with FeNO, EBC pH and 8-oxodG in urine. Seasonal and yearly average NO2 concentrations at the home location significantly influenced nasal tryptase. GIS data were linked with EBC markers (pH and IL-?) and nasal tryptase. No associations with 8-isoprostane in EBC and nasal ECP were observed. Itchy rash during the last 12 months and familial asthma were linked with yearly average BC at the home. Conclusion: This study adds to existing evidence that air pollution affects respiratory health in children, and that these effects might be mediated by oxidative stress. The study was financed by the Flemish Administration of Environment, Nature and Energy (LNE), Flemish Environment Agency (VMM), and Flemish Agency for Care and Health (VAZG).

Early progesterone cessation after in vitro fertilization/intracytoplasmic sperm injection: a randomized, controlled trial

To investigate the effect of stopping progesterone (P) support at week 5 versus week 8 on ongoing pregnancy rate after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Prospective, randomized, controlled trial. University-affiliated infertility center. A total of 220 patients with intrauterine pregnancy demonstrated by transvaginal ultrasound after IVF/ICSI. Luteal phase support with micronized vaginal P was suspended at week 5 or at week 8. Ongoing pregnancy rate, miscarriage rate, and number of bleeding episodes. Progesterone levels were similar on the day of the first pregnancy ultrasound exam (149 ± 108 vs. 167 ± 115 ng/mL). Significantly more bleeding episodes were observed in the first trimester in the group with early cessation of P supplementation (18.0 ± 2.6 vs. 7.2 ± 1.3 episodes). Miscarriage rates among singleton pregnancies were similar in the two groups (5/80 vs. 6/79). Vaginal P supplementation after IVF/ICSI can be safely withdrawn at 5 weeks' gestation, because cycle outcome was similar to conventional luteal phase support up to 8 weeks of pregnancy. NCT01177904.

Synthesis of Available Accommodations for Students with Visual Impairments on Standardized Assessments

Because of mandates found in Individuals with Disabilities Education Act (IDEA 2004, P.L 108-446) that specifically focus on assessment, most states have developed a set of policies that focus on types of accommodations that can be provided to students with disabilities. Students with visual impairments require a unique set of accommodations. Braille and large print have been consistently found to be among two most often identified specific accommodations that are allowed (Bolt & Thurlow, 2004; Christensen, Lazarus, Crone, & Thurlow, 2008). However, limited research has reviewed more specific assessment accommodations that may be needed by students with visual impairments, such as abacus, talking calculators, and scribes. The purpose of study presented here was to develop a better understanding of scope of available accommodations that can be provided to students with visual impairments on state-mandated assessments in Grades 3-12 across United States and of similarities and differences in accommodations provided within states. The research question asked what specific testing accommodations are available for students with visual impairments when taking state-mandated standardized assessments. METHODOLOGY An accommodation exists for purpose of providing a student with disabilities with access to academic materials, including a student who is taking a test (Allman, 2006). Accommodations are typically categorized as (1) timing or scheduling, (2) (3) setting, and (4) presentation (Allman, 2006). The researchers (the authors) accessed all 50 states' testing policy and procedures manuals via website of National Center for Educational Outcomes (), which maintains a database of links to each state. We created a specific list of accommodations based on literature and on best practices for education of children with visual impairments. We then reviewed each state's testing policy and procedures manual and noted if state specifically allowed accommodation using a dichotomous statement (yes or no). They also searched for a generic clause (that is, the escape clause) that allowed use of any accommodation based on individual needs of a student as documented in student's Individualized Education Program (IEP). To establish interrater reliability, 50% of states had at least two researchers review materials to ensure a level of agreement of over 95%. All data met established criteria of 95% agreement. The data were analyzed using Statistical Package for Social Sciences (SPSS) 18. FINDINGS The findings are summarized in Tables 1, 2, 3, and 4. Table 1 presents findings in relation to accommodations that focus on timing and scheduling, which can be summarized as any change in amount of time provided for a student or any change in when a student takes assessment that deviates from normal testing schedule. The five items in this category were all found in less than half states except for allowing multiple day of exam (56%). Of five items, four allow for extended testing time for various reasons. In reviewing data for these four items for each state, we found that 42 states (84%) list a specific accommodation that provides an extended amount of testing time for a student who is taking a test. Table 2 presents findings in reference to setting, which denotes a change in where an of an assessment takes place. Although there were only two items in this category, small group administration was found in 88% of states' policy manuals. Table 3 reflects findings in relation to response, which covers how answers are provided by a student. The most listed accommodation in this category was use of a scribe to record answers for student. The descriptions of this accommodation did not state whether scribe marks answers during or after examination, just that a scribe may be used. …