Differences In Test Performance Research Articles

Relative Skeletal Maturity and Performance Test Outcomes in Elite Youth Middle Eastern Soccer Players.

This study aimed to explore the influence of differences in relative skeletal maturity on performance test outcomes in elite youth soccer players from the Middle East. We integrated skeletal age and performance assessments using mixed-longitudinal data available for 199 outfield players (chronological age range, 11.7 to 17.8 yr) enrolled as academy student-athletes (annual screening range, 1 to 5 visits). Skeletal age was determined as per the Tanner-Whitehouse II protocol. Relative maturity was calculated as the difference (∆) between Tanner-Whitehouse II skeletal age minus chronological age. Performance test outcomes of interest were 10-m sprinting, 40-m sprinting, countermovement jump height, and maximal aerobic speed. Separate random-effects generalized additive models quantified differences in performance test outcomes by relative skeletal maturity. Estimated differences were deemed practically relevant based on the location of the confidence interval (95% CI) against minimal detectable change values for each performance test outcome. For 40-m sprinting, differences of +0.51 s (95% CI, +0.35 to +0.67 s) and +0.62 s (95% CI, +0.45 to +0.78 s) were practically relevant for relative maturity status of ∆ = -1.5 yr versus ∆ = +0.5 and ∆ = +1 yr, respectively. For countermovement jump height, a difference of -8 cm (95% CI, -10 to -5 cm) was practically relevant for ∆ = -1.5 yr versus ∆ = +1 yr relative maturity status comparison. Effects for 10-m sprinting and maximal aerobic speed were unclear. Integration of skeletal age and performance assessments indicated that conventional maturity status classification criteria were inconsistent to inform player development processes in our sample. Between-player differences in test performance may depend on a substantial delay in skeletal maturation (∆ ≤ -1.5 yr) and the performance outcome measure.

Sensory nerve conduction studies in probable painful neuropathy: comparing surface and near-nerve nerve conduction techniques

IntroductionWe compared sensory nerve conduction studies (NCS) using surface and near-nerve recording electrodes in 53 patients with clinical probable painful neuropathy. Our aim was to validate the use of both...

Research Review: Neuropsychological functioning in young anorexia nervosa: A meta-analysis.

Cognitive inflexibility and compulsive behaviours are commonly observed in patients with anorexia nervosa (AN) and are often considered to be caused by impairments in executive functioning and visuospatial processing. Despite an increasing number of young individuals presenting with AN, there is a lack of meta-analytic evidence on the neuropsychological functioning in this population. Our primary aim was to review and synthesize the differences in neuropsychological test performance between young people with AN and healthy controls, and to explore potential moderators. A database search following PRISMA guidelines of MEDLINE, PsycINFO, ISI Web of Science and Epistemonikos was conducted. Hedges' g served as an effect size indicating the standardized mean differences. We utilized mixed-effects meta-regression and machine learning meta-analyses to identify relevant moderators. Sixteen studies met the inclusion criteria with a total of 1333 participants (665 with AN) and 59 effect sizes. Random-effects meta-analyses demonstrated a small and insignificant difference between young individuals with AN and controls ( = -0.144, 95% CI [-0.328, 0.041]) in overall neuropsychological functioning. However, the difference was significant for the cognitive domains of memory, working memory and visuospatial abilities. Moderator and machine-learning analyses revealed a stronger negative effect in older participants and moderator effects of country and assessment quality. Our findings highlight the significant impact of age on neuropsychological test performance in patients with AN. There is a need for a more widespread inclusion of potentially confounding variables in primary studies as well as instruments specifically targeted at younger populations.

Clinical evaluation of non-invasive prenatal screening in 32,394 pregnancies from Changzhi maternal and child health care hospital of Shanxi China.

BackgroundNon-invasive prenatal screening (NIPS) is a highly sensitive and specific screening test to detect fetal chromosomal abnormalities. The primary objective of this study was to evaluate the NIPS as an effective method for prenatal detection of aneuploidies in both high-risk and low-risk pregnancies.MethodsIn current study, we performed NIPS in 32,394 pregnancies, out of which results were available in 32,361 (99.9%) of them. Illumina sequencing was performed for NIPS screening. Hypothesis Z test was used to classify fetal autosomal aneuploidy of T21, T18, and T13. Karyotyping was performed to determine the true negative and true positive NIPS results.ResultsAmong the 32,361 confirmed samples, 164 cases had positive results and 32197 cases had negative results. Of these positive cases, 116 cases were trisomy 21, 34 cases were trisomy 18 and 14 cases were trisomy 13. No false negative results were found in this cohort. The overall sensitivity and specificity were 100% and 99.91%, respectively. There was no significant difference in test performance between the 7,316 high-risk and 25,045 low-risk pregnancies, (sensitivity, 100% vs 100% (P>0.05); specificity, 99.96% vs 99.95% (P > 0.05)). Factors contributing to false-positive results included fetal copy number variants (CNVs), fetal mosaicism and typically producing Z scores between 3 and 4. Moreover, we analyzed NIPS wholegenome sequencing to investigate the Single Nucleotide Polymorphisms (SNPs) associations with drug response or risk of disease. As compare to the 1000g East Asian genome data, the results revealed a significant difference in 7,285,418 SNPs variants of Shanxi pregnant women including 19,293 clinvar recorded variants and 7,266,125 non-clinvar recorded.ConclusionsOur findings showed that NIPS was an effective assay that may be applied as routine screening for fetal trisomies in the prenatal setting. In addition, this study also provides an accurate assessment of significant differences in 7,285,418 SNPs variants in Shanxi pregnant women that were previously unavailable to clinicians in Shanxi population.

Recovery After ACL Reconstruction in Male Versus Female Adolescents: A Matched, Sex-Based Cohort Analysis of 543 Patients.

Background:Differences in postoperative recovery after anterior cruciate ligament reconstruction (ACLR) between men and women have been demonstrated in the adult population. Sex-based differences have been incompletely investigated in adolescents, which represent the subpopulation most affected by ACL injury.Purpose/Hypothesis:The purpose of this study was to compare the 6-month postoperative functional recovery after ACLR between adolescent boys and girls. It was hypothesized that significant differences in postoperative strength, dynamic balance, and functional hop test performance would be seen between the sexes.Study Design:Cohort study; Level of evidence, 3.Methods:Included in this study were athletes aged 12 to 19 years with closed or closing growth plates who underwent ACLR with hamstring autograft between May 2014 and May 2018 at a single institution. All athletes had undergone strength and functional testing between 5 and 8 months postoperatively. Exclusion criteria were previous knee surgery (contralateral or ipsilateral knee), concomitant injury/surgery other than meniscal tear/repair, allograft supplementation, and incomplete medical records. The limb symmetry index (LSI) for strength (measured with handheld dynamometer), as well as dynamic Y-balance and functional hop test performance, was compared between groups. To account for differences in physical characteristics between the sexes, 1-way between-group multivariate analysis of covariance was used to analyze the data.Results:Overall, 543 patients (211 boys, 332 girls) were included. There was no significant difference in age, body mass index, incidence of concomitant meniscal pathology, use of regional anesthesia, or time to functional testing between cohorts. Female athletes demonstrated a statistically significantly greater deficit in quadriceps strength LSI compared with male athletes (boys, +3.4%; girls, –2.3%; P = .011). Both male and female athletes demonstrated 33% hamstring strength deficits, with no statistically significant sex-based differences in dynamic balance or functional hop testing.Conclusion:Female athletes demonstrated greater quadriceps strength deficits than male athletes at 6 months after ACLR with hamstring autograft. Severe hamstring strength deficits persisted in both male and female patients at this time point. The correlation of such deficits to risk of ACL retear warrants continued study in the adolescent population and may support a delay in return to sports, which has been suggested in the more recent literature.

Concordance of multiple methods to define resiliency and vulnerability to sleep loss depends on Psychomotor Vigilance Test metric.

Sleep restriction (SR) and total sleep deprivation (TSD) reveal well-established individual differences in Psychomotor Vigilance Test (PVT) performance. While prior studies have used different methods to categorize such resiliency/vulnerability, none have systematically investigated whether these methods categorize individuals similarly. Forty-one adults participated in a 13-day laboratory study consisting of two baseline, five SR, four recovery, and one 36 h TSD night. The PVT was administered every 2 h during wakefulness. Three approaches (Raw Score [average SR performance], Change from Baseline [average SR minus average baseline performance], and Variance [intraindividual variance of SR performance]), and within each approach, six thresholds (±1 standard deviation and the best/worst performing 12.5%, 20%, 25%, 33%, and 50%) classified Resilient/Vulnerable groups. Kendall's tau-b correlations examined the concordance of group categorizations of approaches within and between PVT lapses and 1/reaction time (RT). Bias-corrected and accelerated bootstrapped t-tests compared group performance. Correlations comparing the approaches ranged from moderate to perfect for lapses and zero to moderate for 1/RT. Defined by all approaches, the Resilient groups had significantly fewer lapses on nearly all study days. Defined by the Raw Score approach only, the Resilient groups had significantly faster 1/RT on all study days. Between-measures comparisons revealed significant correlations between the Raw Score approach for 1/RT and all approaches for lapses. The three approaches defining vigilant attention resiliency/vulnerability to sleep loss resulted in groups comprised of similar individuals for PVT lapses but not for 1/RT. Thus, both method and metric selection for defining vigilant attention resiliency/vulnerability to sleep loss is critical.

Instructing students on effective sequences of examples and problems: Does self‐regulated learning improve from knowing what works and why?

AbstractNowadays, students often practice problem‐solving skills in online learning environments with the help of examples and problems. This requires them to self‐regulate their learning. It is questionable how novices self‐regulate their learning from examples and problems and whether they need support. The present study investigated the open questions (1) to what extent students' (novices) task selections align with instructional design principles and (2) whether informing them about these principles would improve their task selections, learning outcomes, and motivation. Higher education students (N = 150) learned a problem‐solving procedure by fixed sequences of examples and problems (FS‐condition), or by self‐regulated learning (SRL). The SRL participants selected tasks from a database, varying in format, complexity, and cover story, either with (ISRL‐condition) or without (SRL‐condition) watching a video detailing the instructional design principles. Students' task‐selection patterns in both SRL conditions largely corresponded to the principles, although tasks were built up in complexity more often in the ISRL‐condition than in the SRL‐condition. Moreover, there was still room for improvement in students' task selections after solving practice problems. The video instruction helped students to better apply certain principles, but did not enhance learning and motivation. Finally, there were no test performance or motivational differences among conditions. Although these findings might suggest it is relatively ‘safe’ to allow students to independently start learning new problems‐solving tasks using examples and problems, caution is warranted: It is unclear whether these findings generalize to other student populations, as the students participating in this study have had some experience with similar tasks or learning with examples. Moreover, as there was still room for improvement in students' task selections, follow‐up research should investigate how we can further improve self‐regulated learning from examples and practice problems.

Male-Female Differences in Push-up Test Performance at Various Cadences.

Rozenek, R, Byrne, JJ, Crussemeyer, J, and Garhammer, J. Male-Female Differences in Push-up Test Performance at Various Cadences. J Strength Cond Res 36(12): 3324-3329, 2022-Push-up (PU) testing is widely used to assess upper-extremity muscular endurance. However, little information exists regarding the influence of cadence on PU performance. Forty-four healthy men and women (age range = 21-36 years) completed 4 PU test sessions on separate days in a randomized order using standard PUs. Cadences of 30, 45, and 60 PU·min -1 were used for 3 tests, whereas a fourth test was performed at a self-selected (SS) cadence. The total number of PUs completed, vertical ground reaction forces (vGRFs) acting on each hand and the feet, and the sum of the vGRFs were determined for each test. Results showed men performed more PU than women at any cadence ( p ≤ 0.05) and had a faster mean SS cadence (49.9 ± 11.4 PU·min -1 vs 42.8 ± 8.4 PU·min -1 ) ( p ≤ 0.05). The maximum number of PU were performed when using either the SS cadence or 60 PU·min -1 , with little difference observed between them ( p ≤ 0.05). The sum of vGRFs was greatest at 60 PU·min -1 and when scaled to body mass (BM) represented 1.58 ± 0.14x and 1.33 ± 0.08x BM for men and women, respectively. As cadence increased, men shifted more weight to the hand contact points compared with women ( p ≤ 0.05). Distinct differences in SS cadence and distribution of forces were observed between the sexes suggesting different strategies while performing the PU test. These differences should be considered when selecting a protocol for PU testing.

Cognitive Correlates of Instrumental Activities of Daily Living Performance in Parkinson Disease Without Dementia

ObjectiveTo investigate cognitive correlates of instrumental activities of daily living (IADL) performance among people with Parkinson disease (PD) without dementia. DesignCross-sectional. SettingAcademic medical center. ParticipantsVolunteer sample (N=161) comprising participants with PD without dementia (n=102) and healthy comparison (HC) participants (n=59). InterventionsNot applicable. Main Outcome MeasuresPerformance-based assessment of cognitively-demanding IADL (meal preparation, bill paying, shopping, medication management, small home repair), neuropsychological tests (attentional control/flexibility, planning, working memory, memory, crystallized intelligence), and measures of motor function and other characteristics (eg, depressive symptoms). ResultsThere were no group differences in neuropsychological test performance (P>.06). The PD group performed more poorly than the HC group on a number of cognitive IADL tasks (P<.04). After accounting for the effects of motor impairment and other disease-related characteristics, neuropsychological test performance accounted for a small but unique portion of the variance in performance of all cognitive IADL combined, meal preparation, shopping, and medication management in the PD group (R2=4%-13%; P≤.01). ConclusionsThe PD group had cognitive IADL performance limitations despite being unimpaired on neuropsychological tests. Within PD, neuropsychological test performance accounted for a small but significant portion of the variance in cognitive IADL performance over and above the effects of motor and other impairments. These results support the added value of using performance-based IADL assessments in functional evaluations of individuals with early and mild PD without dementia.

Is pregnancy brain real? Comparison of dual task cost during overground walking in pregnant versus control women.

Many pregnant women report that their memory is impaired compared to non-pregnancy, but results of studies of cognitive abilities are mixed. The effect of pregnancy on dual tasking, or performance of two tasks simultaneously, has not been studied, however. What is the effect of walking overground at a self-selected speed while also performing a cognitive task on gait and cognitive performance during 3rd trimester of pregnancy compared to non-pregnant controls? A total of n = 22 3rd trimester pregnant women (mean 33.3 ± 3.3 weeks gestation, age 32.1 ± 4.7 years) and n = 21 non-pregnant controls (age 31.9 ± 3.3 years) were recruited to participate. All participants performed single task walking on a GAITRite gait analysis system and performed three cognitive tests while walking: serial 3 and 7 subtraction tests and a phoneme monitoring test. Participants completed the same assessments while seated and order of the testing was counterbalanced. Dual task cost (DTC) was calculated using the formula (Single task score - Dual task score)/Single task score)*100. Independent t-tests or Mann Whitney U tests were used to compare the two groups depending on normality of data. There were no significant differences in cognitive test performance between control and pregnant women while walking or seated (p > 0.05). There were no significant differences between groups for DTC during any cognitive tests, but DTC was significantly greater for walking velocity in pregnant women compared to controls for serial 3 (p < 0.001) and serial 7 (p = 0.005) but not phoneme monitoring (p = 0.061). Pregnant women had elevated cost of dual tasking, though the decrements were not in cognitive tests but in gait, specifically with greater DTC of walking velocity. This suggests that pregnant women modify their walking velocity to preserve cognitive function during activities requiring focus on both cognitive and physical tasks.

Impact of a Season of Bike Patrol on Police Officers' Level of Fitness: A Pilot Study.

Bike patrollers must have a good level of fitness to perform their patrolling duties adequately and effectively by bike and accomplish specific work tasks, which may require the use of various physical capacities. However, there is little information on the real workload associated with bike patrol and its impact on health. The purpose of this study was to assess the general physical fitness of police officers before and after a season of bike patrolling and then quantify its effects on each patroller’s health. All six male police officers (29.5 ± 4.3 years old) performed two complete physical fitness evaluations (PRE- and POST-season), which included anthropometric measurements (weight, waist circumference, and body mass index), a push-up test, a sit-up test, a grip strength test, a vertical jump test, a sit-and-reach test, and an aerobic capacity test on a bicycle ergometer. Paired t-tests were used to evaluate the differences in test performance between the PRE- and POST-season. Grip strength, estimated VO2max, and power deployed on the bike all showed significant improvement after the season (p-value 0.0133; 0.007; and 0.003, respectively). No significant differences were found among the evaluation’s other components (p > 0.05). Results show the workload associated with a bike patrol season caused a considerable improvement in grip strength, VO2max, and power deployed on the bike, and might be beneficial for their overall health as a work-integrated avenue to keep the officers fit for duty. Further research on the subject is suggested.

Uniportal VATS pleural biopsy in the diagnosis of exudative pleural effusion: awake or intubated?

BackgroundThe aim of this study is to compare the diagnostic efficacy and safety of video-assisted thoracoscopic surgery (VATS) with awake VATS (AVATS) pleural biopsy in undiagnosed exudative pleural effusions.MethodsThe diagnostic efficacy of pleural biopsy by uniportal VATS under general anesthesia or AVATS under local anesthesia and sedation performed by the same surgeon in patients with undiagnosed exudative pleural effusion between 2007 and 2020 were retrospectively evaluated. Test sensitivity, specificity, positive predictive value and negative predictive value were compared as well as age, gender, comorbidities, procedure safety, additional pleural-based interventions, duration time of operation and length of hospital stay.ResultsOf 154 patients with undiagnosed exudative pleural effusion, 113 (73.37%) underwent pleural biopsy and drainage with VATS, while 41 (26.62%) underwent AVATS pleural biopsy. Sensitivity, specificity, positive predictive value and negative predictive value were 92, 100, 100, and 85.71% for VATS, and 83.3, 100, 100, and 78.9% for AVATS, respectively. There was no significant difference in diagnostic test performance between the groups, (p = 0.219). There was no difference in the rate of complications [15 VATS (13.3) versus 4 AVATS (9.8%), p = 0.557]. Considering additional pleural-based interventions, while pleural decortication was performed in 13 (11.5%) cases in the VATS group, no pleural decortication was performed in AVATS group, (p = 0.021). AVATS group was associated with shorter duration time of operation than VATS (22.17 + 6.57 min. Versus 51.93 + 8.85 min., p < 0.001). Length of hospital stay was relatively shorter in AVATS but this was not statistically significant different (p = 0.063).ConclusionsOur study revealed that uniportal AVATS pleural biopsy has a similar diagnostic efficacy and safety profile with VATS in the diagnosis and treatment of patients with undiagnosed pleural effusion who have a high risk of general anesthesia due to advanced age and comorbidities. Accordingly, uniportal AVATS pleural biopsy may be considered in the diagnosis and treatment of all exudative undiagnosed pleural effusions.

Age-related differences in memory for “who,” “when,” and “where” are detectable in middle-aged adults

ABSTRACT Our study examined age-related differences across the adult lifespan using a recently developed test assessing memory for “who, when, and where” in addition to associations among these elements. Young (ages 18–25), middle-aged (ages 40–55), and older adults (ages 60+) were asked to remember a sequence of pictures of different faces paired with different places and place the pairs in the correct sequence. Young adults remembered significantly mores face-place pairs in the correct sequence than middle-aged (p < .05) and older adults (p < .05), but there were no significant differences between middle-aged and older adults. Furthermore, young adults remembered significantly more face-place pairs irrespective of sequence than older adults (p < .05). However, there were no other significant differences among the groups.Using a rapidly administered test that integrates aspects of everyday episodic memory, we found evidence for age-related differences in test performance beginning in middle age.

Neuroimaging evidence for a network sampling theory of individual differences in human intelligence test performance

Despite a century of research, it remains unclear whether human intelligence should be studied as one dominant, several major, or many distinct abilities, and how such abilities relate to the functional organisation of the brain. Here, we combine psychometric and machine learning methods to examine in a data-driven manner how factor structure and individual variability in cognitive-task performance relate to dynamic-network connectomics. We report that 12 sub-tasks from an established intelligence test can be accurately multi-way classified (74%, chance 8.3%) based on the network states that they evoke. The proximities of the tasks in behavioural-psychometric space correlate with the similarities of their network states. Furthermore, the network states were more accurately classified for higher relative to lower performing individuals. These results suggest that the human brain uses a high-dimensional network-sampling mechanism to flexibly code for diverse cognitive tasks. Population variability in intelligence test performance relates to the fidelity of expression of these task-optimised network states.

Assessment of differential neurocognitive performance based on the number of performance validity tests failures: A cross-validation study across multiple mixed clinical samples

Objective: This cross-sectional study examined the effect of number of Performance Validity Test (PVT) failures on neuropsychological test performance among a demographically diverse Veteran (VA) sample (n = 76) and academic medical sample (AMC; n = 128). A secondary goal was to investigate the psychometric implications of including versus excluding those with one PVT failure when cross-validating a series of embedded PVTs. Method: All patients completed the same six criterion PVTs, with the AMC sample completing three additional embedded PVTs. Neurocognitive test performance differences were examined based on number of PVT failures (0, 1, 2+) for both samples, and effect of number of criterion failures on embedded PVT performance was analyzed among the AMC sample. Results: Both groups with 0 or 1 PVT failures performed better than those with ≥2 PVT failures across most cognitive tests. There were nonsignificant differences between those with 0 or 1 PVT failures except for one test in the AMC sample. Receiver operator characteristic curve analyses found no differences in optimal cut score based on number of PVT failures when retaining/excluding one PVT failure. Conclusion: Findings support the use of ≥2 PVT failures as indicative of performance invalidity. These findings strongly support including those with one PVT failure with those with zero PVT failures in diagnostic accuracy studies, given that their inclusion reflects actual clinical practice, does not reduce sample sizes, and does not artificially deflate neurocognitive test results or inflate PVT classification accuracy statistics.

Performance Analysis in Football-Specific Tests by Para-Footballers With Cerebral Palsy: Implications for Evidence-Based Classification.

The objectives of this study were to analyze whether there were differences among para-footballers with different types and degrees of brain impairment (ie,bilateral spasticity, athetosis/ataxia, unilateral spasticity, minimum impairment criteria, or no impairment) in performing 3 football-specific tests requiring ball dribbling, to analyze whether there was an association among the results obtained in the 3 tests, and to determine whether the performance in the tests was associated with competitive level, level of training, or years' experience in para-footballers with cerebral palsy (CP). A total of 123 footballers took part in the study, 87 of whom were footballers with CP and 36 who were without impairment. Both groups were assessed in 3 football-specific tests (Stop and Go, Turning and Dribbling, and the Illinois Agility Test). The results showed that the footballers without impairment recorded a better performance in all tests (P < .01) in comparison with the CP players. No significant differences in test performance were observed among the CP players from different competitive levels. However, significant differences (P < .01) were observed between players with diplegia or athetosis/ataxia compared with players with hemiplegia or minimum impairment level. Performance in the tests did not correlate with years of football experience, weekly strength training sessions, or specific football training in the footballers with CP (P = .12-.95). These findings suggest the possible inclusion of these tests in the classification process for footballers with CP because they discriminate among functional classes and are resistant to training and competitive level.

Spatial Abilities for Architecture: Cross Sectional and Longitudinal Assessment With Novel and Existing Spatial Ability Tests.

This study examined individual differences in spatial abilities of architecture students. Students at different educational levels were assessed on spatial ability tests that varied in their domain-specificity to architecture, with the hypothesis that larger differences between beginner and advanced students will emerge on more domain-specific tests. We also investigated gender differences in test performance and controlled for general reasoning ability across analyses. In a cross sectional study, master students (N = 91) outperformed beginners (N = 502) on two novel tests involving perspective taking and object composition, as well as on a standardized visualization of cross-sections test, but not on a standardized mental rotations test. Longitudinally (N = 117), spatial performance improved after the first bachelor year on visualization of cross-sections, object composition and mental rotation. Although both genders showed higher spatial test performance with increased experience, male students outperformed females across tests and levels of education. The results overall confirmed improvements in spatial performance during architecture studies, with partial support for the domain-specificity hypothesis. A gender gap among advanced students calls for further examining architecture-specific spatial thinking.

Restudying With the Quiz in Hand: When Correct-Answer Feedback is No Better Than Minimal Feedback

Quizzing (testing) can enhance students’ metacognitive accuracy, restudy behaviors, and final test performance. Researchers have not examined, however, the effect of quiz feedback and the availability of the quiz during restudy on these indirect effects of quizzing. We examined three types of quiz feedback: correct-answer, right/wrong, and minimal. In Experiment 1, when the quiz and feedback were available during restudy, participants in all three conditions followed a discrepancy reduction study policy. There were no differences in final test performance in Experiment 1, implying that the degree of feedback elaboration did not impact learners’ benefit from quizzing and restudy. In Experiment 2, when we retracted access to the quiz and feedback during restudy, restudy was impaired, and the minimal condition performed worse on the final test than the correct-answer condition. It appears that correct-answer feedback is critical if quizzes are unavailable; if they are available, the type of feedback has much less impact.

Effects of obstructive sleep apnea on human spatial navigational memory processing in cognitively normal older individuals.

Obstructive sleep apnea (OSA) prevalence increases with age, but whether OSA-related sleep disruption could interrupt the processing of previously encoded wake information thought to normally occur during sleep in cognitively normal older adults remains unknown. Fifty-two older (age = 66.9 ± 7.7 years, 56% female), community-dwelling, cognitively normal adults explored a 3-D maze environment and then performed 3 timed trials before (evening) and after (morning) sleep recorded with polysomnography with a 20-minute morning psychomotor vigilance test. Twenty-two (22) participants had untreated OSA [apnea-hypopnea index (AHI4%) ≥ 5 events/h] where severity was mild on average [median (interquartile range); AHI4% = 11.0 (20.7) events/h] and 30 participants had an AHI4% < 5 events/h. No significant differences were observed in overnight percent change in completion time or in the pattern of evening presleep maze performance. However, during the morning postsleep trials, there was a significant interaction between OSA group and morning trial number such that participants with OSA performed worse on average with each subsequent morning trial, whereas those without OSA showed improvements. There were no significant differences in morning psychomotor vigilance test performance, suggesting that vigilance is unlikely to account for this difference in morning maze performance. Increasing relative frontal slow wave activity was associated with better overnight maze performance improvement in participants with OSA (r = .51, P = .02) but not in those without OSA, and no differences in slow wave activity were observed between groups. OSA alters morning performance in spatial navigation independent of a deleterious effect on morning vigilance or evening navigation performance. Relative frontal slow wave activity is associated with overnight performance change in older participants with OSA, but not those without.

Performance of Long-Term CT and PET/CT Surveillance for Detection of Distant Recurrence in Patients with Resected Stage IIIA-D Melanoma.

Follow-up for patients with resected stage IIIA-D melanoma may include computed tomography (CT) or positron emission tomography (PET)/CT imaging to identify distant metastases. The aim of this study was to evaluate the test performance over follow-up time, of structured 6- and 12-monthly follow-up imaging schedules in these patients. We conducted a retrospective analysis of consecutive resected stage IIIA-D melanoma patients from Melanoma Institute Australia (2000-2017). Patients were followed until a confirmed diagnosis of distant metastasis, end of follow-up schedule, or death. Test accuracy was evaluated by cross-classifying the results of the test against a composite reference standard of histopathology, cytology, radiologic imaging, and/or clinical follow-up, and then quantified longitudinally using logistic regression models with random effects. In total, 1373 imaging tests were performed among 332 patients. Distant metastases were detected in 110 (33%) patients during a median follow-up of 61months (interquartile range 38-86), and first detected by imaging in 86 (78%) patients. 152 (68%) patients had at least one false-positive result. Sensitivity of the schedule over 5years was 79% [95% confidence interval (CI) 70-86%] and specificity was 88% (95% CI 86-90%). There was no evidence of a significant difference in test performance over follow-up time or by American Joint Committee on Cancer (AJCC) substage. The positive predictive value ranged between 33 and 48% over follow-up time, reflecting a ratio of 1:2 false-positives per true-positive finding. Regular 6- or 12-monthly surveillance imaging using CT or PET/CT has reasonable and consistent sensitivity and specificity over 5-year follow-up for resected stage IIIA-D melanoma patients. These data are useful when discussing the risks and benefits of long-term follow-up.