Good Predictor Of Success Research Articles

Nerve root sedimentation sign on MRI: A triage screen for leg dominant symptoms?

PurposeSurgical indications for lumbar spinal stenosis are controversial, but most agree that leg dominant pain is a better predictor of success after decompression surgery. The objective of this study is to analyze the ability of the Nerve Root Sedimentation Sign (SedSign) on MRI to differentiate leg dominant symptoms from non-specific low back pain.MethodsThis was a retrospective review of 367 consecutive patients presenting with back and/or leg pain. Baseline clinical characteristics included Oswestry disability index (ODI), visual analog pain scores, EuroQol Group 5-Dimension Self-Report (EQ5D) and Saskatchewan Spine Pathway Classification (SSPc). Inter- and intra-rater reliability for SedSign was 73% and 91%, respectively (3 examiners).ResultsSedSign was positive in 111 (30.2%) and negative in 256 (69.8%) patients. On univariate analysis, a positive SedSign was correlated with age, male sex, several ODI components, EQ5D mobility, cross-sectional area (CSA) of stenosis, antero-posterior diameter of stenosis, and SSPc pattern 4 (intermittent leg dominant pain). On multivariate analysis, SedSign was associated with age, male sex, CSA stenosis and ODI walking distance. Patients with a positive SedSign were more likely to be offered surgery after referral (OR 2.65). The sensitivity and specificity for detecting all types of leg dominant pain were 37.4 and 82.8, respectively (ppv 77.5%, npv 43.8%).ConclusionsPatients with a positive SedSign were more likely to be offered surgery, in particular non-instrumented decompression. The SedSign has high specificity for leg dominant pain, but the sensitivity is poor. As such, its use in triaging appropriate surgical referrals is limited.

Seven principles of toolpath design in conventional metal spinning

Spinning sheet metal parts successfully requires the design of a complex toolpath to avoid workpiece failure. Notwithstanding decades of research, industrial CNC spinning of new parts today still relies on trial and error, which results in considerable time waste and does not guarantee optimisation of the toolpath. Yet, hand spinning artisans in non-industrial settings can successfully spin new parts first time thanks to the skill accumulated in years of practice. So this paper asks: is there a way to capture and parameterise human skill to drive research into automation? What rules do hand spinners follow? A haptic spinning system is implemented to capture and parameterise the skill of six spinning artisans. Their speech and actions are recorded in a set of over 70 experimental trials and a database of toolpaths is created including information on the trajectory of the roller, applied forces and shape of the workpiece, alongside their speech. The database is analysed, and seven principles for toolpath design are formulated: 1. Take small bites, 2. Stay on the mandrel, 3. Use forward and backward passes, 4. Push in the right place, 5. Go at the right speed, 6. Keep the flange at the right angle, 7. Use a draft. Quantitative toolpath parameters are developed to parameterise the first six principles: the average plastic strain in each toolpass, the fraction of workpiece shape on the mandrel, the fraction of backward passes, the position of the force peak, the feed ratio and the concavity of the toolpass. In trials on thinner and larger blanks than previously investigated in the literature, these parameters appear to be a good predictor of success. This suggests that displacement control alone is not sufficient to automate toolpath design, and that new parameters relating to force and shape control must be employed.

Predictors of success of high-flow nasal cannula in the treatment of acute hypoxemic respiratory failure

BackgroundHigh-flow nasal cannula (HFNC) therapy is used in the treatment of acute respiratory failure (ARF), and is both safe and effective in reversing hypoxemia. In order to minimize mortality and clinical complications associated to this practice, a series of tools must be developed to allow early detection of failure. The present study was carried out to: (a) examine the impact of respiratory rate (RR), peripheral oxygen saturation (SpO2), ROX index (ROXI = [SpO2/FiO2]/RR) and oxygen inspired fraction (FiO2) on the success of HFNC in patients with hypoxemic ARF; and (b) analyze the length of stay and mortality in the ICU, and the need for mechanical ventilation (MV). MethodsA retrospective study was carried out in the medical-surgical ICU of Hospital de Montilla (Córdoba, Spain). Patients diagnosed with hypoxemic ARF and treated with HFNC from January 2016 to January 2018 were included. ResultsOut of 27 patients diagnosed with ARF, 19 (70.37%) had hypoxemic ARF. Fifteen of them (78.95%) responded satisfactorily to HFNC, while four (21.05%) failed. After two hours of treatment, RR proved to be the best predictor of success (area under the ROC curve [AUROC] 0.858; 95%CI 0.63–1.05; p=0.035). For this parameter, the optimal cutoff point was 29rpm (sensitivity 75%, specificity 87%). After 8h of treatment, FiO2 and ROXI were reliable predictors of success (FiO2: AUROC 0.95; 95%CI 0.85–1.04; p=0.007 and ROXI: AUROC 0.967; 95%CI 0.886–1.047; p=0.005). In the case of FiO2 the optimal cutoff point was 0.59 (sensitivity 75%, specificity 93%), while the best cutoff point for ROXI was 5.98 (sensitivity 100%, specificity 75%). Using a Cox regression model, we found RR<29rpm after two hours of treatment, and FiO2<0.59 and ROXI>5.98 after 8h of treatment, to be associated with a lesser risk of MV (RR: HR 0.103; 95%CI 0.11−0.99; p=0.05; FiO2: HR 0.053; 95%CI 0.005−0.52; p=0.012; and ROXI: HR 0.077; 95%CI 0.008−0.755; p=0.028, respectively). ConclusionsRR after two hours of treatment, and FiO2 and ROXI after 8h of treatment, were the best predictors of success of HFNC. RR<29rpm, FiO2<0.59 and ROXI>5.98 were associated with a lesser risk of MV.

Examining the impact of pre-university qualifications on success in interdisciplinary science

ABSTRACT Whether the current post-16 qualifications system in the UK is fit for purpose has long been under discussion, with many calling for a broader, more interdisciplinary approach to preparation for university. This paper examines the relationship between post-16 (A-level) qualifications and degree success for students on the University of Exeter’s innovative Natural Sciences programme, with particular emphasis on whether it is possible to be successful at degree level in subjects not studied at A-level. Maths was found to be the best predictor of success in interdisciplinary science and no one science was found to be more important than the others for preparing students for the bespoke interdisciplinary first year of the degree programme. The data also demonstrates that these students can be successful in later years in subjects not studied at A-level which they would otherwise have been prohibited from studying at university through their lack of core entry requirements. We acknowledge the unique nature of the cohort under analysis and the fact they self-select for this type of programme, but discuss how the study provokes questions and debate about pre-university qualification requirements and the way we structure our school and university curricula to maximise the opportunities for the next generation of STEM graduates.

World-Class Sprinters' Careers: Early Success Does Not Guarantee Success at Adult Age.

To quantify how many of the top 50 under-18 (U18) sprinters in the world managed to become top 50 ranked as adult competitors. The authors also described the career trajectory of athletes ranked in the top 50 during either U18 or senior category. A total of 4924 male and female athletes competing in sprint races and ranked in the International Association of Athletics Federations (now World Athletics) lists in any of the seasons between the 2000 and 2018 were included in the study. The athletes ranked in the top 50 positions of all-time lists during U18, senior, or both categories were analyzed. Only 17% of the male and 21% of the female top 50 ranked U18 managed to become top 50 ranked senior athletes. The top 50 ranked senior athletes consistently produced yearly larger improvements during late adolescence and early adulthood compared with those who ranked in the top 50 at U18. Furthermore, top 50 ranked senior athletes reached their peak performance later compared with the top 50 ranked only in U18. This study confirms that early success in track and field is not a good predictor of success at senior level in sprinting events. The yearly performance improvements and their tracking provide the most suitable approach to identify athletes more likely to succeed as elite performers in adulthood. The authors hope that the results of this study can provide useful comparative data and reference criteria for talent-identification and -development programs.

Predator–prey relationships within natural, restored, and created vernal pools

We performed a multiyear monitoring study to compare amphibian habitat quality among four natural, four restored, and six created pools. We used successful reproduction and metamorphosis of two vernal pool indicator species, the wood frog and spotted salamander, to represent desired outcomes. Ordination techniques were used to identify the aspects of habitat quality that were most correlated with desired outcomes. Previously published results indicated that pool depth, volume, and hydroperiod were among the best predictors of success, regardless of pool type. Observations in the first few years of monitoring also suggested that pools with longer hydroperiods had a greater abundance of aquatic predators of eggs and larvae of indicator species. This follow‐up study further explores and compares predator–prey relationships among pool types. We quantified within‐pool predator and prey abundance and diversity and collected another year of data on the reproductive success of indicator species. Our results confirmed that mean predator abundance was eight times higher in pools with longer hydroperiods. We documented a 96% decrease in wood frog survival rates in a semi‐permanent, natural pool following a 41% decrease in overhead canopy cover and an increase in green frog abundance. At the same time, wood frog reproductive success increased in nearby restored pools with lower predator abundance. Pools with the highest mean survival rates for the two indicator species combined were short‐ or long‐cycle pools (i.e. hydroperiod of 12–35 weeks) with low predator abundance (i.e. &lt;1 organism L−1) and greater proportions of arthropod prey relative to other food items.

How do business schools compete in Latin America? Stability and best predictors of success for the AmericaEconomia MBA Ranking

ABSTRACT The main aim of this paper is to present a longitudinal analysis of the AmericaEconomia MBA Ranking for the period 2005–2014. AmericaEconomia was the first international ranking specifically devoted to Latin American business schools, and with data gathered from this publication, we build a panel to study its stability and the main determinants of a school‘s position in such ranking. We examine the reliability of the ranking, that is whether changes in the relative positions are not just due to white noise, and compare its stability with those of the US and other global rankings. We also empirically determine which are the key quality variables this ranking is promoting for Latin America Business Schools and the evolution of these business schools during the period under study. Unlike previous literature that usually considers dynamic Tobit models for ranking analysis, we put forwards an alternative methodology based on a system GMM estimator with first-differenced instruments. We argue that dynamic Tobit models are appropriate only if you have truncated data about the ranking variable but full data on Business Schools variables.

Efficacy of Cartoons as a Distraction Technique for Children Undergoing Suture of Facial Lacerations in the Emergency Department.

To show the efficacy of cartoon as a distraction technique in suturing a child patient in the emergency room. We studied children aged 2 to 8 years who had sustained a facial laceration 3 cm or less that required suturing from September 2015 to November 2016. We used local anesthesia and attempted to place the sutures without sedation while showing the children cartoons instead. If the first attempt failed, 1 more attempt was made. The patients were divided into 3 groups: success, success on second attempt, and failure. Age, location and size of the wound, and scores on the FACES Pain Rating Scale (FPS) before and after local anesthesia were recorded. The study included 106 children. Cartoon distraction was most effective for those aged 3 to 6 years (4.6 ± 1.9 years). The second-attempt group tended to be older, whereas the failure group was much younger (mean age, 7.4 ± 1.0 vs 2.7 ± 1.8 years). The FPS-R score differed widely among the groups. The success group tended to have a low score before and after local anesthetic injection (4.1 ± 2.0 and 3.1 ± 1.3), whereas the second-attempt and failure groups had much higher scores after injection (8.0 ± 1.7 and 8.8 ± 0.8; 5.2 ± 2.6 and 9.3 ± 0.8). Cartoon distraction techniques can reduce the treatment duration and number of assistants, which also makes it appropriate for the emergency room. In addition, our results indicate that the pre-/post-local injection FPS score is a good predictor of success.

Are good fighters also good singers? The relationship between acoustic traits and fight success in the treefrog Pithecopus nordestinus (Phyllomedusidae)

Morphological characteristics are known to be important predictors of victory in aggressive disputes in the animal world. Among anurans, however, acoustic communication also plays an important role in intrasex conflicts. Although there is evidence for the influence of spectral parameters of calls (e.g., fundamental and dominant frequencies) in anuran disputes, the role that temporal parameters (e.g., duration and repetition rate) play in success during physical conflicts is still poorly understood. We describe the behavior of male frogs in agonistic interactions and investigate the functions of the different types of calls emitted in different social contexts. We also evaluate how body characteristics (mass and body size) and bioacoustic characteristics (repetition rate of the calls) influence success in physical conflicts of Pithecopus nordestinus (Anura: Phyllomedusidae). Agonistic disputes involved gradation in the emission of calls, visual displays, and physical clashes. The fighting call increased in proportion during clashes, indicating a function associated with aggression/intimidation. The uneasiness call (new subcategory herein defined) was only performed by losers during physical clashes, suggesting a meaning of submission or restlessness. No differences were found in any of the morphological parameters between winners and losers of physical disputes. On the other hand, the repetition rate of the aggressive call was positively related to success in fights and proved to be a good predictor of success in fights between males of P. nordestinus. Our results contribute to understanding the influence of temporal parameters of calls on success in physical disputes of this Neotropical treefrog.

Success at Veterinary School: Evaluating the Influence of Intake Variables on Year-1 Examination Performance.

A major challenge in admissions to veterinary medical degrees is to select those students most suitable for clinical training programs and careers from a large pool of applicants with very high academic ability. Predicting the success of students in a veterinary course is challenging, and relatively few objective studies have been undertaken to identify factors that facilitate progression through this educational experience. Prior educational attainment is considered by some to be a good predictor of success at undergraduate level. The aims of this study were to analyze intake data such as educational history and demographic factors of students entering the University of Edinburgh and to investigate possible relationships between these data and academic performance in the first year at veterinary school. Data were collated for three veterinary intakes, including school qualification, subjects, grades, grade point average (GPA), degree classification, domicile, gender, and age. Performance was measured by marks achieved in first-year veterinary degree examinations. Relationships between marks and the influence of intake variables were statistically analyzed via ANOVA. For school-leaving entrants, the presence of straight A grades in school was linked to better exam performance. Students with an A grade in Chemistry or Biology performed better; A grades in Mathematics and Physics did not show such a consistent linkage with performance. Higher GPA was associated with better performance in first year for students in a graduate entry program. This study shows prior educational attainment does appear to be linked with subsequent performance in the first year at veterinary school.

COVID-19 in the Americas: Strategies that Mark the Difference.

Four months after COVID-19 was declared a pandemic, it has found a new epicenter: the Americas. With over four million cases and nearly half a million deaths at this writing, the United States is providing the best example of a failed response to a crisis in which GDP is not proving the best predictor of success. Zero coordinat-ed national strategy combined with unnecessary delays in testing, confusing and often contradictory messaging, and politicization of even the most elementary measures to combat the virus have led some US states to surpass infection and death rates in even the most hard-hit countries. Brazil, where government fi nally resumed reporting, is second only to the USA, its authorities admitting 2.4 million cases and over 300,000 deaths thus far. And by all counts, as in many countries, numbers are vastly underestimated.

The value of prostate-specific antigen monitoring during salvage radiotherapy: a retrospective study and systematic review with meta-analysis

Use of salvage radiotherapy (SRT) after cancer surgery has a low disease control rate. Low prostate-specific antigen (PSA) levels in the blood pre-SRT seem to be the best predictor of success. Our study used PSA monitoring during and after treatment to investigate if PSA levels during SRT can give further information about its chances of success. In a retrospective cohort of 78 patients submitted to salvage radiotherapy (SRT) for biochemical relapse after cancer surgery, we assess PSA values at start of the treatment, 1 week before the end of treatment, and every 3 months for at least 2 years. Post-treatment PSA in our series and the systematic review of the literature aimed to investigate the prognostic value of PSA variation for biochemical disease-free survival. The results suggest that a decline in PSA levels after at least 45 Gy of radiation therapy dosage or a decrease of at least 0.2 ng/mL compared with the start value may be a favorable prognostic factors for biochemical disease-free survival. These results need confirmation using prospective data before being applied to clinical practice and could help physician to choose the correct therapeutic strategy.

Perceptual-cognitive expertise in combat sports: a narrative review and a model of perception-action. [Habilidades perceptivo-cognitivas en deportes de combate: una revisión narrativa y un modelo de percepción-acción

Despite the many studies on physical and physiological features of combat sport athletes, there has been considerably less consideration of psychological factors. Here, we present a narrative review of literature related to perceptual-cognitive skill in combat sports that require the athlete to score points by hitting or touching the opponent’s body with the hands, feet or weapon: boxing, French boxing, fencing, kung fu (wushu), karate, taekwondo and other martial arts. Based on a thorough search of literature, we synthesised findings from empirical studies on Reaction Time, Anticipation, Visual Search and Information Pick-up. Contrary to the belief of coaches, there was no clear consensus regarding Reaction Time being a good predictor of success in combat sports. However, consistent with findings from other sports, expert combat sport athletes better anticipate the opponent’s actions based on information perceived before and during the attack. This is likely facilitated by experts using a gaze fixation strategy (i.e., visual pivot) that facilitates information pick-up. In the final section, we present a model that describes how the evolving perception-action relationship between the attacking athlete and opponent depends on distance, attack progression and opponent reaction. Suggestions are provided for training and for future research in combat sports.

Predictores de éxito del tratamiento con cánula nasal de alto flujo en el fallo respiratorio agudo hipoxémico

High-flow nasal cannula (HFNC) therapy is used in the treatment of acute respiratory failure (ARF) and is both safe and effective in reversing hypoxemia. In order to minimize mortality and clinical complications associated to this practice, a series of tools must be developed to allow early detection of failure. The present study was carried out to: (i)examine the impact of respiratory rate (RR), peripheral oxygen saturation (SpO2), ROX index (ROXI=[SpO2/FiO2]/RR) and oxygen inspired fraction (FiO2) on the success of HFNC in patients with hypoxemic ARF; and (ii)analyze the length of stay and mortality in the ICU, and the need for mechanical ventilation (MV). A retrospective study was carried out in the medical-surgical ICU of Hospital de Montilla (Córdoba, Spain). Patients diagnosed with hypoxemic ARF and treated with HFNC from January 2016 to January 2018 were included. Out of 27 patients diagnosed with ARF, 19 (70.37%) had hypoxemic ARF. Fifteen of them (78.95%) responded satisfactorily to HFNC, while four (21.05%) failed. After two hours of treatment, RR proved to be the best predictor of success (area under the ROC curve [AUROC] 0.858; 95%CI: 0.63-1.05; P=.035). For this parameter, the optimal cutoff point was 29rpm (sensitivity 75%, specificity 87%). After 8hours of treatment, FiO2 and ROXI were reliable predictors of success (FiO2: AUROC 0.95; 95%CI: 0.85-1.04; P=.007 and ROXI: AUROC 0.967; 95%CI: 0.886-1.047; P=.005). In the case of FiO2 the optimal cutoff point was 0.59 (sensitivity 75%, specificity 93%), while the best cutoff point for ROXI was 5.98 (sensitivity 100%, specificity 75%). Using a Cox regression model, we found RR<29rpm after two hours of treatment, and FiO2<0.59 and ROXI>5.98 after 8hours of treatment, to be associated with a lesser risk of MV (RR: HR 0.103; 95%CI: 0.11-0.99; P=.05; FiO2: HR 0.053; 95%CI: 0.005-0.52; P=.012; and ROXI: HR 0.077; 95%CI: 0.008-0.755; P=.028, respectively). RR after two hours of treatment, and FiO2 and ROXI after 8hours of treatment, were the best predictors of success of HFNC. RR<29rpm, FiO2<0.59 and ROXI>5.98 were associated with a lesser risk of MV.

Electronic Preparatory Test for Mathematics Undergraduates: Implementation, Results and Correlations

We present a study of the implementation of the Electronic Preparatory Test for beginning undergraduates reading mathematics at the University of Hull. The Test comprises two elements: diagnostic and self-learning. The diagnostic element identifies gaps in the background knowledge, whilst the self-learning element guides students through an upcoming material. The Test lends itself to an early identification of weak and strong students coming from a wide range of background, allowing follow-ups to be made on a topic-specific basis. The results from the Tests, collected over three years, correlate positively with end-of-year examination results. We show that such a Preparatory Test can be a better predictor of success in the first-year examination in comparison with university entry qualifications alone.

Predicting success in pharmaceutical calculations

IntroductionUnderstanding preadmission predictors of success in pharmacy calculations, an important aspect of pharmacy practice, could impact admissions selection and advising practices. The objective of this study was to determine which student specific preadmission variables best predict success in a pharmaceutical calculations course. MethodsPreadmission data from 388 students who completed a one semester pharmaceutical calculations course between 2013 and 2016 were evaluated. This retrospective analysis was performed to determine which of the independent preadmission variables were positively correlated to the pharmaceutical calculations course grade. Fifteen preadmission variables, including demographics, grade point average (GPA), Pharmacy College Admission Test (PCAT) score, prior degrees, and number of pre-professional credit hours completed, were evaluated. Descriptive statistics were used for baseline characteristics and relative importance analysis was used to examine association between the dependent and independent variables. ResultsThe relative importance analysis revealed eight of the fifteen preadmission variables were significantly correlated with final grades in pharmaceutical calculations. Overall, 26.1% of the variance was explained by these variables. GPA (cumulative and science specific) and PCAT (quantitative and verbal) were the strongest indicators. ConclusionsPreadmission GPA and PCAT scores were the best predictors of success in a pharmaceutical calculations course. About one quarter of the variance was explained by the identified predictive variables, therefore other factors, not evaluated in this study, likely influence the success in pharmaceutical calculations and should be investigated to determine a more dependable set of predictors.

Serial Weekly Measurements of the Timed Inspiratory Effort Index Can Predict Successful Prolonged Weaning.

Patients who require prolonged weaning from mechanical ventilation represent a major challenge in intensive care, and the timed inspiratory effort (TIE) index has been shown to be a clinically valuable tool to predict weaning success. To evaluate whether weekly serial measurements of the TIE index can predict the success in prolonged weaning. A prospective observational study in which the subjects who started the weaning process off mechanical ventilation underwent weekly measurements of the TIE index. The area under the receiver operating characteristic curve was used to evaluate the accuracy of the TIE index as a predictor of weaning success. A multivariate Cox regression model was developed to test the association of TIE index values of ≥1.0 cm H2O/s with a failure of weaning. Seventy subjects were selected. Their median (IQR) age was 72 (62-78) y, the median (IQR) duration of mechanical ventilation was 17.5 (14-28) d, and the median (IQR) APACHE II (Acute Physiology and Chronic Health Evaluation) II score was 28 (24-31). Thirty-five of the 70 subjects (50%) died, 22 of them after successful weaning. A total of 224 tests were performed over 56 d. The area under the receiver operating characteristic curve of the TIE index was 0.93. In the analysis of the probability of success during the follow-up (Kaplan-Meier method), a significant difference was obtained in favor of those with a TIE index of ≥ 1.0 cm H2O/s (53% vs 32%, P = .030). In the multivariate Cox regression analysis, values of the TIE index ≥ 1.0 cm H2O/s revealed an inverse, strong, and independent association with failure (hazard ratio 0.36, 95% CI 0.15-0.91; P = .030). The following variables were also found to have an independent but direct association with failure: age and length of time before weaning. When measured weekly, a TIE index of ≥1.0 cm H2O/s was a good predictor of success in subjects who required prolonged weaning in our hospital.

Current Practices and Perceptions of Admission Criteria at Physical Therapist Education Programs in the United States

Introduction. Entry-level Doctor of Physical Therapy (DPT) programs in the United States (US) have developed admission criteria (AC) to identify applicants most capable of program success; however, there is little evidence to support these criteria. The purpose of this study was to 1) gather data on the use and weighting of AC, 2) explore the perceptions of the value of AC, 3) explore a possible discrepancy between the use of AC and their perceived value, 4) determine whether differences in AC exist between programs with higher versus lower licensure pass rates, higher versus lower student retention rates, and across geographic regions in the US. Subjects. All DPT programs (N = 218) in the US accredited by the Commission on Accreditation of Physical Therapy Education were eligible for recruitment in this study. The survey was completed by a program director, an admission committee chair, or a faculty member familiar with the program's admission process. Of the 218 programs invited to complete the survey, 73 responded with a response rate of 33.5%. Methods. An anonymous, 30-item survey was used for data collection. Descriptive and comparative statistical methods were used on the data as a whole and by subgroups. Results. Undergraduate overall grade point average (GPA), math/science GPA, or verbal and quantitative Graduate Record Examination (GRE) scores were weighted heavily in admission decisions. The personal essay, volunteer hours, and letters of recommendation were not considered predictive of program success. There were significant differences in the proportion of programs that use the verbal and quantitative GRE scores when subdivided by licensure pass rate, either ≥95% or &lt;95% (P = .005 and P = .049, respectively). There were no proportional differences in the utilization or weighting of criteria when programs were divided by student retention rate, either ≥95% or &lt;95%. Geographic differences were found in the use and weighting of AC when comparing the West region with other parts of the US. Conclusion. Previous literature suggests that undergraduate GPA is the best predictor of success in a DPT program; however, this study found no significant differences between the use or weight given to the GPA on licensure examination pass rates or student retention rates. Programs may wish to reconsider requiring a number of criteria that were not weighted heavily or considered to be a top predictor of success in a DPT program, particularly those criteria that are resource intensive.

What Shall We Do About Grit? A Critical Review of What We Know and What We Don’t Know

Grit is a construct that is widely studied by educational researchers and that has generally been enthusiastically received by educational practitioners. This essay highlights that many of the core claims about grit have either been unexamined or are directly contradicted by the accumulated empirical evidence. Specifically, there appears to be no reason to accept the combination of perseverance and passion for long-term goals into a single grit construct, nor is there any support for the claim that grit is a particularly good predictor of success and performance in an educational setting or that grit is likely to be responsive to interventions. I describe avenues for future research on grit that may help to clarify if grit can contribute to our understanding of success and performance. These avenues include examinations of possible configural relationships between passion and perseverance, whether grit or grit facets represent necessary but not sufficient conditions for performance, interactions between ability and either grit or the facets of grit in the prediction of performance, possible polynomial relationships between grit or grit facets and performance, and improvements in the manner in which grit is assessed. Alternative predictors of performance that are more strongly related to success and performance and that may be more responsive to interventions are also discussed.

Efficacy of the NICHD vaginal birth after cesarean delivery calculator: a single center experience

Objective: As the cesarean delivery rate has risen future pregnancy outcomes are impacted including the decision to undergo a repeat cesarean or a vaginal birth after cesarean (VBAC) in the subsequent pregnancy. A calculator was developed by the maternal fetal medicine units (MFMUs) network in 2007 to estimate the chance of successful VBAC and is used widely. The purpose of this study was to investigate the calculator’s validity on our obstetric patient population.Study design: This was a retrospective study of patients attempting a VBAC delivery at a single center from January 2012 to June 2014. Chances for success were estimated using the MFMU network VBAC calculator in 201 evaluable patients. We then compared the calculator’s results with the outcomes observed. In order to determine if the MFMU VBAC calculator was accurately predicting successful vaginal deliveries, we discretized our dataset by binning into MFMU score deciles. Each decile was then tested for significant deviations from the predicted success rate using an exact binomial test. Significance was determined at 0.05 levels.Results: Two hundred and one patients were included. Our results demonstrated higher actual VBAC success than anticipated by using the MFMU network calculator for patients with scores in the 40–80% decile range. When stratified by race, we found the calculator to be a better predictor of success in African-American patients, as the calculator appears to underestimate success in white and Hispanic patients.Conclusion: Calculators are helpful to facilitate patient counseling and shared decision-making regarding the patient’s choice for VBAC. When providing such counseling, the potential for reduced predicted VBAC success in the mid-decile range with the MFMU calculator should be recognized.