Reliability of flywheel hip extension and leg curl tests and their associations with isokinetic hamstring strength.

Sequence-dependent effects of iTBS and perceptual learning on binocular balance.

Virtual reality in physiological education: Influence of learning modality and learner characteristics on learning outcomes.

Comparison of visual and electronic assessments of active cervical range of motion in university varsity level American football players: a three-point cohort study.

improving students’ TOEFL ICT scores at Universitas dr. Soebandi. The research employed a quantitative approach using a quasi-experimental design. The population of this study consisted of university students, while the sample was selected through purposive sampling from two second-semester Pharmacy classes, namely Class 23A and Class 23B, with a total of 60 students. Class 23A was assigned as the experimental group and taught using Discussion-Based Learning, while Class 23B served as the control group and was taught using the conventional lecture method. Data were collected through TOEFL pre-test and post-test instruments adapted from Barron’s TOEFL, 6th Edition by Pamela J. Sharpe. The data were analysed using the Independent Sample T-Test through SPSS. The findings showed that the average pre-test scores of the experimental and control groups were relatively similar, namely 382 and 379, indicating comparable initial ability. After the treatment, the post-test results revealed that the experimental group achieved an average score of 437, while the control group obtained 405. The score improvement of the experimental group (+55) was higher than that of the control group (+26). Statistical analysis showed that the significance value (Sig. 2-tailed) was 0.014, which was lower than 0.05, and the t-count value (3.32) was higher than the t-table value (2.00). Therefore, the null hypothesis was rejected and the alternative hypothesis was accepted. It can be concluded that Discussion-Based Learning had a significant positive effect on improving students’ TOEFL ICT scores.

ABSTRACT Studies suggest positive associations between cooperative learning, academic self-efficacy, learning approaches, and cognitive flexibility. However, research analysing these variables in one system remains scarce. This study examined the relationship between cooperative learning, academic self-efficacy, learning approaches, and cognitive flexibility among 365 Cambodian pre-service teachers from two teacher education colleges, and further tested the mediating roles of academic self-efficacy and learning approaches. Structural equation analyses revealed direct and indirect effects of cooperative learning on cognitive flexibility through academic self-efficacy and deep learning approaches, operating both independently and sequentially. Mediating effects through surface learning approaches were not statistically significant. This research advances existing literature by uncovering how cooperative learning develops pre-service teachers’ cognitive flexibility via academic self-efficacy and deep learning approaches.

Co-administration of digoxin and trans-2-decenoic acid ethyl ester improves motor learning performance in mice.

The vestibular ocular motor screen (VOMS) and the Sport Concussion Assessment Tool 6 (SCAT6) are point-of-care concussion assessments administered immediately or soon after sports participation or exercise. To retain validity and accuracy, the results of these tests should not be affected by sporting activity. We assessed the effect on the mVOMS (modified VOMS) and SCAT6 immediately and 20 minutes after performance training in high school athletes. Nonrandomized pilot experimental study. High School, Buffalo, NY. Nonconcussed athletes (n = 23, 39% male, 15.5 ± 1.0 years). Performance Training (pretraining, post-training, 20 minutes post-training). mVOMS and SCAT6 scores (standardized assessment of concussion, modified balance error scoring system, timed tandem gait [TTG], dual task tandem gait [DTTG]). TTG (P = 0.005) and DTTG (P = 0.045) improved significantly from prepractice to immediate postpractice and from pretraining to 20 minutes post-training (TTG [P = 0.002], DTTG [P = 0.006]). There were no other differences in SCAT6 or mVOMS scores among the 3 time points. SCAT6 and mVOMS performance was not adversely affected by moderately intense exercise training in high school athletes. TTG and DTTG performance improved after exercise, consistent with the learning effect. Further research should be conducted across other populations to increase generalizability. Clinicians should be confident that fatigue and exertion from acute performance training activities are not likely to affect the performance of these widely used sideline concussion assessment tools.

Sublexical semantic decoding during incidental novel word learning in natural Chinese reading.

To analyze the effect of intraocular pressure (IOP) characteristics on the 5-year rate of visual field (VF) Mean Deviation (MD) progression in the HORIZON trial. Post-hoc analysis of data from a randomized clinical trial. Patients with glaucoma and visually significant cataract randomized to cataract surgery (CS) with or without the implant of the Hydrus Microstent (HMS). One eye of each participant with at least 3 reliable VFs (false positive errors < 15%) over at least 1 year was included. We used a published Bayesian hierarchical model, designed to minimize the effect of perimetric noise and learning. We compared the mean rate of MD progression between the two arms and measured the effect of post-operative mean IOP (MIOP), peak washed-out and mean washed-out IOP (WO-PIOP and WO-MIOP) and day-1 IOP. These IOP metrics were mean-centered and standardized (divided by their standard deviation, SD), to allow a direct comparison of their effect. Mean rate of MD progression. Data from 517 eyes (352 in the CS-HMS arm) were analyzed. The MD rate was -0.55 [-0.72, -0.39] dB/year (Mean [95%-Credible Intervals]) for the CS only arm and -0.30 [-0.38, -0.22] for the CS-HMS arm (44.6 [18.0, 64.2]% reduction, p = 0.004). Increase in all IOP metrics was significantly associated with a faster MD rate. MIOP, WO-MIOP and WO-PIOP had similar proportional effects. Day-1 IOP had a considerably smaller effect. The difference in rate between the two arms remained significant after adjusting for MIOP (p= 0.002), but was largely eliminated after adjusting for WO-MIOP and WO-PIOP (p= 0.396). The MD rate in the CS arm remained significantly faster than CS-HMS (p = 0.001) after removing eyes with a day-1 IOP spike (IOP > 40 mmHg or 10 mmHg above the washed-out baseline IOP). The MD rate was significantly slower in the CS-HMS arm in the HORIZON trial, compared to CS alone. This difference was not explained by day-1 IOP spikes or MIOP, but was largely accounted for by WO-IOP metrics.

Acquiring competencies in intraprofessional collaboration (IntraPC) across the primary care (PC)-secondary care (SC) interface is essential to prevent adverse outcomes in the increasingly complex care for older adults. The workplace-based learning intervention Secondary Primary care Intraprofessional Collaboration Education (SPICE) was developed to foster IntraPC learning among co-located PC and SC residents during a geriatric rotation in the Netherlands. Understanding how learning through SPICE translates into clinical practice remains challenging and may require innovative evaluation methods. This study explored the longer-term effects of SPICE using a new collective evaluation approach. We used the effects forum, a collective evaluation method originating from applied social sciences that combines timeline analysis, mixed focus groups, and knowledge co-construction. PC and SC residents, supervisors, and patients collaboratively constructed a timeline of IntraPC learning moments during SPICE and the following six months. Participants discussed how and why these moments influenced their collaborative behavior and clinical practice. Data were analyzed using thematic analysis. Seventeen participants took part in two distinct effects forums. Residents reported gaining insight into patients' care continuum and developing greater mutual understanding across PC and SC. This facilitated more proactive handovers, which could improve continuity across care settings. Residents also transferred IntraPC learning into new contexts through reflection and dialogue, creating a ripple effect of learning that extending beyond the initial intervention. Workplace-based IntraPC learning can lead to meaningful changes in collaborative behavior and clinical practice. By capturing shared experiences over time, the effects forum provided insight into how learning translated into practice and supported ongoing reflection. Collective evaluation offers a valuable approach to understanding the impact of workplace learning interventions in complex healthcare settings, with potential implications for further improving continuity and patient safety through IntraPC learning across the PC-SC interface.

Medication reviews (MRs) are increasingly implemented to optimize medication use and address drug-related problems in patients with complex pharmacotherapy, with medication review type 2a (MR2a) representing an intermediate format involving a pharmacist-led structured assessment with patient interview, based on clinical and medication data, without direct prescriber interaction. Despite their widespread implementation, systematic and operational approaches to evaluate the quality of MRs remain limited. In Belgium, Medication Review type 2a (MR2a) has been implemented in routine practice of community pharmacies since 2023, yet no validated instruments exist to evaluate the quality of written MR2a reports. This study aimed to adapt the existing BRANT-MERQS framework for the quality evaluation of MR2a reports and to assess the usability, reproducibility and reliability of the resulting tool (BRANT-MERQS-2A). Relevant criteria were selected from the original BRANT-MERQS and expanded with criterion-specific instructions to form the BRANT-MERQS-2A. Initial testing involved two student assessors independently evaluating 98 MR2a reports, with interrater agreement (IRA) assessed using weighted Cohen's Kappa. In a subsequent extended testing phase, the same reports were assessed by 61 final-year pharmacy students, with three randomly selected students evaluating each MR2A report. Interrater reliability was evaluated using the Intraclass Correlation Coefficient (ICC) and Gwet's AC1. Assessment duration was recorded to evaluate feasibility. Initial testing demonstrated strong IRA between the two student assessors. In the extended student cohort, agreement at the criterion level ranged from poor to moderate, with an overall ICC of 0.62, indicating moderate reliability. Criteria differed in discriminatory capacity, with some showing high absolute agreement but limited variability. Assessment time decreased over successive rounds, reflecting a learning effect and improved efficiency. The BRANT-MERQS-2A provides a feasible and structured approach for assessing the quality of MR2a reports. While variability at criterion level reflects the inherent complexity of MR2a, the tool demonstrates potential for self-and peer-assessment and offers a valuable foundation for further refinement and integration into routine quality monitoring.

Flipped learning is a learning model in which students are active and effective. This study is a quasi-experimental study conducted using a pretest-posttest-follow-up test design with experimental and control groups to evaluate the effect of flipped learning on the education of second-year dental students regarding the facial nerve in neuroanatomy. The study was conducted with 59 students in the experimental (n = 28) and control (n = 31) groups in the 2nd year of Giresun University Faculty of Dentistry. Data were collected using the "Student Demographic Characteristics Form", "Facial Nerve Anatomy Knowledge Test", and "Flipped Learning Feedback Form". Students in the experimental group were trained using the flipped learning method prepared by the researchers. Students in the control group were trained using the traditional education method. Permission and ethical approval were obtained from the institution where the study was conducted (19.03.2025, no:2025/47). A statistically significant difference was found between the pretest, posttest, and follow-up test scores on the facial nerve anatomy knowledge test for students in the experimental group (p = 0.000). A statistically significant difference was also found between the pretest, posttest, and follow-up test scores for students in the control group (p = 0.022). However, no statistically significant difference was found between the experimental and control groups across all three tests (p > 0.05). Students in the experimental group rated the benefits of the flipped learning method as beneficial, with a median value of 4 (3-4). In this study, both flipped learning and the traditional teaching method significantly improved students' knowledge of facial nerve anatomy. However, no statistically significant difference was found between the groups. As a student-centered approach, flipped learning can serve as a complementary method to traditional anatomy education.

Nursing students often struggle with the fluids and electrolytes course because of the complexity, extensive detail, and fleeting nature of the content. Evidence indicates that the flipped classroom approach can enhance learning and performance among students in the medical professions compared to traditional methods. This study aimed to compare the effects of two teaching approaches, the flipped classroom and traditional lecture-based learning, on nursing students' academic performance and perceptions of the classroom environment. This was a single-blind, parallel-group, pretest-posttest randomized controlled trial. The study was conducted with 58 nursing students at Qom University of Medical Sciences, Iran, during the 2019-2020 academic year. Participants were randomly assigned using a computer-generated block randomization sequence to either the intervention group (flipped classroom, n = 29) or control group (lecture-based learning, n = 29). The primary outcome was academic performance, measured by researcher-developed 20-item multiple-choice knowledge test. The secondary outcome was perceptions of the classroom environment, assessed using the College and University Classroom Environment Inventory (CUCEI). Data were analyzed using descriptive and inferential statistics with SPSS version 26. All analyses followed the intention-to-treat principle and included all 58 randomized participants. There was no statistically significant difference in the mean scores of knowledge test between the two groups prior to the intervention (t = 1.265, 95% CI: [-0.30, 1.33], P = 0.211). After controlling for pretest scores, ANCOVA revealed a significant and large effect of the flipped classroom on post-test knowledge (F = 104.719, P < 0.001, partial η² = 0.65). A one-way MANOVA on the seven CUCEI subscales yielded a significant multivariate effect (Pillai's Trace = 0.93, F = 109.30, P < 0.001, partial η² = 0.93). With a Bonferroni-corrected alpha of 0.007, the flipped classroom group demonstrated significantly higher scores on Satisfaction, Involvement, Task Orientation, and Innovation, while no significant differences were found for Personalization, Student Cohesiveness, and Individualization. The findings suggest that the flipped classroom approach can improve nursing students' academic performance and perceptions of the classroom environment. These results highlight the potential value of integrating active, student-centered pedagogies into nursing curricula. However, given the small sample size, short study duration, lack of long-term follow-up to assess knowledge retention, and single-institution design, further research with larger and more diverse samples is needed to confirm these results. The study was retrospectively registered in the Iranian Clinical Trials Registry (IRCT) with the trial number IRCT20240610062078N2 on December 21, 2025.

When animals learn the behavioral relevance of sensory features, response selectivity in primary sensory areas increases for those features. However, the effect of learning on neuronal activity in higher-level areas associated with decision-making in the parietal cortex, compared with primary sensory cortex, is not yet known. We used two-photon calcium imaging to determine how learning modifies neural representations in the primary visual cortex (V1) and posterior parietal cortex (PPC) in a visual go/no-go orientation discrimination task in male and female mice. We found that behavior improvements after learning were associated with increased neuronal selectivity in both V1 and PPC. The increased selectivity in PPC was mainly driven by neurons preferring the rewarded go stimulus, while neurons in V1 increased their selectivity for both the rewarded go and unrewarded no-go stimulus. Furthermore, feature preference was robust in V1 neurons but reorganized in PPC after learning. Finally, feature preference after learning was preserved across contexts in V1 but not in PPC, where many neurons switched their preference to the rewarded feature during active task engagement. Our results demonstrate that learning a visually guided discrimination task increased information about relevant sensory features through distinct changes in the bottom and top levels of the visual cortical hierarchy. Visual cortex neurons encode visual features with increased reliability but with preserved feature preferences after learning, while parietal neurons reorganize their feature preferences in a task-dependent manner.

ABSTRACT This paper examines how import spillovers affect innovation efficiency across different innovation contexts in China by using a Chinese regional panel dataset from 2001 to 2020. The results indicate the coexistent of two opposing mechanisms of import spillovers: learning effects and adverse crowd-out effects. The import spillovers positively affect R&D efficiency and IPR protection positively moderates the relationship between import spillovers and R&D efficiency. Moreover, IPR and R&D efficiency present an inverted U-shaped relationship. By contrast, import spillovers negatively affect commercialization efficiency and IPR protection negatively moderates the relationship between import spillovers and commercialization efficiency. There is significant heterogeneity impact in different regions. These findings contribute to understanding the impact of IPR protection on innovation in emerging markets.

This study examines the effect of a self-regulated learning (SRL) intervention on English reading achievement and reading behavior of Chinese secondary school students. The intervention is an eight-step form that was developed based on Zimmerman’s three-phase cyclical model. A concurrent embedded mixed-methods design was employed to collect data at a secondary school in a second-tier city in China, involving 208 students from Grades 7 and 8 in a quasi-experimental study, and 18 of these students in a qualitative study. The results showed that students in the experimental groups achieved significantly higher English reading scores. The students reported their engagement with the intervention and their comments on its impact in the qualitative data, revealing individual differences in the use and perceptions of the intervention form. This study has practical implications for improving SRL-based instruction in EFL settings and for enriching teacher professional development in integrating both subject-based training and SRL-based instruction.

Open-set semi-supervised object detection (OSSOD) is an emerging research area that relaxes the assumption of closed-set in semi-supervised object detection (SSOD), allowing unlabeled data to contain both in-distribution (ID) and out-of-distribution (OOD) samples. In the face of OSSOD, existing approaches expect to completely filter out OOD samples from unlabeled data for conventional semi-supervised learning. Different from it, we find that the effective use of OOD samples in unlabeled data can also facilitate feature learning and thus boost the detection performance of ID categories under open set conditions. Specifically, we perform refined instance-level consistency regularization (ICR) on all the detected instances (including the OOD ones) on unlabeled images, while introducing a novel OOD-aware contrastive learning (OCL) that clusters ID objects and pushes away OOD samples in the intra-class feature space, enhancing the compactness of ID features while emphasizing the discrimination between ID and OOD objects. Based on the distinguished features, we further design a prototype-based multimetric adaptive matching (MAM) approach, which identifies ID/OOD samples by adaptively measuring multiscale feature similarity between samples and class prototypes according to the specific category. With the help of this approach, more reliable ID/OOD samples can be mined from unlabeled data for contrastive learning, while the consistency regularization (CR) can be weighted according to the matching scores, correcting the biasing effects of OOD objects. Extensive experiments demonstrate that our design can effectively utilize OOD samples to optimize feature learning while avoiding their detrimental effects in semi-supervised learning, which ultimately greatly improves the detection capability of the model in open-set scenarios by a large margin over current state-of-the-art works.

ABSTRACT This study explores new sources of entrepreneurial self-efficacy focusing on play and learning. The study also considers the influence of the family context on this relationship. While extensive research has explored the origins of self-efficacy beliefs, we know little about the combined effects of emotions and cognitions. Building on social cognitive theory, we explore (a) the effect of a playful approach on forming entrepreneurial self-efficacy beliefs; (b) the mediating role of entrepreneurial learning; and (c) the moderating effects of marital status and offspring. We collected data through a survey with 349 entrepreneurs. Results indicate that playful approach has a significant and positive impact on entrepreneurial self-efficacy beliefs and that entrepreneurial learning mediates it. A moderated relationship is also observed such that, for single entrepreneurs, playful approach has a stronger influence on entrepreneurial learning, influencing entrepreneurial self-efficacy beliefs. Results are discussed in terms of implication for theory and practice.

ObjectiveFigure copy and recall tests are sensitive measures of visuoconstruction and visual episodic memory, but their clinical is constrained by labor-intensive manual scoring. We developed and validated an automated, element-level scoring pipeline using Vertex AI object detection for the tablet-based figure copy and recall tasks in the California Cognitive Assessment Battery (CCAB). The automated scoring pipeline duplicated the scoring procedures used by expert manual raters.MethodsA normative sample of 2,011 community-dwelling adults aged 18-90 completed figure copy and delayed recall trials at baseline, with subsamples retested at 1 day and at 6, 18, and 30 months. Participants completed the drawings with their index finger on a tablet computer with finger position digitized to analyze the speed and timing of individual drawing strokes A convolutional object-detection model trained on the Vertex AI AutoML Vision platform identified each of twelve canonical figure elements in rendered drawings. Separate element presence and location scores were computed after homographically warping drawings onto a canonical template to produce trial-level Element, Location, and Total scores. To compare Vertex and human scores, Vertex AI and expert human raters independently scored 1500 randomly selected drawings to evaluate inter-rater agreement, including a common subset of 100 drawings scored by Vertex AI and all raters.ResultsTotal scores were virtually indistinguishable (r = 0.966) from human-human agreement (mean r = 0.971) as were Element presence scores (mean r = 0.959 vs. r = 0.963). Location-score agreement (r = 0.951) was slightly below the human-human mean (r = 0.972) due to pixel-level analysis by Vertex AI that was impossible for human raters. The Vertex pipeline showed no preferential advantage for the single expert rater who categorized Elements during training. Automated scores showed strong demographic gradients, age effects on Recall (r = -0.32) were approximately twice those in Copy conditions (r = -0.16). A Memory Cost score (Recall - Copy) showed a monotonic age-related decline from +0.40 z in the youngest subjects to -0.54 z in the oldest. Kinetic analysis revealed that drawing speed and efficiency showed significant age-related changes. Overnight test-retest reliability was high (Recall r = 0.72) and the Recall trial showed a large overnight learning effect (&[Delta] = +1.18) that continued with repeated tests up to 30 months (&[Delta] = +0.75).ConclusionsThe computer vision pipeline described here preserves the element-level structure of expert manual scoring and recovers the memory-specific clinical signals of the delayed recall trial. Overall agreement with human rates was approximately an order of magnitude greater than previously described automated scoring approaches. Automatic, computer vision scoring of figure copy and delayed recall removes scoring barriers that impede the more extensive use of figure copy and recall tests.Key FindingsA fully automated computer vision pipeline incorporated Vertex AI to score element presence and location in a figure copy and recall task in 9,117 drawings from 2,011 cognitively normal adults,In validation samples, score agreement between Vertex AI score and three expert human raters was indistinguishable from human–human agreement (r = 0.966 vs. r = 0.971).Age effects on delayed Recall scores were twice those of Copy scores (r = −0.32 vs. r = −0.16). As a result, a Memory Cost score (Recall − Copy in z units) declined monotonically with age from +0.40 z in the youngest stratum to −0.54 z in the oldest.Test–retest reliability was high at a 1-day retest interval for Recall (r = 0.72) but obscured by ceiling effects for Copy (r = 0.48). The Recall trial showed large overnight learning effect (Δz = +1.18) that persisted up to 30 months (Δz = +0.75).A parallel motor-temporal analysis of drawing time, stroke count, and pause structure revealed that older subjects produced jerkier strokes (r = 0.19) and showed longer intersegment pauses during recall (r = 0.19).