Natural Courses Research Articles

MNG-01 NATURAL HISTORY OF ASYMPTOMATIC MENINGIOMAS: REVIEW WITH META-ANALYSES

Frequency of meningioma as an incidental finding in neuroimaging study is increasing. It is important to characterize tumors that will grow to be symptomatic in order to select appropriate treatment and radiological follow-up because long-term observation may increase the risk of surgery due to enlargement of the tumors and aging of patients. [Methods]We reviewed 26 studies that analyzed natural courses in asymptomatic or untreated meningiomas. RESULTS: In time-growth rate analysis, nearly 70% of meningiomas showed radiological progression defined by a volume criteria and the rate approached plateau at 5–6 years. About half of incidental meningiomas presented a decelerating growth pattern or no growth while less than one-fourth of them grew exponentially. Growth pattern change could be affected by the length of follow-up period. Radiological progression, growth speed (annual volume change (AVC) or relative growth rate (RGR)) and symptomatic progression had each different factor related to their progression. Younger age, non-calcification and high intensity on T2 weighted image related to radiological progression and rapid growth speed but not to symptomatic progression. Tumors in men and lager size were likely to be symptomatic in meta-analysis. AVC (>= 2.1cm3/year) was the strongest indicator for symptom development. In the group of AVC >=2.1cm3/year, progression free rate was 69.3% at 3 years, and reached to 55.4% at 6 years whereas 100% in slower growth group. [Conclusion]Radiological features may not be useful for prediction of symptom development except for perifocal edema in a long term. This may be due to dynamic change of these radiological markers in a long term. Quantitative tumor size and growth speed especially AVC were important factors for decision of treatment.

The natural course of unruptured intracranial aneurysms in a Chinese cohort: protocol of a multi-center registration study in CIAP

BackgroundSubarachnoid hemorrhage (SAH) accounts for 4.4% of cerebral vascular disease, which is one of the leading causes of death in China. Rupture of intracranial aneurysms (IAs) is the most common cause of SAH. The natural history of unruptured IAs (UIAs) and the risk factors for rupture are among the key issues regarding the pathogenesis of IA and SAH that remain unclear in the Chinese population.MethodsThe China Intracranial Aneurysm Project (CIAP) is a prospective, observational, multicenter registry study of the natural courses, risk factors for the onset and rupture, treatment methods, comorbidity management and other aspects of intracranial aneurysms. To date, there are five studies in the CIAP. CIAP-1 is a prospective observational cohort study of UIAs. More than 5000 patients who will be followed for at least 1 year are expected to be enrolled in this cohort. These participants come from more than 20 centers that represent different regions in China. Enrollment began on May 1, 2017, and will take approximately 5 years. A nationwide online database of UIAs will be built. Participants’ basic, lifestyle, clinical and follow-up information will be collected. The blood samples will be stored in the Central Biological Specimen Bank. Strict standards have been established and will be followed in this study to ensure efficient implementation.DiscussionThe natural course of UIAs in the Chinese population will be explored in this registry study. In addition, the risk factors for the rupture of the UIAs and the joint effect of those factors will be analyzed. The present study aims to create a nationwide database of UIAs and investigate the natural course of UIAs in China.Trial registration The Natural Course of Unruptured Intracranial Aneurysms in a Chinese Cohort (ClinicalTrials.gov Identifier: NCT03117803). Registered: July 5, 2017

Clinical and neuropsychological study of natural course of light cognitive failure, Alzheimer disease and parkinson dementia

This study is to examine the natural courses of Alzheimer Disease (AD), Light Cognitive Failure (LCF) and Parkinson's Dementia(PD) cases free of any therapeutic procedure and with neuropsychological test series; to determine the transformation ratio of these cases to dementia and to examine the courses of clinical factors. 120 patients consisting of 72 AD, 16 PD and 32 LCF patients and 24 healthy controls who are the spouses of the patients or healthy volunteers. Department between years 2009 - 2018, have been included in the research. In the LCF group, MMSE, forward and backward counting range, calculation, abstraction, praxis, memory of word list, understanding, construction, clock drawing scores have been higher than the other groups but lower than the control group. In the LCF group, total NPI and NPI trouble scores have been lower than the other groups. In the PD group, total NPI scores have been determined to be higher than the AD and LCF groups. Total NPI trouble score has been higher for the AD group when compared with PD and LCF groups. In the LCF group, for 11 % of the patients, diagnosis have transformed to AD in the control period. We determined that 11,1% of the patients with LCF cogenesis had transformation to AD, in this group no transformation to PD has been observed in the control time period, no transformation in the healthy control group has been observed.

Natural courses and long-term results of type A acute aortic intramural haematoma and retrograde thrombosed type A acute aortic dissection: a single-centre experience.

Few reports on the outcomes of patients treated for Stanford type A acute aortic intramural haematoma (TAAIMH) and retrograde thrombosed type A acute aortic dissection exist. This study aimed to evaluate their long-term results and predictors of adverse outcomes. We retrospectively analysed 40 patients with TAAIMH and retrograde thrombosed type A acute aortic dissection. All patients underwent urgent surgery on presentation of life-threatening complications. Before discharge, 18 patients underwent open aortic surgery, and 22 were treated with medical therapy alone. Clinical features of these patients and image appearances were reviewed, and the relationship with overall survival, aortic events, and aortic death was investigated. The in-hospital mortality rate was 4.5% (1 patient) with medical therapy alone and 11.1% (2 patients) with surgical intervention. No patient with initial medical therapy required urgent surgery for life-threatening complications beyond 3 days of admission. The overall survival and aortic death-free survival rates at 1, 5 and 10 years were 85.0%, 72.5% and 59.8% and 90.0%, 81.6% and 77.1%, respectively. TAAIMH associated with penetrating aortic ulcer (PAU) was a risk factor of aortic events (P = 0.020) and significantly influenced aortic death-free survival (P = 0.003). Urgent surgery for complicated TAAIMH and retrograde thrombosed type A acute aortic dissection patients and initial medical therapy for uncomplicated patients show favourable long-term survival rates. TAAIMH is frequently associated with PAU; PAU enlargement is common. Although PAU can remain stable for years, it is a strong predictor of poor prognosis. For optimal long-term results, surgical repair is recommended for TAAIMH associated with PAU.

P09.04 Natural history of meningiomas: review with meta-analyses

Abstract BACKGROUND A recent investigation using MRI showed 2.5% frequency of meningioma as an incidental finding in the population-based neuroimaging study. Although observation has been a mainstay in asymptomatic meningiomas, it may increase the risk of surgery due to enlargement of the tumors and aging of patients. It is important to characterize tumors that will grow to be symptomatic in order to select appropriate treatments and radiological follow-up. MATERIAL AND METHODS We reviewed 26 studies (3 from the same institute) that analyzed natural courses in asymptomatic or untreated meningiomas. Radiological progression of tumor was redefined as tumor growth by 15% of initial volume or more whenever possible. To adjust the difference of follow-up interval in each study, the percentages of growing tumors in each study were compared with each mean follow-up period. Individual data were extracted from seven studies for univariate or multivariate analyses. Weighted meta-analyses were performed using the 25 studies. RESULTS In time-growth rate analysis, nearly 70% of meningiomas showed radiological progression defined by a volume criteria and the rate approached plateau at 5–6 years. Meta-analyses showed that each radiological progression, growth speed (annual volume change (AVC) or relative growth rate (RGR)) and symptomatic progression had different factors related to their progression. Age, calcification and high intensity on T2 weighted image related to radiological progression and growth speed but not to clinical progression. In individual data analyses, tumor size (diameter 2.6cm (AUC 0.773; specificity 0.759, sensitivity 0.800), volume 5.6cm3 (AUC 0.775, specificity 0.717, sensitivity 0.800)) was a possible marker for symptomatic growth.AVC (>= 2.1cm3/year) was the strongest indicator for clinical progression. In the group of >=2.1cm3/year, Kaplan-Meier analysis showed that progression free rate was 69.3% at 3 years, and reached to 55.4% at 6 years whereas 100% in slower growth group. CONCLUSION Radiological features may not be very much useful for prediction of clinical progression except for perifocal edema. This may be due to dynamic changes of these radiological markers in a long term. Initial quantitative tumor size and growth speed especially AVC were reliable factors for decision of treatment for asymptomatic meningiomas.

Pembentukan Sikap Ilmiah Melalui Pembelajaran Kooperatif pada Mata Kuliah Ilmu Alamiah Dasar

The purpose of this study is to determine the formation of scientific attitudes of students after using jigsaw type cooperative learning and STAD (student team achievement division) in basic natural science courses. The method used in this research is to form a group of students consisting of 4-5 people to discuss a theme related to the theme of lectures. After students receive the theme from the lecturer, each group discusses it. The results showed that 91.3% curious attitude, 90.18% respect for facts, critical thinking 93.62%, 90.83% openness, 88.4% perseverance, honesty, 97.02%, responsibility 90 , 31%. From the results of the assessment showed the scientific attitude of students included in the excellent category. The conclusion of this study is that learning Basic Natural Sciences by using jigsaw cooperative learning and STAD (student team achievement division) can form scientific attitudes very well.

The role of natural science courses to implement the environmental education in elementary school (curriculum 2013)

Human behaviour is strongly influenced by prerequisite knowledge, residential, working place, and schools/studying place situation as well as friend or companion’s behaviour. Soldiers have different behaviours compared to educators, doctors, farmers, traders, and so forth. To make students become environmentally friendly-human beings, they need to have knowledge on how to protect the environment. Since 1986, the Republic of Indonesia government has included environmental education into school curriculum; and the end is the 2013 curriculum (C-13). There are eight subject courses in elementary school’s 2013 curriculum. Of the eight subjects, Natural Science is relevant subjects as a means to implement the environmental education (EE) concepts. Natural Science is taught in grades IV, V, and VI using thematic approaches for 9 x 40 minutes a week. However, the implementation of C-13 in elementary schools is still less optimal because there are still many prerequisite factors to be fulfilled, such as: infrastructure, learning resources, teachers’ skills, and assessment systems. In conclusion, Natural Science subjects has a significant role to debrief the environmental education concepts especially in elementary school. Thus, learning model and media of natural science need to be further developed.

Makulaveränderungen bei Grubenpapille – „Optic disc pit maculopathy“ (ODP-M)

An optic disc pit is arare congenital abnormality of the optic nerve, which in most cases presents as a unilateral finding. Clinically, agreyish oval excavation is seen, most commonly on the temporal side of the optic nerve disc. The optic disc pit alone normally does not lead to substantial symptoms or functional limitations; however, when amaculopathy with intraretinal and/or subretinal fluid and additional other morphological changes in the macula occur, this leads to adecrease in visual acuity. With spectral domain optical coherence tomography (SDOCT) it is possible to identify the various forms of expression, which show different natural courses. Especially the presence of subretinal fluid and defects in the outer retinal layers have apoor prognosis and have the highest risk for further deterioration. Spontaneous resolution can occur but is rare. Observation is recommended in the first step. In cases of progression or pronounced deterioration, surgical intervention is indicated. Many different techniques have been proposed but there is no gold standard at the moment. Most of the surgical approaches comprise pars plana vitrectomy with peeling of the internal limiting membrane (ILM) and gas endotamponade. Newer methods, such as the ILM flap technique also show good results. Generally, it is important to know that postoperative healing and resorption of the fluid often take along time period of up to 1 year or even longer.

Electrochemical aptamer biosensor for As3+ based on apta deep trapped Ag-Au alloy nanoparticles-impregnated glassy carbon electrode

ABSTRACTArsenic is toxic, so being able to detect and monitor arsenic in aqueous environments is important. Here, we report a biosensor for As3+ (Arsenic (III)) which uses a glassy carbon electrode modified with Ag-Au alloy NPs (i.e. Silver and gold alloy nanoparticles) and loaded with an aptamer. The electrode contains apta deep trapped Ag-Au alloy NPs, and the detection method employs cyclic voltammetry and differential pulse voltammetry. Captured As3+ ions undergo electrochemical reaction, producing a significant increase in the current which is observed in the voltammetry curves. This current increase is a result of the electrocatalytic properties of the NPs. The electrode is used for the determination of As3+ in real water samples. The activity curve is linear for As3+ concentrations of 0.01µg/L to 10 µg/L, and the detection limit is 0.003 × 10−3µg/L. The operation of the biosensor is reproducible, stable, and selective, and the biosensor performs well in determining As3+ in water from natural water courses, lakes, and wells.

Exploring Student Responses Regarding Most Difficult Coursework Prior to Financial and Managerial Accounting

This exploratory study surveys students regarding what they consider to be the most difficult college course taken prior to both financial and managerial accounting. Students also provide insight as to what made those courses difficult. Financial accounting student responses point to math, economics, and natural science courses as being the most difficult. Top factors affecting course difficulty are the professor, course content, and workload. Managerial accounting student responses point to accounting, math, and natural science courses as being the most difficult. Top factors affecting course difficulty are content, professor, and workload.

Factors affecting surgical resection and treatment outcomes in patients with pulmonary mucormycosis.

Surgical resection is the cornerstone treatment for pulmonary mucormycosis, a lethal fungal infection. It is unclear why some patients do not receive surgery, and the natural courses of these patients have not been well evaluated. A retrospective review was performed using the medical records of 20 patients with pathologically-confirmed pulmonary mucormycosis. We evaluated the reasons for not receiving surgery and compared treatment outcomes between patients who did and did not undergo surgery. Overall survival rate was 50%. Nine of 11 (82%) patients who underwent surgery survived; however, only 1 of 9 (11%) patients who did not undergo surgery survived. Reasons for not receiving surgery were death shortly after diagnosis (n=1), altered mental state (n=1), refractory underlying disease (n=3), and refusal by patient due to concern of operative risk (n=4). Patients who did not undergo surgery were more likely to be older (P=0.018), have a longer duration of steroid use (P=0.021), higher lactate dehydrogenase level (P=0.039), higher sequential organ failure assessment (SOFA) score (P=0.035), and higher rate of cytomegalovirus (CMV) infection (P=0.020) than those did receive surgery. Surgery was the only favorable survival factor in multivariable analyses (adjusted odds ratio for survival =15.45; P=0.029). The main reasons for not undergoing surgery in patients with pulmonary mucormycosis were the gravity of underlying diseases and concerns for operative risk. Although overall survival rate was poor, it was significantly higher in patients who received pulmonary resection surgery. The decision to undergo lung resection is time-sensitive and essential in improving survival rate in patients suffering from pulmonary mucormycosis, despite perioperative risks.

Removal of emerging contaminants from wastewater using nanofiltration for its subsequent reuse: Full–scale pilot plant

Effluents from wastewater treatment plants (WWTPs) are widely recognized as the main source of emerging contaminants (including stimulants and antibiotics) in natural water courses. The problem is aggravated in those regions where water is scarce and its reuse is necessary. With the aim of avoiding these problems, the present paper reports the results obtained by installing a nanofiltration membrane at the outlet of the secondary decanter at the WWTP situated in the municipality of Medina Sidonia (SW Spain). Permeate samples were taken over a period of 72 h while the membranes were operating. Contaminants belonging to the aforementioned families (caffeine, theobromine, theophylline, amoxicillin and penicillin G) were analysed by means of liquid chromatography with mass spectrometry (UPLC-MS). The results indicate that nanofiltration removed these contaminants from the wastewater turning the treated water as suitable to be reused for all the uses included in the Spanish Royal Decree 1620/2007 on water regeneration and reuse.

Analyses of natural courses of Japanese patients with Alzheimer's disease using placebo data from placebo-controlled, randomized clinical trials: Japanese Study on the Estimation of Clinical course of Alzheimer's disease

IntroductionSymptomatic anti-Alzheimer's disease (AD) drugs have been commonly used for the treatment of AD. Knowing the natural courses of patients with AD on placebo is highly relevant for clinicians to understand their efficacy and for investigators to design clinical studies. MethodsThe data on rating scales for dementia such as Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and Severe Impairment Battery were extracted from eight previous Japanese Phase II and III studies. Natural courses of Japanese AD patients in placebo groups were evaluated and statistically analyzed in a pooled and retrospective fashion. ResultsDecreases in ADAS-cog and Severe Impairment Battery was larger at week 22 or 24 than at week 12. Scores of ADAS-cog appeared to deteriorate faster in moderate AD than in mild AD. DiscussionThe present data will provide clinicians following up patients with AD with helpful information on how to manage AD patients and investigators with instruction for clinical study design.

Cold Urticaria: Clinical Features and Natural Course in a Tropical Country.

PurposeTo review the clinical features and natural courses of cold urticaria (ColdU) in a tropical country.MethodsA retrospective chart review was performed of patients who visited Siriraj Urticaria Clinic, Siriraj Hospital, Bangkok, Thailand, and were diagnosed with ColdU between 2007 and 2018. Data on provocation and threshold tests, clinical courses, and laboratory work-up were analyzed and compared with data reported by studies in temperate countries.ResultsOf 1,063 chronic urticaria patients, 27 (2.5%) were diagnosed with ColdU, with a mean age of symptom onset of 34.8 years. Half of the patients had a history of atopy, and 1 (3.7%) had a history of anaphylaxis. All patients were positive to 1 of 3 provocation tests: an ice cube test; TempTest 4.0; or a tray filled with ice, salt and water. Thirteen patients underwent the ice cube test, and all had positive results. TempTest was performed on 15 patients, 8 of whom had positive results, with a mean critical temperature threshold (CTT) of 21.0°C. All of the 7 patients who had a negative TempTest result later produced positive results to the immersion of their hand and forearm in a tray filled with ice, salt, and water. All patients were treated with H1-antihistamines, the vast majority (96.3%) being non-sedating H1-antihistamines. Some (14.8%) needed to be administered oral corticosteroids, ciclosporin, or omalizumab. Six patients (22.2%) were in remission. A Kaplan-Meier survival curve demonstrated 5-year and 10-year remission rates of 13.8% and 42.6%, respectively.ConclusionsThe rate of anaphylaxis in patients with ColdU in a tropical country was lower than those reported by other studies conducted intemperate climates. On the other hand, the number of female patients, mean age at symptom onset, atopy rate, rate of concomitant chronic spontaneous urticaria and mean CTT were higher.

THE SV RATIO IN THERMODYNAMIC PROCESSES

Thermodynamic processes take special place not just in the physical approach to understanding nature, but in almost every single natural science, and also humanistic ones. The speed of establishing balanced state in a certain thermodynamic system is proportional to ratio between area and volume of its interior bodies. Scaling laws play an important role in analyzing influence of the ratio between bodies' area and volume in thermodynamic systems. In general, scaling laws explore dependency of a certain physical quantity on dimensions' changes. In this work, Galileo's "Two new sciences" is mentioned, in which the geometrical and material enlargements of a body are compared. His mathematical cradle experiments-initiated formulation of scaling laws (so have Kepler's analysis of planets' kinematics and Newtown's description of gravitational interaction done). In the upcoming text, the simplest scaling law is explained-the law of dependency of S/V ratio on a change of body's dimensions. It also includes description of an influence the ratio has on the speed of establishing thermal equilibrium. Cooling and warming processes are described, as well as matching dependencies of their speed on body's area and volume. Considering that there are warm-blooded organisms in organic world, that is, organisms whose temperature does not depend on the temperature of their environment, the description of the model suitable for exploring that phenomenon is given. To be more precise, as energy is being generated on cell level, or, in every part of the organism, heating of the body via microwave and infrared emission is modelled. Comparisons of these two ways of heating are made, followed by dependency of establishing thermal equilibrium on body's dimensions. At the end, it is pointed out how important exploring of the scaling laws is, since they haven't been given a special place in natural science courses, and, generally speaking, belong to many sciences and science disciplines. It is being predicted that scaling laws are going to be explored more intensively, especially having the miniaturization of many devices and creating robots of sub-cell dimensions in mind.

A Unified Deep-Learning Model for Classifying the Cross-Country Skiing Techniques Using Wearable Gyroscope Sensors.

The automatic classification of cross-country (XC) skiing techniques using data from wearable sensors has the potential to provide insights for optimizing the performance of professional skiers. In this paper, we propose a unified deep learning model for classifying eight techniques used in classical and skating styles XC-skiing and optimize this model for the number of gyroscope sensors by analyzing the results for five different configurations of sensors. We collected data of four professional skiers on outdoor flat and natural courses. The model is first trained over the flat course data of two skiers and tested over the flat and natural course data of a third skier in a leave-one-out fashion, resulting in a mean accuracy of ~80% over three combinations. Secondly, the model is trained over the flat course data of three skiers and tested over flat course and natural course data of one new skier, resulting in a mean accuracy of 87.2% and 95.1% respectively, using the optimal sensor configuration (five gyroscope sensors: both hands, both feet, and the pelvis). High classification accuracy obtained using both approaches indicates that this deep learning model has the potential to be deployed for real-time classification of skiing techniques by professional skiers and coaches.

Manning’s roughness coefficient for the Doce River

ABSTRACT The Manning’s roughness coefficient is used for various hydraulic modeling. However, the decision on what value to adopt is a complex task, especially when dealing with natural water courses due to the various factors that affect this coefficient. For this reason, most of the studies carried out on the subject adopt a local approach, such as this proposal for the Doce River. Due to the regional importance of this river in Brazil, the objective of this article was to estimate the roughness coefficient of Manning along the river, in order to aid in hydraulic simulations, as well as to discuss the uncertainties and variations associated with this value. For this purpose, information on flow rates and water depths were collected at river flow stations along the river. With this information, the coefficients were calculated using the Manning equation, using the software Canal, and their space-time variations were observed. In addition, it was observed that the uncertainties in flow and depth measurements affect the value of the Manning coefficient in the case studied.

Age-dependent differences in response to partial-thickness cartilage defects in a rat model as a measure to evaluate the efficacy of interventions for cartilage repair

The objectives of this study are (1) to examine age-dependent longitudinal differences in histological responses after creation of partial-thickness articular cartilage defects (PTCDs) in rats and to use this model (2) to objectively evaluate the effectiveness of interventions for cartilage repair. Linear PTCDs were created at a depth of 100 μm in the weight-bearing region of the medial femoral condyle in rats of different ages (3 weeks, 6 weeks, 10 weeks and 14 weeks). One day, one week, two weeks, four weeks and twelve weeks after PTCD generation, spontaneous healing was evaluated histologically and immunohistochemically. Effects of interventions comprising mesenchymal stem cells (MSCs) or platelet-rich plasma (PRP) or both on 14-week-old PTCD rats were evaluated and compared with natural courses in rats of other ages. Younger rats exhibited better cartilage repair. Cartilage in 3-week-old and 6-week-old rats exhibited nearly normal restoration after 4–12 weeks. Cartilage in 14-week-old rats deteriorated over time and early signs of cartilage degeneration were observed. With injection of MCSs alone or MSCs + PRP, 14-week-old PTCD rats showed almost the same reparative cartilage as 6-week-old rats. With injection of PRP, 14-week-old PTCD rats showed almost the same reparative cartilage as 10-week-old rats. This model will be of great use to objectively compare the effects of interventions for small cartilage lesions and may help to advance the development of disease-modifying osteoarthritis drugs.

The progress pattern and natural courses of myopic macularpathy

Myopic macularpathy is the main cause of the decline of visual function in high myopia, which including tigroid fundus, lacquer cracks, diffuse retinal choroid atrophy, plaque retinal choroid atrophy, choroidal neovascularization (CNV), Fuchs spot and posterior staphyloma. The tigroid fundus is the initial myopic retinopathy. The lacquer cracks is a special lesion in the posterior pole of high myopia. When the lacquer cracksen enlarge or lacquer cracks progress to plaque retinal choroid atrophy should be paid to monitoring the occurrence of CNV. Myopic macularpathy progression include two mode. One is from tigroid fundus-—lacquer cracks-—plaque retinal choroid atrophy-—CNV to macular atrophy. And the other is from tigroid fundus-—diffuse retinal choroid atrophy-—atrophy enlarge to diffuse retinal choroid atrophy with plaque retinal choroid atrophy or plaque retinal choroid atrophy occurence on the border of posterior staphyloma. Understanding the progression patterns and natural course of these lesions will help the clinic to further understand the course of high myoipa. Key words: Myopia,degenerative/complications; Choroidal neovascularization; Review

Enhancing Student Learning on Emerging Infectious Diseases: An Ebola Exemplar

Throughout global history, various infectious diseases have emerged as particularly relevant within an era. Some examples include the Bubonic plague of the fourteenth century, the Spanish Influenza pandemic of 1918, the HIV epidemic of the 1980s, and the Zika virus outbreak in 2015–16. These instances of emerging infectious disease represent ideal opportunities for timely, relevant instruction in natural and health science courses through case studies. Such instructional approaches can promote student engagement in the material and encourage application and higher-order thinking. We describe here how the case study approach was utilized to teach students about emerging infectious diseases using the 2014–16 Ebola virus outbreak as the subject of instruction. Results suggest that students completing the case study not only had positive perceptions of the mode of instruction, but also realized learning gains and misconception resolution. These outcomes support the efficacy of case pedagogy as a useful teaching tool in emerging infectious diseases, and augment the paucity of literature examining Ebola virus knowledge and misconceptions among undergraduate students within United States institutions.