Test Scores Research Articles

The validity of studying healthy aging with cognitive tests measuring different constructs

A clinically useful characterization of the cognitive aging process requires the development of valid and robust behavioral tests, with an emphasis on explaining and understanding typical inter-individual variability in cognition. Here, using a dataset that includes behavioral scores collected with the National Institute of Health Toolbox Cognition Battery (NIHTB-CB) and other auxiliary tests, we examined (1) the differences between young and old adults across different cognitive domains, (2) the strength of across-subject correlations in behavioral test scores, (3) the consistency of low-dimensional behavioral representations across age using factor analysis, and (4) the accuracy of behavioral scores in predicting participants’ age. Our results revealed that (1) elderly females had better verbal episodic memory scores than elderly males, (2) across-subject correlations between behavioral tests varied with age group, (3) although a three-factor model explained the behavioral data in both age groups, some tasks loaded to different factors between the two groups, and (4) age-performance relationship (i.e. a regression model linking age to cognitive scores) in one group cannot be extrapolated to predict age in the other group, indicating an inconsistency in age-performance relationships across groups. These findings suggest that executive function tests might tap into different cognitive processes in different age groups, which might ultimately suggest that a statistically significant between-group difference in test performance might not always reflect differences in the same underlying cognitive processes. Overall, this study calls for more caution when interpreting age-related differences and similarities between age groups with different cognitive abilities even when the same tests are used.

Effect of intermittent theta burst stimulation on upper limb function in stroke patients: a systematic review and meta-analysis.

Stroke is a serious health issue that affects individuals, families, and society. Particularly, the upper limb dysfunction caused by stroke significantly reduces the quality of life for patients and may lead to psychological issues. Current treatment modalities are not fully effective in helping patients regain upper limb motor function to optimal levels. Therefore, there is an urgent need to explore new rehabilitation methods to address this issue. The purpose of this meta-analysis and systematic review is to explore the effects of intermittent theta burst stimulation (iTBS) on upper limb function in stroke patients. We searched PubMed, Cochrane Library, Embase, Web of Science, PEDro and China National Knowledge Internet as of April 8, 2024. Retrieved a total of 100 articles. Standardized mean differences (SMDs) and 95% confidence intervals (CI) were calculated. The study included a total of 9 trials and involved 224 patients. The results demonstrate that compared to the control group, iTBS therapy significantly improved Fugl-Meyer assessment-upper extremity (FMA-UE) scores (SMD = 0.88; 95% CI = 0.11-1.66; P = 0.03, I 2 = 84%), Action Research Arm Test (ARAT) scores (SMD = 0.83; 95% CI = 0.16-1.50; P = 0.02, I 2 = 57%), and Barthel Index (BI) scores (SMD = 0.93; 95% CI = 0.53-1.32; P < 0.0001, I 2 = 0%) in stroke patients. The comprehensive evidence suggests that iTBS has superior effects in improving upper limb function and activities of daily living in stroke patients.

Ten-words recall test: an effective tool to differentiate mild cognitive impairment from subjective cognitive decline.

Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are stages 2 and 3, respectively, of the Alzheimer's continuum. The Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog's) ten-words recall test is a validated method for the early detection of cognitive impairment in Alzheimer's disease. However, limited studies have investigated its ability to differentiate between SCD and MCI. 203 participants with SCD and 62 participants with MCI underwent multiple neuropsychological assessments. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment-Basic (MOCA-B) served as brief global cognition tests. A binary logistic regression model was used to analyze the potential factors affecting MCI. The accuracy of the ten-words recall test was assessed using the area under the receiver operating characteristic (ROC) and the area under the curve (AUC). The neuropsychological assessment revealed significant differences in the ten-words recall test scores between the SCD (median age 61 years; 70.44% female) and MCI (median age 64 years; 61.29% female) groups (p < 0.001), with the MCI group scoring the highest. Using a cut-off value of 3.15 for the ten-words recall test, sensitivity for distinguishing MCI from SCD reached 87%, while specificity stood at 61% (AUC 0.777, p < 0.001). DeLong's test indicated no statistically significant difference in the ten-words recall test's ability to distinguish between SCD and MCI compared to the total score of ADAS-Cog (AUC 0.833, p) and MMSE (AUC 0.784, p > 0.05). However, a significant difference was observed when compared to MoCA-B (AUC 0.973, p < 0.001). In the population with an education level of ≤ 9 years, the optimal cut-off value for the ten-words recall test was 3.15, yielding a sensitivity of 91% and a specificity of 45% (AUC = 0.674, p = 0.030). In the population with an education level > 9 years, the optimal cut-off value was 3.63, resulting in a sensitivity of 79% and a specificity of 71% (AUC = 0.785, p < 0.001). The ten-words recall test from the ADAS-cog may detect MCI early owing to its simplicity and quick administration. It is an effective and convenient tool for rapidly identifying mild cognitive impairment.

The FinSwed study: Using verbal NEPSY-II subtests with a cultural minority group

While it has been established that cultural differences in test performance are common, few studies have compared groups from different countries that speak the same language. The aim of this study was to investigate the generalizability of selected linguistic and verbal memory subtests from the Swedish NEPSY-II to the Finland-Swedish minority group. The participants were 275 Swedish-speaking children from Finland aged 5–16-years. The performance was compared to the U.S. norms used in the test. The Finland-Swedish children scored around scaled score 12 and significantly higher than the normative mean on the subtests Comprehension of Instructions, Phonological Processing, Word Generation Semantic, List Memory, and Sentence Repetition, whereas no significant differences to the norms emerged for the subtests Word Generation Initial Letter, Narrative Memory, and Word List Interference. There was a significant age effect for two subtests, with scaled scores increasing with age. Lower parental education and male sex were associated with lower test scores on some subtests, whereas bilingualism was not. The findings were viewed in relation to previous comparison studies involving the NEPSY-II/NEPSY. The differences were suggested to relate to cultural, educational, and test-related differences between Finland, Sweden, and the U.S. The results add to the clinical utility of the NEPSY-II.

Evaluating Students' Academic Progress in the Role of Fuzzy Logic

This paper explores the role of fuzzy logic in the assessment of student performance in local high school, Badr, Libya, positing that it offers a more flexible and accurate alternative to traditional categorization methods of academic achievement. Conventional assessment tools, such as standardized test scores and GPAs, often yield a distorted and overly simplistic view of student performance. Utilizing a mixed-methods research design, this study compares the performance, attendance, and self-reported satisfaction of students assessed through fuzzy logic with those evaluated by traditional methods. The results demonstrate that students assessed using fuzzy logic achieved higher average scores and expressed greater satisfaction with the assessment process. Additionally, educators employing fuzzy logic provided more detailed and constructive feedback, enriching the learning experience. Thus, this research indicates that fuzzy logic can effectively mitigate the shortcomings of traditional assessment methods, enhancing the recognition of diverse student abilities. The findings advocate for the integration of fuzzy logic in educational assessment practices to promote inclusivity and improved learning outcomes.

Growth, physical, and cognitive function in children who are born HIV-free: School-age follow-up of a cluster-randomised trial in rural Zimbabwe.

Globally, over 16 million children were exposed to HIV during pregnancy but remain HIV-free at birth and throughout childhood by 2022. Children born HIV-free (CBHF) have higher morbidity and mortality and poorer neurodevelopment in early life compared to children who are HIV-unexposed (CHU), but long-term outcomes remain uncertain. We characterised school-age growth, cognitive and physical function in CBHF and CHU previously enrolled in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial in rural Zimbabwe. The SHINE trial enrolled pregnant women between 2012 and 2015 across 2 rural Zimbabwean districts. Co-primary outcomes were height-for-age Z-score and haemoglobin at age 18 months (clinicaltrials.gov NCT01824940). Children were re-enrolled if they were aged 7 years, resident in Shurugwi district, and had known pregnancy HIV-exposure status. From 5,280 pregnant women originally enrolled, 376 CBHF and 2016 CHU reached the trial endpoint at 18 months in Shurugwi; of these, 264 CBHF and 990 CHU were evaluated at age 7 years using the School-Age Health, Activity, Resilience, Anthropometry and Neurocognitive (SAHARAN) toolbox. Cognitive function was evaluated using the Kaufman Assessment Battery for Children (KABC-II), with additional tools measuring executive function, literacy, numeracy, fine motor skills, and socioemotional function. Physical function was assessed using standing broad jump and handgrip for strength, and the shuttle-run test for cardiovascular fitness. Growth was assessed by anthropometry. Body composition was assessed by bioimpedance analysis and skinfold thicknesses. A caregiver questionnaire measured demographics, socioeconomic status, nurturing, child discipline, food, and water insecurity. We prespecified the primary comparisons and used generalised estimating equations with an exchangeable working correlation structure to account for clustering. Adjusted models used covariates from the trial (study arm, study nurse, exact child age, sex, calendar month measured, and ambient temperature). They also included covariates derived from directed acyclic graphs, with separate models adjusted for contemporary variables (socioeconomic status, household food insecurity, religion, social support, gender norms, caregiver depression, age, caregiver education, adversity score, and number of children's books) and early-life variables (length-for-age-Z-score) at 18 months, birthweight, maternal baseline depression, household diet, maternal schooling and haemoglobin, socioeconomic status, facility birth, and gender norms. We applied a Bonferroni correction for the 27 comparisons (0.05/27) with threshold of p < 0.00185 as significant. We found strong evidence that cognitive function was lower in CBHF compared to CHU across multiple domains. The KABC-II mental processing index was 45.2 (standard deviation (SD) 10.5) in CBHF and 48.3 (11.3) in CHU (mean difference 3.3 points [95% confidence interval (95% CI) 2.0, 4.5]; p < 0.001). The school achievement test score was 39.0 (SD 26.0) in CBHF and 45.7 (27.8) in CHU (mean difference 7.3 points [95% CI 3.6, 10.9]; p < 0.001); differences remained significant in adjusted analyses. Executive function was reduced but not significantly in adjusted analyses. We found no consistent evidence of differences in growth or physical function outcomes. The main limitation of our study was the restriction to one of two previous study districts, with possible survivor and selection bias. In this study, we found that CBHF had reductions in cognitive function compared to CHU at 7 years of age across multiple domains. Further research is needed to define the biological and psychosocial mechanisms underlying these differences to inform future interventions that help CBHF thrive across the life-course. ClinicalTrials.gov The SHINE follow-up study was registered with the Pan-African Clinical Trials Registry (PACTR202201828512110). The original SHINE trial was registered at NCT https://clinicaltrials.gov/study/NCT01824940.

Predictors of Early Intervention Referral after a Positive Developmental Screen in Community Primary Care Clinics

BackgroundPrimary care physicians (PCPs) may rely upon factors other than screening test scores in making referral decisions to developmental services. This study investigated which patient, provider, and screening test factors predict a PCP’s IDEA Part C Early Intervention (EI) referral after a positive screening test result. MethodsChild demographics, developmental screening test results and EI referral decisions were collected via medical record review of 2,756 15-, 18-, 24- and 30-month well-child checks conducted at 7 community primary care clinics in 4 Oregon counties, in 2020-2021. A provider survey collected PCP demographic and professional characteristics. We tested the association of receipt of EI referral with screening test (Ages & Stages-3 [ASQ-3] and Modified Checklist for Autism in Toddlers – Revised [MCHAT-R]) scores, provider demographic information, child demographic data (sex, language, race/ ethnicity), using multivariable logistic regression. Results54.1% of children with positive MCHAT-R screens, and 42% of children with positive ASQ-3 screens received EI referrals. Multivariable analyses showed that MCHAT-R score, ASQ-3 Communication and Gross Motor scores were associated with referral after a positive screen. Child sex, race, ethnicity, and language, and provider demographics had no multivariable association with referral. Referral rates varied substantially by site and individual provider. ConclusionThe majority of toddlers with positive developmental screens were not receiving EI referrals from their PCP during the COVID-19 pandemic. Screening test thresholds and clinical thresholds for EI referral differ substantially, and some portions of the ASQ-3 do not seem to impact provider referral decisions. These findings may help inform physician training on developmental screening in primary care, specifically during times of unprecedented healthcare challenges.

Understanding Burn Management For Nursing Students

Background: Managing burn injuries, particularly in mass-burn scenarios, requires immediate first aid and early care, which are critical for improving outcomes. The quality of burn treatment is highly dependent on the knowledge and practical skills of nursing students, particularly those assigned to burn units. Knowledge Gap: Despite the critical nature of burn care, limited research has been conducted on the level of knowledge nursing students possess in this area, especially in regions like Basra, Iraq. Aims: This study aimed to assess the knowledge of burn management among nursing students at Basrah University, identifying gaps and correlations with sociodemographic factors. Methodology: A descriptive cross-sectional study was conducted among 150 nursing students at Basrah College of Nursing. Data was collected using a structured questionnaire divided into two sections: (1) sociodemographic information, and (2) burn management knowledge, assessed through a standardized 3-point Likert scale. Results: The majority of respondents (78% female, 22% male) were aged 19-28 years. The results revealed that students demonstrated a good level of knowledge regarding burn management. Furthermore, there was a highly significant correlation between the academic stage of the students and their test scores, suggesting that academic progression improves burn management understanding. Novelty: This study provides one of the first comprehensive assessments of burn care knowledge among nursing students in southern Iraq, highlighting the critical role of academic progression in enhancing practical burn care skills. Implications: The study suggests that incorporating practical burn care training into nursing education can significantly improve clinical outcomes in mass-burn scenarios. Highlights: Knowledge of burn care improves with academic progression among nursing students. Majority of participants were female, aged 19-28 years. Enhanced burn care training is essential in nursing education curricula. Keywords: Burn management, Nursing students, Knowledge assessment, Basrah University, Cross-sectional study

Characterizing the Effects of Concussion and Head Impact Exposure: Design, Methods, and Participant Traits of the CARE 2.0 Study.

This article describes the design, methods, and participant characteristics of the second phase of the Concussion Assessment, Research, and Education (CARE) Consortium study ("CARE 2.0") of the effects of concussion and repetitive head impact exposure on neuropsychiatric health. The authors conducted a prospective multisite observational study of male and female collegiate athletes and military service academy cadets and midshipmen participating in the CARE study. Participants were assessed at three time points: undergraduate baseline (UB), before departure from university or service academy (exit), and up to 6 years following graduation (postgrad) via an online battery of brain health assessments. Participant characteristics were compared across the three time points and four levels of head impact exposure. A total of 4,643 participants completed the exit assessment, and 3,981 completed the postgrad assessment. Relative to the UB assessment cohort, the exit and postgrad assessment cohorts differed with respect to the percentage of women, baseline Wechsler Test of Adult Reading scores, National Collegiate Athletic Association division category, sport contact level, and number of previous concussions. The median standardized difference across balancing variables, assessment time points, and degree of head impact exposure was 0.12 (with 90% of effect sizes ≤0.29). Although there were some statistically significant differences between participants across assessments, the effect sizes were modest, and overall the data suggest that the exit and postgrad cohorts reflect the characteristics of the baseline cohort. The CARE study design and its large, richly characterized sample provide an opportunity to answer important questions about cumulative and persistent effects of concussion and repetitive head impact exposure on neuropsychiatric health.

Application of a validated prognostic plasma protein biomarker test for renal decline in type 2 diabetes to type 1 diabetes: the Fremantle Diabetes Study Phase II

BackgroundThere are scant data relating to prognostic biomarkers for chronic kidney disease (CKD) complicating type 1 diabetes. The aim of this study was to assess the performance of the plasma protein biomarker-based PromarkerD test developed and validated for predicting renal decline in type 2 diabetes in the context of type 1 diabetes.MethodsThe baseline PromarkerD test score was determined in 91 community-based individuals (mean age 46.2 years, 56.5% males) with confirmed type 1 diabetes recruited to the longitudinal observational Fremantle Diabetes Study Phase II. The performance of the PromarkerD test in predicting the risk of incident CKD (estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 in people without CKD at baseline) or an eGFR decline of ≥ 30% over the next four years was determined. The score can range from 0 to 100%, and is categorized as representing low (< 10%), moderate (10% to < 20%) or high (≥ 20%) risk.ResultsThe area under the receiver operating characteristic curve was 0.93 (95% confidence interval 0.87–0.99) for the composite renal endpoint, indicating strong predictive accuracy. The positive and negative predictive values at moderate (10% to < 20%) and high (≥ 20%) risk PromarkerD cut-offs were 46.7–50.0% and ≥ 92.0%, respectively.ConclusionsThese preliminary data suggest that PromarkerD is at least as good a prognostic test for renal decline in type 1 as type 2 diabetes.

Preliminary assessment of a robotic system for overground gait in children with cerebral palsy

PurposeCerebral palsy is one of the leading causes of chronic disability in children. The current pilot study investigated (1) whether an exoskeleton system enables physiological gait patterns and (2) whether the system is user-friendly enough to envision its use in a clinical setting.Design/methodology/approachParticipants included a convenience sample of six children with cerebral palsy. Following informed consent, study volunteers underwent baseline assessments, participated in eight sessions during which they used the exoskeleton system with the objective of achieving proficiency in use of the system, and underwent an end-of-study assessment of walking. Satisfaction and usability questionnaires were given to the family/caregiver.FindingsAll participants achieved a more regular gait pattern and improved their 6-Minute Walk Test scores. Overall satisfaction and usability were rated as good.Practical implicationsThe exoskeleton system enabled physiological gait patterns, and the system was user-friendly enough to envision its use in a clinical setting.Originality/valueThere is potential for guiding treatment plans for individuals with cerebral palsy.

Mode of delivery and behavioral and neuropsychological outcomes in children at 10 years of age.

Previous studies have reported that mode of delivery, particularly cesarean delivery (CD), is associated with neurodevelopmental outcomes in children. This study evaluates behavioral and neuropsychological test scores in children based on mode of delivery. Children enrolled in the Raine Study from Western Australia, born between 1989 and 1992 by instrumental vaginal delivery (IVD), elective CD, and non-elective CD, were compared to those with spontaneous vaginal delivery (SVD). The primary outcome was the Child Behavior Checklist (CBCL) administered at age 10. Secondary outcomes included evaluations of language, motor function, cognition, and autistic traits. Multivariable linear regression was used to evaluate score differences by mode of delivery adjusted for sociodemographic and clinical characteristics, and Poisson regression was used to evaluate for increased risk of clinical deficit. Of 2,855 children, 1770 (62.0 %) were delivered via SVD, 480 (16.8 %) via IVD, 346 (12.1 %) via elective CD, and 259 (9.1 %) via non-elective CD. Non-elective CD was associated with higher (worse) CBCL Internalizing (+2.09; 95 % CI 0.49, 3.96; p=0.01) scores, and elective CD was associated with lower (worse) McCarron Assessment of Neuromuscular Development (MAND) (-3.48; 95 % CI-5.61,-1.35; p=0.001) scores. Differences were not seen in other outcomes, and increased risk of clinical deficit was not observed with either the CBCL Internalizing or MAND scores. Differences in behavior and motor function were observed in children delivered by CD, but given that score differences were not associated with increased incidence of clinical deficit, clinical significance may be limited.

Impact Of Cawthorne Cooksey Exercise And Strength Training On Gait And Balance Related Impairments In Multiple Sclerosis Patient : A Case Study

Background: Multiple sclerosis commonly develops between 20 to 40 years of age, however also seen in older populations. It is more common in females than in males. Fatigue, impaired coordination, pain ,blurred vision, weakness in limbs are often the complaints. Objective: A case study is to provide evidence of the feasibility, acceptance and benefits of Cawthorne Cooksey exercise and strength training in gait and balance related impairments of a multiple sclerosis patient. Method: 58 years old multiple sclerosis patient was provided an individualised therapy for 3 weeks. Outcome measures included Tinetti Performance Oriented Mobility Assessment (Tinetti POMA) and Timed Up and Go (TUG). Result: Findings demonstrated the effectiveness of the cawthorne cooksey exercise and strength training for use by multiple sclerosis patient with gait and balance impairments. Conclusion: The Tinetti POMA Scale and TUG test scores suggested improved gait and balance. However the results were not clinically significant.

Does Early Childhood Education Matter on Reading Achievement Among Arab Countries

Our research focuses on the impact of Early Childhood Education (ECE) in the reading achievement of pupils in primary schools in MENA countries. The study employed the international data from PIRLS 2016 to identify the effect of early literacy practices on later reading attainment. Leveraging data from the 2016 Progress in International Reading Literacy Study (PIRLS) by the International Association for the Evaluation of Educational Achievement, we utilize ordinary least squares (OLS) regression and quantile regression to estimate education production functions for each country individually. This approach enables us to assess how coefficients on explanatory variables vary across the spectrum of test scores. The results show that in MENA countries, early childhood education, which develops pupils’ skills acquisition before formal schooling, improves their reading performance. In sum, The Early childhood education effect can be reinforced through government policy and family background. In addition, we recommend a universal access to early childhood education., concentration of early childhood services in the private sector makes the programs confined only to wealthy people who can afford them, especially people living in urban cities and improve the quality of early education by implementing appropriate curricula and modern teaching.

Serum Derivatives–Reactive Oxygen Metabolite Levels as a Marker of Clinical Conditions in Patients with Bronchial Asthma, COPD, or Asthma–COPD Overlap: A Prospective Study

Background: Oxidative stress plays an important role in the pathophysiology of bronchial asthma (BA), chronic obstructive pulmonary disease (COPD), and asthma–COPD overlap (ACO), but its relevance has not been fully elucidated. The aim of this study was to measure the levels of oxidative stress and investigate its clinical significance in patients with BA, COPD, or ACO. Methods: We recruited 214 patients between June 2020 and May 2023 (109 patients with BA, 63 with COPD, and 42 with ACO). To assess clinical conditions, we evaluated patient characteristics, results of respiratory function tests and blood tests, and administered several questionnaires. We evaluated oxidative stress using the test for derivatives–reactive oxygen metabolites (d–ROMs) in serum. Results: The d–ROMs levels were significantly higher in patients with COPD or ACO than in patients with BA. There was no difference in serum d–ROMs levels between the COPD and ACO groups. In BA, d–ROMs levels were positively correlated with interleukin (IL)-6, IL-8, serum amyloid A (SAA), and C-reactive protein (CRP) levels; white blood cell (WBC) and neutrophil counts; and St. George’s Respiratory Questionnaire (SGRQ) scores, and they were negatively correlated with forced expiratory volume in 1 s (%FEV1) and asthma control test (ACT) score. In COPD, d–ROMs levels were positively correlated with IL-6, SAA, and CRP levels; WBC, neutrophil, and eosinophil counts; and COPD assessment test (CAT) and SGRQ scores, and they were negatively correlated with forced vital capacity (%FVC), %FEV1, and %FEV1/FVC scores. In ACO, d–ROMs levels were positively correlated with IL-6, SAA, tumor necrosis factor alpha (TNF-α), and CRP levels; and CAT and SGRQ scores, and they were negatively correlated with %FVC and %FEV1 scores. Conclusions: Serum d–ROMs levels may serve as a marker reflecting clinical conditions such as systemic inflammation, symptom severity, and airflow limitation in patients with BA, COPD, and ACO.

Wordwall.net: Developing the 7th Grade Students’ Reading Comprehension

Reading comprehension is a topic vastly studied in the field of language learning. With the rapid development of digital technology, more focus on digital tools regarding reading comprehension is deemed necessary to find the best tool to aid its improvement. This study aimed to discover how the wordwall.net website affected seventh-grade students' reading comprehension in a descriptive text learning topic at SMP Al Amanah South Tangerang. The current quantitative study used a pre-experimental design. Twenty-eight students of class VII C were the sample for this investigation. The pre and post-tests serve as data-collecting tools. Using the t-test formula, the researcher examines how student test scores differ both before and after the treatment is applied. The paired sample t-test table shows the t count is 10.726, and the critical t at the significant level (p) = 0.05 is 1.703. Considering these results, the alternative hypothesis (Ha) is conceded. A significant effect of using the wordwall.net website for reading comprehension in grade 7 at SMP Al-Amanah has been found. The study shows that wordwall.net and other similar sites can be very helpful in making learning more fun and interactive, leading to better grades for students.

Meningkatkan Hasil Belajar (Pada Materi Aku Memiliki Kemampuan) Bagi Peserta Didik Kelas VII SMP Negeri 1 Kualuh Hulu

This study aims to improve the learning outcomes of Grade VII students on the topic "I Have Abilities" through the application of the Problem-Based Learning (PBL) model for students at SMP Negeri 1 Kualuh Hulu in the 2024/2025 academic year. The PBL method was chosen for its ability to enhance student engagement, critical thinking skills, and problem-solving abilities relevant to everyday life. This research employs a classroom action research (CAR) design involving two cycles of action. Data were collected through learning outcome tests, observations of the learning process, and evaluation questionnaires. The results of the study show a significant improvement in students' learning outcomes, as evidenced by increased test scores and positive feedback from students regarding the learning process. The implementation of the PBL model also demonstrated improvements in students' collaboration skills and learning motivation. Therefore, the use of the Problem-Based Learning model can be considered effective in improving students' learning outcomes in the taught material.

Physical Activity and Cognitive Function Among Older Adults, United States

ABSTRACT Introduction Physical activity (PA) is a modifiable risk factor associated with cognitive health. However, the existing literature regarding the relationship between PA and cognitive functions among individuals ≥ 60 years remains inconclusive. Method We used data from the 2011–2014 National Health and Nutrition Examination Survey for this study. The Global Physical Activity Questionnaire (GPAQ) was used to assess PA. Cognitive function was assessed using the Animal Fluency Test Score. Multinomial logistic regression was used to examine the association adjusting for potential confounders. Results A total of 2947 participants were included in the analyses. Among the participants, 32% were physically active, males (53%), and non-Hispanic White individuals (80%). Physically active participants had decreased odds of Alzheimer’s disease (AOR 0.63, 95% CI: 0.45–0.89). In the gender- and race-specific strata, PA was associated with reduced odds of Alzheimer’s among females (AOR 0.54, CI: 0.34–0.86) and non-Hispanic White individuals (AOR 0.54, CI: 0.30–0.97). Conclusion Age, gender, and race modify the association between PA and cognitive function. Further research is needed to study the different forms of PA and their association with cognitive function.

Enhancing self-directed learning with custom GPT AI facilitation among medical students: A randomized controlled trial

ABASTRACT Objective This study aims to assess the impact of LearnGuide, a specialized ChatGPT tool designed to support self-directed learning among medical students. Materials and methods In this 14-week randomized controlled trial (ClinicalTrials.gov NCT06276049), 103 medical students were assigned to either an intervention group, which received 12 weeks of problem-based training with LearnGuide support, or a control group, which received identical training without AI assistance. Primary and secondary outcomes, including Self-Directed Learning Scale scores at 6 and 12 weeks, Cornell Critical Thinking Test Level Z scores, and Global Flow Scores, were evaluated with a 14-week follow-up. Mann-Whitney U tests were used for statistical comparisons between the groups. Results At 6 weeks, the intervention group showed a marginally higher median Self-Directed Learning Scale score, which further improved by 12 weeks (4.15 [95% CI, 0.82 to 7.48]; p = 0.01) and was sustained at the 14-week follow-up. Additionally, this group demonstrated notable improvements in the Cornell Critical Thinking Test Score at 12 weeks (7.11 [95% CI, 4.50 to 9.72]; p < 0.001), which persisted into the 14-week follow-up. The group also experienced enhancements in the Global Flow Score from 6 weeks, maintaining superiority over the control group through 12 weeks. Conclusions LearnGuide significantly enhanced self-directed learning, critical thinking, and flow experiences in medical students, highlighting the crucial role of AI tools in advancing medical education.

Prevalence of Dentine Hypersensitivity in Vital Abutment Teeth being prepared for Fixed Partial Dentures or Crowns

Objective: To determine the prevalence of dentine hypersensitivity during the preparation of vital abutment teeth for Fixed Partial Dentures or Crowns and its association with patient’s gender, age, and location of tooth. Study Design &amp; Setting: This is a descriptive cross-sectional study of patients with 150 abutments of either crown or fixed partial dentures, carried out in the department of Prosthodontics at Armed Forces Institute of Dentistry (AFID) Rawalpindi from June to December 2021. Methodology: The Dentine Hypersensitivity was recorded on a VAS (Visual Analogue Scale) of 0-10 after the patient reported pain during exposure to thermal stimulus i.e. cold water from a 5cc syringe at 1cm distance during or just after the tooth preparation. Results: In this study, the prevalence of Dentine Hypersensitivity was 13.3% with a mean dentine hypersensitivity score (VAS) for cold water test (Mean ± SD) of 0.61±1.756. Independent samples t-tests were used to determine the difference in hypersensitivity between genders, two age groups, and type of tooth (anterior/ posterior). It showed significant results with p-values of 0.002, 0.002, and 0.003 respectively. Conclusion: Within the limitations of this study, it was highlighted that the preparation of vital teeth for conventional porcelain fused to metal (PFM) crown or fixed dental prosthesis results in dentine hypersensitivity in a considerable number of cases, with a higher incidence in women, younger patients, and vital anterior abutments.