Top Tenth Research Articles

The effectiveness of employing a visual learning strategy in developing the reading comprehension skills of vertical poetry among outstanding tenth grade students

Introduction. Using visual learning tools to enhance reading comprehension of vertical poetry is a fresh and modern take on schooling. Using visual assistance, this method seeks to improve students' comprehension and interpretation of poetry, a form that frequently exposes intricate topics and structures. In today's digital world, where visual information is everywhere, this method presents a one-of-a-kind chance to get students more invested in poetry study and enjoyment. Aim. This study's overarching goal is to determine whether or not visual learning tactics may improve the reading comprehension of vertical poetry among Jordan's top tenth graders. Research methods. A test was built to measure reading comprehension skills to achieve the study objectives. The study sample consisted of (71) outstanding tenth grade students, who were randomly distributed into two groups: an experimental group and the number of its students was (35); (18) females, and (17) males, studied according to the visual learning strategy, and the control group consisted of (36) students; (18) females, and (18) males, studied according to the regular learning strategy. Results. The study found that exceptional students' reading comprehension skills improved significantly when diverse teaching strategies were used, with visual learning techniques having the greatest impact on the experimental group. Posttest scores in the literary taste domain increased significantly from pretest levels; for example, in visual learning they increased from 8.52 to 10.52, and in regular learning they increased from 7.34 to 12.08. Both the pre- and post-tests showed the same pattern of improved performance in all domains of reading comprehension. As an example, literal domain posttest scores increased from 6.22 to 9.10, whereas literal domain pretest scores increased from 6.22 to 7.02. Regardless of the learning approach used, the study demonstrated that both male and female students improved to similar levels; for the gender variable in different reading comprehension domains (literal, deductive, critical, literary taste, creative), the F values were: 1.239, 0.362, 0.005, 0.079, and 0.068 respectively.These values, all obtained at the significance level (α = 0.05), indicate a lack of statistically significant differences between male and female students in these domains.This shows that visual learning and other similar teaching tactics work equally well for students of both sexes when it comes to improving their reading comprehension. In conclusion, the study showed that the fields of literal, deductive, and literature taste vary among students, as the outstanding students have the highest abilities. the visual learning strategy had a positive effect on the absorption and retention of Arabic poetry among the tenth-grade outstanding students.

The Application of Weighted Ranking Method Using Combination of ROC and CPI to Select Eligible Family for Keluarga Harapan Program Aids

The Keluarga Harapan Program (KHP), a financial assistance, is a program launched by the government to deal with poverty in various regions of Indonesia by conducting direct surveys and collecting data on disadvantaged families in each region. However, the issue is that many recipients do not meet the appropriate criteria or are not categorized as recipients. The Composite Performance Index and Rank Centeroid algorithms are a solution in the selection process for the recipients for the KHP by carrying out the analysis and comparison stages of whether they are categorized as KM (Disadvantage Families) through several stages. The results obtained based on analysis for recipient selection with a minimum performance index coverage value of 70% can be categorized as eligible to receiv assistance. In this study, 50 KM data samples were taken with the highest assessment value 128.41. In the top tenth ranking of the highest score from the 50 data held indicated that they were truly entitled to receive PKH KM financial assistance. Before using this method, only around 40% was eligible recipients.

Usability Evaluation of a Noninvasive Neutropenia Screening Device (PointCheck) for Patients Undergoing Cancer Chemotherapy: Mixed Methods Observational Study.

Patients with cancer undergoing cytotoxic chemotherapy face an elevated risk of developing serious infection as a consequence of their treatment, which lowers their white blood cell count and, more specifically, their absolute neutrophil count. This condition is known as neutropenia. Neutropenia accompanied by a fever is referred to as febrile neutropenia, a common side effect of chemotherapy with a high mortality rate. The timely detection of severe neutropenia (<500 absolute neutrophil count/μL) is critical in detecting and managing febrile neutropenia. Current methods rely on blood draws, which limit them to clinical settings and do not allow frequent or portable monitoring. In this study, we demonstrated the usability of PointCheck, a noninvasive device for neutropenia screening, in a simulated home environment without clinical supervision. PointCheck automatically performs microscopy through the skin of the finger to image the blood flowing through superficial microcapillaries and enables the remote monitoring of neutropenia status, without requiring venipuncture. This study aimed to evaluate the usability of PointCheck, a noninvasive optical technology for screening severe neutropenia, with the goal of identifying potential user interface, functionality, and design issues from the perspective of untrained users. We conducted a multicenter study using quantitative and qualitative approaches to evaluate the usability of PointCheck across 154 untrained participants. We used a mixed method approach to gather usability data through user testing observations, a short-answer qualitative questionnaire, and a standardized quantitative System Usability Scale (SUS) survey to assess perceived usability and satisfaction. Of the 154 participants, we found that 108 (70.1%) scored above 80.8 on the SUS across all sites, with a mean SUS score of 86.1 across all sites. Furthermore, the SUS results indicated that, out of the 151 users who completed the SUS survey, 145 (96%) found that they learned how to use PointCheck very quickly, and 141 (93.4%) felt very confident when using the device. We have shown that PointCheck, a novel technology for noninvasive, home-based neutropenia detection, can be safely and effectively operated by first-time users. In a simulated home environment, these users found it easy to use, with a mean SUS score of 86.1, indicating an excellent perception of usability and placing this device within the top tenth percentile of systems evaluated for usability by the SUS. ClinicalTrials.gov NCT04448314; https://clinicaltrials.gov/ct2/show/NCT04448314 (Hospital Universitario 12 de Octubre registration) and NCT04448301; https://clinicaltrials.gov/ct2/show/NCT04448301 (Boston Medical Center registration).

Using Machine Learning Algorithms With In Situ Hyperspectral Reflectance Data to Assess Comprehensive Water Quality of Urban Rivers

Remotely sensed hyperspectral data can support more effective water quality monitoring. Nevertheless, the variability and complexity of urban river water make it hard to retrieve comprehensive water quality characteristics directly, so that most current water quality assessments rely on semiempirical, semianalytical, or bio-optical approaches. In this study, we carried out simultaneous <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">in situ</i> hyperspectral data and water quality measurements. We used the 382 hyperspectral data from urban rivers of Zhongshan City in the Pearl River Delta to test how well the random forest (RF) and one-dimensional convolutional neural networks (1D-CNNs) algorithms retrieved the newly established water quality index (WQI). The RF algorithm also identified essential wavelengths for retrieving the WQI. Our results demonstrate that the RF and 1D-CNN algorithms performed well in WQI estimations. The 1D-CNN model performed significantly better than the RF model, especially on high WQI samples. Both models were insensitive to smoothing of the hyperspectral data, showing that the noise of the original hyperspectral reflectance data has a limited impact on the algorithms. In addition, when we used the essential wavelength data (mainly located between 580–590 nm and near 722, 751, 821, and 830 nm) as input data, we achieved better retrieval results. The 1D-CNN model performed the best with an <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$R^{2}$ </tex-math></inline-formula> of 0.87, RMSE of 0.574, and RPIQ of 3.082 when we used the top tenth percentile of the essential wavelength data. This study demonstrates the potential of the 1D-CNN algorithm for hyperspectral data analysis to retrieve comprehensive water quality.

Health spending expenditures for commercial plans are predominantly concentrated among a small population of high-intensity consumers across settings of care.

BACKGROUND: Rising health care spending has sparked new efforts to constrain health care expenditures. OBJECTIVE: To explore how health care spending is distributed across consumers and how utilization patterns compare across health care resource expenditures (eg, hospital, outpatient care). METHODS: Using the IQVIA PharMetrics Plus database, we conducted a retrospective claims analysis for the 2018 plan year to examine commercial health care spending and utilization across 5 settings of care: ambulatory services, inpatient services, office visits, pharmacy services, and additional services. RESULTS: Consistent with findings from previous analyses of total health spending, total health care spending for a large commercially insured population was largely concentrated within a small population of high-intensity consumers. These patterns persist when looking at individual segments of spending, including spending on prescription drugs and inpatient and ambulatory services. Inpatient spending was the most concentrated, with 97% of spending occurring within the top tenth percentile of patients. CONCLUSIONS: Our findings suggest that health care spending for commercial plans is predominantly concentrated within a small population of high-intensity consumers across all settings of care. Curbing rising health care spending will require systemwide evaluation of the value of spending within and across settings of care for a subset of high-resource-use patients. This is particularly important for health care settings with the highest concentration of spending, including inpatient care. DISCLOSURES: This study was funded by the National Pharmaceutical Council (NPC). Ciarametaro, Buelt, and Dubois are employed by the NPC. Kleinrock and Campbell are employed by IQVIA, which was contracted by the NPC for data analysis.

A PRISMA review of research on music practice

We employed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method to systematically review research on music practice from 1928 until June 2020 and identified a total of 3,102 records using our inclusion criteria, of which a total of 296 were eventually selected for the final analysis. We tabulated percentages and frequencies of (a) publications in ten-year periods, (b) type of publications, (c) sampling by geographical location, (d) methodologies used, (e) the top tenth percentile of the most highly cited research, and (f) topics covered. Our analyses reveal that particularly strong growth occurred in the literature between 2000 and 2020. In the literature we retrieved, the most commonly sampled research participants were those in the United States, followed by the United Kingdom and Australia. Quantitative research designs were most prevalent, accounting for two-thirds of all studies reviewed (66.2%), with questionnaires and recordings being the most common methods of data collection. Non-empirical papers (17.5%) as well as studies incorporating qualitative (13.5%) and mixed-methods designs (3.1%) were much less prevalent. Ericsson et al.’s (1993) seminal study of deliberate practice, Driskell et al.’s (1994) review of the research literature on mental practice, and Sloboda et al.’s (1996) study of young musicians were by far the most often cited. Overall, the most common topics addressed were deliberate practice, practice strategies, mental practice, the benefits of practice, metacognition, self-regulation, and self-efficacy, suggesting that music practice is a rich, multifaceted, and complex activity. In light of the findings, recommendations for practice and implications for future research are provided.

Export-Import Performance of Major Agricultural Commodities in India

Recent trends in the international trade scenario and related shifts in India’s foreign trade policy have had far-reaching consequences for India’s general agricultural sector and, in particular, for agricultural exports. The Indian product of agriculture has played an important part in the global product of agriculture. For many agricultural commodities, India used to be the key export spot. The present study established the growth and output of agricultural exports from India during the time (2000-2019). India is the top tenth exporter of agricultural products in the world. Top exports comprise sugar, beef, rice, and shrimp. Export of principal agricultural products including rice, wheat, sugar, cotton, fruits, and vegetables are ‘free’ whereas export of pulses (excluding chickpea) and edible vegetable oil in bulk (excluding coconut and rice bran oils) are ‘restricted’ to meet domestic demand. Indian agricultural exports have increased, but the proportion of agricultural exports to the country’s overall exports has decreased. The research also explores the evolving behavior of the allocation of each category of commodities to the overall agricultural export basket. It covers the major agricultural products/crops which, over different periods, contribute to the maximum share of total agricultural exports (2000-2019). Higher agricultural exports would mean better price realization for farmers, increased awareness regarding good agricultural practices, and consequently thrust for quality also.

Abdominal and gluteo-femoral markers of adiposity and risk of vascular-metabolic mortality in a prospective study of 150000 Mexican adults.

AimsResults of previous studies of abdominal adiposity and risk of vascular-metabolic mortality in Hispanic populations have been conflicting. We report results from a large prospective study of Mexican adults with high levels of abdominal adiposity.Methods and resultsA total of 159 755 adults aged ≥35 years from Mexico City were enrolled in a prospective study and followed for 16 years. Cox regression, adjusted for confounders, yielded mortality rate ratios (RRs) associated with three markers of abdominal adiposity (waist circumference, waist–hip ratio, and waist–height ratio) and one marker of gluteo-femoral adiposity (hip circumference) for cause-specific mortality before age 75 years. To reduce reverse causality, deaths in the first 5 years of follow-up and participants with diabetes or other prior chronic disease were excluded. Among 113 163 participants without prior disease and aged 35–74 years at recruitment, all adiposity markers were positively associated with vascular-metabolic mortality. Comparing the top versus bottom tenth of the sex-specific distributions, the vascular-metabolic mortality RRs at ages 40–74 years were 2.32 [95% confidence interval (CI) 1.84–2.94] for waist circumference, 2.22 (1.71–2.88) for the waist–hip ratio, 2.63 (2.06–3.36) for the waist–height ratio, and 1.58 (1.29–1.93) for hip circumference. The RRs corresponding to each standard deviation (SD) higher usual levels of these adiposity markers were 1.34 (95% CI 1.27–1.41), 1.31 (1.23–1.39), 1.38 (1.31–1.45), and 1.18 (1.13–1.24), respectively. For the markers of abdominal adiposity, the RRs did not change much after further adjustment for other adiposity markers, but for hip circumference the association was reversed; given body mass index and waist circumference, the RR for vascular-metabolic mortality for each one SD higher usual hip circumference was 0.80 (0.75–0.86).ConclusionsIn this study of Mexican adults, abdominal adiposity (and in particular the waist–height ratio) was strongly and positively associated with vascular-metabolic mortality. For a given amount of general and abdominal adiposity, however, higher hip circumference was associated with lower vascular-metabolic mortality.

Grey matter volume and structural covariance associated with schizotypy

In this study, we applied brain grey matter volume and structural covariance methods on T1 weighted images to delineate potential structural brain changes in individuals with high schizotypy, who were defined as healthy individuals scoring in the top tenth percentile of the Schizotypal Personality Questionnaire (SPQ). Eighty-seven college students with high schizotypy and 122 controls were recruited in China. Differences in grey matter volume and volume covariance between the two groups, and correlations of grey matter volume with SPQ scores in the high schizotypy group were examined. We found that individuals with high schizotypy had decreased grey matter volume at the left medial superior frontal gyrus (medsFG) extending towards the superior frontal gyrus, decreased structural covariance within the right medsFG, between the right superior frontal gyrus (sFG), the right superior temporal gyrus and the right anterior insula; and increased structural covariance between the caudate and the right inferior temporal gyrus. Correlation analysis revealed that grey matter volume of the left middle temporal pole and the right sFG correlated positively with the SPQ total scores, volume of the bilateral cerebellum 9 sub-region correlated negatively with the SPQ cognitive-perceptual sub-scale scores, volume of the bilateral striatum correlated positively with the SPQ interpersonal sub-scale scores, and volume of the bilateral superior temporal pole correlated positively with the SPQ disorganization sub-scale scores in the high schizotypy group. These results highlight important grey matter structural changes in the medsFG in individuals with high schizotypy.

Partial recovery of disturbed V-J pairing profiles of T-cell receptor in people living with HIV receiving long-term antiretroviral therapy.

Chronic human immunodeficiency virus (HIV) infection not only causes a gradual loss of CD4+ T cells but also leads to a disturbance of the T cell receptor (TCR) repertoire. In people living with HIV (PLWH), monitoring TCR repertoire is challenged by the inconsistency of complementarity determining region 3 (CDR3) and limited cell numbers in clinical samples. Thus, a quantitative method is necessary for monitoring the TCR repertoire in PLWH. We characterized the TCR V-J pairing profile of naïve and memory CD4+ T cells in healthy donors, HIV-infected antiretroviral therapy (ART)-naïve patients and long-term (over 5 years) ART-experienced patients by performing TCR sequencing. We developed a V-J index with 18 parameters which were subdivided into five categories (expression coverage, cumulative percentage of the top tenth percentile, diversity, intra-individual similarity and inter-individual similarity). In ART-naïve patients, 14 of the 18 parameters were significantly altered. Long-term ART recovered ten parameters. The four unrecovered parameters were related to inter-individual similarity. Therefore, these findings indicate that long-term ART could only partially recover TCR V-J pairs and introduce newly impacted V-J pairs. Moreover, these results provide new insights into the V-J pairing of the TCR and into the disturbance of TCR repertoire in HIV infection.Electronic Supplementary MaterialSupplementary material is available for this article at 10.1007/s11427-020-1718-2 and is accessible for authorized users.

P3824Body composition and mortality from vascular or metabolic causes among 150,000 participants in the Mexico City Prospective Study

Abstract Background Higher body-mass index is associated with increased mortality from vascular disease, renal disease and other metabolic causes. However, body mass reflects both fat and lean mass, which may have very different effects on risk. We investigated the individual and joint relevance of fat and lean mass to mortality from these causes, using data from the Mexico City Prospective Study. Methods Between 1998 and 2004, 150,000 adults from Mexico City were recruited into a prospective study and tracked for cause-specific mortality for 14 years. Fat and lean mass at recruitment were predicted using Mexican-specific anthropometric equations, validated in a subset of participants with additional bio-impedance measures. Cox regression was used to assess the relevance of fat and lean mass at recruitment to mortality from a vascular, renal, or other metabolic cause at ages 35–74 years. Analyses were adjusted for age at risk, sex, residential district, education, recreational physical activity, smoking and alcohol consumption. To avoid reverse causality, analyses excluded those with diabetes or other chronic diseases at recruitment, and deaths in the first 5 years of follow-up. Mortality rate ratios (RRs) relate to the differences per SD of the usual values of various factors or the differences between the top tenth and bottom fifth of the values. Results Among 112,923 participants aged 35–74 years, mean (SD) fat mass in men and women was 22.0 (6.4) kgs and 29.4 (7.8) kgs respectively, while mean (SD) lean mass was 54.9 (7.2) kgs and 39.2 (5.0) kgs respectively. In both men and women, equation-predicted fat and lean mass closely matched the bio-impedance values (all r&gt;0.86). Both fat and lean mass were positively and approximately log-linearly associated with mortality from a vascular or metabolic cause. However, the association of lean mass with mortality was more than accounted for by the correlation of lean with fat mass. Hence, after adjustment for fat mass, lean mass was inversely associated with risk. For a given amount of fat mass, the RR for vascular/metabolic mortality comparing those in the top tenth versus bottom fifth of the predicted lean mass was 0.35 (95% CI 0.24–0.52). Conversely, for a given amount of lean mass, the RR comparing those in the top tenth versus bottom fifth of the predicted fat mass was 4.06 (3.06–5.39). The RRs associated with each SD higher fat mass (1.51, 1.40–1.63) or lean mass (0.79, 0.73–0.86) appeared to be little affected by age, sex, or levels of other confounders, and were broadly similar for the major vascular, renal, and other metabolic mortality. The height-adjusted RRs were 1.41 (1.30–1.53) for fat mass and 0.91 (0.82–1.00) for lean mass. Conclusions In this Mexican cohort, predicted fat and lean mass had opposing effects on vascular and other metabolic deaths, with no evidence of any thresholds throughout the ranges studied.

Variation in outcomes among 24/7 percutaneous coronary intervention centres for patients resuscitated from out-of-hospital cardiac arrest

BackgroundPatients treated at 24/7 percutaneous coronary intervention (PCI) centres following out-of-hospital cardiac arrest (OHCA) have better outcomes than those treated at non-24/7 PCI centres. However, variation in outcomes between 24/7 PCI centres is not well studied. ObjectivesTo evaluate variation in outcomes among 24/7 PCI centres and to assess stability of 24/7 PCI centre performance. MethodsAdult patients in the California Office of Statewide Health Planning and Development Patient Discharge Database with a “present on admission” diagnosis of cardiac arrest admitted to a 24/7 PCI centre from 2011 to 2015 were included. Primary outcome was good neurologic recovery at hospital discharge. Secondary outcomes were survival to hospital discharge, cardiac catheterisation, and DNR orders within 24 h. Data were analysed using mixed effects logistic regression models. Hospitals were ranked each year and overall. ResultsOf 27,122 patients admitted to 128 24/7 PCI centres, 41% (11,184) survived and 27% (7188) had good neurologic recovery. Adjusted rates of good neurologic recovery (18%–39%; p,0.001), survival (32%–51%; p < 0.0001), cardiac catheterisation (11%–49%; p < 0.0001) and DNR orders within 24 h (4.8%–49%; p < 0.0001) varied between 24/7 PCI centres. For the 26 hospitals with mean good neurologic rankings in the top or bottom tenth during 2011–2013, 14 (54%) remained in their respective tenth for 2014–2015. ConclusionSignificant variation exists between 24/7 PCI centres in good neurologic recovery following OHCA and persists over time. Future studies should evaluate hospital-level factors that contribute to these differences in outcomes between 24/7 PCI centres.

The Distributional Effects of the Trump and Clinton Tax Proposals

Hillary Clinton and Donald Trump, the Democratic and Republican candidates for President of the U.S. in 2016, proposed several changes in the federal tax code. Hillary Clinton would add a personal income tax surcharge of 4% on high annual incomes, limit the tax benefits of non-charitable deductions, set a minimum tax rate of 30% on taxpayers earning more than one million dollars a year, increase the tax rates on capital gains for taxpayers in the top tax bracket, and expand the base of the estate tax. Donald Trump would reduce the number of personal income tax rates, increase the standard personal deduction, cut all taxes on business income to no more than 15%, and abolish the inheritance tax. Using a tax calculator model, we estimate the static effects of these very different changes. Over a ten-year period, Clinton’s proposals would raise federal tax revenue by a total of $816 billion, an increase of 1.9% over projected baseline revenue, while Trump’s tax changes would lower tax revenue by $9.8 trillion. Clinton’s higher taxes would reduce incomes and revenue somewhat, while Trump’s tax cuts would potentially boost output substantially. Using an extended simulation model, we find that 86% of the incremental tax burden of Clinton’s tax increases would fall on those in the top tenth of the income distribution. Most other taxpayers would see only minor changes in their tax burdens, and the revenue and redistributive effects of her proposed changes are relatively modest. Meanwhile, 70% of Trump’s tax cuts would go to those in the top decile, and the effects are large, with gains of over $15,000 annually per person for this group, compared to gains of less than $500 per person for the poorest 40% of the population. On tax policy, the two candidates propose strikingly different policies.

Income Equality Across Cities

This paper investigates why the level of income inequality differs across U.S. cities and why some cities experience faster increases in the level of inequality than others. The rising level of income inequality in the US has received growing attention from both researchers and policy makers. Using the Decennial Census and the American Community Survey (ACS), this study also finds that income inequality increased for most U.S. cities over the past thirty years. The changes in inequality, however, show different patterns in different time periods. From 1980 to 2000, the income of both the bottom and the top 10th percentiles increased in most cities, despite the increase of income inequality. In the most recent decade, however, the income of both the bottom and the top deciles decreased, but the income of the bottom tenth decreased more than the top. This suggests that there may be different reasons behind the changes in the level of inequality over time. In the most recent decade, we find that negative labor market conditions best explain the increase of income inequality. When the economy turns negative, those in the bottom tenth percentile experience greater drops in the levels of their incomes compare to those in the top tenth, as they are more likely to lose their jobs. In addition, we find that inequality is lower in MSAs with higher wage minimums and higher shares of union members, suggesting that these policies have some effectiveness in reducing income inequality.

Tópicos sobre retenção escolar em Portugal através do PISA: qualidade e equidade

No enquadramento das medidas necessárias à Estratégia Europa 2020 - no que concerne à prevenção da saída antecipada, identificam-se grupos de risco de retenção escolar com base na definição frequencista de probabilidade e no modelo de regressão logística multinível. A análise de dados do PISA 2012 sugere que a retenção precoce é um forte preditor da retenção tardia e que a probabilidade de retenção precoce é 35 vezes maior no primeiro décimo da distribuição do nível socioeconómico dos alunos comparativamente com o décimo superior. A razão de chances apurada considerando o modelo logístico multinível indica que os sujeitos do sexo masculino têm, em média, 1.7 vezes mais chance de ficar retidos; por cada unidade de desvio padrão adicional no nível socioeconómico do aluno, a razão de chances de não retenção aumenta 1.5 vezes e quadruplica por unidade da escala de composição socioeconómica da população discente. No que se refere ao autoconceito em Matemática, por cada unidade de desvio padrão adicional, a razão de chances de não retenção aumenta 1.5 vezes. Tendo em mente o debate internacional sobre o efeito de longo prazo da retenção escolar na trajetória individual e sabendo que Portugal se encontra entre os países da OCDE com maior grau de desigualdade na distribuição do rendimento, a interpretação dos resultados obtidos recomenda a conceção, planeamento e implementação de medidas de intervenção orientadas à melhoria das aprendizagens nos grupos de risco, tendo o 1º e 2º ciclos do ensino básico como prioritários. do nível socioeconómico dos alunos comparativamente com o décimo superior. A razão de chances apuradas considerando o modelo logístico multinível com variável resposta retenção (sim/não), indica que os sujeitos do sexo masculino têm, em média, 1.5 vezes mais chance de ficar retidos; por cada unidade de desvio padrão adicional no nível socioeconómico do aluno, a razão de chances de não retenção aumenta 1.3 vezes e, no que se refere ao autoconceito em Matemática, por cada unidade de desvio padrão adicional, a razão de chances de não retenção aumenta 1.4 vezes. Os resultados evidenciam que para os alunos mais desfavorecidos socialmente se configura um imenso cenário de desigualdade de oportunidades, com início na escola, a partir dos 7 anos de idade. Tendo em mente o debate internacional sobre o efeito de longo prazo da retenção escolar na trajetória individual e sabendo que Portugal se encontra entre os países da OCDE com maior grau de desigualdade na distribuição do rendimento, a interpretação dos resultados obtidos recomenda a conceção, planeamento e implementação de medidas de intervenção orientadas à melhoria das aprendizagens nos grupos de risco, tendo o 1º e 2º ciclos do ensino básico como prioritários.

Cycle training for children: Which schools offer it and who takes part?

PurposeThe ‘Bikeability’ cycle training scheme, a flagship policy of the government in England, aims to give children the skills and confidence to cycle more safely and more often. Little, however, is known about the scheme׳s reach. This paper examined which schools offer Bikeability, and which children participate in cycle training.MethodsWe used operational delivery data to examine which primary schools in England offered Bikeability. Predictors included the deprivation level of the student body and the local prevalence of cycling. We then examined cycle training participation using data from 6986 participants (age 10–11) in the nationally-representative Millennium Cohort Study. Parents reported whether their child had completed formal cycle training, along with other child and family factors. We used operational data to identify children whose school had previously delivered Bikeability.Results55% of schools offered Bikeability to the cohort of children leaving primary school in 2012; this fell to 48% in schools in the top tenth for student deprivation. Among Millennium Cohort participants, 47% of children had completed cycle training; this proportion rose to 68% among children whose schools had offered Bikeability. In adjusted robust Poisson regression models, participation rates were lower among minority ethnic children, particularly South Asians; among children who played sport less often; and among children whose parents were poorer or less educated. The magnitude of these differences was largest among children whose schools had not offered Bikeability (all p≤0.02 for interaction, except for income where p=0.09), although trends in the same direction were observed in schools that had offered Bikeability.ConclusionsOffering high-quality cycle training free of charge in English schools reduced but did not eliminate inequalities in cycle training participation. Further promoting the scheme to parents and schools, particularly in deprived areas, would be expected to increase uptake and help reduce current inequalities in participation.

Inequalities in the London bicycle sharing system revisited: impacts of extending the scheme to poorer areas but then doubling prices

Cycling confers transport, health and environmental benefits, and bicycle sharing systems are an increasingly popular means of promoting urban cycling. Following the launch of the London bicycle sharing system (LBSS) in 2010, women and residents of deprived areas were under-represented among initial users. This paper examines how the profile of users has changed across the scheme’s first 3 years, using total-population registration and usage data. We find that women still make fewer than 20% of all ‘registered-use’ LBSS trips, although evidence from elsewhere suggests that the introduction of ‘casual’ use has encouraged a higher overall female share of trips. The proportion of trips by registered users from ‘highly-deprived areas’ (in the top tenth nationally for income deprivation) rose from 6% to 12%. This was due not only to the 2012 LBSS extension to some of London’s poorest areas, but also to a steadily increasing share of trips by residents of highly-deprived areas in the original LBSS zone. Indirect evidence suggests, however, that the twofold increase in LBSS prices in January 2013 has disproportionately discouraged casual-use trips among residents of poorer areas. We conclude that residents in deprived areas can and do use bicycle sharing systems if these are built in their local areas, and may do so progressively more over time, but only if the schemes remain affordable relative to other modes.

TSG-6 activity as a novel biomarker of progression in knee osteoarthritis

To establish whether there is an association between TSG-6 activity and osteoarthritis progression. TSG-6 activity was determined in 132 synovial fluids from patients with OA of the knee, using a novel quantitative TSG-6 activity assay. The association between TSG-6 activities at baseline and four distinct disease progression states, determined at 3-year follow-up, was analyzed using logistic regression. There was a statistically significant relationship between TSG-6 activity at baseline and all OA progression states over a 3-year period. Patient knees with TSG-6 activities in the top tenth percentile, compared to the median activity, had an odds ratio (OR) of at least 7.86 (confidence interval (CI) [3.2, 20.5]) for total knee arthroplasty (TKA) within 3 years, and of at least 5.20 (CI [1.8, 13.9]) after adjustment for confounding factors. Receiver operating characteristic (ROC) analysis for knee arthroplasty yielded a cut-off point of 13.3 TSG-6 activity units/ml with the following parameters: area under the curve 0.90 (CI [0.804, 0.996]), sensitivity 0.91 (CI [0.59, 0.99]), specificity 0.82 (CI [0.74, 0.88]) and a negative predictive value (NPV) of 0.99 (CI [0.934, 0.994]). The TSG-6 activity is a promising independent biomarker for OA progression. Given the high NPV, this assay may be particularly suitable for identifying patients at low risk of rapid disease progression and to assist in the timing of arthroplasty.

Outcome-Driven Thresholds for Ambulatory Pulse Pressure in 9938 Participants Recruited From 11 Populations

Evidence-based thresholds for risk stratification based on pulse pressure (PP) are currently unavailable. To derive outcome-driven thresholds for the 24-hour ambulatory PP, we analyzed 9938 participants randomly recruited from 11 populations (47.3% women). After age stratification (<60 versus ≥60 years) and using average risk as reference, we computed multivariable-adjusted hazard ratios (HRs) to assess risk by tenths of the PP distribution or risk associated with stepwise increasing (+1 mm Hg) PP levels. All adjustments included mean arterial pressure. Among 6028 younger participants (68 853 person-years), the risk of cardiovascular (HR, 1.58; P=0.011) or cardiac (HR, 1.52; P=0.056) events increased only in the top PP tenth (mean, 60.6 mm Hg). Using stepwise increasing PP levels, the lower boundary of the 95% confidence interval of the successive thresholds did not cross unity. Among 3910 older participants (39 923 person-years), risk increased (P≤0.028) in the top PP tenth (mean, 76.1 mm Hg). HRs were 1.30 and 1.62 for total and cardiovascular mortality, and 1.52, 1.69, and 1.40 for all cardiovascular, cardiac, and cerebrovascular events. The lower boundary of the 95% confidence interval of the HRs associated with stepwise increasing PP levels crossed unity at 64 mm Hg. While accounting for all covariables, the top tenth of PP contributed less than 0.3% (generalized R(2) statistic) to the overall risk among the elderly. Thus, in randomly recruited people, ambulatory PP does not add to risk stratification below age 60; in the elderly, PP is a weak risk factor with levels below 64 mm Hg probably being innocuous.

Multi-Locus Candidate Gene Analyses of Lipid Levels in a Pediatric Turkish Cohort: Lessons Learned onLPL, CETP, LIPC, ABCA1,andSHBG

Cardiovascular risk factors and atherosclerosis precursors were examined in 365 Turkish children and adolescents. Study participants were recruited at five different state schools. We tested single and multi-locus effects of six polymorphisms from five candidate genes, chosen based on prior known association with lipid levels in adults, for association with low (≤10th percentile) high density lipoprotein cholesterol (HDL-C) and high (≥90th percentile) triglycerides (TG), and the related continuous outcomes. We observed an association between CETP variant rs708272 and low HDL-C (allelic p=0.020, genotypic p=0.046), which was supported by an independent analysis, PRAT (PRAT control p=0.027). Sex-stratified logistic regression analysis showed that the B2 allele of rs708272 decreased odds of being in the lower tenth percentile of HDL-C measurements (OR=0.36, p=0.02) in girls; this direction of effect was also seen in boys but was not significant (OR=0.64, p=0.21). Logistic regression analysis also revealed that the T allele of rs6257 (SHBG) decreased odds of being in the top tenth percentile of TG measurements in boys (OR=0.43, p=0.03). Analysis of lipid levels as a continuous trait revealed a significant association between rs708272 (CETP) and LDL-C levels in males (p=0.02) with the B2B2 genotype group having the lowest mean LDL-C; the same direction of effect was also seen in females (p=0.05). An effect was also seen between rs708272 and HDL-C levels in girls (p=0.01), with the B2B2 genotype having the highest mean HDL-C levels. Multi-locus analysis, using quantitative multifactor dimensionality reduction (qMDR) identified the previously mentioned CETP variant as the best single locus model, and overall model, for predicting HDL-C levels in children. This study provides evidence for association between CETP and low HDL-C phenotype in children, but the results appear to be weaker in children than previous results in adults and may also be subject to gender effects.