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ObjectiveTo determine the usefulness of a personalized tool and its effect on the decision-making process for those with vestibular schwannoma (VS).Study designProspective study.SettingSingle institution, academic tertiary care lateral skull base surgery program.PatientsPatients diagnosed with VS.InterventionsA comprehensive clinical decision support (CDS) tool was constructed from a previously published retrospective patient-reported data obtained from members of the Acoustic Neuroma Association from January to March 2017. Demographic, tumor, and treatment modality data, including associated side effects, were collected for 775 patients and integrated in an interactive and personalized web-based tool.Main outcome measuresPre- and posttool questionnaires assessing the process of deciding treatment for VS using a decisional conflict scale (DCS) and satisfaction with decision (SWD) scale were compared.ResultsA pilot study of 33 patients evaluated at a single institution tertiary care center with mean ± SD age of 63.9 ± 13.5 years and with average tumor size of 7.11 ± 4.75 mm were surveyed. CDS implementation resulted in a mean ± SD total DCS score decrease from 43.6 ± 15.5 to 37.6 ± 16.4 ( p < 0.01) and total SWD score increase from 82.8 ± 16.1 to 86.2 ± 14.4 ( p = 0.04), indicating a significant decrease in decisional conflict and increase in satisfaction.ConclusionsImplementing a decision-making tool after diagnosis of VS reduced decisional conflict and improved satisfaction with decision. Patients considered the tool to be an aid to their medical knowledge, further improving their comfort and understanding of their treatment options. These findings provide a basis for developing predictive tools that will assist patients in making informed medical decisions in the future.

Objectives  Dispersion of bone dust in the posterior fossa during retrosigmoid craniectomy for vestibular schwannoma (VS) resection could be a source of meningeal irritation and lead to development of persistent postoperative headaches (POH). We aim to determine risk factors, including whether the presence of bone spicules that influence POH after retrosigmoid VS resection. Design  Present study is a retrospective case series. Setting  The study was conducted at a tertiary skull-base referral center. Participants  Adult patients undergoing VS resection via a retrosigmoid approach between November 2017 and February 2020 were included for this study. Main Outcome Measures  Development of POH lasting ≥ 3 months is the primary outcome of this study. Results  Of 64 patients undergoing surgery, 49 had complete data (mean age, 49 years; 53% female). Mean follow-up time was 2.4 years. At latest follow up, 16 (33%) had no headaches, 14 (29%) experienced headaches lasting

AbstractOutcomes in adult and pediatric patients with acute lymphoblastic leukemia (ALL) have improved over successive generations due to rigorously conducted clinical trials and incorporation of novel therapeutic agents. Despite these advances, approximately 20% of high-risk pediatric patients and 50% of adults with ALL will fail to achieve long-term remission with frontline chemotherapy protocols, mostly due to relapse. The ability to predict which patients with ALL are more likely to relapse allows for early intensification of therapy and/or incorporation of novel immunotherapies with the goal of relapse prevention. In this review, we outline the most robust clinical predictors of relapse in ALL with a focus on measurable residual disease (MRD) and genomics. We also discuss application of these prognostic tools in different clinical settings including frontline treatment, pre-/post-allogeneic stem cell transplant, and pre-/post-Chimeric Antigen Receptor T-cell therapy. [ABSTRACT FROM AUTHOR]

During a five-year period the authors taught over 100 students in a graduate course (The Nature of Science) counting toward teacher certification at the Harvard Graduate School of Education. Despite the fact that students had undergraduate degrees in the sciences, most of them found the application of models in science challenging and the epistemological consequences unsettling. Moreover, students found it especially difficult to use a model to correctly generate predictions, which was starkly illustrated with the application of Archimedes' principle during our unit on floating and sinking. We examine the deceptive belief that student success with algorithms and word problems leads to conceptual understanding as well as the conceptual change necessary to understand the relationship between evidence and inference as explored in the nature of science. Considering the apparently strong science backgrounds of our students, we doubt that typical pre-college students can achieve the goals described in the National Science Education Standards in the short time typically allotted for their science studies. We explore the issues students face in "understanding" science as well as the impact of science education on students and teachers, and implications for policy makers and pre-service programs.

Interview data from secondary and postsecondary science instructors explored their in-depth views on preparing students for college science. Professors expressed a high level of consensus concerning two factors: general student skills and mathematics preparation. Teachers, who expressed lower levels of consensus, did agree on the importance of mathematics, but also highlighted a variety of factors that promote active pedagogy in the classroom as well as the importance of technology, textbooks, other materials, and assessments. Given this divergence, the authors explored the research supporting the value of these factors as well as highlighted possible strategies for narrowing the gap. (Contains 5 figures and 3 tables.)

Building on J. Dewey's (1907) original work with the laboratory school, the College of Education and Health Professions at the University of Texas-Arlington is expanding the original concept to include partners throughout a school system and the community in order to support and advance learning in multiple learning environments. The goal is to establish a network of schools, administrators, teachers, graduate students, and policymakers; not necessarily everyone, but a critical mass of vested partners working collaboratively in what we call a Research Schools Network (RSN). The Network uses the new field of Mind, Brain and Education (MBE) to develop a theoretical and practical foundation for addressing educational challenges in the community. This article explores how the college has partnered with Arlington Independent School District (AISD), neighboring universities, the business community, and our state representative to develop and define new paradigms that not only promote MBE as an academic field, but also inform and are informed by the community it seeks to serve.

We probed the impact of two teaching strategies, "guided inquiry" and "argumentation," on students' conceptual understanding of the conservation of matter. Conservation of matter is a central concept in middle school science curriculum and a prerequisite upon which rests more complex constructs in chemistry. The results indicate that guided inquiry was particularly effective in improving students' conceptual understanding, as evidenced by pre/posttest results and by a skill analysis of in-depth interviews of student dyads. We also discuss how the challenges inherent to educational contexts can undermine the quality and limit the impact of empirical research carried out in many schools. We suggest how these challenges could be met in the emerging infrastructures for change called the Research Schools Network.

This study relates the performance of college students in introductory science courses to the amount of content covered in their high school science courses. The sample includes 8310 students in introductory biology, chemistry, or physics courses in 55 randomly chosen U.S. colleges and universities. Students who reported covering at least 1 major topic in depth, for a month or longer, in high school were found to earn higher grades in college science than did students who reported no coverage in depth. Students reporting breadth in their high school course, covering all major topics, did not appear to have any advantage in chemistry or physics and a significant disadvantage in biology. Care was taken to account for significant covariates: socioeconomic variables, English and mathematics proficiency, and rigor of their preparatory high science course. Alternative operationalizations of depth and breadth variables result in very similar findings. We conclude that teachers should use their judgment to reduce coverage in high school science courses and aim for mastery by extending at least 1 topic in depth over an extended period of time. (Contains 4 tables, 6 figures and 4 footnotes.)

This study examines Indonesian students' understanding of conservation of matter, balancing of equations and stoichiometry. Eight hundred and sixty-seven Grade 12 students from 22 schools across four different cities in two developed provinces in Indonesia participated in the study. Nineteen teachers also participated in order to validate the 25-question survey used with all students. Significant differences in student success in answering specific questions occurred when comparing high-achievement and low-achievement schools. However, in general, student understanding of this fundamental principle in chemistry was low. The study found that the average score for all students on the survey was 41%. The findings suggest that students are most successful in solving problems used by teachers and textbooks that are algorithmic-based (i.e., stoichiometry). As there were no strong positive correlations between student performance on conceptual questions and algorithmic questions, we suggest that further research should focus on teaching practices and curricula that support the development of the students' conceptual understanding. (Contains 3 tables and 4 figures.)

This study characterizes how learning and teaching differs as the responsibility for choosing curriculum goals and the strategies to reach those goals shifts between teacher and the students. Three different pedagogical approaches were used with 125 seventh-grade and eighth-grade students. All three curricula focus on electromagnetism, and were taught by two teachers in different schools over a two-week period. When students had control over the strategies employed to reach goals, their engagement stayed high. All three curricula advanced student understanding to some degree; however, large and significant gains were seen only for the pedagogy in which teachers set the specific learning goals and students had control over how to achieve them. Microdevelopment, a principle by which short-term learning recapitulates the stages seen in long-term developmental growth, is found to be a useful framework for curriculum development and for analyzing changes in student understanding. In general, initial "tinkering" activities are best followed by attempts at representing phenomena, only then to be followed by abstract conceptualization. On balance, we find that students benefit most from freedom to control the procedures that they generate in response to well-structured goals presented by the teacher. (Contains 6 figures, 5 tables and 5 notes.)

Students learn important concepts and ways of thinking by building on their own actions and experiences. In much of higher education, the primacy of textbooks and the lectures that accompany them are inconsistent with the nature of student learning. Some students manage to learn despite the problems from this emphasis, but educators can do much better. Good teachers can shift the chemistry of their classes to build on the dynamics of the learning process and use texts and lectures from their discipline as supports for learning instead of having textbooks and lectures dominate the curriculum. This article offers an approach from cognitive science intended to help educators facilitate active student learning using these traditional disciplinary materials. The dynamic skill theory described in this article provides tools and concepts for analyzing how students move at diverse rates along various pathways as they learn a subject. This contrasts with the linear view of education that is assumed by most textbooks and lectures and that is prominent in our society, which expects progress to move in a linear and upward fashion. Texts as well as instructors must face the dynamic nature of learning. Students progress at different rates, along different pathways, and their rates and pathways vary with changes in context, support, and motivation. (Contains 7 notes and 1 resource.)

Explores the tension between passive and active learning among master's degree students working on their teaching certificate in science. Emphasizes the developmental nature of learning and that constructionist pedagogies need to be clearly integrated in university courses, especially those focused on teaching. (EV)

Objectives  To analyze the relationship between preoperative and intraoperative auditory brain stem response (ABR) characteristics and hearing outcomes in patients with vestibular schwannomas (VS) undergoing hearing preservation (HP) surgery via a middle cranial fossa (MCF) approach. Design  Prospective study. Setting  Academic tertiary skull base referral center. Methods  Pre- and postoperative pure-tone average (PTA) and word recognition score (WRS) were examined. Intraoperative ABR wave III latency, wave V latency, and amplitude were recorded. HP was defined as postoperative WRS ≥50%. Participants  Adult patients with VS and WRS ≥50% who underwent MCF tumor resection between November 2017 and September 2019. Main Outcome Measures  Postoperative hearing outcomes. Results  Sixty patients were included. Mean tumor size was 9.2 mm (range, 3–17). HP rates were 56.7% for the cohort and 69.7% for tumors <10 mm. A complete loss of wave V was associated with an 82.9% increase in postoperative PTA (p  < 0.001) and 97.2% decrease in WRS (p  < 0.001), whereas a diminished wave V was correlated with 62.7% increase in PTA (p  < 0.001) and 55.7% decrease in WRS (p  = 0.006). A diminished or absent wave V, but not increased wave III/V latency or decreased wave V amplitude, was correlated with a decline in postoperative hearing class (r  = 0.735, p  < 0.001). Receiver-operating characteristic analysis demonstrated that a stable wave V has the highest accuracy in predicting HP (sensitivity of 82.6%, specificity of 84.8%). Conclusion  Of the examined preoperative and intraoperative ABR characteristics, a stable wave V intraoperatively was the strongest predictor of HP after MCF resection of VS. Level of Evidence  Level III. [ABSTRACT FROM AUTHOR]