Students Bypass the Syllabus to Utilize Alternate LMS Locations for Assignment Deadlines.

The syllabus is a required document for all courses to provide students with course information, policies, and assignment deadlines. The goals of this study were to investigate students' perception of the role of the syllabus, preferred location of assignment deadlines, and the style of receiving deadline notifications. Faculty (n=14) and students (n=324) from community colleges through professional schools were invited to participate and complete a survey. We used a mixed method design of survey questions, and the results demonstrated that students defined a syllabus as both a contract and learning tool and that it should be flexible. Students ranked assignment deadlines as the most important part of the syllabus, yet a follow-up question indicated most referred to four distinct locations in their Learning Management System (LMS) to find these deadlines. While students preferred to receive deadline notifications on their smartphones, they also wanted to be reminded by faculty in class. This study helps faculty to obtain a glimpse of current student practices. We recommend that faculty communicate with students the role and expected use of the syllabus in their course while emphasizing its use to identify deadlines. This renewed practice will be time well spent to avoid student confusion and missed deadlines.

Management of non-union of rib fractures secondary to trauma: A scoping review.

OBJECTIVE: Rib fracture non-union is an uncommon complication of traumatic rib fractures. Our objective was to perform a scoping review of the literature for the management of rib fracture non-union. This included analysis of the variations in surgical technique, complications experienced, and reported outcomes. METHODS: We conducted a scoping review and searched databases (MEDLINE, CINAHL, and Embase). We performed abstract and full-text screening, and abstracted data related to pre-operative assessment, surgical technique, complications, and reported outcome measures. RESULTS: We included 29 articles of which 19 were case reports and 10 were case series. The data quality was generally heterogeneous. The studies included 229 patients and the commonest symptoms of rib fracture non-union included chest pain, clicking, dyspnea and deformities. The patients underwent surgical management of rib fracture non-union (excluding first rib fractures) using various techniques. The majority used surgical stabilization of rib fracture with or without a graft. The reported outcomes were inconsistent between studies, but showed high rates of union (>94 %), reduction in reported VAS scores, and improved return to work when included. Implant failure occurred in 10 % of the 229 total patients reported in our studies, the re-operation rate was 13 %, and the overall complication rate was 27 %. CONCLUSION: Surgical management of rib fracture non-union often involving locking plates and screws with or without a graft has been shown in several case reports and series as an effective treatment with acceptable implant failure and complication rates. Surgical management is therefore a viable option for symptomatic patients. Further research is required to determine optimal management strategies that further reduce surgical complications for these patients.

Together is better - RibScore and SCARF in the prediction of pulmonary complications and association with SSRF.

BACKGROUND: Optimal treatment of patients with rib fractures requires identification of those patients at risk of pulmonary complications. It is also important to determine which patients would benefit from Surgical Stabilisation of Rib Fractures (SSRF). This study aims to validate two scoring systems (RibScore and SCARF score) in predicting complications and association with SSRF in an Australian trauma population. Clinical observation suggests that complications and criteria for SSRF is associated with anatomical and physiological factors. Therefore it is hypothesized that utilisation of an anatomical (RibScore) and physiological (SCARF) in conjunction will have improved predictive ability. METHOD: Retrospective cohort study of rib fracture patients admitted to an Australian Level I trauma centre from Jan 2017 to Jan 2021. RibScore and SCARF score were calculated. Multivariate logistic regression was performed to determine risk factors associated with complications and SSRF, as well the scoring systems' ability via ROC AUC. RESULTS: 1157 patients were included. Higher median RibScore (1vs0; p < 0.001) and SCARF score (3vs1, p < 0.001) was associated with development of complications. Similarly for SSRF, RibScore (3vs0; p < 0.001), SCARF score (3vs1; p < 0.001) were higher. On multivariate analysis, increasing RibScore and SCARF score were associated with an increased risk of respiratory failure, pneumonia, death, and SSRF. The sensitivity for a patient with a high risk score in either RibScore or SCARF increased to 96.3 % in identifying pulmonary complications (from 66.7 % in RibScore and 88 % in SCARF, when used individually) and 91.9 % in identifying association with SSRF (from 86.5 % in RibScore and 70.3 % in SCARF). CONCLUSION: RibScore and SCARF score demonstrate predictive ability for complications and SSRF in an Australian trauma rib fracture population. Combining a radiological score with a clinical scoring system demonstrates improved sensitivity over each score individually for identifying patients at risk of complications from rib fractures, those who may require SSRF, and those who are low risk. STUDY TYPE: Retrospective Cohort Study LEVEL OF EVIDENCE: Level III.

Promoting student interest in plant biology through an inquiry-based module exploring plant circadian rhythm, gene expression, and defense against insects.

We present a weeklong curricular module for high school biology students that promotes knowledge of phytohormones, the circadian clock, and the Central Dogma. The module, which relies on easily accessible items and requires minimal space, integrates a hands-on experiment that guides students through replicating research examining circadian entrainment in postharvest cabbage from groceries. This work found that plants have cyclical, circadian expression of genes that produce phytohormones, and that such cyclical expression influences herbivory by caterpillars. Such cyclical patterns were found in plants both in situ and in postharvest cabbage. This work thus provides an ideal platform to shape student conceptions of circadian rhythms, gene expression, and plant herbivory by having students use light timers to entrain postharvest cabbage to alternating light and dark cycles and then measuring herbivory in these plants. The results should replicate previous work and demonstrate less herbivory when both plant and caterpillar are entrained to the same light and dark cycles since the expression of phytohormones involved in plant defense will be greatest when caterpillars are active. The module then concludes with a discussion of gene regulation and how this influences phytohormones. This module was field tested at four public schools, reaching over 600 students, and we present data demonstrating that the module led to learning gains and likely increases in interest in plant biology and self-efficacy.

Variations in Student Approaches to Problem Solving in Undergraduate Biology Education.

Existing research has investigated student problem-solving strategies across science, technology, engineering, and mathematics; however, there is limited work in undergraduate biology education on how various aspects that influence learning combine to generate holistic approaches to problem solving. Through the lens of situated cognition, we consider problem solving as a learning phenomenon that involves the interactions between internal cognition of the learner and the external learning environment. Using phenomenography as a methodology, we investigated undergraduate student approaches to problem solving in biology through interviews. We identified five aspects of problem solving (including knowledge, strategy, intention, metacognition, and mindset) that define three qualitatively different approaches to problem solving; each approach is distinguishable by variations across the aspects. Variations in the knowledge and strategy aspects largely aligned with previous work on how the use or avoidance of biological knowledge informed both concept-based and nonconcept-based strategies. Variations in the other aspects revealed intentions spanning complete disengagement to deep interest with the course material, different degrees of metacognitive reflections, and a continuum of fixed to growth mindsets. We discuss implications for how these characterizations can improve instruction and efforts to support development of problem-solving skills.

Exploring pathways to food science careers in Southern California: A case study in food science career development.

Southern California is a diverse region that is home to a high concentration of food science companies, with an increasing demand for additional food scientists and technologists to join this workforce. Despite this abundance of food science companies and the high demand for jobs, there is currently a shortage in the number of qualified food scientists and technologists in the region. This shortage is also observed within higher education, with declining enrollments in the food science graduate and undergraduate programs across Southern California. Here, we conduct a case study to explore the factors that influence students from Southern California to pursue or not pursue careers in food science. We surveyed both undergraduate and graduate students currently enrolled in food science as well as industry professionals in the region to determine sources of knowledge about the discipline, and motivations and barriers for pursuing careers in food science. We also surveyed high school educators in the region to gain additional perspectives on how food science is being introduced at the secondary level, if at all. Our results demonstrate that many students and high school educators are not knowledgeable about career options within food science and that students who are pursuing food science largely report similar motivations for pursuing the discipline as those currently working in the food science industry. We conclude by discussing implications for the food science education community within Southern California and beyond.

An initiative to assess and improve the resources and patient care processes used among Chest Wall Injury Society collaborative centers study (CWIS-CC2).

BACKGROUND: Over the last two decades, the acute management of rib fractures has changed significantly. In 2021, the Chest Wall injury Society (CWIS) began recognizing centers that epitomize their mission as CWIS Collaborative Centers. The primary aim of this study was to determine the resources, surgical expertise, access to care, and institutional support that are present among centers. METHODS: A survey was performed including all CWIS Collaborative Centers evaluating the resources available at their hospital for the treatment of patients with chest wall injury. Data about each chest wall injury center care process, availability of resources, institutional support, research support, and educational offerings were recorded. RESULTS: Data were collected from 20 trauma centers resulting in an 80% response rate. These trauma centers were made up of 5 international and 15 US-based trauma centers. Eighty percent (16 of 20) have dedicated care team members for the evaluation and management of rib fractures. Twenty-five percent (5 of 20) have a dedicated rib fracture service with a separate call schedule. Staffing for chest wall injury clinics consists of a multidisciplinary team: with attending surgeons in all clinics, 80% (8 of 10) with advanced practice providers and 70% (7 of 10) with care coordinators. Forty percent (8 of 20) of centers have dedicated rib fracture research support, and 35% (7 of 20) have surgical stabilization of rib fracture (SSRF)-related grants. Forty percent (8 of 20) of centers have marketing support, and 30% (8 of 20) have a web page support to bring awareness to their center. At these trauma centers, a median of 4 (1-9) surgeons perform SSRFs. In the majority of trauma centers, the trauma surgeons perform SSRF. CONCLUSION: Considerable similarities and differences exist within these CWIS collaborative centers. These differences in resources are hypothesis generating in determining the optimal chest wall injury center. These findings may generate several patient care and team process questions to optimize patient care, patient experience, provider satisfaction, research productivity, education, and outreach. LEVEL OF EVIDENCE: Therapeutic/Care Management; Level V.

Exploring the Performance of Geometry-Based Markerless Registration in a Simulated Surgical Environment: A Comparative Study of Registration Algorithms in Medical Augmented Reality.

Augmented Reality (AR) has been utilized in multiple applications in the medical field, such as augmenting Computed Tomography (CT) images onto the patient's body during surgery. However, one of the challenges in its utilization is to register the pre-operative CT images to the patient's body accurately. The current registration process requires prior attachment of tracking markers, and their localization within the body and CT images. This process can be cumbersome, error-prone, and dependent on the surgeon's experience. Moreover, there are cases where medical instruments, drapes, or the body may occlude the markers. In light of these limitations, markerless registration algorithms have the potential to aid the registration process in the clinical setting. While those algorithms have been successfully used in other sectors, such as multimedia, they have not yet been thoroughly investigated in a clinical setting, especially in surgery, where there are more challenging cases with different positions of the patients in the image and the surgical environment. In this paper, we benchmarked and evaluated the performance of 6 state-of-the-art markerless registration algorithms from the multimedia sector by registering a CT image onto the whole-body phantom dataset acquired from a simulated surgical environment. We also analyzed the suitability of these algorithms for use in the surgical setting and discussed their potential for the advancement of AR-assisted surgery.Clinical Relevance-Our study provides insight into the potential of AR-assisted surgery and helps practitioners in choosing the most suitable registration algorithm for their needs to improve patient outcomes, reduce the risk of surgical errors and shorten the time of preoperative planning.

Hepatic artery pseudoaneurysm rupture: A case report.

Hepatic artery pseudoaneurysms are an uncommon complication of blunt hepatic trauma typically presenting in a delayed fashion. A 40-year-old male presented to a trauma centre after a 6-metre fall from a construction site with multiple injuries including a grade IV liver laceration centred around the porta hepatis. This liver injury was managed non-operatively. On day sixteen of admission, he had a sudden cardiac arrest from haemorrhagic shock with a subsequent CT demonstrating a ruptured extrahepatic proper hepatic artery pseudoaneurysm. Despite laparotomy and vessel repair, he died from pulmonary complications of aspiration pneumonia and acute lung injury associated with massive transfusion. The literature demonstrates conflicting views regarding the utility of repeat CT to detect a pseudoaneurysm in asymptomatic, non-operatively managed patients with blunt hepatic trauma. In particular, the literature does not distinguish the utility of repeat routine CT for intrahepatic and extrahepatic hepatic artery pseudoaneurysm, the latter if which is rarer. Current guidelines recommend against it, but there are observational studies suggesting utility, particularly in high grade (≥IV) liver injury. In patients with a high-grade injury extending to the porta hepatis, repeat imaging should be considered to detect possible pseudoaneurysm.

Investigating the Influence of Assessment Question Framing on Undergraduate Biology Student Preference and Affect.

Nearly all undergraduate biology courses rely on quizzes and exams. Despite their prevalence, very little work has been done to explore how the framing of assessment questions may influence student performance and affect. Here, we conduct a quasi-random experimental study where students in different sections of the same course were given isomorphic questions that varied in their framing of experimental scenarios. One section was provided a description using the self-referential term "you", placing the student in the experiment; another section received the same scenario that used classmate names; while a third section's scenario integrated counterstereotypical scientist names. Our results demonstrate that there was no difference in performance throughout the semester between the sections, nor were there differences in students' self-reported stress and identity. However, students in all three sections indicated that they most preferred the self-referential framing, providing a variety of reasons that suggest that these variants may influence how well a student reads and processes the question. In addition, our results also indicate that the framing of these scenarios can also have a large impact on some students' affect and attitude toward the question. We conclude by discussing implications for the biology education research community and biology instructors.

Neutral theory and beyond: A systematic review of molecular evolution education.

Molecular evolution-including the neutral theory of molecular evolution-is a major sub-discipline of evolution and is widely taught in undergraduate evolution courses. However, despite its ubiquity, there have not been any previous attempts to compile and review the molecular evolution education literature. Here, we draw upon the framework proposed in a past literature review examining the broader evolution education landscape to conduct a literature review of papers related to molecular evolution education, classifying the contributions of such papers to evolution pedagogy as well as evolution education research. We find that there remains very limited coverage of molecular evolution in the education literature, with existing papers focusing primarily on providing new instructional modules and strategies for teaching molecular evolution. Our work suggests several areas of critical need as well as opportunities to advance evolution education and evolution education research, including compiling instructional goals for the sub-discipline, developing validated assessments, and investigating student thinking related to molecular evolution. We conclude by providing general strategies, advice, and a novel curricular activity for teaching molecular evolution and the neutral theory of molecular evolution.

How to convert a submuscular/dual plane reconstruction to a pre-pectoral pocket implant reconstruction.

A conversion from subpectoral breast reconstruction to pre-pectoral breast reconstruction can help with animation resolution and improved patient satisfaction. We describe the conversion technique involving removal of the existing implant, creating a neo-pre-pectoral pocket and restoring the pectoral muscle to its natural position.

Reading Primary Scientific Literature: Approaches for Teaching Students in the Undergraduate STEM Classroom.

Teaching undergraduate students to read primary scientific literature (PSL) is cited as an important goal for many science, technology, engineering, and math (STEM) classes, given a range of cognitive and affective benefits for students who read PSL. Consequently, there are a number of approaches and curricular interventions published in the STEM education literature on how to teach students to read PSL. These approaches vary widely in their instructional methods, target student demographic, required class time, and level of assessment demonstrating the method's efficacy. In this Essay, we conduct a systematic search to compile these approaches in an easily accessible manner for instructors, using a framework to sort the identified approaches by target level, time required, assessment population, and more. We also provide a brief review of the literature surrounding the reading of PSL in undergraduate STEM classrooms and conclude with some general recommendations for both instructors and education researchers on future areas of investigation.

Expert consensus guidance on respiratory physiotherapy and rehabilitation of patients with rib fractures: An international, multidisciplinary e-Delphi study.

BACKGROUND: There is limited research supporting optimal respiratory physiotherapy or physical rehabilitation strategies for patients with rib fractures. The aim of this study was to develop key recommendations for the physiotherapy management of patients with rib fractures. METHODS: A three-round modified e-Delphi survey design, using an international Delphi panel including physiotherapy clinicians, researchers and lecturers, physician associates, trauma surgeons, and intensivists, was used in this study. The draft recommendations were developed by the Steering Group, based on available research. Over three rounds, panelists rated their agreement (using a Likert scale) with regard to recommendation for physiotherapists delivering respiratory physiotherapy and physical rehabilitation to patients following rib fractures. Recommendations were retained if they achieved consensus (defined as ≥70% of panelists ≥5/7) at the end of each round. RESULTS: A total of 121 participants from 18 countries registered to participate in the study, with 87 (72%), 77 (64%), and 79 (65%) registrants completing the three rounds, respectively. The final guidance document included 18 respiratory physiotherapy and rehabilitation recommendations, mapped over seven clinical scenarios for patients (1) not requiring mechanical ventilation, (2) requiring mechanical ventilation, (3) with no concurrent fracture of the shoulder girdle complex, (4) with a concurrent fracture of the shoulder girdle complex, (5) with/without concurrent upper limb orthopedic injuries, (6) undergoing surgical stabilization of rib fractures, and (7) at hospital discharge. CONCLUSION: This guidance provides key recommendations for respiratory physiotherapy and physical rehabilitation of patients with rib fractures. It could also be used to inform future research priorities in the field. LEVEL OF EVIDENCE: Therapeutic/Care Management; Level IV.

Insight from Biology Program Learning Outcomes: Implications for Teaching, Learning, and Assessment.

Learning goals and objectives are a key part of instruction, informing curricular design, assessment, and learning. These goals and objectives are also applied at the programmatic level, with program learning outcomes (PLOs) providing insight into the skills that undergraduate biology programs intend for their students to master. PLOs are mandated by all major higher education accreditation agencies and play integral roles in programmatic assessment. Despite their importance, however, there have not been any prior attempts to characterize PLOs across undergraduate biology programs in the United States. Our study reveals that many programs may not be using PLOs to communicate learning goals with students. We also identify key themes across these PLOs and differences in skills listed between institution types. For example, some Vision & Change core competencies (e.g., interdisciplinary nature of science; connecting science to society; quantitative reasoning) are highlighted by a low percentage of programs, while others are shared more frequently between programs. Similarly, we find that biology programs at 4-year institutions likely emphasize PLOs relating to computational skills and research more than at 2-year institutions. We conclude by discussing implications for how to best use PLOs to support student learning, assessment, and curricular improvements.

Prospective Surveillance with Compression for Subclinical Lymphedema: Symptoms, Skin, and Quality-of-Life Outcomes.

Background: Patients underwent a compression (sleeve and gauntlet) intervention for subclinical breast cancer-related lymphedema (S-BCRL). Physical, emotional, and quality-of-life (QoL) outcomes were examined. Associations of change in extracellular fluid alone through bioimpedance spectroscopy (BIS) or change in whole-arm volume through tape measure with the outcomes at time of S-BCRL were explored. Methods and Results: We enrolled newly diagnosed nonmetastatic breast cancer patients for surveillance up to 36 months postoperatively. Upon detection of S-BCRL, a 28-day compression intervention was initiated. Data were obtained through physical examination/measurement and self-report instruments: skin examination, Lymphedema Symptom Intensity and Distress Survey-Arm, and Functional Assessment of Cancer Therapy General (FACT-G), Breast (FACT-B), and FACT-B+4. Improvements with intervention were observed in the proportion of patients reporting symptom scores ≥3 in function (Cohen's d = -0.46, p < 0.01), in biobehavioral (Cohen's d = -0.30, p < 0.05), maximum number of skin conditions (Cohen's d = -0.34, p < 0.05. 3), FACT-B (Cohen's d = 0.52, p < 0.01), and FACT-B + four (Cohen's d = -0.42, p < 0.01). At the study endpoint, compared with those who did not progress, chronic breast cancer-related lymphedema (C-BCRL) progressing patients had higher overall symptom scores (p = 0.037), more skin conditions (p = 0.009), and lower total FACT-G and FACT-B scores (p < 0.05). At the time of S-BCRL, detection of greater BIS unit change correlated with higher symptom, skin condition, and QoL values. Greater whole-arm volume change correlated with higher FACT-B+4 scores (all p < 0.05). Conclusions: Prospective surveillance, symptom assessment, and compression intervention promote low progression rates from S-BCRL to C-BCRL and as such reduce symptom burden. This closed study is registered with ClinicalTrials.gov NCT02167659.

Intentions and willingness to engage in risky driving behaviour among high school adolescents: evaluating the bstreetsmart road safety programme.

OBJECTIVE: To investigate the impact of a road safety programme on adolescents' willingness to engage in risky behaviour as probationary drivers, adjusted for covariates of interest. METHOD: The bstreetsmart is a road safety programme delivered to around 25 000 adolescent students annually in New South Wales. Using a smartphone-based app, student and teacher participation incentives, students were surveyed before and after programme attendance. Mixed-methods linear regression analysed pre/post-modified Behaviour of Young Novice Driver (BYNDS_M) scores. RESULTS: 2360 and 1260 students completed pre-event and post-event surveys, respectively. Post-event BYNDS_M scores were around three points lower than pre-event scores (-2.99, 95% CI -3.418 to -2.466), indicating reduced intention to engage in risky driving behaviours. Covariates associated with higher stated intentions of risky driving were exposure to risky driving as a passenger (1.21, 95% CI 0.622 to 2.011) and identifying as non-binary gender (2.48, 95% CI 1.879 to 4.085), adjusting for other predictors. CONCLUSIONS: Trauma-informed, reality-based injury prevention programmes can be effective in changing short-term stated intentions to engage in risky driving, among a pre-independent driving student population. The adolescent novice driver age group is historically challenging to engage, and injury prevention action must be multipronged to address the many factors influencing their behaviour.

Characterizing First-Year Biology Majors' Motivations and Perceptions of the Discipline.

Understanding why students choose to major in biology provides important insight into the motivations of biology majors. It is similarly important to investigate how biology majors perceive the discipline, including associated activities, such as independent research, which can influence students' interests in the field and likelihood to persist in science, engineering, technology, and math. However, there has been little work done examining biology student motivations and perceptions, particularly at non-research-intensive universities or after the COVID-19 pandemic started. To address this gap, we surveyed the first-year cohort of biology majors at a private, comprehensive university. We found that students largely reported choosing the major because of interest in the field and/or the fact that the major would prepare them for specific careers. We also found that students had skewed conceptions of several major subdisciplines of biology (ecology and evolution; cell and molecular biology; and anatomy and physiology). Finally, most students reported not knowing what independent research is or presented naive conceptions of research. Our work offers a characterization of how first-year students at our university perceive the discipline, and we conclude by discussing changes that our program has made to address these results as well as implications for instructors and biology administrators.

Exploring physiology instructors' use of core concepts: pedagogical factors that influence choice of course topics.

The physiology core concepts are designed to guide instructors in undergraduate physiology courses. However, although past work has characterized the alignment of physiology programs with the core concepts, it is unclear to what extent these core concepts have influenced instructors' pedagogical decisions or how represented these core concepts are across physiology courses. We surveyed undergraduate physiology instructors to determine their familiarity with the core concepts, the impact of the core concepts on their teaching, as well as the alignment of their courses with these core concepts. Instructors report predominantly relying on textbooks and past syllabi of their courses as resources that influence their instructional decisions on which topics to include in a course. However, many instructors report reorganizing their physiology courses in subsequent iterations or reducing the number of concepts covered to allow more time for critical thinking and active learning. In addition, we find that the majority of instructors indicate that they are not knowledgeable about the list of physiology core concepts and that the influence of these core concepts is limited even for those who report familiarity with the list of core concepts. Finally, we find that instructors report uneven coverage of physiology core concepts in their courses, with some core concepts ubiquitous while others are sparsely covered. We conclude by discussing implications of our work for the physiology education community and call for the continued development of resources to support new physiology instructors and the need to promote coverage of certain core concepts in physiology courses.NEW & NOTEWORTHY The physiology core concepts are a critical resource for undergraduate physiology instructors. Despite this, little past work has investigated the impact of these core concepts across institutions. We find that most instructors are unfamiliar with these core concepts and instead rely on other resources when developing and revamping their physiology courses. We also identify uneven coverage of the core concepts in the curriculum and offer implications for the physiology education community.