Increasing Trainee Engagement in Surgery Societies: The Society of Asian Academic Surgeons Experience.

INTRODUCTION: Surgical societies provide a plethora of resources for trainees; however, these opportunities are often underused due to suboptimal guidance, sponsorship, or mentorship. Here, we present the Society of Asian Academic Surgeons (SAAS) experience in enhancing the trainee experience and engagement in a surgical society focused on professional development. MATERIALS AND METHODS: We conducted an interactive idea-generating session during the 2022 SAAS Conference with all Associate Members (trainees) present in Honolulu, HI. Recurrent themes, concepts, and ideas/suggestions were carefully considered when planning the next SAAS Conference in Baltimore, MD. We employed a more targeted approach to trainee engagement at the 2023 SAAS Conference, with breakout sessions geared toward various levels of trainees, in addition to increased social events and networking opportunities. We obtained feedback from trainees in attendance through an electronic survey and informal conversations with faculty and Associate Members. RESULTS: Opportunities for surgical subspecialty networking was the most well-received portion of our formal Career Development program. The majority of trainees in attendance were medical students or junior residents who valued the exposure to junior faculty and those in leadership positions at academic institutions. The addition of a group text for easy communication among trainees and informal social activities for Associate Member networking among themselves were crucial in improving the overall conference experience. CONCLUSIONS: Opportunities to maximize trainee engagement in surgical societies are heightened during in-person conferences. Targeted session topics, guided networking opportunities, and creating channels for easier communication along with more social events have enhanced the overall experience for aspiring and current surgical trainees.

Dialogic reading with attention-deficit-hyperactivity disorder (ADHD) kindergarteners: Does reading with parents or siblings enhance their language development?

Dialogic reading (DR) is an interactive reading approach that enhances the language development of children. This study aims to extend DR to the shared reading context involving children with attention-deficit-hyperactivity disorder (ADHD) and their older siblings and to examine the effects of DR with parents/siblings on the language development of Chinese children with ADHD. This study included 850 Chinese kindergarteners with ADHD and their parents/older siblings. These children were pretested on their Chinese receptive vocabulary, expressive vocabulary, character reading, listening comprehension, and reading interest and were randomly assigned to four groups, namely, dialogic reading with parents (PR-DR), dialogic reading with siblings (SR-DR), parent reading control (PR-C), and sibling reading control (SR-C). After a 12-week intervention period, they were posttested on the same measures. Results show that both DR with parents and siblings effectively enhanced language skills and reading interest in children with ADHD. In addition, those children who read with their older siblings demonstrated greater improvements in their expressive vocabulary, character reading skills, morphological awareness, phonological awareness, and reading interest yet achieved a smaller growth in their listening comprehension compared with those who read with their parents. These findings showed the positive effects of DR on the language development of children with ADHD and highlight the importance of involving siblings in home literacy activities to facilitate the language development of these children. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Using Human-Centered Design to Improve a Surgery Resident Well-Being Program.

INTRODUCTION: Surgery resident mental health, burnout, and overall well-being are constantly scrutinized, and improving surgery resident well-being programs continuously requires refinement. We sought to evaluate the effectiveness of human-centered design (HCD) sprints to enhance our surgery resident well-being program. METHODS: An HCD sprint was conducted with 34 surgery residents in a single session using seven separate domains, including Mental Health/Reflection and Therapy; Mentoring or Faculty Engagement; Physical Well-being; Retreats; Scheduled Breaks or Free Time; Social Connection; and Well-being Lectures, Emails, or Curriculum. Responses were characterized as: "How might we", Suggestions, Useful, and Not Useful. RESULTS: Well-being Lectures, Emails, or Curriculum were overwhelmingly viewed, as Not Useful (77%), as was Mental Health/Reflection and Therapy (42%). Scheduled Breaks or Free Time was viewed as the most Useful (42%). This category also had the most suggestions and "How might we" ideas for improvement (41%). Lastly, Suggestions and "How might we" ideas were also common for improving Mentoring or Faculty Engagement (31% and 29%, respectively). These results were incorporated into multiple strategies to improve surgery resident well-being and also shared in a Department of Surgery Grand Rounds. CONCLUSIONS: Surgery resident well-being and a targeted approach by a well-being program are critical to a residency program, particularly with the arduous nature of surgical training during the pandemic resulting in periods of prolonged social isolation. HCD sprints are an effective means to refine a surgery resident well-being program and to involve the residents themselves in that process.

Exploring the Genetic and Environmental Etiologies of Phonological Awareness, Morphological Awareness, and Vocabulary Among Chinese-English Bilingual Children: The Moderating Role of Second Language Instruction.

This study investigated the associations among bilingual phonological awareness, morphological awareness, and vocabulary by focusing on their genetic and environmental etiologies. It also explored the influence of family socio-economic status (SES) and language exposure amount on the genetic and environmental effects. A twin study was conducted with 349 pairs of Chinese-English bilingual twins (mean age = 7.37 years). Cross-language transfer was found in phonological and morphological awareness but not in vocabulary knowledge. A common genetic overlap was found among these bilingual abilities. We also found a common shared environmental effect that may account for the cross-language transfer in phonological awareness and the associations among English abilities. SES and language exposure were significant environmental influences on bilingual phonological awareness and English vocabulary. More teaching in Chinese was related to a stronger genetic effect on Chinese morphological awareness, whereas more teaching in English was related to a stronger environmental impact on English abilities.

What does genetic research tell us about the origins of language and literacy development? A reflection on Verhoef et al. (2020).

Quantitative genetic research has set the stage for the exploration of genetic influences and the underlying mechanisms that undergird language and literacy development. Following this line of enquiry, Verhoef et al. (2020) address a critical issue related to genetic processes by comparing whether the genetic mechanism known as innovation or amplification plays a more pivotal role in literacy development during the period of early childhood to early adolescence, using the cutting-edge technique called the genome-wide complex trait analysis. This commentary reviews and discusses the implications of the provocative findings that stem from their study and offers concrete directions for future research. Embedded in our reflections are discussions related to the generalist genes vs genetic specificity debate, language universality vs specificity, as well as the role of environment in genetic influences. Taken together, the discussions in the commentary have highlighted the need for more in-depth explorations of the interplay between genes and literacy development through a multi-disciplinary approach.

Contribution of Vocabulary Knowledge to Reading Comprehension Among Chinese Students: A Meta-Analysis.

This study investigated the correlation between vocabulary knowledge and reading comprehension. To address the correlation picture under Chinese logographical scripts, the researchers investigated the potential explanation for the correlation via Reading Stage, Information Gap, Content-based Approach, and Cognition and Creativity Theory approaches. This study undertook a meta-analysis to synthesize 89 independent samples from primary school stage to Master's degree stage. Results showed the correlation picture as an inverted U-shape, supporting the idea that vocabulary knowledge contributed a large proportion of variance on text comprehension and might also support the independent hypothesis of the impact of vocabulary knowledge on reading comprehension. In each education stage, the correlation between vocabulary knowledge and reading comprehension was independent in that it did not interact with any significant moderators. This study informed that the vocabulary knowledge not only determined text comprehension progress through facial semantic meaning identification but also suggested that the coordinate development of vocabulary knowledge, grammatical knowledge, and inference would be better in complexity comprehension task performance.

High neutrophil-lymphocyte ratio is not independently associated with worse survival or recurrence in patients with extremity soft tissue sarcoma.

BACKGROUND: Soft tissue sarcomas are a heterogenous group of neoplasms without well-validated biomarkers. Cancer-related inflammation is a known driver of tumor growth and progression. Recent studies have implicated a high circulating neutrophil-lymphocyte ratio as a surrogate marker for the inflammatory tumor microenvironment and a poor prognosticator in multiple solid tumors, including colorectal and pancreatic cancers. The impact of circulating neutrophil-lymphocyte ratio in soft tissue sarcomas has yet to be elucidated. METHODS: We performed a retrospective analysis of patients undergoing curative resection for primary or recurrent extremity soft tissue sarcomas at academic centers within the US Sarcoma Collaborative. Neutrophil-lymphocyte ratio was calculated retrospectively in treatment-naïve patients using blood counts at or near diagnosis. RESULTS: A high neutrophil-lymphocyte ratio (≥4.5) was associated with worse survival on univariable analysis in patients with extremity soft tissue sarcomas (hazard ratio 2.07; 95% confidence interval, 1.54-2.8; P < .001). On multivariable analysis, increasing age (hazard ratio 1.03; 95% confidence interval, 1.02-1.04; P < .001), American Joint Committee on Cancer T3 (hazard ratio 1.89; 95% confidence interval, 1.16-3.09; P = .011), American Joint Committee on Cancer T4 (hazard ratio 2.36; 95% confidence interval, 1.42-3.92; P = .001), high tumor grade (hazard ratio 4.56; 95% confidence interval, 2.2-9.45; P < .001), and radiotherapy (hazard ratio 0.58; 95% confidence interval, 0.41-0.82; P = .002) were independently predictive of overall survival, but a high neutrophil-lymphocyte ratio was not predictive of survival (hazard ratio 1.26; 95% confidence interval, 0.87-1.82; P = .22). CONCLUSION: Tumor inflammation as measured by high pretreatment neutrophil-lymphocyte ratio was not independently associated with overall survival in patients undergoing resection for extremity soft tissue sarcomas.

Effect of Twinning on Chinese and English Vocabulary Knowledge.

Vocabulary knowledge was tested in a native (Cantonese-Chinese) and foreign (English) language in 150 twins and 150 singletons aged 6-11 years, matched on age, gender, grade level, nonverbal intelligence, parents' education, family income, and number of siblings and household members. The singletons clearly outperformed the twins on the native vocabulary, but this "twinning effect" was much less noticeable for the foreign vocabulary. The effect on English vocabulary was further reduced after exposure to English at home was controlled. Given that these participants learned most of their English in school rather than home, the present findings support the notion that the twinning effect is associated with increased competition for family interaction in twins compared with singletons.

RAS Mutation Status Confers Prognostic Relevance in Patients Treated With Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Colorectal Cancer.

BACKGROUND: Metastatic colorectal cancer (mCRC) with peritoneal carcinomatosis is an increasingly prevalent disease that carries significant mortality if left untreated. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) in this patient population is associated with improved outcomes but high morbidity. We sought to study the prognostic significance of the known genomic driver, RAS, in patients with mCRC undergoing CRS/HIPEC to allow for improved assessment of risk-benefit ratio in this patient population. METHODS: Patients undergoing CRS/HIPEC for mCRC between 2010 and 2017 at our institution were identified. Patient demographics, RAS mutation status, perioperative morbidity, overall survival (OS), and relapse-free survival (RFS) were evaluated. RESULTS: Forty-seven patients met inclusion criteria. RAS mutant versus RAS wild-type groups were well matched with no difference in the clinicopathologic factors between groups. RAS mutation was associated with decreased RFS but no difference in OS. CONCLUSIONS: RAS mutation is an independent marker of early recurrence in patients undergoing CRS/HIPEC for mCRC and may identify patients who do not derive benefit from this high-risk procedure.

Reading Picture Books With Elements of Positive Psychology for Enhancing the Learning of English as a Second Language in Young Children.

This study aimed to investigate the learning effectiveness of reading picture books with EMPATHICS elements using dialogic reading techniques in enhancing young children's English language learning and creativity. EMPATHICS is an acronym of Emotion and Empathy, Meaning and Motivation, Perseverance, Agency and Autonomy, Time, Habits of Mind, Intelligences, Character Strengths, and Self Factors (Oxford, 2016). It adopted a quasi-experimental design, and 78 kindergarten children aged from 4 to 5 years old in a cluster group were randomly assigned to the experimental and control groups. Both groups read the same four picture books with their homeroom teachers, including two readers suggested in the curriculum and two picture books with enriched elements for 12 sessions over 8 weeks. A doubly multivariate analysis was used to measure the main time and group effects and the interaction effect on the performance of English receptive vocabulary, syntactic complexity, and verbal creativity of the two groups across three different times. There were significant differences only in the interactive effect on syntactic complexity. Children in the experimental condition gave responses with more complex syntactic structures. Significant time effects for receptive vocabulary, syntactic complexity, and verbal creativity were observed in all children. Reading enriched English texts better prepares children to creatively and effectively express themselves. This study extends previous research in two ways. First, this study is one of the few studies on the effectiveness of dialogic reading using EMPATHICS-enriched picture books among young language learners. Second, this study investigates the effects of dialogic teaching on English as a second language development in young children. The educational implications will be discussed.

Home environmental influences on children's language and reading skills in a genetically sensitive design: Are socioeconomic status and home literacy environment environmental mediators and moderators?

This twin study examined how family socioeconomic status (SES) and home literacy environment (HLE) contributes to Chinese language and reading skills. It included 312 Chinese twin pairs aged 3 to 11. Children were individually administered tasks of Chinese word reading, receptive vocabulary and reading-related cognitive skills, and nonverbal reasoning ability. Information on home environment was collected through parent-reported questionnaires. Results showed that SES and HLE mediated shared environmental influences but did not moderate genetic influences on general language and reading abilities. Also, SES and HLE mediated shared environmental contributions to receptive vocabulary and syllable and rhyme awareness, but not orthographic skills. The findings of this study add to past twin studies that focused on alphabetic languages, suggesting that these links could be universal across languages. They also extend existing findings on SES and HLE's contributions to reading-related cognitive skills.

Perception of Native English Reduced Forms in Adverse Environments by Chinese Undergraduate Students.

Previous research has shown that learners of English-as-a-second-language (ESL) have difficulties in understanding connected speech spoken by native English speakers. Extending from past research limited to quiet listening condition, this study examined the perception of English connected speech presented under five adverse conditions, namely multi-talker babble noise, speech-shaped noise, factory noise, whispering and sad emotional tones. We tested a total of 64 Chinese ESL undergraduate students, using a battery of listening tasks. Results confirmed that the recognition of English native speech was more challenging for Chinese ESL learners under unfavorable listening conditions, in comparison to a noise-free listening condition. These findings carry significant implications for the importance of training and assessments on connected speech perception across various listening environments.

Less is More in Hong Kong: Investigation of Biscriptal and Trilingual Development Among Chinese Twins in a (Relatively) Small City.

One salient characteristic of twin studies and the related behavioral genetics paradigm is the requirement of a large sample size. Countries or regions that are large in size and highly populated are at an advantage when implementing twin studies. However, given the fascinating and promising results obtained from twin studies, many researchers based in smaller countries or regions may still want to conduct twin studies in order to address local and theoretical issues. In this article, we have outlined the development of twin studies in Hong Kong, one of the Special Administrative Regions of China. The historical development and design of the two major twin studies of language and reading development implemented within Hong Kong are discussed, providing insights to researchers who also aspire to conduct twin studies in small regions.

Adequacy of Using a Three-Item Questionnaire to Determine Zygosity in Chinese Young Twins.

The present study examined the adequacy of a three-item parent questionnaire in determining the zygosity of young Chinese twins and whether there was any association between parent response accuracy and some demographic variables. The sample consisted of 334 pairs of same-sex Chinese twins aged from 3 to 11 years. Three scoring methods, namely the summed score, logistic regression, and decision tree, were employed to evaluate parent response accuracy of twin zygosity based on single nucleotide polymorphism (SNP) information. The results showed that all three methods achieved high level of accuracy ranging from 91 to 93 % which was comparable to the accuracy rates in previous Chinese twin studies. Correlation results also showed that the higher the parents' education level or the family income was, the more likely parents were able to tell correctly that their twins are identical or fraternal. The present findings confirmed the validity of using a three-item parent questionnaire to determine twin zygosity in a Chinese school-aged twin sample.

Helicopter Scene Response for Stroke Patients: A 5-Year Experience.

OBJECTIVE: The purpose of this study was to examine the usefulness of an emergency medical service (EMS)-requested air medical helicopter response directly to the scene for a patient with clinical evidence of an ischemic cerebrovascular accident (CVA) and transport to a regional comprehensive CVA center. METHODS: CareFlight, an air medical critical care transportation service, is based in Dayton, OH. The 3 CareFlight helicopters are geographically located and provided transport to all CVA scene patients in this study. A retrospective chart review was completed for all CareFlight CVA scene flights for 5 years (2011-2015). A total of 136 adult patients were transported. EMS criteria included CVA symptom presence for less than 3 hours or awoke abnormal, nonhypoglycemia, and a significantly positive Cincinnati Prehospital Stroke Scale. RESULTS: The majority of patients (75%) met all 3 EMS CVA scene criteria; 27.5% of these patients received peripheral tissue plasminogen activator, and 9.8% underwent a neurointerventional procedure. CONCLUSION: Using a 3-step EMS triage for acute CVA, air medical transport from the scene to a comprehensive stroke center allowed for the timely administration of tissue plasminogen activator and/or a neurointerventional procedure in a substantive percentage of patients. Further investigation into air medical scene response for acute stroke is warranted.

Coarse and fine N1 tuning for print in younger and older Chinese children: Orthography, phonology, or semantics driven?

Visual expertise in distinguishing words from objects and word-like stimuli is a fundamental skill that is important for children to become proficient readers. This expertise can be indexed by the N1 component of ERPs at the neural level. However, the nature of N1 tuning for print is controversial in terms of onset of the latency, lateralization and the neural mechanism of the N1. This study aimed to investigate whether two groups of Chinese children could discriminate characters/character-like stimuli from visual controls (i.e., coarse N1 tuning) and distinguish characters from character-like stimuli (i.e., fine N1 tuning). We also explored the cognitive-linguistic correlates of N1 tuning. Seventeen children in the younger group (M=7.7 years) and 13 in the older group (M=9.4 years) were all required to finish a character decision task with character, pseudocharacter, noncharacter, and stroke combination conditions using ERP testing. Both the pseudocharacters and noncharacters were unpronounceable, and the main difference between the two conditions was in orthographic presentation (i.e., radical position). Children were also administered measures of reading fluency, reading accuracy, RAN, phonological skill and vocabulary knowledge. ERP results showed that a significantly larger N1 was observed in the characters, pseudocharacters, and noncharacters as compared to the stroke combinations in both groups. The N1 for characters and pseudocharacters was also significantly larger than that for noncharacters in both groups. Both coarse and fine N1s were larger for younger children than for older children, and the N1 was bilateral in younger children, but left lateralized in older children. Correlational analyses showed that the coarse N1 tuning of real characters versus visual controls was moderately correlated with reading fluency and accuracy but not RAN, phonology, or vocabulary. Taken together, our study suggests that both coarse and fine N1 tuning occurs in both younger and older children, when performing character decisions. Under such task demands, orthography, rather than phonology or semantics, seems to be the driver of coarse N1 tuning for print in Chinese children.

Genetic and environmental overlap between Chinese and English reading-related skills in Chinese children.

This twin study examined the relative contributions of genes and environment on 2nd language reading acquisition of Chinese-speaking children learning English. We examined whether specific skills-visual word recognition, receptive vocabulary, phonological awareness, phonological memory, and speech discrimination-in the 1st and 2nd languages have distinct or overlapping genetic and environmental origins. A sample of 279 Chinese twin pairs with a mean age of 6 years was tested. Univariate twin analyses were used to identify sources of individual variations in reading abilities and related cognitive-linguistic skills in Chinese and English, respectively. They were used to show both similar and distinctive patterns in these skills across Chinese and English. Bivariate Cholesky decomposition analyses indicated genetic overlaps between all parallel Chinese and English variables, as well as shared environmental overlaps in receptive vocabulary and phonological awareness. The phenotypic correlations between 1st and 2nd language skills previously observed in cross-linguistic studies could be explained by the shared genetic and environmental influences found in this twin study. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Generalist genes and cognitive abilities in Chinese twins.

This study considered how far nonverbal cognitive, language and reading abilities are affected by common genetic influences in a sample of 312 typically developing Chinese twin pairs aged from 3 to 11 years. Children were individually given tasks of Chinese word reading, receptive vocabulary, phonological memory, tone awareness, syllable and rhyme awareness, rapid automatized naming, morphological awareness and orthographic skills, and Raven's Colored Progressive Matrices. Factor analyses on the verbal tasks adjusted for age indicated two factors: Language as the first factor and Reading as the second factor. Univariate genetic analyses indicated that genetic influences were substantial for nonverbal cognitive ability and moderate for language and reading. Multivariate genetic analyses showed that nonverbal cognitive ability, language and reading were influenced by shared genetic origins, although there were specific genetic influences on verbal skills that were distinct from those on nonverbal cognitive ability. This study extends the Generalist Genes Hypothesis to Chinese language and reading skills, suggesting that the general effects of genes could be universal across languages.

The Genetic and Environmental Foundation of the Simple View of Reading in Chinese.

The Simple View of Reading (SVR) in Chinese was examined in a genetically sensitive design. A total of 270 pairs of Chinese twins (190 pairs of monozygotic twins and 80 pairs of same-sex dizygotic twins) were tested on Chinese vocabulary and word reading at the mean age 7.8 years and reading comprehension of sentences and passages one year later. Results of behavior-genetic analyses showed that both vocabulary and word reading had significant independent genetic influences on reading comprehension, and the two factors together accounted for most but not all of the genetic influences on reading comprehension. In addition, sentence comprehension had a stronger genetic correlation with word reading while passage comprehension showed a trend of stronger genetic overlap with vocabulary. These findings suggest that the genetic foundation of the SVR in Chinese is largely supported in that language comprehension and decoding are two core skills for reading comprehension in nonalphabetic as well as alphabetic written languages.

Immigrant students' emotional and cognitive engagement at school: a multilevel analysis of students in 41 countries.

Central to student learning and academic success, the school engagement of immigrant children also reflects their adaptation to a primary institution in their new country. Analysis of questionnaire responses of 276,165 fifteen-year-olds (50 % female) and their 10,789 school principals in 41 countries showed that school engagement has distinct, weakly-linked cognitive and emotional components. Native students had weaker attitudes toward school (cognitive engagement) but greater sense of belonging at school (emotional engagement) than immigrant students or students who spoke a foreign language at home. Students with better teacher-student relationships, teacher support or a classroom disciplinary climate often had a greater sense of belonging at school and had better attitudes toward school than other students. While immigrant students often have solid attitudes toward school, teachers can help them feel a greater sense of belonging at school.