Mutations in a Novel, Cryptic Exon of the Luteinizing Hormone/Chorionic Gonadotropin Receptor Gene Cause Male Pseudohermaphroditism

Joerg Gromoll and colleagues describe the identification and characterization of a novel exon that appears to be a new regulatory element within the luteinizing hormone/chorionic gonadotropin receptor gene of three individuals with Leydig cell hypoplasia

Application of the New Classification on Patients with a Disorder of Sex Development in Indonesia

Disorder of sex development (DSD) patients in Indonesia most often do not receive a proper diagnostic evaluation and treatment. This study intended to categorize 88 Indonesian patients in accordance with the new consensus DSD algorithm. Diagnostic evaluation including clinical, hormonal, genetic, imaging, surgical, and histological parameters was performed. Fifty-three patients were raised as males, and 34 as females. Of 22 patients with 46, XX DSD, 15 had congenital adrenal hyperplasia, while in one patient, an ovarian Leydig cell tumor was found. In all 58 46, XY DSD patients, 29 were suspected of a disorder of androgen action (12 with an androgen receptor mutation), and in 9, gonadal dysgenesis was found and, in 20, severe hypospadias e.c.i. Implementation of the current consensus statement in a resource-poor environment is very difficult. The aim of the diagnostic workup in developing countries should be to end up with an evidence-based diagnosis. This is essential to improve treatment and thereby to improve the patients' quality of life

The Four-Tier Continuum of Academic and Behavioral Support (4T-CABS) Model:An Integrated Model for Medical Student Success

Not all students cope successfully with the demands of medical school, and students' struggles may result in study delay or dropout. To prevent these outcomes, medical schools need to identify students who are experiencing academic difficulties and provide them with timely interventions through access to support programs. Although the importance of early identification and intervention is well recognized, less is known about successful strategies for identifying and supporting struggling students. Building on the literature and their own empirical findings, the authors propose an integrated, school-wide model for medical student success comprising a continuum of academic and behavioral support. This Four-Tier Continuum of Academic and Behavioral Support (4T-CABS) model focuses on improving both academic and behavioral outcomes by offering support for students at four levels, which range from adequate instruction for all, to targeted small-group interventions, to individualized support, and also include exit support for students who might be better off in another degree program. Additionally, medical schools should provide both academic and behavioral support; set high, yet realistic expectations and clearly communicate these to students; and intervene early, which requires timely identification of at-risk students who would benefit from the different types and tiers of support. Finally, interventions should be evidence based and fit the needs of the identified groups of students. The authors argue that adopting the core principles of the 4T-CABS model will enable medical schools to maximize academic engagement and performance for all students

The effect of a short integrated study skills programme for first-year medical students at risk of failure:A randomised controlled trial

<p>Background: There is a need for outcome-based studies on strategies for supporting at-risk medical students that use long-term follow-up and contemporaneous controls.</p><p>Aim: To measure the effect of a short integrated study skills programme (SSP) on the study progress of at-risk medical students.</p><p>Methods: First-year students identified as at-risk of academic failure at 7 months after enrolment were invited to participate in the randomised controlled trial. Participants were randomly assigned to the SSP group or to a control group receiving standard academic support. Effects of SSP were measured on the short (passed first exam after intervention), medium (obtained enough credits to proceed to second year) and long term (completed first-year curriculum within 2 years).</p><p>Results: SSP participants (n = 43) more often passed the first exam after the intervention than controls (n = 41; 30% versus 12%; X-2 (1) = 4.06, p <0.005, effect size = 0.22), in particular those who had previously passed at least one exam. No medium or long-term effect was found. Participants who had attended four or five SSP sessions outperformed those who had attended fewer sessions on all outcome measures.</p><p>Conclusion: A short, integrated SSP benefited some, but not all students. Our advice is to focus support efforts on at-risk students who have demonstrated commitment and academic potential.</p>