The Association between Critical Thinking and Scholastic Aptitude on First-time Pass Rate of the National Physical Therapy Examination

Objectives: 1) To investigate the relationships among critical thinking (CT) abilities, overall academic performance in the Doctorate of Physical Therapy (DPT) program as measured by cumulative grade point average (GPA), and National Physical Therapy Examination (NPTE) licensure scores, and 2) To determine if NPTE scores were significantly different between groups of students who were classified as having low, moderate or high CT abilities. Background: It is well-established that physical therapy practice requires good clinical reasoning skills. Passage of the NPTE is required for licensure. Research to date has been mixed as to whether CT abilities or GPA can predict success on national board licensure examinations such as the NPTE. The conflicting results may be partially due to weak research methodologies, uncontrolled confounders, and the use of non-standardized assessment instruments. Methods and Measures: A convenience sample of 91 DPT students completed a standard assessment of CT abilities three times. Repeated measure (RM) general linear model (GLM) tests were run to determine if mean California Critical Thinking Skills Test (CCTST) scores changed significantly over the course of the DPT program. A Pearson’s correlation matrix was constructed to investigate the relationships among NPTE scores, GPA, and CT. A univariate GLM test was run to determine if there was a statistically significant difference in mean NPTE scores between low, medium, and high CCTST groups. Results: Complete sets of the three CCTST scores were available for 69 students, and NPTE scores were available for 73 graduates. The strongest correlation with the first-time NPTE score was the GPA (r = 0.735, p = 0.001), followed by the CCTST score at Measurement 1 (r = 0.413, p = 0.0001). Graduates who were classified as having low CT abilities had a 100% failure rate on the first attempt for the NPTE, and scored significantly lower on the exam compared to graduates with moderate or high CT abilities (615.33, 634.6, and 652.43, respectively p = 0.0005). Conclusion: Implementing pedagogical practices that foster CT abilities and/or using a CCTST score of 18 or greater as DPT program entry criterion may equate to greater first-time NPTE pass rates for program graduates

A method to define the priority for maintenance and repair works of Italian motorway tunnels

The construction of motorways in Italy dates back to 1921 and still lasts today. Along them there is a large number of tunnels, many of which have been in service for more than 50 years and have experienced various levels of decay due to aging. An extensive assessment and inspection plan is taking place finalized to highlight situations where maintenance and repair works are needed to guarantee the continuation of service in safe conditions and functionality. Due to the number of tunnels, the need arises to classify them and define priorities for intervention on the basis of a first assessment and of a robust and scientific-based tool to orientate the investments. This paper describes the methodology that was developed by the Authors for this purpose, assessing the attention level of every tunnel. The method relies on a quantitative approach that allows quantifying the risk based on five risk factors composed of a number of relevant parameters. Their relative interaction, which guided the scores assigned to each parameter, was assessed by applying the Rock Engineering System [2]. A number of examples of existing tunnels are shown to illustrate the application of the method and to draw conclusions about its validity and reliability

The Relationship between Knee Valgus and Clinical Measures in Professional Basketball: A CART Analysis

Background/Purpose: Lower extremity injuries occur at an amplified rate in professional basketball. Evidence suggests that knee frontal plane valgus may be associated with risk of injury. The Landing Error Scoring System includes the assessment of maximum knee valgus during a countermovement jump. The investigation of interactions among linear and non-linear factors may help the understanding of the interdependence of various measures and poor performance on the knee valgus displacement (KVD) component of the LESS in professional basketball players. The purpose of this study was to investigate predictors of knee valgus displacement on the LESS. We hypothesize that a positive finding on the knee valgus displacement component of the LESS will be predicted by select clinical measures. Methods: 47 professional basketball players participated. Measurements were completed as part of preseason mobility screening prior to the 2015-16 and 2016-17 NBA seasons. Classification and Regression Tree Analysis (CART) were used to investigate linear and non-linear interactions among predictors and their influence on KVD in players who performed the LESS test. Results: Of the 47 players included in this study, 16 players did not test positive for KVD on the LESS test and 31 did. Pruning resulted in 4 splits (r2=0.507) demonstrating that KVD was predicted by total hip rotation range of motion, dominant leg hip external rotation, and standing arch height index measure. Predictive modeling, classified 18 of the 31 players with KVD and 8 of the 16 players who tested negative for KVD. The area under the ROC curve was .9183, suggesting that classification of players using this model was not random. Conclusion: KVD and performance on the LESS has been linked with injury. CART analysis captured linear and non-linear interactions between clinical measures suggesting that lower extremity biomechanical factors may be associated with predicting KVD during performance on the LESS. Clinical Relevance: KVD and the LESS test has been shown to be predictive of injury. Identifying which clinical measures may be linked with poor performance on this test may aide clinicians in determining appropriate interventions that may be associated with improved scores and minimize risk of injury.https://ecommons.udayton.edu/dpt_symposium/1000/thumbnail.jp

Fluctuations and differential contraction during regeneration of Hydra vulgaris tissue toroids

We studied regenerating bilayered tissue toroids dissected from Hydra vulgaris polyps and relate our macroscopic observations to the dynamics of force-generating mesoscopic cytoskeletal structures. Tissue fragments undergo a specific toroid-spheroid folding process leading to complete regeneration towards a new organism. The time scale of folding is too fast for biochemical signalling or morphogenetic gradients which forced us to assume purely mechanical self-organization. The initial pattern selection dynamics was studied by embedding toroids into hydro-gels allowing us to observe the deformation modes over longer periods of time. We found increasing mechanical fluctuations which break the toroidal symmetry and discuss the evolution of their power spectra for various gel stiffnesses. Our observations are related to single cell studies which explain the mechanical feasibility of the folding process. In addition, we observed switching of cells from a tissue bound to a migrating state after folding failure as well as in tissue injury. We found a supra-cellular actin ring assembled along the toroid's inner edge. Its contraction can lead to the observed folding dynamics as we could confirm by finite element simulations. This actin ring in the inner cell layer is assembled by myosin- driven length fluctuations of supra-cellular {\alpha}-actin structures (myonemes) in the outer cell-layer.Comment: 19 pages and 8 figures, submitted to New Journal of Physic

3D Voronoi Tessellation for the Study of Mechanical Behavior of Rocks at Different Scales

Numerical investigation of crack damage development and microfracturing in brittle rocks is a widely studied topic, given the number of applications involved. In the framework of the Discrete Element Method (DEM) formulation, the grain-based distinct element model with random polygonal blocks can represent an alternative to the Bonded-Particle Model (BPM) based on particles. Recently, a new engine called Neper has been made available for generating 3D Voronoi grains. The aim of this study is to investigate the applicability of a Neper-based 3D Voronoi tessellation technique for the simulation of the mechanical macro response of rocks. Simulation of unconfined compression tests on synthetic specimens is conducted and a calibration procedure tested. The issue related to scale effects is also addressed, with an application to the case study of a deep geothermal reservoir

Phantom Materials for Elastography

Abstract-Acoustic and mechanical properties are reported for gelatin materials used to construct tissue-like phantoms for elasticity imaging (elastography). A device and procedure for measuring elastic properties are described. The measured compression forces were comparable to results obtained from finite element analysis when linear elastic media are assumed. Also measured were the stress relaxation, temporal stability, and melting point of the materials. Aldehyde concentration was used to increase the stiffness of the gelatin by controlling the amount of collagen cross-linking. A broad range of tissue-like elastic properties was achieved with these materials, although gels continued to stiffen for several weeks. The precision for elastic modulus measurements ranged from less than 0.1% for 100 kPa samples to 8.9% for soft ( 10 kPa), sticky samples

Chemotherapy-Response Monitoring of Breast Cancer Patients Using Quantitative Ultrasound-Based Intra-Tumour Heterogeneities

© 2017 The Author(s). Anti-cancer therapies including chemotherapy aim to induce tumour cell death. Cell death introduces alterations in cell morphology and tissue micro-structures that cause measurable changes in tissue echogenicity. This study investigated the effectiveness of quantitative ultrasound (QUS) parametric imaging to characterize intra-tumour heterogeneity and monitor the pathological response of breast cancer to chemotherapy in a large cohort of patients (n = 100). Results demonstrated that QUS imaging can non-invasively monitor pathological response and outcome of breast cancer patients to chemotherapy early following treatment initiation. Specifically, QUS biomarkers quantifying spatial heterogeneities in size, concentration and spacing of acoustic scatterers could predict treatment responses of patients with cross-validated accuracies of 82 ± 0.7%, 86 ± 0.7% and 85 ± 0.9% and areas under the receiver operating characteristic (ROC) curve of 0.75 ± 0.1, 0.80 ± 0.1 and 0.89 ± 0.1 at 1, 4 and 8 weeks after the start of treatment, respectively. The patients classified as responders and non-responders using QUS biomarkers demonstrated significantly different survivals, in good agreement with clinical and pathological endpoints. The results form a basis for using early predictive information on survival-linked patient response to facilitate adapting standard anti-cancer treatments on an individual patient basis

A coarse-to-fine approach to prostate boundary segmentation in ultrasound images

BACKGROUND: In this paper a novel method for prostate segmentation in transrectal ultrasound images is presented. METHODS: A segmentation procedure consisting of four main stages is proposed. In the first stage, a locally adaptive contrast enhancement method is used to generate a well-contrasted image. In the second stage, this enhanced image is thresholded to extract an area containing the prostate (or large portions of it). Morphological operators are then applied to obtain a point inside of this area. Afterwards, a Kalman estimator is employed to distinguish the boundary from irrelevant parts (usually caused by shadow) and generate a coarsely segmented version of the prostate. In the third stage, dilation and erosion operators are applied to extract outer and inner boundaries from the coarsely estimated version. Consequently, fuzzy membership functions describing regional and gray-level information are employed to selectively enhance the contrast within the prostate region. In the last stage, the prostate boundary is extracted using strong edges obtained from selectively enhanced image and information from the vicinity of the coarse estimation. RESULTS: A total average similarity of 98.76%(± 0.68) with gold standards was achieved. CONCLUSION: The proposed approach represents a robust and accurate approach to prostate segmentation