A Comparison of Adolescents\u27 Digital and Print Reading Experiences: Does Mode Matter?

The purpose of this mixed-methods research study was to investigate the comprehension and motivation of 36, sixth-grade students reading moderately challenging text under two conditions: Nook or book. Using a Sequential Explanatory Design model, quantitative data were collected prior to qualitative data collection (Creswell & Plano Clark, 2011). A Matched Pairs Design model (Hinkle, Wiersma, & Jurs, 2003) was employed for the quantitative portion of the study with 18 participants randomly assigned to the Nook group and 18 participants randomly assigned to the book group. Nook group participants were instructed to use the following electronic features during reading: highlighting, note taking, and dictionary usage. The book group participants received instruction for using actual highlighters, sticky notes, and dictionaries during reading. Participants read and responded to Sounder (Armstrong, 1969) in either a traditional or digital (Nook) format. Quantitative data included scores on a reading motivation survey and summative comprehension test. Qualitative data included students’ journal entries, researcher’s field notes, and participants’ verbal responses to interview questions. Results indicate the Nook group achieved higher overall comprehension scores with statistically significant higher inferential comprehension scores than the book group. Nook group participants also read approximately 3 minutes longer per day, chose a free-write response option (as opposed to responding to researcher-constructed writing prompts), and cited text more frequently in journal responses than book group participants. Findings suggest that engaging students in reading digital text and teaching them to use the technology’s facilitative features has the potential to improve student’s reading comprehension of moderately challenging text

The Diagnosis, Management, and Postnatal Prevention of Intraventricular Hemorrhage in the Preterm Neonate

Intraventricular hemorrhage (IVH) occurs in 20% to 25% of very low birthweight preterm neonates and may be associated with significant sequelae. Infants who have IVH are at risk for posthemorrhagic hydrocephalus and periventricular leukomalacia; as many as 75% of those who have parenchymal involvement of hemorrhage suffer significant neurodevelopmental disability. Because of the prevalence of IVH and the medical and societal impact of this disease, many postnatal pharmacologic prevention strategies have been explored. Randomized clinical prevention trials should provide long-term neurodevelopmental follow-up to assess the impact of preterm birth, injury, and pharmacologic intervention on the developing brain

Mutations in phosphoinositide metabolizing enzymes and human disease

Phosphoinositides are implicated in the regulation of a wide variety of cellular functions. Their importance in cellular and organismal physiology is underscored by the growing number of human diseases linked to perturbation of kinases and phosphatases that catalyze interconversion from one phosphoinositide to another. Many such enzymes are attractive targets for therapeutic interventions. Here, we review diseases linked to inheritable or somatic mutations of these enzymes

Establishing successful cerebrospinal fluid flow for radioimmunotherapy

Successful delivery of intraventricular radioimmunotherapy is contingent on adequate CSF flow. The authors present a patient with medulloblastoma in whom obstructed CSF flow was causing hydrocephalus, which was initially corrected by implantation of a programmable shunting device. While managing the hydrocephalus, an endoscopic third ventriculostomy (ETV) needed to be performed in a collapsed ventricular system to ensure adequate radioimmunotherapy distribution. This 18-month-old patient with medulloblastoma involving leptomeningeal dissemination presented for intraventricular radioimmunotherapy. A CSF In-111-DTPA scintigraphy study obtained through the existing programmable ventriculoperitoneal shunt demonstrated activity in the lateral and third ventricles, but no activity over the cerebral convexities or spinal canal, consistent with obstruction at the level of the cerebral aqueduct. By maximization of ventricular size in a controlled setting, the patient was able to undergo a trial of ETV through very small ventricles. A postoperative CINE MR imaging study confirmed patent ETV. The pressure settings on the shunt were kept at the highest opening pressure (200 mm H2O) to maximize flow through the stoma and improve the distribution of CSF throughout the subarachnoid space. The CSF flow scintigraphy study was again performed, this time with tracer activity demonstrated down the thecal sac at 3 hours, and symmetrically over the cerebral convexities at 24 hours. The patient began weekly intraventricular administration of I-131-3F8 therapy. Successful rerouting of CSF flow for the purpose of therapeutic radioisotope administration is possible. Endoscopic third ventriculostomy can be considered in patients with programmable shunting devices; normal or slit ventricles do not preclude successful ETV. (hap://thejns.org/doi/abs/10.3171/2011.12.PEDS11433

308 EGFR Gene Amplification Predicts a Poor Response to Bevacizumab in Recurrent Glioblastoma

Abstract INTRODUCTION The highly vascular malignant brain tumor glioblastoma multiforme (GBM) appears to be an ideal target for anti-angiogenic therapy; however, clinical trials to date suggest the VEGF antibody bevacizumab affects only progression free survival without any benefit on overall survival. Here we analyze a group of patients with GBM who received bevacizumab treatment and are stratified according to tumor molecular and genomic profile (TCGA classification), with the goal of identifying molecular predictors of the response to bevacizumab. METHODS We performed a retrospective review of patients with a diagnosis of glioblastoma multiforme who were treated with bevacizumab in the recurrent setting at Memorial Sloan-Kettering Cancer Center, from 2006 to 2014. Treatment was discontinued by individual neuro-oncologists, based on clinical and radiographic criteria. Pre- and post- treatment imaging and genomic subtype were available on 83 patients; We analyzed clinical progression, and time to radiographic progression (rP) on MRI flair and T1 weighted images with contrast, quantified tumor volumes as well as the development of multifocal lesions. EGFR gene amplification and MGMT promotor methylation status were determined by FISH. RESULTS >EGFR gene amplification was significantly associated with a shorter time to progression both in univariate (P = < 0.001) and multivariate analysis (P = 0.011). Patients with classical tumors had a significantly shorter time to progression than mesenchymal and proneural patients (2.5 vs 6.32 and 5.2 months respectively, P = 0.001), although it lost its significance (P = 0.262) on multivariate analysis when correcting for EGFR status. Overall survival was significantly shorter in patients with EGFR- amplified GBM treated with bevacizumab. CONCLUSION EGFR gene amplification and classical subtype by TCGA analysis are associated with significantly shorter time to progression for patients with recurrent GBM when treated with bevacizumab. These findings can have a significant impact on decision making and should be further validated prospectively