The Effectiveness of a Combined Program of Direct Instruction and Phonological Awareness on Reading Fluency, Reading Comprehension, and Working Memory for First Grade Elementary School Students with Reading Problems

This study aimed to investigate the effectiveness of the integrative training program consisted of a direct instruction and phonological awareness, compared with phonology and direct instruction programs on reading skills, and working memory in the first grade girl students with reading problems (RP). This study used pretest-posttest and follow-up sessions with experimental and control groups. Sixty girl students with RP were recruited through the purposeful sampling method (n = 15 in 4 groups), and the experimental groups were taught during 13 eighty-minute sessions. Measuring instruments included Diagnostic Reading Test, Phonological Awareness Test, Wechsler Memory, and Raven's Matrices. Mixed MANOVA analysis revealed that the DI group had better improvement in RC and WM rather than the PA group, and the PA group had better improvement in PA. The integrative group had better improvement in both PA and forward memory compared with the other two groups. This is probably due to receiving both instructions at the same time. Accordingly, it is concluded that the integrative method can be used for students with RP. phonologicalawareness, direct instruction, integrative method, comprehension, working memor

Central nervous system microstructural alterations in Type 1 diabetes mellitus: A systematic review of diffusion Tensor imaging studies

Aims: Type 1 diabetes mellitus (T1DM) is a chronic childhood disease with potentially persistent CNS disruptions. In this study, we aimed to systematically review diffusion tensor imaging studies in patients with T1DM to understand the microstructural effects of this entity on individuals' brains METHODS: We performed a systematic search and reviewed the studies to include the DTI studies in individuals with T1DM. The data for the relevant studies were extracted and a qualitative synthesis was performed. Results: A total of 19 studies were included, most of which showed reduced FA widespread in optic radiation, corona radiate, and corpus callosum, as well as other frontal, parietal, and temporal regions in the adult population, while most of the studies in the juvenile patients showed non-significant differences or a non-persistent pattern of changes. Also, reduced AD and MD in individuals with T1DM compared to controls and non-significant differences in RD were noted in the majority of studies. Microstructural alterations were associated with clinical profile, including age, hyperglycemia, diabetic ketoacidosis and cognitive performance. Conclusion: T1DM is associated with microstructural brain alterations including reduced FA, MD, and AD in widespread brain regions, especially in association with glycemic fluctuations and in adult age

Systemic Inflammation Biomarkers Ratio as Predictors of Clinical Outcomes in Ischemic Stroke

Background: Strokes are among the major causes of disabilities worldwide. In recent years, there has been considerable interest in evaluating stroke prognoses. Objectives: In this investigation, we studied the association of lymphocyte-monocyte ratio (LMR), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and ESR-CRP ratio (ECR) with 3 months outcomes among those with acute ischemic stroke (AIS). Materials & Methods: We carried out the present cross-sectional investigation among AIS patients at an academic hospital in northern Iran (from 2019 to 2021). Within 24 hours after the onset of symptoms, laboratory and clinical data of the patients were obtained. We assessed the results using the modified rankin scale (mRS) 90 days after the initial assessment. Statistical significance for comparing descriptive data was determined as P<0.05. Results: We entered 341 participants (Mean±SD age: 69.10±13.55 years, 53.1% female) into this investigation. Based on univariate analysis, there were poor correlations between NLR (r=0.361, P<0.001), PLR (r=0.215, P<0.05), CRP (r=0.234, P<0.001), LMR (r=-0.184, P<0.05), and ECR (r=-0.191, P<0.05) and a 3-month mRS. Also, after three months, the NLR, PLR, and CRP values were higher in the patients who died, but the LMR (P<0.001) and ECR (P<0.05) were lower. In multivariate comparison, only ECR was independently higher among the participants who died within 3 months (P<0.05). Conclusion: In this study, ECR within 24 hours of symptoms onset was related to functional outcomes and mortality at 3-month follow-up. Thus, ECR might provide valuable prognostic information at a relatively low cost