Política de álgebra universal I, acesso, e desigualdade: Resultados de uma pesquisa nacional

Many in the US view algebra as a gatekeeper to advanced study of mathematics, and increasing enrollment in algebra courses as a strategy to address unequal access to educational opportunity. As a result, universal enrollment policies, which require all students to complete Algebra I by grade 8 or 9, have garnered attention in school districts or states. Based on a view that school districts are the primary implementers of state and national policy in the US, this study surveyed a nationally representative sample of districts to investigate the prevalence of such policies and their relationship to algebra enrollment. Districts reported substantial increases in Algebra I enrollments in eighth grade, although ninth grade remains the most common year students enroll. Only 26% of districts reported having universal enrollment policies; in these districts, linear regression indicated that an association with higher eighth grade Algebra I enrollment was moderated by poverty level (measured by FRL). As a result, universal policies, while decreasing within-district disparities, may increase disparities between districts. These disparities may be explained by maximally maintained inequality (Raftery Hout, 1993) and effectively maintained inequality theories (Lucas, 2001), which posit that more affluent groups take deliberate action to perpetuate inequalities.Muchas personas en EEUU ven la álgebra como un portero para el estudio de matemáticas avanzadas y más inscripciones en cursos de álgebra como una estrategia para abordar el acceso desigual a las oportunidades educativas. La álgebra I en le nivel 8 o 9 se ha prestado atención a los distritos o estados escolares. En base a una visión de que los distritos escolares son los principales implementadores de la política estadual y nacional en los Estados Unidos, este estudio investigó una muestra de distritos para investigar la prevalencia de dichas políticas y su relación con la matrícula de álgebra. Los distritos reportaron aumentos sustanciales en las inscripciones de Álgebra I en le nivel 8, aunque la matrícula de le nivel 9 es más común. Sólo el 26% de los distritos relataron tener políticas universales de matrícula y regresión lineal indicaron que una asociación con inscripción superior en álgebra I de le nivel 8 fue moderada por el nivel de pobreza en esos distritos. Como resultado, al disminuir las disparidades dentro del distrito, las políticas universales pueden aumentar las disparidades entre los distritos. Esas disparidades pueden ser explicadas por la desigualdad máxima mantenida (Raftery Hout, 1993) y teorías de desigualdad efectivamente mantenidas (Lucas, 2001), que argumentan que grupos más afluentes toman acciones deliberadas para perpetuar las desigualdades.Muchas pessoas em EUA ven a álgebra como um portero para o estudo de matemáticas avançadas e mais inscrições em cursos de álgebra como uma estratégia para abordar o acesso desigual às oportunidades educativas. A álgebra I en le nivel 8 o 9 se ha prestado atenção a distritos ou estados escolares. Na base de uma visão de que os distritos escolares são os principais implementadores da política estadual e nacional nos Estados Unidos, este estudo investigou uma amostra de distritos para investigar a prevalência de políticas e sua relação com a matrícula de álgebra. Os distritos reportaram aumentos substanciales em inscrições de Álgebra I en le nivel 8, embora a matrícula do nível 9 es más común. Apenas os 26% dos distritos relataram ter políticas universais de matrícula e regresso lineal indicando que é uma associação com inscrição superior em álgebra I do nível 8 foi moderada pelo nível de propriedade de seus imigrantes. Como resultado, al disminuir as disparidades dentro do distrito, as políticas universais podem aumentar as disparidades entre os distritos. Estudo das expectativas para a desigualdade máxima da manutenção (Raftery Hout, 1993) e teorias de desigualdad efetivamente mantenidas (Lucas, 2001), que argumentan que grupos mais afluentes toman acciones deliberadas para perpetuar las desigualdades

A Multidimensional Framework of Collaborative Groups’ Disciplinary Engagement

Abstract This research is aimed at developing novel theory to advance innovative methods for examining how collaborative groups progress toward productively engaging during classroom activity that integrates disciplinary practices. This work draws on a situative perspective, along with prior framings of individual engagement, to conceptualize engagement as a shared and multidimensional phenomenon. A multidimensional conceptualization affords the study of distinct engagement dimensions, as well as the interrelationships of engagement dimensions that together are productive. Development and exploration of an observational rubric evaluating collaborative group disciplinary engagement (GDE) is presented, leveraging the benefits of observational methods with a rubric specifying quality ratings, enabling the potential for analyses of larger samples more efficiently than prior approaches, but with similar ability to richly characterize the shared and multidimensional nature of group engagement. Mixed-methods analyses, including case illustrations and profile analysis, showcase the synergistic interrelations among engagement dimensions constituting GDE. The rubric effectively captured engagement features that could be identified via intensive video analysis, while affording the evaluation of broader claims about group engagement patterns. Application of the rubric across curricular contexts, and within and between lessons across a curricular unit, will enable comparative studies that can inform theory about collaborative engagement, as well as instructional design and practice

Sunitinib in combination with docetaxel in patients with advanced solid tumors: a phase I dose-escalation study

PURPOSE: Sunitinib in combination with docetaxel enhances antitumor activity in xenograft models of human breast and non-small cell lung cancer. We assessed the maximum tolerated doses (MTDs), safety, pharmacokinetic profiles, and preliminary efficacy of sunitinib plus docetaxel in patients with advanced solid tumors. METHODS: In this phase I study, successive patient cohorts received sunitinib 25, 37.5, or 50 mg/day for 4 weeks of a 6-week cycle (Schedule 4/2, 4 weeks on, 2 weeks off) or for 2 weeks of a 3-week cycle (Schedule 2/1, 2 weeks on, 1 week off) with docetaxel 60 or 75 mg/m(2) IV q21d to determine the MTDs of this treatment combination. RESULTS: Fifty patients enrolled: 10 on Schedule 4/2 and 40 on Schedule 2/1. MTDs were established as sunitinib 25 mg on Schedule 4/2 with docetaxel 60 mg/m(2) q21d, and as sunitinib 37.5 mg on Schedule 2/1 with docetaxel 75 mg/m(2) q21d. On Schedule 2/1, the most frequent dose-limiting toxicity was neutropenia (±fever; grade [G]3/4, n = 5) and the most common G3/4 non-hematologic adverse event (AE) was fatigue (G3, n = 8). Hematologic AEs were managed with growth factor support in 11 of 23 (48%) patients treated at Schedule 2/1 MTD. Three patients achieved a partial response at the Schedule 2/1 MTD. There were no pharmacokinetic drug–drug interactions with either schedule. CONCLUSIONS: Oral sunitinib 37.5 mg/day on Schedule 2/1 with docetaxel 75 mg/m(2) IV q21d is a clinically feasible regimen with a manageable safety profile, no pharmacokinetic drug–drug interactions, and shows antitumor activity in patients with advanced solid tumors

Adjuvant chemotherapy with or without bevacizumab in patients with resected non-small-cell lung cancer (E1505): an open-label, multicentre, randomised, phase 3 trial.

BackgroundAdjuvant chemotherapy for resected early-stage non-small-cell lung cancer (NSCLC) provides a modest survival benefit. Bevacizumab, a monoclonal antibody directed against VEGF, improves outcomes when added to platinum-based chemotherapy in advanced-stage non-squamous NSCLC. We aimed to evaluate the addition of bevacizumab to adjuvant chemotherapy in early-stage resected NSCLC.MethodsWe did an open-label, randomised, phase 3 trial of adult patients (aged ≥18 years) with an Eastern Cooperative Oncology Group performance status of 0 or 1 and who had completely resected stage IB (≥4 cm) to IIIA (defined by the American Joint Committee on Cancer 6th edition) NSCLC. We enrolled patients from across the US National Clinical Trials Network, including patients from the Eastern Cooperative Oncology Group-American College of Radiology Imaging Network (ECOG-ACRIN) affiliates in Europe and from the Canadian Cancer Trials Group, within 6-12 weeks of surgery. The chemotherapy regimen for each patient was selected before randomisation and administered intravenously; it consisted of four 21-day cycles of cisplatin (75 mg/m2 on day 1 in all regimens) in combination with investigator's choice of vinorelbine (30 mg/m2 on days 1 and 8), docetaxel (75 mg/m2 on day 1), gemcitabine (1200 mg/m2 on days 1 and 8), or pemetrexed (500 mg/m2 on day 1). Patients in the bevacizumab group received bevacizumab 15 mg/kg intravenously every 21 days starting with cycle 1 of chemotherapy and continuing for 1 year. We randomly allocated patients (1:1) to group A (chemotherapy alone) or group B (chemotherapy plus bevacizumab), centrally, using permuted blocks sizes and stratified by chemotherapy regimen, stage of disease, histology, and sex. No one was masked to treatment assignment, except the Data Safety and Monitoring Committee. The primary endpoint was overall survival, analysed by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00324805.FindingsBetween June 1, 2007, and Sept 20, 2013, 1501 patients were enrolled and randomly assigned to the two treatment groups: 749 to group A (chemotherapy alone) and 752 to group B (chemotherapy plus bevacizumab). 383 (26%) of 1458 patients (with complete staging information) had stage IB, 636 (44%) had stage II, and 439 (30%) had stage IIIA disease (stage of disease data were missing for 43 patients). Squamous cell histology was reported for 422 (28%) of 1501 patients. All four cisplatin-based chemotherapy regimens were used: 377 (25%) patients received vinorelbine, 343 (23%) received docetaxel, 283 (19%) received gemcitabine, and 497 (33%) received pemetrexed. At a median follow-up of 50·3 months (IQR 32·9-68·0), the estimated median overall survival in group A has not been reached, and in group B was 85·8 months (95% CI 74·9 to not reached); hazard ratio (group B vs group A) 0·99 (95% CI 0·82-1·19; p=0·90). Grade 3-5 toxicities of note (all attributions) that were reported more frequently in group B (the bevacizumab group) than in group A (chemotherapy alone) were overall worst grade (ie, all grade 3-5 toxicities; 496 [67%] of 738 in group A vs 610 [83%] of 735 in group B), hypertension (60 [8%] vs 219 [30%]), and neutropenia (241 [33%] vs 275 [37%]). The number of deaths on treatment did not differ between the groups (15 deaths in group A vs 19 in group B). Of these deaths, three in group A and ten in group B were considered at least possibly related to treatment.InterpretationAddition of bevacizumab to adjuvant chemotherapy did not improve overall survival for patients with surgically resected early-stage NSCLC. Bevacizumab does not have a role in this setting and should not be considered as an adjuvant therapy for patients with resected early-stage NSCLC.FundingNational Cancer Institute of the National Institutes of Health

An eHealth System Supporting Palliative Care for Patients with Non-Small Cell Lung Cancer: A Randomized Trial

BACKGROUND: In this study, the authors examined the effectiveness of an online support system (Comprehensive Health Enhancement Support System [CHESS]) versus the Internet in relieving physical symptom distress in patients with non-small cell lung cancer (NSCLC). METHODS: In total, 285 informal caregiver-patient dyads were assigned randomly to receive, for up to 25 months, standard care plus training on and access to either use of the Internet and a list of Internet sites about lung cancer (the Internet arm) or CHESS (the CHESS arm). Caregivers agreed to use CHESS or the Internet and to complete bimonthly surveys; for patients, these tasks were optional. The primary endpoint-patient symptom distress-was measured by caregiver reports using a modified Edmonton Symptom Assessment Scale. RESULTS: Caregivers in the CHESS arm consistently reported lower patient physical symptom distress than caregivers in the Internet arm. Significant differences were observed at 4 months (P = .031; Cohen d = .42) and at 6 months (P = .004; d = .61). Similar but marginally significant effects were observed at 2 months (P = .051; d = .39) and at 8 months (P = .061; d = .43). Exploratory analyses indicated that survival curves did not differ significantly between the arms (log-rank P = .172), although a survival difference in an exploratory subgroup analysis suggested an avenue for further study. CONCLUSIONS: The current results indicated that an online support system may reduce patient symptom distress. The effect on survival bears further investigation

The Phenotype of the C9ORF72 Expansion Carriers According to Revised Criteria for bvFTD

Background The C9ORF72 expansion is one of the most common genetic etiologies observed with behavioural variant frontotemporal dementia (bvFTD). Revised diagnostic criteria for bvFTD (FTDC) were recently introduced but only a few studies have evaluated the accuracy of these criteria. Objective The objective of the study was to evaluate the applicability of the FTDC criteria and assess the psychiatric history of these patients. Methods The study examined 36 patients carrying the C9ORF72 expansion and suffering from bvFTD (N = 32) or from bvFTD with motor neuron disease (bvFTD-MND, N = 4). Neuropsychological, neuropsychiatric, structural brain imaging and PET/SPECT data were evaluated. Results We found 0.75 sensitivity (SD 0.44, 95% CI 0.57-0.87) for possible bvFTD and 0.64 (SD 0.44, 95% CI 0.57-0.87) for probable bvFTD. The sensitivity was even higher in bvFTD patients without MND, i.e., 0.81 for possible bvFTD and 0.69 for probable bvFTD. PET/SPECT was normal in 17.6% of scanned patients with bvFTD. A history of psychiatric symptoms (psychotic and/or mood symptoms) was detected in 61% of cases. Conclusions The FTDC possible and probable bvFTD criteria seem to identify the majority of the C9ORF72 expansion carriers with bvFTD, even though they exhibit only a limited number of behavioral criteria but a significant amount of psychiatric symptoms. The presence of a normal PET/SPECT does not exclude the possibility the C9ORF72 associated bvFTD.Peer reviewe

Myosteatosis as a Shared Biomarker for Sarcopenia and Cachexia Using MRI and Ultrasound

PurposeEstablish bedside biomarkers of myosteatosis for sarcopenia and cachexia. We compared ultrasound biomarkers against MRI-based percent fat, histology, and CT-based muscle density among healthy adults and adults undergoing treatment for lung cancer.MethodsWe compared ultrasound and MRI myosteatosis measures among young healthy, older healthy, and older adults with non-small cell lung cancer undergoing systemic treatment, all without significant medical concerns, in a cross-sectional pilot study. We assessed each participant's rectus femoris ultrasound-based echo intensity (EI), shear wave elastography-based shear wave speed, and MRI-based proton density fat-fraction (PDFF). We also assessed BMI, rectus femoris thickness and cross-sectional area. Rectus femoris biopsies were taken for all older adults (n = 20) and we analyzed chest CT scans for older adults undergoing treatment (n = 10). We determined associations between muscle assessments and BMI, and compared these assessments between groups.ResultsA total of 10 young healthy adults, 10 older healthy adults, and 10 older adults undergoing treatment were recruited. PDFF was lower in young adults than in older healthy adults and older adults undergoing treatment (0.3 vs. 2.8 vs. 2.9%, respectively, p = 0.01). Young adults had significantly lower EI than older healthy adults, but not older adults undergoing treatment (48.6 vs. 81.8 vs. 75.4, p = 0.02). When comparing associations between measures, PDFF was strongly associated with EI (ρ = 0.75, p < 0.01) and moderately negatively associated with shear wave speed (ρ = −0.49, p < 0.01) but not BMI, whole leg cross-sectional area, or rectus femoris cross-sectional area. Among participants with CT scans, paraspinal muscle density was significantly associated with PDFF (ρ = −0.70, p = 0.023). Histological markers of inflammation or degradation did not differ between older adult groups.ConclusionPDFF was sensitive to myosteatosis between young adults and both older adult groups. EI was less sensitive to myosteatosis between groups, yet EI was strongly associated with PDFF unlike BMI, which is typically used in cachexia diagnosis. Our results suggest that ultrasound measures may serve to determine myosteatosis at the bedside and are more useful diagnostically than traditional weight assessments like BMI. These results show promise of using EI, shear wave speed, and PDFF proxies of myosteatosis as diagnostic and therapeutic biomarkers of sarcopenia and cachexia

Chromosome 9p21 in sporadic amyotrophic lateral sclerosis in the UK and seven other countries:a genome-wide association study

BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease of motor neurons that results in progressive weakness and death from respiratory failure, commonly within about 3 years. Previous studies have shown association of a locus on chromosome 9p with ALS and linkage with ALS-frontotemporal dementia. We aimed to test whether this genomic region is also associated with ALS in an independent set of UK samples, and to identify risk factors associated with ALS in a further genome-wide association study that combined data from the independent analysis with those from other countries.METHODS: We collected samples from patients with sporadic ALS from 20 UK hospitals and obtained UK control samples from the control groups of the Depression Case Control study, the Bipolar Affective Case Control Study, and the British 1958 birth cohort DNA collection. Genotyping of DNA in this independent analysis was done with Illumina HumanHap550 BeadChips. We then undertook a joint genome-wide analysis that combined data from the independent set with published data from the UK, USA, Netherlands, Ireland, Italy, France, Sweden, and Belgium. The threshold for significance was p=0·05 in the independent analysis, because we were interested in replicating a small number of previously reported associations, whereas the Bonferroni-corrected threshold for significance in the joint analysis was p=2·20×10(-7)FINDINGS: After quality control, samples were available from 599 patients and 4144 control individuals in the independent set. In this analysis, two single nucleotide polymorphisms in a locus on chromosome 9p21.2 were associated with ALS: rs3849942 (p=2·22×10(-6); odds ratio [OR] 1·39, 95% CI 1·21-1·59) and rs2814707 (p=3·32×10(-6); 1·38, 1·20-1·58). In the joint analysis, which included samples from 4312 patients with ALS and 8425 control individuals, rs3849942 (p=4·64×10(-10); OR 1·22, 95% CI 1·15-1·30) and rs2814707 (p=4·72×10(-10); 1·22, 1·15-1·30) were associated with ALS.INTERPRETATION: We have found strong evidence of a genetic association of two single nucleotide polymorphisms on chromosome 9 with sporadic ALS, in line with findings from previous independent GWAS of ALS and linkage studies of ALS-frontotemporal dementia. Our findings together with these earlier findings suggest that genetic variation at this locus on chromosome 9 causes sporadic ALS and familial ALS-frontotemporal dementia. Resequencing studies and then functional analysis should be done to identify the defective gene.</p