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Casadevante et al. (Curr Psychol 42: 4272–4285, 2023) used an objective test and found that regulation of response speed was related to better performance in a category learning task. The present study aims at analysing whether the relation between regulation of response speed and learning exists in an associative learning task. We developed ad hoc the Treasure Forest, an objective test consisting of a computerized associative learning task. We conducted a first study with 86 university students to assess the relation between spontaneous response speed and learning. Results showed that participants who acted slowly learned more than their mates who acted faster ( t (83) = 8.898, p < .001, η 2 = .672). Moreover, some students who began the task acting too fast to learn decreased their response speed by the second half of the task and simultaneously their learning index improved ( t (11) = 2.325, p < .05, d = .721). Hence, self-regulating the response speed was linked to associative learning. We conducted a second study to analyse the influence of an external speed regulation on learning. The intervention group ( N = 99) was prevented from clicking more than one click per second while the control group ( N = 85) acted without restrictions. The intervention group achieved a higher learning index than the control group, who acted faster ( t (160) = 4.828, p < .001, η 2 =.117). Hence, regulating response speed promoted associative learning. We concluded that regulating response speed promoted associative learning, and we hypothesized that training self-regulation of response speed may improve learning and academic performance. Besides, we highlight the utility of employing objective test for analysing self-regulation.

The rubber hand illusion is a perceptual illusion in which participants experience an inanimate rubber hand as belonging to their own body. The illusion is elicited by synchronously stroking the rubber hand and the participant’s real hand, which is hidden from sight. The feeling of owning the rubber hand is accompanied by changes in hand position sense (proprioception), so that when participants are asked to indicate the location of their (unseen) hand, they indicate that it is located closer to the rubber hand. This “proprioceptive drift” is the most widely used objective measure of the rubber hand illusion, and from a theoretical perspective, it suggests a close link between proprioception and the feeling of body ownership. However, the critical question of whether a causal relationship exists between changes in hand position sense and changes in limb ownership is unknown. Here we addressed this question by devising a novel setup that allowed us to mechanically manipulate the position of the participant’s hand without the participant noticing, while the rubber hand illusion was being elicited. Our results showed that changing the sensed position closer to or farther away from the rubber hand did not change the strength of the rubber hand illusion. Thus, the illusion is not dependent on changes in hand position sense. This finding supports models of body ownership and central body representation that hold that proprioceptive drift and the subjective illusion are related to different central processes.

We know from the literature that high cognitive load can impede performance and educational outcomes. Previous measures of cognitive load have largely relied on subjective scales but few have explored more objective measures. This paper aims to address this issue by examining the validity of electroencephalography (or EEG) as an objective measure of cognitive load in the context of educational video. EEG is an online brain measure of the electrical activity that a population of neurons elicits when they are activated. Theta power is a brain oscillation ranging from 4 to 7 Hz that has been linked to cognitive and memory performance. We manipulated the linguistic complexity of three texts delivered by a speaker on video to induce a simple, a moderate and a complex level of cognitive load amongst a sample of students pursuing postgraduate studies through the medium of English as a second language (n = 35). We specifically measured intrinsic cognitive load via a subjective scale, a recall test, and theta power as an objective measure (average cognitive load). Our results show that the subjective scale was significantly different across the three levels of linguistic complexity. However, theta power and recall were only significantly different between the two most distinct levels of linguistic complexity. Although, this finding suggests theta power may not be as sensitive for average cognitive load as the subjective scale for intrinsic cognitive load, a correlation analysis shows that theta power was correlated with self-reported cognitive load. However, it may need more power compared to the subjective scale. These findings suggest that theta power may be developed into a valid objective measure of average cognitive load although its true potential lies in the possibility to measure online fluctuations in cognitive load or instantaneous cognitive load.

ObjectivesThe NICE guidelines recommend objective tests for diagnosis of asthma in children.1 The primary care Quality and Outcomes Framework (QOF) has resulted in children being referred to hospitals for asthma diagnostic tests.2 The project aimed to assess the adherence to NICE guidelines, the utilisation of diagnostic methods and their impact on medication changes.MethodsA prospective/retrospective multi-centre quality improvement (QI) project was conducted, involving paediatric patients aged 5–16 years referred for asthma diagnosis. Data was collected anonymously from seven hospitals within the West Midlands Paediatric Asthma Network from September 2022 to September 2023. The Forced Expiratory Volume in 1 sec (FEV1), Forced Vital Capacity (FVC), Fractional Exhaled Nitric Oxide (FeNO), Bronchodilator Reversibility (BDR), Asthma Control Test (ACT), patient demographics and medication changes were analysed.ResultsAmong 111 children referred for spirometry, 97/111 (87.8%) underwent spirometry, but only 19/97 (19.5%) had BDR testing. The most common reason for not completing spirometry was the child’s inability (8/14, 57.1%). Despite presenting with symptoms, a significant proportion of children had normal spirometry results, both with a history of cough and wheeze (53/55, 96.3%) and wheeze on examination (5/6, 83.3%). FeNO testing was performed in 56/111 (50.4%) of cases, with 36/56 (64.2%) showing normal results. 21/34 (61.7%) in the cough and wheeze group and 2/4 (50%) in the wheeze on examination group had normal FeNO (< 35 ppb). ACT was documented in 72/111 (64.8%) of cases. In those with abnormal ACT (<=19), 31/35 (88.5%) had normal spirometry and 26/35 (74.2%) had normal FeNO. Of the 111 children, 82/111 (73.8%) were already on inhaled steroids, and 51/111 (45.9%) had no medication changes post-spirometry. Notably, despite normal spirometry, 48/92 (52.1%) of children had medication changes. In children already on inhaled steroids, even with normal results, medication changes were seen.ConclusionPaediatric asthma diagnosis remains primarily clinical, with objective tests such as spirometry and FeNO having limited impact on altering diagnosis or management.3 The study suggests that if these tests are conducted, they should be performed when the child is highly symptomatic. Consequently, the allocation of time and resources for objective tests should be carefully considered when clinical history strongly suggests asthma. This study underscores the importance of re-evaluating the timing and need for a different diagnostic approach in confirming the diagnosis of paediatric asthma.ReferencesAsthma: diagnosis, monitoring and chronic asthma management, NICE guideline, 22 March 2021.Quality and Outcomes Framework guidance for 2021/22.Clare Murray, et al. Diagnosis of asthma in symptomatic children based on measures of lung function: an analysis of data from a population-based birth cohort study, October 2017.

BackgroundThe use of biologic agents allows the application of precision medicine in the treatment of paediatric severe asthma.AimTo describe the real-life effectiveness of biologic agents in children with severe asthma.MethodsWe analysed demographics, clinical characteristics, phenotype and lung function of children with severe asthma pre and post initiation of a biologic agent from 2019 to 2023.Results8 children were included, 62% male. Biologics (mepolizumab (6), omalizumab (1), dupilumab (1) ), were initiated at a median age of 12 (IQR 10.8–13.3) years. All patients had objective testing to confirm asthma.Baseline CT chest findings were compatible with asthma, and showed no other significant pathology. Flexible bronchoscopy was normal in 88% of patients, with left upper lobe bronchomalacia in 1 child. Bronchoalveolar lavage cytology showed median eosinophils of 3.5% (0.3–6.9).Abstract 7681 Table 1Characteristics of patient cohort pre and post biologics[Image Omitted. See PDF.]Mean number of asthma attacks/child/year requiring systemic corticosteroids fell from 5.9 at baseline to 3 at one-year post-biologics, and hospital admissions/child/year from 2 to 0.5. 75% patients reported significant improvements in paediatric quality of life scores post biologics.ConclusionsMost children with severe asthma had improved asthma control and fewer attacks after initiation of a biologic. Vigilance is needed to continue to promote adherence to preventer inhalers whilst on biologics.

Background Realistic, portable, and scalable lectures, cadaveric models, 2D atlases and computer simulations are being combined more frequently for teaching anatomy, which result in major increases in user satisfaction. However, although digital simulations may be more portable, interesting, or motivating than traditional teaching tools, whether they are superior in terms of student learning remain unclear. This paper presents a study in which the educational effectiveness of a virtual reality (VR) skull model is compared with that of cadaveric skulls and atlases. The aim of this study was to compare the results of teaching with VR to results of teaching with traditional teaching methods by administering objective questionnaires and perception surveys. Methods A mixed-methods study with 73 medical students was conducted with three different groups, namely, the VR group ( N  = 25), cadaver group ( N  = 25) and atlas group ( N  = 23). Anatomical structures were taught through an introductory lecture and model-based learning. All students completed the pre- and post-intervention tests, which comprised a theory test and an identification test. The theory test consisted of 18 multiple-choice questions, and the identification test consisted of 25 fill-in-the-blank questions. Results The participants in all three groups had significantly higher total scores on the post-intervention test than on the pre-intervention test; the post-intervention test score in the VR group was not statistically significantly higher than the post-intervention test score of the other groups (VR: 30 [IQR: 22–33.5], cadaver: 26 [IQR: 20–31.5], atlas: 28[IQR: 20–33]; p  > 0.05). The participants in the VR and cadaver groups provided more positive feedback on their learning models than the atlas group (VR: 26 [IQR: 19–30], cadaver: 25 [IQR: 19.5–29.5], atlas: 12 [IQR: 9–20]; p  < 0.001). Conclusions The skull virtual learning resource (VLR) was equally efficient as the cadaver skull and atlas in teaching anatomy structures. Such a model can aid individuals in understanding complex anatomical structures with a higher level of motivation and tolerable adverse effects.

[...]in ICS-naive patients with asthma, FeNO correlates with airway eosinophilia. 15 Hence if FeNO is available and normal, this means a diagnosis of asthma characterised by eosinophilic airway inflammation, and therefore being ICS-responsive, is unlikely. [...]we need to go beyond umbrella labels for airway diseases such as asthma, and move to phenotyping childhood airway diseases in terms of parameters such as fixed and variable airflow obstructions, presence or otherwise, and nature of, airway inflammation, and whether there is chronic infection.

BackgroundChildren and young people (CYP) with asthma in the UK are at higher risk of poor outcomes compared with other high-income European countries due to factors including poor access to high-quality asthma reviews, diagnostic testing and inconsistent postattack reviews. The Leicester Integrated Care Board funded the first UK pilot asthma hub for CYP, to investigate the feasibility and effectiveness of hubs, in providing postattack reviews along with providing asthma education, the opportunity to carry out diagnostic lung function tests and optimise treatment.MethodsClinical pilot study including CYP aged 4–17 years referred to the hub with uncontrolled asthma or postattack from November 2021 to April 2022. CYP received a structured clinical assessment including National Institute for Health and Care Excellence (NICE) first-line diagnostic investigations for asthma including spirometry, bronchodilator reversibility (BDR) and fraction of exhaled nitric oxide (FeNO).ResultsOf 312 CYP referred (mean age 8.6±3.2 years; 42% women), 266 (85.3%) attended their appointment. Median time from referral to review was 2 days (IQR 1–3). Three CYP (1.1%) were severely unwell at review and required further hospital treatment. In the 231 CYP who completed first-line tests, asthma was confirmed for 73 (31.6%) based on NICE diagnostic criteria for CYP. Twenty-two per cent of children with normal baseline spirometry had ≥12% BDR.ConclusionPaediatric asthma hubs are a feasible model of care to deliver CYP postasthma attack reviews and identify high-risk patients requiring further treatment. Spirometry, BDR and FeNO testing allowed diagnostic confirmation in a significant proportion of CYP.

Background Given the importance of aligning assessments with curriculum standards and the necessity for valid, structured, and standardized multiple-choice tests, this study aimed to conduct a quantitative and qualitative analysis of MCQ exams within the basic medical sciences departments at the Faculty of Medicine of Tabriz University of Medical Sciences in 2023. Methods This descriptive-analytical study was conducted to quantitatively and qualitatively analyze all tests administered in the basic medical sciences groups at Tabriz University of Medical Sciences during the first semester of the 2023 academic year. The core basic courses evaluated in this study included Anatomical Sciences, Physiology, Microbiology & Parasitology, Immunology, Medical Physics, Biochemistry, and Genetics. The questions' Facility Value, discrimination index, and each exam’s internal consistency (by KR20) were evaluated. Qualitative assessments of the tests were conducted to assess content validity, and reliability, ensuring alignment with the educational objectives of basic medical sciences. Results Overall analysis revealed that 404 (50%) questions were appropriately difficult. The effectiveness of distractors was commendable, with only 1.8% being classified as non-functional. Of 810 questions, only 1.2% had a negative discrimination index, while 559(69%) showed a good discrimination index. Validity analysis revealed that 96.6% of the curriculum content was adequately covered in the exams based on the blueprints. All of the questions assessed recall level of cognition. Conclusion This analysis showed that most questions were functioning effectively. However, a subset could benefit from refinement to enhance their clarity and effectiveness in assessment.