The Prevalence of Impostor Phenomenon in Medical Students in Slovenia: Effects of Gender, Year of Study, and Clinical Work Experience.

Phenomenon: Impostor syndrome (IS) is manifested in the fear of failing and being exposed as incompetent, despite exceptional professional performance. IS has been recognized in many professions, including medicine. Understanding IS prevalence and risk factors is critical to ensure the well-being of medical students and, by extension, future physicians. Approach: It was expected that IS is highly prevalent in medical students, higher in women and associated with year of study and prior clinical experience. The Clance Impostors Phenomenon Scale (CIPS) was used to collect the responses from of medical students in May 2023. Questionnaires were distributed online to both public medical faculties in Slovenia. Findings: 207 medical students (157 women, 50 men; mean age: 23.2 ± 2.6 years) completed the questionnaire (response rate = 13.1%). Women exhibited higher CIPS scores (66.0 ± 13.9) compared to men (58.8 ± 15.1) (p = 0.005). Neither age (r = 0.05; p = 0.464) nor year of study (r = 0.03; p = 0.653) was correlated with CIPS score. There were also no differences in CIPS score between students with (63.4 ± 15.2) and without (64.7 ± 13.9) prior clinical work experience (p = 0.531). Insights: The results of the present study suggest that IS can occur at any stage of medical education, with a slightly higher prevalence in women. This study contributes to the understanding of IS among medical students and calls for addressing environmental factors and taking supportive measures to mitigate the impact of IS and promote medical students' well-being and success.

Reciprocal Associations among Social-Emotional Competence, Interpersonal Relationships and Academic Achievements in Primary School.

The study aimed to examine the reciprocal associations among social-emotional competence (SEC), interpersonal relationships (including teacher-student relationships and peer relationships) and academic achievements in reading, mathematics and science of primary school students. The Chinese versions of the Delaware Social and Emotional Competency Scale, Teacher-student Relationship Scale, Peer-nomination method and Academic Achievement Tests were used to measure students' SEC, teacher-student relationships, peer relationships (including social preference (SP) and social impact (SI)) and academic achievements, respectively. In total, 3995 fourth-grade students participated in the first survey, and 2789 of them were tracked in the follow-up survey two years later. Structural equation modelling was employed to investigate the cross-lagged relationships among the variables across time. The results showed the reciprocal associations between SEC with academic achievements and teacher-student relationships, as well as between academic achievements with SP and teacher-student relationships. Moreover, variations in these reciprocal associations were observed across the subjects of reading, mathematics and science. In summary, this study offers new insights for enhancing students' SEC, interpersonal relationships and academic achievements, and implications for future subject-specific education can be derived by considering the complex interplay in the subjects of reading, mathematics and science.

Impact of Sickle Cell Disease on Academic Performance: A Cross Sectional Study.

Purpose: Sickle cell disease (SCD) is a multisystemic disease that results in diverse clinical manifestations in the form of acute and chronic complications. This study aims to assess the academic achievements of patients with SCD. Methods and Materials: A cross-sectional study was a study conducted among adult patients with SCD from the eastern province of Saudi Arabia, where SCD is more widespread than in other regions. Results: A total of ninety patients with SCD, whose median age was 32.33 ± 11.84, were retrospectively evaluated. Of the total number, 32 (35.5%) did not obtain a secondary higher education certificate, and five (3.3%) were illiterate. Sixty-three (70%) of the patients were female, indicating no significant association between gender and education level (p-value > 0.05). The patients' mean annual hospitalizations and emergency visits totaling 4.7 and 8.43, respectively, were not significantly associated with education (p-value > 0.05). Throughout the patients' lives, mean blood transfusions and ICU admissions occurred 6.29 and 2.75 times, respectively, which were not significantly associated with education level (p-value > 0.05). However, education was inversely proportional to a history of splenectomy and cholecystectomy (p < 0.05). Laboratory parameters (hemoglobin level, WBC, platelets, and hemoglobin F) showed no significant associations with education level (p-value > 0.05). Patients with sickle-thalassemia exhibited a trend of being better-educated than those without the diseases, but the difference did not reach statistical significance (p-value > 0.05). A linear regression analysis revealed no significant associations among clinical and laboratory parameters. Conclusion: SCD is a multisystemic disease that impacts socioeconomic status, learning ability, and academic achievements. More research is needed to identify factors that predict poor performance. Additionally, intelligence quotient (IQ) and cognitive assessment should be incorporated into early screening programs for SCD in order to implement preventive measures and a thorough investigation of underlying causes.

Learning motivations and effort beliefs in Confucian cultural context: A dual-mode theoretical framework of achievement goal.

For decades, results of international academic assessments have shown that students in the Confucian cultural circle performed outstandingly well. However, many studies also showed that East Asian students often experienced high pressure and had low interest in academic learning. The "high achievement but low interest" phenomenon has aroused great interest in psychologists and educators. From the emic perspective of cultural psychology, this theoretical article aims to propose (1) a dual-mode framework of achievement goals to conceptualize the motivation for academic learning and (2) two kinds of effort beliefs (obligation-oriented and improvement-oriented belief about effort) students may develop when pursuing academic achievement in societies influenced by Confucian heritage culture. Moreover, a series of empirical studies based on the framework are presented in this article to show that (1) Chinese students' academic striving is motivated not only by their interest but also by role obligation or virtue of effort, (2) students' effort beliefs could predict their learning emotion and behavioral tendency, and (3) students' effort beliefs could be influenced by their parents' and teachers' effort beliefs. The theoretical and practical implications of the framework are discussed.

The effects of the superstar learning system on learning interest, attitudes, and academic achievements.

The COVID-19 pandemic has contributed to the production of a mobile learning app--the Superstar Learning System. Designed by Superstar Company, the Superstar Learning System is a mobile application for curriculum learning assisted with PPTs, knowledge dissemination, and management sharing based on micro-service architecture. To identify the effects of the Superstar Learning System, we randomly selected 71 tertiary students to participate in the study. The data were obtained through three research instruments: a scale to measure learning interest, a scale to measure learning attitudes, and a scale to measure academic achievements. Based on the analysis of a Mann-Whitney U test, it was concluded that the Superstar Learning System could: (1) enhance significantly more learning interest than the multimedia projecting system, (2) cultivate significantly more positive attitudes of students than the multimedia projecting system, and (3) lead to significantly better academic achievements than the multimedia projecting system. In the future, interdisciplinary cooperation, involving statistics, computer sciences, education, linguistics, and related disciplines, is necessary to arrive at solid conclusions.

Longitudinal impact of parent-teacher relationship on middle school students' academic achievements in China.

Objective: The study aims to discuss the longitudinal impact of the parent-teacher relationship on students' academic achievements in China. Method: Based on the China Education Panel Survey, covering the data from 438 classes of 112 schools in 28 county-level administrative areas in China, we used the hierarchical linear model to analyze the data. Results: We found that the parents' active communication with teachers, parents' participation in parent meetings, teachers' active contact, whether parents are afraid to communicate with teachers, and parents' willingness to participate in parent meetings have significant relationships with students' academic achievements. At the class level, the extent of teachers' stress from parents' requests and teachers' perception of respect from parents also affected students' academic achievements significantly in the Chinese context. Conclusion: There was a longitudinal association between the parent-teacher relationship and students' academic achievements. The practical implication was discussed in the paper.

Personality and brain contribute to academic achievements of medical students.

There are many factors that influence the academic achievements of medical students, but how personality and brain modulate the academic achievements of medical students remains unclear. The study collected the personality, brain imaging, and academic data from 448 medical students at Tianjin Medical University with admission time between 2008 and 2017. Four types of academic achievements, including behavioral and social sciences, clinical sciences and skills, basic biomedical sciences, and scientific methods, were assessed by the academic records of 58 courses. Personality was evaluated by Tridimensional Personality Questionnaire and Neuroticism Extraversion Openness Personality Inventory. Brain structural and functional properties, including gray matter volume, spontaneous brain activity and functional connectivity, were computed based on magnetic resonance imaging (MRI). Linear regression was used to evaluate the associations between personality and academic achievements. A voxel-wise correlation was used to identify areas of the brain where structural and functional properties were associated with academic achievements. Mediation analysis was used to test whether brain properties and personality independently contribute to academic achievements. Our results showed that novelty seeking (NS) was negatively correlated, and conscientiousness was positively correlated with all types of academic achievements. Brain functional properties showed negatively correlated with academic achievement in basic biomedical sciences. However, we did not find any mediation effect of the brain functional properties on the association between personality (NS and conscientiousness) and academic achievement in basic biomedical sciences, nor mediation effect of the personality (NS and conscientiousness) on the association between brain functional properties and academic achievement in basic biomedical sciences. These findings suggest that specific personality (NS and conscientiousness) and brain functional properties independently contribute to academic achievements in basic biomedical sciences, and that modulation of these properties may benefit academic achievements among medical students.

Academic Achievements, Satisfaction with Studies and Risky Behaviours among First-Year Students of Kaunas (Lithuania) Universities, 2000-2017.

Risky behaviours are prevalent among university students and may affect academic achievements. This study aimed to evaluate the associations between academic achievements, satisfaction with studies and risky behaviours among first-year students of Kaunas (Lithuania) universities. Three cross-sectional surveys were conducted in 2000, 2010, and 2017. The self-administered questionnaires were filled in during lectures and assessed frequency and amount of alcohol consumption, drinking problems (CAGE test), smoking and drug use frequency, and academic achievements. The associations between risky behaviours and academic achievements were analysed using multivariable logistic regression analysis. Altogether 3325 students (1341 men and 1984 women) aged 20.0 (1.5) years participated in the survey. The proportion of students who consumed alcohol at least once a week and drank 11 or more standard alcoholic units (SAU) a week decreased. Every fifth student reported a drinking problem. Daily smoking prevalence declined, and drug use increased among male students. Multivariable logistic regression analysis revealed that frequent alcohol consumption and problem drinking were associated with low importance of good grades. Students who rated their academic performance below average and were dissatisfied with studies were more likely to consume ≥11 SAU a week. Daily smoking was more common among students who reported low importance of good grades and academic performance below average. A higher prevalence of drug use was found only in male students who declared low importance of good grades. Health promoting interventions at the individual and student community level are required to reduce the prevalence of substance use and improve the academic achievements of students.

The Relationship between Personality, Motivation and Academic Performance at Medical Students from Romania.

The academic and health system requirements are constantly growing due to the continuous development of this sector. Therefore, it is important to investigate the structural factors that improve performance in the medical system. The aim of our pilot study is to analyze if there are associations or correlations between personality and motivation and the results obtained for the National Residency Exam of Romanian medical graduates. We conducted a prospective pilot study on 179 medical students from George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania between February 2021 and December 2021, who were evaluated by the DECAS, IM, and SPM scale. Our results showed that all the dimensions of personality according to the Big Five Model, which include openness (OR = 0.392, p = 0.01), extraversion (OR = 0.512, p = 0.03), conscientiousness (OR = 3.671, p = 0.004), agreeableness (OR = 2.791, p = 0.07), and emotional stability (OR = 4.863, p = 0.0003), are statistically associated with the result obtained. Motivation also plays an important role in academic achievements, through motivational persistence and motivational involvement which correlates with the conscientiousness dimension and the result obtained. This study confirms that both personality structure and motivation are associated or correlated with the academic results of medical students and represent a starting point for future research.

Impact of Intercalated Degree on Post-graduate Career Progression and Academic Development in the UK: A Rapid Review of the Literature.

An intercalated degree offers medical students an avenue to explore their interests and become competent in scientific literacy. Although intercalating can pose a financial burden and time commitment, they do provide competitive academic and speciality training applications. The aim of this review was to explore academic development and subsequent outcomes of career progression. Medline and EMBASE were systematically searched using keywords. After the removal of duplicates, the studies were screened against the inclusion criteria. For the five studies included in this review, a narrative synthesis was performed. The two main themes were academic development and career progression. All studies showed a plethora of academic achievements during and after intercalation. Two studies showed that students are more likely to enter a career in academic medicine. A further two studies have shown that the transferable skills of academia have allowed alumni to make more competitive applications for foundation year and speciality training. The results have shown a correlation between academic achievements and an increase in competitiveness in foundation programmes and speciality applications. There are clear discrepancies in the success of academic careers depending on the institution and type of intercalated degree. Current literature suggests a master's degree results in more academic success compared to a bachelor's degree. Due to the sheer diversity of intercalated degrees offered to medical students in the UK, there is limited literature on post-graduate career progression. More research should be undertaken to look at the implications of intercalation on post-graduate career progression.

Cognitive Abilities and Academic Achievement as Intercultural Competence Predictors in Russian School Students.

The development of intercultural competence (ICC) is important for the modern personality in an unstable and diverse world, but there is a lack of research on this phenomenon in the context of age, gender and intellectual differences. The purpose of the present exploratory study is to identify relations between ICC, cognitive abilities and academic achievements among Russian school students. The sample included 106 (55% female) students in the 9th grade of Moscow secondary school. ICC was measured with the author's modification of The Intercultural Sensitivity Scale by Khuhlaev and Chibisova, developed on the basis of the Developmental Model of Intercultural Sensitivity by Bennett. Cognitive abilities were determined with the School Test of Intellectual Development by Akimova et al. Academic achievements were evaluated using GPA. The findings of our research show that: (1) higher academic achievements and cognitive abilities usually characterize schoolchildren, who are not inclined to absolutize cultural differences and do not consider them to be barriers to intercultural interaction; (2) the most significant predictors of ICC features from the studied cognitive abilities are analogy and generalization, but generalization has opposite impacts in male and female students. This fact should be taken into account in the context of ICC developments, especially in male school students prone to ethnocentrism.

Assessment of Fear of Failure Among Medical Students at King Saud University.

Background: Fear of failure (FoF) is described as a "dispositional tendency to avoid failure in achievement settings." It may potentially and adversely affect students' ability to perform well in their educational activities. Objectives: To measure FoF among medical students at King Saud University, FoF between men and women, academic levels, grade point average (GPA), and other factors among medical students were compared. Method: A cross-sectional observational study was carried out using a stratified random sampling method. A total of 455 medical students completed "the Performance Failure Appraisal Inventory" during the academic year 2019-2020 at King Saud University, Riyadh, Saudi Arabia. Results: The results showed that the mean of FoF was -0.3117. Moreover, higher levels of fear of devaluing one's self-estimate were seen in women, and higher levels of fear of important others losing interest were seen in men. A significant relation was seen between different academic levels and fear of shame and embarrassment, fear of upsetting important others, as well as FoF. Higher levels of FoF were seen in those who had a GPA below 3.5 and a GPA greater than 4.9. Also, it was high in students who were not interested in studying medicine. The Cronbach's α value of 0.93 of all items indicates good internal consistency, and the factor analysis confirms five items of an instrument. Conclusion: The overall level of FoF was low among medical students at King Saud University. However, the domains and levels of FoF differed significantly according to gender, academic level, GPA, and interest in studying medicine.

Influence of Physical Fitness and Attention Level on Academic Achievements of Female and Male Military Academy Cadets in Poland.

A professional soldier should be characterized not only by high physical fitness but also by high intellectual and cognitive skills. Therefore, it is important to focus on the future commanding cadre-cadets that are educated in military academies. The aim of the study was to look for correlations between the level of physical fitness and attention and academic achievements (AA) in different subjects among cadets studying at military academies. The research group consisted of students of a military academy in Poland, i.e., 228 cadets, including 31 women and 197 men. Correlations between explained and explanatory variables were assessed using Pearson's correlation. Correlations between AA and somatic parameters and motor components were analysed using optimal regression, using the best subset method. A statistical difference was found between men and women in terms of the level of somatic and motor development; men also performed significantly better in practical military subjects. In the female group, dominant hand strength is a significant determinant of AA in civilian and theoretical military subjects. The findings suggest the need for specialized training aimed at bridging the major differences in physical fitness between men and women by placing greater emphasis on muscle strength development.

[Master DOU Han-qing's academic achievements in acupuncture and moxibustion].

Master DOU Han-qing is one famous acupuncturist in the Jin and Yuan Dynasties of China. In consideration of his newly neatened works DOU Taishi Zhenjing (Master DOU's Canon of Acupuncture,《》), Zhenjiu Jicheng (Compendium of Acupuncture and Moxibustion,《》) and Panshijin Zhici Michuan (Panshijin Secretly Bequeathed Techniques of Straight Needling,《》) which were not paid enough attention in the past, we make a systematic and comprehensive summary about his academic achievements in the present paper. There are six main aspects about Dou's academic achievements: blending the essence of sages' acupuncture theories and clinical experience, correcting predecessors' mistakes; innovating the needlingmethods; expanding the clinical applications of acupoints and paying attention to combination of meridian acupoints and extra-points in clinical practice; inheriting and developing acupuncture prescriptions in the Song Dynasty, creating new diagnostic and treatment modes; initiating needling techniques of various schools in the Ming Dynasty; and describing the contents of acupuncture and moxibustion in the form of odes. Moreover, we also put forward some of our enlightenments and considerations about DOU Han-qing's academic achievements.

Effects of Classroom Active Desks on Children and Adolescents' Physical Activity, Sedentary Behavior, Academic Achievements and Overall Health: A Systematic Review.

The purpose of this systematic review was to examine the effects of active desks in the school setting on sedentary behavior, physical activity, academic achievements and overall health among children and adolescents aged 5-17 years. A systematic literature search was conducted using five databases until October 2020. Twenty-three studies were included. Studies reported an increase of around 36% in energy expenditure for cycling desks and between 15% and 27.7% for upright active desks. Children increased inhibitory control and selective attention capacity while using cycling desks. A heterogeneous quality of design and of results were observed limiting comparisons and conclusions for each active desk. Despite the lack of strong methodology for the included studies, active desks appear to be a promising intervention in classrooms to improve health-related outcomes in children aged 5-17 years. Due to weak methodology, future studies with stronger study designs and methodology are needed to better inform policy and practice about the role of classroom active desks on health-related outcomes in children and adolescents.

Estudio comparativo de técnicas de analítica del aprendizaje para predecir el rendimiento académico de los estudiantes de educación superior / Comparative study of learning analytics techniques to predict student academic performance in higher education

Resumen La deserción escolar involucra diversos factores, entre ellos, el compromiso del estudiante, a través del cual se puede predecir su éxito en la escuela. Ese compromiso tiene varios componentes, tales como conductual, emocional y cognitivo. La motivación y el compromiso están fuertemente relacionadas, ya que la primera es un precursor del compromiso. El objetivo de este estudio fue comparar la eficacia de la regresión lineal contra dos técnicas de minería de datos para predecir el rendimiento académico de los estudiantes en la educación superior. Se hizo un estudio transversal explicativo en el que se encuestó a 222 estudiantes universitarios de una institución pública de la Ciudad de México. Se realizó un análisis de regresión lineal jerárquico (RL) y de técnicas de analítica del aprendizaje, como redes neuronales (RN) y máquinas de vector soporte (SVM). Para evaluar la exactitud de las técnicas de analítica del aprendizaje se realizó un análisis de varianza (ANOVA). Se compararon las técnicas de analítica del aprendizaje y de regresión lineal usando la validación cruzada. Los resultados mostraron que el compromiso conductual y la autoeficacia tuvieron efectos positivos en el desempeño del estudiante, mientras que la pasividad mostró un efecto negativo. Asimismo, las técnicas de RL y de SVM pronosticaron igualmente el desempeño académico de los estudiantes. La RL tuvo la ventaja de producir un modelo simple y de fácil interpretación. Por el contrario, la técnica de SVM generó un modelo más complejo, aunque, si el modelo tuviese como objetivo el pronóstico del desempeño, la técnica SVM sería la más adecuada, ya que no requiere la verificación de ningún supuesto estadístico.

Abstract The issue of school dropout involves factors such as students' engagement that can predict his or her success in school. It has been shown that student engagement has three components: behavioral, emotional and cognitive. Motivation and engagement are strongly related since the former is a precursor of engagement. The aim of this study was to compare the efficiency of linear regression against two data mining techniques to predict the students' academic performance in higher education. A descriptive cross-sectional study was carried out with 222 students from a public higher education institution in Mexico city. An analysis of hiererchical linear regression (LR) and learning analytics techniques such as neural networks (NN) and support vector machine (SVM) was conducted. To assess the accuracy of the learning analytics techniques, an analysis of variance (ANOVA) was carried out. The techniques were compared using cross validation. The results showed that behavioral engagement and self-efficacy had positive effects on student achievements, while passivity showed a negative effect. Likewise, the LR and SVM techniques had the same performance on predicting students' achievements. The LR has the advantage of producing a simple and easy model. On the contrary, the SVM technique generates a more complex model. Although, if the model were aimed to forecast the performance, the SVM technique would be the most appropriate, since it does not require to verify any statistical assumption.

Reduced organizational skills in adults with ADHD are due to deficits in persistence, not in strategies.

BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) is commonly associated with poor organizational skills, as per the definition of ADHD. However, the contribution of each of the following factors (and their interactions) to the aforementioned poor organization, while comparing individuals with and without ADHD, has not been analyzed in-depth: Work Organization; Communication Clarity; Punctuality; Goal-oriented behaviour; Assiduity; Workspace Organization; Strategies; and Attentiveness. The purpose is to examine the self-reported levels of organizational skills in adults with and without ADHD. METHODS: Seven hundred seventy-four (n = 303 with a diagnosis of ADHD) adults from the community were recruited online. Participants completed a measure of organizational skills and a screening measure of ADHD. RESULTS: Participants with a diagnosis of ADHD displayed lower scores than individuals without a diagnosis of ADHD on all organizational skills with the exception of using strategies to remain organized and learn new information. Higher levels of education were associated with higher levels of organizational skills. While there was no difference between males and females with ADHD, females without ADHD scored higher than males without ADHD. CONCLUSION: This study supports that individuals with ADHD can efficiently develop strategies, but may have difficulties using those strategies in a continuous manner. Suggestions to increase organizational skills in adults with ADHD are presented.

Consistent use of proactive control and relation with academic achievement in childhood.

As children become older, they better maintain task-relevant information in preparation of upcoming cognitive demands. This is referred to as proactive control, which is a key component of cognitive control development. However, it is still uncertain whether children engage in proactive control consistently across different contexts and how proactive control relates to academic abilities. This study used two common tasks-the AX Continuous Performance Task (AX-CPT) and the Cued Task-Switching Paradigm (CTS)-to examine whether proactive control engagement in 102 children (age range: 6.91-10.91 years) converges between the two tasks and predicts academic abilities. Proactive control indices modestly correlated between tasks in higher but not lower working-memory children, suggesting that consistency in proactive control engagement across contexts is relatively low during childhood but increases with working memory capacity. Further, working memory (but not verbal speed) predicted proactive control engagement in both tasks. While proactive control as measured by each task predicted math and reading performance, only proactive control measured by CTS additionally predicted reasoning, suggesting that proactive control can be used as a proxy for academic achievements.

Executive functions predict literacy and mathematics achievements: The unique contribution of cognitive flexibility in grades 2, 4, and 6.

Research has shown that cognitive flexibility plays a critical role in students' learning and academic achievement. However, the unique contribution of cognitive flexibility to academic achievement across schooling is not fully understood. Thus, this study tested whether cognitive flexibility explained a significant amount of variance in academic achievement (i.e., literacy and mathematics outcomes) across Grades 2, 4, and 6, above and beyond fluid intelligence, inhibitory control, working memory, attention, and planning. The sample included 243 second graders, 284 fourth graders, and 203 sixth graders. For Grades 4 and 6, we found that better performance on the flexibility score was associated with better academic outcomes after controlling for fluid intelligence, attention, inhibitory control, working memory, and planning. This effect was not observed for Grade 2. Our findings showed that cognitive flexibility is a key component for school achievement, particularly for older students.

Intermittent hypoxia and long-term neurological outcome: How are they related?

This review looks at data on potential associations between intermittent hypoxia (IH) and impaired neurodevelopment in infants and children. In extremely preterm infants (<28 wk gestation), such an association has been established based on a secondary analysis of Canadian Oxygen Trial data. These showed, in 997 infants, that the odds of developing cognitive or language impairment at 18 months corrected age were 3 times higher in infants who were in the highest decile for %time spent with events where pulse oximeter saturation (SpO2) was <80% for ≥1 min during their first 10 postnatal weeks compared to those who had very few such events after birth. In older term and preterm infants, the occurrence of 5 or more events with prolonged apnea and bradycardia during home monitoring was associated with 5 points less on the mental development index of the Bayley-II scales. For older children, associations between sleep-disordered breathing and impaired cognition/academic achievements have also been established, but not consistently, and it remains unclear whether this association is primarily mediated via IH or via sleep deprivation. Animal data show that IH may cause apoptosis particularly in the hippocampus. Although we need to stress that associations cannot prove causality, current evidence provides support for IH to be detected and prevented early. Future studies should focus on IH rather than on apnea/bradycardia.