Background We and others have identified mutually-exclusive molecular subgroups of meningiomas, however, the implications of this classification for clinical prognostication remain unclear. Integrated genomic and epigenomic analyses implicate unique oncogenic processes associated with each subgroup, suggesting the potential for divergent clinical courses. The aim of this study was to understand the associated clinical outcomes of each subgroup, as this could optimize treatment for patients. Methods We analyzed outcome data for 469 meningiomas of known molecular subgroup, including extent-of-resection, post-operative radiation, surveillance imaging, and time to recurrence, when applicable. Statistical relationships between outcome variables and subgroup were assessed. Features previously associated with recurrence were further investigated after stratification by subgroup. We used Kaplan-Meier analyses to compare progression free survival, and identified factors significantly associated with recurrence using Cox proportional hazards modeling. Results Meningioma molecular subgroups exhibited divergent clinical courses at two years of follow-up, with several aggressive subgroups (NF2, PI3K, HH, TRAF7) recurring at an average rate of 22x higher than others (KLF4, POLR2A, SMARCB1). PI3K-activated tumors recurred earlier than other subgroups, but had intermediate long-term outcome. Among low-grade tumors, HH and TRAF7 meningiomas exhibited elevated recurrence compared to other subgroups. Recurrence of NF2 tumors was associated with male gender, high-grade, and elevated Ki-67. Multi-variate analysis identified molecular subgroup as an independent predictor of recurrence, along with grade and previous recurrence. Conclusion We describe distinct clinical outcomes and recurrence rates associated with meningioma molecular subgroups. Our findings emphasize the importance of genomic characterization to guide post-operative management decisions for meningiomas.

Teaching organic chemistry requires supporting learning strategies that meaningfully engage students with the challenging concepts and advanced problem-solving skills needed to be successful. Such meaningful learning experiences should encourage students to actively choose to incorporate new concepts into their existing knowledge frameworks by appealing to the cognitive, affective, and psychomotor domains of learning. This study provides a qualitative analysis of students’ meaningful learning experiences after completing three Writing-to-Learn (WTL) assignments in an organic chemistry laboratory course. The assignments were designed to appeal to the three domains necessary for a meaningful learning experience, and this research seeks to understand if and how the WTL assignments promoted students’ meaningful learning. The primary data collected were the students’ responses to open-ended feedback surveys conducted after each assignment. These responses were qualitatively analyzed to identify themes across students’ experiences about their meaningful learning. The feedback survey analysis was triangulated with interviews conducted after each assignment. The results identify how the assignments connected to students’ existing knowledge from other courses and indicate that assignment components such as authentic contexts, clear expectations, and peer review supported students’ meaningful learning experiences. These results inform how assignment design can influence students’ learning experiences and suggest implications for how to support students’ meaningful learning of organic chemistry through writing.