First-grade students often encounter challenges in understanding and solving arithmetic word problems due to their limited reading comprehension abilities. Despite these difficulties, students may employ arbitrary strategies, such as combining numbers based on specific keywords, even if they lack a full understanding of the problems. Research suggests that effective mathematical reasoning involves the use of visual mental representations during the problem-solving process. To address this, some studies have explored methods to enhance students’ comprehension of word problems. Building on this, the current study explores the impact of first-grade pupils creating visual representations of problem situations on their comprehension and the number of correct solutions. In a typical math class, 45 first graders received a paper-and-pencil task, and, in a visual context, they solved similar problems after reading and illustrating the situation. The findings reveal that while most participants correctly represented the problem situations through drawing, about half struggled to determine the numeric solutions. Nevertheless, the visual context led to an increase in the number of correct problem solutions compared to the normal context, suggesting the potential benefits of incorporating visual representations in enhancing comprehension and problem-solving skills.

Background/Objectives: Cardiovascular diseases are the most important cause of mortality in chronic obstructive pulmonary disease (COPD). Speckle-tracking echocardiography (2D-STE) can be used for assessing atrial and ventricular function, and its role in COPD is underexplored. The main objective of this study was to investigate prognostic associations in patients with COPD using 2D-STE echocardiography and laboratory biomarkers. Methods: The study included 70 participants, divided into two groups: 55 patients diagnosed with COPD and 15 healthy controls. All four cardiac chambers were analyzed with standard ultrasound and 2D-STE techniques. We measured NT-proBNP and several oxidative stress biomarkers: reduced glutathione (GSH), the GSH/GSSG ratio, malondialdehyde (MDA), and Caspase-3. Results: An NT-proBNP level above 325 pg/mL independently predicts advanced COPD stages (GOLD grades 3 and 4), with statistically significant results at a 95% confidence interval (CI) (p = 0.001). Additionally, 2D-STE identified reduced right ventricular (RV) and left ventricular (LV) strain in COPD patients before changes in LV ejection fraction. RV and LV strain measurements (RV4CLS < −16.15%, RVFWSL < −18.6%, LV GLS < −19.45%) along with PASP > 37.5 mmHg are independent predictors of advanced COPD stages, demonstrating significance at a 95% CI (p = 0.001). A positive correlation was observed between NT-proBNP, ultrasound parameters assessing RV systolic function, LV longitudinal strain impairment, and PASP. Conclusions: NT-proBNP serves as an independent biomarker of pulmonary hypertension and secondary right heart overload and independently predicts advanced COPD stages (GOLD grades 3 and 4) alongside RV and LV strain measurements.