bluuebunny/crossref_metadata_2025 huggingface dataset:
E-learning policy in Saudi Arabia: Challenges and successes
Authors: Aljaber Abdullah
Published: May 2018

E-learning is a sector of Saudi Arabian education that is witnessing significant growth, particularly in higher education. This article aims to provide a historical overview of the development and evolution of e-learning in Saudi Arabia. With the Ministry of Higher Education at the core of education and e-learning, the article will explore recent e-learning-related developments in King Saud University, King Faisal University, King Abdulaziz University and the Saudi Electronic University. As part of this analysis, the article will explore the challenges that are being encountered and the strategies that each of these institutions is implementing to support and develop e-learning. It is equally important to evaluate the role played by international partners, particularly the UK and the US, in supporting e-learning financially, socially and technologically. The Kingdom of Saudi Arabia has obtained significant support from the US and UK, with both countries contributing to the establishment of an integrated model for e-learning curriculums and information management systems in Saudi Arabia. Finally, this analysis explores the growth potential of e-learning and the efforts being made to support Saudi Arabia’s growing university student population. The article includes an exploration of the methods of evaluating, securing and modifying the current systems.
Sustainability and learning: Aesthetic and creative responses in a digital culture
Authors: Sclater Madeleine
Published: May 2018

The research presented in this article strives to answer the question: how do we educate for sustainability? I have provided evidence that arts-based educational research methods and major cultural resources provide very rich learning experiences that extend across disciplinary boundaries and can be crafted into pedagogical practices that help orientate learners of all levels to issues of sustainability. The article addresses the challenge of developing pedagogies for socio-ecological sustainability across disciplines in higher education. I present three kinds of conceptual resources in support of this project: theoretical influences that provide a range of lenses through which I can focus on my research concerns and pedagogical developments; methodological innovations – the use of the Dérive combined with a narrative record; and real-world aesthetic resources derived from gallery visits, an architectural exploration and interactive, scientific visits to major botanical gardens in Europe. I also briefly outline the importance of research resources derived from my own interdisciplinary work in virtual worlds - technology enhanced learning (TEL). These resources have led to a fusion of ideas from my own empirical research and personal experiences and observations in the real world. The most significant outcome of my Dérive experiences is a reminder of the power of aesthetic and emotional responses in learning activities. The blending of digital and analogue conceptual resources has synergised my thinking about pedagogies of sustainability, and increased my understanding of the importance of engagement with the real world, the role of emotion in learning and the power of experiential learning. I argue that personal and collective responses to artwork can act synergistically, and that community learning and individual learning are linked in informal settings, as evidenced by the Dérives presented in this article.
Suspected dietary-related Wernicke’s encephalopathy
Authors: Pugh Gregory , Iqbal Hassan , Bramall Jon
Published: May 2018

A 64-year-old female presented with fluctuating level of consciousness of unclear cause. She had radiological features of right middle lobe consolidation and raised inflammatory markers, but normal computed tomography scan of head and normal cerebrospinal fluid results. She was intubated and ventilated with nasogastric feeding for four days and had fully recovered after six days. Upon recovery, the patient disclosed that she had maintained an ice cream-only diet for three years prior to this presentation. She was therefore diagnosed with Wernicke’s encephalopathy secondary to dietary insufficiency of thiamine, which was acutely precipitated by pneumonia and recovered following establishment of appropriate nutrition.
Spina bifida in pregnancy: A review of the evidence for preconception, antenatal, intrapartum and postpartum care
Authors: Sivarajah Kenga , Relph Sophie , Sabaratnam Radha , Bakalis Spyros
Published: May 2018

Women with spina bifida in pregnancy require complex multi-disciplinary management. Most women have uncomplicated pregnancies; however, complications are more frequent than in ‘low risk’ pregnancies. Careful antenatal planning and management of the complications can optimise outcome. There are currently no guidelines on the management of pregnant women with spina bifida, but there is a growing body of evidence from case reports and series examining the antenatal and postnatal course of these women. In this review, we examine the available literature and provide a framework on the prenatal counselling, antenatal, intrapartum and postnatal management of pregnant women with spina bifida.
Using anti-Xa level for adjusting intravenous unfractionated heparin infusion in peripartum thromboembolic disease
Authors: Tse Enrica , Khurana Rshmi , Clarke Gwen , Sia Winnie
Published: May 2018

Background

Intravenous unfractionated heparin infusion is often used to minimize the duration of time without anticoagulation around delivery in pregnant patients with high thrombotic risk. Activated partial thromboplastin time is commonly used to monitor and adjust heparin dose. However, using activated partial thromboplastin time is problematic in pregnancy because activated partial thromboplastin time response to unfractionated heparin is attenuated due to elevated Factor VIII levels and may lead to incorrect dosing.

Case

We report a case of deep venous thrombosis occurring in a term pregnancy managed by intravenous unfractionated heparin adjusted using anti-Xa level around the time of delivery. We modified the intravenous unfractionated heparin nomogram by using anti-Xa levels instead of activated partial thromboplastin time and observed lower dosing of unfractionated heparin than otherwise required to achieve and maintain target levels.

Conclusion

This report demonstrates the feasibility and effectiveness of using anti-Xa level to monitor and adjust intravenous unfractionated heparin infusion in pregnancy.
The matter of the reproductive microbiome
Authors: Schoenmakers Sam , Steegers-Theunissen Regine , Faas Marijke
Published: May 2018

The preconceptional presence of microbiota in the female and male reproductive organs suggests that fertilization is taking place in a nonsterile environment and contributes to reproductive success. The concept of embryonic development in a sterile uterus has also been challenged with recent reports of the existence of a microbiome of the placenta, amniotic fluid and the fetal gut in normal, uncomplicated pregnancies. The maternal origins of the microbiota colonising the fetus and its surroundings are unknown as are the mechanisms of maternal-to-fetal transfer. In this review, we aim to highlight the preconception male and female microbiome, the maternal vaginal and gut microbiome during pregnancy and the fetal microbiome, including their possible roles in reproduction, and maternal and neonatal pregnancy outcome.
Subacute Sclerosing Panencephalitis Presenting as Choreoathetosis and Basal Ganglia Hyperintensities
Authors: Tandra Harish Varma , Roy Pritam Singha , Sharma Rahul , Bhatia Vikas , Saini Arushi Gahlot
Published: May 2018

Subacute sclerosing panencephalitis is a devastating neurodegenerative disorder characterized by cognitive and memory deterioration, personality changes, behavior abnormalities, and a steady motor decline. Extrapyramidal manifestations are commonly seen in the advanced stage of the disease. We discuss a 10-year-old boy with subacute sclerosing panencephalitis presenting with generalized choreoathetosis, myoclonus, and cognitive decline. He had not been immunized for measles. His elder sister had a viral exanthematous illness 4 years ago. Magnetic resonance imaging revealed bilateral, asymmetric putaminal hyperintensities. A diagnosis of subacute sclerosing panencephalitis was confirmed by periodic complexes in the electroencephalograph and elevated antimeasles antibody titers in the blood and cerebrospinal fluid (1:625). Our case highlights that atypical clinical and radiological features of subacute sclerosing panencephalitis should always be borne in mind in children from endemic areas. Generalized choreoathetosis and bilateral putaminal involvement in the index case add to the spectrum of atypical presentations of subacute sclerosing panencephalitis in children.
Achievement of low-density lipoprotein cholesterol goals in 18 countries outside Western Europe: The International ChoLesterol management Practice Study (ICLPS)
Authors: Danchin Nicolas , Almahmeed Wael , Al-Rasadi Khalid , Azuri Joseph , Berrah Abdelkrim , Cuneo Carlos Alberto , Karpov Yuri , Kaul Upendra , Kayıkçıoğlu Meral , Mitchenko Olena , Ruiz Alvaro J , Aguilar Salinas Carlos A , Santos Raul D , Mercier Florence , Blom Dirk ,   for the ICLPS Investigators
Published: May 2018

Background

Little is known about the achievement of low density lipoprotein cholesterol (LDL-C) targets in patients at cardiovascular risk receiving stable lipid-lowering therapy (LLT) in countries outside Western Europe.

Methods

This cross-sectional observational study was conducted in 452 centres (August 2015−August 2016) in 18 countries in Eastern Europe, Asia, Africa, the Middle East and Latin America. Patients ( n = 9049) treated for ≥3 months with any LLT and in whom an LDL-C measurement on stable LLT was available within the previous 12 months were included.

Results

The mean±SD age was 60.2 ± 11.7 years, 55.0% of patients were men and the mean ± SD LDL-C value on LLT was 2.6 ± 1.3 mmol/L (101.0 ± 49.2 mg/dL). At enrolment, 97.9% of patients were receiving a statin (25.3% on high intensity treatment). Only 32.1% of the very high risk patients versus 51.9% of the high risk and 55.7% of the moderate risk patients achieved their LDL-C goals. On multivariable analysis, factors independently associated with not achieving LDL-C goals were no (versus lower dose) statin therapy, a higher (versus lower) dose of statin, statin intolerance, overweight and obesity, female sex, neurocognitive disorders, level of cardiovascular risk, LDL-C value unknown at diagnosis, high blood pressure and current smoking. Diabetes was associated with a lower risk of not achieving LDL-C goals.

Conclusions

These observational data suggest that the achievement of LDL-C goals is suboptimal in selected countries outside Western Europe. Efforts are needed to improve the management of patients using combination therapy and/or more intensive LLTs.
Seeking virtual social support through blogging: A content analysis of published blog posts written by people with chronic pain
Authors: Tsai Samuel , Crawford Emma , Strong Jenny
Published: May 2018

Objective

People with chronic pain often have limited avenues for social support. Social isolation often develops as their abilities to engage in daily social and vocational activities decrease. With recent advancements in technology and increasing use of social media, virtual platforms such as blogging may provide opportunities for social support. This study analyzed published blog posts of people with chronic pain to investigate how social support occurs through blogging for chronic pain blog users and the nature of such online interactions.

Methods

A total of 810 blog posts published from January 2014 to December 2015 on 44 publicly accessible chronic pain blogs were collected and analyzed through qualitative phenomenological thematic analysis.

Results

The Virtual Online Support Sequence (VOSS) was identified through the exchange of online comments; this sequence defines the process by which virtual social support can be established through the process of chronic pain blogging. Three subthemes were also identified in relation to social support in the online blogging environment: (a) the virtual community of pain blogging; (b) establishing social support through the VOSS; and (c) recounting everyday experiences related to pain.

Conclusions

These findings suggest that blogging can be useful in seeking, receiving and providing social support for people with chronic pain. Understanding this mechanism behind establishing virtual social support may potentially encourage people with chronic pain to pursue additional support online if they have limited face-to-face opportunities.
Dietary Intake, Attitudes toward Healthy Food, and Dental Pain in Low-Income Youth
Authors: Nicksic N.E. , Massie A.W. , Byrd-Williams C.E. , Kelder S.H. , Sharma S.V. , Butte N.F. , Hoelscher D.M.
Published: May 2018

Few studies have examined the relation between food consumption and related attitudes and dental pain among children. The objective of this study is to examine the associations of healthy and unhealthy food items, attitudes toward healthy food, and self-efficacy of eating healthy with dental pain among children. A cross-sectional analysis was performed using child survey data from the Texas Childhood Obesity Research Demonstration (TX CORD) project. Fifth-grade students ( n = 1,020) attending 33 elementary schools in Austin and Houston, Texas, completed the TX CORD Child Survey, a reliable and valid survey instrument focused on nutrition and physical activity behaviors. All nutrition questions ask about the number of times food and beverage items were consumed on the previous day. Dental pain was reported as mouth or tooth pain in the past 2 wk that made their mouth hurt so much that they could not sleep at night. Mixed-effects logistic regression models were used to test the association between 10 unhealthy food items, 9 healthy food items, 2 health attitudes, and self-efficacy with dental pain. All models controlled for sociodemographic variables. In total, 99 (9.7%) students reported dental pain. Dental pain was associated with intake of the following unhealthy items: soda, fruit juice, diet soda, frozen desserts, sweet rolls, candy, white rice/pasta, starchy vegetables, French fries/chips, and cereal (adjusted odds ratio [AOR], 1.27–1.81, P < 0.01). The intake of other vegetables (AOR, 1.56; P < 0.01), a healthy item, and the attitude that healthy food tastes good (AOR, 1.59; P = 0.04) were also positively associated with dental pain. The attitude of eating healthier leads to fewer health problems (AOR, 0.50) and self-efficacy for healthy eating (AOR, 0.44) were negatively associated with dental pain ( P < 0.01). Interventions should focus on improving oral health by reducing intake of unhealthy foods and educating children and families on the importance of diet as a means of reducing dental caries.

Knowledge Transfer Statement: The results of this study can be used to inform researchers on potential food items and psychosocial measures to examine in low-income, minority populations for longitudinal research. These results would also be useful to educators who could incorporate oral health care and nutrition education into school curriculums.
关于 “有朋自远方来” 原为 “友朋自远方来” 之可能性
Authors: 大形彻
Published: May 2018

摘要

《论语 · 学而》开头的 “有朋自远方来” 的 “有” 字自古以来很少有异议, 大多作存在状态解。考虑到 《论语》的成书过程笔者认为这一说法并非完全不能商榷。本文对比了《论语》各版本以及敦煌抄本的文字 异同, 结合历代注、疏中的说法对 “有朋” 写为 “友朋” 的实例进行了分析。进一步, 我们梳理了 “又” 、 “有” 、 “友” 、 “有” 之间的通假字关系, 对 “有朋” 或为 “友朋” 的可能性进行了考察。另外还结合了以往日本学者对《论语》的训读读法, 以及现代汉语翻译的实例, 对本文的观点进行了补充。
Ammoniovoltaite, (NH4)2Fe2+5Fe3+3Al(SO4)12(H2O)18, a new mineral from the Severo-Kambalny geothermal field, Kamchatka, Russia
Authors: Zhitova Elena S. , Siidra Oleg I. , Belakovsky Dmitry I. , Shilovskikh Vladimir V. , Nuzhdaev Anton A. , Ismagilova Rezeda M.
Published: May 2018

Ammoniovoltaite, (NH4)2Fe2+5Fe3+3Al(SO4)12(H2O)18, is a new voltaite-group mineral. The mineral was discovered at the Severo-Kambalny (North-Kambalny) geothermal field, Kambalny volcanic ridge, Southern Kamchatka, Russia. Ammoniovoltaite forms at ~100°C around geothermal gas/steam vents in association with alunogen, tschermigite and pyrite. Crystals of ammoniovoltaite have euhedral habit, are up to 50 µm in size and grow on alunogen plates. Ammoniovoltaite is black with vitreous lustre, opaque, brittle and water-soluble. Neither cleavage nor parting is found, the fracture is conchoidal. The mineral is isotropic, with the refractive index n = 1.602(2) (589 nm). Infrared spectra contain an absorption band at 1433 cm–1 distinctive for the ammonium ion. The chemical composition is (iron content is given in accordance with Mössbauer data, H2O calculated from a crystal-structure refinement, wt.%): FeO 13.26, Fe2O3 11.58, MgO 2.33, ZnO 0.04, Al2O3 2.74, SO3 47.46, K2O 0.19, CaO 0.11, (NH4)2O 2.96, H2O 16.03, total 96.70. The empirical formula based on S = 12 atoms per formula unit is [(NH4)1.88K0.08Ca0.04]Σ2.00(Fe2+3.74Mg1.17Fe3+0.05Zn0.01)Σ4.97(Fe3+2.89Al0.09)Σ2.98Al1.00(SO4)12.00(H2O)18.00. The crystal structure has been refined to R1 = 0.031 and 0.030 on the basis of 1217 and 1462 unique reflections with I >2σ(I) collected at 100 K and room temperature, respectively. Ammoniovoltaite is the ammonium analogue of voltaite. The mineral is cubic, Fd$\bar{3}$c, a = 27.250(1) Å and V = 20234(3) Å3 (at 100 K); and a = 27.322(1) Å and V = 20396(3) Å3 (at RT), with Z = 16. The strongest lines of the powder X-ray diffraction pattern [d, Å (I, %) (hkl)] are: 9.67 (74) (022), 7.90 (56) (222), 5.58 (84) (422), 3.560 (100) (731), 3.418 (100) (008) and 2.8660 (37) (931). A brief review of ammonium minerals from various volcanically active geological environments is given.
Somersetite, Pb8O(OH)4(CO3)5, a new complex hydrocerussite-related mineral from the Mendip Hills, England
Authors: Siidra Oleg I. , Nekrasova Diana O. , Turner Rick , Zaitsev Anatoly N. , Chukanov Nikita V. , Polekhovsky Yury S. , Spratt John , Rumsey Mike S.
Published: May 2018

The new mineral somersetite, has been found at Torr Works (‘Merehead quarry’) in Somerset, England, United Kingdom. Somersetite is green or white (typically it is similar visually to hydrocerussite-like minerals but with a mint-green tint), forms plates and subhedral grains up to 5 mm across and up to 2 mm thick. In bi-coloured crystals it forms very thin intergrowths with plumbonacrite. The empirical formula of somersetite is Pb8.00C5.00H4.00O20. The simplified formula is Pb8O(OH)4(CO3)5, which requires: PbO = 87.46, CO2= 10.78, H2O = 1.76, total 100.00 wt.%.

The infrared spectrum of somersetite is similar to that of plumbonacrite and, to a lesser degree, hydrocerussite. Somersetite is hexagonal,P63/mmc,a= 5.2427(7),c= 40.624(6) Å,V= 967.0(3) Å3andZ= 2. The eight strongest reflections of the powder X-ray diffraction (XRD) pattern [d,Å(I)(hkl)] are: 4.308(33)(103), 4.148(25)(104), 3.581(40)(107), 3.390(100)(108), 3.206(55)(109), 2.625(78)(110), 2.544(98)(0.0.16) and 2.119(27)(1.0.17). The crystal structure was solved from single-crystal XRD data givingR1= 0.031. The structure of somersetite is unique and consists of the alternation of the electroneutral plumbonacrite-type [Pb5O(OH)2(CO3)3]0and hydrocerussite-type [Pb3(OH)2(CO3)2]0blocks separated by stereochemically active lone electron pairs on Pb2+. There are two blocks of each type per unit cell in the structure, which corresponds to the formula [Pb5O(OH)2(CO3)3][Pb3(OH)2(CO3)2] or Pb8O(OH)4(CO3)5in a simplified representation. The 2Dblocks are held together by weak Pb–O bonds and weak interactions between lone pairs.
Graftonite-(Mn), ideallyM1MnM2,M3Fe2(PO4)2, and graftonite-(Ca), ideallyM1CaM2,M3Fe2(PO4)2, two new minerals of the graftonite group from Poland
Authors: Pieczka Adam , Hawthorne Frank C. , Ball Neil , Abdu Yassir , Gołębiowska Bożena , Włodek Adam , Żukrowski Jan
Published: May 2018

Two new minerals of the graftonite group, graftonite-(Mn), ideallyM(1)MnM(2),M(3)Fe2(PO4)2, and graftonite-(Ca), ideallyM(1)CaM(2),M(3)Fe2(PO4)2, were discovered in phosphate nodules of two beryl–columbite–phosphate pegmatites at Lutomia and Michałkowa, respectively, in the Góry Sowie Block, Lower Silesia, southwest Poland. Graftonite-(Mn) is pinkish brown, whereas graftonite-(Ca) shows more brownish colouration. Both minerals have a vitreous lustre, a good cleavage observed along (010) and irregular fracture; both are transparent and neither of them is fluorescent. They are brittle and have a Mohs hardness of ~5. The minerals are non-pleochroic, colourless in all orientations, biaxial (+), with mean refractive indices α = 1.710(2) and 1.690(2), β = 1.713(2) and 1.692(2), and γ = 1.725(2) and 1.710(5), respectively. With complete order of Ca at theM(1) site, the formulae of the holotype crystals areM(1)(Mn0.70Ca0.30)M(2),M(3)(Fe1.34Mn0.60Mg0.06Zn0.01)Σ3(PO4)2for graftonite-(Mn) andM(1)(Ca0.98Mn0.02)M(2),M(3)(Fe1.38Mn0.56Mg0.05)Σ3(PO4)2for graftonite-(Ca). Both crystal chemistry and crystal-structure refinement (R1= 2.34 and 1.63%, respectively) indicate that theM(1) site is occupied dominantly by Mn in graftonite-(Mn) and by Ca in graftonite-(Ca), and theM(2) andM(3) sites are occupied by Fe2+and Mn2+, with Fe2+dominant over Mn2+at the aggregateM(2) +M(3) sites. Graftonite-(Mn) and graftonite-(Ca) are isostructural with graftonite,M(1)FeM(2),M(3)Fe2(PO4)2(monoclinic system; space-group symmetryP21/c), with the unit-cell parametersa= 8.811(2) Å,b= 11.494(2) Å,c= 6.138(1) Å, β = 99.23(3)° and V = 613.5(4) Å3, anda= 8.792(2) Å,b= 11.743(2) Å,c= 6.169(1) Å, β = 99.35(3)° andV= 628.5(1) Å3, respectively. The densities calculated on the basis of molar weights and unit-cell volumes are 3.793 g/cm3for graftonite-(Mn) and 3.592 g/cm3for graftonite-(Ca). The eight strongest lines in powder X-ray diffraction patterns on the basis of single-crystal data are, respectively [d, Å,I(hkl)]: 2.874, 100, (230 + 040); 2.858, 79, (221); 3.506, 73, (130); 2.717, 79, ($\bar{3}$11); 2.952, 55, (131); 2.916, 53, ($\bar{1}$12); 2.899, 44, (300); 3.016, 35, ($\bar{1}$02); and 3.654, 100, (130); 2.979, 85, (221); 3.014, 77, (230); 3.042, 76, (040 +$\bar{1}$12); 2.834, 68, ($\bar{3}$11); 3.097, 57, (131); 3.133, 56, ($\bar{1}$02); 2.542, 30, (311). Both minerals are common primary phosphates in phosphate nodules, occurring as lamellar intergrowths with sarcopside ± triphylite/lithiophilite, products of exsolution from a (Li,Ca)-rich graftonite-like parent phase crystallized at high temperature from P-bearing hydrosaline melts.
What's in a name? That which we call IPF, by any other name would act the same
Authors: Wells Athol U. , Brown Kevin K. , Flaherty Kevin R. , Kolb Martin , Thannickal Victor J.
Published: May 2018

Idiopathic pulmonary fibrosis (IPF) remains a truly idiopathic fibrotic disease, with a modest genetic predilection and candidate triggers but no overall explanation for the development of disease in non-familial cases. Agreement on terminology has contributed to major clinical and translational advances since the millennium. It is likely that the entity currently captured by the term “IPF” will be radically reclassified over the next decade, either through “splitting” (into IPF subgroups responding selectively to individual disease-modifying agents) or through “lumping” of IPF with other forms of progressive fibrotic lung disease (with shared pathogenetic mechanisms and IPF-like disease behaviour). In this perspective, we summarise the clinical and pathogenetic justification for a focus on “the progressive fibrotic phenotype” in future clinical and translational research. By this means, we can hope to address the needs of non-IPF patients with inexorably progressive fibrotic disease, currently disenfranchised by lack of access to agents that are efficacious in IPF. In this regard, ongoing trials of anti-fibrotic therapies in non-IPF patients with progressive fibrosis may be highly influential. Future revision of IPF nomenclature may be warranted if there are major conceptual changes but without compelling justification, the benefits of renaming IPF are likely to be outweighed by the resulting confusion.
Prognostic value of cardiovascular parameters in computed tomography pulmonary angiography in patients with acute pulmonary embolism
Authors: Beenen Ludo F.M. , Bossuyt Patrick M.M. , Stoker Jaap , Middeldorp Saskia
Published: May 2018

The value of various computed tomography parameters for prognosis and risk stratification in acute pulmonary embolism is controversial. Our objective was to evaluate the impact of specific cardiovascular computed tomography pulmonary angiography parameters on short- and long-term clinical outcomes.

We analysed radiological and clinical data of 1950 patients with acute pulmonary embolism who participated in an international randomised clinical trial on anticoagulants. Parameters included right/left ventricular ratio, septal bowing, cardiothoracic ratio, diameters of pulmonary trunk and aorta, and intrahepatic/azygos vein contrast medium backflow. Associations with mortality, recurrent venous thromboembolism (VTE), hospitalisation, bleeding and adverse events were assessed over the short term (1 week and 1 month) and long term (12 months).

Pulmonary trunk enlargement was the only parameter significantly associated with mortality over both the short and long term (OR 4.18 (95% CI 1.04–16.76) at 1 week to OR 2.33 (95% CI 1.36–3.97) after 1 year), as well as with recurrent VTE and hospitalisation.

Most of the evaluated radiological parameters do not have strong effects on the short- or long-term outcome in patients with acute pulmonary embolism. Only an enlarged pulmonary trunk diameter carries an increased risk of mortality and recurrent VTE up to 12 months, and can be used for risk stratification.
S-25OHD Is Associated With Hand Grip Strength and Myopathy at 5 Years in Girls: An Odense Child Cohort Study
Authors: Al-Jwadi Rada Faris , Jespersen Eva , Dalgård Christine , Bilenberg Niels , Christesen Henrik Thybo
Published: May 2018

Context

Severe vitamin D deficiency may lead to myopathy in adults. Little is known about vitamin D and muscle strength in children.

Objective

To test whether hand grip strength (HGS) in 5-year-old children is associated with serum 25-hydroxyvitamin D (S-25OHD).

Design

Observational study in the population-based Odense Child Cohort, Denmark. At 5 years, anthropometrics, body fat percentage by skinfold measurements, HGS (n = 881), and S-25OHD2+3 (n = 499) were obtained.

Results

Mean (SD) HGS was higher for boys compared with girls [8.76 (1.76) vs 8.1 (1.64) kg, P < 0.001]. Mean (SD) 5-year S-25OHD was 70.7 (24.5) nmol/L. HGS was directly associated with height in girls and with weight (directly) and body fat percentage (inversely) in both sexes (P < 0.01 for all). In girls, 5-year S-25OHD was associated with HGS, adjusting for height, weight, and body fat percentage [β = 0.011 (95% CI: 0.004; 0.019), P = 0.003]. S-25OHD ≥75 nmol/L was associated with higher HGS compared with values <50 nmol/L [adjusted β = 0.783 (95% CI: 0.325; 1.241), P = 0.001]. The odds of having myopathy (HGS <10th percentile) were reduced by approximately 70% for S-25OHD ≥50 vs <50 nmol/L [adjusted OR: 0.310 (95% CI: 0.126; 0.762), P = 0.011]. No associations were seen for boys. Pregnancy or umbilical cord S-25OHD did not associate with 5-year HGS.

Conclusions

Five-year S-25OHD was independently associated with HGS and myopathy in girls but not in boys. Muscle strength may be dependent on vitamin D status even in the higher range in preschool girls. The sex difference remains unexplained.
Altered Asparagine and Glutamate Homeostasis Precede Coronary Artery Disease and Type 2 Diabetes
Authors: Ottosson Filip , Smith Einar , Melander Olle , Fernandez Céline
Published: May 2018

Context

Type 2 diabetes mellitus (T2DM) is accompanied by an increased risk for coronary artery disease (CAD), but the overlapping metabolic disturbances preceding both diseases are insufficiently described.

Objective

We hypothesized that alterations in metabolism occur years before clinical manifestation of T2DM and CAD and that these alterations are reflected in the plasma metabolome. We thus aimed to identify plasma metabolites that predict future T2DM and CAD.

Design

Through use of targeted liquid chromatography-mass spectrometry, 35 plasma metabolites (amino acid metabolites and acylcarnitines) were quantified in 1049 individuals without CAD and diabetes, drawn from a population sample of 5386 in the Malmö Preventive Project (mean age, 69.5 years; 31% women). The sample included 204 individuals who developed T2DM, 384 who developed CAD, and 496 who remained T2DM and CAD free during a mean follow-up of 6.1 years.

Results

In total, 16 metabolites were significantly associated with risk for developing T2DM according to logistic regression models. Glutamate (OR, 1.96; P = 5.4e-12) was the most strongly associated metabolite, followed by increased levels of branched-chain amino acids. Incident CAD was predicted by three metabolites: glutamate (OR, 1.28; P = 6.6e-4), histidine (OR, 0.76; P = 5.1e-4), and asparagine (OR, 0.80; P = 2.2e-3). Glutamate (OR, 1.48; P = 1.6e-8) and asparagine (OR, 0.75; P = 1.8e-5) were both associated with a composite endpoint of developing T2DM or CAD.

Conclusion

Several plasma metabolites were associated with incidence of T2DM and CAD; elevated glutamate and reduced asparagine levels were associated with both diseases. We thus discovered associations that might help shed additional light on why T2DM and CAD commonly co-occur.
Regression: The Apple Does Not Fall Far From the Tree
Authors: Vetter Thomas R. , Schober Patrick
Published: May 2018

Researchers and clinicians are frequently interested in either: (1) assessing whether there is a relationship or association between 2 or more variables and quantifying this association; or (2) determining whether 1 or more variables can predict another variable. The strength of such an association is mainly described by the correlation. However, regression analysis and regression models can be used not only to identify whether there is a significant relationship or association between variables but also to generate estimations of such a predictive relationship between variables. This basic statistical tutorial discusses the fundamental concepts and techniques related to the most common types of regression analysis and modeling, including simple linear regression, multiple regression, logistic regression, ordinal regression, and Poisson regression, as well as the common yet often underrecognized phenomenon of regression toward the mean. The various types of regression analysis are powerful statistical techniques, which when appropriately applied, can allow for the valid interpretation of complex, multifactorial data. Regression analysis and models can assess whether there is a relationship or association between 2 or more observed variables and estimate the strength of this association, as well as determine whether 1 or more variables can predict another variable. Regression is thus being applied more commonly in anesthesia, perioperative, critical care, and pain research. However, it is crucial to note that regression can identify plausible risk factors; it does not prove causation (a definitive cause and effect relationship). The results of a regression analysis instead identify independent (predictor) variable(s) associated with the dependent (outcome) variable. As with other statistical methods, applying regression requires that certain assumptions be met, which can be tested with specific diagnostics.
When the Cherokee Became Indigenous:Cherokee Nation v. Georgiaand its Paradoxical Legalities
Authors: Bens Jonas
Published: May 2018

When representatives of the Cherokee nation went to the US Supreme Court in 1831 to sue the state of Georgia, they initiated a paradoxical endeavor. They argued that they were a “foreign state,” but subjected themselves at the same time to the jurisdiction of the court of another state. In the course of this campaign, they transformed themselves from a political to a legal subject and took the position of what today would be called an “indigenous” community. The court translated the paradoxical formation of indigeneity—being legally incorporated and excluded at the same time—into the legal text of the judgment by inventing the contradictory phrase “domestic dependent nation.” Analyzing as an autoethnographic text the bill that the Cherokee nation presented to the Supreme Court, this essay investigates how the Cherokee’s indigeneity was produced in their interaction with the legal field of the (post)colonial state and how the paradoxical roots of indigeneity can serve as a starting point from which to rethink the native-settler relationship and the indigenous condition.
Material Enactments
Authors: Steinmetz Julia
Published: May 2018

Artists Cassils and Yishay Garbasz offer up a series of material enactments on and through the body that articulate a transformational aesthetics of trans subjectivity, one less concerned with representation than with actions and their indexical impacts. Both artists seek out, create, and become transformational objects for the alteration of self-experience. In so doing, each stretches and exceeds the limits of the identitarian, holding together the complexities of conflict and leaving room for the work of the unconscious in expansive imaginings of what it is to act as an artist in the sphere of the political while inhabiting the messy materiality of the body in the world. As viewers, we are drawn into complex dynamics of enacting the desires and fantasies of the psyche on, in, and through the materiality of the flesh.
A temperature-adjusted developmental timer for precise embryonic staging
Authors: Winkley Konner , Veeman Michael
Published: May 2018

Developmental biology research depends on careful staging of developing embryos, but the rate of development is extremely sensitive to the temperature at which embryos are raised. It is not always practical to grow embryos at a precisely controlled temperature, so here we describe a simple, inexpensive device based on an Arduino-compatible microprocessor and temperature sensor that provides a metric of developmental time that is compensated for changes in temperature. The underlying assumption is that the rate of development will be linear with respect to temperature over an organism's thermal tolerance range. The device measures the ambient temperature and integrates effective degree-minutes over time. For convenience, this is displayed to the user as a temperature-adjusted standard developmental time. In initial testing we have found the device to be extremely helpful for fixing Ciona embryos during precise developmental windows.
The Hippo pathway effector Wwtr1 regulates cardiac wall maturation in zebrafish
Authors: Lai Jason K. H. , Collins Michelle M. , Uribe Veronica , Jiménez-Amilburu Vanesa , Günther Stefan , Maischein Hans-Martin , Stainier Didier Y. R.
Published: May 2018

Cardiac trabeculation is a highly regulated process that starts with the delamination of compact layer cardiomyocytes. The Hippo signaling pathway has been implicated in cardiac development but many questions remain. We have investigated the role of Wwtr1, a nuclear effector of the Hippo pathway, in zebrafish and find that its loss leads to reduced cardiac trabeculation. However, in mosaic animals, wwtr1−/− cardiomyocytes contribute more frequently than wwtr1+/− cardiomyocytes to the trabecular layer of wild-type hearts. To investigate this paradox, we examined the myocardial wall at early stages and found that compact layer cardiomyocytes in wwtr1−/− hearts exhibit disorganized cortical actin structure and abnormal cell-cell junctions. Accordingly, wild-type cardiomyocytes in mosaic mutant hearts contribute less frequently to the trabecular layer than when present in mosaic wild-type hearts, indicating that wwtr1−/− hearts are not able to support trabeculation. We also found that Nrg/Erbb2 signaling, which is required for trabeculation, could promote Wwtr1 nuclear export in cardiomyocytes. Altogether, these data suggest that Wwtr1 establishes the compact wall architecture necessary for trabeculation, and that Nrg/Erbb2 signaling negatively regulates its nuclear localization and therefore its activity.
A blood capillary plexus-derived population of progenitor cells contributes to genesis of the dermal lymphatic vasculature during embryonic development
Authors: Pichol-Thievend Cathy , Betterman Kelly L. , Liu Xiaolei , Ma Wanshu , Skoczylas Renae , Lesieur Emmanuelle , Bos Frank L. , Schulte Dorte , Schulte-Merker Stefan , Hogan Benjamin M. , Oliver Guillermo , Harvey Natasha L. , Francois Mathias
Published: May 2018

Despite the essential role of the lymphatic vasculature in tissue homeostasis and disease, knowledge of the organ-specific origins of lymphatic endothelial progenitor cells remains limited. The assumption that most murine embryonic lymphatic endothelial cells (LECs) are venous derived has recently been challenged. Here, we show that the embryonic dermal blood capillary plexus constitutes an additional, local source of LECs that contributes to the formation of the dermal lymphatic vascular network. We describe a novel mechanism whereby rare PROX1-positive endothelial cells exit the capillary plexus in a Ccbe1-dependent manner to establish discrete LEC clusters. As development proceeds, these clusters expand and further contribute to the growing lymphatic system. Lineage tracing and analyses of Gata2-deficient mice confirmed that these clusters are endothelial in origin. Furthermore, ectopic expression of Vegfc in the vasculature increased the number of PROX1-positive progenitors within the capillary bed. Our work reveals a novel source of lymphatic endothelial progenitors employed during construction of the dermal lymphatic vasculature and demonstrates that the blood vasculature is likely to remain an ongoing source of LECs during organogenesis, raising the question of whether a similar mechanism operates during pathological lymphangiogenesis.
Simulated work-loops predict maximal human cycling power
Authors: Martin James C. , Nichols Jennifer A.
Published: May 2018

Fish, birds, and lizards sometimes perform locomotor activities with maximized muscle power. Whether humans maximize muscular power is unknown because current experimental techniques cannot be applied non-invasively. This study uses simulated muscle work loops to examine whether voluntary maximal cycling is characterized by maximized muscle power. The simulated work loops leverage experimentally measured joint angles, anatomically realistic muscle parameters (muscle-tendon lengths, velocities, and moment arms), and a published muscle model to calculate powers and forces for thirty-eight muscles. For each muscle, stimulation onset and offset were optimized to maximize muscle work and power for the complete shortening/lengthening cycle. Simulated joint powers and total leg power (i.e., summed muscle powers) were compared to previously reported experimental joint and leg powers. Experimental power values were closely approximated by simulated maximal power for the leg (intraclass correlation coefficient (ICC)=0.91), the hip (ICC=0.92), and knee (ICC=0.95), but less closely for the ankle (ICC=0.74). Thus, during maximal cycling, humans maximize muscle power at the hip and knee, but the ankle acts to transfer (instead of maximize) power. Given that only the timing of muscle stimulation onsets and offsets were altered, these results suggest that human motor control strategies may optimize muscle activations to maximize power. The simulations also provide insights into biarticular muscles by demonstrating that the powers at each joint spanned by a biarticular muscle can be substantially greater than the net power produced by the muscle. Our work loop simulation technique may be useful for examining clinical deficits in muscle power production.
Psychological and Behavioral Responses to Interval and Continuous Exercise
Authors: STORK MATTHEW J. , GIBALA MARTIN J. , MARTIN GINIS KATHLEEN A.
Published: May 2018

Purpose

To compare psychological responses to, and preferences for, moderate-intensity continuous training (MICT), high-intensity interval training (HIIT), and sprint interval training (SIT) among inactive adults; and to investigate the relationships between affect, enjoyment, exercise preferences, and subsequent exercise behavior over a 4-wk follow-up period.

Methods

Thirty inactive men and women (21.23 ± 3.81 yr), inexperienced with HIIT or SIT, completed three trials of cycle ergometer exercise in random order on separate days: MICT (45 min continuous; approximately 70% to 75% of HR maximum (HRmax)); HIIT (10 × 1 min bouts at approximately 85% to 90% HRmax with 1-min recovery periods); and SIT (3 × 20-s “all-out” sprints with 2-min recovery periods). Perceived exertion (RPE), affect, and arousal were measured throughout the trials and enjoyment was measured postexercise. Participants rank-ordered the protocols (1–3) according to preference and logged their exercise over a 4-wk follow-up.

Results

Despite elevated HR, RPE, and arousal during work periods (P’s < 0.05), and negative affect during HIIT and SIT, enjoyment and preferences for MICT, HIIT, and SIT were similar (P’s > 0.05). In-task affect was predictive of postexercise enjoyment for each type of exercise (r’s = 0.32 to 0.47; P’s < 0.05). In-task affect and postexercise enjoyment predicted preferences for HIIT and SIT (r
s’s = −0.34 to −0.61; P’s < 0.05), but not for MICT (P’s > 0.05), respectively. Over the follow-up, participants completed more MICT (M = 6.11 ± 4.12) than SIT sessions (M = 1.39 ± 1.85; P < 0.01, d = 1.34). Although participants tended to complete more sessions of MICT than HIIT (M = 3.54 ± 4.23; P = 0.16, d = 0.56), and more sessions of HIIT than SIT (P = 0.07, d = 0.60), differences were not significant. In-task affect predicted the number of sessions of MICT (r = 0.40; P < 0.05), but not HIIT or SIT (P’s > 0.05).

Conclusions

This study provides new evidence that a single session of HIIT and SIT can be as enjoyable and preferable as MICT among inactive individuals and that there may be differences in the exercise affect–behavior relationship between interval and continuous exercise.
Characterization of culturable airborne bacteria and antibiotic susceptibility profiles of indoor and immediate-outdoor environments of a research institute
Authors: Abiola Isawumi , Abass Adiza , Duodu Samuel , Mosi Lydia
Published: May 2018

Background:The study was conducted to determine the bacterial composition and antibiotic susceptibility profiles of a research institute at the University of Ghana where workers and students spend about 70-85% of their lives in indoor and immediate-outdoor environments. This is imperative as one-third of the recognized infectious diseases are transmitted through airborne-route. Furthermore, the increasing rate of bacterial antimicrobial resistance associated with such environments poses serious public health challenges.

Methods:A total of 42 airborne samples were collected from eight major sites at the Department of Biochemistry, Cell and Molecular Biology (BCMB), using passive bacterial sampling techniques. Standard phenotypic microbiological procedures were used to characterize the isolates. Antibiotic susceptibility profiles were determined using standard disk diffusion method and guidelines of Clinical and Laboratory Standards Institute (CLSI).

Results:Four groups of bacterial isolates were identified from the total samples collected with Gram positive bacilli as the most common. All the isolates showed resistance to beta lactam and sulfonamide classes of antibiotics with full resistance (100%) to ampicillin and penicillin. In total, seven different anti-biotypes were observed with the highest susceptibility displayed towards tetracycline and gentamycin. Significantly, the various air sampling sites of the institute indicated the presence of bacteria with the majority showing multiple antibiotics resistance.

Conclusions:Although the recovery of bacteria from supposed sterile environments calls for attention, the observed low contamination rate as compared to the WHO standard suggests a minimum risk of exposure of students and workers to airborne microbial contamination.
Chronic pancreatitis: review and update of etiology, risk factors, and management
Authors: Pham Angela , Forsmark Christopher
Published: May 2018

Chronic pancreatitis is a syndrome involving inflammation, fibrosis, and loss of acinar and islet cells which can manifest in unrelenting abdominal pain, malnutrition, and exocrine and endocrine insufficiency. The Toxic-Metabolic, Idiopathic, Genetic, Autoimmune, Recurrent and Severe Acute Pancreatitis, Obstructive (TIGAR-O) classification system categorizes known causes and factors that contribute to chronic pancreatitis. Although determining disease etiology provides a framework for focused and specific treatments, chronic pancreatitis remains a challenging condition to treat owing to the often refractory, centrally mediated pain and the lack of consensus regarding when endoscopic therapy and surgery are indicated. Further complications incurred include both exocrine and endocrine pancreatic insufficiency, pseudocyst formation, bile duct obstruction, and pancreatic cancer. Medical treatment of chronic pancreatitis involves controlling pain, addressing malnutrition via the treatment of vitamin and mineral deficiencies and recognizing the risk of osteoporosis, and administering appropriate pancreatic enzyme supplementation and diabetic agents. Cornerstones in treatment include the recognition of pancreatic exocrine insufficiency and administration of pancreatic enzyme replacement therapy, support to cease smoking and alcohol consumption, consultation with a dietitian, and a systematic follow-up to assure optimal treatment effect.
Pulmonary epithelial barrier and immunological functions at birth and in early life - key determinants of the development of asthma? A description of the protocol for the Breathing Together study
Authors: Turner Steve , Custovic Adnan , Ghazal Peter , Grigg Jonathan , Gore Mindy , Henderson John , Lloyd Clare M. , Marsland Ben , Power Ultan F. , Roberts Graham , Saglani Sejal , Schwarze Jurgen , Shields Michael , Bush Andrew
Published: May 2018

Background.  Childhood asthma is a common complex condition whose aetiology is thought to involve gene-environment interactions in early life occurring at the airway epithelium, associated with immune dysmaturation.  It is not clear if abnormal airway epithelium cell (AEC) and cellular immune system functions associated with asthma are primary or secondary.  To explore this, we will (i) recruit a birth cohort and observe the evolution of respiratory symptoms; (ii) recruit children with and without asthma symptoms; and (iii) use existing data from children in established STELAR birth cohorts.    Novel pathways identified in the birth cohort will be sought in the children with established disease.  Our over-arching hypothesis is that epithelium function is abnormal at birth in babies who subsequently develop asthma and progression is driven by abnormal interactions between the epithelium, genetic factors, the developing immune system, and the microbiome in the first years of life.

Methods.  One thousand babies will be recruited and nasal AEC collected at 5-10 days after birth for culture.  Transcriptomes in AEC and blood leukocytes and the upper airway microbiome will be determined in babies and again at one and three years of age. In a subset of 100 individuals, AEC transcriptomes and microbiomes will also be assessed at three and six months.  Individuals will be assigned a wheeze category at age three years.  In a cross sectional study, 300 asthmatic and healthy children aged 1 to 16 years will have nasal and bronchial AEC collected for culture and transcriptome analysis, leukocyte transcriptome analysis, and upper and lower airway microbiomes ascertained.  Genetic variants associated with asthma symptoms will be confirmed in the STELAR cohorts. 

Conclusions.  This study is the first to comprehensively study the temporal relationship between aberrant AEC and immune cell function and asthma symptoms in the context of early gene-microbiome interactions.