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Diabetes mellitus and obesity are major public health issues that significantly impact the health care system. The next generation of health care providers will need a deep understanding of the pathophysiology of these diseases if we are to prevent, treat, and eventually cure these diseases and ease the burden on patients and the health care system. Physiology core concepts are a set of core principles, or "big ideas," identified by physiology educators that are thought to promote long-term retention, create a deeper understanding, and help with formation of critical thinking skills. Here we describe our scaffolded teaching approach in an upper year undergraduate pathophysiology course to educate students about these two diseases and discuss how learning about the basis of these highly integrative diseases from the biochemical to whole body level is a meaningful tool in the physiology educator toolbox to reinforce physiology core concepts. This teaching strategy is designed to engage students in the scientific process and hone their problem-solving skills such that they are hopefully equipped to treat and eventually cure these diseases as they move forward in their careers.

The practical work described here is designed for third-year bachelor students in Life Sciences attending a kidney physiology course. It illustrates how urinary biochemistry can be used for a medical diagnosis. Students have to measure glucose, proteins, and creatinine concentrations in three simulated urine samples. First, they independently elaborate detailed protocols from the biochemical kit's technical sheets. Second, after correction of the protocols by the teacher, they perform the biochemical assays. Finally, students write a report in which they interpret the biochemical data and use them in the context of histological images assigned to each urine sample. With their results, their theoretical background and scientific articles supplied by the teacher, they establish the diagnosis indicating which patients are diseased and from which disease they are suffering (diabetes without nephropathy, diabetic nephropathy or hypertensive nephropathy). The originality of this practical work is to give student autonomy from the start of the project by requiring them to write the protocols, and determine the diagnosis by themselves. Simple and inexpensive, this practical forces students to mobilize their knowledge in renal physiology and pathophysiology as well as those acquired in other disciplines such as biochemistry or cellular biology. A survey conducted on two classes of students confirmed that this type of training helps students to better understand renal physiology, to realize the importance of interdisciplinarity (biochemistry, histology, and physiology) and to develop confidence in their ability to work independently., (© 2021 International Union of Biochemistry and Molecular Biology.)

A renovation incorporated Innovative Learning Environments' design principles. The exploratory study used a Basic Mixed Method, Convergent Parallel Research Design. Behavioral observations and photographic tracing, two surveys (pre- and post-intervention), interviews, and instrument testing. Overall findings: (a) students and educators are excited to come to school, (b) far less negative/destructive behavioral issues, and (c) a sense of pride/belonging imbued. Specifically: (a) ILE designs at the ergo-dynamic furniture level are not as intuitive as hoped, (b) teaching practices guide the use of solutions, (c) students made intuitive use of the ergo-dynamic products in seated positions at both macro and micro levels, and (d) students still had too much sedentary time. Recommendation - provide holistic understanding for all stakeholders of ILEs' positive impact.

Sex and fertility education is essential to enable people to make informed choices. School is an important source of education, so we examined the current curriculum relating to sex and fertility education in England and compared it with students' accounts of their experiences. We analysed the Awarding Body GCSE science and biology specifications (for 14-16 year-olds) and the A-level biology specifications (for 16-18 year-olds), as these related to relationships, sexuality and fertility. An online survey was conducted with 221 16-17 year-old school students to evaluate their views about their sex and fertility education. We found significant variation between the specifications of the Awarding Bodies at both GCSE and A level. Most of the specifications specify sexually transmitted infections (STIs), hormonal aspects of reproduction and contraception. In the school survey, students indicated that topics such as puberty, contraception and STIs were more likely to be learnt in school. However, topics such as endometriosis, menopause and miscarriage were more likely to be learnt outside school. From both our curriculum analysis and student survey we conclude that there are significant gaps in the curriculum with many important topics being neglected.

During adolescence, increases in pubertal hormones lead to reproductive maturity as well as changes in cognitive development. Yet, little is known about how to best characterize interindividual differences in hormone concentrations. The goal of the current study was to examine the antecedents and consequences of membership in empirically derived hormone profiles. Data were drawn from 10,816 youth (48.1% female, M[subscript age] = 9.91, SD[subscript age] = 0.63) in the Adolescent Brain Cognitive Development (ABCD) study. Latent profile analysis (LPA) stratified by sex was used to derive hormone profiles using basal testosterone, dehydroepiandrosterone and estradiol (girls only). Eight profiles (four female profiles and four male profiles) were identified. They primarily represented differences in hormone levels (e.g., low hormonal milieus vs. high hormonal milieus), but also reflected discordance (e.g., high estradiol versus. high testosterone). There were limited sociodemographic differences, particularly after correcting for multiple comparisons, but youth with higher hormone milieus exhibited better inhibitory control, visuospatial processing and decision-making skills even after adjusting for age, pubertal status and demographic data. Thus, youth-centered approaches that focus on patterns of individual characteristics suggest that hormonal markers may provide unique information about associations between biological and cognitive development.

This study examines stress biomarkers over the process of teaching and their associations with demographics, emotions, and mental health of 56 English as Foreign Language teachers. Participating teachers were invited to complete a questionnaire packet and provide saliva samples over three-time points (i.e., before, during, and end of teaching). Afterward, the saliva samples were assayed for cortisol and [alpha]-amylase as stress biomarkers. The results showed a significant change in the concentrations of cortisol and [alpha]-amylase over the teaching process. In addition, being female, younger, more educated, and having more teaching experience were significantly associated with a higher level of [alpha]-amylase, particularly before and during class time, thereby reflecting a greater level of stress. However, emotions and general mental health were not significantly associated with cortisol and [alpha]-amylase over time. The findings highlighted the changes of biomarkers over the process of teaching and their relationships with other variables.

Virtual Reality (VR) involves the coupling of visual communication hardware and software. The technology is capable of offering transformative educational practice and is increasingly being adopted within the biochemistry domain to better understand complex biochemical processes. This article documents a pilot study for the efficacy of VR in biochemistry education at undergraduate university level, focusing on the citric acid cycle: a central process for extracting energy in most cellular life forms. 10 participants were equipped with a VR headset and electrodermal activity (EDA) sensors, then immersed within a digital environment where they were able to learn the 8 main steps of the citric acid cycle within a virtual lab by completing 8 levels of activity. Post and pre surveys were taken, along with EDA readings throughout the students' interaction with VR. Research findings support the hypothesis that VR increase students' understanding, particularly if students feel engaged, stimulated and intend to use the technology. Moreover, EDA analysis indicated that the majority of participants demonstrate enhanced engagement in the education-based VR-experience as measured by elevated levels of skin conductance, a marker for autonomic arousal and a measure of engagement in an activity.

Dyslexia is a neurodevelopmental disorder characterized by persistently slow and effortful reading. It is associated with core cognitive deficits in decoding words, but it also presents significant challenges associated with, for example, anxiety and stress related to academic performance. We asked, thus, whether, reading out loud would be associated with elevated stress for readers with dyslexia, relative to good readers, and we investigated stress-related hormone response in these two groups. We carried out an acute psychosocial stress test (Trier Social Stress Test-Children adapted for children, TSST-C), which included a reading out loud task. We carried out a quasi-experimental study with an experimental group of participants with Developmental Dyslexia (n = 17), and a control group, with good readers (n = 18). During the stress test, we collected six saliva samples for evaluation of two stress-related hormones, cortisol, and adrenocorticotropic hormone (ACTH) levels. We found a main effect for group for ACTH and for cortisol levels. We also found significantly higher levels of ACTH in the dyslexic group at the end of the task, and during the post-task recovery period. Results are discussed in the light of the less-understood emotional impact of dyslexia, and of a recently proposed role for stress as a trigger for increased risk of development of dyslexia. Lastly, we underscore the contribution for the evidence of the emotional impact of learning disorders, especially, as is the case, from a population generally underrepresented in cognitive neuroscience research (i.e., Latin-American children).

The rush to remote learning during the COVD-19 pandemic has caused instructors to rapidly adapt mechanisms of learning. Here, I describe an online concept mapping activity for membrane transport mechanisms that can be accomplished by students working together remotely and either synchronously or asynchronously., (© 2020 International Union of Biochemistry and Molecular Biology.)

Accurate assessment of saliva sampling time is essential for studies that collect cortisol sample in ambulatory settings. This study examined the sampling time assessed by user-submitted photos via a mobile application (ZEMI) compared with MEMSCaps™. Intra-class correlation coefficient (ICC) of the time differences between when the 16 adolescents in the study were prompted to collect the sample and (1) when the MEMSCaps™ was opened (Time[subscript M]), and (2) when photos of the corresponding sample were submitted (Time[subscript Z]) was computed to evaluate the agreement of sampling times. The average Time[subscript M] and Time[subscript Z] 12.06 ± 65.80 and 16.13 ± 52.07 minutes, respectively. The pooled ICC between Time[subscript M] and Time[subscript Z] was 0.986 (95% CI: 0.959-0.995), suggesting excellent correspondence between the two measurements.

We examined associations between prenatal oxidative stress (OS) and child autism-related outcomes. Women with an autistic child were followed through a subsequent pregnancy and that younger sibling's childhood. Associations between glutathione (GSH), glutathione disulfide (GSSG), 8-oxo-deoxyguanine (8-OHdG), and nitrotyrosine and younger sibling Social Responsiveness Scale (SRS) scores were examined using quantile regression. Increasing GSH:GSSG (suggesting decreasing OS) was associated with minor increases in SRS scores (50th percentile [beta]: 1.78, 95% CI: 0.67, 3.06); no other associations were observed. Results from this cohort with increased risk for autism do not support a strong relationship between OS in late pregnancy and autism-related outcomes. Results may be specific to those with enriched autism risk; future work should consider other timepoints and biomarkers.

Background: This study examines the relationship between adolescents' biophysiological stress (i.e. cortisol, alpha-amylase and oxidative stress) and the development of grit and school engagement over one school year. Aims: The study aims to identify how objective stress affects grit and three dimensions of school engagement. Based on the conservation of resources (COR) theory, the study considers lower- and higher-track school students and their genders. Sample: The sample consists of secondary school students (N = 82; M[subscript Age] = 13.71; SD = 0.67; 48% girls) from Germany. Methods: Students participated in a questionnaire and a biophysiological study in the first semester (t1) of the school year and completed the same questionnaire at the end of the school year (t2). After conducting whole-sample analysis, a multi-group cross-lagged panel model was calculated to identify differences among students at lower- and higher-track schools. Results: Whole-sample analysis reveals that students who exhibit high levels of cortisol report lower cognitive school engagement at t2, whereas students who exhibit high levels of alpha-amylase exhibit less grit at t2. Additionally, lower-track students who exhibited high cortisol levels reported lower cognitive and emotional school engagement throughout the school year. Furthermore, higher-track students with high oxidative stress levels reported lower grit and behavioural school engagement at t2. Conclusions: Examining the relationship between biophysiological stress markers and grit and school engagement of students at lower- and higher-track schools indicates that the educational context and its specific subculture shapes physiological stress reactions, which are related differently to grit and engagement dimensions.

Background: This study examined the relations between students' expectancies for success and a physiological component of test anxiety, salivary cortisol, during an authentic testing setting. Aims: The aim of the study was to better understand the connection between shifts in students' control appraisals and changes in the physiological component of test anxiety. Sample: The study comprised 45 undergraduate engineering majors in the United States. Methods: Survey data concerning students' expectancy for success and saliva samples were taken before, during and after the practice midterm examination prior to their actual in-class examination. Results: Students' expectancy for success declined during the examination while cortisol levels declined from the beginning to middle of the examination and began to increase again as a function of time. Although students' initial levels of expectancy for success and cortisol were not correlated, there was a negative relation between change in cortisol and change in expectancy for success. Conclusions: Our study demonstrates a relation between salivary cortisol, a physiological component of test anxiety and students' expectancy for success in an authentic testing context. Most students saw a decrease in cortisol during the examination, suggesting anticipatory anxiety prior to the test and a return to homeostasis as the examination progressed. Some students, however, did not see a declination in cortisol, suggesting they may not have recovered from pre-examination anxiety. The negative relation between change in cortisol and expectancy for success suggests that students who had the greatest decrease in expectancy for success saw the smallest recovery in cortisol.

Background: Teachers' stress, affect and general occupational well-being influence their teaching and their students. However, how teachers' daily physiological stress and positive affect are related in the classroom is unknown. To reduce teachers' stress and enhance their positive affect, it is crucial to understand how occupational well-being relates to stress and affect. Aim: The aim of the study was to examine the relationships between teachers' daily physiological stress and positive affect in authentic classroom settings and the roles played by teachers' self-efficacy beliefs, perceptions of school climate and burnout symptoms in daily stress and affect. Sample: The sample consisted of 45 classroom teachers. Method: Daily physiological stress was assessed by measuring salivary cortisol levels three times in two days. Positive affect was reported by experience sampling at the same time that cortisol was collected. Questionnaires were used to assess self-efficacy beliefs, perceptions of school climate and burnout symptoms. Three-level modelling with random intercepts and slopes was used to analyse the relationships between daily stress and affect and the effect of teachers' general occupational well-being on stress and affect. Results: No relationships were evident between teachers' physiological stress and positive affect or between daily changes of stress and affect. Self-efficacy beliefs were related to lower stress and higher affect in the middle of the school day. Having sufficient school resources were related to higher positive affect. Teachers' burnout symptoms were associated with lower positive affect. Conclusions: We emphasize the potential for self-efficacy and perceptions of school resources as targets for intervening in teachers' stress and affect.

The authentic teaching and learning approach introduces real-world scenarios into the classroom to better engage Generation Z students. Considering this, we introduced an authentic learning practical exercise (breakfast meal and glycemic variation) to undergraduate biology students at the University of La Reunion (France). Here, students were initially briefed regarding the practical and subsequently determined their baseline glucose values (glucometer). They then consumed 200 mL of fruit juice together with a pain au chocolat (chocolate pastry) and subsequently recorded their glucose values at regular intervals. The last reading was done after 150 min, and they thereafter plotted such data to reveal temporal glycemic variations. During this time, the students also worked on a report to document information collected and began to supply responses to several listed questions. Three weeks after completion of the practical, we evaluated whether this intervention would lead to changes in their views regarding the nature and regularity of breakfast meal intake (employing survey questions). Our findings show that a reasonable proportion of the students indicated that the intervention did change their dietary habits, with 50% sometimes opting for an improved breakfast, whereas 10% also changed their habits albeit for only a small while. Of note, >60% of students indicated that they changed their breakfast intake habits by the end of the endocrinology module. These findings show that the beneficial effects of authentic teaching approaches may elicit relatively long-lasting changes in terms of breakfast behavioral patterns in young people and that such effects may also impact the broader society. New & Noteworthy: This study introduced an authentic learning exercise (endocrinology practical exercise) to undergraduate biology students and ascertained whether it changed their views regarding the nature and regularity of breakfast meals. Here, many altered their breakfast dietary habits, which persisted even after the completion of their module. Authentic teaching approaches can therefore trigger relatively long-lasting changes in terms of breakfast behavioral patterns in young people and may also impact the broader society.

Fetal androgen exposure may be associated with autism spectrum disorder (ASD). We studied 1777 mother-child pairs in the prospective Odense Child Cohort. Prenatal androgen exposure was assessed by maternal 3rd trimester testosterone concentrations, maternal polycystic ovary syndrome (PCOS), and 3 months offspring anogenital distance. ASD traits were assessed at age 3 years with the ASD-symptom scale of the Child Behavior Checklist for ages 1 1/2-5 years. Maternal testosterone was positively associated with traits of ASD in boys (p < 0.05). Maternal PCOS was associated with increased offspring ASD traits (p = 0.046), but became non-significant after excluding parental psychiatric diagnosis. Offspring anogenital distance was not linked to ASD traits. Higher prevalence of ASD in boys could be linked to higher susceptibility to fetal androgen exposure.

The development of young children can be disrupted by repeated stress because stress triggers a response which changes the chemistry of their bodies (National Scientific Council on the Developing Child (NSCDC), 2014). Adverse Childhood Experiences (ACEs) is used to describe stressful or traumatic experiences which threaten children's development. The degree to which children are impacted by ACEs varies due to a variety of factors such as age and gender, severity and duration of exposure, and the presence or absence of supportive adults. ACEs create risk but are not fate. However, there is evidence that toxic stress does have the potential to impact a child's future outcomes (Centers for Disease Control Vital Signs, 2019; Tennessee Department of Health, 2015). Brain development is at the highest level during the early years. Stress can be damaging to health and well-being if activated too often or for too long (toxic stress). Adrenaline and cortisol are produced in response to stress and prepare the body to respond to adversity. Sustained or frequent stress can lead to impairment in brain architecture and developing organs affecting learning, memory, and self-regulation (NSCDC, 2014; NSCDC, 2020). ACEs are preventable. Safe, stable, and nurturing relationships help children reach their potentials and reduce the likelihood and harm linked to ACEs (CDC, 2019). Resilience is built by supplying safe environments, giving caring attention, building trusting relationships, listening to feelings, responding in positive ways, and providing opportunities for success (Pizzolongo & Hunter, 2011).

College freshmen experience unique stressors when transitioning from high school to college. In Idaho, the freshman attrition rate is higher than the national average, which may be partially explained by the higher prevalence of depression in this region. The current study investigated the potential of cortisol, a stress hormone, to be a biomarker for depression to help identify those freshmen with depression that may be at a higher risk of dropping out. In a group of 45 college freshmen, no correlations were observed between serum cortisol and depression severity as measured by the Patient Health Questionnaire 9 (PHQ-9). However, those with a self-reported history of depression scored significantly higher on the PHQ-9, confirming the reliability and validity of the PHQ-9 in a college student population.

Introduction: A previous study has evaluated the association between serum tumour necrosis factor-like weak apoptosis inducer (TWEAK) levels and autism spectrum disorder (ASD). In line with this investigation, the present study aimed to measure serum TWEAK levels to determine whether their eventual alteration might have etiopathogenetic significance in children with ASD. Methods: A total of 40 treatment-naive children with ASD and 40 healthy children as controls were included in the present study. The Schedule for Affective Disorders and Schizophrenia for School-Aged Children--Present and Lifetime Version, DSM-5 was used by a psychiatrist to screen the healthy controls for psychiatric disorders after a physical examination by a paediatrician. The clinical severity of the ASD symptoms was assessed by the Childhood Autism Rating Scale. Venous blood samples were collected, and serum TWEAK levels were measured. Results: This study included 80 children in total, with 40 (50.0%) in the patient group and 40 (50.0%) in the healthy control group. Thirty four (85.0%) of the participants in the patient group, and 31 (77.5%) in the healthy control group, were male, and the remainder were female. The distribution of the gender ratio was statistically similar between groups (p = 0.568). The volunteers were between 36 and 59 months old. The average age in the patient group was 46.0 ± 6.5, while that in the healthy control group was 45.2 ± 6.7. The ages were also statistically similar between groups (p = 0.615). The TWEAK values of the patient group were found to be statistically higher than those of the healthy control group (p < 0.001). Discussion: This study examined whether serum TWEAK levels were related to ASD in childhood. Our findings indicate that children with ASD have higher TWEAK levels when compared to other children. The findings further indicate that serum TWEAK levels could be related to ASD etiopathogenesis independent of ASD symptom severity.

Impedance (Z), resistance (R), reactance (Xc), and phase angle (PhA) are sensitive to shifts in fluid between intra- and extracellular compartments, as would occur with nutrient uptake into skeletal muscle, but remains largely unexplored. To explore the sensitivity of whole-body and segmental (arms, legs, trunk) bioimpedance to acute feeding, 27 young adults completed three feeding conditions on separate occasions in randomized, cross-over design [high-carbohydrate (CHO), high-protein (PRO), fasted (FAST); standardized for fluid]. Bioimpedance was completed one-hour post-meal. Differences between feeding conditions at 5, 50, 250 kHz were evaluated. At 5 kHz, whole-body Xc and PhA were significantly different with CHO (p = 0.017), but not PRO (p = 0.152), compared to FAST; there were no significant differences at 50 or 250 kHz (p > 0.05). Segmental bioimpedance was significantly different with CHO and PRO compared to FAST [5 kHz: (Arms: Z, R, Xc,PhA; Trunk: Z, R; p = 0.002), 50 kHz:(Arms: Z, R, Xc; Trunk: Z, R, Xc; p < 0.02), 250 kHz:(Arms: Z, R; Trunk: Z, R; Legs: PhA; p = 0.009)]. Results suggest segmental bioimpedance at 5 kHz is sensitive to acute nutrition. Further exploration is warranted.

Background: Personal Health literacy (PHL) is essential in cardiovascular risk management. Hindrances in PHL can lead to poor cardiovascular outcomes. Purpose: To investigate whether limited PHL is associated with lower likelihoods of i) overall cardiovascular health and ii) individual cardiovascular health components as defined by the American Heart Association's Life Simple (LS7). Methods: Multi-Ethnic Study of Atherosclerosis participants (N = 3719; median age[range]: 59[45-84]) completed a PHL questionnaire in 2016-2018. PHL was classified as limited (score [greater than or equal to]10) or adequate (score <10). LS7 components were measured in 2000-2002. Robust Poisson regression was employed to compute prevalence ratios and 95% confidence intervals (PR[95%CI]) of LS7 measures. Results: 14.7% of participants had limited PHL. Limited PHL was associated with lower likelihoods of optimal LS7 (0.69[0.50, 0.95], p = 0.02) and average LS7 (0.95[0.88, 1.02], p = 0.15) after adjustment. Limited PHL was significantly associated with a 7% lower likelihood of ideal fasting blood glucose level after adjustment (0.93[0.89, 0.98], p < 0.01). Discussion: Limited PHL was modestly associated with suboptimal cardiovascular health and elevated blood glucose, independent of income and education. Translation to Health Education Practice: Health educators and providers should equitably address PHL barriers to improve cardiovascular management and quality of care for patients and communities.

One of the overlapping curriculum designs indicates the mismatch of teaching materials with the cognitive level process and student development, impacting the unstructured qualification of mastery of the material. On the other hand, the breadth and depth of teaching materials in the curriculum must be following students' mental development and level of cognitive processes. This study aims to collect the opinions of science teachers in junior high schools and biology teachers in high schools about the learning continuum design on reproducing living things. The method used is a survey. The study population is a hypothetical population with a convenience sample. The sample involved in this study were 111 teachers in Bantul Regency and Yogyakarta City. The data collection method used a questionnaire distributed through four subject teachers' conference (MGMP). The data obtained were analyzed using descriptive analysis. The results showed several sub-aspects of reproduction of living things that cannot be taught in elementary schools. The material for propagating fungi, protists, bacteria, and viruses starts in grade VII with a cognitive level of C1 (remembering), after previously students received material about types of animals and plants in grade VI (elementary school). Furthermore, the material on reproductive anatomy and physiology can only be given to class IX with cognitive level C2 (understanding) and continued in class X and XI with cognitive level C4 (analyzing). Especially for reproductive anatomy and physiology, fungi were introduced to class VII with C1 level cognitive processes (remembering). This teacher opinion generates a learning continuum grid that can help policymakers improve educational curriculum.

Learning endocrine physiology can be challenging. Some physiological concepts are abstract, making the process of learning more difficult for students. The comprehension of basic concepts, such as chemical hormone classification, is essential to understand the differences in synthesis, secretion, transport, and mechanism of action of hormones. To assist the students on this subject, we developed an analogy between the basic concepts of hormone synthesis, transport, and mechanism of action and a bank robbery as a first approach to engage and stimulate their learning process. In the analogy, the students are asked to help identify and characterize two bank robbery crews based on a set of evidence collected by the police. The goal is to identify the general profile of lipid- and water-soluble hormones synthesis, transport, and mechanism of action on target cells. When applying the activity, the students showed a great deal of interest in solving the crime and they seemed to understand the similarities between the analogy and the subject.

The objective of this research was to develop robust predictive models of the gains in working memory (WM) and fluid intelligence (Gf) following executive attention training in children, using genetic markers, gender, and age variables. We explore the influence of genetic variables on individual differences in susceptibility to intervention. Sixty-six children (males: 54.2%) aged 50.9-75.9 months participated in a four-weeks computerized training program. Information on genes involved in the regulation of dopamine, serotonin, norepinephrine, and acetylcholine was collected. The standardized pre- to post-training gains of two dependent measures were considered: WM Span backwards condition (WISC-III) and the IQ-f factor from the Kaufman Brief Intelligence Test (K-BIT). A machine-learning methodology was implemented utilizing multilayer perceptron artificial neural networks (ANN) with a backpropagation algorithm. Both ANN models reached high overall accuracy in their predictive classification. Variations in genes involved in dopamine and norepinephrine neurotransmission affect children's susceptibility to benefit from executive attention training, a pattern that is consistent with previous studies.

Renal clearance encompasses a somewhat abstract concept, which makes it a hard-to-visualize phenomenon. It is a confusing topic for students and a difficult task for the instructor to teach. In order to improve or facilitate the teaching-learning process of renal clearance, an alternative strategy is presented here. To properly characterize the components of renal clearance, this didactic model splits renal clearance into two distinct portions of flow rates. The information is organized in a sequential structure, from the simplest ideas to the most complex concepts, assisting both teacher and student in addressing renal clearance.

Dysregulation of biological stress response, as measured by cortisol output, has been a primary candidate mechanism for how social experiences become biologically embedded. Cortisol is the primary output of the hypothalamic pituitary adrenal (HPA) axis. Cortisol levels vary systematically across the day and change in response to both sudden, acute stress experiences as well as prolonged exposure to environmental stress. Using data from 8- to 15-year-old twins in the Texas Twin Project, we investigate the extent to which genetic influences are shared across different measures of cortisol output: chronic cortisol accumulations in hair (n = 1,104), diurnal variation in salivary output (n = 488), and salivary response to a standardized, acute in-laboratory stressor (n = 537). Multivariate twin models indicate that genetic factors regulating cortisol response to the in-laboratory stressor are separable from those regulating baseline cortisol levels, naturally occurring diurnal variation in cortisol, and hair cortisol levels. These findings illustrate that novel environments can reveal unique genetic variation, reordering people in terms of their observed phenotype rather than only magnifying or mitigating preexisting differences.

Difficulty index and its derivative performance index (PFI) have been commonly used to measure student learning outcomes. However, these indexes have a high volatility and low sensitivity. This work has established the simplex learning index (SLI), which has a low volatility and high sensitivity. To construct SLI, students were divided into two groups based on their scores on the whole quiz. The item SLI and lecture SLI were derived from the results of students in the high-scoring group. Exam results from nine cohorts of medical students in two phases of learning were analyzed. The volatility, measured by the ratio between the standard deviation and the mean, was >65% lower in SLI than in PFI. Using the lecture SLI as a metric, one lecture B22 (Metabolism of Amino Acids), was identified that had an average SLI of 0.66 in earlier four student cohorts in "phase 1 learning." Two major changes were made on the lecture, lecture organization and the delivery method, in phase 2. Students from recent five cohorts in phase 2 had an average SLI of 0.84, which was 26.6% higher than that in phase 1 (P < 0.02). In contrast, when PFI was used, the change was only 13.46% and insignificant (P = 0.29). In the same period, implementation of the same delivery method did not yield significant changes in learning outcomes in lecture B24 (Metabolism of Nucleotides). Taken together, this work shows that SLI is a better indicator for learning outcomes and suggests that lecture reorganization is the key to improved student learning.

Pulse oximetry has become the standard of care in operating rooms, intensive care units, and hospitals worldwide. A pulse oximeter continuously and noninvasively monitors the functional oxygen saturation of hemoglobin in arterial blood (Sa[subscript O2]). Sa[subscript O2] is so important in medical care that it is often regarded as a fifth vital sign. Before pulse oximetry, arterial puncture for blood gas analysis was the only method available to determine Sa[subscript O2] and to identify the presence of hypoxemia. Pulse oximetry is based on the principle that oxygenated hemoglobin (O2Hb) absorbs more near-infrared light than deoxyhemoglobin (HHb) and HHb absorbs more red light than O[subscript 2]Hb. It is important to understand the principles of pulse oximetry, how the equipment works, and its limitations to interpret the information it provides. Accordingly, we used colored balloons to introduce the physics of how a pulse oximeter detects and measures oxyhemoglobin and deoxyhemoglobin in pulsatile (arterial) and nonpulsatile (venous and capillary) blood. The foundations of oximetry started in the 1700s with Johann Lambert (1728-1777). We approached this complex physics in a straightforward way while still providing an understanding of the fundamental concepts developed by Johann Lambert in 1760.

Hyperserotonemia, or elevated levels of whole blood serotonin (WB5-HT), was the first biomarker linked to autism spectrum disorder (ASD). Despite numerous studies investigating the etiology of hyperserotonemia, results have been inconsistent. Recent findings suggest a relationship between the immune system and hyperserotonemia. The current study investigated whether intestinal 5-HT levels, 5-HT gene expression, or intestinal cell types predict WB5-HT. Participants included thirty-one males aged 3-18 who were classified into one of three groups: ASD and functional GI issues, typically developing with GI issues, and typically developing without GI issues. Samples from a lower endoscopy were analyzed to examine the pathways in predicting WB-5HT. Results demonstrated an association between T-Lymphocytes and WB5-HT.

Small group learning activities have been shown to improve student academic performance and educational outcomes. Yet, we have an imperfect understanding of the mechanisms by which this occurs. Group learning may mediate student stress by placing learning in a context where students have both social support and greater control over their learning. We hypothesize that one of the methods by which small group activities improve learning is by mitigating student stress. To test this, we collected physiological measures of stress and self-reported perceived stress from 26 students in two undergraduate classes. Salivary cortisol and testosterone were measured within students across five contexts: a) pre-instructional baseline, b) following a traditional lecture, c) after participating in a structured small group learning activity, d) following completion of multiple choice, and e) essay sections of an exam. Results indicate students have lower salivary cortisol after small group learning activities, as compared to traditional lectures. Further, there is no evidence of a relationship between physiological measures of stress and self-reported perceived stress levels. We discuss how structured small group activities may be beneficial for reducing stress and improving student-learning outcomes.

The vitreous, the vasculature of the retina, macular pigments, phototransduction, retinal pigment epithelium, Bruch's membrane and the extracellular matrix, all play an important role in the normal function of the retina as well as in diseases. Understanding the pathophysiology allows us to target treatment. As ocular angiogenesis, immunity and inflammation are covered elsewhere, those subjects will not be discussed in this chapter., (© 2016 S. Karger AG, Basel.)

Previous studies have reported dysbiosis in the gut microbiota (GM) of children with autism spectrum disorders (ASD), which may be a determining factor on child development through the microbiota-gut-brain axis. However, it is not clear if there is a specific group of dysbiotic bacteria in ASD. The aim of this study was to carry out a meta-analysis on the studies that analyze GM in children with ASD. 18 studies fulfilled our selection criteria. Our results showed a lower relative abundance of "Streptococcus" (SMD[subscript +] = -0.999; 95% CI -1.549, -0.449) and "Bifidobacterium" genera (SMD[subscript +] = -0.513; 95% CI -0.953, -0.073) in children with ASD. Overall, the "Bifidobacterium" genera is involved. However, differences found between studies are attributed to factors such as reporting bias.

Neonatal jaundice has been suggested as a perinatal risk factor for autism spectrum disorder (ASD). We examined UGT1A1 polymorphisms to assess the potential of neonatal jaundice as a risk factor for ASD in children by using DNA extracted from preserved umbilical cord. In total, 79 children with ASD were genotyped for "UGT1A1*28" (c.-41-40dup), "UGT1A1*6" (c.211 G > A), and "UGT1A1*27" (c.686 C > A). The allele frequency of "UGT1A1*6" (OR = 1.34, p = 0.26) and "UGT1A1*28" (OR = 0.80, p = 0.54) and the prevalence of "UGT1A1*28/*6" diplotypes did not differ significantly from those in the control population. No "UGT1A1*27" allele was detected in the subjects. ASD symptom assessment scores were not associated with "UGT1A1*28/*6/*27" genotypes or "UGT1A1*28/*6" diplotypes. These results suggest that neonatal jaundice is not significantly associated with ASD.

In this study, it was aimed to determine the negative effect of different types of exercise on ovarian reserve of sedentary women. A total of 40 sedentary women who met the criteria for admission to work were categorized as aerobic exercise (AE; n:20; age: 33.0±2.0 years old) and strength exercise (SE; n:20; age: 32.7±2.1 years old) groups. Participants in both groups received two different exercises of 60-minute with an intensity of 60-70% for 16 weeks and 4 days per week. Participants' anthropometric (body weight, BMI, waist and hip circumference, waist and hip rate (WHR)), estradiol (E2), luteinizing hormone (LH) follicle stimulating hormone (FSH), and levels antimülerian hormone (AMH), which used as over-reserve indicators, were measured for before and after exercise. Comparisons of these parameters were evaluated at p<0.01 and 0.05 levels. The mean of anthropometric and biochemical parameters of the AE and SE groups were statistically similar in before exercise. After exercise program, body weight, BMI, waist and hip circumference values of both groups were significantly decreased (p<0.01 and p<0.05). There was no significant correlation between AMH, E2, FSH and LH levels of the AE group (p>0.05). In the SE group, there was a decrease in AHM level (p<0.05) and an increase in FSH level (p<0.01). There was no significant correlation between E2, and LH levels of the SE group (p>0.05). As a results; strength exercise triggers to decrease in serum AMH levels and to increase in serum FSH levels. For this reason, strength exercise practices can have negative consequences for fertility, especially for women with lower ovarian reserve values.

The purpose of this study is to introduce an activity which has been designed in accordance with Science, Technology, Engineering, Mathematics (STEM) education within the scope of 5E learning model and to present the implementation steps of it. The activity plan is on the topics of Nerves, Hormones and Homeostasis in Human Physiology Unit in 11th grade biology curriculum. The activity was implemented with the participation of 49 students at a public high school. For the implementation of the activity, the students were divided into groups of five and they tried to complete the activity in four class hours. The participant students stated that they both learned and enjoyed learning while they were creating their model. Moreover, the teachers who implemented the activity stated that the equipment used in the activity is easy to access, which creates an advantage for the activity to be done in class.

Students find it hard to understand acid-base homeostasis and the mechanisms involved in compensating for acid-base imbalances, including the role of the lungs and kidneys in this process. We have developed a laboratory activity based on collaborative problem-based learning and human patient simulators (HPSs) to teach this topic. Students (n=50) were divided into small groups and presented with five cases of acid-base imbalances simulated in HPSs. After recording various parameters including arterial blood gases, they collaborated in identifying the specific acid-base imbalance. An anonymous survey following the laboratory activity revealed that this laboratory improved their understanding of acid-base regulation (92%), improved quantitative understanding of acid-base physiology (90%), and improved understanding of acid-base imbalances (94%).

Purpose: To evaluate whether levels of cortisol, a stress-related hormone, predicted response to intensive speech-language intervention for individuals with chronic aphasia (IWA). Secondary analyses explored baseline cortisol levels, change following intervention, association between cortisol levels and aphasia severity, self-reported communicative distress, and chronic stress. Method: Afternoon salivary cortisol levels were measured in 14 IWA during the first and last weeks of a 4-week intensive speech-language intervention epoch. Behavioral outcome measures were collected pre- and postintervention. Results: Cortisol levels did not significantly predict treatment response in this sample of IWA, although a positive trend was present. Baseline cortisol levels were not abnormally elevated, did not change from pre- to postintervention, and were not significantly correlated with any of the behavioral outcome measures. Discussion: Although afternoon salivary cortisol levels did not robustly predict treatment response in this participant sample, future studies may be warranted that include IWA with elevated levels of cortisol at pretreatment.

The choice of cortisol sampling times in early childhood studies varies widely. Given that recommendations on sampling protocols are largely based on adults, the present study aimed to broaden current knowledge by examining how reliably cortisol measures obtained at different daytimes would reveal between-individual differences in toddlers' cortisol levels. Parents were instructed to take 10 saliva samples consecutively (five per day) from their toddler (N = 19; M[subscript age] = 15.8 months, SD[subscript age] = 4.2 months). Intra-class correlations (ICCs) were computed to evaluate cortisol reliability. Cortisol samples taken in the morning between 30 and 80 min after awakening and bedtime samples were most reliable in differentiating between children (ICCs [greater than or equal to] 0.80). Wake-up cortisol samples taken within the first 30 min after awakening and afternoon samples showed moderate reliabilities (ICCs = 0.64), whereas the reliability of noon samples was poor (ICC = 0.43). Therefore, when investigating cortisol in young children while being restricted to a few samples only, assessing cortisol in the morning (at least 30 min after awakening) and at bedtime would be advisable.

Feedback loop reasoning is an essential part of systems thinking, which includes the analysis and description of system behaviour and regulative measures. In feedback loops, every change can simultaneously represent a cause and an effect. Research on reasoning in feedback loops is limited to investigating students' existing mental models. This thinking-aloud study extends insight to the field by providing causal loop diagrams to examine reasoning related to feedback loops. High school students (N = 30, 14-16 years) analysed system behaviours and regulative measures based on the regulation of blood glucose. We developed a category system examining students' prior knowledge and different reasoning patterns (general feedback loop reasoning, reversing cause-effect relationships, and explanations of equilibrium). Our results indicate that students consider direct, or direct and incomplete indirect cause-effect relationships. However, their response patterns vary depending on different task types (system behaviour, regulative measures, and complex system behaviour). Regarding equilibrium, most students explained it through opposing external factors, while only a few considered feedback loop mechanisms that maintain equilibrium. Therefore, we would recommend that teachers distinguish between the hidden dynamics of regulative processes and the visible maintenance of stable conditions by using appropriate external representations to explain phenomena such as equilibrium.

Regulation is a key concept for understanding the dynamics of metabolism in bacteria. This report outlines a simple laboratory experiment aimed at studying a key form of regulation in bacterial metabolism, exemplifying how microbes switch the flux of carbon towards alternative metabolic fates as a function of nutrient availability and according to their physiological status. The experiment involves the use of a "Sinorhizobium meliloti" wild-type strain and its isogenic derivative carrying a null mutation in the gene encoding the synthase that generates the storage polymer polyhydroxybutyrate (PHB). These strains serve to characterise the effects of growth phase and carbon availability at the end of balanced growth on the extent of PHB accumulation by rhizobia. The experimental set-up can be completed in a main 4-h laboratory session, followed by an additional 1-h session after an initial incubation for subsequent bacterial-colony counting (48 h), and requires equipment usually available at any university. The protocol described here is performed by the undergraduates of our biochemistry course. We consider this exercise to be a useful complementary tool for spotlighting the concept of metabolic regulation in bacteria and for promoting scientific thinking along with the development of students' wet-bench laboratory skills.

The relationships among the scores of major subjects taught in the first preclinical year of a Thai medical school, previous academic achievements, and daily life activities are rarely explored. We therefore performed an exploratory study identifying various factors possibly related to the educational scores of these medical students. Questionnaires were sent out to all first preclinical year medical students, with 79.8% being returned (245/307 questionnaires). Positive correlations were revealed between the premedical year grade point average (pre-MD GPA) and anatomy, physiology, and biochemistry scores (R = 0.664, 0.521, and 0.653, respectively, P < 0.001 for all) by Pearson's method. Using multiple linear regression analysis, anatomy scores could be predicted by pre-MD GPA, student satisfaction with anatomy, the percentage of expected reading, monthly earnings, reading after class and near exam time, and duration of sleeping periods near exam time (R = 0.773, R(2) = 0.598, P < 0.001). Physiology scores could be estimated by pre-MD GPA, the percentage of expected reading, monthly earnings, and percentage of those who fell asleep during class and near exam time (R = 0.722, R(2) = 0.521, P < 0.001). Biochemistry scores could be calculated by pre-MD GPA, the percentage of expected reading, motivation to study medicine, student satisfaction with biochemistry, and exam performance expectations (R = 0.794, R(2) = 0.630, P < 0.001). In conclusion, pre-MD GPA and the percentage of expected reading are factors involved in producing good academic results in the first preclinical year. Anatomy and biochemistry, but not physiology, scores are influenced by satisfaction.

This article provides a qualitative examination of student responses to an enjoyable online experience illustrating structure-function relationships of chemical messengers (neurotransmitters) in the human nervous system via text messaging emojis (often employed during mobile phone messaging). The "N.A.M.E." (Neurotransmitters as Messaging Emojis) FUN! experience was presented to 216 undergraduate health professions students enrolled in a human physiology course during Spring 2020 (N = 117) and Spring 2021 (N = 99) semesters as a learning tool, during a time in which students struggled with the concepts of neurotransmitter function. Additional goals for this fun experience design are to 1) engage health professions students in the topics of chemical messengers in the nervous system, and provide 2) a learning tool for students enrolled in the human physiology courses and 3) a memorization online worksheet for select neurotransmitter function. Student participants were able to access the online neurotransmitter fun experience via mobile phone and/or laptop. Resulting analyses of the voluntary and anonymous survey highlight positive responses in both Spring 2020 and 2021 semesters to the online "N.A.M.E." experience and furthermore the recommendation of student participants to include this online experience in future lecture assignments for the Human Physiology course. Here, we examine several data sets (tables) as we review student choices for matching emojis to neurotransmitter function and qualitative responses on the efficacy of this online match-up fun as a learning tool in a human physiology course for health professions.

The main purpose of the present study is to comparatively examine the effects of Whole body vibration (WBV) trainings on some biochemical bone-turnover markers (Beta-CTx, Osteocalcin) in terms of osteoporosis. Twenty-four sedentary women (mean age = 37.12 ± 1.84 years) participated in the study. The participants were randomly divided to 3 groups: whole body vibration exercise group (WBV, n = 8), classical resistance exercise group (CR, n = 8), and control group (CO, n = 8). Vibration trainings and classical resistance trainings were applied in similar exercise models for major muscle groups three days a week for eight weeks, not on consecutive days but in the same contexts. Of biochemical values, Beta-CTx and Osteocalcin were analysed by using Cobas e 411 ECLIA (Electro Chem. Luminance Immune Assay) method before and after the eight-week exercise period. For intra-group comparisons paired-samples t-test, for inter-group comparisons one way ANOVA, and for multi-comparisons Tukey test were used. While a statistically significant difference was found between pretest posttest of Beta-CTx and Osteocalcin values of CR (p<0.05), there was not a significant difference in WBV and CO groups (p>0.05). A statistically significant difference was found between the groups in terms of pretest posttest biochemical value changes (Beta-CTx, Osteocalsin) of the participants (p<0.05). As a result, eight-week WBV training in premenopausal women can be considered as safe in terms of biochemical values' (Beta-CTx, Osteocalcin) remaining unchanged. On the other hand, CR training made significant changes on the values in question. Whether this change is an acute effect or not has become a raising question. This case can be studied in premenopausal women in further research.

This study was conducted to determine the acute changes after the 20 m shuttle run test in the biochemical parameters and heart rates of wrestlers competing in international competitions on a study population of 21 wrestlers. The mean age of participants was 24.14±2.01 years, mean heights 176±0.06 cm, body weight 76.48±14.76 kg, MaxVO[subscript 2] 52.78±3.20 ml/kg/min, and mean BMI 24.44±2.63 kg/m[superscript 2]. 20-meter run and sit-up test was applied to measure the MaxVO[subscript 2] scores of included subjects. Heart rates were monitored using a Polar heart rate monitor before and after the tests. The blood samples that collected at the same time intervals from the vena cephalica were stored in tubes without anticoagulants. The samples were then centrifuged for 10 minutes at 5000 rpm to obtain serum samples, and analyzed. The data obtained were treated using SPSS 15.0 software. This study showed that there was a significant increase (p<0.05) in post-test glucose, HDL-cholesterol and urea concentrations compared to pre-test levels. While the post-test LDL cholesterol concentration was significantly reduced (p<0.05), acute changes in other biochemical parameters were found to be statistically insignificant (p>0.05). It can be concluded that mean glucose, HDL and urea were increased while LDL was reduced after the 20 m shuttle run test in wrestlers.

Accidents caused by human errors illustrate the fragility of cognitive processing and its coordination by executive functions against stress. To better understand how core executive functions change over time, influence each other, and are affected by chronic stress exposure, a prospective cohort study was conducted from 2016 to 2019. Five hundred sixteen German adults aged 25-55 years (mean age/education age: 38.0/11.3 years, 67% females, 94% occupied, 20% smokers) completed at least one internet-based biannual assessment of response inhibition, updating, and set shifting using a Go/NoGo, spatial 2-Back, and Number-Letter task, respectively. Chronic stress exposure was indicated by self-reports on the Perceived Stress Scale (PSS) and hair cortisol concentrations (HCC). Statistical analyses were performed by multivariatestochastic differential equation modeling. All indicators of executive functions (task-specific RTs in target trials or their contrast to nontarget trials) and chronic stress showed intraindividual stability over time (12% to 63% of their variance was attributable to trait influences). With respect to lagged mutual associations, faster Go/NoGo target RTs predicted faster Number-Letter target RTs later in time, while faster Number-Letter target RTs predicted higher HCC later in time (both with maximum effect sizes of d [approximately equal to] 0.1 standard deviations). However, PSS was not predictive of later HCC and vice versa. None of the chronic stress indicators significantly predicted indicators of executive functions at subsequent time points. These findings suggest that set shifting is capable of modulating the body's physiological response to chronic stress exposure, whereas executive functions appear comparably robust against chronic stress exposure.

Hemolytic disease of the newborn (HDN) is a potentially fatal condition caused by a Rhesus (Rh) antigen incompatibility between a mother and fetus. As a result, determining the Rh status of expectant parents is a routine clinical assessment. Both the physiological and immunological basis of this condition are taught to undergraduate students. At the University of South Australia, some undergraduate immunology students find this topic challenging. The author designed, implemented, and assessed the impact of an interactive simulation to facilitate student learning of HDN. The students were actively engaged in determining the blood grouping and Rh status of an expectant mother and father and then determining the possibility of developing HDN. The simulation was found to take only 15 min to complete yet led to a significant increase in student performance in an end of semester exam question. Student perceived understanding was found to significantly improve following the introduction of the simulation, even though the content had been covered in a formal lecture. Student feedback was highly positive of this learning approach. In conclusion, short, interactive simulations can be used effectively to enhance student learning of challenging concepts.

Adults with intellectual and developmental disabilities (IDD) are at a greater risk of developing high cholesterol and cardiovascular disease. We examined whether physical inactivity, obesity, and diabetes were predictive of reported high cholesterol and whether there were any mediating effects of diabetes on the relationship between obesity and high cholesterol in 1,618 adults with IDD across five years. Results suggest that obesity and diabetes were significantly associated with high cholesterol after adjusting for age, sex, and residence type with a partial mediator effect of diabetes in the relationship between obesity and high cholesterol across all time points. Further research is needed to explore the causal mechanisms behind the relationships between obesity, diabetes, and high cholesterol.

An experiment was developed for a first year food chemistry laboratory course that demonstrates the influence of several aspects of polysacharide structure on the rate of amylase catalyzed hydrolysis. The experiment would be particularly well-suited to a first year chemistry course that was targeted at nonchemistry majors, such as health related disciplines. The experiment illustrates numerous chemical concepts from the a versus [beta] glycosidic bonds to branched versus linear polymers to spectroscopy versus RGB color space. There are several general concepts related to analytical chemistry and enzymatic catalysis that are relevant to health and nutrition with regards to the glycemic index, resistant starches, and dietary fiber. Students use their camera phone and image analysis to quantify polysacharide hydrolysis based on reaction with the chromophore dinitrosalicylic acid. The experiment provides a strong visual and quantitative tool showing how a proxy for the glycemic index is influenced by the amylose to amylopectin ratio of a starch and the influence of having an a or [beta] glycosidic bond. A motivating factor for developing the experiment was studies showing tools that assist people's understanding of the glycemic index have beneficial health outcomes.

This study aimed to investigate the role of leptin, ghrelin, neuropeptide Y, and nesfatin-1 in young children with autism spectrum disorder (ASD). A total of 44 children with ASD and 44 healthy controls aged 18-60 months were included. Plasma levels of hormones were measured using commercial enzyme-linked immunosorbent assay kits. Plasma leptin and ghrelin levels were significantly higher in the ASD group than in the control group. However, no significant difference for plasma neuropeptide Y and nesfatin-1 levels was detected between the groups. No relation was found between the severity of ASD symptoms, severity of eating problems, and plasma levels of hormones. Leptin and ghrelin may play a potential role in the pathogenesis of ASD.