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Research about the development of the graphomotor side of writing is very scarce. The goal of this study was to gain a better understanding of what constitutes graphic complexity of written material by determining the impact of graphic characteristics on handwriting production. In this end, the pen stroke of cursive handwriting was precisely described through an algorithm of detection of seven graphic characteristics: the number of angles, turn backs, curves in X and Y, pen-ups and modified links. Twenty typically developing children in grade 2 completed a single-word dictation task, composed of 48 items, on a digital writing tablet. All 48 words were regular words, highly frequent for second graders, and varied in terms of their graphic structure. Their handwriting production for each word was assessed in terms of both legibility and speed. A general linear mixed model was run to determine the impact of each graphic characteristic on handwriting performance. In agreement with our hypothesis, the results showed that words have different levels of graphic complexity. The following characteristics, in order of importance, significantly influenced negatively handwriting legibility: modified links, angles, curves, pen-ups and length. Regarding speed, the angles were the only characteristic that made children slow down while handwriting. These findings represent novelty in the field of research on writing. Unlike the usual approaches, it focused on investigating the graphic complexity at the word-level. It offers for the first time a universal classification of the graphic characteristics of words and it enables the quantification of the graphic complexity of words. [This work was presented at the SIG Writing International Conference 2016 (Liverpool, UK).]

• Abetalipoproteinemia (ABL) is a rare monogenic familial hypobetalipoproteinemia caused by bi-allelic variants in MTTP gene. • We identified four French-Canadian patients homozygous for the same MTTP variant. • The ABL carrier frequency in Saguenay-Lac-Saint-Jean is estimated at 1:203. • This represents the 2nd highest worldwide carrier estimates for ABL. • Screening for ABL should be considered in this population. Abetalipoproteinemia (ABL) is a rare recessive genetic disease caused by bi-allelic pathogenic variants in the microsomal triglyceride transfer protein (MTTP) gene. This disease is characterized by a deficiency in the secretion of apolipoprotein B-containing lipoproteins. Patients with ABL present with neurological, hematological, and gastrointestinal symptoms due to fat malabsorption and a deficiency in liposoluble vitamins. In this report, we present a total of four ABL cases, including three new cases, all originating from the same French-Canadian founder population in Saguenay-Lac-Saint-Jean, Québec, Canada. These individuals are homozygous for the same pathogenic variant in the MTTP gene (c.419dup, p.Asn140Lysfs*2). We found that this variant is more common than anticipated in this population, with an estimated carrier frequency of 1:203. Early diagnosis is essential to initiate treatment known to prevent complications associated with ABL. Population carrier screening or newborn screening for ABL should be considered in this French-Canadian founder population. [ABSTRACT FROM AUTHOR]

AimsThe objective of the Aliskiren Trial on Acute Heart Failure Outcomes (ASTRONAUT) was to determine whether aliskiren, a direct renin inhibitor, would improve post-discharge outcomes in patients with hospitalization for heart failure (HHF) with reduced ejection fraction. Pre-specified subgroup analyses suggested potential heterogeneity in post-discharge outcomes with aliskiren in patients with and without baseline diabetes mellitus (DM).Methods and resultsASTRONAUT included 953 patients without DM (aliskiren 489; placebo 464) and 662 patients with DM (aliskiren 319; placebo 343) (as reported by study investigators). Study endpoints included the first occurrence of cardiovascular death or HHF within 6 and 12 months, all-cause death within 6 and 12 months, and change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 1, 6, and 12 months. Data regarding risk of hyperkalaemia, renal impairment, and hypotension, and changes in additional serum biomarkers were collected. The effect of aliskiren on cardiovascular death or HHF within 6 months (primary endpoint) did not significantly differ by baseline DM status (P = 0.08 for interaction), but reached statistical significance at 12 months (non-DM: HR: 0.80, 95% CI: 0.64-0.99; DM: HR: 1.16, 95% CI: 0.91-1.47; P = 0.03 for interaction). Risk of 12-month all-cause death with aliskiren significantly differed by the presence of baseline DM (non-DM: HR: 0.69, 95% CI: 0.50-0.94; DM: HR: 1.64, 95% CI: 1.15-2.33; P < 0.01 for interaction). Among non-diabetics, aliskiren significantly reduced NT-proBNP through 6 months and plasma troponin I and aldosterone through 12 months, as compared to placebo. Among diabetic patients, aliskiren reduced plasma troponin I and aldosterone relative to placebo through 1 month only. There was a trend towards differing risk of post-baseline potassium ≥6 mmol/L with aliskiren by underlying DM status (non-DM: HR: 1.17, 95% CI: 0.71-1.93; DM: HR: 2.39, 95% CI: 1.30-4.42; P = 0.07 for interaction).ConclusionThis pre-specified subgroup analysis from the ASTRONAUT trial generates the hypothesis that the addition of aliskiren to standard HHF therapy in non-diabetic patients is generally well-tolerated and improves post-discharge outcomes and biomarker profiles. In contrast, diabetic patients receiving aliskiren appear to have worse post-discharge outcomes. Future prospective investigations are needed to confirm potential benefits of renin inhibition in a large cohort of HHF patients without DM.

The visual system converts the distribution and wavelengths of photons entering the eye into patterns of neuronal activity, which then drive motor and endocrine behavioral responses. The gene products important for visual processing by a living and behaving vertebrate animal have not been identified in an unbiased fashion. Likewise, the genes that affect development of the nervous system to shape visual function later in life are largely unknown. Here we have set out to close this gap in our understanding by using a forward genetic approach in zebrafish. Moving stimuli evoke two innate reflexes in zebrafish larvae, the optomotor and the optokinetic response, providing two rapid and quantitative tests to assess visual function in wild-type (WT) and mutant animals. These behavioral assays were used in a high-throughput screen, encompassing over half a million fish. In almost 2,000 F2 families mutagenized with ethyl nitrosourea, we discovered 53 recessive mutations in 41 genes. These new mutations have generated a broad spectrum of phenotypes, which vary in specificity and severity, but can be placed into only a handful of classes. Developmental phenotypes include complete absence or abnormal morphogenesis of photoreceptors, and deficits in ganglion cell differentiation or axon targeting. Other mutations evidently leave neuronal circuits intact, but disrupt phototranscluction, light adaptation, or behavior-specific responses. Almost all of the mutants are morphologically indistinguishable from WT, and many survive to adulthood. Genetic linkage mapping and initial molecular analyses show that our approach was effective in identifying genes with functions specific to the visual system. This collection of zebrafish behavioral mutants provides a novel resource for the study of normal vision and its genetic disorders.

The present study examined the extent to which preschool classroom supports--relational support (RS) and instructional support (IS)--are associated with children's language development and whether these associations vary as a function of children's language ability. The language skills of 360 children within 95 classrooms were assessed using an expressive narrative task in the fall and spring of the preschool year, teachers rated RS in the fall, and observations of IS were collected across the year. Research Findings: Hierarchical linear models revealed main effects of IS, but not RS, on preschoolers' development of expressive language skills. In addition, the associations between RS and IS on children's expressive language development were moderated by children's fall language ability. Specifically, the association between IS and language development was stronger for children with stronger expressive language skills, and the association between RS and language development was stronger for children with weaker expressive language skills. Practice or Policy: These findings suggest that professional development for preschool teachers might focus on aligning classroom supports with the needs of children with weaker language skills who are at risk for difficulty acquiring literacy.

Background: Globally, overweight and obesity affect over one-third of the global population and it is projected that by 2030 obesity will affect more than half of the world population. The current burden of overweight and obesity is attributed to high rates of unhealthy eating and physical inactivity as it had also been revealed in Tanzania. The substantially increased prevalence of malnutrition at young ages is associated with a high incidence of non-communicable diseases in the young population and ultimately increased premature deaths. Objectives: This study aimed to assess eating habits, physical exercise patterns, and the overweight/obesity status among undergraduate students at the Muhimbili University of Health and Allied Sciences (MUHAS). Methods: A quantitative cross-sectional study was conducted between January and March 2022 by employing a stratified sampling technique to recruit 232 undergraduate nursing students. A selfadministered questionnaire and anthropometric measurements were used to obtain data which were finally analyzed using SPSS version 25. Results: The prevalence of overweight/obesity was 20.2%. Approximately 43% of the participants were physically inactive, with a higher proportion among females compared to males p=0.001. Male participants were more likely to perform physical exercises for a longer duration (≥ 30 minutes per day) compared to female participants, p=0.008. The consumption of more than three meals per day was associated with an increased odds of being overweight/obese than the consumption of three meals or less per day (OR: 3.11; 95%CI: 1.11-8.73). Similarly, the average long duration of sleeping per day (eight hours or more) was associated with an increased odds of being overweight/obese than sleeping less than eight hours per day (OR: 2.08; 95%CI: 1.06-4.11). Conclusions: The findings revealed high rates of unhealthy eating habits, physical inactivity patterns and a significant prevalence of overweight/obesity. This indicates a need for developing actionable interventions and national health programs to promote healthy eating habits and physical activity, particularly among university students. [ABSTRACT FROM AUTHOR]

Purpose: In this study, the authors used sequential analysis to explore bidirectional and dynamic dependencies between mothers' question use and children's verbal participation during shared reading. Method: The sample was composed of mothers and their preschool-age children with specific language impairment (SLI; n = 14). Each mother and child extratextual utterance was transcribed and coded. Mother utterances were coded as "questions" or "other"; in turn, questions were coded for cognitive challenge and topic directiveness. Child utterances were coded as "verbal participation" (related to the book) or "other"; utterances designated as verbal participation were also coded for level of production (minimal, low, high) on the basis of their mean length of utterance. Results: Descriptive data show variability in mothers' question use and some variability in the level of children's verbal participation during shared reading. However, mothers' question use did not facilitate higher levels of verbal participation by children. Furthermore, the level of children's verbal participation did not influence the cognitive challenge and topic directiveness of mothers' question use. Conclusions: The findings were contrary to hypotheses and collectively suggest potentially unique and challenging verbal dynamics between mothers and their young children with SLI during shared-reading experiences. Future directions for research are discussed.

Purpose: Speech-language pathologists (SLPs) and reading professionals provide educational services to children who are at risk for reading difficulties, although these professions do not necessarily coordinate efforts. To date, there is limited evidence regarding the proportion of children who receive services from both professionals. The current study reports the prevalence and overlap of speech-language and reading services provided to kindergartners and first graders in Virginia. Method: This study analyzed a population-level database of reading screening scores from 74,730 kindergartners and 75,088 first graders. Information regarding the speech-language services received by these children was obtained. Prevalence rates of speech-language impairment, reading risk, and comorbidity were calculated. The distribution of children receiving speech-language services across categories of reading competence was examined. Results: Findings indicated that approximately 6% of the children received speech-language services and 11.1% of the kindergartners and 13.7% of the first graders received reading services. One-quarter of the children receiving speech-language services also received reading services. Furthermore, children receiving speech-language services received reading services at twice the rate of children who were not receiving speech-language services in both kindergarten (23.1% vs. 9.1%) and first grade (25.2% vs. 11.3%). Clinical Implications: This study provides empirical support for improving coordination between SLPs and reading professionals.

There is a perceived shortage of male teachers in education, particularly at the primary/junior (P/J) level where male teachers in Canada account for a dwindling minority. Included among the many factors inhibiting males from becoming P/J teachers are perceptions that males might be unduly vulnerable to false accusations of inappropriate conduct with pupils, frequently of a sexual nature. This paper highlights findings of research exploring the experiences of male P/J teachers in Ontario. Results of an online survey completed by 223 male P/J teachers are discussed; 28 of these teachers reported they had been suspected of having had inappropriate contact with pupils and wrote online comments outlining their experience. The findings are discussed in the context of what it means to be a male assuming a non-traditional role of working with young children in today's milieu. (Contains 3 notes.)