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Cervical Artery Dissection is an important cause of stroke in the young. Data on incidence and associations of recurrence in patients with cervical artery dissection are lacking. Increased Vertebral Artery Tortuosity Index has been reported in patients with cervical artery dissection and associated with earlier age of arterial dissection in patients with connective tissue disease.To test the hypothesis that increased vertebral artery tortuosity is associated with recurrent cervical artery dissection.We reviewed data from a single-center registry of cervical artery dissection patients enrolled between 2011-2021. CT angiography was reviewed for neck length, vertebral artery dominance, and vertebral artery tortuosity index. Incidence rate of recurrent dissection was calculated using Poisson regression. Differences between groups were analyzed using the Kruskal-Wallis rank sum test and Fisher's exact test.The cohort included 155 patients: women (56%), mean (SD) age 42 (±10) years, and 116 single and 39 multiple artery dissections. Eleven (7.1%) had a recurrence with an incidence rate (95% CI) of 1.91 (1.06, 3.44) per 100 person-years. Vertebral artery tortuosity did not differ significantly between single and recurrent groups (median (IQR) 46.81 (40.85, 53.91) vs 44.97 (40.68, 50.62) p = 0.388). Morphometric characteristics of height, neck length, and BMI were not associated with recurrence. There was no difference in vertebral artery tortuosity by dissection location (carotid vs vertebral).In this single center cohort of patients with cervical artery dissection, there was no difference in VTI between single and recurrent groups.

The learning environment has been found to be related to mathematics anxiety at a variety of educational levels, including higher education, but to date has not been investigated in relation to preservice teachers. It has been previously found that preservice teachers often harbour high levels of mathematics anxiety, and that mathematics-anxious teachers devote less time to the subject area, teach in less effective ways, and can even transmit anxiety to their students. Mathematics teaching anxiety is a construct separate from mathematics anxiety, and the relationship between the two has shown very mixed results. To date, the relationship between the learning environment and mathematics teaching anxiety has not been examined. This cross-sectional study in the UAE examined the relationship between 157 preservice teachers’ perceptions of their mathematics learning environments in a teacher education programme and reports of their mathematics anxiety and mathematics teaching anxiety. The learning environment was predominantly negatively related to mathematics anxiety across a number of scales, but predominantly positively related to mathematics teaching anxiety, indicating that the learning environment is of utmost importance in teacher education and must be carefully attended to.

Experiential learning is a critical component of sport management education and industry preparation; however, the inclusion of time-intensive experiential projects can displace content learning. Blended learning integrates face-to-face and online instruction to enable the space to maximize multiple learning types. This article proposes an innovative experiential project that integrates blended learning—implemented in a sport event management course—with reflection and scholarship supporting the pedagogical strategies. The article concludes with implications to optimize blended learning (e.g., multimedia, pedagogical workshops, course evaluation), enhance communication (e.g., office hours, discussion forum, orientation video), and expand student learning outcomes (e.g., reading outlines, video lectures, student assessment).

Although school and education system leaders can mandate teachers’ participation in professional development activities, various school-related, teacher-related and student-related factors influenc...

Because adolescent life satisfaction is associated with important affective, behavioural and health-related outcomes during both adolescence and later life, strategies for promoting adolescent life satisfaction have potential social value. In the study reported in this article, associations are reported between perceptions of the school climate and reports of bullying, resilience and life satisfaction for 6120 Australian adolescents. The study extended past research, which has given little attention to either the relationships between these variables or the relative roles of various school climate sub-constructs. Aspects of the school climate explained 41% of the variance in adolescents’ resilience, 16% of the variance in bully victimisation, and 54% of the variance in life satisfaction. Further, resilience was positively associated with life satisfaction. These results affirm the importance of the psychosocial school climate as a mechanism for improving adolescent (and life-course) outcomes, strengthening calls for schools to give greater attention to improving their psychosocial climates.

A recurring debate in mixed methods research involves the relationship between research methods and research paradigms. Whereas some scholars appear to assume that qualitative and quantitative rese...

As part of major education reform efforts underway in the United Arab Emirates (UAE), teachers have been introducing cooperative teaching methods in their science classes. Given the limited research carried out in this context, we aimed to: first, provide evidence to support a modified and translated (Arabic/English) version of a well-known learning environment instrument; and, second, to examine whether relationships exist between the learning environment and students’ attitudes, engagement and science career aspirations in science classes in the unique context of the UAE. The sample included 784 students in 34 lower-secondary science classes in eight public schools in Abu Dhabi, UAE. The findings supported the validity of the dual-language Arabic/English version of the What Is Happening In this Class? (WIHIC) when used in this context. Also all five learning environment scales were statistically significantly (p

Introduction While patients with acute uncomplicated appendicitis may be treated conservatively, those who suffer from complicated appendicitis require surgery. We describe a logistic regression equation to calculate the likelihood of acute uncomplicated appendicitis and complicated appendicitis in patients presenting to the emergency department with suspected acute appendicitis. Materials and methods A cohort of 895 patients who underwent appendicectomy were analysed retrospectively. Depending on the final histology, patients were divided into three groups; normal appendix, acute uncomplicated appendicitis and complicated appendicitis. Normal appendix was considered the reference category, while acute uncomplicated appendicitis and complicated appendicitis were the nominal categories. Multivariate and univariate regression models were undertaken to detect independent variables with significant odds ratio that can predict acute uncomplicated appendicitis and complicated appendicitis. Subsequently, a logistic regression equation was generated to produce the likelihood acute uncomplicated appendicitis and complicated appendicitis. Results Pathological diagnosis of normal appendix, acute uncomplicated appendicitis and complicated appendicitis was identified in 188 (21%), 525 (59%) and 182 patients (20%), respectively. The odds ratio from a univariate analysis to predict complicated appendicitis for age, female gender, log2 white cell count, log2 C-reactive protein and log2 bilirubin were 1.02 (95% confidence interval, CI, 1.01, 1.04), 2.37 (95% CI 1.51, 3.70), 9.74 (95% CI 5.41, 17.5), 1.57 (95% CI 1.40, 1.74), 2.08 (95% CI 1.56, 2.76), respectively. For the same variable, similar odds ratios were demonstrated in a multivariate analysis to predict complicated appendicitis and univariate and multivariate analysis to predict acute uncomplicated appendicitis. Conclusions The likelihood of acute uncomplicated appendicitis and complicated appendicitis can be calculated by using the reported predictive equations integrated into a web application at www.appendistat.com. This will enable clinicians to determine the probability of appendicitis and the need for urgent surgery in case of complicated appendicitis.

Purpose: The purpose of this research was to examine the methodological factors that judges perceive as reasons for excluding the expert testimony of forensic accountants in order to map this rationale onto the Daubert standard., Methodology: A case study research design using a qualitative content analysis of 34 federal cases involving methodological violations of the Daubert standard was selected. Open and axial coding was applied to the judicial statements to ascertain the general themes as well as the specific categories that constituted those themes., Findings: Judges primarily excluded testimony based on deficiencies in evidence, methods, and reasoning. Deficiencies in evidence and method were isomorphic with the Daubert standard, whereas deficiencies in reasoning were unique to this analysis. Further, these thematic categories were interconnected in ways not explicitly expressed in the Federal Rules of Evidence., Originality/Value: This study provided a detailed understanding of how judges understood methodological deficiencies when applying the Daubert standard in order to exclude the testimony of forensic accountants. Practical insights on what forensic accountants should focus on when analyzing their own methodological concerns is obtained., peer-reviewed

Previous studies have identified dementia as a risk factor for death from coronavirus disease 2019 (COVID-19). However, it is unclear whether Alzheimer’s disease (AD) is an independent risk factor for COVID-19 case fatality rate. In a retrospective cohort study, we identified 387,841 COVID-19 patients through TriNetX. After adjusting for demographics and comorbidities, we found that AD patients had higher odds of dying from COVID-19 compared to patients without AD (Odds Ratio: 1.20, 95%confidence interval: 1.09–1.32, p

The analysis of heterogeneous subpopulations of circulating tumor cells (CTCs) is critical to enhance our understanding of cancer metastasis and enable non-invasive cancer diagnosis and monitoring. The phenotypic variability and plasticity of these cells – properties closely linked to their clinical behavior – demand techniques that isolate viable, discrete fractions of tumor cells for functional assays of their behavior and detailed analysis of biochemical properties. Here, we introduce the Prism Chip, a high-resolution immunomagnetic profiling and separation chip which harnesses a cobalt-based alloy to separate a flowing stream of nanoparticle-bound tumor cells with differential magnetic loading into ten discrete streams. Using this approach, we achieve exceptional purity (5.7 log white blood cell depletion) of isolated cells. We test the differential profiling function of the integrated device using prostate cancer blood samples from a mouse xenograft model. Using integrated graphene Hall sensors, we demonstrate concurrent automated profiling of single cells and CTC clusters that belong to distinct subpopulations based on protein surface expression.

The central role of teacher professional development in educational improvement is well-documented, and the investments of time and money into teacher professional development across the globe are ...

Promoting adolescent mental health is a global priority, and schools have an important role to play. This systematic mixed- methods literature review examined relationships between the psychosocial school climate and adolescents’ mental health, mapping the scope and quality of recent research. Forty-eight relevant primary studies published in 2000–2017 were identified and analysed. These studies highlight associations between the school climate and student mental health, although the lack of experimental and longitudinal studies precludes causal claims. Future research directions include: further investigation of the roles of school safety and the psychosocial academic environment on adolescent mental health; greater consistency in the conceptualisation of both school climate and mental health; and clarification of the influence of demographic variables on individual students’ experiences.

Background Rectovaginal fistulas (RVF) and anovaginal fistulas (AVF) in Crohn’s disease (CD) are rare, debilitating conditions that present substantial disease and treatment burdens for women. In this systematic literature review (SLR), articles relating to the epidemiology and burden of CD-related RVF and AVF were assessed in order to summarize evidence from observational studies and highlight knowledge gaps. Methods Articles published in the past 10 years in PubMed and Embase that provide data on incidence, prevalence and insight into the patient experience and disease burden of CD-related RVF and AVF (PROSPERO registration number CRD42020177732) were identified. Two trained reviewers used pre-specified eligibility criteria to identify studies for inclusion and evaluate risk of bias using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool for observational studies. Data were extracted for a range of variables, including study type and design, population, outcomes and limitations. Results Of the 582 records identified, 316 full-text articles were assessed, and 16 studies that met a priori eligibility criteria were included (Figure). Three epidemiology studies were identified, with one study estimating the prevalence of RVF to be 2.3% in women with CD. No studies relating to the incidence or prevalence of AVF were identified. Seven of 12 treatment-pattern studies reported that patients had or required additional procedures before and/or after the intervention of interest, demonstrating substantial treatment burden. Of the nine studies that reported healing/success across multiple surgical types, rates ranged from 14.4% to 81.0%. In the seven studies that assessed clinical outcomes, healing rates were in the range 50–75%, with varying estimates dependent on population and intervention. Two studies reported recurrence rates of 13.3–55.8% across multiple surgical interventions. Patient-reported outcomes obtained using standardized measures were reported in only one of the 16 studies and were limited to overall health related quality of life, faecal incontinence-related quality of life and female sexual function index. None of the 16 studies included reported healthcare-resource utilization in this patient population. Conclusion This SLR shows the high disease and treatment burdens of RVF and AVF in patients with CD and identifies multiple evidence gaps in this field. The published literature lacks robust, generalizable data and demonstrates a compelling need for substantial novel research into these rare and debilitating sequelae of CD. Sponsor: Takeda Pharmaceuticals USA, Inc.

One hallmark feature of Parkinson’s disease (PD) is Lewy body pathology associated with misfolded alpha-synuclein. Previous studies have shown that striatal injection of alpha-synuclein preformed fibrils (PFF) can induce misfolding and aggregation of native alpha-synuclein in a prion-like manner, leading to cell death and motor dysfunction in mouse models. Here, we tested whether alpha-synuclein PFFs injected into the medial prefrontal cortex results in cognitive deficits in mouse models as measured by interval timing, which is reliably disrupted in PD patients and in rodent models. We injected human alpha-synuclein PFF or monomers in the medial prefrontal cortex pre-injected with adeno-associated virus (AAV) overexpressing human alpha-synuclein. Despite notable medial prefrontal cortical synucleinopathy, we did not observe consistent deficits in fixed-interval timing. These results suggest that cortical alpha-synuclein does not reliably disrupt interval timing in rodent models.HighlightsCortical injection of alpha-synuclein preformed fibrils (PFF) induces diffuse synucleinopathyCortical injection of PFFs does not affect interval timing in miceMedial prefrontal cortical synucleinopathy does not reliably disrupt interval timing

Schools and education systems are being challenged to improve the evaluation of teacher professional development, yet there is a lack of practical tools for doing so. This article describes the development and validation of a new instrument to assess teachers’ perceptions of the impact of professional development. This instrument, designed to be time- and cost-effective, was theoretically grounded and, as evidenced by the results reported in this article, psychometrically sound. The instrument was completed twice (examining different types of professional development) by 393 teachers. The results for both data-sets demonstrated a strong factor structure with good internal consistency for all scales. Further data analysis indicated that the scales could effectively distinguish between the experiences of different groups of teachers. The finalised instrument, named the Impact of Teacher Professional Development Questionnaire, is presented in full, and the practical advantages and limitations of the ...

The current push for principals’ to be accountable for student outcomes has led to a renewed interest in the role of leadership in instructional improvement. This article describes the development ...

Given that schools are, potentially, powerful sites for influencing adolescent behaviour, it is important that there is greater understanding of the psychosocial aspects of the school climate that can be leveraged for this purpose. The research reported in this article used structural equation modelling (with data from a sample of 6120 students at Australian high schools) to examine the influence of the psychosocial school-level environment on students’ self-reported experiences of bully victimisation (i.e. being victims of bullying) and engagement in delinquent behaviours. Further, we examined whether bully victimisation mediated the relationships between school climate variables and delinquent behaviours. School connectedness and rule clarity were negatively associated with both bully victimisation and delinquency (p

Over the past 40 years, numerous instruments have been developed to assess the learning environment for a variety of purposes. Despite this plethora of available surveys, there are few that have been developed for use at the primary school level, and even fewer that have been comprehensively validated. This article describes the development of a long-overdue learning environment survey that is suited to primary school students. Evidence to support the validity of the survey, in terms of translation and criterion validity, was guided by Trochim and Donnelly’s (2006) construct validity framework. A pilot test involving one class of 30 students and interviews with six students was used to examine the face validity of individual items. Analyses of data collected from 609 students in 31 classes supported the convergent, concurrent, discriminant and predictive validity, the results of which were all satisfactory. This article is significant in that it provides educators and researchers with a valid tool to assess the learning environment. The instrument, named the Classroom Climate Questionnaire—Primary (CCQ-P), is described and its practical advantages and limitations are discussed.

// Staci L. Haney 1 , Cheryl Allen 2 , Michelle L. Varney 1 , Kaitlyn M. Dykstra 2 , Eric R. Falcone 3 , Sean H. Colligan 2 , Qiang Hu 4 , Alyssa M. Aldridge 5 , Dennis L. Wright 3 , Andrew J. Wiemer 3 and Sarah A. Holstein 1 1 Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA 2 Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA 3 Department of Pharmaceutical Sciences, University of Connecticut, Storrs, CT, USA 4 Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY, USA 5 Brown University, Providence, RI, USA Correspondence to: Sarah A. Holstein, email: sarah.holstein@unmc.edu Keywords: myeloma, tropolone, histone deacetylase, unfolded protein response, apoptosis Received: January 21, 2017 Accepted: June 02, 2017 Published: June 16, 2017 ABSTRACT Tropolones are small organic compounds with metal-directing moieties. Tropolones inhibit the proliferation of cancer cell lines, possibly through their effects on metalloenzymes such as select histone deacetylases (HDACs). Pan-HDAC inhibitors are therapeutically beneficial in the treatment of multiple myeloma, however there is interest in the use of more selective HDAC inhibitor therapy to minimize adverse side effects. We hypothesized that tropolones might have anti-myeloma activities. To this end, a series of novel α-substituted tropolones were evaluated for effects on multiple myeloma cells. While all tested tropolones showed some level of cytotoxicity, MO-OH-Nap had consistently low IC 50 values between 1–11 μM in all three cell lines tested and was used for subsequent experiments. MO-OH-Nap was found to induce apoptosis in a concentration-dependent manner. Time course experiments demonstrated that MO-OH-Nap promotes caspase cleavage in a time frame that was distinct from the pan-HDAC inhibitor suberoylanilide hydroxamic acid (SAHA). Furthermore, MO-OH-Nap- and SAHA-treated cells possess unique gene expression patterns, suggesting they promote apoptosis via different mechanisms. In particular, MO-OH-Nap increases the expression of markers associated with endoplasmic reticulum stress and the unfolded protein response. Synergistic cytotoxic effects were observed when cells were treated with the combination of MO-OH-Nap and the proteasome inhibitor bortezomib. However, treatment with MO-OH-Nap did not abrogate the bortezomib-induced increase in aggresomes, consistent with an HDAC6-independent mechanism for the observed synergy. Collectively, these finding support further investigation into the usefulness of α-substituted tropolones as anti-myeloma agents.

Background Surgical site infections (SSIs) are noteworthy and costly complications. New recommendations from a national organization have urged the elimination of traditional surgeon's caps (surgical skull caps) and mandated the use of bouffant caps to prevent SSIs. Objective To report SSI rates for >15 000 class I (clean) surgical procedures 13 mo before and 13 mo after surgical skull caps were banned at a single site with 25 operating rooms. Methods SSI data were acquired from hospital infection control monthly summary reports from January 2014 to March 2016. Based on a change in hospital policy mandating obligatory use of bouffant caps since February 2015, data were categorized into nonbouffant and bouffant groups. Monthly and cumulative infection rates for 13 mo before (7513 patients) and 13 mo after (8446 patients) the policy implementation were collected and analyzed for the groups, respectively. Results An overall increase of 0.07% (0.77%-0.84%) in the cumulative rate of SSI in all class I operating room cases and of 0.03% (0.79%-0.82%) in the cumulative rate of SSI in all spinal procedures was noted. However, neither increase reached statistical significance (P > .05). The cumulative rate of SSI in neurosurgery craniotomy/craniectomy cases decreased from 0.95% to 0.75%; this was also not statistically significant (P = 1.00). Conclusion National efforts at improving healthcare performance are laudable but need to be evidence based. Guidelines, especially when applied in a mandatory fashion, should be assessed for effectiveness. In this large, single-center series of patients undergoing class I surgical procedures, elimination of the traditional surgeon's cap did not reduce infection rates.

This study examined the relationships between principals’ leadership, school climate, and teachers’ sense of self-efficacy. Drawing on existing scales, this study examined six aspects of principal leadership (professional interaction, participatory decision-making, individual support, intellectual stimulation and moral perspective) and four school climate factors (staff collegiality, goal consensus, work pressure, resource adequacy, and staff freedom). The participants included 604 Indonesian teachers drawn from 27 high schools. The data were analysed using Structural Equation Modeling. The results indicated statistically significant and positive relationships between leadership style, school climate, and teacher self-efficacy. With the exception of individual support, the relationships between principal leadership and teacher self-efficacy were largely indirect, mediated through staff collegiality and goal consensus.

Genome-scale functional genetic screens can be used to interrogate determinants of protein expression modulation of a target of interest. Such phenotypic screening approaches typically require sorting of large numbers of cells (>108). In conventional cell sorting techniques (i.e. fluorescence-activated cell sorting), sorting time, associated with high instrument and operating costs and loss of cell viability, are limiting to the scalability and throughput of these screens. We recently established a rapid and scalable high-throughput microfluidic cell sorting platform (MICS) using immunomagnetic nanoparticles to sort cells in parallel capable of sorting more than 108 HAP1 cells in under one hour while maintaining high levels of cell viability (Ref. 1). This protocol outlines how to set-up MICS for large-scale phenotypic screens in mammalian cells. We anticipate this platform being used for genome-wide functional genetic screens as well as other applications requiring the sorting of large numbers of cells based on protein expression.

Genome-scale functional genetic screens are used to identify key genetic regulators of a phenotype of interest. However, the identification of genetic modifications that lead to a phenotypic change requires sorting large numbers of cells, which increases operational times and costs and limits cell viability. Here, we introduce immunomagnetic cell sorting facilitated by a microfluidic chip as a rapid and scalable high-throughput method for loss-of-function phenotypic screening using CRISPR–Cas9. We used the method to process an entire genome-wide screen containing more than 108 cells in less than 1 h—considerably surpassing the throughput achieved by fluorescence-activated cell sorting, the gold-standard technique for phenotypic cell sorting—while maintaining high levels of cell viability. We identified modulators of the display of CD47, which is a negative regulator of phagocytosis and an important cell-surface target for immuno-oncology drugs. The top hit of the screen, the glutaminyl cyclase QPCTL, was validated and shown to modify the N-terminal glutamine of CD47. The method presented could bridge the gap between fluorescence-activated cell sorting and less flexible yet higher-throughput systems such as magnetic-activated cell sorting. Immunomagnetic cell sorting implemented in a microfluidic chip can perform loss-of-function CRISPR–Cas9-mediated phenotypic screening at higher throughput than fluorescence-activated cell sorting.

Genome-scale functional genetic screens can identify key regulators of a phenotype of interest, such as determinants of protein expression or modification. Here, we present a rapid, high-throughput approach to phenotypic CRISPR-Cas9 screening. To study factors that modulate the display of CD47 on the cell surface, we processed an entire genome-wide screen containing more than 108cells in under one hour and maintained high levels of cell viability using a highly scalable cell sorting technology. We robustly identified modulators of CD47 function including QPCTL, an enzyme required for formation of the pyroglutamyl modification at the N-terminus of this protein.

The decision to move is influenced by sensory, attentional, and motivational cues. One such cue is the quality of the tactile input, with noxious or unpleasant sensations causing an animal to move away from the cue. Processing of painful and unpleasant sensation in the cortex involves multiple brain regions, although the specific role of the brain areas involved in voluntary, rather than reflexive movement away from unpleasant stimuli is not well understood. Here, we focused on the medial subdivision of secondary motor cortex, which is proposed to link sensory and contextual cues to motor action, and tested its role in controlling voluntary movement in the context of an aversive tactile cue. We designed a novel, 3D-printed tactile platform consisting of innocuous (grid) and mildly noxious (spiked) surfaces (50:50 % of total area), which enabled monitoring neuronal activity in the medial frontal cortex by two-photon imaging during a sensory preference task in head-fixed mice. We found that freely moving mice spent significantly less time on a spiked-surface, and that this preference was eliminated by administration of a local anesthetic. At the neuronal level, individual neurons were differentially modulated specific to the tactile surface encountered. At the population level, the neuronal activity was analyzed in relation to the events where mice chose to "stop-on" or "go-from" a specific tactile surface and when they "switched" surfaces without stopping. Notably, each of these three scenarios showed population activity that differed significantly between the grid and spiked tactile surfaces. Collectively, these data provide evidence that tactile quality is encoded within medial frontal cortex. The task pioneered in this study provides a valuable tool to better evaluate mouse models of nociception and pain, using a voluntary task that allows simultaneous recording of preference and choice.

We investigated (1) whether the learning environment perceptions of students in classes frequently exposed to multimedia differed from those of students in classes that were not, (2) whether exposure to multimedia was differentially effective for males and females and (3) relationships between students’ perceptions of the learning environment and student engagement in classes that were exposed to multimedia. The sample involved 365 high-school students in 16 classes, nine that were frequently exposed to multimedia and seven that were not. Two instruments were administered to students: one to assess students’ perceptions of the learning environment and another to assess student engagement. There were statistically significant differences between the two groups for all of the learning environment scales, as well as statistically significant interactions between exposure to multimedia and sex for three learning environment scales (Involvement, Task Orientation and Equity). Finally, the learning environment in mathematics classes that involved multimedia was related to student engagement. These results offer potentially important insights into how student exposure to multimedia could promote more positive learning environments and improve student engagement in mathematics.

The flow around an isolated cylinder with a Boger fluid was studied experimentally by partially immersing a small vertical cylinder in a test fluid contained in an annular tank slowly rotating on a turntable. To approximate isolation, the ratio of the tank width to cylinder diameter varied from 40/1 to 300/1, and Reynolds numbers ranged from 10−5 to 0.5. Drag was measured by a custom-made mechanical/optical system and the flow field was mapped using particle image velocimetry (PIV). The experimental liquids were two Newtonian fluids and two polyisobutylene/polybutene Boger fluids, and the cylinders had various diameters. The Newtonian drag data, corrected for end and wall effects, agree with Kaplun's low-Re asymptotic formula. Elasticity increased the drag, starting at a Deborah number of 0.6, by 50% at a De of 2.5, and by more at higher Deborah numbers. PIV measurements were made around a cylinder—upstream, downstream, and transversely—and at 180° from it. The velocity measurements showed that the wake increased with De, among other findings. To relate the increased drag to fluid elasticity, normal stresses due to elasticity were found from deformation rates derived from the PIV data, but these stresses appear to be insufficient to account for the effect.

The ability to navigate stairs step-over-step is an important functional outcome following severe lower leg injury and is difficult for many patients. Ankle-foot orthoses, such as the Intrepid Dynamic Exoskeletal Orthosis (IDEO), are often prescribed to improve function. This study compared stair climbing mechanics between IDEO users and able-bodied control participants. Thirteen IDEO users who sustained severe lower leg injury and 13 controls underwent biomechanical gait analysis. Participants ascended and descended a 16-step instrumented staircase without handrail use at a controlled cadence of 80 steps/min. Peak joint angles, moments, powers, and ground reaction forces, and integrated mechanical work were calculated. Independent t-tests with Bonferroni-Holm corrections were used to compare controls to IDEO and sound limbs. Reduced ankle range of motion on the IDEO limb resulted in compensatory strategies while ascending or descending stairs. During ascent, IDEO users had greater bilateral hip power during pull-up (p

This article reports on the differential effectiveness of a teacher professional development programme for teachers in urban and rural schools in Indonesia. The study employed an embedded mixed methods design that involved the concurrent collection of both quantitative and qualitative data. The quantitative component involved a pre–post design in which two surveys were administered to a sample of 2417 students drawn from 66 classes in 32 lower secondary schools (960 from urban schools and 1457 from rural schools). The qualitative component involved six case study teachers and two students from each of their classes. Qualitative information was gathered using teacher and student interviews, classroom observations and teacher reflective journals. The quantitative results suggested that there were disparities between the usefulness of the knowledge and skills imparted during the programme for teachers in urban and rural schools. The themes that emerged from the data gathered using qualitative methods helped ...

Individuals with leg amputations who use passive prostheses have greater metabolic demands than non-amputees likely due to limited net positive work compared to a biological ankle. New powered ankle-foot prostheses can perform net positive mechanical work to aid push-off capabilities, which may reduce metabolic demands.Compare step-to-step transition work and metabolic demand during level and inclined walking using passive and powered ankle-foot prostheses.Repeated measures.Six individuals with transtibial amputation and six able-bodied controls walked at a standardized speed across level ground and up a 5° incline. Calculated measures included mechanical work during step-to-step transitions from the trailing prosthetic to leading intact limb, steady state metabolic rate, and ankle joint kinetics and kinematics.The powered prosthesis generated 63% greater trailing limb step-to-step transition work than the passive during level walking only (p = 0.004). Metabolic rate was lower with the powered prosthesis during level (p = 0.006) but not inclined walking (p = 0.281). The powered prosthesis increased ankle power compared to the passive, to the extent that power was normalized to controls during inclined walking and greater than controls during level walking.The powered prosthesis improved ankle power, metabolic rate, and step-to-step transition work on level ground, with few negative consequences on inclines. These results may be used to guide the development and use of actively powered prosthetic devices in high-functioning individuals.Overall, powered devices offer biomechanical and metabolic benefits over passive energy storage and return designs on level ground and perform as well as a passive model on inclines. The lower metabolic demand when using the powered device may delay fatigue for individuals with transtibial amputation when walking over level ground.

FoxP3(+) Treg cells and anergic T cells are the two regulatory phenotypes of T-cell responses associated with helminth infection. Here, we examine the T-cell responses in mice during Fasciola hepatica infection, and to its tegumental coat antigens (FhTeg) that are shed from the fluke every 2-3 h. FhTeg comprises a rich source of glycoproteins, mainly oligomannose N-glycans that bind to mannose receptor. This study demonstrated a novel mechanism for the T-cell unresponsiveness observed during F. hepatica infection and after injection with FhTeg. Markers of T-cell anergy, such as GRAIL, EGR2, ICOS, and ITCH, are enhanced amongst CD4(+) T-cell populations during infection and following FhTeg injection. This is characterized by a lack of cytokine responses and reduced proliferative activity, which can be reversed with the addition of IL-2. FhTeg-activated dendritic cells (DCs) suppress T cells in vitro as measured by enhanced GRAIL and CTLA4 by RNA and suppressed cytokine expression in anti-CD3 stimulated CD4(+) T cells. FhTeg-treated DCs have enhanced MR expression, which is critical for DC-CD4(+) T-cell communication. Taken together, this study presents markers of anergy in a mouse model of F. hepatica infection, and improves our understanding of host-pathogen interactions and how helminths modulate host immunity.

Image-reversal soft lithography enables the straightforward fabrication of high-performance biosensors without requiringhigh-resolution photolitography.

Lewy body dementias are characterized by deposition of alpha-synuclein (α-syn) protein aggregates known as Lewy bodies and Lewy neurites in cortical regions, in addition to brainstem. These aggregates are thought to cause the death of dopaminergic neurons in the substantia nigra and other vulnerable cell types in patients, leading to parkinsonism. There is evidence from mice that localized overexpression of wild-type α-syn leads to dopaminergic cell death in the substantia nigra. However, it is not known how cortical neurons are affected by α-syn. In this study, we used viral overexpression of α-syn to investigate whether localized overexpression within the cortex affects the density, length, and morphology of dendritic spines, which serve as a measure of synaptic connectivity. An AAV2/6 viral vector coding for wild-type human α-syn was used to target overexpression bilaterally to the medial prefrontal cortex within adult mice. After ten weeks the brain was stained using the Golgi-Cox method. Density of dendritic spines in the injected region was increased in layer V pyramidal neurons compared with animals injected with control virus. Immunohistochemistry in separate animals showed human α-syn expression throughout the region of interest, especially in presynaptic terminals. However, phosphorylated α-syn was seen in a discrete number of cells at the region of highest overexpression, localized mainly to the soma and nucleus. These findings demonstrate that at early timepoints, α-syn overexpression may alter connectivity in the cortex, which may be relevant to early stages of the disease. In addition, these findings contribute to the understanding of α-syn, which when overexpressed in the wildtype, non-aggregated state may promote spine formation. Loss of spines secondary to α-syn in cortex may require higher expression, longer incubation, cellular damage, concomitant dopaminergic dysfunction or other two-hit factors to lead to synaptic degeneration.

Purpose Traumatic subdural hemorrhage (SDH) is associated with high mortality, yet many patients are not managed surgically. We sought to understand what factors might be associated with SDH enlargement to contribute to the triage of these conservatively managed patients. Materials and methods A consecutive series of 117 patients admitted to our institution's level 1 trauma center for SDH between January 1, 2010 and December 31, 2010 were evaluated. Volumetric measurement of SDHs was performed on initial and follow-up head computed tomography (CT) scans with recording of initial midline shift and classification by location. Multimodel analysis quantified associations with change in SDH volume. Results Systolic blood pressure, presence of subarachnoid hemorrhage, and initial SDH volume demonstrated positive associations with change in SDH volume, while initial midline shift and transfusion of platelets demonstrated negative associations. Initial convexity SDH volume demonstrated positive association with change in convexity SDH volume, while initial midline shift and transfusion of platelets demonstrated negative associations. Anticoagulant/antiplatelet use demonstrated positive association with change in tentorial SDH volume, while time between CT scans demonstrated negative association. Conclusions Platelet transfusion, anticoagulation, and hypertension have significant associations with expansion in non-surgical cases of SDH. Monitoring these factors may assist triaging these patients.

Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB) are common causes of dementia worldwide. Although considered separate entities based on the relative temporal onset of motor symptoms vs. diagnosis of dementia, it is unknown if these diseases truly have distinct cognitive profiles. We hypothesized that patients divided into PDD and DLB categories strictly by temporal criteria would have different neuropsychological profiles. We investigated this question via neuropsychological testing of PDD and DLB patients at the University of Iowa. We performed retrospective chart analysis and review of neuropsychological testing of clinically diagnosed patients with PDD or DLB, who had presented to University of Iowa’s dementia and movement disorder clinics. Forty-seven patients diagnosed by the treating neurologist as PDD or DLB were included. Neuropsychological performance was compared between groups, and as a function of the relative timing of the motor diagnosis vs. diagnosis of dementia. We found that both PDD and DLB patients showed severe deficits in executive function, visual–spatial processing, and verbal learning. However, we found no significant differences in neuropsychological performance between groups, and neuropsychological performance could not reliably account for the relative timing of motor diagnosis vs. diagnosis of dementia. Our data support the idea that DLB and PDD are on a neuropsychological spectrum.

Helminth infection and their secreted antigens have a protective role in many immune-mediated inflammatory disorders such as inflammatory bowel disease, rheumatoid arthritis and multiple sclerosis. However, studies have focused primarily on identifying immune protective mechanisms of helminth infection and their secreted molecules on dendritic cells and macrophages. Given that mast cells have been shown to be implicated in the pathogenesis and progression of many inflammatory disorders, their role should also be examined and considered as cellular target for helminth-based therapies. As there is a dearth of studies examining the interaction of helminth-derived antigens and mast cells, this review will focus on the role of mast cells during helminth infection and examine our current understanding of the involvement of mast cells in TH 1/TH 17-mediated immune disorders. In this context, potential mechanisms by which helminths could target the TH 1/TH 17 promoting properties of mast cells can be identified to unveil novel therapeutic mast cell driven targets in combating these inflammatory disorders.

Individuals with unilateral transfemoral amputation demonstrate significantly increased rates of osteoarthritis in their sound knee. This increased risk is likely the result of altered knee mechanical loading and gait compensations resulting from limited function in the prosthetic limb. Altered knee loading as calculated using loading rates and peak external knee adduction moments and impulses have been associated with both the development and progression of knee osteoarthritis in other populations. The purpose of this study was to determine if young individuals with transfemoral amputation demonstrate biomechanical indicators of increased knee osteoarthritis risk.Fourteen young male Service Members with unilateral transfemoral amputation and 14 able-bodied service members underwent biomechanical gait analysis at three standardized walking velocities. A two-way ANOVA (group × speed) with unpaired comparisons with Bonferroni-Holm post-hoc corrections assessed statistical significance and effect sizes (d) were calculated.Normalized peak external knee adduction moments and impulses were 25.7% (P0.014, d0.994) and 27.1% (P0.012, d1.019) lower, respectively, in individuals with trans-femoral amputation than controls when averaged across speeds, and effect sizes were large. External knee flexor moments were not, however, different between groups and effect sizes were generally small (P0.380, d0.338). Maximal loading rates were significantly greater in individuals with amputation and effect sizes were large (P0.001, d1.644).Individuals with transfemoral amputation did not demonstrate biomechanical risk factors for high medial compartment knee joint loads, but the increased loading rates could place the sound knee at greater risk for cartilage or other tissue damage, even if not localized to the medial compartment.

This study examined the relations between school climate variables and students’ feeling of wellbeing, life satisfaction, ethnic identity, moral identity and resilience. Furthermore, the study also examined the interrelationships between these five outcome variables. Six aspects of the school climate were measured: teacher support, peer connectedness, school connectedness, affirming diversity, rule clarity and reporting and seeking help. The participants included 2202 students, the data from whom included 2122 cases that were complete and usable (1058 boys and 1059 girls) from six public high schools in Perth, Western Australia. These data were analysed by means of structural equation modelling (SEM) analysis. All six school climate factors were related to student wellbeing. These relations were primarily indirect (with the exception of teacher support, school connectedness and affirming diversity which had a direct influence), mediated through the students’ sense of ethnic and moral identity, resilience and life satisfaction.

The purpose of this study, in part, was to confirm the factor structure of the School-Level Environment Questionnaire, which assesses six school climate factors that can be considered important for improving schools. The study also tested a research model of the relationships between the school climate, teachers’ self-efficacy and job satisfaction. The participants included 781 Western Australian high-school teachers in 29 schools. When the data were analysed by means of structural equation modelling, teacher self-efficacy and teacher job satisfaction were both related to school climate dimensions and there was also a relationship between teacher self-efficacy and job satisfaction. These results provide practical information for improving school climate and suggest that it is worthwhile for school principals to consider factors within the school climate and how they might be enhanced.

This article reports research into associations between students’ perceptions of the school climate and self-reports of ethnic and moral identity in high schools in Western Australia. An instrument was developed to assess students’ perceptions of their school climate (as a means of monitoring and guiding schools as they are challenged to become more inclusive and grapple with increasingly diverse populations) and administered to 4067 students, 63 % of whom were aged between 12 and 17 years, in eight schools. The same students also responded to a survey developed to assess ethnic and moral identity. Analysis of the data indicated strong, positive associations between the school climate and students’ ethnic and moral identity. The results suggest that, for schools wishing to promote students’ ethnic and moral identity, it would be beneficial to consider important elements of the school climate identified in the new survey.