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Opportunities and infrastructure for active living are an important aspect of a community’s design, livability, and health. Features of the built environment influence active living and population levels of physical activity, but objective study of the built environment influence on active living behaviors is challenging. The use of emerging technologies for active living research affords new and promising means to obtain objective data on physical activity behaviors and improve the precision and accuracy of measurements. This is significant for physical activity promotion because precise measurements can enable detailed examinations of where, when, and how physical activity behaviors actually occur, thus enabling more effective targeting of particular behavior settings and environments. The aim of this focused review is to provide an overview of trends in emerging technologies that can profoundly change our ability to understand environmental determinants of active living. It discusses novel technological approaches and big data applications to measure and track human behaviors that may have broad applications across the fields of urban planning, public health, and spatial epidemiology.

Squamous cell carcinoma, a rare malignancy of upper urinary tract accounts for 1.4% of all renal malignancies [1]. These tumours are mostly seen in the adults and less commonly in the pediatric age groups. Most of the cases present incidentally because they are masqueraded by pyonephrosis or hydonephrosis which occurs at an advanced stage of the disease and hence poor prognosis. A screening CT for long stand renal stone or newer imaging modalities are required for early detection and improving prognosis of the patients. Here we present a case of renal squamous cell carcinoma in 55 yrs old male with a staghorn calculus.

Background and Context: Using a transformative learning framework, this qualitative study examines the perspectives and practices of 70 middle and high school content area teachers who attended two or more summer professional development workshops. Objective: This study describes how teachers' disciplinary perspectives and backgrounds influence their understanding of CT infusion and their implementation of CT-infused lessons. Method: Data sources for this qualitative comparative case study analysis included: retrospective video reflections, implementation surveys, post-PD surveys, and instructional materials. Findings: Analysis revealed differences in terms of disorienting dilemmas teachers faced, shifts in their frames of reference, the form of classroom CT infusion, and their integration of specific CT concepts. Implications: This study contributes a comparative analysis of how teachers from different content areas come to understand CT infusion and implement CT-infused pedagogical practices to support their disciplinary teaching. Findings indicate the importance of including all teachers, STEM and non-STEM, in CT infusion efforts.

Background and Objective: Teacher assessment research suggests that teachers have good conceptual understanding of CT. However, to model CT-based problem-solving in their classrooms, teachers need to develop the ability to recognize when and how to apply CT skills. Does existing professional development (PD) equip teachers to know when and how to apply CT skills? What factors should PD providers consider while developing trainings for CT application skills? Method: This retrospective observational study used a binomial regression model to determine what factors predict teachers' probability of performing well on a CT application skills test. Participants: Participants of this study were 129 in-service K-12 teachers from a community of practice in India. Findings: Results show that teachers who have received at least one CT training, who have a higher teaching experience, and are currently teaching CT will have a higher probability of applying CT skills correctly to problems irrespective of the subject they teach and their educational backgrounds. However, receiving a higher number of CT PD trainings was a negative predictor of teachers' performance. Implications: Implications for school administrators, professional development providers, and researchers are discussed. Teachers need ample opportunity to teach CT in their teaching schedules. Continuous professional development does not necessarily result in improved CT application skills unless careful consideration is given to the pedagogies used and to the resolution of misconceptions that teachers may have developed in prior training. Mixing plugged and unplugged pedagogical approaches may be beneficial to encourage transfer of CT application skills across different types of problems. Last, there is a need to develop valid and reliable instruments that measure CT application skills of teachers.

Student perception is an essential component in education; especially in engineering courses, which involve complex spatial processes, manipulation and interpretation of graphs, diagrams, and concepts. Incorporation of special training instructions improve spatial skills of learners, assisting them to acquire enhanced conceptual knowledge. Through this paper, concept validation of using immersive and interactive technology to attain better understanding of engineering fundamentals is presented. An Augmented Reality (AR) based Interactive Learning Environment (ILE) was developed for engineering undergraduates. Students were pre- and post-tested for technical knowledge through well-defined questionnaire and were administered different instructional treatments; viz. traditional teaching (control group) and ILE-based teaching (treatment group), for topics from control theory. Results of an empirical study indicate that students who were instructed through ILE scored more as they acquired similar perception through interactive visualization, thereby validating the use of AR for educational settings. By utilizing interactive 2D (2-dimensional) simulations, the research work ensures that 3D (3-dimensional) models developed to demonstrate theoretical topics using AR would also be feasible for implementation in classroom environments. The findings of this work instantiate a correlation between the role of interactive visualization and student's learning for future studies.

Competencies (knowledge, skills, and dispositions) enable employers and educators to speak a common language regarding what computing graduates are expected to demonstrate on the job. This study focuses on competencies required by managers in the computing industry, based on semi-structured interviews of ten individuals in managerial roles, such as directors, project managers, and product managers with prior experience in computing-related roles. Constant Comparative for Naturalistic Inquiry was used to analyze the data. The most frequently discussed managerial skills included leadership, project management, hiring and evaluating candidates, and mentorship. In addition, professional skills such as communication, problem-solving, and lifelong learning were mentioned, along with essential dispositions that support the development of these skills, e.g., collaborative mindset, lifelong learning orientation, and self-regulation. Participants also emphasized the need to make judgments, build relationships, and collaborate within or outside their team. Career readiness in the computing industry is not limited to entry-level jobs; professionals should have the opportunity to navigate their preferred career path--whether they aspire to move down a technical or managerial path. This study can contribute to both students' and educators' understanding of the managerial career path and what types of competencies and experiences should be included in computing education programs to set them up for success across their career path. Implications for pedagogical approaches will also be discussed.

Epidermolysis Bullosa Simplex (EBS) has been subclassified into various subtypes on the basis of clinical features and histopathology predominantly into three divisions: Simplex, Junctional and Dystrophic. EBS is characterised by inter-epidermal blistering with minor internal engrossment. It’s always inherited in an autosomal dominant fashion and is also the least severe type of EB. More recently a recessive form of EBS has been described. The Koebner type of EBS (EBS-K), also known as the non-dowling meara or more recently the other generalised form, is usually presented at birth and is one of the rare presentations of EBS. Though always present with an extensive family history EBS-K is very rarely associated with de novo mutation.

BACKGROUND. Most GWAS of plasma proteomics have focused on White individuals of European ancestry, limiting biological insight from other ancestry-enriched protein quantitative loci (pQTL). METHODS. We conducted a discovery GWAS of approximately 3,000 plasma proteins measured by the antibody-based Olink platform in 1,054 Black adults from the Jackson Heart Study (JHS) and validated our findings in the Multi-Ethnic Study of Atherosclerosis (MESA). The genetic architecture of identified pQTLs was further explored through fine mapping and admixture association analysis. Finally, using our pQTL findings, we performed a phenome-wide association study (PheWAS) across 2 large multiethnic electronic health record (EHR) systems in All of Us and BioMe. RESULTS. We identified 1,002 pQTLs for 925 protein assays. Fine mapping and admixture analyses suggested allelic heterogeneity of the plasma proteome across diverse populations. We identified associations for variants enriched in African ancestry, many in diseases that lack precise biomarkers, including c/s-pQTLs for cathepsin L (CTSL) and Siglec-9, which were linked with sarcoidosis and non-Hodgkin's lymphoma, respectively. We found concordant associations across clinical diagnoses and laboratory measurements, elucidating disease pathways, including a cis-pQTL associated with circulating CD58, WBC count, and multiple sclerosis. CONCLUSIONS. Our findings emphasize the value of leveraging diverse populations to enhance biological insights from proteomics GWAS, and we have made this resource readily available as an interactive web portal. FUNDING. NIH K08 HL161445-01A1; 5T32HL160522-03; HHSN268201600034I; HL133870., Introduction Large-scale GWAS have uncovered thousands of loci implicated in human disease. However, genotype is often far removed from phenotype, limiting insight into the pathological processes that result in disease. [...]

Peutz-Jeghers syndrome is inherited as an autosomal dominant disorder presenting as hamartomatous polyps in small bowel with mucocutaneous pigmentation. We here present a case of 14 years old male presenting with symptoms of intestinal obstruction and mucocutaneous pigmentation along with family history of similar rashes, in both his mother and brother.

Background: In elderly patients, use of adjuvant with small doses of local anesthetics is a preferred technique for spinal anesthesia for lower limb surgeries. This study tested the hypothesis that addition of small doses of clonidine augments the spinal block levels produced by hyperbaric bupivacaine in elderly without affecting the side-effects if any of clonidine in these patients. Materials and Methods: This was a prospective, randomized, double-blind study. Above 60 years male patients were allocated to three equal groups. Group C received 9 mg hyperbaric bupivacaine without clonidine while Group C 15 and Group C 30 received 15 μg and 30 μg clonidine with hyperbaric bupivacaine respectively for spinal anesthesia. Effect of clonidine on sensory block levels was the primary study outcome measure. Motor blockade and hemodynamic parameters were also studied. Results: A significantly higher median block levels were achieved in Group C 15 (P < 0.001) and Group C 30 (P = 0.015) than Group C. Highest median sensory block level, the mean times for sensory regression to T 12 level and motor block regression were statistically significant between Groups C 15 and C and between Groups C 30 and C. On comparison of fall in systolic blood pressure trends, there was no significant difference in the clonidine groups as compared with the control group. Conclusions: In elderly patients, clonidine when used intrathecally in doses of 15 μg or 30 μg with bupivacaine, significantly potentiated the sensory block levels and duration of analgesia without affecting the trend of systolic blood pressure as compared to bupivacaine alone. Clonidine in doses of 30 μg however facilitated the ascent of sensory level block to unexpectedly higher dermatomes for a longer time.

Although many novel gene-metabolite and gene-protein associations have been identified using high-throughput biochemical profiling, systematic studies that leverage human genetics to illuminate causal relationships between circulating proteins and metabolites are lacking. Here, we performed protein-metabolite association studies in 3,626 plasma samples from three human cohorts. We detected 171,800 significant protein-metabolite pairwise correlations between 1,265 proteins and 365 metabolites, including established relationships in metabolic and signaling pathways such as the protein thyroxine-binding globulin and the metabolite thyroxine, as well as thousands of new findings. In Mendelian randomization (MR) analyses, we identified putative causal protein-to-metabolite associations. We experimentally validated top MR associations in proof-of-concept plasma metabolomics studies in three murine knockout strains of key protein regulators. These analyses identified previously unrecognized associations between bioactive proteins and metabolites in human plasma. We provide publicly available data to be leveraged for studies in human metabolism and disease.

• Research produced during the pandemic showed pre-diagnosis physical activity was associated with substantially lower risk of severe coronavirus disease 2019 (COVID-19) outcomes. • Pandemic restrictions on common places for physical activity were associated with decreased physical activity and increased sedentary behavior. • There were few studies of interventions to increase physical activity during the pandemic, the role of physical activity in COVID-19 inequities, and built environment contributions to COVID-19 outcomes. • Emerging research priorities include physical activity and long COVID and physical activity as a vaccine adjuvant. • Except for recommendations from the World Health Organization, physical activity was widely ignored in public health guidance.

Rationale: Chronic obstructive pulmonary disease (COPD) is a complex disease characterized by airway obstruction and accelerated lung function decline. Our understanding of systemic protein biomarkers associated with COPD remains incomplete. Objectives: To determine what proteins and pathways are associated with impaired pulmonary function in a diverse population. Methods: We studied 6,722 participants across six cohort studies with both aptamer-based proteomic and spirometry data (4,566 predominantly White participants in a discovery analysis and 2,156 African American cohort participants in a validation). In linear regression models, we examined protein associations with baseline forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC). In linear mixed effects models, we investigated the associations of baseline protein levels with rate of FEV1 decline (ml/yr) in 2,777 participants with up to 7 years of follow-up spirometry. Results: We identified 254 proteins associated with FEV1 in our discovery analyses, with 80 proteins validated in the Jackson Heart Study. Novel validated protein associations include kallistatin serine protease inhibitor, growth differentiation factor 2, and tumor necrosis factor-like weak inducer of apoptosis (discovery β = 0.0561, Q = 4.05 × 10-10; β  = 0.0421, Q = 1.12 × 10-3; and β = 0.0358, Q = 1.67 × 10-3, respectively). In longitudinal analyses within cohorts with follow-up spirometry, we identified 15 proteins associated with FEV1 decline (Q

Background: Continuous thoracic paravertebral block (TPVB) provides effective analgesia for unilateral multiple fractured ribs (MFR). However, prolonged infusion of local anaesthetic (LA) in high doses can predispose to risk of LA toxicity, which may be reduced by using safer drugs or drug combinations. This study was conducted to assess efficacy and safety of paravertebral infusion of ropivacaine and adrenaline with or without fentanyl to provide analgesia to patients with unilateral MFR. Methods: Thirty adults, having ≥3 unilateral MFR, with no significant trauma outside chest wall, were studied. All received bolus of 0.5% ropivacaine 0.3 ml/kg through paravertebral catheter, followed by either 0.1-0.2 ml/kg/hr infusion of ropivacaine 0.375% with adrenaline 5 μg/ml in group RA or ropivacaine 0.2% with adrenaline 5 μg/ml and fentanyl 2 μg/ml in group RAF. Rescue analgesia was provided by IV morphine. Results: Statistical analysis was performed using unpaired Student t-test, Chi-square test and repeated measures ANOVA. After TPVB, VAS scores, respiratory rate and PEFR improved in both groups with no significant inter-group differences. Duration of ropivacaine infusion, morphine requirements, length of ICU and hospital stay, incidence of pulmonary complications and opioid-related side-effects were similar in both groups. Ropivacaine requirement was higher in group RA than group RAF. No patient showed signs of LA toxicity. Conclusion: Continuous paravertebral infusion of ropivacaine 0.375% with adrenaline 5 μg/ml at 0.1-0.2 ml/kg/hr provided effective and safe analgesia to patients with unilateral MFR. Addition of fentanyl 2 μg/ml allowed reduction of ropivacaine concentration to 0.2% without decreasing efficacy or increasing opioid-related side-effects.