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Aging dramatically increases the risk of cardiovascular diseases in human. Animal models are of great value to study cardiac aging, and zebrafish have become a popular model for aging study recently. However, there is limited knowledge about the progression and regulation of cardiac aging in zebrafish. In this study we first validated the effectiveness of a panel of aging-related markers and revealed their spatial-temporal specificity. Using these markers, we discovered that cardiac aging in zebrafish initiated at mid-age around 24 months, followed by a gradual progression marked with increased DNA damage, inflammatory response and reduced mitochondrial function. Furthermore, we showed aging-related expression profile change in zebrafish hearts was similar to that in rat hearts. Overall, our results provide a deeper insight into the cardiac aging process in zebrafish, which will set up foundation for generating novel cardiac aging models suitable for large scale screening of pharmaceutical targets.

Posterior vitreous detachment (PVD) is a separation between the posterior vitreous cortex and internal limiting membrane. Although PVD was historically considered an acute event, recent studies using spectral-domain optical coherence tomography (SD-OCT) revealed a gradual progression of PVD in healthy subjects. Although SD-OCT improved PVD studies, the narrow imaging angle and long examination time were problematic to allow wide angle capture. The Xephilio OCT-S1 (Canon), a swept-source OCT (SS-OCT) device, can obtain up to 23-mm of widefield B-scan images in a single acquisition. We used this widefield SS-OCT to quantitatively evaluate the PVD stage in 214 healthy subjects aged 4–89 years and determine whether PVD stages differ between the bilateral eyes of each patient. Age was significantly positively correlated with the overall PVD stage (ρ = 0.7520, P

Bearings acts as fusing components in bridges and transfer loads from superstructures to substructures. During earthquakes, bridge bearings may be subjected to large axial compressive loads and lateral displacements, and consequently experience severe damages. In this paper, an input energy-based (IEB) and a sliding displacement-based (SDB) damage index are proposed for quantifying seismic damage of the bridge bearings. The IEB damage index, previously proposed by authors, as the ratio of the dissipated energy to the earthquake input energy, and the SDB damage index is defined considering yielding displacement of the bearings corresponding to their sliding threshold. To evaluate the ability of the proposed damage indices in damage assessment of the bridge bearings, the force–displacement behavior of three commonly used bearings including elastomeric bearing, lead–rubber bearing, and flat sliding bearing are developed using rheological models. A set of the bearing specimens experimentally tested under cyclic/seismic loadings is adopted to calibrate the reliability of the damage indices. The results show that the IEB damage index provides a reasonably gradual progression of damage throughout the loading history and gives acceptable values for sliding and failure damage levels of the bearings more convincingly than the SDB damage model with respect to the experiment observations.

A Thousand Years Hence examines the gradual progression, century by century, of leading trends in the late nineteenth century, notably in the labour movement, politics, technology (including space travel), the growing equality of women, and religion. Yet in religious matters Brown was anything but quiet, and was ever seeking a fling at White, whom he usually and easily discomfited by throwing at him a ready succession of Scripture texts. The great, benign blue star was, of course, heaven, and the fierce and still greater red was hell; and much religious capital, and countless conversions, were made of such powerful religious accessories. The end in religion, as in all else for man in this world, Reed asserted, was righteousness and usefulness of life. And lastly came Reed’s forecast of the religious future, in which the Church of reasonableness and good common sense would have made a more effective development.

Plants have evolved several adaptive mechanisms to cope with water-limited conditions. While most of them are through constitutive traits, certain “acquired tolerance” traits also provide significant improvement in drought adaptation. Most abiotic stresses, especially drought, show a gradual progression of stress and hence provide an opportunity to upregulate specific protective mechanisms collectively referred to as “acquired tolerance” traits. Here, we demonstrate a significant genetic variability in acquired tolerance traits among rice germplasm accessions after standardizing a novel gradual stress progress protocol. Two contrasting genotypes, BPT 5204 (drought susceptible) and AC 39000 (tolerant), were used to standardize methodology for capturing acquired tolerance traits at seedling phase. Seedlings exposed to gradual progression of stress showed higher recovery with low free radical accumulation in both the genotypes compared to rapid stress. Further, the gradual stress progression protocol was used to examine the role of acquired tolerance at flowering phase using a set of 17 diverse rice genotypes. Significant diversity in free radical production and scavenging was observed among these genotypes. Association of these parameters with yield attributes showed that genotypes that managed free radical levels in cells were able to maintain high spikelet fertility and hence yield under stress. This study, besides emphasizing the importance of acquired tolerance, explains a high throughput phenotyping approach that significantly overcomes methodological constraints in assessing genetic variability in this important drought adaptive mechanism.

Introduction Sexuality is a multifaceted and makes up part of the lives of all individuals. Aim To evaluate the teaching of sexual health to students in the basic cycle of an undergraduate course in medicine. Methods A descriptive, cross-sectional study was conducted using primary data on the teaching of sexual health in the first 4 years of the course. The students were contacted personally and given a self-administrated questionnaire on the teaching of sexual health. The questionnaire was based on studies conducted with physicians and medical students regarding their educational background in sexual health. The degree of satisfaction regarding the learning process was determined using a ten-point scale; on which, a score of 1 to 5 indicated dissatisfaction and of 6 to 10 satisfaction. Main outcome measures The main outcome measure was a self-administered questionnaire addressing the teaching of sexual health in the first 4 years and how this knowledge affected relationships with patients. Results A total of 216 students answered the questionnaire. Only 27.27% and 22% of the students in the first and second years, respectively, reported having classes related to sexual medicine, whereas 38.1% (third year) and 54.40% (fourth year) had such classes. Regarding satisfaction, the weighted mean was 4.55 and the modes were 5 and 6. In the evaluation of their expectations about learning sexual health, 46 (67.6%) reported feeling non-confident, 18 (26.5%) did not answer the question, and 4 (5.9%) reported feeling confident. Conclusion This study revealed a gradual progression in the offer of content related to sexual medicine to students throughout the medicine course, with weighted means of 2.6 (first year), 2.82 (second year), 3.58 (third year), and 4.55 (fourth year). However, the findings indicate that the teaching of this subject remains deficient and students feel unsatisfied and unprepared for their future practice of medicine.

Artistic gymnastics, rhythmic gymnastics, and trampoline are an enormously popular group of sports with over 50 million youth and athletes of all ages participating around the globe. The use of apparatus for artistic gymnastics and trampoline places the athlete at heights which increase their risk of head, neck, fractures, or other catastrophic injuries. Each facet of gymnastics but particularly rhythmic gymnastics emphasizes the importance of flexibility which places the athlete at increased risk of joint injuries. In addition, each facet of gymnastics but particularly rhythmic gymnastics places a high value on fitness and visual esthetic which can place the athlete at risk of relative energy deficit syndrome or the female athlete triad. For artistic gymnasts, the increased upper extremity demands compared to other sports place these athletes at increased risk of upper extremity injuries. Prevention targets early recognition of overuse injuries and thorough treatment of prior injuries. A gradual progression in technical skill levels have also been shown to reduce the risk of more severe injuries.

Background COVID-19 is a pandemic disease and is important to know the nature of the disease during follow-up. We aimed to study different imaging signs and changes that occurred during the initial scan, follow-up, and complications. Moreover, to study the CT severity score and its relation to the patients’ clinical condition using oxygen saturation as a parameter. This was a retrospective study conducted on 125 patients, including 293 CT studies, from March till the end of August 2020. The mean age was 47.4 ± 15.7 years and 64.8% of the patients were males. All patients proved to have COVID-19 by the RT-PCR test. The CT studies of the patients were divided into four stages according to the timing after the onset of symptoms. The incidence of different CT features, patterns, complications, CT severity score, and oxygen saturation were recorded in different stages. Results During follow-up studies, GGOs were the most constant and common CT features. Consolidation and crazy paving showed gradual progression to reach the peak at the 3rd stage. Mixed attenuation pattern was the commonest pattern at the 3rd stage while a pure GGO pattern was the commonest feature in other stages. The complications occurred mostly in the 3rd stage. Nevertheless, the CT severity score showed an inverse relation with oxygen saturation. Conclusion Radiological evaluation of COVID-19 pneumonia showed gradual progression till the peak critical stage at 8-14 days from the onset of symptoms. Consolidation and mixed attenuation pattern can be considered as CT signs of disease severity.

Background Alzheimer’s disease (AD) reserve theory is based on specific individual characteristics that are associated with a higher resilience against neurodegeneration and its symptoms. A given degree of AD pathology may contribute to varying cognitive decline levels in different individuals. Although this phenomenon is attributed to reserve, the biological mechanisms that underpin it remain elusive, which restricts translational medicine research and treatment strategy development. Methods Network-based approaches were integrated to identify AD reserve related genes. Then, AD brain transcriptomics data were clustered into co-expression modules, and a Bayesian network was developed using these modules plus AD reserve related phenotypes. The directed acyclic graph suggested that the module was strongly associated with AD reserve. The hub gene of the module of interest was filtered using the topological method. Validation was performed in the multi-AD brain transcriptomic dataset. Results We revealed that the RALYL (RALY RNA Binding Protein-like) is the hub gene of the module which was highly associated with AD reserve related phenotypes. Pseudo-time projections of RALYL revealed the changes in relative expression drivers in the AD and control subjects over pseudo-time had distinct transcriptional states. Notably, the expression of RALYL decreased with the gradual progression of AD, and this corresponded to MMSE decline. Subjects with AD reserve exhibited significantly higher RALYL expression than those without AD reserve. Conclusion The present study suggests that RALYL may be associated with AD reserve, and it provides novel insights into the mechanisms of AD reserve and highlights the potential role of RALYL in this process.

The clinical characteristics of genetic Creutzfeldt-Jakob disease (gCJD) with a V180I mutation in the PRNP gene (V180I gCJD) are unique: elderly-onset, gradual progression, sporadic fashion, and cortical oedematous hyper-intensity on diffusion-weighted MRI (DW-MRI). This phenotype may become a potential target of future clinical therapeutic trials. The average disease duration of V180I gCJD patients is 23–27 months; however, considerably long-term survivors are also reported. The factors influencing survival and the clinicopathological characteristics of long-term survivors remain unknown. Herein, we report clinicopathological findings of a long-term survivor of V180I gCJD. A 78-year old woman was admitted to our hospital due to dementia and left hand tremor approximately 1.5 months after symptom onset. Neurological examination revealed dementia, frontal signs, and left hand tremor at admission. She had no family history of dementia or other neurological disease. DW-MRI revealed cortical oedematous hyper-intensities in the bilateral frontal lobes and the right temporal and parietal lobes. PRNP gene analysis indicated a V180I mutation with methionine homozygosity at codon 129. The symptoms gradually progressed, and she died of aspiration pneumonia 61 months after symptom onset. Neuropathological examination revealed severe cerebral atrophy with moderate to severe gliosis, but the brainstem was well preserved. Various-sized and non-confluent vacuole type spongiform changes were extensively observed in the cerebral cortices. Prion protein (PrP) immunostaining revealed weak and synaptic-type PrP deposits in the cerebral cortices. We consider that long-term tube feeding, and very mild brainstem involvement may be associated with the long-term survival of our V180I gCJD patient.

Background One recent study reports cancer driver mutations in deep endometriosis, but its biological/clinical significance remains unclear. Since the natural history of endometriosis is essentially gradual progression toward fibrosis, it is thus hypothesized that the six driver genes reported to be mutated in endometriosis (the RP set) may play important roles in fibrogenesis but not necessarily malignant transformation. Methods Extensive PubMed search to see whether RP and another set of driver genes not yet reported (NR) to be mutated in endometriosis have any roles in fibrogenesis. All studies reporting on the role of fibrogenesis of the genes in both RP and NR sets were retrieved and evaluated in this review. Results All six RP genes were involved in various aspects of fibrogenesis as compared with only three NR genes. These nine genes can be anchored in networks linking with their upstream and downstream genes that are known to be aberrantly expressed in endometriosis, piecing together seemingly unrelated findings. Conclusions Given that somatic driver mutations can and do occur frequently in physiologically normal tissues, it is argued that these mutations in endometriosis are not necessarily synonymous with malignancy or premalignancy, but the result of enormous pressure for fibrogenesis.

Background Muscle injuries are common in professional sports, especially in football. Recent epidemiological studies showed that muscle injuries account for more than 30% of professional football injuries (1.8-2.2/1000 h exposure); however, even though there are significant differences within a European comparison, a single professional football team diagnosed on average 12 muscle injuries per season, corresponding to more than 300 availability days lost. Objective The aim of this work is to present the diagnosis, general treatment and comprehensive management of muscle injuries in professional football. Material and methods The present work is based on current scientific findings, experiences of the authors and examples from routine practice in the management of muscle injuries in a professional sports environment. Results and conclusion The authors present a model of gradual progression for the treatment of muscular injuries and their rehabilitation. Due to the time-pressured nature of the professional sports environment, often promoted by coaches and media, this model could help lead players to recover as quickly as possible and return to competitive sports without relapse or sequel injury. This model integrates the player into the treatment plan. The progression sequences in the rehabilitation should be made clear to players and other parties involved, which are crucial for optimal healing. Even if absolute certainty cannot be achieved, i.e. the occurrence of re-injury or secondary injury, this model attempts to minimize the level of risk involved for the returning athlete. Since it is hardly possible to act strictly in line with more conservative guidelines due to the particular circumstances of the professional sport environment, the experiences of the authors are presented in the sense of best practice in order to support future decision-making processes.

Primary lymphoedema is a rare disorder. Often presents at a young age with asymptomatic limb oedema with gradual progression. We present a 16-year-old woman who presented with a history of swelling of the left lower limb for 6 years. There was the presence of isolated left lower limb oedema, which was a non-pitting type. The patient underwent imaging studies and was diagnosed to have primary lymphoedema. The patient was managed conservatively as the patient did not have any other problems other than the left lower limb oedema.

Both would-be and practicing seafarers need good physical fitness as they face one of the most high-risk jobs. For the Maritime Academy of Asia and the Pacific, physical fitness is one of the qualifications for acceptance. This paper presents the evaluation of a six-week physical fitness training program designed for probationary cadets aspiring to take maritime undergraduate degrees at the Academy. A training program with gradual progression was developed, focusing on endurance, strength, speed and flexibility. We used the physical fitness test results (push-ups, sit-ups, sit and reach, 3.2-km run, flex hang and pull-ups) as indicators of the effectiveness of the program. There is statistically significant evidence to say that the program caused the improvement on the scores of the students in terms of endurance, strength and speed. Moreover, the program can still be enhanced by adding more exercises addressing flexibility.

This paper provides a system design framework for a human-robot interaction system. The design introduces a human-augmented robotic intelligence embedded in a human-robot interaction system. The motivations behind the system design are spoken dialogue systems, Wizard-of-OZ framework, and existing HRI designs for socially intelligent robots. In this work, we explain how artificial intelligence of human-robot interaction system is enhanced by human intelligence through collaboration. The collaborative artificial intelligence enables the system to learn from demonstration. The main objective and the gradual progression from this paper is to build an iterative interactive system that is capable of achieving human-robot interaction similar to the nuances of human-human interaction.

OBJECTIVES After mitral repair for degenerative mitral regurgitation (MR), no or mild (≤1+/4+) residual MR should remain. Occasionally patients are left with more than mild residual MR (>1+/4+) for a number of reasons. The aim of this study was to assess the late implications of such a suboptimal repair in a matched cohort study. METHODS From 2006 to 2013, a total of 2158 patients underwent mitral repair for degenerative MR in our institution. Fifty patients (2.3%) with residual MR >1+ at hospital discharge (study group) were matched up to 1:2 with 91 patients operated on during the same period who were discharged with MR ≤1+ (control group). The median follow-up was 8 years (interquartile range 6.3–10.1, longest 12.7 years). A comparative analysis of the outcomes in the 2 groups was performed. RESULTS Overall survival at 8 years was 87 ± 8% in the study group and 92 ± 3% in the control group (P = 0.23). There were 3 late deaths (6.0%) in the study group and 6 deaths (6.6%) in the control group. Freedom from reoperation was similar (P = 1.0). At 8 years the prevalence of MR ≥3+ was significantly higher in the study group (15.6% vs 2.1%, P CONCLUSIONS Residual MR more than mild at hospital discharge is associated with lower durability of mitral repair and the need for more medical therapy in the long term. However, even an initial optimal result does not completely arrest the progression of the degenerative process.

Owing to increasing external pressures on both faculty and learners, the practice of bedside teaching is declining. The objective of this paper is to provide an overview of educational strategies to foster bedside teaching in the current clinical practice environment for surgical educators. General strategies include building a culture within the program that promotes the atmosphere of a learning community, and providing scaffolding for trainees that fosters gradual progression to autonomous practice. Specific techniques for bedside teaching include CAMEO, the "one-minute preceptor", and mini-presentations or peer-teaching. The intentional and proactive implementation of these strategies alongside others can assist educators in capturing the "redeemable moments" that occur in the course of routine clinical care at the patient's bedside.

The title is "Mixed Marriage Between Javanese and Acehnese Ethnics in Pante Ceureumen District, West Aceh Regency". The research problem is how the process of mixed marriages between Javanese and Acehnese ethnics in Pante Ceureumen District, West Aceh Regency. The purpose of writing is to determine the implementation of intermarriage between Javanese and Acehnese in Pante Ceureumen District, West Aceh Regency. The research method used is ethnographic research methods or reports on an ethnic group, which are written based on the results of field research and use a "gradual progression". In this study, the authors concentrate on one of the stages, namely finding cultural themes. The main data of this research is qualitative data obtained through interviews with mixed married couples. Data collection techniques used include observation techniques, interview techniques. The data analysis process was carried out since the data collection in the field took place in stages and was described in writing. The conclusion of the research obtained is that mixed marriages between Javanese and Acehnese in Pante Ceureumen District are carried out through socio-economic relations, socio-political relations and socio-cultural relations and are driven by factors of similarity in education, occupation, place of residence, religion and also because of a mate. and arranged marriage. The implementation of mixed marriages between Javanese and Acehnese ethnics in Pante Ceureumen District, uses the customs of the two ethnicities. The traditional mixed marriage culture between Javanese ethnicities that is still being carried out includes the stage of proposing, fiance, seeds, bebet and weights as well as the wedding party. Meanwhile, the traditional mixed marriage culture that is carried out includes the stage of meulakee, ranub kong haba, ranub gaca, gatib, intat linto and tung dara baro.

Family can be an important educational agent if it has the tools to teach its members. This study investigated the effectiveness of a computerized reading and writing teaching program applied with students with intellectual disabilities in their own residences, having their family members as monitors. The program included positive teaching techniques, such as ongoing feedback and gradual progression according to the student’s performance. The teaching tasks included matching dictated with printed words and pictures and also constructing printed words from constituent letters and syllables. All students began the program with less than 20 % correct responses in naming words on pretest trials. The posttest results showed an average of 89.3 % of correct responses for teaching words and 52 % correct responses for generalization words. These results indicate that in-home implementation of this program by families can be a promising teaching approach for students with intellectual disabilities.

In the present study, we have analyzed the spatial patterns of seasonal-scale diurnal cycle of three main pollutants, NO2, SO2, and O3, across five stations in Delhi. We used hourly data collected by the local pollution monitoring agencies for the time period, October 2010 to September 2013. Harmonic analysis was used to detect the diurnal cycle in the observed patterns of pollutants across Delhi. The results of our study indicated a consistently higher level of concentrations of all the pollutants at two of the stations, IGI Airport and Civil Lines, while lower concentration levels were observed in the mixed use residential areas of Shadipur and NSIT Dwarka. A clockwise gradual progression in the time of maximum from east to west was observed in the case of SO2 during each season. The time of maximum for O3 for each season was in the early evening hours, 1800 local standard time (LST). Moreover, there were little spatial variations in the peak time of occurrence of NO2 and O3 at the seasonal scale.

Rotator cuff repairs have increased. Although clinical trials have examined the effect of immobilization and timing of passive range of motion (ROM) on patient outcomes and structural integrity, there is controversy as to the timing and progression for therapy. Primary goals are restoring function while maintaining the structural integrity of the repair. We advocate for a protocol of 4 to 6 weeks of immobilization, followed by protected passive ROM, which is followed by a gradual progression to active ROM and then appropriate resistance exercise program for most all rotator cuff repairs. The rate of progression should be adjusted individually.

The gradual progression to self-management is a critical milestone for children/adolescents with diabetes. This article provides recommendations to facilitate collaboration between the student’s family, diabetes healthcare provider, and school nurse to support and implement a plan that enables the child/adolescent to acquire the skills and knowledge necessary to successfully transition to independent management of diabetes.

Once cardiac arrest has occurred, the chances for neurologically intact recovery dramatically decline. While some types of cardiac arrest, mostly those of arrhythmogenic origin, can hardly be foreseen, the majority of cardiac arrests are preceded by clinical signs indicating the nearing cardiovascular collapse. In most patients, cardiac arrest is the final pathway of a gradual progression of symptoms. There are no clear cut-off values of such preterminal signs but rather an insidious trend of symptoms. It is essential to recognize these clinical signs as all of them must be addressed timely and adequately. A summary of clinical signs commonly preceding cardiac arrest is shown in Table 4.1.

Se examinan las relaciones entre la conciencia fonémica y la memoria fonológica en dos tramos del trayecto inicial del aprendizaje de la lectura y la escritura: el principio y el final del primer grado escolar. En un diseño transeccional correlacional participaron dos grupos muestrales. El Grupo 1, compuesto por 25 niños (edad media de 6 años, 3 meses), de ambos sexos, de idéntica procedencia sociocultural, que no presentaban retraso mental, trastornos específicos del lenguaje, ni alteraciones neurológicas, y que iniciaban el primer año escolar. El Grupo 2, formado por 25 niños (edad media de 6 años, 9 meses), de características idénticas que el anterior, pero que finalizaban el primer año escolar. Para evaluar la conciencia fonémica se administraron pruebas de segmentación fonológica, elisión y unión de fonemas; la memoria fonológica fue examinada a través de pruebas de retención de palabras y pseudopalabras. Los resultados muestran una correlación positiva moderadamente alta entre ambas variables en los dos grupos muestrales, observándose una progresión gradual de la actuación de los niños, particularmente en las tareas de conciencia fonémica., O trabalho examina as relações entre a consciência fonêmica e a memória fonológica em dois trechos do trajecto inicial da aprendizagem da leitura e a escritura: princípio e finalização do primeiro grau escolar. No desenho transeccional correlacional, participaram dois grupos amostrais. O Grupo 1: 25 meninos (média de idade de 6 anos, 3 meses), de ambos sexos, de idêntica procedência sociocultural, que não apresentavam atraso mental, transtornos específicos da linguagem, nem alterações neurológicas e que iniciavam no primeiro ano escolar. O Grupo 2: 25 meninos (média de idade de 6 anos, 9 meses), de características idênticas que o anterior, mas que finalizavam no primeiro ano escolar. Para avaliar a consciência fonêmica administraram-se provas de segmentação fonológica, elisión e união de fonemas; a memória fonológica foi examinada através de provas de retenção de palavras e de pseudopalavras. Os resultados mostraram uma correlação positiva moderadamente alta entre ambas variáveis nos dois grupos amostrais, observando-se uma progressão gradual da actuação dos meninos, particularmente nas tarefas de consciência fonémica., This paper explores the relationship between phonemic awareness and phonological memory in the early stages of learning of reading and writing: at the beginning and the end of the first school year. In empirical work, cross-sectional correlational design, participated two sample groups: Group 1 (G1), composed of 25 children whose mean age was 75 months, both sexes, same sociocultural origin, who had no intellectual disability, specific language or neurological and who started the first school year. Group 2 (G2), consisting of 25 children whose mean age was 81 months, with identical characteristics as above, but who finished the first year. To assess phonemic awareness were administered phonological segmentation, phoneme deletion and phoneme union tasks; phonological memory was examined by testing retention of words and non-words. The results showed a moderately high positive correlation between both variables in the two sample groups, showing a gradual progression of the performance of children, particularly in phonemic awareness tasks., Facultad de Psicología

Our article examines four of Aparna Sen's films, 36 Chowringhee Lane, Mr and Mrs Iyer, Paromitar Ek Din (House of Memories), and 15 Park Avenue, and locates a gradual progression in the emergent agencies of the leading women characters in the context of feminist movements in India. The first section of the article situates Aparna Sen as actor and director in the context of Bengali and New Wave/Parallel Cinema in order to provide readers with a background to her career. Then we demonstrate that Sen emphasizes self-reliance and self-fulfilment, the keys of strategic feminism in Kolkata, as each of her characters enacts self-motivated agencies. While Ms Stoneham is forced to embrace her loneliness, Mrs Iyer protects a Muslim co-passenger's life on her own; while Sanaka and Paromita resist their lives' boundaries on their own, Meethi boldly steps into her ‘reality’ all by herself. We also argue that Sen's polyvocal feminist lens includes the pluralistic identities of women in India, including different affili...

While Alzheimer’s disease (AD) classical diagnostic criteria rely on clinical data from a stablished symptomatic disease, newer criteria aim to identify the disease in its earlier stages. For that, they incorporated the use of AD’s specific biomarkers to reach a diagnosis, including the identification of Aβ and tau depositions, glucose hypometabolism, and cerebral atrophy. These biomarkers created a new concept of the disease, in which AD’s main pathological processes have already taken place decades before we can clinically diagnose the first symptoms. Therefore, AD is now considered a dynamic disease with a gradual progression, and dementia is its final stage. With that in mind, new models were proposed, considering the orderly increment of biomarkers and the disease as a continuum, or the variable time needed for the disease’s progression. In 2011, the National Institute on Aging and the Alzheimer’s Association (NIA-AA) created separate diagnostic recommendations for each stage of the disease continuum—preclinical, mild cognitive impairment, and dementia. However, new scientific advances have led them to create a unifying research framework in 2018 that, although not intended for clinical use as of yet, is a step toward shifting the focus from the clinical symptoms to the biological alterations and toward changing the future diagnostic and treatment possibilities. This review aims to discuss the role of biomarkers in the onset of AD.

We report a case of atrial fibrillation with rheumatic heart disease (RHD) who had intracardiac thrombus and cardiogenic cerebral embolism with rivaroxaban therapy. Intracardiac thrombus disappeared after switching from rivaroxaban to warfarin. Patients of RHD have the possibility of gradual progression of valvular disease even if they are old, so we need to distinguish nonvalvular atrial fibrillation from RHD before starting direct oral anticoagulants.

A right-handed woman developed pseudobulbar palsy and a particular writing disturbance mainly composed of omission of kana letters (OKL) at the age of 79, followed by gradual progression of generalized motor disturbance and mutism. She died at the age of 88. Postmortem examination revealed frontotemporal lobar degeneration. The precentral cortex and premotor area were the most severely degenerated among the affected frontal, parietal, and temporal lobes. The omission of kana letters has been recently reported as a characteristic feature of writing disturbance in Japanese amyotrophic lateral sclerosis (ALS). Our case indicates that OKL is not specific to ALS, and that the prefrontal and precentral cortices, common lesions between our case and ALS, are responsible for OKL. This case also shows that OKL can be caused by a pathomechanism independent from other types of writing error. The neurolinguistic analysis of our case suggests the disturbance of the moraic frame of words in the transcription process of morae into kana letters or kana-letter cards.

The target article's emphasis on distinguishing sign from gesture may resolve one important objection to gesture-first theories of language evolution. However, this approach risks undervaluing the gradual progression from nonlanguage to language over hominin evolution, and in emerging sign systems today. I call for less emphasis on drawing boundaries and more emphasis on understanding the processes of change.

Grasses began to diversify in the late Cretaceous Period and now dominate more than one third of global land area, including three-quarters of agricultural land. We hypothesize that their success is likely attributed to the evolution of highly responsive stomata capable of maximizing productivity in rapidly changing environments. Grass stomata harness the active turgor control mechanisms present in stomata of more ancient plant lineages, maximizing several morphological and developmental features to ensure rapid responses to environmental inputs. The evolutionary development of grass stomata appears to have been a gradual progression. Therefore, understanding the complex structures, developmental events, regulatory networks, and combinations of ion transporters necessary to drive rapid stomatal movement may inform future efforts towards breeding new crop varieties.

РЕЗЮМЕ. Для визначення глибини депресивних змін обстежено 70 хворих на анкілозивний спондилоартрит(АТ) з використанням тесту Бека та шкали Тейлора. Встановлено, що найвищий рівень депресивних розладівзустрічається за умов вперше встановленого діагнозу анкілозивного спондилоартриту. Надалі при адекватномулікуванні вдається домогтися значного покращення психоемоційного стану на 1–10 році захворювання. Протепри поступовому прогресуванні захворювання за умов незворотних змін якість життя значно погіршується, щопроявляється значним погіршанням в психоемоційній сфері і потребує медикаментозної корекції.КЛЮЧОВІ СЛОВА: анкілозивний спондилоартрит, депресія.

Inquiry activity is a major source of student investigation which both of the national curriculumstandards strongly emphasize for achieving scientific literacy. The purpose of this study was to examine inquiryactivities incorporated in high school biology textbooks used in China and Korea. The inquiry activities wereexamined with regard to inquiry level and science process skills. Bell's and a modification of Padilla's frameworkwere used in these analyses. Results show that the Korean textbooks were more exclusively occupied by simpleinquiry activities - None of them provided activity more complex than level 2 inquiry. In addition, the Koreantextbooks had uniformly basic science process skills, whereas their Chinese counterparts gave students somechallenges for higher level process skills. Therefore, it cannot be guaranteed that the activities in the Koreantextbooks are helpful in guiding students toward a gradual progression to high-level inquiry. Implications forinquiry-based science education were suggested based on the results of the study. Key words: school science, biology textbook, inquiry activity, ChinaMiyang High School, The Republic of Korea∙

Cats with glaucoma typically present late in the course of disease. It is likely that glaucoma in cats is under-diagnosed due to its insidious onset and gradual progression, as well as limitations of some commonly used tonometers in this species. Treatment of glaucoma in feline patients presents a clinical challenge, particularly as glaucoma is often secondary to other disease processes in cats. In this review, we consider the clinical features, pathophysiology, and classification of the feline glaucomas and provide current evidence to direct selection of appropriate treatment strategies for feline glaucoma patients.

Research conducted over the past 20 years has found that there have been changes in attitudes towards romantic relationships in late modernity. Partners expect more of relationships, and they are abandoned more easily than they were in the past. Religious fundamentalists reject both late-modern and modern attitudes towards romantic love, but the question of how moderate religious individuals and groups are affected by these changes remains unexamined. The article addresses this issue by focusing on the case of Israeli Religious-Zionist singles. Using Anthony Giddens' model of a gradual progression from a romantic love to a confluent love ideal type, the article claims that while Religious-Zionist dating norms encourage the romantic love ideal type of relationship, singles have gravitated toward a confluent love mindset; the rabbis, in an attempt to remedy the situation, adopt the Ultra-Orthodox ideology that views romantic love as superfluous. The results indicate that moderate religious individuals are i...

Upper extremity injuries in the pediatric patient are common, but are often more difficult to diagnose compared to their adult counterparts due to the gradual progression of cartilage ossification. Common pediatric upper extremity injuries include fractures and soft tissue trauma. Less prevalent injuries include sport specific overuse injuries. Fractures in the pediatric population are best described using the Salter-Harris classification, which has management and prognostic implications. Most pediatric upper extremity injuries can be managed with an initial trial of immobilization and early range of motion, followed by surgical intervention if necessary. Children have a robust healing response to bony and soft tissue injuries, and have good outcomes with appropriate management.

The present study was designed to address two issues: first, to identify the different development stages that eight expert Spanish basketball coaches go through; and second, to determine the possible factors that have contributed to the formative or training, process of the expert coach. Qualitative data were gathered in semi-structured interviews. The coaches worked with the men’s first Spanish Basketball League (“ACB” league) or the Spanish national selection. Our findings reveal four stages in the coach development process. These stages were the consequence mainly of a gradual progression in thinking and reflective practice that enabled the coach to optimize the necessary skills for high performance. In addition, all the coaches interviewed reflected an intense dedication and commitment over many years to their work, as well as an ongoing quest for improvement. Key words : development; stages; expertise; basketball coaches. Resumen El presente estudio fue disenado para hacer frente a dos cuestiones: en primer lugar, identificar las diferentes etapas formativas de ocho entrenadores expertos en baloncesto, y en segundo lugar, determinar los posibles factores que han contribuido a la formacion del entrenador experto. La metodologia utilizada es la cualitativa y la tecnica de recogida de datos fue la entrevista semiestructurada. Los entrenadores entrevistados pertenecian a la liga ACB o a la seleccion nacional espanola. Nuestros resultados ponen de manifiesto cuatro etapas en el desarrollo de su pericia. Estas etapas son consecuencia principalmente de un desarrollo de su conocimiento, asi como de una profunda reflexion practica que permitio al entrenador optimizar las habilidades necesarias para trabajar en el alto rendimiento. Ademas, todos los entrenadores reflejan una intensa dedicacion y compromiso durante muchos anos hacia su trabajo, asi como una busqueda constante por mejorar. Palabras clave : formacion; estadios; pericia; entrenadores de baloncesto. doi:10.5232/ricyde2009.01702 Texto completo en PDF ---------------------------------------------------------------------- References/referencias Abraham, A.; Collins, D., & Martindale, R. (2006). The coaching schematic: Validation through expert coach consensus. Journal of Sports Sciences, 24 (6), 549-564. doi:10.1080/02640410500189173 PMid:16611568 Cassidy, T., & Rossi, T. (2006). Situating Learning: (Re)examining the notion of apprenticeship in coach education. International Journal of Sports Sciences & Coaching, 1 (3), 235-246. doi:10.1260/174795406778604591 Cote, J. (2006). The development of coaching knowledge. International Journal of Sports Sciences and Coaching, 1 (3), 217-222. doi:10.1260/174795406778604609 Ericsson, K. A.; Krampe, R., & Tesch-Romer, C. (1993). The role of deliberate practice in the acquisition of expert performance. Phychological Review, 100 (3), 363-406. doi:10.1037/0033-295X.100.3.363 Ericsson, K.A., & Lehmann, A.C. (1996). Expert and exceptional performance: Evidence on maximal adaptations on task constraints. Annual Review of Psychology, 47, 273-305. doi:10.1146/annurev.psych.47.1.273 PMid:15012483 Gilbert, W.D., & Trudel, P. (2004). Analysis of coaching science research published from 1970-2001. Research Quarterly for Exercise and Sport, 75 (4), 388-399. PMid:15673038 Gilbert, W.D.; Cote, J., & Mallett, C. (2006). Developmental paths and activities of successful sport coaches. International Journal of Sports Science and Coaching, 1 (1), 69-76. doi:10.1260/174795406776338526 Irwin, G.; Hanton, S., & Kerwin, D.G. (2006). Reflective practice and the origin of elite coaching knowledge. Reflective Practice, 5 (3), 425-442. doi:10.1080/1462394042000270718 Jones, R.; Armour, K., & Potrac, P. (2003). Constructing Expert Knowledge: A case study of a top-level professional soccer coach. Sport, Education and Society, 8 (2), 213-229. doi:10.1080/13573320309254 Moreno, M. P.; Moreno, A.; Iglesias, D.; Garcia, L.; Del Villar, F. (2007). Effect of a mentoring through reflection program on the verbal behavior of beginner volleyball coaches: a case study. Revista Internacional de Ciencias del Deporte. 8(3), 12-24. Retrieved September 29, 2007, from doi:10.5232/ricyde2007.00802 Nelson, L.J.; Cushion, C.J., & Potrac, P. (2006). Formal, nonformal and informal coach learning: A holistic conceptualisation. International Journal of Sports Sciences & Coaching, 1 (3), 247-259. doi:10.1260/174795406778604627 Potrac, P.; Jones, R., & Armour, K. (2002). “It’s all about getting respect”: The coaching behaviours of an expert English soccer coach. Sport, Education and Society, 7, 183-202. doi:10.1080/1357332022000018869 Saury, J., & Durand, M. (1998). Practical knowledge in expert coaches: On site study of coaching in sailing. Research Quarterly for Exercise and Sport, 69, 254 – 266. PMid:9777662 Trudel, P. (2006). What the coaching science literature has to say about the roles of coaches in the development of elite athletes. International Journal of Sports Sciences & Coaching, 1 (2), 127-130. doi:10.1260/174795406777641221

The paper conducts an empirical investigation into the effects of financial liberalization policies on the growth of 19 countries in sub-Saharan Africa (SSA). Two indexes are constructed which measure the gradual progression and institutional changes involved in financial liberalization. Because these indexes track specific financial liberalization policies, they provide better measures of financial liberalization than the indicators of financial development often used in the literature. Panel data estimates show a significant positive relationship between economic growth and financial liberalization policies. Our results are robust to alternative specifications of the model, and also across slow- and fast-growing countries.

THE FREQUENCY OF OVERUSE INJURIES IN CHILDREN HAS INCREASED IN RECENT YEARS. INCREASED INTEREST IN SPORTS AS WELL AS THE INCREASE IN SPORTS SPECIALIZATION BY CHILDREN IS ONE CAUSE. EXTRINSIC AND INTRINSIC FACTORS PREDISPOSE AN INDIVIDUAL TO OVERUSE INJURIES, BUT ONE SYSTEMATIC CAUSE IS IMPROPER TRAINING. OVERUSE INJURIES RESULT FROM REPEATED SUBMAXIMAL STRESS FOLLOWED BY INADEQUATE RECOVERY. CHILDREN INCUR SPECIFIC OVERUSE INJURIES AS THE RESULT OF GROWTH. STRATEGIES FOR PREVENTING OVERUSE INJURIES INCLUDE (A) THE USE OF VARIED PRACTICE TO REDUCE JOINT STRESS AND ENHANCE LEARNING, (B) PLANNED REST, (C) GRADUAL PROGRESSION, AND (D) CROSS-TRAINING

Objective: To assess intracochlear trauma using two different round window-related cochleostomy techniques in human temporal bones. Methods: Twenty-eight human temporal bones were included in this study. In 21 specimens, cochleostomies were initiated inferior to the round window (RW) annulus. In seven bones, cochleostomies were drilled anterior-inferior to the RW annulus. Limited cochlear implant electrode insertions were performed in 19 bones. In each specimen, promontory anatomy and cochleostomy drilling were photographically documented. Basal cochlear damage was assessed histologically and electrode insertion properties were documented in implanted bones. Results: All implanted specimens showed clear scala tympani electrode placements regardless of cochleostomy technique. All 21 inferior cochleostomies were atraumatic. Anterior-inferior cochleostomies resulted in various degrees of intracochlear trauma in all seven bones. Conclusion: For atraumatic opening of the scala tympani using a cochleostomy approach, initiation of drilling should proceed from inferior to the round window annulus, with gradual progression toward the undersurface of the lumen. While cochleostomies initiated anterior-inferior to the round window annulus resulted in scala tympani opening, many of these bones displayed varying degrees of intracochlear trauma that may result in hearing loss. When intracochlear drilling is avoided, the anterior bony margin of the cochleostomy remains a significant intracochlear impediment to in-line electrode insertion.

The study by Knopman et al.1 in this issue of Neurology ® examines how variations in the pattern and degree of mild cognitive deficits, common in older adults without dementia, predict the development of dementia. What the study reveals is not entirely novel and essentially confirms clinical intuition: individuals with broader and deeper cognitive impairments have the highest risk of future dementia. The study's main accomplishment, however, is the light it shines on what is obscured when a categorical construct such as mild cognitive impairment (MCI)2 is applied to what is clearly a continuous process—the gradual progression of MCI to dementia and Alzheimer disease.

We describe a case of ossifying fibroma of the mandibular coronoid process in a 30-year-old woman. The patient presented with a chief complaint of a noticeable swelling of the right side of the face. On the basis of the clinical and radiographic findings, as well as the history of gradual progression, a benign fibro-osseous lesion of the right mandibular coronoid process was clinically diagnosed. Under general anesthesia, coronoidectomy was performed through an intraoral. approach. The histopathological diagnosis was an ossifying fibroma of the right mandibular coronoid process. Radiographic and clinical examinations showed no sign of recurrence 16 months after surgery.

A 23-year-old female reported with atopic asthma and allergic rhinitis diagnosed in childhood, and complaints of frequent exacerbations since adolescence. Spirometry showed gradual progression of obstruction – at the age of 20 – representing very severe obturation. The patient never smoked and had no exposition to any potential irritation factors. Due to frequent exacerbations, the patient often required systemic glucocorticoids; at the age of 21, she was diagnosed with TB. After the antituberculosis treatment was completed, reversibility test was negative, and slow progression of obstruction was still observed (FEV1 20% of predicted value). The patient had presented depression symptoms. She was qualified for anti-IgE treatment; after 8 months, clinically significant improvement was observed – the number of exacerbations was reduced and systemic GCS has been stopped. Spirometry had showed improvement with FEV1 – 38% of predicted. As the exercise tolerance improved, the patient has resumed her academic studies.