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The study aims to replicate the previous found association of 5-HTTLPR and inertia of negative affect in daily life of adolescents and young adults. Data of 877 adolescents (aged 14–21 years) of the Behavior and Mind Health (BeMIND) study (epidemiological cohort study, Dresden, Germany) were genotyped for 5-HTTLPR/rs25531, grouped into SS/SLG/SLA/LGLA/LGLG vs. LALA, and provided ratings on negative affect items, depression and anxiety (Patient-Reported Outcomes Measurement Information System) eight times a day over 4 days. Multilevel regression models did not reveal an association of 5-HTTLPR genotype and inertia of negative affect, nor associations with inertia of anxiety or depression. Inertia of negative affect seems not to be a psychological mechanism through which 5-HTTLPR acts on psychopathology.

Most adolescents and young adults who experience psychological distress do not seek professional help. This study aims to enhance the understanding of sociodemographic, psychological, and clinical characteristics associated with the underuse of health services by adolescents and young adults with mental disorders. Data from a cross-sectional, epidemiological study with a population-based sample (N = 1180 participants, 14–21 years old) were used. Participants completed a fully standardized, computer-assisted diagnostic interview (DIA-X-5/D-CIDI) administered by trained clinical interviewers to assess lifetime mental disorders according to DSM-5 as well as lifetime health service use for mental health problems, and completed self-report questionnaires to assess various psychological variables (e.g., stigma). Predictors of health service use were examined using univariate and multiple logistic regression analyses, data were weighted for age and sex to improve representativeness Of n = 597 participants with any lifetime mental disorder, 32.4% [95% CI 28.4; 36.7] had ever used any health services because of a mental health, psychosomatic, or substance use problem. Even less had received psychotherapeutic or pharmacological treatment (Cognitive Behavioral Therapy: 12.1% [9.5; 15.2]; other psychotherapy: 10.7% [8.4; 13.7]; medication: 5.4% [3.7; 7.8]). High education was associated with less health service use (low/ middle/ other vs. high education: 53.8% vs. 26.9%; OR = 0.26, p p

If the gut of Octopus vulgaris is ligated at both ends, the animal loses weight at about 10% per day at 21°C, dying after about 48 h. Ligation of the ducts to the midgut gland has the same effect. If one or both ducts are cannulated and led to the exterior with a sufficient length of duct remaining, sea water is taken up by peristalsis and there is little or no weight loss. As body weight falls, blood and urine osmolality remain unchanged, but blood conductivity falls and blood copper concentration rises, indicating a loss of salts as well as water. Muscle dry weight, as a percentage of muscle wet weight, increases as body weight falls. Octopus is hyperosmotic compared with sea water and the rate of ultrafiltration through the branchial heart appendages into the kidney sacs is estimated to be sufficient to account for the observed body weight losses. Each side of the midgut gland, connected to the gut by a digestive duct, includes two distinct structures. One, the digestive gland, produces enzymes and is also concerned with absorption of the fluid and paniculate products of digestion. The other, the digestive gland appendage (the so-called ‘pancreas9), is composed of cells with characteristics that strongly indicate bulk fluid transport; it seems likely that this is the principal site of the fluid uptake. This evidently includes salts as well as water, since sea water taken into the gut (notably by rectal pumping) is not concentrated as fluid is withdrawn.

Pancreatic ductal adenocarcinoma (PDAC) is characterized by KRAS- and autophagy-dependent growth. We and others recently demonstrated that inhibition of the RAF-MEK-ERK pathway resulted in upregulated autophagy, and that dual treatment with the autophagy inhibitor hydroxychloroquine (HCQ)/chloroquine (CQ) and MEK or ERK inhibitors (MEKi, ERKi) synergistically blocked PDAC growth. These findings provided rationale for our initiation of Phase I/II clinical trials evaluating the combination of MEKi (binimetinib; NCT04132505) or ERKi (LY3214996; NCT04386057) with HCQ in PDAC. However, HCQ/CQ are not specific or potent autophagy inhibitors. Thus, we sought to identify a more efficacious autophagy inhibition strategy. To this end, we performed a CRISPR-Cas9 mediated genetic loss-of-function screen with a library encompassing cancer signaling pathways in the presence or absence of CQ. In the absence of CQ, we identified PIKfyve, a lipid kinase critical for the recycling dynamics of lysosomes, as an essential autophagy-related gene in PDAC cells. PIKfyve inhibition, by the clinical candidate inhibitor apilimod, resulted in potent reduction of autophagic flux and growth. Additionally, PIKfyve inhibition resulted in robust intracellular vacuolization. Vacuoles stained positive for the lysosomal marker, LAMP1, and exhibited reduced acidity and impaired cargo degradation. Importantly, when we inhibited MEK, with the clinical stage MEKi mirdametinib, and PIKfyve (with apilimod) together, we observed decreased MEKi-induced autophagic flux and synergistic impairment of PDAC cell proliferation. Growth inhibition was due in part to an induction of apoptosis unique to combination treatment. Synergistic growth suppression was maintained in a panel of patient derived PDAC organoids, suggesting this may be an efficacious therapeutic strategy for PDAC treatment. In the presence of CQ, our CRISPR-Cas9 screen showed that loss of upstream autophagy-related genes sensitized PDAC cells to CQ treatment. Validation indicated that vertical inhibition (dual inhibition of distinct nodes of a linear pathway) of the autophagy pathway further reduced autophagic flux relative to inhibition of any single node and synergistically reduced PDAC cell growth. Furthermore, combining ERK-MAPK inhibition with vertical inhibition of autophagy improves the in vitro efficacy of this treatment strategy. Ongoing studies are aimed at delineating the mechanism underlying the synergy observed with anti-autophagy inhibitor combinations and further validation in more advanced preclinical models of PDAC. Citation Format: Jonathan M. DeLiberty, Clint A. Stalnecker, Kristina Drizyte-Miller, Elyse G. Schechter, Noah L. Pieper, Runying Yang, Channing J. Der, Adrienne D. Cox, Kirsten L. Bryant. Improving the efficacy of dual ERK-MAPK and autophagy inhibition as a therapeutic strategy for pancreatic ductal adenocarcinoma. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4851.

Purpose Because of the increasingly higher expectations of accrediting organizations, calls for greater accountability from state governments, and students’ demand for an education that prepares them for a career, most hospitality programs are now required to have an effective assessment of learning outcomes process. The increasing popularity of the assessment of learning outcomes process is viewed as highly positive because it can be considered as best practices in higher education. The paper aims to discuss this issue. Design/methodology/approach This is Part 1 of a two-part article that provides an overview of the justifications for implementing an assessment of learning outcomes process, the steps that were developed by two hospitality programs and the experiences of the two programs during implementation of the seven steps. Part 1 includes foundational principles of the process and the first three of the seven steps. Findings The steps in a closed-loop assessment of learning outcomes process are relatively detailed; however, because of changes in expectations of stakeholders and the requirements of accreditors, they are now mandatory for most hospitality programs. Therefore, the choice is not whether to implement them, but when to implement them. From a competitive standpoint, it is to the program’s advantage to begin as soon as possible. Another factor to consider is that the implementation of an effective closed-loop assessment of learning outcomes process will take several years to complete. Originality/value This paper is presenting a critical view of one of, if not the most important concepts in higher education, the closed-loop assessment of learning outcomes process. Hopefully, the information on the process that is provided and the experiences of the two programs can shorten the learning curve for other hospitality programs.

Pancreatic ductal adenocarcinoma (PDAC) is characterized by KRAS- and autophagy-dependent tumorigenic growth. We determined the role of mutationally activated KRAS, found in ~95% of PDAC, in supporting autophagy. Surprisingly, acute KRAS suppression was associated with increased autophagic flux. Pharmacologic inhibition of ERK MAPK phenocopied the genetic silencing of KRAS and increased autophagic flux. We speculated that the loss of ERK-driven metabolic processes may induce compensatory mechanisms to increase autophagy. We then addressed whether ERK inhibition increased PDAC dependence on autophagy. Supporting this possibility, we found that cotreatment with the autophagy inhibitor chloroquine (CQ) synergistically enhanced ERK inhibitor-mediated anti-proliferative activity. Our findings, together with similar observations by others, provided the rationale for our initiation of Phase I/II clinical trials evaluating the combination of MEKi (binimetinib; NCT04132505) or ERKi (LY3214996; NCT04386057) with hydroxychloroquine (HCQ) in PDAC. Our ongoing studies are centered on developing additional combinations for targeting autophagy. First, we performed a CRISPR/Cas-9 mediated genetic loss-of-function screen in the presence of CQ to determine additional sensitizers as well as mediators of resistance to autophagy inhibition. Top sensitizers included multiple facilitators of the DNA damage response, mTOR pathway components, and genes involved in the upstream regulation of the autophagy pathway. Second, we determined that autophagic signaling is temporally regulated following RAS pathway inhibition and hypothesize that further dissection of this regulation will improve current anti-nutrient scavenging treatment strategies. We conclude that concurrent suppression of multiple metabolic processes, to block compensatory rebound activities, will be needed for effective PDAC treatment. Citation Format: Jonathan M. DeLiberty, Ryan Robb, Claire E. Gates, Noah L. Pieper, Runying Yang, Clint A. Stalnecker, Kirsten L. Bryant. Enhancing autophagy inhibition as a therapeutic strategy for pancreatic cancer [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer; 2022 Sep 13-16; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2022;82(22 Suppl):Abstract nr B007.

The objectives of this study were to assess the effects of a single transdermal administration of flunixin meglumine (FM) in early postpartum Holstein Friesian dairy cows on serum concentrations of inflammatory and metabolic markers, uterine health, and indicators of pain. The hypothesis was that the anti-inflammatory, antipyretic, and analgetic effects of the pharmaceutic agent would reduce systemic inflammation, resulting in improved metabolic and inflammatory profile, diminished incidence of metritis, and reduced expression of pain. A total of 500 cows (153 primiparous, 347 multiparous) from 3 different commercial dairy farms in the northeast of Germany were included in a randomized controlled clinical trial. Farms were preselected based on high haptoglobin concentrations in their fresh lactating cows. Cows were excluded if they had experienced dystocia, stillbirth, or twin birth, or if they showed any signs of milk fever, retained fetal membranes, or fever (40°C). The cows were treated once with either FM (3.33 mg/kg) or a placebo as control (CON) through transdermal administration between 24 to 36 h postpartum (d 2). General health examinations were performed (daily from d 2-8 and additionally on d 15 postpartum), vaginal discharge was assessed using the Metricheck device (d 8 and 15 postpartum) and serum samples were analyzed for inflammatory and metabolic markers (d 2, 4, and 6 postpartum). Effects of treatment, parity, sampling day, and their interactions were evaluated using mixed effects models. Primiparous cows treated with FM showed lower serum haptoglobin concentrations (0.90 ± 0.08 vs. 1.17 ± 0.07 g/L; ± standard error of the mean) and higher serum albumin concentrations (35.5 ± 0.31 vs. 34.8 ± 0.31 g/L) on d 6 postpartum. They also had a lower risk for purulent vaginal discharge with or without a fever compared with CON cows on d 15 postpartum (odds ratio for CON vs. FM: 1.63, 95% CI: 1.26-2.00), and body temperature was lower throughout the first 15 d in milk (39.1 ± 0.11 vs. 39.2 ± 0.11°C). Multiparous cows treated with FM had lower serum β-hydroxybutyrate concentrations on d 4 postpartum (0.71 ± 0.05 vs. 0.78 ± 0.05 mmol/L) and d 6 postpartum (0.74 ± 0.05 vs. 0.80 ± 0.05 mmol/L). Regardless of parity, FM-treated cows were significantly less likely to abduct their tail from their body (14.3 vs. 23.6%) and show an arched back (27.9 vs. 39.7%) on the day after treatment compared with CON cows. It can be concluded that FM treatment slightly reduced inflammation and diminished the risk for metritis in primiparous cows, improved metabolic profile in multiparous cows, and reduced expressions of pain in all cows.

The study aims to replicate the previous found association of 5-HTTLPR and inertia of negative affect in daily life of adolescents and young adults. Data of 877 adolescents (aged 14-21 years) of the Behavior and Mind Health (BeMIND) study (epidemiological cohort study, Dresden, Germany) were genotyped for 5-HTTLPR/rs25531, grouped into SS/SL

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Aging and many pathologies that affect gait are associated with reduced ankle power output and thus trailing limb propulsion during walking. However, quantifying trailing limb propulsion requires sophisticated measurement equipment at significant expense that fundamentally limits clinical translation for diagnostics or gait rehabilitation. As a component of joint power, our purpose was to determine if shank acceleration estimated via accelerometers during push-off can serve as a clinically feasible surrogate for ankle power output and peak anterior ground reaction forces (GRF) during walking. As hypothesized, we found that young adults modulated walking speed via changes in peak anterior GRF and peak ankle power output that correlated with proportional changes in shank acceleration during push-off, both at the individual subject (R2 ≥ 0.80, p

Background Following the ban on antimicrobial usage for growth promotion in animal husbandry in the EU, non-antimicrobial agents including heavy metal ions (e.g. zinc and copper), prebiotics or probiotics have been suggested as alternatives. Zinc has extensively been used in pig farming, particularly during weaning of piglets to improve animal health and growth rates. Recent studies, however, have suggested that high dietary zinc feeding during weaning of piglets increases the proportion of multi-drug resistant E. coli in the gut, contraindicating the appropriateness of zinc as an alternative. The underlying mechanisms of zinc effects on resistant bacteria remains unclear, but co-selection processes could be involved. In this study, we determined whether E. coli isolates from intestinal contents of piglets that had been supplemented with high concentrations of zinc acquired a higher tolerance towards zinc, and whether multi-drug resistant isolates tolerated higher zinc concentrations. In addition, we compared phenotypic zinc and copper resistance of E. coli isolates for possible correlation between phenotypic resistance/tolerance to different bivalent ionic metals. Results We screened phenotypic zinc/copper tolerance of 210 isolates (including antimicrobial resistant, multi-drug resistant, and non-resistant E. coli) selected from two, independent zinc-feeding animal trials by determining a zinc/copper minimal inhibitory concentration (Merlin, Bornheim-Hersel, Germany). In both trials, groups of piglets were supplemented either with high dietary zinc (> 2000 ppm) or control (50–70 ppm, background) concentrations. Our observations showed that high concentration zinc exposure did not have an effect on either zinc or copper phenotypic tolerance of E. coli isolates from the animals. No significant association was found between antimicrobial resistance and phenotypic zinc/copper tolerance of the same isolates. Conclusion Our findings argue against a co-selection mechanism of antimicrobial drug-resistance and zinc tolerance after dietary zinc supplementation in weaning piglets. An explanation for an increase in multi-drug resistant isolates from piglets with high zinc dietary feeding could be that resistant bacteria to antimicrobial agents are more persistent to stresses such as zinc or copper exposure.

Congenital heart diseases (CHD) are the most common types of congenital organ defects. Thanks to medical progress in congenital cardiology and heart surgery, most children with CHD reach adulthood. Despite primarily successful treatment residual and subsequent conditions as well as (non)cardiac comorbidities can influence the chronic course of the disease and lead to a higher morbidity and mortality. Adults with congenital heart disease (ACHD) in Germany are not tied to the healthcare structure despite the great need for aftercare. According to the results of the medical care of ACHD (MC-ACHD) study, ACHD centers and specialists in Germany are insufficiently perceived despite increased complication rates and the great need for specialist guidance. General practitioners and patients are not adequately informed about existing ACHD facilities. A better awareness of the ACHD problem should be created at the level of primary medical supply in order to optimize care and to reduce morbidity and mortality. Improved future-oriented patient care includes lifelong regular follow-up and the possibility of interdisciplinary, integrated medical care of CHD.

Older adults walk with greater metabolic energy consumption than younger for reasons that are not well understood. We suspect that a distal-to-proximal redistribution of leg muscle demand, from muscles spanning the ankle to those spanning the hip, contributes to greater metabolic energy costs. Recently, we found that when younger adults using biofeedback target smaller than normal peak propulsive forces (F(P)), they do so via a similar redistribution of leg muscle demand during walking. This alludes to an experimental paradigm that emulates characteristics of elderly gait independent of other age-related changes relevant to metabolic energy cost. Thus, our purpose was to quantify the metabolic and limb- and joint-level mechanical energy costs associated with modulating propulsive forces during walking in younger adults. Walking with larger F(P) increased net metabolic power by 47% (main effect, p=0.001), which was accompanied by small by relatively uniform increases in hip, knee, and ankle joint power and which correlated with total joint power (R(2)=0.151, p=0.019). Walking with smaller F(P) increased net metabolic power by 58% (main effect, p

Given the increased use of performance assessments (PAs) in higher education to evaluate achievement of learning outcomes, it is important to address the barriers related to ensuring quality for this type of assessment. This article presents a design-based research (DBR) study that resulted in the development of a Validity Inquiry Process (VIP). The study’s aim was to support faculty in examining the validity and reliability of the interpretation and use of results from locally developed PAs. DBR was determined to be an appropriate method because it is used to study interventions such as an instructional innovation, type of assessment, technology integration, or administrative activity ( Anderson & Shattuck, 2012 ). The VIP provides a collection of instruments and utilizes a reflective practice approach integrating concepts of quality criteria and development of a validity argument as outlined in the literature ( M.T. Kane, 2013 ; Linn, Baker, & Dunbar, 1991 ; Messick, 1994 ).

Locally developed performance-based assessment instruments must provide evidence of validity and reliability supporting their intended interpretation and use. Accrediting bodies, such as the Council for the Accreditation of Educator Preparation (CAEP), require Educator Preparation Programs (EPPs) to provide this evidence in their accreditation self-study. However, faculty may not have the expertise to conduct an effective examination of their assessments. This chapter describes a process for gathering evidence to build a validity argument for locally developed performance-based assessments. Grounded in measurement theory, the Validity Inquiry Process (VIP) guides faculty through a reflective practice approach towards making defensible claims about the use of results from locally developed performance-based assessments. Using this process, faculty can have greater confidence in using their performance-based assessments to provide feedback to their students, as well as offer assurances of program quality or to identify areas for improvement.

Although the influx of religiously committed evangelical Christians to the Republican Party has dominated both the popular press and the scholarly literature, a similarly stunning shift has occurred among American Catholics. This article addresses the causes and effects of that shift by focusing on how the American Left covered Catholicism in its publications. Content analyses of The Nation, In These Times, and Mother Jones indicate that although the American Left was largely positive toward Catholicism during the late 1970s and 1980s, by the 1990s the religious frames changed. As the religious right rose in prominence and power, the American Left altered its perspective of Catholics and conflated its political values with those of the religious right. This shift among “elite” opinion leaders in the press reflected and may have exacerbated partisan shifts already underway within the general public.

A method to account for the effect of interfacial surfactant con-centration on multi-phase flows has been proposed by Schranner &Adams (2016). The therein validated method builds up on the thesharp-interface method of Huet al.(2006). This work advances themethod to simulate and analyse configurations of industrial appli-cability. In the majority of these configurations temperature gradi-ents, commonly due to local heat sources or sinks, are the dominantcause of the Marangoni flow. In order to account for the Marangonieffect properly, the temperature distribution within the two-phaseflows under consideration has to be known. In this work, two nu-merical approaches for the calculation of the temperature are pre-sented and evaluated. In the first approach the temperature trans-port equation, realized as a scalar transport equation, is coupled tothe finite volume algorithm of Schranner & Adams (2016). The un-derlying method for the second approach is the weakly compress-ible high-resolution approach for incompressible flows (Schranneret al.(2013)), which is generalized to compressible and incompress-ible flows. The extension to multi-phase flows with discontinuousphases is formulated in this work. The approaches are evaluatedand compared on basis of the test flow proposed by Pendse & Es-maeeli (2010). It is sufficiently complex in its evolution, yet simplein its set-up and permits comparison to an analytical reference so-lution. The application of the methods to further thermocapillaryflows is pursued. Both methods are robust and correctly predict theevolution of the Marangoni flows and temperature fields. Numeri-cal experiments indicate that the passive scalar method is faster thanthe energy equation method. Yet, for two-phase flows with fluids ofvery diverse properties the energy equation method is more accu-rate.

Recent scholarship has outlined and debated theories of a culture war taking place within the United States, with religious traditionalists pitted against nonorthodox religious believers and nonbelievers. Some scholars and commentators contend that the American Left has contributed to this culture war through its hostility toward Americans of faith. This theory, which I call the Irreverent Left thesis, purports that such hostility has caused religious traditionalists to abandon the Democratic Party for the Republican Party, leading to Republican victories in national politics. This article examines whether the Left has become more hostile to religion. Using content analysis of American Left publications— The Nation, In These Times, and Mother Jones— I examine the attitudes of progressive elites from 1977 to 2000. Findings indicate that although the American Left has become more hostile toward religious faith, this hostility is more likely a result of the shifting partisan loyalties than a cause.

CHARGE syndrome is an autosomal dominant malformation syndrome caused by mutations in the CHD7 gene. The majority of cases are sporadic and only few familial cases have been reported. In these families, mosaicism in one parent, as well as parent- to-child transmission of a CHD7 mutation, has been described. In some further cases, germline mosaicism has been suggested. Here, we report the first case in which germline mosaicism could be demonstrated in a father of two affected children with CHARGE syndrome. The truncating mutation c.7302dupA in exon 34 of the CHD7 gene was found in both affected children but was not detected in parental lymphocytes. However, in DNA extracted from the father's spermatozoa, the c.7302dupA mutation could be identified. Furthermore, mutation analysis of DNA isolated from 59 single spermatozoa revealed that the c.7302dupA mutation occurs in 16 spermatozoa, confirming germline mosaicism in the father of the affected children. This result has a high impact for genetic counselling of the family and for their recurrence risk in further pregnancies.

Sulfur deficiency and toxicity in livestock is associated with decreased performance and diseases. However, little is known about the diagnostics of sulfur status in dairy herds. The objectives of this study were to describe sulfur concentrations in feed rations in German dairy herds, to assess associations between feed sulfur concentrations and health and milk yield, to determine suitable laboratory diagnostic methods of sulfur status, and to propose reference values for the assessment of sulfur status in different sample media.Between 2006 and 2014, a total of 569 dairy herds were visited. Blood, urine, and hair samples were obtained from 10 animals per group in the groups -3 to 0, 0 to 1, 3 to 5, and 15 to 18 weeks post partum (p. p.) (farms200 animals) or -3 to 0, 0 to 5, and 6 to 20 weeks p. p. (farms ≤ 200 animals). Pooled whole blood, serum, plasma, urine, and hair samples (n = 5663) were analyzed by ICP-OES. The sulfur content of the total mixed ration (TMR) of the group -3 to 0 weeks p. p. was determined in a certified feed laboratory (n = 625). Data analyses were performed using ANOVA, Chi-squared test and Spearman-correlation. Reference values were determined using the 2.5% and 97.5% percentiles.Median sulfur concentration in the feed rations was 2.3 g/kg dry matter (DM). Deficiency ( 1.6 g/kg DM; 31% of farms) and oversupply ( 4.0 g/kg DM; 11% of farms) of sulfur in feed rations were regularly diagnosed. Sulfur deficiency was associated with reduced milk yield (p 0.001), retained placenta (OR = 1.74; p = 0.037), milk fever (OR = 2.68; p 0.001) and silent heat (OR = 2.56; p = 0.014). Positive correlations were found between sulfur concentration in feed rations and sulfur content in urine (r = 0.50), serum (r = 0.17), plasma (r = 0.18) and whole blood (r = 0.16). Reference values for sulfur diagnostics in dairy herds were proposed.Diagnostics of sulfur status in dairy herds is relevant for veterinary practitioners and can be performed using TMR analysis and clinical laboratory parameters. Urine can be considered a short-term parameter, serum, plasma, and whole blood as intermediate parameters, and hair as a long-term parameter for the evaluation of the sulfur status.

The psychometric properties of the Achievement Goal Questionnaire (AGQ), when modified for a general academic context, were examined. Previous research has found evidence of a four-factor structure of achievement goal orientation when this measure was used in a course-specific context. This study is an important addition to goal orientation research for the following two reasons: (a) It provides additional support for four distinct factors of goal orientation, and (b) it answers the call for examining achievement goal orientation measures at different levels of specificity. The authors found that the four-factor structure of goal orientation replicated when used in a general academic context.

It is unclear whether depressive symptoms are a risk factor for incident diabetes or diabetes is a risk factor for depressive conditions. Therefore, we examined the longitudinal bidirectional associations between depressive symptoms and type 2 diabetes (T2D) as well as the impact of both diseases on (all cause) mortality in a sample of primary care patients over a 3.5-years follow-up period on average. Depressive symptomatology, defined by the Depression Screening Questionnaire (DSQ), was examined both categorically and dimensionally. Patients were categorized as normal fasting glucose (NFG), impaired fasting glucose (IFG), and T2D (untreated, oral antidiabetics, insulin/combined treatment) according to physician ratings and baseline lab values. Incidence rates of T2D were 25.6 and 20.9 per 1000 person-years for those with and without depressive symptoms, respectively. The unadjusted risk of incident type 2 diabetes was 1.03 times higher (CI(95%): 1.01-1.06) for each 1-point increment in DSQ score. The incidence rates of elevated depressive symptoms per 1000 person-years were 30.5 for NFG, 34.2 for IFG, 36.4 for untreated T2D, 32.3 for oral treated T2D, and 47.8 for insulin/combined-treated T2D patients. Compared to NFG patients, insulin-treated patients had a higher risk of incident depressive symptoms (HR: 1.71; CI(95%): 1.03-2.83) and oral-treated patients had a lower risk (HR: 0.58; CI(95%): 0.36-0.96). Higher mortality rates were associated with both diseases compared to patients without T2D or depressive symptoms at baseline (HR: 2.49; CI(95%):1.45-4.28). Results indicate that especially insulin treatment in T2D patients is associated with incident depressive symptoms.

The purpose of this chapter is to review literature over the past ten years regarding technology tools that are being used in higher education to assess student learning. Three commonly used technology tools are examined: electronic portfolios, course management systems, and audience response systems. More specifically, each tool was studied in order to determine how it improved student learning and development, what issues might impede student learning and development, and what future directions we could explore in order to maximize the potential of the learning tool. Broad themes were then identified from the review, and three suggestions were made to teachers and researchers: (1) expand current research in this area, (2) get to know student background and characteristics before incorporating assessment technology tools, and (3) reconsider pedagogy and practice when integrating technology used for assessment.