A Snapshot of Gay-Straight Alliance Clubs and Student Well-Being in Western Canadian High Schools

Gay-Straight Alliance (GSA) clubs promote safer school environments for students. GSAs typically refer to student-led, teacher-supported school clubs that serve youth of diverse gender identities and sexual orientations. This study investigated the relationship between students' awareness of school-based GSAs and their bullying experiences, mental health, self-determination, and relationships at school and home. Findings showed that LGBTQ2S+ students experienced higher rates of bullying and symptoms of depression and scored lower on self-determination subscales than cisgender heterosexual students. Interestingly, students who were aware of their school's GSA club scored higher on the self-determination subscales regarding family relationships and lower on bullying compared to students who were unaware of their school's GSA club. LGBTQ2S+ students had lower rates of comfort with their sexual orientation at home and school than their cisgender heterosexual students. Implications and future directions are discussed.

Lessons Learned and Future Directions of MetaTutor: Leveraging Multichannel Data to Scaffold Self-Regulated Learning With an Intelligent Tutoring System

Self-regulated learning (SRL) is critical for learning across tasks, domains, and contexts. Despite its importance, research shows that not all learners are equally skilled at accurately and dynamically monitoring and regulating their self-regulatory processes. Therefore, learning technologies, such as intelligent tutoring systems (ITSs), have been designed to measure and foster SRL. This paper presents an overview of over 10 years of research on SRL with MetaTutor, a hypermedia-based ITS designed to scaffold college students' SRL while they learn about the human circulatory system. MetaTutor's architecture and instructional features are designed based on models of SRL, empirical evidence on human and computerized tutoring principles of multimedia learning, Artificial Intelligence (AI) in educational systems for metacognition and SRL, and research on SRL from our team and that of other researchers. We present MetaTutor followed by a synthesis of key research findings on the effectiveness of various versions of the system (e.g., adaptive scaffolding vs. no scaffolding of self-regulatory behavior) on learning outcomes. First, we focus on findings from self-reports, learning outcomes, and multimodal data (e.g., log files, eye tracking, facial expressions of emotion, screen recordings) and their contributions to our understanding of SRL with an ITS. Second, we elaborate on the role of embedded pedagogical agents (PAs) as external regulators designed to scaffold learners' cognitive and metacognitive SRL strategy use. Third, we highlight and elaborate on the contributions of multimodal data in measuring and understanding the role of cognitive, affective, metacognitive, and motivational (CAMM) processes. Additionally, we unpack some of the challenges these data pose for designing real-time instructional interventions that scaffold SRL. Fourth, we present existing theoretical, methodological, and analytical challenges and briefly discuss lessons learned and open challenges.

Deconstructing Canada’s efforts to integrate artificial intelligence in medicine and medical education

Artificial intelligence (AI) has gained momentum in the last decade in various professional domains, but its usage remains scarce in the field of medicine. Available AI-enhanced devices are not integrated in a consistent fashion throughout Canadian health facilities, and current medical practitioners and students are not well prepared for AI’s impact on their careers. Undergraduate medical students lack fundamental knowledge of AI in medicine, from its impact on patient care and its potential as an adjunct decision-making tool, to the general fundamentals of how AI-enhanced devices work. Currently, postgraduates don’t have access to AI-enhanced devices; this could potentially limit their understanding of how these devices might affect their future clinical practice. Canadian medical universities can play a critical role in familiarizing students with these new devices. Incorporating new topics into the already heavily charged medical curricula may be challenging, but students could make use of extracurricular activities to learn the concept of AI and strengthen interdisciplinary collaboration. Educational institutions would also need to propose policies for the safe and ethical use of devices in classrooms or internships. However, they might require guidance to draft new policies targeting AI in medical education. Canadian medical associations could take the lead to draft AI policies in healthcare to guide the equal and safe implementation of AI-enhanced devices across the Canadian medical community. Our paper will explore the work that has been done related to AI-specific policies in healthcare, focusing on Canada, and provide key points that could be used to organize future policies.

A laminated energetic electrostatic analyzer for 0-5 keV charged particles

A compact electrostatic energy bandpass filter based on a laminated analyzer design has been developed to measure charged particle fluxes at energies ranging from 0 to 5 keV. The sensor head has been successfully tested against a low energy magnetically filtered plasma source and an ion beam source capable of producing energetic ions in the range of 100-1250 eV. Additionally, the instrument has demonstrated the ability to accurately measure negative spacecraft frame charging using a low Earth orbit plasma simulator. The effects of the spacecraft frame charging on the measured energy distribution measurements and the impact regarding the derived charged particle density and temperature parameters are also examined.

Mycobacterium avium subsp. hominissuis Infection in a captive-bred kiang (Equus kiang)

Equids are considered highly resistant to mycobacterial infections and clinical cases have been described in domestic horses only. Mycobacterium bovis is the most common species reported, although a single report exists of disease due to definitively diagnosed infection with Mycobacterium avium subsp. hominissuis in two domestic horses. This is the first report of a mycobacterial infection in a kiang (Equus kiang), or indeed any wild equid. The animal had chronic loss of condition and serum biochemical changes suggestive of liver disease and chronic infection. Further investigation showed a chronic granulomatous enteritis, lymphadenitis and hepatitis with focal granulomatous pneumonia due to systemic infection with M. avium subsp. hominissuis. The distribution and severity of the lesions suggested that the route of infection was alimentary.

Orosomucoid influences the response to antidepressants in major depressive disorder

Orosomucoid, an acute phase protein, carries basic drugs including antidepressants in plasma. Elevated levels have been reported in patients with depression. It has yet to be established whether orosomucoid concentration influences antidepressant response. The orosomucoid gene (ORM1) is polymorphic and the protein isoforms have differing pharmacokinetic properties which could alter plasma profile and blood brain barrier transport of antidepressants. Outpatients (n = 157) in a randomised control trial of fluoxetine versus nortriptyline were genotyped for the ORM1 variants. Plasma concentrations of acute phase proteins were also measured. Outcomes were the completion of an adequate six week trial of antidepressant and response. Response was defined as an improvement >/=60% on the Montgomery-Asperg Depression Rating Scale (MADRS) over six weeks. The first notable finding was that individuals with an ORM1*S/*S genotype were less likely to complete an adequate six week trial of an antidepressant (OR = 4.707, 95% CI 1.769-12.527, P = 0.002). The second was that higher orosomucoid concentrations were found in antidepressant non-responders (91.4%) than responders (79.1%) (F1, 106 = 5.669, P = 0.019). These findings highlight the potential importance of variables such as orosomucoid which impact on drug availability on the therapeutic efficacy of antidepressant drugs.

IRF5 Genetic Risk Haplotype Influences Host B Cell Gene Responses to Epstein-Barr Virus (EBV) (49.14)

Both gene and environment interactions play keyroles in the development of systemic lupus erythematosus (SLE). We examined effects of the IRF5 lupus risk haplotype upon the host's B cell response to the binding or infection with EBV, a suspected environmental trigger for SLE. Whole genome microarray expression profile data was collected from cells exposed to EBV for 16 hours. Analysis of gene expression by gene set enrichment analysis revealed that key differences in expression between SLE patients and controls (or individuals carrying the IRF5 risk and non-risk haplotype) were in a subset of interferon response genes. Patients with the IRF5 risk haplotype have a heightened interferon signature under all experimental conditions; whereas, the patients with the IRF5 protective haplotype have a B cell interferon signature similar to that of unrelated, matched controls. Overexpression of interferon pathway genes in B cells following viral exposure in control individuals carrying the IRF5 risk haplotype suggests that the IRF5 risk alleles alone can modulate ones biological response to the environmental insult. Patients carrying either the IRF5 risk or non-risk alleles appear to already be predisposed to having a higher interferon signature even without exposure to virus, suggesting that other genetic factors are also influencing the interferon response, independent of virus. Support by NIH (AI007633 and AI31584).

A polymorphism within interleukin-21 receptor (IL21R) confers risk for systemic lupus erythematosus and is associated with malar rash in lupus patients (49.17)

Interleukin (IL) 21 is a member of the type I cytokine superfamily that exerts a variety of effects on the immune system including B cell activation, plasma cell differentiation, and immunoglobulin production. The IL21 receptor (IL21R) is expressed on B cells, T cells, NK cells, and monocyte-derived dendritic cells. The expression of IL21R is reduced in B cells from lupus patients, while IL21 serum levels are increased in both lupus patients and some lupus-murine models. We recently reported that polymorphisms within the IL21 gene are associated with increased susceptibility to lupus. Herein, we genotyped SNPs in the IL21R gene located on chromosome 16p11. We identify and confirm the association between rs3093301 and lupus in two independent European-derived and Hispanic cohorts (p=7.2X10-5). In addition, the presence of the homozygous risk genotype in rs3093301 (A/A) was associated with the development of malar rash in the European-derived female lupus patients (OR=2.83, 95% CI=1.56-5.13, p=0.00045).

C8orf13/BLK association with systemic lupus erythematosus across different ethnicities (136.28)

SLE is a complex autoimmune disease with immunological abnormalities that targets B cell functions and development. Previous genome-wide association studies identified C8orf13/BLK as a novel SLE risk factor. BLK (B lymphoid tyrosine kinase) has been shown to have potential effects on B cell develoment. The main objectives of this study are to: 1.) assess this association in independent populations and 2.) determine if BLK risk alleles correlate with alteration in peripheral blood B cell development and protein expression. We genotyped 52 SNPs within the C8orf13/BLK region in European-derived, Asian and African American populations. rs13277113 is associated with SLE in all three populations. A few novel upstream SNPs within the intergenic region demonstrate a stronger association in Asians. Flow cytometry data suggests there is a significant difference in BLK expression and T2 cells B cell numbers between high-risk and non-risk individuals based on the risk haplotype. Our results suggest that the BLK genetic polymorphisms alter immune system development and function to increase the risk for SLE development. Supported by NIH RR020143, RR015577, NIAID-DAIT-BAA-05-11, AI031584, AR053483, AR48940, AI063274, AR052125, AR043247 and OCAST # HR08-037.

Maternal separation alters serotonergic transporter densities and serotonergic 1A receptors in rat brain

RATIONALE

The basic mechanisms underlying the association between early life maternal separation and adulthood psychiatric disorders are largely unknown. One possible candidate is the central serotonergic system, which is also abnormal in psychiatric illnesses. Neuroadaptational changes in serotonergic transporter and serotonergic 1A receptors may underlie links between early life stress and adulthood psychiatric disorders.

OBJECTIVE

The aim of this study was to investigate the consequences of a rat model of maternal separation on serotonergic transporter and serotonergic 1A receptor densities and function in adult rat forebrain.

METHODS

Rat pups were separated from dams from postnatal day 2 to postnatal day 14, each day, for zero time, 15 min and 180 min to determine the time-course of effects. A non-handled group was added to control for the effects of handling by an experimenter compared with the animal facility-reared group. Quantitative [(125)I]3beta-(4-iodophenyl)tropan-2beta-carboxylic acid methyl ester and [(125)I]-mPPI autoradiography was used to determine serotonergic transporter and serotonergic 1A densities, respectively. Adult rats were challenged with saline or serotonergic 1A agonist (+) 8-hydroxy-2-(di-n-propylamino)tetralin, 0.4 mg/kg, s.c.) and plasma adrenocorticotropic hormone and corticosterone were determined.

RESULTS

serotonergic transporter and serotonergic 1A densities were significantly lower in the non-handled group in the paraventricular, arcuate, dorsomedial and ventromedial nuclei of the hypothalamus. The non-handled group also displayed lower serotonergic transporter and serotonergic 1A densities in the basolateral anterior, basolateral ventral and basomedial amygdaloid nuclei. Serotonergic transporter densities were also decreased in the CA3 area of the hippocampus in the non-handled group. In contrast, the maternal separation 15 min group displayed the highest serotonergic transporter and serotonergic 1A densities in the basomedial nucleus of amygdala, basolateral anterior nucleus of amygdala, basolateral ventral nucleus of amygdala and basomedial nucleus of amygdala amygdaloid nuclei.

CONCLUSIONS

Early life maternal separation and the extent of handling can alter adult brain serotonergic transporter and serotonergic 1A levels and function in the forebrain. Alterations in these serotonergic systems by early rearing conditions might increase vulnerability for behavioral disorders in adulthood.

Genetic linkage of systemic lupus erythematosus with chromosome 11q14 (SLEH1) in African-American families stratified by a nucleolar antinuclear antibody pattern

Systemic lupus erythematosus (SLE) is an autoimmune disease with complex genetics. We evaluated pedigrees multiplex for SLE that had an affected with antinucleolar antibodies to increase the homogeneity for genetic linkage analysis. We found a significant linkage effect on chromosome 11q14 at marker D11S2002 in African-American Pedigrees. This effect produced a maximum LOD score of 5.62 using a dominant inheritance model with 95% penetrance in males and 99% penetrance in females. The results were supported by multipoint linkage analysis. Fine mapping of the region with two additional markers within 6 cM of D11S2002 further provided evidence of linkage in this region. Linkage at D11S2002, named SLEH1, was previously found in some of these same African-American pedigrees multiplex for SLE, but who were stratified by hemolytic anemia (Kelly et al, submitted). In conclusion, an important SLE susceptibility gene, SLEH1 at 11q14, is identified in African-Americans when stratifying pedigrees by antinucleolar autoantibodies.

Exploring the experiences of beginning registered nurses entering the acute care setting

This study begins to explore some of the social and political issues surrounding the practices of the graduate nurse. Utilising an ethnographic methodology with a critical intent, 4 graduate nurses describe their experiences of clinical practice. The major themes raised or issues that were embedded within the nurses' stories revolved around power and control enmeshed within nursing practice. The themes discussed relate to the graduates' perception of their own competence, and the concepts of the ideal nurse, the socialisation of graduates into the ward culture, being on insider or outsider and a good or bad nurse. The resulting discussion utilises the theoretical framework of Foucault's governmentality to suggest ways in which nurses and graduates might make sense of these issues.

Regulation of connexin43 expression and function by prostaglandin E2 (PGE2) and parathyroid hormone (PTH) in osteoblastic cells

Connexin43 (Cx43) forms gap junctions that mediate intercellular communication between osteoblasts. We have examined the effects of prostaglandin E2 (PGE2) and parathyroid hormone (PTH) on gap junctional communication in the rat osteogenic sarcoma cells UMR 106-01. Incubation with either PGE2 or PTH rapidly (within 30 min) increased transfer of negatively charged dyes between UMR 106-01 cells. This stimulatory effect lasted for at least 4 h. Both PGE2 and PTH increased steady-state levels of Cx43 mRNA, but only after 2-4 h of incubation. Transfection with a Cx43 gene construct linked to luciferase showed that this effect of PTH was the result of transcriptional upregulation of Cx43 promoter. Stimulation of dye coupling and Cx43 gene transcription were reproduced by forskolin and 8Br-cAMP. Exposure to PGE2 for 30 min increased Cx43 abundance at appositional membranes in UMR 106-01, whereas total Cx43 protein levels increased only after 4-6 h of incubation with either PGE2 or PTH. Inhibition of protein synthesis by cycloheximide did not affect this early stimulation of dye coupling, but it significantly inhibited the sustained effect of PTH and forskolin on cell coupling. In summary, both PTH and PGE2, presumably through cAMP production, enhance gap junctional communication in osteoblastic cell cultures via two mechanisms: initial rapid redistribution of Cx43 to the cell membrane, and later stimulation of Cx43 gene expression. Modulation of intercellular communication represents a novel mechanism by which osteotropic factors regulate the activity of bone forming cells.

The use of the Heimlich maneuver in near drowning: Institute of Medicine report

The application of the Heimlich maneuver as the initial and perhaps only step for opening the airway in all near-drowning victims has been proposed by Henry Heimlich and Edward Patrick, contrary to current resuscitation guidelines for the treatment of near-drowning victims established by the Emergency Cardiac Care (ECC) Committee of the American Heart Association. Although the Heimlich maneuver is useful for the removal of aspirated solid foreign bodies, there is no evidence that death from drowning is frequently caused by aspiration of a solid foreign body that is not effectively treated by the current ECC recommendations. Furthermore, the evidence is insufficient to support the proposition that the Heimlich maneuver is useful for the removal of aspirated liquid. Moreover, because there is no evidence to support Heimlich's hypothesis that substantial amounts of water are aspirated by near-drowning victims or that such aspirated liquid causes brain damage and death, the available evidence does not support routine use of the Heimlich maneuver in the care of near-drowning victims. The routine use of the Heimlich maneuver for treatment of near drowning raises several concerns: (a) the amount of time it would take to repeat this maneuver and how long this would delay the initiation of artificial ventilation; (b) possible complications of the Heimlich maneuver, especially if the near drowning is associated with a cervical fracture; and (c) the prospect of teaching rescue workers a different protocol than that which is taught at present for resuscitating victims of cardiopulmonary arrest from all causes other than near drowning.(ABSTRACT TRUNCATED AT 250 WORDS)

In vivo functioning of creatine phosphokinase in human forearm muscle, studied by 31P NMR saturation transfer

31P nuclear magnetic resonance (NMR) saturation transfer has been used to measure enzymatic flux through the creatine phosphokinase reaction in the direction of ATP synthesis in the human forearm muscle flexor digitorum superficialis. Modification of the ratio method for measurement of spin-lattice relaxation (R. Freeman, H.D.W. Hill, and R. Kaptein, J. Magn. Reson. 7, 82(1972]was tested and used to appreciably shorten the duration of the measurement. Under conditions of steady state work intracellular pH decreased slightly by 0.06 units and the spin-lattice relaxation time of phosphocreatine in muscle was unchanged, while flux from phosphocreatine to ATP was 64 +/- 10% of the resting value. This is contrary to the increase in flux of 155% predicted from previous saturation transfer studies carried out in vitro on rabbit skeletal muscle creatine phosphokinase using metabolite concentrations to mimic those in vivo (E.A. Shoubridge, J.L. Bland, and G.K. Radda, Biochim. Biophys. Acta 805, 72 (1984]. This discrepancy could be accounted for by an underestimation of the ADP concentrations to which the enzyme is exposed due to inaccurate assumptions about the total metabolite concentrations, or possibly by compartmentation of creatine phosphokinase and its reactants.

Clinical characteristics of diabetic patients with serious pedal infections

The clinical characteristics of 55 diabetic patients referred for treatment of serious pedal infections were surveyed. These patients had been infected for 22.5 +/- 5.0 weeks prior to referral. A majority had received therapy with oral antibiotics and approximately one third had received no antibiotic therapy. The average age of the patients was 53.5 years; average duration of disease, 18 years; and mean weight, 135% of ideal. All had poor glycemic control, as judged by hemoglobin A1c determinations. The patients had a high prevalence of diabetic complications, particularly peripheral neuropathy and nephropathy. Approximately 69% were hypertensive. Although their corrected ESRs were elevated, mean total WBC counts were not. A majority of the patients had zinc deficiency. Most of their infections involved multiple organisms, particularly staphylococcus species, enterococcus, and gram-negative aerobes. These observations suggest that the clinical characteristics of these patients in part explain the difficult nature of their infections and argue the need for early, aggressive antibiotic therapy.

Percutaneous drainage of abscesses in the postoperative abdomen that is difficult to explore

We have evaluated our experience with computerized tomography and ultrasonography guided percutaneous drainage of extrahepatic abdominal fluid collections in a group of 22 patients. The most common goal was to avoid or delay surgery on abdomens in which reoperation would be difficult, mainly in high-risk patients. Drainage of pancreatic fluid collections or abscesses was also attempted in a small number of the patients. Percutaneous drainage was curative in 69 percent of those with nonpancreatic abscesses but in only 33 percent of those with abscesses associated with the pancreas. There were no complications attributable to the procedure or to delays in subsequent surgical drainage. Two patients died from problems not directly related to the use of percutaneous drainage. Percutaneous catheter drainage of nonpancreatic abdominal abscesses can play a useful role in patients who are carefully selected because they possess a complex abdominal anatomy distorted by previous surgery and infection or they are at high risk if surgical exploration is carried out.

Wiskott-Aldrich syndrome: cellular impairments and their implication for carrier detection

A family in which two male siblings were affected with Wiskott-Aldrich syndrome (WAS) was studied using G-6-PD isoenzymes as an X-linked marker in order to investigate the nature of cellular abnormalities. Isolated peripheral blood cell types from the doubly heterozygous mother of the affected males seemingly failed to express the G-6-PD allele in cis position with the WAS allele while her cultured skin fibroblasts expressed both G-6-PD alleles. Additionally, a histogram analysis of platelet size revealed a single population of abnormally small platelets in the affected propositus, whereas the heterozygous mother had no appreciable small platelet subpopulation. In vitro culture of hemopoietic progenitor cells of the heterozygous mother showed that the majority of progenitor cells did not express the WAS allele. However, a small number of cells expressing the G-6-PD type linked with the WAS allele were detected. The proportion of the latter progenitors was significantly higher among more primitive progenitors (those giving rise to later appearing colonies). This observation suggests that selection against cells expressing the Wiskott-Aldrich defect takes place in the hemopoietic system of the heterozygous female and offers a possible means of carrier detection in some women. Linkage studies in this family revealed one example of probable recombination between the loci for WAS and G-6-PD among three informative subjects, suggesting that these two loci may not be closely linked on the X-chromosome.