Developing a scale to explore self-regulatory approaches to assessment and feedback with academics in higher education

Introduction

Students need to acquire high level self-regulatory skills if they are to be successful within higher education, and academics need support in facilitating this. In this article we explore how the current research gap between knowledge of self-regulatory assessment and feedback (SRAF) practices, and academics' professional training in it can be bridged.

Methods

SRAF tools were used with academics to explore their understandings of and training needs in SRAF; central to this work was the development of a SRAF scale. We consider the value of such tools in supporting academics' professional development needs in SRAF. The reliability and validity of the SRAF scale was tested using exploratory factor analyses (EFA).

Results

Iterative EFA resulted in a 17 item support required SRAF scale (SR). Two underpinning factors: Creating the Conditions for SRAF, and Supporting Students' SRAF Skills Development were identified. The reliability of the instrument supported its primary use as a tool to facilitate academics' professional development in fostering students' self-regulatory skills.

Discussion

Our findings highlight the importance of supporting academics in developing strategies to maximize students' metacognitive skills and motivation in assessment and feedback, contingent on effective assessment design. Such professional development needs to be mindful of individual and contextual factors impacting academics' access to, and confidence and competence in, using SRAF in practice. This research is important in highlighting potential disconnects between where academics' focus their attention in assessment, and what is known to have most impact on student learning success. The SRAF tools have considerable potential in supporting translation of theory into practice as part of sustained professional development for academics in higher education.

A neuroimaging measure to capture heterogeneous patterns of atrophy in Parkinson's disease and dementia with Lewy bodies

INTRODUCTION

Parkinson's disease (PD) and Dementia with Lewy bodies (DLB) show heterogeneous brain atrophy patterns which group-average analyses fail to capture. Neuroanatomical normative modelling overcomes this by comparing individuals to a large reference cohort. Patient-specific atrophy patterns are measured objectively and summarised to index overall neurodegeneration (the 'total outlier count'). We aimed to quantify patterns of neurodegenerative dissimilarity in participants with PD and DLB and evaluate the potential clinical relevance of total outlier count by testing its association with key clinical measures in PD and DLB.

MATERIALS AND METHODS

We included 108 participants with PD and 61 with DLB. PD participants were subclassified into high and low visual performers as this has previously been shown to stratify those at increased dementia risk. We generated z-scores from T1w-MRI scans for each participant relative to normative regional cortical thickness and subcortical volumes, modelled in a reference cohort (n = 58,836). Outliers (z < -1.96) were aggregated across 169 brain regions per participant. To measure dissimilarity, individuals' Hamming distance scores were calculated. We also examined total outlier counts between high versus low visual performance in PD; and PD versus DLB; and tested associations between these and cognition.

RESULTS

There was significantly greater inter-individual dissimilarity in brain-outlier patterns in PD poor compared to high visual performers (W = 522.5; p < 0.01) and in DLB compared to PD (W = 5649; p < 0.01). PD poor visual performers had significantly greater total outlier counts compared to high (β = -4.73 (SE = 1.30); t = -3.64; p < 0.01) whereas a conventional group-level GLM failed to identify differences. Higher total outlier counts were associated with poorer MoCA (β = -0.55 (SE = 0.27), t = -2.04, p = 0.05) and composite cognitive scores (β = -2.01 (SE = 0.79); t = -2.54; p = 0.02) in DLB, and visuoperception (β = -0.67 (SE = 0.19); t = -3.59; p < 0.01), in PD.

CONCLUSIONS

Neuroanatomical normative modelling shows promise as a clinically informative technique in PD and DLB, where patterns of atrophy are variable.

Exploring the Educational Value of Popular Culture in Web-Based Medical Education: Pre-Post Study on Teaching Jaundice Using "The Simpsons"

BACKGROUND

The potential of popular culture as a tool for knowledge delivery and enhancing engagement in education is promising but not extensively studied. Furthermore, concerns exist regarding learning fatigue due to increased reliance on videoconferencing platforms following the COVID-19 pandemic. To ensure effective web-based teaching sessions that maintain attention spans and enhance understanding, innovative solutions are necessary.

OBJECTIVE

This study aims to evaluate the use of specific popular culture case studies to enhance student engagement in a web-based near-peer teaching session.

METHODS

We delivered a web-based teaching session to undergraduate medical students in the United Kingdom. The session included clinical vignettes and single-best-answer questions using characters from "The Simpsons" television show as patient analogies for various causes of jaundice. A pre-post survey, employing a 7-point Likert scale, was distributed to gather data from participants.

RESULTS

A total of 53 survey responses were collected. Participants reported significantly improved understanding of jaundice after the session compared to before the session (median 6, IQR 5-6 vs median 4, IQR 3-4.5; P<.001). The majority of participants agreed that the inclusion of "The Simpsons" characters enhanced their knowledge and made the teaching session more memorable and engaging (memorability: median 6, IQR 5-7; engagement: median 6, IQR 5-7).

CONCLUSIONS

When appropriately integrated, popular culture can effectively engage students and improve self-perceived knowledge retention. "The Simpsons" characters can be used pedagogically and professionally as patient analogies to deliver teaching on the topic of jaundice.

Assessing the Publicity and Reach of Peer-Led Online Medical Teaching: A Single-Event Evaluation

PURPOSE

The COVID-19 pandemic caused significant disruption to higher education, including medical studies. Online learner support became urgently necessary, and peer-support of learning was needed to supplement formal teaching. This study evaluates the impact and delivery media of OSCEazy, a student-led initiative supporting formal teaching across institutional and national boundaries.

METHODS

A survey was created on Google Forms and disseminated via the Zoom chat function to all the participants at the end of our event titled, "The Cardiology Station".

RESULTS

A large proportion (99.5%) of the students have a Facebook account and (98.7%) use it to keep track of medical events (p=0.45 for comparison). However, a very small proportion of use their other social media to keep up with medical events (p<0.0001 for comparison).

CONCLUSION

It is evident from our results, that most of our participants used Facebook to keep track of medical events. The use of their other social media platforms (Instagram, etc) to keep track of medical events was limited. Thus, it is important for any organisation, such as ours, who conduct online events to evaluate which platform is most suitable for them to use to publicise their events.

Combined neurosurgical and orbital intervention for spheno-orbital meningiomas - the Manchester experience

PURPOSE

Surgical resection of spheno-orbital meningioma (SOM) is challenging, requiring a multidisciplinary surgical approach. We present our experience of the surgical management of patients with SOM.

METHODS

A retrospective analysis of patients with SOM who underwent joint neurosurgical and orbital surgical procedures between January 2000 and June 2017. Pre-operative clinical signs, indication for surgery, surgical complications and post-operative outcomes were recorded.

RESULTS

Twenty-four operations were performed. Mean age was 49.5 years. Ninety-two percent of patients were female. Pre-operatively mean Snellen acuity vision was 6/12; 13 (54%) had an RAPD; 12 (50%) had reduced colour vision; 16 (67%) had a visual field defect. The majority (21 patients, 88%) had proptosis (average 4.5 mm ± 2.8 mm). The indication for surgery was evidence of visual dysfunction in 17 (71%), the remaining 7 (29%) had high risk of visual loss clinically or radiologically. Three-months post operatively, vision was stable in 13 (58%), improved in 6 (21%) and worse in 5 (17%). Average long-term follow-up was 82 months (1-220). Fourteen (58%) maintain improved or stable visual function. Four (17%) had reduced vision due to regrowth of the tumour at an average of 24 months.

CONCLUSION

SOMs are very challenging to treat surgically. In this cohort the patients were predominantly young females with aggressive disease. Visual function was improved or stabilised in 79% of the patients.

E pluribus unum: the potential of collaborative learning to enhance Microbiology teaching in higher education

Collaborative learning, where students work together towards a shared understanding of a concept, is a well-established pedagogy, and one which has great potential for higher education (HE). Through discussion and challenging each other's ideas, learners gain a richer appreciation for a subject than with solitary study or didactic teaching methods. However, collaborative learning does require some scaffolding by the teacher in order to be successful. Collaborative learning can be augmented by the use of Web 2.0 collaborative technologies, such as wikis, blogs and social media. This article reviews some of the uses of collaborative learning strategies in Microbiology teaching in HE. Despite the great potential of collaborative learning, evidence of its use in Microbiology teaching is, to date, limited. But the potential for collaborative learning approaches to develop self-regulated, deep learners is considerable, and so collaborative learning should be considered strongly as a viable pedagogy for HE.

Rapid Increase in Neural Conduction Time in the Adult Human Auditory Brainstem Following Sudden Unilateral Deafness

Individuals with sudden unilateral deafness offer a unique opportunity to study plasticity of the binaural auditory system in adult humans. Stimulation of the intact ear results in increased activity in the auditory cortex. However, there are no reports of changes at sub-cortical levels in humans. Therefore, the aim of the present study was to investigate changes in sub-cortical activity immediately before and after the onset of surgically induced unilateral deafness in adult humans. Click-evoked auditory brainstem responses (ABRs) to stimulation of the healthy ear were recorded from ten adults during the course of translabyrinthine surgery for the removal of a unilateral acoustic neuroma. This surgical technique always results in abrupt deafferentation of the affected ear. The results revealed a rapid (within minutes) reduction in latency of wave V (mean pre = 6.55 ms; mean post = 6.15 ms; p < 0.001). A latency reduction was also observed for wave III (mean pre = 4.40 ms; mean post = 4.13 ms; p < 0.001). These reductions in response latency are consistent with functional changes including disinhibition or/and more rapid intra-cellular signalling affecting binaurally sensitive neurons in the central auditory system. The results are highly relevant for improved understanding of putative physiological mechanisms underlying perceptual disorders such as tinnitus and hyperacusis.

Bilateral vestibular schwannomas in older patients: NF2 or chance?

BACKGROUND

Neurofibromatosis type 2 (NF2) is an autosomal dominant condition with high spontaneous mutation rate which predisposes to the development of multiple nerve sheath tumours (schwannomas), meningiomas and ependymoma. The cardinal feature and main diagnostic criterion for the diagnosis of NF2 remains the development of bilateral vestibular schwannoma (BVS). With increasing use of MRI screening the possibility of a 'chance' diagnosis of BVS has been mooted with a potential frequency of one in two million people in their lifetime. Until now, however, no evidence for such an event has been published. We aimed to demonstrate that chance occurrence can occur and to estimate its frequency among those with just BVS late in life.

METHODS

Two vestibular schwannomas from the same patient were DNA sequenced and underwent loss of heterozygosity analysis.

RESULTS

We show that a man who developed BVS, at ages 52 and 67 years developed these tumours sporadically by demonstrating that there were no molecular events in common between the two tumours. Furthermore from a database of over 1200 patients with NF2, we have estimated that ~25% of cases of BVS over 50 years and 50% over 70 years of age where no other features of NF2 are present represent a chance occurrence rather than due to an underlying mosaic or constitutional NF2 mutation.

CONCLUSIONS

Patients presenting with BVS later in life should be appraised of the potential likelihood they may not have NF2 and the resultant further reduction in risks of transmission to offspring.

Creatine supplementation: can it improve quality of life in the elderly without associated resistance training?

INTRODUCTION

Ageing is associated with decreased muscle mass, strength, power and function, and reduction in bone density and mineral content, leading to reduced independence and increased risk of falls. Creatine supplementation is reported to improve muscular strength and performance with training in younger athletes, and therefore could benefit older individuals.

AIMS

This review critically appraises the current literature on whether creatine supplementation enhances muscular performance and function, body composition, bone mineral density and content in older adults without the addition of resistance training, and thus determines whether creatine supplementation can lead to an improved lifestyle for the sedentary elderly population.

RESULTS

There is conflicting evidence regarding the usefulness of creatine supplementation in older subjects. Generally, however, creatine supplementation, without associated resistance training, seems to enhance muscular strength, power and endurance, increase lean body mass (LBM) and improve the functional capacity of the elderly. Furthermore, it has been demonstrated that increased muscle mass due to creatine supplementation can result in increased local bone density. It appears that the effect of creatine supplementation is more beneficial in larger muscles and less effective in smaller muscles, however there are exceptions. The mechanism by which creatine supplementation works requires further research, however it is likely that the effects of creatine are related to creatine kinase activity, providing enhanced energy production for greater muscular contraction.

CONCLUSIONS

These data indicate that creatine supplementation without associated training in the elderly could potentially delay atrophy of muscle mass, improve endurance and strength, and increase bone strength, and thus may be a safe therapeutic strategy to help decrease loss in functional performance of everyday tasks.

Body mass index and risk of pneumonia: a systematic review and meta-analysis

The aims of our meta-analysis were to examine the pattern and gender's influence on body mass index (BMI) - pneumonia relationship. Published studies were searched from PubMed, Web of Science, Cochrane Library databases using keywords of pneumonia, BMI and epidemiologic studies. Random-effects analysis was applied to estimate pooled effect sizes from individual studies. The Cochrane Q-test and index of heterogeneity (I(2) ) were used to evaluate heterogeneity, and Egger's test was used to evaluate publication bias. Random-effects meta-regression was applied to examine the pattern and gender's influence on BMI-pneumonia relationship. A total of 1,531 studies were initially identified, and 25 studies finally were included. The pooled relative risk (RR) and meta-regression model revealed a J-shaped relationship between BMI and risk of community-acquired pneumonia (underweight, RR 1.8, 95% confidence interval [CI], 1.4-2.2, P < 0.01; overweight, 0.89, 95%CI, 0.8-1.03, P, 0.1; obesity, 1.03, 95% CI, 0.8-1.3, p. 8) and U-shaped relationship between BMI and risk of influenza-related pneumonia (underweight, RR 1.9, 95% CI, 1.2-3, P < 0.01; overweight, 0.89, 95% CI, 0.79-0.99, P, 0.03; obesity, 1.3, 95% CI, 1.05-1.63, p. 2; morbidity obesity, 4.6, 95% CI, 2.2-9.8, P < 0.01); whereas, no difference in risk of nosocomial pneumonia was found across the BMI groups. Gender difference did not make significant contribution in modifying BMI-pneumonia risk relationship.

Outcome of translabyrinthine surgery for vestibular schwannoma in neurofibromatosis type 2

OBJECTIVES

To analyse the long-term outcome of translabyrinthine surgery for vestibular schwannoma (VS) in neurofibromatosis type 2 (NF2). RESEARCH TYPE: Retrospective cohort study.

SETTING

Two tertiary referral NF2 units.

PATIENTS

One hundred and forty eight translabyrinthine operations for patients with VS were performed. Preoperative stereotactic radiotherapy had been performed on 12(9.4%) patients.

RESULTS

Mean tumour size was 3.1 cm. Total tumour excision was achieved in 66% of cases, capsular remnants were left in 24% of cases, and subtotal excision was achieved in 5% and partial removal was achieved in 5%. The radiological residual/recurrence rate was 13.9%. The perioperative mortality was 1.6%. At 2 years postoperatively, facial function was expressed in terms of House-Brackmann score (HB): HB 1 in 53.4%, HB 1/2 in 61.3%, HB 1-3 in 83.2% and HB 4-6 in 16.8%. All nine patients who underwent surgery following failed stereotactic radiotherapy had HB 3 function or better. Among 9.5% of the cases, 14 facial nerves were lost during surgery and repaired using direct anastomosis or grafting. There was no tinnitus present preoperatively in 27% of the cases, and 22% of patients developed tinnitus postoperatively. In patients with preoperative tinnitus, 61% remained the same, 17% got it resolved and only in 21% it worsened. The preoperative hydrocephalus rate was 26%, and among 15% of the cases five ventriculo-peritoneal (VP) shunts were performed. The cerebrospinal fluid leak rate was 2.5%. Fifty-six patients underwent auditory brainstem implantation (ABI) and two patients had cochlear implant (CI) sleepers inserted.

CONCLUSIONS

The management of patients with NF2 presents the clinician with a formidable challenge with many patients still presenting themselves late with the neurological compromise and a large tumour load. There is still an argument for the management by observation until the neurological compromise dictates interventional treatment particularly with the option of hearing rehabilitation with ABI or CI. The translabyrinthine approach provides a very satisfactory means of reducing the overall tumour volume.

Idiopathic osseous hyperplasia of the nasal turbinates in a Welsh terrier

A three-year-old Welsh terrier was presented with a 6-month history of progressive stertor, exercise intolerance and sneezing which was unresponsive to symptomatic treatment. A large calcified mass occupying the entire rostral right nasal cavity was defined with computed tomography. The mass was completely removed via a dorsal rhinotomy. Histopathological examination of the mass revealed osseous hyperplasia of the nasal turbinates. The excision led to complete resolution of clinical signs and there has been no recurrence 18 months after surgery.

Determinants of variation in human serum paraoxonase activity

Paraoxonase-1 (PON1) is associated with high-density lipoprotein (HDL) particles and is believed to contribute to antiatherogenic properties of HDLs. We assessed the determinants of PON1 activity variation using different substrates of the enzyme. PON1 activity in serum samples from 922 participants in the San Antonio Family Heart Study was assayed using a reliable microplate format with three substrates: paraoxon, phenyl acetate and the lactone dihydrocoumarin. There were major differences among results from the three substrates in degree of effect by various environmental and genetic factors, suggesting that knowledge of one substrate activity alone may not provide a complete sense of PON1 metabolism. Three significant demographic covariates (age, smoking status and contraceptive usage) together explained 1-6% of phenotypic variance, whereas four metabolic covariates representing lipoprotein metabolism (apoAII, apoAI, triglycerides and non-HDL cholesterol) explained 4-19%. Genes explained 65-92% of phenotypic variance and the dominant genetic effect was exerted by a locus mapping at or near the protein structural locus (PON1) on chromosome 7. Additional genes influencing PON1 activity were localized to chromosomes 3 and 14. Our study identified environmental and genetic determinants of PON1 activity that accounted for 88-97% of total phenotypic variance, suggesting that few, if any, major biological determinants are unrepresented in the models.

Improved transcriptional activators and their use in mis-expression traps in Arabidopsis

The synthetic transcription factor LhG4 has been used in numerous mis-expression studies in plants. We show that the sequence encoding the LhG4 activation domain, derived from Saccharomyces cerevisiae GAL4, contains several cryptic polyadenylation signals in Arabidopsis. The GAL4-derived sequence was modified according to preferred Arabidopsis codon usage, generating LhG4AtO which was faithfully transcribed in Arabidopsis plants. In protoplasts, LhG4AtO achieved maximum transactivation of the pOp promoter with 10-fold less input DNA than LhG4. The same methods were used to compare 10 other LhG4 derivatives that carried alternative natural or synthetic activation domains. Lh214 and Lh314, which contain synthetic activation domains comprising trimers of a core acidic activation domain, directed threefold more GUS expression from the pOp promoter with 20-fold less input DNA than LhG4. In contrast, when expressed from the CaMV 35S promoter in transgenic plants carrying a pOp-GUS reporter, Lh214 and Lh314 yielded transformants with substantially lower GUS activities than other constructs including LhG4AtO and LhG4 which performed similarly. When incorporated into an enhancer-trapping vector, however, LhG4AtO and Lh314 yielded enhancer traps with approximately twice the frequency of LhG4, suggesting that the modified activation domains offer improved performance when expressed from weaker transcription signals. To increase the number of LhG4 patterns available for mis-expression studies, we describe a population of enhancer-trap lines obtained with LhG4AtO in a pOp-GUS background. We show that enhancer-trap lines can transactivate an unlinked pOp-green fluorescent protein (pOp-GFP) reporter in the pattern predicted by staining for GUS activity.

Zig-zag bicoronal scalp incision for cranio-facial cases in paediatric neurosurgery

TECHNIQUE

We present the use of a zig-zag bicoronal scalp incision for cranial-facial cases in paediatric neurosurgery.

CONCLUSION

The authors believe that this technique leads to improved cosmesis, especially when the hair is wet.

High risk of surgical intervention in hereditary pancreatitis

Background

The aim of the study was to quantify the risk of surgical intervention in families with hereditary pancreatitis referred to the European Registry of Hereditary Pancreatitis and Familial Pancreatic Cancer (EUROPAC).

Methods

Recruitment to EUROPAC started in 1997; families were considered if two or more members had chronic pancreatitis of unknown aetiology. Families were tested for protease serine 1 (PRSS1) mutations using polymerase chain reaction restriction digestion, sequencing the PRSS1 gene-screened negative families. Clinical information about surgical intervention was obtained from family members and referring clinicians, and the cumulative incidence of surgical intervention in the N291 and R122H mutation groups was determined with the Kaplan–Meier method.

Results

Forty-four families had the R122H mutation, 21 the N291 mutation, and 31 were negative for both. Some 14 (35 per cent) of 40 patients (median age 26·5 (95 per cent confidence interval (c.i.) 21·5–36·3) years) with the N291 mutation had an operative procedure for complications of pancreatitis, compared with 21 (25 per cent) of 83 patients (median age 24 (95 per cent c.i. 13·8–35·8) years) with the R122H variant. This resulted in a cumulative lifetime risk for surgical intervention of 0·6 (95 per cent c.i. 0·5–0·8) for the R122H mutation and 0·6 (0·5–0·8) for the N291 mutation (P = 0·11, log rank test).

Conclusion

Hereditary pancreatitis carries a significantly increased risk of surgical intervention in this cohort of patients, which equates to an estimated lifetime risk of around 60 per cent. The risk of surgery appears to be independent of PRSS1 mutation type.

The Arabidopsis Rab GTPase family: another enigma variation

The Arabidopsis genome sequence reveals that gene families such as the Rab GTPase family, which encodes key determinants of vesicle-targeting specificity, are considerably more diverse in plants and mammals than in yeast. In mammals, this diversity appears to reflect the complexity of membrane trafficking. Phylogenetic analyses indicate that, despite its large size, the Arabidopsis Rab family lacks most of the Rab subclasses found in mammals. The Arabidopsis Rab family has, however, undergone a distinct 'adaptive radiation' that has given rise to proteins that may perform plant-specific functions.

Steps of nuclear pore complex disassembly and reassembly during mitosis in earlyDrosophilaembryos

The mechanisms of nuclear pore complex (NPC) assembly and disassembly during mitosis in vivo are not well defined. To address this and to identify the steps of the NPC disassembly and assembly, we investigated Drosophila embryo nuclear structure at the syncytial stage of early development using field emission scanning electron microscopy (FESEM), a high resolution surface imaging technique, and transmission electron microscopy. Nuclear division in syncytial embryos is characterized by semi-closed mitosis, during which the nuclear membranes are ruptured only at the polar regions and are arranged into an inner double membrane surrounded by an additional ‘spindle envelope’. FESEM analysis of the steps of this process as viewed on the surface of the dividing nucleus confirm our previous in vitro model for the assembly of the NPCs via a series of structural intermediates, showing for the first time a temporal progression from one intermediate to the next. Nascent NPCs initially appear to form at the site of fusion between the mitotic nuclear envelope and the overlying spindle membrane. A model for NPC disassembly is offered that starts with the release of the central transporter and the removal of the cytoplasmic ring subunits before the star ring.

Chromosome 17 and the inducible nitric oxide synthase gene in human essential hypertension

Essential hypertension is a common multifactorial trait that results in a significantly increased risk for heart attack and stroke. The condition has a genetic basis, although at present the number of genes is unknown. In order to identify such genes, we are utilising a linkage scanning approach using microsatellite markers and affected sibships. Here we provide evidence for the location of at least one hypertension susceptibility locus on chromosome 17. Analysis of 177 affected sibpairs gave evidence for significant excess allele sharing to D17S949 (SPLINK: P=0.0029; MAPMAKER SIBS: P=0.0033; ASPEX: P=0.0061; GENEHUNTER: P=0.0096; ANALYZE (SIBPAIR): P=0.0025) on 17q22-24, with significant allele sharing also indicated for an additional marker, D17S799 (SPLINK: P=0.025; MAPMAKER SIBS: P=0.025) located close to the centromere. Since these two genomic regions are well separated, our results indicate that there may be more than one chromosome 17 locus affecting human blood pressure. Moreover, further investigation of this chromosome, utilizing a polymorphism within the promoter of the iNOS candidate gene, NOS2A, revealed both increased allele sharing among sibpairs (SPLINK: P=0.02; ASPEX: P=0.00004) and positive association (P=0.034) of NOS2A to essential hypertension. Hence these results indicate that chromosome 17 and, more specifically, the NOS2A gene may play a role in human essential hypertension.

Association of estrogen receptor and glucocorticoid receptor gene polymorphisms with sporadic breast cancer

We have utilized a cross-sectional association approach to investigate sporadic breast cancer. Polymorphisms in 2 candidate genes, ESRalpha and GRL, were examined in an unrelated breast cancer-affected and age-matched control population. Several polymorphic regions within the ESRalpha gene have been identified, and some alleles of these polymorphisms have been found to occur at increased levels in breast-cancer patients. Additionally, variations in GRL have the potential to disrupt cell transcription and may be associated with cancer formation. We analyzed 3 polymorphisms, from codons 10 (TCT to TCC), 325 (CCC to CCG) and 594 (ACA to ACG) of ESRalpha, and a highly polymorphic dinucleotide repeat, D5S207, located within 200 kb of the GRL. When allelic frequencies of the codon 594 (exon 8) ESR polymorphism were compared between affected and unaffected populations, a significant difference was observed (p = 0.005). Results from the D5S207 dinucleotide repeat located near GRL also indicated a significant difference between the tested case and control populations (p = 0.001). Allelic frequencies of the codon 10 and codon 325 ESR polymorphisms were not significantly different between populations (p = 0.152 and 0.181, respectively). Our results indicate that specific alleles of the ESR gene (alpha subtype) and a marker for the GRL gene locus are associated with sporadic breast-cancer development in the tested Caucasian population and justify further investigation of the role of these and other nuclear steroid receptors in the etiology of breast cancer.

Novel DNA copy number losses in chromosome 12q12--q13 in adenoid cystic carcinoma

In order to find common genetic abnormalities that may identify loci of genes involved in the development of adenoid cystic carcinoma (ACC), we investigated DNA copy number changes in 24 of these tumors by comparative genomic hybridization (CGH). Our results indicate that unlike many carcinomas, ACCs have relatively few changes in DNA copy number overall. Twenty tumors had DNA copy number changes, which were mostly restricted to a few chromosomal arms. A frequent novel finding was the loss of DNA copy number in chromosome 12q (eight tumors, 33%) with the minimal common overlapping region at 12q12--q13. Deletion in this region has not been reported to be frequent in other types of cancer analyzed by CGH. In addition, deletions in 6q23-qter and 13q21--q22 and gains of chromosome 19 were observed in 25% to 38% of ACCs. Deletion of 19q, previously reported in a small series of ACC, was not identified in the current group of carcinomas. The current CGH results for chromosomes 12 and 19 were confirmed by microsatellite allelotyping. These results indicate that DNA copy number losses in 12q may be important in the oncogenesis of ACC and suggest that the 12q12--q13 region may harbor a new tumor-suppressor gene.

A new polymorphism for the RI22H mutation in hereditary pancreatitis

BACKGROUND AND AIMS

Hereditary pancreatitis (HP) is a rare form of recurrent acute and chronic pancreatitis. Mutations in the cationic trypsinogen (protease serine 1, PRSS1) gene have been identified as causing HP. The R122H (previously known as R117H) mutation is the commonest and can be detected by a single and rapid polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP) based technique using the AflIII enzyme. This test however may give a false negative result in the presence of a neutral polymorphism within the enzyme recognition site. The frequency of this event was examined by sequencing studies in patients with HP and in healthy controls.

METHODS

Of 60 families identified by the UK and Ireland consortium of EUROPAC (European Registry for Hereditary Pancreatitis and Familial Pancreatic Cancer), 51 were screened for R122H, N29I, and A16V mutations using standard techniques, and by sequencing of all five exons of cationic trypsinogen.

RESULTS

Twelve families had the N29I mutation, one family had A16V and, on standard testing, 15 families had the R122H mutation. An additional family with the R122H mutation was found on direct sequencing. The false negative result was due to a neutral polymorphism C-->T at the third base of the codon, not affecting the amino acid coded for, destroying the AflIII restriction site. This polymorphism was not observed in 50 DNA specimens (100 chromosomes) from controls nor from 50 individuals from PRSS1 mutation negative HP families. A novel mutation specific PCR was developed to avoid this pitfall.

CONCLUSIONS

One of the 16 families with HP and an R122H mutation contained a polymorphism affecting the AflIII restriction site. Adoption of an alternative R122H assay is important for genetic studies in individuals with apparent HP.

Associations between outdoor air pollution and hospital admissions in Brisbane, Australia

The authors investigated the effects of ambient air pollution on hospital admissions in Brisbane, Australia. The authors used the Air Pollution on Health: European Approach protocol to examine the effects of particles, ozone, sulfur dioxide, and nitrogen dioxide on daily hospital admissions for asthma and respiratory, cardiovascular, and digestive disorders (control diagnosis) that occurred during the period 1987-1994. Ozone was consistently associated with admissions for asthma and respiratory disease-with little evidence of a threshold. In two-pollutant models, the ozone effect was relatively unaffected by the control for high levels of other pollutants. Particulate pollution (measured by nephelometry) was associated positively with admissions for respiratory disease and admissions for asthma in summer, whereas a negative association was observed for cardiovascular admissions. Although sulfur dioxide was associated significantly with admissions for respiratory and cardiovascular disese, a significant association was also found for the control diagnosis of digestive disorders. No significant associations were found for nitrogen dioxide over the study period, although significantly positive seasonal interactions were found for asthma and respiratory disease in autumn, winter, and spring. It was concluded that current levels of ambient air pollution in Brisbane make a significant contribution to the variation in daily hospital admissions for asthma and respiratory disease.

Early onset and tropical forcing of 100,000-year Pleistocene glacial cycles

Between 1.5 and 0.6 Myr ago, the period of the Earth's glacial cycles changed from 41 kyr, the period of the Earth's obliquity cycles, to 100 kyr, the period of the Earth's orbital eccentricity, which has a much smaller effect on global insolation. The timing of this transition and its causes pose one of the most perplexing problems in palaeoclimate research. Here we use complex demodulation to examine the phase evolution of precession and semiprecession cycles--the latter of which are phase-coupled to both precession and eccentricity--in the tropical and extratropical Atlantic Ocean. We find that about 1.5 Myr ago, tropical semiprecession cycles (with periods of about 11.5 kyr) started to propagate to higher latitudes, coincident with a growing amplitude envelope of the 100-kyr cycles. Evidence from numerical models suggests that cycles of about 10 kyr in length may be required to explain the high amplitude of the 100-kyr cycles. Combining our results with consideration of a modern analogue, we conclude that increased heat flow across the equator or from the tropics to higher latitudes around 1.5 Myr ago strengthened the semiprecession cycle in the Northern Hemisphere, and triggered the transition to sustained 100-kyr glacial cycles.

Relationships between environmental factors and lung function of asthmatic subjects in south east Queensland, Australia

Few panel studies have investigated the relationships between air pollutants and air spora and lung function change in asthmatic subjects. This article examines the association of outdoor air pollutant concentrations and air spora with the decrease in lung function (measured by morning peak expiratory flow) of two groups of asthmatic subjects in the subtropical environment of South East Queensland, Australia. Lung function responses were stratified by age, allergy status, and location, and seasonal effects were examined. Allergy status and age were found to be important, with air pollutants such as ozone and particles associated with decreases in lung function in allergic individuals older than 15 years. Fungal spore counts were strongly associated with a decrease in lung function in allergic adults, especially in those over 54 years, only in seasons when these air spora peak. Analysis for the entire study period indicates that the effect of ozone on peak expiratory flow in the allergic group can sometimes be confounded by air spora effects, indicating that in a subtropical climate the impact of ozone on asthma severity can be accurately estimated only when the confounding effects of air spora are included.

Characteristics of rural dust events shown to impact on asthma severity in Brisbane, Australia

Wind erosion in arid inland Australia leads to dust plumes which can pass over populated coastal areas in Eastern Australia, such as Brisbane. Such events can lead to concerns about respiratory health problems because they significantly increase the fine particle component of atmospheric aerosols. This paper examines the particulate characteristics of 11 dust events in Brisbane and associations with daily diary records (peak expiratory flow, symptoms) of people with asthma, and hospital emergency attendances for asthma during a number of seasons between 1992 and 1994. These dust events are frequently, but not always, characterised by higher particulate levels and higher ratios of fine to coarse particulates. The results indicate that a number of dust events were significantly associated with changes in asthma severity, but general relationships could not be determined. Given that the phenomenon of wind-blown dust is not isolated to the Australian continent, these findings raise important questions about the effects of wind-blown dust in other parts of the world.

A linkage and cross-sectional study of hypertension and obesity using a poly (A) Alu-repeat polymorphism at the glucagon receptor gene locus (17q25)

1. Previous glucagon receptor gene (GCGR) studies have shown a Gly40Ser mutation to be more prevalent in essential hypertension and to affect glucagon binding affinity to its receptor. An Alu-repeat poly(A) polymorphism colocalized to GCGR was used in the present study to test for association and linkage in hypertension as well as association in obesity development. 2. Using a cross-sectional approach, 85 hypertensives and 95 normotensives were genotyped using polymerase chain reaction primers flanking the Alu-repeat. Both hypertensive and normotensive populations were subdivided into lean and obese categories based on body mass index (BMI) to determine involvement of this variant in obesity. For the linkage study, 89 Australian Caucasian hypertension affected sibships (174 sibpairs) were genotyped and the results were analysed using GENEHUNTER, Mapmaker Sibs, ERPA and SPLINK (all freely available from http:@linkage.rockefeller.edu./soft/list.hmtl). 3. Cross-sectional results for both hypertension and obesity were analysed using Chi-squared and Monte Carlo analyses. Results did not show an association of this variant with either hypertension (chi(2) = 6.9, P = 0.14; Monte Carlo chi(2) = 7.0, P = 0.11; n = 5000) or obesity (chi(2) = 3.3, P = 0.35; Monte Carlo chi(2) = 3.26, P = 0.34; n = 5000). In addition, results from the linkage study using hypertensive sib-pairs did not indicate linkage of the poly(A) repeat with hypertension. Hence, results did not indicate a role for the Alu-repeat in either hypertension or obesity. However, as the heterozygosity of this poly(A) repeat is low (35%), a larger number of hypertensive sib-pairs may be required to draw definitive conclusions.