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Accurate assessment and effective feedback are crucial for cultivating learners' abilities of collaborative problem‐solving and critical thinking in online inquiry‐based discussions. Based on quantitative content analysis (QCA), there has been a methodological evolvement from descriptive statistics to sequential mining and to network analysis for mining coded discourse data. Epistemic network analysis (ENA) has recently gained increasing recognition for modelling and visualizing the temporal characteristics of online discussions. However, due to methodological restraints, some valuable information regarding online discussion dynamics remains unexplained, including the directionality of connections between theoretical indicators and the trajectory of thinking development. Guided by the community of inquiry (CoI) model, this study extended generic ENA by incorporating directional connections and stanza‐based trajectory tracking. By examining the proposed extensions with discussion data of an online learning course, this study first verified that the extensions are comparable with QCA, indicating acceptable assessment validity. Then, the directional ENA revealed that two‐way connections between CoI indicators could vary over time and across groups, reflecting different discussion strategies. Furthermore, trajectory tracking effectively detected and visualized the fine‐grained progression of thinking. At the end, we summarize several research and practical implications of the ENA extensions for assessing the learning process.Practitioner notesWhat is already known about this topic Assessment and feedback are crucial for cultivating collaborative problem‐solving and critical thinking in online inquiry‐based discussions. Cognitive presence is an important construct describing the progression of thinking in online inquiry‐based discussions. Epistemic network analysis is gaining increasing recognition for modelling the temporal characteristics of online inquiries. What this paper adds Directional connections between discourses can reflect different online discussion strategies of groups and individuals. A pair of connected discourses coded with the community of inquiry model can have different meanings depending on their temporal order. A trajectory tracking approach can uncover the fine‐grained progression of thinking in online inquiry‐based discussions. Implications for practice and/or policy Besides the occurrences of individual discourses, examining the meanings of directional co‐occurrences of discourses in online discussions is worthwhile. Groups and individuals can employ different discussion strategies and follow diverse paths to thought development. Developmental assessment is crucial for understanding how participants achieve specific outcomes and providing adaptive feedback. Assessment and feedback are crucial for cultivating collaborative problem‐solving and critical thinking in online inquiry‐based discussions. Cognitive presence is an important construct describing the progression of thinking in online inquiry‐based discussions. Epistemic network analysis is gaining increasing recognition for modelling the temporal characteristics of online inquiries. Directional connections between discourses can reflect different online discussion strategies of groups and individuals. A pair of connected discourses coded with the community of inquiry model can have different meanings depending on their temporal order. A trajectory tracking approach can uncover the fine‐grained progression of thinking in online inquiry‐based discussions. Besides the occurrences of individual discourses, examining the meanings of directional co‐occurrences of discourses in online discussions is worthwhile. Groups and individuals can employ different discussion strategies and follow diverse paths to thought development. Developmental assessment is crucial for understanding how participants achieve specific outcomes and providing adaptive feedback. [ABSTRACT FROM AUTHOR]

Objective: Recently, Christianson syndrome (CS) has been determined to be caused by mutations in the X-linked Na(+) /H(+) exchanger 6 (NHE6). We aimed to determine the diagnostic criteria and mutational spectrum for CS.Methods: Twelve independent pedigrees (14 boys, age = 4-19 years) with mutations in NHE6 were administered standardized research assessments, and mutations were characterized.Results: The mutational spectrum was composed of 9 single nucleotide variants, 2 indels, and 1 copy number variation deletion. All mutations were protein-truncating or splicing mutations. We identified 2 recurrent mutations (c.1498 c>t, p.R500X; and c.1710 g>a, p.W570X). Otherwise, all mutations were unique. In our study, 7 of 12 mutations (58%) were de novo, in contrast to prior literature wherein mutations were largely inherited. We also report prominent neurological, medical, and behavioral symptoms. All CS participants were nonverbal and had intellectual disability, epilepsy, and ataxia. Many had prior diagnoses of autism and/or Angelman syndrome. Other neurologic symptoms included eye movement abnormalities (79%), postnatal microcephaly (92%), and magnetic resonance imaging evidence of cerebellar atrophy (33%). Regression was noted in 50%, with recurrent presentations involving loss of words and/or the ability to walk. Medical symptoms, particularly gastrointestinal symptoms, were common. Height and body mass index measures were below normal ranges in most participants. Behavioral symptoms included hyperkinetic behavior (100%), and a majority exhibited high pain threshold.Interpretation: This is the largest cohort of independent CS pedigrees reported. We propose diagnostic criteria for CS. CS represents a novel neurogenetic disorder with general relevance to autism, intellectual disability, Angelman syndrome, epilepsy, and regression. [ABSTRACT FROM AUTHOR]

Objective Recently, Christianson syndrome (CS) has been determined to be caused by mutations in the X-linked Na+/H+ exchanger 6 ( NHE6). We aimed to determine the diagnostic criteria and mutational spectrum for CS. Methods Twelve independent pedigrees (14 boys, age = 4-19 years) with mutations in NHE6 were administered standardized research assessments, and mutations were characterized. Results The mutational spectrum was composed of 9 single nucleotide variants, 2 indels, and 1 copy number variation deletion. All mutations were protein-truncating or splicing mutations. We identified 2 recurrent mutations (c.1498 c>t, p.R500X; and c.1710 g>a, p.W570X). Otherwise, all mutations were unique. In our study, 7 of 12 mutations (58%) were de novo, in contrast to prior literature wherein mutations were largely inherited. We also report prominent neurological, medical, and behavioral symptoms. All CS participants were nonverbal and had intellectual disability, epilepsy, and ataxia. Many had prior diagnoses of autism and/or Angelman syndrome. Other neurologic symptoms included eye movement abnormalities (79%), postnatal microcephaly (92%), and magnetic resonance imaging evidence of cerebellar atrophy (33%). Regression was noted in 50%, with recurrent presentations involving loss of words and/or the ability to walk. Medical symptoms, particularly gastrointestinal symptoms, were common. Height and body mass index measures were below normal ranges in most participants. Behavioral symptoms included hyperkinetic behavior (100%), and a majority exhibited high pain threshold. Interpretation This is the largest cohort of independent CS pedigrees reported. We propose diagnostic criteria for CS. CS represents a novel neurogenetic disorder with general relevance to autism, intellectual disability, Angelman syndrome, epilepsy, and regression. Ann Neurol 2014;76:581-593 [ABSTRACT FROM AUTHOR]

Providing coaching to participants in inquiry‐based online discussions contributes to developing cognitive presence (CP) and higher‐order thinking. However, a primary issue limiting quality and timely coaching is instructors' lack of tools to efficiently identify CP phases in massive discussion transcripts and effectively assess learners' cognitive development. This study examined a computational approach integrating text mining and co‐occurrence analysis for assessing CP and cognitive development in online discussions based on the community of inquiry (CoI) framework. First, text classifiers trained on different language models were evaluated for identifying and coding the CP phases. Second, epistemic network analysis (ENA) was employed to model cognitive patterns reflected by co‐occurrences between the coding elements. Results indicated that text classifiers trained on the state‐of‐the‐art language model Bidirectional Encoder Representations from Transformers (BERT) can address the efficiency issue in coding CP phases in discussion transcripts and obtain substantial agreements (Cohen's k = 0.76) with humans, which outperformed other baseline classifiers. Furthermore, compared to traditional quantitative content analysis, ENA can effectively model the temporal characteristics of online discourse and detect fine‐grained cognitive patterns. Overall, the findings suggest a feasible path for applying learning analytics to tracking learning progression and informing theory‐based assessments. Practitioner notesWhat is already known about this topic Cognitive presence is an important construct describing the progression of thinking in online inquiry‐based discussions.Most studies used self‐report instruments or quantitative content analysis to measure and assess cognitive presence.More efficient and effective approaches were needed by instructors to support assessment of cognitive development and determine coaching strategies.What this paper adds An integrated computational approach for the developmental and formative assessment of cognitive presence was proposed and evaluated.A BERT‐based text classification model could efficiently code massive transcripts and achieve substantial agreements with human coders.Epistemic network analysis effectively revealed the process of cognitive development and identified representative discussion patterns and behaviours.Implications for practice and/or policy The proposed approach can considerably reduce the pressure on instructors, enabling them to focus on quality coaching and feedback.Compared to frequencies of individual codes, the connective features between codes carry more insights for assessing cognitive patterns.Learners in a discussion group play different roles and produce diverse paths of cognitive development. [ABSTRACT FROM AUTHOR]

Explores a variety of meanings for and experiences in learning in community. Importance of the learning spaces; Production of content situated in the daily life concerns of the members; Encouragement of citizens to produce local knowledge.

Describes how a geographically bounded group can become a community of practice by creating its own local knowledge. Creation of local knowledge; Way of building capacity to take action on its problems; Creation of knowledge that is useful for sustaining learning in a community.

This study focuses on outpatient behavioral management of oppositional-defiant teenagers that engage in aggressive behaviors. Sixteen subjects, 13 male and three female, are followed through an alternating treatment, single case design, ABCD: baseline; cognitive therapy coupled with the REST (Real Economy System for Teens) program for parental outpatient behavioral management; combined cognitive, REST, and response cost; and finally REST with response cost to control aggressive behaviors. The response cost was designed to control aggression. Response cost involved the parents identifying seven reinforcers, objects, and activities that are important to the teen. They are rank ordered, with item one being most important and item seven being least important. An aggressive act means the loss of an item for 1 year, beginning with item seven and progressing upward. This study finds that aggressive behaviors do not decrease with cognitive therapy and the REST program. When the more stringent response cost program is implemented in addition to the cognitive and REST techniques, the acts of aggression do respond to treatment. Thus, it is concluded that adding a stringent parent management response cost program offers a tool therapists can use in treating aggressive, oppositional-defiant teenagers on an outpatient basis without the need for hospitalization. Aggr. Behav. 25:321–330, 1999. © 1999 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Behavioral treatments for the eating disorder pica are reviewed. An extensive search of the literature yielded five previous reviews, 45 articles, and 3 dissertations. Interventions designed to reduce pica are described, including self-protective devices, overcorrection, water mist and aromatic ammonia, brief restraint, differential reinforcement, discrimination training, patient self-report, and ecological modifications. Many interventions were associated with reductions or eliminations of pica and required few hours of intensive therapist or staff involvement. Methodological problems with the published data base on pica are assessed. Suggestions for further primary research and reviews are included. [ABSTRACT FROM AUTHOR]

The present study examines the principal components structure of the Bulimia Test, developed originally with college women. In the present study, college women and junior high school and high school student samples from a rural catchment area were included. Overall, results suggest a high level of congruence, with good replication of factors across samples. The exception was the basic concept of binging. follow-up interviews of adolescent subjects suggested that younger women may often misconstrue the meaning of important inventory items, e.g., that the term binge pertains to simple overeating. Thus, such subjects are prone to overacknowledge symptoms and thereby erroneously inflate prevalence estimates. The implications are that the validity of the binge factor of the original Bulimia Test may be questionable for younger subjects. [ABSTRACT FROM AUTHOR]

The most frequently used measure of dietary restraint in controlled experiments involving arduous dieters is the Revised Restraint Scale (Herman & Mack, 1975). To date, researchers who have used the measure in controlled experiments have created a "high" versus "low" artificial dichotomy based on a median split of scores on the scale, apparently in an attempt to apply a standard analysis of variance model. The present study replicates a basic ice cream taste test experiment. It compares study results that emerge from using the Revised Restraint Scale as an artificial dichotomy ("factor") versus a continuous independent variable in a general linear model. Results showed that an important joint effect emerged when restraint was treated as a continuous variable, which would likely have gone undetected using standard ANOVA, and that a greater proportion of variance could be accounted for in the continuous variable model. Researchers to date may have failed to optimally outline the nature of the relationship between dietary restraint and other variables that have been of interest. [ABSTRACT FROM AUTHOR]

The present paper reviews some of the historical references to the concept of bulimia found in the medical literature of the last 300 years. Bulimia is an eating disorder that is widely believed to be of very recent, historical origin. The current diagnostic category of bulimia may be denoted as ‘new’, largely because of increased prevalence, and changes that have occurred in symptoms seen as constituting the syndrome. However, available references show clearly that various conceptualizations of bulimia extend back several hundred years. Also, treatment approaches that are consistent with presumed etiology have been offered by several early writers. While bulimia has recently been viewed as an emergent variant of anorexia nervosa, historical evidence suggests that earlier conceptualizations of the term describe a symptom as well as a discrete syndrome. Despite the fact that the diagnosis and use of concept of bulimia has been variable historically, its dramatic fundamental feature has remained consistent. [ABSTRACT FROM AUTHOR]

Introduces a series of articles on learning and community.

Metabolism in cancer cells is rewired to generate sufficient energy equivalents and anabolic precursors to support high proliferative activity. Within the context of these competing drives aerobic glycolysis is inefficient for the cancer cellular energy economy. Therefore, many cancer types, including colon cancer, reprogram mitochondria‐dependent processes to fulfill their elevated energy demands. Elevated glycolysis underlying the Warburg effect is an established signature of cancer metabolism. However, there are a growing number of studies that show that mitochondria remain highly oxidative under glycolytic conditions. We hypothesized that activities of glycolysis and oxidative phosphorylation are coordinated to maintain redox compartmentalization. We investigated the role of mitochondria‐associated malate–aspartate and lactate shuttles in colon cancer cells as potential regulators that couple aerobic glycolysis and oxidative phosphorylation. We demonstrated that the malate–aspartate shuttle exerts control over NAD+/NADH homeostasis to maintain activity of mitochondrial lactate dehydrogenase and to enable aerobic oxidation of glycolytic l‐lactate in mitochondria. The elevated glycolysis in cancer cells is proposed to be one of the mechanisms acquired to accelerate oxidative phosphorylation. [ABSTRACT FROM AUTHOR]

This study investigated whether video lectures instructed by a heightened level of expressiveness instructor were better than those instructed by a conventional level of expressiveness instructor or audio‐only in promoting students' online learning, and what kind of effects do instructor's facial expressions have on students' learning. Three different types of video lectures (one with a heightened level of expressiveness instructor, one with a conventional level of expressiveness instructor and one with the instructor' audio only) were used to study the effects of instructor's facial expressions. Sixty‐nine participants from Chinese Normal University were selected to learn with these video lectures. Results of this study indicated that video lectures with a heightened level of expressiveness instructor were better than those with a conventional level of expressiveness instructor and audio‐only ones with regard to improving students' arousal level and learning satisfaction. Instructor's facial expressions had no significant influence on participants' short‐term recall (p = .90), while instructor's facial expressions did influence students' medium‐term recall (p = .03). Instructor's facial expressions played a key role in students' online learning. [ABSTRACT FROM AUTHOR]

Key Clinical Message Appendiceal mucoceles ( AMs) infrequently arise from an underlying malignancy. Treatment has progressed toward a less aggressive approach over time; they can be managed by appendectomy-only unless pathology reveals malignancy. The ultimate goal of management is to prevent AM rupture, avoiding the syndrome of pseudomyxoma peritonei. [ABSTRACT FROM AUTHOR]

Background: Continuous administration of levodopa-carbidopa intestinal gel (carbidopa-levodopa enteral suspension) through a percutaneous endoscopic gastrojejunostomy is a treatment option for advanced Parkinson disease (PD) patients with motor fluctuations resistant to standard oral medications. Safety data from 4 prospective studies were integrated to assess the safety of this therapy.Methods: Safety data from 4 studies were summarized using 2 overlapping data sets, permitting the separation of procedure/device-associated (n = 395) from non-procedure/device adverse events (n = 412).Results: At the data cutoff, median exposure to levodopa-carbidopa intestinal gel was 911 days (range, 1-1980 days) with 963 total patient-years of exposure. Procedure/device adverse events occurred in 300 patients (76%), and serious adverse events occurred in 68 (17%); most frequently reported procedure/device adverse events and serious adverse events were complications of device insertion (41% and 8%, respectively) and abdominal pain (36% and 4%, respectively). Non-procedure/device adverse events occurred in 92% (379), with most frequently reported being insomnia (23%) and falls (23%); 42% (171) had non-procedure/device serious adverse events, with most frequently reported being pneumonia (5%) and PD symptoms (2%). Adverse events led to discontinuation in 17% (72), most frequently because of complication of device insertion (2.4%). There were 34 treatment-emergent deaths (8.3%) in the overlapping data sets, 2 of which (0.5%) were considered "possibly related" to the treatment system.Conclusion: In the largest collection of levodopa-carbidopa intestinal gel safety data from prospective clinical studies, procedure/device events were frequently reported and occasionally life threatening. Most non-procedure/device events were typical for levodopa treatment and an elderly population. These factors combined with high treatment efficacy led to a relatively low discontinuation rate in advanced PD patients. [ABSTRACT FROM AUTHOR]