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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]

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]

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]

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]

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]

Background Lentiviral vectors are being used with increasing frequency in human clinical trials. We were the first to use lentiviral vectors in clinical trials in 2003. Our lentiviral vector encoded a long RNA antisense sequence to the HIV-1 envelope and was used in an ex vivo autologous setting to provide viral load control in HIV-1 positive subjects failing anti-HIV therapy. A total of 65 subjects have been treated in Phase 1 and Phase 2 trials in six institutions. Methods Good manufacturing practices (GMP) lots of the lentiviral vector used in our clinical trials were assayed for the presence of replication competent lentivirus (RCL). RCL assays were conducted at two stages. The first testing was performed on samples collected immediately following bulk harvest of the GMP product lot and consisted of 1 × 108 cells used in production. RCL assays were also performed on aliquots of the final fill of the vector by the inoculation of at least 5% of the GMP final fill volume into C8166 cells, passaged for at least ten passages and tested for RCL by p24 enzyme-linked immunosorbent assay and vesicular stomatitis virus-G envelope DNA. Results Following 263 infusions of autologous, transduced cells, no adverse events have been detected in these subjects, with some followed for more than 8 years following infusions. More than 4.3 × 1012 VRX496 proviral copies were administered to these 65 subjects. Conclusions Data from this small population suggest that there is no apparent risk for serious adverse events with the use of lentiviral vectors. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Simvastatin has been shown to increase bone growth when applied topically to murine bone; however, it causes considerable soft tissue inflammation at high doses (2.2 mg), making future clinical use problematic. This study evaluated the effect of lower simvastatin doses and cyclooxygenase (COX) synthase inhibitors on tissue inflammation and bone growth in rats and gene expression in mice.Methods: Adult female rats were untreated or treated with a single dose of 0.1, 0.5, 1.0, 1.5, or 2.2 mg simvastatin in methylcellulose gel in a polylactic acid membrane (SIM) on the lateral aspect of the mandible. The contralateral mandible side was implanted with methylcellulose gel/polylactic acid membrane alone (GEL), and five rats in each dose pairing were evaluated histomorphometrically after 3, 7, and 24 days. Subsequent rats were similarly treated with 0.5 mg simvastatin (optimal dose) and daily intraperitoneal injections of COX-2 inhibitor (NS-398; 1 mg/kg x 7 days; N = 16), general COX inhibitor (indomethacin; 1 mg/kg x 7 days; N = 16), or no inhibitor (N = 10) and evaluated histomorphometrically after 7 or 24 days by analysis of variance (ANOVA). Gene arrays were also used to evaluate osteogenic gene expression from 0.5 mg simvastatin in murine calvaria (N = 12).Results: There was a 45% increase in bone area with 0.5 mg simvastatin versus gel control (P <0.001; similar to the 2.2-mg dose), and clinical swelling was reduced compared to the high simvastatin dose (P <0.05). The 0.1-mg simvastatin dose failed to stimulate significant bone growth. NS-398 and indomethacin reduced inflammation and bone growth. Simvastatin significantly upregulated procollagen, fibronectin, and matrix metalloproteinase-13 genes.Conclusion: Reducing the simvastatin dose from 2.2 to 0.5 mg reduced inflammation to a more clinically acceptable level without sacrificing bone-growth potential, but COX-associated inflammation appears to be necessary for in vivo bone growth. [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 instrumental case study using the embedded single-case study design was conducted at a large midwestern university. Data collection included documents, descriptive statistics, and interviews. The themes of remaining, retiring, and returning appeared as patterns during data analysis. As universities experience the trend toward longer working lifespans, it is important that HRD practitioners include age in diversity discussions. Along with this, career development and training and development opportunities need to be reexamined.

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]

Pharyngeal reconstruction commonly involves grafts or flaps. Recent reports have emphasized the advantages of skin graft reconstruction. The purpose of this paper is to assess the results of pharyngeal reconstruction with the pectoralis musculocutaneous flap following composite resection and neck dissection. Thirty-five patients who had predominantly advanced disease (88% stage IV) were treated in the Department of Otolaryngology at The Ohio State University. Oral diet was tolerated by 73.5% of the patients at the time of discharge. Of these, 80% were on a soft diet. Ultimately, 91% of the patients were able to tolerate an oral diet. The median hospital stay was 13 days. The estimated blood loss, blood replacement, complications, days to decannulation, and surgical time were analyzed. These results suggest that flap reconstruction leads to short hospitalization and provides an excellent opportunity for an oral diet. [ABSTRACT FROM AUTHOR]

Gastric pull-up or free jejunal interposition was used for reconstruction after total laryngopharyngectomy in 31 patients. Complications and functional outcomes of the two methods are compared. Primary swallowing was achieved in 86% of patients after gastric pull-up and in 82% of patients after jejunal interposition. Patients who underwent jejunal interposition were able to swallow sooner and had a shorter hospital stay than patients who underwent gastric pull-up. Esophageal tumor recurrence after jejunal interposition was not observed. Hepatic failure occurred in two gastric pull-up patients, leading to perioperative death in one. Flap necrosis occurred in two jejunal interposition patients and one gastric pull-up patient. Two additional fistulas occurred in jejunal interposition patients as a result of microvascular complications. Stricture developed in four jejunal interposition patients, requiring revision surgery in two. Minor complications were more common in the gastric pull-up group. Long-term speech and swallowing function are compared. Our current choice of jejunal interposition or gastric pull-up for reconstruction after total laryngopharyngectomy primarily depends on the location of the tumor. [ABSTRACT FROM AUTHOR]

The typical distribution and clinical characteristics of cutaneous lesions in the neonatal lupus erythematosus (NLE) syndrome are similar to those of subacute cutaneous LE, both of which are associated with Ro/SS-A antibody and photosensitivity. Thus it is prudent to advise the use of sunscreens in affected infants. Resolution of the cutaneous lesions corresponds temporally to the disappearance of transplacentalIy passed maternal IgG Ro/SS-A antibody at approximately 6 months of age. Theoretically, at this point the disease is inactive and sunscreens could be discontinued, although protection from long-term sun exposure is recommended for all persons.

Mastocytosis refers to a spectrum of clinical and laboratory abnormalities attributable to tissue infiltration by large numbers of mast cells and to the discharge of various biologically active substances by these cells. It most commonly results in cutaneous manifestations during childhood but may develop at any age or involve almost any organ system. The treatment of mastocytosis has become considerably more practicable in recent years with the availability of agents that directly inhibit mast cells or temporarily reduce their quantity in the skin. [ABSTRACT FROM AUTHOR]

Postoperative speech function may be influenced by a number of treatment variables. The objective of this study was to examine the relationships among various treatment factors to determine the impact of these measures on speech function. Speech function was tested prospectively in 142 patients with surgically treated oral and oropharyngeal cancer 3 months after treatment. Each patient's speech was recorded during a 6- to 7-minute conversation and while performing a standard articulation test, producing speech outcome measures of percent correct consonant phonemes and percent conversational understandability. Correlational analyses were used to determine the relationships among the speech outcome measures and 14 treatment parameters. Speech function was mildly to moderately negatively correlated with most surgical resection variables, indicating that larger amounts of tissue resected were associated with worse speech function. Overall measures of conversational understandability and percent correct consonant phonemes were related to extent of oral tongue resection, floor of mouth resection, soft palate resection, and total volume of tissue resected. These relationships varied depending on the method of surgical closure. Method of surgical reconstruction had a profound impact on postoperative speech function 3 months after treatment and was an important factor in determining how oral tongue resection influenced articulation and intelligibility. The combination of closure type, percent oral tongue resected, and percent soft palate resected had the strongest relationship with overall speech function for patients with surgically treated oral and oropharyngeal cancer 3 months after treatment. [ABSTRACT FROM AUTHOR]

Introduces a series of articles on learning and community.