Reading Aloud with Bilingual Learners: A Fieldwork Project and Its Impact on Mainstream Teacher Candidates

This study describes the components of a field-based Read Aloud Project (RAP) in which teacher candidates create and implement language and literacy rich read-alouds for bilingual learners. In addition, an examination of the impact of such a project on several areas of teacher candidates’ pedagogical expertise reveals that the RAP produces positive learning experiences for teacher candidates and may be worth replicating in other teacher education contexts to support the preparation of linguistically responsive teachers

Control of Blood Glucose for Type-1 Diabetes by Using Reinforcement Learning with Feedforward Algorithm

Source at https://doi.org/10.1155/2018/4091497.Background: Type-1 diabetes is a condition caused by the lack of insulin hormone, which leads to an excessive increase in blood glucose level. The glucose kinetics process is difficult to control due to its complex and nonlinear nature and with state variables that are difficult to measure. Methods: This paper proposes a method for automatically calculating the basal and bolus insulin doses for patients with type-1 diabetes using reinforcement learning with feedforward controller. The algorithm is designed to keep the blood glucose stable and directly compensate for the external events such as food intake. Its performance was assessed using simulation on a blood glucose model. The usage of the Kalman filter with the controller was demonstrated to estimate unmeasurable state variables. Results: Comparison simulations between the proposed controller with the optimal reinforcement learning and the proportional-integral-derivative controller show that the proposed methodology has the best performance in regulating the fluctuation of the blood glucose. The proposed controller also improved the blood glucose responses and prevented hypoglycemia condition. Simulation of the control system in different uncertain conditions provided insights on how the inaccuracies of carbohydrate counting and meal-time reporting affect the performance of the control system. Conclusion: The proposed controller is an effective tool for reducing postmeal blood glucose rise and for countering the effects of external known events such as meal intake and maintaining blood glucose at a healthy level under uncertainties

Cell‐free protein synthesis for the screening of novel azoreductases and their preferred electron donor

Azoreductases are potent biocatalysts for the cleavage of azo bonds. Various gene sequences coding for potential azoreductases are available in databases, but many of their gene products are still uncharacterized. To avoid the laborious heterologous expression in a host organism, we developed a screening approach involving cell-free protein synthesis (CFPS) combined with a colorimetric activity assay, which allows the parallel screening of putative azoreductases in a short time. First, we evaluated different CFPS systems and optimized the synthesis conditions of a model azoreductase. With the findings obtained, 10 azoreductases, half of them undescribed so far, were screened for their ability to degrade the azo dye methyl red. All novel enzymes catalyzed the degradation of methyl red and can therefore be referred to as azoreductases. In addition, all enzymes degraded the more complex and bulkier azo dye Brilliant Black and four of them also showed the ability to reduce p-benzoquinone. NADH was the preferred electron donor for the most enzymes, although the synthetic nicotinamide co-substrate analogue 1-benzyl-1,4-dihydronicotinamide (BNAH) was also accepted by all active azoreductases. This screening approach allows accelerated identification of potential biocatalysts for various applications

Long-term survival and life expectancy following an acute heart failure hospitalization in Australia and New Zealand

Aims: Contemporary long-term survival following a heart failure (HF) hospitalization is uncertain. We evaluated survival up to 10 years after a HF hospitalization using national data from Australia and New Zealand, identified predictors of survival, and estimated the attributable loss in life expectancy. Methods and results: Patients hospitalized with a primary diagnosis of HF from 2008–2017 were identified and all-cause mortality assessed by linking with Death Registries. Flexible parametric survival models were used to estimate survival, predictors of survival and loss in life expectancy. A total of 283 048 patients with HF were included (mean age 78.2 ± 12.3 years, 50.8% male). Of these, 48.3% (48.1–48.5) were surviving by 3 years, 34.1% (33.9–34.3) by 5 years and 17.1% (16.8–17.4) by 10 years (median survival 2.8 years). Survival declined with age with 53.4% of patients aged 18–54 years and 6.2% aged ≥85 years alive by 10 years (adjusted hazard ratio [aHR] for mortality 4.84, 95% confidence interval [CI] 4.65–5.04 for ≥85 years vs. 18–54 years) and was worse in male patients (aHR 1.14, 95% CI 1.13–1.15). Prior HF (aHR 1.20, 95% CI 1.18–1.22), valvular and rheumatic heart disease (aHR 1.11, 95% CI 1.10–1.13) and vascular disease (aHR 1.07, 95% CI 1.04–1.09) were cardiovascular comorbidities most strongly associated with long-term death. Non-cardiovascular comorbidities and geriatric syndromes were common and associated with higher mortality. Compared with the general population, HF was associated with a loss of 7.3 years in life expectancy (or 56.6% of the expected life expectancy) and reached 20.5 years for those aged 18–54 years. Conclusion: Less than one in five patients hospitalized for HF were surviving by 10 years with patients experiencing almost 60% loss in life expectancy compared with the general population, highlighting the considerable persisting societal burden of HF. Concerted multidisciplinary efforts are needed to improve post-hospitalization outcomes of HF

The co-inheritance of alpha-thalassemia and sickle cell anemia is associated with better hematological indices and lower consultations rate in Cameroonian patients and could improve their survival

BACKGROUND: Co-inheritance of α-thalassemia was reported to be associated with a delayed age of disease onset among Cameroonian Sickle Cell Anemia (SCA) patients. The present study aimed to explore the correlation between α-thalassemia, hematological indices, and clinical events in these patients. Methods and FINDINGS: We studied 161 Cameroonian SCA patients and 103 controls (59.1% HbAA) with median ages of 17.5 and 23 years. RFLP-PCR was used to confirm SCA genotype and to describe haplotypes in the HBB-like genes cluster. Multiplex Gap-PCR was performed to investigate the 3.7 kb α-globin gene deletions. SNaPshot PCR, capillary electrophoresis and cycle sequencing were used for the genotyping of 10 SNPs in BCL11A , HMIP1/2 , OR51B5/6 and HBG loci, known to influence HbF levels. Generalised linear regression models adjusted for age, sex and SNPs genotypes was used to investigate effects of α-thalassemia on clinical and hematological indices. The median rate of vaso-occlusive painful crisis and hospitalisations was two and one per year, respectively. Stroke was reported in eight cases (7.4%). Benin haplotype was the most prevalent (66.3%; n = 208 chromosomes). Among patients, 37.3% ( n = 60) had at least one 3.7 kb deletion, compared to 10.9% ( n = 6) among HbAA controls (p<0.001). Among patients, the median RBC count increased with the number of 3.7 kb deletions [2.6, 3.0 and 3.4 million/dl, with no, one and two deletions (p = 0.01)]. The median MCV decreased with the number of 3.7 kb deletion [86, 80, and 68fl, with no, one and two deletions (p<0.0001)], as well as median WBC counts [13.2, 10.5 and 9.8×10 9 /L (p<0.0001. The co-inheritance of α-thalassemia was associated with lower consultations rate (p = 0.038). CONCLUSION: The co-inheritance of α-thalassemia and SCA is associated with improved hematological indices, and lower consultations rate in this group of patients. This could possibly improve their survival and explain the higher proportion of α-thalassemia among patients than controls

Self and Microbiota-Derived Epitopes Induce CD4⁺ T Cell Anergy and Conversion into CD4⁺Foxp3⁺ Regulatory Cells

The physiological role of T cell anergy induction as a key mechanism supporting self-tolerance remains undefined, and natural antigens that induce anergy are largely unknown. In this report, we used TCR sequencing to show that the recruitment of CD4+CD44+Foxp3−CD73+FR4+ anergic (Tan) cells expands the CD4+Foxp3+ (Tregs) repertoire. Next, we report that blockade in peripherally-induced Tregs (pTregs) formation due to mutation in CNS1 region of Foxp3 or chronic exposure to a selecting self-peptide result in an accumulation of Tan cells. Finally, we show that microbial antigens from Akkermansia muciniphila commensal bacteria can induce anergy and drive conversion of naive CD4+CD44-Foxp3− T (Tn) cells to the Treg lineage. Overall, data presented here suggest that Tan induction helps the Treg repertoire to become optimally balanced to provide tolerance toward ubiquitous and microbiome-derived epitopes, improving host ability to avert systemic autoimmunity and intestinal inflammation

Association of variants at BCL11A and HBS1L-MYB with hemoglobin F and hospitalization rates among sickle cell patients in Cameroon

BACKGROUND: Genetic variation at loci influencing adult levels of HbF have been shown to modify the clinical course of sickle cell disease (SCD). Data on this important aspect of SCD have not yet been reported from West Africa. We investigated the relationship between HbF levels and the relevant genetic loci in 610 patients with SCD (98% HbSS homozygotes) from Cameroon, and compared the results to a well-characterized African-American cohort. Methods and FINDINGS: Socio-demographic and clinical features were collected and medical records reviewed. Only patients >5 years old, who had not received a blood transfusion or treatment with hydroxyurea were included. Hemoglobin electrophoresis and a full blood count were conducted upon arrival at the hospital. RFLP-PCR was used to describe the HBB gene haplotypes. SNaPshot PCR, Capillary electrophoresis and cycle sequencing were used for the genotyping of 10 selected SNPs. Genetic analysis was performed with PLINK software and statistical models in the statistical package R. Allele frequencies of relevant variants at BCL11A were similar to those detected in African Americans; although the relationships with Hb F were significant (p <.001), they explained substantially less of the variance in HbF than was observed among African Americans (∼ 2% vs 10%). SNPs in HBS1L-MYB region ( HMIP ) likewise had a significant impact on HbF, however, we did not find an association between HbF and the variations in HBB cluster and OR51B5/6 locus on chromosome 11p, due in part to the virtual absence of the Senegal and Indian Arab haplotypes. We also found evidence that selected SNPs in HBS1L-MYB region ( HMIP ) and BCL11A affect both other hematological indices and rates of hospitalization. CONCLUSIONS: This study has confirmed the associations of SNPs in BCL11A and HBS1L-MYB and fetal haemoglobin in Cameroonian SCA patients; hematological indices and hospitalization rates were also associated with specific allelic variants

Treadmill Training for Infants with Down Syndrome: A Case Study

Background: Children with Down syndrome (DS) experience motor delays particularly with ambulation. Previous research has suggested that a 5 time per week, 8 minute per session protocol for treadmill training (TT) was effective in earlier acquisition of walking. Purpose: To examine the effectiveness of a home-based 2 time per week, 20 minute per session TT protocol on the development of independent step taking in an infant with DS. Methods: A 20-month-old boy with DS, underwent a repair for esophageal atresia at 5 months, and currently uses a feeding tube. He was independently sitting and non-ambulatory. Weekly Zoom meetings were conducted to examine the child on the treadmill and administer the weekly questionnaire. The parents were instructed on how to safely hold their child over the treadmill and how to adjust if the child was not taking steps. Modifications to the original protocol were allowed to support completion of the 40 minutes per week. Results: Results indicated unsubstantial improvements for the gross motor function measure (GMFM) scores and step count but found a decrease in the number and length of breaks. Improvements in crawling speed, stair navigation, environmental exploration, and cognitive development were observed. Conclusion: To our knowledge, this is the first study examining treadmill training in an infant with DS who had an esophageal atresia repair and now utilizes a feeding tube. The participant’s extensive medical history, limited time of the study, and poor adherence could have impacted the observed results. Further research on optimal dosage is needed