Cough and reflux esophagitis in children: their co-existence and airway cellularity

BACKGROUND: There are no prospective studies that have examined for chronic cough in children without lung disease but with gastroesophageal reflux (GER). In otherwise healthy children undergoing flexible upper gastrointestinal endoscopy (esophago-gastroscopy), the aims of the study were to (1) define the frequency of cough in relation to symptoms of GER, (2) examine if children with cough and reflux esophagitis (RE) have different airway cellularity and microbiology in bronchoalveolar lavage (BAL) when compared to those without. METHODS: Data specific for chronic cough (>4-weeks), symptoms of GER and cough severity were collected. Children aged <16-years (n = 150) were defined as 'coughers' (C+) if a history of cough in association with their GER symptoms was elicited before BAL were obtained during elective esophago-gastroscopy. Presence of esophagitis on esophageal biopsies was considered reflux esophagitis positive (E+). RESULTS: C+ (n = 69) were just as likely as C- (n = 81) to have esophagitis, odds ratio 0.87 (95%CI 0.46, 1.7). Median neutrophil percentage in BAL was significantly different between groups; highest in C+E- (7, IQR 28) and lowest in C-E+ (5, IQR 6). BAL positive bacterial culture occurred in 20.7% and were more likely present in current coughers (OR 3.37, 95%CI 1.39, 8.08). Airway neutrophilia (median 20%, IQR 34) was significantly higher in those with BAL positive bacterial cultures than those without (5%, 4; p = 0.0001). CONCLUSION: In children without lung disease, the common co-existence of cough with symptoms of GER is independent of the occurrence of esophagitis. Airway neutrophilia when present in these children is more likely to be related to airway bacterial infection and not to esophagitis

Conventional approach to harmonious coordinated Cadastral Database weakness

The eKadaster system depended solely on the use of coordinated cadastral database known as the National Digital Cadastral Database (NDCDB) with an expected accuracy of ±10cm. Till date, there is an approximately of 7.8 million land parcels and 21.9 million boundary markers in the NDCDB that covers the total area of 132,183 km2. However, the NDCDB accuracy of ±10cm is still not at a satisfactory acceptance level and the adjustment keeps continuing without carrying out verification to the data sources weakness of varying accuracy and input errors. Thus, the foremost important corrective is to ensure the adjustment input files to have the exact value of the sources by further divided the existing adjustment blocks into smaller blocks to verify the input data line by line. A well distributed cadastral control points and latest NDCDB accessibility are also extensively needed to plan and to strengthen the adjustment network. The comparison result of the randomly picked ground truthing points in the field has shown a significant impact on the displacement accuracy that meet the expected tolerance of ±10cm or better after the data input file is cleaned without input error. And to further strengthen the adjustment network in order to make NDCDB accuracy better, the current cadastral control points shall need to tie to a highest accuracy fundamental network

Longitudinal grey and white matter changes in frontotemporal dementia and Alzheimer's disease

Behavioural variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) dementia are characterised by progressive brain atrophy. Longitudinal MRI volumetry may help to characterise ongoing structural degeneration and support the differential diagnosis of dementia subtypes. Automated, observer-independent atlas-based MRI volumetry was applied to analyse 102 MRI data sets from 15 bvFTD, 14 AD, and 10 healthy elderly control participants with consecutive scans over at least 12 months. Anatomically defined targets were chosen a priori as brain structures of interest. Groups were compared regarding volumes at clinic presentation and annual change rates. Baseline volumes, especially of grey matter compartments, were significantly reduced in bvFTD and AD patients. Grey matter volumes of the caudate and the gyrus rectus were significantly smaller in bvFTD than AD. The bvFTD group could be separated from AD on the basis of caudate volume with high accuracy (79% cases correct). Annual volume decline was markedly larger in bvFTD and AD than controls, predominantly in white matter of temporal structures. Decline in grey matter volume of the lateral orbitofrontal gyrus separated bvFTD from AD and controls. Automated longitudinal MRI volumetry discriminates bvFTD from AD. In particular, greater reduction of orbitofrontal grey matter and temporal white matter structures after 12 months is indicative of bvFTD

Designing Playful Games and Applications to Support Science Centers Learning Activities

In recent years there has been a renewed interest on science, technology, engineering, and mathematics (STEM) education. Following this interest, science centers\u27 staff started providing technology enhanced informal STEM education experiences. The use of well-designed mobile and ubiquitous forms of technology to enrich informal STEM education activities is an essential success factor. The goal of our research is to investigate how technology applications can be better used and developed for taking full advantage of the opportunities and challenges they provide for students learning about STEM concepts. In our approach, we have conducted a series of interviews with experts from science center curating and outdoor learning activities development, with the final goal of exploring and improving current learning environments and practices. This paper presents the development of set of design considerations for the development of STEM games and applications of young students. An initial set of best practices was first developed through semi-structures interviews with experts; and afterwards, by employing content analysis, a revised set of considerations was obtained. These results are useful for STEM education teachers, curriculum designers, curators and developers for K-12 education environments

The empirical approach to strengthen coordinated cadastral database accuracy

The coordinated cadastral database in Malaysia is known as National Digital Cadastral Database (NDCDB) with an expected accuracy of ±10cm in rural and ±5cm in urban area. Till date, there are approximately 7.8 million land parcels and 22 million boundary markers in the NDCDB for the whole of Peninsular Malaysia and Federal Territory of Labuan covering total area of 132,183 km2. Since 2010, NDCDB block adjustment has been carried out continuously without giving prime concern to eliminate gross errors in the adjustment's input data. This approach aims to propose a methodology to improve the positional accuracy of the existing NDCDB through utilisation of the current eKadaster application. A comprehensive investigation in the office and field processes has been carried out to prove the efficiency of the methodology introduced. This investigation was focused on the East Coast Rail Link (ECRL) right of way (ROW) survey from Dungun to Besut where displacement of 1 to 6 meters relative to the NDCDB coordinates, as shown in the Land Acquisition (LA) Plan, have been identified. Areas involved are coded as Block T10701, T1100101 and T1100102 which are located in Lubuk Kawah and Pelagat Sub-districts, in the state of Terengganu. Positional accuracy of the NDCDB after adjustment was further verified by comparing the coordinates of randomly picked ground proofing points in the field using Real-Time Kinematic (RTK) observation. This will determine the Root Mean Square Error (RMSE) of the respective NDCDB Block based on actual observations and adjusted coordinate values. With that, it can be concluded that the proposed approach is reasonably practical and capable to improve and strengthen the positional accuracy of existing coordinated cadastral database used in Malaysia

Disrupting education using smart mobile pedagogies

© Springer Nature Switzerland AG 2019. As mobile technologies become more multifaceted and ubiquitous in society, educational researchers are investigating the use of these technologies in education. A growing body of evidence shows that traditional pedagogies still dominate the educational field and are misaligned with the diverse learning opportunities offered by the use of mobile technologies. There is an imperative to question those traditional notions of education, including how, where and when teaching and learning are enacted, and to explore the possible mediating roles of new mobile technologies. New smart pedagogies, which embrace the affordances offered by mobile technologies, have the potential to disrupt notions of schooling. In this chapter, we examine the nature of smart pedagogies and their intersection with mobile pedagogies. We unpack notions of innovation and disruption. We then discuss smart mobile learning activities for school students identified from a Systematic Literature Review, together with the pedagogical principles underpinning them. We argue to encourage smart pedagogies, teacher educators should support teachers to implement ‘feasible disruptions’. Consequently, implications for teacher education are explored

Unusual finding of endocervical-like mucinous epithelium in continuity with urothelium in endocervicosis of the urinary bladder

Endocervicosis in the urinary bladder is a rare benign condition. We present a case in a 37-year-old woman with classical clinical and pathological features of endocervicosis. The unusual observation of endocervical-like mucinous epithelium in continuity with the urothelium in addition to fully developed endocervicosis prompted immunohistochemical profiling of the case using antibodies to cytokeratins (AE1/AE3, CK19, CK7, CK5/6, CK20), HBME-1, estrogen receptor (ER) and progesterone receptor (PR) to assess the relationship of the surface mucinous and endocervicosis glandular epithelia. The surface mucinous epithelium, urothelium and endocervicosis glands were immunopositive for AE1/AE3, CK7 and CK19 while CK20 was only expressed by few urothelial umbrella cells. The surface mucinous epithelium was CK5/6 and HBME-1 immunonegative but showed presence of ER and PR. This was in contrast to the urothelium's expression of CK5/6 but not ER and PR. In comparison, endocervicosis glands expressed HBME-1, unlike the surface mucinous epithelium. The endocervicosis epithelium also demonstrated the expected presence of ER and PR and CK5/6 immunonegativity. The slightly differing immunohistochemical phenotypes of the surface mucinous and morphologically similar endocervicosis glandular epithelium is interesting and requires further clarification to its actual nature. The patient has remained well and without evidence of disease 18-months following transurethral resection of the lesion

Chronic Intestinal Failure in Children : An International Multicenter Cross-Sectional Survey

Background: The European Society for Clinical Nutrition and Metabolism database for chronic intestinal failure (CIF) was analyzed to investigate factors associated with nutritional status and the intravenous supplementation (IVS) dependency in children. Methods: Data collected: demographics, CIF mechanism, home parenteral nutrition program, z-scores of weight-for-age (WFA), length or height-for-age (LFA/HFA), and body mass index-for-age (BMI-FA). IVS dependency was calculated as the ratio of daily total IVS energy over estimated resting energy expenditure (%IVSE/REE). Results: Five hundred and fifty-eight patients were included, 57.2% of whom were male. CIF mechanisms at age 1-4 and 14-18 years, respectively: SBS 63.3%, 37.9%; dysmotility or mucosal disease: 36.7%, 62.1%. One-third had WFA and/or LFA/HFA z-scores 125%. Multivariate analysis showed that mechanism of CIF was associated with WFA and/or LFA/HFA z-scores (negatively with mucosal disease) and %IVSE/REE (higher for dysmotility and lower in SBS with colon in continuity), while z-scores were negatively associated with %IVSE/REE. Conclusions: The main mechanism of CIF at young age was short bowel syndrome (SBS), whereas most patients facing adulthood had intestinal dysmotility or mucosal disease. One-third were underweight or stunted and had high IVS dependency. Considering that IVS dependency was associated with both CIF mechanisms and nutritional status, IVS dependency is suggested as a potential marker for CIF severity in children.Peer reviewe

Different Factors Affecting Human ANP Amyloid Aggregation and Their Implications in Congestive Heart Failure

Atrial Natriuretic Peptide (ANP)-containing amyloid is frequently found in the elderly heart. No data exist regarding ANP aggregation process and its link to pathologies. Our aims were: i) to experimentally prove the presumptive association of Congestive Heart Failure (CHF) and Isolated Atrial Amyloidosis (IAA); ii) to characterize ANP aggregation, thereby elucidating IAA implication in the CHF pathogenesis.A significant prevalence (85\%) of IAA was immunohistochemically proven ex vivo in biopsies from CHF patients. We investigated in vitro (using Congo Red, Thioflavin T, SDS-PAGE, transmission electron microscopy, infrared spectroscopy) ANP fibrillogenesis, starting from α-ANP as well as the ability of dimeric β-ANP to promote amyloid formation. Different conditions were adopted, including those reproducing β-ANP prevalence in CHF. Our results defined the uncommon rapidity of α-ANP self-assembly at acidic pH supporting the hypothesis that such aggregates constitute the onset of a fibrillization process subsequently proceeding at physiological pH. Interestingly, CHF-like conditions induced the production of the most stable and time-resistant ANP fibrils suggesting that CHF affected people may be prone to develop IAA.We established a link between IAA and CHF by ex vivo examination and assessed that β-ANP is, in vitro, the seed of ANP fibrils. Our results indicate that β-ANP plays a crucial role in ANP amyloid deposition under physiopathological CHF conditions. Overall, our findings indicate that early IAA-related ANP deposition may occur in CHF and suggest that these latter patients should be monitored for the development of cardiac amyloidosis

Conditionally reprogrammed primary airway epithelial cells maintain morphology, lineage and disease specific functional characteristics

© 2017 The Author(s). Current limitations to primary cell expansion led us to test whether airway epithelial cells derived from healthy children and those with asthma and cystic fibrosis (CF), co-cultured with an irradiated fibroblast feeder cell in F-medium containing 10 µM ROCK inhibitor could maintain their lineage during expansion and whether this is influenced by underlying disease status. Here, we show that conditionally reprogrammed airway epithelial cells (CRAECs) can be established from both healthy and diseased phenotypes. CRAECs can be expanded, cryopreserved and maintain phenotypes over at least 5 passages. Population doublings of CRAEC cultures were significantly greater than standard cultures, but maintained their lineage characteristics. CRAECs from all phenotypes were also capable of fully differentiating at air-liquid interface (ALI) and maintained disease specific characteristics including; defective CFTR channel function cultures and the inability to repair wounds. Our findings indicate that CRAECs derived from children maintain lineage, phenotypic and importantly disease-specific functional characteristics over a specified passage range