Maturational Staging of the Midpalatal and Zygomaticomaxillary Sutures: A Morphological Study Using CBCT

Objective: The aim of this study was to observe the patency of the midpalatal (MPS) and zygomaticomaxillary (ZMS) sutures relative to age, gender, cervical vertebrae maturation stage (CVMS), palatal and zygomatic dimensions and malocclusion. Method: The sample comprised of 278 subjects selected from one private orthodontic office. The necessary information from their records was reviewed and documented. Their pre-treatment cone-beam computed tomography (CBCT) images were obtained for orthodontic diagnosis and treatment planning purposes. These images were exported to the Invivo 5 program (Anatomage, San Jose, California), in which orthogonal and oblique sections were obtained from the MPS and ZMS for morphologic evaluation. The five MPS (A, B, C as open; D, E as closed) and five ZMS (A, B as open; C, D, E as closed) morphological maturational stages of patency were classified based on previous studies (Angelieri et al 2015, 2017) by a single examiner. Cohen’s kappa was applied for intraexaminer agreements, and their values were 0.95 and 0.83 for the MPS and ZMS, respectively. Result: The patency of the MPS and ZMS are significantly associated with age, gender, CVMS and Angle Class I and Class II malocclusions. The MPS patency is associated with the palatal depth/length (Pd/Pl) ratio, while the ZMS patency is not. Statistically, Class III malocclusion was found to significantly related to the ZMS patency, but not at the MPS. Conclusion: There is a strong association of an open MPS when ZMS is open. In Class I and II malocclusions in which maxillary expansion is indicated, the MPS is normally open in CVMS I and II. In Class I or mild Class III malocclusions in which maxillary expansion and a facemask is considered, the MPS and ZMS should be evaluated at CVMS II or earlier. Deeper and shorter palates are associated with open MPS

Factors affecting language proficiency of English language learners at language institutes in the United States

The purpose of this study was to investigate the perspectives of English language\ud learners (ELLs) about the importance of the five factors, learning environment, learning\ud strategies, motivation, beliefs, and linguistic distance related to learning English and to\ud determine the relationship between these factors with ELLs' language learning and their\ud language proficiency. Two questions guided this study: (l) What do ELLs perceive to\ud be the important factors contributing to their language learning? (2) What are the\ud relationships between these factors and ELLs' language proficiency?\ud A total of 606 ELLs who studied at English language institutes in the United\ud States constituted the final sample. The 43 item survey was used to explore ELLs'\ud perspectives about English language learning. Employing a series of statistical\ud techniques, descriptive analyses, confirmatory factor analyses, and multiple regression,\ud this study investigated the important factor contributing to language learning from ELLs'\ud perspectives.\ud Findings revealed that ELLs' perceive that their beliefs about language learning\ud were the important factor contributing to their language learning, followed by the\ud learning environment, learning strategies, motivation, and linguistic distance. The\ud linguistic distance subscale had the less importance ratings. In addition, the relationship\ud between five factors and ELLs' language proficiency, the results showed that two of the\ud five factors (learning strategies and linguistic distance) contributed significantly to the\ud prediction of ELLs' language proficiency, and motivation is marginally significantly to\ud the prediction of ELLs' language proficiency. That is, learning strategies was the most\ud important effect on ELLs' language proficiency, followed by linguistic distance, and\ud motivation.\ud Learning a language is a complex process. In order to broaden students' desire to\ud learn in school, teachers may need to consider the activities carefully to increase ELLs'\ud interest to learn more and provide the opportunities for them to express their opinion in\ud the classroom. This learning process involves teachers, the learning environment in the\ud classroom and outside the classroom as well as the learners' cooperation. This research\ud has implications for further study of relationship among factors that ELLs perceive to be\ud important to language learning and to instruction in language institutes.Simpson, Anne Dr.\ud Compton-Hall, Margaret Dr.\ud Patterson, Leslie Dr.\ud Dam, Phap Dr.\ud Yang, Philip Dr

Teaching Musculoskeletal Physical Diagnosis Using A Web-based Tutorial and Pathophysiology-Focused Cases

ObjectiveTo assess the effectiveness of an experimental curriculum on teaching first-year medical students the musculoskeletal exam as compared to a traditional curriculum.BackgroundMusculoskeletal complaints are common in the primary care setting. Practitioners are often deficient in examination skills and knowledge regarding musculoskeletal diseases. There is a lack of uniformity regarding how to teach the musculoskeletal examination among sub-specialists. We propose a novel web-based approach to teaching the musculoskeletal exam that is enhanced by peer practice with pathophysiology-focused cases. We sought to assess the effectiveness of an innovative musculoskeletal curriculum on the knowledge and skills of first-year medical students related to musculoskeletal physical diagnosis as compared to a traditional curriculum. The secondary purpose of this study was to assess satisfaction of students and preceptors exposed to this teaching method.MethodsThis quasi-experimental study was conducted at a single LCME-accredited medical school and included a convenience sample from 2 consecutive classes of medical students during the musculoskeletal portion of their physical diagnosis class. We conducted a needs assessment of the traditional curriculum used to teach musculoskeletal examination. The needs assessment informed the development of an experimental curriculum. One class (control group) received the traditional curriculum while the second class (experimental group) received the experimental curriculum, consisting of a web-based musculoskeletal tutorial, pathophysiology-focused cases, and facilitator preparation. We used multiple-choice questions and musculoskeletal OSCE scores to assess differences between knowledge and skills in the 2 groups.ResultsThe sample consisted of 140 students in each medical school class. There were no statistically significant differences between the 2 groups. One hundred seven students from the control group and 120 students from the experimental group took the multiple-choice examination. The average score was 66% (95% CI= 59.7-72.3) for the control group and 66% (95% CI = 60.5-71.5) for the experimental group. There was no difference between the median musculoskeletal OSCE scores between the 2 groups. The experimental group was satisfied with the new teaching method and gained the additional benefit of a persistent resource.ConclusionsThis web-based experimental curriculum was as effective as the traditional curriculum for teaching the musculoskeletal exam. Additionally, users were satisfied with the web-based training and benefited from a persistent resource

Using Environmental DNA to Detect Whales and Dolphins in the New York Bight

Determining how cetaceans and other threatened marine animals use coastal habitats is critical to the effective conservation of these species. Environmental DNA (eDNA) is an emerging tool that can potentially be used to detect cetaceans over broad spatial and temporal scales. In particular, eDNA may present a useful complementary method for monitoring their presence during visual surveys in nearshore areas, and for co-detecting prey. In conjunction with ongoing visual surveys, we tested the ability of eDNA metabarcoding to detect the presence and identity of cetaceans in the New York Bight (NYB), and to identify fish species (potential prey) present in the area. In almost all cases in which humpback whales and dolphins were visually observed, DNA from these species was also detected in water samples. To assess eDNA degradation over time, we took samples in the same location 15 and 30min after a sighting in seven instances, and found that eDNA often, but not always, dropped to low levels after 30min. Atlantic menhaden were detected in all samples and comprised the majority of fish sequences in most samples, in agreement with observations of large aggregations of this important prey species in the NYB. While additional data are needed to better understand how factors such as behavior and oceanographic conditions contribute to the longevity of eDNA signals, these results add to a growing body of work indicating that eDNA is a promising tool to complement visual and acoustic surveys of marine megafauna

Structural and molecular rationale for the diversification of resistance mediated by the Antibiotic_NAT family

The environmental microbiome harbors a vast repertoire of antibiotic resistance genes (ARGs) which can serve as evolutionary predecessors for ARGs found in pathogenic bacteria, or can be directly mobilized to pathogens in the presence of selection pressures. Thus, ARGs from benign environmental bacteria are an important resource for understanding clinically relevant resistance. Here, we conduct a comprehensive functional analysis of the Antibiotic_NAT family of aminoglycoside acetyltransferases. We determined a pan-family antibiogram of 21 Antibiotic_NAT enzymes, including 8 derived from clinical isolates and 13 from environmental metagenomic samples. We find that environment-derived representatives confer high-level, broad-spectrum resistance, including against the atypical aminoglycoside apramycin, and that a metagenome-derived gene likely is ancestral to an aac(3) gene found in clinical isolates. Through crystallographic analysis, we rationalize the molecular basis for diversification of substrate specificity across the family. This work provides critical data on the molecular mechanism underpinning resistance to established and emergent aminoglycoside antibiotics and broadens our understanding of ARGs in the environment

Select Biomarkers on the Day of Anterior Cruciate Ligament Reconstruction Predict Poor Patient-Reported Outcomes at 2-Year Follow-Up: A Pilot Study

Background. The majority of patients develop posttraumatic osteoarthritis within 15 years of anterior cruciate ligament (ACL) injury. Inflammatory and chondrodegenerative biomarkers have been associated with both pain and the progression of osteoarthritis; however, it remains unclear if preoperative biomarkers differ for patients with inferior postoperative outcomes. Hypothesis/Purpose. The purpose of this pilot study was to compare biomarkers collected on the day of ACL reconstruction between patients with good or poor 2-year postoperative outcomes. We hypothesized that inflammatory cytokines and chondrodegenerative biomarker concentrations would be significantly greater in patients with poorer outcomes. Study Design. Prospective cohort design. Methods. 22 patients (9 females, 13 males; age = 19.5 ± 4.1 years; BMI = 24.1 ± 3.6 kg/m2) previously enrolled in a randomized trial evaluating early anti-inflammatory treatment after ACL injury. Biomarkers of chondrodegeneration and inflammation were assessed from synovial fluid (sf) samples collected on the day of ACL reconstruction. Participants completed Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) questionnaires two years following surgery. Patients were then categorized based on whether their KOOS Quality of Life (QOL) score surpassed the Patient Acceptable Symptom State (PASS) threshold of 62.5 points or the IKDC PASS threshold of 75.9 points. Results. Patients that failed to reach the QOL PASS threshold after surgery (n = 6, 27%) had significantly greater sf interleukin-1 alpha (IL-1α; p = 0.004), IL-1 receptor antagonist (IL-1ra; p = 0.03), and matrix metalloproteinase-9 (MMP-9; p = 0.01) concentrations on the day of surgery. Patients that failed to reach the IKDC PASS threshold (n = 9, 41%) had significantly greater sf IL-1α (p = 0.02). Conclusion. These pilot data suggest that initial biochemical changes after injury may be an indicator of poor outcomes that are not mitigated by surgical stabilization alone. Biological adjuvant treatment in addition to ACL reconstruction may be beneficial; however, these data should be used for hypothesis generation and more definitive randomized clinical trials are necessary

HIV Infection and the Risk of World Health Organization-Defined Sudden Cardiac Death

Background People living with HIV have higher sudden cardiac death (SCD) rates compared with the general population. Whether HIV infection is an independent SCD risk factor is unclear. Methods and Results This study evaluated participants from the Veterans Aging Cohort Study, an observational, longitudinal cohort of veterans with and without HIV infection matched 1:2 on age, sex, race/ethnicity, and clinical site. Baseline for this study was a participant\u27s first clinical visit on or after April 1, 2003. Participants were followed through December 31, 2014. Using Cox proportional hazards regression, we assessed whether HIV infection, CD4 cell counts, and/or HIV viral load were associated with World Health Organization (WHO)–defined SCD risk. Among 144 336 participants (30% people living with HIV), the mean (SD) baseline age was 50.0 years (10.6 years), 97% were men, and 47% were of Black race. During follow‐up (median, 9.0 years), 3035 SCDs occurred. HIV infection was associated with increased SCD risk (hazard ratio [HR], 1.14; 95% CI, 1.04–1.25), adjusting for possible confounders. In analyses with time‐varying CD4 and HIV viral load, people living with HIV with CD4 counts \u3c 200 cells/mm3 (HR, 1.57; 95% CI, 1.28–1.92) or viral load \u3e 500 copies/mL (HR, 1.70; 95% CI, 1.46–1.98) had increased SCD risk versus veterans without HIV. In contrast, people living with HIV who had CD4 cell counts \u3e 500 cells/mm3 (HR, 1.03; 95% CI, 0.90–1.18) or HIV viral load \u3c 500 copies/mL (HR, 0.97; 95% CI, 0.87–1.09) were not at increased SCD risk. Conclusions HIV infection is associated with increased risk of WHO‐defined SCD among those with elevated HIV viral load or low CD4 cell counts

Challenges in quantifying changes in the global water cycle

Human influences have likely already impacted the large-scale water cycle but natural variability and observational uncertainty are substantial. It is essential to maintain and improve observational capabilities to better characterize changes. Understanding observed changes to the global water cycle is key to predicting future climate changes and their impacts. While many datasets document crucial variables such as precipitation, ocean salinity, runoff, and humidity, most are uncertain for determining long-term changes. In situ networks provide long time-series over land but are sparse in many regions, particularly the tropics. Satellite and reanalysis datasets provide global coverage, but their long-term stability is lacking. However, comparisons of changes among related variables can give insights into the robustness of observed changes. For example, ocean salinity, interpreted with an understanding of ocean processes, can help cross-validate precipitation. Observational evidence for human influences on the water cycle is emerging, but uncertainties resulting from internal variability and observational errors are too large to determine whether the observed and simulated changes are consistent. Improvements to the in situ and satellite observing networks that monitor the changing water cycle are required, yet continued data coverage is threatened by funding reductions. Uncertainty both in the role of anthropogenic aerosols, and due to large climate variability presently limits confidence in attribution of observed changes

The Grizzly, September 9, 2004

Make a Difference: How to Register to Vote • Computer Thefts Under Investigation • Republicans say Yes to Four More Years with Bush • A Costly Look at Carelessness • STAR Sponsors One Night • Turnpike Tolls Increase for Commuters • Insider\u27s Tips to Undergraduate and Graduate Awards • Been to Synagogue Lately? • Safety First • Segregation by Letter? • The Pop-up Problem • UC Fringe Festival Opens Wednesday • Parking at Ursinus Robs Convenience • Opinions: Is Technology Making Life Easier or Lazier?; Life During Wartime; Lick it, Stamp it, Mail it and then Rock the Vote • 2004 Bears Football Outlook • UC Hires new Cross Country / Track & Field Coach • Now that Stanton is Gone: Men\u27s Basketball Preview • Bearcox Preview • Olympic Games: Competitive or Controversial?https://digitalcommons.ursinus.edu/grizzlynews/1563/thumbnail.jp