Adoption of innovative e-learning support for teaching: A multiple case study at the University of Waikato

In response to recent social, economic, and pedagogical challenges to tertiary-level teaching and learning, universities are increasingly investigating and adopting elearning as a way to engage and motivate students. This paper reports on the first year of a two-year (2009-2010) qualitative multiple case study research project in New Zealand. Using perspectives from activity theory and the scholarship of teaching, the research has the overall goal of documenting, developing, and disseminating effective and innovative practice in which e-learning plays an important role in tertiary teaching. A “snapshot” of each of the four 2009 cases and focused findings within and across cases are provided. This is followed by an overall discussion of the context, “within” and “across” case themes, and implications of the research

Multiple POT1–TPP1 Proteins Coat and Compact Long Telomeric Single-Stranded DNA

Telomeres are nucleoprotein complexes that cap and protect the ends of linear chromosomes. In humans, telomeres end in 50–300 nt of G-rich single-stranded DNA (ssDNA) overhangs. Protection of telomeres 1 (POT1) binds with nanomolar affinity to the ssDNA overhangs and forms a dimer with another telomere-end binding protein called TPP1. Whereas most previous studies utilized telomeric oligonucleotides comprising single POT1–TPP1 binding sites, here, we examined 72- to 144-nt tracts of telomeric DNA containing 6–12 POT1–TPP1 binding sites. Using electrophoretic mobility gel shift assays, size-exclusion chromatography, and electron microscopy, we analyzed telomeric nucleoprotein complexes containing POT1 alone, POT1–TPP1, and a truncated version of POT1 (POT1-N) that maintains its DNA-binding domain. The results revealed that POT1-N and POT1–TPP1 can completely coat long telomeric ssDNA substrates. Furthermore, we show that ssDNA coated with human POT1–TPP1 heterodimers forms compact, potentially ordered structures

Predictores de una estancia hospitalaria prolongada en una Unidad Integral para Atención de Accidente Cerebrovascular

Objetivo Analizar las complicaciones intrahospitalarias de estancia hopitalaria prolongada en pacientes con accidente cerebrovascular isquémico o accidente isquémico transitorio, ingresados en la unidad de accidente cerebrovascular de un hospital terciario. Método Se trata de un estudio evaluativo correlacional. Todos los primeros pacientes con accidente cerebrovascular isquémico o ataque isquémico transitorio ingresados fueron analizados retrospectivamente. Durante la estancia hospitalaria, los factores predictivos de hospitalización prolongada considerados fueron: 1) complicaciones clínicas (neumonía, infección del tracto urinario, daño por presión y trombosis venosa profunda), y 2) complicaciones neurológicas (accidente cerebrovascular isquémico maligno y transformación hemorrágica sintomática). Resultados 353 pacientes fueron dados de alta en el período de estudio. La edad media fue de 64,1±13,7 años y 186 (52,6%) eran hombres. El tiempo medio de estancia hospitalaria fue de 13,7±14,3 días. La neumonía (25,3±28,8 días, p<0,001), la infección del tracto urinario (32,9±45,2 días, p<0,001) y el accidente cerebrovascular maligno (29,1±21,4 días, p<0,001) aumentado significativamente la duración de la estancia hospitalaria en comparación con los pacientes sin ninguna complicación (11.2±7.1 días). Conclusión Este estudio mostró que de las tres complicaciones retrasaron el alta hospitalaria en pacientes ingresados en una unidad de accidente cerebrovascular, dos eran prevenibles: la neumonía y la infección del tracto urinario. Las medidas más intensas para evitarlas deben incluirse en los indicadores de rendimiento para reducir la duración de la estancia hospitalaria en unidades de accidente cerebrovascular.Objective to analyze the in-hospital complications of prolonged hospital stay in patients with ischemic stroke or transient ischemic attack, admitted to the stroke unit of a tertiary hospital. Method this is an evaluative correlational study. All first-ever ischemic stroke or transient ischemic attack patients admitted were retrospectively analyzed. During hospital stay, the predictors of long-term hospitalization considered were: 1) clinical complications (pneumonia, urinary tract infection, pressure damage and deep vein thrombosis), and 2) neurological complications (malignant ischemic stroke and symptomatic hemorrhagic transformation). Results 353 patients were discharged in the study period. Mean age was 64.1±13.7 years old and 186 (52.6%) were men. The mean time of hospital stay was 13.7±14.3 days. Pneumonia (25.3±28.8 days, p<0.001), urinary tract infection (32.9±45.2 days, p<0.001) and malignant stroke (29.1±21.4 days, p<0.001) increased significantly the length of hospital stay compared to patients without any complications (11.2±7.1 days). Conclusion this study showed that three complications delayed hospital discharge in patients admitted in a stroke unit, two preventable ones: pneumonia and urinary tract infection. More intense measures to avoid them should be included in the performance indicators to reduce the length of hospital stay in stroke units.Objetivo analisar as complicações intra-hospitalares de internação prolongada em pacientes com AVC isquêmico ou ataque isquêmico transitório, internados na unidade de AVC de um hospital terciário. Método trata-se de um estudo correlacional avaliativo. Todos os pacientes com primeira incidência de acidente vascular cerebral isquêmico ou ataque isquêmico transitório admitidos foram analisados retrospectivamente. Durante a internação hospitalar, os fatores preditores de internação prolongada foram: 1) complicações clínicas (pneumonia, infecção do trato urinário, lesão por pressão e trombose venosa profunda), e 2) complicações neurológicas (acidente vascular cerebral isquêmico maligno e transformação hemorrágica sintomática). Resultados 353 pacientes receberam alta no período do estudo. A média de idade foi de 64,1±13,7 anos e 186 (52,6%) eram homens. O tempo médio de internação hospitalar foi de 13,7±14,3 dias. Pneumonia (25,3±28,8 dias, p<0,001), infecção do trato urinário (32,9±45,2 dias, p<0,001) e acidente vascular cerebral maligno (29,1±21,4 dias, p<0,001) aumentaram significativamente o tempo de permanência hospitalar em relação aos pacientes sem quaisquer complicações (11,2±7,1 dias). Conclusão este estudo mostrou que três complicações atrasaram a alta hospitalar em pacientes internados em uma unidade de AVC, duas delas evitáveis: pneumonia e infecção do trato urinário. Medidas mais intensas para evitá-las devem ser incluídas nos indicadores de desempenho para reduzir o tempo de permanência hospitalar nas unidades de AVC

Acidentes por quedas e fratura do fêmur na população idosa

Aim: this study aims to know the characteristics of elderly people hospitalized for femoral fracture and extrinsic factors related to accidents due to falls. Method: this is a crosssectional and descriptive study, carried out from February 2012 to February 2013, with 108 elderly patients hospitalized due to a femoral fracture in a medium-sized hospital in Pelotas city. The variables of socioeconomic and demographic data were analysed in relation to the extrinsic factors of falls in the elderly population. Results: most of the interviewees were retired, widowed, literate, and suffered a fractured femur due to the fall in their own homes. Most of the houses did not have adaptations inside and the available rugs were not non-slip. Conclusions: the findings show that accidents due to falls can be avoided with simple measures; however an evaluation of the elderly and of the environment in which they live is necessary, identifying the risks for falls.Objetivo: conocer las características de ancianos hospitalizados con fractura de fémur y los factores externos relacionados a los accidentes por caídas. Método: estudio transversal y descriptivo, realizado en el período de febrero de 2012 a febrero de 2013, con 108 ancianos internados, en un hospital de porte mediano del municipio de Pelotas, debido a la fractura de fémur. Las variables analizadas fueron los datos socioeconómicos y demográficos relacionados a las causas de caídas de ancianos. Resultados: la mayoría de los dos entrevistados eran jubilados, viudos, sabían leer y escribir y tuvieron fractura del fémur a causa de caída en sus propias residencias. La mayoría de los domicilios no poseían adaptaciones en su interior y las alfombras disponibles no eran antideslizantes. Conclusión: los datos evidencian que los accidentes por caídas en la población anciana pueden ser evitados con medidas sencillas, pero se hace necesaria una evaluación de la persona anciana y del ambiente en que vive, identificando los que pueden tener riesgos por caídas.Objetivo: conhecer as características de idosos hospitalizados com fratura do fêmur e os fatores extrínsecos relacionados aos acidentes por quedas. Método: estudo transversal e descritivo, realizado no período de fevereiro de 2012 a fevereiro de 2013, com 108 idosos internados em um Hospital de médio porte do município de Pelotas devido a fratura do fêmur. As variáveis analisadas foram dados socioeconômicos e demográficos relacionados aos fatores extrínsecos de quedas em idosos. Resultados: a maior parte dos entrevistados eram aposentados, viúvos, sabiam ler e escrever e sofreram fratura do fêmur devido à queda em suas próprias residências. A maioria dos domicílios não possuía adaptações no seu interior e os tapetes disponíveis não eram antiderrapantes. Conclusão: os dados mostram que os acidentes por quedas na população idosa podem ser evitados com medidas simples, todavia se faz necessário uma avaliação da pessoa idosa e do ambiente em que vive, identificando os idosos com risco para quedas

Single-inhaler triple therapy fluticasone furoate/umeclidinium/vilanterol versus fluticasone furoate/vilanterol and umeclidinium/vilanterol in patients with COPD:results on cardiovascular safety from the IMPACT trial

BACKGROUND: This analysis of the IMPACT study assessed the cardiovascular (CV) safety of single-inhaler triple therapy with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) versus FF/VI and UMEC/VI dual therapy. METHODS: IMPACT was a 52-week, randomized, double-blind, multicenter Phase III study comparing the efficacy and safety of FF/UMEC/VI 100/62.5/25 mcg with FF/VI 100/25 mcg or UMEC/VI 62.5/25 mcg in patients ≥40 years of age with symptomatic chronic obstructive pulmonary disease (COPD) and ≥1 moderate/severe exacerbation in the previous year. The inclusion criteria for the study were intentionally designed to permit the enrollment of patients with significant concurrent CV disease/risk. CV safety assessments included proportion of patients with and exposure-adjusted rates of on-treatment CV adverse events of special interest (CVAESI) and major adverse cardiac events (MACE), as well as time-to-first (TTF) CVAESI, and TTF CVAESI resulting in hospitalization/prolonged hospitalization or death. RESULTS: Baseline CV risk factors were similar across treatment groups. Overall, 68% of patients (n = 7012) had ≥1 CV risk factor and 40% (n = 4127) had ≥2. At baseline, 29% of patients reported a current/past cardiac disorder and 58% reported a current/past vascular disorder. The proportion of patients with on-treatment CVAESI was 11% for both FF/UMEC/VI and UMEC/VI, and 10% for FF/VI. There was no statistical difference for FF/UMEC/VI versus FF/VI or UMEC/VI in TTF CVAESI (hazard ratio [HR]: 0.98, 95% confidence interval [CI]: 0.85, 1.11; p = 0.711 and HR: 0.92, 95% CI: 0.78, 1.08; p = 0.317, respectively) nor TTF CVAESI leading to hospitalization/prolonged hospitalization or death (HR: 1.19, 95% CI: 0.93, 1.51; p = 0.167 and HR: 0.96, 95% CI: 0.72, 1.27; p = 0.760, respectively). On-treatment MACE occurred in ≤3% of patients across treatment groups, with similar prevalence and rates between treatments. CONCLUSIONS: In a symptomatic COPD population with a history of exacerbations and a high rate of CV disease/risk, the proportion of patients with CVAESI and MACE was 10-11% and 1-3%, respectively, across treatment arms, and the risk of CVAESI was low and similar across treatment arms. There was no statistically significant increased CV risk associated with the use of FF/UMEC/VI versus FF/VI or UMEC/VI, and UMEC/VI versus FF/VI. TRIAL REGISTRATION: NCT02164513 (GSK study number CTT116855)

Providing the Missing Link: the Exposure Science Ontology ExO

Environmental health information resources lack exposure data required to translate molecular insights, elucidate environmental contributions to diseases, and assess human health and ecological risks. We report development of an Exposure Ontology, ExO, designed to address this information gap by facilitating centralization and integration of exposure data. Major concepts were defined and the ontology drafted and evaluated by a working group of exposure scientists and other ontology and database experts. The resulting major concepts forming the basis for the ontology are exposure stressor , exposure receptor , exposure event , and exposure outcome . Although design of the first version of ExO focused on human exposure to chemicals, we anticipate expansion by the scientific community to address exposures of human and ecological receptors to the full suite of environmental stressors. Like other widely used ontologies, ExO is intended to link exposure science and diverse environmental health disciplines including toxicology, epidemiology, disease surveillance, and epigenetics

Post hoc Analysis for Detecting Individual Rare Variant Risk Associations Using Probit Regression Bayesian Variable Selection Methods in Case-Control Sequencing Studies

Rare variants (RVs) have been shown to be significant contributors to complex disease risk. By definition, these variants have very low minor allele frequencies and traditional single-marker methods for statistical analysis are underpowered for typical sequencing study sample sizes. Multimarker burden-type approaches attempt to identify aggregation of RVs across case-control status by analyzing relatively small partitions of the genome, such as genes. However, it is generally the case that the aggregative measure would be a mixture of causal and neutral variants, and these omnibus tests do not directly provide any indication of which RVs may be driving a given association. Recently, Bayesian variable selection approaches have been proposed to identify RV associations from a large set of RVs under consideration. Although these approaches have been shown to be powerful at detecting associations at the RV level, there are often computational limitations on the total quantity of RVs under consideration and compromises are necessary for large-scale application. Here, we propose a computationally efficient alternative formulation of this method using a probit regression approach specifically capable of simultaneously analyzing hundreds to thousands of RVs. We evaluate our approach to detect causal variation on simulated data and examine sensitivity and specificity in instances of high RV dimensionality as well as apply it to pathway-level RV analysis results from a prostate cancer (PC) risk case-control sequencing study. Finally, we discuss potential extensions and future directions of this work

The POT1-TPP1 telomere complex is a telomerase processivity factor

Telomeres were originally defined as chromosome caps that prevent the natural ends of linear chromosomes from undergoing deleterious degradation and fusion events. POT1 ( protection of telomeres) protein binds the single-stranded G-rich DNA overhangs at human chromosome ends and suppresses unwanted DNA repair activities. TPP1 is a previously identified binding partner of POT1 that has been proposed to form part of a six-protein shelterin complex at telomeres. Here, the crystal structure of a domain of human TPP1 reveals an oligonucleotide/oligosaccharide-binding fold that is structurally similar to the beta-subunit of the telomere end-binding protein of a ciliated protozoan, suggesting that TPP1 is the missing beta-subunit of human POT1 protein. Telomeric DNA end-binding proteins have generally been found to inhibit rather than stimulate the action of the chromosome end-replicating enzyme, telomerase. In contrast, we find that TPP1 and POT1 form a complex with telomeric DNA that increases the activity and processivity of the human telomerase core enzyme. We propose that POT1 - TPP1 switches from inhibiting telomerase access to the telomere, as a component of shelterin, to serving as a processivity factor for telomerase during telomere extension.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/62923/1/nature05454.pd