The Chopin Etudes: a Study Guide for Teaching and Learning Opus 10 and Opus 25

The etudes of Chopin are masterworks of the piano literature and are designed to go beyond mere technical exercises; moreover, each etude represents not only a technical study but also has a distinct musical character. Alarmingly, the current trend seems to be to assign the Chopin etudes at an increasingly young age to students who are not yet equipped either technically or musically to handle them. As Chopin’s pupil, Carl Mikuli, commented in the preface to his Chopin edition, the etudes were meant for “more advanced students.” If Chopin had intended his etudes for students at an intermediate level, he would have assigned them to most of his students; however, only a limited number of students had his permission to work on their master’s etudes. As a teacher, I have always felt the need to devise a systematic teaching plan to guide students to handle the challenges of these pieces both physically and musically. This study examines the repertoire which might help prepare a student to learn the etudes without overstraining his/her muscular and mental ability. Rooted in Chopin’s teaching and his recommendation of the pieces to learn before tackling the etudes themselves, this pedagogical study guide intends to help students and teachers to work progressively towards the study of these works. While pinpointing some exercises and simple pieces to assign to a student in preparation for studying the individual etudes, helpful works of later composers are also liberally incorporated, as well as some suggestions for practicing the etudes themselves. Finally, I shall provide my own “re-ordering” of the etudes, with a progressive degree of difficulty, as an additional aid to a young pianist who may eventually want to learn the entire opus 10 and opus 25

Wnt/β-Catenin Signaling Pathway Is Necessary for the Specification but Not the Maintenance of the Mouse Retinal Pigment Epithelium

β-Catenin (Ctnnb1) has been shown to play critical roles in the development and maintenance of epithelial cells, including the retinal pigment epithelium (RPE). Ctnnb1 is not only a component of intercellular junctions in the epithelium, it also functions as a transcriptional regulator in the Wnt signaling pathway. To identify which of its functional modalities is critically involved in mouse RPE development and maintenance, we varied Ctnnb1 gene content and activity in mouse RPE lineage cells and tested their impacts on mouse eye development. We found that a Ctnnb1 double mutant (Ctnnb1$^{dm}$), which exhibits impaired transcriptional activity, could not replace Ctnnb1 in the RPE, whereas Ctnnb1$^{Y654E}$, which has reduced affinity for the junctions, could do so. Expression of the constitutively active Ctnnb$^{1∆ex3}$ mutant also suppressed the development of RPE, instead facilitating a ciliary cell fate. However, the post-mitotic or mature RPE was insensitive to the loss, inactivation, or constitutive activation of Ctnnb1. Collectively, our results suggest that Ctnnb1 should be maintained within an optimal range to specify RPE through transcriptional regulation of Wnt target genes in the optic neuroepithelium

Wnt/β-Catenin Signaling Pathway Is Necessary for the Specification but Not the Maintenance of the Mouse Retinal Pigment Epithelium

β-Catenin (Ctnnb1) has been shown to play critical roles in the development and maintenance of epithelial cells, including the retinal pigment epithelium (RPE). Ctnnb1 is not only a component of intercellular junctions in the epithelium, it also functions as a transcriptional regulator in the Wnt signaling pathway. To identify which of its functional modalities is critically involved in mouse RPE development and maintenance, we varied Ctnnb1 gene content and activity in mouse RPE lineage cells and tested their impacts on mouse eye development. We found that a Ctnnb1 double mutant (Ctnnb1dm), which exhibits impaired transcriptional activity, could not replace Ctnnb1 in the RPE, whereas Ctnnb1Y654E, which has reduced affinity for the junctions, could do so. Expression of the constitutively active Ctnnb1∆ex3 mutant also suppressed the development of RPE, instead facilitating a ciliary cell fate. However, the post-mitotic or mature RPE was insensitive to the loss, inactivation, or constitutive activation of Ctnnb1. Collectively, our results suggest that Ctnnb1 should be maintained within an optimal range to specify RPE through transcriptional regulation of Wnt target genes in the optic neuroepithelium.</p

Sex differences in the factors that affect medical lethality in elderly suicide attempters

ObjectivesThis study aimed to identify sex differences in the factors that affect medical lethality in elderly suicide attempters.MethodsA total of 253 elderly suicide attempters and 351 middle-aged attempters (comparison group) who visited the emergency room at a general hospital were included. The sociodemographic and clinical characteristics of the patients were investigated. The Chi-squared test and logistic regression analysis were performed. And Spearman’s correlation coefficient was calculated.ResultsIn older males, the risk of high lethality was lower when attempting suicide due to the loss of family members [adjusted odds ratio (AOR): 0.08]. The risk increased as the intent to die became more certain (some AOR: 11.31, certain AOR: 28.75), and this association became more pronounced with age (rho middle-aged: 0.329; young-old: 0.387; old-old: 0.415). In older females, the risk was lower when employed (AOR: 0.28). The method of suicide attempt also affected lethality (agricultural chemicals AOR: 3.71; psychiatric medication AOR: 0.31).ConclusionSex differences in the factors that affect medical lethality were identified among elderly suicide attempters. In particular, medical lethality can be predicted by the degree of suicide intention in older males. These findings will help to establish more efficient preventive strategies with specific targets

Use of smart glasses for ultrasound-guided peripheral venous access: a randomized controlled pilot study

Objective Smart glasses can provide sonographers with real-time ultrasound images. In the present study, we aimed to evaluate the utility of smart-glasses for ultrasound-guided peripheral venous access. Methods In this randomized, crossover-design, simulation study, 12 participants were recruited from the emergency department residents at a university hospital. Each participant attempted ultrasound-guided peripheral venous access on a pediatric phantom at intervals of 5 days with (glasses group) or without (non-glasses group) the use of smart glasses. In the glasses group, participants confirmed the ultrasound image through the lens of the smart glasses. In the non-glasses group, participants confirmed the ultrasound image through the display viewer located next to the phantom. Procedure time was regarded as the primary outcome, while secondary outcomes included the number of head movements for the participant, number of skin punctures, number of needle redirections, and subjective difficulty. Results No significant differences in procedural time were observed between the groups (non-glasses group: median time, 15.5 seconds; interquartile range [IQR], 10.3 to 27.3 seconds; glasses group: median time, 19.0 seconds; IQR, 14.3 to 39.3 seconds; P=0.58). The number of head movements was lower in the glasses group than in the non-glasses group (glasses group: median, 0; IQR, 0 to 0; non-glasses group: median, 4; IQR, 3 to 5; P<0.01). No significant differences in the number of skin punctures or needle restrictions were observed between the groups. Conclusion Our results indicate that smart-glasses may aid in ensuring ultrasound-guided peripheral venous access by reducing head movements

Factors associated with satisfaction with pediatric emergency department services in Korea: analysis of Korea Health Panel Data 2010 to 2012

Objective We aimed to investigate the factors related to satisfaction with the pediatric emergency department service in Korea. Methods This study examined data from the Korea Health Panel Data from 2010 to 2012. Pediatric patients who visited the emergency department at least once between 2010 and 2012 in Korea were included. Data were collected on patient satisfaction with the emergency department service, and factors related to the patient characteristics, emergency department service process, and medical institution. We compared the dissatisfied and satisfied groups, and calculated the odds ratios for satisfaction according to each variable. Results A total of 1,505 emergency department visits from 947 pediatric patients during the 3-year period were analyzed. We estimated that about 79.5% of patients in the population were satisfied. The odds of expressing satisfaction were higher among males than in females, and among patients who were hospitalized after emergency department treatment compared to those who were transferred to another hospital. Conversely, the odds of expressing satisfaction were lower among patients who had a chronic disease, a financial source other than National Health Insurance, experienced hospitalization within 1 year. Conclusion Our study results might be helpful for establishing a satisfactory pediatric emergency medical service system. In the future, further prospective studies evaluating the causal relationships between the relevant factors and patient satisfaction are warranted

THE EFFECTS OF WEARING ROLLER SHOES ON GROUND REACTION FORCE CHARACTERISTICS DURING WALKING

Roller shoes have become increasingly popular among children and it features retractable wheels which allowing the user to walk or roll without changing the footwear. Maintaining balance during forward walking with roller shoes is not an easy task. To prevent falling backward, the user needs to lock the knees and tighten the ankles and thighs while the upper body is slightly leaning forward. Constant walking with roller shoes forces the user to walk in a manner much different from normal gait. Prolonged exposure to un-natural stresses on human body forces our body to evolve by strengthening those incorrect, and temporary functions (Clement et aI., 1981). For children, the chronic stress may lead to serious injuries in the lower extremity later in life. If any potential' of injury exists in a movement it is critical to examine the associated forces that may lead to injury. To the best of our knowledge, the effects of wearing roller shoes on ground reaction forces (GRF) characteristics have rarely been studied, especially in the youth population. Thus, the purpose of this study was to compare GRF characteristics during walking wearing jogging and roller shoes