Developing Extension Professionals to Develop Extension Programs: A Case Study for the Changing Face of Extension

Development of Cooperative Extension programs depends upon the skills and abilities of competent Extension professionals. The most effective manner of building program development competencies in these Extension professionals is through professional development. A wide variety of competencies are necessary for Extension professionals to develop programs, including strong interpersonal skills. Differences exist between the professional development efforts of Extension institutions and are highlighted herein. Major challenges to delivery of professional development include time and budget, but these can be overcome through planning and innovation and use of online or hybrid methods. Professional development for program development is essential to furthering Extension’s mission, especially during times of rapid change

A zebrafish functional genomics model to investigate the role of human A20 variants in vivo

Germline loss-of-function variation in TNFAIP3, encoding A20, has been implicated in a wide variety of autoinflammatory and autoimmune conditions, with acquired somatic missense mutations linked to cancer progression. Furthermore, human sequence data reveals that the A20 locus contains ~ 400 non-synonymous coding variants, which are largely uncharacterised. The growing number of A20 coding variants with unknown function, but potential clinical impact, poses a challenge to traditional mouse-based approaches. Here we report the development of a novel functional genomics approach that utilizes a new A20-deficient zebrafish (Danio rerio) model to investigate the impact of TNFAIP3 genetic variants in vivo. A20-deficient zebrafish are hyper-responsive to microbial immune activation and exhibit spontaneous early lethality. Ectopic addition of human A20 rescued A20-null zebrafish from lethality, while missense mutations at two conserved A20 residues, S381A and C243Y, reversed this protective effect. Ser381 represents a phosphorylation site important for enhancing A20 activity that is abrogated by its mutation to alanine, or by a causal C243Y mutation that triggers human autoimmune disease. These data reveal an evolutionarily conserved role for TNFAIP3 in limiting inflammation in the vertebrate linage and show how this function is controlled by phosphorylation. They also demonstrate how a zebrafish functional genomics pipeline can be utilized to investigate the in vivo significance of medically relevant human TNFAIP3 gene variants.Daniele Cultrone, Nathan W. Zammit, Eleanor Self, Benno Postert, Jeremy Z. R. Han, Jacqueline Bailey ... et al

Effects of a mutual recovery intervention on mental health in depressed elderly community-dwelling adults: a pilot study

BackgroundThe prevalence of depression in the elderly is growing worldwide, and the population aging in China makes depression a major health problem for the elderly adults and a tremendous burden to the society. Effective interventions should be determined to provide an approach solving the problem and improving the situation. This study examined the effectiveness of a mutual recovery program intervention on depressive symptom, sleep quality, and well-being in community-dwelling elderly adults with depressive symptom in Shanghai.MethodsRecruitment was performed between July 2012 and August 2012. Using a cluster randomized wait-list controlled design, we randomized 6 communities (n = 237) into either the intervention group (3 communities, n = 105) or to a wait-list control group (3 communities, n = 132). All participants met the inclusion criteria for depression, which were defined by The Geriatric Depression Scale (GDS-15). From March to May of 2013, participants in the intervention group underwent a 2-month mutual recovery program intervention. The intervention included seven 90-min, weekly sessions that were based on a standardized self-designed schedule. Depression was used as primary outcome at three measurement moments: baseline (T1), before intervention at 24 weeks (T2), and immediately after intervention at 32 weeks (T3). Well-being and sleep quality were used as the secondary outcomes, and were evaluated based on the WHO-5 Well-being Index (WHO-5) and the Self-administered Sleep Questionnaire (SSQ). Finally, a total of 225 participants who completed all the sessions and the three measurements entered the final analysis. Mixed-model repeated measures ANOVAs were performed to estimate the intervention effects.ResultsThere was no significant difference in gender, marriage, age structure, post-work type, and education background between the intervention and control group at baseline. Multivariate ANOVAs showed that there was no significant difference within the groups in terms of sleep, well-being, and depression at baseline and before the intervention. Mixed-model repeated measures ANOVAs detected a group × time interaction on depression, sleep, and well-being and showed a favorable intervention effect within groups immediately after the intervention.ConclusionsThe mutual recovery program could be a creative and effective approach to improve mental health in older community-dwelling adults with depressive symptom

Langzeitresultate der Behandlung von Schallleitungsstörung bei Kindern mit dem Knochenleitungshörgerät ADHEAR

Hintergrund: Stirnbandintegrierte Knochenleitungshörgeräte (SBKL-HGs) erzielen bei Kindern mit permanenten Schallleitungsstörungen oder chronisch drainierenden Ohren wegen Kopfdrucks, Schwitzens oder kosmetischer Stigmata oft nur eine mäßige Trageakzeptanz. Eine Alternative bietet das Knochenleitungshörgerät ADHEAR mit einem Audioprozessor auf einem mastoidal aufgeklebten Pflaster. Eine Anwenderstudie evaluierte den audiologischen und klinischen Nutzen des Systems verglichen mit dem durch SBKL-HGs erreichten.Material und Methoden: Zehn schallleitungsgestörte Kinder (0.7-9.7 Jahre) nutzen vergleichend das ADHEAR und SBKL-HGs. Die unverstärkten und verstärkten Ton- bzw. Reaktionsschwellen sowie das Sprachverstehen in Ruhe und Störschall wurden initial mit beiden Geräten und nach 8 Wochen allein mit dem ADHEAR gemessen. Fragebogenbasiert wurden Trageverhalten sowie Patienten- und Elternzufriedenheit bewertet. Mittlerweile liegen Langzeitergebnisse vor, und vier weitere Kinder wurden mit ADHEAR-Geräten versorgt.Ergebnisse: Bereits bei der ersten Anwendung überstieg der funktionelle Gewinn mit dem ADHEAR, gemittelt über 0.5, 1, 2, und 4 kHz, den mit SBKL-HGs erreichten (34.7 dB ± 14.1 vs. 27.7 dB ± 14.7, p=.012, n=11 Ohren) (Neumann et al. 2019). Das Sprachverstehen in Ruhe und Störschall (n=8) verbesserte sich für beide Gerätetypen vergleichbar gegenüber der unversorgten Situation. Die Eltern von acht Kindern bewerteten das ADHEAR als nützlich. Nach durchschnittlich 13 Monaten Tragedauer (n=4) verbesserten sich der durchschnittliche funktionelle Gewinn mit dem ADHEAR, Pflasterhalt und Trageakzeptanz weiter. Acht Wochen nach Erstanpassung trugen sechs, ein Jahr später acht Kinder das ADHEAR dauerhaft, ebenso die vier weiteren Kinder.Diskussion: Mittlerweile nutzen 12 von 14 Kindern das ADHEAR dauerhaft, darunter zwei mit Mehrfachbehinderung. Anfängliche Probleme bezüglich Tragekomforts, Pflasterhalts, Hautreaktionen und Rückkopplungspfeifen wurden weitgehend überwunden. Ein Kind erhielt ein Mittelohrimplantat, für ein weiteres läuft die Vorbereitung dafür.Fazit: Das ADHEAR bietet damit eine gute Versorgungsoption für Kinder mit Schallleitungsstörungen oder chronisch drainierenden Ohren

Basal ganglia alterations and brain atrophy in Huntington's disease depicted by transcranial real time sonography

OBJECTIVES AND METHODS—Transcranial real time sonography (TCS) was applied to 49 patients with Huntington's disease and 39 control subjects to visualise alterations in the echotexture of the basal ganglia. For comparison T1 weighted, T2 weighted, and fast spin echo MRI was performed in 12 patients with Huntington's disease with and in nine patients without alterations of the basal ganglia echotexture as detected by TCS and T1 weighted, T2 weighted, and fast spin echo MRI. Furthermore, the widths of the frontal horns, third ventricle, and the lateral ventricles were depicted in TCS examinations and correlations examined with corresponding CT slices.
RESULTS—Eighteen out of 45 (40%) of the patients with Huntington's disease with adequate insonation conditions showed hyperechogenic lesions of at least one basal ganglia region. In 12 patients TCS depicted hyperechogenic lesions of the substantia nigra; in six patients the head of the caudate nucleus was affected. The lentiform nucleus (n=3) and the thalamus (n=0) were less often affected or spared. Hyperechogenic lesions were significantly more frequent in patients with Huntington's disease than in 39 control subjects, who had alterations of the echotexture in 12.8% (4/39) of the examinations. The number of CAG repeats and the clinical status correlated with the identification of hyperechogenic lesions of the substantia nigra (p<0.01). Hyperechogenic lesions of the caudate nucleus were associated with an increased signal intensity in T2 weighted MR images (p<0.05). All TCS parameters indicating brain atrophy correlated with CT findings (p<0.0001).
CONCLUSIONS—TCS detects primarily abnormalities of the caudate nucleus and substantia nigra in Huntington's disease. These changes in the echotexture may represent degenerative changes in the basal ganglia matrix and are partially associated with CAG repeat expansion and the severity of clinical findings.


Detecting Stripe Artifacts in Ultrasound Images

Brain perfusion diseases such as acute ischemic stroke are detectable through computed tomography (CT)-/magnetic resonance imaging (MRI)-based methods. An alternative approach makes use of ultrasound imaging. In this low-cost bedside method, noise and artifacts degrade the imaging process. Especially stripe artifacts show a similar signal behavior compared to acute stroke or brain perfusion diseases. This document describes how stripe artifacts can be detected and eliminated in ultrasound images obtained through harmonic imaging (HI). On the basis of this new method, both proper identification of areas with critically reduced brain tissue perfusion and classification between brain perfusion defects and ultrasound stripe artifacts are made possible