Pandemic Teaching: Exploration of Instructional Method Shifts

COVID-19 forced educators to unexpectedly move to distance teaching, requiring a shift in instructional methods. This study examined practices instructors integrated into their online and face-to-face facilitation over the long term

Mechanisms Predisposing Penile Fracture And Long-term Outcomes On Erectile And Voiding Functions

Purpose. To determine the mechanisms predisposing penile fracture as well as the rate of long-term penile deformity and erectile and voiding functions. Methods. All fractures were repaired on an emergency basis via subcoronal incision and absorbable suture with simultaneous repair of eventual urethral lesion. Patients' status before fracture and voiding and erectile functions at long term were assessed by periodic follow-up and phone call. Detailed history included cause, symptoms, and single-question self-report of erectile and voiding functions. Results. Among the 44 suspicious cases, 42 (95.4%) were confirmed, mean age was 34.5 years (range: 18-60), mean follow-up 59.3 months (range 9-155). Half presented the classical triad of audible crack, detumescence, and pain. Heterosexual intercourse was the most common cause (28 patients, 66.7%), followed by penile manipulation (6 patients, 14.3%), and homosexual intercourse (4 patients, 9.5%). "Woman on top" was the most common heterosexual position (n = 14, 50%), followed by "doggy style" (n = 8, 28.6%). Four patients (9.5%) maintained the cause unclear. Six (14.3%) patients had urethral injury and two (4.8%) had erectile dysfunction, treated by penile prosthesis and PDE-5i. No patient showed urethral fistula, voiding deterioration, penile nodule/curve or pain. Conclusions. "Woman on top" was the potentially riskiest sexual position (50%). Immediate surgical treatment warrants long-term very low morbidity. © 2014 Leonardo O. Reis et al.Kamdar, C., Mooppan, U.M.M., Kim, H., Gulmi, F.A., Penile fracture: Preoperative evaluation and surgical technique for optimal patient outcome (2008) BJU International, 102 (11), pp. 1640-1644. , 2-s2.0-56649083856 10.1111/j.1464-410X.2008.07902.xKramer, A.C., Penile fracture seems more likely during sex under stressful situations (2011) Journal of Sexual Medicine, 8 (12), pp. 3414-3417. , 2-s2.0-82955237445 10.1111/j.1743-6109.2011.02461.xSawh, S.L., O'Leary, M.P., Ferreira, M.D., Berry, A.M., Maharaj, D., Fractured penis: A review (2008) International Journal of Impotence Research, 20 (4), pp. 366-369. , 2-s2.0-48249147767 10.1038/ijir.2008.12Amit, A., Arun, K., Bharat, B., Navin, R., Sameer, T., Shankar, D.U., Penile fracture and associated urethral injury: Experience at a tertiary care hospital (2013) Canadian Urological Association Journal, 7, pp. E168-E170Moslemi, M.K., Evaluation of epidemiology, concomitant urethral disruption and seasonal variation of penile fracture: A report of 86 cases (2013) Canadian Urological Association Journal, 7, pp. E572-E575Hatzichristodoulou, G., Dorstewitz, A., Gschwend, J.E., Herkommer, K., Zantl, N., Surgical management of penile fracture and long-term outcome on erectile function and voiding (2013) The Journal of Sexual Medicine, 10, pp. 1424-1430Nomura, J.T., Sierzenski, P.R., Ultrasound diagnosis of penile fracture (2010) Journal of Emergency Medicine, 38 (3), pp. 362-365. , 2-s2.0-77949914168 10.1016/j.jemermed.2008.03.010Ash, A., Miller, J., Preston, D., Point-of-care ultrasound used to exclude penile fracture (2012) Critical Ultrasound Journal, 417Beysel, M., Tekin, A., Gürdal, M., Yücebaş, E., Dengör, F., Evaluation and treatment of penile fractures: Accuracy of clinical diagnosis and the value of corpus cavernosography (2002) Urology, 60 (3), pp. 492-496. , 2-s2.0-0036753673 10.1016/S0090-4295(02)01813-7Gamal, W.M., Osman, M.M., Hammady, A., Aldahshoury, M.Z., Hussein, M.M., Saleem, M., Penile fracture:;ong-term results of surgical and conservative management (2011) Journal of Trauma, 71 (2), pp. 491-493. , 2-s2.0-80051783736 10.1097/TA.0b013e318209311

Onset of human preterm and term birth is related to unique inflammatory transcriptome profiles at the maternal fetal interface.

BackgroundPreterm birth is a main determinant of neonatal mortality and morbidity and a major contributor to the overall mortality and burden of disease. However, research of the preterm birth is hindered by the imprecise definition of the clinical phenotype and complexity of the molecular phenotype due to multiple pregnancy tissue types and molecular processes that may contribute to the preterm birth. Here we comprehensively evaluate the mRNA transcriptome that characterizes preterm and term labor in tissues comprising the pregnancy using precisely phenotyped samples. The four complementary phenotypes together provide comprehensive insight into preterm and term parturition.MethodsSamples of maternal blood, chorion, amnion, placenta, decidua, fetal blood, and myometrium from the uterine fundus and lower segment (n = 183) were obtained during cesarean delivery from women with four complementary phenotypes: delivering preterm with (PL) and without labor (PNL), term with (TL) and without labor (TNL). Enrolled were 35 pregnant women with four precisely and prospectively defined phenotypes: PL (n = 8), PNL (n = 10), TL (n = 7) and TNL (n = 10). Gene expression data were analyzed using shrunken centroid analysis to identify a minimal set of genes that uniquely characterizes each of the four phenotypes. Expression profiles of 73 genes and non-coding RNA sequences uniquely identified each of the four phenotypes. The shrunken centroid analysis and 10 times 10-fold cross-validation was also used to minimize false positive finings and overfitting. Identified were the pathways and molecular processes associated with and the cis-regulatory elements in gene's 5' promoter or 3'-UTR regions of the set of genes which expression uniquely characterized the four phenotypes.ResultsThe largest differences in gene expression among the four groups occurred at maternal fetal interface in decidua, chorion and amnion. The gene expression profiles showed suppression of chemokines expression in TNL, withdrawal of this suppression in TL, activation of multiple pathways of inflammation in PL, and an immune rejection profile in PNL. The genes constituting expression signatures showed over-representation of three putative regulatory elements in their 5'and 3' UTR regions.ConclusionsThe results suggest that pregnancy is maintained by downregulation of chemokines at the maternal-fetal interface. Withdrawal of this downregulation results in the term birth and its overriding by the activation of multiple pathways of the immune system in the preterm birth. Complications of the pregnancy associated with impairment of placental function, which necessitated premature delivery of the fetus in the absence of labor, show gene expression patterns associated with immune rejection

Yield-related salinity tolerance traits identified in a nested association mapping (NAM) population of wild barley

Producing sufficient food for nine billion people by 2050 will be constrained by soil salinity, especially in irrigated systems. To improve crop yield, greater understanding of the genetic control of traits contributing to salinity tolerance in the field is needed. Here, we exploit natural variation in exotic germplasm by taking a genome-wide association approach to a new nested association mapping population of barley called HEB-25. The large population (1,336 genotypes) allowed cross-validation of loci, which, along with two years of phenotypic data collected from plants irrigated with fresh and saline water, improved statistical power. We dissect the genetic architecture of flowering time under high salinity and we present genes putatively affecting this trait and salinity tolerance. In addition, we identify a locus on chromosome 2H where, under saline conditions, lines homozygous for the wild allele yielded 30% more than did lines homozygous for the Barke allele. Introgressing this wild allele into elite cultivars could markedly improve yield under saline conditions.Stephanie Saade, Andreas Maurer, Mohammed Shahid, Helena Oakey, Sandra M. Schmöckel, Sónia Negrão, Klaus Pillen and Mark Teste

NuSTAR Observations of AGN with Low Observed X-ray to [OIII] Luminosity Ratios: Heavily Obscured AGN or Turned-Off AGN?

Type 2 active galactic nuclei (AGN) show signatures of accretion onto a supermassive black hole through strong, high-ionization, narrow emission lines extended on scales of 100s to 1000s of parsecs, but they lack the broad emission lines from close in to the black hole that characterize type 1 AGN. The lack of broad emission could indicate obscuration of the innermost nuclear regions, or could indicate that the black hole is no longer strongly accreting. Since high-energy X-rays can penetrate thick obscuring columns, they have the power to distinguish these two scenarios. We present high-energy NuSTAR observations of 9 Seyfert 2 AGN from the IRAS 12 micron survey, supplemented with low-energy X-ray observations from Chandra, XMM-Newton, and Swift. The galaxies were selected to have anomalously low observed 2-10 keV luminosities compared to their [O III] optical luminosities, a traditional diagnostic of heavily obscured AGN, reaching into the Compton-thick regime for the highest hydrogen column densities ($N_{\rm H} > 1.5 \times 10^{24}\, {\rm cm}^{-2}$). Based on updated [O III] luminosities and intrinsic X-ray luminosities based on physical modeling of the hard X-ray spectra, we find that one galaxy was misclassified as type 2 (NGC 5005) and most of the remaining AGN are obscured, including three confirmed as Compton-thick (IC 3639, NGC 1386, and NGC 3982). One galaxy, NGC 3627, appears to be recently deactivated. Compared to the original sample the 9 AGN were selected from, this is a rate of approximately 1%. We also find a new X-ray changing-look AGN in NGC 6890.Comment: 42 pages, Accepted for publication in Ap

Prescription and Other Medication Use in Pregnancy

OBJECTIVE: To characterize prescription and other medication use in a geographically and ethnically diverse cohort of women in their first pregnancy. METHODS: In a prospective, longitudinal cohort study of nulliparous women followed through pregnancy from the first trimester, medication use was chronicled longitudinally throughout pregnancy. Structured questions and aids were used to capture all medications taken as well as reasons they were taken. Total counts of all medications taken including number in each category and class were captured. Additionally, reasons the medications were taken were recorded. Trends in medications taken across pregnancy and in the first trimester were determined. RESULTS: Of the 9,546 study participants, 9,272 (97.1%) women took at least one medication during pregnancy with 9,139 (95.7%) taking a medication in the first trimester. Polypharmacy, defined as taking at least five medications, occurred in 2,915 (30.5%) women. Excluding vitamins, supplements, and vaccines, 73.4% of women took a medication during pregnancy with 55.1% taking one in the first trimester. The categories of drugs taken in pregnancy and in the first trimester include the following: gastrointestinal or antiemetic agents (34.3%, 19.5%), antibiotics (25.5%, 12.6%), and analgesics (23.7%, 15.6%, which includes 3.6%; 1.4% taking an opioid pain medication). CONCLUSION: In this geographically and ethnically diverse cohort of nulliparous pregnant women, medication use was nearly universal and polypharmacy was common

Embodied GHG emissions of buildings – The hidden challenge for effective climate change mitigation

Buildings are major sources of greenhouse gas (GHG) emissions and contributors to the climate crisis. To meet climate-change mitigation needs, one must go beyond operational energy consumption and related GHG emissions of buildings and address their full life cycle. This study investigates the global trends of GHG emissions arising across the life cycle of buildings by systematically compiling and analysing more than 650 life cycle assessment (LCA) case studies. The results, presented for different energy performance classes based on a final sample of 238 cases, show a clear reduction trend in life cycle GHG emissions due to improved operational energy performance. However, the analysis reveals an increase in relative and absolute contributions of so‐called ‘embodied’ GHG emissions, i.e., emissions arising from manufacturing and processing of building materials. While the average share of embodied GHG emissions from buildings following current energy performance regulations is approximately 20–25% of life cycle GHG emissions, this figure escalates to 45–50% for highly energy-efficient buildings and surpasses 90% in extreme cases. Furthermore, this study analyses GHG emissions at time of occurrence, highlighting the ‘carbon spike’ from building production. Relating the results to existing benchmarks for buildings’ GHG emissions in the Swiss SIA energy efficiency path shows that most cases exceed the target of 11.0 kgCO$^{2}$eq/m$^{2}$a. Considering global GHG reduction targets, these results emphasize the urgent need to reduce GHG emissions of buildings by optimizing both operational and embodied impacts. The analysis further confirmed a need for improving transparency and comparability of LCA studies