Tablet‐based technology has become a conduit for the administration of curriculum‐based measurement (CBM) tools. Using tablets to administer CBM probes has many advantages; however, little is known ...about how students perform on CBMs when administered via a tablet. The current investigation compared digits correct per minute obtained from 44 third‐grade students on CBM addition fluency probes administered via three different modalities. Students completed the probes using traditional paper and pencil, a tablet using their fingers to write the answer, or a tablet application using a keyboard to type the answer. A within‐subjects group design showed students performed significantly better on the tablet when using their finger to write the answer, even though most students (58%) indicated this was their least preferred modality. The discussion focuses on the implications for educators and the use of different CBM modalities for interindividual and intraindividual comparisons.
Practitioner points
Third‐grade students responded to math facts faster when writing with their fingers on an iPad, even compared to paper and pencil.
The results are inconsistent with other studies that found students were faster when using paper and pencil.
Finally, most third‐grade students preferred answering addition facts with a pencil on paper.
Dental caries is a highly prevalent diet-related disease and is a major public health problem. A goal of modern dentistry is to manage non-cavitated caries lesions non-invasively through ...remineralization in an attempt to prevent disease progression and improve aesthetics, strength, and function. Remineralization is defined as the process whereby calcium and phosphate ions are supplied from a source external to the tooth to promote ion deposition into crystal voids in demineralized enamel, to produce net mineral gain. Recently, a range of novel calcium-phosphate-based remineralization delivery systems has been developed for clinical application. These delivery systems include crystalline, unstabilized amorphous, or stabilized amorphous formulations of calcium phosphate. These systems are reviewed, and the technology with the most scientific evidence to support its clinical use is the remineralizing system utilizing casein phosphopeptides to stabilize and deliver bioavailable calcium, phosphate, and fluoride ions. The recent clinical evidence for this technology is presented and the mechanism of action discussed. Biomimetic approaches to stabilization of bioavailable calcium, phosphate, and fluoride ions and the localization of these ions to non-cavitated caries lesions for controlled remineralization show promise for the non-invasive management of dental caries. PUBLICATION ABSTRACT
It is well documented that memory is heritable and that older adults tend to have poorer memory performance than younger adults. However, whether the magnitudes of genetic and environmental ...contributions to late-life verbal episodic memory ability differ from those at earlier ages remains unresolved. Twins from 12 studies participating in the Interplay of Genes and Environment in Multiple Studies (IGEMS) consortium constituted the analytic sample. Verbal episodic memory was assessed with immediate word list recall (N = 35,204 individuals; 21,792 twin pairs) and prose recall (N = 3805 individuals; 2028 twin pairs), with scores harmonized across studies. Average test performance was lower in successively older age groups for both measures. Twin models found significant age moderation for both measures, with total inter-individual variance increasing significantly with age, although it was not possible definitively to attribute the increase specifically to either genetic or environmental sources. Pooled results across all 12 studies were compared to results where we successively dropped each study (leave-one-out) to assure results were not due to an outlier. We conclude the models indicated an overall increase in variance for verbal episodic memory that was driven by a combination of increases in the genetic and nonshared environmental parameters that were not independently statistically significant. In contrast to reported results for other cognitive domains, differences in environmental exposures are comparatively important for verbal episodic memory, especially word list learning.
•Verbal episodic memory performance is poorer at older ages compared to midlife.•Individual variance in verbal episodic memory shows an increase across age.•Environmental variance unique to individuals is more important than genetic variance.•Genetic variance is greater for remembering a prose passage than a list of words.
Summary
Background
The British Association of Dermatologists Biologic Interventions Register (BADBIR) is a prospective, observational cohort designed to assess the long‐term safety of biologic and ...conventional systemic therapies used for adults with moderate‐to‐severe psoriasis in the U.K. and Republic of Ireland.
Objectives
To describe the demographics, disease severity and comorbidities of patients with psoriasis on enrolment into BADBIR, and to highlight differences in those commencing biologics compared with those on conventional systemic therapies.
Methods
Baseline data were collected from 151 dermatology departments in the U.K. and Republic of Ireland. Descriptive analysis was conducted.
Results
As of August 2014, 8399 patients were registered with BADBIR; 5065 (60%) received biologics, of whom 52·8% received adalimumab, 24·6% etanercept, 18·7% ustekinumab and 3·9% infliximab. In the comparator cohort 44·1% received methotrexate, 23·1% ciclosporin, 18·0% acitretin and 7·6% fumaric acid esters. Overall 4897 (58%) were male. Patients on biologics had a higher mean ± SD age and disease duration than patients on conventional systemic therapies (46·3 ± 12·7 vs. 44·3 ± 14·3 years and 23·0 ± 12·6 vs. 19·0 ± 13·4 years, respectively; both P < 0·001). Mean body mass index, Psoriasis Area and Severity Index and Dermatology Life Quality Index scores for patients on biologics were higher than for those on conventional systemic therapies (31·0 ± 7·2 vs. 30·1 ± 7·3 kg m−2; 16·4 ± 8·3 vs. 15·5 ± 7·9 and 17·4 ± 7·5 vs. 15·0 ± 7·1, respectively; all P < 0·001). In total 71% of all patients had comorbidities and 47% had more than one comorbidity. The most frequent comorbidities were obesity (42·1%), hypertension (25·7%), depression (22·1%) and psoriatic arthritis (17·1%).
Conclusions
BADBIR is an invaluable resource to study the safety and effectiveness of both biologic and conventional systemic therapies. Understanding differences in baseline characteristics between cohorts is crucial in undertaking future pharmacovigilance studies.
What's already known about this topic?
The baseline demographics of patients with psoriasis commencing biologic therapies are well described in the setting of clinical trials.
What does this study add?
Data collected by the British Association of Dermatologists Biologic Interventions Register reveal that the demographics (e.g. male‐to‐female ratio), phenotypes of psoriasis and comorbidities of patients with psoriasis commencing conventional systemic or biologic therapies in routine clinical practice in the U.K. and Republic of Ireland are different from those reported in a clinical trial setting.
Summary
Background
The persistence and effectiveness of systemic therapies for moderate‐to‐severe psoriasis in current clinical practice are poorly characterized.
Objectives
To systematically review ...observational studies investigating the persistence and effectiveness of acitretin, ciclosporin, fumaric acid esters (FAE) and methotrexate, involving at least 100 adult patients with moderate‐to‐severe psoriasis, exposed to therapy for ≥ 3 months.
Methods
MEDLINE, Embase, the Cochrane Library and PubMed were searched from 1 January 2007 to 1 November 2017 for observational studies reporting on persistence (therapy duration or the proportion of patients discontinuing therapy during follow‐up) or effectiveness improvements in Psoriasis Area and Severity Index (PASI) or Physician's Global Assessment (PGA). This review was registered with PROSPERO, number CRD42018099771.
Results
Of 411 identified studies, eight involving 4624 patients with psoriasis were included. Variations in the definitions and analyses of persistence and effectiveness outcomes prevented a meta‐analysis from being conducted. One prospective multicentre study reported drug survival probabilities of 23% (ciclosporin), 42% (acitretin) and 50% (methotrexate) at 1 year. Effectiveness outcomes were not reported for either acitretin or ciclosporin. The persistence and effectiveness of FAE and methotrexate were better characterized, but mean discontinuation times ranged from 28 to 50 months for FAE and 7·7 to 22·3 months for methotrexate. At 12 months of follow‐up, three studies reported that 76% (FAE), 53% (methotrexate) and 59% (methotrexate) of patients achieved ≥ 75% reduction in PASI, and one reported that 76% of FAE‐exposed patients achieved a markedly improved or clear PGA.
Conclusions
The comparative persistence and effectiveness of acitretin, ciclosporin, FAE and methotrexate in real‐world clinical practice in the past decade cannot be well described due to the inconsistency of the methods used.
What's already known about this topic?
Research examining acitretin, ciclosporin, fumaric acid esters (FAE) and methotrexate for the treatment of moderate‐to‐severe psoriasis has focused on safety and efficacy in randomized controlled trials.
The persistence and effectiveness of acitretin, ciclosporin, FAE and methotrexate since the introduction of biologic therapies in real‐world clinical practice are poorly understood.
What does this study add?
This systematic review examines the persistence and effectiveness of methotrexate, acitretin, ciclosporin and FAE for moderate‐to‐severe psoriasis.
Data on the persistence and effectiveness of systemic therapies are lacking, particularly for acitretin and ciclosporin.
The definitions of persistence and reporting of effectiveness are inconsistent.
Further good‐quality observational studies are needed to explore the real‐world persistence and effectiveness of systemic treatments used for psoriasis.
Linked Comment: Garcia-Doval and Sbidian. Br J Dermatol 2019; 181:237.
Plain language summary available online
The fraction of core-collapse supernovae (CCSNe) occurring in the central regions of galaxies is not well constrained at present. This is partly because large-scale transient surveys operate at ...optical wavelengths, making it challenging to detect transient sources that occur in regions susceptible to high extinction factors. Here we present the discovery and follow-up observations of two CCSNe that occurred in the luminous infrared galaxy (LIRG) NGC 3256. The first, SN 2018ec, was discovered using the ESO HAWK-I/GRAAL adaptive optics seeing enhancer, and was classified as a Type Ic with a host galaxy extinction of
A
V
= 2.1
−0.1
+0.3
mag. The second, AT 2018cux, was discovered during the course of follow-up observations of SN 2018ec, and is consistent with a subluminous Type IIP classification with an
A
V
= 2.1 ± 0.4 mag of host extinction. A third CCSN, PSN J10275082−4354034 in NGC 3256, was previously reported in 2014, and we recovered the source in late-time archival
Hubble
Space Telescope imaging. Based on template light curve fitting, we favour a Type IIn classification for it with modest host galaxy extinction of
A
V
= 0.3
−0.3
+0.4
mag. We also extend our study with follow-up data of the recent Type IIb SN 2019lqo and Type Ib SN 2020fkb that occurred in the LIRG system Arp 299 with host extinctions of
A
V
= 2.1
−0.3
+0.1
and
A
V
= 0.4
−0.2
+0.1
mag, respectively. Motivated by the above, we inspected, for the first time, a sample of 29 CCSNe located within a projected distance of 2.5 kpc from the host galaxy nuclei in a sample of 16 LIRGs. We find, if star formation within these galaxies is modelled assuming a global starburst episode and normal IMF, that there is evidence of a correlation between the starburst age and the CCSN subtype. We infer that the two subgroups of 14 H-poor (Type IIb/Ib/Ic/Ibn) and 15 H-rich (Type II/IIn) CCSNe have different underlying progenitor age distributions, with the H-poor progenitors being younger at 3
σ
significance. However, we note that the currently available sample sizes of CCSNe and host LIRGs are small, and the statistical comparisons between subgroups do not take into account possible systematic or model errors related to the estimated starburst ages.
Summary
Background
Evidence of the comparative effectiveness of biological therapies for psoriasis on health‐related quality of life (HRQoL) in routine clinical practice is limited.
Objectives
To ...examine the comparative effectiveness of adalimumab, etanercept and ustekinumab on HRQoL in patients with psoriasis, and to identify potential predictors for improved HRQoL.
Methods
This was a prospective cohort study in which changes in HRQoL were assessed using the Dermatology Life Quality Index (DLQI) and EuroQoL‐5D (EQ‐5D) at 6 and 12 months. Multivariable regression models were developed to identify factors associated with achieving a DLQI of 0/1 and improvements in the EQ‐5D utility score.
Results
In total, 2152 patients with psoriasis were included, with 1239 patients on adalimumab, 517 on etanercept and 396 on ustekinumab; 81% were biologic naïve. For the entire cohort, the median (interquartile range) DLQI and EQ‐5D improved from 18 (13–24) and 0·73 (0·69–0·80) at baseline to 2 (0–7) and 0·85 (0·69–1·00) at 6 months, respectively (P < 0·001). Similar improvements were achieved at 12 months. At 12 months, multivariable regression modelling showed that female sex, multiple comorbidities, smoking and a higher DLQI or a lower EQ‐5D utility score at baseline predicted a lower likelihood of achieving a DLQI of 0/1 or improvement in the EQ‐5D. Compared with adalimumab, patients receiving etanercept, but not ustekinumab, were less likely to achieve a DLQI of 0/1. There was no significant difference between the biological therapies in EQ‐5D improvement.
Conclusions
In routine clinical practice biological therapies produce marked improvement in HRQoL, which is influenced by the choice of biological therapy, baseline impairment in HRQoL, lifestyle characteristics and comorbidities. These findings should help inform selection of optimal biological therapy for patients related to improvements in HRQoL.
What's already known about this topic?
Evidence of the comparative effectiveness of biological therapies for psoriasis on health‐related quality of life (HRQoL) in routine clinical practice is limited.
Earlier observational studies were either cross‐sectional, thereby limiting the ability to compare changes in HRQoL, or cohort studies that have not taken into account important clinical factors that could influence treatment response, such as alterations in dosing regimens of biological therapies and the concomitant use of conventional systemic treatments for psoriasis.
What does this study add?
This large prospective cohort study found that in routine clinical practice, the use of biological therapies for psoriasis was associated with marked improvements in HRQoL over 12 months.
These improvements were influenced by the choice of biological therapy, baseline impairment in HRQoL, lifestyle characteristics and comorbidities.
Compared with adalimumab, patients receiving etanercept were less likely to achieve a DLQI of 0/1, but there was no significant difference between ustekinumab and adalimumab in the proportion of patients achieving a DLQI of 0/1.
There was no significant difference between the three biological therapies in level of improvement in the EQ‐5D.
Linked Comment: Finlay. Br J Dermatol 2017; 177:1164–1165.
Background: Dental erosion is an increasingly prevalent problem in Australia, with the consumption of sports beverages suggested as a risk factor. The aim of this study was to compare the erosive ...potential of Australian sports beverages.
Methods: Ten beverages were selected and analysed to determine their pH, titratable acidity and apparent degree of saturation with respect to apatite. The erosive potential of the beverages was measured by human enamel surface loss and surface softening following a 30‐minute exposure. A taste testing panel was established to determine the palatability of the sports beverages.
Results: All sports beverages except Sukkie and Endura produced substantial surface loss and surface softening. Compared with the other sports beverages, Sukkie and Endura had a higher pH, lower titratable acidity and higher calcium content. However, Sukkie and Endura were deemed to be less palatable than the other more acidic sports beverages.
Conclusions: The majority of the sports beverages tested produced dental erosion in this in vitro model. However, two new products Sukkie and Endura have lower erosive potential but also lower palatability.
Abstract
Flat-spectrum radio quasars (FSRQs) are the most luminous blazars at GeV energies but only rarely emit detectable fluxes of TeV gamma rays, typically during bright GeV flares. We explore the ...gamma-ray variability and spectral characteristics of three FSRQs that have been observed at GeV and TeV energies by Fermi-LAT and VERITAS, making use of almost 100 hr of VERITAS observations spread over 10 yr: 3C 279, PKS 1222+216, and Ton 599. We explain the GeV flux distributions of the sources in terms of a model derived from a stochastic differential equation describing fluctuations in the magnetic field in the accretion disk and estimate the timescales of magnetic flux accumulation and stochastic instabilities in their accretion disks. We identify distinct flares using a procedure based on Bayesian blocks and analyze their daily and subdaily variability and gamma-ray energy spectra. Using observations from VERITAS, as well as Fermi, Swift, and the Steward Observatory, we model the broadband spectral energy distributions of PKS 1222+216 and Ton 599 during very high energy (VHE)–detected flares in 2014 and 2017, respectively, strongly constraining the jet Doppler factors and gamma-ray emission region locations during these events. Finally, we place theoretical constraints on the potential production of PeV-scale neutrinos during these VHE flares.
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