Inclusive education is now advocated as best practice in schools. However, the extent to which adolescents with severe disabilities access the abundant social and academic experiences available in ...general education classes remains uncertain. We conducted multiple observations of 146 U.S. high school students with severe disabilities (including intellectual disability, autism, or multiple disabilities), who were enrolled in at least one general education class. Peer interactions with classmates tended to be very infrequent for most students with severe disabilities. Moreover, rates of peer interaction were the lowest during large-group instruction and when students were sitting next to paraprofessionals or special educators rather than with their peers. Academic engagement also varied across students and was highest during small-group instruction, during 1-on-1 work with adults, and when students sat near their peers. Observations of a comparison sample of peers attending these same classes revealed striking overall differences in social and academic participation. We offer recommendations for research and practice aimed at bolstering inclusive education in high schools.
Offenbacher S, Barros S, Mendoza L, Mauriello S, Preisser J, Moss K, de Jager M, Aspiras M. Changes in gingival crevicular fluid inflammatory mediator levels during the induction and resolution of ...experimental gingivitis in humans. J Clin Periodontol 2010; 37: 324–333. doi: 10.1111/j.1600‐051X.2010.01543.x
Aim: The goal of this study is to characterize the changes in 33 biomarkers within the gingival crevicular fluid during the 3‐week induction and 4‐week resolution of stent‐induced, biofilm overgrowth mediated, experimental gingivitis in humans.
Methods: Experimental gingivitis was induced in 25 subjects for 21 days followed by treatment with a sonic powered toothbrush for 28 days. Clinical indices and gingival crevicular fluids were collected weekly during induction and biweekly during resolution. Samples were analysed using a bead‐based multiplexing analysis for the simultaneous measurements of 33 biomarkers within each sample including cytokines, matrix‐metalloproteinases (MMPs) and adipokines. Prostaglandin‐E2 was measured by enzyme‐linked immunoadsorbant assay. Statistical testing using general linear models with structured covariance matrices were performed to compare stent to contralateral (non‐stent) changes in clinical signs and in biomarker levels over time.
Results: Gingivitis induction was associated with a significant 2.6‐fold increase in interleukin 1‐β (IL‐β), a 3.1‐fold increase in IL‐1α and a significant decrease in multiple chemokines as well as MMPs‐1, ‐3 and 13. All changes in clinical signs and mediators rebounded to baseline in response to treatment in the resolution phase.
Conclusions: Stent‐induced gingivitis is associated with marked, but reversible increases in IL‐αa and IL‐1β with suppression of multiple chemokines as well as selected MMPs.
Objective: To examine the mortality rate and causes of death in a cohort of 300 patients with systemic lupus erythematosus (SLE). Methods: A retrospective analysis was performed on all patients ...attending the SLE clinic between 1978 and 2000. Information was obtained on those patients lost to follow up. Cause of death was analysed and categorised as early (<5 years after diagnosis of SLE) and late (>5 years after diagnosis of SLE). Standardised mortality rates were obtained. Results: The patients were followed up for a median of 8.3 years. Seventy three (24%) patients were no longer followed up at the end of the study period, of whom 41 (14%) had died. Of the 32 patients lost to follow up, 14 were being actively followed up within the UK, 16 were followed up outside the UK, and two patients were untraceable. The most common cause of death was malignancy, which accounted for eight (20%) deaths, followed by infection and vascular disease, which accounted for seven (17%) deaths each. Conclusions: Malignancy was the most common cause of death. Cause of death varied depending on disease duration. Forty per cent of early deaths were due to SLE related renal disease, whereas 23% of late deaths were due to vascular causes. Death due to infection occurred throughout the follow up period. There was a fourfold increased risk of death in our cohort of patients with SLE compared with the general population.
Information about pain and injury from equipment on a particular deployment is not disaggregated in the literature; thus, the nature of the issue is unclear.
To determine the prevalence of pain or ...injury during a particular deployment that military personnel attributed to equipment they used on this deployment; and to document the types of equipment they identified, the type of pain or injury and how they thought the pain or injury occurred.
This paper analyses data from a deployment and health survey of Australian Defence Force personnel. The participants are 8932 personnel who deployed to Iraq and 6534 who deployed to Afghanistan. Participants indicated whether they experienced pain or injury from equipment they used on deployment and detailed their experiences in response to an open-ended question (n = 563).
Sixteen per cent of Iraq-deployed and 21% of Afghanistan-deployed participants reported pain or injury from equipment they used on deployment. Body armour was the most common equipment identified; however, a wide range of equipment was related to pain or injury. A new finding is that pain or injury related to armour was attributed to its wear in vehicles and during vehicle ingress or egress.
Knowledge of the nature of pain or injury related to equipment used on deployment may help inform improved designs and practices to reduce or prevent avoidable harm to serving personnel.
Introduction
Astarte borealis
holds great potential as an archive of seasonal paleoclimate, especially due to its long lifespan (several decades to more than a century) and ubiquitous distribution ...across high northern latitudes. Furthermore, recent work demonstrates that the isotope geochemistry of the aragonite shell is a faithful proxy of environmental conditions. However, the exceedingly slow growth rates of
A. borealis
in some locations (<0.2mm/year) make it difficult to achieve seasonal resolution using standard micromilling techniques for conventional stable isotope analysis. Moreover, oxygen isotope (δ
18
O) records from species inhabiting brackish environments are notoriously difficult to use as paleoclimate archives because of the simultaneous variation in temperature and δ
18
O
water
values.
Methods
Here we use secondary ion mass spectrometry (SIMS) to microsample an
A. borealis
specimen from the southern Baltic Sea, yielding 451 SIMS δ
18
O
shell
values at sub-monthly resolution.
Results
SIMS δ
18
O
shell
values exhibit a quasi-sinusoidal pattern with 24 local maxima and minima coinciding with 24 annual growth increments between March 1977 and the month before specimen collection in May 2001.
Discussion
Age-modeled SIMS δ
18
O
shell
values correlate significantly with both
in situ
temperature measured from shipborne CTD casts (r
2
= 0.52, p<0.001) and sea surface temperature from the ORAS5-SST global reanalysis product for the Baltic Sea region (r
2
= 0.42, p<0.001). We observe the strongest correlation between SIMS δ
18
O
shell
values and salinity when both datasets are run through a 36-month LOWESS function (r
2
= 0.71, p < 0.001). Similarly, we find that LOWESS-smoothed SIMS δ
18
O
shell
values exhibit a moderate correlation with the LOWESS-smoothed North Atlantic Oscillation (NAO) Index (r
2
= 0.46, p<0.001). Change point analysis supports that SIMS δ
18
O
shell
values capture a well-documented regime shift in the NAO circa 1989. We hypothesize that the correlation between the SIMS δ
18
O
shell
time series and the NAO is enhanced by the latter’s influence on the regional covariance of water temperature and δ
18
O
water
values on interannual and longer timescales in the Baltic Sea. These results showcase the potential for SIMS δ
18
O
shell
values in
A. borealis
shells to provide robust paleoclimate information regarding hydroclimate variability from seasonal to decadal timescales.
Parental expectations have long been studied as a factor in increasing adolescent educational aspirations, often linking these expectations to parental level of education and involvement in academic ...endeavours. This study further explores this relationship in a statewide Midwestern sample of parents and their adolescent children. Regression analysis and independent samples t-tests were used to predict adolescent aspirations and compare groups. Results suggest that adolescent educational aspirations can to some degree be predicted by parental expectations. Parents reported high expectations for their children despite low levels of personal educational attainment. However, these high expectations were buffered by a reported unfamiliarity with college requirements and an expressed concern about college affordability and limited awareness of financial aid opportunities. Limitations and suggestions for future research and intervention are discussed.
In a previous report, we demonstrated the inverse association of high serum 8-isoprostane levels, a marker for oxidative stress, with decreased serum IgG antibodies to oral bacteria. The association ...between increased serum IgG with increased plaque and periodontitis (increased probing depths) was attenuated by high systemic oxidative stress. Other investigations have reported a role for systemic oxidative stress as a stimulus of hepatic C-reactive protein (CRP) response. These observations led us to hypothesize that the reported relationship of periodontitis to elevated serum CRP, a systemic inflammatory marker, may be modified by oxidative stress and that the levels of serum antibodies to oral bacteria might be an intermediary explanatory variable linking the association of systemic oxidative stress, periodontal disease, and levels of CRP. This hypothesis was explored as a secondary analysis of the Dental ARIC (Atherosclerosis Risk in Communities) study using serum levels of CRP, serum IgG levels to 16 oral organisms, serum levels of 8-isoprostane, and periodontal status. The findings indicate periodontitis is associated with high CRP in the presence of elevated oxidative stress that serves to suppress the IgG response. Only within the highest 8-isoprostane quartile was periodontitis (pocket depth) associated with increased serum CRP levels (P = 0.0003). Increased serum IgG antibody levels to oral bacteria were associated with lowered serum CRP levels. Thus, systemic oxidative stress, which has been demonstrated to be associated with increased levels of CRP in other studies, appears to be associated with the suppression of bacterial-specific IgG levels, which in the presence of periodontal disease can result in an enhanced systemic CRP response. Conversely, individuals with increased serum IgG antibodies to plaque bacteria exhibit lowered serum CRP levels. These 2 factors, oxidative stress and the serum IgG response, appear to function in opposing directions to modify serum levels of CRP and the association with periodontitis.
Vascular endothelial growth factor (VEGF) acts, in part, by triggering calcium ion (Ca(2+)) entry. Here, we sought understanding of a Synta66-resistant Ca(2+) entry pathway activated by VEGF.
...Measurement of intracellular Ca(2+) in human umbilical vein endothelial cells detected a Synta66-resistant component of VEGF-activated Ca(2+) entry that occurred within 2 minutes after VEGF exposure. Knockdown of the channel-forming protein Orai3 suppressed this Ca(2+) entry. Similar effects occurred in 3 further types of human endothelial cell. Orai3 knockdown was inhibitory for VEGF-dependent endothelial tube formation in Matrigel in vitro and in vivo in the mouse. Unexpectedly, immunofluorescence and biotinylation experiments showed that Orai3 was not at the surface membrane unless VEGF was applied, after which it accumulated in the membrane within 2 minutes. The signaling pathway coupling VEGF to the effect on Orai3 involved activation of phospholipase Cγ1, Ca(2+) release, cytosolic group IV phospholipase A2α, arachidonic acid production, and, in part, microsomal glutathione S-transferase 2, an enzyme which catalyses the formation of leukotriene C4 from arachidonic acid. Shear stress reduced microsomal glutathione S-transferase 2 expression while inducing expression of leukotriene C4 synthase, suggesting reciprocal regulation of leukotriene C4-synthesizing enzymes and greater role of microsomal glutathione S-transferase 2 in low shear stress.
VEGF signaling via arachidonic acid and arachidonic acid metabolism causes Orai3 to accumulate at the cell surface to mediate Ca(2+) entry and downstream endothelial cell remodeling.
The purpose of this study was to evaluate the microbial community (MC) composition as it relates to salivary metabolites and periodontal clinical parameters in a 21-d biofilm-overgrowth model. ...Subjects (N = 168) were enrolled equally into 5 categories of periodontal status per the biofilm-gingival interface classification. Microbial species within subgingival plaque samples were identified by human microbiome identification microarray. Whole saliva was analyzed by liquid chromatography–mass spectrometry and gas chromatography–mass spectrometry for metabolite identification. Phylum was grouped into MCs according to principal component analysis. Generalized linear and regression models were used to examine the association among MC, species, periodontal clinical parameters, and salivary metabolome. Multiple comparisons were adjusted with the false discovery rate. The study population was distributed into 8 distinct MC profiles, designated MC-1 to MC-8. MC-2 explained 14% of the variance and was dominated by Synergistetes and Spirochaetes. It was the only community structure significantly associated with high probing depth (P = 0.02) and high bleeding on probing (P = 0.008). MC-2 was correlated with traditional periodontal pathogens and several newly identified putative periodontal pathogens: Fretibacterium fastidiosum, Fretibacterium sp. OT360/OT362, Filifactor alocis, Treponema lecithinolyticum, Eubacterium saphenum, Desulfobulbus sp./OT041, and Mogibacterium timidum. Synergistetes phylum was strongly associated with 2 novel metabolites—cyclo (-leu-pro) and cyclo (-phe-pro)—at 21 d of biofilm overgrowth (P = 0.02). In subjects with severe periodontitis (P2 and P3), cyclo (-leu-pro) and cyclo (-phe-pro) were significantly associated with increased changes in probing depth at 21 d of biofilm overgrowth (P ≤ 0.05). The analysis identified a MC dominated by Synergistetes, with classic and putative newly identified pathogens/pathobionts associated with clinical disease. The metabolomic discovery of 2 novel cyclodipeptides that have been reported to serve as quorum-sensing and/or bacteriocidal/bacteriostatic molecules, in association with Synergistetes, suggests a potential role in periodontal biofilm dysbiosis and periodontal disease that warrants further investigation.
Summary
Background
Maintenance anti‐tumour necrosis factor‐α (anti‐TNFα) treatment for Crohn's disease is the standard of care for patients with an inadequate response to corticosteroids and ...immunomodulators.
Aim
To compare the efficacy and safety of infliximab and adalimumab in clinical practice and assess the value of concomitant immunomodulator therapy.
Methods
We performed an observational cohort study in consecutive patients with Crohn's disease qualifying for anti‐TNFα treatment in Australia and New Zealand between 2007 and 2011. Demographic and clinical data were prospectively recorded to identify independent factors associated with induction and maintenance of response to infliximab or adalimumab, or to either anti‐TNFα therapy.
Results
Three hundred and twenty‐seven patients (183 infliximab, 144 adalimumab) successfully applied for treatment. Eighty‐nine percent responded in all groups and median maintenance of response was similar for the two agents. Concomitant immunomodulator with infliximab, but not adalimumab, demonstrated a significantly longer response overall (P = 0.002), and significantly fewer disease and treatment‐related complications (P = 0.017). Corticosteroids at baseline, and/or in the preceding 12 months, were associated with a 9–13 times greater risk of disease flare during maintenance treatment as compared to no corticosteroids (P < 0.0001). Maintenance of response was similar in the anti‐TNF naïve and anti‐TNF experienced subgroups.
Conclusions
In this large, real‐life study, we demonstrate infliximab and adalimumab to have similar response characteristics. However, infliximab requires concomitant immunomodulator to achieve optimal maintenance of response comparable to adalimumab monotherapy. The results of this study will assist clinicians in further optimising patient care in their day‐to‐day clinical practice.
Linked Content
This article is linked to Barreiro‐de Acosta and Gisbert and Radford and Hartnell et al papers. To view these articles visit https://doi.org/10.1111/apt.13929 and https://doi.org/10.1111/apt.13968.
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