Brainstem atrophy in focal epilepsy destabilizes brainstem-brain interactions: Preliminary findings.

BACKGROUND: MR Imaging has shown atrophy in brainstem regions that were linked to autonomic dysfunction in epilepsy patients. The brainstem projects to and modulates the activation state of several wide-spread cortical/subcortical regions. The goal was to investigate 1. Impact of brainstem atrophy on gray matter connectivity of cortical/subcortical structures and autonomic control. 2. Impact on the modulation of cortical/subcortical functional connectivity. METHODS: 11 controls and 18 patients with non-lesional focal epilepsy (FE) underwent heart rate variability (HRV) measurements and a 3 T MRI (T1 in all subjects, task-free fMRI in 7 controls/ 12 FE). The brainstem was extracted, and atrophy assessed using deformation-based-morphometry. The age-corrected z-scores of the mean Jacobian determinants were extracted from 71 5x5x5 mm grids placed in brainstem regions associated with autonomic function. Cortical and non-brainstem subcortical gray matter atrophy was assessed with voxel-based-morphometry and mean age corrected z-scores of the modulated gray matter volumes extracted from 380 cortical/subcortical rois. The profile similarity index was used to characterize the impact of brainstem atrophy on gray matter connectivity. The fMRI was preprocessed in SPM12/Conn17 and the BOLD signal extracted from 398 ROIs (16 brainstem). A dynamic task-free analysis approach was used to identify activation states. Connectivity HRV relationship were assessed with Spearman rank correlations. RESULTS: HRV was negatively correlated with reduced brainstem right hippocampus/parahippocampus gray matter connectivity in controls (p \u3c .05, FDR) and reduced brainstem to right parietal cortex, lingual gyrus, left hippocampus/amygdala, parahippocampus, temporal pole, and bilateral anterior thalamus connectivity in FE (p \u3c .05, FDR). Dynamic task-free fMRI analysis identified 22 states. The strength of the functional brainstem/cortical connectivity of state 15 was negatively associated with HRV (r = -0.5, p = .03) and positively with decreased brainstem-cortical (0.49, p = .03) gray matter connectivity. CONCLUSION: The findings of this small pilot study suggest that impaired brainstem-cortex gray matter connectivity in FE negatively affects the brainstem\u27s ability to control cortical activation

A multinational, multi-institutional study of assessment of programming skills of first-year CS students

In computer science, an expected outcome of a student's education is programming skill. This working group investigated the programming competency students have as they complete their first one or two courses in computer science. In order to explore options for assessing students, the working group developed a trial assessment of whether students can program. The underlying goal of this work was to initiate dialog in the Computer Science community on how to develop these types of assessments. Several universities participated in our trial assessment and the disappointing results suggest that many students do not know how to program at the conclusion of their introductory courses. For a combined sample of 216 students from four universities, the average score was 22.89 out of 110 points on the general evaluation criteria developed for this study. From this trial assessment we developed a framework of expectations for first-year courses and suggestions for further work to develop more comprehensive assessments

Mapping the Division of Labour in Long-Term Residential Care Across Jurisdictions

Despite the international emphasis on care in private homes, the demand for long-term residential care is rising given the growing number of older persons and those living with severe disabilities. Rising acuity levels of residents have resulted in calls for more training for care providers and concerns have been raised about the supply of workers, drawing attention to the working conditions, pay, benefits and status attached to work in long-term residential care. This industry is a link in the international care chain, with wealthy countries seeking workers from poorer countries. Yet, cross-national data sources provide limited information on the long-term residential care labour force, reflecting the value attached to the sector and the level of concern about the well-being of the labour force. Data that are available indicate that care is prioritized, divided and measured in different ways in different contexts and that there are varying degrees of precariousness experienced by workers. The evidence from the data also suggests that the public not-for-profit sector and unionization are critical shelters for the mostly women providers. Using a feminist political economy approach, this thesis outlines data available from statistical sources in Europe and North America with a case examination of four countries: Canada, the United States, the United Kingdom and Sweden. It critically maps the comparative data on the supply of labour in this industry of health and social care, as well as on their locations and relations. It illustrates the extent to which the framing of care in conventional terms, influenced by both neoliberal and medical notions of care, limits the statistical infrastructure in terms of its capacity to adequately measure workforces involved in long-term residential care and to provide a basis for addressing the continuing supply of labour in this sector

Cryptosporidium Priming Is More Effective than Vaccine for Protection against Cryptosporidiosis in a Murine Protein Malnutrition Model

Cryptosporidium is a major cause of severe diarrhea, especially in malnourished children. Using a murine model of C. parvum oocyst challenge that recapitulates clinical features of severe cryptosporidiosis during malnutrition, we interrogated the effect of protein malnutrition (PM) on primary and secondary responses to C. parvum challenge, and tested the differential ability of mucosal priming strategies to overcome the PM-induced susceptibility. We determined that while PM fundamentally alters systemic and mucosal primary immune responses to Cryptosporidium, priming with C. parvum (106 oocysts) provides robust protective immunity against re-challenge despite ongoing PM. C. parvum priming restores mucosal Th1-type effectors (CD3+CD8+CD103+ T-cells) and cytokines (IFNγ, and IL12p40) that otherwise decrease with ongoing PM. Vaccination strategies with Cryptosporidium antigens expressed in the S. Typhi vector 908htr, however, do not enhance Th1-type responses to C. parvum challenge during PM, even though vaccination strongly boosts immunity in challenged fully nourished hosts. Remote non-specific exposures to the attenuated S. Typhi vector alone or the TLR9 agonist CpG ODN-1668 can partially attenuate C. parvum severity during PM, but neither as effectively as viable C. parvum priming. We conclude that although PM interferes with basal and vaccine-boosted immune responses to C. parvum, sustained reductions in disease severity are possible through mucosal activators of host defenses, and specifically C. parvum priming can elicit impressively robust Th1-type protective immunity despite ongoing protein malnutrition. These findings add insight into potential correlates of Cryptosporidium immunity and future vaccine strategies in malnourished children