A Unifying Computational Framework for Teaching and Active Learning

Traditionally, learning has been modeled as passively obtaining information or actively exploring the environment. Recent research has introduced models of learning from teachers that involve reasoning about why they have selected particular evidence. We introduce a computational framework that takes a critical step toward unifying active learning and teaching by recognizing that meta‐reasoning underlying reasoning about others can be applied to reasoning about oneself. The resulting Self‐Teaching model captures much of the behavior of information‐gain‐based active learning with elements of hypothesis‐testing‐based active learning and can thus be considered as a formalization of active learning within the broader teaching framework. We present simulation experiments that characterize the behavior of the model within three simple and well‐investigated learning problems. We conclude by discussing such theory‐of‐mind‐based learning in the context of core cognition and cognitive development.     

Pericyte depletion results in hypoxia-associated epithelial-to-mesenchymal transition and metastasis mediated by met signaling pathway

The functional role of pericytes in cancer progression remains unknown. Clinical studies suggest that low numbers of vessel-associated pericytes correlated with a drop in overall survival of patients with invasive breast cancer. Using genetic mouse models or pharmacological inhibitors, pericyte depletion suppressed tumor growth but enhanced metastasis. Pericyte depletion was further associated with increased hypoxia, epithelial-to-mesenchymal transition (EMT), and Met receptor activation. Silencing of Twist or use of a Met inhibitor suppressed hypoxia and EMT/Met-driven metastasis. In addition, poor pericyte coverage coupled with high Met expression in cancer cells speculates the worst prognosis for patients with invasive breast cancer. Collectively, our study suggests that pericytes within the primary tumor microenvironment likely serve as important gatekeepers against cancer progression and metastasis.     

Testing a Path-Analytic Mediation Model of How Motivational Enhancement Physiotherapy Improves Physical Functioning in Pain Patients

Purpose Pain is a complex phenomenon not easily discerned from psychological, social, and environmental characteristics and is an oft cited barrier to return to work for people experiencing low back pain (LBP). The purpose of this study was to evaluate a path-analytic mediation model to examine how motivational enhancement physiotherapy, which incorporates tenets of motivational interviewing, improves physical functioning of patients with chronic LBP. Methods Seventy-six patients with chronic LBP were recruited from the outpatient physiotherapy department of a government hospital in Hong Kong. Results The re-specified path-analytic model fit the data very well, χ ²(3, N = 76) = 3.86, p = .57; comparative fit index = 1.00; and the root mean square error of approximation = 0.00. Specifically, results indicated that (a) using motivational interviewing techniques in physiotherapy was associated with increased working alliance with patients, (b) working alliance increased patients’ outcome expectancy and (c) greater outcome expectancy resulted in a reduction of subjective pain intensity and improvement in physical functioning. Change in pain intensity also directly influenced improvement in physical functioning. Conclusions The effect of motivational enhancement therapy on physical functioning can be explained by social–cognitive factors such as motivation, outcome expectancy, and working alliance. The use of motivational interviewing techniques to increase outcome expectancy of patients and improve working alliance could further strengthen the impact of physiotherapy on rehabilitation outcomes of patients with chronic LBP.     

A community-based education trial to improve backyard poultry biosecurity in rural Cambodia

The emergence and spread of Highly Pathogenic Avian Influenza H5N1 has caused substantial poultry-related economic losses and public health concerns in relation to a potential pandemic. While biosecurity measures for commercial poultry industry are of the highest standards, these measures are difficult to implement and often unaffordable for backyard poultry farming, particularly in tropical and low-income settings. We designed a feasible biosecurity intervention to improve flock hygiene in Cambodia, – based on community hygiene, cleaning of poultry flock areas and human and poultry movement control. We conducted a cluster randomized and controlled intervention trial in 18 villages in Takeo province to evaluate improvements in biosecurity-related knowledge and practices. The intervention relied on community involvement and community education using special information dissemination tools. We trained village teams (VT) to assist villagers in implementing the intervention using a cascade training approach, in which a few individuals were trained, who in turn trained a larger group of people. During the 14 month follow up, we conducted observational and interview-based surveys (baseline vs. final surveys, VT supervision visits, monitoring surveys) to assess VTs’ motivation, intervention messages dissemination and the implementation of recommended measures. Most of villagers (95%, confidence interval: 87.8–100.0%) in intervention villages received general information about how to raise poultry. Farmers in intervention villages reported to have made more changes (≥1 biosecurity related practice during the study period) compared with that of control villages (70.0% (260/372) vs. 22.6% (85/377), p value < 0.01). When observing biosecurity-related practices in intervention villages, overall scores increased significantly (p < 0.05). Practices such as use of quarantine cages for new and sick birds, limitation of people movement in backyards and waste management reached high scores during the 15-months period within five of the nine intervention villages. Cascade training managed to reach out to almost all villagers and significantly influence changes in biosecurity practices in the community. However, further follow-ups are needed to assess whether practices-related changes persist over a longer period of time.     

Pharmacological actions of a novel, high-affinity, and selective human dopamine D(3) receptor antagonist, SB-277011-A

SB-277011-A (trans-N-[4-[2-(6-cyano-1,2,3, 4-tetrahydroisoquinolin-2-yl)ethyl]cyclohexyl]-4-quinolininecarboxamide), is a brain-penetrant, high-affinity, and selective dopamine D(3) receptor antagonist. Radioligand-binding experiments in Chinese hamster ovary (CHO) cells transfected with human dopamine D(3) or D(2 long) (hD(3), hD(2)) receptors showed SB-277011-A to have high affinity for the hD(3) receptor (pK(i) = 7.95) with 100-fold selectivity over the hD(2) receptor and over 66 other receptors, enzymes, and ion channels. Similar radioligand-binding data for SB-277011-A were obtained from CHO cells transfected with rat dopamine D(3) or D(2). In the microphysiometer functional assay, SB-277011-A antagonized quinpirole-induced increases in acidification in CHO cells overexpressing the hD(3) receptor (pK(b) = 8.3) and was 80-fold selective over hD(2) receptors. Central nervous system penetration studies showed that SB-277011-A readily entered the brain. In in vivo microdialysis studies, SB-277011-A (2. 8 mg/kg p.o.) reversed the quinelorane-induced reduction of dopamine efflux in the nucleus accumbens but not striatum, a regional selectivity consistent with the distribution of the dopamine D(3) receptor in rat brain. SB-277011-A (2-42.3 mg/kg p.o.) did not affect spontaneous locomotion, or stimulant-induced hyperlocomotion. SB-277011-A (4.1-42.2 mg/kg p.o.) did not reverse prepulse inhibition deficits in apomorphine- or quinpirole-treated rats, but did significantly reverse the prepulse inhibition deficit in isolation-reared rats at a dose of 3 mg/kg p.o. SB-277011-A (2.5-78. 8 mg/kg p.o.) was noncataleptogenic and did not raise plasma prolactin levels. Thus, dopamine D(3) receptor blockade produces few of the behavioral effects characteristic of nonselective dopamine receptor antagonists. The effect of SB-277011-A on isolation-induced prepulse inhibition deficit suggests that blockade of dopamine D(3) receptors may benefit the treatment of schizophrenia.     

Comorbidities and complications influence the diagnosis and management of geriatric supraglottitis

Introduction

This study aimed to assess the differences in the clinical characteristics, management, and outcomes of supraglottitis between geriatric and nongeriatric adults over a 30-month period.

Methods

All adult patients admitted to the emergency department with suspected supraglottitis and who underwent laryngoscopy for confirmation were included. We collected the clinical characteristics, management, and outcomes of these patients and compared geriatric (≥ 60 years old) and nongeriatric (12-59 years old) groups in terms of these data.

Results

Eighty-one geriatric patients and 205 nongeriatric patients were reviewed during the study period. The accuracies of the clinical suspicions of supraglottitis were lower in the geriatric group (geriatric vs nongeriatric, 29.4% vs 47.3%, P = .008). The geriatric group constituted 19.8% of all supraglottitis patients. Comorbidities were discovered in 74.1% of the geriatric group and 25.4% of the nongeriatric group (P = .000). The complication rate in the geriatric patients was almost twice that of the nongeriatric patients (20.8% vs 10.8%). Additionally, the geriatric patients exhibited tendencies toward longer periods of intubation, hospitalization, and stay in the intensive care unit.

Conclusions

The clinical characteristics and management were similar between the geriatric and nongeriatric supraglottitis patients. Nevertheless, the comorbidities altered the clinical presentations of the geriatric patients and resulted in lower diagnostic accuracy. Additionally, the elevated complication rates of the geriatric patient might have negatively affected their outcomes.