Unusually difficult clinical presentation of an infant suffering from congenital cytomegalovirus (CMV) infection combined with alpha 1-antitrypsin (A1AT) deficiency

Congenital Cytomegalovirus (CMV) infection and alpha 1-antitrypsin (A1AT) deficiency are separately well described entities, but their simultaneous occurrence can pose a special challenge to a clinician, especially dealing with optimal diagnostic as well as therapeutic approach. Congenital CMV infection is the most common vertically transmitted infection in developed countries. In 85–95% of newborns it runs asymptomatic, while in others it is presented with jaundice, petechias, hepatosplenomegaly and central nervous system damage. A1AT deficiency is on the other hand, the most common genetic liver disease in children, and the clinical spectrum varies from the accidentally detected increased levels of transaminases through to the severe infant cholestasis that can progress to cirrhosis. The following case report describes a two-month old male with severe clinical presentation of congenital CMV infection probably exacerbated due to A1AT deficiency comorbidity. The clinical manifestations and unusually difficult clinical signs this infant presented lead to assumption that the additional liver damage exists. Extensive laboratory analyses were performed, including PCR for CMV DNA, A1AT serum concentration, A1AT genotyping, followed and confirmed with phenotyping. Patient was treated parenteral with ganciclovir, what continued with oral valganciclovir and supportive therapy. Intensive and thorough supportive treatment of the infant resulted in satisfactory progress and excellent outcome. Patient was followed-up till the age of 18 months. The presented case provides excellent example about successful overcoming obstacles in differential diagnosis of A1AT in neonates and infants. Medical charts analysis was the methodology used in making this report.     

Web 3.0: Implications for Online Learning

The impact of Web 3.0, also known as the Semantic Web, on online learning is yet to be determined as the Semantic Web and its technologies continue to develop. Online instructors must have a rudimentary understanding of Web 3.0 to prepare for the next phase of online learning. This paper provides an understandable definition of the Semantic Web and its terminology, and then explores possible implications of Web 3.0 on online learning. The foundation of the Semantic Web is data integration. By using metadata, “display only” data is converted to meaningful information which can be located, evaluated, and delivered by software agents. Web 3.0 technologies will assist online instructors in the areas of course development, learner support, assessment, and record keeping. Online students will benefit from learning personalization and knowledge construction powered by the Semantic Web.     

Anatomy, medical education, and human ancestral variation

It is argued in this article that the human body both in health and disease cannot be fully understood without adequately accounting for the different levels of human variation. The article focuses on variation due to ancestry, arguing that the inclusion of information pertaining to ancestry in human anatomy teaching materials and courses should be carried out and implemented with care and in line with latest developments in biological anthropology and related sciences. This seems to be of particular importance in the education of health professionals, as recent research suggests that better knowledge of human variation can improve clinical skills. It is also argued that relatively small curricular changes relating to the teaching of human variation can produce significant educational gains.     

Pedagogy in Counselor Education: A 10‐Year Content Analysis of Journals

This content analysis includes 230 peer‐reviewed articles regarding teaching and learning published in journals of the American Counseling Association and its divisions between January 2001 and December 2010. Results include examination of focus, pedagogical foundations, and the methodologies used. Implications for the scholarship of teaching and learning in counselor education are discussed.     

The Role of Classroom-Level Child Behavior Problems in Predicting Preschool Teacher Stress and Classroom Emotional Climate

Research Findings: Despite the abundance of research suggesting that preschool classroom quality influences children's social-emotional development, the equally important and related question of how characteristics of children enrolled in a classroom influence classroom quality has rarely been addressed. The current article focuses on this question while also considering teacher stress as a mediator of the relationship between child behavior problems and classroom emotional climate. Data came from 2 low-income samples. Ordinary least squares regression revealed that higher levels of child externalizing behavior problems in the fall predicted higher teacher stress in the spring. Teacher stress was nonlinearly related to classroom emotional climate in the spring: Moderate levels of teacher stress were associated with higher (i.e., more positive) classroom emotional climates, and low and high levels of teacher stress were associated with lower classroom emotional climates. Contrary to expectations, higher levels of child externalizing behavior problems were related to higher classroom emotional climates. There was no evidence that teacher stress mediated this relationship. Practice or Policy: These results are discussed in terms of strategies to reduce the disruptive influence of child behavior problems on the classroom emotional climate as well as strategies to limit high levels of preschool teacher stress.     

Reading fluency: The whole is more than the parts

This study examined the relative contributions of phonological awareness, orthographic pattern recognition, and rapid letter naming to fluent word and connected-text reading within a dyslexic sample of 123 children in second and third grades. Participants were assessed on a variety of fluency measures and reading subskills. Correlations and hierarchical multiple regression analyses were carried out to explore these relationships. The results demonstrate that phonological awareness, rapid letter naming, and orthographic pattern recognition contribute to word-reading skills. Furthermore, rapid naming, orthographic pattern recognition, and word reading fluency moderately predict different dimensions of connected-text reading (i.e., rate, accuracy, and comprehension) whereas phonological awareness contributes only to the comprehension dimension of connected-text reading. The findings support the multidimensional nature of fluency in which the whole is more than its parts.     

Innovation and productivity among heterogeneous firms

This paper examines the links between firm innovation and productivity using the largest cross-country panel dataset assembled for this purpose to date. We use harmonized and comparable data on a total of 40,577 small, medium and large firms surveyed in the World Bank Enterprise Surveys (WBES) and provide some support for the reported patterns previously found in the innovation literature. Our results indicate that estimates from studies using cross-section data may be upward biased but nevertheless, innovative firms are significantly and economically more productive in both the manufacturing and services sectors.