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كتاب مغامرات سيدة سمك القرش واهتمت يوجيني كلارك بالقرش منذ ان كانت في التاسعة من عمرها وغطست في المحيطات حول العالم وسبحت مع كل أنواع القرش وهذه العالمة والغطاسة الشهيرة هوجمت من قبل سرطان بحري عملاق كما علقت في غواصة صغيرة في قاع المحيط ولكن هذه الاخطار لم تكن لتثنيها عن خوض أهوال البحار.

To determine whether genetic variation within the MHC locus influences the risk of developing systemic juvenile idiopathic arthritis (sJIA), we examined a dense set of MHC region single nucleotide polymorphisms, classic HLA alleles, and the individual amino acids of HLA molecules in nine independent sJIA case-control populations. Association testing revealed that genetic variants within the MHC class II gene cluster significantly influenced sJIA risk in every study population. The strongest risk factor for sJIA was HLA-DRB1*11 , which conferred at least a two-fold increase in disease risk in each population studied. These data implicate the interaction of antigen presenting cells with T cells in the pathogenesis of sJIA. Systemic juvenile idiopathic arthritis (sJIA) is an often severe, potentially life-threatening childhood inflammatory disease, the pathophysiology of which is poorly understood. To determine whether genetic variation within the MHC locus on chromosome 6 influences sJIA susceptibility, we performed an association study of 982 children with sJIA and 8,010 healthy control subjects from nine countries. Using meta-analysis of directly observed and imputed SNP genotypes and imputed classic HLA types, we identified the MHC locus as a bona fide susceptibility locus with effects on sJIA risk that transcended geographically defined strata. The strongest sJIA-associated SNP, rs151043342 [ P = 2.8 × 10 −17 , odds ratio (OR) 2.6 (2.1, 3.3)], was part of a cluster of 482 sJIA-associated SNPs that spanned a 400-kb region and included the class II HLA region. Conditional analysis controlling for the effect of rs151043342 found that rs12722051 independently influenced sJIA risk [ P = 1.0 × 10 −5 , OR 0.7 (0.6, 0.8)]. Meta-analysis of imputed classic HLA-type associations in six study populations of Western European ancestry revealed that HLA-DRB1*11 and its defining amino acid residue, glutamate 58, were strongly associated with sJIA [ P = 2.7 × 10 −16 , OR 2.3 (1.9, 2.8)], as was the HLA-DRB1*11—HLA-DQA1*05—HLA-DQB1*03 haplotype [6.4 × 10 −17 , OR 2.3 (1.9, 2.9)]. By examining the MHC locus in the largest collection of sJIA patients assembled to date, this study solidifies the relationship between the class II HLA region and sJIA, implicating adaptive immune molecules in the pathogenesis of sJIA.

To study muscle biopsy tissue from patients with juvenile dermatomyositis (JDM) in order to test the reliability of a score tool designed to quantify the severity of histological abnormalities when applied to biceps humeri in addition to quadriceps femoris. Additionally, to evaluate whether elements of the tool correlate with clinical measures of disease severity. 55 patients with JDM with muscle biopsy tissue and clinical data available were included. Biopsy samples (33 quadriceps, 22 biceps) were prepared and stained using standardised protocols. A Latin square design was used by the International Juvenile Dermatomyositis Biopsy Consensus Group to score cases using our previously published score tool. Reliability was assessed by intraclass correlation coefficient (ICC) and scorer agreement (α) by assessing variation in scorers' ratings. Scores from the most reliable tool items correlated with clinical measures of disease activity at the time of biopsy. Inter- and intraobserver agreement was good or high for many tool items, including overall assessment of severity using a Visual Analogue Scale. The tool functioned equally well on biceps and quadriceps samples. A modified tool using the most reliable score items showed good correlation with measures of disease activity. The JDM biopsy score tool has high inter- and intraobserver agreement and can be used on both biceps and quadriceps muscle tissue. Importantly, the modified tool correlates well with clinical measures of disease activity. We propose that standardised assessment of muscle biopsy tissue should be considered in diagnostic investigation and clinical trials in JDM.

Objectives To identify patient characteristics and surgical factors associated with patient-reported outcomes over 5 years following primary total hip replacement (THR). Design Prospective cohort study. Setting Seven hospitals across England and Scotland. Participants 1431 primary hip replacements for osteoarthritis. Main outcome measures The Oxford Hip Score (OHS) was collected preoperatively and each year up to 5 years postoperatively. Repeated measures such as linear regression modelling are used to identify patient and surgical predictors of outcome and describe trends over time. Results The majority of patients demonstrated substantial improvement in pain/function in the first year after surgery—between 1 and 5 years follow-up, there was neither further improvement nor decline. The strongest determinant of attained postoperative OHS was the preoperative OHS—those with worse preoperative pain/function had worse postoperative pain/function. Other predictors with small but significant effects included: femoral component offset—women with an offset of 44 or more had better outcomes; age—compared to those aged 50–60, younger (age <50) and older patients (age >60) had worse outcome, increasing body mass index (BMI), more coexisting diseases and worse Short Form 36 mental health (MH) was related to worse postoperative pain/function. Assessment of change in OHS between preoperative  and postoperative assessments revealed that patients achieved substantial and clinically relevant symptomatic improvement (change), regardless of variation in these patient and surgical factors. Conclusions Patients received substantial benefit from surgery, regardless of their preoperative assessments and surgical characteristics (baseline pain/function, age, BMI, comorbidities, MH and femoral component offset). Further research is needed to identify other factors that can improve our ability to identify patients at risk of poor outcomes from THR surgery.

Background It is currently impossible to predict the prognosis of patients with juvenile dermatomyositis (JDM). The aim of this study was to find clinical features most strongly associated with outcome variables in JDM as a first step towards tailor-made treatment. Methods In a large, prospectively followed, multicenter cohort study of 340 patients with JDM, each contributing multiple visits, a Bayesian model of disease activity was developed, using the four continuous outcome variables creatine kinase (CK), childhood myositis assessment score (CMAS), manual muscle testing of 8 muscle groups (MMT8) and the physician’s global assessment of disease activity (PGA). Covariates were clinical signs and symptoms. Correlations among visits of the same patient were resolved by introducing subject-specific random effects. Results Myalgia and dysphonia were associated with worse disease activity according to all outcome variables. Periorbital rash, rash on the trunk, rash over large joints, nail fold changes and facial swelling were associated with higher PGA. Notably, periorbital rash was also associated with higher CK and lower CMAS and nail fold changes with lower CMAS. Contractures were associated with lower CMAS and MMT8 and higher PGA. Patients with higher CMAS exhibited a higher MMT8 as well. PGA had the highest probability among the four outcome variables of being abnormal even if the other three outcome variables were normal. Conclusions The signs and symptoms associated with disease activity could be used to stratify patients and adapt treatment plans to disease activity. The correlation between CMAS and MMT8 and the unique information captured by PGA implied that PGA should be maintained as an outcome variable, whereas CMAS and MMT8 might be simplified.

A poem is presented.

In the Eighteenth Dynasty, particularly during the reign of Amenhotep III (ca.1391—1353 BCE), Egypt reached new heights in terms of both the geographic extent of its empire and contact with the larger Mediterranean world. Trade and diplomacy flourished, the army and bureaucracy expanded, and the city of Thebes thrived. The royal tombs and mortuary temples of the period were located on the west bank of the Nile, opposite the great Temple of Amun at Karnak, and nearby, nestled into the rocky hills of the low desert, were the tombs of the nobles who served the royal family and priesthood. The majority of these tombs had three parts: an exterior terraced courtyard, a T-shaped chapel, and a subterranean shaft and burial chamber. The tomb chapels were open to the public and decorated with a series of colorful and captivating wall-paintings long termed by scholars “scenes of daily life”. These scenes should be understood not only as preserving for eternity what was literally depicted, but also as multi-faceted tools in which the architecture, art, and text worked in tandem for the regeneration and eternal well-being of the tomb owner by communicating and eternalizing his identity, an integral part of successfully achieving rebirth in the Afterlife.This dissertation explores, for the first time, the extensive and detailed representation of costume in these scenes and how it functioned as a means of communicating and reinforcing identity, a critical component of the decorative program that has not been sufficiently addressed in previous scholarship. The term “costume” encompasses any combination of clothing, hair, jewelry and other accoutrements, and body modifications (such as tattooing, piercings, etc.) used by one individual to communicate with another. Costume is an effective means of communicating information that could be considered awkward to relay verbally, information such as age, gender, sexual preference and availability, marital status, etc. Therefore, it often provides a wealth of information that would otherwise be unavailable to the viewer due to rules of decorum. Here, two case studies are presented to show how costume was used as a form of non-verbal communication to help establish and maintain the identity of the tomb owner and other individuals present in the tomb chapel decorative programs: the tomb of Nebamun (British Museum) and Menna (TT 69), two officials in the court of Amenhotep III.While costume has long been acknowledged as a form of non-verbal communication, it remains to be a topic explored in depth in Egyptology. There is no established framework within the field for undertaking such a study; therefore, approaches developed by anthropologists and sociologists for studying the use of costume will be combined with art-historical and archaeological examinations of the scenes to arrive at a model for analyzing the use of costume in this context. Further themes that will be explored include the efficacy of non-verbal communication within the tomb chapels, theories regarding the establishment and expression of identity, and issues surrounding the authenticity of the identity being expressed and the ways in which costume could be manipulated to alter identity.

Despite more than a half-century of attempts to right it, disparity in the educational success rates of Latinx students versus their White peers persists in schools across the United States. As schools try to eliminate this discrepancy, they often work toward improving standardized test scores via quick-fix strategies rather than investigating systemic changes. Few ask Latinx students themselves about what they need to succeed. The testimonios —or counter-narratives—of six Latinx high school students about their middle school experiences produced stories of school environments tainted by ethnic slurs, stereotyping, and microaggressions by White students and teachers. They also shared stories of good relationships with teachers and the value of a diverse population of school students. Latinx students asked to see themselves and their culture in the school curriculum. They offered their own reasons why Latinx students might not succeed, citing cultural norms while also asking for release from the constant comparison to White peers. Schools must begin to right past inequities by acknowledging their own failures in helping Latino students succeed, embracing the cultural and social capital offered by Latinx, and working toward providing a safe school environment and a bias-free and culturally relevant curriculum.

I used video and movement data obtained from animal-borne video and data recorders (VDRs) and histological data obtained from vibrissal pads of elephant seals to address the questions: When, where, how, and on what prey do female southern elephant seals forage? Although the annual cycle of southern elephant seals for breeding, molting, and foraging is well known, there is little information about their foraging strategies, hunting tactics, habitat-associations and sensory biology at sea. I deployed VDRs and satellite telemeters on eight female southern elephant seals from Península Valdés, Argentina, during their two-month post-breeding migration. I identified three distinct dive types and their functions (foraging, resting and transiting) in the deep waters of the Patagonian continental slope and Argentine Basin. Compared to resting and transit dives, foraging dives were deeper and less linear with bursts of speed, steeper descent and ascent angles, longer two-dimensional and three-dimensional dive paths, and greater variation in speed, descent angle, and vertical head movements. The primary prey identified on video included herring smelt (Argentinidae) and myctophids (Myctophidae). Seals foraged at a mean maximum depth of 469 m with a mean water temperature of 3.7°C and mean salinity of 33.8 psu associated with Sub-Antarctic Mode Water, Antarctic Intermediate Water and Upper Circumpolar Deep Water. These habitat associations were similar to those for elephant seals from other colonies. Compared to foraging and transit dives, resting dives were longer in duration with shorter two-dimensional dive paths, lower stroking rates and speeds, and greater variation in pitch and roll angle during descent. Transit dives were shallower and more linear with higher swim speeds and stroking rates, shorter durations, shallower ascent angles, and farthest straight-line distances traveled. I provide evidence that elephant seal vibrissae have similar microstructure and innervation to other seals, adding to the growing body of evidence that species in the family Phocidae, and perhaps all pinnipeds, possess highly sensitive vibrissae that form a sensory system for prey detection and capture.In summary, female southern elephant seals from Península Valdés immediately depart the coast after breeding and travel to the continental slope while making shallow transit dives with little variation in easterly heading. Once beyond the continental shelf, they begin making deep foraging dives along the continental slope and Argentine Basin in cold water that arises from southern polar regions. While at sea for 75 days, they travel an average horizontal distance of 6,080 km and make 2,815 foraging dives. Their primary prey are small fish, some of which are bioluminescent, that they detect and capture in total darkness using vision and the tactile sensory system in their vibrissae. Between bouts of foraging dives, they make transit dives to new foraging areas or rest and probably sleep at an average maximum depth of 375 m. Of the 26 species of seals in the family Phocidae, southern elephant seals are the deepest diving and most pelagic, spending 10 months per year at sea and 89% of their time submerged while transiting, hunting and resting at depth.

Recent developments in welfare reform legislation and specifically, the drive to move welfare recipients off public assistance and into the workforce, have focused attention on child care programs for children 0-6 years old. Description is provided of the comprehensive French system (itscreches andecoles maternelles), and the training required of their caregivers and teachers. Comparisons are drawn with U.S. efforts in this area and implications are discussed in terms of how to improve our early child care and education programs and break the cycle of poverty. Specific policy recommendations include implementing preschool programs for all 4-6 year olds and increasing the availability of quality child care programs for children 0-3 years.[PUBLICATION ABSTRACT]