register size
Interesting the highest and lowest prescribing ICB have similar obesity register size
register size
Interesting the highest and lowest prescribing ICB have similar obesity register size
numerical programming
La programación numérica se refiere a técnicas computacionales utilizadas para encontrar soluciones aproximadas a problemas matemáticos que no pueden resolverse analíticamente. Se basa en algoritmos que permiten realizar cálculos de manera eficiente y precisa.
Tomado de Prezi
By pushing out the language to the wider world, the open-source project that had for months been the preserve of only a handful of people was suddenly being critiqued by thousands of people at once
Como otros compañeros comentaron anteriormente, acá es interesante ver como el pensar Julia como un proyecto de código abierto permitió que en su lanzamiento miles de personas ofrecieran sus críticas y eventualmente cientos se volvieran sus colaboradores. También, hacia el final de éste párrafo, es valioso el comentario de Shah que reconoce el papel de estos colaboradores en hacer que Julia sea lo que se conoce actualmente.
Esta filosofía y metodología hoy en día juegan un papel importante en la sociedad pues el capitalismo ha buscado acaparar los espacios en los que se comparte libremente el conocimiento y donde existe colaboración sin que haya necesariamente una competencia de por medio.
it was still just a hobby project
Esta reflexión en torno al impacto que tuvo Julia para otros y cómo para sus creadores fue en principio un proyecto asociado a su hobby de la programación me parece muy interesante. Actualmente he visto en internet que hay personas que promueven el desarrollar pasatiempos y dedicar tiempo a cultivar nuestros gustos y aficiones, para recuperar un poco el espacio que hemos cedido en nuestras vidas a las pantallas y al consumismo como práctica para atacar el aburrimiento.
Con este ejemplo podemos ver que dedicar tiempo a desarrollar nuestros intereses personales puede resultar en proyectos que impactan a grupos de personas y/o a nosotros mismos.
and one of the biggest innovations was multiple dispatch
Acá resulta interesante cómo la característica de multiple dispatch, de la que algunos de los desarrolladores de Julia no estaban muy seguros de implementar en un principio, termino convirtiéndose una de los elementos más importantes que permitió la adherencia al lenguaje por parte de los usuarios.
Programmers who were previously core R and MATLAB users began to dabble with Julia, translating simple code with loops into the new programming language and finding that they could get enormous speed gains—in some cases, up to 200 times faster than in the original languages.
Este segmento refleja la intención original al crear Julia, de hacer un lenguaje para programadores aficionados que combinara velocidad y profundidad, y cómo fue en efecto adaptado por aquellas personas que usaban herramientas en las que se inspiró como MATLAB y R, pero que encontraron un mayor desempeño al implementar Julia.
promotion and conversion system
Sobre la Conversión y la Promoción en Julia, se puede consultar Conversion and Promotion en el Manual de Julia Documentation
floating-point
"Punto flotante" se refiere a un conjunto de tipos de datos que codifican números reales, incluidas fracciones y decimales. Los tipos de datos de punto flotante permiten un número distinto de dígitos después del punto decimal, mientras que los tipos de datos de punto fijo tienen un número determinado de dígitos reservado antes y después del punto decimal. Por lo tanto, los tipos de datos de punto flotante pueden representar una mayor variedad de números que los tipos de datos de punto fijo.
Tomado de MathWorks
multiple dispatch
Una de las características más notables de Julia es su uso de lo que se conoce como multiple dispatch, que en esencia significa que una misma función puede definirse de distintas maneras, según el número y el tipo de los argumentos que recibe.
Tomado de Claves para programar en Julia. Capítulo 1. Multiple dispatch de la Universitat Politècnica de València (UPV).
trying to code a system that would end up replacing the programming languages he used at his day job.
Como en el caso de Ruby, acá se menciona que Karpinski se inspiró en otros lenguajes de programación que le eran familiares para crear uno solo que cumpliera con las características de los anteriores.
there’s a pretty ASCII logo colored with rings

ASCII art
El Arte ASCII (pronunciado arte áski) es un término colectivo utilizado para describir imágenes que se han producido utilizando únicamente el conjunto de caracteres ASCII.
Tomado de la Wikipedia
I/O runtime libraries
Bibliotecas de tiempo de ejecución de entradas y salidas.
GitHub
GitHub es una plataforma de desarrollo colaborativo para alojar proyectos utilizando el sistema de control de versiones Git (como vimos en el video de Shirky), y se utiliza principalmente para la creación de código fuente de programas de computadora. Su software fue escrito en Ruby on Rails.
Adaptado de la Wikipedia
The Goldilocks ideal
En diseño web y programación,
The Goldilocks Approach significa "El enfoque de Ricitos de Oro". Este término está basado en el clásico cuento infantil Ricitos de Oro y se refiere a que, ante la presencia de tres opciones; la opción 1 implica más de lo necesario, la opción 2 implica la medida adecuada o correcta y la opción 3 es insuficiente. Las características de la opción 1 y 3, provocan que la opción 2 sea la mas deseable y óptima. Debido a la armonía y proporción con que se visualizan los elementos, en este caso, de un sitio.
Tomado de Wiki Casiopea
En comunicación,
The Goldilocks principle describes the amount, type, and detail of communication necessary in a system to maximise effectiveness while minimising redundancy and excessive scope on the "too much" side and avoiding incomplete or inaccurate communication on the "too little" side.
Tomado de la Wikipedia
R
R es un entorno de software libre para computación estadística y gráficos.
Edelman’s law
En la teoría de matrices aleatorias, Edelman es conocido por la distribución de Edelman del valor singular más pequeño de matrices aleatorias.
Tomado de la Wikipedia
Ruby
"Ruby es un lenguaje de programación interpretado, reflexivo y orientado a objetos, creado por el programador japonés Yukihiro «Matz» Matsumoto, quien comenzó a trabajar en Ruby en 1993, y lo presentó públicamente en 1995. Combina una sintaxis inspirada en Python y Perl con características de programación orientada a objetos similares a Smalltalk."
Tomado de la Wikipedia
C
C es:
Un lenguaje de programación de propósito general, compilado (el código se transforma en un ejecutable antes de usarse) y estructurado (el código se organiza en funciones, bloques e instrucciones).
Tomado de OpenWebinars
MATLAB
MATLAB es:
"un entorno de programación y cálculo numérico para el desarrollo de algoritmos, y análisis y visualización de datos."
Disponible en la web de MathWorks, su desarrollador.
mentor and protégé might become Study Buddies, choosing to learn together about a new instructional methodology or reading current articles on classroom related research. This common focus provides a launching point for creating new ideas and trying new strategies. The learning aspect is deepened when we identify and share feedback about our mutual experimentation and set new goals for learning and sharing.
I have never thought about this as a collaboration strategy before but I think this could be really useful. Attending PD together and learning new strategies side by side could be so supportive!
Learning-focused mentors also monitor their own internal processes to calibrate, modify and align their actions with their intention to maintain relationship and produce learning.
I believe both the mentee and mentor both need to be intentional about their actions. They also need to be reflective.
now clearly bell-shaped
The histogram for n=100 means has too few bins to discern a bell curve.
GoodWill Hunting (1997) and Legally Blonde (2001)
Great movies!
a form of charity
Tying the bow.
how migrants understand their own experience
Not only must we make policy that acknowledges climate displacement, but we must also somehow acknowledge the migrant as a person. Their own experience of themselves might be as innocent victims.
they are all problematic from a climate justice perspective.
Perhaps any justice perspective.
absolves the North from its obligation to reduce its carbon footprint by treating climate change as inevitable and beyond human control.137
This is where the responsibility should fall.
full, prior, and informed consent
What would that look like in practice?
the dangers of top-down governmental decision-making
The government will always make decisions without giving the affected group any power in it, then tie a bow on it and advertise that it is the "safest choice"
“entrepreneurial”
Trojan horse
well-being rather than relying on the protection of the state.1
What about placing responsibility on the countries that contributed to most of it?
threats
Interesting choice of words.
state-governed regulation of mobility
Does the government control where and how people can move?
the world will experience one of the greatest waves of migration and displacement in modern history.
This is a major cause of fear. My own personal memories of Hurricane Sandy were scary enough. Imagine natural disasters of this level? Imagine 200 million people in 2050 with nowhere to go.
The following year, Hurricane Katrina devastated New Orleans, laying bare the ways that pre-existing injustices (including poverty, segregation, and substandard housing) magnify the impacts of storms and flooding, which will only grow worse with climate change. 28
In 2005, Hurricane Katrina devastated New Orleans. Those living in Brooklyn, NY can remember both Hurricane Sandy and Irene. Brooklynites had to take precautions as well. People taped their windows and stayed indoors. This is an experience to remember since New York doesn't often suffer from hurricanes. It creates fear and makes the impacts of storms and flooding more real for people who live far away from those places.
By adopting this principle, the UNFCCC acknowledges that the responsibility to address climate change should be proportionate to a country’s contribution to the problem and capacity to address it.5
The UNFCCC adopts Principle 7 of the Rio Declaration articulates CBDR (common but differentiated responsibility) and therefore creates some fairness for the issue of climate injustice.
In 2004, the Congressional Black Caucus Foundation released a report on the disproportionate impact of climate change on African Americans (including health impacts from heat waves and increased pollution) and their relatively minimal contribution to the problem given their lower-than-average greenhouse gas emissions.
This is an important point to think about. What groups of people are contributing average and above average greenhouse gas emissions?
make the victims whole
Side note; I always find this phrase strange. A person who has undergone emotional or physical harm, material or financial loss, is incomplete and to redress the harm would be to fill in their missing parts and make them whole again.
the SDGs appear to endorse the migration management approach discussed and critiqued in Part II of this article
This makes sense. The UN emerges from and is structured along the lines of stratified Western and postcolonial societies. Management of populations by elites, however well-meaning, is its raison d'etre. Economics is the common language.
accountable
I believe a bottom-up approach is essential to this accountability, e.g. a strong (non-nativist) labor movement
Target 13.3 (education and capacity-building), countries should take into account the language and cultural practices of climate migrants (both internally displaced persons and those who cross national borders).
Curious what this would mean in practice. Government employed anthropologists advising education policy? Expanded language accommodations for migrants? A broader question would have to do with the obligations of host countries to allow cultural autonomy and, conversely, the necessity of migrants to adapt to their new home.
prevent climate- induced displacement.
Rather than treating it as inevitable, as in the legal policy approaches discussed above
There is a long history of planned relocations in the Global South to accommodate large-scale infrastructure projects, such a dams, highways, and mine
There is some resonance to this in the fight between Robert Moses and Jane Jacobs in the 1960s. Compared to what the author discusses here the NYC example can be considered a "first world problem" but still the pattern is there.
planned relocation
This phrase is potentially dangerous--climate displacement could be used as a reasoning for forcibly displacing populations, an internationally recognized war crime https://ihl-databases.icrc.org/en/customary-ihl/v1/rule129
If these migrants are unskilled or undocumented, there is a risk that they will be subjected to unsafe and exploitative working conditions
Part of the problem (in my opinion) is the division--even within labor advocacy--of workers into skilled and unskilled classes
migration becomes an opportunity to improve lives and promote “climate-smart” development as long as it is carefully managed by states and institutions of global governance
A distinctly biopolitical approach. What does "carefully managed" mean here? Who manages whom? This section is informed by a critical eye at neoliberal policy.
It is merely a lust of the blood and a permission 0707 of the will. Come, be a man! Drown thyself? Drown 0708 cats and blind puppies.
"Iago is trying to persuade Roderigo to give up his hopeless love for Desdemona and instead use his money to win her through other means. He is blunt and cynical, telling Roderigo to “be a man” by taking practical action rather than drowning himself in despair. The “drown cats and blind puppies” line is a vulgar, contemptuous way of telling Roderigo to stop being weak and pathetic"
Copilot is saying this was a choice of instinct for the most part.
The tyrant custom, most grave senators, 0592 Hath made the flinty and steel ⌜couch⌝ of war 0593 My thrice-driven bed of down
This should be played with tons of emotion, showing how he is ready for the mission and will push through things.
Devour up my discourse
She is greedy due to her fascination for his tales.
Most potent, grave, and reverend signiors, 0421 My very noble and approved good masters: 0422 That I have ta’en away this old man’s daughter, 0423 It is most true; true I have married her. 0424 95 The very head and front of my offending 0425 Hath this extent, no more
"Othello addresses the Duke and senators, admitting he has married Desdemona but says that is the only wrong. He explains that his life has been shaped by war, so he is not skilled in polite conversation, and offers to tell the full, unembellished story of how he and Desdemona fell in love, countering the charges of sorcery"
He really is explaining that his mean way of speaking is from his time in the military.
With his free duty recommends you thus, 0378 And prays you to believe him.
"The messenger has just reported that the Turkish forces, originally said to be bound for Rhodes, have been redirected toward Cyprus. Montano, a trusted officer, is the source of this update, and his “free duty” means he is offering this intelligence willingly and without obligation. The messenger’s request that the Duke “believe him” is an appeal to accept Montano’s account as reliable"
Copilot does give a good explanation of the context in the play, but it doesn't explain the emotions behind Montano's praying for them to believe hm.
DUKE, ⌜reading a paper⌝ 0330 There’s no composition in ⟨these⟩ news 0331 That gives them credit. FIRST SENATOR, ⌜reading a paper⌝ 0332 Indeed, they are disproportioned. 0333 My letters say a hundred and seven galleys. DUKE 0334 5 And mine, a hundred forty. SECOND SENATOR, ⌜reading a paper⌝
I love how that all are together reading a paper. I bet this scene is intriguing to watch as they all read about the news and find things out together.
Cannot but feel this wrong as ’twere their own.
Everyone must feel the injustices here.
For an abuser of the world, a practicer 0304 Of arts inhibited and out of warrant.—
"You could paraphrase Brabantio’s charge as: “I am arresting you for corrupting the world, for practicing forbidden magic, and for doing so without legal authority.” It’s both a legal accusation and a moral indictment, reflecting Brabantio’s belief that Othello’s relationship with Desdemona is the product of illicit, unlawful mean"
Yes, this explains the meaning, but It is still hard to understand and is confusing when trying to picture a play scene from copilots interpretation due to the lack of emotion.
May speak unbonneted to as proud a fortune 0233 As this that I have reached. For know, Iago, 0234 But that I love the gentle Desdemona,
Othello is speaking from self assurance, he is saying that he would not trade his freedom for anything at all if he did not love her. Not wealth, not anything, he is doing it for himself.
I did full hard forbear him. But I pray you, sir, 0219 Are you fast married? Be assured of this, 0220 That the magnifico is much beloved,
"The phrase “full hard forbear him” means that Iago restrained himself from acting on his impulse to harm Brabantio. “Forbear” here means to hold back, refrain from doing something, and “full hard” intensifies it, meaning with great difficulty or against strong temptation."
This starts to show Lagos lack of self-control. You start to see his flaws and his childish behaviors more and more as the play goes on. Its almost as he is whining.
Pray you lead on. At every house I’ll call. 0204 I may command at most.—Get weapons, ho! 0205 205 And raise some special officers of
"The quote is from Othello Act 1, Scene 1, spoken by Brabantio as he mobilizes his household and allies to search for Othello, reflecting his anger and the play’s early themes of jealousy, accusation, and social conflict"
This completly takes away from the dramatic scene and acts as just a bland story instead.
sir, you are one of those that will not 0123 serve God if the devil bid you. Because we come to 0124 do you service and you think we are ruffians, you’ll 0125 125 have your daughter covered with a Barbary horse, 0126 you’ll have your nephews neigh to you, you’ll hav
"This exchange happens in a dark street outside Brabantio’s home in Venice. Iago and Roderigo are trying to warn Brabantio that his daughter, Desdemona, is “making the beast with two backs” with Othello, a Moor. Iago uses crude, animal imagery — “Barbary horse” (a North African horse breed), “nephews neigh to you,” “coursers for cousins,” and “gennets for germans” — to suggest that Othello is a wild, untamed animal and that their union will produce “beastly” offspring AllGreatQuotes AllGreatQuotes +1 .
The “devil” reference earlier in the speech is ironic: Iago is sarcastically telling Brabantio that even if he were to “serve God” or “serve the devil,” he should listen, because they are “coming to do you service” Shakespeare Navigators Shakespeare Navigators . In reality, Iago’s “service” is to sow suspicion and conflict between Brabantio and Othello."
Copilot made an extremely long explained version, again with zero emotional context of this line.
Whip me such honest knaves! Others there are 0054 Who, trimmed in forms and visages of duty, 0055 55 Keep yet their hearts attending on themselves,
Lago would rather be punished than be fake. And he isn't being motivated by anything for Othello. He is upset at people for faking their own selves for Othello and is expressing that. I think this in a play would be a very serious and quiet scene with Lago talking quiet loudly.
Off-capped to him; and, by the faith of man, 0012 I know my price, I am worth no worse a place.
Lago is mad that Othello chose Cassio over him. He is trying to say he is more qualified than anyone else for the lieutenant role.
Fetzer, Johann: Rückblick auf das große Brandunglück durch welches die Stadt Reutlingen im September des Jahres 1726 in Schutt und Asche gelegt worden. Reutlingen 1998, Reprint von 1826Kurz, Hermann: Eine reichsstädtische Glockengießerfamilie, in Hermann Kurz: Erzählungen, herausgegeben von Friedemann Schmoll, Tübingen 2009.Stübler, Eberhard: Der große Brand von Reutlingen 1726. Reutlingen 1926.Werner Ströbele: Der Stadtbrand von 1726 – ein Ereignis schafft Bilder, in Stadt-Bild-Geschichte, Reutlingen in Ansichten aus fünf Jahrhunderten, Reutlingen 1990, S. 49-56.Wolfgang Jung: Der große Stadtbrand 1726, in: Wilhelm Borth, Bernd Breyvogel, Wolfgang Jung: Reutlingen – von der Reichsstadtherrlichkeit zur selbstbewußten Großstadt, Reutlingen 2013, S. 107-111.
Literatur über Stadtbrand Reutlingen
urban planners have the potential to seek bold and innovative pathways towards plans and policies that can protect communities from exacer- bated contamination while contributing to the fight against climate catastrophe
Justice-oriented urban planning is certainly widespread in academia and advocacy circles--but does it have a foothold in actual city governments? Even the progressive Mamdani administration seems to be pushing for an unsustainable amount of new housing development without a plan for infrastructure to support it. (I am not an expert, this is a genuine question).
peoples with the longest-living knowledge of Earth’s natural ecological systems
Entails recognizing as legitimate Indigenous science and knowledge
In an extractive-based economy, the nature of work is exploitative, whereas in a regenerative economy, work is viewed as more cooperative in nature and focuses on establish- ing a deep democracy rooted in equity.
Reimagining the human-nonhuman relationship and restructuring the political economy of labor are two sides of the same coin: extraction of resources/exploitation of labor
The principles included a commitment to building alternative structures, bottom-up decision making, allowing people to speak for themselves, working together in solidarity and mutuality, building just rela- tionships, and a commitment to self-transformation
Examples of how a justice-based framework entails (necessitates?) reorganization and reinscription of societal practices involving differential power.
f toxic economic activity (e.g., mining, military, and dumps)
Interesting, and apt, that military is listed as an economic activity
Healthy pastures are good for the ecosystem. They can reduce soil erosion, improve water quality, increase plant diversity and provide high quality wildlife habitat
Кетамин мэтью пэри.
он так воевал против наркотивов 30 лет, а умер передоза кетами, который ему прописал врач.
5 челов за судили в мая 2026 года. все они признали вину (+- 3 года).
боже пэри покупал китамин у фиг знает кого, его просто нагло обманывали врачи и просто им пользовались, а он как я понял, после первых доз уже ничего с этим поделать и не мог.
сангва - голивудсткий накродилер. она тусовалась в тусовке звёзд и поэтому она хоть и была барыгой, но знакомой барыгой. - ей доверяли. так сказать она нашла не занятую нишу.
Маск юзает кетамин и возможно не мало.
Мило что кетамин входит в соц пакет при трудоустройстве.
кетамин - наркотик, а не транквилизаатор.
даже изначально, когда его использовали для лошадей. сначала использовали припарат (ксилозин), который расслабляют лошадь, а уже потом использует кетами как анетстик, чтоб убрать чувство боли.
кетами при маленьком количестве снимает дерпессию.
Кетамин официально разрешен, но как анестетик - для анестезии. таким образом врачи его могут покупать, но использовать его с другой целью
asyncio
まずは◯◯します。みたいな書き出しがあると読みやすいかなと。
本題に入る前に~とか
直接比較は行っていません。
間接的な比較は行われる?
ループ間でのデータ共有やExecutorとの使い分けも紹介します。
これは「確認すること」ではない
通常版
通常版がなにを指すかがわかりにくいので、 free-threadedではない、とか、GILがある、とかなにか補足してほしい
Python非同期
Pythonの非同期処理で、とか
試してみます。
試してなにをしたいのか、を書いてほしい
x
この表現が一般的じゃないなら「asyncioとfree~~の関連」に関する、みたいに明示してほしい
関心は
なにの関心か、もしくは誰の?
ree-threaded
先頭のFが抜けている
。
そもそもなんのためにそれを紹介するのか、モチベーションを書いてほしいと思った
apparente beweging
de waarneming van beweging terwijl er in werkelijkheid niets beweegt
Functionalisme
Wat doet de geest en waarom?
Éducation : La Place des Parents dans le Labyrinthe Scolaire
https://www.france.tv/documentaires/8862921-darons-daronnes-dans-le-labyrinthe-scolaire.html
Ce document analyse les dynamiques complexes entre les familles et l'institution scolaire en France, telles qu'elles ont été débattues par un panel d'experts (sociologues, psychologues, enseignants et journalistes).
Le constat central révèle une tension entre un sentiment de « surinvestissement » parental — exacerbé par une compétition scolaire précoce et des outils numériques omniprésents — et un prétendu « désinvestissement » rapporté par les enquêtes internationales comme PISA.
L'analyse met en lumière que la réussite scolaire dépend moins du contrôle direct des contenus que d'un « capital scolaire » permettant des formes d'apprentissage informel et une maîtrise des codes de l'école.
Le système actuel, perçu comme de plus en plus complexe et inégalitaire, impose une charge mentale croissante aux parents, tout en peinant à définir clairement la frontière entre le rôle de l'éducateur et celui de l'enseignant.
La nécessité d'une clarification des attentes et d'une refonte du « vivre ensemble » à l'école apparaît comme une urgence pour apaiser les relations entre tous les acteurs.
Le débat sur l'implication des parents est marqué par des conclusions contradictoires selon le prisme utilisé (données statistiques vs réalité du terrain).
Les données PISA : Les résultats suggèrent un désinvestissement des parents français, basé sur des données déclaratives où les élèves évaluent leurs échanges avec leurs parents.
La réalité vécue : Un « surinvestissement » est observé, notamment dans les zones urbaines (comme Paris), où la compétition pour l'accès aux meilleurs lycées et au supérieur commence très tôt.
L'aspect économique : Historiquement, l'investissement dans l'école a augmenté car le diplôme est devenu le déterminant principal de la position sociale.
Les experts distinguent l'investissement quantitatif (faire les devoirs à la place de l'enfant) de l'investissement qualitatif :
L'anticipation : Préparer le cartable la veille aide l'enfant à passer du statut de « joueur » à celui d'« élève ».
L'intérêt pour la vie scolaire : Discuter de la journée et des relations sociales à l'école est un prédicteur de réussite plus fiable que le simple contrôle des notes.
Le succès scolaire reste fortement corrélé au milieu social, non seulement par les moyens financiers, mais par la possession de codes culturels spécifiques.
Les parents diplômés transmettent naturellement une aisance face à l'institution.
Ils pratiquent des formes d'apprentissage informel (jeux de logique, discussions à table) qui sont plus bénéfiques que l'apprentissage formel précoce.
| Type d'activité | Impact sur l'apprentissage | Observations | | --- | --- | --- | | Activités formelles (ex: cahiers de vacances) | Moins bénéfiques si forcées | Souvent privilégiées par les milieux moins favorisés par peur de l'échec. | | Activités informelles (ex: jeux de société, cuisine) | Très prédictif | Développent des capacités transversales réutilisables à l'école. | | Activités extrascolaires | Prédictif de la courbe d'apprentissage | Dépendent fortement des moyens financiers et du temps disponible des parents. |
L'école française est critiquée pour la pression qu'elle exerce sur les familles, transformant parfois le foyer en « succursale » de l'Éducation nationale.
La multiplication des choix : Avec les réformes successives, les élèves et les parents doivent choisir des spécialités de plus en plus tôt, créant un stress permanent.
L'opacité des plateformes : Des outils comme Pronote ou Parcoursup sont perçus comme des labyrinthes complexes, même pour les parents francophones et diplômés.
La sélection par Parcoursup : La peur d'être mal classé sur les listes d'attente pousse les parents à des stratégies de compétition extrêmes.
L'héritage du COVID : La période de confinement a forcé les parents à devenir « parents-profs », une expérience souvent vécue comme cauchemardesque et révélatrice de la difficulté du métier d'enseignant.
L'analyse souligne une déconnexion entre les attentes de l'école et les mécanismes réels d'apprentissage.
La métacognition est la capacité de comprendre et de réguler ses propres processus d'apprentissage.
Elle n'est pas explicitement enseignée à l'école française, alors qu'elle est un levier majeur de réduction des inégalités.
Elle s'acquiert souvent par le jeu (ex: élaborer des stratégies pour faire un puzzle).
Critique d'une école « réactionnaire »
Certains experts pointent du doigt l'obsession française pour des savoirs jugés secondaires par rapport aux standards internationaux :
L'accent excessif sur l'écriture cursive ou la mémorisation de poésies sans objectif pédagogique clair (comme la prosodie).
Un système qui sépare trop l'enfant (individu) de l'élève (sujet scolaire), créant un décalage pour ceux qui n'ont pas les codes comportementaux attendus.
Le document conclut sur la nécessité de redéfinir le contrat entre l'école et les parents pour éviter l'implosion du système.
Explicitation des attentes : Les enseignants doivent rendre explicites les « implicites » scolaires, notamment pour les familles éloignées du système.
Valorisation de l'autorité : Le déni d'autorité ressenti par les enseignants est en partie dû à l'évolution des structures familiales (mouvement anti-autoritaire depuis les années 70).
Loyauté cognitive : Les parents doivent éviter de remettre en cause le professeur devant l'enfant pour ne pas placer ce dernier dans un conflit de loyauté paralysant.
Acceptation de l'altérité : Reconnaître que les enfants peuvent avoir des aspirations différentes de celles de leurs parents (ex: métiers techniques ou artisanaux).
L'école ne doit pas être uniquement un lieu de compétition et de sélection (le « bagage monnayable »), mais un espace où l'on apprend ensemble, indépendamment du genre ou de l'origine sociale.
La réussite d'un pays dépend de sa capacité à réformer cette éducation pour qu'elle cesse de générer de l'anxiété et de l'exclusion.
We will begin by examining and bedding-in the course's key approaches to learning. Central to this is the concept of 'Scrumage', a variant of 'agile' education that we have adapted for this course.
Agile/Scrum emerges from software-development project management — a term for a fixed, output-driven work cycle - potentially a term that runs counter to paragogics. Agile/Scrum is industrial/corporate innovation-pipeline vocabulary: a process (development) subordinated to output of 'product'
La motivation à l'activité physique : Entre contrainte et liberté
Ce document de synthèse analyse les mécanismes de la motivation liés à l'activité physique, tels qu'exposés par Aïna Chalabaev, professeure en sciences et techniques des activités physiques et sportives (STAPS).
Le constat de départ est paradoxal : bien que l'activité physique soit reconnue comme une priorité de santé publique et une résolution fréquente pour 30 % des Français, la majorité de la population échoue à maintenir ses objectifs sur le long terme.
Les points clés à retenir sont les suivants :
Évolution scientifique : Depuis les années 1980, l'approche est passée de l'étude de l'entraînement intensif à une analyse globale des liens entre activité physique modérée et santé.
Le modèle COMB : La pratique physique dépend de trois facteurs majeurs : la Capacité (physique et psychologique), l'Opportunité (facteurs externes et environnementaux) et la Motivation (processus internes).
Distinction cruciale : Il est impératif de distinguer l'inactivité physique (non-atteinte des recommandations) de la sédentarité (temps passé assis), car un individu peut être à la fois "sportif" et "sédentaire", avec des risques sanitaires distincts.
Le fossé de l'intention : Près de la moitié des personnes ayant l'intention de bouger n'y parviennent pas, en raison de bénéfices perçus comme trop lointains, d'affects négatifs ou de contraintes structurelles.
Pistes d'action : L'efficacité des interventions repose sur la fixation d'objectifs graduels, le plaisir immédiat et la déconstruction des mythes (comme les 10 000 pas ou la focalisation exclusive sur la perte de poids).
L'activité physique fait l'objet de recommandations internationales strictes, documentées depuis les années 2000 par des expertises collectives (INSERM, OMS).
L'OMS (2020) préconise pour les adultes :
Activité physique : 250 à 300 minutes d'activité modérée par semaine (soit environ 30 minutes par jour).
Sédentarité : Une limitation explicite du temps passé assis.
Enfants/Adolescents : 60 minutes d'activité quotidienne.
Malgré la diffusion de slogans tels que "Manger Bouger", les objectifs sont rarement atteints :
Environ 22,8 % des hommes et 31 % des femmes n'atteignent pas les 30 minutes quotidiennes.
Plus de 80 % des enfants et adolescents sont en dessous des recommandations.
95 % de la population adulte est considérée "à risque" si l'on cumule le manque d'activité et le temps sédentaire.
Pour comprendre pourquoi l'engagement échoue, la recherche s'appuie sur le modèle "COMB", qui synthétise les facteurs déterminants du comportement.
| Facteur | Composantes | Exemples de freins ou leviers | | --- | --- | --- | | Capacité | Physique et Psychologique | Connaissances des bienfaits, perception de ses propres aptitudes. | | Motivation | Processus internes | Objectifs (santé, plaisir), habitudes développées, énergie investie. | | Opportunité | Facteurs externes | Environnement physique (pistes cyclables, parcs), soutien social, emploi du temps. |
L'analyse identifie plusieurs représentations sociales qui agissent comme des freins à la pratique.
L'activité physique est souvent associée à tort à la performance, au sport intensif, à la jeunesse ou à la masculinité. Scientifiquement, elle englobe tout mouvement augmentant la dépense énergétique :
Activités domestiques : Repassage, jardinage, nettoyage.
Mobilité active : Monter les escaliers, marcher pour se déplacer.
Activité professionnelle : Selon le type de métier.
L'inactivité et la sédentarité sont deux comportements distincts.
La sédentarité (temps assis) présente des risques propres qui ne sont que partiellement compensés par une séance de sport quotidienne.
Il est recommandé de fragmenter le temps sédentaire (se lever 2 minutes toutes les heures).
L'objectif des 10 000 pas n'est pas une recommandation scientifique mais un slogan marketing issu des JO de Tokyo en 1964.
Les bénéfices sur la mortalité apparaissent dès 2 500 pas par jour.
La courbe de bénéfice tend à stagner entre 7 000 et 8 000 pas, notamment chez les seniors.
L'idée que le sport fait maigrir de manière spectaculaire est nuancée. Une pratique seule n'induit généralement qu'une perte de 1 à 3 kg.
Si la perte de poids est l'unique motivation, le risque de découragement est élevé. Les bénéfices réels (glycémie, cholestérol, bien-être, image corporelle) sont souvent moins visibles immédiatement mais plus critiques pour la santé.
L'étude des populations montre que le problème n'est plus de convaincre de l'intérêt du sport, mais d'aider à passer à l'action.
Rapport coût-bénéfice défavorable : Pratiquer 30 minutes par jour durant toute une vie représente une année entière de temps investi pour un gain d'espérance de vie allant de 4 mois à 4 ans.
Temporalité des bénéfices : Les effets sur la santé sont lointains (années/décennies), tandis que l'effort est immédiat et parfois désagréable.
Affects négatifs : Peur du jugement, anxiété, inconfort physique lié à l'effort.
Poids de l'automatisme : Modifier une habitude est coûteux cognitivement, alors que la sédentarité est facilitée par l'environnement moderne (écrans, livraisons à domicile).
La recherche en sciences comportementales suggère des techniques pour favoriser la création de nouvelles habitudes sans passer par la culpabilisation.
Réévaluer la capacité perçue : Comprendre que 5 minutes d'activité faible valent mieux que rien et augmentent progressivement le sentiment de compétence.
Fixer des objectifs graduels : Commencer par des sessions très courtes (5 minutes) plutôt que de viser directement les recommandations de l'OMS.
Prioriser le court terme : Se concentrer sur le plaisir immédiat, le bien-être après la séance ou le lien social plutôt que sur l'espérance de vie lointaine.
Modifier l'environnement : Intégrer l'activité dans les contraintes (ex: se garer à 5 minutes du travail).
Monitorer les progrès : Utiliser des outils de suivi (applications, montres) pour rendre les progrès visibles.
Le choix et l'autonomie : Laisser l'individu choisir le type d'activité et les conditions de pratique pour favoriser le plaisir et réduire la sensation de contrainte.
Conclusion : Si l'individu dispose d'une marge de manœuvre, l'inactivité physique demeure un phénomène complexe lié à des structures sociétales.
L'enjeu est de passer d'une vision de "dépassement de soi" à une intégration naturelle et plaisante du mouvement dans le quotidien.
The clone() method creates a new array with its own memory but contains references to the same objects for non-primitive data types.
Q. Meaning the array is new but the elements in the array point to the same location as that of the original?? so if i access an element and mutate the element the element in the original array also gets affected?
That is accurate—this behavior is known as a shallow copy.
When you clone an array of objects in Java:
Mutating the object's internal state affects both arrays because both array slots point to the exact same object in memory.
Reassigning the reference at an array index affects only that array, because the array containers themselves are separate objects.
Q. so we can add new elements without the other knowing that's the main usecase of the clone
Yes, that is a primary use case—isolating the array structure and references so one array can be modified, reordered, or reassigned without affecting the other. This pattern is commonly known as defensive copying
manipulate
Doesnot mean immutable: When you perform a "manipulation" on a String—such as .toUpperCase(), .concat(), or .replace()—Java never modifies the original String object. Instead, it generates and returns a brand-new String object containing the transformed text, leaving the original object completely untouched.
BufferedReader Class
Characters
Console Class
text and passwords
44. What is covariant return type?A covariant return type allows an overridden method in a subclass to return an object of the subclass type instead of the superclass type.It is used in method overriding. The return type of the child class method must be a subclass of the parent class return type. It improves code readability and type safety
``` class Animal {} class Dog extends Animal {}
class Parent { Animal getAnimal() { return new Animal(); } }
class Child extends Parent { @Override Dog getAnimal() { // Covariant: Dog is a subclass of Animal return new Dog(); } } ```
``` import java.util.List; import java.util.ArrayList;
class DataProvider { List<String> fetchData() { return new ArrayList<>(); } }
class FastDataProvider extends DataProvider { @Override ArrayList<String> fetchData() { // Covariant: ArrayList implements List return new ArrayList<>(); } } ```
Filter Streams are special stream classes in Java that add extra functionality to existing input and output streams. They wrap another stream and process the data while it is being read or written.Filter streams enhance stream operations such as buffering, data conversion, and object serialization. They do not directly connect to a data source or destination; instead, they work on top of another stream
Primary Domain * Reading and writing raw bytes/characters to files, network sockets, or memory.
What "Filter" Means * Wraps/decorates an existing I/O stream to add features (e.g., buffering, primitive data parsing, or encryption).
Design Pattern * Decorator Pattern (wraps an underlying InputStream or OutputStream).
Example
// FileInputStream provides raw byte reading.
// BufferedInputStream (a FilterStream) wraps it to add buffer capabilities for speed.
InputStream fileStream = new FileInputStream("data.txt");
InputStream bufferedStream = new BufferedInputStream(fileStream);
Anthropic launches Claude Code Projects, an ‘always-on’ conversation that remembers and delegates your long-running dev work
Overview & Purpose
Architecture & Workflow ("Threads do the work, Claude directs it")
Persistent Shared Memory & Knowledge
Execution Environment & Limitations
Rollout, Pricing, & Competitive Landscape
Jev vs Claude: Who Wins?
Jev and Claude (Claude Code / Sonnet) operate at entirely different layers of the software engineering stack:
Choice, Score, Noul) alongside calibrated confidence scores.Choice), probability distributions, and calibrated confidence levels.The benchmark evaluated an Arbitrum Alignment gate from an actual judging workflow (2026 Arbitrum Open House London Online Buildathon):
The Dataset:
satisfied, 7 not_satisfied, 18 insufficient_evidence.Accuracy Results:
Choice + 4 diagnostic Noul primitives): 100.0% accuracy (0 false passes, 0 false flags across 306 decisions).The Critical Calibration Difference:
confidence >= 0.5 allowed 98% automated processing with 100% accuracy, safely escalating the uncertain 2% to human review.not_satisfied instead of insufficient_evidence."Keep the Policy Whole" (Key Engineering Insight):
Noul primitives and reconstructing the decision logic manually via Python/code conditionals.Use Jev for:
Use Claude Code / Frontier Claude for:
行为克隆(Behavior Cloning)与负对数似然训练目标
TgF344-AD
DOI: 10.21203/rs.3.rs-7072571
Resource: Rat Resource and Research Center (RRID:SCR_002044)
Curator: @Apiekniewska
SciCrunch record: RRID:SCR_002044
TgF344-AD rats
DOI: 10.21203/rs.3.rs-7072571
Resource: RRID:RRRC_00699
Curator: @bandrow
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AB_330248
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SciCrunch record: RRID:AB_330248
AB_2534079
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Curator: @scibot
SciCrunch record: RRID:AB_2534079
AB_2249358
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SciCrunch record: RRID:AB_2249358
AB_561053
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Curator: @scibot
SciCrunch record: RRID:AB_561053
AB_2798136
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Curator: @scibot
SciCrunch record: RRID:AB_2798136
AB_2800199
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SciCrunch record: RRID:AB_2800199
AB_2534069
DOI: 10.1016/j.isci.2026.115716
Resource: (Thermo Fisher Scientific Cat# A-11001, RRID:AB_2534069)
Curator: @scibot
SciCrunch record: RRID:AB_2534069
AB_10839118
DOI: 10.1016/j.isci.2026.115716
Resource: (Cell Signaling Technology Cat# 2500, RRID:AB_10839118)
Curator: @scibot
SciCrunch record: RRID:AB_10839118
AB_10013641
DOI: 10.1016/j.isci.2026.115716
Resource: (Cell Signaling Technology Cat# 6943, RRID:AB_10013641)
Curator: @scibot
SciCrunch record: RRID:AB_10013641
AB_2174466
DOI: 10.1016/j.isci.2026.115716
Resource: (Cell Signaling Technology Cat# 2541, RRID:AB_2174466)
Curator: @scibot
SciCrunch record: RRID:AB_2174466
AB_2160882
DOI: 10.1016/j.isci.2026.115716
Resource: (Cell Signaling Technology Cat# 3528, RRID:AB_2160882)
Curator: @scibot
SciCrunch record: RRID:AB_2160882
AB_477629
DOI: 10.1016/j.isci.2026.115716
Resource: (Sigma-Aldrich Cat# V9131, RRID:AB_477629)
Curator: @scibot
SciCrunch record: RRID:AB_477629
AB_2291558
DOI: 10.1016/j.isci.2026.115716
Resource: RRID:AB_2291558
Curator: @scibot
SciCrunch record: RRID:AB_2291558
AB_2128060
DOI: 10.1016/j.isci.2026.115716
Resource: (BD Biosciences Cat# 610467, RRID:AB_2128060)
Curator: @scibot
SciCrunch record: RRID:AB_2128060
AB_10891442
DOI: 10.1016/j.isci.2026.115716
Resource: (Cell Signaling Technology Cat# 8556, RRID:AB_10891442)
Curator: @scibot
SciCrunch record: RRID:AB_10891442
RRID:AB_2307391
DOI: 10.1016/j.isci.2026.115716
Resource: (Jackson ImmunoResearch Labs Cat# 111-035-144, RRID:AB_2307391)
Curator: @scibot
SciCrunch record: RRID:AB_2307391
AB_10694415
DOI: 10.1016/j.isci.2026.115716
Resource: (Cell Signaling Technology Cat# 4848, RRID:AB_10694415)
Curator: @scibot
SciCrunch record: RRID:AB_10694415
RRID:AB_2338505
DOI: 10.1016/j.isci.2026.115716
Resource: (Jackson ImmunoResearch Labs Cat# 115-035-068, RRID:AB_2338505)
Curator: @scibot
SciCrunch record: RRID:AB_2338505
AB_3698765
DOI: 10.1016/j.isci.2026.115716
Resource: RRID:AB_3698765
Curator: @scibot
SciCrunch record: RRID:AB_3698765
AB_476749
DOI: 10.1016/j.isci.2026.115716
Resource: (Sigma-Aldrich Cat# A5979, RRID:AB_476749)
Curator: @scibot
SciCrunch record: RRID:AB_476749
plasmid_208049
DOI: 10.1126/sciadv.adj9479
Resource: RRID:Addgene_208049
Curator: @olekpark
SciCrunch record: RRID:Addgene_208049
Plasmid_213962
DOI: 10.1038/s42003-023-05739-5
Resource: RRID:Addgene_213962
Curator: @olekpark
SciCrunch record: RRID:Addgene_213962
单体式与层次式如何取舍
分2类: 1. 单体式:同一个网络承接多个任务。 同时又分为 单系统(同时生成文字和动作指令)和双系统(外挂一个专家模型)。 2. 层次式:先规划再执行。
Highlights can be created by clicking the
comentario sobre un tema interesante
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commencer à
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appelle
Monster - The Automatic
Wallace & Gromit: Curse Of The Were Rabbit Veg Contest Chase Scene Music
From an adult’s point of view, I was destructive and out of control, but as a child I didn’t think of it that way. I never wanted to destroy. I wanted to create.
His creative nature most likely went on to inspire his career in life
한 가지를 제안
추가로 중추신경계 억제에 의한 낙상 위험을 줄이는 제안, 말초혈관병 증상을 개선하기 위한 제안이 가능하다.
Several conclusions are generally true for all bonds
nog ff aan chat vragen
MD-1001 STGD1 44 c.6089G>A p.(Arg2030Gln) 47 c.6410G>A p.(Cys2137Tyr) - - - - - - - This study
This variant is found in compound heterozygosity with c.6089G>A p.(Arg2030Gln) in family MD-1001 in this study. No phenotype information provided. Not eligible for PP4 due to age of onset not being provided.
Intersection of Stargardt Dystrophy and AIDS: A Case Report
PMID:39991341
Gene: ABCA4
Disease: Stargardt
Supplementary data. bjophthalmol-2018-312064supp004.pdf
This variant is found on pg 16 in proband 14075. Compound heterozygous for c.6817-2A>C. MEH institute (UK). Said to have Stargardt based on the following criteria: "(1) patients (at least 6 years old) with at least two ABCA4 variants or one ABCA4 variant associated with a typical STGD1 phenotype and (2) presence of a well-defined atrophic lesion with/without flecks at the most recent visit of at least 300 µm in diameter (the total area of all lesions <12 mm2)." No additional details provided
Pt-75Mc.4539 + 2028C > Tp.[= ,Arg1514Leufs*36]c.2453G > Ap.(Gly818Glu)
Case#: Pt 7, male, 60yo at report, onset between 6-49yo, Irish
DiseaseAssertion: Stargardt
FamilyInfo: family 5
CasePresentingHPOs:
CaseHPOFreeText: VA: OD=6/36 OS=6/120, FAF and OCT in figure 2, FAF WRT vascular arcades=beyond, beaten bronze appearance, yellow flecks centrally, peripapillary sparing, central retinal thickness: OD=100 microns OS=117 microns, optical coherence tomography (OCT) atrophy horizontal width: OD=6000 microns OS=5446 microns
CaseNotHPOs:
CaseNotHPOFreeText: bulls eye pattern, flecks peripherally
GenotypingMethod: Target capture NGS of the exons and known pathogenic intronic regions of ABCA4, whole-gene single molecule molecular inversion probe (smMIP) based sequencing of ABCA4 as well as 40 kb of flanking sequence, direct Sanger sequencing, or WGS
PreviouslyPublished: n/a
Variant: c.4539 + 2028C > T p.[= ,Arg1514Leufs*36]; c.2453G> A p.(Gly818Glu)
ClinVar: 99135; 236116
CAID: CA227000; CA10576057
SupplementalData: n/a
Patients and Methods The protocol of the study adhered to the provisions of the Declaration of Helsinki. After informed consent was obtained, blood samples were taken and molecular analysis on the ABCA4 gene was performed as described by Maugeri et al. 14 The charts of patients with ABCA4 mutations who originally had received diagnoses of isolated or autosomal recessive CRD were reviewed. All patients originated from the University Medical Centre Nijmegen (Nijmegen, The Netherlands) and the University of Heidelberg (Heidelberg, Germany). In this study the diagnosis of CRD was based on the following criteria: initial symptoms of blurred central vision without a history of night blindness, impairment of color vision, and fundoscopic evidence of maculopathy without or with mild peripheral retinopathy. 3 4 5 7 8 In patients with recordable ERGs a cone–rod pattern of degeneration had to be present (i.e., the photopic b-wave impairment had to be greater than or equal to the scotopic b-wave amplitude impairment). Patients 9250 and 13163, who had nonrecordable ERGs, were included because their histories and clinical features were similar to those of other patients with cone–rod degeneration and they were believed to represent advanced cases of CRD. In addition to an ophthalmic examination, Goldmann kinetic perimetry routinely was performed using III-4-e and I-4-e isopters. Color vision was tested with the Ishihara and Panel D15 tests, except in patients 9369, 9378, and 10125, who were tested under conditions described earlier. 18 Because these patients were examined in two different clinics and ERGs were recorded over a long period, the methods, instrumentation, and analysis techniques of the electroretinography varied. The ERGs in patients 9369, 9378, 10125, and 11872 were performed as described by Thijssen et al. 19 The ERG method used in patients 9370, 9553, 9633, and 13163 was described by Alexandridis and Krastel. 20 The ERGs of the remaining patients (9250, 9371, and 9650) are of a more recent date and were performed according to International Society for Clinical Electrophysiology of Vision (ISCEV) standards. 21 Fundus photographs were taken in most patients and some of the patients (9650, 9369, 9378, and 10125) also underwent fluorescein angiography. Results The characteristics of 12 patients with ABCA4-associated retinal dystrophy resembling CRD are summarized in Table 1 . Most did not have affected family members, and therefore their retinal dystrophies could not be classified as autosomal dominant, autosomal recessive or X-linked. Four patients reported a brother or sister with subnormal vision. In view of the reputedly normal visual acuity of the parents and the molecular defects, the inheritance pattern of the gene defects in these patients (individuals 9303, 9369, 9553, and 13163) was classified as autosomal recessive. The visual acuity of the patients did not exceed 20/200 and, on average, was much lower. With the exception of patient 9553, the age of onset was at or before the age of 12, and in each of the patients, blurred vision was the initial symptom. Night blindness did not occur except in patients 9378 and 10125, in the final stages of retinal degeneration. Evidence of maculopathy in the form of bull’s eye maculopathy or pigmentary changes was present in all the patients reported in this study (Fig. 1A) . The functional equivalent of the mainly centrally located retinal disease was a central scotoma, varying from 8° to more than 40°. In all but one patient, the scotoma was absolute. Only in patient 9378 was the central scotoma relative and surrounded by absolute scotomas. Fundoscopic evidence of early peripheral involvement of the retina was mild, and only in the later stages of the disease did peripheral changes characteristic of RP, such as narrowing of retinal vessels and bone spicula, occur in patients 9369 (Fig. 1B) and 10125. Similarly, mild constriction of the visual fields occurred only in two patients (9650 and 10125) and only in the advanced state. Color vision was tested in 10 patients. Six demonstrated a red–green defect, and in two of these (patients 11872 and 10125), it was accompanied by a blue-yellow defect. In the remaining four patients, color vision was so severely disturbed that the exact type of impairment could not be assessed. The ERG recordings demonstrated degeneration of both rods and cones. When ERG responses could be elicited, the cones appeared to be affected as much as the rod photoreceptors and, in most of the patients, even more severely. The ERG responses in five patients progressively deteriorated until no photopic and scotopic responses could be recorded. In these patients, with exception of patients 9250 and 13163, ERG recordings of an earlier date were used in Table 1 . This applies to patient 9369, in whom an ERG was recorded at age 12 (all ERG responses had been nondetectable since the age of 21), patient 9378 at age 33 (all ERG responses at age 46 were nondetectable), and patient 10125 at age 8 (in 1998, at age 28, the ERG responses were no longer detectable). Recent ERG findings were not available for patients 9650 and 9371. Their ERGs were recorded in 1989 and 1985, respectively. The remaining ERG data were derived from ERG recordings performed in the past 4 years. Of patient 9371 only the ERG data in the left eye were available. Two patients warrant a more detailed description, due to the unusual course of their retinal dystrophies. Patient 9378, at the age of 12, had blurred vision with fundoscopic evidence of irregular chorioretinal atrophy in the posterior pole. At that time, there were no peripheral abnormalities on ophthalmoscopy, and there was no history of night blindness. The ERG demonstrated an equal reduction of both cone- and rod-mediated responses. Later in life, however, fundoscopic changes developed that were characteristic of RP, and the patient reported a decrease in night vision. With fluorescein angiography partly confluent patches of chorioretinal atrophy were visible (Fig. 1C) . The clinical picture of patient 10125 differed from that of the other patients, despite the mutation in the ABCA4 gene. Initially, disease in this patient was diagnosed as STGD because of the bull’s eye maculopathy, the granular pigment alterations in the macular area, and the pisciform flecks surrounding the posterior pole. At age 8 his visual acuity had decreased to 20/200 in both eyes. When he was referred to our clinic in 1998 at the age of 28, peripheral degeneration in the form of narrow retinal vessels and deposition of peripheral bone spicula had developed, in addition to the earlier described disease of the central retina. A fluorescein angiogram showed typical findings: a central small hypofluorescent spot enclosed by an ellipsoid—a markedly hyperfluorescent area that in turn was surrounded by hyperfluorescent dots against a dark background, most likely caused by obscuration of choroidal background fluorescence (Fig. 1D) . Early ERG recordings were not available, and the ERG tracings recorded at age 28 represent the final stage of the degenerative process, with absence of both cone and rod responses. This retinal dystrophy seemed to have evolved from STGD into more widespread retinal degeneration, resulting in loss of function of both rods and cones. Discussion Progressive CRD is a clinically heterogeneous retinal disorder, but typical findings include reduced visual acuity, impairment of the central visual field, color vision deficits, and fundoscopic evidence of maculopathy, with no or few midperipheral retinal pigment deposits. 3 4 7 8 There is some dispute about typical ERG findings in CRD. Some state that the diagnosis of CRD must be based on the reduction or absence of cone responses in the presence of quantitatively less reduction in rod responses, whereas others state that an equal impairment of both photoreceptor systems, if accompanied by the characteristic features, suffices to justify the diagnosis of CRD. 3 7 8 22 Several propositions have been made in the past to classify cone–rod disorders. Some classification systems have focused on individual case reports and were based on nosologic aspects; others have made a distinction according to the various patterns of inheritance. 3 6 23 24 In recent studies, Szlyk et al. 7 and Yagasaki et al. 8 made use of full-field ERGs, dark adaptometry, and modified perimetric techniques to identify functionally distinct subtypes of CRD. Finally, over the past few years, a molecular genetic classification of CRD has emerged. At the moment, four genes and three loci have been implicated in autosomal dominant CRD, whereas one X-linked locus has been described. 25 26 27 28 29 30 31 32 Thus far, two loci and one gene (ABCA4) have been associated with autosomal recessive CRD. 12 33 34 The genetic heterogeneity seen in CRD is matched by the range of the clinical findings attributed by various investigators to this type of retinal dystrophy. Whatever the classification system used, some patients display retinal disorders that cannot be classified satisfactorily. Often, these retinal degenerations involve overlapping features. Krill et al. 5 reported that 9 of 45 patients with cone degenerations showed typical features associated with fundus flavimaculatus. Heckenlively 2 described 76 patients with cone–rod patterns on the ERG in whom retinal disease otherwise met the standard definition of RP (progressive peripheral visual field loss with ring scotoma). Alternatively, as seen in patient 10125 in this study, patients with STGD have been described who had progressive peripheral retinal degeneration with severe abnormalities in the ERG and electro-oculogram (EOG) later in life—a condition that has been described by Fishman 4 as secondary progressive cone–rod dysfunction. The association of CRD and a dark choroid has also been described previously. 35 36 The atypical pattern of retinal degeneration with confluent patches of chorioretinal atrophy in patient 9378 resembles that in another previously described unrelated patient with CRD-like disease caused by mutations in ABCA4. 37 In the molecular genetic study by Maugeri et al., 14 in which 11 of the 12 patients with autosomal recessive CRD described in this study were analyzed, ABCA4 mutations were found in 13 of 20 unrelated patients, strongly suggesting that ABCA4 mutations are the major cause of this disorder. If this is true, the genetic heterogeneity in autosomal recessive CRD, compared with, for example, classic RP, is surprisingly low. Because autosomal recessive inheritance is believed to be the most frequent mode of inheritance of monogenic chorioretinal disorders, it is very possible that a large fraction of the patients with CRD who have been clinically studied previously carry ABCA4 mutations. In that case, the explanation for the high variability of the clinical findings in autosomal recessive CRD would not be genetic heterogeneity but rather the genotype–phenotype model for ABCA4. According to this model, there is an inverse relationship between the presumed residual ABCA4 function as an N-retinylidene-PE flippase and the severity of the disorder. 12 37 38 As a consequence, a continuum of phenotypes is to be expected, ranging from STGD to CRD to RP. Although this is probably a simplified representation of reality and needs corroboration by detailed biochemical studies of individual mutations, as described previously, this model explains why mutations in the ABCA4 gene could give rise to phenotypes that do not satisfy the standard classification of retinal dystrophies. 39 Two patients in this study may reflect borderline CRD phenotypes. Patient 9553 carries a combination of a mild (2588G>C) and severe ABCA4 mutation, which, according to the genotype–phenotype model described earlier, should be associated with STGD. We have previously discussed that most likely, one of the pathologic mutations has not yet been identified in this patient. 14 However, the age of onset in this patient (25 years) is relatively high, and although other features such as visual acuity, perimetry, and ERG findings are typical of CRD, this may indicate a relatively mild subtype. Another more convincing example of blending of ABCA4-associated phenotypes is patient 10125. The molecular findings in this patient have not yet been described elsewhere. He carries a severe splice site mutation (IVS30+1G→T) in combination with a nucleotide change leading to a stop codon at Gln1029. A patient with RP who was homozygous for the IVS30+1G→T mutation has been described, 12 whereas the Q1029X mutation has not been described. Both mutations can be considered to be null alleles. According to the proposed ABCA4 model, the clinical phenotype in patient 10125 should be RP. Instead, this patient exhibits a typical retinal dystrophy, which gradually progresses from STGD to a more widespread degeneration of photoreceptors in a cone–rod pattern later in life. At present, both rod and cone ERG responses are not detectable, indicative of a final stage similar to that in many patients with RP. Functional studies are necessary to clarify whether these specific ABCA4 mutations are responsible for the particular progression of the retinal degeneration in this patient, or whether other as yet unknown modifying factors play a role. In this study we have described 12 unrelated patients with retinal dystrophy resembling CRD caused by mutations in the ABCA4 gene. In a previous study we described the ophthalmic features in five siblings with CRD-like retinal dystrophy who were carrying ABCA4 mutations. 37 From the clinical data of these patients and previous molecular studies in patients with autosomal recessive CRD, two important conclusions can be drawn. 12 14 First, the genetic basis of autosomal recessive CRD is less heterogeneous than was thought, based on the variability in clinical features, because mutations in the ABCA4 gene seems to be the major pathologic cause. Second, given the wide clinical spectrum of CRD-like phenotypes associated with ABCA4 mutations, detailed clinical subclassifications are difficult and may not be very useful. Supported by the British Retinitis Pigmentosa Society, the Rotterdamse Vereniging Blindenbelangen, the Algemene Nederlandse Vereniging ter Voorkoming van Blindheid, the Stichting Blindenhulp, the Stichting de Drie Lichten, the Gelderse Blindenvereniging and the Landelijke Stichting voor Blinden en Slechtzienden and the Stichting voor Ooglijders. Submitted for publication June 15, 2001; revised December 21, 2001; accepted January 2, 2002. Commercial relationships policy: N. The publication costs of this article were defrayed in part by page charge payment. This article must therefore be marked “advertisement” in accordance with 18 U.S.C. §1734 solely to indicate this fact. Corresponding author: B. Jeroen Klevering, Department of Ophthalmology, University Medical Centre Nijmegen, PO Box 9101, 6500 HB, Nijmegen, The Netherlands; b.klevering@ohk.azn.nl. Table 1. View Table Patients with Cone–Rod Degeneration and ABCA4 MutationsTable 1. Patients with Cone–Rod Degeneration and ABCA4 Mutations Patient Sex Current Age (ys) ABCA4 Mutations* Visual Acuity Age of Onset (ys) Fundoscopy Color Vision Perimetry ERG Cone (μV), † ERG Rod (μV), † OD OS OD OS OD OS 9250 M 30 1622T→C; 3113C→T 194G→A CF CF 6 Pigment clumping in the macula NP Large central scotoma over 40° ND, ‡ ND, ‡ 9303 M 21 1622T→C; 3113C→T 20/400 20/400 7 Granular pigmentary changes in the macula Diffusely disturbed Central scotoma of 20° Severely decreased, § Severely decreased, § 9369 F 40 6601-6602deIAG LP LP 8 Irregular hypopigmentation, mainly in the posterior pole. In later stages: attenuated vessels and bone spicula temporal to the macula Red-green defect Central scotoma varying from 10–30° 65 (65%) 80 (80%), ∥ 140 (90%) 160 (nl), ∥ 9370 M 15 1622T→C; 3113C→T 20/200 20/200 7 Granular aspect of the macula NP Concentric central scotoma of 8° 10 (13%) 9 (13%), ¶ 29 (29%) 29 (23%), ¶ 9371 M 38 1622T→C; 3113C→T 1622T→C;3113C→T 20/400 20/400 10 Bull’s eye maculopathy Red-green defect Concentric central scotoma of 20° NP 29 (16%), ‡ NP 54 (30%), ‡ 9378 F 50 768G→T CF CF 12 Bull’s eye maculopathy, narrow vessels in periphery with mild granular changes of the pigment epithelium and confluent patches of chorioretinal atrophy Severely disturbed Large, absolute, paracentral scotomas, relative scotoma centrally 20 (20%) 30 (30%), ∥ 70 (47%) 90 (60%), ∥ 9553 F 45 2588G→C IVS35del-2→+2del4 20/400 20/400 25 Bull’s eye maculopathy. Peripheral diffuse motting of RPE Severely disturbed Large central scotoma over 40° 14 (14%) 19 (19%), ¶ 41 (41%) 24 (24%), ¶ 9633 M 22 1622T→C; 3113C→T 4469G→A 20/400 20/200 12 Atrophy of retinal pigment epithelium in posterior pole. Early stages of bull’s eye maculopathy Red-green defect Central scotoma of 20° 12 (16%) 12 (16%), ¶ 61 (62%) 39 (39%), ¶ 9650 F 20 3364G→A 20/400 20/400 5 Central granular aspect Red-green defect Large central scotoma of 30° and relative constriction of III-4 70 (39%) 106 (59%), ‡ 272 (nl) 115 (76%), ‡ 10125 M 30 IVS30+1G→T 3085C→T 20/200 20/200 8 Central hypopigmentation with dark surrounding, resembling bull’s eye. Later in life: peripheral changes characteristic of RP Severe red-green defect; mild blue-yellow defect Central scotoma of 10–15° with mild peripheral restriction 75 (75%) 80 (80%), ∥ 130 (87%) 140 (93%), ∥ 11872 M 30 634C→T 20/200 20/200 10 Bull’s eye pattern Severely disturbed; blue-yellow more than red-green Central scotoma of 25° 23 (23%) 35 (35%), ∥ 110 (73%) 95 (63%), ∥ 13163 M 15 1622T→C;3113C→T IVS36+1G→A 20/400 20/200 6 Granular aspect of retinal pigment epithelium in macula. Slightly pale optic disc Severely disturbed Central scotoma of 10–15,° no peripheral involvement ND, ¶ ND, ¶ CF, count fingers; LP, light perception; ND, not detectable; NP, not performed. * Allele 1, first line; allele 2, second line. † Between parentheses: percentage of the ERG value compared to the lower limit of the normality; normal ERG values are indicated nl. ‡ Minimal values for ERG recordings: 150 μV for the photopic ERG, 180 μV for the scotopic ERG. § ERG performed with skin electrodes. ∥ Minimal values for ERG recordings: 100 μV for the photopic ERG, 150 μV for the scotopic ERG. ¶ Minimal values for ERG recordings: 99 μV for the photopic ERG, 75 μV for the scotopic ERG. Figure 1. View OriginalDownload Slide (A–D) Fundus photographs and fluorescein angiograms in eyes of patients with (atypical) CRD. (A) Patient 11872 with bull’s eye maculopathy. (B) Patient 9369, demonstrating CRD in the later stages with attenuation of the retinal arterioles and irregular pigmentation temporal to the macula. (C) Fluorescein angiograms in patient 9378 showing confluent patches of chorioretinal atrophy. (D) Patient 10125 with central hypofluorescence enclosed by an ellipsoid hyperfluorescent area. In the surrounding area, hyperfluorescent flecks are visible, and the choroidal background fluorescence seems blocked, as seen in STGD.
Case#: Klevering Patient 9369, female, Netherlands, 40yo at report, 8yo at onset
DiseaseAssertion: cone-rod degenerations/ ABCA4-associated retinal dystrophy resembling CRD
FamilyInfo: "In view of the reputedly normal visual acuity of the parents and the molecular defects, the inheritance pattern of the gene defects in these patients (individuals 9303, 9369, 9553, and 13163) was classified as autosomal recessive."
CasePresentingHPOs:
CaseHPOFreeText: Visual acuity: light perception OU. Fundoscopy: Irregular hypopigmentation, mainly in the posterior pole. In later stages: attenuated vessels and bone spicula temporal to the macula. Red-green defect of color vision. Perimetry: Central scotoma varying from 10–30°. ERG Cone (μV): OD-80 (80%), OS-140 (90%) from 12 yo (all ERG responses had been non-detectable since the age of 21). ERG Rod (μV): 160 (nl). Fundus photographs and fluorescein angiograms show CRD in the later stages with attenuation of the retinal arterioles and irregular pigmentation temporal to the macula. Narrowing of retinal vessels and bone spicula (Fig 1B). Fundus description (PMID: 10958761): atrophy of the RPE around the optic disk, bone spicules along arteries and venules in the mid-periphery, and attenuated arterioles (Fig 1D)
CaseNotHPOs:
CaseNotHPOFreeText:
GenotypingMethod: single-strand conformation polymorphism (SSCP) and direct-sequencing techniques to look for mutations in the 50 exons and flanking intron sequences of the ABCA4 gene
PreviouslyPublished: Maugeri et al (PMID: 10958761)
Variant: c.6601_6602delAG
CAID: CA227421
SupplementalData: n/a
MD-0302 ABCA4 12 c.1622T>C p.Leu541Pro 42 c.5882G>A p.Gly1961Glu 17 Yes ABCR400
another case with 541 variant potentially not in cis with 1038
Whole exome sequencing identifies a novel splice-site mutation in IMPG2gene causing Stargardt-like juvenile macular dystrophy in a northIndian family
PMID:35973334
Gene: ABCA4
HGNC ID: 34
Case#: the youngest sister II.7, aged 12 years, was the least affected
Variant splice-site variant NC_000003.11(NM_016247.3):c.1239 + 1G > T [Chr3:100972539C > A
FammilyInfo two-generation north Indian family with three members affected with Stargardt-like macular dys trophy
CasePresentingHPOs:ow vision and difficulty in night vision, with symptoms starting in the early second decade of life, which progressed slowly over time
PedrigreeIn the results section is mentioned
CaseHPOFreeText:NA
CaseNotHPOs:Na
CaseNotHPOFreeText:NA
Genotyping Method:2.3. Validation of identified variant by Sanger sequencing
PreviouslyPublished:NA
ABCA4-retinopathy
Case#: 1 male, 24 years old, from consanguineous parents, Somali ancestry.
DiseaseAssertion: ABCA4-related retinopathy Stargardt disease
FamilyInfo: Single affected individual consanguineous parents, Somali ancestry. No additional information about family is provided in text.
CasePresentingHPOs: HP:0000572- reduced central vision, HP:0001102- Angioid streaks, HP:0007980- retinal pigment epithelium atrophy, HP:0007401- Macular atrophy, HP:0000630- Abnormal retinal arterial/arteriolar morphology
CaseHPOFreeText: Presents with reduced central vision, Fundus autofluorescence (FAF) showed angioid streaks, reduced signal in the central macula indicative of retinal pigment epithelium atrophy. Electrophysiological testing showed severe macular dysfunction with generalized retinal involvement.
CaseNotHPOs: HP:0200070- Peripheral retinal atrophy
CaseNotHPOFreeText: Peripheral retina appears unaffected after ultra-widefield FAF imaging
Genotyping Method: PCR-amplification and Sanger sequencing of ABCA4 on Exon 42, Stargardt/Macular dystrophy SmartPanel v5; Molecular Vision Laboratory, Hillsboro, Oregon tested DNA for mutations which confirmed findings of ABCA4, with no additional pathogenic mutations found.
PreviouslyPublished: PMID: 22261738, 1 male, 24 years old, from consanguineous parents, Somali ancestry presenting with reduced vision.
Variant: NM_000350.3(ABCA4):c.5882G>A (p.Gly1961Glu)
ClinVar: Variation ID: 7888
CAID: N/A
SupplementalData: N/A
20/28/2/18/ female CRD c.1654 G>A c.4363 T>C 35, 35 38, 34 52, 57 4, 5 45.0, 42.5 1.0, 0.7
Case#: Subject 20, 28yo, 18yo at first ffERG, Sweden, female
DiseaseAssertion: CRD, group 2
FamilyInfo: n/a
CasePresentingHPOs:
CaseHPOFreeText: extensive atrophies in the posterior pole. peripheral pigmentations. few peripapillary changes. Normal thickness of the most central segment recorded on OCT. total absence of the PIL (photoreceptor integrity line) and RPE atrophy on the OCT B-scans. ETDRS VA score= 35, 35. Rod ffERG= 38, 34 Ampl (µV). Combined ffERG= 52, 57 Ampl (µV). Cone ffERG= 4, 5; 45.0, 42.5 Amp IT (µV; ms). mERG sum= 1.0, 0.7 Ampl (µV). Group 2 with larger central scotomas from 10° to 35°
CaseNotHPOs:
CaseNotHPOFreeText:
GenotypingMethod: Sequence analysis of the entire coding region of the ABCA4 gene was performed.
PreviouslyPublished: n/a
Variant: c.1654G>A; c.4363T>C
CAID: CA239745
SupplementalData: n/a
Disruption in Bruch membrane in patients with Stargardt disease
PMID: 22060670
Gene: ABCA4
HGNC ID: 34
Modification of the PROM1 Disease Phenotype by a Mutation inABCA4
PMID: PMC6777736
Gene: ABCA4
HGNC ID: 34