Search

Catering for the mathematical needs of disabled learners equitably and productively requires the anti-ableist preparation and professional development of teachers. In CAPTeaM (Challenging Ableist Perspectives on the Teaching of Mathematics), we design tasks that emulate inclusion-related challenges from the mathematics classroom, and we engage teachers with these tasks in workshop settings. In this paper, we focus on evidence from one type of task in which participants engage in small groups with solving a mathematical problem while at least one of them is temporarily and artificially deprived of access to a sensory field or familiar channel of communication. In this paper, we focus on evidence of emerging resignification -- discursive and affective shifts in the participating teachers' sense-making about what makes the construction of mathematical meaning possible and valuably different -- as they work on the tasks. By linking Vygotsky's vision about the educational changes required to empower and include disabled learners with more contemporary ideas from embodied cognition and disability studies, our analyses show how engagement with the tasks affects participants' realisation and appreciation of interdependencies between learners, teacher, resources, and emotions, highlights alternative forms of mathematical agency and gives opportunities to turn initial sense of impasse and despair into joy.

This cross-sectional observational study sought to examine the environmental correlates of physical activity and screen-time among youth with autism spectrum disorder (ASD). Parents of youth with ASD (n = 1,165) from seven countries/regions provided responses to an online survey form measuring environmental correlates (i.e., physical activity neighborhood environment, social network, social trust and cohesion, bedroom media, social home environment) and outcomes (i.e., physical activity, screen-time). Multiple linear regression analyses were conducted to determine environmental predictors of the outcomes. Physical activity neighborhood environment (B = 0.15, p = 0.047), social network (B = 0.16, p = 0.02), and social home environment (B = 1.07, p < 0.001) were significantly associated with physical activity, whereas social trust and cohesion and bedroom media were not. Further, social trust and cohesion (B = -0.14, p = 0.001), bedroom media (B = 0.10, p = 0.001), and social home environment (B = -0.16, p < 0.001) were significantly associated with screen-time while neighborhood environment and social network were not. The identified environmental attributes of physical activity and screen-time behaviors should be targeted for health promotion among youth with ASD.

With a runtime of 47 years, Saturday Night Live has long served as a societal mirror that captures and creates popular culture. In recent years the show has been criticized for its lack of diverse hosts, cast and staff. Out of 930 episodes only seven episodes have been hosted by an Asian host, four of whom identify as Chinese. This research examined those four episodes through quantitative analysis, finding that the qualities of each of the hosts' characters range from just below neutral to moderately positive. The use of stereotypes and satirical racial humor varied. Jackie Chan and Lucy Liu's episodes had the highest concentration of both overt and covert stereotypes, while Awkwafina had a similar number with a lower concentration. The infrequency of Chinese representation on the show is a social issue. Such a small sample size does not allow for conclusions to be drawn. Rather, this research paints a picture of how the four Chinese hosts are portrayed on SNL as influenced by their own unique identities and the year of their appearance. In addition, the insights this case study offers has implications for shows performed in colleges and K-12 schools. Directors and sponsors of school based shows can learn from this case study how to avoid perpetuating stereotypes and how to advance diversity, equity and inclusion at their institutions.

This study aimed to identify the prevalence of current smoking and examine the association between meeting combinations of the 24-h movement guidelines and current smoking in autistic adults. This cross-sectional study administered an electronic survey to a national sample of autistic adults in the United States. The study outcome was current smoking. Independent variables included the 24-h movement behaviors. Multivariable statistical modeling was used to assess the study aims. The study sample (n = 259) had a mean age of 31.05 years (standard deviation = 7.70), 58.7% were male, 11.2% were fully independent, and 35.5% were current smokers. Current smokers met significantly fewer 24-h movement guidelines than non-smokers (mean = 1.52 (standard deviation = 0.73) vs mean= 1.93 (standard deviation = 0.88), respectively, t = 3.77, p < 0.01). Autistic adults with high levels of sedentary behavior were almost three times more likely (odds ratio = 2.784, 95% confidence interval = 1.490, 5.237) to be a current smoker than those who did not meet these guidelines. Autistic adults not meeting sleep and sedentary behavior recommendations had a 1.581 increased odds (odds ratio = 1.581 95% confidence interval = 1.25, 2.001) of being a smoker as compared to those meeting these recommendations. Current smoking was highly prevalent in this sample. Improving sleep health and reducing sedentary time may be viable intervention targets to help promote smoking cessation in autistic adults.

Placement as a form of work-integrated learning is a valued element of undergraduate education. Prior work explores how placement provides a site for developing professional values, skills and competences as well as identifying how students build awareness of professional requirements. Greater focus on how such processes of awareness are realised, negotiated and enacted is still required. This study frames student placement experiences as enabling processes of recursive negotiation between the self and the setting. The empirical contribution is to document and track this with 40 students on accounting placements, interviewed at three points in time (pre-, during, post-placement) exploring their subjective experiences. Findings evidence various trajectories of experience emerging from which a model capturing four distinct forms of fit (personal, reflected, projected, absence of fit) with professional identity is developed. This suggests student placement experiences in all their variations lead to and constitute more than merely technical or academic outcomes. Conceptually framing placement experiences as recursive negotiations between the self and the setting in the professionalisation journey uncovers how professional identity formation processes are constructed and (re)negotiated. As well as providing students with terminology to understand and articulate the multiplicity of possible placement experiences, educators, employers and professional bodies can benefit from the more nuanced possibilities for work-integrated learning that are suggested.

Operational definitions have a significant history in applied behavior analysis. The practice's importance stems from the role operational definitions play in detecting an event, human thought, or action. While operationalizing target behaviors has enjoyed widespread practice, some concerns have recently arisen with translation validity and detection accuracy. Additionally, a review of the literature produces few articles assessing the validity of operational definitions. Pinpoints represent an alternative for describing target behaviors. A pinpoint has a formula for construction that includes using an action verb, an object, or event that receives the action, and a comprehensibly defined context where the observation of the action verb + object or event occurs. Pinpoints also have few empirical studies demonstrating their validity. The following experiment compared the detection accuracy of an operational definition for self-injurious behavior and a corresponding pinpoint across professionals who worked in a school that served clients with autism spectrum disorder. The results indicate lower accuracy scores for the operational definition when compared to the pinpoint. Additionally, the consistency of scores varied more for the operational definition than the pinpoint.

Abstract The impact of adjuvants on malaria vaccine-induced antibody repertoire is poorly understood. Here, we characterize the impact of two adjuvants, Alhydrogel® and AS01, on antibody clonotype diversity, binding and function, post malaria vaccination. We expressed 132 recombinant anti-Pfs230D1 human monoclonal antibodies (mAbs) from participants immunized with malaria transmission-blocking vaccine Pfs230D1, formulated with either Alhydrogel® or AS01. Anti-Pfs230D1 mAbs generated by Alhydrogel® formulation showed higher binding frequency to Pfs230D1 compared to AS01 formulation, although the frequency of functional mAbs was similar between adjuvant groups. Overall, the AS01 formulation induced anti-Pfs230D1 functional antibodies from a broader array of germline sequences versus the Alhydrogel® formulation. All mAbs using IGHV1-69 gene from the Alhydrogel® cohort bound to recombinant Pfs230D1, but did not block parasite transmission to mosquitoes, similar to the IGHV1-69 mAbs isolated from the AS01 cohort. These findings may help inform vaccine design and adjuvant selection for immunization with Plasmodium antigens.

Abstract Obstructive sleep apnea (OSA) and hypertension are two important modifiable risk factors for cardiovascular disease and mortality. Numerous studies have highlighted the interplay between these two conditions. We provide a critical review of the current literature on the role of the OSA as a risk factor for hypertension and its effect on blood pressure (BP). We discuss several key topics: the effect of OSA on nocturnal BP, BP response to continuous positive airway pressure (CPAP) treatment, CPAP effect on BP in refractory hypertension, the role of OSA in BP variability (BPV), and maladaptive cardiac remodeling mediated by OSA’s effect on BP. Finally, we discuss the unique aspects of ethnicity and social determinants of health on OSA with a focus on Asian populations and the disparity in BP control and cardiovascular outcomes.

Abstract Aims Currently, there is no reliable biomarker to detect pre‐heart failure in humans. An early risk signal is an elevated left atrial pressure (LAP) and preliminary results from animal studies strongly suggest the neuropeptide neuromedin U (NMU) is released in response to this increase in LAP. However, it is unknown whether NMU is elevated in patients with heart failure. Therefore, the aim of this study was to assess if NMU levels are elevated in human cases of heart failure. Methods and results Twenty‐four serum samples were obtained from patients in stage II and III heart failure from the Royal Papworth Hospital in Cambridge UK and tested using a selective NMU‐ELISA; the data were compared with serum obtained commercially from self‐declared healthy donors. NMU concentrations in serum from heart failure patients were significantly higher (P = 0.0007; unpaired Student's t‐test) than control, 8.48 ± 0.67 ng/mL (mean ± SEM) versus 5.43 ± 0.46 ng/mL. There was no significant difference between NYHA stage II and III patients (P = 0.85, unpaired Student's t‐test), which were 8.33 ± 0.89 ng/mL (n = 9) and 8.6 ± 0.95 ng/mL (n = 15), respectively. Only mean right atrial pressure was found to have a significant correlation with serum NMU (R = 0.81, P

Abstract Environmental and lifestyle factors, including air pollution, impaired diet, and low physical activity, have been associated with cardiometabolic risk factors in childhood and adolescence. However, environmental and lifestyle exposures do not exert their physiological effects in isolation. This study investigated associations between an exposome score to measure the impact of multiple exposures, including diet, physical activity, sleep duration, air pollution, and socioeconomic status, and serum metabolites measured using LC-MS and NMR, compared to the individual components of the score. A general population of 504 children aged 6–9 years at baseline was followed up for eight years. Data were analysed with linear mixed-effects models using the R software. The exposome score was associated with 31 metabolites, of which 12 metabolites were not associated with any individual exposure category. These findings highlight the value of a composite score to predict metabolic changes associated with multiple environmental and lifestyle exposures since childhood.

Peatland restoration and rehabilitation action has become more widely acknowledged as a necessary response to mitigating climate change risks and improving global carbon storage. Peatland ecosystems require restoration time spans of the order of decades and, thus, cannot be dependent upon the shorter-term monitoring often carried out in research projects. Hydrological assessments using geospatial tools provide the basis for planning restoration works as well as analysing associated environmental influences. “Restoration” encompasses applications to pre-restoration and post-restoration scenarios for both bogs and fens, across a range of environmental impact fields. The aim of this scoping review is to identify, describe, and categorize current process-based modelling uses in peatlands in order to investigate the applicability and appropriateness of ecohydrological and/or hydrological models for northern peatland restoration. Two literature searches were conducted using the entire Web of Science database in September 2022 and August 2023. Of the final 211 papers included in the review, models and their applications were categorized according to this review's research interests in seven distinct categories aggregating the papers' research themes and model outputs. Restoration site context was added by identifying 229 unique study site locations from the full database, which were catalogued and analysed against raster data for the Köppen–Geiger climate classification scheme. A majority of northern peatland sites were in temperate oceanic zones or humid continental zones that experienced snow. Over one in five models from the full database of papers were unnamed and likely intended for single use. Key themes emerging from topics covered by papers in the database included the following: modelling restoration development from a bog growth perspective, the prioritization of modelling greenhouse gas (GHG) emissions dynamics as a part of policymaking, the importance of spatial connectivity within or alongside process-based models to represent heterogeneous systems, and the increased prevalence of remote sensing and machine learning techniques to predict restoration progress with little physical site intervention. Models are presented according to their application to peatlands or broader ecosystem and organized from most to least complex. This review provides valuable context for the application of ecohydrological models in determining strategies for peatland restoration and evaluating post-intervention development over time.

Abstract Aim To test a serious game intervention about nursing and midwifery perceptions among adolescent school children. Background Nursing and midwifery professions face challenges in recruitment, with persistent gender stereotypes and a lack of clarity regarding the roles contributing to this issue. This study addresses the need for innovative approaches to reshape perceptions and encourage career exploration in adolescent school children. Design Employing a pre/post-test design, this study involved 137 post-primary students aged sixteen or seventeen in the United Kingdom. Methods Data collection occurred between November 2022 to April 2023, involving three post-primary schools. Participants engaged with a digital serious game designed to address misconceptions and promote a more accurate understanding of nursing and midwifery. Participants completed pre- and post-intervention questionnaires, including an adapted version of the Nursing as a Career Choice Questionnaire. Statistical analyses included descriptive statistics, paired t-tests, and independent groups t-tests. Results The serious game intervention resulted in statistically significant improvements in students’ perceptions across multiple domains. Overall, participants showed higher mean post-test scores (M = 139.57, SD = 15.10) compared to their mean pre-test score (M = 131.06, SD = 14.73) on the questionnaire. The domains of self-efficacy (p

Abstract Background As a key determinant of ill-health, family violence is inadequately responded to within Aotearoa New Zealand health policy and practice. Without adequate system support, health professionals can often be unsure of what to do, or how to help. Developed in response to this system gap, ‘Atawhai’ aims to make it easier for primary care professionals to respond to family violence. Methods Underpinned by indigenous Māori customs, Atawhai combines complexity theory and participatory research methodologies to be responsive to the complexity involved in family violence. We worked with 14 primary care professionals across ten whakawhitiwhiti kōrero wānanga (meetings for deliberate dialogue) to identify and develop primary care system pathways and tools for responding to family violence. This paper focuses on the development of Atawhai through wānanga and observation methods. Methods used to capture change will be reported separately. Findings Atawhai is a relational response to family violence, focused on developing a network of trusted relationships between health and social care professionals to support safe responses to those accessing care. This study identified four key health system pathways to responsiveness and developed associated tools to support health care responsiveness to family violence. We found the quality of relationships, both among professionals and with those accessing care, coupled with critical reflection on the systems and structures that shape policy and practice are essential in generating change within primary care settings. Conclusions Atawhai is a unique health care response to family violence evidenced on empirical knowledge of primary care professionals. Our theoretical lens calls attention to parts of the system often obscured by current health care responses to family violence. Atawhai presents an opportunity to develop a grassroots-informed, long-term response to family violence that evolves in response to needs.

Abstract Background Induced pluripotent stem cell-derived microglia (iMGL) represent an excellent tool in studying microglial function in health and disease. Yet, since differentiation and survival of iMGL are highly reliant on colony-stimulating factor 1 receptor (CSF1R) signaling, it is difficult to use iMGL to study microglial dysfunction associated with pathogenic defects in CSF1R. Methods Serial modifications to an existing iMGL protocol were made, including but not limited to changes in growth factor combination to drive microglial differentiation, until successful derivation of microglia-like cells from an adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) patient carrying a c.2350G > A (p.V784M) CSF1R variant. Using healthy control lines, the quality of the new iMGL protocol was validated through cell yield assessment, measurement of microglia marker expression, transcriptomic comparison to primary microglia, and evaluation of inflammatory and phagocytic activities. Similarly, molecular and functional characterization of the ALSP patient-derived iMGL was carried out in comparison to healthy control iMGL. Results The newly devised protocol allowed the generation of iMGL with enhanced transcriptomic similarity to cultured primary human microglia and with higher scavenging and inflammatory competence at ~ threefold greater yield compared to the original protocol. Using this protocol, decreased CSF1R autophosphorylation and cell surface expression was observed in iMGL derived from the ALSP patient compared to those derived from healthy controls. Additionally, ALSP patient-derived iMGL presented a migratory defect accompanying a temporal reduction in purinergic receptor P2Y12 (P2RY12) expression, a heightened capacity to internalize myelin, as well as heightened inflammatory response to Pam3CSK4. Poor P2RY12 expression was confirmed to be a consequence of CSF1R haploinsufficiency, as this feature was also observed following CSF1R knockdown or inhibition in mature control iMGL, and in CSF1R WT/KO and CSF1R WT/E633K iMGL compared to their respective isogenic controls. Conclusions We optimized a pre-existing iMGL protocol, generating a powerful tool to study microglial involvement in human neurological diseases. Using the optimized protocol, we have generated for the first time iMGL from an ALSP patient carrying a pathogenic CSF1R variant, with preliminary characterization pointing toward functional alterations in migratory, phagocytic and inflammatory activities. Graphical Abstract

Abstract In the mid-1990s, the identification of BRCA1/2 genes for breast cancer susceptibility led to testing breast MRI accuracy in screening women at increased risk. From 2000 onwards, ten intraindividual comparative studies showed the marked superiority of MRI: the sensitivity ranged 25−58% for mammography, 33−52% for ultrasound, 48−67% for mammography plus ultrasound, and 71−100% for MRI; specificity 93–100%, 91–98%, 89–98%, and 81–98%, respectively. Based on the available evidence, in 2006–2007, the UK National Institute for Clinical Excellence and the American Cancer Society recommended MRI screening of high-risk women, followed by other international guidelines. Despite evidence-based medicine ideally requiring randomised controlled trials (RCTs) for policy changes regarding screening procedures, breast MRI for high-risk screening was adopted in many countries worldwide. In 2019, the results of the “DENSE” RCT were published in favour of breast MRI screening of women with extremely dense breasts compared to mammography alone, showing a reduction of more than 80% of the interval cancer rate in women who attended MRI screening. Even though international recommendations in favour of this practice were issued, substantial obstacles still prevent health systems from adopting breast MRI for screening women with extremely dense breasts. A paradox is evident: we adopted a screening procedure without evidence from RCTs, and now that we have this level-1 evidence for the same procedure, we fail to do so. This critical review tries to explain the differences between the two cases, as examples of the complex pathways of translating radiological research into everyday practice. Critical relevance statement The high-level evidence in favour of breast MRI screening of women with extremely dense breasts is failing to persuade policy makers to translate this into clinical practice. Key points • Breast MRI screening of high-risk women was adopted on basis of the evidence provided by test accuracy comparative studies showing an MRI performance greatly superior to that of mammography. • Breast MRI screening of women with extremely dense breasts has not been adopted although the evidence of a large reduction in interval cancer rate from a RCT. • We illustrate the differences between the two cases, as an example of the complex ways of translation of radiological research in clinical practice according to the EBM theory. Graphical Abstract

Abstract In the initial hours following the application of the calcium channel blocker (CCB) nifedipine to microtissues consisting of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs), we observe notable variations in the drug’s efficacy. Here, we investigate the possibility that these temporal changes in CCB effects are associated with adaptations in the expression of calcium ion channels in cardiomyocyte membranes. To explore this, we employ a recently developed mathematical model that delineates the regulation of calcium ion channel expression by intracellular calcium concentrations. According to the model, a decline in intracellular calcium levels below a certain target level triggers an upregulation of calcium ion channels. Such an upregulation, if instigated by a CCB, would then counteract the drug’s inhibitory effect on calcium currents. We assess this hypothesis using time-dependent measurements of hiPSC-CMs dynamics and by refining an existing mathematical model of myocyte action potentials incorporating the dynamic nature of the number of calcium ion channels. The revised model forecasts that the CCB-induced reduction in intracellular calcium concentrations leads to a subsequent increase in calcium ion channel expression, thereby attenuating the drug’s overall efficacy. The data and fit models suggest that dynamic changes in cardiac cells in the presence of CCBs may be explainable by induced changes in protein expression, and that this may lead to challenges in understanding calcium based drug effects on the heart unless timings of applications are carefully considered.

Breast augmentation is considered one of the most commonly performed procedures by aesthetic plastic surgeons, representing 16 % of all global plastic surgery procedures in 2020. Given the fact that thoracic trauma comprises over 20 % of trauma worldwide, it is unsurprising that there is potential for overlap between these two patient populations. Here, we present the case of a 59-year-old patient who had undergone bilateral breast augmentation over 10 years prior to presentation. They arrived as a highest-level trauma activation after being a helmeted cyclist struck by a motor vehicle resulting in significant left-sided thoracic trauma. Following stabilization in the trauma bay, CT imaging of the thorax demonstrated multifocal left pulmonary contusions and lacerations, multiple left-sided rib fractures (ribs 2–12), a small left pneumothorax, and left-sided subcutaneous emphysema. Imaging also demonstrated the presence of bilateral breast implants with the left implant appearing irregular in shape with the retropectoral space corresponding to the implant capsule having evidence of significant free air (capsular pneumatosis) concerning for acute traumatic rupture of the capsule. While undergoing surgical stabilization of her left-sided rib fractures, one of her ribs was noted to have violated the posterior wall of the breast capsule. Upon implant removal, the implant was found to have ruptured with tears in the shell corresponding to patient's rib fractures. This case represents a rare and unexpected complication of traumatic rib fractures; mainly the traumatic rupture of a silicone breast implant, which was identified by the presence of capsular pneumatosis on CT imaging. Presence of this rare radiographic sign (capsular pneumatosis) in the setting of a patient who has undergone breast augmentation should raise concern for possible implant rupture and capsule violation, even in the absence of external signs of penetrating injury.