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There is a critical issue of special education teacher shortages in the United States. Student populations, many of whom are multilingual and have disabilities, continue to grow while there is a decrease in the teaching workforce. One policy initiative developed to combat the teacher shortage is the Assistant to Teacher Program. The Assistant to Teacher Program is a school district policy that aims to fill high-need teacher vacancies by supporting paraprofessionals to become certified teachers in a career advancement cohort. This qualitative study examines the working experiences of multilingual paraprofessionals in special education and their perceptions of the Assistant to Teacher program within their school district. A thematic analysis reveals the bureaucratic and financial obstacles that multilingual paraprofessionals encounter in their career advancement, and their working conditions specific to special education as linguistic liaisons. Findings from the study are then linked to recommended policy actions intended to mitigate special education workforce disparities.

A multiple-probe design was used to investigate planning and persuasive paragraph writing by three secondary students with disabilities and writing difficulties. The intervention consisted of one-on-one explicit instruction in persuasive writing and the use of a technology-based graphic organizer (TBGO) with embedded strategies and supports. Dependent variables included the number of sentences and overall holistic writing quality. The results were mixed. Two adolescents with the primary diagnosis of learning disabilities improved their writing performance when using the TBGO and remained above baseline levels when the TBGO was removed. One more participant diagnosed with autism demonstrated modest changes in the quantity and quality of his writing. Students reported positive perceptions of the TBGO, indicating a socially valid intervention. Implications, limitations, and directions for future research are discussed.

Mesothelial cells, in the outermost layer of internal organs, are essential for both organ development and homeostasis. Although the parietal mesothelial cell is the primary origin of mesothelioma that may highjack developmental signaling, the signaling pathways that orchestrate developing parietal mesothelial progenitor cell (MPC) behaviors, such as MPC pool expansion, maturation, and differentiation, are poorly understood. To address it, we established a robust protocol for culturing WT1+ MPCs isolated from developing pig and mouse parietal thorax. Quantitative qPCR and immunostaining analyses revealed that BMP4 facilitated MPC differentiation into smooth muscle cells (SMCs). In contrast, FGF2 significantly promoted MPC progenitor pool expansion but blocked the SMC differentiation. BMP4 and FGF2 counterbalanced these effects, but FGF2 had the dominant impact in the long-term culture. A Wnt activator, CHIR99021, was pivotal in MPC maturation to CALB2+ mesothelial cells, while BMP4 or FGF2 was limited. Our results demonstrated central pathways critical for mesothelial cell behaviors.

While technology-based interventions enhance instruction and improve outcomes for students with disabilities, implementing and integrating technology in authentic learning environments continues to be a challenge. Based on the experiences of a variety of Stepping-Up Technology Implementation projects funded by the U.S. Department of Education, Office of Special Education Programs, this mixed-methods study explored the essential factors for the successful implementation of technology-based interventions in K-12 schools and early childhood programs. Based on the qualitative analysis of projects' implementation reports and responses to the follow-up questionnaire, four major themes emerged. The barriers and facilitators to technology implementation were reported across such areas as (a) developing and sustaining buy-in, (b) ensuring implementation fidelity to support the intervention, (c) research-to-practice dilemmas, and (d) data serving multiple purposes. The discussion and practical implications for supporting technology implementation are provided.

Background & Aims: The intestinal epithelium functions both in nutrient absorption and as a barrier, separating the luminal contents from a network of vascular, fibroblastic, and immune cells underneath. After injury to the intestine, multiple cell populations cooperate to drive regeneration of the mucosal barrier, including lymphatic endothelial cells (LECs). A population of granulocytic immature myeloid cells (IMCs), marked by Hdc, participate in regeneration of multiple organs such as the colon and central nervous system, and their contribution to intestinal regeneration was investigated. Methods: By using male and female histidine decarboxylase (Hdc) green fluorescent reporter (GFP) mice, we investigated the role of Hdc+ IMCs in intestinal regeneration after exposure to 12 Gy whole-body irradiation. The movement of IMCs was analyzed using flow cytometry and immunostaining. Ablation of Hdc+ cells using the HdcCreERT2 tamoxifen-inducible recombinase Cre system, conditional knockout of Prostaglandin-endoperoxidase synthase 2 (Ptgs2) in Hdc+ cells using HdcCre; Ptgs2 floxed mice, and visualization of LECs using Prox1tdTomato mice also was performed. The role of microbial signals was investigated by knocking down mice gut microbiomes using antibiotic cocktail gavages. Results: We found that Hdc+ IMCs infiltrate the injured intestine after irradiation injury and promote epithelial regeneration in part by modulating LEC activity. Hdc+ IMCs express Ptgs2 (encoding cyclooxygenase-2/COX-2), and enables them to produce prostaglandin E2. Prostaglandin E2 acts on the prostaglandin E2 receptor 4 receptor (EP4) on LECs to promote lymphangiogenesis and induce the expression of proregenerative factors including R-spondin 3. Depletion of gut microbes leads to reduced intestinal regeneration by impaired recruitment of IMCs. Conclusions: Altogether, our results unveil a critical role for IMCs in intestinal repair by modulating LEC activity and implicate gut microbes as mediators of intestinal regeneration.

There is a critical shortage of special education teachers. To address this shortage, states have allowed alternative licensure paths such as issuing provisional licenses in order for individuals to take teaching positions while they complete coursework for the teaching license. These provisionally-licensed teachers are expected to fill the roles of fully-licensed teachers on day one. In this paper, we describe a pilot program for provisionally-licensed teachers in which we incorporated eCoaching and bug-in-ear coaching in the first semester and second semester of coursework. Results are largely positive. Implications are discussed.

Internship is a critical feature of teacher preparation programs and can be one of the most influential experiences for teacher candidates. New technologies, such as eCoaching, demonstrate promising results in providing richer experiences to teacher candidates during internship. eCoaching allows university supervisors to provide real-time feedback on instruction and has proven effective at improving teacher change. However, eCoaching is different from traditional university supervision. In this case study, we describe the evolution of a traditional university supervisor using eCoaching for the first time and the support she needs to be effective. Implications are discussed.

We examined whether there was a functional relation between BIE eCoaching with parents of young children with language disorders and parent provision of natural communication opportunities and whether parents maintained their provision of natural communication opportunities when the intervention was faded. Data also were collected to assess the social validity of the intervention. The results indicate that BIE eCoaching with parents of young children with language disorders was effective in increasing parent provision of natural communication opportunities. Parents maintained their provision of natural language opportunities above baseline levels after intervention was withdrawn. All participants strongly agreed that BIE eCoaching was helpful for changing their communication practices with their child and would recommend it to other parents of children with language disorders.

Written expression is often difficult for students with and without learning disabilities. Research-based strategies to support this essential skill include self-regulated learning strategies, technology, and tools for planning and writing. This article describes a multifaceted technology-based writing intervention with embedded self-regulated learning strategies known as a computer-based graphic organizer or CBGO. The CBGO is described to assist teachers in their efforts to support upper elementary and middle school students to plan and write a high-quality persuasive paragraph. Recommendations for instructional use are discussed.

Clinical outcomes in colorectal cancer (CRC) correlate with T cell infiltrates, but the specific contributions of heterogenous T cell types remain unclear. To investigate the diverse function of T cells in CRC, we profiled 37,931 T cells from tumors and adjacent normal colon of 16 patients with CRC with respect to transcriptome, TCR sequence, and cell surface markers. Our analysis identified phenotypically and functionally distinguishable effector T cell types. We employed single-cell gene signatures from these T cell subsets to query the TCGA database to assess their prognostic significance. We found 2 distinct cytotoxic T cell types. GZMK+KLRG1+ cytotoxic T cells were enriched in CRC patients with good outcomes. GNLY+CD103+ cytotoxic T cells with a dysfunctional phenotype were not associated with good outcomes, despite coexpression of CD39 and CD103, markers that denote tumor reactivity. We found 2 distinct Treg subtypes associated with opposite outcomes. While total Tregs were associated with good outcomes, CD38+ Tregs were associated with bad outcomes independently of stage and possessed a highly suppressive phenotype, suggesting that they inhibit antitumor immunity in CRC. These findings highlight the potential utility of these subpopulations in predicting outcomes and support the potential for novel therapies directed at CD38+ Tregs or CD8+CD103+ T cells.

Acetylcholine regulates intestinal epithelial secretion via muscarinic Gq-coupled receptors but its role in cell differentiation is unclear. Here, the authors show that Prox1-positive endocrine cells are sensors for the cholinergic intestinal niche and can trigger increased differentiation of enteroendocrine DCLK1-positive tuft cells.

Background & Aims: Intestinal crypts have a remarkable capacity to regenerate after injury from loss of crypt base columnar (CBC) stem cells. After injury, facultative stem cells (FSCs) are activated to replenish the epithelium and replace lost CBCs. Our aim was to assess the role of insulin-like growth factor-1 (IGF-1) to activate FSCs for crypt repair. Methods: The intestinal regenerative response was measured after whole body 12-Gy γ-irradiation of adult mice. IGF-1 signaling or its downstream effector mammalian target of rapamycin complex 1 (mTORC1) was inhibited by administering BMS-754807 or rapamycin, respectively. Mice with inducible Rptor gene deletion were studied to test the role of mTORC1 signaling in the intestinal epithelium. FSC activation post-irradiation was measured by lineage tracing. Results: We observed a coordinate increase in growth factor expression, including IGF-1, at 2 days post-irradiation, followed by a surge in mTORC1 activity during the regenerative phase of crypt repair at day 4. IGF-1 was localized to pericryptal mesenchymal cells, and IGF-1 receptor was broadly expressed in crypt progenitor cells. Inhibition of IGF-1 signaling via BMS-754807 treatment impaired crypt regeneration after 12-Gy irradiation, with no effect on homeostasis. Similarly, rapamycin inhibition of mTORC1 during the growth factor surge blunted the regenerative response. Analysis of Villin-CreERT2;Rptorfl/fl mice showed that epithelial mTORC1 signaling was essential for crypt regeneration. Lineage tracing from Bmi1-marked cells showed that rapamycin blocked FSC activation post-irradiation. Conclusions: Our study shows that IGF-1 signaling through mTORC1 drives crypt regeneration. We propose that IGF-1 release from pericryptal cells stimulates mTORC1 in FSCs to regenerate lost CBCs.

Preclinical models of breast cancer have established mechanistic links between psychological stress and cancer progression. However, epidemiological evidence linking stress and cancer is equivocal. We tested the impact of stress exposure in female mice expressing the mouse mammary tumor virus polyoma middle-T antigen (MMTV-PyMT), a spontaneous model of mammary adenocarcinoma that mimics metastatic hormone receptor–positive human breast cancer development. MMTV-PyMT mice were socially isolated at 6 to 7 weeks of age during premalignant hyperplasia. To increase the potency of the stressor, singly housed mice were exposed to acute restraint stress (2 hours per day for 3 consecutive days) at 8 to 9 weeks of age during early carcinoma. Exposure to this dual stressor activated both major stress pathways, the sympathetic nervous system and hypothalamic-pituitary-adrenal axis throughout malignant transformation. Stressor exposure reduced mammary tumor burden in association with increased tumor cleaved caspase-3 expression, indicative of increased cell apoptosis. Stress exposure transiently increased tumor vascular endothelial growth factor and reduced tumor interleukin-6, but no other significant alterations in immune/inflammation-associated chemokines and cytokines or changes in myeloid cell populations were detected in tumors. No stress-induced change in second-harmonic generation-emitting collagen, indicative of a switch to a metastasis-promoting tumor extracellular matrix, was detected. Systemic indicators of slowed tumor progression included reduced myeloid-derived suppressor cell (MDSC) frequency in lung and spleen, and decreased transforming growth factor β (TGF-β) content in circulating exosomes, nanometer-sized particles associated with tumor progression. Chronic β-adrenergic receptor (β-AR) blockade with nadolol abrogated stress-induced alterations in tumor burden and cleaved caspase-3 expression, lung MDSC frequency, and exosomal TGF-β content. Despite the evidence for reduced tumor growth, metastatic lesions in the lung were not altered by stress exposure. Unexpectedly, β-blockade in nonstressed mice increased lung metastatic lesions and splenic MDSC frequency, suggesting that in MMTV-PyMT mice, β-AR activation also inhibits tumor progression in the absence of stress exposure. Together, these results suggest stress exposure can act through β-AR signaling to slow primary tumor growth in MMTV-PyMT mice.

Myocardial ischemia–reperfusion injury stabilizes the hypoxia-inducible factor HIF2-alpha. Here, the authors show that HIF2-alpha protects the heart from injury via induction of the epidermal growth factor amphiregulin, and that amphiregulin administration is cardioprotective in mice.

The microbiome is an emerging key co-factor in the development of esophageal cancer, the sixth leading cause of cancer death worldwide. However, there is a paucity of data delineating how the microbiome contributes to the pathobiology of the two histological subtypes of esophageal cancer: esophageal squamous cell carcinoma and esophageal adenocarcinoma. This critical knowledge gap is partially due to inadequate modeling of host–microbiome interactions in the etiology of esophageal cancers. Recent advances have enabled progress in this field. Three dimensional (3D) organoids faithfully recapitulate the structure and function of the normal, preneoplastic, and neoplastic epithelia of the esophagus ex vivo and serve as a platform translatable for applications in precision medicine. Elsewhere in the gastrointestinal (GI) tract, the co-culture of 3D organoids with the bacterial microbiome has fostered insight into the pathogenic role of the microbiome in other GI cancers. Herein, we will summarize our current understanding of the relationship between the microbiome and esophageal cancer, discuss 3D organoid models of esophageal homeostasis, review analogous models of host–microbiome interactions in other GI cancers, and advocate for the application of these models to esophageal cancers. Together, we present a promising, novel approach with the potential to ameliorate the burden of esophageal cancer-related morbidity and mortality via improved prevention and therapeutic interventions.

Scripted lesson plans and/or professional development alone may not be sufficient to encourage teachers to reflect on the quality of their teaching and improve their teaching. One learning tool that teachers may use to improve their teaching is Lesson Study (LS). LS is a collaborative process involving educators, based on concepts of iteration and revision, to improve instruction. The initial use of an adapted version of LS referred to as a microteaching lesson study (MLS) is described in this article. Our purpose is to illustrate the process of MLS used by a group of researchers when developing lesson plans for teaching students with learning disabilities. We describe MLS, and then (1) share an application of MLS used by a research team in developing a writing intervention, and (2) discuss how the MLS format was mirrored with K-12 teachers during professional development training.

This mixed methods study explored elementary and secondary educators' perceptions of their school district's responsiveness to intervention (RTI) initiative. Teachers and administrators were surveyed regarding (a) the perceived feasibility and effectiveness of educational practices that are inherent within RTI models, (b) perceived knowledge of basic RTI concepts, and (c) perceived preparedness to implement specific components of RTI within their district. A majority of respondents reported that educational practices common to RTI models (e.g., progress monitoring, evidence-based instruction) were both feasible for the classroom and effectively implemented at their school. In addition, most understood the basic principles of RTI. However, responses indicated that educators need more specific guidance about "how" to implement. Lack of understanding of RTI and need for guidance for implementation were particularly pronounced at the high school level. Findings from the current study are consistent with the existing RTI literature. We conclude with recommendations for professional development of RTI and implications for practice specifically at the secondary level.

The complex three-way interaction between airflow, tissue, and sound, for asymmetric vocal fold vibration, is not well understood. Current modeling efforts are not able to explain clinical observations where drastic differences in sound production are often observed, with no noticeable differences in the vocal fold kinematics. To advance this understanding, an acoustical model for voiced sound generation in the presence of asymmetric intraglottal flows is developed. The source model operates in conjunction with a wave reflection analog propagation scheme and an asymmetric flow description within the glottis. To enable comparison with prior work, the source model is evaluated using a well-studied two-mass vocal fold model. The proposed source model is evaluated through acoustic measures of interest, including radiated sound pressure level, maximum flow declination rate, and spectral tilt, and also via its effects on the vocal fold dynamics. The influence of the model, in comparison to the standard symmetric Bernoulli flow description, results in an increased transfer of energy from the fluid to the vocal folds, increased radiated sound pressure level and maximum flow declination rate, and decreased spectral tilt. These differences are most pronounced for asymmetric vocal fold configurations that mimic unilateral paresis and paralysis, where minor kinematic changes can result in significant acoustic and aerodynamic differences. The results illustrate that fluid effects arising from asymmetric glottal flow can play an important role in the acoustics of pathological voiced speech.

The WHAT'S UP? strategy is a type of interactive writing between a student with social, emotional, and/or behavioral challenges and an adult. The written exchange serves as a technique for involving a student in "talking" about what can be better and engaging the student in a problem-solving process. The strategy encompasses components of problem-solving strategy skills, the self-regulated strategy development model, and interactive writing. The authors describe the strategy and how the strategy can be employed in the classroom.

The "No Child Left Behind Act" mandates that teachers employ evidence-based practices (EBPs) in the classroom in order to improve student performance. For students with emotional and behavioral disorders (EBD) to be successful, particularly in inclusive settings, the most salient practices would probably be those promoting classroom organization and sound behavior management. However, data suggest that many teachers feel that they are insufficiently prepared to handle challenging behaviors. While disciplines such as psychology and medicine have attempted to identify effective practices from scientific evidence, the field of special education is arguably more challenging. The complexities of special education and its research base include such factors as the often extreme variability of participants in research investigations, the overrepresentation of culturally and linguistically diverse individuals in special education, and the low prevalence of some disability types, to name only a few. All of these are barriers to setting specific evaluation criteria or benchmarks that can be used broadly to identify EBPs. Despite these challenges, a number of processes have been undertaken to identify EBPs in the field of special education in order to support teachers and their students in the classroom. While controversies and disagreements about what constitutes "evidence-based" continue, a number of organizations have developed lists of practices they promote as evidence-based. One result of this is a number of Web-based technical assistance networks or centers. The Federal Resource Center for Special Education (FRC) provides assistance to state education agencies in order to improve programs, practices, and policies affecting children and youth with disabilities. The FRC also supports six Regional Resource Centers throughout the country, and collaborates with the Technical Assistance and Dissemination (TA&D) Network, funded by the U.S. Department of Education's Office of Special Education Programs. This article provides a sampling of the types of resources available, including a brief description of several relevant organizations and the practices they promote as evidence-based for students with challenging behaviors. (Contains 1 table.)

Teacher preparation programs provide preservice teachers with evidence-based teaching strategies, skills of behavior management, and various field experiences. The greatest learning however, is acquired the very first year of instruction in the teacher's own classroom. Teaching students with emotional and/or behavioral disorders (EBD) may prove to be the most challenging for preservice teachers. However, when teachers begin to take a proactive role in shaping their perceptions and subsequent behaviors toward a student with EBD, looking closely for the student hiding underneath these behaviors, a positive learning environment and a positive student-teacher relationship ensues. One cannot exist without the other. In this article, the author discusses four considerations that may improve the way teachers think about students with EBD as members of the positive learning environment: (1) reflection; (2) relationships; (3) roles; and (4) resources. The author believes that when teachers consider reflection, relationships, roles, and resources, not only are students with EBD supported, but all students are given the opportunity for high achievement. (Contains 2 figures.)

Written dialogue journals are intended to improve writing and encourage positive social skills by promoting individualized written discussions between a teacher and students' emotional and behavioral needs. This study investigated expressive writing using dialogue journals with five elementary students with emotional and behavioral disturbance (EBD), using a multiple baseline design across baseline, intervention, maintenance, and generalization phases. Students were randomly assigned to treatment order to meet randomization test assumptions. Baseline data were collected from student responses to traditional writing prompts. Individualized dialogue journals, in which students and teachers communicated daily to observed social behavioral issues, were implemented for the duration of the intervention. Dependent measures included student attention to task, length and quality of student written entries, and a student satisfaction survey. Visual analysis indicated an increase in time on task for all participants, and an increase in length of writing and writing quality for four of the five participants. Randomization tests applied to these data yielded significant results for all writing measures. In addition, survey results suggested that participants regarded the dialogue journals with mild satisfaction overall. Implications for future research are discussed. (Contains 4 tables and 3 figures.)

Background Cervical cancer (CC) is the second leading cancer in women and is the most common in those aged 15 to 44 years. Medicinal plant extracts have been used as homeopathic preparations for health benefits. Rubus idaeus (RI) is used to treat disorders of the female genital tract and produces cytotoxic effects. However, the use of homeopathically prepared RI in combination with low level laser therapy has not previously been explored. Aim The study aims to investigate the in-vitro effects of homeopathically prepared RI alone and in combination as a potential photosensitizer with Low-level laser irradiation (LLLI) at fluencies of 5, 10, and 15 J/cm 2. Methods HeLa CC cells were treated with RI (D3, D6, and 30cH homeopathic preparations). Cells were then treated with RI IC 50 and 680 nm laser diode at 5, 10, and 15 J/cm 2 fluencies, and the results compared with untreated control cells. Trypan blue viability, lactate dehydrogenase (LDH) cytotoxicity, and adenosine triphosphate (ATP) proliferation assays were used to analyze the cellular dose-responses along with inverted microscopy, Hoechst staining and Annexin-V/PI staining. Results RI D3 alone demonstrated an ability to reduce cellular viability to 59% and also to reduce ATP levels. The subsequent combined treatment protocol of RI D3 with all fluencies of laser demonstrated an increase in cellular ATP and increased LDH levels compared with the control. Conclusion The increased ATP and LDH levels observed in the combined treatment protocol of 680 nm laser and RI D3 at fluencies of 5, 10 and 15 J/cm 2 , show that the Warburg effect might have been induced in the CC cells – an increase in glucose uptake and the preferential production of lactate, even in the presence of oxygen. More research, including work on other cell lines, needs to be conducted to identify if RI and perhaps a different wavelength of laser irradiation could have potential in inducing cell death in cancer cells. [ABSTRACT FROM AUTHOR]

A special education teacher describes how she used dialogue journals both to communicate with her emotionally disturbed students and improve the students' writing skills. An inset summarizes the research on dialogue journals. An analysis of topics written about by students including requests, feelings, hopes, family, school, peers, and wishes is reported. (Contains 8 references.) (DB)

Background. A deficiency of D-chiro-inositol-inositolphosphoglycan mediator (DCI-IPG) may contribute to insulin resistance in polycystic ovary syndrome (PCOS). Whether the relationship between impaired DCI-IPG release and insulin resistance is specific to PCOS rather than obesity is unknown. We assessed insulin-released DCI-IPG and its relationship to insulin sensitivity at baseline and after weight loss in obese women with and without PCOS. Methods. Obese PCOS (n=16) and normal (n=15) women underwent 8 weeks of a hypocaloric diet. The Matsuda index, area under the curve DCI-IPG (AUCDCI-IPG), AUCinsulin, and AUCDCI-IPG/AUCinsulin were measured during a 2 hr OGTT at baseline and 8 weeks. Results. PCOS women had lower AUCDCI-IPG/AUCinsulin at baseline and a significant relationship between AUCDCI-IPG/AUCinsulin and Matsuda index (p=0.0003), which was not present in controls. Weight loss was similar between PCOS (−4.08 kg) and normal women (−4.29 kg, p=0.6281). Weight loss in PCOS women did not change the relationship between AUCDCI-IPG/AUCinsulin and Matsuda index (p=0.0100), and this relationship remained absent in control women. Conclusion. The association between AUCDCI-IPG/AUCinsulin and insulin sensitivity was only found in PCOS but not in normal women, and this relationship was unaffected by weight loss. DCI and its messenger may contribute to insulin resistance in PCOS independent of obesity.

We would like to submit the following correction to our recently published paper [1] due to the error in classification of children as anemic [...]