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Deletion-based accounts of verb phrase ellipsis (VPE) predict that this construction requires a syntactically identical antecedent, but previous research shows that some antecedent-target mismatches are perceived as relatively acceptable in experiments (see e.g. Arregui et al., 2006; Miller & Hemforth, 2014). So far, the acceptability of these mismatches has been explained mostly by licensing conditions on VPE or by ellipsis-specific processing mechanisms. This article explores to what extent the acceptability of mismatches follows from the more general principles of an information-theoretic account of language use, which has been independently evidenced for other omission phenomena: To avoid under- or overutilizing the hearer’s processing resources, predictable VPs are more likely to be omitted, whereas unpredictable ones are more likely to be realized. This hypothesis is tested with three experiments that investigate a gradual acceptability cline between VPE mismatches which has been reported by Arregui et al. (2006). First, an acceptability rating study replicates the overall pattern found by Arregui et al. (2006) and confirms that the effect is specific to ellipsis. Second, a production task shows that the acceptability differences are indeed related to a gradual decrease in the predictability of the target VP, which is also reflected in the likelihood of participants producing VPE. Finally, a self-paced reading experiment shows that VPE is more acceptable when it is easier to process. Overall, the experimental results support the information-theoretic account and suggest that no specific syntactic constraints or reconstruction mechanisms might be required to account for the acceptability cline observed for the mismatches investigated.

BACKGROUND: Venous thromboembolism (VTE) is a preventable medical condition which has substantial impact on patient morbidity, mortality, and disability. Unfortunately, adherence to the published best practices for VTE prevention, based on patient centered outcomes research (PCOR), is highly variable across U.S. hospitals, which represents a gap between current evidence and clinical practice leading to adverse patient outcomes. This gap is especially large in the case of traumatic brain injury (TBI), where reluctance to initiate VTE prevention due to concerns for potentially increasing the rates of intracranial bleeding drives poor rates of VTE prophylaxis. This is despite research which has shown early initiation of VTE prophylaxis to be safe in TBI without increased risk of delayed neurosurgical intervention or death. Clinical decision support (CDS) is an indispensable solution to close this practice gap; however, design and implementation barriers hinder CDS adoption and successful scaling across health systems. Clinical practice guidelines (CPGs) informed by PCOR evidence can be deployed using CDS systems to improve the evidence to practice gap. In the Scaling AcceptabLE cDs (SCALED) study, we will implement a VTE prevention CPG within an interoperable CDS system and evaluate both CPG effectiveness (improved clinical outcomes) and CDS implementation. METHODS: The SCALED trial is a hybrid type 2 randomized stepped wedge effectiveness-implementation trial to scale the CDS across 4 heterogeneous healthcare systems. Trial outcomes will be assessed using the RE2-AIM planning and evaluation framework. Efforts will be made to ensure implementation consistency. Nonetheless, it is expected that CDS adoption will vary across each site. To assess these differences, we will evaluate implementation processes across trial sites using the Exploration, Preparation, Implementation, and Sustainment (EPIS) implementation framework (a determinant framework) using mixed-methods. Finally, it is critical that PCOR CPGs are maintained as evidence evolves. To date, an accepted process for evidence maintenance does not exist. We will pilot a Living Guideline process model for the VTE prevention CDS system. DISCUSSION: The stepped wedge hybrid type 2 trial will provide evidence regarding the effectiveness of CDS based on the Berne-Norwood criteria for VTE prevention in patients with TBI. Additionally, it will provide evidence regarding a successful strategy to scale interoperable CDS systems across U.S. healthcare systems, advancing both the fields of implementation science and health informatics. TRIAL REGISTRATION: Clinicaltrials.gov - NCT05628207. Prospectively registered 11/28/2022, https://classic. CLINICALTRIALS: gov/ct2/show/NCT05628207 .

As diversity grows in schools, educators must consider how to create environments where students develop respect and empathy toward others. Integrating high quality multicultural literature provides meaningful experiences for students to investigate society and acknowledge and interrogate their own beliefs and biases. While many teachers acknowledge the importance of incorporating literature that reflects the diverse populations of schools, effectively implementing multicultural literature into the learning environment is both a complex and analytical task. This phenomenological research design examines how primary teachers use multicultural texts for classroom read alouds.

Abstract Introduction Sinks have been introduced near patients to improve hand hygiene as part of infection prevention and control measures. However, sinks are a known reservoir for gram-negative bacterial pathogens in particular and their removal to prevent bacterial infections in intensive care patients is currently recommended by several international guidelines. Methods Healthcare workers (HCWs) in 15 intensive care units (ICUs) in Germany were given the opportunity to complete an anonymous survey on the use of sinks between August 2022 and January 2023. Observations were then made in three participating ICUs to determine the frequency and reason for contact with the sink. Results 258 questionnaires were returned (nurses 87%). 90% found it useful to very useful to have a sink in the patient room, and 56% reported using it daily for hand hygiene. We observed 33 contacts between nurses and sinks over 17 h. In 20/33 (60%) cases, the sink was used for waste disposal. In 3/33 (10%) it was used for hand washing. Discussion Sinks are still used for daily care in intensive care units. Educational Interventions in existing buildings to minimise risk through “sink hygiene” (i.e. separation of sinks for water disposal and uptake) can make an important contribution to infection prevention.

Abstract Background Patient safety has become a priority issue in health policy strategies in Germany in the last several years, and is especially important in the era of climate change. This study aimed to assess public perceptions about the patient safety impact of climate change and the demographic and socioeconomic factors influencing patient perception in Germany. Methods A cross-sectional study was conducted in Germany in 2023, using data from the TK Monitor of Patient Safety. The TK Monitor of Patient Safety is a national survey of the population on the state of safety in medical care. Self-reported data were collected from 1,000 randomly selected adults living in Germany. Demographic and socioeconomic variables were regressed on climate change perception using an ordinal logistic regression approach. Results Our results revealed that half of respondents are concerned about climate change affecting their health and 40% of the respondents would like to have climate-sensitive health counseling by their general practitioner. The results showed that demographic variables, such as gender and age, and socioeconomic variables, such as education level and income, are important factors influencing the perception of climate change-related patient safety risks. However, no association was found between urban/rural residence and patient perception. Conclusions Our study highlights patient safety as a public health concern in the era of climate change. The German public appears to view climate change as harmful to patient safety. Our findings also show that it is necessary to carry out diagnoses focused on demographic and socioeconomic factors to determine which aspects should be strengthened through programs aimed at reducing patient safety risks associated with climate change.

Abstract RNA modifications play a pivotal role in the regulation of RNA chemistry within cells. Several technologies have been developed with the goal of using RNA modifications to regulate cellular biochemistry selectively, but achieving selective and precise modifications remains a challenge. Here, we show that by using designer organelles, we can modify mRNA with pseudouridine in a highly selective and guide-RNA-dependent manner. We use designer organelles inspired by concepts of phase separation, a central tenet in developing artificial membraneless organelles in living mammalian cells. In addition, we use circular guide RNAs to markedly enhance the effectiveness of targeted pseudouridinylation. Our studies introduce spatial engineering through optimized RNA editing organelles (OREO) as a complementary tool for targeted RNA modification, providing new avenues to enhance RNA modification specificity.

Reflection is an important tool to help preservice teachers (PSTs) develop the skills and competence needed for effective teaching. Written and verbal reflections offer opportunities for novices to look back on their lesson implementation, but video allows them to step back "into the moment" to review their actions as they occurred in real time. This study examines PSTs' perceptions of participating in a video reflection session embedded within a larger, integrated practicum experience as a way to increase their professional noticing of and reflection on salient teaching moments. We report on findings about the ways in which structured sessions such as this can help PSTs strive toward professional noticing of opportunities to employ ambitious pedagogy and provide implications for how this structure can support teacher development and be adapted and adopted in other teacher preparation programs.

A growing corpus of interdisciplinary scholarship focuses on migration, particularly the increasing intensity of forced migration, or displacement, and the sociocultural, political, and symbolic dimensions of global resettlement. Yet, there are limited empirical studies on how U.S. educators in urban contexts address these processes, including but not limited to displacement-based trauma and associated student needs. While educational scholarship has examined structural issues affecting increased educator burnout, a research paucity also exists regarding how educators experience relevant stress related to these dynamics. This article presents findings from a multi-method qualitative case study that examined how high school educators leveraged available educational policy and practice supports to address refugee and hurricane displaced student needs. Our research underscores multi-level system complexity that influences school-related resettlement processes, and specifically as relevant to supporting student mental health and mitigating educator stress. Utilizing a critical and social ecological theoretical approach, our findings offer a framework for anti-deficit, cultural and linguistically responsive, and trauma-informed student practices, who in rebuilding a new home in the U.S., can experience continued and new forms of marginalization. Implications for educational research and leadership practice are discussed.

Genetic variants in the SLC6A1 gene can cause a broad phenotypic disease spectrum by altering the protein function. Thus, systematically curated clinically relevant genotype-phenotype associations are needed to understand the disease mechanism and improve therapeutic decision-making. We aggregated genetic and clinical data from 172 individuals with likely pathogenic/pathogenic (lp/p) SLC6A1 variants and functional data for 184 variants (14.1% lp/p). Clinical and functional data were available for a subset of 126 individuals. We explored the potential associations of variant positions on the GAT1 3D structure with variant pathogenicity, altered molecular function and phenotype severity using bioinformatic approaches. The GAT1 transmembrane domains 1, 6 and extracellular loop 4 (EL4) were enriched for patient over population variants. Across functionally tested missense variants (n = 156), the spatial proximity from the ligand was associated with loss-of-function in the GAT1 transporter activity. For variants with complete loss of in vitro GABA uptake, we found a 4.6-fold enrichment in patients having severe disease versus non-severe disease (P = 2.9 × 10-3, 95% confidence interval: 1.5-15.3). In summary, we delineated associations between the 3D structure and variant pathogenicity, variant function and phenotype in SLC6A1-related disorders. This knowledge supports biology-informed variant interpretation and research on GAT1 function. All our data can be interactively explored in the SLC6A1 portal (https://slc6a1-portal.broadinstitute.org/).

Abstract Relicts of subducted oceanic lithosphere provide key information for the tectonic reconstructions of convergent margins. In the Central Alps, such relicts occur as isolated mafic–ultramafic lenses within the migmatites of the southern Adula nappe and Cima-Lunga unit. Analysis of the major-, minor-, and accessory minerals of these ophiolitic relicts, combined with zircon and rutile U–Pb ages and zircon oxygen isotopes, allows the reconstruction of different stages of their complex evolution. The mafic–ultramafic suite in Valle di Moleno consists of chlorite-harzburgites associated with metarodingites and retrogressed eclogites. Relic omphacite and kyanite in retrogressed eclogites provide evidence for subduction-related metamorphism. Increasing XPrp in the garnet mantle towards the rim documents heating during high-pressure metamorphism up to 800–850 °C. Polyphase inclusions and chemical zoning in garnet suggest fluid-assisted melting during high-pressure metamorphism dated at 31.0 ± 0.9 Ma. In Val Cama, chlorite-harzburgites, metarodingites and calcsilicate-metasediments occur. Detrital zircon ages in the metasediment suggest a Mesozoic deposition. The metarodingite-metaperidotite-metasediment association and the low δ18O signatures of zircon (δ18O 3.0–3.7‰), inherited from seafloor metasomatism of the protoliths, show that the rocks are derived from former altered oceanic crust. Amphibolite facies metamorphism related to the Central Alps Barrovian evolution in Val Cama occurred at 28.8 ± 1.5 Ma. The combined data from Moleno and Cama indicate a rapid transition (~ 2 Ma) from subduction to collisional metamorphism with corresponding exhumation rates of 3–6 cm/year. Fast exhumation tectonics may have been favored by slab break-off or slab extraction. U–Pb dating of rutile from both localities yields ages of ~ 20 Ma, suggesting that these rocks remained at amphibolite-facies conditions for about 10 Ma and underwent a second fast exhumation of 3 cm/year associated with vertical movements along the Insubric line.

Abstract The resonant excitation of electronic transitions with coherent laser sources creates quantum coherent superpositions of the involved electronic states. Most time-resolved studies have focused on gases or isolated subsystems embedded in insulating solids, aiming for applications in quantum information. Here, we focus on the coherent control of orbital wavefunctions in the correlated quantum material Tb2Ti2O7, which forms an interacting spin liquid ground state. We show that resonant excitation with a strong THz pulse creates a coherent superposition of the lowest energy Tb 4f states. The coherence manifests itself as a macroscopic oscillating magnetic dipole, which is detected by ultrafast resonant x-ray diffraction. We envision the coherent control of orbital wavefunctions demonstrated here to become a new tool for the ultrafast manipulation and investigation of quantum materials.