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This study was designed to increase our understanding about characteristics and the impact of sensory symptoms (SS) and signs of hyperarousal (HA) in individuals with fragile X syndrome (FXS) from childhood through early adulthood and by gender. Data derived from the Fragile X Online Registry With Accessible Research Database (FORWARD), a natural history study of FXS, were analyzed using descriptive statistics and multivariate linear and logistic regression models to examine SS and signs of HA, their impact on behavioral regulation and limitations on the subject/family. The sample (N = 933) consisted of 720 males and 213 females. More males were affected with SS (87% vs. 68%) and signs of HA (92% vs. 79%). Subjects who were endorsed as having a strong sensory response had more comorbidities, including behavioral problems. The predominant SS was difficulty with eye gaze that increased with age in both genders. As individuals age, there was less use of non-medication therapies, such as occupational therapy (OT)/physical therapy (PT), but there was more use of psychopharmacological medications and investigational drugs for behaviors. Multiple regression models suggested that endorsing SS and signs of HA was associated with statistically significantly increased ABC-C-I subscale scores and limited participation in everyday activities. This study improves our understanding of SS and signs of HA as well as their impact in FXS. It supports the need for more research regarding these clinical symptoms, especially to understand how they contribute to well-known behavioral concerns.

Introduction: For general surgeons practising in rural areas, multiple factors influence care beyond skills learned in residency. The British Columbia Privileging Dictionary (BCPD) defines core and non-core procedures that shape the scope of general surgeons. Moreover, the Royal College has adopted a Competence by Design (CBD) curriculum which employs entrustable professional activities (EPAs) that list surgical skill residents must be proficient in by graduation. Our goal is to understand the current practice patterns of rural general surgeons in BC based on these policies and local factors. Methods: Medical service plan (MSP) data were collected from 2011 to 2021 based on general surgeons working in rural subsidiary agreement (RSA) communities. The MSP fee codes were organised into core or non-core procedures, as outlined by the BCPD. EPAs were assessed and compared to the non-core procedures. Results: From 2011 to 2021, 223,103 procedures were performed in rural sites in BC. On average, 90.97 (standard deviation = 20.78) of procedures done in all communities were BCPD core procedures. The most common non-core surgical care performed by general surgeons was in plastic surgery (n = 8035). Over 8 of procedures performed were not general surgery EPAs. Notably, none of the EPAs are considered non-core privileges and all EPAs have been performed in rural settings. Conclusion: General surgeons working in rural settings perform multiple procedures outside of EPAs which account for over 8 of their caseload and approximately 6 of procedures performed are non-core privileges. This provides some insight into the potential limitations of the BCPD on graduates hoping to practise in rural communities. As the CBD curriculum has been reported to provide a more flexible approach to learning, it may be tailored to suit residents' learning and career goals, including varied surgical skills to suit rural needs. Introduction: Pour les chirurgiens généraux exerçant en zone rurale, de multiples facteurs influencent les soins, et ce au-delà des compétences acquises en résidence. Le British Columbia Privileging Dictionary (BCPD) définit les procédures essentielles et non essentielles qui déterminent le champ d'action des chirurgiens généraux. En outre, le Collège royal a adopté un programme d'études intitulé « La compétence par conception » (CPC) qui utilise des activités professionnelles confiables (APC) qui énumèrent les compétences chirurgicales que les résidents doivent maîtriser avant d'obtenir leur diplôme. Notre objectif est de comprendre les modes de pratique actuels des chirurgiens généralistes ruraux en Colombie-Britannique en fonction de ces politiques et des facteurs locaux. Méthodes: Les données du Medical Service Plan (MSP, Plan de service médical) ont été recueillies entre 2011 et 2021 auprès des chirurgiens généralistes travaillant dans les communautés du « Rural Subsidiary Agreement » (RSA). Les codes d'honoraires du MSP ont été organisés en procédures essentielles ou non essentielles, comme indiqué par le BCPD. Les APC ont été évalués et comparés aux procédures non essentielles. Résultats: Entre 2011 et 2021, 223 103 procédures ont été réalisées dans des sites ruraux en Colombie-Britannique. En moyenne, 90,97 (écart-type = 20,78) des procédures effectuées dans toutes les communautés étaient des procédures de base du BCPD. Les soins chirurgicaux non essentiels les plus courants effectués par les chirurgiens généraux étaient la chirurgie plastique (n = 8035). Plus de 8 des procédures réalisées n'étaient pas des APC de chirurgie générale. Il est à noter qu'aucune des APC n'est considérée comme un privilège non essentiel et que toutes ont été réalisées en milieu rural. Conclusion: Les chirurgiens généraux travaillant en milieu rural pratiquent de nombreuses procédures en dehors de l'APC, représentant plus de 8 de leur charge de travail et environ 6 des procédures pratiquées sont des privilèges non essentiels. Cela donne une idée des limites potentielles du BCPD pour les diplômés qui espèrent exercer dans les communautés rurales. Étant donné que le programme d'études CPC est réputé offrir une approche plus souple de l'apprentissage, il peut être adapté aux objectifs d'apprentissage et de carrière des résidents, notamment en leur permettant d'acquérir des compétences chirurgicales variées pour répondre aux besoins des zones rurales. Keywords: Medical education, residency, rural surgery, Author(s): Rebecca M. Afford (corresponding author) [1]; Sara D. Bolin [1]; Madeleine E. Armstrong [1]; Tracy M. Scott [1]; Ahmer A. Karimuddin [1] INTRODUCTION General surgery residency in Canada is [...]

Laboratory chemical synthesis research typically lacks the preplanned hazard responses found in production-scale industrial laboratories. Chemical safety management is a known challenge in education-based facilities, which is concerning for academic and national laboratory environments working with inexperienced student researchers. At the Molecular Foundry, a U.S. Department of Energy (DOE) user facility, a chemical safety management form has been developed that follows DOE's Integrated Safety Management (ISM) process, which evaluates the risks and hazards associated with all forms of work. An ISM form for chemical synthesis is described here in detail. It is regularly used to guide chemical safety discussions between researchers and supervisors, to plan accident responses, and to establish triggers, at which point a reevaluation of the work is needed. The form makes it straightforward to know what limits researchers may work within and makes it clear which procedure changes will require a new safety assessment and discussion before work continues. The ISM form for synthesis is being successfully used in three fields of chemistry: Inorganic, Organic, and Biological. The form has also been adapted for liquid sample preparation in electron microscopy. Upper management, supervisors, students, and general users are engaged in this process. It is hoped that sharing this knowledge will enable educational institutions and other laboratories to develop similar methods to help researchers and supervisors understand the hazards as well as the working limits of any protocol, helping researchers to work more independently and safely within the laboratory.

Abstract Functional magnetic resonance imaging (fMRI) has dramatically advanced non-invasive human brain mapping and decoding. Functional near-infrared spectroscopy (fNIRS) and high-density diffuse optical tomography (HD-DOT) non-invasively measure blood oxygen fluctuations related to brain activity, like fMRI, at the brain surface, using more-lightweight equipment that circumvents ergonomic and logistical limitations of fMRI. HD-DOT grids have smaller inter-optode spacing (~ 13 mm) than sparse fNIRS (~ 30 mm) and therefore provide higher image quality, with spatial resolution ~ 1/2 that of fMRI, when using the several source-detector distances (13–40 mm) afforded by the HD-DOT grid. Herein, simulations indicated reducing inter-optode spacing to 6.5 mm, creating a higher-density grid with more source-detector distances, would further improve image quality and noise-resolution tradeoff, with diminishing returns below 6.5 mm. We then constructed an ultra-high-density DOT system (6.5-mm spacing) with 140 dB dynamic range that imaged stimulus-evoked activations with 30–50% higher spatial resolution and repeatable multi-focal activity with excellent agreement with participant-matched fMRI. Further, this system decoded visual stimulus position with 19–35% lower error than previous HD-DOT, throughout occipital cortex.

Abstract The COVID-19 pandemic may have impacted disabilities among people living with HIV; however, data on the association between COVID-19 pandemic-related healthcare disruptions and disabilities among people living with HIV is limited. We aimed to evaluate the association between COVID-19-affected HIV care behaviors and disability domains among people living with HIV in Belize. A cross-sectional study was conducted at the Western Regional Hospital and Southern Regional Hospital between August and October 2021 among people living with HIV in Belize aged ≥ 21 years and on antiretroviral therapy. A self-reported questionnaire captured data on demographic and clinical characteristics (gender, age, ethnicity, marital status, employment, education, CD4 count, and viral load), COVID-19-affected HIV care behaviors, and disability across six domains (physical, cognitive, and mental-emotional symptoms and impairments; uncertainty; difficulties carrying out day-to-day activities; and social inclusion challenges) using the Short-Form HIV Disability Questionnaire. Univariate and multivariate logistic regression analyses were employed to analyze the data. Of the 489 participants, 276 (56.4%) were women and 213 (43.6%) were men. After adjusting for covariates, (age, gender, employment, CD4 count, viral load, COVID-19-affected HIV care behaviours), our results showed that people living with HIV, whose HIV care behaviors were greatly affected by COVID-19, were more likely to have disabilities across various domains: physical (adjusted odds ratio (AOR): 1.61, 95% confidence interval (CI): 1.08–2.41, p = 0.018), cognitive (AOR: 2.49, 95% CI: 1.58–3.94, p

Children with dyslexia frequently also struggle with math. However, studies of reading disability (RD) rarely assess math skill, and the neurocognitive mechanisms underlying co-occurring reading and math disability (RD+MD) are not clear. The current study aimed to identify behavioral and neurocognitive factors associated with co-occurring MD among 86 children with RD. Within this sample, 43% had co-occurring RD+MD and 22% demonstrated a possible vulnerability in math, while 35% had no math difficulties (RD-Only). We investigated whether RD-Only and RD+MD students differed behaviorally in their phonological awareness, reading skills, or executive functions, as well as in the brain mechanisms underlying word reading and visuospatial working memory using functional magnetic resonance imaging (fMRI). The RD+MD group did not differ from RD-Only on behavioral or brain measures of phonological awareness related to speech or print. However, the RD+MD group demonstrated significantly worse working memory and processing speed performance than the RD-Only group. The RD+MD group also exhibited reduced brain activations for visuospatial working memory relative to RD-Only. Exploratory brain-behavior correlations along a broad spectrum of math ability revealed that stronger math skills were associated with greater activation in bilateral visual cortex. These converging neuro-behavioral findings suggest that poor executive functions in general, including differences in visuospatial working memory, are specifically associated with co-occurring MD in the context of RD.

Purpose: Developmental dyslexia is proposed to involve selective procedural memory deficits with intact declarative memory. Recent research in the domain of category learning has demonstrated that adults with dyslexia have selective deficits in Information-Integration (II) category learning that is proposed to rely on procedural learning mechanisms and unaffected Rule-Based (RB) category learning that is proposed to rely on declarative, hypothesis testing mechanisms. Importantly, learning mechanisms also change across development, with distinct developmental trajectories in both procedural and declarative learning mechanisms. It is unclear how dyslexia in childhood should influence auditory category learning, a critical skill for speech perception and reading development. Method: We examined auditory category learning performance and strategies in 7- to 12-year-old children with dyslexia (n = 25; nine females, 16 males) and typically developing controls (n = 25; 13 females, 12 males). Participants learned nonspeech auditory categories of spectrotemporal ripples that could be optimally learned with either RB selective attention to the temporal modulation dimension or procedural integration of information across spectral and temporal dimensions. We statistically compared performance using mixed-model analyses of variance and identified strategies using decision-bound computational models. Results: We found that children with dyslexia have an apparent selective RB category learning deficit, rather than a selective II learning deficit observed in prior work in adults with dyslexia. Conclusion: These results suggest that the important skill of auditory category learning is impacted in children with dyslexia and throughout development, individuals with dyslexia may develop compensatory strategies that preserve declarative learning while developing difficulties in procedural learning.

Vector-borne infections persist as a significant issue in both human and animal health. Many of the most common vector-borne infections in the USA, especially tick-borne infections, are known to be zoonotic, including Lyme disease, anaplasmosis, and ehrlichiosis, and these infections may also negatively impact the health of infected animals. Convenient patient-side assays for the detection of antibodies to Borrelia burgdorferi, Anaplasma spp., and Ehrlichia spp., and antigen of Dirofilaria immitis have allowed for the generation of robust and large-scale prevalence data in dogs. Data of similar scale and distribution are not available in cats, and most feline prevalence studies have evaluated a small sample size with limited geographic distribution. The objective of this study was to evaluate the prevalence of antibodies to B. burgdorferi, Anaplasma spp., and Ehrlichia spp., and D. immitis antigen among shelter cats across the USA, a population that is presumably at high risk for ectoparasitism and, consequently, exposure to vector-borne infections. In total, 2232 whole blood samples were collected from shelter cats across four regions of the USA—South, Northeast, Midwest, and West—and were evaluated using the Idexx SNAP® 4Dx® Test. Ectoparasites were also opportunistically collected from cats during blood collection and morphologically identified. The prevalence of at least one vector-borne infection was 2.60%, and the nationwide prevalence was 1.88% for B. burgdorferi, 0.54% for Anaplasma spp., 0.09% for Ehrlichia spp., and 0.55% for D. immitis. A total of 1120 ectoparasites were collected from 423 cats, including 27 ticks and 1093 fleas. Although the overall prevalence of the pathogens in this survey is relatively low, we observe that there is an increased exposure risk regionally for some agents, with geographic distributions in this study mostly coinciding with established human and canine distributions. Understanding these findings in an assumed non-protected population of cats allows us to extrapolate the risk to pet cats if they are not provided routine veterinary care, including a broad-spectrum parasite prevention program.

Abstract Background Interventions focused on cognitive function in neurodivergent children typically focus on single functions, e.g. working memory training. They are often focused on ‘deficit’ models and lack an emphasis on understanding areas of individual strengths and difficulties as a prerequisite to appropriate support. The multidimensional nature and phenotypic variability of cognitive profiles in these children indicate a need for a multicomponent-tailored intervention programme focused on understanding and supporting an individual child’s cognitive functioning. Aims The ‘EPIC’ intervention (Edinburgh Psychoeducation Intervention for Children and Young People) is focused on improving cognition, learning and behaviour in neurodivergent children such as those with attention deficit hyperactivity disorder (ADHD) or who are autistic. Building on our previous co-production work, this study aimed to use a participatory methods approach to develop EPIC practices and materials in relation to our key principles which include psychoeducation, multicomponent, individualised approach, strengths and difficulties profiling and pairing of a child’s individual strengths and difficulties with internal and external strategies. We also set out to assess the feasibility and acceptability of EPIC, and pilot this novel tool-kit intervention with neurodivergent children and their parents and teachers. Methods The intervention practices, materials and strategies of EPIC were co-produced with neurodivergent children, their parents, teachers and clinicians taking a strengths and difficulties approach. Identification of psychoeducation activities and strategy practices (e.g. mind-maps, chunking), testing of feasibility and collection of pilot data were conducted over a bi-weekly 8-week programme. Eleven neurodivergent children aged 7 to 12 completed the 16-session individualised programme. Acceptability and feasibility were ascertained via qualitative reports elicited within child and teacher interviews and child ratings of enjoyment. Pilot evaluation data was collected pre- and post-intervention participation, and across cognitive assessments (CANTAB, BRIEF), educational attainment (WIAT) and parent and teacher questionnaires measuring clinical symptoms and behaviour (Conners, AQ, SDQ, self-perception). Data was compared with a matched neurodivergent treatment-as-usual control group (N = 9). Results The co-produced EPIC intervention was both feasible to deliver and acceptable to children, parents and their teachers. Pilot data identified that the 8-week intervention improved cognition (short-term and working memory) and literacy (receptive vocabulary, oral word fluency, listening comprehension). Improvements in the intervention group were also found for parent-reported child behavioural difficulties and aggression, and teacher-reported scholastic competence. Effect sizes generated (Cohen’s d) ranged from 0.65 to 2.83. Parents reported continuing to use EPIC strategies when interviewed over a year after participating in the programme. Conclusion The current study met our objectives fully. ‘EPIC’ (Edinburgh Psychoeducation Intervention for Children and Young People) is feasible in home and school contexts and improves a range of aspects of cognition, learning and behaviour in neurodivergent children. Our findings show EPIC is suitable to be assessed within a full-scale trial.

Background and Aim: Climatic conditions significantly impact the life stages and distribution patterns of ticks and tick-borne diseases. South Africa’s central plateau and various biomes offer a distinct landscape for studying the geography’s effects. The study estimated tick species prevalence and the influential factors on their survival. Materials and Methods: Ticks were gathered from communal cattle in South African provinces including Limpopo (LP), Gauteng (GP), Mpumalanga (MP), KwaZulu-Natal (KZN), the Eastern Cape (EC), and the Free State (FS), from September 2020 to November 2022. Using data from South African weathercasts, the annual climate was assessed. Results: A total of 3,409 ticks were collected, with the highest infestation observed in KZN (45%), followed by LP (26%), EC (19%), GP (5%), MP (2%), and the FS (2%). The most prevalent tick species were Amblyomma hebraeum (55.1%), Rhipicephalus evertsi evertsi (13.9%) and Rhipicephalus (Boophilus), and decoloratus (11.9%). Other species included R. (Boophilus) microplus (10.85%), Hyalomma marginatum (4.8%), Rhipicephalus appendiculatus (1.4%), Harpalus rufipes (0.8%), Rhipicephalus exophthalmos (0.2%), Rhipicephalus glabroscutatus (0.2%), Rhipicephalus sanguineus (0.2%), Haemaphysalis silacea (0.5%), Ixodes pilosus (0.1%), and Rhipicephalus simus (0.1%). The infestations were most prevalent on farms in Pongola and KZN. The temperature fluctuated between 12°C and 35°C during data gathering, while humidity varied between 40% and 65%. Conclusion: This study showed that ticks survive optimally in warm temperatures and high humidity conditions. Livestock farms with high tick infestations may be associated with several risk factors. These practices could involve suboptimal grazing, insufficient acaricidal treatment, and detrimental effects resulting from traditional animal husbandry. Future research is needed to longitudinally evaluate the effects of climate change on tick populations, pathogen transmission, hosts, habitats, and human behavior, influencing potential exposure risks.

Research Findings: This study examined the association between preschool children's social-emotional competence (SEC), defined by their social skills and problem behaviors, and numeracy skills. It also examined if any subdomains of SEC predicted preschool numeracy above and beyond latent social skills or problem behaviors variables. Data came from a state-funded prekindergarten evaluation study (N = 684) and were collected using teacher-reported SEC and direct assessments. Using structural equation modeling, we found that social skills in the fall of preschool significantly predicted numeracy in the spring of preschool and that the subdomain of cooperation predicted numeracy skills above and beyond the social skill latent construct. Problem behaviors were not significantly associated with SEC. Practice or Policy: The findings suggest that the social skills children enter preschool with may help them develop early numeracy skills across preschool. In addition, teaching math concepts to preschoolers in ways that are also social in nature may be beneficial. Practice implications include promoting numeracy skills in children through SEC development by encouraging parent involvement and providing socialized educational experiences before they enter preschool.

Background: Rural general surgeons perform many procedures outside the conventional scope of the specialty. Unique to British Columbia, the Rural Practice Subsidiary Agreement (RSA) formally defines rurality in the province. Our goal is to understand the scope of practice for BC's rural general surgeons and whether it has been affected over time by changing privileging guidelines. Methods: Medical Services Plan (MSP) data were collected from 2011 to 2021 for procedures billed by general surgeons in communities defined by the RSA as rural. We categorized codes from the MSP based on surgical specialty. For each community, we calculated the totals for these categories considering what other surgical specialties were present as well as changes over time. Results: From 2011 to 2021, 222 905 procedures were performed in 23 rural communities in BC. Colonoscopies were the most frequently performed procedure (n = 80114, 35.9%), followed by colorectal (n = 23891, 10.7%) and hernia procedures (n = 20 911, 9.4%). The most common unconventional procedures were plastic surgeries (n = 8077, 3.6%). Classification within the RSA did not significantly influence the percentage of unconventional general surgery procedures performed (p = 0.4). When another surgical specialty was present, there was often a decrease in the number of that specialty's procedures performed by general surgeons. Over the past decade, rural general surgeons performed fewer unconventional general surgery procedures (p < 0.001). Conclusion: General surgeons working in rural communities perform a variety of procedures based on resources, community need, and access to other specialists. Over the last decade, this appears to have been influenced by new privileging guidelines. Understanding the scope of rural general surgery can inform training opportunities and, as there is a migration away from rural surgeons performing as many unconventional procedures, can elucidate the implications on patients and communities. Contexte : En r gion rurale, les chirurgiens g n ralistes effectuent beaucoup d'interventions sortant du cadre conventionnel de pratique de leur sp cialit . La Colombie-Britannique est actuellement la seule province avoir mis en place l'entente Rural Practice Subsidiary Agreement (RSA), qui d finit officiellement la ruralit dans la province. Notre objectif est de mieux d limiter le champ de pratique des chirurgiens g n ralistes exer ant en milieu rural en Colombie-Britannique et de d terminer s'il a t affect dans le temps par l' volution des directives concernant l'octroi de privil ges. M thodes : Des donn es du r gime d'assurance maladie de la province (Medical Services Plan, ou MSP) pour la p riode de 2011 2021 ont t recueillies pour les interventions factur es par des chirurgiens g n ralistes dans les communaut s d sign es rurales selon la RSA. Nous avons class les codes du MSP selon la sp cialit chirurgicale. Pour chaque collectivit , nous avons calcul les totaux pour ces cat gories, tout en tenant compte des autres sp cialit s chirurgicales pr sentes et des changements dans le temps. R sultats : De 2011 2021, 222 905 interventions ont t effectu es dans 23 collectivit s rurales en Colombie-Britannique. La colonoscopic tait l'intervention la plus courante (n = 80 114, 35,9%), suivie des chirurgies colorectales (n = 23 891, 10,7%) et des r parations de hernies (n = 20 911, 9,4%). Parmi les interventions non classiques, la chirurgie plastique occupait le premier rang (n = 8077, 3,6%). La classification selon la RSA n'a pas eu d'influence significative sur le pourcentage de chirurgies g n rales non classiques effectu es (p = 0,4). Lorsqu'un prestataire d'une autre sp cialit chirurgicale tait pr sent, on observait souvent une baisse du nombre d'interventions de cette sp cialit effectu es par les g n ralistes. Au cours de la derni re d cennie, les chirurgiens g n ralistes en milieu rural ont effectu moins d'interventions de chirurgie g n rale non classiques (p < 0,001). Conclusion : Dans les collectivit s rurales, les chirurgiens g n ralistes effectuent un ventail d'interventions qui varie selon les ressources, les besoins communautaires, et l'acc s d'autres sp cialistes. Durant la derni re d cennie, cette diversit semble avoir t influenc e par les nouvelles directives concernant l'octroi de privil ges. En connaissant le champ de pratique des chirurgiens g n ralistes en milieu rural, on peut guider les occasions de formation et, alors que les g n ralistes effectuent de moins en moins d'interventions non classiques, mieux comprendre ce que cela signifie pour la patient le et les collectivit s., For Canadians in rural, remote, and northern settings, access to specialty surgical care is more challenging than in urban communities. Although the Canada Health Act states that its primary objective [...]

Physical vapor deposition can prepare organic glasses with high kinetic stability. When heated, these glassy solids slowly transform into supercooled liquid in a process known as rejuvenation. In this study, we anneal vapor-deposited glasses of methyl-m-toluate for 6 h at 0.98Tg to observe rejuvenation using dielectric spectroscopy. Glasses of moderate stability exhibited partial or full rejuvenation in 6 h. For highly stable glasses, prepared at substrate temperatures of 0.85Tg and 0.80Tg, the 6 h annealing time is ∼2% of the estimated transformation time, and no change in the onset temperature for the α relaxation process was observed, as expected. Surprisingly, for these highly stable glasses, annealing resulted in significant increases in the storage component of the dielectric susceptibility, without corresponding increases in the loss component. These changes are interpreted to indicate that short-term annealing rejuvenates a high frequency relaxation (e.g., the boson peak) within the stable glass. We compare these results to computer simulations of the rejuvenation of highly stable glasses generated by using the swap Monte Carlo algorithm. The in silico glasses, in contrast to the experiment, show no evidence of rejuvenation within the stable glass at times shorter than the alpha relaxation process. [ABSTRACT FROM AUTHOR]

For many reasons, higher education is shifting toward more online instruction. As this shift occurs, educators and administrators should be aware that the efficacy of online courses may be influenced by course content. Specifically, student learning may suffer as courses utilizing significant quantitative content, such as accounting and finance, transition from in-person instruction to online. We investigate this possibility in three quasi-experiments, which compare online and face-to-face instruction in four disparate business minor courses. In our first study we obtain the predicted interaction, such that online students performed worse than traditional students, and more so in quantitatively heavy classes. In order to encourage better performance, we design an intervention based on distributed practice theory, encouraging students to engage with material more frequently. However, this intervention fails, replicating the interaction in Study 2. For Study 3, we design a more extensive intervention based on social learning theory, asking teachers to employ a variety of tactics to boost their feedback and interpersonal contact with students. This new intervention is successful, with online students performing equally well regardless of the volume of quantitative content in the course. Findings are discussed in terms of their teaching implications and the need for more theory-based research.

Children with Attention Deficit Hyperactivity Disorder (ADHD) are more at risk for academic underachievement compared to their typically developing peers. Understanding their greatest strengths and challenges at school, and how these can be supported, is vital in order to develop focused classroom interventions. Ten primary school pupils with ADHD (aged 6-11 years) and their teachers (N = 6) took part in semi-structured interviews that focused on (1) ADHD knowledge, (2) the child's strengths and challenges at school, and (3) strategies in place to support challenges. Thematic analysis was used to analyse the interview transcripts and three key themes were identified; classroom-general versus individual-specific strategies, heterogeneity of strategies, and the role of peers. Implications relating to educational practice and future research are discussed.

Laboratory chemical synthesis research typically lacks the preplanned hazard responses found in production-scale industrial laboratories. Chemical safety management is a known challenge in education-based facilities, which is concerning for academic and national laboratory environments working with inexperienced student researchers. At the Molecular Foundry, a U.S. Department of Energy (DOE) user facility, a chemical safety management form has been developed that follows DOE’s Integrated Safety Management (ISM) process, which evaluates the risks and hazards associated with all forms of work. An ISM form for chemical synthesis is described here in detail. It is regularly used to guide chemical safety discussions between researchers and supervisors, to plan accident responses, and to establish triggers, at which point a reevaluation of the work is needed. The form makes it straightforward to know what limits researchers may work within and makes it clear which procedure changes will require a new safety assessment and discussion before work continues. The ISM form for synthesis is being successfully used in three fields of chemistry: Inorganic, Organic, and Biological. The form has also been adapted for liquid sample preparation in electron microscopy. Upper management, supervisors, students, and general users are engaged in this process. It is hoped that sharing this knowledge will enable educational institutions and other laboratories to develop similar methods to help researchers and supervisors understand the hazards as well as the working limits of any protocol, helping researchers to work more independently and safely within the laboratory.

This study assessed seasonal variations in water quality and their impact on the Inyaka Dam and Crocodile River in Mpumalanga Province, South Africa. A total of 206 water samples were collected across four seasons to analyse parameters including pH, turbidity, electrical conductivity (EC), temperature, Manganese (Mn), Iron (Fe), phosphate (PO43−), nitrate-nitrogen (NO3-N), E. coli, total coliforms, faecal streptococci, and Bifidobacteria. Principal component analysis (PCA) and Pearson correlation identified major pollutants and their seasonal variations, while cluster analysis grouped water quality by parameter fluctuations.Findings indicated that water quality in both the Inyaka Dam and the Crocodile River exceeded permissible limits. In the Inyaka Dam, summer rainfall (202.68 mm) spurred microbial growth, including E. coli and Bifidobacteria, while winter saw elevated levels of PO43−, EC, Fe, and NO3-N. The Crocodile River exhibited its poorest water quality in summer, with high levels of conductivity, turbidity, Fe, Mn, and NO3-N, driven largely by rainfall. Winter pollution in the river was marked by E. coli, PO43−, total coliforms, NO3-N, and Bifidobacteria.The study highlights significant pollution in the Crocodile River, particularly in summer, linked to rainfall and effluent discharges. Microbial pollution persisted across seasons, influenced by both weather and point-source contamination. The winter season exacerbated water quality deterioration in the Crocodile River due to reduced flow, while Inyaka Dam's winter pollution was attributed to lake stratification.

Telomeres are the protective caps at the ends of linear chromosomes of eukaryotic organisms. Telomere binding proteins, including the six components of the complex known as shelterin, mediate the protective function of telomeres. They do this by suppressing many arms of the canonical DNA damage response, thereby preventing inappropriate fusion, resection and recombination of telomeres. One way this is achieved is by facilitation of DNA replication through telomeres, thus protecting against a “replication stress” response and activation of the master kinase ATR. On the other hand, DNA damage responses, including replication stress and ATR, serve a positive role at telomeres, acting as a trigger for recruitment of the telomere-elongating enzyme telomerase to counteract telomere loss. We postulate that repression of telomeric replication stress is a shared mechanism of control of telomerase recruitment and telomere length, common to several core telomere binding proteins including TRF1, POT1 and CTC1. The mechanisms by which replication stress and ATR cause recruitment of telomerase are not fully elucidated, but involve formation of nuclear actin filaments that serve as anchors for stressed telomeres. Perturbed control of telomeric replication stress by mutations in core telomere binding proteins can therefore cause the deregulation of telomere length control characteristic of diseases such as cancer and telomere biology disorders.

C-C chemokine receptor 2 (CCR2) is a dual-function receptor. Similar to other G protein-coupled chemokine receptors, it promotes monocyte infiltration into tissues in response to the chemokine CCL2, and, like atypical chemokine receptors (ACKRs), it scavenges chemokine from the extracellular environment. CCR2 therefore mediates CCL2-dependent signaling as a G protein-coupled receptor (GPCR) and also limits CCL2 signaling as a scavenger receptor. We investigated the mechanisms underlying CCR2 scavenging, including the involvement of intracellular proteins typically associated with GPCR signaling and internalization. Using CRISPR knockout cell lines, we showed that CCR2 scavenged by constitutively internalizing to remove CCL2 from the extracellular space and recycling back to the cell surface for further rounds of ligand sequestration. This process occurred independently of G proteins, GPCR kinases (GRKs), β-arrestins, and clathrin, which is distinct from other "professional" chemokine scavenger receptors that couple to GRKs, β-arrestins, or both. These findings set the stage for understanding the molecular regulators that determine CCR2 scavenging and may have implications for drug development targeting this therapeutically important receptor.

Background: High-level payment data provided by Doctors of BC showed a 19.7% pay disparity in annual payments between female and male general surgeons in fiscal year 2019/20, and this was previously as high as 30% in 2012/13. This study aimed to examine the impact of targeted fee increases on pay disparity by sex over time. Methods: The top 35 fees billed by female general surgeons, representing 76.3% of total payments, were retrospectively analyzed. The pay disparity by sex was calculated for each individual fee from 2000/01 to 2019/20. Results: There were notable billing differences between female and male general surgeons. Female surgeons billed breast oncology procedures, malignancy consultations and visits, and peritoneal malignancy surgical procedures in greater proportions than did their male counterparts. Male surgeons billed hemorrhoid banding and rigid proctosigmoidoscopy in greater proportions than their female counterparts. With targeted fee increases, pay disparity by sex worsened for 17 of the top 35 fees but improved for the other 18 from 2010/11 to 2019/20, to varying degrees, resulting in an overall reduction in pay disparity by sex from 23% to 15%. If across-the-board fee increases had been implemented instead of targeted fee increases, the disparity in 2019/20 would have been 19% instead of 15%. Conclusion: Targeted fee increases reduced pay disparity between male and female general surgeons compared with theoretical across-the-board fee increases in British Columbia from 2010/11 to 2019/20, but not uniformly; some fee increases resulted in increased disparity. Other physician groups should conduct a similar analysis and allocate future fee changes with the aim of improving rather than worsening disparity. Contexte : Les données sur les honoraires de haut niveau fournies par les médecins britanno-colombiens ont montré une disparité salariale annuelle de 19,7% entre les chirurgiennes et les chirurgiens pour l'année fiscale 2019/20; cette disparité atteignait 30% en 2012/13. La présente étude visait à mesurer l'impact des augmentations ciblées des honoraires sur la disparité salariale entre les sexes au fil du temps. Méthodes : Les 35 principaux honoraires facturés par les chirurgiennes générales, représentant 76,3% des paiements totaux, ont été analysés rétrospectivement. La disparité salariale selon le sexe a été calculée pour chacun des honoraires entre 2000/01 et 2019/20. Résultats : On a observé des différences de facturation notables entre les chirurgiennes et les chirurgiens de chirurgie générale. Comparativement à leurs homologues masculins, les chirurgiennes ont facturé davantage pour des interventions d'oncologie mammaire, des avis et consultations pour cancer et des interventions pour des cancers péritonéaux. De leur côté, les chirurgiens ont facturé pour des ligatures d'hémorroïdes et des proctosigmoidoscopies rigides plus que leurs homologues féminines. Avec les augmentations d'honoraires ciblées, la disparité salariale selon le sexe s'est accentuée pour 17 des 35 principaux honoraires, mais elle s'est améliorée à divers degrés pour les 18 autres, entre 2010/11 et 2019/20, donnant lieu à une réduction globale de la disparité salariale selon le sexe de 23% à 15%. Si on avait appliqué des augmentations généralisées des honoraires plutôt que des augmentations ciblées, la disparité en 2019/20 aurait été de 19% plutôt que de 15%. Conclusion : En Colombie-Britannique, entre 2010/11 et 2019/20, les augmentations ciblées des honoraires ont réduit la disparité salariale entre les hommes et les femmes qui exercent en chirurgie générale comparativement à des augmentations généralisées théoriques, mais non de façon uniforme; certaines augmentations d'honoraires ont aggravé la disparité. D'autres groupes de médecins gagneraient à procéder à une analyse similaire et à appliquer d'éventuels changements d'honoraires de manière à atténuer et non pas aggraver la disparité., In 2021, Doctors of BC (DoBC), the medical association for all physicians in British Columbia, provided the economics committee of each specialty section with Medical Services Plan payment data from [...]

Background: Human papillomavirus (HPV) remains the most prevalent sexually transmitted infection in the United States (U.S.). By the age of 45, over 80% of Americans will contract HPV, which creates a significant public health concern. Despite the availability of effective vaccines, low vaccination uptake continues to be a challenge, particularly in Tennessee. Additionally, the Advisory Committee on Immunization Practices (ACIP) recently expanded recommendations for HPV vaccine usage to include adults aged 27–45, suggesting a population with the potential to experience a gap in preventative care. To understand the underlying factors that may hinder Tennesseans from receiving the HPV vaccine, we conducted a cross-sectional survey from 29 June to 17 August 2023 among adults aged 18 to 45 in Tennessee. The survey was developed and informed by a scoping review regarding the various constructs and frameworks used in vaccine hesitancy and our previous qualitative work. Using theory-based instruments and previous qualitative data, this study aimed to determine the underlying factors that may hinder Tennesseans from receiving the HPV vaccine, focusing on those adults within the recently approved age range of 27–45 years old. Methods: An Exploratory Factor Analysis of 2011 participants ultimately included five factors, which explain 70.3% of the variability. These were Benefits/Trust, Perceived Susceptibility, Attitude/Behavioral Control, Perceived Barriers, and Perceived Severity. All Cronbach alphas were greater than 0.80, indicating that each factor was reliable. Results: When stratifying by various demographics, our analysis found that race emerged as a significant factor (p = 0.002), while the interaction of race and vaccination status was not significant (p = 0.753). Black respondents had significantly lower levels of Benefits/Trust than White (p < 0.001) and Asian respondents (p = 0.030), with no significant differences between White and Asian respondents. Conclusions: These findings underscore the importance of researchers, healthcare professionals, public health officials, and policymakers in addressing these demographic differences to effectively increase vaccination rates and reduce HPV-associated cancer risks in Tennessee. Further studies are needed for targeted interventions to address these disparities.

Increasing evidence has shown that the COVID-19 outbreak has impacted adolescents' mental health. Utilising a mixed-method design, the current study examined a total of 518 adolescent perspectives (60% female), in Scotland, on what "has" and "could" help their mental health in the context of COVID-19. A reflexive thematic analysis revealed three themes in relation to what "has" helped adolescents' mental health since the COVID-19 outbreak. These related to findings about the value of: (1) engaging in recreational activities, (2) engaging with friends, and (3) the disruption to schooling. The remaining four themes related to what could have helped adolescents mental health and wellbeing since the COVID-19 outbreak. These focussed on (1) better support: in relation to mental health; school work; and communication, (2) contact with friends, and (3) more opportunities for recreational activities. Males were more likely to report recreational activities "had" helped and less likely to report better support "could" have helped. Adolescents who reached clinical threshold for depression and anxiety and those with elevated PTSD-like symptoms about COVID-19 were more likely to state more support "could" have helped, and adolescents who reached clinical threshold for depression were "less" likely to report that friends could have helped their mental health. The findings may inform mental health policy and interventions in the recovery from the COVID-19 pandemic.

Best practices in early childhood include using measures to identify children's social-emotional and behavioral needs within routine, naturalistic preschool contexts. Aligned with best practices, we examined the combined utility of two contextual measures, a teacher report and a direct observation of classroom behavior, in the context of interactions with teachers, peers, and learning tasks. Latent profile analysis (N = 527 children) identified four profile groups: (a) well-adjusted and positively engaged, (b) high externalizing and conflict engagement, (c) adequately adjusted/mildly disengaged in learning tasks, and (d) elevated internalizing behavior and low engagement. Children's profile classification was associated concurrently with emotion regulation and social competence. Teachers independently reported on children's social-emotional or academic concerns. Teachers' reports of social-emotional concerns comported for children in the externalizing profile but did not comport for the internalizing group. Findings illustrate the utility of a contextual assessment approach for early identification and intervention, particularly for children who display internalizing behavior.

The current revolution of digital health technology and machine learning offers enormous potential to improve patient care. Nevertheless, it is essential to recognize that dermatology requires an approach different from those of other specialties. For many dermatological conditions, there is a lack of standardized methodology for quantitatively tracking disease progression and treatment response (clinimetrics). Furthermore, dermatological diseases impact patients in complex ways, some of which can be measured only through patient reports (psychometrics). New tools using digital health technology (e.g., smartphone applications, wearable devices) can aid in capturing both clinimetric and psychometric variables over time. With these data, machine learning can inform efforts to improve health care by, for example, the identification of high-risk patient groups, optimization of treatment strategies, and prediction of disease outcomes. We use the term personalized, data-driven dermatology to refer to the use of comprehensive data to inform individual patient care and improve patient outcomes. In this paper, we provide a framework that includes data from multiple sources, leverages digital health technology, and uses machine learning. Although this framework is applicable broadly to dermatological conditions, we use the example of a serious inflammatory skin condition, chronic cutaneous graft-versus-host disease, to illustrate personalized, data-driven dermatology.