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There are more than 300 anti-Queer policies that are being proposed and implemented across the nation that impact education, including Tennessee's Senate Bill 1229; Virginia's "2022 Model Policies on the Privacy, Dignity, and Respect for all Students and Parents in Virginia's Public Schools;" and Florida's "Parental Rights in Education Bill" CS/CS/HB 1557, expanded April 2023, which prohibits topics of gender and sexuality in K-12 public education, unless related to reproductive health lessons. This policy brief offers a critique of three assumptions that can be applied to analyze how anti-Queer policies influence Queerness in rural schools. Those assumptions are: (1) Does the policy make assumptions on one type of parent? (2) How does the policy define gender and sexual identities? and (3) Will the policy erase rural queer educators and students?

For this paper, we developed and validated the "Orientation to School Renewal" instrument, a 21-item instrument, based on seven factors, which allows schools to measure their school renewal efforts. The research is based on Goodlad's notion of school renewal. Through an extensive literature review and our work over an eight-year period engaged in discussions with over 110 principals and 300 teachers, we gradually developed dimensions of the construct of school renewal. We then obtained survey data from a sample of 1,195 teachers in 83 schools, and validated the instrument using confirmatory factor analysis and other procedures. The seven factors identified from the literature and discussions with K-12 educators and confirmed via the validation process included: (a) focus on students and their achievements, (b) continuous school improvement, (c) balance between the internal and external influences, (d) the dialogue, decision, action and evaluation (DDAE) process, (e) implementation integrity, (f) implementers as active developers, and (g) internal responsibility and professionalism. Researchers and practitioners can use the instrument to collect valid and reliable data to measure, evaluate, and understand school renewal.

Objective Acute renal replacement therapy (RRT) is an important life saving technology used in critical care. However, variation in clinical practice for initiation and maintenance of RRT can increase healthcare costs and worsen patient outcomes. In Alberta, Canada, a province-wide electronic health record provides a unique opportunity to measure and evaluate clinical practice. The present study aims to improve the quality of RRT delivery in Alberta critical care units by providing feedback on key performance indicators (KPIs) for RRT based on current evidence. Approach KPIs for RRT included an initiation pathway based on threshold lab values, and measures of RRT quality such as the time from order to treatment initiation, the average life of dialysis filters, and the actual vs. prescribed fluid removal. Clinical KPI definitions were mapped to data available in the electronic health record to evaluate current practice and track changes in KPIs over time. Results Mapping the clinical guidelines to the electronic health record took significant time and effort in a large team with expertise on both the data and clinical sides. Each KPI data definition went through several cycles of development, validation and refinement before being included in the dashboards and reports given to participating sites. Conclusions Providing accurate data on RRT ordering and delivery practices is an important step in aligning acute RRT delivery with current best practice, ultimately improving the quality of care and reducing unnecessary costs. Implications Electronic health records provide a powerful tool for evaluating clinical decisions and implementing best practice guidelines.

Introduction We previously investigated the frequency of screening for celiac disease (CD) based on tissue transglutaminase antibody testing (tTG-IgA) and developed the first incident cohort of celiac autoimmunity in Canada. Methods Administrative data sources used in this study were population-based and covered the entire province of Alberta (~4.3M residents during study period). Various approaches to querying data were employed within a diverse team of health information managers, data analysts, clinical scientists, and gastroenterologists. This process involved a broad search for CD screening tests, thorough data inspection/cleaning, and numerous discussions to determine potential explanations for the findings. Results Approximately ~950,000 records for tTG-IgA were first identified. Records were then excluded due to missing/invalid patient identifiers or test results (0.8%), non-Alberta residency (0.4%), and duplicate records (1.1%). A final dataset included ~920,000 tTG-IgA tests on ~680,000 unique patients, which was also validated through a separate query performed by an analyst external to the study team. A conservative approach to excluding as many potential prevalent cases of CD was applied given a robust algorithm for CD has not yet been established in Canada. The final rate of celiac autoimmunity (34 per 100,000) offered further face validity based on prior estimates of diagnosed CD in Alberta and other countries reporting on celiac autoimmunity. Conclusion When developing a novel case definition or investigating unfamiliar outcomes using routinely collected data, collaboration across several disciplines is highly recommended. Certain stages of the project may require additional scrutiny and discussion to ensure findings are valid and reliable.

Group A Streptococcus (GAS) is a strict human pathogen possessing a unique pathogenic trait that utilizes the cooperative activity of NAD+-glycohydrolase (NADase) and Streptolysin O (SLO) to enhance its virulence. How NADase interacts with SLO to synergistically promote GAS cytotoxicity and intracellular survival is a long-standing question. Here, the structure and dynamic nature of the NADase/SLO complex are elucidated by X-ray crystallography and small-angle scattering, illustrating atomic details of the complex interface and functionally relevant conformations. Structure-guided studies reveal a salt-bridge interaction between NADase and SLO is important to cytotoxicity and resistance to phagocytic killing during GAS infection. Furthermore, the biological significance of the NADase/SLO complex in GAS virulence is demonstrated in a murine infection model. Overall, this work delivers the structure-functional relationship of the NADase/SLO complex and pinpoints the key interacting residues that are central to the coordinated actions of NADase and SLO in the pathogenesis of GAS infection.

Recently, the number of books featuring both queer and rural youth experiences has increased (Kedley et al., 2022), including Jamison’s (2021) Hillbilly Queer: A Memoir. The present study examined how this book functions as a memoir about young adult experiences and analyzed the possibilities it offers rural queer students as well as rural and/or queer educators. Through a queer autoethnographic literary analysis, the authors draw upon their experiences as once closeted rural queer youth and former openly queer secondary English language arts educators teaching in rural and rural-serving public schools. This study found important benefits for rural queer adolescents and significant implications for the English language arts classroom.

Through an expansive international effort that involved data collection on 12 small-angle X-ray scattering (SAXS) and four small-angle neutron scattering (SANS) instruments, 171 SAXS and 76 SANS measurements for five proteins (ribonuclease A, lysozyme, xylanase, urate oxidase and xylose isomerase) were acquired. From these data, the solvent-subtracted protein scattering profiles were shown to be reproducible, with the caveat that an additive constant adjustment was required to account for small errors in solvent subtraction. Further, the major features of the obtained consensus SAXS data over the q measurement range 0-1 Å-1 are consistent with theoretical prediction. The inherently lower statistical precision for SANS limited the reliably measured q-range to 2.2 Å-1 showed good mutual agreement, affirming that this region has interpretable features for structural modelling. SAS measurements with inline size-exclusion chromatography (SEC) proved to be generally superior for eliminating sample heterogeneity, but with unavoidable sample dilution during column elution, while batch SAS data collected at higher concentrations and for longer times provided superior statistical precision. Careful merging of data measured using inline SEC and batch modes, or low- and high-concentration data from batch measurements, was successful in eliminating small amounts of aggregate or interparticle interference from the scattering while providing improved statistical precision overall for the benchmarking data set.

Background: Perturbation-based balance training (PBT) is a promising fall risk reduction method that involves inducing unexpected perturbations to balance to train participants reactive balance control. Due to the unpredictable nature of PBT, its acceptability to older adults could present a barrier to the implementation of PBT in the community. Aim/Purpose: The purpose of this study was to assess the perceived acceptability of a community-based PBT program to both older adults and healthcare professionals (HCPs). Methods: Nineteen older adults (aged 69.6 ± 6.6 years, 17 women, 2 men) and three HCPs participated in the qualitative study. Participants completed four PBT sessions facilitated in conjunction with HCPs. Interviews, based on the theoretical framework of acceptability, were conducted before and after PBT and analyzed using template analysis. Results: PBT was perceived as effective by older adults and HCPs. However, HCPs perceived the equipment cost as a substantial barrier to feasibility in the community.

Objective Fatigue, headache, problems sleeping and numerous other symptoms have been reported to be associated with long COVID. However, many of these symptoms coincide with symptoms reported by the general population, possibly exacerbated by restrictions/precautions experienced during the COVID-19 pandemic. This study examines the symptoms reported by individuals who tested positive for COVID-19 compared with those who tested negative.Design Observational study.Setting The study was conducted on adult residents in Alberta, Canada, from October 2021 to February 2023.Participants We evaluated self-reported symptoms in 7623 adults with positive COVID-19 tests and 1520 adults who tested negative, using surveys adapted from the internationally standardised International Severe Acute Respiratory and emerging Infection Consortium (ISARIC)-developed COVID-19 long-term follow-up tools. These individuals had an index COVID-19 test date between 1 March 2020 and 31 December 2022 and were over 28 days post-COVID-19 testing.Primary outcome measures The primary outcomes were to identify the symptoms associated with COVID-19 positivity and risk factors for reporting symptoms.Results Fatigue was the top reported symptom (42%) among COVID-19-positive respondents, while headache was the top reported symptom (32%) in respondents who tested negative. Compared with those who tested negative, COVID-19-positive individuals reported 1.5 times more symptoms and had higher odds of experiencing 31 out of the 40 listed symptoms during the postinfectious period. These symptoms included olfactory dysfunction, menstruation changes, cardiopulmonary and neurological symptoms. Female sex, middle age (41–55 years), Indigeneity, unemployment, hospital/intensive care unit (ICU) admission at the time of testing and pre-existing health conditions independently predicted a greater number and variety of symptoms.Conclusions Our results provide evidence that COVID-19 survivors continue to experience a significant number and variety of symptoms. These findings can help inform targeted strategies for the unequally affected population. It is important to offer appropriate management for symptom relief to those who have survived the acute COVID-19 illness.

Purpose: To evaluate the quality of the interspace between the prostate and rectum and assess the effect on the dose to the rectum by measuring the spacer quality score (SQS) before and after implanting a hydrogel rectal spacer. Methods and Materials: Thirty patients with prostate cancer were treated with stereotactic ablative body radiation therapy as part of the SPORT clinical trial. Each patient had a 10 mL polyethylene glycol hydrogel spacer inserted transperineally. Computed tomography scans were acquired before and after spacer insertion, 10MV flattening filter free (FFF) stereotactic ablative body radiation therapy (SABR) treatment plans were generated using each image set. To calculate the SQS, the prostate-rectal interspace (PRI) was measured in the anterior-posterior orientation, parallel to the anatomic midline at the prostate base, apex, and midgland on the prespacer and postspacer computed tomography. Measurements were taken in 3 transverse positions between the prostate and the rectum, and PRI scores of 0, 1, and 2 were assigned if the interspace between prostate and rectum was

Despite numerous tutorials and standards written to the technical community on X-ray photoelectron spectroscopy (XPS), difficulties with data acquisition, analysis, and reporting persist. This work focuses on common errors in XPS that are frequently observed in the scientific literature and their sources. Indeed, this work covers: (i) XPS data collection, initial data analysis, and data presentation, (ii) Handling XPS backgrounds, (iii) Common errors in XPS peak fitting, and (iv) XPS data presentation and reporting. Graphical examples of errors and appropriate ways of handling data and correcting errors are provided. Additional readings are listed for greater in-depth exploration of the subjects discussed.

This study evaluates the feasibility of the NIH Toolbox Cognition Battery (NIH-TCB) for use in autism spectrum disorder (ASD). 116 autistic children and adolescents and 80 typically developing (TD) controls, ages 3-17 years, completed four NIH-TCB tasks related to inhibitory control, cognitive flexibility, processing speed, and episodic memory. While the majority of autistic and TD children completed all four tasks, autistic children experienced greater difficulties with task completion. Across autistic and TD children, performance on NIH-TCB tasks was highly dependent on IQ, but significant performance differences related to ASD diagnosis were found for two of four tasks. These findings highlight the potential strengths and limitations of the NIH-TCB for use with autistic children.

Structural and mutational analyses reveal interactions between NAD+-glycohydrolase and Streptolysin O critical for Group A Streptococcus virulence, validated in a murine infection model.

Abstract Pigs are commonly maintained on total intravenous anaesthesia when used in comparative medical research to study controlled manual ventilation of the lung. In this case study, four pigs were anaesthetised with a total intravenous anaesthetic infusion of alfaxalone and dexmedetomidine for up to 24 h whilst being mechanically ventilated. Cardiovascular parameters, blood gas values and body temperature were minimally affected throughout the anaesthetic period. Additional analgesia is recommended when utilising this drug combination for procedures that involve noxious stimuli.

Plain English summary Cancer patients and their family members have unique and lived experience with the condition. Therefore, collaborating with them is important in cancer science. We aimed to create such a collaboration in Newfoundland and Labrador, Canada. In 2021, we successfully formed our diverse collaborative group. Currently, our group includes 12 public representatives. We meet online and discuss matters important to members. We also design studies and events together. Our discussions have identified four topics that need further research and policy changes such as information needs and unique needs of caregivers and family members. Our activities expand over time. For example, lately we started to advocate for other cancer patients and families. In conclusion, we formed a successful cancer patient, family member, and researcher collaborative group. Our work informs the public, healthcare systems, and scientists on important cancer related matters.

IntroductionDigitalisation offers innovative solutions within maternity services; however, vulnerable groups risk being overlooked. University College London Hospital's (UCLH) successful implementation of a digital maternity app, MyCare, gives women access to test results, information about appointments, and enables communication with healthcare professionals (HCPs). Yet, little is known about access and engagement among vulnerable pregnant women.MethodologyResearch was conducted over a 3-month period (April–June 2022) in the Maternity Department at UCLH, UK. MyCare datasets were analysed, and anonymised surveys completed by vulnerable pregnant women and HCPs.ResultsLower rates of utilisation and engagement with MyCare were seen in vulnerable pregnant women especially among refugee/asylum seekers, those with mental health issues, and those facing domestic violence. Non-users were also more likely to be individuals from ethnic minority backgrounds, with a lower average social-deprivation-index decile, whose first language was not English, and with a significant history of non-attendance to appointments. Patient and HCP surveys highlighted various barriers to MyCare engagement, including a lack of motivation, limited language options, low e-literacy levels, and complex app interfaces.ConclusionThe use of a single digital tool, without a formulated pathway to identify and assist those not accessing or engaging with it, risks unequal care provision which may exacerbate health inequalities. This research advances the idea that digital exclusion is not necessarily a matter of access to technology, but an issue of a lack of engagement with these tools. Therefore, vulnerable women and HCPs must be integral to the implementation of digital strategies, to ensure no one is left behind.

Channel catfish (Ictalurus puncatus) and freshwater drum (Aplodinotus grunniens) are two commercially and recreationally important species in large rivers of the Midwestern United States. Understanding their population demographics is essential to managing sustainable populations. In this study, we determined and compared the size structure, individual growth, and mortality estimates of channel catfish and freshwater drum among the Illinois River and sections of the Mississippi, Ohio, and Wabash rivers to provide a current baseline for managing these populations. Results suggest that both fishes differed in size structure among rivers. Compared to all other rivers, the Mississippi River freshwater drum growth rate was the highest and the theoretical maximum length was the lowest, and the Ohio River annual mortality was lowest. Channel catfish growth did not differ among rivers, but annual mortality was significantly higher in the Mississippi River compared to the Wabash River. Given the importance of these two fishes, better understanding of their population demographics in these systems is essential to improving current and future fisheries management programs.

Abstract The formation of aggregates and biofilms enhances bacterial colonisation and infection progression by affording protection from antibiotics and host immune factors. Despite these advantages there is a trade-off, whereby bacterial dissemination is reduced. As such, biofilm development needs to be controlled to suit adaptation to different environments. Here we investigate members from one of largest groups of bacterial adhesins, the autotransporters, for their critical role in the assembly of bacterial aggregates and biofilms. We describe the structural and functional characterisation of autotransporter Ag43 variants from different Escherichia coli pathotypes. We show that specific interactions between amino acids on the contacting interfaces of adjacent Ag43 proteins drives a common mode of trans-association that leads to cell clumping. Furthermore, subtle variation of these interactions alters aggregation kinetics and the degree of compacting within cell clusters. Together, our structure–function investigation reveals an underlying molecular basis for variations in the density of bacterial communities.

Gestational diabetes mellitus (GDM) is a known risk factor for stillbirth (Rosenstein et al., 2012) [1]. Delayed villous maturation (DVM), predominantly seen in term placentas in pregnancies complicated with glucose dysmetabolism, may in part be a consequence of excessive maternal glucose leading to release of fetal insulin and other growth factors that promote excessive placental growth at the expense of villous maturation (Redline, 2012) [2]. We present three cases of under-diagnosed/treated glucose dysmetabolism in women in their first pregnancies cared for in other hospitals in the United Kingdom (UK) with the fatal fetal/neonatal outcomes and confirmed DVM in the placenta and congenital pneumonia on post-mortem examination in all three cases. This cluster supports a hypothesis that DVM and glucose dysmentabolism may make babies more susceptible to severe perinatal infection. All three cases received the antenatal care in their subsequent pregnancies in our unit and had confirmed glucose dysmetabolism which was treated and resulted in healthy babies. [ABSTRACT FROM AUTHOR]