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Background: Bladder cancer with divergent differentiation (BCDD) comprises a heterogenous group of tumors with a poor prognosis, and differential expression of nectin‐4 and programmed death ligand‐1 (PD‐L1) has been reported in BCDD. Importantly, nectin‐4 expression in bladder cancer is associated with response to enfortumab vedotin, and PD‐L1 expression is associated with responses to immune checkpoint inhibitors (ICIs). Methods: The authors conducted a retrospective review identifying 117 patients with advanced or metastatic BCDD who were treated at Winship Cancer Institute from 2011 to 2021. They performed immunohistochemistry staining for nectin‐4 and PD‐L1 expression by histologic subtype as well as genomic analysis of these patients, including RNA sequencing, whole‐exome sequencing, and fusion detection analysis as well as a subgroup genomic analysis of patients with BCDD who received ICIs. Results: The results indicated that nectin‐4 expression was highest in the groups who had the squamous and plasmacytoid subtypes, whereas the group that had the sarcomatoid subtype (70.8%) had the highest proportion of PD‐L1–positive patients. Genomic analysis yielded several key findings, including a 50% RB1 mutation rate in patients who had small cell BCDD, targetable PIK3CA mutations across multiple subtypes of BCDD, and significantly higher expression of TEC in responders to ICIs. Conclusions: In this study, the authors identified clinically relevant data on nectin‐4 and PD‐L1 expression in patients with rare bladder tumors. They also identified several novel findings in the genomic analysis that highlight the role of precision medicine in this population of patients. Larger, prospective studies are needed to validate these hypothesis‐generating data. In this study, the authors performed a retrospective analysis focused on the histologic and genomic characterization of bladder cancer with divergent differentiation. The results indicated that nectin‐4 expression was highest in patients with squamous and plasmacytoid differentiation, whereas patients who had sarcomatoid differentiation (70.8%) had the highest proportion of programmed death ligand‐1–positive disease, and several novel findings were identified in the genomic analysis that have potential clinical implications for these patients with rare tumors. [ABSTRACT FROM AUTHOR]

School‐based mental health professionals consistently report that they are either not prepared to support grieving students, or do not have time to integrate crisis intervention support into their hectic schedule. Given that inadequate school mental health services can increase a bereaved student's risk of developing emotional problems, it is critical that school psychologists increase their comfort in grief. This study surveyed 75 school psychologists in the Northwestern United States regarding their training and experience in grief support. A reflexive thematic analysis identified four themes related to the challenges and recommendations in grief support: lack of training, limited role of the school psychologist, lack of formalized grief response system, and lack of school and community resources. Furthermore, only 3% of participants reported taking the lead in providing grief support and 64% provide grief support fewer than five times a year. The majority (81%) reported that they had zero courses devoted to grief support during their graduate degree, with more participants (67%) obtaining grief training postdegree. Study limitations, areas for further research, and implications for schools and school psychologists are also discussed. Practitioner Points: School Psychologists identified challenges and recommendations in providing grief support related to lack of training, limited role of the school psychologist, lack of formalized grief response system, and lack of school and community resources.The majority of school psychologists do not take the lead in providing grief support and provide it fewer than five times a year.The majority of school psychologists received their training in grief postdegree instead of during their graduate training. [ABSTRACT FROM AUTHOR]

Background: Advanced penile squamous cell carcinoma (pSCC) is a rare and aggressive malignancy with limited success of immune‐checkpoint inhibitors (ICIs). Approximately half of pSCC cases are associated with human papillomavirus (HPV) infection. Methods: Evaluation was done retrospectively of the landscape of somatic alterations and ICI‐related biomarkers in pSCC by using the Caris Life Sciences data set with the aim to establish signatures for HPV‐dependent oncogenesis. The pSCC tumors were analyzed by using next‐generation sequencing (NGS) of DNA and RNA. Programmed death ligand 1 (PD‐L1) expression was evaluated by immunohistochemistry (IHC). Microsatellite instability (MSI) was tested by fragment analysis, IHC (SP142; ≥1%), and NGS. Tumor mutational burden (TMB)–high was defined as ≥10 mutations/Mb. HPV16/18 status was determined by using whole‐exome sequencing (WES) when available. Significance was adjusted for multiple comparisons (q value <.05). Results: NGS of the overall cohort (N = 108) revealed TP53 (46%), CDKN2A (26%), and PIK3CA (25%) to be the most common mutations. Overall, 51% of tumors were PD‐L1+, 10.7% had high TMB, and 1.1% had mismatch repair–deficient (dMMR)/MSI‐high status. Twenty‐nine patients had their HPV status made available by WES (HPV16/18+, n = 13; HPV16/18−, n = 16). KMT2C mutations (33% vs. 0%) and FGF3 amplifications (30.8% vs. 0%) were specific to HPV16/18+ tumors, whereas CDKN2A mutations (0% vs. 37.5%) were exclusive to HPV16/18− tumors. TMB‐high was exclusively found in the HPV16/18+ group (30.8%). The two groups had comparable PD‐L1 and dMMR/MSI‐H status. Conclusions: In a large and comprehensive NGS‐based evaluation of somatic alterations in pSCC, HPV16/18+ versus HPV16/18− pSCCs were molecularly distinct tumors. Our finding that TMB‐high is exclusive to HPV16/18+ tumors requires confirmation in larger data sets. Plain Language Summary: Penile squamous cell carcinoma (pSCC) is a rare and aggressive malignancy in the advanced setting, with poor prognosis and little success with immune‐checkpoint inhibitors (ICIs) in an unselected patient approach. Human papillomavirus (HPV) infection is a known risk factor for pSCC; its impact on genomic tumor profiling is less defined.Using next‐generation sequencing, we explored the genetic landscape and ICI‐related biomarkers of pSCC and HPV‐driven oncogenic molecular signatures.Our results indicate that HPV‐positive and HPV‐negative pSCCs are molecularly distinct tumors. Increased tumor mutational burden is associated with HPV‐positive tumors, and could serve as a biomarker for predicting therapeutic response to ICI‐based therapies.Our results support the growing literature indicating that HPV status in pSCC can be used to guide patient stratification in ICI‐based clinical trials. This study reports on the genetic landscape of immune‐checkpoint inhibitor (ICI) biomarkers in penile squamous cell carcinoma (pSCC) and shows that HPV‐positive and HPV‐negative tumors are molecularly distinct, which is consistent with prior studies. Tumor mutational burden–high status was associated with HPV‐positive tumors. These results support that HPV status in pSCC can be used to guide patient stratification in ICI‐based clinical trials. [ABSTRACT FROM AUTHOR]

Background: We developed a novel risk scoring system for urothelial cancer (UC) patients receiving immune checkpoint inhibitors (ICI). Methods: We conducted a retrospective review of 67 UC patients treated with ICI at Winship Cancer Institute of Emory University from 2015 to 2018. Using stepwise variable selection in Cox proportional hazard model and Sullivan's weighting schema, baseline platelet‐to‐lymphocyte ratio (PLR), presence of liver metastasis, baseline albumin, and baseline Eastern Cooperative Oncology Group performance status (ECOG PS) were used for risk scoring. Patients were categorized into good risk (risk score 0‐1), intermediate risk (risk score 2‐3), and poor risk (risk score 4‐6). Univariable (UVA) and multivariable analysis (MVA) and Kaplan‐Meier method were used to assess overall survival (OS) and progression free survival (PFS). Results: The Emory Risk Scoring System had C‐statistics of 0.74 (Standard Error = 0.047) in predicting OS and 0.70 (Standard Error = 0.043) in predicting PFS. Compared to good risk patients, poor risk patients had significantly shorter OS and PFS in both UVA and MVA (all P <.001), and intermediate risk patients had significantly shorter OS and PFS in both UVA and MVA (all P <.03). Conclusions: Risk scoring using baseline PLR, presence of liver metastasis, baseline albumin, and baseline ECOG PS may effectively predict OS and PFS in UC patients receiving ICI. [ABSTRACT FROM AUTHOR]

The purpose of the current study is to investigate the relationships between suicidal thoughts and behaviors (STBs), school climate, and student demographics among middle school students. The study was conducted with a sample of 152,191 middle school students across 607 schools within 182 school districts in a southeastern state. Results support prior research that positive perceptions of school climate are associated with fewer reports of STB. Participants identified family reasons, bullying, peer problems, and 'other' as the most common reasons for STB. Further, older students and males were more likely to engage in STB than their counterparts. When examining cross-sectional interactions, race/ethnicity moderated the relationship between school climate and STB. Findings from the study support the role of school psychologists in advocating for prevention and intervention STB supports for middle school students with particular attention to students who may be at increased risk based on group identification. Implications for future research and practice are discussed. [ABSTRACT FROM AUTHOR]

Background The process of induction of labour ( IOL) commonly involves cervical ripening, using mechanical or pharmacological methods. However, the optimum protocol of IOL remains undetermined. Aims To report the maternal, neonatal and process outcomes for women being induced with a balloon catheter or prostaglandin E2 gel ( PGE2). Materials and methods Matched retrospective cohort study of women requiring IOL at term with a modified Bishop's score ( MBS) <7. Those who underwent cervical ripening with a double balloon catheter were matched 1:1 for parity, indication and MBS score to those using PGE2 gel. The primary outcome measure was mode of birth. Results After exclusions, data from 427 women induced with a balloon catheter were able to be matched to 427 women induced with PGE2 gel. Compared to women receiving PGE2 gel, those induced using a balloon catheter were more likely to have an unassisted vaginal birth (50.4% vs 42.9%; P = 0.028), a lower mean estimated blood loss (420 vs 481 mL; P = 0.028), a reduction in fetal acidaemia (2.4% vs 8.8%; P = 0.003) and a greater likelihood experiencing vaginal delivery within 24 h (33.7% vs 25.8%; P = 0.011). Conclusion Similar to findings in randomised controlled trials and meta-analyses of IOL methods, we observed more unassisted vaginal births, less blood loss, decreased fetal acidaemia, and a greater likelihood of vaginal delivery within 24 h, with use of balloon catheter as compared to PGE2 vaginal gel. [ABSTRACT FROM AUTHOR]

Because school violence is widespread, social and emotional competence must be targeted. Second Step is a social and emotional violence-prevention curriculum that teaches prosocial skills and reduces aggressive behavior. The purpose of this study was to examine the effects of Second Step implementation on students ( N = 403) in preschool through fourth grade who were predominately Latino, English language learners, and from families with low socioeconomic status. The data of 165 out of the 403 students were included in the present study. Analyses consisted of paired-samples t-tests to identify changes in social and emotional knowledge and behavioral and emotional risk. Results showed that there was a significant increase in both social and emotional knowledge and behavioral and emotional risk following the implementation of Second Step. These results are discussed with regard to previous and future research, limitations, and implications for school practice. [ABSTRACT FROM AUTHOR]

Path analyses were applied to test a model that includes internalizing and externalizing behavior problems as predictors of suicidal behaviors in children. Parents of an inpatient sample of boys (N = 87; M age = 9.81 years) rated the frequency of suicidal ideation and completed standardized measures of behavior problems. Blind raters rated the severity of the children's suicidal behaviors. Results revealed a significant direct effect for suicidal ideation on suicide attempt and for depressive symptoms on suicidal ideation. There was also a significant indirect path from impulsivity to suicidal ideation through aggressive and depressive symptoms. Clinical implications are discussed. [ABSTRACT FROM AUTHOR]

The article shares the author's response concerning on the critique of Colin Clarke on her book "Dropping Anchor, Setting Sail: Geographies of Race in Black Liverpool." The author is intrigued by Clarke's concern that in a book about place there are no pictures. The author said that the books cover provides the only concession to reader's perceived need to see Liverpool, but it does so in a way calls attention to the act of looking.

Analyzes the concept in which the terms `black Liverpool' and `black America' are used in relation to how black identity is constituted in Liverpool, England. Reference to the book `There Ain't No Black in the Union Jack: The Cultural Politics of Race and Nation,' by Paul Gilroy; Information on black Liverpudlians relations with black American servicemen, who were stationed outside their city for 25 years after World War II.

Objectives/Hypothesis: To evaluate the long-term outcome of intraoral removal of large submandibular gland calculi. Study Design: Retrospective cohort study. Methods: A retrospective review (1995–2008) of 118 patients with submandibular calculi ≥10 mm treated by intraoral surgical removal with preservation of the salivary gland. Results: Calculi were completely removed in 103/118 (87.3%) cases, partially removed in 14/118 (11.9%), with failure to remove any fragments in only 1/118 (0.8%). After a mean follow-up of 42 months, 101/118 (85.6%) cases remained asymptomatic, 17/118 (14.4%) cases had modest obstructive or infective symptoms, 4/118 (3.4%) cases suffered recurrent stones, and in 1/118 (0.8%) case persistent symptoms dictated salivary gland removal. Conclusions: The data suggest that the majority of large submandibular gland calculi can be removed by gland-preserving procedures retaining an asymptomatic salivary gland. This casts doubt on the commonly held premise that salivary stones normally lead to chronic sialoadenitis, which is the basis for the current policy of sialoadenectomy. Laryngoscope, 2010 [ABSTRACT FROM AUTHOR]

White clover mosaic virus was isolated from glasshouse-grown sweet pea plants with conspicuous flower ‘break’ symptoms. Plant growth was severely affected. The virus was transmissible by sap inoculation to sweet pea and other leguminous species. It was found naturally in Trifolium repens growing nearby. No natural vector is known. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: To evaluate the long-term outcome of intraoral removal of large submandibular gland calculi., Study Design: Retrospective cohort study., Methods: A retrospective review (1995-2008) of 118 patients with submandibular calculi > or = 10 mm treated by intraoral surgical removal with preservation of the salivary gland., Results: Calculi were completely removed in 103/118 (87.3%) cases, partially removed in 14/118 (11.9%), with failure to remove any fragments in only 1/118 (0.8%). After a mean follow-up of 42 months, 101/118 (85.6%) cases remained asymptomatic, 17/118 (14.4%) cases had modest obstructive or infective symptoms, 4/118 (3.4%) cases suffered recurrent stones, and in 1/118 (0.8%) case persistent symptoms dictated salivary gland removal., Conclusions: The data suggest that the majority of large submandibular gland calculi can be removed by gland-preserving procedures retaining an asymptomatic salivary gland. This casts doubt on the commonly held premise that salivary stones normally lead to chronic sialoadenitis, which is the basis for the current policy of sialoadenectomy.