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Work engagement is crucial for organisational success, yet many organisations struggle with low engagement rates. Previous research hints at a potential link between reverse mentoring and work engagement, prompting a deeper investigation into this relationship. Drawing from the Job Demands‐Resources (JD‐R) framework and Social Exchange Theory (SET), this study examines the impact of reverse mentoring on work engagement, with knowledge sharing as a mediating factor and self‐efficacy and perceived organisational support as moderators. Through a survey of 340 middle managers across 10 multinational corporations in Sri Lanka, the study reveals significant effects between reverse mentoring and work engagement, with knowledge sharing playing a crucial mediating role. Additionally, the study demonstrates the moderating influences of self‐efficacy and perceived organisational support on work engagement and knowledge sharing, thus contributing novel insights to the existing literature in the shade of JD‐R and SET perspectives. [ABSTRACT FROM AUTHOR]

Introduction/Aims: Eteplirsen, approved in the US for patients with Duchenne muscular dystrophy (DMD) with exon 51 skip‐amenable variants, is associated with attenuated ambulatory/pulmonary decline versus DMD natural history (NH). We report overall survival in a US cohort receiving eteplirsen and contextualize these outcomes versus DMD NH. Methods: US patients with DMD receiving eteplirsen were followed through a patient support program, with data collected on ages at eteplirsen initiation and death/end of follow‐up. Individual DMD NH data were extracted by digitizing Kaplan–Meier (KM) curves from published systematic and targeted literature reviews. Overall survival age was analyzed using KM curves and contextualized with DMD NH survival curves; subanalyses considered age groups and duration of eteplirsen exposure. Overall survival time from treatment initiation was also evaluated. Results: A total of 579 eteplirsen‐treated patients were included. During a total follow‐up of 2119 person‐years, median survival age was 32.8 years. DMD NH survival curves extracted from four publications (follow‐up for 1224 DMD NH controls) showed overall pooled median survival age of 27.4 years. Eteplirsen‐treated patients had significantly longer survival from treatment initiation versus age‐matched controls (age‐adjusted hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.44–0.98; p <.05). Longer treatment exposure was associated with improved survival (HR, 0.15; 95% CI, 0.05–0.41; p <.001). Comparisons using different DMD NH cohorts to address common risks of bias yielded consistent findings. Discussion: Data suggest eteplirsen may prolong survival in patients with DMD across a wide age range. As more data become available, the impact of eteplirsen on survival will be further elucidated. [ABSTRACT FROM AUTHOR]

While the Department of Defense (DoD) infrastructure is no stranger to extremes, recent events have been unprecedented, with climate change acting as a growing risk multiplier. To assess the level of exposure of DoD installations to extreme weather and climate events, site‐specific climate information is needed. One way to bridge the scale gap between outputs from existing global climate models (GCMs) and sites is climate downscaling. This makes the information more relevant for impact assessment at the DoD installation and facility scale. However, downscaling GCMs is beset by a myriad of challenges and sources of uncertainty, and downscaling methods were not designed with specific infrastructure planning and design needs in mind. Here, we evaluate state‐of‐the‐science dynamical downscaling and statistical downscaling and bias correction for climate variables (i.e., temperature and precipitation) at the daily scale. We also combine downscaling approaches in novel ways to optimize computational efficiency and reduce uncertainty. Furthermore, we examine the sensitivity of the downscaled outputs to the choice of reference data and quantify the relative uncertainty related to downscaling approach, reference data, and other factors across the climate variables and aggregation scales. Results show that empirical quantile mapping (EQM), a statistical downscaling, consistently performs well and has less sensitivity to the choice of reference data. Moreover, the hybrid downscaling that leverages EQM improves the performance of dynamical downscaling. Our findings highlight that the choice of reference data dominates uncertainties in temperature downscaling, while their role is more muted for precipitation but still non‐negligible. Plain Language Summary: The Department of Defense (DoD) faces unprecedented challenges in assessing the impacts of extreme weather and climate events on its infrastructure. To address this issue, this study explores climate downscaling, a method of making global climate models output more applicable to specific DoD facilities. The evaluation focuses on dynamic and statistical downscaling methods for daily temperature and precipitation. Results show that the statistical approach, empirical quantile mapping (EQM), consistently performs well and is less sensitive to the choice of reference data. A hybrid downscaling that combines dynamical downscaling and EQM improves overall performance compared to the dynamical downscaling alone. This study highlights the impact of observational uncertainty at local scales on providing decision‐relevant climate change information. It emphasizes the need to enhance observational capabilities for reliable local‐scale climate information and to address observational uncertainties in climate downscaling applications. Key Points: Empirical quantile mapping (EQM) performs best among downscaling techniques and hybrid WRF‐EQM consistently improves dynamical downscaling performanceThe choice of reference data dominates uncertainty in downscaled temperatures while their role is more muted but non‐negligible in precipitation [ABSTRACT FROM AUTHOR]

Understanding changes in the hazard component of climate risk is important to inform societal resilience planning in a changing climate. Here, we examine local changes in wind speed, rainfall, and flooding related to tropical cyclones (TCs) and compare them across statistical and dynamical modeling approaches. Our focus region is the Delaware River Basin, located in the northeastern United States. We pair event‐based downscaling with large ensemble climate model information to capture the details of extreme TC wind, rain, and flooding, and their likelihood, in a changing climate. We identify local TCs in the Community Earth System Model 2 Large Ensemble (CESM2‐LENS). We find fewer TCs in the future, but these future storms have higher wind speeds and are wetter. We also find that TCs produce heavier 3‐day precipitation distributions than all other summertime weather events, with TCs constituting a larger percentage of the upper tail of the full precipitation distribution. With this information, we identify a small collection of 200‐year return events and compare the resulting TC rain and wind across dynamical and statistical downscaling methods. We find that dynamical downscaling produces peak rain rates far higher than CESM or the statistical downscaling method. It can also produce quite different future changes in precipitation totals for the small set of events considered here. This leads to vastly different flood responses. Overall, our results highlight the need to interpret future changes of event‐based simulations in the context of downscaling method limitations. Plain Language Summary: We examine the impact of tropical cyclones on the Delaware River Basin draining to Trenton, New Jersey from a wind, precipitation, and flood perspective. First, we analyze outputs from a large 100‐member climate model ensemble to examine projected changes in wind speed and precipitation for TCs. We find the climate model ensemble indicates that TCs are expected to be more intense in the future. Next, due to the coarse spatial resolution of the climate model outputs, we perform statistical and dynamical downscaling on 12 selected events to understand the impact of the selected methodology on projected changes in hazards. Our results show differences for wind, precipitation, and flooding depending on the selected downscaling approach. Key Points: Large climate model ensemble analysis coupled with the event‐based downscaling allows the exploration of the character and likelihood of rare, high‐impact tropical cyclones (TCs) on regional scalesTCs impacting a watershed in the U.S. Northeast as represented by a climate model large ensemble are fewer, stronger, and wetter in the futureThe choice of statistical versus dynamical downscaling of TC precipitation matters for the flood response [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study is to assess US operative trends and outcomes of ulcerative colitis (UC) patients undergoing total proctocolectomy with ileal pouch−anal anastomosis (TPC‐IPAA) or completion proctectomy with IPAA (CP‐IPAA). Methods: Adult UC patients who underwent TPC‐IPAA or CP‐IPAA were analysed retrospectively using the 2016–2020 American College of Surgeons National Surgical Quality Improvement Program database. Factors associated with 30‐day overall and serious morbidity were identified using multivariable logistic regression. Results: A total of 1696 patients were identified, with 958 patients (56.5%) undergoing TPC‐IPAA and 738 (43.5%) undergoing CP‐IPAA. A greater proportion of TPC‐IPAAs were performed each year (except in 2019) compared to CP‐IPAAs over the study period (P trend <0.001). Unadjusted analysis showed comparable rates of overall (20.8% vs. 24.4%, P = 0.076) and serious morbidity (14.3% vs. 12.7%, P = 0.352) between TPC‐IPAA and CP‐IPAA patients. Robotic TPC‐IPAA had no differences in complications compared to laparoscopic and open approaches. Robotic CP‐IPAA had higher anastomotic leak rates and longer hospital length of stay compared to laparoscopic and open approaches. Obesity was associated with increased odds of overall and serious morbidity for patients who underwent TPC‐IPAA. Steroid/immunosuppressive therapy was associated with increased odds of overall and serious morbidity for patients who underwent CP‐IPAA. Conclusions: Obese patients should be informed of their increased morbidity risk and offered counselling on weight loss prior to surgery when feasible. Patients on steroid/immunosuppressive therapy within 30 days preoperatively should not undergo CP‐IPAA or should delay surgery until they can be safely off those medications. [ABSTRACT FROM AUTHOR]

This study proposed a framework to evaluate multivariate return periods of hurricanes using event‐based frequency analysis techniques. The applicability of the proposed framework was demonstrated using point‐based and spatial analyses on a recent catastrophic event, Hurricane Ian. Univariate, bivariate, and trivariate frequency analyses were performed by applying generalized extreme value distribution and copula on annual maximum series of flood volume, peak discharge, total rainfall depth, maximum wind speed, wave height and storm surge. As a result of point‐based analyses, return periods of Hurricane Ian was investigated by using our framework; univariate return periods were estimated from 39.2 to 60.2 years, bivariate from 824.1 to 1,592.6 years, and trivariate from 332.1 to 1,722.9 years for the Daytona‐St. Augustine Basin. In the Florida Bay‐Florida Keys Basin, univariate return periods were calculated from 7.5 to 32.9 years, bivariate from 36.5 to 114.9 years, and trivariate from 25.0 to 214.8 years. Using the spatial analyses, we were able to generate the return period map of Hurricane Ian across Florida. Based on bivariate frequency analyses, 18% of hydrologic unit code 8 (HUC8) basins had an average return period of more than 30 years. Sources of uncertainty, due to the scarcity of analysis data, stationarity assumption and impact of other weather systems such as strong frontal passages, were also discussed. Despite these limitations, our framework and results will be valuable in disaster response and recovery. Key Points: We introduced a new framework for evaluating multivariate return periods of hurricane events through event‐based frequency analysesUsing this framework, we estimated the univariate, bivariate, and trivariate return periods of Hurricane IanA return period map was produced using the framework to identify the HUC8 basins affected by Hurricane Ian [ABSTRACT FROM AUTHOR]

Climate change increases the frequency and intensity of extreme precipitation, which in combination with rising population enhances exposure to major floods. An improved understanding of the atmospheric processes that cause extreme precipitation events would help to advance predictions and projections of such events. To date, such analyses have typically been performed rather unsystematically and over limited areas (e.g., the U.S.) which has resulted in contradictory findings. Here we present the Multi‐Object Analysis of Atmospheric Phenomenon algorithm that uses a set of 12 common atmospheric variables to identify and track tropical and extra‐tropical cyclones, cut‐off lows, frontal zones, anticyclones, atmospheric rivers (ARs), jets, mesoscale convective systems (MCSs), and equatorial waves. We apply the algorithm to global historical data between 2001–2020 and associate phenomena with hourly and daily satellite‐derived extreme precipitation estimates in major climate regions. We find that MCSs produce the vast majority of extreme precipitation in the tropics and some mid‐latitude land regions, while extreme precipitation in mid and high‐latitude ocean and coastal regions are dominated by cyclones and ARs. Importantly, most extreme precipitation events are associated with phenomena interacting across scales that intensify precipitation. These interactions are a function of the intensity (i.e., rarity) of extreme events. The presented methodology and results could have wide‐ranging applications including training of machine learning methods, Lagrangian‐based evaluation of climate models, and process‐based understanding of extreme precipitation in a changing climate. Plain Language Summary: Increases in intense precipitation and faster onsets of droughts are just two of many precipitation‐related extreme events that worsen under progressive climate change. Surprisingly little is known about the weather systems that are driving these changes in many regions around the world. In order to better predict and prepare for these events, scientists need an improved understanding of the causes of the involved atmospheric processes and their interactions. A new algorithm called the Multi‐Object Analysis of Atmospheric Phenomenon has been developed to identify and track different types of weather systems, such as tropical and extra‐tropical cyclones, that can lead to extreme precipitation. The algorithm was applied to global weather data from 2001 to 2020. The results showed that certain types of weather systems, such as mesoscale convective systems, are frequently involved in causing the most extreme precipitation. Additionally, the study found that most extreme precipitation events are caused by a combination of different weather systems working together and that these interactions differ depending on event intensity. This research could be useful for improving climate models and understanding how extreme precipitation is likely to change in the future. Key Points: We track cyclones, anticyclones, jets, mesoscale convective systems (MCSs), atmospheric rivers, fronts, and equatorial wavesExtreme precipitation is typically associated with multiple atmospheric phenomena that interact across scalesMCSs are involved in most extreme precipitation events in the tropics and many sub‐tropical and mid‐latitude regions [ABSTRACT FROM AUTHOR]

The UK government is proposing to replace M‐level national award for special educational needs co‐ordination training, mandated for SENCos in England, with an unaccredited national professional qualification. Such downgrading of their qualification level is intended to significantly increase the number of qualified SENCos; however, this is likely to reduce SENCos' capacity to exercise 'advocacy leadership' in support of students at risk of marginalization and social exclusion. We reject a neoliberal political discourse of continual improvement that neglects the need for critical literacy and research‐informed inclusive practice on the part of SENCos, and suggest that endemic exclusionary practices in English schools are more likely to go unchallenged. The move towards nonaccredited SENCo status risks their deprofessionalisation, and this proposal is linked to an academisation agenda and efforts to normalize a trichotomised education system (comprising mainstream, 'special' and 'alternative' provision) by presenting such changes as an improvement. [ABSTRACT FROM AUTHOR]

Objective: Foreign body aspiration events are frequent in young children and in the geriatric population. They may result in several complications such as hypoxia, edema, cardiac arrest, and death. Recently, two commercially available devices, the LifeVac and DeChoker, have entered the market with the claim of relieving foreign body aspiration. Both devices are portable, nonpowered, suction devices that are being considered for use in large public spaces such as schools, airports, and malls despite previous studies detailing variable efficacy. In this study, we aim to contribute further data on the safety and efficacy of these devices through a fresh cadaver model. Methods: Commonly aspirated foods of three different sizes (saltines, grapes, and cashews) were placed at the level of the true vocal folds in a fresh cadaver. Three participants performed two trials with each food and device. Device use was performed to manufacturer specifications. Results: The DeChoker resulted in gross injury to the tongue and failed to remove the obstruction in all trials. LifeVac was successful in removing the barium‐moistened saltines but failed to remove all other foreign bodies. Both devices applied significant pressure to the tongue. Conclusion: With the exception of the LifeVac removing saltine crackers, all trials were entirely unsuccessful in relieving foreign body aspiration. Additionally, both devices may cause significant pressure and injury to the oral cavity in a clinical setting. We conclude bystanders should continue to follow International Liaison Committee on Resuscitation's guidelines on resuscitation to aid with relieving foreign body aspiration. Level of Evidence: 4 In this study, we test the efficacy of the LifeVac and DeChoker, two commercially available antichoking suction devices, to relieve foreign body aspiration. The devices were tested in a fresh cadaver model and found to show minimal to no success in removing the foreign bodies. We conclude these devices should not replace current International Liaison Committee on Resuscitation's recommendations for choking. Additional evidence is necessary to support the usage of these devices in a time‐critical event. [ABSTRACT FROM AUTHOR]

This study assesses the potential influence of global navigation satellite system (GNSS) radio occultation (RO) data assimilation on the forecast skill of tropical cyclone formation over the western North Pacific in September–October 2019 through a regional model. Data from the Constellation Observing System for Meteorology, Ionosphere, and Climate mission II are applied. The forecast skill considers the hits and misses for nine developing cases and the false alarms and correct negatives for 23 non‐developing cases. Forecasts assimilating GNSS RO data reduce the false alarm ratio by 20% and increase the accuracy rate by 19%, compared to forecasts without GNSS RO data. Assimilation of GNSS RO data increases mid‐level moisture around the disturbance centers at the initial time of the forecasts. It also increases low‐level vorticity for developing cases but decreases vorticity throughout most of the troposphere for non‐developing cases. These lead to improved forecast performance for tropical cyclone formation. Plain Language Summary: Tropical cyclone formation is very sensitive to local atmospheric conditions such as moisture, temperature, and winds. Getting these conditions correct is therefore critical for accurate forecasts of tropical cyclone formation. Satellite data are commonly used to characterize atmospheric conditions over the remote oceans where tropical cyclones tend to form. New satellite data, specifically from the radio occultation of global navigation satellite systems, provide fine scale information on moisture, temperature, and pressure. This new information suffers less from contamination by clouds and precipitation than the traditional microwave and infrared satellite observations, and may further improve the representation of atmospheric conditions. In addition to cases of tropical cyclone formation, this study pays particular attention to the quality of forecasts of disturbances that did not develop into tropical cyclones—something that is often overlooked when assessing the quality of tropical cyclone formation forecasts. We find that incorporating radio occultation data into the regional model can improve the local environmental conditions for tropical cyclone formation forecasts. This leads to fewer false alarms and higher hit rates. These improvements may provide critical guidance for tropical cyclone formation forecasters. Key Points: Potential forecast skill of tropical cyclone formation is analyzed for nine developing and 23 non‐developing cases in September–October 2019Assimilation of radio occultation data reduces the false alarm ratio by 20% and increases the accuracy rate by 19%The vorticity improved by radio occultation data is likely a key contributing factor to the improved tropical cyclone formation forecasts [ABSTRACT FROM AUTHOR]

This article covers the anticancer activities and mechanisms of action of Cu(II) complexes of flavonoid‐derived quercetin and 1,10‐phenanthroline ligands. The antiproliferative activity of the complex and its ligands was evaluated by MTT, ATP, and SRB viability assays in human lung cancer cells (A549, H1299). Findings for apoptosis were determined by fluorescent staining, flow cytometry analysis, and the M30 antigen method. In addition, the mechanism of action of the complex was investigated by Annexin V staining, caspase 3/7 activity, ROS formation, and cell cycle analysis. The involvement of caspases, thus, apoptosis was confirmed by rescuing cell death by using a pan‐caspase inhibitor (Z‐VAD‐FMK). Again, increased ROS levels in the cell showed that death may occur by apoptosis. For this reason, the accuracy of ROS‐induced apoptosis in cells has been proven as a result of the application of N‐acetylcysteine (NAC), which is a ROS inhibitor. The efficacy of the complex was compared with Cisplatin and ligands. The results showed that the Cu(II) flavonoid complex is cytotoxic on lung cancer cells and may have the potential to act as an effective metal‐based anticancer drug with a lower IC50 over Cisplatin. [ABSTRACT FROM AUTHOR]

Introduction/aims: Hereditary transthyretin-mediated amyloidosis with polyneuropathy (hATTR-PN) progressively affects patients' functionality and compromises health-related quality of life (HRQL). The aim of this study was to quantify the projected long-term treatment effects of inotersen vs placebo on HRQL measures.Methods: The inotersen phase 2/3 randomized, double-blind, placebo-controlled trial NEURO-TTR (NCT01737398, 65 weeks) and its subsequent open-label extension (OLE; NCT02175004, 104 weeks) included 172 (112 inotersen and 60 placebo) patients. Placebo double-blind period and overall inotersen-inotersen (double-blind/OLE) treatment period (170 weeks) data were used to extrapolate the long-term placebo-placebo effect using mixed-effects models with repeated measures. Changes from baseline in the Norfolk Quality of Life-Diabetic Neuropathy (QoL-DN) and 36-Item Short Form Health Survey version 2 (SF-36v2) in hATTR-PN were estimated. Differences in changes were compared between the inotersen-inotersen and extrapolated placebo-placebo arms.Results: Inotersen-inotersen patients maintained their HRQL with an observed change ranging from 10.3% improvement (Norfolk QoL-DN item "Pain kept you awake at night") to 11.6% deterioration (SF-36v2 Activities of Daily Living subdomain). The extrapolated placebo-placebo results suggest greater deterioration over time compared with inotersen-inotersen treatment on Norfolk QoL-DN total score (23.6; 95% confidence interval [CI], 8.9-38.3; P < .01), Activities of Daily Living (4.6; 95% CI, 2.0-7.3; P < .001), and "Pain kept you awake at night" (1.2; 95% CI, 0.4-1.9; P < .01). Similarly, greater deterioration was expected for the SF-36v2 Physical Component Summary (8.0; 95% CI, 3.2-12.8, P < .01), Bodily Pain (7.8; 95% CI, 2.0-13.5; P < .01), and Physical Functioning (10.6; 95% CI, 5.5-15.6; P < .0001).Discussion: Long-term (>3 years) inotersen treatment was associated with slowing and, in some domains, halting of deterioration in key HRQL outcome measures, particularly physical functioning and pain. [ABSTRACT FROM AUTHOR]

Introduction/aims: Hereditary transthyretin amyloidosis with polyneuropathy (ATTRv-PN) is a genetic condition associated with significant morbidity and mortality. In this study we aimed to identify patient subgroups exhibiting the greatest health-related quality of life (HRQL) benefit from inotersen treatment.Methods: We examined data from the inotersen phase 2/3 randomized, controlled trial for ATTRv-PN, NEURO-TTR (NCT01737398, 66 weeks). LASSO regression models predicted changes in Norfolk QoL-DN total score (TQoL, range -4 to 136; higher scores indicate poorer HRQL) from baseline in the inotersen and placebo arm, respectively. Individualized efficacy scores (ES) were calculated as differences between predicted change scores had patients received inotersen vs placebo. Patients were ranked by ES to define the greatest-benefit subpopulation (top 50%). Characteristics of the top 50% and bottom 50% of patients were compared.Results: The overall mean ± standard deviation TQoL change was -0.20 ± 19.13 for inotersen (indicating no change) and 10.77 ± 21.13 for placebo (indicating deterioration). Within the highest-benefit patients, mean TQoL change was -11.03 ± 17.06 (improvement) for inotersen and 11.24 ± 22.97 (deterioration) for placebo (P < .001). Compared with the overall population, patients in the greatest-benefit subpopulation were younger, more likely to have polyneuropathy disability (PND) scores 1 or 2, less likely to have received prior tafamidis or diflunisal treatment, and more likely to have Val30Met mutations and higher (worse) baseline TQoL.Conclusions: Patients who were younger and/or at earlier polyneuropathy stages experienced greater HRQL benefits from inotersen over 66 weeks. These findings underscore the need for early diagnosis and treatment initiation, especially among more severely affected patients in early stages of ATTRv-PN. [ABSTRACT FROM AUTHOR]

'Twice exceptionality' describes the coexistence of a learning difficulty or disability (SEN/D) and exceptional performance in one area of learning. A popular discourse around autism and savantism in the United States promotes a hierarchical differentiation of the 'twice exceptional' based on measured intelligence and commodifies support for this group. Such support is designed to appeal to a neoliberal ethos of seeking competitive advantage in a marketised system. Alternatively, special educational needs co‐ordinators (SENCOs) could raise awareness and promote a non‐hierarchical understanding of 'twice exceptionality' in schools, thereby highlighting what is missed when allegedly science‐based discourses become hegemonic within education and when governmentally mandated accountability practices are prioritised over professional judgement and the interests of individual students. Calls for 'twice exceptionality' to be recognised as a SEN/D category risk additional pressures on SENCOs at a time when governmental demands on SENCOs throughout the COVID‐19 pandemic have served to heighten existing tensions associated with the neoliberalisation of education (commercialisation, commodification, decentralisation, and residualisation). Nevertheless, SENCOs could play a key role in addressing longer‐term processes affecting children with dis/abilities and learning difficulties such as stigmatisation and, in this instance, discriminatory configurations of 'giftedness'. [ABSTRACT FROM AUTHOR]

A survey‐based investigation of teachers' concerns was conducted the following adaptation of Sharma and Desai's 'Concerns about Integrated Education (CIE) Scale' two decades ago. The terminology was adjusted and 'integrated' became 'inclusive', and 'Special Educational Needs and / or Disability (SEND)' replaced 'disability' in a novel 'Concerns about Inclusive Education Scale'. A purposive sample included the public and private education sectors. An online questionnaire was completed in April 2020 (n = 93) by teachers (66: state mainstream, 18: independent, 5: UK‐based international schools, 3: SEND specialists, 1: alternative provision). Statistical analysis of closed questions aimed to identify teachers' concerns about IE for children with SEND and was complemented by qualitative analysis of data generated through open‐ended questions. Varied understandings of what IE means and longstanding concerns were identified. The highest level of concern was evidenced around resources, specifically, funding for specialist and support staff, resources, and appropriate infrastructure. Qualitative data analysis suggested that children with SEND risk being perceived as an onerous adjunct to an already stressful 'regular' teaching role. Few respondents mentioned national performance monitoring and accountability regimes in this context and, instead, viewed additional paraprofessional and external support as self‐evident solutions to excessive workloads, neglecting the implications for equity in education. [ABSTRACT FROM AUTHOR]

A small‐scale study investigated the role of SENCos in England immediately prior to, during and following the first closure of schools nationally in March 2020 due to the Covid‐19 pandemic. A mixed‐methods research strategy comprising semi‐structured interviews and a national online survey generated data related to SENCos' involvement in strategic planning for crisis conditions, focusing specifically on students with special educational needs and disabilities (SEND) and concerns about exclusionary practices. Findings suggest that pandemic conditions have exacerbated familiar issues related to the SENCo role and SEND provision in English schools, such as engagement in reactive firefighting, onerous workloads, uneven SENCo involvement in strategic planning, and schools' failure to prioritise students with SEND. Minimal evidence of 'advocacy leadership' or of SENCos challenging exclusionary practices was found. As in earlier research, evidence was also found for disparities between anecdotal and published data relating to illegal exclusion. [ABSTRACT FROM AUTHOR]

This paper provides an outline of, and rationale for, an international research project that will identify commonalities and disparities in illegal school exclusionary practices in Australia and England. The aims here are to situate such practices within a global context and to map the events and processes through which children and young people, particularly those with 'special' educational needs and disabilities, are removed from school in Australia and England. The research we advocate is premised on evidence that inequitable and illegal exclusionary practices are endemic in education systems globally; hence, 'pushout syndrome' in the USA, 'off rolling' in England, facilitated 'dropout' in Italy and 'grey exclusions' in Australia. The authors argue that the repeated commissioning of research by national governments and school inspectorates, intended to accurately ascertain the scale of this problem and its impact on the life trajectories of the excluded, serves to defer meaningful action to prevent its occurrence. School exclusion, whether legal or illegal, can be conceptualized as a process rather than an event, and this paper discusses a descriptive continuum through which exclusionary practices in Australia and England can be mapped An experiential continuum is proposed that facilitates a thematic mapping of contributory factors, identified from a relevant literature, as a preliminary analytical framework for future research. [ABSTRACT FROM AUTHOR]

Aim: We investigate how susceptibility to mass bleaching varies between closely related coral species, and the validity of applying these susceptibility data (at the appropriate taxonomic level) across geographical regions. We also conduct a preliminary analysis of factors likely to affect geographical variability and examine which data are required for adequate assessment of the risk to species and regional populations from repeated mass bleaching events. Location: Twenty‐two sites in the central Great Barrier Reef, Australia (GBR) and 30 sites in the central Maldives Archipelago (MA). Time period: 2002 for the GBR and 2016 for the MA. Major taxa studied: Corals (order Scleractinia). Methods: After marine heat‐wave conditions, timed in situ surveys recorded bleaching responses of 7,368 coral colonies exposed to similar levels of temperature stress at a similar depth of occurrence and with similar subsequent mortality. In each region, a separate phylogenetic mixed model was used to estimate deep‐time phylogenetic‐, contemporary‐ (indicative of recent adaptation/acclimatization) and local‐scale effects. The results were compared between regions in relative terms as a hierarchy of species susceptibilities. Results: Susceptibility varied widely between regions: 27 of 106 species analysed were in the same quartile for relative susceptibility in both regions. Closely related species varied widely in their individual susceptibilities. Phylogenetic effects were moderate in both regions, but greater contemporary effects in the MA suggested recent evolution and acclimatization, consistent with a stronger history of recent bleaching events. Main conclusions: The high regional and intrageneric variation in susceptibility to bleaching described here suggests that there might be important differences in the extent to which these Indian and Pacific Ocean coral populations are exhibiting responses to deep‐time evolutionary changes, on the one hand, versus recent adaptation, on the other. We reveal a concerning lack of regional‐scale data identifying species most at risk from this, the greatest current threat to coral reefs. [ABSTRACT FROM AUTHOR]

This article reports an unprecedented exploratory small‐scale investigation of the views of senior school leaders in southwest England relating to 'off‐rolling' (illegal exclusionary practices). 'Off‐rolling' is conceptualised as a policy technology, however, the conceptual framework used in data analysis derives from Foucault's treatment of power and pleasure, and the constitution in discourse of novel 'permanent realities'. Relations of force that senior school leaders routinely navigate in neoliberal education cultures characterised by 'performativity' are highlighted. The latter describes pressures to evidence efficiency and continual improvement, including high‐stakes performance monitoring and, in England, a national school inspection regime. The response rate to this online and predominantly qualitative survey was poor, which was attributed to the illegality of 'off‐rolling' and the risk that academic research in this area could be perceived to reproduce the power–knowledge relations associated with a national school inspection regime and familiar neoliberal political or professional discourses around training of education professionals (where both are framed as addressing deficits to achieve improvements). Nevertheless, findings from a key question inviting comment on scenarios drawn from the authors' teaching experience are presented here, as they highlight the issues arising in research of sensitive topics. Reliance on brief vignettes to explore levels of understanding was, arguably, a limitation of the study, risking participants interpreting this device as unwelcome external scrutiny. It is argued that Ofsted's definition of 'off‐rolling' as gaming (manipulation of academic performance data) effectively discourages recognition of exclusionary practices that are not irrefutably related to academic performance as such. [ABSTRACT FROM AUTHOR]

This study analyses the impacts of tropical cyclones (TCs) that formed in monsoon and easterly environments on the major coastlines of the western North Pacific (WNP) basin during 1981–2009. The TC formation processes, defined as the development of tropical cloud cluster to TC, associated with monsoon environments (monsoon trough, monsoon confluence, and north of monsoon trough) are categorized into monsoon‐type TCs (monsoon‐TCs). Similarly, those associated with easterly flow environments (easterly flow west and southwest of subtropical high) are categorized into easterly‐type TCs (easterly‐TCs). Monsoon‐TCs form farther westward and at lower latitudes than easterly‐TCs, contributing to higher landfall proportion on the coastal countries for monsoon‐TCs. Monsoon‐TCs have a higher probability of affecting southern China, Taiwan and Vietnam, while easterly‐TCs tend to affect eastern China, southern Japan and the Philippines. Monsoon‐TCs have more widely dispersed rainfall and slower translation speed during landfall than easterly‐TCs. These characteristics are consistent with stronger environmental moisture transport and weaker steering flow in monsoon environments. Landfalling TC intensity and size are not different between easterly‐ and monsoon‐TCs. Both easterly‐ and monsoon‐TCs have interannual (1–4 years) and interdecadal (8–11 years) variability, which are related to variability of the large‐scale monsoon trough. El Niño–Southern Oscillation is significantly correlated with the interannual variability of easterly‐ and monsoon‐TCs, and changes in the monsoon‐TC landfall proportion and easterly‐TC landfall intensity. The interdecadal variability mainly affects the background vorticity and cyclonic circulation, leading to changes in the formation number of easterly‐ and monsoon‐TCs. In summary, this study provides evidence for connections between multiscale variability of the large‐scale monsoon and easterly patterns, TC formation environments, and TC impacts on the WNP coasts. [ABSTRACT FROM AUTHOR]

This article considers the role of the SENCo during Covid‐19 pandemic conditions of school lockdown with partial reopening for children classified as 'vulnerable'. It is argued that the existing pressures and tensions already experienced by SENCos – for example, related to time, workload, status, and their prescribed managerial and strategic role – have been highlighted by pandemic conditions. Pressures resulting specifically from the pandemic are reflected by considering how SENCos will adjust to enact their role during this time. It is concluded that an advocacy role for pupils with special educational needs and disability, who are at risk of becoming increasingly marginalised within school and wider communities during this pandemic, should now be considered a central element of the SENCo's remit. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to explore the subjective experiences of participants who: (1) received a psychosocial intervention as part of an addiction recovery research trial, and (2) responded to treatment through drug reduction, with the intention of eliciting qualitative change processes of recovery. Design: Data were collected using semi‐structured interviews designed to capture detailed descriptions of participants' experiences of recovery within the intervention. Methods: Eleven participants who had achieved drug abstinence or significant drug reduction by successfully completing the psychosocial intervention took part in the study. The data were analysed using interpretative phenomenological analysis (IPA). Results: Five superordinate themes were identified relating to (1) An active, individualised and skills‐based intervention that validates a new way of being; (2) Staff that foster good working relationships based on trust and safety within services that do not stigmatise; (3) To be understood individually, historically and psychologically, and with regard to the pernicious relationship with drugs; (4) Motivation is personal, intrinsic, requires vigilance and is driven forward by periods of success through abstinence; and (5) Interpersonal connectedness is essential to recovery; family is a key reason to abstain and friendships can either facilitate or hinder success. Conclusions: These findings suggest that the success of the psychosocial intervention may be due to a combination of modality specific factors and also broader holistic aspects that were provided through intervention. Future research is required to generalise these findings to wider addiction populations. Practitioner points: Review of the evidence base suggests the need to move beyond testing addiction interventions and instead understand change processes through psychosocial intervention.Narratives of lived experience of those undergoing psychosocial intervention inform us that specific features relating to intervention, working relationship, motivation, identity and interpersonal factors instigate recovery.Practitioners should consider a multi‐faceted approach in designing and applying psychosocial intervention for addiction. [ABSTRACT FROM AUTHOR]

Aim: We sought to determine the frequency and patterns of delayed medical care seeking for young children with skull fractures. Methods: We identified accidental skull fractures <4 years old, 2011–2012. Child abuse paediatricians abstracted retrospective data and paediatric radiologists re‐reviewed images. 'Delays' were defined as presentation at ≥6 h. 'Minor accidents' included falls <4 feet and low force trauma, while 'major accidents' included higher height falls and major force events. We studied the frequency and duration of care delays, the signs or symptoms leading to care, and the duration of delays after signs or symptoms developed. Results: Two hundred and ten children had accidental skull fractures. Delays were less likely with major accidents (4.9%), than with minor accidents (25.8%) (RR = 0.32 [0.15–0.70]). Children came to care for scalp swelling (STS) (39%), the injury event (36.2%), altered consciousness (15.2%) and vomiting (10.5%). Delayed onset of STS (78.6%) caused most delayed care. Early STS was firm, (17.6%) versus delayed (5.0%), as opposed to soft or fluctuant. Conclusion: Delayed care seeking is common for minor, but not major accidental infant and toddler skull fractures. Most followed delayed onset of signs and symptoms. Delayed care seeking alone should not imply child abuse. [ABSTRACT FROM AUTHOR]

This think piece argues for a novel qualitative methodology that permits social justice researchers, including National Award for Special Educational Needs Coordination students, to highlight the profound affects of exclusionary school practices for parents of children with SEN and/or disabilities (SEND). Such children are proportionately effected by these practices. The piece was prompted by multi‐strand research into 'off rolling' (illegal exclusionary practices), in which 53 parents described the process through which their child was removed from roll and their relationship with the school's SEN coordinator (SENCo). A preview of the latter is given, which suggests that SENCos' capacity to influence senior leader decision making around exclusion can be limited. A 'wavelength methodology' permits the highlighting of moral injury and provokes difficult questions around school policy, discriminatory practices and SENCo efficacy in minimising exclusion of students with SEND. [ABSTRACT FROM AUTHOR]

Precipitation extremes are increasing globally due to anthropogenic climate change. However, there remains uncertainty regarding impacts upon flood occurrence and subsequent population exposure. Here, we quantify changes in population exposure to flood hazard across the contiguous United States. We combine simulations from a climate model large ensemble and a high‐resolution hydrodynamic flood model—allowing us to directly assess changes across a wide range of extreme precipitation magnitudes and accumulation timescales. We report a mean increase in the 100‐year precipitation event of ~20% (magnitude) and >200% (frequency) in a high warming scenario, yielding a ~30–127% increase in population exposure. We further find a nonlinear increase for the most intense precipitation events—suggesting accelerating societal impacts from historically rare or unprecedented precipitation events in the 21st century. Plain Language Summary: Heavy rainfall is increasing globally due to human‐caused global warming. However, it is still unclear how these increases in heavy rainfall might affect flood risk. In this paper, we investigate how global warming and population changes together may be affecting the number of people at risk from floods in the United States. We combine simulations from a climate model and flood model—allowing us to consider a wide range of heavy rainfall events. We report a ~20% increase in the size and a >200% increase in the frequency of very heavy and rare rainfall events, which leads to a ~30–127% increase in the number of people at risk from floods. Finally, we find that the heaviest rainfall events increase by the widest margin—suggesting the possibility of major increases in damage and disruption caused by severe floods in the 21st century. Key Points: Population exposure to flood hazard is increasing due to both climate‐driven increases in extreme rainfall as well as demographic shiftsThere is a wide range of plausible increases in population exposed to flood hazard, depending strongly on climate and growth scenarioWe find a nonlinear increase for most extreme events, suggesting accelerating societal impacts from historically unprecedented rainfall [ABSTRACT FROM AUTHOR]

'Off‐rolling' is widely defined as the illegal removal of students from a school roll, unlike permanent exclusion, which involves sanctioned formal procedures. It is a practice that brings very different logics, political agendas, governmental imperatives and the associated matter of school leader professional identity into sharp relief. Deviant professional identities have already been discursively constituted, despite the current lack of research into the motivation of senior school leaders who engage in 'off‐rolling'. This article draws on Foucault to explore tensions between a political standards and an inclusion agenda, and to consider how the professional identities of senior school leaders are shaped such that 'off‐rolling' becomes possible. It is suggested that chronic underfunding of the inclusion agenda has combined with what England's Office for Standards in Education, Children's Services and Skills (Ofsted) now describes as an over‐emphasis on academic performance to create unsustainable pressures on many senior school leaders. The descriptor 'contextual roll management' may therefore be more appropriate. The moral outrage which accompanies public and political discourse around 'off‐rolling' is theorised with reference to Apple, Ball and Popkewitz. Such moral indignation distracts attention from the wider socio‐political and economic context within which schools are now required to deliver academic progress and inclusion. We conclude the article by outlining key empirical questions that have yet to be addressed. [ABSTRACT FROM AUTHOR]

Backgound: Functional endoscopic sinus surgery (FESS) can be challenging as novices become accustomed to handling endoscopes and instruments while navigating complex sinonasal anatomy. Experts demonstrate fluid and efficient motions when addressing pathology. The training process from novice to expert relies on hands‐on experience in cadaveric laboratories and preceptorship models that require significant time and expense. This study aims to validate the use of a virtual coach to guide users step‐by‐step through a basic FESS. Methods: Seventeen surgeons were grouped into novice (n = 10) and expert (n = 7) based on self‐reported levels of surgical experience. Users were trained using the maxillary antrostomy module in the Neurorhinological Surgery (NRS) simulator combining the physical craniofacial model with virtual reality (VR)‐tracked surgical instruments in the VR operating room. The virtual coach guided the user using surgical videos, auditory, and visual cues. The coach recorded data for each subject including the number of times borders of the nasal cavity were encountered and time to completion. Users graded the usefulness of the virtual coach on a Likert questionnaire. Results: Face validity of our NRS simulator was replicated by user questionnaires, and construct validity replicated by differentiation between novice and expert level surgeons (p < 0.01). Novices contacted a significantly higher number of anatomic borders (n = 17) and had a longer operative time (t = 370 seconds). All users reported high scores on the benefit and usefulness of the virtual coach. Conclusion: The virtual coach provides a useful tool to enhance FESS education by providing objective real‐time data in a novel mixed‐reality surgical environment. [ABSTRACT FROM AUTHOR]

Background: Despite computer‐aided design and computer‐aided manufacturing (CAD/CAM) technology improving prosthesis fit, errors inherent to digital workflow still exist. Purpose: To measure scanning/milling errors, and identify factors influencing marginal (MD) and internal discrepancy (ID). Materials and Methods: After scanning, 22 conical abutments in 5 master casts, 6 suprastructures with more than 2 implants (3, 4, and 6) were CAD designed. Angular deviation and errors in the vertical/horizontal planes were analyzed using a coordinate measuring machine (CMM). CAD suprastructures were milled and MD/ID evaluated with micro‐computed tomography (CT) and optic microscopy (OM) at one screw test (OST) and final fit test (FFT). Results: Mean scanning errors, at the vertical/horizontal planes, and angulation error were 3 μm ± 13, 44 μm ± 34, 0.3° ± 0.2°, respectively. Angulation errors nearly double in structures >3 abutments (0.26°vs 0.4°). OM MD in FFT/OST was 57.7 μm ± 13.9/100.7 μm ± 34.6, respectively. Micro‐CT FFT‐MD was 38.9 μm ± 12.8. Lineal/perimetral ID was 49.6 μm ± 11.9 and 108.2° ± 41.8, respectively. Structures >3‐implants were 2.3 times more likely to present higher MD (CI95%:0.4‐13.6). Nearly all the internal horizontal gap was due to scanning errors (44 of 49.6 μm). Horizontal scanning errors were three times more likely to present greater ID (CI95%:0.5‐17.4). Conclusion: Horizontal plane scanning errors are greater than vertical errors. Scanning angulation/milling errors are higher for suprastructures>3implants. Scanning/milling errors are associated with ID/MD, respectively, leading to micro‐gap formation. A CMM reduces scanning errors in >3‐implant‐frameworks before milling the final piece. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of Maryland's 2010 Total Patient Revenue (TPR) global budget reform in eight rural hospitals on population-level hospital rates of utilization three years after implementation.Data Sources/study Setting: Data on all inpatient discharges and outpatient department visits from the Health Services Cost Review Commission, population data from Claritas Demographic Reports, and county-level data from the Area Health Resource File.Study Design: We use a difference-in-differences approach to compare changes in utilization rates over time in the reform areas comprising 125 Zip Code Tabulation Areas (ZCTAs) and in two control hospital areas (66 ZCTAs and 327 ZCTAs, respectively). We examine several inpatient and outpatient measures and distinguish between relatively discretionary and nondiscretionary utilization.Data Collection: Admissions data are hospital-reported discharge abstracts of all encounters in Maryland during 2008-2013. Population data are derived from the US Census.Principal Findings: We find no statistically significant changes in admissions, either overall or discretionary. We find a statistically significant 8.9 percent (95%CI = [1.8, 16.0]) reduction in outpatient visits, with a statistically significant reduction of 14.8 percent (95%CI = [5.3, 24.3]) visits not to the Emergency Department.Conclusions: We find that the TPR reform decreased outpatient utilization but did not affect inpatient utilization. [ABSTRACT FROM AUTHOR]

Successful pregnancy requires a tightly-regulated equilibrium of immune cell interactions at the maternal-fetal interface (i.e., the decidual tissues), which plays a central role in the inflammatory process of labor. Most of the innate immune cells in this compartment have been well characterized; however, adaptive immune cells are still under investigation. Herein, we performed immunophenotyping of the decidua basalis and decidua parietalis to determine whether exhausted and senescent T cells are present at the maternal-fetal interface and whether the presence of pathological (i.e., preterm) or physiological (i.e., term) labor and/or placental inflammation alter such adaptive immune cells. In addition, decidual exhausted T cells were sorted to test their functional status. We found that (1) exhausted and senescent T cells were present at the maternal-fetal interface and predominantly expressed an effector memory phenotype, (2) exhausted CD4+ T cells increased in the decidua parietalis as gestational age progressed, (3) exhausted CD4+ and CD8+ T cells decreased in the decidua basalis of women who underwent labor at term compared to those without labor, (4) exhausted CD4+ T cells declined with the presence of placental inflammation in the decidua basalis of women with preterm labor, (5) exhausted CD8+ T cells decreased with the presence of placental inflammation in the decidua basalis of women who underwent labor at term, (6) both senescent CD4+ and CD8+ T cells declined with the presence of placental inflammation in the decidua basalis of women who underwent preterm labor, and (7) decidual exhausted T cells produced IFNγ and TNFα upon in vitro stimulation. Collectively, these findings indicate that exhausted and senescent T cells are present at the human maternal-fetal interface and undergo alterations in a subset of women either with labor at term or preterm labor and placental inflammation. Importantly, decidual T cell function can be restored upon stimulation. [ABSTRACT FROM AUTHOR]

Objective: To characterize the rate of guideline-concordant initiation of oral anticoagulation (OAC) among elderly Veterans with atrial fibrillation (AF) and high stroke risk.Data Sources/study Setting: Veterans Health Administration (VHA) Corporate Data Warehouse (CDW) linked with Medicare claims 2011-2015.Study Design: We identified 6619 elderly, high stroke-risk patients with a new episode of AF initially diagnosed in the VHA during fiscal years 2012-2015. We used logistic regression to estimate marginal effects of associations between patient characteristics and OAC initiation within 90 days of the first AF episode.Data Extraction Methods: We identified OACs using generic drug names. We calculated comorbidities and risk scores using diagnosis codes from 1 year of baseline data.Principal Findings: Overall, 66.5% of Medicare-eligible Veterans with AF at high risk of stroke initiated an OAC within 90 days. We found lower initiation rates for patients enrolled in Medicare Part D and those ineligible for drug co-payment subsidies. OAC initiation rates increased during the study among VHA-reliant patients but not among dual VHA-Part D enrollees.Conclusions: One-third of elderly Veterans at risk of stroke are not receiving recommended therapy. Increased coordination between Medicare and VHA providers may lead to improvements in anticoagulation quality and stroke prevention. [ABSTRACT FROM AUTHOR]

Invasive lobular carcinoma (ILC) of the breast is a very common disease. Despite its prevalence, these tumors are relatively understudied. One reason for this is a relative lack of models for ILC. This challenge was addressed by Brisken and colleagues through development of an intraductal injection‐based xenograft system for the study of ERα+ breast cancers, including both ILC and more common invasive ductal carcinoma (IDC; Sflomos et al, 2016). In this issue of EMBO Molecular Medicine, the same group have applied intraductal injection‐based xenografts to identify novel tumor cell‐specific transcriptional signatures in ILC (Sflomos et al, 2021). In doing so they found overexpression of lysyl oxidase‐like 1 (LOXL1) to be both responsible for the frequently seen stiff collagen‐rich extracellular matrix of lobular breast cancer and essential for their robust growth and metastatic dissemination in vivo, thereby identifying a novel therapeutic target. [ABSTRACT FROM AUTHOR]

Pathogenic variants in the fibroblast growth factor receptor 3 (FGFR3) gene are responsible for a broad spectrum of skeletal dysplasias, including achondroplasia (ACH). The classic phenotype of ACH is caused by two highly prevalent mutations, c.1138G > A and c.1138G > C (p.Gly380Arg). In the homozygous state, these variant results in a severe skeletal dysplasia, neurologic deficits, and early demise from respiratory insufficiency. Although homozygous biallelic mutations have been reported in patients with ACH in combination with hypochondroplasia or other dominant skeletal dysplasias, thus far, no cases of heterozygous biallelic pathogenic ACH‐related variants in FGFR3 have been reported. We describe a novel phenotype of an infant with two ACH‐related mutations in FGFR3, p.Gly380Arg and p.Ser344Cys. Discordant features from classic ACH include atypical radiographic findings, severe obstructive sleep apnea, and focal, migrating seizures. We also report the long‐term clinical course of her father, who harbors the p.Ser344Cys mutation that has only been reported once previously in a Japanese patient. The phenotype of heterozygous biallelic mutations in FGFR3 associated with ACH is variable, underscoring the importance of recognition and accurate diagnosis to ensure appropriate management. [ABSTRACT FROM AUTHOR]

ABSTRACT: Climate change caused by green house gas emissions is now following the trend of rapid warming consistent with a RCP8.5 forcing. Climate models are still unable to represent the mesoscale convective processes that occur at resolutions ∼O(3 km) and are not capable of resolving precipitation patterns in time and space with sufficient accuracy to represent convection. In this article, the UK Met Office precipitation observations are compared with the simulations for the period 1990–1995 followed by a simulation of a near‐future period 2031–2036 for a regional nested weather model. The convection‐permitting model, resolution ∼O(3 km), provides a good correspondence to the observational precipitation data and demonstrates the importance of explicit convection for future summer precipitation estimates. The UK summer precipitation is reduced slightly (∼10%) for 2031–2036 and there is no evidence of an increase in the peak maximum hourly precipitation magnitude. A similar pattern is observed over the whole European inner model domain. The results using the Kain–Fritsch convective parameterization scheme at a resolution ∼O(12 km) in the outer domain increase summer precipitation by ∼10% for the UK. The average precipitation rate per event increases, dry periods extend and wet periods shorten. As part of the change, 10‐m winds of <3 m s−1 become more common – a scenario that would impact on power generation from wind turbines through calmer conditions and cause more frequent pollution episodes. [ABSTRACT FROM AUTHOR]

Ultimately, risk reduction from the implementation of building codes is due to not only the extent of the code as it applies to new construction, but also to the intensity of local adoption and enforcement. It is normally an open question as to how well a code is maintained and enforced at the local level, even for a relatively strong adopted statewide code such as the Florida Building Code. We test the importance of the intensity of building code implementation at the local level for reducing Florida windstorm losses by utilizing Building Code Effectiveness Grading Schedule (BCEGS®) rating data. BCEGS ratings provide a joint assessment of local building code effectiveness in terms of the strength of the adopted codes in addition to how well these adopted codes are enforced. We find that both components provide value in reducing windstorm losses in Florida, with the extent of the statewide code being the dominant effect reducing losses on the order of 72 percent. Although not as substantial in terms of its loss reduction magnitude, intensively implementing building codes at the local level by ensuring codes are properly administered and enforced at this scale provides additional loss reduction value on the order of 15-25 percent. Understanding the relative value of these two implementation components is important to better inform building code policy and enforcement efforts given continuously updated codes. [ABSTRACT FROM AUTHOR]

Objective: Fetoscopic endoluminal tracheal occlusion (FETO) may improve outcome of severe isolated congenital diaphragmatic hernia (iCDH). We aimed to identify any discrepancy between initial assessment at the referring hospital and the evaluation at the fetal surgery center, and to document parental decisions following counseling for fetal surgery.Design: Single center retrospective study on patients with presumed iCDH either referred for assessment and counseling or referred for fetal surgery. Discordant findings were defined as either a >10% difference in lung size, discordant liver position or associated anomalies.Results: Outcomes from 129 consecutive assessments over 24 months were analyzed. Among fetal surgery referrals, 2% did not have CDH, and 10% had undiagnosed associated anomalies. Liver position was discordant in 7%. Thirty-three per cent had discordant lung size. Ninety-four per cent of patients eligible for surgery underwent FETO. In patients referred because of suspicion of CDH, associated anomalies were found in 14%. Fetal liver and lung assessments were discordant in 50% resp. 38%. Of those patients eligible for FETO, 26% requested termination. For three patients, the postnatal course was marked by a genetic or syndromic additional diagnosis.Conclusion: Discordances between initial assessment before referral and evaluation in our institution were frequent, some of them clinically relevant. © 2017 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This article follows an earlier publication highlighting the changing role of special educational needs co-ordinators (SENCos) in England. SENCos are now required to manage change strategically and deliver inclusive school cultures. School-based action research undertaken by a teacher studying for the postgraduate National Award for SEN Co-ordination (NASENCO) is featured in the article; a strategic review of resource allocation increased the availability and quality of interventions for students with special educational needs and disabilities (SEND). The commentary which frames the study acknowledges that many SENCos are not yet members of a senior school management team (SMT) despite their mandated strategic whole-school remit. Featuring the process through which one SENCo has strived to enhance SEND provision and develop context-specific key performance indicators brings official guidance on the SENCo's role in strategic change management into sharp focus, raising questions that should concern both SMTs and non-SMT SENCos. [ABSTRACT FROM AUTHOR]

Jordan insists that teachers should be free to exercise their professionalism and that respect for difference is integral to that professionalism. For Connor, this implies teachers who can critically consider the discourses available to them as practitioners. The authors draw upon the philosophising of Gilles Deleuze to develop an account of teaching and learning as an autonomous creative process in which teachers contribute to rather than strictly control outcomes. This account of teaching as processual following resonates with Jordan's vision of equity for autistic or neuro-atypical pupils and compassionate professionalism. It rests less easily with intensive behaviourist-training programmes and educational cultures premised on the assumption that outcomes can, and should, be pre-determined and precisely engineered. From a Deleuzian perspective, ethical practice is the interplay of conceptual, perceptual and affective knowledge, and it is suggested that intuitive practice involves a similar interplay along with numerous contextual considerations. A Deleuzian theory of simulation is initially outlined and accords with the emphasis placed by Jordan on reimagining an educational system in which all pupils are valued and supported to develop their varied talents and teachers are free to assess the suitability of particular methods for individual pupils. [ABSTRACT FROM AUTHOR]

The 'lamppost' model is often used to describe the X-ray source geometry in AGN, where an infinitesimal point source is located on the black hole spin axis. This is especially invoked for narrow line Seyfert 1 (NLS1) galaxies, where an extremely broad iron line seen in episodes of low X-ray flux can both be explained by extremely strong relativistic effects as the source approaches the black hole horizon. The most extreme spectrum seen from the NLS1 1H0707-495 requires that the source is less than 1 GM / c2 above the event horizon in this geometry. However, the source must also be large enough to intercept sufficient seed photons from the disc to make the hard X-ray Compton continuum which produces the observed iron line/reflected spectrum. We use a fully relativistic ray tracing code to show that this implies that the source must be substantially larger than 1 GM / c2 in 1H0707-495 if the disc is the source of seed photons. Hence the source cannot fit as close as 1 GM / c2 to the horizon, so the observed spectrum and variability are not formed purely by effects of strong gravity but probably also by changes in corona and inner accretion flow geometry. (© 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [ABSTRACT FROM AUTHOR]

We present the results from our Suzaku observations of the Galactic black hole binary 4U 1630-47. 4U 1630-47 was observed in the very high state (VHS) during the 2012 September-October outburst. The inner disk appears slightly truncated by comparison with a previous high/soft state (HSS) of this source, even by taking into account energetic coupling between the disk and corona. The spectra do not show the Doppler-shifted emission lines indicating baryonic jets that were seen four days previously in an XMM-Newton observation, despite the source being in a similar state. There are no significant absorption lines from highly ionized iron ions. We also observed 4U 1630-47 in the HSS simultaneously with Suzaku and NuSTAR in an early epoch of the 2015 outburst. All Suzaku spectra in the HSS show variable iron-K absorption line features. We find that the ionization state of the disk wind rapidly increased when the continuum showed significant spectral hardening. This behavior is consistent with that expected from a thermally driven wind. (© 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [ABSTRACT FROM AUTHOR]

This article highlights the changing role of special educational needs co-ordinators (SENCos) in England. SENCos are now required to manage change strategically and deliver inclusive school cultures. A school-based evaluative study undertaken by a teacher who is studying for the postgraduate National Award for SEN Co-ordination (NASENCO) for SENCos is featured within the article to illustrate the principles and techniques associated with strategic change management. The study is framed by a commentary that also includes references to more critical treatments of the shift towards quantified performance assessment, monitoring and management (of pupils, teachers and schools) which has been read as a displacement of professional judgement-based teaching practice. [ABSTRACT FROM AUTHOR]

An abstract of the article "Primary maternal cytomegalovirus infections: how accurate is fetal ultrasound to predict sequelae in the offspring?" by M. Leyder is presented.

Levels of circulating tumor cells (CTCs) in blood have prognostic value in early and metastatic breast cancer. CTCs also show varying degrees of concordance with molecular markers of primary tumors they originate from. It is expected that individual cells reflect the heterogeneity and evolution of tumor cells as they acquire new functions and differential responses to chemotherapy. However, a degree of commonality is also plausible, highlighting alterations that allow tumor cells to perform CTC-defining activities such as invasion and intravasation. Using a matched tumor-normal approach, we performed high-resolution copy number profiling of CTCs from breast cancer to identify occult changes occurring during progression to metastasis. We identified a signature of recurrent gain in CTCs, consisting of 90 minimal common regions (MCRs) of copy number gain. These were predominantly found across chromosome 19 and were identified at low frequencies (3-4%) in 787 primary breast carcinomas examined. CTC genomic signatures clustered into two groups independent of subtype: a dormancy-related signature with 16 MCRs (AKT2, PTEN, CADM2); and a tumor-aggressiveness related signature with 358 MCRs (ANGPTL4, BSG, MIR-373). There were two MCRs in common between the groups on 19q13 and 21q21, containing genes involved in resistance to anoikis, TGFβ-signaling and metastasis (TFF3, LTBP4, NUMBL). Furthermore, a region harboring the ERBB2 gene was gained in a majority of patients. Regions 20q13 and 15q24 were associated with distant metastasis. The distinctiveness of CTC signatures highlights cell populations with different functional or metastatic potential. Such novel targets could help to specifically identify and block dissemination. [ABSTRACT FROM AUTHOR]

A novel protocol was developed for ecological prioritization of coral reefs for inclusion in a marine reserve network. Standard benthic survey data were normalized and combined in a conservation priority index (CPI) which rates individual candidate sites according to their ecological values and their potential contributions to an effective network., The CPI differentiates between sites on the basis of strength or weakness of surrogates for desirable attributes such as benthic biodiversity, reef-building capacity and hard-coral resilience., Biodiversity and reef-building attributes (more is better) were assigned progressive weightings (high abundance, high score), whereas neutral or detrimental attributes (less is better) were assigned regressive weightings (high abundance, low score)., Abundance of small corals (new recruits and remnants) was included as an indicator of a site's potential for recovery following disturbance., The CPI rankings were used in conjunction with multidimensional scaling to prioritize candidate sites for a proposed reserve network near Salvador, Brazil. The information is complementary to considerations of existing uses and socio-economic considerations, in the prioritization of reefs for protection., The approach ensured that ecological inputs to the broader marine spatial planning process embraced both representativeness of biodiversity per se and the investigator's evaluation of key qualitative site attributes (amount, size, and resilience indicators for the critical architectural components hard coral and encrusting coralline algae)., Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]