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BACKGROUND: Although many molecules have been investigated as biomarkers for spinal cord injury (SCI) or ischemic stroke, none of them are specifically induced in central nervous system (CNS) neurons following injuries with low baseline expression. However, neuronal injury constitutes a major pathology associated with SCI or stroke and strongly correlates with neurological outcomes. Biomarkers characterized by low baseline expression and specific induction in neurons post-injury are likely to better correlate with injury severity and recovery, demonstrating higher sensitivity and specificity for CNS injuries compared to non-neuronal markers or pan-neuronal markers with constitutive expressions. METHODS: In animal studies, young adult wildtype and global Atf3 knockout mice underwent unilateral cervical 5 (C5) SCI or permanent distal middle cerebral artery occlusion (pMCAO). Gene expression was assessed using RNA-sequencing and qRT-PCR, while protein expression was detected through immunostaining. Serum ATF3 levels in animal models and clinical human samples were measured using commercially available enzyme-linked immune-sorbent assay (ELISA) kits. RESULTS: Activating transcription factor 3 (ATF3), a molecular marker for injured dorsal root ganglion sensory neurons in the peripheral nervous system, was not expressed in spinal cord or cortex of naïve mice but was induced specifically in neurons of the spinal cord or cortex within 1 day after SCI or ischemic stroke, respectively. Additionally, ATF3 protein levels in mouse blood significantly increased 1 day after SCI or ischemic stroke. Importantly, ATF3 protein levels in human serum were elevated in clinical patients within 24 hours after SCI or ischemic stroke. Moreover, Atf3 knockout mice, compared to the wildtype mice, exhibited worse neurological outcomes and larger damage regions after SCI or ischemic stroke, indicating that ATF3 has a neuroprotective function. CONCLUSIONS: ATF3 is an easily measurable, neuron-specific biomarker for clinical SCI and ischemic stroke, with neuroprotective properties. HIGHLIGHTS: ATF3 was induced specifically in neurons of the spinal cord or cortex within 1 day after SCI or ischemic stroke, respectively. Serum ATF3 protein levels are elevated in clinical patients within 24 hours after SCI or ischemic stroke. ATF3 exhibits neuroprotective properties, as evidenced by the worse neurological outcomes and larger damage regions observed in Atf3 knockout mice compared to wildtype mice following SCI or ischemic stroke.

Most neuroimaging studies linking regional brain volumes with cognition correct for total intracranial volume (ICV), but methods used for this correction differ across studies. It is unknown whether different ICV correction methods yield consistent results. Using a brain-wide association approach in the MRI substudy of UK Biobank (N = 41,964; mean age = 64.5 years), we used regression models to estimate the associations of 58 regional brain volumetric measures with eight cognitive outcomes, comparing no correction and four ICV correction approaches. Approaches evaluated included: no correction; dividing regional volumes by ICV (proportional approach); including ICV as a covariate in the regression (adjustment approach); and regressing the regional volumes against ICV in different normative samples and using calculated residuals to determine associations (residual approach). We used Spearman-rank correlations and two consistency measures to quantify the extent to which associations were inconsistent across ICV correction approaches for each possible brain region and cognitive outcome pair across 2320 regression models. When the association between brain volume and cognitive performance was close to null, all approaches produced similar estimates close to the null. When associations between a regional volume and cognitive test were not null, the adjustment and residual approaches typically produced similar estimates, but these estimates were inconsistent with results from the crude and proportional approaches. For example, when using the crude approach, an increase of 0.114 (95% confidence interval [CI]: 0.103-0.125) in fluid intelligence was associated with each unit increase in hippocampal volume. However, when using the adjustment approach, the increase was 0.055 (95% CI: 0.043-0.068), while the proportional approach showed a decrease of -0.025 (95% CI: -0.035 to -0.014). Different commonly used methods to correct for ICV yielded inconsistent results. The proportional method diverges notably from other methods and results were sometimes biologically implausible. A simple regression adjustment for ICV produced biologically plausible associations.

Within the Caribbean, the number of students pursuing postgraduate studies in higher education institutions (HEIs) has increased over the years. Consequently, locally contextualised epistemologies and empowering methods are needed to help adult learners in Caribbean higher education (HE) navigate their studies. This paper presents findings from a photovoice study undertaken with postgraduate adult learners at an HEI in Jamaica. Participants used photographs, written reflections and group discussions to explore their HE journey. Given the intervening nature of the pandemic in the immediate period after the study was conceptualised and participants engaged, this paper focuses on the ways in which photovoice offered participants opportunities to make meaning of their HE journey. Findings demonstrate that the use of photovoice was transformative in how it empowered participants through the opportunity to engage in self-discovery and discuss their thoughts and emotions, facilitated peer support, and how it enabled adult learners to forge resilience as they undertook their studies.

Underrepresentation of historically marginalized populations in clinical trials continues to threaten the validity of health intervention research. Evidence supports the merits of intercept and other proactive forms of recruitment for achieving more equitable representation. However, researchers also report lower retention and adherence to protocols among these populations, particularly in longitudinal studies. Few studies have compared recruitment methods for longitudinal randomized trials testing health interventions, with even fewer having done so for trials involving ecological momentary assessment (EMA). As intervention research integrates EMA and other data collection approaches requiring substantial participant effort, it is critical to better understand the effectiveness and implications of strategies to improve the representativeness of health research. This secondary data analysis compared outcomes of proactive and reactive recruitment strategies (mobile lab intercepts and internet/flyer advertising, respectively) in study inclusion, task completion, and retention within a 14-day randomized controlled trial that used EMA to evaluate cigarette package health messages. Proactive recruitment resulted in higher proportions of participants with low income and education, limited health literacy, and of diverse racial/ethnic makeup. However, this recruitment method also resulted in lower task completion, especially in the second week of the trial period, and lower retention, although group differences were not explained by participant sociodemographic characteristics targeted by inclusion efforts. We conclude that proactive recruitment via intercepts is an effective strategy for health intervention research that aims to include stakeholders from historically marginalized groups but that researchers and funders must recognize these methods require additional resources, considerations, and capacity to address non-trivial challenges to successful participation.

BACKGROUND: The field of toxicology has witnessed substantial advancements in recent years, particularly with the adoption of new approach methodologies (NAMs) to understand and predict chemical toxicity. Class-based methods such as clustering and classification are key to NAMs development and application, aiding the understanding of hazard and risk concerns associated with groups of chemicals without additional laboratory work. Advances in computational chemistry, data generation and availability, and machine learning algorithms represent important opportunities for continued improvement of these techniques to optimize their utility for specific regulatory and research purposes. However, due to their intricacy, deep understanding and careful selection are imperative to align the adequate methods with their intended applications. OBJECTIVES: This commentary aims to deepen the understanding of class-based approaches by elucidating the pivotal role of chemical similarity (structural and biological) in clustering and classification approaches (CCAs). It addresses the dichotomy between general end point-agnostic similarity, often entailing unsupervised analysis, and end point-specific similarity necessitating supervised learning. The goal is to highlight the nuances of these approaches, their applications, and common misuses. DISCUSSION: Understanding similarity is pivotal in toxicological research involving CCAs. The effectiveness of these approaches depends on the right definition and measure of similarity, which varies based on context and objectives of the study. This choice is influenced by how chemical structures are represented and the respective labels indicating biological activity, if applicable. The distinction between unsupervised clustering and supervised classification methods is vital, requiring the use of end point-agnostic vs. end point-specific similarity definition. Separate use or combination of these methods requires careful consideration to prevent bias and ensure relevance for the goal of the study. Unsupervised methods use end pointagnostic similarity measures to uncover general structural patterns and relationships, aiding hypothesis generation and facilitating exploration of datasets without the need for predefined labels or explicit guidance. Conversely, supervised techniques demand end point-specific similarity to group chemicals into predefined classes or to train classification models, allowing accurate predictions for new chemicals. Misuse can arise when unsupervised methods are applied to end point-specific contexts, like analog selection in read-across, leading to erroneous conclusions. This commentary provides insights into the significance of similarity and its role in supervised classification and unsupervised clustering approaches. https://doi.org/10.1289/EHP14001, Introduction Chemical hazard and risk assessments aim to estimate toxicological outcomes and evaluate the potential risks that chemicals may pose to human health and the environment. However, studying chemicals one-by-one [...]

BACKGROUND: Organophosphate esters (OPEs), used ubiquitously as flame retardants and plasticizers in consumer products, are suspected of having developmental toxicity. OBJECTIVES: Our study aimed to estimate associations between prenatal exposure to OPEs and fetal growth, including both ultrasound (head circumference, abdominal circumference, femur length, and estimated fetal weight) and delivery [birth weight z-score, small-for-gestational age (SGA), and large-for-gestational age (LGA)] measures of growth. METHODS: In the LIFECODES Fetal Growth Study (2008-2018), an enriched case--cohort of 900 babies born at the small and large ends of the growth spectrum, we quantified OPE biomarkers in three urine samples per pregnant participant and abstracted ultrasound and delivery measures of fetal growth from medical records. We estimated associations between pregnancy-averaged log-transformed OPE biomarkers and repeated ultrasound measures of fetal growth using linear mixed-effects models, and delivery measures of fetal growth using linear (birth weight) and logistic (SGA and LGA) regression models. RESULTS: Most OPE biomarkers were positively associated with at least one ultrasound measure of fetal growth, but associations with delivery measures were largely null. For example, an interquartile range (IQR; 1.31 ng=mL) increase in bis(2-chloroethyl) phosphate concentration was associated with larger z-scores in head circumference [mean difference (difference): 0.09; 95% confidence interval (CI): 0.01, 0.17], abdominal circumference (difference: 0.10; 95% CI: 0.02, 0.18), femur length (difference: 0.11; 95% CI: 0.03, 0.19), and estimated fetal weight (difference: 0.13; 95% CI: 0.04, 0.22) but not birth weight (difference: 0.04; 95% CI: -0.08, 0.17). At delivery, an IQR (1.00 ng=mL) increase in diphenyl phosphate (DPHP) concentration was associated with an SGA birth (odds ratio: 1.46; 95% CI: 1.10, 1.94). CONCLUSIONS: In a large prospective cohort, gestational OPE exposures were associated with larger fetal size during pregnancy, but associations at delivery were null. DPHP concentrations were associated with heightened risk of an SGA birth. These findings suggest that OPE exposure may affect fetal development. https://doi.org/10.1289/EHP14647, Introduction Organophosphate esters (OPEs) are high-production chemicals in widespread global use. (1) They are organic esters of phosphoric acid--containing alkyl chains or aryl groups, which may be halo-genated or nonhalogenated. [...]

This study examines a three-year teacher wellness initiative in five Colorado, USA, school districts. It focuses on teacher professional development (PD) about self-care and burnout, the value participants attached to the training, and change in teachers' lifestyles, self-care practices, and burnout. Results reveal the value teachers attached to the PD and lifestyles do not show significant differences over time. Self-care practices and burnout show statistically significant improvement during the intervention years, although magnitudes of the differences are small, indicating negligible practical significance.

This article explores critical studies in education by examining avenues through which teacher education programs problematize racial mismatch in K-12 classrooms. More specifically, the article describes the efforts of a regional teacher education program to support its pre-service teachers by providing opportunities to engage with racially diverse populations of students. This was accomplished through an elementary and middle school STEM summer enrichment program serving over 500 students from Title I schools. Pre-service teachers were surveyed about their experience and reported how they perceive students, race, and themselves within the context of a Title I school setting. Findings, centering on the exploration of pre-service teachers' attitudes, suggest the need for pre-service teachers to be engaged with diverse school settings and populations during their teacher education programs.

Active teaching methods are believed to facilitate higher-order thinking skills and prepare allied health students for independent clinical decision-making. This quantitative, correlational study aimed to explain the relationships between student preferences for active over traditional methods and their beliefs, the frequency and positiveness of their experiences, and the extent of knowledge they have received regarding active and traditional teaching methods. Two hundred and thirty students completed a 53-item online survey. Students were enrolled in a Doctor of Physical Therapy, Masters in Speech-language Pathology, or Bachelor of Science Nursing program in one of seventeen participating institutions across a ten-state Midwest region. A combination of student knowledge, student beliefs, and positive student experiences with active over traditional methods predicted 72.5% (R[superscript 2] = 0.725, p = <0.001) of the variance of student preferences for active methods. When students have clarity about the expectations of active learning methods, how they benefit their learning, believe they are responsible for learning and take the initiative, and perceive a positive experience, they prefer active methods over traditional methods. The results inform health professional education programs with recommendations that influence pedagogical change to support faculty and prepare students for clinical practice, higher-order thinking skills, and workforce expectations.

Behavior analysts collaborating within interdisciplinary teams are likely to find themselves at difficult crossroads. Some of these crossroads include implementing alternative treatments, defining and determining risk and harm, and evaluating research and interventions. The purpose of this paper is to highlight some of these crossroads and provide guidelines on successfully navigating them. We contend that it is possible to navigate these crossroads while minimizing harm or risk for the client, adhering to the principles of science and behavior analysis, and remaining respectful of all members of the interdisciplinary team. That is, we can maintain the scientific tenets of philosophic doubt, empiricism, and experimentation, while remaining humble, and ensuring our clients access the most effective interventions available.

Leaf and colleagues (2016) provided a definition and description of progressive applied behavior analysis (ABA) in the context of autism treatment in which a behavior analyst takes a structured, yet flexible, approach to treatment that is responsive to the learner and includes on-going, in-the-moment analysis of teaching. Since Leaf and colleagues' publication, there have been many research and dissemination advancements across the domains outlined in the original paper. This includes advancements in the types of progressive procedures implemented, instructional arrangements, progressive reinforcement strategies, preventive functional analysis, progressive discrete trial teaching, data collection, progressive curriculum development, and staff training. The purpose of this paper is to highlight these advances citing peer-reviewed research where possible. Although many advancements have occurred, there is still a great need in the field of ABA for more clinicians and researchers to evaluate and implement procedures associated with the progressive approach to ABA. The paper will conclude with a call to action for behavior analysts to move away from rigid, protocolized, and conventional ABA practices and move towards implementing progressive ABA.

The case focuses upon 1) a public health outcome, namely improving access to healthcare, 2) systems and design thinking approaches to software development and the internet of things, 3) mockup tools and user interface design, 4) understanding stakeholder requirements and feature requests, 5) presentation of a prototype application. This case presents a blend of healthcare management and technology concerns and is an appropriate capstone project for an undergraduate information systems course. Depending on the instructor's individual academic needs, the various assignments can also be modified for lower-level courses. The tasks were originally designed by one of the authors for a course called Creating Solutions with Integrated Technology and are used with permission.

Practice makes perfect…this saying is a popular cliché, but it has validity when referencing the abundance of practice necessary to learn and master a new technique or skill. Like playing a game, honing a skill, or using a new technique, teaching requires practice to learn and improve. Working with preservice STEM teachers (PSTs), my goal was to develop ways for PSTs to practice teaching to gain experience, hone skills, and learn new techniques. This narrative describes the process undertaken to create a virtual microteaching opportunity that will provide PSTs practice time and additional teaching experience.