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AimsTo assess heart failure (HF) in-hospital quality of care and outcomes before and during the COVID-19 pandemic.Methods and resultsPatients hospitalized for HF with ejection fraction (EF)

Universal screening of students is increasing as programs are implemented for improving social emotional learning (SEL) skills. Assessments used to conduct SEL screenings focus on social emotional strengths; however, such assessments can provide a broader characterization of students' wellbeing by concurrently screening for emotional behavior concerns (EBC). This article describes the development of brief EBC-Internalizing and EBC-Externalizing scales designed to augment the SSIS SEL Brief Scales (SSIS SEL"b") Teacher and Student Forms. To further evaluate the utility of concurrently screening for SEL and EBCs, we examined distributions of SEL scores at each EBC Concern level. Both the Teacher and Student assessments of SEL skills and EBC behaviors maximized efficiency and yielded reliable and valid scores that provide insights regarding the interplay of these behavior constructs. The SSIS SEL"b" and EBC scales can be administered together as the SSIS SEL"b" + Mental Health Scales to provide efficient measurement of the whole social emotional child. The article examines the study's limitations, follow-up research, and implications for using brief universal screenings and instructional programs to advance the wellbeing of students.

Using a case study approach, we explored the science and math classroom experiences of urban high school students. Our purposeful sample included 11 high-achieving students (mostly minoritized students) who graduated from the same school and participated in an out-of-school science and medicine/health program. Using 35 semistructured interviews collected over 3 years, we focused on understanding the multiple contextual factors that contributed to the restructuring of students' science experiences and reshaping of their science identity formation during high school. We expanded on Carlone and Johnson's (2007) science identity model to propose an updated model for understanding students' experiences within science, technology, engineering, mathematics, and medicine/health contexts. Our findings suggested that an integration of supports, resources, and opportunities lies at the core of what influences students' science identities, which they revealed are inclusive of their science interest/passion, knowledge, participation, and achievements. Our study's contribution is a unique perspective of the cultivation and sustainability of students' science identities at the secondary level.

The purpose of this paper is to present a conversation about how impact has been seen and felt by youth and adult co-researchers in a long-term, school-based youth participatory action research (YPAR) project, "Courageous Conversations." To stay true to the epistemological commitments of YPAR, and in an effort to speak back to neocolonial and neoliberal definitions of impact, we have intentionally chosen to center the words of the school-based co-researchers (Emily, Katelyn, Mrwa, Ashleigh, and LeAnne) as they have conceptualized, identified, and discussed the impact of YPAR. Through non-traditional formatting, we seek to disrupt conventional, academic modes of conveying knowledge, which often have the result of silencing many voices and amplifying only a select few. We use various devices like text boxes and tables to reflect the messiness and fluidity of participatory knowledge creation and to connect the reflective conversation of members of our YPAR collective to broader and ongoing debates around the impact of YPAR.

Self-regulated learning theory is central to computer supported collaborative learning (CSCL) and depends on learner autonomy to create socially shared learning, and yet function within the restraints and goals of a specific class pedagogy. By integrating the rich theoretical CSCL literature with an inductively derived theory of role-playing game practice, we develop an insightful foundation for designing, implementing, and measuring the effectiveness of low-cost scripts. This takes the form of a prompt (mere exposure prompt) that nudges learners toward a pedagogical goal while maintaining freedom of learner creativity and minimizing instructor intrusion. We assert learner engagement can be viewed through the lens of role-playing's emphasis on aligning players' creative agendas with game design to create a shared imagined space. Through behavioral trace data and social network analysis, we measure behaviors that differ between test/control groups, receiving the prompt, and comparing a fully online versus blended course delivery over a semester of group-based simulated business negations following role-playing game design principles. Fully online test group members accurately recall the prompt's messages while exhibiting behaviors congruent with the pedagogical script. Learners in the blended mode recall the prompt, but their behavior is unchanged. This suggests socially shared regulation of learning in the classroom context conforms to established classroom norms, overlooking the script prompt. Learners in the fully online mode, in contrast, initiate fewer social interactions, but search out opportunities across many players, thereby demonstrating the effect of the script prompt message.

Temporal lobe epilepsy, a common drug-resistant epilepsy in adults, is primarily a limbic network disorder associated with predominant unilateral hippocampal pathology. Structural MRI has provided an in vivo window into whole-brain grey matter structural alterations in temporal lobe epilepsy relative to controls, by either mapping (i) atypical inter-hemispheric asymmetry; or (ii) regional atrophy. However, similarities and differences of both atypical asymmetry and regional atrophy measures have not been systematically investigated. Here, we addressed this gap using the multisite ENIGMA-Epilepsy dataset comprising MRI brain morphological measures in 732 temporal lobe epilepsy patients and 1418 healthy controls. We compared spatial distributions of grey matter asymmetry and atrophy in temporal lobe epilepsy, contextualized their topographies relative to spatial gradients in cortical microstructure and functional connectivity calculated using 207 healthy controls obtained from Human Connectome Project and an independent dataset containing 23 temporal lobe epilepsy patients and 53 healthy controls and examined clinical associations using machine learning. We identified a marked divergence in the spatial distribution of atypical inter-hemispheric asymmetry and regional atrophy mapping. The former revealed a temporo-limbic disease signature while the latter showed diffuse and bilateral patterns. Our findings were robust across individual sites and patients. Cortical atrophy was significantly correlated with disease duration and age at seizure onset, while degrees of asymmetry did not show a significant relationship to these clinical variables. Our findings highlight that the mapping of atypical inter-hemispheric asymmetry and regional atrophy tap into two complementary aspects of temporal lobe epilepsy-related pathology, with the former revealing primary substrates in ipsilateral limbic circuits and the latter capturing bilateral disease effects. These findings refine our notion of the neuropathology of temporal lobe epilepsy and may inform future discovery and validation of complementary MRI biomarkers in temporal lobe epilepsy.

Breast cancer and heart failure share several known clinical cardiovascular risk factors, including age, obesity, glucose dysregulation, cholesterol dysregulation, hypertension, atrial fibrillation and inflammation. However, to fully comprehend the complex interplay between risk of breast cancer and heart failure, factors attributed to both biological and social determinants of health must be explored in risk-assessment. There are several social factors that impede implementation of prevention strategies and treatment for breast cancer and heart failure prevention, including socioeconomic status, neighborhood disadvantage, food insecurity, access to healthcare, and social isolation. A comprehensive approach to prevention of both breast cancer and heart failure must include assessment for both traditional clinical risk factors and social determinants of health in patients to address root causes of lifestyle and modifiable risk factors. In this review, we examine clinical and social determinants of health in breast cancer and heart failure that are necessary to consider in the design and implementation of effective prevention strategies that altogether reduce the risk of both chronic diseases.

Meningiomas are the most common primary intracranial tumors. There are no effective medical therapies for meningioma patients, and new treatments have been encumbered by limited understanding of meningioma biology. Here, we use DNA methylation profiling on 565 meningiomas integrated with genetic, transcriptomic, biochemical, proteomic and single-cell approaches to show meningiomas are composed of three DNA methylation groups with distinct clinical outcomes, biological drivers and therapeutic vulnerabilities. Merlin-intact meningiomas (34%) have the best outcomes and are distinguished by NF2/Merlin regulation of susceptibility to cytotoxic therapy. Immune-enriched meningiomas (38%) have intermediate outcomes and are distinguished by immune infiltration, HLA expression and lymphatic vessels. Hypermitotic meningiomas (28%) have the worst outcomes and are distinguished by convergent genetic and epigenetic mechanisms driving the cell cycle and resistance to cytotoxic therapy. To translate these findings into clinical practice, we show cytostatic cell cycle inhibitors attenuate meningioma growth in cell culture, organoids, xenografts and patients.