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BackgroundDespite the benefits of smoking cessation, maintaining abstinence during a quit attempt is difficult, and most attempts result in relapse. Innovative, evidence-based methods of preventing relapse are needed. We present a smartwatch-based relapse prevention system that uses passive detection of smoking to trigger just-in-time smoking cessation support. ObjectiveThis study aims to evaluate the feasibility of hosting just-in-time smoking cessation support on a smartwatch and the acceptability of the “StopWatch” intervention on this platform. MethodsThe person-based approach for intervention development was used to design the StopWatch smoking relapse prevention intervention. Intervention delivery was triggered by an algorithm identifying hand movements characteristic of smoking from the smartwatch’s motion sensors, and the system-generated intervention messages (co-designed by smokers) were delivered on the smartwatch screen. A total of 18 smokers tested the intervention over a 2-week period, and at the end of this period, they provided qualitative feedback on the acceptability of both the intervention and the smartwatch platform. ResultsParticipants reported that the smartwatch intervention increased their awareness of smoking and motivated them to quit. System-generated intervention messages were generally felt to be relevant and timely. There were some challenges with battery life that had implications for intervention adherence, and the bulkiness of the device and the notification style reduced some participants’ acceptability of the smartwatch platform. ConclusionsOur findings indicate our smoking relapse prevention intervention and the use of a smartwatch as a platform to host a just-in-time behavior change intervention are both feasible and acceptable to most (12/18, 66%) participants as a relapse prevention intervention, but we identify some concerns around the physical limitations of the smartwatch device. In particular, the bulkiness of the device and the battery capacity present risks to adherence to the intervention and the potential for missed detections. We recommend that a longer-term efficacy trial be carried out as the next step.

Chromolaena odorata (Asteraceae: Eupatorieae) is a sprawling shrub native to the Americas, and a destructive invader of much of the humid tropics and subtropics of the Old World. Opportunistic native-range exploration in 1995 identified a stem-boring weevil, Lixus aemulus, as a promising biological control candidate agent. Host-specificity testing was conducted on L. aemulus in South Africa using laboratory no-choice and paired-choice tests. Three invasive alien plants closely related to C. odorata may be utilized by L. aemulus but no indigenous, ornamental or crop species in South Africa was or is expected to be attacked by the weevil. A native-range field survey was conducted in Brazil to determine the exact identity of the host plant L. aemulus had been collected in 1995, and to identify additional host-plant species. Genetic assessments of the Lixus sp.(p.). adults collected on the three host plants (C. odorata, Chromolaena laevigata and Heterocondylus vitalbae) reveal these individuals are L. aemulus and the weevil can be classed as an oligophage in its native range. Over 5,500 adults were released in South Africa, but overall establishment has been poor. The most likely explanation appears to be a climate mismatch between the region of South Africa invaded by C. odorata and the collection locality in Rio Branco, Acre state, Brazil. Additionally, because the full extent of the native range of L. aemulus is unknown, it is uncertain whether individuals can be sourced from an area whose climate resembles that of South Africa. Furthermore, despite being oligophagous, L. aemulus may perform sub-optimally on the southern African C. odorata biotype.

COVID-19 resulted in a pivot to remote teaching and learning in most North American colleges and universities. All of a sudden faculty expected students to use a variety of digital technologies. Here we report on the technologies post-secondary students had to use and on the problems experienced by students with and without disabilities (e.g., mobility and visual impairments, attention deficit hyperactivity disorder, mental health related disabilities). In a sample of 24 post-secondary students, we found a series of problems related to: software and platform issues; connectivity; how professors managed their courses; classmates' computer behaviors; and equipment issues. We also learned about several beneficial practices and ways to avoid problems that can be retained for future hybrid and blended courses. By giving a voice to post-secondary students our research can inform policies and practices to create a more resilient and inclusive society.

Fulvia fulva and Dothistroma septosporum are closely related apoplastic pathogens with similar lifestyles but different hosts: F. fulva is a pathogen of tomato, whilst D. septosporum is a pathogen of pine trees. In 2012, the first genome sequences of these pathogens were published, with F. fulva and D. septosporum having highly fragmented and near-complete assemblies, respectively. Since then, significant advances have been made in unravelling their genome architectures. For instance, the genome of F. fulva has now been assembled into 14 chromosomes, 13 of which have synteny with the 14 chromosomes of D. septosporum, suggesting these pathogens are even more closely related than originally thought. Considerable advances have also been made in the identification and functional characterization of virulence factors (e.g., effector proteins and secondary metabolites) from these pathogens, thereby providing new insights into how they promote host colonization or activate plant defence responses. For example, it has now been established that effector proteins from both F. fulva and D. septosporum interact with cell-surface immune receptors and co-receptors to activate the plant immune system. Progress has also been made in understanding how F. fulva and D. septosporum have evolved with their host plants, whilst intensive research into pandemics of Dothistroma needle blight in the Northern Hemisphere has shed light on the origins, migration, and genetic diversity of the global D. septosporum population. In this review, we specifically summarize advances made in our understanding of the F. fulva-tomato and D. septosporum-pine pathosystems over the last 10 years.

BACKGROUND: In 2014, germline signal transducer and activator of transcription (STAT) 3 gain-of-function (GOF) mutations were first described to cause a novel multisystem disease of early-onset lymphoproliferation and autoimmunity. OBJECTIVE: This pivotal cohort study defines the scope, natural history, treatment, and overall survival of a large global cohort of patients with pathogenic STAT3 GOF variants. METHODS: We identified 191 patients from 33 countries with 72 unique mutations. Inclusion criteria included symptoms of immune dysregulation and a biochemically confirmed germline heterozygous GOF variant in STAT3. RESULTS: Overall survival was 88%, median age at onset of symptoms was 2.3 years, and median age at diagnosis was 12 years. Immune dysregulatory features were present in all patients: lymphoproliferation was the most common manifestation (73%); increased frequencies of double-negative (CD4-CD8-) T cells were found in 83% of patients tested. Autoimmune cytopenias were the second most common clinical manifestation (67%), followed by growth delay, enteropathy, skin disease, pulmonary disease, endocrinopathy, arthritis, autoimmune hepatitis, neurologic disease, vasculopathy, renal disease, and malignancy. Infections were reported in 72% of the cohort. A cellular and humoral immunodeficiency was observed in 37% and 51% of patients, respectively. Clinical symptoms dramatically improved in patients treated with JAK inhibitors, while a variety of other immunomodulatory treatment modalities were less efficacious. Thus far, 23 patients have undergone bone marrow transplantation, with a 62% survival rate. CONCLUSION: STAT3 GOF patients present with a wide array of immune-mediated disease including lymphoproliferation, autoimmune cytopenias, and multisystem autoimmunity. Patient care tends to be siloed, without a clear treatment strategy. Thus, early identification and prompt treatment implementation are lifesaving for STAT3 GOF syndrome.

BackgroundMultisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments.MethodsThe Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370.FindingsWe enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8·0 years [IQR 4·2-11·4], 1191 [59·3%] male and 818 [40·7%] female, and 825 [41·1%] White). 680 (33·8%) patients received primary treatment with intravenous immunoglobulin, 698 (34·7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24·2%) with glucocorticoids alone; 59 (2·9%) patients received other combinations, including biologicals, and 85 (4·2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1·09 (95% CI 0·75-1·58; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids and 0·93 (0·58-1·47; corrected p value=1·00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1·04 (95% CI 0·91-1·20; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids, and 0·84 (0·70-1·00; corrected p value=0·22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0·15 [95% CI 0·11-0·20]; p

The Caught Being Good Game (CBGG) is an evidence-based practice used in classrooms to reduce disruptive classroom behavior. This approach to classwide intervention has been implemented and its effectiveness demonstrated across grade levels and types of disruptive behavior. Teachers report that the CBGG is an easy classroom management strategy to implement. Although several studies have been published demonstrating its utility, less research has examined how variations in the contingencies employed impact outcomes. In the current study, the CBGG was implemented across three classrooms in an effort to replicate previous findings. As well, the magnitude of reward/reinforcement was manipulated to determine whether this parameter affected intervention efficacy. Results of the study demonstrated appropriate classroom behavior increased across three elementary classrooms. The impact of magnitude of reward/reinforcement was idiosyncratic across the three classrooms, with no uniform impact of magnitude on intervention outcomes. Reasons why magnitude of reinforcement may not have impacted the efficacy of the CBGG are discussed.

This article evaluates the impact of volunteering with a music education project for children and adults with learning disabilities on the professional development and career trajectory of music students at a Conservatoire in the United Kingdom. A mixed-methods online questionnaire captured the impact of volunteering with Melody Music Birmingham. Findings suggest that volunteering was a powerful aspect of the respondents' learning, potentially influencing their career choices, perceptions and attitudes. Further training and experiences for Conservatoire students in engaging with, supporting, and delivering music-making for people with learning disabilities are recommended.

Music is motivational, accessible and engaging for individuals with learning disabilities. Several systematic reviews have addressed the effects of music activity on people with learning disabilities; however, none has specifically reviewed the use of musical activity with people with profound and multiple learning disabilities. This review aimed to: 1. identify peer-reviewed studies and describe the characteristics of evidence-based musical activity used with people with profound and multiple learning disabilities and 2. evaluate and analyse the effectiveness of these music-based interventions and identify gaps within current research. A systematic search was conducted in April 2021 identifying seven peer-reviewed studies which included music-based interventions with at least one person with profound and multiple learning disabilities. Findings reveal the interventions varied in their frequency, duration and content. The outcome of most (n=6) interventions documented the development of the participants' social skillset. Interventions were predominantly (n=6) implemented by facilitators with musical expertise. The diverse and novel nature of the reviewed studies highlights a need to expand and enhance research with this population.